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Sample records for universal antenatal screening

  1. Is congenital pulmonary airway malformation really a rare disease? Result of a prospective registry with universal antenatal screening program.

    Lau, C T; Kan, A; Shek, N; Tam, P; Wong, K K Y

    2017-01-01

    Congenital pulmonary airway malformation (CPAM) is an increasingly recognized disease with potential mortality. Owing to limited published studies, the true incidence is yet to be determined. We carried out this prospective study with the aim to estimate its true incidence on a population basis. An antenatal ultrasonography program was implemented since 2009. Fetuses with suspected intra-thoracic lesions were monitored by regular follow-ups. Antenatal course, postnatal outcomes, and other demographics were compared to those of patients with CPAM in the previous decades (1989-2008). The incidence of CPAM was calculated in different periods. 66 CPAM patients were identified between 2009 and 2014 with 62 patients being detected by antenatal scan. In contrast, 45 patients were identified between 1989 and 2008 with 27 patients being detected antenatally. The incidence rate during the past and recent period was estimated as ~1 in 27,400 and ~1 in 7200 live births, respectively (p = 0.024). With increasing awareness of clinicians and the universal use of latest ultrasound technology, it is likely that more CPAM cases will be detected in the future. Here, we presented our best estimated incidence rate of CPAM, yet only a larger scale study can reveal its true incidence.

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

    R C E Hughes

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

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

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

    2011-01-01

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

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

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

    2011-01-01

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

  5. Routine antenatal syphilis screening in South West Nigeria - a ...

    Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...

  6. Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis.

    Andreas Kuznik

    2013-11-01

    Full Text Available Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA, where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs averted.The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86% and specificity (99% reported for the immunochromatographic strip (ICS test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48. Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0% to 0.038% (range: 0.002%-0.113%. Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million

  7. Prevention of Congenital Syphilis Through Antenatal Screenings in Lusaka, Zambia: A Systematic Review

    Rehman, Sabah

    2018-01-01

    Congenital syphilis is one of the preventable diseases caused by the gram-negative bacteria Treponema pallidum; yet, it imposes a serious global health and economic burden, with more than half of the cases resulting in serious adverse outcomes, including infant mortality. Mother-to-child transmission (MTCT) of syphilis is estimated at 3.6 million adjusted life years (DALYs) and around $309 million in medical costs. In 2006, an estimated 9.7 million children of age less than five years died in developing countries; almost four million were neonatal deaths. There were 3.2 million stillbirths globally, among whom 95% were in the developing countries. In sub-Saharan Africa, there is an estimated 2.7% (0.1%-10.3%) of pregnant women infected with syphilis, representing more than 900,000 pregnancies at risk each year. There were many non-specific and specific diagnostic tests used in the past, which required laboratory equipment and electricity, but there are many newer tests available now that provide rapid results with high sensitivity and specificity, e.g., the immunochromatographic strip (ICS) and rapid syphilis tests (RST). Early syphilis can be completely eliminated with a single injection of penicillin, which is readily available, cheap, and highly effective, and treating pregnant women with penicillin is 98% effective at preventing congenital syphilis. Targeting women at a high risk of having syphilis makes universal screening in antenatal programs the most efficacious way to prevent syphilis-associated morbidity and mortality. The potential for a program to prevent congenital syphilis in the perinatal, neonatal, and postnatal periods is evident. While considering resource allocation to child survival programs in areas where the prevalence of syphilis is high, officials need to include antenatal syphilis screening, using rapid tests and treatment at the first contact of the mother with the health care system. In countries like Zambia and other resource

  8. Antenatal emotional wellbeing screening in Aboriginal and Torres Strait Islander primary health care services in Australia.

    Gausia, Kaniz; Thompson, Sandra; Nagel, Tricia; Rumbold, Alice; Connors, Christine; Matthews, Veronica; Boyle, Jacqueline; Schierhout, Gill; Bailie, Ross

    2013-12-01

    The aim of this study was to examine the extent to which antenatal emotional wellbeing (EW) assessments are undertaken in primary health care (PHC) centres and factors associated with completion of EW screening. Medical records of 797 pregnant women from 36 PHC centres in five states (NSW, QLD, SA, WA and NT) were audited. Overall, 85% of the women were Aboriginal. The proportion of women with documented screening for EW varied from 5 to 38% between states (mean 17%). Aboriginal women were four times more likely (adjusted Odds Ratio (OR = 4.13, 95% CI = 2.46-6.92) to not be screened for antenatal EW than non-Aboriginal women. Aboriginality, lack of counselling on financial support were independently linked with no screening of EW. Provision of training for health service providers and further research on appropriate screening tools for Aboriginal women are needed to help redress this gap.

  9. Antenatal screening for hepatitis B virus in HIV-infected and ...

    Background. Despite enormous strides in preventing hepatitis B virus (HBV) infection, perinatal transmission still contributes significantly to HBV epidemiology worldwide; this could account for approximately 50% of chronically infected individuals. Objective. To assess the need for HBV screening in antenatal clinics in the ...

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

    Gould, Dinah; Papadopoulos, Irena; Kelly, Daniel

    2012-01-01

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

  11. HIV screening and counseling in antenatal care: perception of postpartum women

    de Souza Praça, Neide; Teixeira Gardel Barrancos, Janaína

    2008-01-01

    This transversal and exploratory study aimed at verifying if pregnant women were receiving antenatal counseling before and after HIV screening. The sample consisted of 161 postpartum HIV-negative women admitted to two maternity hospitals in the city of São Paulo. Interviews were carried out in 2003. Data showed that the number of postpartum women who received pre and post HIV screening counseling during pregnancy was low. The answers of women on the aim of HIV testing were statistically corre...

  12. Attitude of antenatal patients in Enugu toward HIV screening ...

    The reason for declining HIV Screening was that AIDS has no known cure, followed by fear of positive result. Conclusion: The awareness and attitude of Nigeria pregnant women towards HIV Screening and uptake of the test is good. Educational level has a significant effect on the uptake and perceived benefit of the test.

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

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

    2007-01-01

    OBJECTIVES: To estimate the costs and health consequences of three different screening strategies for neonatal alloimmune thrombocytopenia (NAIT). DESIGN: Cost-utility analysis on the basis of a decision tree that incorporates the relevant strategies and outcomes. SETTING: Three health regions......-4 weeks before term. Severely thrombocytopenic newborn were transfused immediately with compatible platelets. MAIN OUTCOME MEASUREMENTS: Quality-adjusted life years (QALYs) and costs. RESULTS: Compared with no screening, a programme of screening and subsequent treatment would generate between 210 and 230...... additional QALYs among 100,000 pregnant women, and at the same time, reduce health care costs by approximately 1.7 million euros. The sensitivity analyses indicate that screening is cost effective or even cost saving within a wide range of probabilities and costs. CONCLUSION: Our calculations indicate...

  14. The quality of risk factor screening during antenatal consultations in Niger.

    Prual, A; Toure, A; Huguet, D; Laurent, Y

    2000-03-01

    A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health programmes over the last decade. The effectiveness of antenatal care as a tool to prevent or predict obstetric complications is being questioned more and more. In addition to the scarcity of reliable data about the predictivity of most risk factors, the quality of the screening must be questioned. The goal of this study was to assess the frequency of risk factors among a sample of pregnant women attending antenatal care in Niger and to assess the quality of the screening of those risk factors. Overall, 330 pregnant women were enrolled in the study. Each woman was examined twice: the first time by a midwife, the second time by one of the authors but without knowledge of the results of the first consultation. Fifty-five percent of pregnant women had at least one risk factor, 31% had more than one. Ninety-one percent of the risk factors were detected at interview. The following risk factors were not systematically searched for by midwives: height (48.5%), blood pressure (43.6%), glycosuria (40.6%), vaginal bleeding (38.2%), oedema (37.3%), parity (17%), age (16%), previous caesarean section (15.2%), previous stillbirth (15.2%) and previous miscarriages (14.8%). This study has shown that, in Niger, the quality of screening for risk factors during antenatal consultation is poor. In the urban settings where this study took place, lack of personnel, lack of equipment, lack of time and poor compliance by women cannot be made responsible for this situation. While screening of these risk factors continues as policy, the quality of screening must be dramatically improved.

  15. Implementation of depression screening in antenatal clinics through tablet computers: results of a feasibility study.

    Marcano-Belisario, José S; Gupta, Ajay K; O'Donoghue, John; Ramchandani, Paul; Morrison, Cecily; Car, Josip

    2017-05-10

    Mobile devices may facilitate depression screening in the waiting area of antenatal clinics. This can present implementation challenges, of which we focused on survey layout and technology deployment. We assessed the feasibility of using tablet computers to administer a socio-demographic survey, the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to 530 pregnant women attending National Health Service (NHS) antenatal clinics across England. We randomised participants to one of two layout versions of these surveys: (i) a scrolling layout where each survey was presented on a single screen; or (ii) a paging layout where only one question appeared on the screen at any given time. Overall, 85.10% of eligible pregnant women agreed to take part. Of these, 90.95% completed the study procedures. Approximately 23% of participants answered Yes to at least one Whooley question, and approximately 13% of them scored 10 points of more on the EPDS. We observed no association between survey layout and the responses given to the Whooley questions, the median EPDS scores, the number of participants at increased risk of self-harm, and the number of participants asking for technical assistance. However, we observed a difference in the number of participants at each EPDS scoring interval (p = 0.008), which provide an indication of a woman's risk of depression. A scrolling layout resulted in faster completion times (median = 4 min 46 s) than a paging layout (median = 5 min 33 s) (p = 0.024). However, the clinical significance of this difference (47.5 s) is yet to be determined. Tablet computers can be used for depression screening in the waiting area of antenatal clinics. This requires the careful consideration of clinical workflows, and technology-related issues such as connectivity and security. An association between survey layout and EPDS scoring intervals needs to be explored further to determine if it corresponds to a survey layout effect

  16. Men's experiences of antenatal screening: a metasynthesis of the qualitative research.

    Dheensa, Sandi; Metcalfe, Alison; Williams, Robert Alan

    2013-01-01

    First to develop a consensus on what is known about men's experiences and involvement in antenatal screening, second to understand whether screening is an appropriate way to engage uninvolved men in pregnancy and third to identify areas requiring further research. A systematic review was conducted to extract relevant qualitative primary research studies, which were subsequently synthesised. International qualitative research papers, in English or with English translations, were identified using twenty-three electronic databases, such as CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA and British Nursing Index. Articles that explored men's views and opinions of antenatal screening and prenatal diagnosis were included. Eighteen relevant research studies that met the inclusion criteria were identified. Each one was appraised as suitable for inclusion using a published appraisal tool. Three themes were constructed, which were (1) men's emotional conflicts, (2) men's focus on information and (3) men's influence on decision-making. Men felt a responsibility towards their unborn child to be involved in screening. Despite this, their input was often limited to supporting their partners, and there was no clearly defined, additional role for them as expectant fathers. Thus screening is not likely to be sufficient as an opportunity to encourage men who are uninvolved in pregnancy to become more involved. Nonetheless, engaging men who were involved in the pregnancy and who attended screening appointments was beneficial in encouraging the responsibility they felt towards their unborn child, and in allowing them to support their partners. Healthcare professionals need to engage those men who show willingness to be involved. Nevertheless trying to engage reluctant men in screening, where there is no clearly defined role for them might create further distance between them and the pregnancy. Alternative ways to engage such men in pregnancy are thus required. Copyright © 2012 Elsevier Ltd

  17. Prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Teaching Hospital in 2014, northwest Ethiopia.

    Asrie, Fikir; Enawgaw, Bamlaku; Getaneh, Zegeye

    2017-01-01

    Thrombocytopenia is a common hematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a cesarean section or other surgical intervention during pregnancy, labor or in the puerperium. The main aim of this study was to determine the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital, northwest Ethiopia. A cross-sectional study was used to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital from January to April 2015. A total of 217 pregnant women were included in the study and a structured pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, history and clinical condition. Blood samples were collected for platelet count and other platelet parameters, which were determined by using SysmexKX 21 automation. The data were entered to Epi info version 6 software and analyzed using SPSS version 20 software. Bivariable and multivariable statistical analyses were used to evaluate the effect of independent variable over the dependent variable. A p -value of women receiving antenatal care service at Gondar University Hospital participated in the study. Thrombocytopenia among 19 pregnant women showed a prevalence of 8.8%. The mean ± standard deviation platelet count was 238.85×10 9 /L (±74.57). Thrombocytopenia was significantly associated with patients who lived rurally (crude odds ratio =4.3, 95% confidence interval 1.48-12.76). The prevalence of thrombocytopenia was 8.8% predominantly with mild type of thrombocytopenia. Thrombocytopenia was higher among pregnant women who lived rurally. Therefore, health care providers should screen routinely for thrombocytopenia to avoid excessive bleeding during pregnancy, especially in women who live

  18. Antenatal syphilis screening using point-of-care testing in low- and middle-income countries in Asia and Latin America: a cost-effectiveness analysis.

    Andreas Kuznik

    Full Text Available Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. In low- and middle-income countries in Asia and Latin America, 20%-30% of women are not tested for syphilis during pregnancy. We evaluated the cost-effectiveness of increasing the coverage for antenatal syphilis screening in 11 Asian and 20 Latin American countries, using a point-of-care immunochromatographic strip (ICS test.The decision analytical cost-effectiveness models reported incremental costs per disability-adjusted life years (DALYs averted from the perspectives of the national health care payer. Clinical outcomes were stillbirths, neonatal deaths, and congenital syphilis. DALYs were computed using WHO disability weights. Costs included the ICS test, three injections of benzathine penicillin, and nurse wages. Country-specific inputs included the antenatal prevalence of syphilis and the proportion of women in the antenatal care setting that are screened for syphilis infection as reported in the 2014 WHO baseline report on global sexually transmitted infection surveillance. Country-specific data on the annual number of live births, proportion of women with at least one antenatal care visit, and per capita gross national income were also included in the model.The incremental cost/DALY averted of syphilis screening is US$53 (range: US$10-US$332; Prob<1*per capita GDP=99.71% in Asia and US$60 (range: US$5-US$225; Prob<1*per capita GDP=99.77% in Latin America. Universal screening may reduce the annual number of stillbirths by 20,344 and 4,270, neonatal deaths by 8,201 and 1,721, cases of congenital syphilis by 10,952 and 2,298, and avert 925,039 and 197,454 DALYs in the aggregate Asian and Latin American panel, respectively.Antenatal syphilis screening is highly cost-effective in all the 11 Asian and 20 Latin American countries assessed. Our findings support the decision to expand syphilis screening in countries with currently low screening rates or

  19. Barriers to antenatal psychosocial assessment and depression screening in private hospital settings.

    Connell, Tanya; Barnett, Bryanne; Waters, Donna

    2017-10-11

    The evidence of benefit for antenatal psychosocial assessment and depression screening has been sufficient to lead the implementation of screening in public hospitals in all states of Australia. Details of the implementation of perinatal screening in private obstetric settings is less well known. As any successful implementation relies on the identification of local barriers, we aimed to determine what perceived or actual barriers may exist for the implementation of evidence-based perinatal screening interventions in private obstetric care, and specifically within small private hospitals. The integrative literature review method offers a structured systematic approach to organise, synthesize and critique research from a range of sources. This method was used to determine what barriers have been identified in implementing psychosocial assessment and depression screening with women receiving obstetric care in private hospital settings. The integrative review findings suggest that barriers to implementing psychosocial screening in the private sector are similar to those experienced in the public sector but may also be influenced by the corporate focus of private services. Barriers were identified among health professionals, within the personal and psychosocial context of women and their families, and at provider or system level. Once identified, barriers can be systematically addressed to enhance the success of implementing psychosocial and depression screening in the private sector. Screening is likely to be influenced by the business models and operating systems of private service providers. Health professionals working within this environment need more support to conduct perinatal assessment within this context. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

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

    Joseph Philip

    2013-01-01

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

  1. Effectiveness of antenatal screening for sickle cell trait: the impact on women's self-report of sickle cell trait status.

    Knight-Madden, J M; Reid, M; Younger, N; Francis, D; McFarlane, S; Wilks, R

    2012-03-01

    The sickle gene frequency in the Jamaican population has not changed over a generation. It is unknown whether routine antenatal screening for sickle cell trait (SCT) has affected women's knowledge of their SCT status. The aim of this study was to compare the prevalence of self-reported SCT in parous women to the prevalence in nulliparous women, men and to the observed prevalence of SCT measured in an antenatal clinic. All participants in the nationally representative Jamaica Health and Lifestyle Survey 2008 were asked whether they had the SCT. The impact of gender, age, educational attainment, geographical location, and pregnancy on self-reported SCT were assessed. The prevalence of SCT in women attending a large antenatal clinic concurrently was compared to that reported by women of child-bearing age in the lifestyle survey. Self-report significantly underestimated the prevalence of SCT (2·9% versus 10·1%, Peducation were more likely than those with presecondary education (P = 0·01) and women more likely than men (3·2% versus 1·1%, P = 0·001) to report having SCT. Women who had been pregnant were no more likely than other women to report having SCT (3·1% versus 4·1%, P = 0·4). Attendance at antenatal clinic where SCT screening is routine, is not associated with increased self-report of SCT. Screening programs must ensure that, as well as technically accurate screening, there is effective communication of the results of screening for SCT to those tested to help reduce the public health burden of sickle cell disease in tropical countries.

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

    Martyn, F

    2011-05-01

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

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

    Martyn, F

    2012-02-01

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

  4. On-site screening for maternal syphilis in an antenatal clinic

    Abstract Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal ...

  5. On-site screening for maternal syphilis in an antenatal clinic ...

    Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal clinic ...

  6. Seroprevalence and determinants of toxoplasmosis in pregnant women attending antenatal clinic at the university teaching hospital, Lusaka, Zambia.

    Frimpong, Christiana; Makasa, Mpundu; Sitali, Lungowe; Michelo, Charles

    2017-01-05

    Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending antenatal clinic at the University Teaching Hospital (UTH). A cross-sectional study was employed where 411 pregnant women attending antenatal clinic at UTH were interviewed using closed ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid test cassettes by CTK Biotech, Inc, USA. The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of association between contact with cats, employment type as well as socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

  7. Cost-effectiveness of HIV and syphilis antenatal screening: a modelling study.

    Bristow, Claire C; Larson, Elysia; Anderson, Laura J; Klausner, Jeffrey D

    2016-08-01

    The WHO called for the elimination of maternal-to-child transmission (MTCT) of HIV and syphilis, a harmonised approach for the improvement of health outcomes for mothers and children. Testing early in pregnancy, treating seropositive pregnant women and preventing syphilis reinfection can prevent MTCT of HIV and syphilis. We assessed the health and economic outcomes of a dual testing strategy in a simulated cohort of 100 000 antenatal care patients in Malawi. We compared four screening algorithms: (1) HIV rapid test only, (2) dual HIV and syphilis rapid tests, (3) single rapid tests for HIV and syphilis and (4) HIV rapid and syphilis laboratory tests. We calculated the expected number of adverse pregnancy outcomes, the expected costs and the expected newborn disability-adjusted life years (DALYs) for each screening algorithm. The estimated costs and DALYs for each screening algorithm were assessed from a societal perspective using Markov progression models. Additionally, we conducted a Monte Carlo multiway sensitivity analysis, allowing for ranges of inputs. Our cohort decision model predicted the lowest number of adverse pregnancy outcomes in the dual HIV and syphilis rapid test strategy. Additionally, from the societal perspective, the costs of prevention and care using a dual HIV and syphilis rapid testing strategy was both the least costly ($226.92 per pregnancy) and resulted in the fewest DALYs (116 639) per 100 000 pregnancies. In the Monte Carlo simulation the dual HIV and syphilis algorithm was always cost saving and almost always reduced DALYs compared with HIV testing alone. The results of the cost-effectiveness analysis showed that a dual HIV and syphilis test was cost saving compared with all other screening strategies. Updating existing prevention of mother-to-child HIV transmission programmes in Malawi and similar countries to include dual rapid testing for HIV and syphilis is likely to be advantageous. Published by the BMJ Publishing Group

  8. Antenatal screening of women for hepatitis B and C in an out-patient department

    Batool, A.; Bano, K.A.; Khan, M.U.I.; Hussain, R.

    2008-01-01

    To determine frequency of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its clinical manifestation in pregnant women. Pregnant women visiting the Gynaecology and Obstetrics out patient's department of Sir Ganga Ram Hospital Lahore for antenatal check-ups from October 2006 to March 2007 were screened for hepatitis B and C. Immune- chromatography was used for initial screening and diagnosis was confirmed by ELISA technique. Data collection included maternal age, parity, symptoms or past history of jaundice, fatigue, tiredness, insomnia, depression, dyspepsia, fever, anorexia and pale stool. Risk factors investigated include past history of some surgical procedures, the dental visit, blood transfusion, tattooing, hospitalization and history of injection. Among the screened population, 7.3% out of 2439 ladies were positive for anti HCV and 2.2% for HBsAg while dual infection with HBV and HCV was observed in 0.08 % . Symptoms observed in hepatitis B patients were fatigue (90%), depression and pale stool (70%), anorexia (60%), jaundice (57.2%), fever (56.4%) and dyspepsia (51.2%). In hepatitis C antibody positive patients fatigue was the main symptom (95.7%) followed by pale stool (84.5%) and depression (80.2%); 63.3% had insomnia, 59.1% had anorexia, 50.7% had fever, 50.7% had jaundice and 43.6% had dyspepsia. Past history of blood transfusion was reported by 32.3% patients, surgery by 42.2% and tattooing was observed in 0.70%. One or more tooth extraction was reported by 50.2% subjects, and 49.25% had history of repeated injections. The frequency of sero-positivity for HBsAg and HCV among pregnant women is alarming. These sero-positive mothers are not only predisposed to chronic consequences of hepatitis, but also are a continuous threat to their offsprings and care providers. Hence, there is a direct need for further epidemiological studies and to take measures for prevention and control of the disease. (author)

  9. An evaluation of routine antenatal depression screening and psychosocial assessment in a regional private maternity setting in Australia.

    Kalra, Harish; Reilly, Nicole; Austin, Marie-Paule

    2018-01-30

    There is limited information relating to routine depression screening and psychosocial assessment programs in private maternity settings in Australia. To describe the psychosocial profile of a sample of private maternity patients who participated in a depression screening and psychosocial risk assessment program as part of routine antenatal care, and to explore women's experience of receiving this component of pregnancy care. We conducted a retrospective medical records audit of 455 consecutive women having a routine psychosocial assessment and referral. Assessment was undertaken using the Edinburgh Postnatal Depression Scale (EPDS) and the Antenatal Risk Questionnaire (ANRQ) for psychosocial risk; 101 women completed a feedback survey about their experience of receiving routine psychosocial care. Of the 87.7% of women who completed both EPDS and ANRQ, 4.3% scored 13 or more on the EPDS. On the ANRQ, 25.3% of women endorsed one risk factor, 11.6% two risk factors and 10.5% three or more risk factors. Elevated EPDS scores were associated with major stresses in the last 12 months, high trait anxiety and significant past mental health issue/s. Acceptability of depression screening and psychosocial risk assessment was high. This study highlights the need for, and acceptability of, depression and psychosocial assessment in the private maternity sector. These findings are particularly timely given the provision of new Medicare Benefits Scheme items for obstetricians to undertake psychosocial assessment (both antenatally and postnally) in line with recommended clinical best practice. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  10. On-site screening for syphilis at an antenatal clinic | Delport | South ...

    Objective. To determine the validity, predictive value and accuracy of the rapid plasma reagin card test performed on site to diagnose active syphilis in pregnant women so that immediate treatment can be offered to prevent congenital syphilis. Design. Open, descriptive study. Setting. Antenatal clinic, Mamelodi Hospital, ...

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

    TU Agan

    2010-07-01

    Full Text Available TU Agan1, JE Ekabua1, AE Udoh1, EI Ekanem1, EE Efiok1, MA Mgbekem21Department of Obstetrics and Gynecology, 2Department of Nursing, College of Medical Sciences, University of Calabar, NigeriaBackground: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable.Objective: The aim of this study is to assess the prevalence of anemia in asymptomatic malaria parasitemic women at first antenatal visit in a tertiary hospital facility.Method: The study was conducted at the antenatal clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria over a three-month period. Five hundred and forty-five pregnant women were recruited after obtaining an informed consent. A structured questionnaire was administered to each participant and two thin and thick blood films were used to identify the malaria parasites and estimate density. The average of two packed cell volumes at booking was determined using two capillary tubes and read from a Hawksleys microhematocrit reader.Results: A total of 545 pregnant women participated in the study. The mean ages of primigravidas and multigravidas were 21.4 ± 3.1 and 24.3 ± 4.0 years. Two hundred and ninety (53.2% were primigravidas while 255 (46.8% were multigravidas. The parasite density in primigravidas was 1297 ± 1234 while that for multigravidas was 661 ± 497 (t = 7.7, P < 0.001. The prevalence of anemia in the study population was 59.6%. There was no statistically significant difference in the prevalence of anemia among the primigravidas (60.3% and the multigravidas (58.8% (χ2 = 1.3, P = 0.08. There was a statistically significant association between severity of parasitemia and degree of anemia (χ2 = 441.1, P < 0.001. There was a statistically significant association between antimalarials use before booking and

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

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

    2012-01-01

    - women who carry a D+ fetus. We present an evaluation of the first national clinical application of antenatal RHD screening. STUDY DESIGN AND METHODS: In each of the five Danish health care regions, blood samples were drawn from D- women in Gestational Week 25. DNA was extracted from the maternal plasma...

  13. Introducing onsite antenatal syphilis screening in Burkina Faso: implementation and evaluation of a feasibility intervention tailored to a local context.

    Bocoum, Fadima Yaya; Tarnagda, Grissoum; Bationo, Fabrice; Savadogo, Justin R; Nacro, Sarata; Kouanda, Séni; Zarowsky, Christina

    2017-05-30

    Although the advantages of introducing point of care testing for syphilis in antenatal care (ANC) are well documented, there is little evidence on how to address structural issues within health systems. A better understanding of how these interventions work in a range of settings and contexts is needed in order to overcome bottlenecks at health system level. To better understand the relationships between implementation and context we developed and implemented an intervention focused on integrating a rapid screening test for syphilis in ANC services in rural primary health care facilities in Burkina Faso. This manuscript describes the intervention and reports on feasibility and acceptability of the intervention, the facilitators and barriers to the implementation of this intervention and the likelihood that point of care test for syphilis will become routinely incorporated in practice. In Kaya Health and Demographic Surveillance System (Kaya HDSS), all 7 primary healthcare facilities were selected for intervention in 2013. A participatory approach was used to design and implement an antenatal syphilis screening intervention. The Normalization Process Model (NPM) proposed by May et al. was adapted in order to identify barriers and facilitators and to explore the likelihood to become routinely incorporated in practice. Registers, Observations (n = 14 ANC 1) of interactions between patients and health workers during ANC and interviews with health workers (n = 14) were our data sources. An intervention that included onsite training, provision of supplies and medicines, quality control and supervision was implemented in 7 health facilities in 2013. Rapid syphilis test and treatment were delivered during ANC within the examination room with no specific additional mechanism regarding staff organization. The perceived barriers were lack of training of all staff, workload, stock-outs of consumables and lack of motivation of staff. Key facilitators included political

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

    Jensen, Lise; Heilmann, Carsten; Smith, Else

    2003-01-01

    The prevalence of hepatitis B virus (HBV) carriage in Denmark is unknown, but expected to be low (0.1%). This study aimed to evaluate the efficacy of selective antenatal screening for HBV infection and the epidemiology of HBV and hepatitis C virus (HCV) among pregnant women. 4098 women were...... included in the study. Blood tests were examined for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc) and anti-HCV. Case records were studied to evaluate whether patients at risk for HBV infection had been tested. Among the 4098 women, 18 10.4%, 95% confidence interval (95% CI) 0.......3-0.71 were HBsAg positive. All had a risk factor for HBV infection. Only 13 (72%) were identified as HBsAg positive in the selective screening programme. 115 women (2.8%, 95% CI 2.3-3.4) were anti-HBc positive only. 95 (83%) were at risk for HBV. Only 72 of these (63%) were tested for HBsAg. The screening...

  15. Domestic violence in pregnancy among antenatal attendees at the University of Port Harcourt Teaching Hospital, Port Harcourt.

    Jeremiah, I; Kalio, G B; Oriji, Vaduneme K

    2011-01-01

    Domestic violence is common worldwide. When it occurs in pregnancy it is associated with maternal and perinatal morbidity and mortality. It is a human rights violation with medical implication which is under-diagnosed and under-reported. This study sought to determine the prevalence of domestic violence during pregnancy and the factors that promotes domestic violence at the family unit. A cross sectional study of antenatal clients seen at the antenatal booking clinic of the University of Port Harcourt Teaching Hospital from 1st June to 31st December 2007. Five hundred clients selected from a simple random technique completed an interviewer administered structured questionnaire which sought information on domestic violence. Data collected was entered into a spreadsheet and analyzed using the statistical package SPSS 15.00 for Windows. The prevalence of domestic violence during pregnancy in this group was 7.8%. Those who experienced domestic violence were mainly those with low education and low parity. The commonest form of domestic violence was verbal abuse (shouting, cursing) occurring in 43.5% of those who have been abused in the index pregnancy and 1.2% of the victims of domestic violence suffered physical injuries from domestic violence in previous pregnancies. However, less than one third disclosed the incident. Women whose husbands indulge in substance abuse or are without jobs were more likely to experience domestic violence. Abdominal pain and miscarriage were the commonest obstetric complications following domestic violence-in pregnancy in this group. Eight percent of our antenatal mothers suffer domestic violence and many of them are unlikely to report it. Unemployment and substance abuse in the partners are major associated factors. Domestic violence in pregnancy has far-reaching adverse consequence on the mother and her unborn fetus such as miscarriage especially when it occasions bodily harm.

  16. The prevalence and bacteriology of asymptomatic bacteriuria among antenatal patients in Nnamdi Azikiwe University Teaching Hospital Nnewi; South Eastern Nigeria.

    Oli, A N; Okafor, C I; Ibezim, E C; Akujiobi, C N; Onwunzo, M C

    2010-12-01

    Urinary tract infection in pregnancy leads to poor pregnancy outcome. Diagnosis and treatment of asymptomatic bacteriuria markedly improves pregnancy outcome as well as reduce the incidence of acute pyelonephritis. To determine the prevalence and bacteriology of asymptomatic bacteriuria among Antenatal patients in our centre, and to know if routine screening will be justifiable. This was a prospective study carried out between April and August 2008. Sample size was statistically determined. Women who consented were interviewed and mid stream urine samples were collected and processed in the microbiology laboratory, using standard microbiological methods. Out of 357 women studied, 65(18.21%) had significant bacteriuria. Escherichia coli was the commonest isolate (25.6%), while proteus mirabilis was the least frequent isolate (3.66%). Women in third trimester had the highest prevalence (25.68%) while those in the first trimester had the least (15.79%). Women that had only primary education had the highest prevalence (27.50%) while those that had tertiary education had the least prevalence (21.10%). The prevalence of significant asymptomatic bacteriuria among the women studied was high. Screening of all the pregnant women and treatment will reduce the incidence and complications of overt urinary tract infection in pregnancy among these women.

  17. Malaria prevalence in pregnant women receiving antenatal care at the health centre of University of Uyo, Nigeria

    Peace Edwin Ubulom

    2017-10-01

    Full Text Available Objective: To assess the prevalence of malaria among pregnant women receiving antenatal care at the health centre of the town campus of University of Uyo, Nigeria. Methods: A total of 1 171 pregnant women participated in the present study. Structured questionnaire was administered to obtain relevant demographic and clinical characteristics of the participants. Thin blood films were obtained and examined for malaria parasites. Data obtained were analyzed using the statistical software SPSS version 20. Results: The results obtained showed that out of the 1 171 pregnant women, 61 (5.21% were positive for malaria infection. The month of July recorded the highest prevalence [19.70% (12 cases], while February, April and June had the lowest prevalence [11.50% (7 cases each]. Results obtained from Chi-square test indicated that the difference in the prevalence of malaria in relation to age was statistically significant (χ2cal = 16.616, χ2tab = 7.815, P 0.05. Conclusions: The prevalence rate of malaria infection among pregnant women was low in the present study. However, malaria in pregnancy still remains a health-care concern in our communities.

  18. Knowledge and perceptions of HIV/AIDS and mother to child transmission among antenatal mothers at Nnamdi Azikiwe University Teaching hospital, Nnewi.

    Igwegbe, A O; Ilika, A L

    2005-12-01

    Knowledge of HIV/AIDS by pregnant mothers is very important in the prevention of mother to child transmission. This study evaluates the knowledge and perceptions of HIV/AIDS and mother to child transmission among pregnant women attending antenatal clinic at a University Teaching Hospital. Pre-tested questionnaires were interviewer administered to 312 pregnant women randomly selected at the antenatal clinic of the Nnamdi Azikiwe University Teaching Hospital Nnewi. The level of awareness of HIV/AIDS among antenatal mothers was very high (99%) and the main sources of information were radio (44.7%), television (38.8%), and print media (34.0%). Though majority (94.2%) was aware HIV infection can coexist with pregnancy, only 76.9% were aware of mother to child transmission. Transplacental (46.1%), breastfeeding (31.7%), and vaginal delivery (16.3%) were the commonly identified routes of vertical transmission. Surprisingly, eighteen respondents (5.8%) indicated that caesarean section is a possible route of vertical transmission. Though the percentage of HIV/AIDS knowledge is high, the level of knowledge and perceptions of mother to child transmission is inadequate. This suggests the need to scale up health education about mother to child transmission in our health facilities.

  19. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia.

    Mengistie, Zemenu; Woldeamanuel, Yimtubezinash; Asrat, Daniel; Adera, Addis

    2014-11-20

    Bacterial vaginosis is one of the most common genital tract infections among reproductive age group. The prevalence of bacterial vaginosis varies from country to country even in the same country it varies among populations of interest. Different social and sexual factors can contribute to the development of bacterial vaginosis. The aim of this study was to determine the prevalence of bacterial vaginosis and to identify the possible risk factors associated among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Randomly selected 57 symptomatic and 195 asymptomatic pregnant women aged between 18 and 40 years visiting obstetric and gynecological clinic from November 2011 to April 2012 screenedusing Gram stain Nugent scoring system. Statistical analysis like univariate analysis to calculate frequencies and proportions, bivariate analysis to see association of selected exposure variables with the outcome variable, and multivariate analysis to check the association of possible factors with bacterial vaginosis by adjusting potential confounding factors was calculated using SPSS (Version 16.0). The prevalence of bacterial vaginosis is 19.4% using Gram stain Nugent scoring system. In addition, prevalence of bacterial vaginosis is 31.6% and 15.9% among symptomatic and asymptomatic pregnant women respectively. A high percentage of bacterial vaginosis positive pregnant women were asymptomatic (63.3%). 36.7% bacterial vaginosis positive pregnant women reported abnormal vaginal discharge with or without unpleasant smell. Multiple lifetime sexual partner (OR: 8.6; 95% CI: 2.5, 29) and previous history of spontaneous abortion (OR: 5.9; 95% CI: 1.5, 23) had remained significantly associated with prevalence of bacterial vaginosis. The prevalence of bacterial vaginosis is higher among asymptomatic pregnant women and associated with the factors previous history of multiple lifetime sexual partner and spontaneous abortion.

  20. Implementing non-invasive prenatal testing into publicly funded antenatal screening services for Down syndrome and other conditions in Aotearoa New Zealand.

    Filoche, Sara; Cram, Fiona; Lawton, Bev; Beard, Angela; Stone, Peter

    2017-10-04

    Non-invasive prenatal testing (NIPT) is a relatively new screen for congenital conditions - specifically, common fetal aneuploidies including Down Syndrome. The test is based on isolating freely circulating fragments of fetal-placental DNA that is present in the mother's blood. NIPT has a superior clinical performance compared to current screening, and has been available privately in Aotearoa New Zealand for the last 4 years. The proposed implementation of NIPT as a publicly funded service may widen the inequity in access to optional antenatal screening that already exists in this country. This paper discusses precautions that can be taken at the health system, organisation, and personnel levels to ensure that access to NIPT is equitable, that services are culturally responsive, and women's informed choice is promoted and protected. The adoption of NIPT into publicly funded services is an example of how genetic screening is becoming mainstreamed into health services; as such our approach may also have relevance around the introduction of other genetic and genomic screening initiatives.

  1. The effect of universal maternal antenatal iron supplementation on neurodevelopment in offspring: a systematic review and meta-analysis.

    Jayasinghe, C; Polson, R; van Woerden, H C; Wilson, P

    2018-05-04

    Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring. Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base. Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results. The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.

  2. NREL Screens Universities for Solar and Battery Storage Potential

    Elgqvist, Emma M [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-12

    In support of the U.S. Department of Energy's SunShot initiative, NREL provided solar photovoltaic (PV) screenings in 2016 and 2017 for universities seeking to go solar. Fifteen universities were selected for screenings based on campus solar and sustainability goals, plans for future solar projects and solar deployment capacity (megawatts), regional diversity, energy costs, and availability of campus energy data for the analysis.

  3. Antenatal screening for aneuploidy--surveying the current situation and planning for non-invasive prenatal diagnosis in New Zealand.

    Eastwood, Ashley; Webster, Dianne; Taylor, Juliet; Mckay, Richard; McEwen, Alison; Sullivan, Jan; Pope-Couston, Rachel; Stone, Peter

    2016-01-29

    To gauge clinical opinion about the current system and possible changes as well as providing a forum for education about Non-Invasive Prenatal Testing (NIPT). A series of workshops for doctors and midwives, supported by the National Screening Unit of the Ministry of Health and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, were held in the main centres of New Zealand. Following a brief education session, a structured evaluation of current screening and future possibilities was undertaken by questionnaire. One hundred and eight maternity carers participated in 5 workshops. Over 40% identified barriers to current screening. More than 60% would support NIPT in the first trimester. The majority of carers provided their own counselling support for women. The survey has shown general enthusiasm for the introduction of publically funded NIPT into prenatal screening in New Zealand. Barriers to utilisation of the current system have been identified and enhancements to screening performance with guidelines around conditions to be screened for would be supported.

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

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

    2015-06-01

    Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

  5. Universal Developmental Screening: Preliminary Studies in Galicia, Spain

    Sarmiento Campos, Jose A.; Squires, Jane; Ponte, Jaime

    2011-01-01

    "A_Tempo" is a research project that is currently under development in Galicia, an autonomous community of Spain. Its main aim is to propose an effective universal screening procedure for early identification of developmental disorders in children from zero to three years of age who attend Galician pre-primary schools.…

  6. Tuberculosis Screening and Targeted Testing of College and University Students

    Journal of American College Health, 2011

    2011-01-01

    Screening and targeted testing for tuberculosis (TB) is a key strategy for controlling and preventing infection on college and university campuses. Early detection provides an opportunity to promote the health of affected individuals through prompt diagnosis and treatment while preventing potential spread to others. Implementation of a screening…

  7. Radioimmunoassay of alpha-foetoprotein in the eluate of dried blood. A method for antenatal screening of neural tube defects

    Travert, G.; Herlicoviez, M.; Laroche, D.

    1979-01-01

    A radioimmunoassay for alpha-foetoprotein (AFP) in dried blood spots is reported. The main technical characteristics (reproducibility, sensitivity, recovery of exogenous AFP added and AFP stability in dried blood) are evaluated. They indicate that this method is feasible and well adapted to AFP measurement during pregnancy. AFP determination in maternal serum allows early detection of at least 80% of neural tube defects. The use of dried blood spots as samples for AFP assay makes our method a possible mass screening test for these malformations, which occur with an incidence of 12 for 10,000 [fr

  8. Cost-effectiveness analysis of neonatal hearing screening program in china: should universal screening be prioritized?

    Huang Li-Hui

    2012-04-01

    Full Text Available Abstract Background Neonatal hearing screening (NHS has been routinely offered as a vital component of early childhood care in developed countries, whereas such a screening program is still at the pilot or preliminary stage as regards its nationwide implementation in developing countries. To provide significant evidence for health policy making in China, this study aims to determine the cost-effectiveness of NHS program implementation in case of eight provinces of China. Methods A cost-effectiveness model was conducted and all neonates annually born from 2007 to 2009 in eight provinces of China were simulated in this model. The model parameters were estimated from the established databases in the general hospitals or maternal and child health hospitals of these eight provinces, supplemented from the published literature. The model estimated changes in program implementation costs, disability-adjusted life years (DALYs, average cost-effectiveness ratio (ACER, and incremental cost-effectiveness ratio (ICER for universal screening compared to targeted screening in eight provinces. Results and discussion A multivariate sensitivity analysis was performed to determine uncertainty in health effect estimates and cost-effectiveness ratios using a probabilistic modeling technique. Targeted strategy trended to be cost-effective in Guangxi, Jiangxi, Henan, Guangdong, Zhejiang, Hebei, Shandong, and Beijing from the level of 9%, 9%, 8%, 4%, 3%, 7%, 5%, and 2%, respectively; while universal strategy trended to be cost-effective in those provinces from the level of 70%, 70%, 48%, 10%, 8%, 28%, 15%, 4%, respectively. This study showed although there was a huge disparity in the implementation of the NHS program in the surveyed provinces, both universal strategy and targeted strategy showed cost-effectiveness in those relatively developed provinces, while neither of the screening strategy showed cost-effectiveness in those relatively developing provinces. This

  9. A Prospective Study of Routine Screening of Hypothyroidism in Antenatal Patients and their Outcome with Levothyroxine Treatment

    Manisha Sahu

    2017-10-01

    Full Text Available Introduction: Pregnancy with hypothyroidism is associated with significant maternal, fetal and neonatal complications. Early diagnosis and treatment can effectively reduce such complications. Aim: To find out the complications that can be prevented or reduced in severity in adequately treated hypothyroid pregnant women. Materials and Methods: Pregnant women attending obstetrics’ OPD upto 20 weeks were screened with serum Thyroid Stimulating Hormone (TSH and free Thyroxine FT4. Those having Subclinical Hypothyroidism (SCH, Overt Hypothyroidism (OH and pre pregnant women with hypothyroid were treated with levothyroxine as per consulting with endocrine unit. They were followed up till delivery and any adverse outcomes were documented such as Pregnancy Induced Hypertension (PIH, Pre Eclamptic Toxemia (PET, Abruption, Preterm Premature Rupture Of Membranes (PPROM, Low Birth Weight (LBW, oligohydramnios, Gestational Diabetes Mellitus (GDM, abortion, Intra Uterine Death (IUD, mode of delivery and Neonatal Intensive Care Unit (NICU admission were compared with similar complications documented among normal pregnant women excluding the treated hypothyroid during a period of one year study. Untreated or late trimester diagnosed hypothyroidism were excluded from study group. Results: Incidence of PIH, GDM, Oligohydramnios, PPROM, NICU admissions and caesarean section were higher among hypothyroid pregnant women though adequately treated than the control pregnant women. But incidence of LBW baby is less and no one had developed PET, Eclampsia or abruption among treated group. Comparing between SCH and OH incidence of PIH is almost equal in both while association of GDM is more in OH. A p-value for PIH, GDM, Oligohydramnios, PPROM developed in hypothyroid pregnant ladies which were calculated by Yates corrected Chi-Square and Fisher’s-exact test from open epic version 3.03a. A p-value is significant (<0.001 for PIH, GDM, PPROM and oligohydramnios but

  10. Decreased Risk of Preeclampsia After the Introduction of Universal Voucher Scheme for Antenatal Care and Birth Services in the Republic of Korea.

    Choe, Seung-Ah; Min, Hye Sook; Cho, Sung-Il

    2017-01-01

    Objectives A number of interventions to reduce disparities in maternal health have been introduced and implemented without concrete evidence to support them. In Korea, a universal voucher scheme for antenatal care and birth services was initiated in December 2008 to improve Korea's fertility rate. This study explores the risk of preeclampsia after the introduction of a universal voucher scheme. Methods Population-based cohort data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) covering 2002-2013 were analysed. A generalized linear mixed model (GLMM) was used to estimate the relationship between the risk of preeclampsia and voucher scheme introduction. Results The annual age-adjusted incidence of preeclampsia showed no significant unidirectional change during the study period. In the GLMM analysis, the introduction of a voucher scheme was associated with a reduced risk of preeclampsia, controlling for potential confounding factors. The interaction between household income level and voucher scheme was not significant. Conclusions for Practice This finding suggests that the introduction of a voucher scheme for mothers is related to a reduced risk of preeclampsia even under universal health coverage.

  11. Universal screening for hepatitis B among pregnant women led to 96% vaccination coverage among newborns of HBsAg positive mothers in Denmark

    Harder, Katja Majlund; Cowan, Susan; Eriksen, Mette Brandt

    2011-01-01

    to examine the effectiveness of universal HBV-screening of pregnant women and HBV-immunizations of their newborn, and to provide a prevalence-estimate for HBV in Denmark. On a opt out basis all women in Denmark attending antenatal care were tested for hepatitis B serology. Vaccination data of the newborns...... follow-up two transmissions (0.5%) have been notified. Among children born of the positive mothers prior to the trial-period 7.3% had been notified. Thus the prevalence of HBV positive mothers has more than doubled in Denmark over the last 40 years, but among women of Danish origin it has decreased 10......-fold. By replacing selective screening with universal, identification of newborns in need of HBV-immunization was increased from 50% to almost complete coverage, and also identifies mothers with high viral load for evaluation of pre-term treatment to interrupt in utero transmission....

  12. Universal newborn hearing screening: preliminary experience at the University Hospital of Cagliari

    Giulia Pinna

    2012-10-01

    Full Text Available Bilateral congenital or acquired sensorineural hearing loss is a pathological condition affecting 1-2 children per 1,000 live births; it represents a major issue in public health because its late identification can negatively affect speech and language development. The aim of hearing screening is to obtain diagnosis and management of hearing loss as soon as possible; in fact early diagnosis and treatment allow children with congenital hearing impairment to acquire adequate linguistic competence. The present study reports our preliminary experience in newborn hearing screening at Neonatology services of University of Cagliari (Italy. During the first semester of surveillance, between January 2012 and June 2012, hearing screening was performed on a total of 901 babies using two different methods, TEOAEs in healthy neonates and automated ABR in high-risk babies. All infants were screened prior to hospital discharge; in some cases, especially for preterm infants of Neonatal Intensive Care Unit and Puericulture Institute, the screening was performed after discharge, to achieve a possible better global and acoustic maturation; 5 cases of hearing impairment were found. In the present study the Authors confirmed that it is possible to start a universal hearing screening in a relatively short time reaching the percentages suggested by Joint Committee on Infant Hearing.

  13. [Neonatal screening - the challenge of an universal and effective coverage].

    Botler, Judy; Camacho, Luiz Antônio Bastos; da Cruz, Marly Marques; George, Pâmela

    2010-03-01

    Newborn screening programs (NSP) aim to detect carriers of several congenital diseases among asymptomatic infants in order to warrant effective intervention. Specimen collection is the first step of a process that should be done in an universal and timely manner. A review of coverage and time of collection was done in NSP of several countries. The search was made in various sources, from 1998 to 2008, with "neonatal screening" and "coverage" as key words. The lack of a typical study design did not allow to the rigor required for a systematic review. Data were grouped in macro-regions. Canada had coverage of 71% in 2006 while the European coverage was of 69% in 2004, with data of 38 countries. In Asia and Pacific region, there were data of 19 countries. In Middle East and North Africa, there were data of 4 countries. In Latin America, the coverage was 49% in 2005, with data of 14 countries. In Brazil, coverage was 80%. Twelve reports had information about timeliness. The conclusion is that epidemiological transition has contributed to NSP success. Developed regions had more universal and timelier collection. In Brazil, government initiative increased access to the NSP, but late collections lead to the need of educational actions and participation of professional organizations in developing specific guidelines definition.

  14. [Cost-effectiveness analysis of universal screening for thyroid disease in pregnant women in Spain].

    Donnay Candil, Sergio; Balsa Barro, José Antonio; Álvarez Hernández, Julia; Crespo Palomo, Carlos; Pérez-Alcántara, Ferrán; Polanco Sánchez, Carlos

    2015-01-01

    To assess the cost-effectiveness of universal screening for thyroid disease in pregnant women in Spain as compared to high risk screening and no screening. A decision-analytic model comparing the incremental cost per quality-adjusted life year (QALY) of universal screening versus high risk screening and versus no screening. was used for the pregnancy and postpartum period. Probabilities from randomized controlled trials were considered for adverse obstetrical outcomes. A Markov model was used to assess the lifetime period after the first postpartum year and account for development of overt hypothyroidism. The main assumptions in the model and use of resources were assessed by local clinical experts. The analysis considered direct healthcare costs only. Universal screening gained .011 QALYs over high risk screening and .014 QALYS over no screening. Total direct costs per patient were €5,786 for universal screening, €5,791 for high risk screening, and €5,781 for no screening. Universal screening was dominant compared to risk-based screening and a very cost-effective alternative as compared to no screening. Use of universal screening instead of high risk screening would result in €2,653,854 annual savings for the Spanish National Health System. Universal screening for thyroid disease in pregnant women in the first trimester is dominant in Spain as compared to risk-based screening, and is cost-effective as compared to no screening (incremental cost-effectiveness ratio of €374 per QALY). Moreover, it allows diagnosing and treating cases of clinical and subclinical hypothyroidism that may not be detected when only high-risk women are screened. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

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

    Agan, TU; Ekabua, JE; Udoh, AE; Ekanem, EI; Efiok, EE; Mgbekem, MA

    2010-01-01

    Background: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable. Objective: The aim of this study is to assess the prevalence of anemia in asymptomatic malaria parasitemic women at first antenatal visit in a tertiary hospital facility. Method: The study was conducted at the antenatal clinic of ...

  16. Conducting Universal Complete Mental Health Screening via Student Self-Report

    Moore, Stephanie A.; Widales-Benitez, Oscar; Carnazzo, Katherine W.; Kim, Eui Kyung; Moffa, Kathryn; Dowdy, Erin

    2015-01-01

    Universal screening is increasingly becoming part of prevention and early intervention best practice in schools. Although the number of schools engaging in universal screening has increased over the past decade, emotional and behavioral problems are often their primary focus. Problem-focused screening, however, does not address positive…

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

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

    2011-01-01

    and 5. We used the same fluorescent dye for the exon 7 and 10 probes to increase sensitivity; exon 5 was VIC labeled. We evaluated possible inhibition of DNA amplification with dilution experiments. We then tested the two multiplex assays with DNA extracted from 97 plasma samples from 38 RhD negative......OBJECTIVE: To evaluate two different multiplex real-time PCR assays detecting fetal RHD for screening of RhD negative women in relation to antenatal RhD prophylaxis. METHODS: We designed a duplex assay for the detection of RHD exon 7 and 10 and a triplex assay for the detection of RHD exon 7, 10...... assay (exon 7/10), accuracy was 94.2%. Detection of exon 5 was less reliable. CONCLUSION: The duplex assay using exon 7/10 was the most reliable for prenatal prediction of fetal RhD type as a candidate assay for screening of RhD negative women in relation to antenatal RhD prophylaxis. The triplex assay...

  18. Improving regional universal newborn hearing screening programmes in Italy.

    Molini, E; Cristi, M C; Lapenna, R; Calzolaro, L; Muzzi, E; Ciciriello, E; Della Volpe, A; Orzan, E; Ricci, G

    2016-02-01

    The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  19. Cost Analysis of Universal Screening vs. Risk Factor-Based Screening for Methicillin-Resistant Staphylococcus aureus (MRSA.

    Virginia R Roth

    Full Text Available The literature remains conflicted regarding the most effective way to screen for MRSA. This study was designed to assess costs associated with universal versus risk factor-based screening for the reduction of nosocomial MRSA transmission.The study was conducted at The Ottawa Hospital, a large multi-centre tertiary care facility with approximately 47,000 admissions annually. From January 2006-December 2007, patients underwent risk factor-based screening for MRSA on admission. From January 2008 to August 2009 universal MRSA screening was implemented. A comparison of costs incurred during risk factor-based screening and universal screening was conducted. The model incorporated probabilities relating to the likelihood of being tested and the results of polymerase chain reaction (PCR testing with associated effects in terms of MRSA bacteremia and true positive and negative test results. Inputted costs included laboratory testing, contact precautions and infection control, private room costs, housekeeping, and length of hospital stay. Deterministic sensitivity analyses were conducted.The risk factor-based MRSA screening program screened approximately 30% of admitted patients and cost the hospital over $780 000 annually. The universal screening program screened approximately 83% of admitted patients and cost over $1.94 million dollars, representing an excess cost of $1.16 million per year. The estimated additional cost per patient screened was $17.76.This analysis demonstrated that a universal MRSA screening program was costly from a hospital perspective and was previously known to not be clinically effective at reducing MRSA transmission. These results may be useful to inform future model-based economic analyses of MRSA interventions.

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

    Nwosu BO

    2015-01-01

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

  1. Barriers and facilitators to the implementation of antenatal syphilis screening and treatment for the prevention of congenital syphilis in the Democratic Republic of Congo and Zambia: results of qualitative formative research.

    Nkamba, Dalau; Mwenechanya, Musaku; Kilonga, Arlette Mavila; Cafferata, Maria Luisa; Berrueta, Amanda Mabel; Mazzoni, Agustina; Althabe, Fernando; Garcia-Elorrio, Ezequiel; Tshefu, Antoniette K; Chomba, Elwyn; Buekens, Pierre M; Belizan, Maria

    2017-08-14

    The impact of untreated syphilis during pregnancy on neonatal health remains a major public health threat worldwide. Given the high prevalence of syphilis during pregnancy in Zambia and Democratic Republic of Congo (DRC), the Preventive Congenital Syphilis Trial (PCS Trial), a cluster randomized trial, was proposed to increase same-day screening and treatment of syphilis during antenatal care visits. To design an accepted and feasible intervention, we conducted a qualitative  formative research. Our objective was to identify context-specific  barriers and facilitators to the implementation of antenatal screening and treatment during pregnancy. Qualitative research included in-depth semi-structured interviews with clinic administrators, group interviews with health care providers, and focus groups with pregnant women in primary care clinics (PCCs) in Kinshasa (DRC) and Lusaka (Zambia). A total of 112 individuals participated in the interviews and focus groups. Barriers for the implementation of syphilis testing and treatment were identified at the a) system level: fragmentation of the health system, existence of ANC guidelines in conflict with proposed intervention, poor accessibility of clinics (geographical and functional), staff and product shortages at the PCCs; b) healthcare providers' level: lack of knowledge and training about evolving best practices, reservations regarding same-day screening and treatment; c) Pregnant women level: late enrollment in ANC, lack of knowledge about consequences and treatment of syphilis, and stigma. Based on these results, we developed recommendations for the design of the PCS Trial intervention. This research allowed us to identify barriers and facilitators to improve the feasibility and acceptability of a behavioral intervention. Formative research is a critical step in designing appropriate and effective interventions by closing the "know-do gap".

  2. Universal Versus Targeted Screening for Lynch Syndrome: Comparing Ascertainment and Costs Based on Clinical Experience.

    Erten, Mujde Z; Fernandez, Luca P; Ng, Hank K; McKinnon, Wendy C; Heald, Brandie; Koliba, Christopher J; Greenblatt, Marc S

    2016-10-01

    Strategies to screen colorectal cancers (CRCs) for Lynch syndrome are evolving rapidly; the optimal strategy remains uncertain. We compared targeted versus universal screening of CRCs for Lynch syndrome. In 2010-2011, we employed targeted screening (age Lynch syndrome and estimated the 5-year costs of preventing CRC by colonoscopy screening, using a system dynamics model. Using targeted screening, 51/175 (29 %) cancers fit criteria and were tested by immunohistochemistry; 15/51 (29 %, or 8.6 % of all CRCs) showed suspicious loss of ≥1 mismatch repair protein. Germline mismatch repair gene mutations were found in 4/4 cases sequenced (11 suspected cases did not have germline testing). Using universal screening, 17/292 (5.8 %) screened cancers had abnormal immunohistochemistry suspicious for Lynch syndrome. Germline mismatch repair mutations were found in only 3/10 cases sequenced (7 suspected cases did not have germline testing). The mean cost to identify Lynch syndrome probands was ~$23,333/case for targeted screening and ~$175,916/case for universal screening at our institution. Estimated costs to identify and screen probands and relatives were: targeted, $9798/case and universal, $38,452/case. In real-world Lynch syndrome management, incomplete clinical follow-up was the major barrier to do genetic testing. Targeted screening costs 2- to 7.5-fold less than universal and rarely misses Lynch syndrome cases. Future changes in testing costs will likely change the optimal algorithm.

  3. Antenatal Bartter syndrome.

    Afzal, Muhammad; Khan, Ejaz A; Khan, Wisal A; Anwar, Viqas; Yaqoob, Asma; Rafiq, Shahid; Azam, Shaheena

    2014-05-01

    Antenatal Bartter syndrome is characterized by severe polyhydramnios in mother leading to premature delivery. Antenatal treatment has proven effective to prevent these problems. Postnatally newborns suffer from recurrent episodes of severe dehydration and electrolyte imbalance which can lead to fatal outcome. These manifestations are likely to be overlooked and missed under the umbrella of diagnosis of prematurity. This premature newborn with antenatal polyhydramnios had severe manifestations of polyuria, recurrent dehydration, electrolyte derangements and metabolic alkalosis. She was managed accordingly but unfortunately could not survive beyond 4 weeks.

  4. Contraceptive‑seeking Behavior of Women Attending Antenatal ...

    Department of Community Medicine, Abia State University Teaching Hospital, Aba, 1Department of Public ... cross‑sectional study of 430 antenatal women using structured self‑administered ... KEY WORDS: Antenatal, contraception, population control Nigeria ... hence, the need to study the contraceptive-seeking behavior.

  5. Screening for Cervical Cancer: Experience from a University ...

    KEY WORDS: Cervical cancer, cervical cytology, north-west Nigeria. Access this article .... involving a larger sample size will give better picture about the prevalent of ... Ridsdale LL. Cervical screening in general practice: Call and recall. J R.

  6. Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

    Solanke Olumuyiwa A

    2009-09-01

    Full Text Available Abstract Background Emerging evidence from a recent pilot universal newborn hearing screening (UNHS programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme. Methods A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses. Results Of the 4615 mothers enrolled, 2584 (56.0% deliveries were vaginal, 1590 (34.4% emergency caesarean and 441 (9.6% elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared

  7. Colorectal Cancer Screening: Knowledge, Perceived Benefits and Barriers, and Intentions among College and University Employees

    Bajracharya, Srijana M.; Wigglesworth, Janet K.

    2013-01-01

    Background: Early detection through routine screening is critical in reducing the incidence rate of colorectal cancer (CRC). Purpose: The purpose of this study was to examine college and university employees' knowledge of CRC issues, their perceptions of the benefits of and barriers to CRC screening, and their intentions toward it. Methods: This…

  8. Asymptomatic bacteriuria in antenatal women

    Lavanya S

    2002-01-01

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

  9. The prevalence and risk factors for Trichomonas vaginalis infection amongst human immunodeficiency virus-infected pregnant women attending the antenatal clinics of a university teaching hospital in Lagos, South-Western, Nigeria.

    Ijasan, Olaolopin; Okunade, Kehinde Sharafadeen; Oluwole, Ayodeji Ayotunde

    2018-01-01

    Trichomonas vaginalis infection is the most prevalent non-viral sexually transmitted infection worldwide. Interactions between this infection and human immunodeficiency virus (HIV) may cause adverse pregnancy outcomes such as preterm labour, premature rupture of membranes, chorioamnionitis, low birth weight and post-abortal sepsis. This study was aimed to determine the prevalence and risk factors of T. vaginalis infection amongst HIV-positive pregnant women attending antenatal care at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. This was an analytical cross-sectional study in which 320 eligible participants which included 160 HIV-positive (case group) and 160 HIV-negative (control group) pregnant women were recruited at the antenatal clinic of LUTH. A structured pro forma was used to collect data from consenting participants after which high vaginal swabs were collected, processed and examined for T. vaginalis. The association between categorical variables was tested using the Chi-square test and Fisher's exact test where applicable. All significances were reported at P women were 10% and 8.1%, respectively (P = 0.559). Significant risk factors for T. vaginalis infection in the HIV-positive pregnant women were early coitarche (P women for T. vaginalis infection as a tool of reducing HIV acquisition, especially in pregnancy, campaign to create better sexual health awareness should be commenced as a way to contributing to the reduction in T. vaginalis infection during pregnancy and perinatal transmission of HIV.

  10. Self-Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST).

    Sandhu, Amindeep; Mosli, Mahmoud; Yan, Brian; Wu, Thomas; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Beaton, Melanie; Rahman, Adam

    2016-05-01

    Malnutrition is common in patients with inflammatory bowel disease (IBD) and is associated with poor outcomes. Our aim is to determine if patient self-administered malnutrition screening using the malnutrition universal screening tool (MUST) is reliable by comparing patient scores with those derived from the healthcare practitioner (HCP), the gold standard. We conducted a prospective validation study at a tertiary Canadian academic center that included 154 adult outpatients with IBD. All patients with IBD completed a self-administered nutrition screening assessment using the MUST score followed by an independent MUST assessment performed by HCPs. The main outcome measure was chance-corrected agreement (κ) of malnutrition risk categorization. For patient-administered MUST, the chance-corrected agreement κ (95% confidence interval [CI]) was 0.83 (0.74-0.92) when comparing low-risk and combined medium- and high-risk patients with HCP screening. Weighted κ analysis comparing all 3 risks groups yielded a κ (95% CI) of 0.85 (0.77-0.93) between patient and HCP screening. All patients were able to screen themselves. Overall, 96% of patients reported the MUST questionnaire as either very easy or easy to understand and to complete. Self-administered nutrition screening in outpatients with IBD is valid using the MUST screening tool and is easy to use. If adopted, this tool will increase utilization of malnutrition screening in hectic outpatient clinic settings and will help HCPs determine which patients require additional nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

  11. Antenatal care--antenatal screening for fetal abnormality.

    Baston, Helen

    2003-02-01

    JOANNA IS NOW 24 WEEKS pregnant. She is feeling very well and finding that now her energy has returned, she is really enjoying being preganant. She still proudly shows her precious scan picture to interested friends and takes the occasional glance herself during quiet moments. Joanna, has a cousin, Susan, who has Down's syndrome. Susan is a happy and loving child who has brought a lot of joy, as well as heartache, to the extended family. Although Joanna has no delusions about the hard work and continuing care that her cousin requires, she would not herself contemplate terminating a pregnancy if her baby had the condition.

  12. Accuracy of quick and easy undernutrition screening tools--Short Nutritional Assessment Questionnaire, Malnutrition Universal Screening Tool, and modified Malnutrition Universal Screening Tool--in patients undergoing cardiac surgery

    van Venrooij, Lenny M. W.; van Leeuwen, Paul A. M.; Hopmans, Wendy; Borgmeijer-Hoelen, Mieke M. M. J.; de Vos, Rien; de Mol, Bas A. J. M.

    2011-01-01

    The objective of this study was to compare the quick-and-easy undernutrition screening tools, ie, Short Nutritional Assessment Questionnaire and Malnutrition Universal Screening Tool, in patients undergoing cardiac surgery with respect to their accuracy in detecting undernutrition measured by a

  13. Minimal impact by antenatal subpatent P. falciparum infections on delivery outcomes in Malawian women: a cohort study.

    Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; vanEijk, Anna; Mwapasa, Victor; terKuile, Feiko; Meshnick, Steven R

    2017-01-01

    Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of RDT-positive women may potentially prevent low birthweight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity were tested at each antenatal visit for P. falciparum using RDT and PCR and followed until delivery. Associations between antenatal infections and delivery outcomes were as...

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

    Al-Ateeq MA

    2015-02-01

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

  15. Screened Coulomb interactions in metallic alloys. I. Universal screening in the atomic-sphere approximation

    Ruban, Andrei; Skriver, Hans Lomholt

    2002-01-01

    We have used the locally self-consistent Green's-function (LSGF) method in supercell calculations to establish the distribution of the net charges assigned to the atomic spheres of the alloy components in metallic alloys with different compositions and degrees of order. This allows us to determine......-site local interaction zone. We demonstrate that the basic mechanism that governs the charge distribution is the screening of the net charges of the alloy components that makes the direct Coulomb interactions short ranged. In the atomic-sphere approximation, this screening appears to be almost independent...

  16. Point-of-care screening for hepatitis B virus infection in pregnant women at an antenatal clinic: A South African experience.

    Nafiisah Chotun

    Full Text Available Elimination of HIV and syphilis mother-to-child transmission (MTCT has received much attention but little consideration has been given to the possibility of elimination of HBV MTCT. In sub-Saharan Africa, HBV vertical transmission continues to be reported and it remains an important public health problem. This study aimed to assess the feasibility of screening pregnant women for HBV using a point-of-care (POC test and implementing interventions to prevent HBV MTCT.In this observational prospective cohort study, HIV-uninfected pregnant women who consented to testing were screened for HBV using a rapid POC test for HBsAg. Positive results were laboratory-confirmed and tested for HBV DNA and serological markers. Women with viral loads ≥ 20 000 IU/ml received tenofovir (TDF treatment and all infants received birth-dose HBV vaccine. Two blood samples collected six months apart from HBV-exposed infants within their first year of life were tested for HBV DNA.Of 144 women who were approached, 134 consented to participating (93% acceptance rate of HBV POC test. Six women tested positive for HBsAg (4.5%; 95% CI 0.99%-8.01%, all confirmed by laboratory testing. Two mothers, M1 and M4, were treated with TDF during their third trimester of pregnancy. Six HBV-exposed infants received the HBV vaccine within 24 hours of birth, of whom two were lost to follow-up and four (including the two born to M1 and M4 had undetectable levels of HBV DNA when tested at the two time points.We found that HBV screening using POC testing fulfilled the criteria considered necessary for implementation. It has acceptable performance, is inexpensive, reliable, and was well accepted by the study participants. Screening pregnant women as part of the HBV MTCT prevention strategy is therefore feasible in a South African clinical setting.

  17. Income Disparities in the Use of Health Screening Services Among University Students in Korea

    Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

    2016-01-01

    Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend income level was 0.45 (0.31–0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of

  18. Incidence of Antenatal Trichomoniasis and Evaluation of Its Role as a Cause of Preterm Birth in Pregnant Women Referring to Minia University Hospital, Egypt

    Amany Mohamed KAMAL

    2018-03-01

    Full Text Available Background: We aimed to determine the incidence of trichomoniasis and its risk factors in Egyptian pregnant women attending the Minia Maternity and Pediatric University Hospital, Minia, Egypt and evaluate its association with preterm birth.Methods: The study was carried out from Aug 2014 to Jun 2015 through 2 phases, the first phase was case-control study, and the second phase was follow-up with intervention. Overall, 300 pregnant women with gestational age of 20-36 weeks with no medical risk factors of preterm labour birth were enrolled. Vaginal swabs were examined by the wet mount microscopy and culture while urine samples were examined by urine analysis. Demographic information was collected. Pregnant women were divided into two groups, study group (with trichomoniasis and control group (without trichomoniasis. Positive cases were subjected to metronidazole treatment.Results: Thirty-five cases were positive for T. vaginalis infection. Maximum cases were detected by culture (11.7% followed by wet mount microscopy (9.7% whereas least number of cases (7.3% was detected by urine examination. Nineteen (54.28% cases had preterm delivery. Post-delivery adverse outcomes were observed in 29 cases (82.8%. The high rate of infection was observed in age group of 20-30 years (P<0.05. In addition, there was a signifi­cant T. vaginalis infection in pregnant women living in rural area, of low socioeconomic and primary educa­tional levels (P<0.05.Conclusion: pregnant women lived in rural area with a low socioeconomic and primary educational levels should be screened for trichomoniasis to reduce the incidence of preterm delivery and low birth weight.

  19. Minimal Impact by Antenatal Subpatent Plasmodium falciparum Infections on Delivery Outcomes in Malawian Women: A Cohort Study.

    Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M; Mwapasa, Victor; Ter Kuile, Feiko O; Meshnick, Steven R

    2017-08-01

    Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity status were tested at each antenatal visit for Plasmodium falciparum, using an RDT and polymerase chain reaction analysis, and were followed until delivery. Associations between antenatal infections and delivery outcomes were assessed with Poisson regression or analysis of variance. Compared with women with no detected antenatal P. falciparum infection, women with positive RDT findings delivered babies with a lower mean birth weight (2960 vs 2867 g; mean difference, -93 g [95% confidence interval {CI}, -27 to -159]; P = .006); this was not observed among women with only subpatent infections (mean birth weight, 3013 g; mean difference, 54 [95% CI, -33-140]; P = .2268). These differences were apparent early in pregnancy, during the second trimester: compared with uninfected women, women with positive RDT findings delivered babies with a lower mean birth weight (mean difference, -94 g [95% CI, -31 to -156]; P = .003), but women with subpatent infections did not (mean difference, 36 g [95% CI, -49-122]; P = .409). Subpatent antenatal P. falciparum infections were not associated with adverse delivery outcomes. The association of patent infections at enrollment with low birth weight suggests the importance of preventing P. falciparum infection early in pregnancy. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  20. Risk factors for major antenatal depression among low-income African American women.

    Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R

    2009-11-01

    Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.

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

    Coulter-Smith, S

    2010-01-01

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

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

    Coulter-Smith, S

    2012-02-01

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

  3. Prevalence of gingivitis and perception of gingival colour among pregnant women attending the antenatal clinic of Lagos University Teaching Hospital, Idi-Araba

    Modupeoluwa Omotunde Soroye

    2016-01-01

    Full Text Available Objective: To determine the prevalence of gingivitis and perception of gingival colour among pregnant women attending the antenatal clinic of a tertiary health institution in Lagos State, Nigeria. Materials and Methods: A single-point assessment was conducted using a self-reported questionnaire completed by participants. Information such as patients′ age, gestational age, educational status, occupation, and perception of gingival colours was obtained. Furthermore, the participants were examined by trained dentists to determine their gingival colours and the presence and severity of gingival inflammation. The data obtained were processed, and descriptive and comparative analyses were done using Epi info version 3.5.1 (2008. Statistical significance was established at P values <0.05. Results: Four hundred and forty-five pregnant women aged between 18 years and 43 years [mean age: 30.3 (±4.61 years] participated in the study. Gestational age was between 4 weeks and 41 weeks with a mean of 23.49 (±9.53 weeks. The prevalence of gingivitis was 85.2%. Two hundred and thirty (51.7% participants described their gingival colour as pink, 127 (28.5% as red, 51 (11.5% as black, 3 (0.7% as white, 2 (0.4% as brown, and 32 (7.2% could not determine the colour of their gingivae. Two hundred and ten (47.2% participants knew that pink was the normal colour of a healthy gingiva. From objective clinical examinations by dentists, 344 (77.3% patients had pink gingivae, 85 (19.1% had pigmented gingivae, and only 16 (3.6% had red gingivae. Conclusion: The higher prevalence of gingivitis during pregnancy is well-established and that observation is corroborated by this study. Since a change in gingival colour may be an early indication of gingival inflammation, early detection and prompt treatment could prevent further periodontal deterioration. Hence, there is the need to incorporate and intensify oral health education during antenatal care so that pregnant women are

  4. Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa.

    Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties

    2018-01-01

    Syphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the 'likelihood of appropriate care' for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries. In this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the 'likelihood of appropriate care'. Based on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7-32%). The largest implementation bottleneck identified was low

  5. Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

    Haviland, Miriam J; Shainker, Scott A; Hacker, Michele R; Burris, Heather H

    2016-01-01

    Objective Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. Methods Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January, 2012 through November, 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥ 20 weeks' gestation) screening vs. optimally-timed screening between the different racial and ethnic groups. Results Among the 2 967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI:1.1-1.5) and Hispanic (RR:1.2; 95% CI:1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (vs. white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). Conclusions Black and Hispanic women may be more likely to have missed or late cervical length screenings. PMID:26987873

  6. A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision.

    Todahl, Jeffrey L; Linville, Deanna; Chou, Liang-Ying; Maher-Cosenza, Patricia

    2008-01-01

    Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.

  7. Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire, Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service.

    Rabito, Estela Iraci; Marcadenti, Aline; da Silva Fink, Jaqueline; Figueira, Luciane; Silva, Flávia Moraes

    2017-08-01

    There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality. A specific questionnaire was administered to complete the 4 screening tools. Outcomes measures included length of hospital stay, transfer to the intensive care unit, presence of infection, and incidence of death. A total of 752 patients were included. The nutrition risk was 29.3%, 37.1%, 33.6%, and 31.3% according to the NRS-2002, MUST, MST, and SNAQ, respectively. All screening tools showed satisfactory performance to identify patients at nutrition risk (area under the receiver operating characteristic curve between 0.765-0.808). Patients at nutrition risk showed higher risk of very long length of hospital stay as compared with those not at nutrition risk, independent of the tool applied (relative risk, 1.35-1.78). Increased risk of mortality (2.34 times) was detected by the MUST. The MUST, MST, and SNAQ share similar accuracy to the NRS-2002 in identifying risk of malnutrition, and all instruments were positively associated with very long hospital stay. In clinical practice, the 4 tools could be applied, and the choice for one of them should be made per the particularities of the service.

  8. Prevalence, Specificity and Titration of Red Cell Alloantibodies in Multiparous Antenatal Females at a Tertiary Care Centre from North India

    Sidhu, Meena; Bala, Renu; Akhtar, Naveen; Sawhney, Vijay

    2015-01-01

    Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 a...

  9. REVIEW OF FOCUSSED ANTENATAL CARE

    Sreelatha

    2015-09-01

    Full Text Available INTRODUCTION: Antenatal care is a comprehensive antepartum programme which involves a coordinated approach to medical care , continuous risk assessment , and psychological support that optimally begins before conception and extends throughout the postpartum period and int erconceptional period . [1] One of major responsibility of obstetrician providing antenatal care is to identify high risk factors based on past history, examination and investigation results. The objective of antenatal care therefore is to assure that every wanted pregnancy results in the delivery of a healthy baby without impairing the mothers health . [2] In a 1914 study by Williams antenatal care reduced fetal mortality by 40%

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

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

    2012-01-01

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

  11. (HIV) infection among pregnant women in an antenatal clinic in Port

    Women attending ante-natal clinic in Nigeria are routinely screened for HIV/AIDS. A retrospective study was conducted between 2000 and 2004 to investigate the prevalence of the human immunodeficiency virus (HIV) infection among pregnant women attending ante-natal clinic in Braithwalte Memorial Hospital (BMH), Port ...

  12. Polish universal neonatal hearing screening program-4-year experience (2003-2006).

    Szyfter, Witold; Wróbel, Maciej; Radziszewska-Konopka, Marzanna; Szyfter-Harris, Joanna; Karlik, Michał

    2008-12-01

    The aim of this paper is to share our experience and observations in running the Universal Neonatal Hearing Screening Program on a national level, present results and indicate some problems that have arisen during these 4 years. Polish Universal Neonatal Hearing Screening Program started back in 2002 in all neonatal units in Poland. Implemented testing methods consisted of test of transient evoked otoacoustic emission (TEOAE) performed in all new born children in their first 2-3 days of life and auditory brainstem response testing (ABR) conducted on children, who did not meet the TEOAE pass criteria. Additional questionnaire registered information on ototoxic drugs and family history of hearing impairment in every newborn. Diagnosed children were further referred for treatment and rehabilitation. After 4 years of running the program (between 2003 and 2006) a total number of 1,392,427 children were screened for hearing impairment, what stands for 96.3% of all delivered babies, registered in Poland. The screening program enabled to identify and refer for further treatment 2485 children with various types of hearing loss, 312 with profound (0.02% of population) and 145 with severe sensorineural hearing loss (0.11% of population). Our results indicate the accuracy of newborn hearing screening which remain an issue. Although improvement is needed in both intervention systems and diagnostic follow-up of hospitals, the Polish Universal Neonatal Hearing Program fully has achieved the main goal, the identification and treatment of hearing impaired children.

  13. Cervical Cancer Knowledge, Perceptions and Screening Behaviour Among Female University Students in Ghana.

    Binka, Charity; Nyarko, Samuel H; Doku, David T

    2016-06-01

    Cervical cancer is becoming a leading cause of death among women in developing countries. Nevertheless, little is known regarding knowledge and perception of cervical cancer and screening behaviour particularly among female tertiary students in Ghana. This study sought to examine the knowledge and perceptions of cervical cancer and screening behaviour among female students in the University of Cape Coast and Ghana Institute of Management and Public Administration in Ghana. A cross-sectional survey design was adopted for the study. Systematic and stratified random sampling techniques were used to select 410 participants for the study. The study found that the participants lacked knowledge on specific risk factors and symptoms of cervical cancer. Also, even though the participants had a fair perception of cervical cancer, they had a poor cervical cancer screening behaviour. Awareness of cervical cancer was significantly influenced by religious affiliation while cervical cancer screening was significantly determined by the working status of the participants. Specific knowledge on cervical cancer and its risk factors as well as regular screening behaviour is paramount to the prevention of cervical cancer. Consequently, the University Health Services should focus on promoting regular cervical cancer awareness campaigns and screening among the students particularly, females.

  14. Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida

    Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa

    2017-01-01

    Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…

  15. Validation of the Rowland Universal Dementia Assessment Scale for Multicultural Screening in Danish Memory Clinics

    Nielsen, Thomas Rune; Andersen, Birgitte Bo; Gottrup, Hanne

    2013-01-01

    Background/Aims: The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study...

  16. English Language Screening for Scientific Staff at Delft University of Technology,

    Klaassen, R.G.; Bos, M.H.P.C.

    2010-01-01

    Delft University of Technology (DUT) screened her (non-native English) scientific staff on their level of English proficiency in the academic year of 2006/2007. In this paper this large scale operation, involving planning, policy decisions, assessment means, advice and training are discussed. Since

  17. Generalizability Theory Reliability of Written Expression Curriculum-Based Measurement in Universal Screening

    Keller-Margulis, Milena A.; Mercer, Sterett H.; Thomas, Erin L.

    2016-01-01

    The purpose of this study was to examine the reliability of written expression curriculum-based measurement (WE-CBM) in the context of universal screening from a generalizability theory framework. Students in second through fifth grade (n = 145) participated in the study. The sample included 54% female students, 49% White students, 23% African…

  18. Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

    Klein, Michael C.; Ciotoli, Carlo; Chung, Henry

    2011-01-01

    Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between…

  19. Implementing Universal Maternal Depression Screening in Home Visiting Programs: A Pragmatic Overview

    Segre, Lisa S.; Taylor, Darby

    2014-01-01

    Maternal depression, although prevalent in low-income women, is not an inevitable consequence of poverty. Nevertheless, depression is a double burden for impoverished women: compromising infant development and diminishing mothers' ability to benefit from or effectively use home visiting services. Without universal screening, depression is often…

  20. Disparities in universal prenatal screening for group B streptococcus--North Carolina, 2002-2003.

    2005-07-22

    Group B streptococcus (GBS) is a leading cause of neonatal morbidity and mortality in the United States. Intrapartum antibiotics administered to women at risk for transmitting GBS to their newborns are effective in preventing perinatal GBS infection. In 2002, CDC, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists recommended universal prenatal screening for vaginal and rectal GBS colonization at 35-37 weeks' gestation. To examine prenatal GBS screening among pregnant women in North Carolina, CDC analyzed 2002 and 2003 data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The proportions of women reporting prenatal screening for GBS were similar in 2002 and 2003 (70% and 74%, respectively); however, for both years, women of Hispanic ethnicity and women who received prenatal care at a hospital or health department clinic were less likely to report prenatal screening for GBS. These findings underscore the need to increase GBS-related education and prevention activities targeted to these populations.

  1. Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia.

    Mohamad Yusuff, Aza Sherin; Tang, Li; Binns, Colin W; Lee, Andy H

    2016-01-01

    To investigate the prevalence of antenatal depression and to assess whether the common risk factors identified in previous studies were applicable to women in Sabah, Malaysia. A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation to complete a self-administered questionnaire regarding their demographic, socioeconomic and health characteristics. The presence of depression was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. The prevalence of antenatal depression was 13.8% [95% confidence interval (CI) 12.3%, 15.3%]. Women who were happy with the pregnancy [odds ratio (OR) 0.43, 95% CI 0.21, 0.89] and those with a planned pregnancy (OR 0.45, 95% CI 0.33, 0.60) were less likely to suffer from antenatal depression. Pregnant mothers who were taking oral contraceptives before pregnancy (OR 1.63, 95% CI 1.20, 2.22) and women who experienced antenatal anxiety (OR 3.17, 95% CI 2.35, 4.26) appeared to have an increased risk of antenatal depression. A substantial proportion of women suffered from antenatal depression in Sabah, Malaysia. Screening and culturally tailored intervention programs targeting vulnerable subgroups of women in the early stage of pregnancy are recommended to deal with the problem.

  2. Astrophysical tests of gravity: a screening map of the nearby universe

    Cabré, Anna; Vikram, Vinu; Jain, Bhuvnesh [Center for Particle Cosmology, Department of Physics and Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, PA 19104-6396 (United States); Zhao, Gong-Bo; Koyama, Kazuya, E-mail: annanusca@gmail.com, E-mail: vinu@sas.upenn.edu, E-mail: gong-bo.zhao@port.ac.uk, E-mail: bjain@physics.upenn.edu, E-mail: Kazuya.Koyama@port.ac.uk [Institute of Cosmology and Gravitation, University of Portsmouth, Dennis Sciama Building, Burnaby Road, Portsmouth, PO1 3FX (United Kingdom)

    2012-07-01

    Astrophysical tests of modified gravity theories in the nearby universe have been emphasized recently by Hui 2009 and Jain 2011. A key element of such tests is the screening mechanism whereby general relativity is restored in massive halos or high density environments like the Milky Way. In chameleon theories of gravity, including all f(R) models, field dwarf galaxies may be unscreened and therefore feel an extra force, as opposed to screened galaxies. The first step to study differences between screened and unscreened galaxies is to create a 3D screening map. We use N-body simulations to test and calibrate simple approximations to determine the level of screening in galaxy catalogs. Sources of systematic errors in the screening map due to observational inaccuracies are modeled and their contamination is estimated. We then apply our methods to create a map out to 200 Mpc in the Sloan Digital Sky Survey footprint using data from the Sloan survey and other sources. In two companion papers this map will be used to carry out new tests of gravity using distance indicators and the disks of dwarf galaxies. We also make our screening map publicly available.

  3. practice of antenatal clinical breast examination in calabar

    user

    population of breast cancer patients in the country than in the west led to this study to determine the proportion of women ... UCTH is low and is significantly related to the cadre and gender of the attending physician. Obstetricians .... regular role nurses play in the antenatal clinics) ... breast and cervical cancer screening? J.

  4. Clients satisfaction of antenatal care services in public and private ...

    Background: Antenatal care involves screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective and educating pregnant women about planning for safe birth. Quality and customer service have been ...

  5. Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

    Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

    2013-04-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

  6. ROUTINE ANTENATAL SYPHILIS SCREENING IN SOUTH WEST ...

    INTRODUCTION. Syphilis, caused by infection with Treponema pallidum, is a muco-cutaneous sexually transmitted infection (STI) with high infectivity in the early stages. It may also be passed transplacentally from the ninth week of gesta- tion onwards1. The basic pathology in all stages is vas- culitis2.Untreated maternal ...

  7. Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

    Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

    2016-12-01

    A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

  8. Improving Universal Suicide Prevention Screening in Primary Care by Reducing False Negatives

    2017-09-01

    craig.bryan@utah.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) University of Utah 8. PERFORMING ORGANIZATION REPORT...screening methods by reducing false negative rates; and (c) to systematically quantify false negative rates across various patient subgroups (e.g., gender ...c) to systematically quantify false negative rates across various patient subgroups (e.g., gender , race, age, deployment history, etc.) to identify

  9. Knowledge, Attitude, and Satisfaction of University Students Regarding Premarital Screening Programs in Kuwait

    Khaled Al-Enezi

    2017-12-01

    Full Text Available The prevalence of genetic blood disorders is high, ranging from 10-25%, in Kuwait. This high prevalence is mainly due to a preventable cause, namely, consanguineous marriages. One of the most successful programs in Kuwait implemented to reduce such high prevalence is premarital screening program. The aim of the study was to determine the level of knowledge, attitude and satisfaction among university students regarding premarital screening program, and to find out the factors influencing knowledge, attitude, and satisfaction of the people toward premarital screening program. A cross-sectional study was conducted among 809 students of Kuwait University during July-October 2016. A self-administered questionnaire including 51 questions was handed out to the participants after taking informed consent. The main outcome variables of this study were: knowledge of hereditary diseases, premarital screening, attitude, and satisfaction toward premarital screening program. The mean ± SD of knowledge score about hereditary diseases was 5.80 ± 2.9 out of a total of 14, and the knowledge score for premarital screening was 3.99 ± 1.2 out of 6. In univariate analysis, knowledge scores about hereditary diseases were significantly associated with marital status (P = 0.043, education in medical faculties (P < 0.001, higher education of father (P = 0.027, higher education of mother (P = 0.001, and presence of hereditary disease in the family (P = 0.003. The level of attitude toward premarital screening program was significantly associated with female gender (P < 0.001, marital status (P = 0.023, higher years of study (P = 0.002, higher family income (P = 0.019. In multivariate analysis, education in medical faculties and presence of hereditary disease in the family were significant predictors of knowledge about hereditary disease. This study identified some demographic factors which determined the outcome of knowledge about premarital screening and hereditary

  10. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study.

    Mekuria, Abebe Basazn; Erku, Daniel Asfaw; Gebresillassie, Begashaw Melaku; Birru, Eshetie Melese; Tizazu, Balem; Ahmedin, Alima

    2017-02-01

    Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia METHODS: An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. From 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17-6.14), illiteracy (AOR: 4.05, CI: 2.47-6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221-7.77) were found to be strong predictors of herbal medicine use. The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.

  11. [Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

    Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

    2017-04-01

    On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

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

    TU Agan; JE Ekabua; AE Udoh; et al

    2010-01-01

    TU Agan1, JE Ekabua1, AE Udoh1, EI Ekanem1, EE Efiok1, MA Mgbekem21Department of Obstetrics and Gynecology, 2Department of Nursing, College of Medical Sciences, University of Calabar, NigeriaBackground: Anemia in pregnancy in malaria endemic areas is a public health challenge that has contributed either directly or indirectly to maternal morbidity and mortality in our environment. Anemia and malaria during pregnancy are highly preventable and treatable.Objective: The aim of this study is to a...

  13. Revised guidelines on management of antenatal hydronephrosis

    Sinha, A.; Bagga, A.; Krishna, A; Bajpai, M.; Srinivas, M.; Uppal, R.; Agarwal, I.

    2013-01-01

    Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. The present guidelines update the recommendations published in 2000. Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. All patients with ANH should undergo postnatal ultrasonography; the intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux (VUR). Infants with VUR should receive antibiotic prophylaxis through the first year of life, and their parents counseled regarding the risk of urinary tract infections. The management of patients with pelviureteric junction or vesicoureteric junction obstruction depends on clinical features and results of sequential ultrasonography and radionuclide renography. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. Further studies are necessary to clarify the role of prenatal intervention, frequency of follow-up investigations and indications for surgery in these patients. PMID:23716913

  14. Identifying the women at risk of antenatal anxiety and depression: A systematic review.

    Biaggi, Alessandra; Conroy, Susan; Pawlby, Susan; Pariante, Carmine M

    2016-02-01

    Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Sexual behavior survey and screening for chlamydia and gonorrhea in university students in South Korea.

    Lee, Seung-Ju; Cho, Yong-Hyun; Ha, U-Syn; Kim, Sae Woong; Yoon, Moon Soo; Bae, Kyunghee

    2005-02-01

    The purpose of the present study was to define the prevalence of genital Chlamydia trachomatis and Neisseria gonorrhoeae infections and status of sexual risk behavior among university students (18-25 years old) in the capital region of South Korea. Participants filled out a self-administered questionnaire related to sexuality. First-void urine was analyzed for chlamydial and gonococcal infection by strand displacement amplification (BDProbTecET, BD Diagnostic Systems, MD). A total of 622 students from 15 colleges in three universities took part in the study. The median age was 21 and 39.1% of them reported having sexual intercourse at least once. The prevalence of C. trachomatis among sexually active men and women was 8.4% and 10.6%, respectively. Gonococcal infection was noted in one symptomatic male. Factors significantly associated with infection were the number of sexual partners during past year and lifetime and condom use. This is the first sexually transmitted infection (STI) screening in university students in South Korea. Urine-based STI screening was both feasible and acceptable in university students in South Korea. It should be considered a routine part of programs to control STI nationally.

  16. Screens

    2016-01-01

    This Sixth volume in the series The Key Debates. Mutations and Appropriations in European Film Studies investigates the question of screens in the context both of the dematerialization due to digitalization and the multiplication of media screens. Scholars offer various infomations and theories of topics such as the archeology of screen, film and media theories, contemporary art, pragmatics of new ways of screening (from home video to street screening).

  17. perception and satisfaction with quality of antenatal care services ...

    of this new focus, measurement of customer satisfaction has become equally important in assessing ... Objectives: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH), ..... National Health Insurance Scheme (NHIS), waivers for staff of the UCH and for People Living with.

  18. Toxoplasmosis among pregnant women attending antenatal clinic in ...

    Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and ...

  19. Socio-demographic determinants of antenatal clinic utilization in a ...

    Socio-demographic determinants of antenatal clinic utilization in a Nigerian university teaching hospital. ... CONCLUSION:Among other social factors female education improved women's ability to take decisions on reproductive matters. Poor education and low socioeconomic status not only increase women's vulnerability ...

  20. Communication of carrier status information following universal newborn screening for sickle cell disorders and cystic fibrosis: qualitative study of experience and practice.

    Kai, J; Ulph, F; Cullinan, T; Qureshi, N

    2009-11-01

    To describe and explore current practice, methods and experience of communicating carrier status information following newborn screening for cystic fibrosis (CF) and sickle cell (SC) disorders, to inform practice and further research. Three linked qualitative studies. All nine health regions in England. Child health screening coordinators in all English health regions, health professionals communicating results to parents and parents of newborn carriers. A preliminary phase of semi-structured telephone interviews with child health screening coordinators in all nine English health regions, and thematic analysis of data; semi-structured face-to-face interviews with purposeful samples of 67 family members of 51 infants identified by universal newborn screening as carriers of CF or SC with data analysis by constant comparison; and semi-structured telephone interviews, and focus groups, with a key informant sample of 16 differing health professionals currently tasked with communicating results to parents in a range of ways, with thematic analysis of data. Methods for and respondents' experiences of communication of carrier results varied considerably within and between regions, and within and between SC and CF contexts. Approaches ranged from letter or telephone call alone, to in-person communication in the clinic or at home, with health professionals from haemoglobinopathy, CF, screening and genetics backgrounds, or from community and primary care, such as health visitors with SC carrier results. Health professionals identified pros and cons of different methods, preferring opportunity for face-to-face communication with parents where possible, particularly for CF carrier results. They were concerned by regional variations in protocols, the lack of availability of translated information on SC carrier results, and the feasibility of sustaining more 'specialist' involvement at current levels, particularly for SC carriers. Parents were often poorly prepared for the

  1. Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening.

    Wroblewska-Seniuk, Katarzyna; Dabrowski, Piotr; Greczka, Grazyna; Szabatowska, Katarzyna; Glowacka, Agata; Szyfter, Witold; Mazela, Jan

    2018-02-01

    The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects. A retrospective analysis of infants diagnosed with hearing deficit based on the database of the universal newborn hearing screening program and medical records of the patients. 27 935 infants were covered by the universal neonatal hearing screening program. 109 (0.39%) were diagnosed with hearing deficit and referred for treatment and rehabilitation. 56 (51.4%) children were diagnosed with conductive, 38 (34.9%) with sensorineural and 15 (13.8%) with mixed type of hearing deficit. Children with sensorineural hearing deficit more frequently suffered from hyperbilirubinemia (p conductive hearing loss were more frequently diagnosed with isolated craniofacial anomalies (p hearing deficit occurred almost 3 times more often bilaterally than unilaterally (p hearing deficit, the difference was not significant. In children with conductive and mixed type of hearing loss the impairment was mainly mild while among those with sensorineural hearing deficit in almost 45% it was severe and profound (p hearing screening test by means of otoacoustic emissions and the final diagnosis of hearing deficit we found that the highest agreement rate was observed in children with sensorineural hearing loss (p hearing deficit was similar in children with sensorineural, conductive and mixed type of hearing loss, only hyperbilirubinemia seemed to predispose to sensorineural hearing deficit and isolated craniofacial malformations seemed to be associated with conductive hearing loss. Sensorineural hearing deficit usually occurred bilaterally and was severe or profound, while conductive and mixed type of hearing deficit were most often of mild degree. Most children with the final diagnosis of sensorineural hearing deficit had positive result of hearing screening by means of otoacoustic emissions. Copyright © 2017 Elsevier B.V. All

  2. Minimal Impact by Antenatal Subpatent Plasmodium falciparum Infections on Delivery Outcomes in Malawian Women: A Cohort Study

    Taylor, Steve M.; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M.; Mwapasa, Victor; ter Kuile, Feiko O.; Meshnick, Steven R.

    2017-01-01

    Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In

  3. The University of Kansas High-Throughput Screening Laboratory. Part II: enabling collaborative drug-discovery partnerships through cutting-edge screening technology.

    McDonald, Peter R; Roy, Anuradha; Chaguturu, Rathnam

    2011-07-01

    The University of Kansas High-Throughput Screening (KU HTS) core is a state-of-the-art drug-discovery facility with an entrepreneurial open-service policy, which provides centralized resources supporting public- and private-sector research initiatives. The KU HTS core was established in 2002 at the University of Kansas with support from an NIH grant and the state of Kansas. It collaborates with investigators from national and international academic, nonprofit and pharmaceutical organizations in executing HTS-ready assay development and screening of chemical libraries for target validation, probe selection, hit identification and lead optimization. This is part two of a contribution from the KU HTS laboratory.

  4. Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

    Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

    2016-05-01

    Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend income level was 0.45 (0.31-0.66; Ptrend income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on

  5. Screening masses in quenched (2+1)d Yang-Mills theory: Universality from dynamics?

    Frigori, Rafael B.

    2010-01-01

    We compute the spectrum of gluonic screening-masses in the 0 ++ channel of quenched 3d Yang-Mills theory near the phase-transition. Our finite-temperature lattice simulations are performed at scaling region, using state-of-art techniques for thermalization and spectroscopy, which allows for thorough data extrapolations to thermodynamic limit. Ratios among mass-excitations with the same quantum numbers on the gauge theory, 2d Ising and λφ 4 models are compared, resulting in a nice agreement with predictions from universality. In addition, a gauge-to-scalar mapping, previously employed to fit QCD Green's functions at deep IR, is verified to dynamically describe these universal spectroscopic patterns.

  6. Diagnosis of antenatal Bartter syndrome.

    Narayan, R; Peres, M; Kesby, G

    2016-01-01

    Bartter syndrome is a rare heterogeneous group of autosomal-recessive salt-losing renal tubular disorders that can present in fetal life (antenatal Bartter syndrome; ABS) as "unexplained" early-onset polyhydramnios, often associated with growth restriction. Prenatal diagnosis of the condition involves assessment of amniotic fluid biochemistry in a setting of polyuric polyhydramnios; with elevated chloride levels considered a consistent and diagnostic finding. Other amniotic fluid biochemical markers have been described, notably increased aldosterone levels, and low total protein levels. NOVEL INSIGHT: Antenatal Bartter syndrome is a heterogeneous group of renal disorders. While certain biochemical features in amniotic fluid might heighten suspicion, final diagnosis can only be made in the postnatal setting. In the setting of unexplained severe polyhydramnios, clinicians should continue to entertain the diagnosis of antenatal Bartter Syndrome and maintain neonatal surveillance, even if amniotic fluid markers do not support the diagnosis.

  7. Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome.

    Legrand, Anne; Treard, Cyrielle; Roncelin, Isabelle; Dreux, Sophie; Bertholet-Thomas, Aurélia; Broux, Françoise; Bruno, Daniele; Decramer, Stéphane; Deschenes, Georges; Djeddi, Djamal; Guigonis, Vincent; Jay, Nadine; Khalifeh, Tackwa; Llanas, Brigitte; Morin, Denis; Morin, Gilles; Nobili, François; Pietrement, Christine; Ryckewaert, Amélie; Salomon, Rémi; Vrillon, Isabelle; Blanchard, Anne; Vargas-Poussou, Rosa

    2018-02-07

    Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome. The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Mutations in genes responsible for types 1-4 have been detected in 75% of cases. In patients without identified genetic cause ( n =42), transient antenatal Bartter syndrome was reported in 12 cases. We analyzed the MAGED2 gene in the entire cohort of negative cases by Sanger sequencing and retrospectively collected clinical data regarding pregnancy as well as the postnatal outcome for positive cases. We detected mutations in MAGED2 in 17 patients, including the 12 with transient antenatal Bartter syndrome, from 16 families. Fifteen different mutations were detected (one whole deletion, three frameshift, three splicing, three nonsense, two inframe deletions, and three missense); 13 of these mutations had not been previously described. Interestingly, two patients are females; in one of these patients our data are consistent with selective inactivation of chromosome X explaining the severity. The phenotypic presentation in our patients was variable and less severe than that of the originally described cases. MAGED2 mutations explained 9% of cases of antenatal Bartter syndrome in a French cohort, and accounted for 38% of patients without other characterized mutations and for 44% of male probands of negative cases. Our study confirmed previously published data and showed that females can be affected. As a result, this gene must be included in the screening of the most severe clinical form of Bartter syndrome. Copyright © 2018 by the American Society of Nephrology.

  8. Setting the stage for universal financial distress screening in routine cancer care.

    Khera, Nandita; Holland, Jimmie C; Griffin, Joan M

    2017-11-01

    Financial burden from cancer treatment is increasingly being recognized as a threat to optimal access, quality, and outcomes of cancer care for patients. Although research in the area is moving at a fast pace, multiple questions remain unanswered, such as how to practically integrate the assessment and management of financial burden into routine health care delivery for patients with cancer. Although psychological distress screening for patients undergoing cancer treatment now is commonplace, the authors raise the provocative idea of universal screening for financial distress to identify and assist vulnerable groups of patients. Herein, the authors outline the arguments to support screening for financial burden in addition to psychological distress, examining it as an independent patient-reported outcome for all patients with cancer at various time points during their treatment. The authors describe the proximal and downstream impact of such a strategy and reflect on some challenges and potential solutions to help integrate this concept into routine cancer care delivery. Cancer 2017;123:4092-4096. © 2017 American Cancer Society. © 2017 American Cancer Society.

  9. Screening for Non-Communicable Diseases among transport employees of a University: A Descriptive Analysis

    Chythra R Rao

    2016-03-01

    Full Text Available Introduction: In most parts of the world today, non-communicable diseases (NCDs are on the rise. Worldwide they are currently responsible for almost half (42% of the premature deaths which occurs before the age of 70. Due to sedentary lifestyle, workers of transportation department may be at a higher risk for development of obesity, hypertension, hypercholesterolemia and hyperglycaemia. Objective: To screen all the transport employees of a university for non-communicable diseases. Methods: This cross-sectional study was carried out among all transport employees to screen for hypertension, Type II diabetes, obesity and visual impairment. Data was collected by personal interviews using a pre designed questionnaire. Anthropometry, blood pressure recording, fasting blood glucose testing, vision assessment followed by electrocardiogram recording was done for all subjects. Results: Out of 90 participants, 10(11.1% had diabetes, 26(28.9% were hypertensive, 36(40.0% were overweight and obese, three individuals had myopia and abnormal colour vision, whereas 17(18.9% had impaired near vision. The screen positives were referred to tertiary care hospital for further management. Over half of the subjects reported alcohol use while 21(23.4% were using tobacco. Only 43(47.8% used seat belts while driving. Conclusion: Proportion of obesity, hypertension, and diabetes was found to be more among the transport employees. This demands an urgent need for appropriate preventive and health promotive interventions to address these chronic diseases.

  10. Development and application of a universal Hemoplasma screening assay based on the SYBR green PCR principle.

    Willi, Barbara; Meli, Marina L; Lüthy, Ruedi; Honegger, Hanspeter; Wengi, Nicole; Hoelzle, Ludwig E; Reusch, Claudia E; Lutz, Hans; Hofmann-Lehmann, Regina

    2009-12-01

    Hemotropic mycoplasmas (hemoplasmas) are the causative agents of infectious anemia in several mammalian species. Their zoonotic potential has recently been substantiated by the identification of a feline hemoplasma isolate in an immunocompromised human patient. Although species-specific diagnostic molecular methods have been developed, their application as screening tools is limited due to the species diversity of hemoplasmas. The goals of this study were to develop a universal hemoplasma screening assay with broad specificity based on the SYBR green PCR principle, to compare the assay with hemoplasma-specific TaqMan PCR, and to analyze potential tick vectors and human blood samples to address the zoonotic potential. The newly developed PCR assay based on the 16S rRNA gene amplified feline, canine, bovine, porcine, camelid, and murine hemoplasmas, as well as Mycoplasma penetrans and Mycoplasma pneumoniae. The lower detection limit for feline and canine hemoplasmas was 1 to 10 copies/PCR. The assay exhibited 98.2% diagnostic sensitivity and 92.1% diagnostic specificity for feline hemoplasmas. All 1,950 Ixodes ticks were PCR negative, suggesting that Ixodes ticks are not relevant vectors for the above-mentioned hemoplasma species in Switzerland. None of the 414 blood samples derived from anemic or immunocompromised human patients revealed a clear positive result. The SYBR green PCR assay described here is a suitable tool to screen for known and so-far-undiscovered hemoplasma species. Positive results should be confirmed by specific TaqMan PCR or sequencing.

  11. Screening program for prostate cancer at a university hospital in eastern Saudi Arabia

    Taha, Saud A.; Kamal, Baher A.

    2005-01-01

    Implementation of a pilot screening program for prostate cancer among Saudi patients that would serve as a nucleus for a Kingdom-wide screening program. A prospective study on 1,213 Saudi males between 50-80 years of age who attended the Outpatient Department at King Fahd Hospital of King Faisal University, Al-Khobar, Kingdom of Saudi Arabia during a period of 18 months (April 2001-October 2002). They were included at random from different clinics including the urology clinic. Free and total prostate specific antigen (PSA) and digital rectal examination (DRE) of the prostate were performed in all patients. Patients with abnormal DRE or PSA were scheduled for transrectal ultrasound (TRUS) and ultrasound guided biopsy of the prostate. Abnormal DRE or PSA were present in 84 out of 1,213 patients. Only 63 patients agreed to have TRUS and ultrasound guided biopsies. Prostate cancer was confirmed in 14 out of 1,192 patients who completed the study (1.17%). The incidence of prostate cancer among Saudi men in this hospital based study is low. A population based screening for prostate cancer may reveal the incidence of this disease. (author)

  12. There is no benefit to universal carotid artery duplex screening before a major cardiac surgical procedure.

    Adams, Brian C; Clark, Ross M; Paap, Christina; Goff, James M

    2014-01-01

    statistically significant predictors of carotid revascularization. A cost analysis of universal screening resulted in an estimated net cost of $378,918 during the study period. The majority of postoperative strokes after cardiac surgery are not related to extracranial carotid artery disease and they are not predicted by preoperative carotid artery duplex scan screening. Consequently, universal carotid artery duplex scan screening cannot be recommended and a selective approach should be adopted. Published by Elsevier Inc.

  13. Universal screening as the great equalizer: Eliminating disproportionality in special education referrals

    Raines, Tara C.

    The overrepresentation of minority students identified for special education services continues to plague schools and serves as a challenge for researchers and practitioners (Ferri & Conner, 2005). Teacher nomination, office discipline referrals (ODR), and functional behavior assessments (FBA) continue to guide referral processes (Bradshaw, Mitchell, O'Brennen, & Leaf, 2010; Eklund, et al., 2009; Mustian, 2010). These methods have been found to be riddled with inconsistencies. Practices used to identify students for behavioral and emotional interventions over-identify students from culturally and linguistically diverse backgrounds. The use of a behavioral and emotional screener to make data-based decisions regarding placement and services could provide an objective assessment of student risk. The first chapter of this dissertation reviews methods used in the identification of students for behavioral and emotional support services. Additionally, the use of universal screening in conjunction with student self-report are proposed as tools for alleviating the overrepresentation of minority students in special education programs for behavioral and emotional disorders. The second chapter of this dissertation explores the measurement equivalence of Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Student form (BESS Student) across the Black, Hispanic, and White participants in the norming sample. The BESS Student as a universal screening tool is poised to alleviate the disproportionate number of children of color identified by schools as having behavior and emotional disorders. This instrument also provides an avenue to identify students with internalizing disorders who are often overlooked in present referral practices (Bradshaw, Buckley, & Ialongo, 2008; Kataoka, Zhang, & Wells, 2002). The findings of the measurement equivalence study suggests that the BESS Student is, as designed, identifying behavioral and

  14. Universal cervical length screening for singleton pregnancies with no history of preterm delivery, or the inverse of the Pareto principle.

    Rozenberg, P

    2017-06-01

    Ultrasound measurement of cervical length in the general population enables the identification of women at risk for spontaneous preterm delivery. Vaginal progesterone is effective in reducing the risk of preterm delivery in this population. This screening associated with treatment by vaginal progesterone is cost-effective. Universal screening of cervical length can therefore be considered justified. Nonetheless, this screening will not appreciably reduce the preterm birth prevalence: in France or UK, where the preterm delivery rate is around 7.4%, this strategy would make it possible to reduce it only to 7.0%. This small benefit must be set against the considerable effort required in terms of screening ultrasound scans. Universal ultrasound screening of cervical length is the inverse of Pareto's principle: a small benefit against a considerable effort. © 2016 Royal College of Obstetricians and Gynaecologists.

  15. Maternal knowledge and attitudes to universal newborn hearing screening: Reviewing an established program.

    Lam, Maggie Yee Yan; Wong, Eddie Chi Ming; Law, Chi Wai; Lee, Helena Hui Ling; McPherson, Bradley

    2018-02-01

    To facilitate early diagnosis of infants with hearing loss, a universal newborn hearing screening program (UNHS) has been implemented in Hong Kong's public hospitals for over a decade. However, there have been no known studies investigating parent attitudes to, and satisfaction with, UNHS since its launch in Hong Kong. The present study aimed to investigate knowledge of UNHS as well as infant hearing development, and attitudes and satisfaction with UNHS, in Hong Kong mothers with newborns. The study was designed to help evaluate and improve an established UNHS public hospital program, based on the perspectives of service users. A researcher-developed questionnaire was administered to 102 mothers whose newborn had received UNHS in the postnatal wards of a large public hospital in Hong Kong. The questionnaire considered parental knowledge of UNHS and infant hearing development, attitudes and satisfaction toward public hospital UNHS. In the knowledge dimension, parents' preferred time and location for pre-test information delivery, interpretation of screening results, and knowledge of hearing developmental milestones were surveyed. In addition, maternal attitudes to and satisfaction with UNHS screening services, the potential impact of UNHS on parent emotions and parent-baby bonding, attitudes toward informed consent, and willingness to comply with diagnostic assessment referral were also be surveyed. Mean participant scores on knowledge of infant hearing development were relatively low (M = 2.59/6.0, SD = 0.90). Many mothers also underestimated the potential ongoing risks of hearing impairment in babies. Around 80% of mothers thought an infant could not have hearing impairment after passing the screening. In addition, one-third of mothers thought a baby could not later develop hearing impairment in infancy or childhood. In terms of attitudes and satisfaction, participants gave somewhat negative ratings for questions regarding receiving sufficient information

  16. Universal neonatal hearing screening program in Shanghai, China: An inter-regional and international comparison.

    Fang, Xingang; Li, Xi; Zhang, Qi; Wan, Jin; Sun, Mei; Chang, Fengshui; Lü, Jun; Chen, Gang

    2016-11-01

    By comparing the Universal Neonatal Hearing Screening (UNHS) program as implemented in Shanghai and other regions in China and countries around the world, this study makes an assessment of the Shanghai model and summarizes the experiences implementing the UNHS program, so as to provide a valuable reference for other countries or regions to carry out UNHS more effectively. Since Shanghai is one of the most developed regions in China, we also examined the relationship between economic development and the UNHS starting year and coverage rate. The study conducted a systematic review of published studies in Chinese and English on the program status of neonatal hearing screening to compare and analyze the implementation of the UNHS program in 20 cities or provinces in China and 24 regions or countries around the world. The literature search in Chinese was conducted in the three most authoritative publication databases, CNKI (China National Knowledge Infrastructure), WANFANGDATA, and CQVIP (http://www.cqvip.com/). We searched all publications in those databases with the keywords "neonatal hearing screening" (in Chinese) between 2005 and 2014. English literature was searched using the same keywords (in English). The publication database included Medline and Web of Science, and the search time period was 2000-2014. Shanghai was one of the first regions in China to implement UNHS, and its coverage rate was among the top regions by international comparison. The starting time of the UNHS program had no relationship with the Gross Domestic Product (GDP) per capita in the same year. Economic level serves as a threshold for carrying out UNHS but is not a linear contributor to the exact starting time of such a program. The screening coverage rate generally showed a rising trend with the increasing GDP per capita in China, but it had no relationship with the area's GDP per capita in selected regions and countries around the world. The system design of UNHS is the key factor

  17. Seroprevalence of venereal disease among pregnant women attending antenatal care (ANC) in Onitsha, Anambra State, Southeast, Nigeria.

    Mbamara, S U; Obiechina, N J A

    2011-01-01

    Venereal Syphilis if not properly and timely treated has been noted to have devastating effects on the fetus and baby. Of all the sexually transmitted infections, however, venereal syphilis is one of the most commonly screened among antenatal women. This screening is usually limited to the tertiary institutions thereby leaving the women who attend private hospitals to a disadvantage. This current research is to determine the seroprevalence of venereal disease among women attending ANC in an Onitsha specialist private hospital and to ascertain the acceptability, and the feasibility of conducting the screening in a private setup. This cross sectional prospective study was conducted among women, who were on their first ANC visit at Grace Specialist Hospital, Nkpor, Southeast Nigeria. They were offered VDRL test by ELISA method and TPHA confirmation test to those who were seropositive to VDRL test. Two thousand nine hundred and ninety six women attended antenatal care during the study period but 1393 women took part in this study giving an uptake rate of 46.5%. The seroprevalence rate to venereal syphilis was 0.6%. Three out of the 8 seropositive results were confirmed with TPHA test. This gives a TPHA/VDRL ratio of 0.43. The highest range of occurrence was 25 29years. There was neither a significant association between age distribution and VDRL screening result (chi2 = 1.13; df =5; p = 0.951) nor between parity distribution and VDRL screening result (chi2 = 6.2; df = 6; p = 0.4007). Although the seroprevalence of venereal syphilis is low but routine universal screening of Venereal syphilis is possible in private hospitals and its establishment should be encouraged.

  18. Stakeholder perspectives on implementing a universal Lynch syndrome screening program: a qualitative study of early barriers and facilitators.

    Schneider, Jennifer L; Davis, James; Kauffman, Tia L; Reiss, Jacob A; McGinley, Cheryl; Arnold, Kathleen; Zepp, Jamilyn; Gilmore, Marian; Muessig, Kristin R; Syngal, Sapna; Acheson, Louise; Wiesner, Georgia L; Peterson, Susan K; Goddard, Katrina A B

    2016-02-01

    Evidence-based guidelines recommend that all newly diagnosed colon cancer be screened for Lynch syndrome (LS), but best practices for implementing universal tumor screening have not been extensively studied. We interviewed a range of stakeholders in an integrated health-care system to identify initial factors that might promote or hinder the successful implementation of a universal LS screening program. We conducted interviews with health-plan leaders, managers, and staff. Interviews were audio-recorded and transcribed. Thematic analysis began with a grounded approach and was also guided by the Practical Robust Implementation and Sustainability Model (PRISM). We completed 14 interviews with leaders/managers and staff representing involved clinical and health-plan departments. Although stakeholders supported the concept of universal screening, they identified several internal (organizational) and external (environment) factors that promote or hinder implementation. Facilitating factors included perceived benefits of screening for patients and organization, collaboration between departments, and availability of organizational resources. Barriers were also identified, including: lack of awareness of guidelines, lack of guideline clarity, staffing and program "ownership" concerns, and cost uncertainties. Analysis also revealed nine important infrastructure-type considerations for successful implementation. We found that clinical, laboratory, and administrative departments supported universal tumor screening for LS. Requirements for successful implementation may include interdepartmental collaboration and communication, patient and provider/staff education, and significant infrastructure and resource support related to laboratory processing and systems for electronic ordering and tracking.

  19. Postnatal Imaging of Antenatal Hydronephrosis

    Kitchens, David M.; Herndon, C. D. Anthony

    2009-01-01

    Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed. PMID:19484160

  20. Postnatal Imaging of Antenatal Hydronephrosis

    David M. Kitchens

    2009-01-01

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

  1. Seroprevalence of toxoplasmosis in antenatal women with bad obstetric history.

    Chintapalli, Suryamani; Padmaja, I Jyothi

    2013-01-01

    The occurrence of fetal death is one of the tragedies that confront the physician providing obstetric care. Among the various agents associated with infections of pregnancy, viruses are the most important followed by bacteria and protozoa. Among protozoal infections in pregnancy, toxoplasmosis is reported to have a high incidence, sometimes causing fetal death. The study was intended to observe the seroprevalence of Toxoplasmosis in pregnant women presenting with bad obstetric history (BOH). A total of 92 antenatal women were included in the study (80 in the study group and 12 in control group). The study group comprised of antenatal women with BOH in the age group of 20-35 years. Antenatal women with Rh incompatibility, pregnancy induced hypertension, diabetes mellitus, renal disorders and syphilis were not included in the study. The control group included women in reproductive age group without BOH. All the samples were screened by enzyme linked immuno sorbent assay (ELISA) for Toxoplasma specific Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies. Of the 80 antenatal women in the study group, 36 (45%) were seropositive for Toxoplasma specific IgG antibodies (P habits, illiteracy, socio-economic status and residential status were also studied. We conclude that toxoplasmosis during pregnancy causes congenital fetal infection with possible fetal loss. ELISA was found to be a sensitive serological test for diagnosis of Toxoplasmosis in pregnant women with BOH. Major cause of fetal loss in BOH cases in the study group was abortion.

  2. Validation of the Rowland Universal Dementia Assessment Scale for multicultural screening in Danish memory clinics.

    Nielsen, T Rune; Andersen, Birgitte Bo; Gottrup, Hanne; Lützhøft, Jan H; Høgh, Peter; Waldemar, Gunhild

    2013-01-01

    The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study was to evaluate the diagnostic accuracy of the RUDAS in a multicultural sample of patients referred to Danish memory clinics. Data were collected from 137 consecutive patients (34 with an immigrant background) in three Danish memory clinics. All patients were given the RUDAS as a supplement to the standard diagnostic workup. Diagnostic accuracy for the RUDAS [area under the curve (AUC) = 0.838] was similar to that of the Mini-Mental State Examination (MMSE; AUC = 0.840). The cutoff score with the best balance of sensitivity, specificity and accuracy was multicultural patient populations. © 2013 S. Karger AG, Basel.

  3. [Detection of thyroid dysfunction in pregnant women: universal screening is justified].

    Vila, Lluís; Velasco, Inés; González, Stella; Morales, Francisco; Sánchez, Emilia; Lailla, José Maria; Martinez-Astorquiza, Txanton; Puig-Domingo, Manel

    2012-11-03

    There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far. However, there is a general agreement about the need for treatment of clinical hypothyroidism during pregnancy and the risks of not doing so. Because it is a common, easily diagnosed and effectively treated disorder without special risk, the working Group of Iodine Deficiency Disorders and Thyroid Dysfunction of the Spanish Society of Endocrinology and Nutrition and Spanish Society of Gynaecology and Obstetrics recommends an early evaluation (before week 10) of thyroid function in all pregnant women. Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester and generated locally in each reference laboratory. Thyrotropin determination would be sufficient for screening purposes and only if it is altered, free thyroxin or total thyroxin would be required. Adequate iodine nutrition is also highly recommended before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus.

  4. Validity and Reliability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in University Students.

    Tiburcio Sainz, Marcela; Rosete-Mohedano, Ma Guadalupe; Natera Rey, Guillermina; Martínez Vélez, Nora Angélica; Carreño García, Silvia; Pérez Cisneros, Daniel

    2016-03-02

    The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), developed by the World Health Organization (WHO), has been used successfully in many countries, but there are few studies of its validity and reliability for the Mexican population. The objective of this study was to determine the psychometric properties of the self-administered ASSIST test in university students in Mexico. This was an ex post facto non-experimental study with 1,176 undergraduate students, the majority women (70.1%) aged 18-23 years (89.5%) and single (87.5%). To estimate concurrent validity, factor analysis and tests of reliability and correlation were carried out between the subscale for alcohol and AUDIT, those for tobacco and the Fagerström Test, and those for marijuana and DAST-20. Adequate reliability coefficients were obtained for ASSIST subscales for tobacco (alpha = 0.83), alcohol (alpha = 0.76), and marijuana (alpha = 0.73). Significant correlations were found only with the AUDIT (r = 0.71) and the alcohol subscale. The best balance of sensitivity and specificity of the alcohol subscale (83.8% and 80%, respectively) and the largest area under the ROC curve (81.9%) was found with a cutoff score of 8. The self-administered version of ASSIST is a valid screening instrument to identify at-risk cases due to substance use in this population.

  5. Detection of thyroid dysfunction in pregnant women: universal screening is justified.

    Vila, Lluís; Velasco, Inés; González, Stella; Morales, Francisco; Sánchez, Emilia; Lailla, José Maria; Martinez-Astorquiza, Txanton; Puig-Domingo, Manel

    2012-11-01

    There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far. However, there is a general agreement about the need for treatment of clinical hypothyroidism during pregnancy and the risks of not doing so. Because it is a common, easily diagnosed and effectively treated disorder without special risk, the working Group of Iodine Deficiency Disorders and Thyroid Dysfunction of the Spanish Society of Endocrinology and Nutrition and Spanish Society of Gynaecology and Obstetrics recommends an early evaluation (before week 10) of thyroid function in all pregnant women. Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester and generated locally in each reference laboratory. Thyrotropin determination would be sufficient for screening purposes and only if it is altered, free thyroxin or total thyroxin would be required. Adequate iodine nutrition is also highly recommended before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  6. Screening and contact precautions – A survey on infection control measures for multidrug-resistant bacteria in German university hospitals

    Lena M. Biehl

    2017-04-01

    Full Text Available Abstract To assess the scope of infection control measures for multidrug-resistant bacteria in high-risk settings, a survey among university hospitals was conducted. Fourteen professionals from 8 sites participated. Reported policies varied largely with respect to the types of wards conducting screening, sample types used for screening and implementation of contact precautions. This variability among sites highlights the need for an evidence-based consensus of current infection control policies.

  7. Web-based alcohol screening and brief intervention for university students: a randomized trial.

    Kypri, Kypros; Vater, Tina; Bowe, Steven J; Saunders, John B; Cunningham, John A; Horton, Nicholas J; McCambridge, Jim

    2014-03-26

    Unhealthy alcohol use is a leading contributor to the global burden of disease, particularly among young people. Systematic reviews suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in settings where it could be sustainably delivered. To evaluate a national web-based alcohol screening and brief intervention program. A multisite, double-blind, parallel-group, individually randomized trial was conducted at 7 New Zealand universities. In April and May of 2010, invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening test were e-mailed to 14,991 students aged 17 to 24 years. Participants who screened positive (AUDIT-C score ≥4) were randomized to undergo screening alone or to 10 minutes of assessment and feedback (including comparisons with medical guidelines and peer norms) on alcohol expenditure, peak blood alcohol concentration, alcohol dependence, and access to help and information. A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes: consumption per typical occasion, drinking frequency, volume of alcohol consumed, an academic problems score, and whether participants exceeded medical guidelines for acute harm (binge drinking) and chronic harm (heavy drinking). A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias. Of 5135 students screened, 3422 scored 4 or greater and were randomized, and 83% were followed up. There was a significant effect on 1 of the 6 prespecified outcomes. Relative to control participants, those who received intervention consumed less alcohol per typical drinking occasion (median 4 drinks [interquartile range {IQR}, 2-8] vs 5 drinks [IQR 2-8]; rate ratio [RR], 0.93 [99.17% CI, 0.86-1.00]; P = .005) but not less often (RR, 0.95 [99.17% CI, 0.88-1.03]; P = .08) or less

  8. Validity of the AUDIT-C screen for at-risk drinking among students utilizing university primary care.

    Campbell, Clare E; Maisto, Stephen A

    2018-03-22

    Research is needed to establish the psychometric properties of brief screens in university primary care settings. This study aimed to assess the construct validity of one such screen, the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), for detecting at-risk drinking among students who have utilized on-campus primary care. 389 students recently seen in university primary care completed a confidential online survey in December 2014. Bivariate correlations between the AUDIT-C and measures of alcohol consumption and negative drinking consequences provided concurrent evidence for construct validity. Receiver Operating Characteristic curve analyses determined optimal cut-off scores for at-risk drinking. The AUDIT-C significantly correlated with measures of alcohol consumption and negative drinking consequences (p AUDIT-C cut-off scores of 5 for females and 7 for males. The AUDIT-C is a valid screen for at-risk drinking among students who utilize university primary care.

  9. Universal neonatal screening for sickle cell disease and other haemoglobinopathies in Ferrara, Italy.

    Ballardini, Elisa; Tarocco, Anna; Marsella, Maria; Bernardoni, Roberto; Carandina, Gianni; Melandri, Claudia; Guerra, Giovanni; Patella, Alfredo; Zucchelli, Miranda; Ferlini, Alessandra; Bigoni, Stefania; Ravani, Anna; Garani, Giampaolo; Borgna-Pignatti, Caterina

    2013-04-01

    Sickle cell disease is the commonest haemoglobinopathy in Africa, the Middle East and India. In recent years, its incidence has increased dramatically also in Europe and North America because of the high rate of migration of people from endemic areas. From January 2009 to January 2010 the number of foreign residents in the province of Ferrara (Italy) increased by 12.2%: most of the immigrants were from countries at high risk of sickle cell disease. Since neonatal screening and prophylactic penicillin in early childhood could reduce mortality by 10 years of age to less than 2%, the aim of this study was to establish a neonatal screening programme for haemoglobinopathies in Ferrara. First we assessed how many pregnant women underwent haemoglobin analysis by high performance liquid chromatography before or during pregnancy and how many of them were carriers of haemoglobinopathies. Subsequently, we verified the feasibility of neonatal screening for sickle cell disease and other haemoglobinopathies, analysing cord blood by high performance liquid chromatography. Neonates found to be positive were managed by a multidisciplinary team to implement all the appropriate prophylactic and therapeutic measures. We found that 59% of women who delivered at the University Hospital of Ferrara, from 2007 to 2009, had undergone high performance liquid chromatography. Of the 41% who were not tested, many were from areas in which sickle cell disease is common. Between September 26th 2010 and January 31st 2012, 1992 neonatal tests were performed and 24 carriers of haemoglobinopathies were identified (16 with HbS, 4 with HbC, 2 with HbE, 1 with HbD Punjab and 1 with HbD-Ouled Rabah); 42.6% of the mothers of these 1,992 neonates had not undergone high performance liquid chromatography during pregnancy. Currently prevention of haemoglobinopathies in Italy is provided during the pre-conception period but only to patients with abnormal blood counts. Neonatal screening is useful and cost

  10. Universal tumor screening for Lynch syndrome: Assessment of the perspectives of patients with colorectal cancer regarding benefits and barriers.

    Hunter, Jessica Ezzell; Zepp, Jamilyn M; Gilmore, Mari J; Davis, James V; Esterberg, Elizabeth J; Muessig, Kristin R; Peterson, Susan K; Syngal, Sapna; Acheson, Louise S; Wiesner, Georgia L; Reiss, Jacob A; Goddard, Katrina A B

    2015-09-15

    Universal tumor screening for Lynch syndrome, the most common form of hereditary colorectal cancer (CRC), has been recommended among all patients newly diagnosed with CRC. However, there is limited literature regarding patient perspectives of tumor screening for Lynch syndrome among patients with CRC who are not selected for screening based on family history criteria. A total of 145 patients aged 39 to 87 years were administered surveys assessing perceived risk, patient perspectives, and potential benefits of and barriers to tumor screening for Lynch syndrome. Associations between patient-specific and cancer-specific factors and survey responses were analyzed. The majority of participants perceived their risk of developing Lynch syndrome as being low, with 9 participants (6.2%) anticipating an abnormal screening result. However, most participants endorsed the potential benefits of screening for themselves and their families, with 84.8% endorsing ≥6 benefits and 50.3% endorsing all 8 benefits. Participants also endorsed few potential barriers to screening, with 89.4% endorsing ≤4 of 9 potential barriers. A common barrier was worry about the cost of additional testing and surveillance, which was endorsed by 54.5% of participants. The level of distress associated with tumor screening for Lynch syndrome, which was very low, was not associated with age or CRC stage. The results of the current study indicate that patients with CRC overall have a positive attitude toward tumor screening for Lynch syndrome, endorse the benefits of screening, and experience low levels of distress. These findings provide insight into patient attitudes toward tumor screening for Lynch syndrome among unselected patients with CRC to inform educational approaches that assist in patient decision-making and guide the successful implementation of screening programs. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  11. Antenatal calcium intake in Malaysia.

    Mahdy, Zaleha Abdullah; Basri, Hashimah; Md Isa, Zaleha; Ahmad, Shuhaila; Shamsuddin, Khadijah; Mohd Amin, Rahmah

    2014-04-01

    To determine the adequacy of antenatal calcium intake in Malaysia, and the influencing factors. A cross-sectional study was conducted among postnatal women who delivered in two tertiary hospitals. Data were collected from antenatal cards, hospital documents and diet recall on daily milk and calcium intake during pregnancy. SPSS version 19.0 was used for statistical analyses. A total of 150 women were studied. The total daily calcium intake was 834 ± 43 mg (mean ± standard error of the mean), but the calcium intake distribution curve was skewed to the right with a median intake of 725 mg daily. When calcium intake from milk and calcium supplements was excluded, the daily dietary calcium intake was only 478 ± 25 mg. Even with inclusion of milk and calcium supplements, more than a third (n=55 or 36.7%) of the women consumed less than 600 mg calcium in their daily diet. The adequacy of daily calcium intake was not influenced by maternal age, ethnicity, income or maternal job or educational status as well as parity. The daily dietary calcium intake of the Malaysian antenatal population is far from adequate without the addition of calcium supplements and milk. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  12. Providers of antenatal care services in Ghana: evidence from Ghana demographic and health surveys 1988-2014.

    Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi

    2017-03-14

    Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour

  13. Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care:

    Smith-Nielsen, Johanne; Lønfeldt, Nicole; Guedeney, Antoine

    2018-01-01

    Background: Infant socioemotional development is often held under informal surveillance, but a formal screening program is needed to ensure systematic identification of developmental risk. Even when screening programs exist, they are often ineffective because health care professionals do not adhe...

  14. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

    Kass, Andrea E.; Jones, Megan; Kolko, Rachel P.; Altman, Myra; Fitzsimmons-Craft, Ellen E.; Eichen, Dawn M.; Balantekin, Katherine N.; Trockel, Mickey; Taylor, C. Barr; Wilfley, Denise E.

    2016-01-01

    Purpose Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. Methods 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. Results Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. Conclusions Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students. PMID:27090854

  15. Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses.

    Kass, Andrea E; Jones, Megan; Kolko, Rachel P; Altman, Myra; Fitzsimmons-Craft, Ellen E; Eichen, Dawn M; Balantekin, Katherine N; Trockel, Mickey; Taylor, C Barr; Wilfley, Denise E

    2017-04-01

    Given shared risk and maintaining factors between eating disorders and obesity, it may be important to include both eating disorder intervention and healthy weight management within a universal eating disorder care delivery program. This study evaluated differential eating disorder screening responses by initial weight status among university students, to assess eating disorder risk and pathology among individuals with overweight/obesity versus normal weight or underweight. 1529 individuals were screened and analyzed. Screening was conducted via pilot implementation of the Internet-based Healthy Body Image program on two university campuses. Fifteen percent of the sample had overweight/obesity. Over half (58%) of individuals with overweight/obesity screened as high risk for an eating disorder or warranting clinical referral, and 58% of individuals with overweight/obesity endorsed a ≥10-pound weight change over the past year. Compared to individuals with normal weight or underweight, individuals with overweight/obesity were more likely to identify as Black, endorse objective binge eating and fasting, endorse that eating disorder-related concerns impaired their relationships/social life and made them feel badly, and endorse higher weight/shape concerns. Results suggest rates of eating disorder pathology and clinical impairment are highest among students with overweight/obesity, and targeted intervention across weight categories and diverse races/ethnicities is warranted within universal eating disorder intervention efforts. Integrating eating disorder intervention and healthy weight management into universal prevention programs could reduce the incidence and prevalence of eating disorders, unhealthy weight control practices, and obesity among university students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Prevalence and factors associated with late antenatal care visit ...

    Flora

    Background: Adequate utilization of antenatal health care services is associated ... access to antenatal care services including provision of ANC services that are free of charge (Gross ... Information about demographic characteristics, antenatal.

  17. Antenatal care and pregnancy outcome in Ghana, the importance of ...

    Antenatal care and pregnancy outcome in Ghana, the importance of women\\'s ... The antenatal characteristics of 503 pregnant women attending maternal and child ... Higher educational level associated with early antenatal care attendance.

  18. Antenatal diagnosis of congenital deafness.

    Isaacson, G

    1988-01-01

    Advances in the field of antenatal diagnosis have made possible the detection of profound sensorineural hearing loss prior to birth. Fetal motion in response to sound and auditory evoked potential testing can determine the presence of fetal hearing in the third trimester of pregnancy. Imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging hold promise for the diagnosis of some forms of congenital deafness in the second trimester fetus. The methods by which congenital deafness soon may be diagnosed and the implications for the otologist are discussed.

  19. Determinants of Antenatal Care Use in Ghana

    Overbosch, G.B.; Nsowah-Nuamah, N.N.N.; van den Boom, G.J.M.; Damnyag, L.

    2004-01-01

    The paper investigates the determinants of antenatal care use in Ghana. In particular, we study how economic factors affect the demand for antenatal care and the probability that the number of visits falls below the recommended number of four. Estimation results from a nested three-level multinomial

  20. The national one week prevalence audit of universal meticillin-resistant Staphylococcus aureus (MRSA admission screening 2012.

    Christopher Fuller

    Full Text Available The English Department of Health introduced universal MRSA screening of admissions to English hospitals in 2010. It commissioned a national audit to review implementation, impact on patient management, admission prevalence and extra yield of MRSA identified compared to "high-risk" specialty or "checklist-activated" screening (CLAS of patients with MRSA risk factors.National audit May 2011. Questionnaires to infection control teams in all English NHS acute trusts, requesting number patients admitted and screened, new or previously known MRSA; MRSA point prevalence; screening and isolation policies; individual risk factors and patient management for all new MRSA patients and random sample of negatives.144/167 (86.2% trusts responded. Individual patient data for 760 new MRSA patients and 951 negatives. 61% of emergency admissions (median 67.3%, 81% (median 59.4% electives and 47% (median 41.4% day-cases were screened. MRSA admission prevalence: 1% (median 0.9% emergencies, 0.6% (median 0.4% electives, 0.4% (median 0% day-cases. Approximately 50% all MRSA identified was new. Inpatient MRSA point prevalence: 3.3% (median 2.9%. 104 (77% trusts pre-emptively isolated patients with previous MRSA, 63 (35% pre-emptively isolated admissions to "high-risk" specialties; 7 (5% used PCR routinely. Mean time to MRSA positive result: 2.87 days (±1.33; 37% (219/596 newly identified MRSA patients discharged before result available; 55% remainder (205/376 isolated post-result. In an average trust, CLAS would reduce screening by 50%, identifying 81% of all MRSA. "High risk" specialty screening would reduce screening by 89%, identifying 9% of MRSA.Implementation of universal screening was poor. Admission prevalence (new cases was low. CLAS reduced screening effort for minor decreases in identification, but implementation may prove difficult. Cost effectiveness of this and other policies, awaits evaluation by transmission dynamic economic modelling, using data from

  1. The national one week prevalence audit of universal meticillin-resistant Staphylococcus aureus (MRSA) admission screening 2012.

    Fuller, Christopher; Robotham, Julie; Savage, Joanne; Hopkins, Susan; Deeny, Sarah R; Stone, Sheldon; Cookson, Barry

    2013-01-01

    The English Department of Health introduced universal MRSA screening of admissions to English hospitals in 2010. It commissioned a national audit to review implementation, impact on patient management, admission prevalence and extra yield of MRSA identified compared to "high-risk" specialty or "checklist-activated" screening (CLAS) of patients with MRSA risk factors. National audit May 2011. Questionnaires to infection control teams in all English NHS acute trusts, requesting number patients admitted and screened, new or previously known MRSA; MRSA point prevalence; screening and isolation policies; individual risk factors and patient management for all new MRSA patients and random sample of negatives. 144/167 (86.2%) trusts responded. Individual patient data for 760 new MRSA patients and 951 negatives. 61% of emergency admissions (median 67.3%), 81% (median 59.4%) electives and 47% (median 41.4%) day-cases were screened. MRSA admission prevalence: 1% (median 0.9%) emergencies, 0.6% (median 0.4%) electives, 0.4% (median 0%) day-cases. Approximately 50% all MRSA identified was new. Inpatient MRSA point prevalence: 3.3% (median 2.9%). 104 (77%) trusts pre-emptively isolated patients with previous MRSA, 63 (35%) pre-emptively isolated admissions to "high-risk" specialties; 7 (5%) used PCR routinely. Mean time to MRSA positive result: 2.87 days (±1.33); 37% (219/596) newly identified MRSA patients discharged before result available; 55% remainder (205/376) isolated post-result. In an average trust, CLAS would reduce screening by 50%, identifying 81% of all MRSA. "High risk" specialty screening would reduce screening by 89%, identifying 9% of MRSA. Implementation of universal screening was poor. Admission prevalence (new cases) was low. CLAS reduced screening effort for minor decreases in identification, but implementation may prove difficult. Cost effectiveness of this and other policies, awaits evaluation by transmission dynamic economic modelling, using data from

  2. Syfilis påvist ved screening i graviditeten

    Vestergaard, Tine; Ibsen, Hans Henning Windeløv

    2012-01-01

    Because of an increasing incidence of syphilis in Denmark, antenatal screening was re-introduced in 2010. We present two cases of latent syphilis diagnosed by antenatal screening alone. Neither of the two women recalled any previous symptoms of the disease. After treatment, both women gave birth...

  3. Malaria and anaemia among pregnant women at first antenatal clinic visit in Kisumu, western Kenya

    Ouma, Peter; van Eijk, Anna M.; Hamel, Mary J.; Parise, Monica; Ayisi, John G.; Otieno, Kephas; Kager, Piet A.; Slutsker, Laurence

    2007-01-01

    OBJECTIVE: To determine the prevalence of malaria and anaemia among urban and peri-urban women attending their first antenatal clinic (ANC) in an area of perennial malaria transmission. METHODS: Between November 2003 and May 2004 we screened first ANC attenders for malaria and anaemia in a large

  4. Cost-effectiveness analysis of universal newborn screening for medium chain acyl-CoA dehydrogenase deficiency in France

    Hamers Françoise F

    2012-06-01

    newborn screening programme to MCADD would appear to be cost-effective. The results of this analysis have been used to produce recommendations for the introduction of universal newborn screening for MCADD in France.

  5. Cost-effectiveness analysis of universal newborn screening for medium chain acyl-CoA dehydrogenase deficiency in France.

    Hamers, Françoise F; Rumeau-Pichon, Catherine

    2012-06-08

    -effective. The results of this analysis have been used to produce recommendations for the introduction of universal newborn screening for MCADD in France.

  6. Socio-economic aspects of extended STD screening in pregnancy

    Postma, Maarten; Jager, Johannes C; de Jong-van den Berg, L T

    2000-01-01

    Screening for sexually transmitted diseases (STDs) in early pregnancy is included in routine antenatal care for several infectious agents in many western European countries. Pharmaco-economics of these interventions have been evaluated. Currently, reconsideration of anternatal screening is ongoing,

  7. Antenatal Testing – A Reevaluation

    Signore, Caroline; Freeman, Roger K.; Spong, Catherine Y.

    2009-01-01

    In August 2007, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health Office of Rare Diseases, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics cosponsored a 2-day workshop to reassess the body of evidence supporting antepartum assessment of fetal well-being, identify key gaps in the evidence, and formulate recommendations for further research. Participants included experts in obstetrics and fetal physiology, and representatives from relevant stakeholder groups and organizations. This article is a summary of the discussions at the workshop, including synopses of oral presentations on the epidemiology of stillbirth and fetal neurological injury, fetal physiology, techniques for antenatal monitoring, and maternal and fetal indications for monitoring. Finally, a synthesis of recommendations for further research compiled from three breakout workgroups is presented. PMID:19300336

  8. Thanatophoric dysplasia: Antenatal to postmortem

    Chanabasappa V Chavadi

    2015-01-01

    Full Text Available Thanatophoric dwarfism (TD, literally meaning death seeking dwarf, is the most common form of lethal bone dysplasia characterized by severe micromelia, extra folds of skin and narrow chest. Other signs include small ribs, underdeveloped lungs, cloverleaf skull, hypertelorism and protuberant abdomen. A short neck, depressed nasal bridge and hypoplastic mandible may also be present. Hydrocephalus is uncommon but is another poor prognostic sign. The diagnosis is usually made with the ultrasonography in the second trimester. Based on the morphological characters, this condition is sub-divided into type 1 and type 2. Fetuses with this condition are either still-born or die shortly after birth. Antenatal sonographic, postpartum radiological and autopsy findings of a case of type 1 TD with a relatively uncommon association of hydrocephalus is discussed.

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

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

    2015-03-01

    Internationally, Tay-Sachs disease (TSD) preconception screening of Ashkenazi Jewish (AJ) individuals and couples has led to effective primary prevention of TSD. In Australia, adolescent preconception genetic screening programs operate mainly in Jewish community high schools. These existing programs offer an effective means of primary prevention of TSD, are cost effective and safe. However, in the broader Australian community TSD screening is not systematically performed and cases still occur in unscreened AJ individuals. In order to improve the effectiveness of Australian screening, there is a need for definitive guidelines for healthcare professionals to facilitate extension of the proven benefits of preconception TSD screening to all AJ individuals at risk. We performed a systematic review of the relevant literature relating to AJ pre-conception and antenatal screening for TSD. The evidence was assessed using an established National Health and Medical Research Council evidence grading system. Evaluations of efficacy of TSD screening programs design and execution, cost-benefit and cost-utility health economic evaluation, and population outcomes were undertaken. The results have been used to propose a model for universal AJ TSD preconception and antenatal screening for the primary care setting. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  10. Internet: a new concept of antenatal education.

    Nikolova, Gergana

    2015-02-01

    Historically antenatal education has been seen as an important part of antenatal care and a mechanism to provide women with close to realistic interpretations of childbirth and motherhood. Through the years, the main themes and emphases of parenting education have changed, sometimes to reflect the new socio-economic structure and sometimes forced by the women themselves seeking specific information and knowledge. Yet again, this time the invasion of online information and social media is about to change the perception and the philosophy of antenatal education from an informative opportunity to a powerful and effective intervention.

  11. Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden.

    Andersson, Ewa; Christensson, Kyllike; Hildingsson, Ingegerd

    2012-08-01

    group-based antenatal care consists of six to nine two-hour sessions in which information is shared and discussed during the first hour and individual examinations are conducted during the second hour. Groups generally consist of six to eight pregnant women. Parent education is built into the programme, which originated in the United States and was introduced in Sweden at the beginning of the year of 2000. to investigate parents' experiences of group antenatal care in four different clinics in Sweden. a qualitative study was conducted using content analysis five group interviews and eleven individual interviews with parents who experienced group-based antenatal care. An interview guide was used. the study was set in four antenatal clinics that had offered group-based antenatal care for at least one year. The clinics were located in three different areas of Sweden. the participants were women and their partners who had experienced group-based antenatal care during pregnancy. Other criteria for participation were mastery of the Swedish language and having followed the care programme. three themes emerged, 'The care-combining individual physical needs with preparation for parenthood, refers to the context, organisation, and content of care'. Group antenatal care with inbuilt parent education was appreciated, but respondents reported that they felt unprepared for the first few weeks after birth. Their medical needs (for physical assessment and screening) were, however, fulfilled. The theme, 'The group-a composed recipient of care', showed the participants role and experience. The role could be passive or active in groups or described as sharers. Groups helped parents normalise their symptoms. The theme, 'The midwife-a controlling professional', showed midwives are ignorant of gender issues but, for their medical knowledge, viewed as respectable professionals. in the four clinics studied, group-based antenatal care appeared to meet parents' needs for physical assessment

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

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

    2003-12-01

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

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

    Moorthy, I.; Joshi, N.; Cook, J.V.; Warren, M.

    2003-01-01

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

  14. Age, place of living and education influences the pregnancy universal thyroid function screening program attendance - questionnaire study.

    Milewicz, Tomasz; Zuk, Małgorzata; Stochmal, Ewa; Hubalewska-Dydejczyk, Alicja; Galicka-Latała, Danuta; Juszczyk, Leszek; Krzysiek, Józef

    2011-01-01

    The aim of this study was to assess attendance at the universal screening programme for thyroid function in pregnancy and attempt to evaluate the influence of age, number of past pregnancies, level of education, and place of residence on the attendance. The study was performed by means of a questionnaire. Our study was performed on the basis of an anonymous questionnaire handed out to 543 women aged 16-45 years, on the third day of their puerperal stay in one of five obstetric wards in southern Poland. The questionnaire contained questions about participation in plasma level measurements of TSH, fT4, total T4, thyroid antibodies or thyroid ultrasound scanning at least once in pregnancy. The rate of attendance at any examination of thyroid function among pregnant women was 26.7%. The highest attendance rate (32.7%) was found among women living in provincial capitals or with higher education (41.3%), whereas the lowest was among women who had completed only primary school (11%) and those living in county towns (15%). The number of previous pregnancies did not influence the thyroid screening attendance. Women over 21 years of age participated in this screening programme more frequently (27.1-30%). Less than one third of pregnant women participated in the thyroid function screening. Place of living, education level, and age were the main factors influencing the attendance rate.

  15. Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia.

    Rashid, Abdul; Mohd, Rokiah

    2017-11-02

    Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support. This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support. The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%). Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.

  16. Antenatal hypnosis training and childbirth experience

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert

    2013-01-01

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

  17. Antenatal education in the transition to motherhood

    Burley, Suzanne Elizabeth

    2003-01-01

    This thesis explores the relationship between antenatal education and the transition to motherhood, focusing on the pre-natal expectations and postnatal experiences of a small sample of first-time mothers in Plymouth. The aims of the study were 1) to investigate the style and content of statutory and voluntary sector antenatal classes in the Plymouth area. 2) To investigate factors affecting non-attendance, including non-attenders' perceptions of them. 3) To examine the role of...

  18. Antenatal education for childbirth-epidural analgesia.

    Cutajar, Lisa; Cyna, Allan M

    2018-05-07

    The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized. This observational study of antenatal education was conducted at a single tertiary referral center for maternity care in Western Sydney, Australia. All three childbirth educators agreed to be video recorded whilst providing information to parents during antenatal classes. Audio data was subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. For the purposes of the current study, data concerning a single topic was used for the analysis-'epidural analgesia for labour'. Language structures used were highly variable between educators, as was the content and time taken for the information being provided. Our findings represent a first attempt to identify baseline information used in the clinical setting of antenatal education in order to categories communication structures used. This study has identified areas for further improvements and consistency in the way educators provide information to parents and has important implications for future midwifery practice, education and research. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. US College and University Student Health Screening Requirements for Tuberculosis and Vaccine-Preventable Diseases, 2012

    Jewett, Amy; Bell, Teal; Cohen, Nicole J.; Buckley, Kirsten; Leino, E. Victor; Even, Susan; Beavers, Suzanne; Brown, Clive; Marano, Nina

    2016-01-01

    Objective: Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases…

  20. Neonatal Screening for Congenital Hypothyroidism in an University Hospital in Tehran, Iran

    Najafian

    2016-05-01

    Full Text Available Background The national program of neonatal screening was performed in 2005 in Iran. According to the studies, the outbreak of congenital hypothyroidism (CH was one in every 670 live births in 2011. The prevalence of the disease in the world is 1 in 3000. The mean prevalence of this disease in Iran is estimated to be 1 in 1,000, which indicates a high prevalence of the disease in Iran. Objectives This study was conducted to investigate the prevalence of congenital hypothyroidism among neonates in the Najmiyeh hospital in Tehran, Iran. Patients and Methods This cross-sectional study was conducted from 2011 to 2014. Most heel blood samples were taken between three and seven days of birth. Thyroid stimulating hormone (TSH was tested using the enzyme-linked immunosorbent assay method. Neonates with abnormal screening results (TSH > 10 mIU/L, Free T4 < 1.6 mg/dL were re-examined. Data were analyzed using the SPSS software. Results A total of 11427 infants were screened. Of 399 re-called subjects (re-call rate = 3%, 57 cases were detected with CH, a CH prevalence of 1:200 (the female:male ratio of 1:1.5. Conclusions The prevalence of CH in our center is high. These results emphasize the importance of the congenital screening program.

  1. Antenatal Bartter Syndrome: A Review

    Y. Ramesh Bhat

    2012-01-01

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

  2. Antenatal Bartter Syndrome: A Review

    Bhat, Y. Ramesh; Vinayaka, G.; Sreelakshmi, K.

    2012-01-01

    Antenatal Bartter syndrome (ABS) is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS. PMID:22518185

  3. Antenatal assessment of fetal maturity

    Gerstner, G.; Reinold, E.; Wolf, G.

    1979-01-01

    334 ultrasound-cephalometries and 231 X-ray fetographies were performed for antenatal assessment of fetal maturity as well as for exact estimation of gestational age in women with unknown date of confinement. The accuracy of the predictions was compared. Ultrasound-cephalometry gave best results when performed until the 20th week of gestation. A correct prediction was obtained in 80.4% of cases. After the 20th week of gestation, the accuracy of prediction decreased. Radiology on the contrary gave optimal results at the end of pregnancy. A correct prediction of the date of confinement was obtained in 73.8% of cases, when the X-ray fetography was performed between the 37th and 40th week of gestation. At the end of gestation radiography should be performed, if there is a discrepancy between ultrasound and clinical estimation or if ultrasound-cephalometry was not carried out in early pregnancy - especially if induction of labour is necessary. (author)

  4. Feasibility of telecare solution for patients admitted with COPD exacerbation: screening data from a pulmonary ward in a university hospital

    Gottlieb, Magnus; Marså, Kristoffer; Andreassen, Helle

    2014-01-01

    are to assess the reasons for the exclusion of patients, and the reasons for patients not consenting to participate, as well as to identify the predictors for consenting or not consenting among the subgroup of eligible patients. Methods: In this study, all data in the screening log were collected over a period...... help patients manage their disease at home and thereby possibly reduce the risk of readmission. Purpose: The primary aim of this study is to assess the feasibility of a telehealth care solution when offered in connection with discharges from a pulmonary ward at a university hospital. Secondary aims...

  5. Mini-Nutritional Assessment, Malnutrition Universal Screening Tool, and Nutrition Risk Screening Tool for the Nutritional Evaluation of Older Nursing Home Residents.

    Donini, Lorenzo M; Poggiogalle, Eleonora; Molfino, Alessio; Rosano, Aldo; Lenzi, Andrea; Rossi Fanelli, Filippo; Muscaritoli, Maurizio

    2016-10-01

    Malnutrition plays a major role in clinical and functional impairment in older adults. The use of validated, user-friendly and rapid screening tools for malnutrition in the elderly may improve the diagnosis and, possibly, the prognosis. The aim of this study was to assess the agreement between Mini-Nutritional Assessment (MNA), considered as a reference tool, MNA short form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and Nutrition Risk Screening (NRS-2002) in elderly institutionalized participants. Participants were enrolled among nursing home residents and underwent a multidimensional evaluation. Predictive value and survival analysis were performed to compare the nutritional classifications obtained from the different tools. A total of 246 participants (164 women, age: 82.3 ± 9 years, and 82 men, age: 76.5 ± 11 years) were enrolled. Based on MNA, 22.6% of females and 17% of males were classified as malnourished; 56.7% of women and 61% of men were at risk of malnutrition. Agreement between MNA and MUST or NRS-2002 was classified as "fair" (k = 0.270 and 0.291, respectively; P < .001), whereas the agreement between MNA and MNA-SF was classified as "moderate" (k = 0.588; P < .001). Because of the high percentage of false negative participants, MUST and NRS-2002 presented a low overall predictive value compared with MNA and MNA-SF. Clinical parameters were significantly different in false negative participants with MUST or NRS-2002 from true negative and true positive individuals using the reference tool. For all screening tools, there was a significant association between malnutrition and mortality. MNA showed the best predictive value for survival among well-nourished participants. Functional, psychological, and cognitive parameters, not considered in MUST and NRS-2002 tools, are probably more important risk factors for malnutrition than acute illness in geriatric long-term care inpatient settings and may account for the low predictive

  6. Endocrine Disruptor Screening Program (EDSP) Universe of Chemicals and General Validation Principles

    This document was developed by the EPA to provide guidance to staff and managers regarding the EDSP universe of chemicals and general validation principles for consideration of computational toxicology tools for chemical prioritization.

  7. Universal Screening for Intimate Partner and Sexual Violence in Trauma Patients - What About the Men? An EAST Multicenter Trial.

    Zakrison, Tanya L; Rattan, Rishi; Milian Valdés, Davel; Ruiz, Xiomara; Gelbard, Rondi; Cline, John; Turay, David; Luo-Owen, Xian; Namias, Nicholas; George, Jessica; Yeh, Dante; Pust, Daniel; Williams, Brian H

    2018-02-14

    A recent EAST-supported, multicenter trial demonstrated a similar rate of intimate partner and sexual violence (IPSV) between male and female trauma patients, regardless of mechanism. Our objective was to perform a subgroup analysis of our affected male cohort as this remains an understudied group in the trauma literature. We conducted a recent EAST-supported, cross-sectional, multicenter trial over one year (03/15-04/16) involving four Level I trauma centers throughout the United States. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Risk factors for male patients were identified. Chi-squared test compared categorical variables with significance at p<0.05. Parametric data is presented as mean +/-standard deviation. A total of 2,034 trauma patients were screened, of which 1,281 (63%) were men. Of this cohort, 119 men (9.3%) screened positive for intimate partner violence, 14.1% for IPSV and 6.5% for sexual violence. On categorical analysis of the HITS screen, the proportion of men that were physically hurt was 4.8% compared to 4.3% for women (p = 0.896). A total of 4.8% of men screened positive for both intimate partner and sexual violence. The total proportion of men who presented with any history of intimate partner violence, sexual violence or both (IPSV) was 15.8%. More men affected by penetrating trauma screened positive for IPSV (p < 0.00001). IPSV positivity in men was associated with mental illness, substance abuse, and trauma recidivism. One out of every twenty men that present to trauma centers is a survivor of both intimate partner and sexual violence, with one out of every six men experiencing some form of violence. Men are at similar risk for physical abuse as women when this intimate partner violence occurs. IPSV is associated with penetrating trauma in men. Support programs for this population may potentially impact associated mental

  8. Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?†

    Cannon, Michael J.; Griffiths, Paul D.; Aston, Van; Rawlinson, William D.

    2014-01-01

    Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries,...

  9. Is Universal Screening Necessary? Incidence of Tuberculosis among Tibetan Refugees Arriving in Calgary, Alberta.

    Lim, Rachel; Jarand, Julie; Field, Stephen K; Fisher, Dina

    2016-01-01

    Background . Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are indiscriminately screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. Design . Retrospective cohort study including Tibetan refugees arriving between 2014 and 2016. Associations between preimmigration factors and incidence of latent and active TB were determined using Chi-square tests. Results . Out of 180 subjects, 49 percent had LTBI. LTBI was more common in migrants 30 years of age or older ( P = 0.009). Treatment initiation and completion rates were high at 90 percent and 76 percent, respectively. No associations between preimmigration factors and treatment completion were found. A case of active TB was detected and treated. Conclusion . Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada.

  10. Screening for Dyslexia in French-Speaking University Students: An Evaluation of the Detection Accuracy of the Alouette Test.

    Cavalli, Eddy; Colé, Pascale; Leloup, Gilles; Poracchia-George, Florence; Sprenger-Charolles, Liliane; El Ahmadi, Abdessadek

    Developmental dyslexia is a lifelong impairment affecting 5% to 10% of the population. In French-speaking countries, although a number of standardized tests for dyslexia in children are available, tools suitable to screen for dyslexia in adults are lacking. In this study, we administered the Alouette reading test to a normative sample of 164 French university students without dyslexia and a validation sample of 83 students with dyslexia. The Alouette reading test is designed to screen for dyslexia in children, since it taps skills that are typically deficient in dyslexia (i.e., phonological skills). However, the test's psychometric properties have not previously been available, and it is not standardized for adults. The results showed that, on the Alouette test, dyslexic readers were impaired on measures of accuracy, speed, and efficiency (accuracy/reading time). We also found significant correlations between the Alouette reading efficiency and phonological efficiency scores. Finally, in terms of the Alouette test, speed-accuracy trade-offs were found in both groups, and optimal cutoff scores were determined with receiver operator characteristic curves analysis, yielding excellent discriminatory power, with 83.1% sensitivity and 100% specificity for reading efficiency. Thus, this study supports the Alouette test as a sensitive and specific screening tool for adults with dyslexia.

  11. CORALINA: a universal method for the generation of gRNA libraries for CRISPR-based screening.

    Köferle, Anna; Worf, Karolina; Breunig, Christopher; Baumann, Valentin; Herrero, Javier; Wiesbeck, Maximilian; Hutter, Lukas H; Götz, Magdalena; Fuchs, Christiane; Beck, Stephan; Stricker, Stefan H

    2016-11-14

    The bacterial CRISPR system is fast becoming the most popular genetic and epigenetic engineering tool due to its universal applicability and adaptability. The desire to deploy CRISPR-based methods in a large variety of species and contexts has created an urgent need for the development of easy, time- and cost-effective methods enabling large-scale screening approaches. Here we describe CORALINA (comprehensive gRNA library generation through controlled nuclease activity), a method for the generation of comprehensive gRNA libraries for CRISPR-based screens. CORALINA gRNA libraries can be derived from any source of DNA without the need of complex oligonucleotide synthesis. We show the utility of CORALINA for human and mouse genomic DNA, its reproducibility in covering the most relevant genomic features including regulatory, coding and non-coding sequences and confirm the functionality of CORALINA generated gRNAs. The simplicity and cost-effectiveness make CORALINA suitable for any experimental system. The unprecedented sequence complexities obtainable with CORALINA libraries are a necessary pre-requisite for less biased large scale genomic and epigenomic screens.

  12. A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda.

    Andrew B Ross

    Full Text Available BACKGROUND: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics. METHODS AND FINDINGS: Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3-20.6, 95% CI from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3-111.5, 95% CI from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits. CONCLUSIONS: The availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.

  13. The cost-effectiveness of targeted or universal screening for vasa praevia at 18-20 weeks of gestation in Ontario.

    Cipriano, L E; Barth, W H; Zaric, G S

    2010-08-01

    To estimate the cost-effectiveness of targeted and universal screening for vasa praevia at 18-20 weeks of gestation in singleton and twin pregnancies. Cost-utility analysis based on a decision-analytic model comparing relevant strategies and life-long outcomes for mother and infant(s). Ontario, Canada. A cohort of pregnant women in 1 year. We constructed a decision-analytic model to estimate the lifetime incremental costs and benefits of screening for vasa praevia. Inputs were estimated from the literature. Costs were collected from the London Health Sciences Centre, the Ontario Health Insurance Program, and other sources. We used one-way, scenario and probabilistic sensitivity analysis to determine the robustness of the results. Incremental costs, life expectancy, quality-adjusted life-years (QALY) and incremental cost-effectiveness ratio (ICER). Universal transvaginal ultrasound screening of twin pregnancies has an ICER of $5488 per QALY-gained. Screening all singleton pregnancies with the risk factors low-lying placentas, in vitro fertilisation (IVF) conception, accessory placental lobes, or velamentous cord insertion has an ICER of $15,764 per QALY-gained even though identifying some of these risk factors requires routine use of colour Doppler during transabdominal examinations. Screening women with a marginal cord insertion costs an additional $27,603 per QALY-gained. Universal transvaginal screening for vasa praevia in singleton pregnancies costs $579,164 per QALY compared with targeted screening. Compared with current practice, screening all twin pregnancies for vasa praevia with transvaginal ultrasound is cost-effective. Among the alternatives considered, the use of colour Doppler at all transabdominal ultrasound examinations of singleton pregnancies and targeted use of transvaginal ultrasound for IVF pregnancies or when the placenta has been found to be associated with one or more risk factors is cost-effective. Universal screening of singleton pregnancies

  14. Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

    Cannon, Michael J; Griffiths, Paul D; Aston, Van; Rawlinson, William D

    2014-09-01

    Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?†

    Cannon, Michael J.; Griffiths, Paul D.; Aston, Van; Rawlinson, William D.

    2015-01-01

    SUMMARY Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd. PMID:24760655

  16. Screening masses in the SU(3) pure gauge theory and universality

    Falcone, R.; Fiore, R.; Gravina, M.; Papa, A.

    2007-01-01

    We determine from Polyakov loop correlators the screening masses in the deconfined phase of the (3+1)d SU(3) pure gauge theory at finite temperature near the transition, for two different channels of angular momentum and parity. Their ratio is compared with that of the massive excitations with the same quantum numbers in the 3d 3-state Potts model in the broken phase near the transition point at zero magnetic field. Moreover we study the inverse decay length of the correlation between the real parts and between the imaginary parts of the Polyakov loop and compare the results with expectations from perturbation theory and mean-field Polyakov loop models

  17. A tailored approach to BRAF and MLH1 methylation testing in a universal screening program for Lynch syndrome.

    Adar, Tomer; Rodgers, Linda H; Shannon, Kristen M; Yoshida, Makoto; Ma, Tianle; Mattia, Anthony; Lauwers, Gregory Y; Iafrate, Anthony J; Chung, Daniel C

    2017-03-01

    To determine the correlation between BRAF genotype and MLH1 promoter methylation in a screening program for Lynch syndrome (LS), a universal screening program for LS was established in two medical centers. Tumors with abnormal MLH1 staining were evaluated for both BRAF V600E genotype and MLH1 promoter methylation. Tumors positive for both were considered sporadic, and genetic testing was recommended for all others. A total 1011 colorectal cancer cases were screened for Lynch syndrome, and 148 (14.6%) exhibited absent MLH1 immunostaining. Both BRAF and MLH1 methylation testing were completed in 126 cases. Concordant results (both positive or both negative) were obtained in 86 (68.3%) and 16 (12.7%) cases, respectively, with 81% concordance overall. The positive and negative predictive values for a BRAF mutation in predicting MLH1 promoter methylation were 98.9% and 41%, respectively, and the negative predictive value fell to 15% in patients ≥70 years old. Using BRAF genotyping as a sole test to evaluate cases with absent MLH1 staining would have increased referral rates for genetic testing by 2.3-fold compared with MLH1 methylation testing alone (31% vs 13.5%, respectively, PMLH1 methylation testing for BRAF wild-type cases only would significantly decrease the number of methylation assays performed and reduce the referral rate for genetic testing to 12.7%. A BRAF mutation has an excellent positive predictive value but poor negative predictive value in predicting MLH1 promoter methylation. A hybrid use of these tests may reduce the number of low-risk patients referred to genetic counseling and facilitate wider implementation of Lynch syndrome screening programs.

  18. An educational program about premarital screening for unmarried female students in King Abdul-Aziz University, Jeddah

    Nahla Khamis Ragab Ibrahim

    2011-03-01

    Full Text Available Summary: The present study was conducted to assess knowledge and attitude of unmarried female students in King Abdul-Aziz University (KAU towards premarital screening (PMS program, to determine predictors of high students’ knowledge scores and to improve their knowledge about PMS through conduction of an educational campaign. Multi-stage stratified random sample method was used with recruitment of 1563 students from all faculties of KAU, during the educational year 2008–2009. The Pre-test included 30 knowledge items and 14 attitude statements with student's response through a 5-point Likert scale. Health education was conducted using audiovisual aids through pre-designed educational materials. Statistical analysis was done by SPSS version 16. Results: Students’ knowledge about the program was generally low before the educational campaign. The predictors of high knowledge scores were being a health science student (aOR = 4.15; 95% CI: 2.97–5.81, age ≥20 years (aOR = 2.78; 95% CI: 2.01–3.85, family history of hereditary diseases and income ≥10,000 SR/month. Regarding attitude, almost all students (99.0% agreed on the importance of PMS. After the educational program, students’ knowledge about PMS was markedly improved. The mean students’ knowledge score was 9.85 ± 5.36 in Pre-test and improved to 18.45 ± 4.96 in Post-test, with a highly statistical significant difference (paired t = 25.40, p < 0.000. Conclusion and recommendations: The educational program was successful in improving students’ knowledge about the PMS. Conduction of similar educational programs and adding PMS in the curriculum of secondary and university education are recommended. Keywords: Premarital, Screening, University students, Educational program, Jeddah, KSA

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

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

    2008-06-15

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

  20. Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania.

    Kaaya, S F; Mbwambo, J K; Kilonzo, G P; Van Den Borne, H; Leshabari, M T; Fawzi, M C Smith; Schaalma, H

    2010-01-01

    Depression during pregnancy may negatively influence social functioning, birth outcomes and postnatal mental health. A cross-sectional analysis of the baseline survey of a prospective study was undertaken with an objective of determining the prevalence and socio-demographic factors associated with depressive morbidity during pregnancy in a Tanzanian peri-urban setting. Seven hundred and eighty seven second to third trimester pregnant women were recruited at booking for antenatal care at two primary health care clinics. Prenatal structured interviews assessed socio-economic, quality of partner relationships and selected physical health measures. Depressive symptoms were measured at recruitment and three and eight months postpartum using the Kiswahili version of the Hopkins Symptom Checklist. Completed antenatal measures available for 76.2% participants, showed a 39.5% prevalence of depression. Having a previous depressive episode (OR 4.35, Ppartner (OR 1.89, Peconomic measures. In conclusion, clinically significant depressive symptoms are common in mid and late trimester antenatal clinic attendees. Interventions for early recognition of depression should target women with a history of previous depressive episodes or low satisfaction with ability to access basic needs, conflict in partner relationships and relatively earlier booking for antenatal care. Findings support a recommendation that antenatal services consider integrating screening for depression in routine antenatal care.

  1. Antenatal imaging of cutis verticis gyrata

    Kennedy, Ana; Perry, David; Battin, Malcolm

    2008-01-01

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

  2. Antenatal imaging of cutis verticis gyrata

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

    2008-05-15

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

  3. A Cross-Sectional Study for Screening of Postural Deficits among University Students

    Ahmed Abdelmoniem Ibrahim

    2017-09-01

    Full Text Available Background: Postural deviations are frequent in university students and may cause pain and functional impairment. Few studies have examined the association between body posture and intrinsic and extrinsic factors. Objective: To assess the prevalence of postural changes in university students, and to determine whether factors such as age, gender, BMI, and physical activity might explain these deviations, this study helping in preventing aggravation of postural deviations and providing the young adolescent students with exercises and help tips for correcting these problems. Design: Cross sectional study. Subjects and Methods: The posture of 48 students in Hail University was assessed by DIER formetric 4D. Their mean age was 20.35 ± 2.678, height was 185.56 ± 7.128 and weight was 54.19 ± 7.085. Results: results revealed positive correlation between height and weight, height and self-image, weight and surface rotation, self-image and pelvic tilting, kyphotic angle and lordotic angle, pelvic tilt and trunk imbalance, lateral deviation and trunk imbalance. Conclusion: high prevalence of abnormalities among students, so it is recommended that all instructors place more emphasis on training and using corrective actions in course one of general physical education. Furthermore, teaching the correct sleeping, sitting and carrying ways will stop high expenses and devoting long times for clinical remedies.

  4. Genome-wide screen for universal individual identification SNPs based on the HapMap and 1000 Genomes databases.

    Huang, Erwen; Liu, Changhui; Zheng, Jingjing; Han, Xiaolong; Du, Weian; Huang, Yuanjian; Li, Chengshi; Wang, Xiaoguang; Tong, Dayue; Ou, Xueling; Sun, Hongyu; Zeng, Zhaoshu; Liu, Chao

    2018-04-03

    Differences among SNP panels for individual identification in SNP-selecting and populations led to few common SNPs, compromising their universal applicability. To screen all universal SNPs, we performed a genome-wide SNP mining in multiple populations based on HapMap and 1000Genomes databases. SNPs with high minor allele frequencies (MAF) in 37 populations were selected. With MAF from ≥0.35 to ≥0.43, the number of selected SNPs decreased from 2769 to 0. A total of 117 SNPs with MAF ≥0.39 have no linkage disequilibrium with each other in every population. For 116 of the 117 SNPs, cumulative match probability (CMP) ranged from 2.01 × 10-48 to 1.93 × 10-50 and cumulative exclusion probability (CEP) ranged from 0.9999999996653 to 0.9999999999945. In 134 tested Han samples, 110 of the 117 SNPs remained within high MAF and conformed to Hardy-Weinberg equilibrium, with CMP = 4.70 × 10-47 and CEP = 0.999999999862. By analyzing the same number of autosomal SNPs as in the HID-Ion AmpliSeq Identity Panel, i.e. 90 randomized out of the 110 SNPs, our panel yielded preferable CMP and CEP. Taken together, the 110-SNPs panel is advantageous for forensic test, and this study provided plenty of highly informative SNPs for compiling final universal panels.

  5. Perception of prenatal services by antenatal clinic attendees in a ...

    DR ADDAH A.O

    2015-09-30

    Sep 30, 2015 ... also been recognised that most women who registered for antenatal care in a particular health ..... is not yet appropriate to embrace focused antenatal care.9 There are still gaps in the continued use of ... higher wages.

  6. Effects of Antenatal Betamethasone and Dexamethasone in Preterm Neonates

    Chen-Yu Chen

    2005-09-01

    Conclusion: In our study, no significant differences between antenatal betamethasone and dexamethasone were found in complications of preterm neonates. Incomplete courses of antenatal corticosteroids were associated with an increased incidence of RDS compared with complete courses.

  7. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.

    Jobe, Alan H; Goldenberg, Robert L

    2018-04-07

    Antenatal corticosteroids are standard of care for pregnancies at risk of preterm delivery between 24-34 weeks' gestational age. Recent trials demonstrate modest benefits from antenatal corticosteroids for late preterm and elective cesarean deliveries, and antenatal corticosteroids for periviable deliveries should be considered with family discussion. However, many women with threatened preterm deliveries receive antenatal corticosteroids but do not deliver until >34 weeks or at term. The net effect is that a substantial fraction of the delivery population will be exposed to antenatal corticosteroids. There are gaps in accurate assessments of benefits of antenatal corticosteroids because the randomized controlled trials were performed prior to about 1990 in pregnancies generally >28 weeks. The care practices for the mother and infant survival were different than today. The randomized controlled trial data also do not strongly support the optimal interval from antenatal corticosteroid treatment to delivery of 1-7 days. Epidemiology-based studies using large cohorts with >85% of at-risk pregnancies treated with antenatal corticosteroids probably overestimate the benefits of antenatal corticosteroids. Although most of the prematurity-associated mortality is in low-resource environments, the efficacy and safety of antenatal corticosteroids in those environments remain to be evaluated. The short-term benefits of antenatal corticosteroids for high-risk pregnancies in high-resource environments certainly justify antenatal corticosteroids as few risks have been identified over many years. However, cardiovascular and metabolic abnormalities have been identified in large animal models and cohorts of children exposed to antenatal corticosteroids that are consistent with fetal programming for adult diseases. These late effects of antenatal corticosteroids suggest caution for the expanded use of antenatal corticosteroids beyond at-risk pregnancies at 24-34 weeks. A way forward

  8. Migraine headaches among university students using id migraine test as a screening tool

    Caylan Ayse

    2011-08-01

    Full Text Available Abstract Background Migraine is a significant health problem, especially for the young people, due to its frequency and accompanying morbidity, causing disability and loss of performance. In this study, our aim was to determine the prevalence of migraine headaches among university students in Edirne, a Turkish city. Methods In this cross-sectional and descriptive study, study population was composed of students registered to Trakya University in the academic year of 2008-2009. Out of these, 3694 of them accepted to participate. Participants who had two or more headaches in the last 3 months formed the headache group. Afterwards, two preliminary questions were applied to the headache group and participants with at least one affirmative response were asked to perform the validated ID-Migraine™ test. Results The mean age of 3694 students participated in the study was 19.23 ± 1.84 (17-39 years, with adolescents:adult ratio being 2.5:1. 1613 students (43.7% did have at least two headaches in the last three months. Migraine-type headache was detected in 266 subjects (7.2% based on the ID-Migraine™ test. Of the migraine group, 72 were male (27.1% and 194 were female (72.9%. There was no significant difference in migraine prevalence between adolescent and adult age groups. Conclusions With a prevalence similar to adults, primary care physicians should be aware of the probability of migraine headaches in university students in order to maintain a successful school performance.

  9. EFFECT OF THYROID DYSFUNCTION IN ANTENATAL MOTHERS

    Anasooya Parail Sankaran

    2016-12-01

    Full Text Available BACKGROUND The aim of the study is to study the effect of thyroid dysfunction in antenatal mothers in Alappuzha one of the coastal areas in South Kerala over a period from January 2012 to January 2015. MATERIALS AND METHODS It is a descriptive study of the effect of thyroid dysfunction among pregnant ladies attending OBG Department in Government Medical College, Alappuzha, a rural medical college at coastal areas of Kerala over a period of 3 years. RESULTS The incidence is found to be maximum in the coastal area, i.e. 84.9%, but p-valve 0.625 is not statistically significant. Thyroid disorder is mostly seen in primigravida (57.8% and between the age of 20 and 25 yrs. (43.2% and the most commonly seen disorder among is subclinical hypothyroidism (73.7% (p valve <.005, which is statistically significant. There is significant increase in maternal complications like preeclampsia, (RR-8.54, p-value 0.014 recurrent abortion (RR-91.13, p-value 0.000, prolonged period of infertility (RR-55.16, p-value 0.000, anaemia (RR-11.37, p-value 0.003 is seen in subclinical hypothyroidism. The foetal complications seen are oligamnios (7.8%, MSAF (9.2%, foetal distress (12.1%, PROM (5.1% and FGR (10.9%. The neonates were admitted in NICU in view of NEC (1.5%, NNJ (24.1%, MAS (6.9%, TTNB (9.5% and HIE (2.9%. CONCLUSION The present study is intended to study the maternal and foetal effects of thyroid dysfunction. After the study, we concluded that there are many adverse maternal, foetal and neonatal effects in pregnancies complicated with thyroid dysfunction. In coastal area, the disease has got a high prevalence and hence there is a need for proper screening and early diagnosis. Proper treatment options are given to the patient.

  10. Screening for psychosocial problems in children attending the pediatric clinic at king Khalid university hospital (KKUH in Riyadh (KSA

    Ibrahim H Al-Ayed

    2008-01-01

    Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  11. Health care providers' knowledge and practice of focused antenatal ...

    ... observational checklist were the instruments for data collection. Findings revealed poor knowledge of concept, components, timing of visits on focused antenatal care and non compliance with the guidelines for the practice of focused antenatal care, because of health workers lack of knowledge on focused antenatal care.

  12. Improving support and education of low-income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening.

    Turner, Barbara J; Craig, Kathryn; Makanji, Vidhi S; Flores, Bertha E; Hernandez, Ludivina

    2017-12-01

    To identify support needs of low-income baby boomers recently diagnosed with chronic hepatitis C virus infection. The U.S. Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945-1965) for hepatitis C because 75% of the estimated 2-3 million persons with chronic infection are in this age range. We hypothesised that persons diagnosed by routine screening would have significant psycho-emotional, cognitive and healthcare challenges that need to be met by collaborative care and services from nurses and other healthcare personnel. Qualitative descriptive study of data from three focus groups with predominantly minority participants (N = 16). Data were analysed using qualitative content analysis, and transcribed data were categorised by three domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants' comments about each theme were calculated. Elucidated domains were as follows: (i) psycho-emotional effects due to social stigma, shame, fear and dealing with risky behaviours; (ii) social effects due to concerns about infecting others; and (iii) cognitive deficits because of poor understanding about hepatitis C virus infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening. This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis which are compounded by poor knowledge and barriers to supportive care. Nursing and other allied health personnel require structured support programmes to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure. © 2017 John Wiley & Sons Ltd.

  13. Determinants of caregivers' awareness of Universal Newborn Hearing Screening in Malaysia.

    Abdul Majid, Abdul Halim; Zakaria, Mohd Normani; Abdullah, Nor Azimah Chew; Hamzah, Sulaiman; Mukari, Siti Zamratol-Mai Sarah

    2017-10-01

    This paper aims to investigate the effects of perceived attitude and anxiety on awareness of UNHS among caregivers in Malaysia. Using cross sectional research approach, data were collected and some 46 out of 87 questionnaires distributed to caregivers attending UNHS programs at selected public hospitals were usable for analysis (response rate of 52.8%). Partial Least Squares Method (PLS) algorithm and bootstrapping technique were employed to test the hypotheses of the study. R square value is 0.205, and it implies that exogenous latent variables explained 21% of the variance of the endogenous latent variable. This value indicates moderate and acceptable level of R-squared values. Findings from PLS structural model evaluation revealed that anxiety has no significant influence (β = -0.091, t = 0.753, p > 0.10) on caregivers' awareness; but perceived attitude has significant effect (β = -0.444, t = 3.434, p economic situation of the caregivers may have contributed to their failure to honor UNHS screening appointments as some of them may need to work to earn a living while some may perceive it a waste of time honoring such appointments. Non-significant relationship between anxiety and caregivers' awareness may be due to religious beliefs of caregivers. Limitations and suggestions were discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Screening For Gestational Diabetes Mellitus Selectively in a University Maternity Hospital

    O’Malley, EG

    2018-06-01

    Gestational diabetes mellitus (GDM) is one of the commonest complications of pregnancy. The prevalence varies depending, for example, on the diagnostic criteria, the screening test used, laboratory standards and the population studied. However, the prevalence is increasing globally due to the increasing levels of maternal obesity. The detection of GDM is important because there are clinical consequences. The woman has an increased risk of pre-eclampsia and of developing Type 2 diabetes mellitus (T2DM) in later life. Up to 70% of those women with GDM develop T2DM by 28 years after the affected pregnancy2. In a pregnancy complicated by GDM there is an increased risk of fetal macrosomia and polyhydramnios due to fetal hyperglycaemia3. This is associated with an increased risk of shoulder dystocia and caesarean delivery4. Neonatal hypoglycaemia may develop due to increased insulin production secondary to intrauterine hyperglycaemia. The offspring also have an increased risk in their childhood and adult life for the development of diabetes, obesity and metabolic syndrome5.

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

    Kessy Flora

    2011-05-01

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

  16. Midwifery basics. Antenatal care: the options available.

    Baston, Helen

    2002-10-01

    This new series of articles is aimed at student midwives. Its purpose is to provide them with a basic understanding of the main issues and concepts surrounding the delivery of antenatal care. Students will be encouraged to seek further information through a series of activities throughout the text. They will also be helped to link theory with practice by following 'Joanna' through her pregnancy.

  17. Antenatal Bartter's syndrome with sensorineural deafness

    Bhamkar, R. P.; Gajendragadkar, A.

    2009-01-01

    Bartter's syndrome is a group of inherited, salt-losing tubulopathies presenting as metabolic alkalosis with normotensive hyperreninemia and hyperaldosteronism. We report here the first case of a neonate with bilateral, sensorineural deafness, a variant of antenatal Bartter's syndrome from an Indian community.

  18. Universal screening for alcohol misuse in acute medical admissions is feasible and identifies patients at high risk of liver disease.

    Westwood, Greta; Meredith, Paul; Atkins, Susan; Greengross, Peter; Schmidt, Paul E; Aspinall, Richard J

    2017-09-01

    Many people who die from alcohol related liver disease (ARLD) have a history of recurrent admissions to hospital, representing potential missed opportunities for intervention. Universal screening for alcohol misuse has been advocated but it is not known if this is achievable or effective at detecting individuals at high risk of ARLD. We systematically screened all admissions to the Acute Medical Unit (AMU) of a large acute hospital using an electronic data capture system in real time. Patients at an increasing risk of alcohol harm were referred for either brief intervention (BI) or further assessment by an Alcohol Specialist Nursing Service (ASNS). Additional data were recorded on admission diagnoses, alcohol unit consumption, previous attendances, previous admissions, length of stay and mortality. Between July 2011 and March 2014, there were 53,165 admissions and 48,211 (90.68%) completed screening. Of these, 1,122 (2.3%) were classified as "increasing", and 1,921 (4.0%) as "high" risk of alcohol harm. High risk patients had more hospital admissions in the three previous years (average 4.74) than the low (3.00) and increasing (2.92) risk groups (prisk patients also had more frequent emergency department (ED) attendances (7.68) than the lower (2.64) and increasing (3.81) groups (prisk group were seen by the ASNS and 1,135 (81.2%) had an Alcohol Use Disorders Identification Test (AUDIT) score over 20 with 527 (37.8%) recording the maximum value of 40. Compared to the other groups, high risk patients had a distinct profile of admissions with the most common diagnoses being mental health disorders, gastro-intestinal bleeding, poisoning and liver disease. Universal screening of admissions for alcohol misuse is feasible and identifies a cohort with frequent ED attendances, recurrent admissions and an elevated risk of ARLD. An additional group of patients at an increasing risk of alcohol harm can be identified in a range of common presentations. These patients can be

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

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

    2014-07-01

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

  20. Psychometric Adaptation of the Beck Hopelessness Scale as a Self-Rated Suicide Risk Screening Instrument Among Nigerian University Students.

    Aloba, Olutayo; Awe, Oluwatosin; Adelola, Aderopo; Olatunji, Philemon; Aloba, Tolulope

    2018-03-01

    Globally, suicide is the most important cause of mortality among adolescents and young adults. The factor that correlates most significantly with suicide is hopelessness. The aim is to explore the psychometric adaptation of the Beck Hopelessness Scale (BHS) as a suicide risk evaluation tool among Nigerian university students. A total of 554 Nigerian students completed the BHS and the Depression Anxiety Stress Scale (DASS). Suicide risk level among them was determined by interviewing them with the Mini International Neuropsychiatric Interview Suicidality module. Cronbach's alpha for the 16-item BHS was 0.87. It exhibited satisfactory concurrent validity with the Mini International Neuropsychiatric Interview (MINI) Suicidality module and the subscales of the DASS among the students. The 2-factor model of the BHS-16 exhibited satisfactory indices of fitness (goodness of fit index = 0.930; parsimonious goodness of fit index = 0.601; comparative fit index = 0.934; incremental fit index = 0.936; Tucker-Lewis index = 0.910; root mean square error of approximation = 0.059; χ 2 / df = 1.9). Receiver operating characteristics curve indicated that the best cutoff score for those categorized as high suicide risk was 7 (sensitivity 0.700, specificity 0.908, AUC = 0.897). The BHS has satisfactory psychometric properties as a suicide risk screening tool among Nigerian university students.

  1. serological screening for ante-natal toxoplasmosis in maiduguri ...

    parasite, Toxoplasma gondii (T. gondii), an obligate intracellular protozoan ... In this study, we examined the immunological status of pregnant .... transplacentally and parasite can cause systemic infection, we posit .... actors for Taenia saginata.

  2. Implementation of universal rapid human immunodeficiency virus screening on labor and delivery.

    Crochet, Stacia; Huang, Chun-Chih; Fries, Melissa; Scott, Rachel K

    2018-03-01

    A case of mother to child transmission (MTCT) of HIV at a medical center in Washington, DC, resulted in the implementation of universal opt-out rapid testing of patients admitted for delivery. This article evaluates the policy's efficacy and implementation. We evaluated the implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. We could not evaluate decrease in MTCT rate secondary to low sample size ( n  = 3324) and no true-positive results. Patients not tested ( n  = 458) were predominately secondary to physician omission (93.7%) and were more likely to be White ( p  < 0.01) and older ( p  < 0.01). There was a negative relationship with physician omission over time. The policy was successfully implemented with decreasing proportions of patients not tested. Earlier inclusion of testing into standard admission orders and nurse-based approach may have expedited adoption. Given the low incidence of new HIV diagnosis in labor, we were unable to assess decrease in MTCT.

  3. Knowledge, attitude, and experience of cervical cancer and screening among Sub-saharan African female students in a UK University.

    Ogbonna, Faith Sopuruchukwu

    2017-01-01

    Cervical cancer is one of the major diseases that affect women of child bearing age. Its main cause is the human papilloma virus; although, other associated factors have been evidenced to increase its risk. Pap-smear screening and vaccination which has been shown to be successful in reducing the incidence and prevalence of the disease in developed countries, has been neglected in developing countries due to lack of knowledge, misconceptions, and cultural beliefs. A cross-sectional study involving only female Sub-Saharan Africa (SSA) students in a UK university setting. One hundred and eighty-six (42%) African female students were recruited from the 442 SSA students attending one of the major Universities in the UK. Seventy-one (38.2%) of the students were aware of cervical screening, but only 20 (10.8%) reported having knowledge of cervical cancer. A small percentage of about 26.9% (50 Students) were already part of this screening program; although, 81 (43.5%) showed willingness to participate in future screening programs. More so, it was evident that student's perception was dependent on their experience of the disease (P = 000) just as their participation in screening program was dependent on their awareness level (P ≤ 0.01). Female African students from the SSA region have poor knowledge of the disease which influenced their attitude toward screening. More needs to be carried out to increase awareness and uptake of screening within the school environment as university setting provides a viable platform to promote healthy behavior. Résumé Contexte: Le cancer du col de l'utérus est l'une des principales maladies qui touchent les femmes en âge de procréer. Sa principale cause est le virus du papillome humain; Bien que, d'autres facteurs associés ont été mis en évidence pour augmenter son risque. Le dépistage du Pap et la vaccination, qui s'est avéré efficace pour réduire l'incidence et la prévalence de la maladie dans les pays développés, a

  4. Effectiveness of prenatal screening for Down syndrome on the basis ...

    %) of 61 AMA women reached genetic counselling in tertiary care: reasons included late initiation of antenatal care and low referral rates from primary care. Conclusion. Prenatal screening and diagnosis for DS based on AMA is working ...

  5. Antenatal breastfeeding education for increasing breastfeeding duration

    Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad

    2014-01-01

    Background Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated. Objectives To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (21 April 2010), CENTRAL (The Cochrane Library 2010, Issue 2), MEDLINE (1966 to April 2010) and SCOPUS (January 1985 to April 2010). We contacted experts and searched reference lists of retrieved articles. We updated the search of the Pregnancy and Childbirth Group’s Trials Register on 28 September 2011 and added the results to the awaiting classification section of the review. Selection criteria All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on duration of BF. We excluded RCTs that also included intrapartum or postpartum BF education. Data collection and analysis We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. Main results We included 17 studies with 7131 women in the review and 14 studies involving 6932 women contributed data to the analyses. We did not do any meta-analysis because there was only one study for each comparison. Five studies compared a single method of BF education with routine care. Peer counselling significantly increased BF initiation. Three studies compared one form of BF education versus another. No intervention was significantly more effective than another intervention in increasing initiation or duration of BF. Seven studies compared multiple methods versus a single method of BF education. Combined BF educational interventions were not

  6. Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS): Psychometric Testing of the National Child Traumatic Stress Network Hurricane Assessment and Referral Tool

    Hansel, Tonya Cross; Osofsky, Joy D.; Osofsky, Howard J.

    2015-01-01

    Background: Post disaster psychosocial surveillance procedures are important for guiding effective and efficient recovery. The Louisiana State University Health Sciences Center Katrina Inspired Disaster Screenings (KIDS) is a model designed with the goal of assisting recovering communities in understanding the needs of and targeting services…

  7. Evaluating the Interpretations and Use of Curriculum-Based Measurement in Reading and Word Lists for Universal Screening in First and Second Grade

    January, Stacy-Ann A.; Ardoin, Scott P.; Christ, Theodore J.; Eckert, Tanya L.; White, Mary Jane

    2016-01-01

    Universal screening in elementary schools often includes administering curriculum-based measurement in reading (CBM-R); but in first grade, nonsense word fluency (NWF) and, to a lesser extent, word identification fluency (WIF) are used because of concerns that CBM-R is too difficult for emerging readers. This study used Kane's argument-based…

  8. Before we begin. The importance of antenatal education.

    Nolan, Mary

    2012-04-01

    A review of the impact of universal antenatal education found that group based programmes which promote the transition to parenthood by focusing on relationships (between the couple and with the baby), and which are participative and build social support, are most likely to be effective (McMillan et al 2009). An Expert Reference Group convened by the Department of Health has designed a Preparation for Birth and Beyond programme to incorporate the evidence about what works and which draws on neurology, sociology and psychology including theories about fetal programming, social capital, self-efficacy, adult learning and health promotion. Learning from the Family Nurse Partnership, the PBB programme builds on parents' strengths and their intrinsic motivation to be the best parents they can for their children.

  9. Cost-effectiveness analysis of universal newborn screening for medium chain acyl-CoA dehydrogenase deficiency in France

    Hamers, Françoise F; Rumeau-Pichon, Catherine

    2012-01-01

    Abstract Background Five diseases are currently screened on dried blood spots in France through the national newborn screening programme. Tandem mass spectrometry (MS/MS) is a technology that is increasingly used to screen newborns for an increasing number of hereditary metabolic diseases. Medium chain acyl-CoA dehydrogenase deficiency (MCADD) is among these diseases. We sought to evaluate the cost-effectiveness of introducing MCADD screening in France. Methods We developed a decision model t...

  10. Antenatal corticosteroids beyond 34 weeks gestation: What do we do now?

    Kamath-Rayne, Beena D; Rozance, Paul J; Goldenberg, Robert L; Jobe, Alan H

    2016-10-01

    benefit. Some of these consequences may include treatment with multiple steroid courses or "treatment creep" in women at 34 to Preterm Steroids Trial, particularly when a high percentage of women do not receive antenatal corticosteroid within 7 days of delivery. Finally, we believe that caution should be exercised before wide-scale universal adoption of antenatal corticosteroid for pregnancies that are at risk of preterm birth at 34 to effects. For a more balanced rationale for the decision to use antenatal corticosteroid treatment in pregnancies at >34 weeks of gestation, we urge for ongoing research into the risks and benefits of antenatal corticosteroid use in preterm infants overall, for better prediction of preterm birth so that antenatal corticosteroid can be administered within the ideal time frame, and for long-term neurodevelopmental follow-up of the participants in the large randomized Antenatal Late Preterm Steroids Trial. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Screening and Brief Interventions for Hazardous and Harmful Alcohol Use among University Students in South Africa: Results from a Randomized Controlled Trial

    Hendry van der Heever

    2013-05-01

    Full Text Available The aim of this study was to assess the effectiveness of Screening and Brief Intervention (SBI for alcohol problems among university students in South Africa. The study design for this efficacy study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous and harmful drinkers in a university setting. The unit of randomization is the individual university student identified as a hazardous or harmful drinker attending public recruitment venues in a university campus. University students were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counseling session on alcohol risk reduction, while the control group received a health education leaflet. Results indicate that of the 722 screened for alcohol and who agreed to participate in the trial 152 (21.1% tested positive for the Alcohol Use Disorder Identification Test (AUDIT (score 8 or more. Among the 147 (96.7% university students who also attended the 12-month follow-up session, the intervention effect on the AUDIT score was −1.5, which was statistically significant (P = 0.009. Further, the depression scores marginally significantly decreased over time across treatment groups, while other substance use (tobacco and cannabis use, self-rated health status and Posttraumatic Stress Disorder (PTSD scores did not change over time across treatment groups. The study provides evidence of effective brief intervention by assistant nurses with hazardous and harmful drinkers in a university setting in South Africa. The short duration of the brief intervention makes it a realistic candidate for use in a university setting.

  12. Prognostic accuracy of antenatal neonatology consultation.

    Kukora, S; Gollehon, N; Weiner, G; Laventhal, N

    2017-01-01

    Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge). When possible, status at last follow-up was recorded for those discharged from the hospital. Prognostic accuracy was assessed using unweighted, multi-level likelihood ratios (LRs). The final cohort included 143 fetuses/infants distributed nearly evenly among the three diagnosis groups. Over half (64%) were assigned an uncertain prognosis, but most of these could be divided into 'likely survivable' or 'likely non-survivable' subgroups. Overall survival for the entire cohort was 62% (89/143). All but one of the fetuses assigned a non-survivable prognosis suffered fetal demise or died before hospital discharge. The neonatologist's antenatal prognosis accurately predicted the probability of survival by prognosis group (LR I=4.56, LR IIA=10.53, LR II=4.71, LR IIB=0.099, LR III=0.040). The LRs clearly differentiated between fetuses with high and low probability of survival. Eleven fetuses (7.7%) had misalignment between the predicted prognosis and outcome. Five died before discharge despite being given category I or IIA prognoses, whereas six infants with category IIB or III prognoses survived to discharge, though some of these were

  13. Antenatal services for Aboriginal women: the relevance of cultural competence.

    Reibel, Tracy; Walker, Roz

    2010-01-01

    Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics

  14. Psychoprophylaxis - Antenatal preparation and actual use during labour

    Bergström, Malin

    2010-01-01

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

  15. An assessment of antenatal care among Syrian refugees in Lebanon.

    Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong

    2015-01-01

    After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Standards of antenatal care are not being met for pregnant Syrian refugee women in

  16. Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

    Ubong Bassey Akpan

    2018-05-01

    CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.

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

    Babalola, Stella

    2014-02-01

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

  18. Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

    Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

    2017-05-01

    women is unexplored. This is the first study to examine the amount and type of smoking cessation support Aboriginal antenatal and postnatal service staff provide to Aboriginal women, staff confidence and their perceived role in delivering smoking cessation care. This information is valuable for developing strategies that assist antenatal and postnatal staff to improve their delivery of smoking cessation care to Aboriginal women. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Prevalence, Specificity and Titration of Red Cell Alloantibodies in Multiparous Antenatal Females at a Tertiary Care Centre from North India.

    Sidhu, Meena; Bala, Renu; Akhtar, Naveen; Sawhney, Vijay

    2016-09-01

    Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens. Alloantibody screening was done, if positive, specificity of alloantibody was ascertained by using commercially available red cell panel by tube method. Rate of alloimmunization was correlated with Rh D status, gravida, previous transfusion history and bad obstetric history. Titration of alloantibody D was done in first and third trimester of pregnancy. In present study most common blood group detected was B positive (38.4 %). Rh D negative cases constituted 7.6 % of total cases. Rate of alloimmunization was 2 %. A significant correlation was seen between Rh D-negative and alloimmunization (21 % in D-negative and 0.45 % in D-positive). There is significant increasing degree of alloimmunization with increase in Gravida. Alloimmunization in females with bad obstetric history was high (4.41 %) as compared to females with no bad obstetric history showing only 1.76 %. Alloantibodies detected were Anti-D, Anti-E, Anti-C and Anti-K. Anti-D constituted 80 % of all alloantibodies detected. Six women in their third trimester had raised titers of anti-D. Most common alloantibody detected was anti-D (80 %). Alloantibodies to other Rh antigens and Kell blood group systems were also identified. To minimize alloimmunization in Rh D negative women, proper Anti D immunoprophylaxis should be implemented.

  20. Intimate partner violence as a predictor of antenatal care service utilization in Honduras.

    Sebert Kuhlmann, Anne K; Foggia, Janine; Fu, Qiang; Sierra, Manuel

    2017-08-21

    To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV) and indicators of antenatal care (ANC) service utilization among Honduran women of reproductive age. Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1) sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits) and (2) early ANC initiation (within the first trimester). Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women's age, education, literacy, residence, household size, religion, parity, wealth, husband's age, and husband's education. Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629), 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR) = 1.25; 95% confidence interval (CI): 1.00-1.56) or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16) were, respectively, 25% and 53% more likely to receive insufficient ANC. Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country.

  1. Intimate partner violence as a predictor of antenatal care service utilization in Honduras

    Anne K. Sebert Kuhlmann

    2017-08-01

    Full Text Available ABSTRACT Objective To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV and indicators of antenatal care (ANC service utilization among Honduran women of reproductive age. Methods Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1 sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits and (2 early ANC initiation (within the first trimester. Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women’s age, education, literacy, residence, household size, religion, parity, wealth, husband’s age, and husband’s education. Results Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629, 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR = 1.25; 95% confidence interval (CI: 1.00-1.56 or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16 were, respectively, 25% and 53% more likely to receive insufficient ANC. Conclusions Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country.

  2. Antenatal care strengthening in Jimma, Ethiopia

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

    2014-01-01

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

  3. Ante-natal ionising radiation and cancer

    Anon.

    1988-01-01

    This editorial comments on the latest reports of the Oxford Survey of Childhood Cancer (now based on Birmingham). With 14759 pairs, the latest survey is over 10-fold larger than the 1958 report and the calculation of fatal childhood cancer rate at one case in 990 ante-natal radiographic examinations is rather larger than the early estimates, in spite of the fetal radiation dose having been halved and the cure rate for childhood leukemia being much improved. Comments are made on the comparisons with bomb survivors, and on the much increased fatal cancer incidence after first trimester radiography. (UK)

  4. Effects of Mischievous Responding on Universal Mental Health Screening: I Love Rum Raisin Ice Cream, Really I Do!

    Furlong, Michael J.; Fullchange, Aileen; Dowdy, Erin

    2017-01-01

    Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high…

  5. The quality of free antenatal and delivery services in Northern Sierra Leone.

    Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

    2017-07-12

    The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of

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

    Bandaralage, Sahan P.S.; Farnaghi, Soheil; Dulhunty, Joel M.; Kothari, Alka

    2016-01-01

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

  7. Depression Trajectories of Antenatally Depressed and Nondepressed Young Mothers: Implications for Child Socioemotional Development.

    Raskin, Maryna; Easterbrooks, M Ann; Lamoreau, Renee S; Kotake, Chie; Goldberg, Jessica

    2016-01-01

    This study explores the longitudinal trajectories of depressive symptoms in young mothers and investigate the consequences of maternal depression for children's birth outcomes and behavioral adjustment. Antenatal depression puts children of young mothers at risk for adjustment difficulties by adversely impacting birth outcomes and maternal symptoms after birth. Data were drawn from a three-wave randomized, controlled trial of a statewide home visiting program for young primiparous women. A subsample of women (n = 400) who were prenatal at intake was used in the analysis. Mothers were divided into an antenatally depressed group (ADG; 40%) and a healthy group (HG) based on their symptoms at intake. Mothers reported depressive symptoms at intake and 12- and 24-month follow-up, and filled out a checklist of child behavior problems at 24 months follow-up. Perinatal and birth outcomes were derived from the Electronic Birth Certificate collected by the State Department of Public Health at discharge from the hospital. ADG and HG had similar pregnancy characteristics and birth outcomes, but ADG reported more child behavioral problems. Multigroup latent growth curve analysis provided evidence for distinct depression trajectories. A mediation hypothesis was not supported. In both groups, steeper increase in symptoms over time predicted more mother-reported child behavioral problems. Findings are consistent with studies linking antenatal depression with post-birth symptoms, underscoring the importance of prenatal screening for depression. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

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

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

    2016-03-15

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

  9. Influence of Antenatal Care on the Haematocrit Value of Pregnant ...

    Context: Antenatal care is generally believed to influence the outcome of any pregnancy. Haematocrit values are important in the assessment of anaemia in pregnancy. A good antenatal care is expected to be associated with good haematocrit values, prevent anaemia in pregnancy, and result in an overall good pregnancy ...

  10. Antenatal care service utilization and associated factors in Metekel ...

    socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...

  11. Factors associated with late antenatal care attendance in selected ...

    Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural ...

  12. Antenatal care visits and pregnancy outcomes at a Kenyan rural ...

    Background: The goal of antenatal care (ANC) is to improve maternal and neonatal outcomes. Fewer ANC visits in focused antenatal care (FANC) model can affect maternal and perinatal outcomes in low income settings where the number ANC visits are often low. Objective: To determine the number of ANC visits and their ...

  13. Variables influencing delay in antenatal clinic attendance among ...

    A delay in deciding to seek antenatal care is predominant among pregnant teenagers in Lesotho. This subsequently leads to delay in reaching treatment and in receiving adequate treatment. Early antenatal care attendance plays a major role in detecting and treating complications of pregnancy and forms a good basis for ...

  14. Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...

    Utilisation of Antenatal Services at the Provincial Hospital, Mongomo, Guinea Equatoria. AAG Jimoh. Abstract. This prospective study was carried out to evaluate the utilisation of antenatal care at the Provincial Specialist Hospital, Mongomo, Guinea Equatoria, paying close attention to the confounding factors affecting ...

  15. Antenatal care services utilization among women of reproductive ...

    Methods: A cross-sectional study was carried out between September and October 2013 among 425 women of reproductive age using a multi-stage sampling technique. Results: Almost all the respondents (93.9%) were aware of antenatal care services. A good proportion of the mothers (90.1%) used antenatal services, ...

  16. Influence of pregnancy perceptions on patterns of seeking antenatal ...

    To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and ...

  17. Antenatal Care and Skilled Birth Attendance in Three Communities ...

    Antenatal Care and Skilled Birth Attendance in Three Communities in Kaduna State, Nigeria. ... Most importantly, safer delivery options that would be acceptable in communities where women traditionally birth at home need to be explored (Afr. J. Reprod. Health 2010; 14[3]: 89-96). Key words: Antenatal care, skilled birth ...

  18. Pattern of Family Planning Methods used by Antenatal Patients in ...

    This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...

  19. Awareness of family planning amongst antenatal patients in a ...

    Aim: This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. Methodology: The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical ...

  20. The Prevalence of Osteoporosis among Antenatal Clinic Attendees ...

    Introduction: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. Material and Methods: This was a cross‑sectional study of booking. Antenatal ...

  1. Pattern and Determinants of Antenatal Booking at Abakaliki ...

    for pregnant women to enable them attain and maintain a state of good health throughout pregnancy and to improve ... subsidization of cost of medical services will help in reversing the trend of late antenatal booking. Keywords: Abakaliki, Antenatal booking, .... Artisan/fashion/ design. 10 (2.9). 3 (30). 7 (70). Civil servant.

  2. Ultrasensitive Single Fluorescence-Labeled Probe-Mediated Single Universal Primer-Multiplex-Droplet Digital Polymerase Chain Reaction for High-Throughput Genetically Modified Organism Screening.

    Niu, Chenqi; Xu, Yuancong; Zhang, Chao; Zhu, Pengyu; Huang, Kunlun; Luo, Yunbo; Xu, Wentao

    2018-05-01

    As genetically modified (GM) technology develops and genetically modified organisms (GMOs) become more available, GMOs face increasing regulations and pressure to adhere to strict labeling guidelines. A singleplex detection method cannot perform the high-throughput analysis necessary for optimal GMO detection. Combining the advantages of multiplex detection and droplet digital polymerase chain reaction (ddPCR), a single universal primer-multiplex-ddPCR (SUP-M-ddPCR) strategy was proposed for accurate broad-spectrum screening and quantification. The SUP increases efficiency of the primers in PCR and plays an important role in establishing a high-throughput, multiplex detection method. Emerging ddPCR technology has been used for accurate quantification of nucleic acid molecules without a standard curve. Using maize as a reference point, four heterologous sequences ( 35S, NOS, NPTII, and PAT) were selected to evaluate the feasibility and applicability of this strategy. Surprisingly, these four genes cover more than 93% of the transgenic maize lines and serve as preliminary screening sequences. All screening probes were labeled with FAM fluorescence, which allows the signals from the samples with GMO content and those without to be easily differentiated. This fiveplex screening method is a new development in GMO screening. Utilizing an optimal amplification assay, the specificity, limit of detection (LOD), and limit of quantitation (LOQ) were validated. The LOD and LOQ of this GMO screening method were 0.1% and 0.01%, respectively, with a relative standard deviation (RSD) < 25%. This method could serve as an important tool for the detection of GM maize from different processed, commercially available products. Further, this screening method could be applied to other fields that require reliable and sensitive detection of DNA targets.

  3. Universe

    2009-01-01

    The Universe, is one book in the Britannica Illustrated Science Library Series that is correlated to the science curriculum in grades 5-8. The Britannica Illustrated Science Library is a visually compelling set that covers earth science, life science, and physical science in 16 volumes.  Created for ages 10 and up, each volume provides an overview on a subject and thoroughly explains it through detailed and powerful graphics-more than 1,000 per volume-that turn complex subjects into information that students can grasp.  Each volume contains a glossary with full definitions for vocabulary help and an index.

  4. Mobile phones improve antenatal care attendance in Zanzibar

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

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during...... included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome...

  5. Prevalence of domestic violence among antenatal women attending a Nigerian hospital.

    Gyuse, A N I; Ushie, A P; Etukidem, A

    2009-01-01

    Health is defined as a state of complete physical, mental, social and spiritual well being and not just the absence of disease. Domestic violence (synonyms: spouse abuse, partner or intimate violence, family violence) is a public health problem which is defined as any intentional abuse of a family member (mostly females but not exclusive) by his/her partner that causes pain or injury. There is paucity of data on domestic violence mainly because of under-reporting by the victims. However, domestic violence is said to be a more frequent occurrence than other recognized pregnancy complications such as pre-eclampsia, twin pregnancy or gestational diabetes for which women are routinely screened during the antenatal period. The aim of the study was to determine the prevalence of domestic violence in pregnant women attending the antenatal clinic of a local Nigerian mission hospital in Jos, Plateau state. This was a cross-sectional, descriptive study of women attending antenatal clinic at ECWA Evangel Hospital, Jos over a six month period using the Abuse Assessment Screen developed by McFarlane to detect the prevalence of domestic violence. The data were analysed using Epi Info Version 2002. Three hundred and forty pregnant women were studied. Majority of them were married and were mostly aged between 20 and 39 years. Domestic violence prevalence was 12.6% (43) in the current pregnancy and 63.2% (215) previously. The study establishes that women in our environment experience domestic violence during pregnancy and majority of them also have a previous history of abuse. There is the need to routinely screen for domestic violence in pregnant women so as to prevent potential adverse pregnancy outcomes and to interrupt existing abuse.

  6. Uptake of health care services and health status of HIV-infected women diagnosed through antenatal HIV screening in Barbados, 1996-2004 Utilización de los servicios de atención sanitaria y estado de salud de las mujeres seropositivas al VIH diagnosticadas mediante el tamizaje prenatal para el VIH en Barbados, 1996-2004

    Alok Kumar; Krishna R. Kilaru; Sheila Forde; Ira Waterman

    2007-01-01

    OBJECTIVES: To study utilization of HIV-related health care services and to describe the health status of HIV-infected women diagnosed through antenatal voluntary counseling and testing (VCT) for HIV infection in Barbados. METHODS: This is a descriptive study. The study population includes all HIV-infected women in Barbados diagnosed as HIV-infected through VCT for HIV infection during 1996-2004. RESULTS: The median duration of HIV infection from time of diagnosis to the time of this report f...

  7. Antenatal breastfeeding education for increasing breastfeeding duration.

    Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad

    2016-12-06

    Breast milk is well recognised as the best food source for infants. The impact of antenatal breastfeeding (BF) education on the duration of BF has not been evaluated. To assess the effectiveness of antenatal breastfeeding (BF) education for increasing BF initiation and duration. We searched Cochrane Pregnancy and Childbirth's Trials Register on 1 March 2016, CENTRAL (The Cochrane Library, 2016, Issue 3), MEDLINE (1966 to 1 March 2016) and Scopus (January 1985 to 1 March 2016). We contacted experts and searched reference lists of retrieved articles. All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on the duration of BF. We included RCTs that only included antenatal interventions and excluded those that combined antenatal and intrapartum or postpartum BF education components. Cluster-randomised trials were included in this review. Quasi-randomised trials were not eligible for inclusion. We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. We assessed the quality of the evidence using the GRADE approach. This review update includes 24 studies (10,056 women). Twenty studies (9789 women) contribute data to analyses. Most studies took place in high-income countries such as the USA, UK, Canada and Australia. In the first five comparisons, we display the included trials according to type of intervention without pooling data. For the 'Summary of findings' we pooled data for a summary effect.Five included studies were cluster-randomised trials: all of these adjusted data and reported adjustments as odds ratios (OR). We have analysed the data using the generic inverse variance method and presented results as odds ratios, because we were

  8. Utilization of pay-in antenatal leave among working women in Southern California.

    Guendelman, Sylvia; Pearl, Michelle; Graham, Steve; Angulo, Veronica; Kharrazi, Martin

    2006-01-01

    Examine antenatal leave arrangements among pregnant workers in California, and the occupational, demographic and well-being characteristics associated with leave taking. Unlike most states, California provides paid pregnancy leave up to 4 weeks antenatally and 6-8 weeks postnatally. Weighted data from postpartum telephone interviews conducted between July 2002 and November 2003 were analyzed for 1214 women participating in a case-control study of birth outcomes in Southern California. Eligible women worked at least 20 h/week during the first two trimesters of pregnancy or through the date of prenatal screening. The overall response rate was 73%. Fifty-two percent of women took no leave, 32% took antenatal leave expecting to return to their job or employer sometime after giving birth, and 9% quit their jobs during pregnancy. For leave-takers with paid leave (69%), the state was the main source of pay (74%). Medical problems (52%) rather than maternity leave benefits (25%) were the most common stated reasons for taking leave. The strongest predictors of leave taking versus working through pregnancy were feeling stressed and tired (adjusted OR = 4.3, 95% CI [2.2-8.2]) and having young children (adjusted OR = 2.1, 95% CI [1.2-3.7]), followed by occupational factors (night shift, unfulfilling and inflexible work, short work tenure). Lack of employer-offered maternity leave benefits was associated with increased quitting relative to both leave taking and working through pregnancy. Maternity benefits influence quitting, but alone do not determine antenatal leave taking. Working pregnant women in California utilize leave cautiously and predominantly to cope with health problems, work dissatisfaction and fatigue.

  9. Antenatal physical activity: a qualitative study exploring women's experiences and the acceptability of antenatal walking groups.

    Currie, Sinéad; Gray, Cindy; Shepherd, Ashley; McInnes, Rhona J

    2016-07-22

    Regular physical activity (PA) can be beneficial to pregnant women, however, many women do not adhere to current PA guidelines during the antenatal period. Patient and public involvement is essential when designing antenatal PA interventions in order to uncover the reasons for non-adherence and non-engagement with the behaviour, as well as determining what type of intervention would be acceptable. The aim of this research was to explore women's experiences of PA during a recent pregnancy, understand the barriers and determinants of antenatal PA and explore the acceptability of antenatal walking groups for further development. Seven focus groups were undertaken with women who had given birth within the past five years. Focus groups were transcribed and analysed using a grounded theory approach. Relevant and related behaviour change techniques (BCTs), which could be applied to future interventions, were identified using the BCT taxonomy. Women's opinions and experiences of PA during pregnancy were categorised into biological/physical (including tiredness and morning sickness), psychological (fear of harm to baby and self-confidence) and social/environmental issues (including access to facilities). Although antenatal walking groups did not appear popular, women identified some factors which could encourage attendance (e.g. childcare provision) and some which could discourage attendance (e.g. walking being boring). It was clear that the personality of the walk leader would be extremely important in encouraging women to join a walking group and keep attending. Behaviour change technique categories identified as potential intervention components included social support and comparison of outcomes (e.g. considering pros and cons of behaviour). Women's experiences and views provided a range of considerations for future intervention development, including provision of childcare, involvement of a fun and engaging leader and a range of activities rather than just walking

  10. Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives.

    Baird, Kathleen; Creedy, Debra K; Saito, Amornrat S; Eustace, Jennifer

    2018-01-15

    Routine enquiry about domestic violence during pregnancy is accepted best practice. Training is essential to improve knowledge and practice. Few studies have undertaken a comprehensive evaluation of training impact over time. To evaluate the longitudinal impact of a domestic violence training and support program to promote midwives' routine antenatal enquiry for domestic violence using a mixed methods design. Data sources included (1) surveys of midwives at 6 months post-training, (2) interviews with key stakeholders at 12 months, (3) chart audit data of screening, risk, and disclosure rates (for 16 months). Measures included midwives' knowledge, preparation for routine enquiry, knowledge of domestic violence and perceptions of impact of the training and support for practice change. Forty (out of 83) participant surveys could be matched and responses compared to baseline and post-training scores. Wilcoxon signed-rank test identified that all 6-month follow-up scores were significantly higher than those at baseline. Level of preparedness increased from 42.3 to 51.05 (Z=4.88, p90%) reported improved confidence to undertake routine inquiry. A chart audit of screening rates revealed that of the 6671 women presenting for antenatal care, nearly 90% were screened. Disclosure of domestic violence was low (<2%) with most women at risk or experiencing violence declining referral. Training, support processes, and referral pathways, contributed to midwives' sustained preparedness and knowledge to conduct routine enquiry and support women disclosing domestic violence. Copyright © 2018. Published by Elsevier Ltd.

  11. OPPORTUNISTIC CERVICAL CANCER SCREENING IN PREGNANCY

    Radha Bai Prabhu T

    2016-01-01

    Full Text Available Introduction: Cervical cancer is the most common malignancy diagnosed during pregnancy. In developing countries where organized screening programmes are lacking, antenatal clinics may provide an opportunity for screening. Objectives: The aim of this study was to analyse the prevalence and management of abnormal cervical cytology in pregnancy. Methodology: This was a prospective study conducted at the Meenakshi Medical College and RI, Kancheepuram, India, from July 2013 to June 2014. Convenience sampling technique was used. After adequate counselling, 300 antenatal mothers between 12 and 34 weeks of gestation were screened with conventional Pap smear. Colposcopy directed biopsy was taken where and when necessary. Results: Among the 300 pregnant women, 90 (30% were primigravidae and 210 (70% were multigravidae. 80% were between 21 and 30 years of age. 290 (96.6% women have never had a pap smear in the past. Conventional Pap smear was taken at 21 weeks of gestation in 20% of cases. ASCUS , LSIL and HSIL were reported in one case each. In those with LSIL and HSIL , Colposcopy directed biopsy was reported as CIN 1 and CIN 2 respectively. These two cases were kept under observation during the antenatal period. The CIN II lesion persisted on postpartum follow up and was treated with LLETZ. Conclusion: In countries like India Pap smear screening during pregnancy is worthwhile and the antenatal clinics provide ample opportunities for the screening.

  12. Utility of antenatal clinical factors for prediction of postpartum outcomes in women with gestational diabetes mellitus (GDM).

    Ingram, Emily R; Robertson, Iain K; Ogden, Kathryn J; Dennis, Amanda E; Campbell, Joanne E; Corbould, Anne M

    2017-06-01

    Gestational diabetes mellitus (GDM) is associated with life-long increased risk of type 2 diabetes: affected women are advised to undergo oral glucose tolerance testing (OGTT) at 6-12 weeks postpartum, then glucose screening every 1-3 years. We investigated whether in women with GDM, antenatal clinical factors predicted postpartum abnormal glucose tolerance and compliance with screening. In women with GDM delivering 2007 to mid-2009 in a single hospital, antenatal/obstetric data and glucose tests at 6-12 weeks postpartum and during 5.5 years post-pregnancy were retrospectively collected. Predictors of return for testing and abnormal glucose tolerance were identified using multivariate analysis. Of 165 women, 117 (70.9%) returned for 6-12 week postpartum OGTT: 23 (19.6%) were abnormal. Smoking and parity, independent of socioeconomic status, were associated with non-return for testing. Fasting glucose ≥5.4 mmol/L on pregnancy OGTT predicted both non-return for testing and abnormal OGTT. During 5.5 years post-pregnancy, 148 (89.7%) women accessed glucose screening: nine (6.1%) developed diabetes, 33 (22.3%) had impaired fasting glucose / impaired glucose tolerance. Predictors of abnormal glucose tolerance were fasting glucose ≥5.4 mmol/L and 2-h glucose ≥9.3 mmol/L on pregnancy OGTT (~2.5-fold increased risk), and polycystic ovary syndrome (~3.4 fold increased risk). Risk score calculation, based on combined antenatal factors, did not improve predictions. Antenatal clinical factors were modestly predictive of return for testing and abnormal glucose tolerance post-pregnancy in women with GDM. Risk score calculations were ineffective in predicting outcomes: risk scores developed in other populations require validation. Ongoing glucose screening is indicated for all women with GDM. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women

    E. Morikawa

    2018-01-01

    Full Text Available Background. Chlamydia trachomatis (CT, Neisseria gonorrhoeae (NG, and Trichomonas vaginalis (TV infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV. In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective. To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods. HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results. Of 442 eligible women, 430 (97.3% agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%, 159 (91.9% received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions. Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.

  14. Factors influencing HIV screening decisions for pregnant migrant women in South East Asia.

    Crozier, Kenda; Chotiga, Pleumjit; Pfeil, Michael

    2013-07-01

    universal screening in pregnancy for HIV is common and migrant women are an identified high risk group. The increasing mobility within countries and migration across borders affects the growing prevalence of HIV, but little is understood about how migrant women view risk of HIV in relation to pregnancy. to explore factors that relate to HIV screening decisions for migrant women. the HIV antenatal counselling experiences of pregnant migrant women were explored in a Grounded Theory study. the four settings were antenatal care units of border hospitals in northern Thailand 38 migrant pregnant women who had been through the HIV screening process at participating antenatal clinics as well as 26 health personnel at the units were purposively recruited and interviewed about their experiences and attitudes to HIV counselling and testing for this group. in-depth interviews were conducted from January to March 2008. The grounded theory technique of open coding was employed and constant comparison took place throughout until saturation was achieved. four themes were identified as common to the women and the health professionals: ineffective provision of information; internal and external barriers to information; implications of migrant status; and perception of risk. where language barriers exist interpreters are required and creative approaches to information giving that do not rely on text are necessary. The organisation of clinics does not currently meet the needs of migrant women and causes stress for health staff due to time constraints. Extra resources should be focussed where there are large numbers of migrants. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Gestational diabetes mellitus: The prevalence, associated factors and foeto-maternal outcome of women attending antenatal care.

    Mohd Azahadi Bin Omar

    2017-08-01

    Full Text Available Objective: The aim of the study is to determine the prevalence of gestational diabetes mellitus (GDM, its associated risk factors, foeto-maternal outcomes and prevalence of postnatal diabetes mellitus (DM. Methods: This is a cross-sectional study using retrospective data from existing antenatal records of new antenatal women who registered at 72 public health clinics in Selangor in January 2014. Results: A total of 745 antenatal records were reviewed. The prevalence of GDM women was 27.9% (n = 184. GDM risks were higher in women aged 35 years old and above and in those with maternal obesity. GDM women had a higher risk of having a non-spontaneous vaginal delivery compared to non-GDM women. The prevalence of postnatal DM among GDM mother was 12.1%. Working GDM mothers were at higher risk of developing postnatal DM. Conclusion: The prevalence of GDM among newly registered women attending antenatal public health care in Selangor was higher than previous studies. Health care personnel need to be vigilant in screening women with risk factors.

  16. U.S. College and University Student Health Screening Requirements for Tuberculosis and Vaccine-Preventable Diseases, 2012

    Jewett, A.; Bell, T; Cohen, NJ.; Buckley, K.; Leino, V.; Even, S.; Beavers, S.; Brown, C.; Marano, N.

    2016-01-01

    Objective Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the U.S. college student health screening requirements among U.S. resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPD) as it relates to the American College Health Association (ACHA) Guidelines. Methods/Participants In April 2012, U.S. college health administrators (N=2858) were sent online surveys to assess their respective school’s TB screening and immunization requirements. Results Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). Conclusion Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges. PMID:26730492

  17. The prevalence of genital Candida species among pregnant women attending antenatal clinic in a tertiary health center in North-west Nigeria

    Daniel Chukwunyere Nnadi

    2017-01-01

    Full Text Available Background: Vulvovaginal candidiasis (VVC is a common genital tract infection that affects the quality of life in many women. It is more prevalent in pregnancy and may lead to complications. Aims and Objectives: The study aimed to determine the prevalence of VVC among pregnant women attending the antenatal clinic of a tertiary health institution in North-West Nigeria and to emphasize the need for accurate diagnosis and adequate treatment. Subjects and Methods: This is a 2-month cross-sectional study performed at the Department of Obstetrics and Gynaecology in association with the Department of Medical Microbiology of the Usmanu Danfodiyo University Teaching Hospital, Sokoto in North-Western Nigeria. It involved pregnant women at various periods of gestation presenting with vaginitis and selected by simple random sampling. A pair of high vaginal swabs was collected aseptically from the study subjects which was used for Gram's staining and inoculation into Sabouraud's dextrose agar (SDA. The samples were then cultured according to standard procedures on sterile SDA. Infection with Candida species was diagnosed by microscopy of a saline wet mount, Gram-stained smear and colony growth on SDA. Results: Of the 288 pregnant women sampled, 175 were positive for candidiasis giving a prevalence rate of 60.8%. The ages of the women ranged from 16 to 45 years with a mean of 26.8 (standard deviation ± 4.93. Pregnant women aged 26–30 years recorded the highest prevalence of 37.1% (65/175. The multigravidae were more affected 41.7% (120/288 than the primigravidae 19.1% (55/288. VVC showed a progressive increase with trimester of pregnancy. Candida albicans was the most prevalent species isolated in 73.7% of the women. Conclusion: There is a high prevalence of VVC among pregnant women in our institution. There is need to educate the women on genital hygiene and practice of regular screening for candidiasis in our antenatal program.

  18. Cost effectiveness of expanded antenatal HIV testing in London

    Postma, MJ; Beck, EJ; Hankins, CA; Mandalia, S; Jager, JC; de Jong-van den Berg, LTW; Sherr, L

    2000-01-01

    Background: Recently the Department of Health announced the introduction in England of voluntary universal HIV screening in early pregnancy to prevent vertical transmission. New data have shown the importance of HIV infection in infants born to mothers who were HIV-negative in early pregnancy and

  19. Antenatal Diagnosis of an XXX Female

    Krone, Lawrence R.; Prichard, Lorraine L.; Bradshaw, Christy L.; Jones, Oliver W.; Peterson, Raymond M.; Dixson, Barbara K.

    1975-01-01

    This report describes the first antenatal diagnosis of an XXX female. Over 150 postnatal cases of XXX females have been described. There is no specific phenotype associated with the sex chromosome abnormality and most such persons are fertile. The frequency of XXX females in mental institutions is 3.9 per 1,000 female subjects whereas the frequency in consecutive newborn infants is 1.1 per 1,000 newborns. Chi-square analysis shows this difference cannot be due to chance. On the other hand, data from consecutive newborn studies suggest that intellectual development in XXX newborns is within normal range. Available evidence favors normal development in XXX female infants although the risk for developmental disabilities may be higher for the XXX than for the XX infant. ImagesFigure 1. PMID:1154778

  20. Antenatal stress: An Irish case study.

    Carolan-Olah, Mary

    2013-05-16

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

  1. The Functional Movement Screen and modified Star Excursion Balance Test as predictors of T-test agility performance in university rugby union and netball players.

    Armstrong, Ross; Greig, Matt

    2018-05-01

    Agility is a functional requirement of many sports, challenging stability, and commonly cited as a mechanism of injury. The Functional Movement Screen (FMS) and modified Star Excursion Balance Test (mSEBT) have equivocally been associated with agility performance. The aim of the current study was to establish a hierarchical ordering of FMS and mSEBT elements in predicting T-test agility performance. Cross-sectional study design. University. Thirty-two female rugby players, 31 male rugby players and 39 female netballers MAIN OUTCOME MEASURES: FMS, mSEBT, T-test performance. The predictive potential of composite FMS and mSEBT scores were weaker than when discrete elements were considered. FMS elements were better predictors of T-test performance in rugby players, whilst mSEBT elements better predicted performance in netballers. Hierarchical modelling highlighted the in-line lunge (ILL) as the primary FMS predictor, whereas mSEBT ordering was limb and sport dependent. The relationship between musculoskeletal screening tools and agility performance was sport-specific. Discrete element scores are advocated over composite scores, and hierarchical ordering of tests might highlight redundancy in screening. The prominence of the ILL in hierarchical modelling might reflect the functional demands of the T-test. Sport-specificity and limb dominance influence hierarchical ordering of musculoskeletal screens. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Antenatal Weight Management: Women’s Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy

    J. A. Swift

    2016-01-01

    Full Text Available The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy sought to examine women’s self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+ were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n=80 between 12 and 14 and 43.0% (n=83 between 20 and 22 weeks. At recruitment 50.3% of participants (n=97 could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2 did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

  3. The Ghanaian Woman's experience and perception of ultrasound use in antenatal care

    Mensah, Y. B.; Nkyekyer, K.; Mensah, K.

    2014-01-01

    The objective of this study is to evaluate how Ghanaian women perceive the use, and their assessment of the experience, of antenatal ultrasound scanning. A cross-sectional study, using interviewer administered questionnaire, from 25th February to 16th April, 2011 was conducted at the Obstetrics Units of Korle Bu Teaching Hospital, Accra, University of Ghana Hospital, Legon and Ga South District Hospital, Weija. A total of 337 clients were randomly selected after delivery and interviewed. Issues addressed included why women went for antenatal ultrasound, their knowledge of the uses of ultrasound in pregnancy, information provided by health care providers, clients’ eagerness to know the sex of their fetuses, and their overall assessment of the ultrasound scanning experience. The results of this study showed that the mean number of scans was 2.2(1.1). Most were performed on the request of a doctor or midwife; 154(45.7%) were not told the reasons for the request and 185(54.9%) did not have the results explained to them. For 239(70.9%) women the sonographer did not explain the procedure before the examination; 89(26.4%) were allowed to ask questions and 61(18.1%) were allowed to see their fetuses on the monitor. One hundred and sixty respondents (47.5%) asked for and were told the sex of their fetuses, with accuracy at delivery of 86.5%. Most respondents perceived antenatal ultrasound as a useful tool. There is lack of information flow from health care providers to clients concerning the indications for the ultrasound, the processes involved and the results of the procedure. Improvements in these areas are needed to enhance the experience of antenatal ultrasound among Ghanaian women

  4. Screening for Dyslexia in French-Speaking University Students: An Evaluation of the Detection Accuracy of the "Alouette" Test

    Cavalli, Eddy; Colé, Pascale; Leloup, Gilles; Poracchia-George, Florence; Sprenger-Charolles, Liliane; El Ahmadi, Abdessadek

    2018-01-01

    Developmental dyslexia is a lifelong impairment affecting 5% to 10% of the population. In French-speaking countries, although a number of standardized tests for dyslexia in children are available, tools suitable to screen for dyslexia in adults are lacking. In this study, we administered the "Alouette" reading test to a normative sample…

  5. Womens' preference in Down syndrome screening

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

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

  6. Antenatal and postnatal depression: A public health perspective

    Saurabh R Shrivastava

    2015-01-01

    Full Text Available Depression is widely prevalent among women in the child-bearing age, especially during the antenatal and postnatal period. Globally, post-partum depression has been reported in almost 10% to 20% of mothers, and it can start from the moment of birth, or may result from depression evolving continuously since pregnancy. The presence of depression among women has gained a lot of attention not only because of the rising incidence or worldwide distribution, but also because of the serious negative impact on personal, family and child developmental outcomes. Realizing the importance of maternal depression on different aspects-personal, child, and familial life, there is a crucial need to design a comprehensive public health policy (including a mental health strategy, to ensure that universal psychosocial assessment in perinatal women is undertaken within the primary health care system. To conclude, depression during pregnancy and in the postnatal period is a serious public health issue, which essentially requires continuous health sector support to eventually benefit not only the woman, but also the family, the community, and health care professionals.

  7. Effects of mischievous responding on universal mental health screening: I love rum raisin ice cream, really I do!

    Furlong, Michael J; Fullchange, Aileen; Dowdy, Erin

    2017-09-01

    Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high school students who completed a schoolwide screening for complete mental health. Student responses were reviewed to detect possible mischievous responses and to examine their association with other survey results. Consistent with previous research, mischievous responding was evaluated by items that are legitimate to ask of all students (e.g., How much do you weigh? and How many siblings do you have?). Responses were considered "mischievous" when a student selected multiple extreme, unusual (less than 5% incidence) response options, such as weighing more than 225 pounds and having 10 or more siblings. Only 1.8% of the students responded in extreme ways to 2 or more of 7 mischievous response items. When compared with other students, the mischievous responders were less likely to declare that they answered items honestly, were more likely to finish the survey in less than 10 min, reported lower levels of life satisfaction and school connectedness, and reported higher levels of emotional and behavioral distress. When applying a dual-factor mental health screening framework to the responses, mischievous responders were less likely to be categorized as having complete mental health. Implications for school-based mental health screening are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Vasa previa screening strategies: a decision and cost-effectiveness analysis.

    Sinkey, R G; Odibo, A O

    2018-05-22

    The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening. Ultrasound-indicated screening was defined as performing a transvaginal ultrasound at the time of routine anatomy ultrasound in response to one of the following sonographic findings associated with an increased risk of vasa previa: low-lying placenta, marginal or velamentous cord insertion, or bilobed or succenturiate lobed placenta. The primary outcome was cost per quality adjusted life years (QALY) in U.S. dollars. The analysis was from a healthcare system perspective with a willingness to pay (WTP) threshold of $100,000 per QALY selected. One-way and multivariate sensitivity analyses (Monte-Carlo simulation) were performed. This decision-analytic model demonstrated that screening pregnancies conceived by IVF was the most cost-effective strategy with an incremental cost effectiveness ratio (ICER) of $29,186.50 / QALY. Ultrasound-indicated screening was the second most cost-effective with an ICER of $56,096.77 / QALY. These data were robust to all one-way and multivariate sensitivity analyses performed. Within our baseline assumptions, transvaginal ultrasound screening for vasa previa appears to be most cost-effective when performed among IVF pregnancies. However, both IVF and ultrasound-indicated screening strategies fall within contemporary willingness-to-pay thresholds, suggesting that both strategies may be appropriate to apply in clinical practice. This article is protected by copyright. All rights reserved. This

  9. Screening for gestational diabetes: examining a breakfast meal test ...

    Objective: This study was performed to analyse the carbohydrate quantity of the non-standardised breakfast meal test consumed as part of a screening test for gestational diabetes. Design: A prospective descriptive design was utilised. Setting: Screening for gestational diabetes was performed in the High-Risk Antenatal ...

  10. Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study

    Kwon, Jung Hye; Lee, Jeong Jae

    2008-01-01

    Purpose To examine the efficacy of cognitive-behavioral therapy (CBT) for the prevention of postpartum depression (PPD) in "at risk" women. Materials and Methods We recruited 927 pregnant women in 6 obstetric and gynecology clinics and screened them using Beck Depression Inventory (BDI). Ninety-nine of the screened women who had significantly high scores in BDI (a score above 16) were selected for the study. They were contacted through by telephone, and 27 who had consented to participate in the study were interviewed via SCID-IV-I. Twenty-seven eligible women were randomly assigned to the CBT intervention (n = 15) and control condition (n = 12). All participants were required to complete written questionnaires, assessing demographic characteristics, depressive symptoms, negative thoughts, dyadic communication satisfaction, and global marital satisfaction prior to treatment and approximately 1 month postpartum. The 15 women in the CBT condition received 9 bi-weekly 1-hour individual CBT sessions, targeting and modifying negative patterns of thinking and behaviors occurring in the context of the dyadic relationship. Results The analysis of covariance (ANCOVA) showed that there were significant differences in all postpartum measures between the 2 groups, indicating that our antenatal intervention with CBT was effective in reducing depressive symptoms and improving marital satisfaction, which lasted until the postpartum period. Conclusion Our pilot study has provided preliminary empirical evidence that antenatal CBT intervention can be an effective preventive treatment for PPD. Further study in this direction was suggested. PMID:18729297

  11. Determinants of Home Delivery among Women attending Antenatal ...

    USER

    Abstract. Unskilled home delivery is a threat to maternal and child health. ... home delivery after attending antenatal services, this study employed a cross-sectional design and a non-probability purposive ... deaths occur in sub-Saharan Africa.

  12. Skilled antenatal care service utilization and its association with the ...

    Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...

  13. Does antenatal care attendance prevent anemia in pregnancy at term?

    2014-10-03

    : all > 0.05). Conclusion: The ... low socioeconomic class[11] and poor maternal education are some of .... significance was set at 95% confidence interval (CI). Results ... the antenatal attendees, a total of 3442 women satisfied.

  14. Antenatal Magnesium Sulfate and Neurologic Outcome in Preterm Infants

    Doyle, Lex W.; Crowther, Caroline A.; Middleton, Philippa; Marret, Stephane

    OBJECTIVE: To systematically review rates of neurologic outcomes reported in childhood for the preterm fetus exposed to antenatal magnesium sulfate. DATA SOURCES: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, CENTRAL (The Cochrane Library 2008, Issue 3), relevant

  15. Proportion and Factors Associated with late Antenatal Care Booking ...

    AJRH Managing Editor

    Booking among Pregnant Mothers in Gondar Town, North West ... of booking, perceived the right time of booking beyond 12 weeks of pregnancy, were not autonomous to use antenatal care ..... blood cell folate concentration at 10-12 weeks.

  16. determinants of first antenatal care visit by pregnant women

    2014-09-01

    Sep 1, 2014 ... Subjects: Four hundred and seventeen (417) pregnant women attending antenatal care ... convenience of opening hours at ANC facility, commuting distance from home to ... identifying maternal education, employment, age,.

  17. Medicinal Plants used during Antenatal Care by Pregnant Women in ...

    USER

    used to manage anaemia and for child development and good health among the pregnant women. ... Keywords: Medicinal Plants, Antenatal, Traditional Birth Attendants, Uganda. Résumé ..... phenomenon, possibly due to their availability and.

  18. Incidence of nevirapine-associated hepatitis in an antenatal clinic ...

    based highly active antiretroviral therapy at a dedicated antenatal antiretroviral clinic between July 2004 and December 2006. Results. Three hundred and ninety women were included in the analysis. Median age was 29 (interquartile range (IQR)

  19. factors affecting antenatal care service utilization in yem special ...

    jhon

    assess antenatal care utilization and factors that affect it in Yem Special Woreda, South Western Ethiopia. METHODS: A ... A pre-tested structured questionnaire consisting of information on socio- ..... model and access to medical care: does it.

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

    Milgrom Jeannette

    2008-04-01

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

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

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-04-16

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

  2. Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months

    Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth

    2012-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal pa...

  3. Effects of Antenatal Maternal Depressive Symptoms and Socio-Economic Status on Neonatal Brain Development are Modulated by Genetic Risk.

    Qiu, Anqi; Shen, Mojun; Buss, Claudia; Chong, Yap-Seng; Kwek, Kenneth; Saw, Seang-Mei; Gluckman, Peter D; Wadhwa, Pathik D; Entringer, Sonja; Styner, Martin; Karnani, Neerja; Heim, Christine M; O'Donnell, Kieran J; Holbrook, Joanna D; Fortier, Marielle V; Meaney, Michael J

    2017-05-01

    This study included 168 and 85 mother-infant dyads from Asian and United States of America cohorts to examine whether a genomic profile risk score for major depressive disorder (GPRSMDD) moderates the association between antenatal maternal depressive symptoms (or socio-economic status, SES) and fetal neurodevelopment, and to identify candidate biological processes underlying such association. Both cohorts showed a significant interaction between antenatal maternal depressive symptoms and infant GPRSMDD on the right amygdala volume. The Asian cohort also showed such interaction on the right hippocampal volume and shape, thickness of the orbitofrontal and ventromedial prefrontal cortex. Likewise, a significant interaction between SES and infant GPRSMDD was on the right amygdala and hippocampal volumes and shapes. After controlling for each other, the interaction effect of antenatal maternal depressive symptoms and GPRSMDD was mainly shown on the right amygdala, while the interaction effect of SES and GPRSMDD was mainly shown on the right hippocampus. Bioinformatic analyses suggested neurotransmitter/neurotrophic signaling, SNAp REceptor complex, and glutamate receptor activity as common biological processes underlying the influence of antenatal maternal depressive symptoms on fetal cortico-limbic development. These findings suggest gene-environment interdependence in the fetal development of brain regions implicated in cognitive-emotional function. Candidate biological mechanisms involve a range of brain region-specific signaling pathways that converge on common processes of synaptic development. © The Author 2017. Published by Oxford University Press.

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

    I. E. Bakhlaev

    2009-01-01

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

  5. Neuromodulation and antenatal depression: a review

    Kim DR

    2015-04-01

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

  6. Universal screening for Lynch syndrome in endometrial cancers: frequency of germline mutations and identification of patients with Lynch-like syndrome.

    Dillon, Jessica L; Gonzalez, Jorge L; DeMars, Leslie; Bloch, Katarzyna J; Tafe, Laura J

    2017-12-01

    Lynch syndrome (LS) is an inherited clinical syndrome characterized by a high risk of colorectal, endometrial (lifetime risk of up to 60%), ovarian, and urinary tract cancers. The diagnosis is confirmed by identification of germline mutations in the DNA mismatch repair genes MLH1, PMS2, MSH2, MSH6, or EPCAM. In 2015, our institution implemented universal screening of endometrial cancer (EC) hysterectomy specimens by mismatch repair immunohistochemistry (IHC) with reflex MLH1 promoter hypermethylation analysis for tumors with loss of MLH1/PMS2 expression. Patients with tumors negative for MLH1 methylation and those with a loss of the heterodimer pair MSH2 and MSH6, or isolated loss of either PMS2 or MSH6 were referred to the Familial Cancer Program for genetic counseling and consideration of germline testing. Between May 2015 to Dec 2016, 233 EC patients were screened by IHC for LS with a median age of 63 years. Sixty tumors (27%) had abnormal IHC staining results. Fifty-one (22%) harbored heterodimeric loss of MLH1 and PMS2, 49 of which showed MLH1 promoter methylation (1 failure, 1 negative). One showed loss of MLH1/PMS2 and MSH6, 2 showed loss of MSH2/MSH6, and 6 had isolated loss of MSH6 only. Ten patients underwent genetic counseling, and germline testing was performed in 8; LS was confirmed in 5 patients (2.1%). In addition, 3 patients with negative germline testing and presumed Lynch-like syndrome were identified and offered additional somatic testing. Universal screening for LS in EC patients has yielded positive results for identification of patients at risk for this inherited syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

    Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep

    2016-01-01

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

  8. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study.

    Sovio, Ulla; White, Ian R; Dacey, Alison; Pasupathy, Dharmintra; Smith, Gordon C S

    2015-11-21

    Fetal growth restriction is a major determinant of adverse perinatal outcome. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those that are healthy and those that are pathologically small. We sought to determine the diagnostic effectiveness of universal ultrasonic fetal biometry in the third trimester as a screening test for small-for-gestational-age (SGA) infants, and whether the risk of morbidity associated with being small differed in the presence or absence of ultrasonic markers of fetal growth restriction. The Pregnancy Outcome Prediction (POP) study was a prospective cohort study of nulliparous women with a viable singleton pregnancy at the time of the dating ultrasound scan. Women participating had clinically indicated ultrasonography in the third trimester as per routine clinical care and these results were reported as usual (selective ultrasonography). Additionally, all participants had research ultrasonography, including fetal biometry at 28 and 36 weeks' gestational age. These results were not made available to participants or treating clinicians (universal ultrasonography). We regarded SGA as a birthweight of less than the 10th percentile for gestational age and screen positive for SGA an ultrasonographic estimated fetal weight of less than the 10th percentile for gestational age. Markers of fetal growth restriction included biometric ratios, utero-placental Doppler, and fetal growth velocity. We assessed outcomes for consenting participants who attended research scans and had a livebirth at the Rosie Hospital (Cambridge, UK) after the 28 weeks' research scan. Between Jan 14, 2008, and July 31, 2012, 4512 women provided written informed consent of whom 3977 (88%) were eligible for analysis. Sensitivity for detection of SGA infants was 20% (95% CI 15-24; 69 of 352 fetuses) for selective ultrasonography and 57% (51-62; 199 of 352 fetuses) for universal ultrasonography (relative sensitivity 2

  9. [A temporal bone CT study of the infants with hearing loss referred from universal newborn hearing screening].

    Tao, Zheng; Li, Yun; Hou, Zheng; Cheng, Lan

    2007-02-01

    To explore the high resolution CT image of temporal bone in infants with hearing loss, and its value in evaluating the cause of hearing loss. In 2005, 0.12 million newborns have been included in the hearing screening system in Shanghai, and 1077 infants have failed to pass the hearing screening. One hundred and eight four infants were diagnosed as congenital hearing loss from mild to profound. A temporal bone HRCT scanning was performed to these infants. Among the 184 patients with congenital hearing loss, HRCT showed that 26 cases (14.1%) were associated with external ear malformation, and 21 cases (11.4%) were associated with middle ear malformation, 31 cases (16.8%) associated with inner ear malformation. The patients with inner ear malformation included 12 cases with Mondini malformation, 1 case with common cavity malformation, 6 cases with large vestibule malformation, 5 cases with internal auditory canal abnormalities, and 10 cases with vestibule, semicircular canals abnormalities. In addition, there were 20 cases (10.8%) with fluid in middle ear. HRCT image play an important role in the differential diagnosis and treatment of infants with congenital hearing loss.

  10. Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

    Aithal, Sreedevi; Aithal, Venkatesh; Kei, Joseph; Driscoll, Carlie

    2012-10-01

    Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known. This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology. Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted. Chart review of 234 infants referred for one or both ears from a newborn hearing screening program in north Queensland was conducted. A total of 211 infants attended the diagnostic appointment. Review appointments to monitor hearing status were completed for 46 infants with middle ear pathology or conductive hearing loss. Diagnosis of hearing impairment was made using an age-appropriate battery of audiological tests. Results were analyzed for both initial and review appointments. Mean age at initial diagnostic assessment was 47.5 days (SD = 31.3). Of the 69 infants with middle ear pathology during initial diagnostic assessment, 18 had middle ear pathology with normal hearing, 47 had conductive hearing loss, and 4 had mixed hearing loss. Prevalence of conductive hearing loss in the newborns was 2.97 per 1,000 while prevalence of middle ear pathology (with or without conductive hearing loss) was 4.36 per 1,000. Indigenous Australians or Aboriginal and Torres Strait Islander (ATSI) infants had a significantly higher prevalence of conductive hearing loss and middle ear pathology than non-ATSI infants (35.19 and 44.45% vs 17.83 and 28.66%, respectively). ATSI infants also showed poor resolution of conductive hearing loss

  11. Maternal health, antenatal and at 8 weeks after delivery, in home versus in-hospital fetal monitoring in high-risk pregnancies

    Monincx, W. M.; Birnie, E.; Zondervan, H. A.; Bleker, O. P.; Bonsel, G. J.

    2001-01-01

    To assess maternal health outcome, comparing high-risk pregnant women to either domiciliary monitoring or in-hospital monitoring, and a low risk pregnant group. Paper and pencil questionnaire, distributed antenatal and 8 weeks after the delivery. A university hospital. Three groups: 130 high-risk

  12. Universal opt-out screening for hepatitis C virus (HCV) within correctional facilities is an effective intervention to improve public health.

    Morris, Meghan D; Brown, Brandon; Allen, Scott A

    2017-09-11

    Purpose Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time. Design/methodology/approach A commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities. Findings Current variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies. Originality/value The commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.

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

    Katharine D Shelley

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

  14. Pattern of sexually transmitted infections in human immunodeficiency virus positive women attending antenatal clinics in north-central Nigeria

    Salamat A Isiaka-Lawal

    2014-01-01

    Full Text Available Background: Sexually transmitted infections (STIs are prevalent during pregnancy and may have adverse sequalae in both mother and fetus. Interactions between these infections and human immunodeficiency virus (HIV synergize and may cause adverse pregnancy outcomes and reverse the gains of prevention of mother to child transmission of HIV. Objectives: The objective of this study is to determine the prevalence of candidiasis, trichomoniasis, gonococcal infection, syphilis, and bacterial vaginosis in HIV pregnant women and compare with HIV negative controls. Materials and Methods: A case-control study was conducted during the period from April to December 2010 at the Department of Obstetrics/Gynecology of University of Ilorin Teaching Hospital and three Primary Health Centers in Ilorin. A total of 160 HIV positive pregnant women attending antenatal clinics were recruited, along with the same number of HIV negative matched controls. A structured proforma was used to collect information from patients, vaginal examination was performed and samples were taken from the endocervix and the posterior vaginal fornix with swab sticks. Results: STIs were recovered from 142 women, giving overall prevalence of 44.4%. HIV infected women had a higher prevalence (60% compared to uninfected (28.8%. The most prevalent STI was vaginal candidiasis (29.1%, followed by bacterial vaginosis (9.7%, and trichomoniasis (5.6%. The prevalence of candidiasis, bacterial vaginosis, and trichomoniasis was higher among HIV positive pregnant women compared to HIV negative controls (P < 0.05. No woman had syphilis or gonorrhea. Conclusion: The prevalence of candidiasis, bacterial vaginosis and trichomoniasis was higher in HIV infected pregnant women compared to uninfected. Routine screening of HIV infected pregnant women for these organisms is advocated.

  15. Percentage of Body Fat and Fat Mass Index as a Screening Tool for Metabolic Syndrome Prediction in Colombian University Students

    Robinson Ramírez-Vélez

    2017-09-01

    Full Text Available High body fat is related to metabolic syndrome (MetS in all ethnic groups. Based on the International Diabetes Federation (IDF definition of MetS, the aim of this study was to explore thresholds of body fat percentage (BF% and fat mass index (FMI for the prediction of MetS among Colombian University students. A cross-sectional study was conducted on 1687 volunteers (63.4% women, mean age = 20.6 years. Weight, waist circumference, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis (BIA and FMI was calculated. MetS was defined as including more than or equal to three of the metabolic abnormalities according to the IDF definition. Receiver operating curve (ROC analysis was used to determine optimal cut-off points for BF% and FMI in relation to the area under the curve (AUC, sensitivity, and specificity in both sexes. The overall prevalence of MetS was found to be 7.7%, higher in men than women (11.1% vs. 5.3%; p < 0.001. BF% and FMI were positively correlated to MetS components (p < 0.05. ROC analysis indicated that BF% and FMI can be used with moderate accuracy to identify MetS in university-aged students. BF% and FMI thresholds of 25.55% and 6.97 kg/m2 in men, and 38.95% and 11.86 kg/m2 in women, were found to be indicative of high MetS risk. Based on the IDF criteria, both indexes’ thresholds seem to be good tools to identify university students with unfavorable metabolic profiles.

  16. The University of Kansas High-Throughput Screening laboratory. Part I: meeting drug-discovery needs in the heartland of America with entrepreneurial flair.

    McDonald, Peter R; Roy, Anuradha; Chaguturu, Rathnam

    2011-05-01

    The University of Kansas High-Throughput Screening (KU HTS) core is a state-of-the-art drug-discovery facility with an entrepreneurial open-service policy, which provides centralized resources supporting public- and private-sector research initiatives. The KU HTS core applies pharmaceutical industry project-management principles in an academic setting by bringing together multidisciplinary teams to fill critical scientific and technology gaps, using an experienced team of industry-trained researchers and project managers. The KU HTS proactively engages in supporting grant applications for extramural funding, intellectual-property management and technology transfer. The KU HTS staff further provides educational opportunities for the KU faculty and students to learn cutting-edge technologies in drug-discovery platforms through seminars, workshops, internships and course teaching. This is the first instalment of a two-part contribution from the KU HTS laboratory.

  17. Initiation of universal tumor screening for Lynch syndrome in colorectal cancer patients as a model for the implementation of genetic information into clinical oncology practice.

    Cohen, Stacey A; Laurino, Mercy; Bowen, Deborah J; Upton, Melissa P; Pritchard, Colin; Hisama, Fuki; Jarvik, Gail; Fichera, Alessandro; Sjoding, Britta; Bennett, Robin L; Naylor, Lorraine; Jacobson, Angela; Burke, Wylie; Grady, William M

    2016-02-01

    Lynch syndrome confers a hereditary predisposition to colorectal and other cancers. Universal tumor screening (UTS) for Lynch syndrome is recommended by several professional societies, but the implementation can be complex. This article describes the evaluation, process development, and initiation of Lynch syndrome UTS at a tertiary referral cancer center. A multidisciplinary team developed the new process design. Issues in 5 themes were noted: timing, funding, second-opinion patients, result processing, and the role of genetics providers. A committee approach was used to examine each issue for process-improvement development. The issues related to testing were addressed individually for the successful implementation of UTS at the institutional level. In the conventional-care period, 9 of 30 cases (30%) received Lynch syndrome screening, and 4 cases were referred to medical genetics. During the 6 months following the implementation of UTS, 32 of 44 patients (73%) received Lynch syndrome screening. The 13 unscreened patients all had identified reasons for nonscreening (eg, financial limitations). Ten patients were referred to medical genetics, which identified no new cases of Lynch syndrome, but a low-risk adenomatous polyposis coli (APC) variant was detected in 1 individual. The implementation of effective Lynch syndrome UTS can feasibly alter practice at the institutional level. This experience with the assessment and management of issues relevant to the successful implementation of a new clinical care paradigm based on emerging technology has implications for the uptake of advances across molecular oncology into clinical practice, and this is highly relevant in the current era of rapidly evolving genomic technology. © 2015 American Cancer Society.

  18. ABO hemolytic disease of the fetus and newborn: thirteen years of data after implementing a universal bilirubin screening and management program.

    Christensen, R D; Baer, V L; MacQueen, B C; O'Brien, E A; Ilstrup, S J

    2018-02-06

    ABO hemolytic disease occurs among neonates with blood groups A or B delivered to group O women. Extreme neonatal hyperbilirubinemia due to ABO disease has been reported, but its frequency is not well known. We sought to determine the odds of developing severe ABO hemolytic disease in the 13 years since adopting universal bilirubin screening/management in the Intermountain Healthcare system. We conducted a retrospective analysis of neonates born between 2004 and 2016, defining "severe hemolytic disease" as; (1) total serum bilirubin (TSB) >25 mg/dL, or (2) hospital readmission for jaundice, or (3) bilirubin encephalopathy. Neonates born to group O (+) mothers were included and considered either; (1) Controls (not at risk for ABO disease because they were group O), (2) Study subjects (at risk for ABO disease because they were group A or B). Of 400,531 live births, 47% were to group O women; 86% of whom were group O (+). Overall, 42,529 (27%) neonates born to group O (+) women had their blood group determined; 29,729 (68%) were O, 10,682 (25%) A, and 3109 (7%) B. Peak TSBs during the first 10 days were higher in group A (11.0 ± 4.2 mg/dL) and B (11.5 ± 4.3) than group O neonates (10.3 ± 4.1). However the relative risks of a TSB ≥25 mg/dL, readmission for jaundice, or kernicterus, were the same in the control vs. study groups. In our health system, severe hemolytic disease in neonates born to group O (+) woman is not more likely in group A or B neonates than in controls (group O). We recognize that in other practices, particularly those who do not have a universal bilirubin screening/management program, ABO hemolytic disease severity might be different than in our system.

  19. Uptake of health care services and health status of HIV-infected women diagnosed through antenatal HIV screening in Barbados, 1996-2004 Utilización de los servicios de atención sanitaria y estado de salud de las mujeres seropositivas al VIH diagnosticadas mediante el tamizaje prenatal para el VIH en Barbados, 1996-2004

    Alok Kumar

    2007-12-01

    Full Text Available OBJECTIVES: To study utilization of HIV-related health care services and to describe the health status of HIV-infected women diagnosed through antenatal voluntary counseling and testing (VCT for HIV infection in Barbados. METHODS: This is a descriptive study. The study population includes all HIV-infected women in Barbados diagnosed as HIV-infected through VCT for HIV infection during 1996-2004. RESULTS: The median duration of HIV infection from time of diagnosis to the time of this report for the 163 women diagnosed during the study period was 72 months (low range, 9 months; high range, 117 months. Of the 163 women, 102 (62.6% had attended the centralized HIV/AIDS clinic for follow-up (care, treatment, and monitoring, whereas 61 (37.4% had never attended the clinic. The median time lag between diagnosis of HIV infection and first presentation to the HIV/AIDS clinic was 36 months (low range, 1 month; high range, 114 months. Of the HIV-infected women who attended the HIV/AIDS clinic, more than one-fourth had severe immunodeficiency at the time of their first follow-up visit. Of the 53 women undergoing highly active anti-retroviral therapy (HAART at the time of the study, 23 (43.4% began the therapy within three months of their first follow-up visit. CONCLUSIONS: Early HIV diagnosis through antenatal VCT is not enough to ensure that women with HIV will get adequate and timely HIV-related health care. These women suffer significant premature mortality, largely related to inadequate follow-up.OBJETIVOS: Estudiar la utilización de los servicios de atención sanitaria relacionados con el VIH y describir el estado de salud de las mujeres infectadas con este virus, diagnosticadas mediante el asesoramiento y la prueba de detección del VIH de carácter voluntario (APDV durante el período prenatal en Barbados. MÉTODOS: Este es un estudio descriptivo. La población de estudio abarcó a todas las mujeres infectadas por el VIH, diagnosticadas en Barbados

  20. Focusing on relationships, not information, respects autonomy during antenatal consultations.

    Gaucher, Nathalie; Payot, Antoine

    2017-01-01

    Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Analfanauts and Fourth Screen: Lack of Infodiets and Media and Information Literacy in Latin American University Students

    Luis M. ROMERO RODRÍGUEZ

    2016-06-01

    Full Text Available Mobile devices have become an integral part of our lives. Through these terminals, users can not only communicate with their peers, but receive and produce vast amounts of information usually through social networks, making us in many ways in mass media. However, the question arises are we ready for it? In this research the problem of analfanauts understood as those individuals who dominate the digital skills necessary to interact with ICT is addressed, but lack sufficient media and information skills to avoid misinformation and structural infoxication present in the networks. In order to analyze these behaviors one quantitative and qualitative a sample of 1,603 university students in Colombia, Venezuela and Peru, consumption, use of social networks and making viral of pseudo-information in the communication system study will be conducted. The results present a forward-profile technical skills, relegating the analytical content consumption exposed digital media, which turns into an exponential growth of prosumer infoxication.

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

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

    2014-01-01

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

  3. Costs of hospitalization in preterm infants: impact of antenatal steroid therapy

    Joice Fabiola Meneguel Ogata

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS. METHOD: Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique. RESULTS: Of 220 patients that met the inclusion criteria, 211 (96% charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU. In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p = 0.008. The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p = 0.008 and a 49% reduction of NICU length of stay (p = 0.011. CONCLUSION: ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age.

  4. Costs of hospitalization in preterm infants: impact of antenatal steroid therapy.

    Ogata, Joice Fabiola Meneguel; Fonseca, Marcelo Cunio Machado; Miyoshi, Milton Harumi; Almeida, Maria Fernanda Branco de; Guinsburg, Ruth

    2016-01-01

    To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS). Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique. Of 220 patients that met the inclusion criteria, 211 (96%) charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU). In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p=0.008). The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p=0.008) and a 49% reduction of NICU length of stay (p=0.011). ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  5. Universal School-Based Implementation of Screening Brief Intervention and Referral to Treatment to Reduce and Prevent Alcohol, Marijuana, Tobacco, and Other Drug Use: Process and Feasibility

    Julie Maslowsky

    2017-12-01

    Full Text Available Screening, Brief Intervention, and Referral to Treatment (SBIRT is an evidence-based approach to reducing substance use in adolescents. An emerging literature shows the promise of school-based SBIRT. However, most school-based SBIRT has only targeted substance-using adolescents and used school-based health clinics, which most schools lack. This project aimed to describe the following: a model for implementing universal SBIRT in high schools without school-based clinics, reasons students most commonly endorsed for reducing or avoiding substance use, students’ perceptions of SBIRT, and students’ intentions to change substance use or remain abstinent following SBIRT. Participants were N = 2513, 9th to 10th grade students in 10 high schools. Students rated SBIRT positively and indicated substantial intentions to reduce or delay substance use following SBIRT. Results support SBIRT’s potential to delay substance use among current abstainers in addition to reducing substance use among current users. This project demonstrates SBIRT’s feasibility as a universal method in high schools without in-school clinics.

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

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

    2014-01-01

    The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small num......-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes....

  7. Effects of a stand-alone web-based electronic screening and brief intervention targeting alcohol use in university students of legal drinking age: A randomized controlled trial.

    Ganz, Thomas; Braun, Michael; Laging, Marion; Schermelleh-Engel, Karin; Michalak, Johannes; Heidenreich, Thomas

    2018-02-01

    Many intervention efforts targeting student drinking were developed to address US college students, which usually involves underage drinking. It remains unclear, if research evidence from these interventions is generalizable to university and college students of legal drinking age, e.g., in Europe. To evaluate the effectiveness of a translated and adapted version of the eCHECKUP TO GO, applied as stand-alone web-based electronic screening and brief intervention (e-SBI), in German university students at risk for hazardous drinking. A fully automated web-based two-arm parallel-group randomized controlled trial was conducted. Participants were randomized to an e-SBI or assessment-only (AO) condition. The current paper analyzed students with baseline AUDIT-C scores ≥3 for women and ≥4 for men (sample at baseline: e-SBI [n=514], AO [n=467]; 3-month follow-up: e-SBI [n=194], AO [n=231]; 6-month follow-up: e-SBI [n=146], AO [n=200]). The primary outcome was prior four weeks' alcohol consumption. Secondary outcomes were frequency of heavy drinking occasions, peak blood alcohol concentration, and number of alcohol-related problems. Mixed linear model analyses revealed significant interaction effects between groups and time points on the primary outcome after 3 and 6months. Compared to students in the AO condition, students in the e-SBI condition reported consuming 4.11 fewer standard drinks during the previous four weeks after 3months, and 4.78 fewer standard drinks after 6months. Mixed results were found on secondary outcomes. The results indicate that evidence on and knowledge of web-based e-SBIs based on US college student samples is transferable to German university students of legal drinking age. However, knowledge of what motivates students to complete programs under voluntary conditions, although rare, is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Audit of antenatal care at a community health centre in Tshwane ...

    Objective: Few studies document the level of compliance with antenatal care protocols in primary health care in South Africa. The aim of this study was to conduct an audit of antenatal care at a community health centre in Tshwane North subdistrict in order to measure the level of compliance of maternity staff with antenatal ...

  9. Antenatal mother–infant bonding scores are related to maternal reports of infant crying behaviour

    Kommers, D.R.; Truijens, S.E.M.; Oei, S.G.; Bambang Oetomo, S.; Pop, V.J.M.

    2017-01-01

    Objective: To assess the relation between antenatal mother–infant bonding scores and maternal reports of infant crying behaviour. Background: Crying is normal behaviour and it is important for parent–infant bonding. Even though bonding starts antenatally, the relation between antenatal bonding

  10. Midwives' emotional wellbeing: impact of conducting a structured antenatal psychosocial assessment (SAPSA).

    Mollart, Lyndall; Newing, Carol; Foureur, Maralyn

    2009-09-01

    To investigate the impact of conducting structured antenatal psychosocial assessments (SAPSA) on midwives' emotional wellbeing. The SAPSA includes screening and assessment tools for domestic violence, childhood trauma, drug and alcohol use, depression, and vulnerability factors. Registered midwives who had conducted the SAPSA with women during the first hospital booking visit at two hospitals in NSW. Data was collected by means of focus group interviews. Four sub-themes were identified that directly impacted upon the midwives' emotional wellbeing: cumulative complex disclosures, frustration and stress, lack of support for midwives and unhealthy coping strategies. There was a cumulative emotional effect with some midwives utilising unhealthy strategies to cope with feelings of frustration, inadequacy and vicarious trauma. Establishment of structured referral pathways for women and supportive systems for midwives is essential prior to implementing the SAPSA.

  11. A Ten-Year Review of Antenatal Complications and Pregnancy Outcomes Among HIV-Positive Pregnant Women.

    Yudin, Mark H; Caprara, Daniela; MacGillivray, S Jay; Urquia, Marcelo; Shah, Rajiv R

    2016-01-01

    To review the incidence of antenatal complications among a cohort of HIV-positive pregnant women over a 10-year period. A retrospective review was performed of all HIV-positive pregnant women receiving multidisciplinary prenatal care at an urban tertiary care centre from March 2000 to March 2010. Collected data included the presence of additional infectious or medical conditions, genetic screening information, and the presence or absence of antenatal complications. One hundred and forty-two singleton pregnancies during the study period were identified. Almost 95% of women were taking combination antiretroviral therapy during pregnancy, and greater than 90% had viral loads less than 1000 copies/ml at delivery. The presence of co-infections was low. Forty-one women (29%) had other medical comorbidities. Genetic screening occurred in 104 pregnancies (73%); 4% were abnormal screens. Rates of any hypertension, gestational diabetes, and fetal growth restriction were all low. Thirty-two percent of women were colonized with group B streptococcus. This study adds strength to the argument that good outcomes can be achieved for HIV-positive pregnant women with good access to both prenatal and HIV care, and appropriate management. Women with HIV should be optimally cared for in advance of and during pregnancy in order to maximize the likelihood of good pregnancy outcomes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  12. Analysis of qualitative data from the investigation study in pregnancy of the ASSIST Version 3.0 (the Alcohol, Smoking and Substance Involvement Screening Test).

    Hotham, Elizabeth D; Ali, Robert L; White, Jason M

    2016-03-01

    to utilise qualitative data from investigation of the screening tool ASSIST Version 3.0 with pregnant women to help determine its appropriateness for this cohort, thus informing potential innovations to enhance the questionnaire׳s utility. pregnant women were co-administered the ASSIST Version 3.0 and three established substance use questionnaires (the T-ACE for alcohol, the Timeline FollowBack for cannabis and the Revised Fagerstrom Questionnaire for tobacco). antenatal clinics and the antenatal ward of the Women׳s and Children׳s Hospital, Adelaide, South Australia. 104 pregnant substance-users. as well as the quantitative date (reported elsewhere), rich qualitative data documenting participants' perspectives and experiences in antenatal care were thematically analysed. Women constantly reported friends and family urging them to stop use. Although care providers also advocated cessation or curtailment of use, this advice was reported as unpredictable, with only some providers strongly attuned to such recommendations. Some women voiced suggestions for the appropriate level of provider advice. While pregnancy was often reported as a motivator for changing substance-using behaviour, others reported continued attachment to use which was clearly linked to dependence. Those who reported successful control of use were in contrast to others who were more pragmatic, sceptical in relation to attributable harms, and disinterested in change. There were limited reports of experiences of discrimination directed to pregnant substance users. However, those instances were clearly linked with subsequent lack of honest discussions with care providers, resulting in an absence of appropriate support. current absence of universal screening for substance use has the potential for less than optimal consequences for both mother and baby. appropriate screening accompanied by honest, non-judgmental dialogue can guide the necessary interventions to achieve better outcomes. The recent

  13. BACTERIAL PROFILE OF ASYMPTOMATIC BACTERIURIA IN ANTENATAL WOMEN AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF THE ISOLATES OBTAINED

    Lavanya Venkata Sayam

    2017-07-01

    Full Text Available BACKGROUND Urinary tract infection in pregnancy is associated with significant morbidity for both the mother and the baby. The aim of this study was to determine the incidence of asymptomatic bacteriuria, the bacterial profile and antibiotic sensitivity pattern of the urinary pathogens isolated from pregnant women attending the OPD of a teaching hospital in a semi-rural area in the outskirts of Visakhapatnam city. MATERIALS AND METHODS The study group included 500 asymptomatic antenatal women in their first or second trimester of pregnancy. They were screened for bacteriuria by the catalase method. Their mid-stream clean-catch samples of urine were cultured by the standard loop semi-quantitative method. Antibiotic sensitivity was tested by the disc-diffusion method. Culture positive cases were advised to strictly follow treatment to avoid future complications. RESULTS 48 (9.6% of the 500 samples were culture positive. 66.66% (32 cases of the positive cases were primigravida. The incidence was also high in the less than 20 years age group. The frequency of isolating coagulase negative Staphylococcus has increased in the present study. Many of the isolates proved to be ESBLs. CONCLUSION The findings of the study re-confirm the results of the earlier studies conducted in Visakhapatnam and elsewhere, and call for an even more vigilant approach to the problem. Prevalence of CONS was not encountered in the earlier study conducted in a similar demographic area, nor was that of the ESBLs. It has thus been proven that early screening of all pregnant women for urinary tract infection is mandatory for those visiting the obstetrician for antenatal checkups.

  14. Prevalence and Determinants of Early Antenatal Care Visit among ...

    AJRH Managing Editor

    Antenatal care (ANC), which is given to pregnant women, is widely used for prevention, early diagnosis and treatment of general medical and ... Les soins prénatals (SP), que reçoivent les femmes enceintes, sont largement utilisés pour la prévention, le diagnostic précoce et ... syphilis, HIV/AIDS and severe anemia and.

  15. Intentions of Registered Antenatal Clinic Patients About Utilizing ...

    Background: Nigeria bears a sizeable proportion of the global HIV burden; mother to child transmission as a major contributor and prevention of mother to child transmission the hope for a HIV-free generation. Objective: To find evaluate how booked antenatal attendees intend to utilize the labour and delivery services of the ...

  16. Factors Influencing Antenatal Care Service Utilization in Hadiya Zone

    Therefore, the objective of this study was to explore factors influencing antenatal care services utilization in Southern Ethiopia. METHODS: A community-based cross sectional study was conducted in Hadiya Zone of Southern Ethiopia from January to February 2009. A multi stage sampling technique was used to select the ...

  17. Implementing focussed antenatal care in sub-Saharan Africa: an ...

    A SWOT Analysis framework was used to assess the situational analysis of antenatal care programmes in sub-Saharan Africa while the Walt and Gilson policy analysis triangle was used to analyse the feasibility of introducing the new WHO ANC model into the sub-region. The content of the WHO model may need to be ...

  18. Quality of Antenatal care services in eastern Uganda: implications ...

    Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Methods Data was collected from 15 health facilities in Eastern Uganda to establish capacity ...

  19. Contraceptive‑seeking Behavior of Women Attending Antenatal ...

    Contraceptive‑seeking Behavior of Women Attending Antenatal Care in a Developing Country: A Veritable Tool for Slowing Population Growth. ... Background: The use of modern contraceptives has been embraced by developed nations as a means of achieving controlled growth rate. Nigeria, Africa's most populous nation ...

  20. Utilization of antenatal care services among teenagers in Ethiopia: A ...

    Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia. Methodology: Raw data collected from all part of the country on child ...

  1. Antenatal corticosteroid use in preterm birth at Kenyatta National ...

    Background: Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malformations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO ...

  2. determinants of first antenatal care visit by pregnant women

    2014-09-01

    Sep 1, 2014 ... M. Turyasiima, R. Tugume, A. Openy, E. Ahairwomugisha, R. Opio, M. Ntunguka and N. Mahulo, Fifth year MBChB ... AT COMMUNITY BASED EDUCATION, RESEARCH AND SERVICE SITES IN ... health workers compared to those who initiate ... sub-Saharan Africa start antenatal care considerably.

  3. Perceptions of pregnant adolescents on the antenatal care received ...

    2018-03-25

    Mar 25, 2018 ... women because of the low self-esteem and stigma associated .... School again will help you to look young because when you give birth to three or four babies .... and older women delay seeking antenatal care14,17,18,21,26.

  4. Audit of antenatal services in primary healthcare centres in Jos ...

    Introduction: Maternal mortality remains a big challenge in developing countries including Nigeria where the figures are amongst the highest in the world. The Nigerian government's response in providing primary healthcare centres (PHCs) in all local government areas is commendable but access to quality antenatal care is ...

  5. Game-based online antenatal breastfeeding education: A pilot.

    Grassley, Jane S; Connor, Kelley C; Bond, Laura

    2017-02-01

    The aim of this study was to evaluate the effect of the Healthy Moms intervention on antenatal breastfeeding self-efficacy and intention and to determine the feasibility of using an online game-based learning platform to deliver antenatal breastfeeding education. The Internet has potential for improving breastfeeding rates through improving women's access to antenatal breastfeeding education. Twelve computer-based breastfeeding education modules were developed using an online learning platform. Changes in participants' breastfeeding self-efficacy and intention pre- and post-intervention were measured using descriptive statistics and a one-way ANOVA. Of the 25 women submitting the pretest, four completed zero quests; seven, orientation only; eight, one to six breastfeeding quests; and six, 10 to 12 breastfeeding quests. No significant differences in breastfeeding self-efficacy and intention were found among the groups. Online antenatal breastfeeding education is feasible; however, further research is warranted to determine if it can affect breastfeeding outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Awareness and desirability of the Nigerian antenatal women about ...

    Results:Of the 650 subjects, 249(38.3%)were aware of analgesia use in labour and their sources of information were through media (30.9%), antenatal counselling (22.9%), friends/relations (17.3%), internet (5.6%) and others – literature/lectures/ symposium (22.9%). The only factor that influence awareness on logistic ...

  7. Determinants of condom use among antenatal clinic attendees in ...

    Conclusion: The reported prevalence of ever use of a condom amongst antenatal clinic attendees is low and inconsistent especially among HIV positive women. Deliberate effort should be used to ensure condom access, availability and correct and consistent use of condoms by women in all sexual acts.

  8. Placenta accreta: MRI antenatal diagnosis and surgical correlation.

    Ha, T P; Li, K C

    1998-01-01

    We describe a case of a placenta previa accreta that was diagnosed antenatally by MRI with subsequent surgical confirmation. We show the advantages of ultrafast MRI single shot (SS) fast spin echo (FSE) techniques for accurate diagnosis with minimal scan time and fetal motion artifacts.

  9. Prevalence of malaria at booking among antenatal clients in a ...

    Administrator

    2Institute for Advanced medical Research and Training, College of Medicine, Ibadan, Nigeria. 3Department of Obstetrics ... MATERIALS AND METHODS. We used a cross sectional ... all part of routine care in the. Prevalence of malaria at booking among antenatal clients in a secondary health care facility in Ibadan, Nigeria ...

  10. Prevalence of malaria among pregnant women attending antenatal ...

    Malaria is a chronic parasitic disease that affects everybody but with pregnant women and children under the age of 5 years as its main target. The adverse complications of malaria in pregnancy makes it of immense public health importance. This study was designed to evaluate the prevalence of malaria among antenatal ...

  11. Antenatal clinical pelvimetry in primigravidae and outcome of labour ...

    Method: A retrospective study of clinical pelvimetry and outcome of labour in primigravidae. Results: The total number of primigravidae included in the study was 268 and of these, 74 were adjudged to have adequate pelvis at antenatal clinical pelvimetry. The APGAR scores at one and five minutes were significantly higher ...

  12. Induced abortion among women attending antenatal clinics in ...

    Objectives: Unsafe abortion is a public health concern because of its impact on maternal morbidity and mortality. The objective of this study was to document on induced abortion in Yaounde, Cameroon. Design: Cross-sectional study. Setting: Six antenatal clinics in Yaounde, Cameroon. Methods: Women attending ...

  13. Antenatal blood donation: Pregnant mothers' attitude, fears and ...

    Up to 150,000 pregnancy-related deaths could be avoided each year through access to safe blood. Antenatal blood donation, which will increase access to safe blood, is one of the ways to reduce maternal mortality in this environment. This study assessed the knowledge, attitude, fears and preferences of pregnant mothers ...

  14. The association of maternal social factors and antenatal care with ...

    Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on ...

  15. Mothers' Antenatal Depression and Their Children's Antisocial Outcomes

    Hay, Dale F.; Pawlby, Susan; Waters, Cerith S.; Perra, Oliver; Sharp, Deborah

    2010-01-01

    Interviews of 120 British adolescents and their parents (80% of a random sample of antenatal patients drawn from a representative urban population and followed longitudinally) revealed that 40 (33%) had been arrested and/or had a diagnosis of "DSM-IV" conduct disorder by 16 years of age; of those, 18 (45%) had committed violent acts.…

  16. Variables influencing delay in antenatal clinic attendance among ...

    Although antenatal care is provided at different levels, Lesotho still has a ... This shortage of health care personnel and the impact of HIV/Aids result in ... of early attendance, denial of the pregnancy by the boyfriend, the fact that sex outside of ..... “My parents were still negotiating with ... want him to pay for the damage he did.

  17. Polyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations

    Laghmani, Kamel; Beck, Bodo B.; Yang, Sung-Sen; Seaayfan, Elie; Wenzel, Andrea; Reusch, Bjorn; Vitzthum, Helga; Priem, Dario; Demaretz, Sylvie; Bergmann, Klasien; Duin, Leonie K.; Goebel, Heike; Mache, Christoph; Thiele, Holger; Bartram, Malte P.; Dombret, Carlos; Altmueller, Janine; Nuernberg, Peter; Benzing, Thomas; Levtchenko, Elena; Seyberth, Hannsjoerg W.; Klaus, Guenter; Yigit, Goekhan; Lin, Shih-Hua; Timmer, Albert; de Koning, Tom J.; Scherjon, Sicco; Schlingmann, Karl P.; Bertrand, Mathieu J. M.; Rinschen, Markus M.; de Backer, Olivier; Konrad, Martin; Koemhoff, Martin

    2016-01-01

    BACKGROUND Three' pregnancies with male offspring in one family were complicated by severe polyhydramnios and prematurity. One fetus died; the other two had transient massive salt-wasting and polyuria reminiscent of antenatal Bartter's syndrome. METHODS To uncover the molecular cause of this

  18. Variables influencing delay in antenatal clinic attendance among ...

    and to make recommendations based on the research findings for the development of policies that will ensure early .... Table 1: Antenatal service utilisation by pregnant adolescents in Lesotho (First visits ... fail to recognise that they are pregnant ..... Demographic and Health Survey 2004. Calverton, Maryland. 2. Safe.

  19. Randomised trial of structured antenatal training sessions to improve the birth process.

    Maimburg, R D; Vaeth, M; Dürr, J; Hvidman, L; Olsen, J

    2010-07-01

    To compare the birth process in nulliparous women enrolled in a structured antenatal training programme, the 'Ready for Child' programme, with women allocated to routine care. A randomised controlled trial. A Danish university hospital. Thousand hundred and ninety-three nulliparous women, recruited before week 22 + 0. Methods Compliance to the protocol was monitored by questionnaires sent to the women by email, and by data from the local birth cohort database. Data were analysed according to the 'intention-to-treat' principle. Women were randomised to receive 9 hours of antenatal training or no formalised training. Of the 1193 women, 603 were randomised to the intervention group and 590 were allocated to the reference group. Cervix dilatation on arrival at the maternity ward, use of pain relief and medical interventions during the birth process, and the women's birth experience. Women who attended the 'Ready for Child' programme arrived at the maternity ward in active labour more often than the reference group [relative risk (RR) 1.45, 95% confidence interval (95% CI) 1.26-1.65, P less epidural analgesia during labour (RR 0.84, 95% CI 0.73-0.97, P less pain relief overall (RR 0.99, 95% CI 0.94-1.04, P women's self-reported birth experiences were similar in the two groups. We found no adverse effects of the intervention. Attending the 'Ready for Child' programme may help women to cope better with the birth process. Adverse effects are few, if any.

  20. Effect of antenatal corticosteroids on postmortem brain weight of preterm babies.

    Murphy, D J

    2001-07-01

    To investigate the effects of single and repeated courses of antenatal corticosteroids on brain growth in very preterm babies. Retrospective study of 110 very preterm babies delivered at a single University Teaching Hospital between 1992 and 1999 who had a full necropsy including detailed examination of the brain. Mean brain weight did not differ significantly between babies who received corticosteroids and those who did not 160 vs. 157 g, (p=0.82), nor was there a difference between mean brain weight of stillborn or liveborn babies in relation to steroid use 164 vs. 159 g, (p=0.84) and 156 vs. 152g (p=0.81). There was no apparent dose-response relationship between the total number of doses of corticosteroids or timing since the first dose of corticosteroids and brain weight, p=0.95 and p=0.87. Single and multiple courses of antenatal corticosteroids had no significant effect on brain growth in babies delivered preterm who died but long-term follow-up studies are required to evaluate the functional neurological outcome of surviving children.

  1. Effect of Antenatal Steroids on Respiratory Morbidity of Late Preterm Newborns: A Randomized Controlled Trial.

    Ontela, Vijaya; Dorairajan, Gowri; Bhat, Vishnu B; Chinnakali, Palanivel

    2018-01-22

    The objective of this article was to study the effect of antenatal dexamethasone on the respiratory morbidity of late preterm newborns. A randomized controlled trial, conducted in Obstetrics and Gynecology Department in collaboration with Neonatology department at JIPMER, India. In total, 155 women were studied in each group. Intention to treat analysis and per protocol analysis were done. Overall 31 (10%) newborns were admitted to intensive care unit. The composite respiratory morbidity (defined as respiratory distress syndrome and/or transient tachypnea of newborn) was observed in 64 (41.6%) infants in the study and 56 (36.2%) infants in the control group. On multivariable-adjusted analysis, use of steroids was not found to be associated with decrease in composite respiratory morbidity [adjusted relative risk 0.91 (95% confidence interval: 0.7-1.2)]. Antenatal dexamethasone does not reduce the composite respiratory morbidity of babies born vaginally or by emergency cesarean to women with late preterm labor. © The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. Awareness of human immunodeficiency virus (HIV) infection among antenatal clients in Nnewi Nigeria.

    Okafor, C I; Dinwoke, V O; Udigwe, G O

    2014-01-01

    To determine the level of awareness of Human Immunodeficiency Virus (HIV) infection among antenatal clients in Nnewi Nigeria. A cross sectional descriptive study of six hundred consecutive antenatal clients attending the Nnamdi Azikiwe University Teaching Hospital and five private specialist hospitals (run by Consultant Obstetricians) in Nnewi was conducted over a six-month period (1st September 2008 -28th February 2009). Anonymous, structured, pretested questionnaire designed to assess the awareness of HIV infection was used. The mean age of all the 600 clients was 31.4 (SD 2.8) years, majority were married (94%) and in the third trimester of pregnancy (69%). Most (58%) attended secondary school while 0.83% had no formal education. Only 2% had complete knowledge of the modes of HIV transmission while majority (96.5%) had partial knowledge. There was a statistically significant relationship between level of education and knowledge of HIV (p < 0.00001). HIV test was done on 419 (69.84%); 37 tested positive giving a seroprevalence rate of 8.83%. Among those tested, only 51.55% had counseling before testing. This study showed that the knowledge of HIV among women of child bearing age and the practice of voluntary counseling and testing are still poor in our environment. Improved public enlightenment and training of health workers are urgently needed.

  3. Quality and uptake of antenatal and postnatal care in Haiti.

    Mirkovic, Kelsey R; Lathrop, Eva; Hulland, Erin N; Jean-Louis, Reginald; Lauture, Daniel; D'Alexis, Ghislaine Desinor; Handzel, Endang; Grand-Pierre, Reynold

    2017-02-02

    Despite improvement, maternal mortality in Haiti remains high at 359/100,000 live births. Improving access to high quality antenatal and postnatal care has been shown to reduce maternal mortality and improve newborn outcomes. Little is known regarding the quality and uptake of antenatal and postnatal care among Haitian women. Exit interviews were conducted with all pregnant and postpartum women seeking care from large health facilities (n = 10) in the Nord and Nord-Est department and communes of St. Marc, Verrettes, and Petite Rivière in Haiti over the study period (March-April 2015; 3-4 days/facility). Standard questions related to demographics, previous pregnancies, current pregnancy, and services/satisfaction during the visit were asked. Total number of antenatal visits were abstracted from charts of recently delivered women (n = 1141). Provider knowledge assessments were completed by antenatal and postnatal care providers (n = 39). Frequencies were calculated for descriptive variables and multivariable logistic regression was used to explore predictors of receiving 5 out of 10 counseling messages among pregnant women. Among 894 pregnant women seeking antenatal care, most reported receiving standard clinical service components during their visit (97% were weighed, 80% had fetal heart tones checked), however fewer reported receiving recommended counseling messages (44% counselled on danger signs, 33% on postpartum family planning). Far fewer women were seeking postnatal care (n = 63) and similar service patterns were reported. Forty-three percent of pregnant women report receiving at least 5 out of 10 counseling messages. Pregnant women on a repeat visit and women with greater educational attainment had greater odds of reporting having received 5 out of 10 counseling messages (2 nd visit: adjusted odds ratio [aOR] =1.70, 95% confidence interval [CI]: 1.09-2.66; 5+ visit: aOR = 5.44, 95% CI: 2.91-10.16; elementary school certificate: a

  4. Assessment of the feasibility and coverage of a modified universal hearing screening protocol for use with newborn babies of migrant workers in Beijing.

    Qi, Beier; Cheng, Xiaohua; En, Hui; Liu, Bo; Peng, Shichun; Zhen, Yong; Cai, Zhenghua; Huang, Lihui; Zhang, Luo; Han, Demin

    2013-08-08

    Although migrant workers account for the majority of newborns in Beijing, their children are less likely to undergo appropriate universal newborn hearing screening/rescreening (UNHS) than newborns of local non-migrant residents. We hypothesised that this was at least in part due to the inadequacy of the UNHS protocol currently employed for newborn babies, and therefore aimed to modify the protocol to specifically reflect the needs of the migrant population. A total of 10,983 healthy babies born to migrant mothers between January 2007 and December 2009 at a Beijing public hospital were investigated for hearing abnormalities according to a modified UNHS protocol. This incorporated two additional/optional otoacoustic emissions (OAE) tests at 24-48 hours and 2 months after birth. Infants not passing a screening test were referred to the next test, until any hearing loss was confirmed by the auditory brainstem response (ABR) test. A total of 98.91% (10983/11104) of all newborn children underwent the initial OAE test, of which 27.22% (2990/10983) failed the test. 1712 of the failed babies underwent the second inpatient OAE test, with739 failing again; thus significantly decreasing the overall positive rate for abnormal hearing from 27.22% to 18.36% ([2990-973 /10983)]; p = 0). Overall, 1147(56.87%) babies underwent the outpatient OAE test again after1-month, of whom 228 failed and were referred for the second outpatient OAE test (i.e. 2.08% (228/10983) referral rate at 1month of age). 141 of these infants underwent the referral test, of whom 103 (73.05%) tested positive again and were referred for a final ABR test for hearing loss (i.e. final referral rate of 1.73% ([228-38/10983] at 2 months of age). Only 54 infants attended the ABR test and 35 (0.32% of the original cohort tested) were diagnosed with abnormal hearing. Our study shows that it is feasible and practical to achieve high coverage rates for screening hearing loss and decrease the referral rates in

  5. Understanding delayed access to antenatal care: a qualitative interview study

    2014-01-01

    Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote

  6. PHYSIOTHERAPY EXERCISES DURING ANTENATAL AND POSTNATAL

    Hannah Rajsekhar

    2015-10-01

    Full Text Available Background: It’s a well-known fact that exercise is good for the mind and body making it beneficial for expectant and new mothers. The challenge of pregnancy, labor and looking after a new born is not an easy task. So the fitter you are the better you will cope with this life changing event. Method: Aerobic and strengthening exercises help in adjusting to the increasing weight and posture changes to cope effectively with the labor and the postnatal period. Although exercises in pregnancy are extremely beneficial, they can cause more harm than good if not done correctly. Medical screening for exercise should be done by the Doctor as well as the Physiotherapist to ensure that the patient underwent a basic screening, assessment or continued monitoring for the right exercise protocol for avoidance of any complications and to ensure the benefits of staying healthy and fit. Results: Evidence shows that exercise training programs designed and delivered by the Physiotherapists can relieve the prenatal post natal problems. Conclusion: Number of studies has shown the positive effects of aerobic and strengthening exercises on pregnant women. The physical changes to a pregnant woman’s body are multiple. There are center of mass changes, pressure on the organs and increased weight gain. In fact, over two thirds of pregnant women experience back pain, one fifth experience pelvic pain and over 40% experience urinary incontinence in their first pregnancy.

  7. Correlates of antenatal body mass index (bmi as a determinant of birth weight – a longitudinal study

    Saurabh Rambiharilal Shrivastava

    2012-09-01

    Full Text Available Objectives: To study the correlation between Body Mass Index (BMI in antenatal period and birth weight of child, along with the socio-demographic determinants of birth weight. Methods: A longitudinal study of one-year duration, from June 2010 to May 2011, was conducted in an urban slum of Mumbai, India. Universal sampling method was employed, including as subjects all pregnant women with minimum two Antenatal Care (ANC visits - and at least one in the third trimester - registered at an urban health centre from June to August 2010. Subjects with any pre-existing co-morbid illness or with past history of giving birth to twins or to any congenitally malformed child, or else, with outcome of still births or home delivery, were excluded. These women were followed up for the next months until delivery. Maternal weight was recorded at each visit and BMI was calculated, or the average BMI, in case of more than one visit in any trimester. Birth weight was recorded using hospital or maternity home records. Results: Prevalence of low birth weight was 26.7%. Correlation between maternal BMI of third trimester and neonatal birth weight was moderately positive. 60.8% of variability in birth weight can be predicted by maternal BMI in third trimester. Conclusions: Third trimester BMI can be used as a predictor of neonatal birth weight. Information, Education and Counseling (IEC activities regarding utilization of Antenatal Care (ANC services can help reducing the incidence of Low Birth Weight (LBW.

  8. Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.

    Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M

    2013-10-01

    To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.

  9. An Approach to Monitor and Initiate Community Led Actions for Antenatal Care in Rural India – A Pilot Study

    Dongre AR

    2009-09-01

    Full Text Available Background and Objective: Utilization of antenatal care in rural India is far from universal. It requires monitoring and identification of specific needs at field level for timely corrective actions. To pilot test the triangulation of rapid quantitative (Lot Quality Assurance Sampling and qualitative (Focus Group Discussion monitoring tools for ensuring antenatal care in a community based program. Methods: The present study was undertaken in surrounding 23 villages of Kasturba Rural Health Training Centre (KRHTC, Anji, which is also a field practice area of Mahatma Gandhi Institute of Medical Sciences (MGIMS, Sewagram. The monthly monitoring and action system of the study was based on the rapid quantitative monitoring tool (Lot Quality Assurance Sampling, LQASto find out poor performing supervision areas and overall antenatal service coverage and the qualitative methods (Focus group discussions (FGDs, and free listing for exploring ongoing operational constraints in the processes for timely decision making at program and community level. A trained program supervisor paid house visit to 95 randomly selected pregnant women from 5 supervision areas by using pre-designed and pre-tested questionnaire. For poor performing indicators, semi structured FGDs and free listing exercise were undertaken to identify unmet service needs and reasons for its poor performance. Results: Registration of pregnancy within 12 weeks improved from 22.8% to 29.6%. The consumption of 100 or more IFA tablets during pregnancy significantly improved from 6.3% to 17.3%. There was significant improvement in awareness among pregnant women regarding danger signs and symptoms during pregnancy. Over three months period, the overall antenatal registration improved from 253 (67% to 327 (86.7%. Conclusion: The present field based monitoring and action approach constructively identified the reasons for failures and directed specific collective actions to achieve the targets.

  10. Provision of medical supply kits to improve quality of antenatal care in Mozambique: a stepped-wedge cluster randomised trial.

    Betrán, Ana Pilar; Bergel, Eduardo; Griffin, Sally; Melo, Armando; Nguyen, My Huong; Carbonell, Alicia; Mondlane, Santos; Merialdi, Mario; Temmerman, Marleen; Gülmezoglu, A Metin

    2018-01-01

    High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served at least 200 new pregnant women per year; they had Maternal and Child Health (MCH) nurses; and they were willing to participate. All women attending antenatal care visits at the participating clinics were included in the trial. Participating clinics were randomly assigned to shift from control to intervention on prespecified start dates. The intervention involved four components (kits with medical supplies, a cupboard to store these supplies, a tracking sheet to monitor stocks, and a one-day training session). The primary outcomes were the proportion of women screened for anaemia and proteinuria, and the proportion of women who received mebendazole in the first antenatal care visit. The intervention was delivered under routine care conditions, and analyses were done according to the intention-to-treat principle. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201306000550192. Between March, 2014, and January, 2016, 218 277 antenatal care visits were registered, with 68 598 first and 149 679 follow-up visits. We found significant improvements in all three primary outcomes. In first visits, 5519 (14·6%) of 37 826 women were screened for anaemia in the control period, compared with 30 057 (97·7%) of 30 772 in the intervention period (adjusted odds ratio 832·40; 99

  11. Antenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application.

    Tsai, Alexander C; Tomlinson, Mark; Dewing, Sarah; le Roux, Ingrid M; Harwood, Jessica M; Chopra, Mickey; Rotheram-Borus, Mary Jane

    2014-10-01

    Randomized controlled trials conducted in resource-limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment, lay health workers can be trained to effectively administer psychological treatments. We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones. Pregnant, Xhosa-speaking women were recruited independently in two cross-sectional studies (N = 1,144 and N = 361) conducted in Khayelitsha, South Africa and assessed for antenatal depression. In the smaller study, community health workers with no training in human subject research were trained to administer the Edinburgh Postnatal Depression Scale (EPDS) during the routine course of their community-based outreach. We compared the operating characteristics of four short and ultrashort versions of the EPDS with the criterion standard of probable depression, defined as an EPDS-10 ≥ 13. The prevalence of probable depression (475/1144 [42 %] and 165/361 [46 %]) was consistent across both samples. The 2-item subscale demonstrated poor internal consistency (Cronbach's α ranged from 0.55 to 0.58). All four subscales demonstrated excellent discrimination, with area under the receiver operating characteristic curve (AUC) values ranging from 0.91 to 0.99. Maximal discrimination was observed for the 7-item depressive symptoms subscale: at the conventional screening threshold of ≥10, it had 0.97 sensitivity and 0.76 specificity for detecting probable antenatal depression. The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression.

  12. Depression Screening

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  13. Comparison of screening methods for anaemia in pregnant women in Awassa, Ethiopia

    Gies, S.; Brabin, B. J.; Yassin, M. A.; Cuevas, L. E.

    2003-01-01

    Screening for anaemia in pregnancy is essential for implementing and monitoring effective antenatal programmes. We compared the diagnostic accuracy of invasive and non-invasive screening methods in a cross-sectional survey of 403 pregnant women attending an urban health centre in Awassa, southern

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

    Boer, K.; Smit, C.; Flier, M. van der; Wolf, F. de; Koopmans †, P.P.; Crevel, R. van; Eggink, A.J.; Groot, R. de; Keuter, M.; Post, F.; Ven, A.J.A.M. van der; Warris, A.; et al.,

    2011-01-01

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

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

    Boer, Kees; Smit, Colette; van der Flier, Michiel; de Wolf, Frank; Bezemer, D. O.; Gras, L. A. J.; Kesselring, A. M.; van Sighem, A. I.; Smit, C.; Zhang, S.; Zaheri, S.; Bronsveld, W.; Hillebrand-Haverkort, M. E.; Prins, J. M.; Branger, J.; Eeftinck Schattenkerk, J. K. M.; Gisolf, J.; Godfried, M. H.; Lange, J. M. A.; Lettinga, K. D.; van der Meer, J. T. M.; Nellen, F. J. B.; van der Poll, T.; Reiss, P.; Ruys, Th A.; Steingrover, R.; van Twillert, G.; Vermeulen, J. N.; Vrouenraets, S. M. E.; van Vugt, M.; Wit, F. W. M. N.; Kuijpers, T. W.; Pajkrt, D.; Scherpbier, H. J.; van Eeden, A.; Brinkman, K.; van den Berk, G. E. L.; Blok, W. L.; Frissen, P. H. J.; Roos, J. C.; Schouten, W. E. M.; Bekendam, D. J.; Weigel, H. M.; Mulder, J. W.; van Gorp, E. C. M.; Wagenaar, J.; Veenstra, J.; Danner, S. A.; van Agtmael, M. A.; Claessen, F. A. P.

    2011-01-01

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

  16. Time and travel costs incurred by women attending antenatal tests: A costing study.

    Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen

    2016-09-01

    to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Okonkwo NS

    2012-03-01

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

  18. Cognizance and utilization about breast cancer screening among the health professional female students and staffs of University Kuala Lumpur, Royal College of Medicine Perak, Malaysia.

    Haque, A T M Emdadul; Mohd Hisham, Muhammad Afif Bin; Ahmad Adzman, Noor Azwa Laili Binti; Azudin, Nur Atiqah Binti; Shafri, Nursakinah Binti; Haque, Mainul

    2016-01-01

    Breast cancer (BC) is a major life-threatening problem and a global concern including Malaysia. BC is an equal threat for both developing and developed countries. The aim of this study was to determine the relationship between sociodemographic factors with knowledge, attitude, and perception on BC screening among the females of University Kuala Lumpur, Royal College of Medicine Perak (UniKL RCMP). This cross-sectional study was conducted from 2015 to 2016. The populations included were the students and staff of UniKL RCMP. The simple sampling method was used and a set of questionnaire was prepared and distributed to the participants who were willing to participate. The data were analyzed by using the SPSS version 17. Of the 220 only 203 questionnaires were returned. Nearly 87.7% of participants indicated genetic factors as the cause of BC, followed by exposure to carcinogenic and X-ray. Excessive smoking (54.2%) and sedentary lifestyle (52.2%) were the risk factors of the BC. 100% of participants thought that breast self-examination (BSE) is important to detect a breast lump and most of them (76.8%) knew what a mammogram is but only 2.0% went for a mammogram. Chemotherapy (71.9%) and surgery (71.9%) were treatments options according to study participants. Nearly 91.1% agreed that regular mammogram could help to detect BC at an early stage. Nearly 88.2% thought BC is not easily curable. Finally, for the attitude on BC screening, most of them knew how to perform BSE (69.0%) with the frequency of 36.0% doing it once a year. The majority of the participants found the good knowledge on BC and on how to perform BSE. Although most of them knew what a mammogram is, only a few have gone for it since perhaps it is recommended for those who are above 50-year-old. Therefore, researchers believe and trust that there is an urgent need of state-funded multicenter study to prevent and early diagnosis of BC in Malaysia.

  19. Antenatal exposure following the Chernobyl accident: neuropsychiatric aspects

    Igumnov, S.A.; Drozdovitch, V.V.

    2004-01-01

    Ten years follow-up investigation of intellectual development of 250 persons from Belarus exposed in utero following the Chernobyl accident and a control group of 250 persons from non- and slightly contaminated regions has been conducted. Neuropsychiatry and psychological examinations were performed among persons of both groups at the age of 6-7, 0-12, and 15-16 years. Mean antenatal external dose among persons of exposed group is 10 ± 13 mGy, maximal dose - 91 mGy. No statistically significant correlation was found in exposed group between individual thyroid dose as well as individual antenatal external dose and IQ at the age of 6-7 years, 10-12 years, and 15-16 years

  20. Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

    Herndon, C.D. Anthony

    2006-01-01

    The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

  1. Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life

    Mutaz Orabi

    2018-03-01

    Full Text Available Objectives: To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US and their clinical outcomes. Methods: This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results: A total of 105 cases were included out of which 83 (79.0% were males and 22 (20.9% were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0% were free of hydronephrosis, 39 (37.1% had mild, 29 (27.6% moderate, and 17 (16.1% had severe hydronephrosis. Half (50.4% of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases were diagnosed by US at the end of first year without any effect on renal function. Conclusions: Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function.

  2. Quality of antenatal care in Zambia: a national assessment

    2012-01-01

    Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601

  3. Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life

    Orabi, Mutaz; Abozaid, Sameh; Sallout, Bahauddin; Abu Shaheen, Amani; Heena, Humariya; Al Matary, Abdulrahman

    2018-01-01

    Objectives To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US) and their clinical outcomes. Methods This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results A total of 105 cases were included out of which 83 (79.0%) were males and 22 (20.9%) were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0%) were free of hydronephrosis, 39 (37.1%) had mild, 29 (27.6%) moderate, and 17 (16.1%) had severe hydronephrosis. Half (50.4%) of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases) were diagnosed by US at the end of first year without any effect on renal function. Conclusions Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function. PMID:29657681

  4. Asymptomatic bacteriuria among antenatal women in Lagos.

    Olamijulo, Joseph Ayodeji; Adewale, Chris Olu; Olaleye, Olalekan

    2016-08-01

    This cross-sectional study was undertaken to determine the prevalence of asymptomatic bacteriuria (ASB), the commonest bacterial isolates and the antibiotic sensitivity pattern among 556 pregnant women in Lagos University Teaching Hospital (LUTH), Nigeria. Women with a bacterial count over 100,000 colony-forming units per millilitre of the same organisms in paired urine samples were considered to have ASB. The prevalence of ASB was 14.6%. Klebsiella was the commonest micro-organism (39.2%) isolated. ASB was significantly associated with marital status, body mass index and parity. There was a significant relationship between urinary nitrites and ASB. The isolated organisms showed remarkable resistance to commonly prescribed antibiotics such as amoxicillin, cloxacillin and trimethoprim but good sensitivity to ofloxacin, gentamycin and ceftazidime. These facts have implications for the management of ASB in pregnancy.

  5. Dimensions of quality of antenatal care service at Suez, Egypt

    Hanan Abbas Abdo Abdel Rahman El Gammal

    2014-01-01

    Full Text Available Introduction: The 5 th millennium development goal aims at reducing maternal mortality by 75% by the year 2015. According to the World Health Organization, there was an estimated 358,000 maternal deaths globally in 2008. Developing countries accounted for 99% of these deaths of which three-fifths occurred in Sub-Saharan Africa. In primary health care (PHC, quality of antenatal care is fundamental and critically affects service continuity. Nevertheless, medical research ignores the issue and it is lacking scientific inquiry, particularly in Egypt. Aim of the Study: The aim of the following study is to assess the quality of antenatal care in urban Suez Governorate, Egypt. Materials and Methods: A cross-sectional primary health care center (PHCC based study conducted at five PHCC in urban Suez, Egypt. The total sample size collected from clients, physicians and medical records. Parameters assessed auditing of medical records, assessing provider and pregnant women satisfaction. Results: Nearly 97% of respondents were satisfied about the quality of antenatal care, while provider′s satisfaction was 61% and for file, auditing was 76.5 ° 5.6. Conclusion: The present study shows that client satisfaction, physicians′ satisfaction and auditing of medical record represent an idea about opportunities for improvement.

  6. Maternal antenatal depression and infant disorganized attachment at 12 months.

    Hayes, Lisa J; Goodman, Sherryl H; Carlson, Elizabeth

    2013-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at three months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at three months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing.

  7. Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations.

    Gaucher, Nathalie; Nadeau, Sophie; Barbier, Alexandre; Janvier, Annie; Payot, Antoine

    2016-11-01

    To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery. In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study. Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks. Spouses/partners were present for 49% of consultations. Most women (90%) reported a positive experience. They found it important to discuss the outcomes of prematurity (96%), but 39% of them reported receiving too much information. Women wanted their spouse/partner to be present (71%) and wished to discuss parental concerns: their roles as mother of a premature baby (82%), their integration in their baby's care (83%), and a better understanding of the neonatal intensive care unit (NICU) environment, including antenatal NICU visits (69%). The majority (56%) wanted a follow-up consultation: this was less likely if a NICU visit had been offered (P parents with child-centered information. Although clinicians follow these guidelines, mothers want personalized information focusing on their individual concerns and questions, such as what they can do for their baby, how NICUs work, and the integration of their family. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Dimensions of Quality of Antenatal Care Sservice at Suez, Egypt

    Rahman El Gammal, Hanan Abbas Abdo Abdel

    2014-01-01

    Introduction: The 5th millennium development goal aims at reducing maternal mortality by 75% by the year 2015. According to the World Health Organization, there was an estimated 358,000 maternal deaths globally in 2008. Developing countries accounted for 99% of these deaths of which three-fifths occurred in Sub-Saharan Africa. In primary health care (PHC), quality of antenatal care is fundamental and critically affects service continuity. Nevertheless, medical research ignores the issue and it is lacking scientific inquiry, particularly in Egypt. Aim of the Study: The aim of the following study is to assess the quality of antenatal care in urban Suez Governorate, Egypt. Materials and Methods: A cross-sectional primary health care center (PHCC) based study conducted at five PHCC in urban Suez, Egypt. The total sample size collected from clients, physicians and medical records. Parameters assessed auditing of medical records, assessing provider and pregnant women satisfaction. Results: Nearly 97% of respondents were satisfied about the quality of antenatal care, while provider's satisfaction was 61% and for file, auditing was 76.5 ± 5.6. Conclusion: The present study shows that client satisfaction, physicians’ satisfaction and auditing of medical record represent an idea about opportunities for improvement. PMID:25374861

  9. Imparting carrier status results detected by universal newborn screening for sickle cell and cystic fibrosis in England: a qualitative study of current practice and policy challenges

    Ulph Fiona

    2007-12-01

    Full Text Available Abstract Background Universal newborn screening for early detection of children affected by sickle cell disorders and cystic fibrosis is currently being implemented across England. Parents of infants identified as carriers of these disorders must also be informed of their baby's result. However there is a lack of evidence for most effective practice internationally when doing so. This study describes current or proposed models for imparting this information in practice and explores associated challenges for policy. Methods Thematic analysis of semi-structured interviews with Child Health Coordinators from all English Health Regions. Results Diverse methods for imparting carrier results, both within and between regions, and within and between conditions, were being implemented or planned. Models ranged from result by letter to in-person communication during a home visit. Non-specialists were considered the best placed professionals to give results and a similar approach for both conditions was emphasised. While national guidance has influenced choice of models, other factors contributed such as existing service structures and lack of funding. Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given. Inadequate consideration of resource and service workload was seen as the main policy obstacle. Clarification of existing guidance; more specific protocols to ensure consistent countrywide practice; integration of the two programmes; and 'normalising' carrier status were suggested as improvements. Conclusion Differing models for communicating carrier results raise concerns about equity and clinical governance. However, this variation provides opportunity for evaluation. Timely and more detailed guidance on protocols with

  10. Clinicopathological characteristics of patients with upper urinary tract urothelial cancer with loss of immunohistochemical expression of the DNA mismatch repair proteins in universal screening.

    Urakami, Shinji; Inoshita, Naoko; Oka, Suguru; Miyama, Yu; Nomura, Sachio; Arai, Masami; Sakaguchi, Kazushige; Kurosawa, Kazuhiro; Okaneya, Toshikazu

    2018-02-01

    To assess the detection rate of putative Lynch syndrome-associated upper urinary tract urothelial cancer among all upper urinary tract urothelial cancers and to examine its clinicopathological characteristics. A total of 143 patients with upper urinary tract urothelial cancer who had received total nephroureterectomy were immunohistochemically stained for the expression of mismatch repair proteins MLH1, PMS2, MSH2 and MSH6. For all suspected mismatch repair-deficient cases, MMR genetic testing was recommended and clinicopathological features were examined. Loss of mismatch repair proteins was found in seven patients (5%) who were thus categorized as putative Lynch syndrome-associated upper urinary tract urothelial cancer. Five of these patients showed dual loss of MSH2/MSH6. Two patients were confirmed to be MSH2 germline mutation carriers. Histologically, all seven tumors were low-grade atypical urothelial carcinoma and showed its unique histological features, such as an inverted papilloma-like growth pattern and a villous to papillary structure with mild stratification of tumor cells. Six tumors had no invasion of the muscularis propria. No recurrence or cancer-related deaths were reported in these seven patients. Just three patients met the revised Amsterdam criteria. This is the first report that universally examined mismatch repair immunohistochemical screening for upper urinary tract urothelial cancers. The prevalence (5%) of putative Lynch syndrome-associated upper urinary tract urothelial cancers is much higher than we had expected. We ascertained that putative Lynch syndrome-associated upper urinary tract urothelial cancers were clinically in the early stage and histologically classified into low-grade malignancy with its characteristic pathological features. The clinicopathological characteristics that we found in the present study could become additional possible markers in the diagnosis of Lynch syndrome-associated upper urinary tract urothelial cancers

  11. Improving the antenatal and post-partum management of women presenting to Sexual Health Services with positive syphilis serology through audit.

    Munro, Christina H; Henniker-Major, Ruth; Homfray, Virginia; Browne, Rita

    2017-08-01

    The incidence of congenital syphilis remains low in the UK, but the morbidity and mortality to babies born to women who are untreated for the condition make testing for the disease antenatally one of the most cost-effective screening programmes. Women attending North Middlesex Hospital, UK with a positive syphilis test at their antenatal booking visit are referred to St Ann's Sexual Health Clinic, London, for management and contact tracing. We were concerned that our initial audit revealed that a large proportion of women referred to our service never attended and recorded partner notification was poor. Following the implementation of recommendations, specifically the introduction of an electronic referral system, re-audit showed an improvement in attendance, contact tracing, documentation and communication.

  12. Pulse oximetry findings in newborns with antenatally diagnosed congenital heart disease.

    Mawson, Isabel E; Babu, Pratusha L; Simpson, John M; Fox, Grenville F

    2018-05-01

    A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of  34 weeks and birth weight > 1.8 kg. A statistically significant increase in the proportion with low admission saturations was seen using ≤ 95% saturation threshold (72% (95% CI 66-78)) compared to ≤ 92% (52% (95% CI 46-59)) and ≤ 90% (46% (95% CI 39-52)). Sub-group analysis found the proportion of neonates with low saturations varied according to the specific CCHD diagnosis with only 20-42% of neonates with aortic stenosis, coarctation of the aorta and pulmonary stenosis having saturations ≤ 95%. The proportion of neonates with low admission oxygen saturation varied by CCHD diagnosis with those without critically reduced pulmonary blood flow not having low admission saturations, in general, even using the ≤ 95% threshold which had the highest proportions of abnormal saturations. This data may assist developing Pulsox screening policies. What is Known: • The addition of pulse oximetry (Pulsox) screening to the routine newborn examination increases the sensitivity of CCHD detection. Pulsox screening is also highly specific for CCHD in asymptomatic neonates, with low false-positive rates. • Early diagnosis of CCHD improves patient outcomes in relation to both morbidity and mortality. What is New: • The proportion of affected infants with an abnormal Pulsox result varies by CCHD diagnosis and screening threshold. In our study using the ≤ 95% threshold gave the highest proportion of neonates with abnormal saturations at admission. • In general, Pulsox yield of abnormal results is low for CCHD diagnoses not associated with critically reduced pulmonary blood flow; however, increasing the Pulsox threshold increased the proportion of infants with an

  13. Frequency of syphilis among antenatal clinic attendee in combined military hospital abbottabad

    Qayum, M.; Shaheen, N.; Khan, M.Q.A.; Ali, W.

    2015-01-01

    Frequency of syphilis among pregnant women attending Combined Military Hospital Abbottabad Study Design: Descriptive study. Material and Methods: A screening for syphilis of 500 married pregnant women presenting to antenatal clinics was carried out using the qualitative Rapid Plasma Regent (RPR) test/ Venereal Disease Research Laboratory (VDRL) test. The Treponema Palladium Haem-Agglutination Assay (TPHA) test was used as confirmatory test for all Venereal Disease Research Laboratory (VDRL) test positive cases. Results: A total of 8 women (1.6%) were positive for Venereal Disease Research Laboratory (VDRL) test. Out of these 4 (0.8%) were positive for Treponema Palladium Haem-Agglutination Assay (TPHA) test. All of these cases have bad obstetrical history. Conclusion: The sero-positivity of Venereal Disease Research Laboratory (VDRL) test is (1.6%), considered high among pregnant women reporting in obstetrics clinics of Combined Military Hospital Abbottabad. Similarly sero-positivity of Treponema Palladium Haem-Agglutination Assay (TPHA) test is (0.8%) considered high among the Venereal Disease Research Laboratory (VDRL) test population. Therefore Screening of syphilis in pregnancy especially in patients having bad obstetrical history (BOH) should be incorporated into the study. (author)

  14. Explaining variation in Down's syndrome screening uptake

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

    2014-01-01

    ), in an attempt to explain the observed variation in national uptake rates. METHODS: We used a mixed methods approach with an embedded design: a) documentary analysis and b) expert stakeholder analysis. National central statistical offices and legal documents were studied first to gain insight in demographic....... RESULTS: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down's syndrome screening policy across the studied countries. However, the additional cost for Down's syndrome screening over and above standard antenatal care in the Netherlands...

  15. Sero-epidemiology of toxoplasmosis and associated risk factors among antenatal women in Ranchi, Jharkhand, India

    Rana Pratap; Ahmad Nadeem Aslami; Manjushri; Narayan Prasad Sahu

    2016-01-01

    Background: Toxoplasmosis seroprevalence in antenatal women has remained a contentious issue in Indian subcontinent. Bad obstetric history (BOH) is specific to women of childbearing age and can be caused by infection with Toxoplama gondii. In Jharkhand, scarce data exist for the roles of toxoplasmosis in the aetiology of adverse pregnancy outcome. Aim: To study the sero-epidemiology of Toxoplasmosis and associated risk factors among antenatal women attending antenatal clinic of a tertiary car...

  16. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes

    No dataset associated with this publication.This dataset is associated with the following publication:Augustine, S. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes. JOURNAL OF CLINICAL MICROBIOLOGY. American Society for Microbiology, Washington, DC, USA, 56(7): 1-2, (2016).

  17. Antenatal diagnosis and management of urinary abnormalities.

    Colodny, A H

    1987-10-01

    severe toxemia. The fetus was found to have a solitary renal cyst. Repeated aspirations of the cyst resulted in resolution of the toxemia, which promptly recurred when fluid reaccumulated in the fetal renal cyst. Insertion of a double-universe catheter from the cyst into the amniotic cavity allowed completion of the pregnancy, with the delivery of an otherwise normal fetus without recurrence of the toxemia. A recent report on fetal surgery from the International Fetal Surgery Registry, coauthored by the strongest advocate of intrauterine intervention, reached these conclusions.(ABSTRACT TRUNCATED AT 400 WORDS)

  18. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

    Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

    2014-01-01

    Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

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

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

    2015-01-01

    of small group antenatal education on obstetric and psycho-social outcomes. CONCLUSIONS: Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well......, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS...

  20. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

    Ruby Angeline Pricilla

    2017-01-01

    Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.

  1. Birth Preparedness and Complication Readiness among Women Attending Antenatal Clinics in Ogbomoso, South West, Nigeria

    Ajibola Idowu, MBBS, FWACP

    2015-10-01

    Full Text Available Background: Information on factors associated with birth preparedness and complication readiness (BP/CR is central in designing cost effective programs for reducing maternal deaths among women. This study assessed factors influencing BP/CR among pregnant women attending antenatal clinic in Ogbomoso, South West Nigeria. Methodology: This is a cross-sectional study conducted between January and April, 2015. Systematic sampling technique was employed to recruit 400 women attending antenatal clinic at Bowen University Teaching Hospital, Ogbomoso, Nigeria. A pre-tested questionnaire was used for data collection and data analysis was done using SPSS version 21. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis. Statistical significance was set at p <0.05. Results: More than half (51.3% of our respondents were in the 30-39 age category. Only 40.3% of these respondents were reported well prepared for births and were complication ready. The proportion of women who had BP/CR was significantly higher among those in the middle socio-economic group (51.6%, p<0.05, those who practiced Christianity (76.4%, p<0.05 and those from Yoruba ethnic group (80.1%, p<0.05. Respondents in lower socio-economic group were 42% less likely to have prepared for birth compared to women in the high socio-economic class (OR: 0.58, 95% CI: 0.34-0.99. Conclusion and Global Health Implications: The proportion of Nigerian women in our sample who were well-prepared for birth and its complication was below average. There is need for more awareness programs on BP/CR; such programs should target all women especially the vulnerable group

  2. Prematuridad extrema y uso materno de corticoides antenatal

    Ramón Acosta Díaz

    2000-12-01

    Full Text Available Con el objetivo de evaluar el uso de corticoides antenatal en las madres con amenaza de parto pretérmino y el efecto sobre los recién nacidos prematuros extremos, se realizó un estudio prospectivo, longitudinal, y analítico entre todos los niños nacidos vivos con edad gestacional menor de 31 semanas y peso inferior a 1 500 g, ocurridos en el Hospital Ginecoobstétrico Provincial Docente "Justo Legón Padilla" de Pinar del Río, desde enero de 1997 hasta julio de 1998. Se estudiaron los 53 niños con estas características. Los datos que se obtuvieron se depositaron en base de datos; para el procesamiento estadístico, se aplicó la prueba de chi cuadrado, con un nivel de significación de p In order to evaluate the antenatal use of adrenal cortex hormones in mothers with preterm delivery threat and its effect on extreme premature infants, it was conducted a prospective, longitudinal and analytical study among the live births with gestational age under 31 weeks and a weight lower than 1 500 g registered at "Justo Legón Padilla" Provincial Gynecoobstetric Teaching Hospital, in Pinar del Río, from January, 1997, to July, 1998. 53 children with these characteristics were studied. The collected data were entered in databases. The chi square test with a level of significance of p<0.05 was used for the statistical processing. Steroids were administered to 32 mothers. A statistically significant reduction of the hyaline membrane disease, the use of ventilation, the complications and mortality was observed with the antenatal use of maternal adrenal cortex hormones. There were no statistically significant differences between the study and the control group as regards sex, mean gestational age (29.0/28.9 weeks and weights (1207.9/1180.0 g.

  3. Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico.

    Heredia-Pi, Ileana; Servan-Mori, Edson; Darney, Blair G; Reyes-Morales, Hortensia; Lozano, Rafael

    2016-06-01

    To propose an antenatal care classification for measuring the continuum of health care based on the concept of adequacy: timeliness of entry into antenatal care, number of antenatal care visits and key processes of care. In a cross-sectional, retrospective study we used data from the Mexican National Health and Nutrition Survey (ENSANUT) in 2012. This contained self-reported information about antenatal care use by 6494 women during their last pregnancy ending in live birth. Antenatal care was considered to be adequate if a woman attended her first visit during the first trimester of pregnancy, made a minimum of four antenatal care visits and underwent at least seven of the eight recommended procedures during visits. We used multivariate ordinal logistic regression to identify correlates of adequate antenatal care and predicted coverage. Based on a population-weighted sample of 9 052 044, 98.4% of women received antenatal care during their last pregnancy, but only 71.5% (95% confidence interval, CI: 69.7 to 73.2) received maternal health care classified as adequate. Significant geographic differences in coverage of care were identified among states. The probability of receiving adequate antenatal care was higher among women of higher socioeconomic status, with more years of schooling and with health insurance. While basic antenatal care coverage is high in Mexico, adequate care remains low. Efforts by health systems, governments and researchers to measure and improve antenatal care should adopt a more rigorous definition of care to include important elements of quality such as continuity and processes of care.

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

    McDonnell, R

    1999-06-01

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

  5. Routine antenatal HIV testing: the responses and perceptions of pregnant women and the viability of informed consent. A qualitative study.

    de Zulueta, Paquita; Boulton, Mary

    2007-06-01

    This qualitative cross-sectional survey, undertaken in the antenatal booking clinics of a hospital in central London, explores pregnant women's responses to routine HIV testing, examines their reasons for declining or accepting the test, and assesses how far their responses fulfil standard criteria for informed consent. Of the 32 women interviewed, only 10 participants were prepared for HIV testing at their booking interview. None of the women viewed themselves as being particularly at risk for HIV infection. The minority (n = 6) of the participants who declined testing differed from those who accepted, by interpreting test acceptance as risky behaviour, privileging the negative outcomes of HIV positivity and expressing an inability to cope with these, should they occur. Troublingly, only a minority of women (n = 9) had a broad understanding of the rationale for the test, and none fulfilled the standard criteria for informed consent. This study suggests that, although routine screening combined with professional recommendation may be successful in increasing uptake, this may be at the cost of eroding informed consent. Protecting third parties (notably fetuses) from a preventable disease may outweigh the moral duty of respecting autonomy, enshrined in Western bioethical tradition. Nevertheless, such a policy should be made transparent, debated in the public domain and negotiated with women seeking antenatal care.

  6. Influence of education on HIV infection among pregnant women attending their antenatal care in Sekondi-Takoradi metropolis, Ghana.

    Orish, Verner N; Onyeabor, Onyekachi S; Boampong, Johnson N; Afoakwah, Richmond; Nwaefuna, Ekene; Acquah, Samuel; Orish, Esther O; Sanyaolu, Adekunle O; Iriemenam, Nnaemeka C

    2014-08-01

    This study investigated the influence of the level of education on HIV infection among pregnant women attending antenatal care in Sekondi-Takoradi, Ghana. A cross-sectional study was conducted at four hospitals in the Sekondi-Takoradi metropolis. The study group comprised 885 consenting pregnant women attending antenatal care clinics. Questionnaires were administered and venous blood samples were screened for HIV and other parameters. Multivariable logistic regression analyses were performed to determine the association between the level of education attained by the pregnant women and their HIV statuses. The data showed that 9.83% (87/885) of the pregnant women were HIV seropositive while 90.17% (798/885) were HIV seronegative. There were significant differences in mean age (years) between the HIV seropositive women (27.45 ± 5.5) and their HIV seronegative (26.02 ± 5.6) counterparts (p = .026) but the inference disappeared after adjustment (p = .22). Multivariable logistic regression analysis revealed that pregnant women with secondary/tertiary education were less likely to have HIV infection compared with those with none/primary education (adjusted OR, 0.53; 95% CI, 0.30-0.91; p = .022). Our data showed an association with higher level of education and HIV statuses of the pregnant women. It is imperative to encourage formal education among pregnant women in this region.

  7. The willingness and constraints to routing HIV screening among ...

    Methods: This descriptive cross- sectional study on 312 pregnant women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, was carried out, to evaluate the knowledge of HIV/AIDS, the practice of voluntary HIV testing and also determine the constraints and motivation to voluntary HIV testing.

  8. Universal CAGE-WANT Questionnaire: “Think & Fill in the Suspect, Self-Assess and Screen! You May Need Help For, What You Have Filled In!”

    Deepak Gupta

    2014-12-01

    Full Text Available In 1970, John A. Ewing [1] developed CAGE questionnaire for identifying hidden alcoholism. It has been almost a half-century since 1970s [2] and CAGE questionnaire has expanded its promise and utility in identifying other addictions like for drug use as CAGE-AID in 1990s [3] and for personal electronic devices as University of Rochester Modified CAGE Questions in 2010s [4]. It seems the time is ripe to document a Universal CAGE Questionnaire (Table 1: Universal CAGE-WANT Questionnaire wherein any and every subject of fascination and/or any and every human urge to WANT can be incorporated for self-assessment and/or screening to identify addiction for the suspected and tested WANT.

  9. Depression, pregnancy-related anxiety and parental-antenatal attachment in couples using preimplantation genetic diagnosis.

    Winter, C; Van Acker, F; Bonduelle, M; Van Berkel, K; Belva, F; Liebaers, I; Nekkebroeck, J

    2016-06-01

    analyses, taking into account covariation between measurements and within couples. Several perinatal covariates as well as social desirability, coping and adult attachment style were controlled for. All three conception groups had similar scores for depression during pregnancy and beyond. Also, pregnancy-related anxiety scales did not differ among the three groups. All groups also followed a similar trajectory in time regarding their scores for anxiety, depression and parental-antenatal attachment. ART groups did not give more socially desirable answers than SC controls. The subsequent moderators: coping and adult attachment style did not add any relevant information. No interaction effects occurred between gender and conception groups. The participants were Caucasian, Dutch-speaking couples, with medium to high socio-economic status, from a single centre. Our data should be replicated by multicultural and multicentre studies. Furthermore, the inclusion of an additional control group of couples who did not opt for PGD but for prenatal diagnosis may point to the most beneficial strategy for the couple. PGD parents invest a similar amount of time and emotion in their future children compared with controls. This implies that successful PGD treatment makes an important psychological contribution towards the well-being of couples given their complex hereditary and family backgrounds. This research project was funded by grants from the internal research council of the Vrije Universiteit Brussel (OZR), the Flemish Fonds Wetenschappelijk Onderzoek (FWO) and the Wetenschappelijk Fonds Willy Gepts (WGFG). UZ Brussel and the Centre for Medical Genetics have received several educational grants for organizing the data collection, from IBSA, Ferring, Organon, Shering-Plough, Merck and Merck Belgium. M.B. has received consultancy and speaker's fees from Organon, Serono Symposia and Merck. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human

  10. A nationwide population analysis of antenatal and perinatal complications among nurses and nonmedical working women

    Chun-Che Huang

    2016-10-01

    Conclusion: Our nationwide population-based study revealed increased risks of antenatal and perinatal complications among nurses compared with those among nonmedical working women. The large-scale observation of the increased antenatal and perinatal complications draws attention to the health issues faced by nursing personnel who represent one of the most important workforces in the healthcare system.

  11. Antenatal small-class education versus auditorium-based lectures to promote positive transitioning to parenthood

    Koushede, Vibeke; Brixval, Carina Sjöberg; Thygesen, Lau Caspar

    2017-01-01

    Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised t...

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

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

    2014-01-01

    Little is known about which elements antenatal education should encompass to meet the needs of parents today. Psycho-social aspects relating to couple- and parenthood have generally not been covered in Danish antenatal education, although studies suggest that parents need this information. The aim...

  13. Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis.

    Chama-Chiliba, Chitalu M; Koch, Steven F

    2015-02-01

    We examine the individual- and community-level factors associated with the utilization of antenatal care, following the adoption of the focused antenatal care (FANC) approach in Zambia. Using the 2007 Zambia Demographic and Health Survey, linked with administrative and health facility census data, we specify two multilevel logistic models to assess the factors associated with (1) the inadequate use of antenatal care (ANC) (defined as three or fewer visits) and (2) the non-use of ANC in the first trimester of pregnancy. Although all women in the selected sample had at least one ANC visit, 40% did not have the minimum number required (four), whereas more than 80% of the initial check-ups did not occur in the first trimester. At the individual level, the woman's employment status, quality of ANC received and the husband's educational attainment are negatively associated, while parity, the household childcare burden and wealth are positively associated with inadequate utilization of ANC. Both individual- and community-level characteristics influence inadequate use and non-use of ANC in the first trimester; however, community-level factors are relatively stronger in rural areas. The results suggest that improving the content of care during ANC visits may foster adequate use of ANC and encourage early initiation of ANC visits. Furthermore, health promotion programmes need to further encourage male involvement in pregnant women's decision to seek ANC to encourage adequate use of services. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  14. Antenatal hypnosis training and childbirth experience: a randomized controlled trial.

    Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Wu, Chun Sen; Nohr, Ellen A

    2013-12-01

    Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience. In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosis group participating in three 1-hour sessions teaching self-hypnosis to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and Mindfulness, and a usual care group receiving ordinary antenatal care only. Wijmas Delivery Expectancy/Experience Questionnaire (W-DEQ) was used to measure the childbirth experience 6 weeks postpartum. The intention-to-treat analysis indicated that women in the hypnosis group experienced their childbirth as better compared with the other two groups (mean W-DEQ score of 42.9 in the Hypnosis group, 47.2 in the Relaxation group, and 47.5 in the Care as usual group (p = 0.01)). The tendency toward a better childbirth experience in the hypnosis group was also seen in subgroup analyses for mode of delivery and for levels of fear. In this large randomized controlled trial, a brief course in self-hypnosis improved the women's childbirth experience. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

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

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

    2007-02-15

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

  16. Antenatal mood and fetal attachment after assisted conception.

    Fisher, Jane R W; Hammarberg, Karin; Baker, Gordon H W

    2008-05-01

    Australian women conceiving with ART are at fourfold risk of admission to early parenting treatment programs compared with those conceiving spontaneously. This study aimed to identify prevalence and determinants of antenatal mood disturbance and other risks for early parenting difficulties after assisted conception. A prospective longitudinal investigation from conception to 18 months postpartum using telephone interviews and self-report questionnaires. Melbourne IVF and Royal Women's Hospital Reproductive Services, Victoria, Australia. A consecutive cohort of English-speaking women with ultrasound-confirmed ART-conceived pregnancies. Standardized psychometric measures of mood, quality of marital relationship, mother-to-fetus emotional attachment, and personality. None. Of the 288 women with confirmed pregnancies, 239 were contactable, and 183 (77%) were recruited, 95% of whom completed both early and late pregnancy assessments. Participants were socioeconomically advantaged, had very good pregnancy health, exceptional marital relationships, normal personality styles, and intense affectionate attachment to the fetus. Very few (<5%) had clinically significant mood disturbance in late pregnancy. There were low rates of antenatal mood disturbance and other risk factors for postpartum depression. Pregnancy and motherhood might be idealized after ART conception, and preparation for the realities of infant care might then be insufficient.

  17. Factors Affecting Antenatal Corticosteroid Administration from the Obstetricians’ Viewpoint

    Emel Kurtoğlu

    2016-02-01

    Full Text Available OBJECTIVE: We aimed to investigate the factors affecting antenatal corticosteroid administration from the obstetricians’ viewpoint. STUDY DESIGN: The pregnant women who delivered between 24 and 34 weeks of gestation were divided into two groups: Group 1, pregnant patients given corticosteroid therapy; Group 2, pregnant patients who were not given corticosteroid therapy. The indications for delivery, gestational week at administration, dosing, residence and manner of transfer of the patients to the tertiary center, and the interval between admission to hospital and delivery were evaluated. RESULTS: The percentage of patients who received antenatal corticosteroid treatment was 68.4%, whereas 31.6% of the pregnant women didn’t receive corticosteroid therapy. The most common indications for preterm delivery were preterm labor and severe preeclampsia. The interval between admission to hospital and delivery was significantly higher in group 1. CONCLUSION: Even though obstetricians are aware of the importance of corticosteroid treatment in preterm deliveries, indications for impending delivery can affect administration of the therapy.

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

    Duncan, K.A.

    2007-01-01

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

  19. Estimating Benzathine Penicillin Need for the Treatment of Pregnant Women Diagnosed with Syphilis during Antenatal Care in High-Morbidity Countries

    Taylor, Melanie M.; Nurse-Findlay, Stephen; Zhang, Xiulei; Hedman, Lisa; Kamb, Mary L.; Broutet, Nathalie; Kiarie, James

    2016-01-01

    Background Congenital syphilis continues to be a preventable cause of global stillbirth and neonatal morbidity and mortality. Shortages of injectable penicillin, the only recommended treatment for pregnant women and infants with syphilis, have been reported by high-morbidity countries. We sought to estimate current and projected annual needs for benzathine penicillin in antenatal care settings for 30 high morbidity countries that account for approximately 33% of the global burden of congenital syphilis. Methods Proportions of antenatal care attendance, syphilis screening coverage in pregnancy, syphilis prevalence among pregnant women, and adverse pregnancy outcomes due to untreated maternal syphilis reported to WHO were applied to 2012 birth estimates for 30 high syphilis burden countries to estimate current and projected benzathine penicillin need for prevention of congenital syphilis. Results Using current antenatal care syphilis screening coverage and seroprevalence, we estimated the total number of women requiring treatment with at least one injection of 2.4 MU of benzathine penicillin in these 30 countries to be 351,016. Syphilis screening coverage at or above 95% for all 30 countries would increase the number of women requiring treatment with benzathine penicillin to 712,030. Based on WHO management guidelines, 351,016 doses of weight-based benzathine penicillin would also be needed for the live-born infants of mothers who test positive and are treated for syphilis in pregnancy. Assuming availability of penicillin and provision of treatment for all mothers diagnosed with syphilis, an estimated 95,938 adverse birth outcomes overall would be prevented including 37,822 stillbirths, 15,814 neonatal deaths, and 34,088 other congenital syphilis cases. Conclusion Penicillin need for maternal and infant syphilis treatment is high among this group of syphilis burdened countries. Initiatives to ensure a stable and adequate supply of benzathine penicillin for treatment

  20. Urinary tract infection and vesicoureteral reflux in children with mild antenatal hydronephrosis.

    Sencan, A; Carvas, F; Hekimoglu, I C; Caf, N; Sencan, A; Chow, J; Nguyen, H T

    2014-12-01

    The postnatal management of mild antenatal hydronephrosis (ANH) remains controversial. The purpose of this study was to evaluate the incidence of UTI and VUR in children with mild ANH in order to determine the necessity of antibiotic prophylaxis (ABP) and VCUG. The data of 1511 patients with various grades of ANH who were referred to Department of Urology, Boston Children's Hospital between January 1998 and January 2010 were reviewed and 760 patients who had mild ANH were identified. The inclusion criteria were: 1) A confirmed report of ANH or actual prenatal ultrasound (US) images. 2) Postnatal evaluation and management conducted at the hospital. 3) Persistent mild hydronephrosis on the first US done between two weeks and three months of age. 4) No other US findings such as ureteral dilatation, duplication anomalies or bladder abnormalities. 5) At least one three-month follow up. Univariate statistical analysis was performed using a Student's t test. Of the 760 patients who were identified, 608 (80%) were males, and 225 (30%) had bilateral mild hydronephrosis. Of these, 475 patients (63%) underwent an initial screening VCUG. VUR was identified in 13 patients (1.7%) with grades varying from 1 to 5. At follow up, hydronephrosis resolved in 67% of the renal units and worsened in 3.3%. Among the 692 patients with available follow-up data, 23 (3.3%) had a documented UTI. Twelve of these children had an initial screening VCUG that was negative for VUR. Of these 12 patients, seven underwent a subsequent RNC with none having VUR; five of the 12 patients did not undergo a repeat evaluation for VUR (four had a UTI after the screening VCUG and one had an afebrile UTI). Eleven of the 23 children with mild ANH did not have an initial screening VCUG, and all underwent a subsequent VCUG/RNC. Only two children were then found to have VUR Grade 4-5. The incidence of UTI and VUR in children with mild ANH is low. Consequently, routine VCUG screening for VUR and the use of long

  1. Language Outcomes in Deaf or Hard of Hearing Teenagers Who Are Spoken Language Users: Effects of Universal Newborn Hearing Screening and Early Confirmation.

    Pimperton, Hannah; Kreppner, Jana; Mahon, Merle; Stevenson, Jim; Terlektsi, Emmanouela; Worsfold, Sarah; Yuen, Ho Ming; Kennedy, Colin R

    This study aimed to examine whether (a) exposure to universal newborn hearing screening (UNHS) and b) early confirmation of hearing loss were associated with benefits to expressive and receptive language outcomes in the teenage years for a cohort of spoken language users. It also aimed to determine whether either of these two variables was associated with benefits to relative language gain from middle childhood to adolescence within this cohort. The participants were drawn from a prospective cohort study of a population sample of children with bilateral permanent childhood hearing loss, who varied in their exposure to UNHS and who had previously had their language skills assessed at 6-10 years. Sixty deaf or hard of hearing teenagers who were spoken language users and a comparison group of 38 teenagers with normal hearing completed standardized measures of their receptive and expressive language ability at 13-19 years. Teenagers exposed to UNHS did not show significantly better expressive (adjusted mean difference, 0.40; 95% confidence interval [CI], -0.26 to 1.05; d = 0.32) or receptive (adjusted mean difference, 0.68; 95% CI, -0.56 to 1.93; d = 0.28) language skills than those who were not. Those who had their hearing loss confirmed by 9 months of age did not show significantly better expressive (adjusted mean difference, 0.43; 95% CI, -0.20 to 1.05; d = 0.35) or receptive (adjusted mean difference, 0.95; 95% CI, -0.22 to 2.11; d = 0.42) language skills than those who had it confirmed later. In all cases, effect sizes were of small size and in favor of those exposed to UNHS or confirmed by 9 months. Subgroup analysis indicated larger beneficial effects of early confirmation for those deaf or hard of hearing teenagers without cochlear implants (N = 48; 80% of the sample), and these benefits were significant in the case of receptive language outcomes (adjusted mean difference, 1.55; 95% CI, 0.38 to 2.71; d = 0.78). Exposure to UNHS did not account for significant

  2. Acceptability and Preferences among Men and Women for Male Involvement in Antenatal Care

    Nompumelelo Yende

    2017-01-01

    Full Text Available Introduction. Male involvement in antenatal care (ANC has been associated with improved prevention of mother-to-child transmission outcomes in Sub-Saharan Africa; yet it remains uncommon. We assess acceptability of male involvement from the male and female perspectives and potential incentives for men to attend ANC. Methods. Adult pregnant women and men attending primary healthcare at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, from October 2013 to January 2014, were recruited using stratified random sampling to ensure equal representation across gender and HIV status. Results. 300/332 individuals (93.8% offered participation consented. Among the 150 women, 97% had a partner; the majority (92% preferred partner attendance at ANC, and 14% reported partner attendance during this pregnancy. The 150 men had low knowledge of services rendered at ANC outside of pregnancy monitoring, and few (19% had previously attended ANC. Blood pressure screening, fatherhood information, and HIV testing were identified by men as incentives for attendance. Women and men expressed high willingness to, respectively, deliver (95% and respond (97% to ANC letter invitations. Conclusion. Invitation letters to promote male involvement in ANC are highly acceptable to pregnant women and men. Focusing invitation messages on fatherhood and primary healthcare rather than HIV testing may provide greater motivation for male involvement.

  3. Frequency of vaginal candidiasis in pregnant women attending routine antenatal clinic

    Parveen, N.; Munir, A.A.; Majeed, R.

    2008-01-01

    To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status. (author)

  4. Early Initiation of Antenatal Care and Factors Associated with Early Antenatal Care Initiation at Health Facilities in Southern Ethiopia

    Mengesha Boko Geta

    2017-01-01

    Full Text Available Antenatal care (ANC is care given to pregnant mothers to timely identify and mitigate pregnancy related problems that can harm mother or fetus. Most of Ethiopian mothers present late for ANC. The aim of this paper was to assess determinants of early antenatal care initiation among pregnant women. Mothers attending Shebedino District Health Centers for ANC between January 12 and February 18, 2015, were invited to the study. Multistage sampling technique and structured questionnaire were used to collect data by trained data collectors. Univariate and bivariate analysis were conducted to study the association between explanatory and outcome variable. Out of 608 women, 132 [21.71%] had their first ANC within the recommended time [before or at 3 months]. Media access [AOR = 2.11 95% CI 1.00, 3.22], knowledge about the correct time of ANC booking [AOR = 4.49 95% CI 2.47, 6.16], and having been advised to book within 12 weeks [AOR = 4.14 95% CI 3.80, 5.21] were determinants of first-trimester booking. Health professionals and care providers should provide full information, advice, and appropriate care about early ANC for every eligible mother.

  5. Comparative effectiveness of single and dual rapid diagnostic tests for syphilis and HIV in antenatal care services in Colombia.

    Gaitán-Duarte, Hernando Guillermo; Newman, Lori; Laverty, Maura; Habib, Ndema Abu; González-Gordon, Lina María; Ángel-Müller, Edith; Abella, Catleya; Barros, Esther Cristina; Rincón, Carlos; Caicedo, Sidia; Gómez, Bertha; Pérez, Freddy

    2016-12-01

    To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC) centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A) or to dual HIV and syphilis rapid diagnostic tests (Arm B). The four main outcomes measured were: (1) acceptability of the test, (2) uptake in testing, (3) treatment on the same day (that is, timely treatment), and (4) treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69%) in Arm A and 16 of 20 patients (80%) in Arm B (relative risk (RR), 1.10; 95% confidence interval (CI): (1.00 -1.20). Treatment at any time was given to 24 of 29 patients (83%) in Arm A and to 20 of 20 (100%) in Arm B (RR, 1.11; 95% CI: 1.01-1.22). There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.

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

    Maximilian de Courten

    2012-07-01

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

  7. Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial

    2014-01-01

    Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. Methods This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. Results The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. Conclusions The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care

  8. An assessment of the clinical utility of routine antenatal screening of ...

    This prospective study was designed to provide the frequencies of the haemoglobin genotypes, ABO and Rh blood groups and their effects on the haematocrit values among pregnant women in Port Harcourt. One hundred and eighty (180) pregnant women at their first clinic attendance and in their first pregnancy (parity - 0) ...

  9. University of Texas Southwestern Medical Center: High-Throughput siRNA Screening of a Non-Small Cell Lung Cancer (NSCLC) Cell Line Panel | Office of Cancer Genomics

    The goal of this project is to use siRNA screens to identify NSCLC-selective siRNAs from two genome-wide libraries that will allow us to functionally define genetic dependencies of subtypes of NSCLC. Using bioinformatics tools, the CTD2 center at the University of Texas Southwestern Medical Center are discovering associations between this functional data (siRNAs) and NSCLC mutational status, methylation arrays, gene expression arrays, and copy number variation data that will help us identify new targets and enrollment biomarkers. 

  10. History and practice of material research on the examples of Material Testing and Materialpruefungsanstalt (MPA) Stuttgart, liquid crystals and screen technology as well as superconductivity. An interdisciplinary teaching project of the University of Stuttgart

    Hentschel, Klaus; Webel, Josef

    2016-01-01

    The knowledge of material research and its history is not very common among scientists and engineers alike. Within the scope of an interdisciplinary teaching project carried out for the first time in the summer semester 2014 and ever since then every summer semester at the University of Stuttgart, an attempt is made to approach material research both from a scientific, technical and historical perspective. The Material Testing and Materials Testing Institute in Stuttgart (MPA), the liquid crystals and the screen technology as well as the superconductivity were selected as topics, which have a long tradition in research and teaching in Stuttgart. In this anthology the materials of the teaching project are summarized. [de

  11. Cost-effectiveness estimates for antenatal HIV testing in the Netherlands

    Rozenbaum, M. H.; Verweel, G.; Folkerts, D. K. F.; Dronkers, F.; van den Hoek, J. A. R.; Hartwig, N. G.; de Groot, R.; Postma, M. J.

    2008-01-01

    This paper provides an estimation of the lifetime health-care cost of HIV-infected children and an update of the cost-effectiveness of universal HIV-screening of pregnant women in Amsterdam (The Netherlands). During 2003-2005, we collected data concerning the prevalence of newly diagnosed

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

    Dayananda Kumar Rajanna

    2013-01-01

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

  13. Features of Joint Capsule Formation After Antenatal Action of Antigen

    A.V. Fedotchenko

    2014-10-01

    Full Text Available In this paper using morphometric, histological, histochemical and statistical methods, we have investigated the dynamics of hip joint capsule formation in white laboratory rats during the postnatal period after intrefetal introduction of antigen. It is found that antenatal effect of antigen leads to an increase in the number of lymphocytes, in particular PNA+, in joint capsule. Against this background, we observed an increase in the proportion of cells, the basic substance and elastic fibers, while reducing the content of collagen fibers, violations in polysaccharides and fibroblasts distribution that indicates the development of dysplastic processes in the hip joint and can be regarded as the leading factor of coxarthrosis development. Experimentally, we have detected arachnodactylia as a visual clinical manifestation of dysplasia.

  14. Approaches to the management of antenatally diagnosed congenital tumours

    Mahony, Rhona; McParland, Peter

    2009-01-01

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

  15. Approaches to the management of antenatally diagnosed congenital tumours

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

    2009-11-15

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

  16. Is voiding cystourethrogram necessary in all cases of antenatal hydronephrosis?

    M S Ansari

    2009-01-01

    Full Text Available Hydronephrosis is the most common genitourinary anomaly as detected on obstetric ultrasonography and the incidence of associated vesicoureteral reflux is around 10-12%. There is inconsistency in the literature regarding which child should under go a voiding cystourethrogram (VCUG in cases of antenatal hydronephrosis (AHN. Besides, there is a scarcity of prospective studies to demonstrate the risk of varying degree of AHN, associated reflux and their long-term impact on the kidneys. The present analysis suggests that children with AHN should undergo an ultrasound within the first month of life and further course of action should be decided on the basis of the individual case. Children with persistent moderate to severe AHN should undergo a VCUG and a functional study.

  17. A case of antenatal Bartter syndrome with sensorineural deafness.

    Lee, Hyun Seung; Cheong, Hae Il; Ki, Chang-Seok

    2010-10-01

    Bartter syndrome type IV, also known as Bartter syndrome with sensorineural deafness (BSND), is caused by loss-of-function mutations in the BSND gene, which encodes barttin, an accessory subunit of chloride channels located in the kidney and inner ear. Patients with BS IV have a highly variable clinical phenotype. This report concerns a Korean male patient with antenatal Bartter syndrome due to a homozygous BSND p.G47R mutation, who presented with severe perinatal symptoms followed by a relatively benign course with preserved renal function after early infancy. In addition, the clinical features and the laboratory data of the patient were compared with those of previously reported patients with the same mutation.

  18. Asymptomatic bacteriuria screened by catheterized samples at pregnancy term in women undergoing cesarean delivery.

    Atacag, T; Yayci, E; Guler, T; Suer, K; Yayci, F; Deren, S; Cetin, A

    2015-01-01

    The objective of this study was to assess the frequency of urinary tract infection (UTI) with urine samples obtained via catheterization among women undergoing cesarean delivery at term pregnancy. A cross-sectional study involving 159 women in whom cesarean delivery was conducted at term pregnancy after a regular follow-up from first to third trimester. For screening and diagnosis of UTI during antenatal period, the authors used dipstick test and microscopic urinalysis, and urine culture was used in the presence of symptomatic UTI unresponsive to initial antibiotic therapy. A urine sample was obtained immediately after insertion of Foley catheter for urine dipstick test, microscopic urinalysis, and culture during cesarean delivery. Obstetric and UTI data were recorded. Of 159 pregnant women, 95 (59.8%) did not develop UTI during antenatal care. There was no patient with symptomatic UTI at the admission for cesarean delivery. The authors found UTI with urine dipstick and microscopic urinalysis in 12 patients and of them, four patients had no history of UTI, and all the remaining eight patients had asymptomatic UTI during antenatal follow-up. UTI according to urine culture was encountered in three patients, two of them had one episode of UTI, and one had two episodes of UTI during antenatal follow-up. After regular antenatal follow-up screening with urine dipstick, microscopic urinalysis, and counseling of pregnant women regarding UTIs, the frequency of bacteriuria decreases considerably during cesarean delivery.

  19. Programming effects of antenatal corticosteroids exposure in male sexual behavior.

    Oliveira, Mário; Leão, Pedro; Rodrigues, Ana-João; Pêgo, José-Miguel; Cerqueira, João-José; Sousa, Nuno

    2011-07-01

    Brain regions implicated in sexual behavior begin to differentiate in the last trimester of gestation. Antenatal therapy with corticosteroids is often used in clinical practice during this period to accelerate lung maturation in preterm-risk pregnancies. Clinical and animal studies highlighted major behavioral impairments induced later in life by these treatments, especially when synthetic corticosteroids are used. To evaluate the implications of acute prenatal treatment with natural vs. synthetic corticosteroids on adult male rat sexual behavior and its neurochemical correlates. Twelve pregnant Wistar rats were injected with dexamethasone (DEX-1 mg/kg), corticosterone (CORT-25 mg/kg), or saline on late gestation (pregnancy days 18 and 19). Following this brief exposure to corticosteroids, we assessed the sexual behavior of the adult male progeny and subsequently associated these behaviors with the levels of catecholamines and mRNA of dopamine and androgen receptors (AR) in brain regions relevant for sexual behavior. Sexual behavior of adult male offspring was assessed by exposure to receptive females. This was associated with serum testosterone levels and levels of catecholamines (determined by high-performance liquid chromatography) and dopamine and AR mRNA expression (real-time polymerase chain reaction [PCR]) in brain regions implicated in sexual behavior. Prenatal DEX exposure resulted in a decreased number and increased mounts and intromissions latencies in adulthood. These findings were associated with decreased levels of serum testosterone and increased hypothalamic expression of AR mRNA. DEX animals also displayed lower dopamine levels and higher dopamine receptor mRNA expression both in hypothalamus and nucleus accumbens (NAcc). The milder phenotype of CORT animals was associated only with decreased dopamine levels in NAcc. Antenatal corticotherapy programs adult male sexual behavior through changes in specific neuronal and endocrine mediators

  20. Validation of the Whooley questions for antenatal depression and anxiety among low-income women in urban South Africa

    Carina Marsay

    2017-04-01

    Full Text Available Background/objective: In South Africa, approximately 40% of women suffer from depression during pregnancy. Although perinatal depression and anxiety are significant public health problems impacting maternal and infant morbidity and mortality, no routine mental health screening programmes exist in the country. A practical, accurate screening tool is needed to identify cases in these busy, resource-scarce settings. Method: A convenience sample of 145 women between 22 and 28 weeks gestation was recruited from Rahima Moosa Hospital antenatal clinic in Johannesburg. All women completed a biographical interview, the Edinburgh Postnatal Depression Scale (EPDS, the Whooley questions and a structured clinical interview. Results: The results demonstrate the sensitivity and specificity of the Whooley questions and the EPDS in identifying depression, anxiety and stress disorders of varying severity. The importance of personal, social and cultural context in influencing the content and expression of these common perinatal conditions was also identified. Discussion and conclusion: The validity of the Whooley questions in the context of urban South Africa, and the importance of ensuring clinical interviews to supplement any screening tools, is emphasised.

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

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

    2012-01-01

    , in implementing the guidelines. These projects have reached out to thousands of pregnant women through capacity building and improvement of access to GDM screening and diagnosis in the developing world and therefore provide a rich field experience on the applicability of the guidelines in resource-poor settings......: This study aimed to investigate whether GDM projects supported by the World Diabetes Foundation in developing countries utilize any of the internationally recommended guidelines for screening and diagnosis of GDM, explore experiences on applicability and usefulness of the guidelines and barriers if any....... Design: A mixed methods approach using questionnaires and interviews was utilised to review 11 GDM projects. Two projects were conducted by the same partner; interviews were conducted in person or via phone by the first author with nine project partners and one responded via email. The interviews were...

  2. The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women.

    John Eastwood

    Full Text Available In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms.A retrospective cohort of mothers (N = 17,564 of all infants born in public health facilities within South Western Sydney Local Health District and Sydney Local Health District in 2014, in the state of New South Wales (NSW, Australia, was enumerated from routinely collected antenatal data to investigate the risk of adverse perinatal outcomes associated with maternal depressive symptoms during pregnancy. Antenatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS. Logistic regression models that adjusted for confounders were conducted to determine associations between antenatal depressive symptoms and low birth weight, early gestational age at birth (<37 weeks, breast feeding indicators and postnatal depressive symptoms.The prevalence of maternal depressive symptoms during pregnancy was 7.0% in the cohort, and was significantly associated with postnatal depressive symptoms [Adjusted Odd Ratios (AOR = 6.4, 95% CI: 4.8-8.7, P<0.001]. Antenatal depressive symptoms was associated with a higher odds of low birth weight [AOR = 1.7, 95% CI: 1.2-2.3, P = 0.003] and a gestational age at birth of <37 weeks [AOR = 1.3, 95% CI: 1.1-1.7, P = 0.018] compared to women who reported lower EPDS scores in antenatal period. Antenatal depressive symptoms were not strongly associated with non-exclusive breast feeding in the early postnatal period.Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate

  3. Re-screening for syphilis at the time of delivery in areas ofhigh ...

    Two hundred women who were screened for syphilis at their initial antenatal visit were rescreened at the time of delivery. Umbilical cord blood specimens as well as maternal sera were tested. Twenty-two (11%) women were rapid plasma reagin (RPR)-positive at booking, while a total of 23 (12%) were RPR-positive at the ...

  4. Exploring the uptake and framing of research evidence on universal screening for intimate partner violence against women: a knowledge translation case study.

    Wathen, C Nadine; Macgregor, Jennifer Cd; Sibbald, Shannon L; Macmillan, Harriet L

    2013-04-12

    Significant emphasis is currently placed on the need to enhance health care decision-making with research-derived evidence. While much has been written on specific strategies to enable these "knowledge-to-action" processes, there is less empirical evidence regarding what happens when knowledge translation (KT) processes do not proceed as planned. The present paper provides a KT case study using the area of health care screening for intimate partner violence (IPV). A modified citation analysis method was used, beginning with a comprehensive search (August 2009 to October 2012) to capture scholarly and grey literature, and news reports citing a specific randomized controlled trial published in a major medical journal on the effectiveness of screening women, in health care settings, for exposure to IPV. Results of the searches were extracted, coded and analysed using a multi-step mixed qualitative and quantitative content analysis process. The trial was cited in 147 citations from 112 different sources in journal articles, commentaries, books, and government and news reports. The trial also formed part of the evidence base for several national-level practice guidelines and policy statements. The most common interpretations of the trial were "no benefit of screening", "no harms of screening", or both. Variation existed in how these findings were represented, ranging from summaries of the findings, to privileging one outcome over others, and to critical qualifications, especially with regard to methodological rigour of the trial. Of note, interpretations were not always internally consistent, with the same evidence used in sometimes contradictory ways within the same source. Our findings provide empirical data on the malleability of "evidence" in knowledge translation processes, and its potential for multiple, often unanticipated, uses. They have implications for understanding how research evidence is used and interpreted in policy and practice, particularly in

  5. Simple educational intervention will improve the efficacy of routine antenatal iron supplementation.

    Senanayake, Hemantha M; Premaratne, Samanthi P; Palihawadana, Thilina; Wijeratne, Sumeda

    2010-06-01

    Sri Lanka has a policy of free provision of iron supplements to pregnant women. However, iron deficiency anemia remains common in pregnancy. We tested the hypothesis that educating women regarding improving bioavailability could improve the efficacy of iron supplementation. The education focused on how best supplements could be taken and on how they should be stored. We carried out a study using a quasi-experimental design on a group of women attending for antenatal care at a suburban University Obstetric Unit in Sri Lanka. The control group had care free of charge including iron supplementation and antihelminthic therapy. In addition, the study group received an education in small groups regarding maximizing bioavailability of iron. Hemoglobin and iron status of the women were compared between the groups at recruitment and at 34 weeks of gestation. The two groups were equally matched in demographic data, and hemoglobin and iron status. There were significant differences between the two groups at 34 weeks in the hemoglobin levels, serum ferritin levels, anemia rates and the number with low ferritin (P tablets in ways that improved their bioavailability. A simple health education improved the efficacy of iron supplementation in this population. Such interventions should be an integral part of iron supplementation programs, especially in populations whose habits tend to reduce the bioavailability of iron.

  6. Knowledge and practice of family planning among antenatal care attendees at Nnewi, south east Nigeria.

    Igwegbe, A O; Ugboaja, J O; Monago, E N

    2010-12-01

    Entrenching an effective family planning program has being a major challenge in Sub Saharan Africa. Determining the knowledge, attitude and practice of family planning among the women is very necessary in order to achieve success. The aim of this study iS to determine the knowledge, and practice of family planning among antenatal women in Nnewi, South East, Nigeria. A descriptive cross sectional study of 356 women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria was carried out over a 5-month period. With the aid of pre-tested interviewer-administered semi structured questionnaires, information on biosocial characteristics, knowledge of, and practice of family planning as well as sources of information on family planning were obtained from the respondents. Data was analysis was done with Epi info statistical package, version 3.5.2 (2008) Three hundred and forty (95.5%) of the respondents knew about family planning out of which 260 (76.5%) had ever used a modern method. The male condom (256; 75.3%) and the natural method (Billings method) (150; 44.1%) were the commonly known methods. Also the commonest used methods were the male condom (144; 55.4%) and Billings method (96; 36.9%). Birth spacing (248; 72.9%) and limiting births (138, 40.6%) were mainly identified as the benefits of family planning and only 6 (1.7%) of the respondents identified family planning as being important in the reduction of maternal mortality. The major sources of information on family planning were health workers (224; 65.9%) and the radio (126; 37.1%). The knowledge and practice of family planning has improved among our women. However, the methods commonly used are those associated with high failure rates. Family panning program managers should recognize this limitation. There is need for public sensitization on the correct use of the Billings method and the male condom. Ultimately, our women should be encouraged to accept the more reliable methods

  7. Review of antenatal-linked voluntary counseling and HIV testing in ...

    Review of antenatal-linked voluntary counseling and HIV testing in Sub-Saharan Africa: lessons and options for Ghana. ... Voluntary counselling and HIV testing has become an integral part of HIV prevention ... AJOL African Journals Online.

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

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

    Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour...... of an antenatal education program in small classes on use of epidural analgesia. Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according...... on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future. Main messages (max 200 anslag): 1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour...

  9. Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring

    Ingstrup, Katja Glejsted; Wu, Chun Sen; Olsen, Jørn

    2016-01-01

    BACKGROUND: Maternal emotional stress during pregnancy has previously been associated with congenital neural malformations, but most studies are based on data collected retrospectively. The objective of our study was to investigate associations between antenatal maternal bereavement due to death...

  10. Barriers to Antenatal Care in an Urban Community in the Gambia ...

    USER

    This qualitative study investigated the barriers to obtaining access to antenatal care ... In-depth interviews were conducted with 25 pregnant women, 13 healthcare workers and 9 male partners. ..... observation of the clinic workplace might have.

  11. Socioeconomic Determinants of the Utilization of Antenatal Care and Child Vaccination in India.

    Zuhair, Mohd; Roy, Ram Babu

    2017-11-01

    Antenatal care and child vaccination services are adopted worldwide to reduce the risk of child mortality, maternal mortality, and burden of infectious diseases. This article examines the effect of socioeconomic factors on the utilization of antenatal care and child vaccination services in India. The generalized linear model has been used along with the Indian National Family Health Survey data for the period 2005-2006. The analysis shows that the health insurance plan has a significant effect on the use of antenatal care but not in the child vaccination. Furthermore, there is inequality in the utilization of antenatal care as well as child vaccination services and it is positively related to the wealth. The study suggests that there is a need to improve the socioeconomic status of the financially weaker section of the society for improving the use of child and maternal care services.

  12. Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants.

    Wei, J C; Catalano, R; Profit, J; Gould, J B; Lee, H C

    2016-05-01

    To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007 to 2013 for infants ⩽32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. In 25 979 very-low-birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio=0.68, 95% confidence interval: 0.62, 0.75) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio=0.51, 95% confidence interval: 0.45, 0.58). This association was seen across gestational ages ranging from 22 to 29 weeks. Although current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age.

  13. How Group Size and Composition Influences the Effectiveness of Collaborative Screen-Based Simulation Training: A Study of Dental and Nursing University Students Learning Radiographic Techniques

    Tor Söderström

    2012-12-01

    Full Text Available This study analyses how changes in the design of screen-based computer simulation training influence the collaborative training process. Specifically, this study examine how the size of a group and a group’s composition influence the way these tools are used. One case study consisted of 18+18 dental students randomized into either collaborative 3D simulation training or conventional collaborative training. The students worked in groups of three. The other case consisted of 12 nursing students working in pairs (partners determined by the students with a 3D simulator. The results showed that simulation training encouraged different types of dialogue compared to conventional training and that the communication patterns were enhanced in the nursing students ́ dyadic simulation training. The concrete changes concerning group size and the composition of the group influenced the nursing students’ engagement with the learning environment and consequently the communication patterns that emerged. These findings suggest that smaller groups will probably be more efficient than larger groups in a free collaboration setting that uses screen-based simulation training.

  14. Factors affecting implementation of perinatal mental health screening in women of refugee background

    Nishani Nithianandan; Melanie Gibson-Helm; Jacquie McBride; Amanda Binny; Kylie M. Gray; Christine East; Jacqueline A. Boyle

    2016-01-01

    Abstract Background For women of refugee background, the increased risk of mental illness associated with pregnancy is compounded by pre- and post-settlement stressors. In Australia, antenatal screening for depression and anxiety symptoms using the Edinburgh Postnatal Depression Scale is recommended for all women. Despite this, screening is not routinely implemented and little is known about barriers and enablers to implementation for women of refugee background. Methods Semi-structured inter...

  15. Antenatal care and morbidity profile of pregnant women in an urban resettlement colony of Delhi, India.

    Rustagi, N; Prasuna, J G; Vibha, M D

    2011-06-01

    The burden of antenatal morbidities and health care services utilization during antenatal period serve an important role in defining service needs and to assess reproductive health status of women. To evaluate the burden of antenatal morbidities in women and to assess the health care utilization by study subjects during antenatal period. A community based follow up study was carried out in an urban resettlement colony of Delhi. All pregnant women in the study area were enrolled and followed for two more visits to collect information about morbidities suffered and health care services utilized during pregnancy. Appropriate tests of significance were applied. Of 358 women enrolled, three hundred could be followed for two more visits. Majority of women (80.3%) suffered one or more morbidities during their current pregnancy but overall care sought for illness during pregnancy was poor. Visits for routine preventive check up was made by most of women (95% and above) but recommended three antenatal visits was significantly low among women of age more than thirty (OR=16.6; 2.2-125.9), of lower middle socio economic status (OR=2.84; 1.16-6.93) and parity three or more (OR=4.37; 1.07-17.83). Women with education status of high school and above had significantly lower odd ratio (OR=0.33; 0.11-0.99) for having less than three antenatal visits. Care sought for antenatal morbidities is still poor among women of urban resettlement colonies and age, parity and education of women has a significant bearing on antenatal visits.

  16. Factors affecting satisfaction on antenatal care services in Sarawak, Malaysia: evidence from a cross sectional study.

    Rahman, Md Mizanur; Ngadan, Deburra Peak; Arif, Mohammad Taha

    2016-01-01

    High levels of satisfaction among women with the antenatal care services will increase the compliance of antenatal visits during pregnancy. Thus, this study was done to assess the level of satisfaction among women on the quality of antenatal care received and the factors influencing thereof. This was a cross-sectional study conducted in the three zones of Sarawak. Women aged 18 years and above, irrespective of ethnic groups, having children aged 3 years and below were included in the study. Data was collected by face-to-face interview using interview schedule. A validated Patient Satisfaction Questionnaire (PSQ-18) was used to assess the satisfaction with antenatal care. A total of 1236 data was analysed using IBM SPSS version 22.0. A p value <0.05 was considered as statistically significant. A multinomial logistic regression analysis revealed that Bidayuh 17.4 % was less likely to be highly satisfied with antenatal care. Similarly, respondents with secondary level of education 29.9 % were less likely to be highly satisfied, whereas, respondents having primary level of education, 1.6 % were less likely to be highly satisfied. However, those who did not spend any money as out of pocket expenses were 1.935 times more likely to be highly satisfied with antenatal care. Overall the studied women were satisfied with the antenatal care services. Ethnicity, level of education and out of pocket expenses appeared to be important predictors of satisfaction with antenatal care. The finding recommends the community-based and language-specific interventions should be implemented to sustain the satisfaction of maternal care.

  17. The service needs of mothers with schizophrenia: a qualitative study of perinatal psychiatric and antenatal workers

    Wan, Ming Wai; Moulton, Steff; Abel, Kathryn M.

    2008-01-01

    Objective: The study sought to (1) understand the perspectives of perinatal psychiatric and antenatal health service workers on the service and support needs of mothers with schizophrenia; (2) obtain their views on the feasibility and potential effectiveness of a proposed parenting intervention tailored for this group. Method: Twenty-eight perinatal psychiatry and antenatal service workers were interviewed using a semi-structured methodology, and anonymised verbatim transcripts analysed for c...

  18. Domestic violence among antenatal attendees in a Kathmandu hospital and its associated factors: a cross-sectional study.

    Shrestha, Monika; Shrestha, Sumina; Shrestha, Binjwala

    2016-11-21

    among pregnant women attending an antenatal clinic. It indicates a need for routine screening during antenatal visits to identify women experiencing violence and thus provide support services, thereby preventing them from adverse health consequences.

  19. Toxicology screen

    ... this page: //medlineplus.gov/ency/article/003578.htm Toxicology screen To use the sharing features on this page, please enable JavaScript. A toxicology screen refers to various tests that determine the ...

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

    Ikeoluwapo O. Ajayi

    2013-08-01

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

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

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

    2013-02-01

    obviously at higher risk of perinatal complications than singletons due to a natural increase in the incidence of fetal anomalies, antenatal disorders and obstetric and neonatal complications associated with the development of two fetuses instead of one. Overall, our review indicates that some antenatal complications are more frequent in assisted-conception twin pregnancies than in spontaneous twin pregnancies but their prevalence is low and thus their impact on the morbidity and mortality of an individual assisted-conception twin pregnancy is limited. Assisted reproduction treatment has become available to older women with pre-existing maternal medical conditions such as chronic hypertension and diabetes. The increased obstetrical risks in this population must be considered prior to attempts at assisted conception, and the transfer of more than one embryo should be avoided in women with a pre-existing maternal medical condition. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  2. Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses.

    Callec, R; Lamy, C; Perdriolle-Galet, E; Patte, C; Heude, B; Morel, O

    2015-08-01

    To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to determine the impact of screening on obstetric and neonatal outcomes. For this prospective cohort study, pregnant women were recruited from two French university maternity centers between 2003 and 2006. Performance measures of third-trimester biometry for the prediction of SGA, defined as estimated fetal weight third-trimester ultrasound had a sensitivity of 29.0% (95% CI, 22.5-36.6%) and specificity of 94.2% (95% CI, 93.0-95.2%). Positive and negative predictive values were 30.8% (95% CI, 23.9-38.7%) and 93.7% (95% CI, 92.5-94.8%), respectively. One hundred and ten SGA neonates went undiagnosed at ultrasound. Compared to the TN neonates considered as of normal weight at ultrasound, planned preterm delivery (before 37 weeks) and elective Cesarean section for a fetal growth indication were 2.4 (P = 0.01) and 2.85 (P = 0.003) times more likely to occur, respectively, in the FP group of non-SGA neonates, diagnosed incorrectly as SGA during the antenatal period. There was no statistically significant difference in 5-min Apgar score third-trimester ultrasound screening for SGA seems poor, as it misses the diagnosis of a large number of SGA neonates. The consequences of routine screening for SGA in a low-risk population may lead to unnecessary planned preterm deliveries and elective Cesarean sections in FP pregnancies, without improved neonatal outcome in the FN pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  3. Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey.

    Zhou, Chi; Ogihara, Atsushi; Chen, Hao; Wang, Weijue; Huang, Liu; Zhang, Baodan; Zhang, Xueni; Xu, Liangwen; Yang, Lei

    2017-11-01

    The aim of this study is to investigate the associations between social capital and antenatal depression among Chinese primiparas. A cross-sectional design was used and a questionnaire survey was conducted with 1471 participants using the intercept method at the provincial hospital in Zhejiang in 2016. Antenatal depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and social capital was assessed by the Chinese version of Social Capital Assessment Questionnaire (C-SCAQ). The prevalence of antenatal depression was assessed among Chinese primiparas in their third trimesters. The antenatal depression prevalence among sub-groups with lower social trust (ST), social reciprocity (SR), social network (SN), and social participation (SP) were significantly higher than those among higher score sub-groups. In the fully adjusted model, primiparas' antenatal depression was significantly associated with ST, SR, SN, and SP. Compared to the structural social capital, the cognitive social capital was a more crucial dimension to the prevalence of antenatal depression. For future community pregnancy health care management programs in China, it might be beneficial to add more social capital related intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Maternal characteristics associated with antenatal, intrapartum, and neonatal zidovudine use in four US cities, 1994-1998.

    Orloff, S L; Bulterys, M; Vink, P; Nesheim, S; Abrams, E J; Schoenbaum, E; Palumbo, P; Steketee, R W; Simonds, R J

    2001-09-01

    To evaluate implementation of 1994 United States Public Health Service guidelines for zidovudine (ZDV) use in HIV-infected women and their newborns by describing the prevalence of use of perinatal ZDV and other antiretrovirals and by investigating determinants of not receiving perinatal ZDV. The Perinatal AIDS Collaborative Transmission Study is a prospective cohort study designed to collect information related to mother-to-child HIV transmission that was conducted in New York City (NY), Newark (NJ), Baltimore (MD), and Atlanta (GA), U.S.A. The current analysis was restricted to infants born between July 1994 and June 1998. Utilization rates for antenatal, intrapartum, and neonatal ZDV increased from 41% to 70% during the 4-year period. Use of combination antiretrovirals increased from fewer than 2% of women in 1994 to 1995 to 35% in 1997 to 1998. Antenatal and neonatal ZDV use increased each year, but intrapartum ZDV use reached a plateau after 1996. Mother-infant pairs with the following characteristics were less likely to have received a complete 3-part ZDV regimen: older maternal age, CD4 count >500 cells/microl, preterm birth, cocaine or heroin use during pregnancy, positive newborn drug screen test result, and smoking or alcohol use during pregnancy. By multivariate logistic regression adjusted for hospital and year of birth, cocaine or heroin use during pregnancy (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.6-3.3), maternal CD4 count (OR, 0.4; 95% CI, 0.2-0.8; comparing 500 cells/microl), and preterm birth (OR, 1.6; 95% CI, 1.1-2.5) remained independently associated with not receiving the complete ZDV regimen. ZDV use by pregnant HIV-infected women and their infants has increased dramatically since publication of the 1994 guidelines. Nevertheless, women who abuse substances, give birth preterm, or have less advanced immunosuppression, were at substantial risk of not receiving the complete ZDV regimen.

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

    Kenyon, Chris Richard; Osbak, Kara; Tsoumanis, Achilleas

    2016-01-01

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

  6. Screening strategies for gestational diabetes mellitus at the Aga ...

    Background: Universal screening strategy for gestational diabetes mellitus offers biochemical screening to all women irrespective of risk factor status while selective strategy screens only those with risk factors. The Aga Khan University Hospital adopted a selective screening protocol by consensus. This study compares both ...

  7. Antenatal care among currently married women in Rajasthan, India

    Alok Chauhan

    2012-10-01

    Full Text Available Objective: To assess the utilization of antenatal care (ANC services among currently married women in Rajasthan. Methods: The data have been extracted from District Level Household and Facility Survey (DLHS-3 which was conducted during 2007-2008, all over India. A total of 12 458 currently married women in the age group of 15-49 were taken as the sample for the study. Cross tabulation and binary logistic regression method were applied to determine the factors influencing ANC. Results: Out of 12 458 respondents, 43.4 percent women not received even a single ANC during their pregnancy period. 45.1 percent of the women not received tetanus toxoid injection and 13.0 percent of the women not received Iron folic acid tablets during their pregnancy period. Only 6.6 percent of women fulfilled the minimum recommendation with regard ANC services. Conclusions: The study points to the avenues through which policy makers can formulate and implement policies on a realistic basis by identifying critical variables and target groups for effective utilisation of ANC.

  8. Gestational Age at First Antenatal Care Visit in Malawi.

    Mkandawire, Paul

    2015-11-01

    This paper examines the gestational age at first antenatal care (ANC) visit and factors associated with timely initiation of ANC in Malawi in a context where maternal and child health services are generally provided for free. Lognormal survival models are applied to Demographic and Health Survey data from a nationally representative sample of women (n = 13,588) of child-bearing age. The findings of this study show that less than 30 % of pregnant women initiate ANC within the World Health Organization recommended gestational timeframe of 16 weeks or earlier. The hazard analysis shows a gradient in the initiation of ANC by maternal education level, with least educated mothers most likely to delay their first ANC visit. However, after adjusting for variables capturing intimate partner violence in the multivariate models, the effect of maternal education attenuated and lost statistical significance. Other significant predictors of gestational age at first ANC include media exposure, perceived distance from health facility, age, and birth order. The findings of the study link domestic violence directly with the gestational age at which mothers initiate ANC, suggesting that gender-based violence may operate through delayed initiation of ANC to undermine maternal and child health outcomes.

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

    Rubin George

    2006-08-01

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

  10. Assessment of nausea and vomiting of pregnancy on antenatal ...

    admin

    place of residence, race/ethnicity, cultural, social, and educational status of ... Research and Publication Committee, University of. Addis Ababa ..... Determinants of Health; (Unpublished doctoral thesis), University of Saskatchewan, Saskatoon,.

  11. Medical improvisation training to enhance the antenatal counseling skills of neonatologists and neonatal fellows: a pilot study.

    Sawyer, Taylor; Fu, Belinda; Gray, Megan; Umoren, Rachel

    2017-08-01

    Neonatologists must be skilled at providing antenatal counseling to expectant parents of premature infants at the limits of viability. We conducted a medical improvisation workshop with the objective of enhancing antenatal counseling skills. Pre- and postworkshop questionnaires were collected to examine the impact of the training. A follow-up survey was distributed 3 months after the workshop to examine the impact of the training on antenatal counseling skills. Nine neonatologists and three neonatal fellows participated in the workshop. Participants reported the skills learned in the workshop could enhance the quality of antenatal counseling. On follow-up survey, 90% of subjects reported improvements in the quality of their antenatal counseling. Participation in a medical improvisation workshop resulted in enhancements of self-perceived antenatal counseling skills. Medical improvisation training may provide a feasible and effective method of communication training for neonatologists. Further research into this innovative method are needed.

  12. Colon cancer screening

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

  13. Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study

    Lau, Yan Kwan; Cassidy, Tali; Hacking, Damian; Brittain, Kirsty; Haricharan, Hanne Jensen; Heap, Marion

    2014-01-01

    Background Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa’s high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy. Methods Participants recruited wer...

  14. Concurrent medical conditions among pregnant women - ignore at their peril: report from an antenatal anesthesia clinic.

    Weiniger, Carolyn F; Einav, Sharon; Elchalal, Uriel; Ozerski, Vladislav; Shatalin, Daniel; Ioscovich, Alexander; Ginosar, Yehuda

    2018-03-19

    Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center. Each consultation focused on the concurrent medical condition. A written anesthesia strategy according to the medical condition and its anesthesia considerations was discussed and given to the patient. Data regarding clinic visits were recorded. A total of 451 clinic women attended the antenatal anesthesia clinic. Maternal age was 31.7 ± 6.0 years (mean ± SD), with gestational age of pregnancy 33.0 ± 5.4 weeks at the clinic visit. Musculoskeletal conditions (23% of all the women seen) were the most frequent concurrent conditions, followed by anesthesia related concerns 20%, neurologic conditions 19%, and cardiac conditions 15%. Women were provided plans that were deliberated carefully rather than being concocted during labor. A wide range of concurrent medical conditions was seen in the antenatal anesthesia clinic, however fewer women attended the clinic than expected according to known population frequencies of concurrent medical conditions. Women with concurrent medical conditions should have labor and anesthesia plans considered during the nine months of pregnancy, prior to delivery, and hospitals should have a means of obtaining this information in a timely manner. Finally, there is a need to develop additional antenatal anesthesia clinics.

  15. The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia.

    Bayou, Yibeltal T; Mashalla, Yohana S; Thupayagale-Tshweneagae, Gloria

    2016-06-15

    There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. This was a quantitative and cross-sectional community based study design which employed a stratified two-stage cluster sampling technique to determine the sample. Data was collected using structured questionnaire administered to 870 women aged 15-49 years. Weighted 'backward selection' logistic regression models were employed to identify predictors of adequacy of antenatal care. Majority of slum residents did not have adequate antenatal care services with only 50.3, 20.2 and 11.0 % of the slum resident women initiated antenatal care early, received adequate antenatal care service contents and had overall adequate antenatal care services respectively. Educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.7 times more likely to receive overall adequate care compared to those with no formal education. Similarly, clients of private healthcare facilities were 2.2 times respectively more likely to receive overall adequate antenatal care compared to those clients of public healthcare facilities. In order to improve ANC adequacy in the study area, the policy-making, planning, and implementation processes should address the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

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

    Charles Bitamazire Businge

    2016-01-01

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

  17. Beyond Critical Congenital Heart Disease: Newborn Screening Using Pulse Oximetry for Neonatal Sepsis and Respiratory Diseases in a Middle-Income Country.

    Jawin, Vida; Ang, Hak-Lee; Omar, Asma; Thong, Meow-Keong

    2015-01-01

    Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country. In a pilot study performed at the University Malaya Medical Centre (UMMC), Malaysia, all apparently healthy term newborns, delivered at UMMC were screened pre-discharge using pulse oximetry. Echocardiography was performed for newborns that had positive screening results on two separate occasions, 1-h apart. Newborns with normal echocardiograms were evaluated and treated for other non-cardiac diseases. Fifteen of 5247 term newborns had positive screening results. The median age at screening was 20 h. Thirteen newborns (0.24%) had significant non-cardiac diseases: sepsis (n = 2) and respiratory diseases (n = 11) that required hospitalization and treatment. The remaining two newborns with normal antenatal ultrasonograms had positive screening test and confirmed to have CCHD. Another 18 newborns with negative screening test were later admitted for treatment of sepsis (n = 16) and penumonia (n = 2). All newborns were treated and alive at the end of the study. The sensitivity and specificity of pulse oximetry screening for non-cardiac diseases were 42% and 99.9% respectively, and 100% and 99.7% for CCHD, respectively. Routine pulse oximetry screening test was effective in identifying newborns with CCHD and other hypoxemia illnesses, which may led to potential life-threatening condition. This study showed that the expanded use of pulse oximetry has immediate implications for low

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

    Augustine Vincent Umoh

    2011-12-01

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

  19. Improving antenatal risk assessment in women exposed to high risks.

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

  20. Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery

    Rumaseuw, R.; Berliana, S. M.; Nursalam, N.; Efendi, F.; Pradanie, R.; Rachmawati, P. D.; Aurizki, G. E.

    2018-02-01

    The government has implemented several programs to prevent and reduce a mother’s mortality rate by enhancing active role of the family. The most responsible family member on maintaining the pregnancy and delivery process is the husband. The husband must be active to take care of his wife. Active participation of the husband in accompanying his wife during pregnancy and the delivery process is one of the substantial factors, which helps the husband to take decisions related to the health of his wife. This study aimed to identify variables and its trends, which significantly affect a husband’s participation in accompanying his wife during pregnancy and the delivery process. The data used in this study was from an Indonesian Demographic Health Survey 2012. The study used binary logistic regression as the analysis method. The result showed as many as 8,237 husbands accompanied their wife in antenatal care and the delivery process. The significant variables affecting the husband participation are the age of the wife, the education of wife, the education of the husband, the occupational status of the wife and the husband, the number of children, pregnancy status, and residency region. The possibility for a husband to accompany his wife is larger in several factors, such as the wife being between the ages of 21 - 35 years old, a husband who minimally graduated from junior high school, a working husband, as well as a wife, and the number of children less than and equal to two and the expected pregnancy. The government should consider those factors to create policy related women’s health and integrate the factors into various sectors.

  1. Knowledge and perception of human papilloma virus vaccine among the antenatal women in a Nigerian tertiary hospital.

    Agida, Teddy E; Akaba, Godwin O; Isah, Aliyu Y; Ekele, Bissalla

    2015-01-01

    Cervical cancer is a major health problem globally, especially in sub-Saharan Africa, Nigeria inclusive. One of the preventive measures is the vaccination of teenagers against oncogenic human papilloma virus. The aim of this study was to find out the level of knowledge mothers possess about these vaccines and their willingness to administer vaccination to their teenage girls. This was a cross-sectional descriptive study of 255 consecutive women attending antenatal clinic at the University of Abuja Teaching Hospital, Abuja. They were given either a self-administered questionnaire or interviewer-administered questionnaire containing both closed and open-ended questions. Information recorded includes socio-demographic variables, knowledge of cervical cancer, knowledge of HPV/HPV vaccines and acceptance of these vaccines for their adolescent girls. The data was analysed using descriptive statistics. The mean age of the respondents was 26.9 years. Over 90% had at least secondary education. A total of 102 (40%) had the knowledge of cancer of the cervix while 153 (60%) had never heard about it. Overall, 236 (92.5%) of them had no idea about the predisposing factors. The study showed that only 23 (9.0%) out of the total respondents had heard about human papilloma virus (HPV) infection. In the same vein, 20 (7.8%) had knowledge about HPV vaccine. Among the respondents, who had the knowledge of HPV and vaccination, 18.2% and 23.4% of them had secondary and tertiary levels of education respectively. Overall, 160 (62.8%) accepted that the vaccines could be administered to their teenage girls. Awareness of cervical cancer, HPV infections, and HPV vaccines is low among antenatal clinic attendees in Gwagwalada, Abuja. However, majority of them would want their girls vaccinated against HPV infections. There is a need for all stakeholders to step up awareness creation for improved HPV vaccination project in Nigeria.

  2. Análise da implantação de programa de triagem auditiva neonatal em um hospital universitário Newborn hearing screening program implantation analysis at a university hospital

    Wilian Maduell de Mattos

    2009-04-01

    Full Text Available Aperda auditiva é mais prevalente que outros distúrbios já rastreados ao nascimento. Esforços têm sido feitos para identificação e tratamento precoces de perdas auditivas por meio de programas de triagem auditiva neonatal. OBJETIVO: Estudo prospectivo com objetivo caracterizar o processo de implantação do Programa de Triagem Auditiva Neonatal (PTAN num Hospital Universitário. Analisar a investigação diagnóstica de perda auditiva em recém-nascidos. Apresentar propostas para aprimoramento do PTAN. MATERIAIS E MÉTODOS: Foram estudados recém-nascidos (RNs submetidos à TAN por emissões otoacústicas transientes (EOAT, reflexo cócleo-palpebral (RCP e Potencial Evocado Auditivo de Tronco Encefálico (PEATE. RESULTADOS: Foram testadas 625 crianças. Na primeira etapa passaram 458 RNs e falharam 155. Retornaram na segunda etapa 122 RNs, sendo que 8 o fizeram por apresentar fator de alto risco para PA. Encaminhados para investigação diagnóstica 12 RNs (1,9%. Dos 5 que retornaram para PEATE, observou-se PA em dois RNs. CONCLUSÃO: O programa testou 81,7% dos candidatos. O índice de adesão ao programa foi 68,2%. Na primeira etapa falharam 26,7% dos RNs. A implantação do programa está em andamento e necessita constantemente de análise das dificuldades, visando solucioná-las a fim de tornar a Triagem Auditiva Neonatal Universal uma realidade.Hearing loss is more prevalent than other disorders found at birth. Efforts have been put up towards the early identification and treatment of hearing loss by means of neonatal hearing screening programs. AIM: prospective study with the goal of characterizing the process of implementing a Neonatal Auditory Screening Program (NASP at a University Hospital. To analyze hearing loss diagnostic investigations in newborns, and to present proposals for NASP improvement. MATERIALS AND METHODS: we studied newborns (NB submitted to Newborn Auditory Screening (NAS by transient evoked otoacoustic

  3. Wealth and antenatal care use: implications for maternal health care utilisation in Ghana.

    Arthur, Eric

    2012-08-06

    The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the

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

    Abubakar Sadiq Umar, MBBS, MPH, MHPM, FWACP

    2015-10-01

    Full Text Available Objective: In Nigeria, wide disparities exist between the different parts of the country, with the states in the North East zone having poor health resources. The objective of this study is to assess whether women’s biological, sociocultural, and economic characteristics are associated with utilization of ante natal care services as measured by number of antenatal care (ANC visits in Yobe State. Methods: This is a secondary data analysis of the 2008 Nigeria Demographic and Health Survey with records from 33,385 women between 15-49 years who had given birth between January 2003 and December 2008 in Yobe State. Bivariate Pearson’s Chi square test and two stages of Multivariate regression analysis were conducted. Results: Women with at least primary level education (adjusted OR (AOR = 2.40; CI 1.24 – 4.67, belonging to professional employment category (AOR = 12.07; CI 0.19 – 75.74 and those who had access to skilled health workers (AOR = 5.13; CI 2.50 – 10.52 are more likely to make the required number of ANC visits compared to those who are illiterates, unemployed and had no access to skilled health workers. Conclusion and Global Health Implications: This study demonstrated that educational level, family wealth income, and availability of skilled health worker were consistently associated with the number of ANC visits even after controlling for covariates. These three covariates are in tandem with the Millenium Development Goals (MDG 1 – eradication of extreme poverty and hunger; MDG 2 – universal basic education; MDG 3 – gender equality; and MDG 4 – maternal mortality. There is the need for inter-sectoral holistic intervention approach.

  5. Contraceptive Awareness and Practice Among Antenatal Attendees in a Tertiary Hospital in South-South Nigeria

    Aniekan Monday Abasiattai

    2011-02-01

    Full Text Available Background: Use of effective contraceptive methods has been shown to improve health, sexual life and partner relations and also significantly reduce maternal and infant mortality by protecting against unplanned pregnancy, high fertility and high parity. The aim of this study is to determine the degree of awareness and practice of contraception by women in Uyo, Nigeria. Materials and Methods: Semi-structured questionnaires were administered to three hundred and seventy women in the antenatal clinic of the University of Uyo Teaching Hospital. Results: Majority of the respondents were 21-30 years old (64.1%, 53.8% were multiparous and 66.5% had tertiary level education. Three hundred and twenty women (87.6% had heard about contraception (OR=49.6, P< 0.001, while only 49.5% of the respondents had practiced contraception previously (OR=0.96, P=0.76 of which the male condom (40.0% and the safe period/calendar method (31.1% were the most commonly practiced methods. Majority of the respondents (66.8% preferred to have 3 to 4 children and 78.4% of the respondents would want to used a method of contraception to either space their family or limit child bearing (OR=13.14, P< 0.001. Fear of side effects (20.0% and previous bad experience (8.8% were the most common reasons given by those respondents who would not want to practice contraception. Conclusion: This study reveals a high level of awareness of contraception but a significant unmet need among the respondents. There is need to intensify public enlightenment campaigns in our environment emphasizing the benefits and safety of modern contraceptive methods. Community leaders and heads of social groups and women organisations should be co-opted in the dissemination of accurate information on contraception. [TAF Prev Med Bull 2011; 10(1.000: 29-34

  6. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids.

    Marcellin, Louis; Senat, Marie Victoire; Benachi, Alexandra; Regis, Sophie; Cabrol, Dominique; Goffinet, François

    2017-05-24

    To evaluate whether routine measurement of cervical length (CL) by transvaginal ultrasound (TVU) in twin pregnancies can enable identification of women who will give birth before 34 weeks and require antenatal corticosteroids (ACSs), and whether it can limit their administration to women who will give birth later. Retrospective comparative study in two tertiary referral centers in France. Women with twin gestations followed in two tertiary university hospital maternity units and who delivered from January 1, 2007 to December 31, 2009 were included. In one center, TVU was targeted to women with cases of suspected preterm labor, while the other center used it monthly for all twin pregnancies. The main outcome measure was the administration of a full course of ACS to twins delivered before 34 weeks. Two hundred and seventy women were eligible in the "targeted use" group, and 296 women in the "routine use" group. The rate of administration of at least one full course of ACS for twins born before 34 weeks did not differ between the two groups (85.0% in the targeted use group and 90.0% in the routine use group, P=0.40), but the rate of such administration for those born after 34 weeks was lower in the targeted use group (25.7% vs. 81.2%, P<0.01). On adjusting for confounders using logistic regression modeling, no significant difference in ACS administration before 34 weeks was found between the two groups [adjusted odds ratio (aOR), 0.71, 95% confidence interval (CI), 0.39-1.30]. Routine monitoring performed every month of CL with TVU does not affect the rate of administration of ACS to twins born before 34 weeks, but is associated with a higher rate of such administration for those born later in the specific center of the study.

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

    Fatimah Fatimah

    2015-11-01

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

  8. Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana

    Jones Asafo Akowuah

    2018-01-01

    Full Text Available Access to quality healthcare still remains a major challenge in the efforts at reversing maternal morbidity and mortality. Despite the availability of established maternal health interventions, the health of the expectant mother and the unborn child remains poor due to low utilisation of interventions. The study examined the socioeconomic determinants of antenatal care utilisation in peri-urban Ghana using pregnant women who are in their third trimester. Two-stage sampling technique was used to sample 200 pregnant women who were in their third trimester from the District Health Information Management System software. Well-structured questionnaire was the instrument used to collect data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyse the data with the help of SPSS and STATA software. The results showed varying utilisation levels of ANC. From the regression result, age, household size, and occupational status were identified as the important socioeconomic determinants of antenatal care utilisation among the respondents. The important system factors which influence antenatal care utilisation by the respondents are distance to ANC, quality of service, and service satisfaction. The study concludes that socioeconomic and health system factors are important determinants of antenatal care utilisation. Stepping up of interventions aimed at improving the socioeconomic status and addressing health system and proximity challenges could be helpful in improving antenatal care utilisation by pregnant women in Ghana.

  9. Antenatal diagnosis, prevalence and outcome of major congenital anomalies in Saudi Arabia: A hospital based study

    Sallout, Bahauddin I.; Al-Hoshan, Manal S.; Attyyaa, Rehman A.; Al-Suleimat, Abdelmane A.

    2008-01-01

    The exact antenatal prevalence of congenital anomalies in Saudi society is unknown. Early antenatal diagnosis of congenital anomalies is crucial for early counseling, intervention and possible fetal therapy. The objective of this study was to evaluate the antenatal frequency of major congenital anomalies and malformations patterns in our hospital population and to evaluate the outcome and perinatal mortality rates for major congenital anomalies. This was a prospective study of the antenatal diagnosis of major fetal congenital anomalies conducted in the ultrasound Department of the Women's Specialized Hospital at King Fahd Medical City from for 7762 patients and 5379 babies delivered in our institution. We diagnosed 217 cases of fetal anomalies. The antenatal prevalence of congenital anomalies was 27.96 per 1000. The median maternal age at diagnosis was 27.5 years. Te median gestational age at diagnosis was 31 weeks. Genitourinary and cranial anomalies were the commonest; for 186 patients delivered in our institution, the birth prevalence was 34.57 per 1000 births. The median gestational age at delivery was 38 weeks. The perinatal mortality arte was 34.9% (65/186), including all cases of intrauterine fetal and neonatal deaths. The prevalence of major congenital anomalies in our population appears to be similar to international figures. Major congenital anomalies are a major cause of perinatal mortality. (author)

  10. Impact of antenatal glucocorticosteroids on whole-genome expression in preterm babies.

    Saugstad, Ola Didrik; Kwinta, Przemko; Wollen, Embjørg Julianne; Bik-Multanowski, Mirosław; Madetko-Talowska, Anna; Jagła, Mateusz; Tomasik, Tomasz; Pietrzyk, Jacek Józef

    2013-04-01

    To study the impact that using antenatal steroid to treat threatened preterm delivery has on whole-genome expression. A prospective whole-genome expression study was carried out on 50 newborn infants, delivered before 32 weeks gestation, who had been exposed to antenatal steroids, including 40 who had received a full antenatal steroid course. Seventy infants not exposed to antenatal steroids formed the control group. Microarray analyses were performed five and 28 days after delivery, and the results were validated by real-time PCR. The study was conducted between September 2008 and November 2010. Twenty thousand six hundred and ninety-three genes were studied in the infants' leucocytes. Thirteen were differentially expressed 5 days after delivery, but there were no differences at day 28. Four genes related to cancer or inflammation were up-regulated. Nine genes were down-regulated: six were Y-linked and associated with malignancies, graft-versus-host disease, male infertility and cell differentiation and three were associated with pre-eclampsia, oxidative stress and chloride/bicarbonate exchange. Seven gene pathways were up-regulated at day five and only one at day 28. These were associated with cell growth, cell cycle regulation, metabolism and apoptosis. Antenatal steroid therapy affects a limited number of genes and gene pathways in leucocytes in preterm babies at day five of life. The effect is short-lived, but long-term effects cannot be ruled out. ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.

  11. National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship?

    Dixon, Jenna; Tenkorang, Eric Y; Luginaah, Isaac N; Kuuire, Vincent Z; Boateng, Godfred O

    2014-01-01

    The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana. Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively. Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit. Women who are educated, living in urban areas and are wealthy were more likely to attend antenatal care than those living in rural areas, uneducated and from poorer households. The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana. © 2013 John Wiley & Sons Ltd.

  12. A randomised controlled multicentre trial of women's and men's satisfaction with two models of antenatal education.

    Bergström, Malin; Kieler, Helle; Waldenström, Ulla

    2011-12-01

    To study women's and men's satisfaction with two models of antenatal education: natural childbirth preparation with psychoprophylaxis, and standard antenatal education including preparation for childbirth and parenthood but no psychoprophylaxis. Randomised controlled multicentre trial. 15 Antenatal clinics in Sweden between January 2006 and May 2007. 1087 Nulliparous women and 1064 of their partners. Both models had four two-hour sessions during pregnancy and one session post partum. The natural model was manual-based and focused on childbirth preparation, including psychoprophylaxis. In the standard care model, the group leader was free to choose her teaching approach, with an equal amount of time allocated to preparation for childbirth and for parenthood. Women's and men's evaluation of antenatal education at three months post partum. The proportion of women and men in each model that expressed satisfaction with the education were compared using χ(2) test. More women and men in the natural groups were satisfied with the education compared with the standard care groups: women 76% versus 68% (p = 0.03) and men 73% versus 65% (p = 0.03). The figures were similar for satisfaction with the childbirth preparation component: 78% and 62% in women (p psychoprophylaxis may better meet expectant parents' expectations than standard antenatal education in Sweden. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. Comparative effectiveness of single and dual rapid diagnostic tests for syphilis and HIV in antenatal care services in Colombia

    Hernando Guillermo Gaitán-Duarte

    Full Text Available ABSTRACT Objective To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. Methods A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A or to dual HIV and syphilis rapid diagnostic tests (Arm B. The four main outcomes measured were: (1 acceptability of the test, (2 uptake in testing, (3 treatment on the same day (that is, timely treatment, and (4 treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. Results A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69% in Arm A and 16 of 20 patients (80% in Arm B (relative risk (RR, 1.10; 95% confidence interval (CI: (1.00 −1.20. Treatment at any time was given to 24 of 29 patients (83% in Arm A and to 20 of 20 (100% in Arm B (RR, 1.11; 95% CI: 1.01−1.22. Conclusions There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.

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

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

    2016-09-21

    Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.

  15. Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial.

    Cherniak, William; Anguyo, Geoffrey; Meaney, Christopher; Yuan Kong, Ling; Malhame, Isabelle; Pace, Romina; Sodhi, Sumeet; Silverman, Michael

    2017-01-01

    In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1) in control communities (rate ratio 5.9, 95% CI 2.6-13.0, padvertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby.

  16. Prevalence of Cytomegalovirus IgG Antibodies among Pregnant Women Visiting Antenatal Clinic, LAUTECH Teaching Hospital in Osogbo, Osun State, Nigeria.

    Akende, Oluwatosin; Akanbi, Olusola Anuoluwapo; Oluremi, Adeolu Sunday; Okonko, Iheanyi Omezuruike; Opaleye, Oluyinka Oladele

    2016-01-01

    Cytomegalovirus (CMV) is one of the predominant viral infections that lead to congenital diseases and teratogenic risks during the perinatal stage. There is paucity of seroepidemiological data on anti-CMV IgG antibody in pregnant women in Osogbo, Osun State, Nigeria. This study was aimed at determining the seroprevalence of Cytomegalovirus IgG antibody among pregnant women visiting antenatal clinic, LAUTECH Teaching Hospital, Osogbo, Nigeria. One hundred and seventy-four sera from the pregnant women were screened by Enzyme linked Immunosorbent Assay (ELISA) for cytomegalovirus (CMV) IgG antibody. Data analysis was done using SPSS software. In this study, 105 of the 174 pregnant women were seropositive for CMV IgG antibodies giving an antibody prevalence of 60%. There was no association found between CMV IgG seropositivity and the subjects' demographic characteristics, however, the 60.0% prevalence of CMV-IgG antibody observed amongst pregnant women in this study demands for vaccines and regular testing for the presence of CMV and its related risk factors in antenatal clinic.

  17. factors associated with late antenatal care attendance in selected ...

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    2University of Zambia School of Medicine, Department of Community Medicine, Lusaka. 3University of Zambia School of Medicine, .... and educating pregnant women about planning for safe birth, emergencies during pregnancy ..... with study done in New South Wales, Australia where it was indicated that younger women ...

  18. Premarital HIV screening in Johor--(2002-2004).

    Khebir, B V; Adam, M A; Daud, A R; Shahrom, C M D

    2007-03-01

    A descriptive study was conducted on premarital HIV screening programme in Johor over a three year period. HIV screenings were done at government clinics and confirmed by accredited laboratories. As a result, 123 new HIV cases were detected (0.17%) from 74,210 respondents. In 2004, 24 cases (64.9%) advanced to marriage (n = 37) after they underwent counselling and six of them married among themselves. Positivity rate from this programme (0.17%) is higher than antenatal screening (0.05%). Despite the implementation of the premarital HIV screening programme, marriage application in Johor rose 2.8% in 2004 compared with 2002. This programme had partly contributed to public awareness against HIV and provides another option in early detection of the disease.

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

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

    2015-01-01

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

  20. Selective imaging modalities after first pyelonephritis failed to identify significant urological anomalies, despite normal antenatal ultrasounds

    Mola, Gylli; Wenger, Therese Ramstad; Salomonsson, Petra

    2017-01-01

    AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis and investig......AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis...... identified all patients initially treated with surgery and avoided 65 scintigraphies. CONCLUSION: Dilated VUR was the dominant anomaly in a cohort with first time pyelonephritis and normal antenatal ultrasound. The optimal imaging strategy after pyelonephritis must be identified....