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Introduction Compliance to routine antenatal medications increases a woman’s chances of achieving a normal pregnancy and having a healthy baby. However, noncompliance is a commonly encountered problem in developing countries including Nigeria. This study investigated compliance to routine antenatal medications as reported by pregnant women receiving antenatal care in a tertiary hospital in Enugu State, Nigeria. Methods A cross-sectional descriptive survey research design was adopted for the study while simple random sampling technique was used to select the 354 pregnant women at Enugu state teaching hospital. A validated structured questionnaire (α=0.72) was utilized for data collection. Analysis of data involved descriptive and inferential statistics. Results Only 32% of pregnant women had a good compliance to their routine antenatal drugs while forgetfulness (27.2%) and vomiting as a side effect of the drug (25.7%) were the major barriers to compliance with routine drugs. Furthermore, there was a statistically significant association between respondents’ compliance with antenatal drugs and number of children as well as level of income (p

In this column, the editor of The Journal of Perinatal Education discussed how the COVID-19 pandemic has altered many aspects of promoting normal pregnancy and birth practices. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth.

Tumors of the ovaries in general and dermoids in particular do not particularly complicate a normal pregnancy, causing the last more or less inconvenience.All ovarian tumors, with the exception of dermoid tumors, differing in relatively large sizes, generally speaking and with the exception of very bulky tumors, lessen the development of pregnancy and especially the course of labor, since these tumors have a tendency to grow upward into the abdominal cavity, thus being removed from small pelvis.

The evaluation of cardiovascular disease in pregnancy is challenging due to overlaps between cardiac and normal pregnancy symptomatology, as well as concerns about the potential impact, if any, of imaging studies on fetal development. We discuss here an approach to the evaluation of the pregnant cardiac patient and review the safety and utility of available diagnostic tests, including labs, electrocardiogram, echocardiography, stress testing, computed tomography, magnetic resonance imaging, and cardiac catheterization. Importantly, the majority of standard imaging studies can be safely performed in pregnancy, and a high index of suspicion must be maintained when evaluating pregnant patients, especially those with preexisting cardiovascular disease.

Fetal neurodevelopment in utero is profoundly shaped by both systemic maternal immunity and local processes at the maternal–fetal interface. Immune pathways are a critical participant in the normal physiology of pregnancy and perturbations of maternal immunity due to infections during this period have been increasingly linked to a diverse array of poor neurological outcomes, including diseases that manifest much later in postnatal life. While experimental models of maternal immune activation (MIA) have provided groundbreaking characterizations of the maternal pathways underlying pathogenesis, less commonly examined are the immune factors that serve pathogen-independent developmental functions in the embryo and fetus. In this review, we explore what is known about the in vivo role of immune factors in fetal neurodevelopment during normal pregnancy and provide an overview of how MIA perturbs the proper orchestration of this sequence of events. Finally, we discuss how the dysregulation of immune factors may contribute to the manifestation of a variety of neurological disorders.

Objective: Vitamin D levels have shown significant geographical distribution, therefore, this study was conducted to evaluate its relationship to a specific geographic area with a high prevalence of vitamin D deficiency to the important maternal manifestation of preeclampsia. This study established the association of vitamin D deficiency to preeclampsia among women of reproductive age. Method: It is a retrospective case-control study done to measure serum vitamin D levels in pregnant women receiving care at the King Fahad Medical City Riyadh with preeclampsia (n=100) and normal pregnancy (controls, n=200) from 2012 to 2014. Odds of developing preeclampsia with vitamin D deficiency were calculated using logistic regression analysis. Results: The mean serum vitamin D level was 25.35?ng/ml in controls and 15.95?ng/ml in pre-eclampsia women. Comparing to those who had a serum vitamin D level of ?50?ng/ml, the odds ratio of developing preeclampsia in women with vitamin D deficiency was 4.2 (95% CI=1.23-14.35) while adjusting for age, BMI and duration of pregnancy. Conclusion: The risk of developing preeclampsia might increase by up to 4-fold in women with vitamin D deficiency. Since preeclampsia could lead to maternal and neonatal complications, vitamin D could be added during pregnancy to decrease these adverse consequences. Keywords: Vitamin D deficiency; preeclampsia; BMI; hypertension. Continuous...

Introduction: Ultrasound elastography is a technique used to quantify biomechanical changes that occur in parenchymal tissue with disease. Recent research has applied the technique to the placenta in order to investigate changes associated with uteroplacental dysfunction. We performed a literature review to summarise the current available information regarding this novel technique. Methods: Pubmed, CINAHL and Embase were searched using the terms “placenta”, “ultrasound” and “elastography”. Only full text studies written in English and limited to placental sonoelastography were included. Results: Twenty-eight studies met the inclusion criteria and were included in this review. Publications were divided into in vivo and ex vivo groups, and further categorised into four subgroups: normal pregnancy, pregnancy-induced hypertension and pre-eclampsia, fetal growth restriction and other pregnancy complications. Conclusion: Ultrasound elastography can quantitatively assess biomechanical properties of the placenta in conditions where placental function is compromised.

Normal pregnancy is a complex and dynamic process that requires significant adaptation from the maternal system. Failure of this adaptive process in pregnancy contributes to many pregnancy related disorders, including the hypertensive disorders of pregnancy. This article discusses placental development and how abnormalities in the process of vascular remodeling contribute to the multisystem maternal and fetal disease that is preeclampsia and fetal growth restriction. We review some of the consequences of this condition on the mother and fetus, aspects of the clinical management of preeclampsia and how it can influence both mother and infant in the postnatal period and beyond.

BACKGROUND Recurrent spontaneous abortion (RSA), presenting as one of the difficult clinical diseases, has a high incidence rate among women of reproductive age, with a rising trend in recent years. OBJECTIVES To confirm a target relationship between miR-24 and CDX1. This study aimed to explore miR-24 expression in decidual tissue under recurrent spontaneous abortion (RSA) and its mechanism of regulating downstream gene CDX1. MATERIAL AND METHODS Female CBA/J mice were mated with male BALB/C mice to establish normal pregnancy models, and mated with male DBA/2 mice to establish RSA models. Recurrent spontaneous abortion model mice were randomized into 5 groups: a model group, a NC group, a miR-24 mimic group, a CDX1 vector group, and a miR-24 mimic+CDX1 vector group. Expressions of miR-24, CDX1, VEGF, cleaved caspase-3, Fas, and FasL, as well as apoptosis in decidual tissues, embryonic development and embryo loss rate were compared. RESULTS Compared with the normal group, the embryo loss rate, apoptosis rate, and the expressions of cleaved caspase-3, Fas and CDX1 in decidual tissue in other groups were significantly increased, and the expressions of miR-24, VEGF, and FasL were significantly decreased (all p < 0.05). The miR-24 mimic group showed the opposite changes when compared with the model group (all p < 0.05). However, CDX1 overexpression can significantly block the protective effect of miR-24 overexpression on embryonic development (p < 0.05). CONCLUSIONS MiR-24 can inhibit CDX1 expression in decidual tissue of RSA mice, thus improving the embryonic development of the mice and reducing the RSA risk.

BACKGROUND Gestational Diabetes Mellitus (GDM) is diabetes diagnosed for the first-time during pregnancy. Infants of diabetic mothers are prone to various neonatal adverse outcomes, including metabolic and hematologic disorders, respiratory distress, cardiac disorders, and neurologic impairment due to perinatal asphyxia and birth traumas, among others. METHODS This was a comparative study conducted in the Department of Obstetrics and Gynaecology, Institute of Maternal and Child Health, Medical College, Calicut. A total of 200 subjects were included in the study. The subjects were divided into two groups comprising of neonates of healthy 150 pregnant women with no history of GDM. The other group included neonates of 50 pregnant women with GDM. Cord blood sample was collected during delivery. Cord blood glucose was determined by the GOD/POD method. Birth weight of newborn was recorded following delivery. The obtained data was tabulated and analysed using appropriate statistical tests. RESULTS The mean birth weight of newborns of women with GDM was 2.96 Kg and mean birth weight of newborns of normal pregnant women was 2.81 Kg. Even though macrosomia was not observed in newborn of GDM in the present study, the birth weight is significantly higher in newborns of women with GDM (p-value

Soluble Fms like tyrosine kinase 1 (sFlt-1) is one of the markers that play a role in the pathogenesis of pregnancy induced hypertension. The aims of the research were to determine the relationship beteween sFlt-1 level and birth weight. The samples were preeclampsia inpartu consisting of 22 peopole,, and normal pregnancy women consisting of 18 people. Analytic observational study with cross sectional was conducted. The level of sFlt-1 was examined using ELISA. Statistic analysis used Kruskal Wallis test, One way Anova test and Pearson correlation test.The result indicate that the characteristics of research subject in preeclampsia group and control group do not have a significant difference (p>0.05).The negative linear relationship occured between sFlt-1 level with birth weight in preeclampsia (p=0,015). While, in the group of normal pregnancy was not available of the relationship either sFlt-1 level with birth weight (p>0.05).

During pregnancy Nitric oxide is one of the most important relaxing factors for myometrium and also in the control of blood flow in uterus and placenta. Nitric oxide is generated by endothelial type II nitric oxide synthase (NOS) and acts as a vasodilator. Objective:To investigate the level of nitric oxide (NO) production in pregnancies complicated by preeclampsia and in normal pregnancy. Materials and Methods: A case control study was undertaken in Department of Gynaecology and Obstetrics of Bangabandhu Sheikh Mujib Medical University (BSMMU), from january to july 2014. The study population was pregnant women having preeclampsia and normal pregnancy who attended the OPD Department of Obstetrics and Gynecology in BSMMU between 29 to 40 weeks of gestation. As because of transient and volatile nature of nitric oxide, it was unsuitable to measure the nitric oxide level by conventional method. However, two stable break down product, nitrate (NO3 -) and nitrate (NO2 -) could be easily detected by sprectophototric means. Nitrate (NO2 -) was first converted to Nitrite (NO3 -) by reduction process using cadmium. Then concentration was measured by using Griess reagent in UV sprectophototric machine. This procedure was done in the Biochemistry Department, Dhaka University. Results: The mean nitrite level was found 18.37}3.64 mol/L in case group and 25.57}2.11mol/ L in control group, which was significantly (p

This state-of-the art manuscript highlights our current understanding of maternal immunization-the practice of vaccinating pregnant women to confer protection on them as well as on their young infants, and thereby reduce vaccine-preventable morbidity and mortality. Advances in our understanding of the immunologic processes that undergird a normal pregnancy, studies from vaccines currently available and recommended for pregnant women, and vaccines for administration in special situations are beginning to build the case for safe scale-up of maternal immunization. In addition to well-known diseases, new diseases are emerging which pose threats. Several new vaccines are currently under development and increasingly include pregnant women. In this manuscript, targeted at clinicians, vaccinologists, scientists, public health practitioners, and policymakers, we also outline key considerations around maternal immunization introduction and delivery, discuss noninfectious horizons for maternal immunization, and provide a framework for the clinician faced with immunizing a pregnant woman.

Extracellular vesicles (EVs) are nanosized, membranous vesicles released by almost all types of cells. Extracellular vesicles can be classified into distinct subtypes according to their sizes, origins and functions. Extracellular vesicles play important roles in intercellular communication through the transfer of a wide spectrum of bioactive molecules, contributing to the regulation of diverse physiological and pathological processes. Recently, it has been established that EVs mediate foetal‐maternal communication across gestation. Abnormal changes in EVs have been reported to be critically involved in pregnancy‐related diseases. Moreover, EVs have shown great potential to serve as biomarkers for the diagnosis of pregnancy‐related diseases. In this review, we discussed about the roles of EVs in normal pregnancy and how changes in EVs led to complicated pregnancy with an emphasis on their values in predicting and monitoring of pregnancy‐related diseases.

Aim: The objective of the study is to evaluate the normal physiological changes in values of major hematological parameters occur during the normal pregnancy Method: Blood samples (5ml EDTA) were taken voluntarily after consent obtained from from 50 healthy pregnant women from 20 to 40 years old who presented themselves at Khartoum teaching during their regularly follow-up. Questionnaires and direct interview were used to collect demographic and clinical data. CBC and part differential (WBC, RBC, Hb, PCV, and platelets), were measured by Sysmex and the plasma clotting time PT and PTT were measured by coagulometer. Results: W'BCs mean value was 7.580 cell/mm3, RBCs mean value was 4.1 x l012/L, Hb mean value was 11.79 g/dL, Platelets mean value was 256 x109/L, PT mean value of the study group was 13.40 seconds and PTT mean value was 36.20 seconds. Conclusion: It can be concluded that no statistical significance in RBCs, HB, platelets. PT and PTT between pregnant women in the three different trimesters while white WBCs count showed different decreased but not statistical significant among the three groups, the highest value was round in the second group followed by the third group and the lowest value found in the first group. Keywords: Normal pregnancy, Hematological Changes, Pregnancy trimesters

Recurrent molar pregnancy is very rare. In this case report, we highlight a case of a patient who experienced five recurrent molar pregnancies without an intervening normal pregnancy. A 22-year-old patient was admitted to our labour room with a fifth consecutive molar pregnancy. The patient underwent suction and evacuation and was followed up with serial serum human chorionic gonadotropin (beta-hCG) estimation. The patient did not require chemotherapy. Karyotype of the patient and her husband was normal. Nonetheless, the couple was counselled for adoption.

Objective The purpose of this study was to analyze serum 25-hydroxyvitamin D levels in normal pregnant women, severe preeclampsia, and severe preeclampsia with complications. Method This research was a cross-sectional study; the sample was 86 third-trimester pregnant women consisting of 44 normal pregnant mothers, 30 severe preeclampsia and 12 people severe preeclampsia with complications. The diagnosis based on obstetrics and gynecology physicians who served at the research hospital. Serum levels of 25-hydroxyvitamin D are measured using VD (vitamin D) human Enzyme-Linked Immunosorbent Assay (ELISA) Kit. Results Serum levels of 25-hydroxyvitamin D showed that there were statistically significant differences in the normal pregnancy group, severe preeclampsia group, and severe preeclampsia group with complications. Low serum 25-hydroxyvitamin D levels were severe in severe preeclampsia, while the highest 25-hydroxyvitamin D serum levels were in complicated severe preeclampsia. Observation on medical records that the majority of severe preeclampsia has received treatment that increases serum levels 25-hydroxyvitamin D. Conclusion Our study found that serum 25-hydroxyvitamin D levels will decrease as preeclampsia worsens and will increase again after receiving treatment. Earlier treatment in the early period of preeclampsia will be better than if there had been severe preeclampsia.

This study presents the analysis and classification of maternal status during healthy pregnancy and postpartum using bispectral features of heart rate variability (HRV). Bispectral analysis is appl...

Hypothesis/aims of study. It is assumed that intestinal dysbiosis, as well as bacterial vaginosis, may be one of the risk factors, and in some cases, the direct cause of pregnancy complications. This study was aimed to assess the intestinal and vaginal microbiocenosis composition in women with threatened miscarriage and normal pregnancy. Study design, materials and methods. The study involved 68 women aged 18 to 35 years (mean age 27.6 0.7 years) in pregnancy from 6 to 18 weeks. The main group consisted of 38 women with threatened miscarriage. The control group included women (n = 30) with normal pregnancy. Patients of the main and control groups were examined in accordance with the requirements of the Ministry of Health order No. 572n. In addition, a qualitative and quantitative microbiological analysis of vaginal discharge and feces was performed using the real-time polymerase chain reaction method. Results. Vaginal dysbiosis was detected in 60.5% of pregnant women of the main group and only 13.3% of women of the control group. In the main group, grade II dysbiosis was found in 23.7% of cases, and grade I dysbiosis in 36.8% of cases, while in the control group, these grades were found only in 3.3% and 10% of cases, respectively. Intestinal dysbiosis was diagnosed in 100% of the examined pregnant women. In patients of the main group, intestinal dysbiosis was detected as follows: grade I in 29% of cases, grade II in 52.6% of cases, and grade III in 18.4% of cases. In patients of the control group, the disorders corresponded mainly to grade I (83.4%) and, to a lesser extent, grade II (16.6%) dysbiosis, there being no cases of severe dysbiosis revealed. Conclusion. Women with threatened miscarriage had the most pronounced dysbiotic changes in vaginal and intestinal microflora compared to the control group. Vaginal dysbiosis was combined with intestinal dysbiosis in 100% of cases in patients of the main and control groups, and the degree of dysbiotic changes in the vaginal microflora was directly proportional to the degree of intestinal dysbiosis.

We studied the intensity of respiratory burst of neutrophils in the venous blood of women at different stages of reproduction using the chemiluminescent method (BHL-07). The analysis of the of luminol-dependent latex-induced luminescence parameters demonstrated that the neutrophils of pregnant women are in the primed state and equally respond to latex-mediated induction during both normal pregnancy and in case of threatened miscarriage or premature birth. However, childbirth leads to the deactivation of neutrophils, while the intensity of active radical generation does not significantly differ from that in non-pregnant women.

OBJECTIVE The aim: To find out typical pathomorphological differences in placenta of women with early and late preeclampsia. PATIENTS AND METHODS Materials and methods: Investigation includes 40 placentas from deliveries in women with preeclampsia (main group) and 40 placentas from physiological delivery in somatically healthy women, who had no complications during pregnancy (control group). Placentas in the main group were devided into two sub-groups (20 in each) - with early and late preeclampsia. Specialties of the blood vessels in normal pregnancy were investigated, and their structural transformation with the developement of preeclampsia, according to the appearence of perinatal pathology. Morphometrical data of the blood stream was investigated with the help of eyepiece and program Image Tools 3,6. RESULTS Results: Significant decrease of weight (p

Objective: to analyze the relationship between the length of marriage to pregnancy with the incidence of preeclampsia.Materials and Methods: This study was an observational analytic study with case control approach. Samples were 33 respondents with preeclampsia and 66 respondents with normal pregnancy, all were primigravida with age of 20-35 years old in Dr. M. Soewandhie Hospital, Surabaya, Indonesia, in January-June 2017. Data were taken from medical record.Results: This study found that the length of marriage until pregnancy was 0-4 months with percentage of 39.4% and 77.3% for case and control group respectively. Chi-square test resulted in p = 0.00 and contingency coefficient = 0.366, which meant there was relationship between the length of marriage to pregnancy and the incidence of preeclampsia in primigravida in Dr. M. Soewandhie Hospital Surabaya from January to June 2017 despite being in low level. The value of odd ratio (OR) was 0.191 (95% CI 0.077-0.473), which means there was a risk of protection for the length of marriage to pregnancy

Dyspnea in the postpartum period can be a symptom of a wide range of causes spanning normal pregnancy to life-threatening pathology. We describe a case of acute postpartum heart failure with preserved systolic function in the absence of pre-eclampsia or prior cardiovascular disease. (Level of Difficulty: Beginner.), Graphical abstract, Dyspnea in the postpartum period can be a symptom of a wide range of causes spanning normal pregnancy to life-threatening pathology…

El embarazo y parto son procesos fisiológicos y sociales que han sufrido múltiples transformaciones a lo largo de los siglos. El presente trabajo estudia la atención al embarazo normal y parto de bajo riesgo desde la perspectiva de madres primerizas atendidas en el Hospital Universitario de Navarra (Pamplona). Para ello, se ha utilizado la técnica cualitativa de entrevistas semiestructuras, realizadas a tres madres, una matrona trabajadora del hospital y una doula que desarrolla su actividad profesional en Navarra. El análisis del discurso identifica las necesidades, problemas, conflictos asistenciales y recoge los aspectos de mejora identificados por las madres. Además, se incluye la visión externa de las profesionales respecto a las experiencias de las mujeres embarazadas y parturientas, los límites percibidos en su trabajo, así como los déficits y progresos que se detectan en el Hospital Universitario de Navarra. Pregnancy and childbirth are physiological and social processes that have undergone multiple transformations over the centuries. This essay investigates the healthcare provided to normal pregnancy and low-risk childbirth from the perspective of first-time mothers attending the Hospital Universitario de Navarra (Pamplona). For this purpose, the qualitative technique of semi-structured interviews has been used, carried out with three mothers, a midwife working at the hospital, and a doula who carries out her professional activity in Navarre. The discourse analysis identifies the needs, problems, issues, healthcare conflicts and collects the aspects for improvement identified by the mothers. It also includes the external view of the professionals with regard to the experiences of pregnant women and women in labour, the limitations perceived in their work, as well as the deficits and progress detected at the Hospital Universitario de Navarra. Graduado o Graduada en Sociología Aplicada por la Universidad Pública de Navarra Soziologia Aplikatuan Graduatua Nafarroako Unibertsitate Publikoan

BACKGROUND: Becoming a mother is one of the most transitional experiences in life. It requires psychological, physical, and social adjustment and adaptation in various areas and can be conceived as both a stressful and joyful experience by many women. Especially, first-time pregnancies are recognised as a period of emotional sensitivity. Moreover, stress is a well-established risk factor for premature birth and low birth weight and might affect the health of the offspring. Thus, this study explores the perception of stress and worries in healthy Danish pregnant nulliparous women.METHODS: We used a qualitative, inductive, exploratory design. Three focus group interviews were conducted with 16 healthy pregnant nulliparous women. Data from the focus group interviews were analysed using content analysis according to Graneheim and Lundman.FINDINGS: Three main categories contributed to the core theme "Identity Limbo". The categories were: (1) The great responsibility, (2) Imagining picture-perfect, and (3) Two-in-one body. The participants expressed that holding on to their current identity was extremely important. They simultaneously tried to incorporate their new identity as mothers, which imposed sadness about saying goodbye to their old life, leaving them in an identity limbo. These women did not experience classic stressors such as bereavement, poverty, or trauma. Still, the great responsibility for the child's future, changes to their work and career, and saying goodbye to their pre-pregnancy identity were all essential contributors to feelings of stress in the women's current pregnancy and life.CONCLUSION: Our findings suggest that the identity limbo triggered by pregnancy can make the transition to motherhood stressful for some women. Therefore, with the potentially severe consequences of stress in mind, developing tools that can help women and midwives focus on the mental transition of pregnancy is needed.

COMPARATIVE MORPHOLOGICAL CHANGES IN SMOOTH MYOCYTES AND MACROFAGES CD16 IN PULMONARY ARTERY AND AORTA IN FETUSES AND NEWBORNS EXPOSED TO CHRONIC INTRAUTERINE HYPOXIASorokina I., Markovsky V., Kaluzhyna O., Pliten O., Hol’yeva N. Background. Oxygen deficiency, both acute and chronic, causes a variety of pathological changes in a number of organs and systems of fetuses and newborns. In particular, there are morphological changes in the vessels. Information in the available literature regarding the morphological state of smooth myocytes (SM) and cells expressing CD16 in the pulmonary artery (PA) and aorta of fetuses and newborns under such conditions of pregnancy is various and insufficient. Subjects and methods. The results of complex pathomorphological research of SM and macrophages CD16 of fetuses and newborns PA and aorta in chronic intrauterine hypoxia with the use of histological (staining with hematoxylin and eosin), immunohistochemical (MCA to Anti-Human Smooth Muscle Actin and MCA to CD16), morphometric, statistical methods are presented in the article. The investigation was performed on WAG line rats, observing all ethical norms and rules of handling of laboratory animals. The location of SM and macrophages CD16 in the wall of the PA and aorta in normal pregnancy and under oxygen deficiency, the density of their location in the field of vision (SM – ×1000, CD16 – ×600) was calculated. A comparative analysis of the morphological characteristics of the studied cells between mentioned vessels was also carried out. Results. The macroscopic examination of the wall of PA and aorta in the group of fetuses and newborns from mothers with physiological pregnancy with a magnifier (×3, 8 diopters) revealed that it was elastic, had a smooth ivorish intima. Smooth muscle cells in PA and aorta during immunohistochemical identification are determined in intima and media, as well as in the adventitial vessels of vessels. With hypoxic effect their number decreased in comparison with control group, and the number of macrophages – increased in both described vessels. Conclusions. The density of smooth myocytes (SM) location in the thickness of the wall of PA and aorta in the fetuses and newborns during the physiological course of pregnancy differs significantly from each other with dominance in the first vessel. Under the influence of experimental chronic intrauterine hypoxia in PA and aorta of fetuses and newborns a significant (p