جستجوی مقالات مرتبط با کلیدواژه "maternal outcome" در نشریات گروه "پزشکی"

This study aimed to compare pregnancy outcomes in pregnant women in the third trimester with and without anemia.

A case-control study was conducted, involving 144 pregnant women with anemia (case group) and 144 pregnant women without anemia (control group) receiving prenatal care in the third trimester between April 2021 and March 2022. Various maternal and neonatal clinical outcomes, such as response to iron intake, incidence of preeclampsia during delivery, rates of cesarean section, postpartum infections, small for gestational age (SGA) infants, Apgar scores at 1 and 5 minutes, and birth weight, were recorded and compared between the two groups.

Mean hemoglobin and hematocrit levels were significantly lower in women with anemia compared to those in the control group (p<0.001). The response rate to iron supplementation was 21.5% in anemic women and 97.2% in non-anemic women (p<0.001). SGA incidence in the case group was 7.6% (11 cases), while it was 2.1% (3 cases) in the control group (p=0.028). Although pre-eclampsia, cesarean section rates, and infant birth weights were lower in the case group compared to the control group, these differences were not statistically significant. No significant differences were observed in the rates of cesarean section, episiotomy site infections, Apgar scores at 1 and 5 minutes between the two groups.

The results of this study indicate a correlation between maternal anemia and adverse neonatal and maternal outcomes, with a significantly higher incidence of SGA among anemic women. Therefore, healthcare providers in preconception care settings should identify anemic women prior to pregnancy initiation and provide appropriate interventions through dietary adjustments and supplements to mitigate adverse pregnancy outcomes.

To investigate the association between intimate partner violence during pregnancy and maternal and neonatal outcomes.

This cross-sectional study was performed on 115 pregnant women referring to an academic center. Demographic data, maternal outcomes (vaginal bleeding during pregnancy, preterm delivery, intrauterine growth restriction, placental abruption, and premature rupture of membrane), and neonatal outcomes (birthweight and Apgar score) were evaluated. Domestic violence against pregnant women was ascertained by a validated domestic violence questionnaire. Finally, the association between domestic violence and maternal and/or neonatal outcomes was investigated.

The prevalence of domestic violence against pregnant women was 67.8%. Psychological violence obtained the highest prevalence (64.3%), followed by economic (34.8%), sexual (18.3%), and physical (12.2%) violence. Regression analysis showed that there was a significant association between domestic violence and preterm labor (P = 0.048, r = 0.385) and between economic violence and placental abruption (P = 0.040, r = 0.391). Also, there was a significant relationship between vaginal bleeding and sexual violence (P = 0.022). Educational level significantly and inversely correlated with economic (r = -0.21) and physical (r = -0.19) violence.

The results of this study indicated that intimate partner violence was commonplace during pregnancy and affected neonatal and maternal outcomes. It is suggested to implement educational programs for healthcare workers and screen all pregnant women for exposure to intimate partner violence to reduce maternal and neonatal complications.

Postpartum hemorrhage continues to be a major cause of maternal mortality and serious morbidity and the majority of cases occur in low and middle-income countries. Data related to postpartum hemorrhage are needed for strategic policy and program development to ensure the implementation of effective interventions for lowering the burden of PPH. Therefore, this study aimed to assess the magnitude and maternal outcome of primary postpartum hemorrhage.

Institutional-based cross-sectional study using retrospective chartreview design was conducted at Alemata General Hospital northern Ethiopia from 1st -5th January 2020. Data were collected using a pre-tested structured and standardized checklist from one-year records of the mothers and their neonate's charts, delivery registration logbooks, and operation registration logbooks.  A total of 185 delivery records were selected by systematic sampling method and reviewed. Texts, figures, and tables were used to summarize and present the overall result.

This study revealed that the magnitude of postpartum hemorrhage was 16 (8.6%), and the most common cause identified was uterine atony. Moreover, maternal vital sign derangement and anemia were the common complications secondary to postpartum hemorrhage.

The magnitude of primary postpartum hemorrhage in the study area was relatively high and it results in serious postpartum morbidities. Uterine atony was found to be the most common cause. To prevent postpartum hemorrhage and accompanying consequences, special attention should be paid to the universal use of active management of the third stage in all labors and early detection and management if a complication arises.

We assessed risk factors, antenatal and intrapartum complications associated with early-onset Gestational diabetes mellitus (GDM) in comparison with late-onset GDM.

This retrospective study included 161 GDM women having singleton pregnancies, without previous medical disorder and delivered at a tertiary care Hospital in Ha’il City, KSA from Dec 2020 till Jun 2021. Women diagnosed at < 24 weeks of pregnancy were grouped as early-onset GDM (n=71) and those diagnosed at ≥ 24 weeks as late-onset GDM (n=90). Both groups were matched for background variables. Chi-square and binary logistic regression analysis were applied with P-value significance at 0.05.

Past history of GDM, macrosomia and stillbirth were significant predictors for early-onset GDM (P value 0.000, 0.002 and 0.040 respectively). Regression analysis showed early-onset GDM significantly increases the risk for recurrent urinary tract infections (AOR 2.35), polyhydramnios (AOR 2.81), reduced fetal movements (AOR 2.13), intrauterine fetal demise (AOR 8.06), macrosomia (AOR 2.16), fetal birth trauma (2.58), low APGAR score at birth (AOR 8.06), and neonatal ICU admissions (AOR 2.65). Rate of preterm birth, hypertensive disorders, labor onset (natural vs. induced) and cesarean section and intrapartum maternal complications were same in both groups.

Early-onset GDM significantly increases certain maternal (recurrent urinary tract infections, polyhydramnios and reduced fetal movements) and fetal complications (intrauterine fetal demise, macrosomia fetal birth trauma, low APGAR score at birth and neonatal ICU admissions). Most of these adverse pregnancy outcomes can be prevented through early registration and screening, close follow up, growth ultrasounds, and provision of efficient emergency and neonatal care services.

Novel coronavirusease 2019 (Covid-19) started in China and caused unexplained pneumonia. The risk of adverse pregnancy outcomes increase in respiratory viral infection during pregnancy. This systematic review was performed to investigate the maternal and neonatal outcomes in pregnant women infected with Covid-19.

In this systematic review, the international databases (PubMed, Cochrane Library, Web of Science, Scopus, Embase, PsycINFO, Google scholar) as well as national databases (SID and Magiran) were searched to find out the articles published from 1 September 2020 to 30  April 2021 regarding maternal and neonatal outcomes in pregnant women infected with Covid-19. Keywords were selected based on Mesh (“Pregnancy”, “Gravidity”, “Delivery”, “Infant”, “Newborn”, “Neonate”, “Outcome”, “Complication”, “Abortion”, “Obstetric Labor, Premature”, “Cesarean Section”, “Fetal Death”, “Infant, Premature”, “Coronavirus Infection”, “COVIDK19”). The full texts of articles were reviewed by two independent reviewers and the relevant data was extracted.

20 studies including 78 pregnant women entered in this review. All women were at third trimester of pregnancy except 2 cases who were less than 28 weeks. The most prevalent clinical symptoms were fever, cough and sore throat. The most common maternal outcomes were intrauterine distress, rupture of membranes and preterm delivery. Most infants delivered by cesarean section. The most common neonatal complications were prematurity, small for gestational age, fetal distress, low birth weight and bacterial pneumonia.

In this systematic review, we found some evidence to suggest that COVID-19 pneumonia causes negative maternal and neonatal outcomes in pregnant women infected with Covid-19.

 Since the first reported respiratory distress syndrome due to the new version of the coronaviruses family, COVID-19, there is a concern about the possible maternal and perinatal outcome of new infection in a short and even long time, our information about the prognosis of pregnancy in sync with COVID-19 is limited. What is our task as scientists in eliminating the unknown facts?

 Here we try to present a couple of pregnant cases in their third trimesters of pregnancy that complicated with two contrary complication of COVID-19 infection, intending to illuminate the best management strategy in COVID-19 infected pregnant.

The first case had experienced thromboembolism, and also bleeding accident, who fortunately survived unlike the other case, who expired due to multi-organ failure and impossibility of anticoagulant agent administration for the suspected pulmonary thromboembolic accident.

 The prior report revealed the thrombo-inflammatory and hypoxic effect of COVID-19 that could lead to microvascular thrombosis and progression, which enforce health care providers, introducing the anticoagulant agents to decline COVID-19 mortality, especially in a critically ill patient. Pregnancy is associated with coagulation abnormality which could intensify the COVID-19-induced coagulopathy. But, one should balance the harm and benefit of such a hazard approach, is there any concern about vascular damage of COVID-19 and subsequent bleeding, that could be exacerbated with high dose anticoagulant agent administration? The other question that we want to discuss in the present report is about comparing the cost and benefit of anticoagulant therapy?

 Considering importance of developing maternal care, the present study was designed to compare the implications of a midwifery-led care (MLC) and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum.

 This clinical trial performed through quasi- experimental method on 200 pregnant women referred to health centers of Kashan, Iran, between 2014 and 2017. Participants were randomly assigned to MLC and standard model of care group (each 100). Data on maternal and neonatal outcomes were collected using self-structured questionnaires and checklists. The validity and reliability of tools were evaluated through content validity and also test-retest and observer reliability. The collected data were analyzed using SPSS version 21 by T test, chi-square and Mann-Whitney.

 The implementation of MLC resulted in improved outcomes including decrease in cesarean section, increase in spontaneous delivery, increase in physiological delivery, increased participation in preparatory classes for labor, decrease in induction, decrease in hospital stay, decrease in the number of prenatal visits, decrease in ultrasound, and increase in mean gestational age at admission (p <0.05). The results also pointed to increased lactation and decreased hospitalization due to jaundice (p < 0.05). There was no statistically significant difference in terms of anesthesia, narcotic use, postpartum hemorrhage, curettage, episiotomy, postpartum infection and postpartum depression. No maternal mortality was observed in two groups.

 Midwifery-led care can lead to improved maternal and neonatal outcomes at least in low-risk pregnant women. More chance of physiological delivery, spontaneous labor and less cesarean section, induction and augmentation were significant.

This study aimed to investigate the effect of assisted reproductive technology (ART) on both maternal and neonatal outcomes in monochorionic (MC) and dichorionic (DC) twin pregnancies.

This retrospective cohort study was conducted on women with twin pregnancies who delivered at Hafez and Hazrat Zeinab hospitals (affiliated to the Shiraz University of Medical Sciences) from March 2013 to May 2018.

In this study, 651 twin pregnancies (122 MC and 529 DC) were analyzed. Among MC twin pregnancies, the adverse maternal and neonatal outcomes were similar between the ART and the spontaneous pregnancies, except for lower 1-minute and 5-minute Apgar scores (5.3 vs. 7.2; P = 0.036 and 6.4 vs. 8.5; P = 0.039, respectively) and a higher fetal death rate in ART group (19% vs. 3.5%, P = 0.001). Among the DC twin pregnancies, the risks for pregnancy-related hypertensive disorders, gestational diabetes mellitus, emergency cesarean section and antenatal corticosteroid exposure significantly increased in the ART group (P < 0.001, P = 0.002, P = 0.014, and P = 0.001, respectively). Furthermore, DC twins showed significantly higher rates of deliveries before the 34 weeks of gestation (44.8% vs. 31.0%, P = 0.002), extremely low birth weight (11.9% vs. 4.0%, P < 0.001), intrauterine fetal growth restriction (29.3% vs. 13.5%, P < 0.001), lower 1-minute (P = 0.009 for fetus A and P = 0.003 for fetus B, respectively) and 5-minute (P < 0.001 for fetus A and P < 0.001 for fetus B, respectively) Apgar scores, perinatal mortality (14.4% vs. 6.9%, P < 0.001) and congenital anomaly (8.3% vs. 2.3%, P = 0.001) after ART treatment. These results were confirmed by multivariate analysis after adjusting for the baseline variables.

Despite the controversial perinatal outcomes in the literature, we found that ART is associated with an increased risk of perinatal morbidity and mortality, particularly in DC twin pregnancies. Therefore, ART twin pregnancies management requires closer surveillance and advanced facilities at tertiary care centers.