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Pertussis is a respiratory disease that can be fatal at all ages but especially in infants before their mandatory vaccination. Recent epidemiological data shows a decrease in the number of pertussis cases, but a resurgence cannot be excluded in the coming years due to the cyclic evolution of the disease and the loosening of hygiene measures. Two approaches are used to protect infants before their vaccination: vaccination of the mother during pregnancy and vaccination of all the infant's close relatives (cocooning). The vaccination of the mother during pregnancy is more effective. The uncertain risk of chorioamniotitis associated with vaccination during pregnancy is insufficient to question this strategy., (Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Objective: Our aim in this study was to identify the incidence of type 2 diabetes mellitus among First Nations women in northwest Ontario with a history of gestational diabetes mellitus (GDM)., Methods: This work was a retrospective cohort study of women diagnosed with GDM using a 50-gram oral glucose challenge test or a 75-gram oral glucose tolerance test from January 1, 2010, to December 31, 2017, at the Sioux Lookout Meno Ya Win Health Centre. Outcomes were assessed based on glycated hemoglobin (A1C) measurements performed between January 1, 2010, and December 31, 2019., Results: The cumulative incidence of T2DM among women with a history of GDM was 18% (42 of 237) at 2 years and 39% (76 of 194) at 6 years. Women with GDM who developed T2DM were of similar age and parity and had equivalent C-section rates (26%) compared to those who did not develop T2DM. They had higher birth weights (3,866 grams vs 3,600 grams, p=0.006) and rates of treatment with insulin (24% vs 5%, p<0.001) and metformin (16% vs 5%, p=0.005)., Conclusions: GDM confers a significant risk for the development of T2DM in First Nations women. Broad community-based resources, food security, and social programming are required., (Copyright © 2023 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Objectives: The article aims to describe tobacco and e-cigarette use among pregnant women: estimate the prevalence, identify the determinants and motivations of these behaviours., Methods: Cross-sectional, multicentre, descriptive observational study using self-administered questionnaires for pregnant women who visited ELENA healthcare centers in May 2021., Results: Of 223 patients, 38% were smokers before pregnancy and 16% continued to smoke during pregnancy. Nearly all the smokers (98%) declared that they had reduced or stopped their tobacco use, mostly without help. Young age, lack of professional activity, an unfavourable reaction to the announcement of the pregnancy, heavy smoking before the pregnancy and the presence of a smoker spouse were associated with smoking during pregnancy. Our study identified 10% of vapers before pregnancy and 7.2% during pregnancy. Of those who vaped during pregnancy, 81% were smokers before pregnancy. Most of them used a nicotine containing liquid and 38% of vapers combined smoking and e-cigarettes during pregnancy. There was no association between vaping during pregnancy and smoking cessation. A minority of women had received information about smoking during pregnancy., Conclusions: The use of electronic cigarettes by pregnant women is a poorly-known reality in France, yet it concerns approximately 7% of the women in our sample. Prospective studies on larger numbers are needed to assess the prevalence of vaping among French pregnant women and its evolution during pregnancy., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Introduction: Emotional regulation is a key factor that could determine the quality of becoming a parent. Since pregnancy is accompanied by changes in the emotional system, fluctuations in emotional regulation may also occur during this period. In 2020, the COVID-19 pandemic had major psychological repercussions on the general population which could have also affected emotional regulation capacities., Objective: The objective of this study was to determine whether emotional regulation has characteristics during pregnancy and to evaluate the influence of the COVID-19 pandemic on the emotional regulation of pregnant women., Method: One hundred fifty-one women aged between 19 and 42 years old participated in this study. Their emotional regulation abilities were assessed using the Difficulties Emotion Regulation Scale before and during the pandemic. A two-factor multivariate analysis of covariance, "parental status" (pregnant vs. childless) and "time of data collection" (before vs. during COVID-19), was conducted to compare the emotional regulation abilities of pregnant women with those of childless women before and during the pandemic., Results: (1) Prior to the pandemic, pregnant women exhibited better emotional regulation skills than childless women, characterized by greater acceptance and understanding of their emotions. (2) During the pandemic: (a) pregnant women's emotional regulation scores were comparable to those of women without children. (b) They also had more difficulty than pre-pandemic pregnant women in identifying their emotions., Conclusion: The lack of improvement in emotional regulation skills in pregnant women during the COVID-19 pandemic is a specific impact of COVID on this population. This could affect their mental health, as well as the emotional adjustment of the mother towards her baby., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

The infant mortality rate (children under five) in Palestine is 21 deaths per 1,000 live births. Palestine has thus successfully reached the threshold set by the Millennium Development Goals for child mortality. However, this rate is higher than in neighboring countries. This indicator is extremely important as it is a highly sensitive indirect measure of population health, poverty and socio-economic development status, as well as the availability and quality of health services in a country. These are all factors that still present challenges in Palestine., (Copyright © 2023. Publié par Elsevier Masson SAS.)

Uterine transplantation is now a possible treatment for absolute uterine infertility. It is currently proposed to women with Mayer-Rokitansky-Küster-Hauser syndrome but indications will likely to expand in the upcoming years. Despite the progressive standardization of the surgical technique and the reduction in perioperative morbidity for both donors and recipients, the number of transplants performed worldwide remains very low compared to the number of women potentially in need. This is partly due to the singularity of uterine transplantation: the uterus is not a vital organ since one can live without a uterus. It is a temporary transplantation that is not performed to extend life but to improve its quality, responding above all to a desire to conceive and bear a child. Beyond the strictly technical aspect, these particularities raise many ethical questions, both on an individual and social level, which should make us question the real place uterine transplantation should take in our society. Answering these questions will allow us to provide better guidance for future eligible couples and to anticipate ethical problems on the long run., (Copyright © 2023 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Perinatal psychopharmacology is an emerging specialty that is gradually developing alongside perinatal psychiatry. The management of psychiatric disorders during the perinatal period is a challenge for perinatal practitioners due to the multiple changes occurring during this crucial period. This little-known specialty still suffers from inappropriate considerations on the impact of psychotropic treatments on the mother and the infant during pregnancy and postpartum, which can promote a deficiency in perinatal psychic care. However, the risks associated with insufficient management of mental health are major, impacting both the mental and physical health of the mother and the infant. In this paper, we propose a perinatal psychopharmacology prescription guide based on available scientific evidence and international and national recommendations. We thus propose a decision-making process formalized on simple heuristics in order to help the clinician to prescribe psychotropic drugs during the perinatal period., (Copyright © 2022 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Résumé: Les personnes souffrant de maladie inflammatoire chronique de l'intestin (MICI) rapportent que leur santé sexuelle est souvent altérée et insuffisamment abordée lors des consultations médicales ; elles conçoivent moins d'enfants que la population générale. Cette revue vise à apporter au thérapeute une synthèse des outils et informations utiles concernant les dysfonctions de la sexualité et la fertilité des patients atteints de MICI. La dysfonction sexuelle est souvent associée à une altération de l'image corporelle et de la qualité de vie des patients ; ses mécanismes sont multiples. Des troubles anxio-dépressifs sont souvent intriqués. La fertilité est très voisine de celle de la population générale mais quelques cas particuliers doivent être connus des gastroentérologues. Une consultation pré-conceptionnelle apportant des informations simples au couple, répondant à ses questions et corrigeant éventuellement ses croyances erronées est d'une aide démontrée et le maintien de la rémission de la MICI (incluant l'utilisation des traitements médicamenteux) est un élément-clé. ..LAN-EN People with IBD report that their sexual health is often impaired and inadequately addressed during medical consultations; they conceive fewer children than the general population. This review aims to provide the therapist with a synthesis of useful tools and information regarding sexual dysfunction and fertility in IBD patients. Sexual dysfunction is often associated with impaired body image and quality of life for patients; its mechanisms are multiple. Anxio-depressive disorders are often entangled. Fertility is very close to that of the general population, but some special cases must be known to gastroenterologists. A pre-conception consultation providing simple information to the couple, answering their questions and possibly correcting their erroneous beliefs is of proven help and the maintenance of the remission of IBD (including the use of drug treatments) is a key element. [ABSTRACT FROM AUTHOR]

Résumé Introduction La grossesse est un évènement important dans la vie de la femme et du couple et pendant lesquels plusieurs changements peuvent être observés. Ces variations peuvent affecter plusieurs domaines notamment la sexualité. Objectif Relever l'impact de la grossesse sur la sexualité de la femme enceinte. Méthodes Nous avons préconisé une étude descriptive sur un échantillon de 100 femmes enceintes suivies en consultation externe de périnatalité. Nous avons utilisé un questionnaire semi-structuré pour explorer les données démographiques et les avis des femmes sur la sexualité. La version arabe validée du index de la fonction sexuelle féminine (FSFI) était utilisée pour évaluer la fonction sexuelle. Résultats L'âge moyen des femmes était de 29,4 ± 5,6 ans. Le score moyen du FSFI était de 23,1 ± 5,8. Soixante-dix pour cent des patientes présentaient une dysfonction sexuelle, cette dysfonction a concerné les trois trimestres de grossesse. Nous avons noté une altération de la sexualité durant la grossesse avec moins de rapports sexuels et de désir ainsi que de l'excitation. Les fausses idées et les mythes concernant le sujet de la sexualité avaient un rôle important dans cette altération. Des facteurs sociaux ainsi que les antécédents gynécologiques ont influencé aussi la fonction sexuelle. D'autres parts, l'entente conjugale et l'harmonie au sein du couple marquaient significativement la relation sexuelle en assurant plus de satisfaction chez les femmes enceintes. Conclusion Soixante-dix pour cent des femmes tunisiennes présentaient une dysfonction sexuelle. Plusieurs fausses idées ainsi que des facteurs sociaux, conjugaux, gynécologiques peuvent souvent influencer la vie sexuelle de la femme enceinte durant cette période délicate. Une meilleure connaissance des facteurs qui interfèrent durant cette période est nécessaire pour améliorer la prise en charge. Summary Introduction Pregnancy is an important stage in women's life. Different changes may occur during this period and can effect many fields especially sexuality. Objective The purpose of this research is to investigate the impact of pregnancy on the sexuality of the pregnant women. Methods A descriptive study was performed on 100 pregnant and healthy women. Demographic data and the concerns of women about sexuality were investigated by a questionnaire. The Female Sexual Function Index (FSFI) questionnaire was used to evaluate sexual dysfunction. Results The mean age of participant women was 29.4 ± 5.6 years. The mean total score of FSFI was 23.1 ± 5.8. Seventy percent of women were at risk of sexual dysfunction, which was noted in all of the three trimesters. An alteration of sexuality during pregnancy was observed with less sexual intercourses, less desire and less arousal. Wrong ideas and even myths were an important role in this alteration. Social factors and the gynecological history were significantly associated with sexual dysfunction and marital harmony was an important element related with sexual satisfaction. Conclusion The prevalence of sexual dysfunction was 70% in our study. Many factors like wrong ideas, social factors, marital harmony and the gynecological history were associated with the sexual dysfunction observed in Tunisian pregnant women. [ABSTRACT FROM AUTHOR]

Résumé Introduction Les prothèses cardiaques chez les femmes enceintes deviennent de plus en plus fréquentes en raison de la persistance du rhumatisme articulaire aigu dans les pays en voie de développement. Notre Objectif est de proposer des stratégies de prise en charge depuis la préconception jusqu’à la grossesse et le post-partum. Matériels et méthode Étude prospective observationnelle de 2009–2014 de parturientes suivies en cardiologie et à la maternité du CHU Oran. Résultats Trente patientes ont été suivies. L’âge moyen était de 30,06 années. La gestité extrême était à 6 gestes. La fraction d’éjection moyenne était égale à 60 % chez 29 cas, 1 seul cas de sténose de la prothèse de type aortique ; 16 ont reçu des HBPM type enoxaparine entre 6 et 12 semaines, 13 ont reçu l’acenoucoumarol (AVK). Une patiente avait eu de l’enoxaparine à dose insuffisante 1 fois/jour et qui a compliqué d’AVC ischémique. L’accouchement s’est effectué par césarienne chez 18 patientes. Sont observés 1 cas d’hypotrophie et un autre cas de prématurité, un avortement d’un fœtus. La mortalité maternelle était nulle. Discussion Les HBPM étaient efficaces à 100 % utilisées à doses suffisantes, la période de relais AVK et HBPM a été critique et elle devrait se faire en milieu hospitalier. Conclusion Le port de prothèse valvulaire est compatible avec la grossesse sous surveillance rigoureuse d’anticoagulant adéquat, les HBPM étaient efficaces à 100 % à condition d’être utilisées à doses suffisantes entre 6–12 semaines d’aménorrhée. Introduction The heart prosthesis pregnant women are becoming more frequent due to the persistence of rheumatic fever in the country sends developments. Objective To propose management strategies from preconception to pregnancy and postpartum. Materials and methods Prospective study from 2009–2014 about parturientes followed in cardiology and maternity on center Hospitalo University Oran. Results Thirty patients were followed, ejection fraction was equal to 60% in 29 cases. A single case of stenosis of the aortic prosthesis. Sixteen received low molecular weight heparins (LMWH) enoxaparine kind between 6 and 12 weeks, 13 received l’acenocoumarol (AVK) in the first quarter. One patient had been insufficient dose enoxaparine to 1/day and complicate ischemic stroke, abortion of a fetus of 16 weeks malformed in a mother who received acenoucoumarol (AVK) in the first quarter. Maternal mortality was null. Discussion LMWHs were 100% effective in sufficient doses, the VKA and LMWH relay period was critical and should be done in a hospital setting. Conclusion Wearing a prosthetic valve is compatible with supervised pregnancy LMWHs were 100% effective, provided they were used in sufficient doses between 6–12 weeks of amenorrhea. [ABSTRACT FROM AUTHOR]

Résumé Introduction La prise en charge des valvulopathies mitrales pendant la grossesse continue à poser un défi au médecin. Objectif Le but de cette étude était d’évaluer les conséquences du rétrécissement mitral sur la mère et le fœtus. Matériel et méthodes Quatre-vingt-trois patientes atteintes d’un rétrécissement mitral (RM) ont été suivies de manière prospective de 2009 à 2012 et évaluées par le stade de la NYHA, l’ECG et l’échocardiographie durant la grossesse et après la délivrance. Résultats Les patientes avaient une forte incidence de complications, l’aggravation du stade de la NYHA a été observée (44,57 %, p = 0,0001), l’insuffisance cardiaque congestive a été retrouvée (27,71 %, p = 0,0001), l’hospitalisation (33,73 %, p = 0,0001), le recours au traitement médical spécifique (53,75 %, p = 0,009), les troubles du rythme (16 %, p < 0,05). Le RM avait ainsi un retentissement sur le nouveau-né, on a eu un taux élevé de prématurité (17,50 %, p = 0,018) une hypotrophie (20,48 %, p = 0,001), le retard de croissance intra-utérine (12,04 %, p = 0,011) ; l’hospitalisation en unité de néonatologie (13,25 %, p = 0,03). Conclusion Le RM serré constitue un groupe à haut risque de complications, un suivi rigoureux doit être exercé pendant la grossesse avec une surveillance du fœtus, la correction de valvulopathie doit être effectuée avant la conception. Introduction The management of pregnancy in patients with mitral valve stenosis disease continues to pose a challenge to the clinician. Objective The aim of study was to evaluate the association between mitral valve stenosis and maternal and fetal out come. Materiel and method Eighty-three pregnant women with mitral valve disease, followed-up from 2009 to 2012, were prospectively evaluated medical history, NYHA class assessment, ECG and echocardiography were performed during pregnancy and after delivery. Results Women with mitral stenosis had significantly clinical higher incidence of complications deterioration of clinical status was observed (44.57%, P = 0.0001) congestive heart failure had observed (27.71%, P = 0.0001), hospitalization (33.73%, P = 0.0001), need of cardiac medications (53.75%, P = 0.009), arrhythmias (16%, P < 0.05), New born outcome, mitral stenosis had an effect on fetal outcome. We had increasing preterm, delivery (17.50%, P = 0.018), hypotrophy (20.48%, P = 0.001), intra-uterine growth retardation (12.04%, P = 0.011) new born hospitalizations (13.25%, P = 0.03) Increased maternal morbidity and unfavorable fetal outcome was seen mostly in patients with moderate and severe mitral stenosis. Conclusion Pregnant with critical mitral stenosis form a high-risk groups of life-threatening complications. There is need for close maternal follow-up and fetal surveillance and repair of mitral stenosis should be performed before pregnancy. [ABSTRACT FROM AUTHOR]

The occurrence of pregnancy in a patient with alport syndrome is rare because this renal disease can impact fertility. We report a case of alport syndrome associated with pregnancy in a parturient woman aged 28 years. Possible premature delivery associated with elevated blood pressure led to hospitalization for patient's mangement. We here report a literature review on the various maternal-foetal complications of alport syndrome and we focus on the management of alport syndrome during pregnancy. [ABSTRACT FROM AUTHOR]

Von Willebrand factor (vWF) is a glycoprotein which plays an important role in hemostasis. Its quantitative or qualitative deficit results in von Willebrand's disease (vWD). The study aims to update the current understanding of the distribution of vWF rates in Moroccan pregnant women and their variability in function of the ABO blood group. We conducted a cross-sectional study of 390 pregnant women from the Rabat-Salé-Kenitra region. Sample size was calculated on the basis of a prevalence of 1%, corresponding to the global prevalence of vWD with a margin of error of 5% and a confidence level of 95%. There were 317 cases (81.28%) of elevated vWF levels (> 160%) out 390 pregnant women. The levels of factor VIII (FVIII) varied in parallel in a significant way (p < 0.001) with the levels of vWF (Pearson's r 0,597). The distribution of the ABO blood groups has had an influence on the level of vWF with a significant difference (p < 0.001) between the four groups: the lowest average level in the group O (188,54±57,02), followed by group A (203,19±54,46), then group AB (219±38,95) and finally group B (221,15±48,63). Our results confirm on the one hand an elevation of the levels of vWF during pregnancy and on the other hand the influence of ABO blood group on the levels of vWF. [ABSTRACT FROM AUTHOR]

Acute pancreatitis (AP) is one of the more common gastrointestinal conditions requiring acute hospitalization and has a rising incidence. Gallstones and alcohol misuse are the main risk factors for acute pancreatitis, but it is also necessary to look for a tumoral obstructive origin. The evaluation of its gravity is essential and depends on clinical, biological and morphological parameters (CTscan at best 72-96 hours after the beginning of the pain). The classification of moderately severe pancreatitis and severe pancreatitis are defined by the presence of complications that are systemic, local, or both. The main complication of necrotizing AP is secondary infection of pancreatic or peripancreatic necrotic tissue (untreated here, because being the object of The interview of the Experts). The fluid resuscitation and the oral-enteral refeeding are main therapeutic issues, associated with a preventive anticoagulation and pain management. Prophylaxis with antibiotic therapy is not recommended. In case of biliary origin, the cholecystectomy must be proposed as soon as possible. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfances, Familles, Generations is the property of Enfances, Familles, Generations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Obésité is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the relationship between prenatal geophagy, maternal prenatal haematological indices, malaria, helminth infections and cognitive and motor development among offspring.Methods: At least a year after delivery, 552 of 863 HIV-negative mothers with singleton births who completed a clinical trial comparing the efficacy of sulfadoxine-pyrimethamine and mefloquine during pregnancy in Allada, Benin, responded to a nutrition questionnaire including their geophagous habits during pregnancy. During the clinical trial, helminth infection, malaria, haemoglobin and ferritin concentrations were assessed at 1st and 2nd antenatal care visits (ANV) and at delivery. After the first ANV, women were administered daily iron and folic acid supplements until three what? post-delivery. Singleton children were assessed for cognitive function at age 1 year using the Mullen Scales of Early Learning.Results: The prevalence of geophagy during pregnancy was 31.9%. Pregnant women reporting geophagy were more likely to be anaemic (AOR = 1.9, 95% CI [1.1, 3.4]) at their first ANV if they reported geophagy at the first trimester. Overall, prenatal geophagy was not associated with maternal haematological indices, malaria or helminth infections, but geophagy during the third trimester and throughout pregnancy was associated with poor motor function (AOR = -3.8, 95% CI [-6.9, -0.6]) and increased odds of geophagous behaviour in early childhood, respectively.Conclusions: Prenatal geophagy is not associated with haematological indices in the presence of micronutrient supplementation. However, it may be associated with poor child motor function and infant geophagy. Geophagy should be screened early in pregnancy. [ABSTRACT FROM AUTHOR]

Thyroid signalling pathways are mandatory for a harmonious fetal brain development. Thus, it is not surprising that inadequate iodine intake and exposure to thyroid disrupters (environment compounds able to disturb the feto-maternal thyroid economy at all levels) may result in developmental cerebral anomalies. If the deleterious impact of iodine deficiency has long been known, the neurodevelopmental risks linked to thyroid disrupters are an emerging concern. Vulnerability of the developing brain during gestation and the first two years of life is due to the rapid growth and differentiation of this organ, following a precisely timed chronology. Thus are defined windows of exposure with specific, mostly irreversible defects depending on timing of exposure and type of compound. Toxicology of Endocrine Disruptors differentiates itself from classical toxicology with very low dose effects and possibly non monotonic dose-effect responses. Exposure via the placenta and nursing reflects maternal exposure, while after birth, infant's direct exposure is added. Laboratory experimental proofs, as well as human epidemiological studies in the cognitive and behavioral fields (autistic syndromes, Attention Deficit Hyperactivity Disorders) are adding up and should lead to preventive decisions targeting women of reproductive age and pregnant women, to protect the brains of future generations. [ABSTRACT FROM AUTHOR]

Copyright of Clio. Femmes, Genre, Histoire is the property of Belin Editeur and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Arterial hypertension is one of the most common conditions that occur during pregnancy in women. It is considered as topical issue whose epidemiological importance is growing. These disorders are a major global health problem. The purpose of this study is to determine the prevalence and to identify risk factors for high blood pressure in pregnancy in our environment. Patients and methods: This is a single-center study conducted at the Hopital Provincial du Nord Kivu in Goma town, from January the 1st, 2008 to December the 31st, 2013. This is a casecontrol study, comparing the outcome Hypertensive women of all types, to a control group of non-hypertensive births recruited by random draw after each delivery in the service, according to the report a witness for one case. Results: For this study, the prevalence of high blood pressure during pregnancy was 1.8%. The risk factors identified (OR, 95% CI) were: lower extremity edema's presence (9.31 [3.57-24.26]), personal history of hypertension (6.35 [1.4 - 28.78]), obesity (4.18 [2.6-6.72]), nulliparity (2.52 [1.58 - 4.03]), primigestity (2.44 [1.49 - 3.99]), large multiparity (2.26 [1.13 - 4.53]), age greater than or equal to 36 years (2.21 [1.17-4.19]) and poor follow-up of antenatal visits (1.62 [1.07-2.44]). Conclusion: The prevalence of high blood pressure during pregnancy seems low in our environment, but the identification of risk factors remains important to prevent its complications. These risk factors were dominated by primigestity and nulliparity. The poor quality of the antenatal visits is also a risk factor because it doesn't allow specific monitoring of pregnant women exposed to this disease, including those with a history of hypertension and obesity. [ABSTRACT FROM AUTHOR]

Le vasa prævia est une complication rare de la grossesse (1/2 000–1/6 000), la dilacération des vaisseaux dans l'aire cervicale de dilatation peut mener à une complication hémorragique grave d'origine fœtale, l'hémorragie de Benckiser provoquant entre 75 et 100 % de mortalité. Le dépistage se réalise en cas de présence de facteurs de risques qui sont les anomalies du placenta (placenta prævia du deuxième trimestre, placenta bipartita, un ou plusieurs cotylédons aberrants), l'insertion vélamenteuse du cordon, les grossesses multiples, la fécondation in vitro. Nous proposons les modalités de dépistage et exposons la prise en charge des patientes lors de la découverte de cette complication. [ABSTRACT FROM AUTHOR]

The diagnosis of splenic infarction is rarely reported in pregnant women. Current incidence of splenic infarction, especially during infectious endocardites as well as diagnostic methods used are poorly specified in the literature. We here report the case of a 26-year old woman with no particular previous history or cardiovascular risk factor who, at the end 14 weeks of amenorrhea, presented to the Emergency Department with febrile syndrome evolving over 10 days and abdominal pain of recent onset at the level of the left hypochondre. Clinical examination showed febrile patient with a temperature of 39.5°C, tenderness of the left hypochondre and panaritium at the level of the palm of the left hand and of the sole of the foot. Gynecological examination was strictly normal. Given this clinical picture, abdominal ultrasound showed mediosplenic anechoic area with hilar apex and with peripheral edges, suggesting splenic infarct. Etiological assessment included echocardiography showing thickened and remodeled oslerian graft on the mitral valve with large valve vegetation and MI grade II. Blood cultures were performed during the febrile peaks and were positive for golden staph. Patient's evolution was marked by the occurrence of large ischemic stroke and worsening of neurological condition, leading to death after several systemic emboli. Splenic infarction in a pregnant woman is very rare. However, clinical and radiological examination of the spleen must be performed in patients with acute abdominal pain of the left hypochondre. In the present case, pain of the left hypochondre associated with fever and Osler's false whitlow was found to be splenic infarction associated with infectious endocarditis. Probabilistic antibiotic therapy as first-line therapy is justified during infective endocarditis and should be secondarily adapted to the bacteriological results. Although rare, splenic infarction can have severe consequences such as abscesses or rupture, which must encourage vigilance. [ABSTRACT FROM AUTHOR]

Malignant Hodgkin's lymphoma or (Hodgkin's disease) accounts for only 10% of all lymphomas but it is one of the most commonly diagnosed subtypes of lymphoma during pregnancy. This is due, in large part, to the maximum of disease incidence which coincides with reproductive age. The management of a pregnant patient with Hodgkin's disease requires multidisciplinary approach as well as effective communication with the patient and her family. The aim is to optimize mother's chances of being cured while ensuring the delivery of a healthy baby. We here report the rare case of a pregnant patient with Hodgkin's disease at 17 weeks of amenorrhea. [ABSTRACT FROM AUTHOR]

Pregnancy in patients with portal hypertension is considered as an at-risk pregnancy that required a multidisciplinary management including obstetricians, hepato-gastroenterologists, pediatricians and anesthesiologists. Portal hypertension is associated with an increased risk of miscarriage, stillbirth and preterm birth. Moreover, there is an increase of the portal pressure during pregnancy with a risk of variceal bleeding especially during the second trimester where the blood volume of the mother rises. In patients with portal hypertension, prenatal counseling is required with an adequate screening of portal hypertension before pregnancy. Prophylaxis of variceal bleeding is recommended in front of medium and large varices in order to improve the prognosis of the mother and the foetus. Upper endoscopy is required before pregnancy or at diagnosis of liver disease if the diagnosis is performed during pregnancy. Adequate prophylaxis of variceal bleeding should be performed by non-selective Beta-blockers or band ligation in front of medium or large varices. Occurrence of variceal bleeding is a severe complication that required a prompt introduction of vasoactive treatment, antibiotics and an upper endoscopy in order to perform band ligation. Vaginal delivery is not contra-indicated and not associated with an increased risk of variceal bleeding. Caesarean delivery is associated with hemorrhage and infectious complications. It should not be systematically performed and only restricted to obstetrical indications. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate blood glucose changes, as measured by a continuous glucose monitoring system, that occur in women with gestational diabetes mellitus (GDM) following an acute bout of moderate-intensity walking after consuming a high-carbohydrate/low-fat meal. This study found that moderate-intensity walking induced greater postprandial glucose control compared with sedentary activity and it appears that moderate-intensity activity may be used to reduce postprandial glucose levels in women with GDM. [ABSTRACT FROM AUTHOR]

Copyright of Revue Economique is the property of Fondation Nationale des Sciences Politiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Venous thromboembolism is a rare but striking complication of pregnancy and puerperium. Risk factors, which differ for pregnancy-related and puerperium-related VTE, are well described. No specific diagnostic algorithm has been currently validated. Treatment is based on weight-adjusted LMWHs, without any available pivotal study. The translation from identified risk factors to thromboprophylaxis regimens is uneasy, not evidence-based, mainly refers to multiple experts' opinion-based guidelines which content can show some discrepancies. No thorough cost-effectiveness analysis is available. A huge evidence-based development has yet to be undertaken. [ABSTRACT FROM AUTHOR]

Résumé Pour devenir un espace de prévention médico-psycho-sociale interdiciplinaire, l’échographie obstétricale (EO) invite au dépassement du clivage entre spécialistes du soma et de la psyché à la maternité. Dans sa pratique coutumière, le cadre échographique joue désormais un rôle essentiel dans l’évolution des processus de maternalité et de paternalité confrontés à l’inquiétante étrangeté du fœtus et à l’incertitude de son devenir humain. Une préparation à la naissance et à la parentalité bien tempérée s’accompagnera d’un espace groupal de réflexivité sur le diagnostic anténatal animé par des professionnels eux-mêmes sensibilisés à ses enjeux cliniques, psychologiques et éthiques. Objective To become a interdisciplinary medico-psycho-social prevention area, obstetric ultrasound invites to overcome the cleavage between specialists of the soma and the psyche at the Maternity Hospital. This contribution is evidence of action research aimed at this goal in a maternity award. Results In its customary practice, the ultrasound frame now plays a vital role in the evolution of maternal and paternal processes, confronted with the disturbing strangeness of the fetus and the uncertainty of its human future. Like a projective test, ultrasound examination induces a parental psychic outpouring by amplifying the conflicts inherent to the prenatal parenting process. At this meeting, parents and professionals are in close intersubjective reciprocity. The threat or confirmation of a fetal anomaly that may lead to a possible IMG (often recklessly denied), gives a potentially tragic tone to this ultrasound approach to antenatal diagnosis. Conclusions The sonographer is a mediator/translator. In this position, he can promote the structuring potential of this examination but, equally, stigmatize the disorganizing valence. In this context, professionals will benefit from a Balint-type group. The formalization of the negotiation between caregivers and parents of a mutually informed consent of this examination and its consequences occupies a crucial place in its ethical and clinical legitimacy. A group of parents led by sonographers will provide a space for reflexivity on antenatal diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The percentage of women who are obese at the time of conception or during pregnancy is increasing, with animal and human studies demonstrating that offspring born to obese dams or mothers are at increased risk for obesity and the metabolic syndrome. Our goal was to confirm in an experimental model of metabolic syndrome in the dam, whether the offspring would be at increased risk of obesity. Conversely, we observed that male offspring born to dams with metabolic syndrome had no alterations in their body mass profiles, whereas female offspring born to dams with metabolic syndrome were heavier at weaning, but exhibited no perturbations in energy metabolism. Moreover, they gained weight at a reduced rate versus female offspring born to healthy dams, and thus weighed less at study completion. Hence, our findings suggest that factors other than increased adiposity and insulin resistance during pregnancy are responsible for the increased risk of obesity in children born to obese mothers. [ABSTRACT FROM AUTHOR]

Objectives: Pregnancy and post-partum viral load suppression is critical to prevent mother-to-child HIV transmission and ensure maternal health. We measured viraemia risk before, during and after pregnancy in HIV-infected women.Methods: Between 2010 and 2015, 1425 HIV-infected pregnant women on lifelong antiretroviral therapy (ART) for at least six months pre-pregnancy were enrolled in a cohort study in rural KwaZulu-Natal, South Africa. Odds ratios were estimated in multilevel logistic regression, with pregnancy period time-varying.Results: Over half of 1425 women received tenofovir-based regimens (n = 791). Median pre-pregnancy ART duration was 2.1 years. Of 988 women (69.3%) with pre-pregnancy viral loads, 82.0%, 6.8% and 11.2% had VL <50, 50-999 and ≥1000 copies/ml, respectively. During pregnancy and at six, 12 and 24 months, viral load was ≥1000 copies/ml in 15.2%, 15.7%, 17.8% and 16.6% respectively; viral load <50 was 76.9%, 77%, 75.5% and 75.8%, respectively. Adjusting for age, clinical and pregnancy factors, viraemia risk (viral load ≥50 copies/ml) was not significantly associated with pregnancy [adjusted OR (aOR) 1.31; 95% CI 0.90-1.92], six months (aOR 1.30; 95% CI 0.83-2.04), 12 months (aOR 0.96; 95% CI 0.58-1.58) and 24 months (aOR 1.40; 95% CI 0.89-2.22) post-partum. Adjusting for ART duration-pregnancy period interaction, viraemia risk was 1.8 during pregnancy and twofold higher post-partum.Conclusions: While undetectable viral load before pregnancy through post-partum was common, the UNAIDS goal to suppress viraemia in 90% of women was not met. Women on preconception ART remain vulnerable to viraemia; additional support is required to prevent mother-to-child HIV transmission and maintain maternal health. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the frequency, the causes and analyze the management of gastrointestinal surgical emergency in pregnancy in the department of general surgery in the teaching hospital of Kara (Togo). It was a retrospective study carried out from 1st January 2013 to 31st December 2017 in the departement of general surgery in the teaching hospital of Kara (Togo). Seven pregnant woman presented with visceral surgical emergency. The mean age was 25 years. The average consultation time was 48 hours. Abdominal pain, nausea and/or vomiting and inability to pass stool were the main presentation symtoms. The main causes were strangulated hernia (42,9%) followed by peritonitis (29,6%) hernia cure (42,9%),washing and drainage (42,9%) and appendicectomy (14,3%) were performed.The outcome was good except from a premature delivery in one case. The visceral surgical emergency is rare in pregnancy. The diagnosis is often late, because of anatomical and physiological changes, which can put into play vital prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Women's dietary habits are very important due to the specific nutritional requirements for reproduction. This study aimed to describe women's dietary habits during pregnancy and breastfeeding and to identify factors influencing these habits. Methods: We conducted a qualitative study of pregnant and breastfeeding women living in Amoron'i Mania region, Madagascar. Eight focus groups (6-10 women per group) and 23 individual interviews were carried out to collect data. Thematic analysis was used and focused on the description of women's dietary habits on the basis of dietary behaviours as well as of sociocultural and economic determinants of the described habits. Results: During pregnancy and breastfeeding, women's dietary habits did not vary considerably except at the very beginning of breastfeeding. They had a little diversified and monotonous diet, poor in fruit and vegetables and poor in proteins. At the very beginning of breastfeeding, during the practice of "mifana" tradition, women had a diet more rich than usual. These dietary habits were influenced by the type of agricultural products in the region and by their availability during the year (self-consumption)as well as by purchasing power (in case of shortage) and tradition. Conclusion: Mothers' dietary habits appear to be inadequate. This study highlights the importance of improving knowledge of the determinants of mothers' dietary behaviours. [ABSTRACT FROM AUTHOR]

Copyright of Revue Universitaire des Sciences Humaines et Sociales is the property of University of Kasdi Merbah Ouargla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé L’implantation en urgence d’une ECMO veino-artérielle au lit du patient sous anesthésie locale peut être le seul geste salvateur devant une défaillance hémodynamique aiguë faisant suspecter le diagnostic d’embolie pulmonaire massive avant même de pouvoir pratiquer l’angioscanner diagnostique. L’embolie pulmonaire massive confirmée, il est possible d’entreprendre la thrombectomie percutanée ou chirurgicale en cas de contre-indication à la fibrinolyse. Emergency bedside veno-arterious ECMO implantation can be the only saving gesture in the suspicion of acute massive pulmonary embolism leading to haemodynamic failure, even before CT-scan imaging. Once the massive pulmonary embolism is confirmed it is possible to undergo surgical or percutaneous pulmonary thrombectomy, when thrombolytic therapy is contraindicated. [ABSTRACT FROM AUTHOR]

The anatomical localization of a myomatous nucleus is a determining factor in the occurrence of uterine fibromyomatous gravidal complications. These complications are mainly attributed to submucosal nuclei which lead to mechanical and vascular endometrial alterations and induce alterations of the stroma as atrophy or ulceration which reduces the chances of placental development. However, regular clinical and ultrasound monitoring, and management by a team that can cope with the various complications, is likely to promote up-toterm progress. The authors report a case of precious pregnancy coexisting with intracavitary myomatous nuclei up to term. They recall the possible complications of uterine leiomyomas on pregnancy and their mechanism of occurrence. [ABSTRACT FROM AUTHOR]

At the end of the XXth century, the medicalisation of pregnancy and childbirth raised the question of the place of the father from the point of view of perinatal care professionals. A GIP colloquium in Brussels highlighted the issues and the sources of this concern. The experience of the man, previously "neither a patient or a visitor", of being recognised by professionals in his role as the mother's "teammate" and partner in important decisions, validates his comforting function and predetermines the role he will play in the development pathway of his child. [ABSTRACT FROM AUTHOR]

Résumé L’aspirine (acide acétylsalicylique) est utilisée depuis l’Antiquité pour ses effets antipyrétiques et antalgiques. Ses propriétés antiagrégantes ont ensuite étendu ses indications à la pathologie vasculaire cérébrale, coronarienne, et finalement à la pathologie vasculaire placentaire. Elle est depuis les années 1980 largement utilisée en prévention de la pré-éclampsie, du retard de croissance intra-utérin, ou encore de la mort fœtale in utero. L’aspirine a également été proposée aux patientes présentant des fausses couches à répétition inexpliquées. Durant la grossesse, sa sécurité d’utilisation a été démontrée pour des doses faibles, de l’ordre de 100 mg par jour. L’efficacité de l’aspirine en prévention de la pré-éclampsie et du retard de croissance intra-utérin d’origine vasculaire a été démontrée chez les patientes à haut risque, il n’existe en revanche pas de bénéfice prouvé à prescrire de l’aspirine chez les patientes à faible risque de maladie vasculaire placentaire, ni en présence de fausses couches à répétition. Aspirin (acetylsalicylic acid) has been used ever since the Antiquity for its painkilling and anti-inflammatory effects. Its antiplatelet properties have then extended its indications to the field of coronaropathy and vascular cerebral disease, and finally to vascular placental disease. Aspirin has been widely prescribed since the 1980's to prevent pre-eclampsia, intra-uterine growth retardation and fetal death of vascular origin. It has also been proposed to prevent unexplained recurrent miscarriages. Its use during pregnancy is considered as safe, provided the daily doses do not exceed 100 mg. Aspirin has been proven efficient to prevent pre-eclampsia and fetal growth restriction in high-risk patients. The benefits of prescribing aspirin have been demonstrated neither for vascular placental disease prevention in low risk patients, nor in cases of unexplained recurrent miscarriages. [ABSTRACT FROM AUTHOR]

In the case of venous thromboembolic disease (VTE), physicians are more and more facing the difficulties of managing VTE and their treatment in frail patients. These patients could present several at risk situation such as: chronic kidney disease (CKD), underweight or malnourished, falls, cognitive impairment, multi-medicated patients, cancer and pregnancy. Guidelines typically recommend anticoagulation. There are multiple challenges in the safe use of anticoagulation in frail patients, including bleeding risk, monitoring and adherence, and polypharmacy. The objective of this review is to explore these at-risk situations and to suggest adequate anticoagulation therapy, when possible, in each of these complex situations. [ABSTRACT FROM AUTHOR]

Background: In South Africa, pregnant women are diagnosed with human immunodeficiency virus (HIV) at antenatal clinics and simultaneously initiated on antiretroviral treatment (ART). An HIV diagnosis together with the initiation of ART has an emotional impact that may influence how pregnant women cope with pregnancy and their adherence to a treatment plan. The aim of the study was to explore the lived experiences of women diagnosed with HIV in the antenatal period in a rural area in the Eastern Cape province of South Africa. Methods: A qualitative approach with a descriptive phenomenological design was utilised. The study applied purposive sampling to select participants from a local community clinic in the Eastern Cape. Ten semistructured interviews were conducted, transcribed and analysed using Colaizzi's framework. Results: Four themes formed the essential structure of the phenomenon being investigated: a reality that hits raw, a loneliness that hurts, hope for a fractured tomorrow and support of a few. Although the participants had to accept the harsh reality of being diagnosed with HIV and experienced loneliness and the support of only a few people, they had hope to live and see the future of their children. Conclusion: Women diagnosed with HIV during pregnancy are ultimately concerned with the well-being of their unborn children, and this concern motivates their adherence to ART. Women's lived experiences are situated in their unique sociocultural context, and although some known challenges remain, counselling and support strategies need to be informed by exploring context-specific issues and involving the local community. [ABSTRACT FROM AUTHOR]