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Sample records for clinical evolution maternal

  1. [Psychiatry at the maternal clinic].

    Science.gov (United States)

    Ammälä, Antti-Jussi

    2015-01-01

    Various mental disorders are encountered at the maternal clinic. Pregnancy predisposes to some mental disorders, most commonly depressive and anxiety disorders. The recognition of substance use disorders during pregnancy is very important, but difficult owing to the associated disgrace. An eating disorder with an onset preceding the pregnancy may cause problems for growth and development of the fetus and should thus be identified early enough. The rare but severe postpartum psychosis may often break out only after discharge from the maternity hospital. Drug therapy during pregnancy requires careful consideration and clear-cut reasoning. PMID:26237899

  2. Evolution of maternal effect senescence

    OpenAIRE

    Moorad, Jacob A.; Nussey, Daniel H

    2015-01-01

    Evolutionary theory underpins our understanding of the aging process. The many aspects of reproduction that decline with maternal age in animals include number of offspring born, offspring size, and neonatal survival. Current theories of aging ignore potential differences in the evolutionary pressures on these traits. Here, we combine two important branches of evolutionary theory to allow consideration of age-dependent selection at both offspring and maternal levels. We show that we should ac...

  3. 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.

  4. 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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    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...

  5. 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.

  6. 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.

  7. [Maternal and infant health services and the public health clinic].

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    Urasaki, S

    1986-11-01

    The public health clinic under the jurisdiction of prefectural government should continue to play a major role in maternal-child health services. Ministry of Health's revision plan for Maternal-child Health Law, according to which maternal-child health services are to be transferred totally to municipal (city-town-village) government, is strongly opposed by public health nurses and others. The plan goes against the current movement and effort to revitalize public health clinics, where more 50% of services rendered are maternal-child health related. Secondly, municipal health centers would have much more difficulty providing quality services than prefectural public health clinics which receive annual federal aid for their operation. Federal funding for maternal-child health care, regardless of jurisdictions, is currently 1/3 of standard unit cost. Extreme financial strain on municipal governments would result in regional differences in the quality of services and/or eventual financial burden on the patients. While the national government is trying to emphasize administrative aspects of the public health clinic, it is ordinary citizens' day to day health problems that people expect the clinic to deal with, individually, via check-ups, health counseling, home visits, public health education and telephone health hot line. PMID:3642046

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

    OpenAIRE

    Aradhana Srivastava; Sanghita Bhattacharyya; Christine Clar; Avan, Bilal I.

    2014-01-01

    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...

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

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    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

  10. 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

  11. A CLINICAL STUDY OF MATERNAL DEATHS DUE TO PPH

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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 mortality is a global problem, facing every country in the world. Target specific interventions are needed for specific population. Fifth millennium development goal (MDG is to reduce maternal mortality by 75% by the year 2015, worthwhile investment for every case provider, results that investing on mothers

  12. 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.

  13. Role of maternal thyroid hormones in the developing neocortex and during human evolution

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    Denise Stenzel

    2013-07-01

    Full Text Available The importance of thyroid hormones during brain development has been appreciated for many decades. In humans, low levels of circulating maternal thyroid hormones, e.g. caused by maternal hypothyroidism or lack of iodine in diet, results in a wide spectrum of severe neurological defects, including neurological cretinism characterized by profound neurologic impairment and mental retardation, underlining the importance of the maternal thyroid hormone contribution. In fact, iodine intake, which is essential for thyroid hormone production in the thyroid gland, has been related to the expansion of the brain, associated with the increased cognitive capacities during human evolution. Because thyroid hormones regulate transcriptional activity of target genes via their nuclear thyroid hormone receptors, even mild and transient changes in maternal thyroid hormone levels can directly affect and alter the gene expression profile, and thus disturb fetal brain development. Here we summarize how thyroid hormones may have influenced human brain evolution through the adaptation to new habitats, concomitant with changes in diet and, therefore, iodine intake. Further, we review the current picture we gained from experimental studies in rodents on the function of maternal thyroid hormones during developmental neurogenesis. We aim to evaluate the effects of maternal thyroid hormone deficiency as well as lack of thyroid hormone receptors and transporters on brain development and function, shedding light on the cellular behavior conducted by thyroid hormones.

  14. 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.

  15. Clinical significance of combined measurement of maternal serum free estriol and human lactogen in pregnant women

    International Nuclear Information System (INIS)

    To evaluate the clinical significance of combined measurement of maternal serum free estriol (FE3) and human lactogen (HPL) for determination of intrauterine fetal growth and development. The serum FE3 and HPL in pregnant women were measured by chemiluminescence and RIA respectively. The results showed that the E3 and HPL levels in pregnant women with pregnancy induced hypertension were lower than the normal controls (P0.05). The combined measurement of maternal serum free estriol and human lactogen has important clinical significance in determination of fetus-placenta function and high risk pregnancy. (authors)

  16. 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.

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

    Science.gov (United States)

    Shrooti, Shah; Mangala, Shrestha; Nirmala, Pokharel; Devkumari, Shrestha; Dharanidhar, Baral

    2016-01-01

    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.

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

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    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…

  19. Changes in Maternal Expressed Emotion toward Clinically Anxious Children following Cognitive Behavioral Therapy

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    Gar, Natalie S.; Hudson, Jennifer L.

    2009-01-01

    The aim of this study was to determine whether maternal expressed emotion (criticism and emotional overinvolvement) decreased across treatment for childhood anxiety. Mothers of 48 clinically anxious children (aged 6-14 years) were rated on levels of criticism (CRIT) and emotional overinvolvement (EOI), as measured by a Five Minute Speech Sample…

  20. 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

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

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    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…

  2. A Dedicated Education Unit for Maternal-Newborn Nursing Clinical Education.

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    Raines, Deborah A

    2016-01-01

    Designing a quality maternal-newborn clinical practice experience for undergraduate nursing students is often challenging. A dedicated education unit (DEU) is a partnership model of clinical education in which students partner with a designated unit-based nurse in providing nursing care within a typical patient care assignment. This article describes the experience of implementing a DEU in a junior level (third year) nursing practice course in a bachelor of science in nursing program curriculum. A DEU model is a perfect fit for maternal-newborn clinical learning experiences and provides a win-win outcome for academic and clinical partners as well as safe patient care. http://dx.doi.org/10.1016/j.nwh.2015.12.005. PMID:26902437

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

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    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

  4. Measuring quality in maternal-newborn care: developing a clinical dashboard.

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    Sprague, Ann E; Dunn, Sandra I; Fell, Deshayne B; Harrold, Joann; Walker, Mark C; Kelly, Sherrie; Smith, Graeme N

    2013-01-01

    Pregnancy, birth, and the early newborn period are times of high use of health care services. As well as opportunities for providing quality care, there are potential missed opportunities for health promotion, safety issues, and increased costs for the individual and the system when quality is not well defined or measured. There has been a need to identify key performance indicators (KPIs) to measure quality care within the provincial maternal-newborn system. We also wanted to provide automated audit and feedback about these KPIs to support quality improvement initiatives in a large Canadian province with approximately 140 000 births per year. We therefore worked to develop a maternal-newborn dashboard to increase awareness about selected KPIs and to inform and support hospitals and care providers about areas for quality improvement. We mapped maternal-newborn data elements to a quality domain framework, sought feedback via survey for the relevance and feasibility of change, and examined current data and the literature to assist in setting provincial benchmarks. Six clinical performance indicators of maternal-newborn quality care were identified and evidence-informed benchmarks were set. A maternal-newborn dashboard with "drill down" capacity for detailed analysis to enhance audit and feedback is now available for implementation. While audit and feedback does not guarantee individuals or institutions will make practice changes and move towards quality improvement, it is an important first step. Practice change and quality improvement will not occur without an awareness of the issues. PMID:23343794

  5. Adaptation and implementation of local maternity dashboards in a Zimbabwean hospital to drive clinical improvement

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    J Crofts

    2014-02-01

    Full Text Available Problem The Commission on Information and Accountability for Women's and Children's Health of the World Health Organization (WHO reported that national health outcome data were often of questionable quality and “not timely enough for practical use by health planners and administrators”. Delayed reporting of poor-quality data limits the ability of front-line staff to identify problems rapidly and make improvements. Approach Clinical “dashboards” based on locally available data offer a way of providing accurate and timely information. A dashboard is a simple computerized tool that presents a health facility's clinical data graphically using a traffic-light coding system to alert front-line staff about changes in the frequency of clinical outcomes. It provides rapid feedback on local outcomes in an accessible form and enables problems to be detected early. Until now, dashboards have been used only in high-resource settings. Local setting An overview maternity dashboard and a maternal mortality dashboard were designed for, and introduced at, a public hospital in Zimbabwe. A midwife at the hospital was trained to collect and input data monthly. Relevant changes Implementation of the maternity dashboards was feasible and 28 months of clinical outcome data were summarized using common computer software. Presentation of these data to staff led to the rapid identification of adverse trends in outcomes and to suggestions for actions to improve health-care quality. Lessons learnt Implementation of maternity dashboards was feasible in a low-resource setting and resulted in actions that improved health-care quality locally. Active participation of hospital management and midwifery staff was crucial to their success.

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

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    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...

  7. 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...

  8. Animal models for clinical and gestational diabetes: maternal and fetal outcomes

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    Kiss Ana CI

    2009-10-01

    Full Text Available Abstract Background Diabetes in pregnant women is associated with an increased risk of maternal and neonatal morbidity and remains a significant medical challenge. Diabetes during pregnancy may be divided into clinical diabetes and gestational diabetes. Experimental models are developed with the purpose of enhancing understanding of the pathophysiological mechanisms of diseases that affect humans. With regard to diabetes in pregnancy, experimental findings from models will lead to the development of treatment strategies to maintain a normal metabolic intrauterine milieu, improving perinatal development by preventing fetal growth restriction or macrosomia. Based on animal models of diabetes during pregnancy previously reported in the medical literature, the present study aimed to compare the impact of streptozotocin-induced severe (glycemia >300 mg/dl and mild diabetes (glycemia between 120 and 300 mg/dl on glycemia and maternal reproductive and fetal outcomes of Wistar rats to evaluate whether the animal model reproduces the maternal and perinatal results of clinical and gestational diabetes in humans. Methods On day 5 of life, 96 female Wistar rats were assigned to three experimental groups: control (n = 16, severe (n = 50 and mild diabetes (n = 30. At day 90 of life, rats were mated. On day 21 of pregnancy, rats were killed and their uterine horns were exposed to count implantation and fetus numbers to determine pre- and post-implantation loss rates. The fetuses were classified according to their birth weight. Results Severe and mild diabetic dams showed different glycemic responses during pregnancy, impairing fetal glycemia and weight, confirming that maternal glycemia is directly associated with fetal development. Newborns from severe diabetic mothers presented growth restriction, but mild diabetic mothers were not associated with an increased rate of macrosomic fetuses. Conclusion Experimental models of severe diabetes during pregnancy

  9. Role of maternal thyroid hormones in the developing neocortex and during human evolution

    OpenAIRE

    Denise Stenzel

    2013-01-01

    The importance of thyroid hormones during brain development has been appreciated for many decades. In humans, low levels of circulating maternal thyroid hormones, e.g. caused by maternal hypothyroidism or lack of iodine in diet, results in a wide spectrum of severe neurological defects, including neurological cretinism characterized by profound neurologic impairment and mental retardation, underlining the importance of the maternal thyroid hormone contribution. In fact, iodine intake, whi...

  10. 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

  11. 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.

  12. Clinical application of maternal serum HPL and INS levels determination for fetal health monitoring during perinatal period

    International Nuclear Information System (INIS)

    Objective: To investigate the possible applicability of maternal serum human placental lactogen (HPL) and insulin levels determination for fetal health monitoring. Methods: Maternal serum HPL and insulin levels were determined with RIA in (1) 70 pregnant women clinically diagnosed as with gestational diabetes (2) 66 pregnant women with hypertension and (3) 110 normal pregnant women as controls. Results: Serum HPL and insulin levels in the women with gestational diabetes were significantly higher than those in the controls (P0.05). Conclusion: Detection of abnormally high or low levels of serum HPL and insulin in pregnant women suggested presence of maternal diseases which might affect fetal development (over weight or growth restriction). This approach was much more sensitive than conventional sonographic examination of fetus. (authors)

  13. 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

  14. 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…

  15. 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

  16. 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...

  17. 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

  18. 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

    Background. Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis that prenatal exposure to these parasites might influence susceptibility to infections such as malaria in childhood.Methods. In a birth cohort of 2,345 mother-child pairs in Uganda, maternal...... helminth and malaria infection status was determined during pregnancy, and childhood malaria episodes recorded from birth to age five years. We examined associations between maternal infections and malaria in the offspring.Results. Common maternal infections were hookworm (45%), Mansonella perstans (21......%), 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...

  19. 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.

  20. Maternal age and spine development in a rotifer: ecological implications and evolution.

    Science.gov (United States)

    Gilbert, John J; McPeek, Mark A

    2013-10-01

    Brachionus calyciflorus typically develops long, defensive spines only in response to a kairomone from the predatory rotifer, Asplanchna. However, in the absence of any environmental induction, females of some clones produce daughters with increasingly long spines as they age; late-born individuals can have posterolateral spines as long as those induced by Asplanchna: up to 50% or more of body length. Here, we construct a model using data from life-table and predator-prey experiments to assess how this maternal-age effect can influence the distribution of spine lengths in reproducing populations and provide defense against Asplanchna predation. When Asplanchna is absent, the frequency of individuals with late birth orders rapidly becomes extremely low; thus, any cost associated with the production of long-spined individuals is minimal. When Asplanchna is present at densities too low for spine induction, and preys selectively on individuals with no or short posterolateral spines, the frequency of long-spined individuals rapidly increases until a stable birth-order structure is reached. As a result, mortality from Asplanchna predation is greatly reduced. The pronounced and novel birth-order effect in this rotifer appears to be an effective bet-hedging strategy to limit predation by Asplanchna when its kairomone induces no or less than maximal spine development. PMID:24358702

  1. Clinical Sequencing Uncovers Origins and Evolution of Lassa Virus.

    Science.gov (United States)

    Andersen, Kristian G; Shapiro, B Jesse; Matranga, Christian B; Sealfon, Rachel; Lin, Aaron E; Moses, Lina M; Folarin, Onikepe A; Goba, Augustine; Odia, Ikponmwonsa; Ehiane, Philomena E; Momoh, Mambu; England, Eleina M; Winnicki, Sarah; Branco, Luis M; Gire, Stephen K; Phelan, Eric; Tariyal, Ridhi; Tewhey, Ryan; Omoniwa, Omowunmi; Fullah, Mohammed; Fonnie, Richard; Fonnie, Mbalu; Kanneh, Lansana; Jalloh, Simbirie; Gbakie, Michael; Saffa, Sidiki; Karbo, Kandeh; Gladden, Adrianne D; Qu, James; Stremlau, Matthew; Nekoui, Mahan; Finucane, Hilary K; Tabrizi, Shervin; Vitti, Joseph J; Birren, Bruce; Fitzgerald, Michael; McCowan, Caryn; Ireland, Andrea; Berlin, Aaron M; Bochicchio, James; Tazon-Vega, Barbara; Lennon, Niall J; Ryan, Elizabeth M; Bjornson, Zach; Milner, Danny A; Lukens, Amanda K; Broodie, Nisha; Rowland, Megan; Heinrich, Megan; Akdag, Marjan; Schieffelin, John S; Levy, Danielle; Akpan, Henry; Bausch, Daniel G; Rubins, Kathleen; McCormick, Joseph B; Lander, Eric S; Günther, Stephan; Hensley, Lisa; Okogbenin, Sylvanus; Schaffner, Stephen F; Okokhere, Peter O; Khan, S Humarr; Grant, Donald S; Akpede, George O; Asogun, Danny A; Gnirke, Andreas; Levin, Joshua Z; Happi, Christian T; Garry, Robert F; Sabeti, Pardis C

    2015-08-13

    The 2013-2015 West African epidemic of Ebola virus disease (EVD) reminds us of how little is known about biosafety level 4 viruses. Like Ebola virus, Lassa virus (LASV) can cause hemorrhagic fever with high case fatality rates. We generated a genomic catalog of almost 200 LASV sequences from clinical and rodent reservoir samples. We show that whereas the 2013-2015 EVD epidemic is fueled by human-to-human transmissions, LASV infections mainly result from reservoir-to-human infections. We elucidated the spread of LASV across West Africa and show that this migration was accompanied by changes in LASV genome abundance, fatality rates, codon adaptation, and translational efficiency. By investigating intrahost evolution, we found that mutations accumulate in epitopes of viral surface proteins, suggesting selection for immune escape. This catalog will serve as a foundation for the development of vaccines and diagnostics. VIDEO ABSTRACT. PMID:26276630

  2. 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

  3. 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.

  4. 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...

  5. 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

  6. Practicing attachment in the real world: improving maternal insightfulness and dyadic emotional availability at an outpatient community mental health clinic.

    Science.gov (United States)

    Ziv, Yair; Kaplan, Betty Ann; Venza, Jimmy

    2016-06-01

    The purpose of the study was to examine the efficacy of an attachment-based intervention program practiced at an outpatient clinic. Changes in parental insightfulness and dyadic emotional availability were assessed in 32 mother-child dyads from pre- to post-intervention. At both data collection points, mothers were interviewed with the Insightfulness Assessment and the mother-child dyad was observed in play sessions coded with the Emotional Availability Scales. Findings revealed a strong association between maternal insightfulness and dyadic emotional availability, both before and after treatment. In terms of intervention efficacy, positive gains were observed in both insightfulness and dyadic emotional availability from pre- to post-intervention. Mothers who changed their classifications from non-insightful to insightful following the intervention showed the greatest gains in emotional availability. These findings have important implications for the type of interventions and service delivery model that could work in real world clinical settings. PMID:26824790

  7. 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

  8. 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)

  9. 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.

  10. 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.

  11. 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

  12. The effect of relational continuity of care in maternity and child health clinics on parenting self-efficacy of mothers and fathers with loneliness and depressive symptoms.

    Science.gov (United States)

    Tuominen, Miia; Junttila, Niina; Ahonen, Pia; Rautava, Päivi

    2016-06-01

    This study explored the parenting self-efficacy of the parents of 18-month-old children in the context of Finnish maternity and child health clinics. This parenting self-efficacy was observed in relation with the relational continuity of care and parents' experienced loneliness and depressive symptoms. The relational continuity of care was provided by a public health nurse in maternity and child health clinics. The participating parents were drawn from the STEPS study that is being carried out by the Institute for Child and Youth Research at the University of Turku. The results showed that relational continuity of care provided by the same public health nurse in the maternity and child health clinics was associated with mothers' higher emotional loneliness and with lower scores on three dimensions of parents' parenting self-efficacy. Loneliness and depressive symptoms negatively influenced parents' parenting self-efficacy - however, in the case where the family had experienced relational continuity of care, the parents' higher levels of depressive symptoms had not weakened their parenting self-efficacy beliefs. These results are discussed in terms of organizing maternity and child health clinic services. PMID:27037491

  13. In search of genetic constraints limiting the evolution of egg size: direct and correlated responses to artificial selection on a prenatal maternal effector.

    Science.gov (United States)

    Pick, J L; Hutter, P; Tschirren, B

    2016-06-01

    Maternal effects are an important force in nature, but the evolutionary dynamics of the traits that cause them are not well understood. Egg size is known to be a key mediator of prenatal maternal effects with an established genetic basis. In contrast to theoretical expectations for fitness-related traits, there is a large amount of additive genetic variation in egg size observed in natural populations. One possible mechanism for the maintenance of this variation is through genetic constraints caused by a shared genetic basis among traits. Here we created replicated, divergent selection lines for maternal egg investment in Japanese quail (Coturnix japonica) to quantify the role of genetic constraints in the evolution of egg size. We found that egg size responds rapidly to selection, accompanied by a strong response in all egg components. Initially, we observed a correlated response in body size, but this response declined over time, showing that egg size and body size can evolve independently. Furthermore, no correlated response in fecundity (measured as the proportion of days on which a female laid an egg) was observed. However, the response to selection was asymmetrical, with egg size plateauing after one generation of selection in the high but not the low investment lines. We attribute this pattern to the presence of genetic asymmetries, caused by directional dominance or unequal allele frequencies. Such asymmetries may contribute to the evolutionary stasis in egg size observed in natural populations, despite a positive association between egg size and fitness. PMID:26956564

  14. Maternally Inherited Diabetes and Deafness (MIDD Syndrome: A Clinical and Molecular Genetic Study of a Taiwanese Family.

    Directory of Open Access Journals (Sweden)

    Yung-Nien Chen

    2004-01-01

    Full Text Available We report on a case of a 48-year-old woman presenting with maternally inherited diabetesmellitus and deafness (MIDD syndrome. Molecular genetic analysis and clinical evaluationwere conducted in the patient and her 4 children to investigate the interrelationbetween an MIDD-associated mitochondrial DNA (mtDNA mutation and clinical manifestations.Various symptoms and markers of MIDD, including seizures, migraines, shortstature, mental retardation, and stroke-like episodes, were reviewed. Diabetes mellitus (DMwas studied by oral glucose tolerance and glucagon stimulation tests. Hearing impairmentwas determined by standard hearing tests and a brainstem auditory evoked potential test.The A3243G and T3271C transitional mutations of mtDNA were investigated from muscleand/or leukocytes and hair follicles. Mitochondrial-related symptoms were not found in thechildren, although they all harbored a heteroplasmic A3243G transition of mtDNA, asdetected in screened samples. For the patient, the proportion of mutant mtDNA was highestin muscle cells followed by hair follicles and then leukocytes. Moreover, the proportion ofmutant mtDNA was also higher in hair follicles than in leukocytes for asymptomatic familymembers. This Taiwanese MIDD family was found to have the A3243G point mutation asrevealed from molecular genetic studies of leukocytes, hair follicles, and muscle tissue.However, no correlation was found between the proportion of mutant mtDNA and clinicalfeatures of any family member.

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

    OpenAIRE

    Pia Deimann; Ursula Kastner-Koller

    2011-01-01

    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 acc...

  16. 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.

  17. 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; Wøjdemann, Karen R; Carlsen, Anting L; Jørgensen, Jennifer M; Gjerris, Anne-Cathrine; Shalmi, Anne-Cathrine; Rode, Line; Sundberg, Karin; Tabor, Ann

    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...

  18. 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

  19. Effect of Acupressure on Maternal Anxiety in Women With Gestational Diabetes Mellitus: A Randomized Clinical Trial.

    Science.gov (United States)

    Bastani, Farideh

    2016-06-01

    Women with diabetes often experience a higher level of anxiety. The aim of the study was to evaluate the effect of acupressure on relieving anxiety of women with gestational diabetes mellitus (GDM). A randomized clinical trial was conducted on 60 women with GDM at a university hospital. The participants were allocated to an experimental and a placebo group (30 women per group). The experimental group received a nurse-provided acupressure at the true point, and the placebo group received pressure (touching) at a sham (false) point. Anxiety was measured immediately in the groups prior to and after a 2-day intervention by a questionnaire and the Visual Analogue Scale. The data were analyzed using descriptive and inferential statistics. Results indicated that the acupressure group had significantly lower anxiety than the placebo group (p ≤ .0001). In conclusion, the effects of acupressure appeared to be effective in reducing anxiety in diabetic pregnant women. PMID:25848127

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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...

  2. 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

  3. 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

  4. 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

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

    OpenAIRE

    Jeremy Hugh Baron

    2010-01-01

    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...

  6. Experimental evolution can unravel the complex causes of natural selection in clinical infections.

    Science.gov (United States)

    Brockhurst, Michael A

    2015-06-01

    It is increasingly clear that rapid evolutionary dynamics are an important process in microbial ecology. Experimental evolution, wherein microbial evolution is observed in real-time, has revealed many instances of appreciable evolutionary change occurring on very short timescales of a few days or weeks in response to a variety of biotic and abiotic selection pressures. From clinical infections, including the chronic bacterial lung infections associated with cystic fibrosis that form a focus of my research, there is now abundant evidence suggesting that rapid evolution by infecting microbes contributes to host adaptation, treatment failure and worsening patient prognosis. However, disentangling the drivers of natural selection in complex infection environments is extremely challenging and limits our understanding of the selective pressures acting upon microbes in infections. Controlled evolution experiments can make a vital contribution to this by determining the causal links between predicted drivers of natural selection and the evolutionary responses of microbes. Integration of experimental evolution into studies of clinical infections is a key next step towards a better understanding of the causes and consequences of rapid microbial evolution in infections, and discovering how these evolutionary processes might be influenced to improve patient health.A video of this Prize Lecture, presented at the Society for General Microbiology Annual Conference 2015, can be viewed via this link: Michael A. Brockhurst https://www.youtube.com/watch?v=N1bodVSl27E. PMID:25957311

  7. 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

  8. 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)

  9. 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...

  10. 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

  11. 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...

  12. 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

  13. Digitization of clinical and epidemiological data from the Kyoto Collection of Human Embryos: maternal risk factors and embryonic malformations.

    Science.gov (United States)

    Kameda, Tomomi; Yamada, Shigehito; Uwabe, Chigako; Suganuma, Nobuhiko

    2012-03-01

    Understanding the causes of congenital anomalies is of prime importance to develop management and/or prevention strategies. It is widely accepted that the occurrence of congenital malformations in fetuses and neonates is heavily correlated with maternal genetic makeup and lifestyle. However, very few epidemiologic analyses have been conducted on the embryonic developmental period because of the rarity of data available. Instigated in 1961, the Kyoto Collection of Human Embryos comprises approximately 45,000 specimens of embryos and fetuses. The collection's most unique feature is that most specimens were added to the collection along with epidemiologic information on the respective mothers. This is the first report on the digitization of data from the collection. A total of 22,262 embryonic specimens were selected on the basis of data integrity. Data related to the embryos were then classified according to the following criteria: developmental stage, sampling period, geographical area, maternal determinant, and external malformation. Results indicate that 7.8% of the embryos exhibit external anomalies and 92.2% are without anomalies. The three most common anomalies were nuchal bleb, holoprosencephaly and spina bifida. A special emphasis was placed on the potential association between maternal determinants and embryonic external anomalies, allowing for statistical analyses. The present study provides further evidence that this collection represents a unique source of information to conduct epidemiological analyses, not only to further the understanding of congenital anomalies but also to help establish preventive health guidelines for pregnant women. PMID:22348783

  14. 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...

  15. 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...... 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 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 IS26 mediated deletions...

  16. Clinical and radiological evolution of a hand arthrosis in twenty-five years

    International Nuclear Information System (INIS)

    The clinical evolution and X rays of an arthrodosis of the hand followed for 25 years is presented. This is a complement of another article published in the magazine, arthrosis viewed by a doctor patient second part. An emphasis is placed on the good results obtained with a new program of exercises. The problems related to the Alignment and instability of the wrist and its collapse are analyzed in depth in both the example X rays as well as the scannography

  17. 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

  18. Effect of Multivitamin-Mineral versus Multivitamin Supplementation on Maternal, Newborns' Biochemical Indicators and Birth Size: A Double-Blind Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohsen Taghizadeh

    2014-03-01

    Full Text Available Objective: Micronutrient deficiency during pregnancy is associated with several complications. This study was designed to determine the effects of received multivitamin-mineral vs. multivitamin supplements on maternal, newborns' biochemical indicators, and birth size. Methods: This double-blind randomized-controlled clinical trial was conducted among 48 Iranian pregnant women, primigravida, aged 18-35 years old in their second and third trimester from December 2011 to September 2012. Subjects were randomly assigned to receive either the multivitamin-mineral (n=24 or multivitamin supplements (n=24 for 20 weeks. Fasting blood samples were taken at baseline and after a 20-week intervention of pregnant women as well as umbilical cord blood of the babies immediately after delivery to measure serum calcium, vitamin D, iron, magnesium, zinc and biomarkers of oxidative stress including plasma total antioxidant capacity and total glutathione. Results: Multivitamin-mineral compared to multivitamin supplementation resulted in a significant increase in maternal serum calcium (0.5 vs. -0.1 mg/dL, p=0.04 and magnesium levels (0.1 vs. -0.2 mg/dL, p<0.001. Furthermore, mean plasma total glutathione levels (1791 ± 566 vs. 1434 ± 622 µmol/l, p=0.04 of the newborns whose mothers received multivitamin-mineral were higher than those whose mothers received multivitamin supplements. Conclusions: Overall, multivitamin-mineral compared to multivitamin supplementation for 20 weeks during pregnancy resulted in a significant increase in maternal serum calcium and magnesium levels as well as a significant elevation of newborn plasma total glutathione levels.

  19. 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.

  20. 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.

  1. 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.

  2. The Effect of Omega-3 Fatty Acid Supplementation on Maternal Depression during Pregnancy: A Double Blind Randomized Controlled Clinical Trial

    OpenAIRE

    Kaviani, Maasumeh; Saniee, Laleh; Azima, Sara; Sharif, Farkhondeh; Sayadi, Mehrab

    2014-01-01

    Background: Depression is one of the most debilitating disorders during pregnancy and its recovery and treatment are among the concerns of obstetrics and gynecology experts. The present study aimed to determine the effect of omega-3 supplement on mild depression during pregnancy among primiparous women. Method: In this double-blind clinical trial, 80 primiparous women were randomly divided into 2 groups of omega-3 and placebo. The experimental group received 1 g omega-3 capsules for 6 weeks. ...

  3. Maternal and perinatal outcomes of induction of labor at term in the university clinics of Kinshasa, DR Congo

    OpenAIRE

    Barthélémy Tandu-Umba; Robert Laala Tshibangu; Andy Mbangama Muela

    2013-01-01

    Objective: This paper aims at assessing outcomes following induction of labor and characteristics likely to predict vaginal delivery. Study design: This is a descriptive retrospective cohort study including all women with singleton pregnancies who delivered at term in the university clinics of Kinshasa, DR Congo, from January 01, 2006 until December 31, 2010. Induction was initiated regardless of cervical status. Methods of induction included: oxytocin perfusion, vaginal Misoprostol, intrace...

  4. Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics.

    OpenAIRE

    Vrijkotte, Tanja; Schreuder, Ysbrand; Van Eijsden, Manon; Hutten, Barbara; Jansen, Eugene; Twickler, Marcel; Vissers, Maud

    2011-01-01

    Abstract Background/Objectives: Lipid disturbances during pregnancy may lead to early onset of metabolic diseases in the offspring. However, there is little knowledge on ethnic differences in lipid levels during pregnancy. We evaluated ethnic differences in non-fasting total cholesterol (TC) and triglyceride (TG) levels during early gestation and the role of demographics, behavioural factors and clinical characteristics. Subjects/Methods: Non-diabetic pregnant women (N=3025) fr...

  5. 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

  6. 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.

  7. 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 ...

  8. 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...

  9. Maternal Microchimerism

    OpenAIRE

    Kanold, Anna Maria

    2013-01-01

    Microchimerism refers to one individual harboring cells or DNA at a low level that derive from another individual. The most common source is pregnancy when cells from the fetus and the mother pass the placenta bidirectionally, and give rise to maternal microchimerism (cells from the mother in the fetus) and fetal microchimerism (cells from the fetus in the mother). The cells persist in the individual, at least until middleage. Several hypotheses have addressed the consequences ...

  10. 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.

  11. 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.

  12. 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. 

  13. 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

  14. Evolution of modern nuclear medicine tumor-imaging diagnostics in clinical oncology

    International Nuclear Information System (INIS)

    The evolution of current nuclear medicine diagnostic is closely related to the technical progress in imaging equipment development, and application of radiopharmaceuticals (Rphs) with a different tumor-uptake mechanism. It is the aim of the study to present groups of tumor-imaging Rphs differing by tumor uptake mechanisms, used in clinical oncology. The obtained results are described, and compared with the ones reported by other researchers. Sensitivity and specificity of Rphs for cardio-scintigraphy with 99mTc - MIBI and 201Tl are relatively high, amounting to 93.7% and 60% respectively, in the various tumors. These indicators depend on the stage, location, histopathology, level of malignancy and biological activity of the neoplasm. 99mTc - MIBI scintigraphy is endowed with considerable diagnostic potential for assaying multiple drug resistance (MDR), and is also a good criterion for its elimination following anti-MDR therapy. The obtained results show that radioimmunoscintigraphy (RIS) using different radiolabeled monoclonal antibodies (MoAb) have high sensitivity and specificity respectively: 86% and 80% in ovarian carcinoma with B72.3 antiTAG; 68.6% and 92.5% in colorectal carcinoma with B73.2 antiTAG, antiCEA, antiCA 19-9; 92% and 83% in breast cancer with antiCEA, 86.8% and 67-69% in malignant melanoma with 225.28s. Receptor scintigraphy may reach up to 86% sensitivity and 100% specificity in tumors saturated with somatostatin receptors. Positron emission tomography (PET) with 18F-FDG enhances the metabolic activity of tumor cells, and attains tumor-detecting rate amounting to 97%. Tumor imaging evolution characterized by the introduction and practical implementation of different Rphs, visualizing the functional and biochemical activity of tumor cells in the primary neoplasm, sentinel lymph nodes and distant metastases. radiolabelling of a variety of new biochemical substances, including DNA and RNA, drugs and lysosomes contributes to a successful imaging of

  15. [Clinical and evolutive profile of Crohn's disease in Hospital Rebagliati (Lima-Peru)].

    Science.gov (United States)

    Bendaño, Teófilo; Frisancho, Oscar

    2010-01-01

    Crohn's Disease (CD) is uncommon in Peru, in that respect, we don't know its clinical and developmental profile. This is a descriptive, retrospective, transversal and observational patients diagnosed with CD in the last 20 years in the Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins'. For the small size of the population, we used a census record. The diagnosis was made using the criteria of Lennard-Jones. We present seventeen cases, most female (11 / 6). The average age was 39.9 years (60% over 40 years). Only one patient had family history (second degree of consanguinity). Sixteen were latins and one white. Clinical manifestations were abdominal pain (88.2%), diarrhea (76.5%), weight loss (76, 5%), bleeding (58.8%) and fever (58.8%). Laboratory findings showed: anemia (76.5%), thrombocytosis (58.8%), hypoalbuminemia (52.9%), leukocytosis (23.5%), nitrogen retention (11.7%), leukopenia (5.9%), and elevated acute phase reactants ( c-reactive protein or erythrocyte sedimentation rate) 76.5%. Extraintestinal manifestations were cutaneous (29.4%), articular diseases (17.6%) and hepatobiliary (11.7%). Five patients (29.4%) received treatment of tuberculosis without success (before diagnosis). Nine patients (52.9%) had acute complications requiring emergency care. The phenotypic pattern type (Montreal's classification) was: non-stricturing non-penetrating 35.3%, stricturing 35.3% and penetrating 29.4%. Inflammation of the ileon was found in 70.5% (47% ileocolonic and ileal 23.5%), nine (53%) had perianal lesions. The activity at diagnosis was mild moderate disease in 8 (47.0%), moderate severe disease in 7 (41.2%) and severe ulminant 2 (11.8%). The macroscopic lesions were predominant stenosis 13 (76.5%), followed by ulcers in 12 (70.6%), erosive erythematous inflammation 11 (64.7%) and thickening of folds in 10 (58.8 %), seven (41%) had fistulas. As initial treatment were used aminosalicylates (13 patients) and systemic corticosteroids in 6

  16. Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nocaudie, M.; Bailliez, A.; Itti, E. [Centre Hospitalier Regional et Universitaire, Lille (France). Service Central de Medecine Nucleaire et Imagerie Fonctionnelle; Bauters, C.; Wemeau, J.L. [Clinique d`Endocrinologie, Centre Hospitalier Regional et Universitaire de Lille (France); Marchandise, X.

    1999-05-01

    Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves` disease, four Hashimoto`s thyroiditis, two isolated in appearance: Means` syndrome). Each patient underwent hormonal (free T{sub 3} and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and {sup 111}In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of {sup 111}In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution ({chi}{sup 2} test, P<0.01). All ten patients in whom scintigraphy was considered positive were clinically improved at 6 months, and of the seven patients in whom scintigraphy was negative, six were not improved. Nevertheless, objective quantitative analysis did not succeed in confirming these results. We conclude that {sup 111}In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed

  17. [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. PMID:27029875

  18. 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。

  19. 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

  20. Clinical, Cognitive and Anatomical Evolution from Nonfluent Progressive Aphasia to Corticobasal Syndrome: A Case Report

    OpenAIRE

    Gorno-Tempini, Maria Luisa; Murray, Ryan C.; Rankin, Katherine P.; Michael W. Weiner; Miller, Bruce L.

    2004-01-01

    Recent clinical and pathological studies have suggested that frontotemporal lobar degeneration (FTLD) and corticobasal syndrome (CBS) show clinical and pathological overlap. We present four years of longitudinal clinical, cognitive and anatomical data in the case of a 56-year-old woman, AS, whose clinical picture evolved from FTLD to CBS. For the first three years, AS showed a progressive speech and language disorder compatible with a diagnosis of the nonfluent aphasia variant of FTLD. At yea...

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. Chromosomal Aberrations Associated with Clonal Evolution and Leukemic Transformation in Fanconi Anemia: Clinical and Biological Implications

    OpenAIRE

    Stefan Meyer; Heidemarie Neitzel; Holger Tönnies

    2012-01-01

    Fanconi anaemia (FA) is an inherited disease with congenital and developmental abnormalities, bone marrow failure, and extreme risk of leukemic transformation. Bone marrow surveillance is an important part of the clinical management of FA and often reveals cytogenetic aberrations. Here, we review bone marrow findings in FA and discuss the clinical and biological implications of chromosomal aberrations associated with leukemic transformation.

  9. 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.

  10. 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...

  11. The evolution of articular cartilage imaging and its impact on clinical practice

    International Nuclear Information System (INIS)

    Over the past four decades, articular cartilage imaging has developed rapidly. Imaging now plays a critical role not only in clinical practice and therapeutic decisions but also in the basic research probing our understanding of cartilage physiology and biomechanics. (orig.)

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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

  18. Use of Clinical Decision Support to Increase Influenza Vaccination: Multi-year Evolution of the System

    OpenAIRE

    Gerard, Mary N.; Trick, William E.; Das, Krishna; Charles-Damte, Marjorie; Murphy, Gregory A.; Benson, Irene M.

    2008-01-01

    Despite recognition that clinical decision support (CDS) can improve patient care, there has been poor penetration of this technology into healthcare settings. We used CDS to increase inpatient influenza vaccination during implementation of an electronic medical record, in which pharmacy and nursing transactions increasingly became electronic. Over three influenza seasons we evaluated standing orders, provider reminders, and pre-selected physician orders. A pre-intervention cross-sectional su...

  19. 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.

  20. 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.

  1. Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

    International Nuclear Information System (INIS)

    Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves' disease, four Hashimoto's thyroiditis, two isolated in appearance: Means' syndrome). Each patient underwent hormonal (free T3 and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and 111In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of 111In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution (χ2 test, P111In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed. (orig.)

  2. 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

  3. [Evolution of autoantibodies profile in systemic lupus erythematosus according to age and clinical manifestations].

    Science.gov (United States)

    Diallo, Mariama Sadjo; Mbengue, Babacar; Seck, Abdoulaye; Ndao, Awa Cheikh; Niang, Maguette Sylla; Cissoko, Yacouba; Thiam, Alassane; Diop, Gora; Diallo, Rokhaya Ndiaye; Diallo, Moussa; Ndongo, Souhaibou; Dièye, Tandakha Ndiaye; Cissé, Mohamed; Kane, Assane; Dièye, Alioune

    2014-01-01

    Clinical features and auto-antibodies profile of 35 Senegalese patients' diagnosed systemic lupus erythematosus (SLE) were analyzed after measurement of antinuclear antibodies (ANA) by IFI, detection of Abs anti-DNA native by ELISA and evaluation of antibodies anti-Sm, anti-RNP, anti-SSA anti-SSB, anti-CCP2, anti-J0, and anti-Scl70 levels by immunodot. Mean age of 33 yrs (18-50 yrs) and sex ratio (F/M) of 16 were found. The most frequent clinical features were rheumatic (88.7%) and cutaneous (79.4%) disorders. ANA and anti-DNAn Abs were detected in 85.7% and 62.5% of the patients respectively. Abs anti-RNP, anti-Sm, anti-SSA, anti-SSB and anti-CCP2 were detected in 30 to 70% of patients. In young patients, the levels of anti-DNAn and anti-Sm Abs were higher than in patients older than 40 yrs (Panti-DNAn, anti-SSA and anti-SSB Abs. Our study shows the interest of a measurement of anti-DNAn, anti-SSA and anti-SSB Abs during the follow of SLE patients particularly in those presenting both rheumatic and cutaneous symptoms. PMID:24876146

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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...

  10. 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

  11. Evolution of DNA aptamers for malignant brain tumor gliosarcoma cell recognition and clinical tissue imaging.

    Science.gov (United States)

    Wu, Qiaoyi; Wu, Liang; Wang, Yuzhe; Zhu, Zhi; Song, Yanling; Tan, Yuyu; Wang, Xing-Fu; Li, Jiuxing; Kang, Dezhi; Yang, Chaoyong James

    2016-06-15

    Gliosarcoma, a variant of glioblastoma multiforme (GBM), is a highly invasive malignant tumor. Unfortunately, this disease still marked by poor prognosis regardless of modern treatments. It is of great significance to discover specific molecular probes targeting gliosarcoma for early cancer diagnosis and therapy. Herein, we have selected a group of DNA aptamers with high affinity and selectivity against gliosarcoma cells K308 using cell-SELEX. All the dissociation constants of these aptamers against gliosarcoma cells were in the nanomolar range and aptamer WQY-9 has the highest affinity and good selectivity among them. Furthermore, truncated aptamer sequence, WQY-9-B, shows similar recognition ability to aptamer WQY-9. In addition, WQY-9-B was found to be able to bind selectively and internalize into cytoplasm of target cancer cell at 37°C. More importantly, compared to a random sequence, aptamer WQY-9-B showed excellent recognition rate (73.3%) for tissue sections of clinical gliosarcoma samples. These data suggests that aptamer WQY-9-B has excellent potential as an effective molecular probe for gliosarcoma diagnosis. PMID:26802746

  12. Bone metastases only pure seminoma, evolution and treatment. Literature review and report of a clinical case

    International Nuclear Information System (INIS)

    The only bone metastases in pure seminoma is a biological entity extremely rare. We report a case studied since 2000, treatment and outcome. Case report: 35. Orquiectomizado in September 2000 AP: pure seminoma in the presence of a neoplastic nodule in the spermatic cord.Adjuvant lumboaorticas, left iliac and inguinal chains Rt., 3060 cGy in 3.2 sem. until December 2000 Normal tumor markers throughout the period. In Oct. 2001 TAC control morfoestructural altered posterior the sixth left costal arch. AP: puncture under TAC. Malignant germ cell tumor compatible with pure seminoma. C.O. single lesion. MDT is performed based on PEB for 4 cycles and additional RT obtaining a complete response with reduction bone lesion, asymptomatic until November 2002, again at the level falls costal, VIP x 3 New relapse dorsal paravertebral June 2003, Gemcitabine and Rt paclitaxel, dose intensification transplant. Keeps score high. Poor prognosis. Discussion: In the literature we found no reports of bone lesions only secondary to a pure seminoma. They are described in the context of a frame overall spread in advanced patients and in more than three or four including accompanying synchronous nodal, liver and lung damage. Subsequent developments mark the disease resistance to treatments performed. The three lines are Qt prior to transplantation have shown that best results for the treatment of disease. We discuss the time introduction thereof to obtain a durable complete response. If the marker not normalized but not displayed clinical or paraclinical disease prognosis is bad in the short term

  13. Growth monitoring in the evolution of clinic based health care through a community based action program.

    Science.gov (United States)

    Chaudhuri, S N

    1988-01-01

    In Calcutta, India a voluntary organization was established in 1975 called the Child in Need Institute (CINI) in order to nutritionally rehabilitate the poor. CINI detected malnutrition by utilizing "weight for age" charts and treated malnutrition with food supplements. Women must purchase a growth card to enter the program. Patients are registered, weighed and plotted, given on ort demonstration, educated in health and nutrition, shown supplementary feeding techniques, given a health check up and immunizations, and are given antenatal care. The growth card is referred to at all stages of the care, which causes mothers to realize that it is very important to their health. CINI eventually established mobile clinics run by women's groups. 50% of all children under 3 participate monthly and 30% more participate at 2-3 month intervals. Mothers are more willing to correct the nutrition of their children when they understand the growth charts. The India Institute of Medical Sciences in 1986 assessed the KAP (knowledge, awareness, performance) of 132 village mothers. They found significant appreciation for growth monitoring. Mothers have also become more aware of the importance of sanitation, frequent feeding, and clean water. The growth chart is a tool, but is also viewed as a symbol of the activities of CINI. PMID:3391668

  14. Clinics in Orthopedic Surgery's Evolution into an International Journal Based on Journal Metrics.

    Science.gov (United States)

    Huh, Sun

    2016-06-01

    This article is aimed at providing evidence of increased international recognition of Clinics in Orthopedic Surgery (CiOS) based on journal metrics. Since 7 years have passed since its launch in 2009, it is time to reflect on the journal's efforts to be recognized as a top-notch journal. The following journal metrics were analyzed from the journal's homepage and Web of Science Core Collection database: number of citable and noncitable articles; number of original articles supported by grants; editorial board members' countries; authors' countries; citing authors' countries; source titles of citing articles; impact factor; total citations; comparison of impact factor with 3 Science Citation Index Expanded journals; and Hirsch index (H-index). Of the total 392 articles, 378 were citable articles (96.4%). Of the total 282 original articles, 52 (18.4%) were supported by research grants. The editorial board members were from 13 countries. Authors were from 20 countries. The number of countries of citing authors was 66. The number of source titles of citing articles was more than 100. The total citations of CiOS have increased from 0 in 2009 to 374 in 2015. The impact factors without self-citations of CiOS were the greatest among 4 Asian journals in 2013 and 2014. The 2015 impact factor was calculated as 0.79 in January 2016. The H-index was 13. CiOS can be considered to have reached the level of top-notch journal in the orthopedic field based on journal metrics. The inclusion of the journal in PubMed Central appears to have increased international relevance of the journal. PMID:27247735

  15. 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.

  16. Identifying 'at risk' women and the impact of maternal obesity on National Health Service maternity services.

    Science.gov (United States)

    Heslehurst, Nicola

    2011-11-01

    Obesity is a public health concern worldwide, arising from multifaceted and complex causes that relate to individual choice and lifestyle, and the influences of wider society. In addition to a long-standing focus on both childhood and adult obesity, there has been more recent concern relating to maternal obesity. This review explores the published evidence relating to maternal obesity incidence and associated inequalities, the impact of obesity on maternity services, and associated guidelines. Epidemiological data comprising three national maternal obesity datasets within the UK have identified a significant increase in maternal obesity in recent years, and reflect broad socio-demographic inequalities particularly deprivation, ethnicity and unemployment. Obese pregnancies present increased risk of complications that require more resource intensive antenatal and perinatal care, such as caesarean deliveries, gestational diabetes, haemorrhage, infections and congenital anomalies. Healthcare professionals also face difficulties when managing the care of women in pregnancy as obesity is an emotive and stigmatising topic. There is a lack of good-quality evidence for effective interventions to tackle maternal obesity. Recently published national guidelines for the clinical management and weight management of maternal obesity offer advice for professionals, but acknowledge the limitations of the evidence base. The consequence of these difficulties is an absence of support services available for women. Further evaluative research is thus required to assess the effectiveness of interventions with women before, during and after pregnancy. Qualitative work with women will also be needed to help inform the development of more sensitive risk communication and women-centred services. PMID:21854697

  17. Hypokalaemia as the only clinical symptom of ACTH ectopic secretion in a case of small cell carcinoma of the lung with very rapid evolution.

    Science.gov (United States)

    Pentimone, F; Donadio, C; Camici, M; Cini, G

    1980-01-01

    A patient with heavy hypokalaemia is described: hypokalaemia and its effects were the unique clinical manifestations of small cell carcinoma of the lung, associated with ACTH ectopic secretion. The rapid unfavourable evolution denotes the explosive behaviour of the syndrome. PMID:7394347

  18. 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...

  19. 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.

  20. 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。

  1. Effects of Mother-Infant Separation on Maternal Attachment Behavior

    Science.gov (United States)

    Leifer, A. D.; And Others

    1972-01-01

    This project hoped to specify the role of early, mother-infant separation in determining later maternal behavior. Clinically, the results suggest that such a separation should be avoided whenever possible and should be minimized when separation is unavoidable. (Authors)

  2. Clonal evolution in CLL patients as detected by FISH versus chromosome banding analysis, and its clinical significance.

    Science.gov (United States)

    Wawrzyniak, Ewa; Kotkowska, Aleksandra; Blonski, Jerzy Z; Siemieniuk-Rys, Monika; Ziolkowska, Ewelina; Giannopoulos, Krzysztof; Robak, Tadeusz; Korycka-Wolowiec, Anna

    2014-02-01

    The acquisition of new aberrations during the course of chronic lymphocytic leukemia (CLL) named clonal evolution (CE) is usually detected by one of the two methods: chromosome banding analysis (CBA) and interphase fluorescence in situ hybridization (I-FISH). The purpose of this study was to compare the usefulness of FISH and CBA for detecting CE and to evaluate its influence on clinical outcome. FISH and CBA were performed at two time points: baseline and follow-up. Thirty-eight previously untreated patients with CLL were included in this study. CBA and I-FISH revealed CE in 15 (39.5%) and 10 (26.3%) patients, respectively. High-risk CE was detected in six cases by CBA and in five cases by I-FISH. In four cases with CE-dependent 17p abnormalities detected by CBA, metaphase FISH was needed for the confirmation of 17p13.1 deletion. Time from first-line to second-line treatment (TTST) and overall survival (OS) did not differ between patients with and without CE, irrespective of the CE-detecting method used. However, shorter OS (P = 0.043) and TTST (P = 0.006) were observed for the patients with potentially relevant CE (rCE) detected by CBA, in which acquired aberrations were present in at least 20% of undivided cells and/or changed baseline karyotype to abnormal or complex and were not resulting from 13q deletion. Our results suggest that some, but not all, CE-dependent aberrations detected by CBA influence clinical outcome. Moreover, I-FISH, which was aimed at detecting aberrations of prognostic significance, was found to be more precise than CBA in their detection, especially TP53 deletion. PMID:24138550

  3. The Turkish version of Maternal Attachment Inventory

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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

    Directory of Open Access Journals (Sweden)

    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

  7. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Maternal Dietary Patterns and Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    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.

  10. Cues of maternal condition influence offspring selfishness.

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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

  15. 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

  16. National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage.

    Science.gov (United States)

    Main, Elliott K; Goffman, Dena; Scavone, Barbara M; Low, Lisa Kane; Bingham, Debra; Fontaine, Patricia L; Gorlin, Jed B; Lagrew, David C; Levy, Barbara S

    2015-01-01

    Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into 4 domains: Readiness, Recognition and Prevention, 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. References contain sample resources and "Potential Best Practices" to assist with implementation. PMID:26059199

  17. National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage.

    Science.gov (United States)

    Main, Elliott K; Goffman, Dena; Scavone, Barbara M; Low, Lisa Kane; Bingham, Debra; Fontaine, Patricia L; Gorlin, Jed B; Lagrew, David C; Levy, Barbara S

    2015-07-01

    Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and System Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. References contain sample resources and "Potential Best Practices" to assist with implementation. PMID:26091046

  18. 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

  19. 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.

  20. Maternal Separation Anxiety and Child Care: Effects on Maternal Behavior.

    Science.gov (United States)

    Storm, Heidi A.; Ridley-Johnson, Robyn

    Maternal separation anxiety influences maternal behavior, attitudes about employment, and employment decisions made by mothers. This study examined the relationship between maternal separation anxiety and the number of hours a child was in substitute care. The sample consisted of 44 mothers and their children who ranged in age from 12 to 41 months…

  1. [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

  2. 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

  3. 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 ...

  4. 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...

  5. 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...

  6. 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.

  7. Measuring quality of maternity care.

    Science.gov (United States)

    Collins, Katherine J; Draycott, Timothy

    2015-11-01

    Health-care organisations are required to monitor and measure the quality of their maternity services, but measuring quality is complex, and no universal consensus exists on how best to measure it. Clinical outcomes and process measures that are important to stakeholders should be measured, ideally in standardised sets for benchmarking. Furthermore, a holistic interpretation of quality should also reflect patient experience, ideally integrated with outcome and process measures, into a balanced suite of quality indicators. Dashboards enable reporting of trends in adverse outcomes to stakeholders, staff and patients, and they facilitate targeted quality improvement initiatives. The value of such dashboards is dependent upon high-quality, routinely collected data, subject to robust statistical analysis. Moving forward, we could and should collect a standard, relevant set of quality indicators, from routinely collected data, and present these in a manner that facilitates ongoing quality improvement, both locally and at regional/national levels. PMID:25913563

  8. Resilience to Maternal Depression in Young Adulthood

    OpenAIRE

    Pargas, Rebecca Cristina Malvar; Brennan, Patricia A.; Hammen, Constance; Le Brocque, Robyne

    2010-01-01

    Using a prospective longitudinal design this study investigated factors associated with resilience in 20-year old offspring of depressed mothers (n=648). Resilient youth were operationally defined as those whose mothers were depressed, but who themselves had no history of recurrent depression, and currently evidenced adequate academic/work and romantic functioning, no Axis I psychopathology, and no clinically significant internalizing behavior problems. Low levels of perceived maternal psycho...

  9. 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...

  10. 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

  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. 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.

  13. 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

  14. 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.

  15. Maternal characteristics influencing birth weight and infant weight gain in the first 6 weeks post-partum: A cross-sectional study of a post-natal clinic population

    Directory of Open Access Journals (Sweden)

    Christopher S Yilgwan

    2012-01-01

    Full Text Available Background: To investigate the relationship between certain maternal characteristic and infant birth weight and weight gain in puerperal women seen at a tertiary health centre. Materials and Methods: We measured the weight of 318, randomly selected infants after a complete physical examination at birth and at 6 weeks postnatal using standard procedures and related them to certain maternal characteristics. Results: There were 318 women and baby pairs. Maternal ages ranged from 16 to 42 years, with a mean of 25.6±1.3 years. Mean birth weight of babies was 3.10±1.89 kg; mean gestational age was 36±4.6 weeks, with 9.4% and 3.0% of babies born having low birth weight or Macrosomia respectively. Mothers from the North of the country, multiparity and systolic and/or diastolic hypertensions were factors associated with low birth weight. At 6 weeks, 27.1% of infants failed to gain weight as expected for their age. Similarly, 37.0% of infants born to mothers with some tertiary education showed slowed weight gain compared with those who had secondary (19.2% or primary (14.7% education, P=0.03. Maternal weight at delivery positively correlated with birth weight of the infant (r=0.357, P<0.001. However, maternal weight and blood pressure negatively correlated with infant weight gain at 6 weeks post-delivery. Conclusion: Our study demonstrates that certain maternal characteristics could play a role in the birth weight and early infant weight gain, and are preventable through simple public health approaches.

  16. 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.

  17. 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...

  18. 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...

  19. 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...

  20. Activation of the Maternal Immune System During Pregnancy Alters Behavioral Development of Rhesus Monkey Offspring

    OpenAIRE

    Bauman, Melissa D.; Iosif, Ana-Maria; Smith, Stephen E. P.; Bregere, Catherine; Amaral, David G.; Patterson, Paul H.

    2014-01-01

    Background: Maternal infection during pregnancy is associated with an increased risk of schizophrenia and autism in the offspring. Supporting this correlation, experimentally activating the maternal immune system during pregnancy in rodents produces offspring with abnormal brain and behavioral development. We have developed a nonhuman primate model to bridge the gap between clinical populations and rodent models of maternal immune activation (MIA). Methods: A modified form of the ...

  1. [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

  2. Reconfiguring Maternity Care?

    DEFF Research Database (Denmark)

    Johannsen, Nis

    at a hospital and a group of researchers which included me. Both initiatives involved numerous seemingly different interests that were held together and related to reconfiguring maternity care. None of the initiatives can unequivocally be labelled a success, as neither managed to change maternity...... care, at least not in the intended manner. It was, however, an achievement to relate the different interests for a period. In this dissertation I will elucidate the proposed changes in the initiatives as well as expound on the manner in which they were proposed. It is argued that the different...... interests involved in the initiatives were not obstacles which the proposed changes should overcome, but are on the contrary necessary, as it is the alliances between the particular interests and the proposed changes that motor the initiatives. The interests were not invented through the initiatives but are...

  3. AN AUDIT OF MATERNAL DEATHS

    Directory of Open Access Journals (Sweden)

    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

  4. Maternal mortality in Bijapur district

    Directory of Open Access Journals (Sweden)

    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.

  5. 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...... 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....

  6. 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

  7. Maternal-fetal conflict.

    Science.gov (United States)

    Fasouliotis, S J; Schenker, J G

    2000-03-01

    Advances in prenatal care have brought about a greater understanding as to the special status of the fetus to the point that it is considered a patient in its own regard. Pregnant women generally follow the medical recommendations of their physicians that are intended for the benefit of their baby. Any situation where maternal well-being or wishes contradict fetal benefit constitutes a maternal-fetal conflict. Such situations include a broad range of possible interventions, non-interventions, and coercive influences. In such cases, the attending physician is expected to attain an attitude that involves either the respect of the woman's autonomy and right to privacy, which precludes any approach other than to accept her decision, or to modify this absolute for the beneficence of the fetus. Current ethical viewpoints range from absolute respect for maternal autonomy with no persuasion allowed, to gentle persuasion and to others which permit intervention and overriding of the woman's autonomy. Court-ordered decisions enforcing the pregnant woman to undergo a procedure in order to improve fetal outcome have been criticized as an invasion of a woman's privacy, limitation of her autonomy, and taking away of her right to informed consent. PMID:10733034

  8. 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.

  9. 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...

  10. 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

  11. 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-...

  12. Maternal Depression, Maternal Expressed Emotion, and Youth Psychopathology

    Science.gov (United States)

    Tompson, Martha C.; Pierre, Claudette B.; Boger, Kathryn Dingman; McKowen, James W.; Chan, Priscilla T.; Freed, Rachel D.

    2010-01-01

    Across development, maternal depression has been found to be a risk factor for youth psychopathology generally and youth depression specifically. Maternal Expressed Emotion (EE) has been examined as a predictor of outcome among youth with depression. The present study explored the associations between youth psychopathology and two…

  13. 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.

  14. 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

  15. Implementation of Point-of-Care Diagnostics Leads to Variable Uptake of Syphilis, Anemia and CD4+ T-Cell Count Testing in Rural Maternal and Child Health Clinics

    OpenAIRE

    De Schacht, Caroline; Lucas, Carlota; Sitoe, Nádia; Machekano, Rhoderick; Chongo, Patrina; Temmerman, Marleen; Tobaiwa, Ocean; Guay, Laura; Kassaye, Seble; Jani, Ilesh V

    2015-01-01

    Introduction: Anemia, syphilis and HIV are high burden diseases among pregnant women in sub-Saharan Africa. A quasi-experimental study was conducted in four health facilities in Southern Mozambique to evaluate the effect of point-of-care technologies for hemoglobin quantification, syphilis testing and CD4+ T-cell enumeration performed within maternal and child health services on testing and treatment coverage, and assessing acceptability by health workers. Methods: Demographic and testing ...

  16. International variation in caesarean section rates and maternal obesity.

    Science.gov (United States)

    O'Dwyer, V; Layte, R; O'Connor, C; Farah, N; Kennelly, M M; Turner, M J

    2013-07-01

    This study examined variations in caesarean section (CS) rates associated with a woman's birthplace and differences in maternal adiposity. Women were enrolled in the 1st trimester. Maternal adiposity was assessed by body mass index (BMI) and bioelectrical impedance analysis (BIA). Irish women were compared with women born in the 14 countries who joined the European Union (EU) before 2004 (EU 14), and with those born in 12 countries who joined following enlargement (EU 12). Of the 2,811 women enrolled, 2,235 women were born in Ireland, 100 in EU 14 countries and 476 in EU 12 countries. Based on a BMI > 29.9 kg/m(2), maternal obesity was higher in Irish (19.8%; n = 443) and EU 14 women (19.0%; n = 19) compared with EU 12 women (9.5%; n = 45), p < 0.001. BIA of maternal body composition confirmed increased adiposity in both the Irish and EU 14 women. Variations in emergency CS rates in primigravidas based on the woman's birthplace were associated with maternal adiposity and induction of labour, both modifiable risk factors for CS. We recommend, therefore, that induction of labour in obese primigravidas should be undertaken only in carefully considered clinical circumstances. Our findings also suggest economic development in Europe may drive an increase in the CS rates mediated through increased levels of maternal obesity and, therefore, public health interventions should focus on optimising a woman's prepregnancy weight. PMID:23815198

  17. Maternal mortality in Vietnam in 1994-95.

    Science.gov (United States)

    Hieu, D T; Hanenberg, R; Vach, T H; Vinh, D Q; Sokal, D

    1999-12-01

    This report presents the first population-based estimates of maternal mortality in Vietnam. All the deaths of women aged 15-49 in 1994-95 in three provinces of Vietnam were identified and classified by cause. Maternal mortality was the fifth most frequent cause of death. The maternal mortality ratio was 155 deaths per 100,000 live births. This ratio compares with the World Health Organization's estimates of 430 such deaths globally and 390 for Asia. The maternal mortality ratio in the delta regions of these provinces was half that of the mountainous and semimountainous regions. Because a larger proportion of the Vietnamese population live in delta regions than elsewhere, the maternal mortality ratio for Vietnam as a whole may be lower than that of the three provinces studied. Maternal mortality is low in Vietnam primarily because a relatively high proportion of deliveries take place in clinics and hospitals, where few women die in childbirth. Also, few women die of the consequences of induced abortion in Vietnam because the procedure is legal and easily available. PMID:10674328

  18. 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

  19. 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

  20. Accuracy of the phase space evolution dose calculation model for clinical 25 MeV electron beams

    International Nuclear Information System (INIS)

    The phase space evolution (PSE) model is a dose calculation model for electron beams in radiation oncology developed with the aim of a higher accuracy than the commonly used pencil beam (PB) models and with shorter calculation times than needed for Monte Carlo (MC) calculations. In this paper the accuracy of the PSE model has been investigated for 25 MeV electron beams of a MM50 racetrack microtron (Scanditronix Medical AB, Sweden) and compared with the results of a PB model. Measurements have been performed for tests like non-standard SSD, irregularly shaped fields, oblique incidence and in phantoms with heterogeneities of air, bone and lung. MC calculations have been performed as well, to reveal possible errors in the measurements and/or possible inaccuracies in the interaction data used for the bone and lung substitute materials. Results show a good agreement between PSE calculated dose distributions and measurements. For all points the differences - in absolute dose - were generally well within 3% and 3 mm. However, the PSE model was found to be less accurate in large regions of low-density material and errors of up to 6% were found for the lung phantom. Results of the PB model show larger deviations, with differences of up to 6% and 6 mm and of up to 10% for the lung phantom; at shortened SSDs the dose was overestimated by up to 6%. The agreement between MC calculations and measurement was good. For the bone and the lung phantom maximum deviations of 4% and 3% were found, caused by uncertainties about the actual interaction data. In conclusion, using the phase space evolution model, absolute 3D dose distributions of 25 MeV electron beams can be calculated with sufficient accuracy in most cases. The accuracy is significantly better than for a pencil beam model. In regions of lung tissue, a Monte Carlo model yields more accurate results than the current implementation of the PSE model. (author)

  1. Accuracy of the phase space evolution dose calculation model for clinical 25 MeV electron beams

    Science.gov (United States)

    Korevaar, Erik W.; Akhiat, Abdelhafid; Heijmen, Ben J. M.; Huizenga, Henk

    2000-10-01

    The phase space evolution (PSE) model is a dose calculation model for electron beams in radiation oncology developed with the aim of a higher accuracy than the commonly used pencil beam (PB) models and with shorter calculation times than needed for Monte Carlo (MC) calculations. In this paper the accuracy of the PSE model has been investigated for 25 MeV electron beams of a MM50 racetrack microtron (Scanditronix Medical AB, Sweden) and compared with the results of a PB model. Measurements have been performed for tests like non-standard SSD, irregularly shaped fields, oblique incidence and in phantoms with heterogeneities of air, bone and lung. MC calculations have been performed as well, to reveal possible errors in the measurements and/or possible inaccuracies in the interaction data used for the bone and lung substitute materials. Results show a good agreement between PSE calculated dose distributions and measurements. For all points the differences - in absolute dose - were generally well within 3% and 3 mm. However, the PSE model was found to be less accurate in large regions of low-density material and errors of up to 6% were found for the lung phantom. Results of the PB model show larger deviations, with differences of up to 6% and 6 mm and of up to 10% for the lung phantom; at shortened SSDs the dose was overestimated by up to 6%. The agreement between MC calculations and measurement was good. For the bone and the lung phantom maximum deviations of 4% and 3% were found, caused by uncertainties about the actual interaction data. In conclusion, using the phase space evolution model, absolute 3D dose distributions of 25 MeV electron beams can be calculated with sufficient accuracy in most cases. The accuracy is significantly better than for a pencil beam model. In regions of lung tissue, a Monte Carlo model yields more accurate results than the current implementation of the PSE model.

  2. 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.

  3. 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.

  4. High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

    International Nuclear Information System (INIS)

    Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy, using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer

  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. 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

  7. 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

  8. Clinical and radiological evolution of Intervened patients of total arthroplasty of hip with prostheses of resuperficialization metal-metal - Preliminary report

    International Nuclear Information System (INIS)

    The articular degeneration of the hip in young patients requires including therapeutical alternatives for the management of this population. The resurfacing prostheses with metal-metal surfaces is an alternative for this type of patients. Reports with short and medium follow up are very promising, besides the different studies of laboratory that bear, the theoretical bases for their success. In this descriptive study, observational cases series type is described the radiological and clinical evolution of patients intervened of total arthroplasty of hip with resurfacing prostheses metal-metal in the hospital el Tunal of Bogota. The results of 31 hips are presented (27 patients) with an age average of 50 years old and a medium follow up of 16 months, with a good post surgical functional result with a median of 96 in the Harris Scores. The complications presented in the patient series are described and their relation with the different factors analyzed

  9. 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.

  10. 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.

  11. Effect of maternal antibiotics on breast feeding infants

    OpenAIRE

    Mathew, J.

    2004-01-01

    Antibiotic usage is fairly common among breastfeeding mothers and there is potential for transfer to infants through breast milk. While most medicines taken by lactating women cause no harm to their babies, at times it can result in serious consequences. This article reviews the principles governing tranfer of maternal antibiotics to breast milk, its clinical significance, and ways to minimise inadvertent infant exposure.

  12. Conquering maternal mortality: skill development in medical curriculum

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    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

  13. 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.…

  14. MATERNAL DEATHS REVIEW: AN APPROACH TOWARDS IMPROVING MATERNAL HEALTH

    Directory of Open Access Journals (Sweden)

    Neelam Anupama

    2014-10-01

    Full Text Available BACKGROUND: To achieve the Millennium Development Goals (MDG adopted at the 2000 Millennium Summit, there are two targets for assessing progress in improving maternal health (MDG 5: Reducing the maternal mortality ratio (MMR by three quarters between 1990 and 2015 and achieving universal access to reproductive health by 2015. Closer examination of maternal mortality level is needed to inform planning of reproductive health programs, to guide advocacy efforts and research at the national and international levels, and to inform decision-making. The audit for the reasons for maternal mortality in a resource poor country is extremely helpful in not only identifying the reasons but also in identifying the preventable causes of maternal mortality. AIMS & OBJECTIVE: 1. To determine the causes of maternal mortality in NSCB Medical College and Hospital of Jabalpur. 2. To study the various socio-demographic factors associated with maternal mortality. MATERIAL AND METHODS: This is a record based study conducted at Obs and Gynae Dept of NSCB medical College, Jabalpur. Mortality Data from January 2012 to December 2012 was analyzed including for all pregnancy-related deaths, their demographic profile, including age, parity, antenatal care record, type of delivery, status of patient i.e., booked or not booked, diagnosis during admission, duration of the hospital stay, and cause of death by reviewing case sheet records. Gynaecological deaths were excluded in this study. Data entry as well analysis was done in Microsoft Excel. RESULTS: Eighty nine maternal deaths were recorded during study period. Most of the deaths were 87(98% unbooked. Majority of the deaths were ANC primi i.e. 57(64%. The major direct cause for deaths were eclampsia 39(44% followed by pre eclampsia 10(11% and haemorrhage 7(8%. Severe anaemia 14(16% followed by hepatitis 5(6% were the most common indirect causes. Maternal mortality ratio was 2182/100,000 live births (89/4078. Antenatal care

  15. Physical activity counseling in maternity and child health care – a controlled trial

    OpenAIRE

    Kinnunen Tarja I; Fogelholm Mikael; Pasanen Matti; Aittasalo Minna; Ojala Katriina; Luoto Riitta

    2008-01-01

    Abstract Background The purpose of the study is to examine the effects and feasibility of individual physical activity (PA) counseling in maternity and child health clinics in Finland. Methods Three clinics including both maternity and child health care signed up for the experimental (EXP) and three for the control group (CON). The participants were 132 pregnant and 92 postpartum primiparas. The nurses in EXP integrated a primary and four booster PA counseling sessions into routine visits. An...

  16. 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

  17. Observing the coupled behavior of geochemistry and flow path evolution during bioreduction using clinical nuclear imaging tomography

    Science.gov (United States)

    Druhan, J. L.; Vandehey, N. T.; Buchko, R.; O'Neil, J. P.; Moses, W. W.; Finsterle, S.; Steefel, C.; Nico, P. S.

    2011-12-01

    start of acetate addition. For each imaging study, following a 30-minute bolus injection of 99mTc-DTPA, a series of 48 images representing a 3D distribution of radioactivity concentration was acquired over a period of 24 hours. Preliminary analysis of the SPECT datasets indicates changes in flow field structure were captured through the series of imaging studies. Using iTOUGH2, first and second moments of the imaged plume are fit as a function of time to obtain permeability values for use in a CrunchFlow reactive transport model. Utilizing the newly established 99mTc-DTPA conservative tracer to track the evolution of physical structure associated with bioreduction and implementing this data into a biogeochemical transport model is anticipated to yield new insight into the coupling between biogenic contaminant remediation and flow-field evolution.

  18. Evolution and summary results of the Stanford randomized clinical trials of the management of Hodgkin's disease: 1962-1984

    International Nuclear Information System (INIS)

    This is a summary report of the Stanford randomized clinical trials of the management of Hodgkin's disease, initiated in 1962. There have been four major changes in the treatment protocols during this 22 year period. Between 1962-67, 132 patients with CS I, II and III disease were enrolled on various radiation trials. Between 1968-74, 367 patients were enrolled on studies primarily evaluating the role of adjuvant MOPP chemotherapy. Between 1974-80, variations in the chemotherapy regimen and the sequences of the combined modality programs were studied. The current studies, initiated in 1980, have enrolled 102 patients, and test a new mild adjuvant chemotherapy, VBM, (vinblastine, bleomycin and methotrexate) and utilizes ABVD in combined modality and alternating regimens. During the two decades of these studies, involving more than 800 patients, the initial remission rate and duration and the survival of all patients treated have progressively improved

  19. Clinical presentation, evolution, and prognosis of precursor B-cell lymphoblastic lymphoma in trials LMT96, EORTC 58881, and EORTC 58951.

    Science.gov (United States)

    Ducassou, Stéphane; Ferlay, Céline; Bergeron, Christophe; Girard, Sandrine; Laureys, Geneviève; Pacquement, Hélène; Plantaz, Dominique; Lutz, Patrick; Vannier, Jean-Pierre; Uyttebroeck, Anna; Bertrand, Yves

    2011-02-01

    In children, lymphoblastic lymphomas represent 30% of Non-Hodgkin lymphomas (NHL), and approximately 15% are precursor B-cell lymphomas (PBLL). Our study evaluated their main clinical characteristics, evolution, and prognosis in three trials. From 1989 to 2008, 53 children with PBLL (median age 7·75 years) were included in three protocols: Malignant Lymphoma Therapy (LMT) 96, European Organization for Research and Treatment of Cancer (EORTC) 58881, and EORTC 58951 using Berlin-Frankfürt-Münster-derived acute lymphoblastic leukaemia (ALL) therapy. There were 10 stage I disease, 9 stage II, 9 stage III and 25 stage IV. Clinical presentation was heterogeneous with a majority of bone lesions and cutaneous or subcutaneous manifestations. At diagnosis 23 patients had bone marrow involvement, and only three had central nervous system involvement. The median follow-up was 74 months. At last follow-up, 45 patients were in continuous complete remission, whereas eight had progressed or had relapsed (7 Stages IV and 1 Stage III) and died. Two patients had a secondary neoplasia, and are still alive. Disease stage was a major prognostic factor, with better overall survival (OS) and event-free survival (EFS) (P < 0·05) rates observed in patients with Stage I to III as compared to those with Stage IV. Treatment with protocols derived from ALL therapy are efficient with an 82% EFS and an 85% OS at 5 years. PMID:21210776

  20. 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. PMID:27101499

  1. 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...

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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, ...

  7. 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

  8. 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...

  9. 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

    2015-08-01

    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. PMID:26738115

  10. 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

  11. 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...

  12. Maternal obesity and preeclampsia

    Directory of Open Access Journals (Sweden)

    Azar Aghamohammadi

    2011-03-01

    Full Text Available Background: Obesity is a modern day epidemic. The incidence appears to be rapidly increasing in bothdeveloped and developing countries and has become much more obvious in the last decade.Aim& Objective: The present research was done with the aim of studying the effects of obesity definedas a first trimester maternal body mass index >30 on the preeclampsia.Methods: This study was a descriptive-comparative study two hundred fifty singleton pregnancies ofwomen with first trimester BMI >30 who delivered at Emam Hospital, Sari Iran during 2008–2009 werestudied A control group with two hundred fifty nine women of normal body mass index matched for ageand parity were selected and incidence of preeclampsia were compared between groups. χ2 and Oddsratioand 95% confidence were used to analyze the data. Statistical significance was defined as P < 0.05.Results: There was a significant relation between obesity and preeclampsia (20.8 vs. 5.8%, P<0.0001compared to non-obese women.Conclusion: Obesity in pregnant women appears to be a risk factor for adverse perinatal outcomes.

  13. 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

  14. Cocaine Addiction in Mothers: Potential Effects on Maternal Care and Infant Development

    Science.gov (United States)

    Strathearn, Lane; Mayes, Linda C.

    2010-01-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may impact maternal care and infant development, exploring brain, behavioral and neuroendocrine mechanisms. There is evidence that cocaine may affect infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant’s development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance abusing mothers provide adequate care for their infant, and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  15. Cocaine addiction in mothers: potential effects on maternal care and infant development.

    Science.gov (United States)

    Strathearn, Lane; Mayes, Linda C

    2010-02-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect, and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may affect maternal care and infant development, exploring brain, behavioral, and neuroendocrine mechanisms. There is evidence that cocaine affects infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant's development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance-abusing mothers provide adequate care for their infant and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  16. 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

  17. 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.

  18. Testing the temporal relationship between maternal and adolescent depressive and anxiety symptoms in a community sample.

    Science.gov (United States)

    Brown, Ruth C; Clark, Shaunna L; Dahne, Jennifer; Stratton, Kelcey J; MacPherson, Laura; Lejuez, C W; Amstadter, Ananda B

    2015-01-01

    Transactional models have been used to explain the relationship between maternal depression and child behavioral problems; however, few studies have examined transactional models for maternal depression and adolescent depression and anxiety. Using an autoregressive cross-lagged analysis, we examined the longitudinal association between maternal and adolescent depression to determine the extent to which maternal depression influences adolescent depression and anxiety, and vice versa, over the course of a 4-year period. Participants were a community sample of 277 mother-adolescent dyads with offspring 10 to 14 years of age at the 1st year used in the analyses (43.7% female; 35% African American, 2.9% Hispanic/Latino). Depressive symptoms were assessed using maternal self-report (Center for Epidemiological Studies-Depression Scale; Radloff, 1977), and adolescent depression and anxiety were assessed by self-report (Revised Child Anxiety and Depression Scale; Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000). The final model, χ(2)(14) = 23.74, p = .05 (TLI = .97, CFI = .98, RMSEA = .05), indicated that maternal depression was significantly associated with adolescent depression 2 years later. Of interest, adolescent depression did not significantly predict maternal depression, and the association between maternal and adolescent depression was not moderated by gender, age, or ethnicity. The association between maternal depression and adolescent anxiety was weaker than that observed for adolescent depression. Results suggest that the transaction model of maternal depression may not extend to adolescent depression and anxiety. Furthermore, maternal depression can have an enduring effect on adolescent depression, and continued research and clinical monitoring over extended periods is warranted. PMID:24702257

  19. 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

  20. 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

  1. Maternal deaths in Tanzania -- a challenge.

    Science.gov (United States)

    1994-08-01

    A reproductive health approach to health care has many consequences for women in Tanzania. Conditions are currently such that in one hospital in Amana there were 30 to 40 deliveries daily, but only 2 beds. The consequence was patients were treated while lying on the floor. The main city hospital did not have a vacuum aspirator, resuscitation equipment for newborns, or a sterilizer. A Dar es Salaam study shows a hospital maternal mortality rate of 754/100,000 live births, which is much higher than the 200-400/100,000 live births estimated by the WHO. The barriers to women's health are low socioeconomic status, poor nutrition, lack of income, lack of employment opportunities, and limited access to basic sanitation. There is discrimination against women in food, education, and economic independence, and social custom that denies decision making about marriage and reproduction. Access to information is limited to mother and child clinics. Men tend not to be involved in family planning or in treatment for sexually transmitted diseases. Strategies have been narrowly focused on maternal mortality, rather than on reproductive health and the right to live. Pregnancy threatens the right to life. PMID:12222520

  2. 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...... objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment...... 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....

  3. 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...... objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment...... 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....

  4. 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.

  5. Maternal postpartum distress and childhood overweight

    DEFF Research Database (Denmark)

    Ajslev, Teresa A; Andersen, Camilla S; Ingstrup, Katja G;

    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....

  6. 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...

  7. 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

  8. 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.

  9. Framing maternal morbidity: WHO scoping exercise

    OpenAIRE

    Vanderkruik, Rachel C; Tunçalp, Özge; Chou, Doris; Say, Lale

    2013-01-01

    Background Maternal morbidity estimations are not based on well-documented methodologies and thus have limited validity for informing efforts to address the issue and improve maternal health. To fill this gap, maternal morbidity needs to be clearly defined, driving the development of tools and indicators to measure and monitor maternal health. This article describes the scoping exercise conducted by the World Health Organization’s Department of Reproductive of Health and Research (WHO/RHR), a...

  10. Prenatal Maternal Stress Programs Infant Stress Regulation

    OpenAIRE

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

    2010-01-01

    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. The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at ...

  11. 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 ...

  12. The importance of maternal nutrition for health

    OpenAIRE

    Irene Cetin; Arianna Laoreti

    2015-01-01

    Nutrition plays a major role in maternal and child health and it is widely recognized that optimum nutrition in early life is the foundation for long-term health. A healthy maternal dietary pattern, along with adequate maternal body composition, metabolism and placental nutrient supply, reduces the risk of maternal, fetal and long-term effects in the offspring. While undernutrition is mainly an issue of low-income countries, malnutrition, due to poor quality diet, is becoming a global health ...

  13. Maternal protein restriction leads to hyperresponsiveness to stress and salt-sensitive hypertension in male offspring

    OpenAIRE

    Augustyniak, Robert A.; Singh, Karan; Zeldes, Daniel; Singh, Melissa; Rossi, Noreen F.

    2010-01-01

    Low birth weight humans often exhibit hypertension during adulthood. Studying the offspring of rat dams fed a maternal low-protein diet is one model frequently used to study the mechanisms of low birth weight-related hypertension. It remains unclear whether this model replicates key clinical findings of hypertension and increased blood pressure responsiveness to stress or high-salt diet. We measured blood pressure via radiotelemetry in 13-wk-old male offspring of maternal normal- and low-prot...

  14. 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 on ......, and staff dedication to the process was questioned. CONCLUSION: Quality assurance of emergency obstetric care might be strengthened by supplementing internal MDA with external CE....

  15. Cocaine Addiction in Mothers: Potential Effects on Maternal Care and Infant Development

    OpenAIRE

    Strathearn, Lane; Mayes, Linda C.

    2010-01-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may impact maternal care and infant development, exploring brain, behavioral and neuroendocrine mechanisms. There is evidence that cocaine may affect infant development both directly, via in utero exposure, and indirectly via alterations in materna...

  16. 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...

  17. Paternal Psychopathology and Maternal Depressive Symptom Trajectory During the First Year Postpartum

    OpenAIRE

    Ross, Randal G.; Zerbe, Gary O.; Hunter, Sharon K.; Kimberly L. D'Anna-Hernandez

    2013-01-01

    Understanding parental psychopathology interaction is important in preventing negative family outcomes. This study investigated the effect of paternal psychiatric history on maternal depressive symptom trajectory from birth to 12 months postpartum. Maternal Edinburgh Postpartum Depression screens were collected at 1, 6 and 12 months and fathers’ psychiatric diagnoses were assessed with the Structured Clinical Interview for DSM-IV from 64 families. There was not a significant difference in the...

  18. 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.…

  19. 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

  20. Relationship between maternal periodontal disease and Apgar score of newborns

    OpenAIRE

    Shirmohammadi, Adileh; Abdollahifard, Sedigeh; Chitsazi, Mohammad-Taghi; Behlooli, Sepideh

    2012-01-01

    Purpose The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. Methods One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were record...

  1. 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...

  2. 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...

  3. 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...

  4. Antecedents of Maternal Separation Anxiety.

    Science.gov (United States)

    Fein, Greta G.; And Others

    1993-01-01

    Examined antecedents of maternal separation anxiety in 83 Italian mothers prior to their infants or toddlers entering group care. Mothers' anxiety did not vary with the child's age. Anxious mothers were younger and less educated, received less support, had temperamentally negative infants, and provided less varied stimulation in the home. (MM)

  5. 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)

  6. 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…

  7. 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.

  8. 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

  9. 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) pmother 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. PMID:26701122

  10. 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

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

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne; Væver, Mette Skovgaard; Tharner, Anne

    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...... development before 6 months of age, that is, at the time when maternal postpartum depressive symptoms are most present. To address this issue, additionally to a long-term measure of infant development, the present study examines early concurrent effects of maternal clinical depression. Method: Mothers (N=85...

  12. Maternal influences on fetal microbial colonization and immune development.

    Science.gov (United States)

    Romano-Keeler, Joann; Weitkamp, Jörn-Hendrik

    2015-01-01

    While critical for normal development, the exact timing of establishment of the intestinal microbiome is unknown. For example, although preterm labor and birth have been associated with bacterial colonization of the amniotic cavity and fetal membranes for many years, the prevailing dogma of a sterile intrauterine environment during normal term pregnancies has been challenged more recently. While found to be a key contributor of evolution in the animal kingdom, maternal transmission of commensal bacteria may also constitute a critical process during healthy pregnancies in humans with yet unclear developmental importance. Metagenomic sequencing has elucidated a rich placental microbiome in normal term pregnancies likely providing important metabolic and immune contributions to the growing fetus. Conversely, an altered microbial composition during pregnancy may produce aberrant metabolites impairing fetal brain development and life-long neurological outcomes. Here we review the current understanding of microbial colonization at the feto-maternal interface and explain how normal gut colonization drives a balanced neonatal mucosal immune system, while dysbiosis contributes to aberrant immune function early in life and beyond. We discuss how maternal genetics, diet, medications, and probiotics inform the fetal microbiome in preparation for perinatal and postnatal bacterial colonization. PMID:25310759

  13. Classification differences and maternal mortality

    DEFF Research Database (Denmark)

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

    1999-01-01

    change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per...... 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001). CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and...... sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected. RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This...

  14. 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.

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. Maternal and fetal outcome in grand multipara

    International Nuclear Information System (INIS)

    Study Design: Case control study. Place and Duration of Study: Gynecology and Obstetric Unit-I of the Jinnah Post Graduate and Medical Centre Karachi, from February 2009 to January 2010. Patients and Methods: One hundred (100) patients of grand multipara (GMP), (parity = 5) and 100 patients of multipara (MP) (parity 2-4) were included in the study. Pregnant women with known medical conditions including essential hypertension, diabetes mellitus, epilepsy, primigravidas, women with previous caesarean section and twin pregnancies were excluded. Patients were admitted through antenatal clinic and emergency. A detailed history was taken and a physical examination was done with special emphasis on obstetrical examination. Investigations like blood CP, Urine D/R, blood grouping and sonogram were done. During labour, mother and neonates were managed according to ward protocols. Maternal and fetal outcomes were compared among GMPs and MPs. Results: A high frequency of anaemia (81% vs 20%), pregnancy induced hypertension (45%, vs. 26%) and gestational diabetes (9%, vs1%) were seen in GMP as compared to MP group. Frequency of malpresentations (26% vs 15%), postpartum hemorrhage (15%, vs 10%) and intrauterine deaths (26%, vs 13%) were higher in GMP group along with a high caesarean delivery rate (GMP 21%, MP 14%). A higher maternal mortality (GMP 4%, MP 1%) and low APGAR score (GMP 12%, MP 4%) were observed among babies born to grand multipara group. Conclusion: Grand multiparity is associated with adverse outcome for both mother and fetus. Effort should be directed to reduce high parity in the community through effective family planning initiatives. Specialized antenatal and obstetrical care facilities should be available. (author)

  20. Socioeconomic factors contributing to exclusion of women from maternal health benefit in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Tajudeen O. Oyewale

    2015-02-01

    Full Text Available Background: An understanding of the predictive effect of socioeconomic characteristics (SECs of women on maternal healthcare service utilisation is essential in order to maximise maternal health benefits and outcomes for the newborn.Objectives: To describe how SECs of women contribute to their exclusion from maternal health benefits in Abuja Municipal Areas Council (AMAC in Abuja, Nigeria.Method: A non-experimental, facility-based cross-sectional survey was done. Data were collected from 384 respondents using a structured interviewer-administered questionnaire. The participants were sampled randomly at antenatal care (ANC clinics in the five district hospitals in AMAC. Data analysis included descriptive statistics, cross-tabulations and measures of inequality. Logistic regression analysis was used to test the relationship between SECs (predictors and maternal healthcare service utilisation.Results: There were differentials in the utilisation of maternal healthcare services (ANC, delivery care, post natal care [PNC] and contraceptive services amongst women withdifferent SECs; and the payment system for maternal healthcare services was regressive. There were inconsistencies in the predictive effect of the SECs of women included in this study (age,education, birth order, location of residence, income group and coverage by health insurance on maternal healthcare service utilisation when considered independently (bivariate analysis as opposed to when considered together (logistic regression, with the exception of birth order, which showed consistent effect.Conclusion: SECs of women were predictive factors of utilisation of maternal healthcare services. There is a need for targeted policy measures and programme actions toward multiple SECs of women in their natural co-existing state in order to optimise maternal health benefits.

  1. 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

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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 ...

  9. 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...

  10. 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…

  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. Maternal Moderators of Child Care: The Role of Maternal Separation Anxiety.

    Science.gov (United States)

    McBride, Susan L.

    1990-01-01

    Investigated the relationships between maternal separation anxiety, maternal employment, and quality of child care for 49 mothers of 2- to 3-year olds in day care centers. Findings suggest that the mother's concern about separation is an important moderator of the effects of maternal employment and child care on children's development. (BB)

  13. 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…

  14. Developing core patient-reported outcomes in maternity: PRO-Maternity.

    Science.gov (United States)

    Mahmud, A; Morris, E; Johnson, S; Ismail, K M

    2014-09-01

    Women-centred maternity PRO measures can generate outcome measures that will allow benchmarking of service delivery using meaningful outcomes that will drive service improvement to ensure commitment to a culture of openness, patient satisfaction, patient safety and the delivery of clinically effective care. Moreover, they can generate new insights into women’s perspectives of healthcare delivery, allowing changes in attitude, practice and organisational services. Once developed, the adoption of PRO measures within units is likely to come at additional cost. However, the expected benefits in improved woman and family satisfaction, reduced legal claims and the presence of an early indicator of compromised quality of care will have the potential to save a significant amount of money for individual units and the wider health economy. PMID:25236628

  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. PMID:11983863

  16. Clinico-pathological discrepancies in the diagnosis of causes of maternal death in sub-Saharan Africa: retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Jaume Ordi

    2009-02-01

    Full Text Available BACKGROUND: Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. METHODS AND FINDINGS: A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n = 139 during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death. Major diagnostic errors were detected in 56 (40.3% maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%, pyogenic bronchopneumonia (35.3%, pyogenic meningitis (40.0%, and puerperal septicemia (50.0%. Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%. CONCLUSIONS: Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

  17. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group. PMID:26975126

  18. 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.

  19. 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

  20. Educación maternal

    OpenAIRE

    Carnicer Fuentes, Inmaculada Concepción

    2010-01-01

    Definir y/o describir los objetivos, metodología y contenidos de la educación maternal como componente del proceso asistencial integrado de atención al “Embarazo, Parto y Puerperio” de la Consejería de Salud de la Junta de Andalucía. Definir y/o describir los aspectos básicos del crecimiento y desarrollo ovular Definir y/o describir los aspectos básicos de la educación sanitaria durante el embarazo, incluyendo aspectos como nutrición, fármacos, vacunas, atención prenatal y prevención ...

  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 Sepsis and Septic Shock.

    Science.gov (United States)

    Chebbo, Ahmad; Tan, Susanna; Kassis, Christelle; Tamura, Leslie; Carlson, Richard W

    2016-01-01

    The year 2015 marked the 200th anniversary of the birth of Ignaz Semmelweis, the Hungarian physician who identified unhygienic practices of physicians as a major cause of childbed fever or puerperal sepsis. Although such practices have largely disappeared as a factor in the development of chorioamnionitis and postpartum or puerperal endometritis, it is appropriate that this article on sepsis in pregnancy acknowledges his contributions to maternal health. This review describes the incidence and mortality of sepsis in pregnancy, methods to identify and define sepsis in this population, including scoring systems, causes, and sites of infection during pregnancy and parturition and management guidelines. PMID:26600449

  3. A systematic review on the effects of maternal calcium supplementation on offspring′s blood pressure

    Directory of Open Access Journals (Sweden)

    Fahimeh Jamshidi

    2015-01-01

    Full Text Available Background: Evidence proposes that maternal calcium (Ca supplement during pregnancy may be inversely associated with the off spring′s blood pressure (BP level. It is suggested that increased maternal Ca intake during pregnancy may result in lower BP in the off spring. The reduction in the incidence of hypertension in mothers is documented but the effects on the off spring are uncertain. Materials and Methods: We conducted a systematic review of the literature to summarize the evidence supporting an association between maternal dietary Ca intake during pregnancy and the BP in the off spring. In this systematic review, relevant papers were selected in three phases. After quality assessment, a reviewer extracted the data while the other one checked the extracted data. We summarized the information regarding the association of maternal Ca intake either by food or supplements with BP in the off spring. Results: Four randomized trials and three observational studies were included in this review. The results were more consistent among the studies including older children (1-9 years where a higher maternal Ca intake was associated with a reduction in the off spring′s systolic BP. One large randomized trial found a clinically and statistically significant reduction in the incidence of elevated BP in 7-year-old children [relative risk (RR = 0.59, 95% confidence interval (CI 0.39-0.90]. Conclusion: Overall, our findings confirm the beneficial effects of maternal Ca intake during pregnancy for the off spring′s BP level.

  4. 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.

  5. 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.

  6. Maternal vitamin C deficiency during pregnancy results in transient fetal and placental growth retardation in guinea pigs

    DEFF Research Database (Denmark)

    Schjoldager, Janne Gram; Paidi, Maya Devi; Lindblad, Maiken Marie;

    2015-01-01

    PURPOSE: Recently, we reported that preferential maternal-fetal vitamin C (vitC) transport across the placenta is likely to be impaired by prolonged maternal vitC deficiency. Maintenance of a basal maternal vitC supply at the expense of the fetus may impair fetal development; however, the knowledge...... of vitC's impact on intrauterine development is sparse. The aim of this study was to explore the effect of maternal vitC status on fetal and placental development in guinea pigs. METHODS: Twenty pregnant Dunkin Hartley guinea pigs were randomized into four groups to receive diets either sufficient...... glutathione elevated compared with controls (p < 0.0001). CONCLUSIONS: Although no clinical differences between CTRL and DEF pups were observed at GD56, the present data suggest that vitC plays a role in early fetal development. Although no clinical differences between CTRL and DEF pups were observed at GD56...

  7. Linkages among reproductive health, maternal health, and perinatal outcomes.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Lassi, Zohra S; Blanc, Ann; Donnay, France

    2010-12-01

    Some interventions in women before and during pregnancy may reduce perinatal and neonatal deaths, and recent research has established linkages of reproductive health with maternal, perinatal, and early neonatal health outcomes. In this review, we attempted to analyze the impact of biological, clinical, and epidemiologic aspects of reproductive and maternal health interventions on perinatal and neonatal outcomes through an elucidation of a biological framework for linking reproductive, maternal and newborn health (RHMNH); care strategies and interventions for improved perinatal and neonatal health outcomes; public health implications of these linkages and implementation strategies; and evidence gaps for scaling up such strategies. Approximately 1000 studies (up to June 15, 2010) were reviewed that have addressed an impact of reproductive and maternal health interventions on perinatal and neonatal outcomes. These include systematic reviews, meta-analyses, and stand-alone experimental and observational studies. Evidences were also drawn from recent work undertaken by the Child Health Epidemiology Reference Group (CHERG), the interconnections between maternal and newborn health reviews identified by the Global Alliance for Prevention of Prematurity and Stillbirth (GAPPS), as well as relevant work by the Partnership for Maternal, Newborn and Child Health. Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented. Most of the interventions reviewed will require more greater-quality evidence before solid programmatic recommendations can be made. However, on the basis of our review, birth spacing, prevention of indoor air pollution, prevention of intimate partner violence before and during pregnancy, antenatal care during pregnancy, Doppler ultrasound monitoring during pregnancy, insecticide-treated mosquito nets, birth and newborn care preparedness via community-based intervention

  8. 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.

  9. 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...

  10. 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

  11. 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.

  12. 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)

  13. 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 h...

  14. Maternal Mortality Among Migrants in Western Europe

    DEFF Research Database (Denmark)

    Pedersen, Grete Skøtt; Grøntved, Anders; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo; Rich-Edwards, Janet

    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. Resu...

  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. 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....

  17. 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…

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. Analysis of maternal microchimerism in rhesus monkeys (Macaca mulatta) using real-time quantitative PCR amplification of MHC polymorphisms

    OpenAIRE

    Bakkour, Sonia; Baker, Chris AR; Tarantal, Alice F; Wen, Li; Busch, Michael P; Lee, Tzong-Hae; McCune, Joseph M

    2014-01-01

    Although pregnancy-associated microchimerism is known to exist in humans, its clinical significance remains unclear. Fetal microchimerism has been documented in rhesus monkeys, but the trafficking and persistence of maternal cells in the monkey fetus and infant have not been fully explored. To investigate the frequency of maternal microchimerism in the rhesus monkey (Macaca mulatta), a real-time polymerase chain reaction (PCR) strategy was developed and validated to target polymorphic major h...

  3. Exercise partially reverses the effect of maternal separation on hippocampal proteins in 6-hydroxydopamine lesioned rat brain

    OpenAIRE

    Dimatelis, JJ; Hendricks, S.; Hsieh, J; Vlok, NM; Bugarith, K; Daniels, WMU; Russell, VA

    2012-01-01

    Animals subjected to maternal separation stress during the early stages of development display behavioural, endocrine and growth factor abnormalities that mirror the clinical findings in anxiety/depression. In addition, maternal separation has been shown to exacerbate the behavioural deficits induced by 6-hydroxydopamine (6-OHDA) in a rat model of Parkinson's disease. In contrast, voluntary exercise reduced the detrimental effects of 6-OHDA in the rat model. The beneficial effects of exercise...

  4. 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 ...

  5. 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...

  6. 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...

  7. 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...

  8. The WHO Maternal Near-Miss Approach and the Maternal Severity Index Model (MSI): Tools for Assessing the Management of Severe Maternal Morbidity

    OpenAIRE

    Souza, Joao Paulo; Cecatti, Jose Guilherme; Parpinelli, Mary Angela; Costa, Maria Laura; ,; Almeida, Elson J; Amaral, Eliana M; Amorim, Melania M; Andreucci, Carla B.; Aquino, Márcia M; Bahamondes, Maria V; Lima, Antonio C Barbosa; Barroso, Frederico; Bione, Adriana; Brum, Ione R.

    2012-01-01

    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 proba...

  9. 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

  10. Optimistic outlook regarding maternity protects against depressive symptoms postpartum.

    Science.gov (United States)

    Robakis, Thalia K; Williams, Katherine E; Crowe, Susan; Kenna, Heather; Gannon, Jamie; Rasgon, Natalie L

    2015-04-01

    The transition to motherhood is a time of elevated risk for clinical depression. Dispositional optimism may be protective against depressive symptoms; however, the arrival of a newborn presents numerous challenges that may be at odds with initially positive expectations, and which may contribute to depressed mood. We have explored the relative contributions of antenatal and postnatal optimism regarding maternity to depressive symptoms in the postnatal period. Ninety-eight pregnant women underwent clinician interview in the third trimester to record psychiatric history, antenatal depressive symptoms, and administer a novel measure of optimism towards maternity. Measures of depressive symptoms, attitudes to maternity, and mother-to-infant bonding were obtained from 97 study completers at monthly intervals through 3 months postpartum. We found a positive effect of antenatal optimism, and a negative effect of postnatal disconfirmation of expectations, on depressive mood postnatally. Postnatal disconfirmation, but not antenatal optimism, was associated with more negative attitudes toward maternity postnatally. Antenatal optimism, but not postnatal disconfirmation, was associated with reduced scores on a mother-to-infant bonding measure. The relationships between antenatal optimism, postnatal disconfirmation of expectations, and postnatal depression held true among primigravidas and multigravidas, as well as among women with prior histories of mood disorders, although antenatal optimism tended to be lower among women with mental health histories. We conclude that cautious antenatal optimism, rather than immoderate optimism or frank pessimism, is the approach that is most protective against postnatal depressive symptoms, and that this is true irrespective of either mood disorder history or parity. Factors predisposing to negative cognitive assessments and impaired mother-to-infant bonding may be substantially different than those associated with depressive symptoms, a

  11. 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

  12. 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

  13. 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

  14. 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.

  15. Fetal and Maternal Effects of Vitamin D

    Directory of Open Access Journals (Sweden)

    Ayşenur Alper Gürz1

    2015-03-01

    Full Text Available 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 preeclampsia, gestational diabetes, periodontal diseases and for fetal or childhood periods there is a significant impact on the development of the skeletal, respiratory and the central nervous systems. In recent years, light of these studies, the knowledge about the vitamin D has been updated and multiple vitamin D supplementation programs has been applied through the definition of "subclinical vitamin D deficiency" and their effects on the non-skeletal system. In many countries, it has been emphasized that vitamin D supplementation should be given to women, especially in the last trimester of pregnancy. However, in developing countries, the presence of vitamin D deficiency continues to be a huge public health problem. In this case, all physicians, especially pediatricians, obstetricians and family physicians should be alert to this important issue.

  16. 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

  17. Familial Risk Factors to Oppositional Defiant Disorder and Conduct Disorder: Parental Psychopathology and Maternal Parenting.

    Science.gov (United States)

    Frick, Paul J.; And Others

    1992-01-01

    In sample of 177 clinic-referred children aged 7-13, association was found between diagnosis of conduct disorder and several aspects of family functioning: maternal parenting (supervision and persistence in discipline) and parent adjustment (paternal antisocial personality disorder and paternal substance abuse). Children with oppositional defiant…

  18. [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

  19. 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.

  20. 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. PMID:25913568

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. GABA Enhancement of Maternal Defense in Mice: Possible Neural Correlates

    OpenAIRE

    Lee, Grace; Gammie, Stephen C.

    2007-01-01

    Previous studies have shown that low doses of GABAA receptor agonists facilitate maternal defense of offspring (maternal aggression), without significantly affecting other maternal behaviors. In addition, it has been demonstrated that endogenous changes in GABAergic neurotransmission occur in association with lactation. This study investigated the effects of GABAA receptor agonist, chlordiazepoxide (CDP), a benzodiazepine (BDZ), on maternal behaviors including aggression, and identified brain...

  8. Combined measurement of maternal serum FE3 and HPL for determination of fetus-placenta function

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical application of combined measurement of maternal serum FE3 and HPL for determination of fetus-placenta function. Methods: Maternal serum FE3 and HPL levels were measured with RIA in 86 complicated and 39 non-complicated pregnant women. Results: Serum FE3 contents in pregnant women complicated with hypertensive syndrome, intrauterine fetal distress, gestation above 33 wks complicated with diabetes and 3rd grade placenta were significantly lower than those in non-complicated ones (p3 and HPL could improve the early diagnosis of high-risk pregnancies

  9. 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

  10. 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

  11. 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...

  12. Postpartum Maternal Sleep, Maternal Depressive Symptoms and Self-Perceived Mother-Infant Emotional Relationship.

    Science.gov (United States)

    Tikotzky, Liat

    2016-01-01

    This study examined the links between maternal sleep, maternal depressive symptoms, and mothers' perceptions of their emotional relationship with their infant in a self-recruited sample of mothers. Eighty mothers of infants 3-18 months old completed sleep diaries for 5 consecutive nights, and questionnaires assessing sleep (Insomnia Severity Index [ISI]), depressive symptom severity (Edinburgh Postnatal Depression Scale [EPDS]), and perceived mother-infant relationship (Postpartum Bonding Questionnaire [PBQ] and Maternal Postnatal Attachment Questionnaire [MPAQ]). Significant correlations, controlling for depression severity, were found between more disturbed maternal sleep and more negative maternal perceptions of the mother-infant relationship. Regression analyses revealed that EPDS showed the strongest association with PBQ, whereas ISI demonstrated the strongest association with MPAQ. The present study highlights the importance of deepening and expanding our understanding of the negative implications of maternal sleep problems. PMID:25127316

  13. 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...

  14. 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...

  15. The Maternal Migration Effect : Exploring Maternal Healthcare in Diaspora Using Qualitative Proxies for Medical Anthropology

    OpenAIRE

    Binder, Pauline

    2012-01-01

    This project explores the 'maternal migration effect'. Following migration to a high-income country with a low maternal mortality rate, we assume that some immigrant women’s reliance upon maternal practices that respond to a low-income, high-mortality context can adversely affect care-seeking and utilization of treatment facilities. At highest risk in the United Kingdom and Sweden are those from Africa's Horn, particularly Somali women who have experienced diasporic migration. By applying con...

  16. Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding.

    Science.gov (United States)

    Reck, C; Zietlow, A-L; Müller, M; Dubber, S

    2016-06-01

    Research investigating maternal bonding and parenting stress in the course of postpartum depression is lacking. Aim of the study was to investigate the development and potential mediation of both constructs in the course of postpartum depression. n = 31 mothers with postpartum depression according to DSM-IV and n = 32 healthy controls completed the German version of the Postpartum Bonding Questionnaire and the Parenting Stress Index at two measuring times: acute depression (T1) and remission (T2). At T1, the clinical group reported lower bonding and higher parenting stress. Bonding was found to partially mediate the link between maternal diagnosis and parenting stress. Furthermore, the clinical group reported lower bonding and higher parenting stress averaged over both measurement times. However, at T2, the clinical group still differed from the controls even though they improved in bonding and reported less parenting stress. A significant increase of bonding was also observed in the control group. Maternal bonding seems to buffer the negative impact of postpartum depression on parenting stress. The results emphasize the need for interventions focusing on maternal bonding and mother-infant interaction in order to prevent impairment of the mother-child relationship. PMID:26592705

  17. 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

  18. 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 ...

  19. Correlates of Maternal Health Care Utilization in Rohilkhand Region, India

    OpenAIRE

    Srivastava, A.; Mahmood, SE; P Mishra; Shrotriya, VP

    2014-01-01

    Background: Until date, the importance of maternal health care services in reducing maternal mortality and morbidity has received a significant recognition. Most of the maternal deaths can be prevented if women have access to basic antenatal, natal and postnatal care. However, uptake of maternal health care services is far from universal even in settings where they are extensively available. Aim: The aim of this study is to assess the pattern and identify underlying factors on maternal health...

  20. Maternal Health Care: The Case of Iron Supplementation in India

    OpenAIRE

    Khan, Rana Ejaz Ali; Raza, Muhammad Ali

    2013-01-01

    Prenatal care is an essential segment of maternal health-care. In this paper an attempt has been made to examine the socioeconomic determinants of maternal iron supplementation and sufficient maternal iron supplementation as components of prenatal care. Micro-data having 25999 and 19764 observations for two models, i.e. maternal iron supplementation and maternal sufficient iron supplementation respectively has been taken from Indian Demographic and Health Survey (IDHS) 2005-06. To estimate th...

  1. Prevention of maternal-fetal transmission of cytomegalovirus.

    Science.gov (United States)

    Adler, Stuart P; Nigro, Giovanni

    2013-12-01

    Reported maternal-to-fetal rates of primary cytomegalovirus (CMV) infection during pregnancy have been between 30% and 50%. The highest rate of symptomatic congenital infection and sequelae occurs in about 25% of infected infants born of mothers with a primary infection during pregnancy. Symptomatic infants demonstrate a constellation of clinical features that reflect placental dysfunction and probable viral infection of the central nervous system of the fetus. In the United States, we estimate that about 8000 affected infants are born each year. Two options may be available to prevent or treat maternal CMV infection during pregnancy, especially for women with exposure to young children in the home. The first is hygienic intervention. Two studies support the simplicity, harmlessness, and effectiveness of hygienic intervention to prevent child-to-mother transmission of CMV among high-risk pregnant women who know they are susceptible. The second is CMV immunoglobulin. A meta-analysis of 2 clinical trials showed an efficacy of 50% if immunoglobulin is given to pregnant women who have acquired a primary CMV infection during pregnancy. These results mean that seronegative pregnant women have options to prevent fetal infection. PMID:24257425

  2. 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.

  3. 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

  4. 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

  5. Reproduction at an advanced maternal age and maternal health.

    Science.gov (United States)

    Sauer, Mark V

    2015-05-01

    Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction. PMID:25934599

  6. Maternal mortality in developing countries: challenges in scaling-up priority interventions.

    Science.gov (United States)

    Prata, Ndola; Passano, Paige; Sreenivas, Amita; Gerdts, Caitlin Elisabeth

    2010-03-01

    Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when appropriate strategies are in place. Such achievable strategies need to include redoubled commitments on the part of local, national and global political bodies, concrete investments in high-yield and cost-effective interventions and the delegation of some clinical tasks from higher-level healthcare providers to mid- or lower-level healthcare providers, as well as improved health-management information systems. PMID:20187734

  7. Polyandry, life-history trade-offs and the evolution of imprinting at Mendelian loci.

    Science.gov (United States)

    Mills, Walter; Moore, Tom

    2004-12-01

    Genomic imprinting causes parental origin-dependent differential expression of a small number of genes in mammalian and angiosperm plant embryos, resulting in non-Mendelian inheritance of phenotypic traits. The "conflict" theory of the evolution of imprinting proposes that reduced genetic relatedness of paternally, relative to maternally, derived alleles in offspring of polygamous females supports parental sex-specific selection at gene loci that influence maternal investment. While the theory's physiological predictions are well supported by observation, the requirement of polyandry in the evolution of imprinting from an ancestral Mendelian state has not been comprehensively analyzed. Here, we use diallelic models to examine the influence of various degrees of polyandry on the evolution of both Mendelian and imprinted autosomal gene loci that influence trade-offs between maternal fecundity and offspring viability. We show that, given a plausible assumption on the physiological relationship between maternal fecundity and offspring viability, low levels of polyandry are sufficient to reinforce exclusively the fixation of "greedy" paternally imprinted alleles that increase offspring viability at the expense of maternal fecundity and "thrifty" maternally imprinted alleles of opposite effect. We also show that, for all levels of polyandry, Mendelian alleles at genetic loci that influence the trade-off between maternal fecundity and offspring viability reach an evolutionary stable state, whereas pairs of reciprocally imprinted alleles do not. PMID:15611195

  8. 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...

  9. The Reset Hypothesis: Lactation and Maternal Metabolism

    OpenAIRE

    Stuebe, Alison M.; Rich-Edwards, Janet W.

    2008-01-01

    For maternal metabolism, pregnancy ends not with delivery, but with weaning. In several recent epidemiological studies, authors have reported an association between duration of breast-feeding and reduced maternal risk of metabolic disease. These findings parallel data from animal models showing favorable changes in metabolism associated with lactation. During gestation, visceral fat accumulates, and insulin resistance and lipid and triglyceride levels increase. These changes appear to reverse...

  10. Why are most organelle genomes transmitted maternally?

    OpenAIRE

    Greiner, Stephan; Sobanski, Johanna; Bock, Ralph

    2014-01-01

    Why the DNA-containing organelles, chloroplasts, and mitochondria, are inherited maternally is a long standing and unsolved question. However, recent years have seen a paradigm shift, in that the absoluteness of uniparental inheritance is increasingly questioned. Here, we review the field and propose a unifying model for organelle inheritance. We argue that the predominance of the maternal mode is a result of higher mutational load in the paternal gamete. Uniparental inheritance evolved from ...

  11. Maternal morbidity associated with in utero transfer.

    OpenAIRE

    Ryan, T. D.; Kidd, G M

    1989-01-01

    OBJECTIVE--To determine the extent of maternal morbidity associated with in utero transfer. DESIGN--Retrospective study of 190 consecutive cases over two years. SETTING--Liverpool Maternity Hospital. PATIENTS--190 Pregnant women were transferred to the hospital under the in utero transfer arrangements from district general hospitals both within and outside the Mersey region. The women admitted were divided into two categories: those in threatened or established uncomplicated preterm labour an...

  12. 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...

  13. IMPACT OF MATERNAL OBESITY ON OBSTETRIC OUTCOMES

    OpenAIRE

    Najafiyan Mahin; Cheraghi Maria; Mahmodi Mandana

    2012-01-01

    Weight gain and obesity are public health problems in pregnant women and is associated with increased risk of maternal and neonatal complications. Objective was to determine maternal, fetal and neonatal complications in obese women. A Prospective study was conducted at Gynecology ward, Razi medical and educational center, Ahvaz, Iran during year 2011. A total of 850 subjects were participated in this study for 18 weeks follow- up. The subjects were divided into two groups. Overweight/ obese (...

  14. Maternal Postpartum Distress and Childhood Overweight

    OpenAIRE

    Ajslev, Teresa A.; Andersen, Camilla S.; Ingstrup, Katja G.; Nohr, Ellen A.; Sørensen, Thorkild I A

    2010-01-01

    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 ...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. Maternal Thyroid Function in Pregnancy may Program Offspring Blood Pressure, but not Adiposity at 20 Years of Age

    DEFF Research Database (Denmark)

    Rytter, Dorte; Andersen, Stine L; Bech, Bodil H; Halldorsson, Thorhallur I; Henriksen, Tine B; Laurberg, Peter; Olsen, Sjurdur F

    2016-01-01

    BACKGROUND: Experimental evidence exists indicating that maternal thyroid hormones during pregnancy may affect the metabolic set point and cardio-vascular function in the offspring. The objective of this study was to investigate the association between maternal thyroid function in week 30 of......-reported anthropometrics (N=645) and a clinically measured blood pressure (N=425). Multiple linear regression was used to estimate the association between maternal thyroid function and offspring BMI, waist circumference and blood pressure. RESULTS: Offspring of subclinical hypothyroid women had higher systolic blood...... circumference. CONCLUSION: Maternal thyroid function during 3rd trimester of pregnancy may affect long term blood pressure in the offspring.Pediatric Research (2016); doi:10.1038/pr.2016.56....

  1. Maternal regulation of offspring development in mammals is an ancient adaptation tied to lactation

    Directory of Open Access Journals (Sweden)

    Michael L. Power

    2013-12-01

    Full Text Available The developmental origins of health and disease (DOHaD is a paradigm for understanding metabolic diseases of modern humans. Vulnerability to disease is linked to perturbations in development during critical time periods in fetal and neonatal life. These perturbations are caused by environmental signals, often generated or transduced by the mother. The regulation of mammalian development depends to a large extent on maternal biochemical signals to her offspring. We argue that this adaptation is ancient, and originated with the evolution of lactation. Lactation evolved earlier than live birth and before the extensive placental development of modern eutherian mammals. Milk contains a host of signaling molecules including nutrients, immunoglobulins, growth factors and metabolic hormones. As evidenced by marsupials, lactation originally served to supply the biochemical factors for growth and development for what is essentially a fetus to a weanling transitioning to independent existence. In placental mammals maternal signaling in earliest life is accomplished through the maternal–placental–fetal connection, with more of development shifted to in utero life. However, significant development occurs postpartum, supported by milk. Mothers of all taxa provide biochemical signals to their offspring, but for non-mammalian mothers the time window is short. Developing mammals receive maternal biochemical signals over an extended period. These signals serve to guide normal development, but also can vary in response to environmental conditions. The ancient adaptation of lactation resulted in a lineage (mammals in which maternal regulation of offspring development evolved to a heightened degree, with the ability to modify development at multiple time points. Modern metabolic diseases may arise due to a mismatch between maternal regulation and eventual circumstances of the offspring, and due to a large proportion of mothers that exceed past evolutionary norms

  2. 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.

  3. Noninvasive Prenatal Molecular Karyotyping from Maternal Plasma

    Science.gov (United States)

    Yu, Stephanie C. Y.; Jiang, Peiyong; Choy, Kwong W.; Chan, Kwan Chee Allen; Won, Hye-Sung; Leung, Wing C.; Lau, Elizabeth T.; Tang, Mary H. Y.; Leung, Tak Y.; Lo, Yuk Ming Dennis; Chiu, Rossa W. K.

    2013-01-01

    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. PMID:23613765

  4. Decay of maternal antibodies in broiler chickens.

    Science.gov (United States)

    Gharaibeh, Saad; Mahmoud, Kamel

    2013-09-01

    The objective of this study was to determine the decay rate of maternal antibodies against major broiler chicken pathogens. A total of 30 one-day-old broiler chicks were obtained from a commercial hatchery and reared in isolation. These chicks were retrieved from a parent flock that received a routine vaccination program. Chicks were bled at hatch and sequentially thereafter every 5 d through 30 d of age. Maternal antibody titers were measured by ELISA for avian encephalomyelitis (AEV), avian influenza virus (AIV), chicken anemia virus (CAV), infectious bursal disease virus (IBDV), infectious bronchitis virus (IBV), infectious laryngotracheitis virus (ILTV), Mycoplasma gallisepticum (MG), Mycoplasma synoviae (MS), and reovirus (Reo). Maternal antibody titers for Newcastle disease virus (NDV) were measured using a hemagglutination inhibition test. Half-life estimates of maternal antibody titers were 5.3, 4.2, 7, 5.1, 3.9, 3.8, 4.9, 4.1, 6.3, and 4.7 d for AEV, AIV, CAV, IBDV, IBV, ILTV, MG, MS, NDV, and Reo, respectively. The statistical analysis revealed significant differences among half-lives of maternal antibody titers against certain pathogens. Furthermore, all maternal antibody titers were depleted by 10 d of age except for IBDV. PMID:23960115

  5. An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG

    International Nuclear Information System (INIS)

    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. (paper)

  6. Pattern of Maternal Complications and Low Birth Weight: Associated Risk Factors among Highly Endogamous Women.

    Science.gov (United States)

    Bener, Abdulbari; Salameh, Khalil M K; Yousafzai, Mohammad T; Saleh, Najah M

    2012-01-01

    Objective. The objective of the study was to examine the pattern of low birth weight LBW, maternal complications, and its related factors among Arab women in Qatar. Design. This is a prospective hospital-based study. Setting. The study was carried out in Women's Hospital, Doha. Subjects and Methods. Pregnant women in their third trimester were identified in the log book of Women's Hospital and recruited into the study during first week of January 2010 to July 2011. Only 1674 (out of 2238) Arab women (74.7%) consented to participate in this study. Data on clinical and biochemistry parameters were retrieved from medical records. Follow-up data on neonatal outcome was obtained from labor room register. Results. The incidence of LBW (rupture of membrane (PROM), maternal occupation, parity, sheesha smoking, and parental consanguinity were significantly different (P < 0.05) between mothers of LBW and normal birth weight NBW (≥2500 g) babies. Multivariable logistic regression analysis revealed that previous LBW, consanguinity, parity, smoking shesha, GDM, APH, anemia, PROM, maternal occupation, and housing condition were significantly associated with LBW adjusting for gestational age. Conclusion. Maternal complications such as GDM, APH, anemia, PROM, and smoking shesha during pregnancy are significantly increasing the risk of LBW outcome. Screening and prompt treatment for maternal complications and health education for smoking cessation during routine antenatal visits will help in substantial reduction of LBW outcome. PMID:22991672

  7. 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

  8. 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

  9. 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

  10. Significant Bacteriuria Among Asymptomatic Antenatal Clinic Attendees In Ibadan, Nigeria

    OpenAIRE

    Aderemi O. Kehinde; Adedapo, Kayode S.; Aimaikhu, Christopher O.; Odukogbe, Akin-tunde A.; Olayemi, Oladapo; Salako, Babatunde

    2011-01-01

    Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospita...

  11. EVOLUCIÓN CLÍNICA DE PACIENTES CON INFARTO AGUDO DE MIOCARDIO TRATADOS CON ANGIOPLASTIA PRIMARIA / Clinical evolution of patients with acute myocardial infarction treated with primary angioplasty

    Directory of Open Access Journals (Sweden)

    Ernesto del Pino Sánchez

    2012-07-01

    objective was to describe patients' clinical evolution with acute myocardial infarction treated by primary coronary angioplasty. Method: A descriptive, longitudinal and prospective study was performed in 69 patients, who were admitted to the Cardiology and Cardiovascular Surgery Institute, from July 1, 2007 to December 31, 2008, between 8 a.m. and 4 p.m. All patients underwent primary coronary angioplasty. A clinical evolution was made during 180 days, where frequency of major clinic events were evaluated: death, re-AMI, angina post-AMI, unstable angina, need of new re-vascularization and major hemorrhage. Results: The tobacco addiction and hypertension had an elevated prevalence. The inferior infarction location and single vessel disease were the most frequent. The immediate successful result prevailed. The failed cases was related with the right coronary artery, TIMI 0-1 flow and evolution time bigger six hours. The major clinic events were limited and it was more frequent during the first 30 days follow-up. Conclusions: Primary coronary angioplasty underwent during the first six hours after symptoms onset is an efficacious procedure, due to the predominance of the successful result and fewer frequency of major clinic events during six months follow-up.

  12. 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

  13. Clonal evolution and clinical significance of copy number neutral loss of heterozygosity of chromosome arm 6p in acquired aplastic anemia.

    Science.gov (United States)

    Betensky, Marisol; Babushok, Daria; Roth, Jacquelyn J; Mason, Philip J; Biegel, Jaclyn A; Busse, Tracy M; Li, Yimei; Lind, Curt; Papazoglou, Anna; Monos, Dimitri; Podsakoff, Gregory; Bessler, Monica; Olson, Timothy S

    2016-01-01

    Acquired aplastic anemia (aAA) results from the T cell-mediated autoimmune destruction of hematopoietic stem cells. Factors predicting response to immune suppression therapy (IST) or development of myelodysplastic syndrome (MDS) are beginning to be elucidated. Our recent data suggest most patients with aAA treated with IST develop clonal somatic genetic alterations in hematopoietic cells. One frequent acquired abnormality is copy-number neutral loss of heterozygosity on chromosome 6p (6p CN-LOH) involving the human leukocyte antigen (HLA) locus. We hypothesized that because 6p CN-LOH clones may arise from selective pressure to escape immune surveillance through deletion of HLA alleles, the development of 6p CN-LOH may affect response to IST. We used single nucleotide polymorphism array genotyping and targeted next-generation sequencing of HLA alleles to assess frequency of 6p CN-LOH, identity of HLA alleles lost through 6p CN-LOH, and impact of 6p CN-LOH on response to IST. 6p CN-LOH clones were present in 11.3% of patients, remained stable over time, and were not associated with development of MDS-defining cytogenetic abnormalities. Notably, no patient with 6p CN-LOH treated with IST achieved a complete response. In summary, clonal 6p CN-LOH in aAA defines a unique subgroup of patients that may provide insights into hematopoietic clonal evolution. PMID:26702937

  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. 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…

  16. 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…

  17. 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…

  18. 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

  19. 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…

  20. 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,…

  1. 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…

  2. 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)…

  3. Exploring the effects of maternal eating patterns on maternal feeding and child eating

    Science.gov (United States)

    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 relationsh...

  4. 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

  5. Maternal and fetal Outcome of pregnancies complicated by ovarian tumor

    International Nuclear Information System (INIS)

    Introduction: Ovarian tumors when occur, endanger two lives, mother and that of fetus. It becomes a therapeutic challenge to evaluate the necessity of immediate intervention for maternal indication versus delaying therapy for fetal indication. Majority of these cysts are benign and usually are functional cysts, dermoid or cyst adenomas. 2-5% of adnexal masses during pregnancy are true malignant neoplasms. Ovarian cancer being the second most frequent gynaecological cancer complicating pregnancy has an average estimated incidence of 1 in 2500 deliveries. Keeping in view all that, a study was conducted in Fatima Memorial Hospital to see maternal and fetal outcome of pregnancies complicated by ovarian tumors. Objective: To determine the maternal and fetal outcome of pregnancies complicated by ovarian tumors. Study Design: Case series descriptive study. Setting: The study was conducted in obstetrics and gynaecology department of Fatima Memorial Hospital, Lahore. Duration of Study: This study was conducted for one year. Subjects and Method: All 14500 pregnant ladies, who visited antenatal clinic and emergency of Fatima Memorial Hospital Lahore for one year, were considered to sort out pregnancies complicated by a co-existent ovarian mass of > 5 cm. Results: Of all 36 patients, included in current study, 24 had surgical and 12 had conservative management. Obstetric out-come revealed one preterm delivery after conservative management. Surgical intervention resulted in two abortions, two pre-term and twenty term deliveries. In both groups, the ratio of abdominal and vaginal delivery was 1:2 respectively. Fetal outcome revealed only one preterm and one IUGR infant in conservative group while surgically managed group revealed two preterm infants, two IUGR and one infant with septicemia. Conclusion: Surgical intervention is a reasonable approach to deal with cases of ovarian tumors with pregnancy, but conservative management may also have comparable obstetric outcome provided

  6. 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.

  7. 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.

  8. 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.

  9. Maternal antibodies in a wild altricial bird: effects on offspring immunity, growth and survival.

    Science.gov (United States)

    Pihlaja, Marjo; Siitari, Heli; Alatalo, Rauno V

    2006-09-01

    . 6. Evidently, there is a trade-off, in magpies, between maternal resources, immune function and growth, shaping the evolution of maternal investment in offspring immunity. PMID:16922851

  10. Maternal postpartum distress and childhood overweight.

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Maternal Plasma DNA and RNA Sequencing for Prenatal Testing.

    Science.gov (United States)

    Tamminga, Saskia; van Maarle, Merel; Henneman, Lidewij; Oudejans, Cees B M; Cornel, Martina C; Sistermans, Erik A

    2016-01-01

    Cell-free DNA (cfDNA) testing has recently become indispensable in diagnostic testing and screening. In the prenatal setting, this type of testing is often called noninvasive prenatal testing (NIPT). With a number of techniques, using either next-generation sequencing or single nucleotide polymorphism-based approaches, fetal cfDNA in maternal plasma can be analyzed to screen for rhesus D genotype, common chromosomal aneuploidies, and increasingly for testing other conditions, including monogenic disorders. With regard to screening for common aneuploidies, challenges arise when implementing NIPT in current prenatal settings. Depending on the method used (targeted or nontargeted), chromosomal anomalies other than trisomy 21, 18, or 13 can be detected, either of fetal or maternal origin, also referred to as unsolicited or incidental findings. For various biological reasons, there is a small chance of having either a false-positive or false-negative NIPT result, or no result, also referred to as a "no-call." Both pre- and posttest counseling for NIPT should include discussing potential discrepancies. Since NIPT remains a screening test, a positive NIPT result should be confirmed by invasive diagnostic testing (either by chorionic villus biopsy or by amniocentesis). As the scope of NIPT is widening, professional guidelines need to discuss the ethics of what to offer and how to offer. In this review, we discuss the current biochemical, clinical, and ethical challenges of cfDNA testing in the prenatal setting and its future perspectives including novel applications that target RNA instead of DNA. PMID:27117661

  13. A case of maternal PKU syndrome despite intensive patient counseling.

    Science.gov (United States)

    Unger, Susette; Weigel, Johannes F W; Stepan, Holger; Baerwald, Christoph G O

    2009-10-01

    We report on a 21-year-old woman with classic phenylketonuria, who presented at our outpatient clinic at week 14 of pregnancy. Despite intensive preconceptional counselling about the risk of raised Phenylalanine (Phe) levels for the offspring and nutritional consultations about the necessity to be on a Phe-restricted diet she had elevated blood Phe concentrations. Phe level could be lowered to the recommended range during a stay as an inpatient, but the patient was not able to maintain the recommended levels due to non-compliance. The patient delivered a newborn with classic maternal PKU syndrome (microcephaly, brachygnathia, congenital heart defect and psychomotoric retardation), which is nowadays rarely seen under preconceptional Phe-restricted diet. With more PKU patients reaching the childbearing age, intensive preconception counselling about maternal PKU syndrome is of pivotal importance for the women. However, a major factor in preventing Phe embryopathy is patient compliance in keeping the diet, which was insufficient in the case presented. PMID:19898791

  14. Maternal Obesity, Inflammation, and Developmental Programming

    Directory of Open Access Journals (Sweden)

    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.

  15. Maternal Infections during Pregnancy and Cerebral Palsy

    DEFF Research Database (Denmark)

    Miller, Jessica E.; Pedersen, Lars Henning; Streja, Elani;

    2013-01-01

    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...... trimester-specific exposures, CP risk was associated with prescriptions redeemed in the first trimester for any antibacterials, beta-lactam antibacterials, and nitrofurantoin, an antibiotic commonly used to treat lower urinary tract infection, and genito-urinary tract infections in the third trimester....... CONCLUSION: Genito-urinary tract infections and antibiotic use during pregnancy were associated with increased risks of CP, indicating that some maternal infections or causes of maternal infections present in prenatal life may be part of a causal pathway leading to CP....

  16. Detection of fetal mutations causing hemoglobinopathies by non-invasive prenatal diagnosis from maternal plasma

    Directory of Open Access Journals (Sweden)

    E D′Souza

    2013-01-01

    Full Text Available Background: Prenatal diagnosis of hemoglobinopathies enables couples at risk to have a healthy child. Currently used fetal sampling procedures are invasive with some risk of miscarriage. A non-invasive approach to obtain fetal deoxyribonucleic acid (DNA for diagnosis would eliminate this risk. Aim: To develop and evaluate a non-invasive prenatal diagnostic approach for hemoglobinopathies using cell-free fetal DNA circulating in the maternal plasma. Settings and Design: Couples referred to us for prenatal diagnosis of hemoglobinopathies where the maternal and paternal mutations were different were included in the study. Materials and Methods: Maternal peripheral blood was collected at different periods of gestation before the invasive fetal sampling procedure was done. The blood was centrifuged to isolate the plasma and prepare DNA. A size separation approach was used to isolate fetal DNA. Nested polymerase chain reaction (PCR-based protocols were developed for detection of the presence or absence of the paternal mutation. Results and Conclusions: There were 30 couples where the parental mutations were different. Of these, in 14 cases the paternal mutation was absent and in 16 cases it was present in the fetus. Using cell-free fetal DNA from maternal plasma, the absence of the paternal mutation was accurately determined in 12 of the 14 cases and the presence of the paternal mutation was correctly identified in 12 of the 16 cases. Thus, this non-invasive approach gave comparable results to those obtained by the conventional invasive fetal sampling methods in 24 cases giving an accuracy of 80.0%. Although the nested PCR approach enabled amplification of small quantities of cell-free DNA from maternal plasma at different periods of gestation after size separation to eliminate the more abundant maternal DNA, an accurate diagnosis of the presence or absence of the paternal mutation in the fetus was not possible in all cases to make it clinically

  17. Schumpeter's Evolution

    DEFF Research Database (Denmark)

    Andersen, Esben Sloth

    This draft of a book on Schumpeter is distributed for commenting. It is a stylised intellectual biography that focus on the emergence and extension of the Schumpeterian vision and analysis of economic and social evolution. The draft provides novel interpretations of Schumpeter's six major books. He...... 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 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...

  18. Relationship between maternal dietary patterns and hypospadias.

    Science.gov (United States)

    de Kort, Christianne A R; Nieuwenhuijsen, Mark J; Mendez, Michelle A

    2011-05-01

    Little is known about the role of maternal nutrition in the development of hypospadias, which is the most common urogenital congenital anomaly. This study investigated the relationship between maternal nutrition and the risk of hypospadias, particularly focusing on maternal food patterns. We compared 471 hypospadias cases with 490 controls in the United Kingdom. A questionnaire including information on life style, occupation, usual maternal diet and dietary supplements was administered using telephone interviews. Cases and controls were compared for individual food item intake and food patterns derived by cluster analysis. Multivariable logistic regression analysis adjusted for income, maternal age, low birthweight, smoking and folic acid supplement use was used to assess the relationship between maternal nutrition and hypospadias. Three food patterns were created with the labels 'health conscious', 'mixed' and 'non-health conscious'. 'Non-health conscious' subjects (low frequency of consumption of yoghurt, cheese, eggs, fruit and vegetables, fish, beans and pulses, olive oil and organic food) had a higher risk of hypospadias (odds ratio 1.54; 95% confidence interval 1.06, 2.26) compared with 'health conscious' subjects (high frequency of consumption of fresh fruit and vegetables, dried fruit, fresh or frozen fish, beans, pulses, soya products, olive oil and organic food), after adjustment for potential confounders. Intakes of individual foods were not strongly associated with hypospadias. We could not exclude the possibility of residual confounding, and this needs to be further investigated. We found an association between food pattern and hypospadias, with those with less health conscious food patterns having a higher risk. Further study is needed to confirm this association. PMID:21470265

  19. Neuroendocrinology of maternal behavior in the rabbit.

    Science.gov (United States)

    González-Mariscal, G

    2001-09-01

    Rabbit maternal behavior consists of building an underground nest of straw and body hair during late pregnancy and displaying, with circadian periodicity, a single 3-min nursing bout/day across lactation. Estrogen, androgen, progesterone, and prolactin regulate specific aspects of nest-building and promote the onset of maternal responsiveness. However, the maintenance of this behavior relies on stimuli from the litter: by preventing mother/young contact at parturition or during early lactation maternal responsiveness is altered or abolished. The brain areas controlling the expression of nest-building and nursing were investigated by implanting estradiol, locating the distribution of estrogen and prolactin receptors, quantifying the expression of immediate-early genes, and lesioning structures of the olfactory system. These studies revealed that: (a) estrogen receptor-alpha, alpha, present in the preoptic region, may mediate the stimulation of nest-building by estradiol; (b) prolactin binding sites, located mainly in periventricular structures, are more abundant in late pregnancy and early lactation; (c) the number of FOS-immunoreactive neurons increases in the lateral septum, but not in the mediobasal hypothalamus, following nursing; (d) the accessory olfactory bulb tonically inhibits the expression of maternal behavior because its removal promotes maternal responsiveness in virgins, which are otherwise unresponsive to daily pup exposure. In summary, rabbits rely on the same hormonal and extrahormonal factors that stimulate maternal behavior in other mammals, yet the way in which such factors promote elaborate nest-building and the unfailing display of circadian nursing is unique to rabbits and warrants future investigation. PMID:11534972

  20. 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

  1. 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

  2. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism.

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-01-01

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1-5% of infants born to women with Graves' disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. PMID:25750228

  3. 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

  4. A case of maternal tetanus in Korea.

    OpenAIRE

    Shin, Dong Hyeon; Park, Jung Ho; Jung, Phil Jin; Lee, Sang Rok; Shin, Jong Hee; Kim, Sei Jong

    2002-01-01

    Tetanus is uncommon in Korea due to the introduction of vaccination programs and advances in public health. A case of maternal tetanus occurred on the 9 day postpartum in a 29-yr-old woman, who had not received a 10-yr-booster of tetanus-diphtheria toxoid after receiving the primary series of tetanus-toxoid-containing vaccine. There has hitherto been no reports on maternal tetanus in Korea. This case illustrates that tetanus remains a medical problem, principally among non- and under-immunize...

  5. Maternal Health and Child Mortality in Rural India

    OpenAIRE

    Pandey, Manoj K.

    2009-01-01

    In this paper, the effect of maternal health on the under-five mortality has been examined. Third wave of micro-level National Family Health Survey 2005-06 data for rural India is used. Using various alternative measures of maternal health, the paper finds strong association between maternal health and child mortality. In particular, the effects of maternal height, weight, presence of any disease and anemia are found significant. Based on our findings, we argue that if the possible generation...

  6. Maternal Neglect: Oxytocin, Dopamine and the Neurobiology of Attachment

    OpenAIRE

    Strathearn, Lane

    2011-01-01

    Maternal neglect, including physical and emotional neglect, is a pervasive public health challenge with serious long-term effects on child health and development. The purpose of this paper is to provide an overview of the neurobiological basis of maternal caregiving, in order to better understand how to prevent and respond to maternal neglect. Drawing from both animal and human studies, key biological systems are identified which contribute to maternal caregiving behavior, focusing on the oxy...

  7. Fetal Programming of Obesity: Maternal Obesity and Excessive Weight Gain

    OpenAIRE

    Seray Kabaran

    2014-01-01

    The prevalence of obesity is an increasing health problem throughout the world. Maternal pre-pregnancy weight, maternal nutrition and maternal weight gain are among the factors that can cause childhood obesity. Both maternal obesity and excessive weight gain increase the risks of excessive fetal weight gain and high birth weight. Rapid weight gain during fetal period leads to changes in the newborn body composition. Specifically, the increase in body fat ratio in the early periods is associat...

  8. Maternal mortality: a cross-sectional study in global health

    OpenAIRE

    Sajedinejad, Sima; Majdzadeh, Reza; Vedadhir, Abouali; Tabatabaei, Mahmoud Ghazi; Mohammad, Kazem

    2015-01-01

    Background Although most of maternal deaths are preventable, maternal mortality reduction programs have not been completely successful. As targeting individuals alone does not seem to be an effective strategy to reduce maternal mortality (Millennium Development Goal 5), the present study sought to reveal the role of many distant macrostructural factors affecting maternal mortality at the global level. Methods After preparing a global dataset, 439 indicators were selected from nearly 1800 indi...

  9. Maternal Lipids Are as Important as Glucose for Fetal Growth

    OpenAIRE

    Kulkarni, Smita R.; Kumaran, Kalyanaraman; Rao, Shobha R.; Chougule, Suresh D.; Deokar, Tukaram M.; Bhalerao, Ankush J.; Solat, Vishnu A.; Bhat, Dattatray S; Fall, Caroline H.D.; Yajnik, Chittaranjan S

    2013-01-01

    OBJECTIVE To study the relationship between maternal circulating fuels and neonatal size and compare the relative effects of glucose and lipids. RESEARCH DESIGN AND METHODS The Pune Maternal Nutrition Study (1993–1996) investigated the influence of maternal nutrition on fetal growth. We measured maternal body size and glucose and lipid concentrations during pregnancy and examined their relationship with birth size in full-term babies using correlation and regression techniques. RESULTS The mo...

  10. 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...

  11. Causes of Maternal Mortality Decline in Matlab, Bangladesh

    OpenAIRE

    Chowdhury, Mahbub Elahi; Ahmed, Anisuddin; Kalim, Nahid; Koblinsky, Marge

    2009-01-01

    Bangladesh is distinct among developing countries in achieving a low maternal mortality ratio (MMR) of 322 per 100,000 livebirths despite the very low use of skilled care at delivery (13% nationally). This variation has also been observed in Matlab, a rural area in Bangladesh, where longitudinal data on maternal mortality are available since the mid-1970s. The current study investigated the possible causes of the maternal mortality decline in Matlab. The study analyzed 769 maternal deaths and...

  12. Maternal Cocaine Use and Mother-Toddler Aggression

    OpenAIRE

    Eiden, Rina D.; Schuetze, Pamela; Colder, Craig; Veira, Yvette

    2011-01-01

    This study examined the direct and indirect associations between maternal cocaine use during pregnancy and mother-toddler aggression in an interactive context at 2 years of child age. We hypothesized that in addition to direct effects of cocaine exposure on maternal and child aggression, the association between maternal cocaine use and mother-toddler aggression may be indirect via higher maternal psychiatric symptoms, negative affect, or poor infant autonomic regulation at 13 months. Particip...

  13. Responses of the Embryonic Epigenome to Maternal Diabetes

    OpenAIRE

    Salbaum, J. Michael; Kappen, Claudia

    2012-01-01

    Maternal diabetes and obesity are independent risk factors for neural tube defects, although it is unclear whether the effects are mediated by common pathogenic mechanisms. In this manuscript, we report a genome-wide survey of histone acetylation in neurulation stage embryos from mouse pregnancies with different metabolic conditions: maternal diabetes, and maternal consumption of a high fat content diet. We find that maternal diabetes, and independently, exposure to high-fat diet, are associa...

  14. Feto-placental adaptations to maternal obesity in the baboon

    OpenAIRE

    Farley, Darren; Tejero, Maria E; Comuzzie, Anthony G.; Higgins, Paul B.; Cox, Laura; Werner, Sherry L.; Jenkins, Susan L.; Li, Cun; Choi, Jaehyek; Dick, Edward J.; Hubbard, Gene B.; Frost, Patrice; Dudley, Donald D.; Ballesteros, Brandon; Wu, Guoyao

    2009-01-01

    Maternal obesity is present in 20–34% of pregnant women and has been associated with both intrauterine growth restriction and large-for-gestational age fetuses. While fetal and placental functions have been extensively studied in the baboon, no data are available on the effect of maternal obesity on placental structure and function in this species. We hypothesize that maternal obesity in the baboon is associated with a maternal inflammatory state and induces structural and functional changes ...

  15. Comparison of the Effects of Maternal Supportive Care and Acupressure (at BL32 Acupoint) on Labor Length and Infant's Apgar Score

    OpenAIRE

    Akbarzadeh, Marzieh; Masoudi, Zahra; Zare, Najaf; Kasraeian, Maryam

    2015-01-01

    Background and Objectives: Prolonged labor leads to increase of cesarean deliveries, reduction of fetal heart rate, and maternal as well as infantile complications. Therefore, many women tend to use pharmacological or non-pharmacological methods for reduction of labor length. The present study aimed to compare the effects of maternal supportive care and acupressure (at BL32 acupoint) on labor length and infant's Apgar score. Methods: In this clinical trial, 150 women with low-risk pregnancy w...

  16. The Effect of Intramuscular Administration of Atropine and Hyoscine Combination on Labor Progress and Maternal and Neonatal Outcomes in Primigravid Women

    OpenAIRE

    Mehri Jamilian; Maryam Karamali; Bahman Sadeghi; Maasoumeh Ghazi Mirsaeed

    2016-01-01

    Background: Previous studies reported that neonatal and maternal complications as well as duration of labor could be diminished through labor management. Therefore, we aimed to evaluate the effect of intramuscular (IM) administration of atropine and hyoscine combination on labor progress and maternal and neonatal outcomes in primigravid women admitted to Taleghani Hospital of Arak, Iran. Methods: In this double-blind, placebo-controlled clinical trial, 216 primigravid women were randomly a...

  17. Retrospective study of maternal HIV-1 and HIV-2 infections and child survival in Abidjan, Côte d'Ivoire.

    OpenAIRE

    De Cock, K M; Zadi, F.; Adjorlolo, G; Diallo, M. O.; Sassan-Morokro, M.; Ekpini, E.; Sibailly, T.; Doorly, R.; Batter, V; Brattegaard, K.

    1994-01-01

    OBJECTIVES--To compare the effects of maternal HIV-1 and HIV-2 infections on outcome of pregnancy, infant mortality, and child survival, and to measure serological concordance between mothers and children. DESIGN--Retrospective cohort study with cross sectional study of concordance for HIV antibodies. SETTING--Hospital, tuberculosis clinic, and maternal and child health centre in Abidjan, Côte d'Ivoire, west Africa. SUBJECTS--986 women who had had a total of 2758 pregnancies since 1980. The l...

  18. Perspectives of professionals participating in the Brazilian Network for the Surveillance of Severe Maternal Morbidity regarding the implementation of routine surveillance: a qualitative study

    OpenAIRE

    Luz, Adriana Gomes; Osis, Maria José Martins Duarte; Ribeiro, Meire; Cecatti, José Guilherme; Amaral, Eliana

    2014-01-01

    Background The Brazilian Network for the Surveillance of Severe Maternal Morbidity was developed in Brazil with the participation of 27 centers in different regions of the country. The objective of the network project was to evaluate the frequency of severe maternal morbidity (near-miss and potentially life-threatening conditions) and the factors involved with these clinical conditions. Over the data collection period, this project implemented a surveillance system to identify these cases in ...

  19. Detection of fetal cell-free DNA in maternal plasma for Down syndrome, Edward syndrome and Patau syndrome of high risk fetus

    OpenAIRE

    Ke, Wei-Lin; Zhao, Wei-Hua; Wang, Xin-Yu

    2015-01-01

    Objective: The study aimed to validate the efficacy of detection of fetal cell-free DNA in maternal plasma of trisomy 21, 18 and 13 in a clinical setting. Methods: A total of 2340 women at high risk for Down syndrome based on maternal age, prenatal history or a positive sesum or sonographic screening test were offered prenatal noninvasive aneuploidy test. According to the prenatal noninvasive aneuploidy test, the pregnant women at high risk were offered amniocentesis karyotype analysis and th...

  20. Interrelations of Maternal Expressed Emotion, Maltreatment, and Separation/Divorce and Links to Family Conflict and Children’s Externalizing Behavior

    OpenAIRE

    Narayan, Angela; Cicchetti, Dante; Rogosch, Fred A.; Toth, Sheree L.

    2015-01-01

    Research has documented that maternal expressed emotion-criticism (EE-Crit) from the Five-Minute Speech Sample (FMSS) predicts family conflict and children’s externalizing behavior in clinical and community samples. However, studies have not examined EE-Crit in maltreating or separated/divorced families, or whether these family risks exacerbate the links between EE-Crit and family conflict and externalizing behavior. The current study examined the associations between maternal EE-Crit, maltre...

  1. Improving quality for maternal care - a case study from Kerala, India

    Science.gov (United States)

    Vlad, Ioana; Paily, VP; Sadanandan, Rajeev; Cluzeau, Françoise; Beena, M; Nair, Rajasekharan; Newbatt, Emma; Ghosh, Sujit; Sandeep, K; Chalkidou, Kalipso

    2016-01-01

    Background: The implementation of maternal health guidelines remains unsatisfactory, even for simple, well established interventions. In settings where most births occur in health facilities, as is the case in Kerala, India, preventing maternal mortality is linked to quality of care improvements. Context: Evidence-informed quality standards (QS), including quality statements and measurable structure and process indicators, are one innovative way of tackling the guideline implementation gap. Having adopted a zero tolerance policy to maternal deaths, the Government of Kerala worked in partnership with the Kerala Federation of Obstetricians & Gynaecologists (KFOG) and NICE International to select the clinical topic, develop and initiate implementation of the first clinical QS for reducing maternal mortality in the state. Description of practice: The NICE QS development framework was adapted to the Kerala context, with local ownership being a key principle. Locally generated evidence identified post-partum haemorrhage as the leading cause of maternal death, and as the key priority for the QS. A multidisciplinary group (including policy-makers, gynaecologists and obstetricians, nurses and administrators) was established. Multi-stakeholder workshops convened by the group ensured that the statements, derived from global and local guidelines, and their corresponding indicators were relevant and acceptable to clinicians and policy-makers in Kerala. Furthermore, it helped identify practical methods for implementing the standards and monitoring outcomes. Lessons learned: An independent evaluation of the project highlighted the equal importance of a strong evidence-base and an inclusive development process. There is no one-size-fits-all process for QS development; a principle-based approach might be a better guide for countries to adapt global evidence to their local context.

  2. Improving quality for maternal care - a case study from Kerala, India [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ioana Vlad

    2016-02-01

    Full Text Available Background: The implementation of maternal health guidelines remains unsatisfactory, even for simple, well established interventions. In settings where most births occur in health facilities, as is the case in Kerala, India, preventing maternal mortality is linked to quality of care improvements. Context: Evidence-informed quality standards (QS, including quality statements and measurable structure and process indicators, are one innovative way of tackling the guideline implementation gap. Having adopted a zero tolerance policy to maternal deaths, the Government of Kerala worked in partnership with the Kerala Federation of Obstetricians & Gynaecologists (KFOG and NICE International to select the clinical topic, develop and initiate implementation of the first clinical QS for reducing maternal mortality in the state. Description of practice: The NICE QS development framework was adapted to the Kerala context, with local ownership being a key principle. Locally generated evidence identified post-partum haemorrhage as the leading cause of maternal death, and as the key priority for the QS. A multidisciplinary group (including policy-makers, gynaecologists and obstetricians, nurses and administrators was established. Multi-stakeholder workshops convened by the group ensured that the statements, derived from global and local guidelines, and their corresponding indicators were relevant and acceptable to clinicians and policy-makers in Kerala. Furthermore, it helped identify practical methods for implementing the standards and monitoring outcomes. Lessons learned: An independent evaluation of the project highlighted the equal importance of a strong evidence-base and an inclusive development process. There is no one-size-fits-all process for QS development; a principle-based approach might be a better guide for countries to adapt global evidence to their local context.

  3. Investing in Maternal Health : Learning from Malaysia and Sri Lanka

    OpenAIRE

    Pathmanathan, Indra; Liljestrand, Jerker; Jo. M. Martins; Lalini C. Rajapaksa; Lissner, Craig; de Silva, Amala; Selvaraju, Swarna; Singh, Prabha Joginder

    2003-01-01

    This study provides the most comprehensive and detailed analysis available on factors behind the decline in maternal mortality in Malaysia and Sri Lanka in the past 50 to 60 years and the magnitude of health system expenditures on maternal health. The main findings are that a modest investment in maternal health services, combined with other poverty reduction measures leads to a fairly rap...

  4. How Does Maternal Employment Affect Children's Socioemotional Functioning?

    Science.gov (United States)

    Lam, Gigi

    2015-01-01

    The maternal employment becomes an irreversible trend across the globe. The effect of maternal employment on children's socioemotional functioning is so pervasive that it warrants special attention to investigate into the issue. A trajectory of analytical framework of how maternal employment affects children's socioemotional functioning originates…

  5. Mediating Links between Maternal Childhood Trauma and Preadolescent Behavioral Adjustment

    Science.gov (United States)

    Min, Meeyoung O.; Singer, Lynn T.; Minnes, Sonia; Kim, Hyunsoo; Short, Elizabeth

    2013-01-01

    Structural equation modeling was used to simultaneously examine maternal psychological distress and social support as mediators linking maternal childhood trauma (MCT) to both maternal and child-reported behavior at 9 years of age in 231 birth mother-child dyads, who were primarily poor, urban, and African American. One half of the mothers…

  6. Pedophiles: mental retardation, maternal age, and sexual orientation.

    Science.gov (United States)

    Blanchard, R; Watson, M S; Choy, A; Dickey, R; Klassen, P; Kuban, M; Ferren, D J

    1999-04-01

    Intellectual functioning, parental age, and sexual orientation in 991 male sexual offenders were investigated. Sources of data included semistructured interviews, clinical charts, phallometric tests, and self-administered questionnaires. The results suggest two main conclusions: (i) Among pedophiles in general, erotic preference moves away from adult women along two dimensions: age and sex. The extent of this movement is greater, along both dimensions, for pedophiles with lower levels of intellectual functioning. (ii) High maternal age (or some factor it represents) increases the likelihood of exclusive sexual interest in boys. Intellectual deficiency (or some factor it represents) decreases the likelihood of exclusive sexual interest in girls. These two factors summate, so that a pedophile with both factors is more likely to be sexually interested in boys than a pedophile with only one. PMID:10483505

  7. Postnatal Depression among Women Attending A Rural Maternity Hospital in South India

    OpenAIRE

    Suguna A, Naveen R, Surekha A

    2015-01-01

    "Introduction: The Diagnostic and Statistical Manual of Mental Disorders (DSM) V defines Postpartum Depression (PND) as depression with onset within 4 weeks of delivery, symptoms lasting for a minimum of two weeks, causing clinically significant impairment of functioning. PND has important implications for the welfare of the family and the development of the child. Objectives were to determine the prevalence of postnatal depression among women attending a rural maternity hospital in Sout...

  8. Severe hypertensive syndrome – descriptive study with adolescents attended at a maternity school

    OpenAIRE

    Andreia Gregório Lima; Isabella Beatriz Barbosa Oliveira; Maria Lúcia Neto de Menezes; Rachel Caroline Alves Leite

    2012-01-01

    This is an exploratory and descriptive study with the objective of analyzing the clinical and obstetric data related to the severe hypertensive disorders in adolescents assisted at a maternity school of Recife. The population was consisted of 186 pregnant adolescents with severe preeclampsia and/or eclampsia between 2003 and 2008. The age ranged between 15 and 19 years; they were black, single and had low education. Most of them were primiparas but the pregnancy recurrence was configured at 1...

  9. Phenylalanine hydroxylase gene mutations in the United States: report from the Maternal PKU Collaborative Study.

    OpenAIRE

    Guldberg, P; Levy, H L; Hanley, W. B.; R. Koch; Matalon, R; Rouse, B. M.; Trefz, F.; de la Cruz, F.; Henriksen, K. F.; Güttler, F

    1996-01-01

    The major cause of hyperphenylalaninemia is mutations in the gene encoding phenylalanine hydroxylase (PAH). The known mutations have been identified primarily in European patients. The purpose of this study was to determine the spectrum of mutations responsible for PAH deficiency in the United States. One hundred forty-nine patients enrolled in the Maternal PKU Collaborative Study were subjects for clinical and molecular investigations. PAH gene mutations associated with phenylketonuria (PKU)...

  10. Evaluation of Maternal Toxicity in Rats Exposed to Multi-Wall Carbon Nanotubes during Pregnancy

    OpenAIRE

    Lim, Jeong-Hyeon; Kim, Sung-Hwan; Lee, In-Chul; Moon, Changjong; Kim, Sung-Ho; Shin, Dong-Ho; Kim, Hyoung-Chin; Kim, Jong-Choon

    2011-01-01

    Objectives The present study investigated the potential adverse effects of multi-wall carbon nanotubes (MWCNTs) on pregnant dams and embryonic development following maternal exposure in rats. Methods MWCNTs were orally administered to pregnant rats from gestational day (GD) 6 through 19 at dose levels of 0, 8, 40, 200, and 1000 mg/kg/day. During the test period, clinical signs, mortality, body weights, food consumption, serum biochemistry, oxidant-antioxidant status, gross findings, organ wei...

  11. Determinants of implementation of maternal health guidelines in Kosovo: mixed methods study

    OpenAIRE

    Straus, Sharon E.; Julia E Moore; Uka, Sami; Marquez, Christine; Gülmezoglu, A Metin

    2013-01-01

    Background One of the challenges to implementing clinical practice guidelines is the need to adapt guidelines to the local context and identify barriers to their uptake. Several models of framework are available to consider for use in guideline adaptation. Methods We completed a multiphase study to explore the implementation of maternal health guidelines in Kosovo, focusing on determinants of uptake and methods to contextualize for local use. The study involved a survey, individual interviews...

  12. Maternal depression and attachment: the evaluation of mother–child interactions during feeding practice

    OpenAIRE

    Santona, Alessandra; Tagini, Angela; Sarracino, Diego; De Carli, Pietro; Pace, Cecilia S.; Parolin, Laura; Terrone, Grazia

    2015-01-01

    Internal working models (IWMs) of attachment can moderate the effect of maternal depression on mother–child interactions and child development. Clinical depression pre-dating birthgiving has been found to predict incoherent and less sensitive caregiving. Dysfunctional patterns observed, included interactive modes linked to feeding behaviors which may interfere with hunger–satiation, biological rhythms, and the establishment of children’s autonomy and individuation. Feeding interactions betwee...

  13. MATERNAL DEPRESSION AND ATTACHMENT: THE EVALUATION OF MOTHER-CHILD INTERACTIONS DURING FEEDING PRACTICE

    OpenAIRE

    Alessandra eSantona; Angela eTagini; Diego eSarracino; Pietro eDe Carli; Cecilia Serena ePace; Laura eParolin; Grazia eTerrone

    2015-01-01

    Internal working models of attachment (IWM) can moderate the effect of maternal depression on mother-child interactions and child development. Clinical depression pre-dating birthgiving has been found to predict incoherent and less sensitive caregiving. Dysfunctional patterns observed, included interactive modes linked to feeding behaviors which may interfere with hunger-satiation biological rhythms and the establishment of children’s autonomy and individuation. Feeding interactions between d...

  14. Study of Relationship between Hypernatremia in Neonates and Way of Maternal Breast Feeding

    OpenAIRE

    H Boskabadi; Godarzi, M; M Zakerihamidi; F. Bagheri

    2014-01-01

    Introduction: The extreme reduction in breast milk intake during the first days of life leads to weight loss, kidney failure and hypernatremia. The aim of this study was to examine the relationship between hypernatremia in neonates and way of maternal breastfeeding in hospitalized infants in Ghaem Hospital of Mashhad.   Materials and Methods: After obtaining parental consent, 687 infants referred to the neonatal ward and clinic of Ghaem hospital of Mashhad participated in this cross-sectional...

  15. Maternal Depression History Moderates Parenting Responses to Compliant and Noncompliant Behaviors of Children with ADHD.

    Science.gov (United States)

    Thomas, Sharon R; O'Brien, Kelly A; Clarke, Tana L; Liu, Yihao; Chronis-Tuscano, Andrea

    2015-10-01

    Maternal depression and parenting are robust predictors of developmental outcomes for children with attention-deficit/hyperactivity disorder (ADHD). However, methods commonly used to examine parent-child interactions in these families do not account for temporal associations between child and parent behavior that have been theorized to maintain negative child behavior. Moreover, studies examining associations between maternal depression and parenting in families of children with ADHD have not compared mothers who were currently depressed, remitted, and never clinically depressed. This study utilized sequential analysis to examine how maternal reinforcement of compliant and noncompliant child behavior differs as a function of maternal depression history. Within the 82 participating mother-child dyads, 21 mothers were currently depressed, 29 mothers had a lifetime history of depression but were in remission for at least 1 month, and 32 mothers had never been clinically depressed. 24 girls (29.6 %) and 57 boys (70.4 %) between the ages of 6-12 years old (M = 8.7, SD = 2.0) and were diagnosed with ADHD. Results indicated that all mothers were less likely to respond optimally than non-optimally to child compliant and noncompliant behaviors during observed parent-child interactions; however, currently depressed mothers were least likely to reinforce child compliance and responded most coercively to child noncompliance relative to the other groups. Remitted mothers in this sample were more coercive than never clinically depressed mothers, but were more likely to follow through with commands than never clinically depressed mothers. Implications for behavioral parent training programs aimed at skill development for depressed mothers of children with ADHD are discussed. PMID:25413021

  16. Impact of Maternal Posttraumatic Stress Disorder and Depression Following Exposure to the September 11 Attacks on Preschool Children's Behavior

    Science.gov (United States)

    Chemtob, Claude M.; Nomura, Yoko; Rajendran, Khushmand; Yehuda, Rachel; Schwartz, Deena; Abramovitz, Robert

    2010-01-01

    To evaluate whether conjoined maternal posttraumatic stress disorder (PTSD) and depression are associated with increased behavioral problems among terrorism-exposed preschool children (N = 116; 18-54 months), this study compared clinically significant child behavioral problem rates among the preschool children of mothers with PTSD and depression,…

  17. The Effects of Race and Maternal Education Level on Children's Retells of the Renfrew Bus Story--North American Edition

    Science.gov (United States)

    van Kleeck, Anne; Lange, Alissa; Schwarz, Amy Louise

    2011-01-01

    Purpose: The Renfrew Bus Story--North American Edition (RBS-NA; C. Glasgow & J. Cowley, 1994) is widely used in clinical and research settings to determine children's language abilities, although possible influences of race and maternal education on RBS-NA performance are unknown. The current study compared RBS-NA retells of 4 groups of children:…

  18. Research Review: Maternal Prenatal Distress and Poor Nutrition--Mutually Influencing Risk Factors Affecting Infant Neurocognitive Development

    Science.gov (United States)

    Monk, Catherine; Georgieff, Michael K.; Osterholm, Erin A.

    2013-01-01

    Background: Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children's neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy--an unhealthy maternal diet and psychosocial…

  19. Reduction of Severe Acute Maternal Morbidity and Maternal Mortality in Thyolo District, Malawi: The Impact of Obstetric Audit

    OpenAIRE

    Thomas van den Akker; Jair van Rhenen; Beatrice Mwagomba; Kinke Lommerse; Steady Vinkhumbo; Jos van Roosmalen

    2011-01-01

    BACKGROUND: Critical incident audit and feedback are recommended interventions to improve the quality of obstetric care. To evaluate the effect of audit at district level in Thyolo, Malawi, we assessed the incidence of facility-based severe maternal complications (severe acute maternal morbidity (SAMM) and maternal mortality) during two years of audit and feedback. METHODOLOGY/PRINCIPAL FINDINGS: Between September 2007 and September 2009, we included all cases of maternal mortality and SAMM t...

  20. Does prenatal care benefit maternal health? A study of post-partum maternal care use.

    Science.gov (United States)

    Liu, Tsai-Ching; Chen, Bradley; Chan, Yun-Shan; Chen, Chin-Shyan

    2015-10-01

    Most studies on prenatal care focus on its effects on infant health, while studying less about the effects on maternal health. Using the Longitudinal Health Insurance claims data in Taiwan in a recursive bivariate probit model, this study examines the impact of adequate prenatal care on the probability of post-partum maternal hospitalization during the first 6 months after birth. The results show that adequate prenatal care significantly reduces the probability of post-partum maternal hospitalization among women who have had vaginal delivery by 43.8%. This finding suggests that the benefits of prenatal care may have been underestimated among women with vaginal delivery. Timely and adequate prenatal care not only creates a positive impact on infant health, but also yields significant benefits for post-partum maternal health. However, we do not find similar benefits of prenatal care for women undergoing a cesarean section. PMID:26189913

  1. The maternal early warning criteria: a proposal from the national partnership for maternal safety.

    Science.gov (United States)

    Mhyre, Jill M; D'Oria, Robyn; Hameed, Afshan B; Lappen, Justin R; Holley, Sharon L; Hunter, Stephen K; Jones, Robin L; King, Jeffrey C; D'Alton, Mary E

    2014-01-01

    Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened by the National Partnership for Maternal Safety used a consensus-based approach to define The Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care as necessary in order to pursue diagnostic and therapeutic interventions. This commentary reviews the evidence supporting the use of early-warning systems, describes The Maternal Early Warning Criteria, and provides considerations for local implementation. PMID:25203897

  2. How did Nepal reduce the maternal mortality? A result from analysing the determinants of maternal mortality.

    Science.gov (United States)

    Karkee, R

    2012-01-01

    Nepal reportedly reduced the maternal mortality ratio by 48% within one decade between 1996-2005 and received the Millennium development goal award for this. However, there is debate regarding the accuracy of this figure. On the basis of framework of determinants of maternal mortality proposed by McCarthy and Maine in 1992 and successive data from Nepal demographic health survey of 1996, 2001 and 2006, a literature analysis was done to identify the important factors behind this decline. Although facility delivery and skilled birth attendants are acclaimed as best strategy of reducing maternal mortality, a proportionate increase in these factors was not found to account the maternal mortality rate reduction in Nepal. Alternatively, intermediate factors particularly women awareness, family planning and safe abortion might have played a significant role. Hence, Nepal as well as similar other developing countries should pay equal attention to such intermediate factors while concentrating on biomedical care strategy. PMID:23478738

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

    Directory of Open Access Journals (Sweden)

    Al Chamat Ahmad

    2010-10-01

    Full Text Available 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 Retrospective facility-based review of cases of near-miss and maternal mortality that took place in the years 2006-2007 at Damascus Maternity University Hospital, Syria. Near-miss cases were defined based on disease-specific criteria (Filippi 2005 including: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. Main outcomes included maternal mortality ratio (MMR, maternal near miss ratio (MNMR, mortality indices and proportion of near-miss cases and mortality cases to hospital admissions. Results There were 28 025 deliveries, 15 maternal deaths and 901 near-miss cases. The study showed a MNMR of 32.9/1000 live births, a MMR of 54.8/100 000 live births and a relatively low mortality index of 1.7%. Hypertensive disorders (52% and haemorrhage (34% were the top causes of near-misses. Late pregnancy haemorrhage was the leading cause of maternal mortality (60% while sepsis had the highest mortality index (7.4%. Most cases (93% were referred in critical conditions from other facilities; namely traditional birth attendants homes (67%, primary (5% and secondary (10% healthcare unites and private practices (11%. 26% of near-miss cases were admitted to Intensive Care Unit (ICU. Conclusion Near-miss analyses provide valuable information on obstetric care. The study highlights the need to improve antenatal care which would help early identification of high risk pregnancies. It also emphasises the importance of both: developing protocols to

  4. Jaundice during pregnancy: maternal and fetal outcome

    Directory of Open Access Journals (Sweden)

    Jayanthi Krishnamoorthy

    2016-08-01

    Conclusions: Jaundice in pregnancy has adverse fetomaternal outcome. Improvement in health awareness, education and regular antenatal checkups, early referrals result in early diagnosis and treatment of jaundice during pregnancy thus reducing maternal and fetal mortality and morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2541-2545

  5. Maternal Characteristics Predicting Young Girls' Disruptive Behavior

    Science.gov (United States)

    van der Molen, Elsa; Hipwell, Alison E.; Vermeiren, Robert; Loeber, Rolf

    2011-01-01

    Little is known about the relative predictive utility of maternal characteristics and parenting skills on the development of girls' disruptive behavior. The current study used five waves of parent- and child-report data from the ongoing Pittsburgh Girls Study to examine these relationships in a sample of 1,942 girls from age 7 to 12 years.…

  6. Feto-maternal outcome in twin pregnancy

    Directory of Open Access Journals (Sweden)

    Amiben V. Gajera

    2015-12-01

    Conclusions: Most of the complications in multiple gestations are preventable. High risk units in the obstetric ward and well developed NICU set up would reduce the maternal, perinatal morbidity and mortality. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1836-1839

  7. Maternal Work Conditions and Child Development

    Science.gov (United States)

    Felfe, Christina; Hsin, Amy

    2012-01-01

    How do maternal work conditions, such as psychological stress and physical hazards, affect children's development? Combining data from the Child Development Supplement of the Panel Study of Income Dynamics and the Occupational Information Network allows us to shed some light on this question. We employ various techniques including OLS with…

  8. Maternal preconception diet and the sex ratio

    NARCIS (Netherlands)

    J.S. Cramer; L.H. Lumey

    2010-01-01

    Temporal variations in the sex ratio, or the ratio of boys to girls at birth, have been widely studied and variously attributed to social changes, conditions of war, and environmental changes. Recently, Mathews et al. ["You are what your mother eats: Evidence for maternal preconception diet influenc

  9. Human maternal plasma proteomic changes with parturition

    Directory of Open Access Journals (Sweden)

    Robert J. Phillips

    2014-12-01

    Significance: Proteomic technology is constantly advancing, and the latest techniques enable gel-free analysis of minimally preprocessed, complex biological samples, enabling simultaneous identification and quantification of many hundreds of proteins. The technique of TMT labelling and Orbitrap mass spectrometry is applicable to the analysis of serial maternal plasma samples in order to identify potential markers of the onset of labour.

  10. Maternal Depression and Childhood Health Inequalities

    Science.gov (United States)

    Turney, Kristin

    2011-01-01

    An increasing body of literature documents considerable inequalities in the health of young children in the United States, though maternal depression is one important, yet often overlooked, determinant of children's health. In this article, the author uses data from the Fragile Families and Child Wellbeing Study (N = 4,048) and finds that maternal…

  11. Maternal diabetes and the fetal heart

    OpenAIRE

    Hornberger, L K

    2006-01-01

    Maternal diabetes mellitus significantly affects the fetal heart and fetal–placental circulation in both structure and function. The influence of pre‐conceptional diabetes begins during embryonic development in the first trimester, with altered cardiac morphogenesis and placental development. It continues to have an influence on the fetal circulation through the second and third trimesters and into the perinatal and neonatal period

  12. Women's Decisions about Breastfeeding and Maternal Employment.

    Science.gov (United States)

    Lindberg, Laura Duberstein

    1996-01-01

    Extends the concept of role incompatibility to examine potential incompatibilities between breastfeeding and maternal employment. Hypothesizes women may face both structural and attitudinal conflicts between these behaviors. Found significantly more women employed part-time are likely to breastfeed and for longer durations than women employed…

  13. Breastfeeding and maternal diet in atopic dermatitis

    OpenAIRE

    Lien, Tina Y.; Goldman, Ran D.

    2011-01-01

    Question Many children are affected by atopic dermatitis (AD) at a very young age. I often consider whether nonpharmacologic interventions could prevent or mitigate the development of AD. Do breastfeeding or changes to the maternal diet help prevent the development of childhood AD?

  14. Social Support and Maternal Depression from Pregnancy to Postpartum: The Association with Positive Maternal Behaviours among Brazilian Adolescent Mothers

    Science.gov (United States)

    Diniz, Eva; Koller, Sílvia H.; Volling, Brenda L.

    2015-01-01

    Adolescent motherhood is a risky situation related to poorer quality of infant caregiving. The lack of social support and increased odds for maternal depression are the main concerns. This study aimed to investigate whether maternal-foetal attachment, social support and maternal depression measured during pregnancy and after birth were associated…

  15. Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

    OpenAIRE

    Bader, Heather N.; Linda M. Bierer; Amy eLehrner; Iouri eMakotkine; Daskalakis, Nikolaos P.; Rachel eYehuda

    2014-01-01

    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 evaluat...

  16. Maternal Age at Holocaust Exposure and Maternal PTSD Independently Influence Urinary Cortisol Levels in Adult Offspring

    OpenAIRE

    Bader, Heather N.; Linda M. Bierer; Lehrner, Amy; Makotkine, Iouri; Daskalakis, Nikolaos P.; Yehuda, Rachel

    2014-01-01

    Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal posttraumatic stress disorder (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: Ninety-five Holocaust offspring and Jewish comparison subjects r...

  17. Relations Among Intimate Partner Violence, Maternal Depressive Symptoms, and Maternal Parenting Behaviors

    OpenAIRE

    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, in this diverse sample of families living in predominantly low-income rural communities (N = 705), higher levels of early IPV were associated with in...

  18. The Effect of Maternal Helminth Infection on Maternal and Neonatal Immune Function and Immunity to Tuberculosis

    OpenAIRE

    Gebreegziabiher, Dawit; Desta, Kassu; Desalegn, Girmay; Howe, Rawleigh; Abebe, Markos

    2014-01-01

    Background M. tuberculosis and helminth infection each affects one third of the world population. Helminth infections down regulate cell mediated immune responses and this may contribute to lower efficacy of BCG vaccination and higher prevalence of tuberculosis. Objective To determine the effect of maternal helminth infection on maternal and neonatal immune function and immunity to TB. Methods In this cross sectional study, eighty five pregnant women were screened for parasitic and latent TB ...

  19. Maternal Depressive Symptoms, Maternal Behavior, and Toddler Internalizing Outcomes: A Moderated Mediation Model

    OpenAIRE

    Hummel, Alexandra C.; Kiel, Elizabeth J.

    2015-01-01

    Maternal depression relates to child internalizing outcomes, but one missing aspect of this association is how variation in depressive symptoms, including mild and moderate symptoms, relates to young children’s outcomes. The current study examined a moderated mediation model to investigate how maternal behaviors may mediate this association in the context of child temperament and gender. Mothers and toddlers completed a free-play/clean-up task in the laboratory. Mothers rated their depressive...

  20. MATERNAL NEAR MISS: AN EXPERIENCE IN RURAL MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Madhavi

    2014-10-01

    Full Text Available : INTRODUCTION: Maternal mortality is an important indicator of health care system. As the mortality rates are consistently decreasing the focus is shifted on maternal near miss which describes severe maternal morbidity which shares the common pathway as mortality. Maternal near miss indicators are relevant in developing world and low resource setting as it indicates the gaps in the health system. In 2009 WHO working group has standardized the criteria for selecting these cases. MATERIAL AND METHODS: This study is performed in rural medical college between October 2012 to september2014 and maternal near miss cases are identified according to WHO criteria. Variables related to age, parity, gestational age, intensive care unit admission, ventilator support, requirement of massive blood transfusion were analyzed. Further the events leading to maternal near miss were studied. Finally the indices like maternal near miss incidence ratio, maternal near miss: maternal mortality ratio and mortality index were calculated. RESULTS: during the study period 2409 deliveries were conducted of which 2385 were live births. Potentially life threatening conditions were identified to be 265 and maternal near miss cases were 22. Maternal near miss incidence ratio was 9.2per 1000 live births, maternal near miss to maternal mortality ratio was 11:1 and mortality index was 8.3%. The leading causes of maternal near miss were abruption and rupture uterus requiring emergency hysterectomy. The morbidity was high in unbooked cases. CONCLUSION: maternal near miss is good alternative indicator of health care system. Lacunae between grass root level and tertiary centers should be filled.

  1. [Costs of maternal-infant care in an institutionalized health care system].

    Science.gov (United States)

    Villarreal Ríos, E; Salinas Martínez, A M; Guzmán Padilla, J E; Garza Elizondo, M E; Tovar Castillo, N H; García Cornejo, M L

    1998-01-01

    Partial and total maternal and child health care costs were estimated. The study was developed in a Primary Care Health Clinic (PCHC) and a General Hospital (GH) of a social security health care system. Maternal and child health care services, type of activity and frequency utilization during 1995, were defined; cost examination was done separately for the PCHC and the GH. Estimation of fixed cost included departmentalization, determination of inputs, costs, basic services disbursements, and weighing. These data were related to depreciation, labor period and productivity. Estimation of variable costs required the participation of field experts; costs corresponded to those registered in billing records. The fixed cost plus the variable cost determined the unit cost, which multiplied by the of frequency of utilization generated the prenatal care, labor and delivery care, and postnatal care cost. The sum of these three equaled the maternal and child health care cost. The prenatal care cost was $1,205.33, the labor and delivery care cost was $3,313.98, and the postnatal care was $559.91. The total cost of the maternal and child health care corresponded to $5,079.22. Cost information is valuable for the health care personnel for health care planning activities. PMID:9528219

  2. Maternal reflective functioning as a multidimensional construct: Differential associations with children's temperament and externalizing behavior.

    Science.gov (United States)

    Smaling, H J A; Huijbregts, S C J; van der Heijden, K B; van Goozen, S H M; Swaab, H

    2016-08-01

    Maternal reflective functioning (RF) has been associated with children's behavioral development. This study examined maternal prenatal and postnatal RF, as measured by the Pregnancy Interview and Parent Development Interview, as multidimensional constructs. It was also examined whether the RF-dimensions were associated with children's temperament and externalizing behavior, as assessed by several questionnaires. The sample consisted of 123 first-time mothers (M age=22.85years, SD=2.21) and their children (M age=19.97months, SD=0.85, 56% male). Two related but distinct dimensions were found for prenatal RF, termed self-focused and child-focused mentalization. Three dimensions were observed for postnatal RF, termed self-focused, child-focused, and relation-focused mentalization. Results showed that prenatal RF negatively related to reported child physical aggression. Postnatal self-focused RF was positively linked to externalizing behavior and negative emotionality in offspring, while relation-focused RF scores were negatively associated with child physical aggression. Findings show that it is important to also look at the specific RF-dimensions when examining the effects of maternal RF on children's behavioral development, as differential associations with behavioral outcomes exist. Discussion further focuses on the importance of these findings in prevention and clinical practice, and suggestions are being made to further improve the measurement of maternal RF-dimensions. PMID:27522031

  3. New mothers' perceptions regarding maternity care services provided in a prefecture of Northern Greece

    Directory of Open Access Journals (Sweden)

    Maria Tsiligiri

    2010-01-01

    Full Text Available Background: The use of health care services during pregnancy assists in decreasing neonatal deaths and improves the quality of life of pregnant women and their newborn children.Aim: To investigate the perceptions of new mothers in a prefecture of Northern Greece regarding the maternity services provided during pregnancy and childbirth.Methodology: The sample consists of 133 mothers of newborn babies who were hospitalised, after in-hospital delivery, between April and June 2008 in a prefecture of Northern Greece. The instrument used for the data collection was the Kuopio Instrument for Mothers (KIM.Results: 97% of participants were married, 42.2% had higher education and 23.3% were full-time employees. 42.9% of the mothers were primiparous and 57.1% were multiparous. 56.8% had vaginal delivery, while 42.9% had caesarean section. 84.2% of the participants stated that they would prefer to have their next delivery in a private maternity clinic, and 3% stated that they would prefer to give birth at home. 15.3% had participated in childbirth preparatory courses. Finally, the participants considered that maternity services, such as pregnancy monitoring, preventative examinations for foetal abnormalities, PAP-test and preventative examinations for breast cancer, should be provided by the state free of charge.Conclusions: It is necessary to further develop and modernize maternity services in such a way that they will correspond to pregnant women’s needs.

  4. What models of maternity care do pregnant women in Ireland want?

    LENUS (Irish Health Repository)

    Byrne, C

    2012-02-01

    The introduction of new models of care in the Irish maternity services has been recommended by both advocacy groups and strategic reports. Yet there is a dearth of information about what models of care pregnant women want. We surveyed women in early pregnancy who were attending a large Dublin maternity hospital. Demographic and clinical details were recorded from the hospital chart. Of the 501 women, 351 (70%) (352 (70.3%) of women wanted shared antenatal care between their family doctor and either a hospital doctor or midwife. 228 (45.5%) preferred to have their baby delivered in a doctor-led unit, while 215 (42.9%) preferred a midwifery-led unit. Of those 215 (42.9%), 118 (55%) met criteria for suitability. There was minimal demand (1.6%) for home births. Choice was influenced by whether the woman was attending for private care or not. Safety is the most important factor for women when choosing the type of maternity care they want. Pregnant women want a wide range of choices when it comes to models of maternity care. Their choice is strongly influenced by safety considerations, and will be determined in part by risk assessment.

  5. Associations Between Maternal Pregravid Obesity and Gestational Diabetes and the Timing of Pubarche in Daughters.

    Science.gov (United States)

    Kubo, Ai; Ferrara, Assiamira; Laurent, Cecile A; Windham, Gayle C; Greenspan, Louise C; Deardorff, Julianna; Hiatt, Robert A; Quesenberry, Charles P; Kushi, Lawrence H

    2016-07-01

    We investigated whether in utero exposure to maternal pregravid obesity and/or gestational diabetes mellitus (GDM) was associated with early puberty in girls. We used data from a longitudinal study of 421 mother-daughter pairs enrolled in an integrated health services organization, Kaiser Permanente Northern California (2005-2012). Girls aged 6-8 years were followed annually through ages 12-14 years. Onset of puberty was assessed using study clinic-based Tanner staging. We examined associations of self-reported pregravid obesity and maternal GDM with timing of the daughter's transition to pubertal maturation stage 2 or above for development of breasts and pubic hair, using accelerated failure time regression models with interval censoring to estimate time ratios and hazard ratios and corresponding 95% confidence intervals. Maternal obesity (pregravid body mass index (BMI; weight (kg)/height (m)(2)) ≥30) was associated with a daughter's earlier transition to breast and pubic hair stage 2+ in comparison with girls whose mothers had pregravid BMI pubic hair stage 2+ than those whose mothers had neither condition (adjusted time ratio = 0.89, 95% confidence interval: 0.83, 0.96; hazard ratio = 2.97, 95% confidence interval: 1.52, 5.83). These findings suggest that exposure to maternal obesity and hyperglycemia places girls at higher risk of earlier pubarche. PMID:27268032

  6. Eye of the beholder? Maternal mental health and the quality of infant sleep.

    Science.gov (United States)

    Goldberg, Wendy A; Lucas-Thompson, Rachel G; Germo, Gary R; Keller, Meret A; Davis, Elysia Poggi; Sandman, Curt A

    2013-02-01

    Transactional models of parenting and infant sleep call attention to bidirectional associations among parenting, the biosocial environment, and infant sleep behaviors. Although night waking and bedtime fussing are normative during infancy and early childhood, they can be challenging for parents. The current study, conducted in the United States between 2003 and 2009, examined concurrent and longitudinal associations between maternal mental health and infant sleep during the first year. Concurrent associations at 6 and 12 months and longitudinal associations from 6 to 12 months were studied in a non-clinic referred sample of 171 economically and culturally diverse families. Mothers with poorer mental health reported that their infants had more night waking and bedtime distress and were more bothered by these sleep issues. Associations between infant sleep and maternal mental health were moderated by culture (Hispanic/Asian vs. other) and by stressors that included high parenting stress, more stressful life events, and low family income. Individual differences in maternal well-being may color mothers' interpretations of infants' sleep behaviors. It may be prudent to intervene to support maternal mental health when infants are referred for sleep problems. PMID:22858167

  7. Passive antibody transfer in chickens to model maternal antibody after avian influenza vaccination.

    Science.gov (United States)

    Faulkner, Olivia B; Estevez, Carlos; Yu, Qingzhong; Suarez, David L

    2013-04-15

    Birds transfer maternal antibodies (MAb) to their offspring through the egg yolk where the antibody is absorbed and enters the circulatory system. Maternal antibodies provide early protection from disease, but may interfere with the vaccination efficacy in the chick. MAb are thought to interfere with vaccine antigen processing that reduces the subsequent immune response. Once MAb titers are depleted, the chick will respond to vaccination, but they are also susceptible to viral infection. This study examines the effect of MAb on seroconversion to different viral-vectored avian influenza virus (AIV) vaccines. Chicks were given passively transferred antibodies (PTA) using AIV hyperimmunized serum, and subsequently vaccinated with a fowlpox-AIV recombinant vaccine (FPr) or a Newcastle disease virus-AIV recombinant vaccine (NDVr). Our results indicate that passively transferred antibodies led to significant reduction of seroconversion and clinical protection from virulent challenge in recombinant virus vaccinated chicks thus demonstrating maternal antibody interference to vaccination. The passive antibody transfer model system provides an important tool to evaluate maternal antibody interference to vaccination. PMID:23398721

  8. Frequency of maternal mortality and morbidity in pregnancy-induced hypertension

    International Nuclear Information System (INIS)

    Background: Pregnancy-induced hypertension (PIH) is defines as hypertension in pregnancy, and is sustained blood pressure >140 mm Hg systolic or 90 mm Hg diastolic. Objective of this study was to see the maternal outcome in terms of morbidity and mortality in PIH. Methods: This descriptive study was conducted in Obstetrics and Gynaecology Unit of Fauji Foundation Hospital, Rawalpindi from January to December 2010. Both booked and un-booked cases were selected after fulfilling inclusion criteria. A detailed history and clinical examination was recorded and relevant investigations were performed. Patients were monitored for rise in blood pressure, development of complications related to hypertensions in pregnancy as well as maternal and perinatal outcome. Results: During this period, 100 patients were admitted with pregnancy-induced hypertension. Majority were un-booked. Primigravida were 60 (60%), and were in age group 21-30 year, remaining were above 30 year. Four patients had placental abruption, 2 pulmonary oedema, 5 HELLP syndrome, 2 severe renal impairment, 20 elevated liver enzyme, 23 uncontrolled blood pressure, 20 server preeclampsia, 10 thrombocytopenia, 3 eclampsia, 10 had impaired coagulation profile, and 1 had maternal death. Conclusion: Pregnancy induced hypertension is a major cause of maternal mortality and morbidity. In Pakistan, its incidence and related mortality are high due to lack of adequate antenatal care. (author)

  9. Prenatal maternal mental health and fetal growth restriction: a systematic review.

    Science.gov (United States)

    Lewis, A J; Austin, E; Galbally, M

    2016-08-01

    Maternal mental disorders during pregnancy are associated with a range of adverse health outcomes for offspring. This systematic review examines studies reporting on the relationship between maternal depression, anxiety or stress during pregnancy and fetal growth measured during pregnancy using ultrasound biometry. A systematic search of PsycINFO, Medline, Scopus, Web of Science and Embase was conducted and 1575 records were identified, with nine studies meeting inclusion criteria gathering data from over 7000 participants. All studies measured depression, six examined anxiety and depression, and five examined all three exposures. The majority measured symptoms rather than clinically diagnosable disorder. Studies consistently reported significant associations between maternal mental health, particularly anxiety symptoms, and reduced fetal head growth. Other fetal growth parameters showed inconsistent findings. A number of studies suggest that cortisol dysregulation associated with maternal mental health may play a role in fetal growth restriction. However, heterogeneity in the timing of growth measurement, assessment measures used for mental health and inconsistencies in adjustment for confounders, limits the synthesis and interpretation of findings. Future studies should consider differences in the timing, intensity and duration of mental health symptoms over pregnancy and should employ diagnostic assessment of mental disorders. Fetal growth should be repeatedly measured and further work is needed to establish the biological mechanisms involved. PMID:26983652

  10. Social exclusion, infant behavior, social isolation, and maternal expectations independently predict maternal depressive symptoms.

    Science.gov (United States)

    Eastwood, John; Jalaludin, Bin; Kemp, Lynn; Phung, Hai; Barnett, Bryanne; Tobin, Jacinta

    2013-01-01

    The objective of the study was to identify latent variables that can be used to inform theoretical models of perinatal influences on postnatal depressed mood and maternal-infant attachment. A routine survey of mothers with newborn infants was commenced in South Western Sydney in 2000. The survey included the Edinburgh Postnatal Depression Scale (EPDS) and 46 psychosocial and health-related variables. Mothers (n = 15,389) delivering in 2002 and 2003 were surveyed at 2-3 weeks for depressive symptoms. Nonlinear principal components analysis was undertaken to identify dimensions that might represent latent variables. Correlations between latent variables and EPDS >12 were assessed by logistic regression. A five-dimension solution was identified, which accounted for 51% of the variance among the items studied. The five dimensions identified were maternal responsiveness, social exclusion, infant behavior, migrant social isolation, and family size. In addition, the variable maternal expectation contributed significantly to total variance and was included in the regression analysis. Regression on EPDS >12 was predictive for all variables except for maternal responsiveness, which was considered an outcome variable. The findings are consistent with the proposition that social exclusion, infant behavior, social isolation among migrant mothers, and maternal expectations are determinants of maternal mood. PMID:23408743

  11. Impact of maternal body mass index on neonatal outcome

    OpenAIRE

    Kalk P; Guthmann F; Krause K; Relle K; Godes M; Gossing G; Halle H; Wauer R; Hocher B

    2009-01-01

    Abstract Introduction Maternal body mass index has an impact on maternal and fetal pregnancy outcome. An increased maternal BMI is known to be associated with admission of the newborn to a neonatal care unit. The reasons and impact of this admission on fetal outcome, however, are unknown so far. Objective The aim of our study was to investigate the impact of maternal BMI on maternal and fetal pregnancy outcome with special focus on the children admitted to a neonatal care unit. Methods A coho...

  12. The importance of maternal nutrition for health

    Directory of Open Access Journals (Sweden)

    Irene Cetin

    2015-10-01

    Full Text Available Nutrition plays a major role in maternal and child health and it is widely recognized that optimum nutrition in early life is the foundation for long-term health. A healthy maternal dietary pattern, along with adequate maternal body composition, metabolism and placental nutrient supply, reduces the risk of maternal, fetal and long-term effects in the offspring. While undernutrition is mainly an issue of low-income countries, malnutrition, due to poor quality diet, is becoming a global health problem.Preconceptional counseling of women of childbearing age should spread awareness of the importance of maternal nutrition before and during pregnancy and should promote a cultural lifestyle change, in favor of a healthy weight before conceiving and balanced healthy diet with high-quality foods consumption. Supplementation and/or fortification can make a contribution when recommended micronutrient intakes are difficult to be met through food alone. In industrialized countries, although a balanced diet is generally accessible, a switch to a high-fat and low-quality diet has led to inadequate vitamin and mineral intake during pregnancy. Evidence do not support a routine multiple micronutrient supplementation but highlights the importance of an individualized approach, in order to recognize nutritional deficiencies of individuals, thus leading to healthful dietary practices prior to conception and eventually to tailored supplementation. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  13. Maternal diabetes and perinatal programming.

    Science.gov (United States)

    Plagemann, A

    2011-11-01

    Alterations of the intrauterine and neonatal environment may predispose for disorders and diseases throughout later life (perinatal programming). Especially, hormones and nutrients are dose-dependent organizers of the developing organism. Studies in offspring of diabetic mothers (ODM) have paradigmatically contributed to the perception of this developmental principle and our understanding of causal mechanisms. Fetal and neonatal hyperinsulinism in consequence of materno-fetal hyperglycaemia is the pathognomic feature in ODM. Epidemiological, clinical, as well as experimental data indicate that both insulin and glucose, when occurring in elevated concentrations during perinatal life, may epigenetically program a predisposition for obesity and diabetes later on. Similar may occur due to pre- and neonatal overfeeding. From a clinical point of view, avoidance of materno-fetal overnutrition, universal diabetes screening in all pregnant women and adequate therapy of all forms of diabetes during pregnancy, as well as avoidance of neonatal overfeeding are therefore recommended. These measures might serve as causal approaches of a genuine prevention to the benefit of long-term offspring health. PMID:21945359

  14. Praying until Death: Apostolicism, Delays and Maternal Mortality in Zimbabwe.

    Science.gov (United States)

    Munyaradzi Kenneth, Dodzo; Marvellous, Mhloyi; Stanzia, Moyo; Memory, Dodzo-Masawi

    2016-01-01

    Religion affects people's daily lives by solving social problems, although it creates others. Female sexual and reproductive health are among the issues most affected by religion. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. We explored apostolic beliefs and practices on maternal health using 15 key informant interviews in 5 purposively selected districts of Zimbabwe. Results show that apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. It causes delays in recognizing danger signs, deciding to seek care, reaching and receiving appropriate health care. The existence of a customized spiritual maternal health system demonstrates a huge desire for positive maternal health outcomes among apostolics. We conclude that apostolic beliefs and practices exacerbate delays between onset of maternal complications and receiving help, thus increasing maternal risk. We recommend complementary and adaptive approaches that address the maternal health needs of apostolics in a religiously sensitive manner. PMID:27509018

  15. STUDY OF MATERNAL MORTALITY IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sandhya Devi

    2015-05-01

    Full Text Available BACKGROUND: A woman dies from complications of child birth every minute . The major causes for maternal mortality in India are uncontrolled fertility , inaccessibility or inadequate utilization of health care facilities , illiteracy , ignorance and gender discrimination . OBJECTIV ES: (1 To identify various causes of maternal deaths in a teaching hospital . (2 To study the profile of population attending the tertiary hospital . Methodology : A retrospective study was conducted in a tertiary hospital over a period of 2 years (January 2013 - December 2014 and data was analysed manually using case sheets and maternal death audit forms . RESULTS: In the study period , there were 11636 deliveries and 97 maternal deaths . The direct causes accounted for 77 maternal deaths with haemorrhage , hype rtension and sepsis as leading causes of maternal mortality . Conclusion : Emphasis on health education , need for regular antenatal checkups and proper training of health personnel is required to reduce maternal mortality .

  16. Representing Evolution

    DEFF Research Database (Denmark)

    Hedin, Gry

    2012-01-01

    article discusses Willumsen's etching in the context of evolutionary theory, arguing that Willumsen is a rare example of an artist who not only let the theory of evolution fuel his artistic imagination, but also concerned himself with a core issue of the theory, namely to what extent it could be applied...

  17. Cepheid evolution

    International Nuclear Information System (INIS)

    A review of the phases of stellar evolution relevant to Cepheid variables of both Types I and II is presented. Type I Cepheids arise as a result of normal post-main sequence evolutionary behavior of many stars in the intermediate to massive range of stellar masses. In contrast, Type II Cepheids generally originate from low-mass stars of low metalicity which are undergoing post core helium-burning evolution. Despite great progress in the past two decades, uncertainties still remain in such areas as how to best model convective overshoot, semiconvection, stellar atmospheres, rotation, and binary evolution as well as uncertainties in important physical parameters such as the nuclear reaction rates, opacity, and mass loss rates. The potential effect of these uncertainties on stellar evolution models is discussed. Finally, comparisons between theoretical predictions and observations of Cepheid variables are presented for a number of cases. The results of these comparisons show both areas of agreement and disagreement with the latter result providing incentive for further research

  18. Maternal serum Dehydroepiandrosterone Sulfate levels and the efficiency of labor

    Directory of Open Access Journals (Sweden)

    "Modares Gilani M

    2001-08-01

    Full Text Available To evaluate the maternal serum dehydroepiandrosterone (DHEA sulfate levels as a factor influencing labor ‘efficiency’ at term and unsuccessful labor induction. This is a prospective study. In this study the mean (± standard error maternal serum DHEA sulfate levels of 90 singleton pregnant women in 3 groups with spontaneous labor, need for augmentation and need for induction were compared.Pregnancies complicated by diabetes mellitus, hypertension, fetal growth restriction, tobacco consumption, corticosteriod use or chorioamintis were excluded. Bishop score of all cases was less than 5. Serum DHEA sulfate levels were measured by radioimmunoassay. Dehydroepiandrosteone sulfate levels and other obstetric variables were correlated retrospectively with the clinically determined requirements of oxytocin augmentation of labor, and the outcome of each induction attempt. The t-test, Variance analysis Kruskal –Wallis test, Mann-Whitney test, chi-square (X2 distribution, linear correlation and regression were used for statistical analysis. P<0.05 was considered statistically significant. This study showed that the mean (± standard error maternal serum DHEA sulfate level was not significantly higher in women who progressed spontaneously through labor (n=30 than in those who required augmentation (n=30 (60.78±4.22 versus 70.38±5.84. No significant difference was found between the mean DHEA sulfate levels of spontaneous labor group (n=30 and cases who had prolonged latent phase (n=21 (66.78±4.22 versus 67.02±7.13 or prolonged active phase disorders (n=9 (60.78±4.22 µg/dl versus 78.22±10.23 µg/dl p=0.25This study showed that the mean maternal serum DEHA sulfate level was significantly higher in women with spontaneous labor (n=30 than in those who needed induction (n=30 (60.78±4.22 µg/dl versus 39.49±4.56 µg/dl, respectively; p=0.001.In the group who needed induction, the mean DHEA sulfate level waa significantly higher in women who

  19. Goodness of fit between prenatal maternal sleep and infant sleep: Associations with maternal depression and attachment security.

    Science.gov (United States)

    Newland, Rebecca P; Parade, Stephanie H; Dickstein, Susan; Seifer, Ronald

    2016-08-01

    The current study prospectively examined the ways in which goodness of fit between maternal and infant sleep contributes to maternal depressive symptoms and the mother-child relationship across the first years of life. In a sample of 173 mother-child dyads, maternal prenatal sleep, infant sleep, maternal depressive symptoms, and mother-child attachment security were assessed via self-report, actigraphy, and observational measures. Results suggested that a poor fit between mothers' prenatal sleep and infants' sleep at 8 months (measured by sleep diary and actigraphy) was associated with maternal depressive symptoms at 15 months. Additionally, maternal depression mediated the association between the interplay of mother and infant sleep (measured by sleep diary) and mother-child attachment security at 30 months. Findings emphasize the importance of the match between mother and infant sleep on maternal wellbeing and mother-child relationships and highlight the role of mothers' perceptions of infant sleep. PMID:27448324

  20. Severe maternal morbidity and near misses in tertiary hospitals, Kelantan, Malaysia: a cross-sectional study

    OpenAIRE

    Norhayati, Mohd Noor; Nik Hazlina, Nik Hussain; Sulaiman, Zaharah; Azman, Mohd Yacob

    2016-01-01

    Background Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia. Methods A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organ...