Relevant bibliographies by topics / Antenatal

Academic literature on the topic 'Antenatal'

Author: Grafiati
Published: 4 June 2021
Last updated: 26 August 2024

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Journal articles on the topic "Antenatal"

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Ernst, Sinja Alexandra, Tilman Brand, Anna Reeske, Jacob Spallek, Knud Petersen, and Hajo Zeeb. "Care-Related and Maternal Risk Factors Associated with the Antenatal Nondetection of Intrauterine Growth Restriction: A Case-Control Study from Bremen, Germany." BioMed Research International 2017 (2017): 1–10. http://dx.doi.org/10.1155/2017/1746146.

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Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR.Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases) to detected IUGR neonates (controls). Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni- and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors.Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally inn=77pregnancies while inn=84it was not detected antenatally (antenatal detection rate: 47.8%). Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background.Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR.
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Henderson, Jane, Tracy Roberts, Jim Sikorski, Jennifer Wilson, and Sarah Clement. "An Economic Evaluation Comparing Two Schedules of Antenatal Visits." Journal of Health Services Research & Policy 5, no. 2 (April 2000): 69–75. http://dx.doi.org/10.1177/135581960000500203.

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Objectives: To conduct an economic evaluation comparing a traditional antenatal visiting schedule (traditional care) with a reduced schedule of visits (new style care) for women at low risk of complications. Methods: Economic evaluation using the results of a randomised controlled trial, the Antenatal Care Project. This took place between 1993 and 1994 in antenatal clinics in South East London and involved 2794 women at low risk of complications. Results: The estimated baseline costs to the UK National Health Service (NHS) for the traditional schedule were £544 per woman, of which £251 occurred antenatally, with a range of £327–1203 per woman. The estimated baseline costs to the NHS for the reduced visit schedule was £563 per woman, of which £225 occurred antenatally, with a range of £274–1741 per woman. Savings from new style care that arose antenatally were offset by the greater numbers of babies in this group who required special or intensive care. Sensitivity analyses based on possible variations in unit costs and resource use and modelled postnatal stay showed considerable variation and substantial overlap in costs. Conclusions: Patterns of antenatal care involving fewer routine visits for women at low risk of complications are unlikely to result in savings to the Health Service. In addition, women who had the reduced schedule of care reported greater dissatisfaction with their care and poorer psychosocial outcomes which argues against reducing numbers of antenatal visits.
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Springer, Drahomira, Jaroslav Loucky, Pavel Tesner, David Cutka, David Stejskal, Vladimir Gregor, and Tomas Zima. "Importance of the integrated test in the Down’s syndrome screening algorithm." Journal of Medical Screening 25, no. 3 (March 25, 2018): 114–18. http://dx.doi.org/10.1177/0969141317752533.

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Objective In the Czech Republic, over 97% of all pregnant women undergo some type of antenatal screening for Down’s syndrome. In about 95% of cases with a confirmed fetal chromosomal abnormality, the pregnancy is terminated. The most commonly used test is the first trimester combined test. We investigated the impact of implementing an integrated sequential test to improve the detection of Down’s syndrome pregnancies. Methods Data on the incidence of congenital defects, number of births, and affected pregnancies terminated are recorded in the National Registry of Congenital Anomalies. Anonymous data on cases of Down’s syndrome diagnosed antenatally or postnatally between 2010 and 2015 in one of the large antenatal care centers were analyzed. Results There were 600 diagnoses of Down’s syndrome (5.7 per 1000 births), 90% of which were made antenatally. Of antenatally detected cases, 80% were indicated for diagnostic procedure by multimarker screening results. In the multimarker screen positive group, 75% cases were first trimester positive and 25% second trimester positive (most of these had positive integrated test results). Among Down’s syndrome cases indicated for antenatal diagnosis by multimarker screening results 6.25% (n = 26) were first trimester negative, and became positive after integration with the second trimester screening results. Conclusions Results from five major Czech antenatal centers confirm that an integrated sequential test would detect 80–85% of Down’s syndrome fetuses in the first trimester and at least an extra 5–10% of Down’s syndrome pregnancies in the second trimester of pregnancy. These are important data that should be considered in implementing the national antenatal screening program.
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Dharmik, Ashish, and Jaikrishan Mittal. "Antenatal Diagnosis and Genetic Counseling." Journal of Neonatology 21, no. 4 (December 2007): 221–25. http://dx.doi.org/10.1177/097321790702100404.

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Antenatal diagnosis plays a major role in management of surgical problems of the fetus. Diagnostic testing in the antenatal period offers parents the option of avoiding the physical suffering and emotional trauma that may occur during the birth of a child with a severe, debilitating illness. Along with diagnosis, a good antenatal counseling reduces parents' stress and assists them to prepare for the hardship of a complicated pregnancy. Various medical and surgical anomalies involving wide range organ systems can be diagnosed antenatally. Antenatally diagnosed congenital surgical anomalies are usually first brought to the notice of the obstetrician who decides the fate of the fetus. Eighty percent of these fetuses are terminated at the level of the obstetrician. These include anencephaly, neural tube defects, polycystic kidneys, gastroschisis and omphalocele where the decision is unequivocal. On the contrary these also include few cases of minor anomalies like unilateral multicystic kidney, unilateral hydronephrosis and cleft lip where the decision of a pediatric surgeon would be to continue the pregnancy. There seems to be a huge scope for fetal therapy and this seems to be particularly possible in certain surgical conditions which are easily accessible with risk of fetal mortality being less (eg. abdominal wall defects). Antenatal diagnosis of various surgical conditions like abdominal wall defects and diaphragmatic abnormalities (eg. Congenital diaphragmatic hernia - CDH) allows early planning of management by a group of specialists including obstetricians, neonatologists, pediatric surgeons, and geneticists. This article discusses various aspects of antenatal diagnosis and counseling, focusing on the surgical aspects along with current status of fetal therapy for various surgical conditions.
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Retnowati, Frida Dwi. "ANALISIS FAKTOR YANG MEMPENGARUHI SIKAP IBU HAMIL DALAM MELAKUKAN KUNJUNGAN ANTENATAL CARE." Pengembangan Ilmu dan Praktik Kesehatan 3, no. 1 (February 15, 2024): 16–28. http://dx.doi.org/10.56586/pipk.v3i1.338.

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Kehamilan merupakan kondisi yang rawan bagi setiap perempuan. Hal ini dikarenakan selama masa kehamilan, ibu hamil mengalami beragam perubahan baik psikologis maupun fisiologis. Kehamilan yang terjadi beresiko untuk mengalami beragam gangguan. Salah satu upaya untuk menurunkan resiko akibat kehamilan yang terjadi adalah dengan melakukan kunjungan antenal care. Namun untuk memastikan ibu hamil melakukan kunjungan antenatal care, dibutuhkan adanya sikap yang positif dari ibu hamil terkait dengan antenatal care itu sendiri. Desain penelitian yang digunakan adalah analitik dengan pendekatan crosssectional. Sampel dalam penelitian ini sebanyak 37 ibu hamil di Desa Masangan Kabupaten Pasuruan. Variabel dalam penelitian ini adalah sikap ibu hamil terhadap antenatal care, usia ibu hamil, pendidikan ibu hamil dan pekerjaan ibu hamil. Uji analisa dilakukan menggunakan uji regresi linear. Dari hasil penelitian didapatkan sebagian besar ibu hamil memiliki sikap negatif terkait kunjungan antenatal care. Dari hasi uji regresi didapatkan untuk faktor usia ibu hamil berpengaruh secara signifikan terhadap sikap antenatal care (p value : 0,004), sedangkan untuk faktor pendidikan (p value : 0,075) dan faktor pekerjaan (0,578) tidak berpengaruh secara signifikan terhadap sikap antenatal care. Antenatal care merupakan salah satu kebutuhan penting yang harus terpenuhi pada ibu hamil. Hal ini dikarenakan melalui antenatal care, perkembangan kehamilan yang terjadi dapat dipantau dan jika didapatkan adanya gangguan kehamilan dapat secara langsung untuk ditangani oleh tenaga kesehatan. Dibutuhkan kerjasama yang baik dari semua pihak untuk memastikan ibu hamil memiliki sikap positif terkait dengan antenatal care
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Siddique, Ayesha, Rafia Gul, Zahid Anwar, Nida Siddique, Faiza ,. Yasin, and Zunaira Naeem Malik. "Characteristics and Outcome of Babies with Antenatal Renal Pelvis Dilatation (RPD)." Pakistan Journal of Medical and Health Sciences 16, no. 11 (November 30, 2022): 228–30. http://dx.doi.org/10.53350/pjmhs20221611228.

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Background: Antenatal renal pelvis dilatation (RPD) is the most common congenital renal anomaly detected on antenatal ul-trasound. The present study was planned to determine the characteristics and outcome of neonates with antenatal renal pel-vis dilatation. Patients and Methods: A prospective, observational, non-interventional study was conducted in Fatima Memorial Hospital over a period of 12 months from April 2021 to March 2022. This study included 130 kidneys of 91 neonates >28 weeks of gestation with antenatally diagnosed isolated renal pelvis dilatation. Postnatal ultrasound was performed at 24-72 hours of life. Cases those resolved spontaneously were labelled as Physiological RPD (Transient RPD) , while all others were labelled as Pathological RPD (Persistent RPD).Descriptive statistics and tests of significance were calculated for all variables. Univariate analysis was performed to compare all possible risk factors for postnatal transient vs. persistent RPD of any grade. Correla-tion coefficients were calculated between risk factors with pathological RPD. Results: Every 4th neonate of antenatally diagnosed RPD had persistent RPD (p<0.05). Only 5% of neonates showed a se-vere variety of persistent RPD. Statistically significant risk factors associated with pathological RPD were maternal anemia, oligohydramnios, diabetes mellitus, gestation age < 37 weeks, birth weight <3 kg, antibiotics administration, admission in in-tensive care unit, urinary tract infections, oliguria, high BUN and creatinine, posterior urethral valve, vesicoureteral reflux, neurogenic bladder and other urinary tract malformations (P<0.05). Persistent RPD had a strong positive direct correlation with the severity of antenatally diagnosed RPD, a moderate positive correlation of persistent RPD was seen with maternal anemia, oligohydramnios, high serum creatinine, PUV, and PUJ. Hence the study will help us in formulating management and follow up plan of our newborns with antenatal RPD. Conclusion: About 71% of neonates with antenatally diagnosed RPD undergo spontaneous resolution. Severe antenatally diagnosed RPD persisted in neonatal life and persistent RPD has a strong correlation with the severity of renal pelvis dilata-tion. Keywords: Ultrasonography, Renal Pelvis Dilatation (RPD), Antenatal, Postnatal, PUJ, Urinary tract malformation, neonatal kidney.
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Balasankar, Soundaiyan, and Jeyaraman Balasubramanian. "A study on postnatal evaluation and follow-up of infants with antenatally detected hydronephrosis." International Journal of Contemporary Pediatrics 4, no. 5 (August 23, 2017): 1677. http://dx.doi.org/10.18203/2349-3291.ijcp20173716.

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Background: Antenatal hydronephrosis(ANH) has now become a frequent diagnosis with the increasing use of antenatal ultrasonography. Objective of present study was to evaluate and follow up infants with antenatally detected hydronephrosis and to determine whether there is significant correlation between anteroposterior renal pelvic diameter detected in antenatal USG and urinary tract anomalies detected postnatally.Methods: After obtaining an informed consent, all neonates with antenatal ultrasound showing hydronephrosis (n=80) were enrolled in the study. Postnatal ultrasound was done at 3 days ,1 month and 6 months of postnatal life. Atleast 6 months followup was done to look for spontaneous resolution or other significant pathology. Micturating cystourethrography/radionuclide scan done in selected cases.Results: Out of 80 cases ,43 had mild,24 had moderate and 13 had severe degrees of hydronephrosis.31 of them (9 mild,10 moderate and 12 with severe hydronephrosis) had postnatal anomaly detected.14 of them (1 mild, 4 moderate and 9 with severe hydronephrosis) underwent surgery. As the grade of antenatal hydronephrosis increases from mild, moderate to severe, the relative risk of postnatal anomaly and requirement of surgical intervention also increased (p value<0.0001).Conclusions: Antenatal hydronephrosis may be associated with significant postnatal urinary tract anomaly with risk quantified by the measurement of anteroposterior renal pelvic diameter(APPD).
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Mäki, P., T. Taka-Eilola, and J. Veijola. "Substance use Disorder in the Offspring of Antenatally Depressed Mothers in the Northern Finland 1966 Birth Cohort: Relationship to Parental History of Severe Mental Disorder." European Psychiatry 41, S1 (April 2017): s246. http://dx.doi.org/10.1016/j.eurpsy.2017.02.025.

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IntroductionMaternal depression during pregnancy is common. However, reports of the adult offspring with maternal antenatal depression are scarce.ObjectivesOur aim was to study whether offspring of antenatally depressed mothers have increased risk for substance use disorder when taking account parental mental disorder.MethodsIn the Northern Finland 1966 Birth Cohort, the mothers of 12,058 children were asked at the antenatal clinic if they felt depressed. The offspring were followed for over 40 years. Substance use disorders were detected using the Finnish Care Register for Health Care, which was also used for identifying severe mental disorders in the parents till 1984.ResultsOf the mothers, 14% had rated themselves as depressed during pregnancy. Of the parents, 10% had had a hospital-treated mental disorder. The risk for substance use disorder was slightly increased in the offspring of antenatally depressed mothers (crude OR 1.6; 95% CI 1.2–2.1), when compared with the cohort members without maternal antenatal depression. The risk for substance use disorder was higher in the offspring with both maternal antenatal depression and parental mental disorder (2.8; 1.7–4.7) than in those with maternal depression but without parental mental disorder (1.4; 1.1–2.0) or those without maternal depression and with parental mental disorder (1.5; 1.1–2.2). The reference group was cohort members without maternal antenatal depression and without parental mental disorder. The association remained significant after adjustment [1].ConclusionsOffspring with both maternal depression during pregnancy and parental severe mental disorder have elevated risk for substance use disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Chougule, Akshaya, Jayashree Purkayastha, Leslie Lewis, Gourav Aiyappa, and Apurv Barche. "Study of Congenital Anomalies of the Kidneys and Urinary Tract in Neonates." Journal of Nepal Paediatric Society 38, no. 3 (December 31, 2018): 176–81. http://dx.doi.org/10.3126/jnps.v38i3.23477.

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Introduction: Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract. In most cases, CAKUT are associated with infant mortality and morbidity in older children and adults. Hence this study was undertaken to follow up antenatally diagnosed cases of CAKUT and see their outcome in the first six months of life. Material and Methods: An observational follow up study was conducted in the department of Paediatrics in a tertiary care hospital. All inborn neonates, whose antenatal anomaly scans showed the presence of CAKUT were included in the study. Abdominal ultrasound (USG) were done on day three of life for all these neonates and those whose day three USGs showed presence of CAKUT were followed up over a period of six months and outcome was assessed. Results: CAKUT was more common among males. Hydronephrosis was the most common CAKUT in antenatal scans. Anomalies of the renal collecting system formed 93.9% of all CAKUT detected on antenatal anomaly scan and 57.4% of these resolved by six months of age. Abnormalities of the renal collecting system together formed 93.9% of all antenatally diagnosed CAKUT and were more common than abnormalities of the renal parenchyma which formed 6.1%. Postnatal resolution on day three USG was seen in seven out of 22 (31.8%) cases of antenatally diagnosed mild hydronephrosis irrespective of their site. Out of the 28 antenatally diagnosed hydronephrosis, 11 (39.3%) resolved at some point during the follow up period of six months. Conclusions: Antenatally diagnosed CAKUT were more common among male foetuses. On day three scan, 29.2% of CAKUT showed resolution. Hydronephrosis remained the most common antenatally as well as postnatally detected CAKUT. Anomalies of renal collecting system were better detected by antenatal scans than anomalies of renal parenchyma
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Sitorus, Samsider, Juliana Purba, Robert Harnat Silalahi, and Jusuf Kristianto. "PENYULUHAN IBU HAMIL TENTANG ANTENATALCARE 10 T DI DESA WILAYAH PUSKESMAS BAHAL GAJAH KABUPATEN DAIRI SUMATERA UTARA INDONESIA." GEMAKES: Jurnal Pengabdian Kepada Masyarakat 2, no. 2 (November 1, 2022): 118–23. http://dx.doi.org/10.36082/gemakes.v2i2.596.

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Pendahuluan: Pemeriksaan kehamilan atau antenatal care suatu program yang terdiri dari: pemeriksaan kesehatan, pengamatan, pendidikan kepada ibu hamil secara terstruktur dan terencana untuk mendapatkan suatu proses kehamilan dan persalinan yang aman dan memuaskan. Pelayanan antenatal care merupakan pelayanan kesehatan yang diberikan oleh tenaga kesehatan yang profesional untuk meningkatkan derajat kesehatan ibu hamil beserta janin dikandungnya. Antenatal care yang dilakukan secara teratur dan komprehensif dapat mendeteksi secara dini kelainan dan risiko yang mungkin timbul selama kehamilan, sehingga kelainan dan risiko tersebut dapat diatasi dengan cepat dan tepat. Tujuan dari pengabdian masyarakat ini adalah untuk meningkatkan pengetahuan ibu hamil melalui Penyuluhan antenatal care) standar 10 T. Metode: Desain dengan survey ibu hamil untuk memberikan penyuluhan tentang pemeriksaan antenatal care standar 10 T kepada 20 orang ibu hamil di 4 desa Wilayah Pusat kesehatan masyarakat Bahal Gajah yakni di desa Siboras, Urukblin, Bahal Gajah, Sumbari Kecamatan Silima Pungga Pungga Kabupaten Dairi. Hasil: Hasil pengabdian masyarakat bahwa pengetahuan ibu hamil tentang antenatal care standar 10 T sebelum penyuluhan mayoritas berpengetahuan kurang 11 orang (55%) setelah diberikan penyuluhan mayoritas berpengetahuan cukup 11 orang (55%), Nilai skore terendah sebelum penyuluhan adalah 35 dan tertinggi 65 sedangkan sesudah penyuluhan nilai skore terendah 50 dan tertinggi 80. Mean sebelum penyuluhan 50 dan sesudah penyuluhan 77 dengan selisih 27, nilai dan p-value < 0,001 atau (p<0,05) artinya ada pengaruh penyuluhan terhadap peningkatan pengetahuan Ibu hamil tentang antenata care. Kesimpulan : terdapat perbedaan yang signifikan, antara pengetahuan sebelum dan sesudah penyuluhan tentang antenatal care standar 10 T . Saran diharapkan kepada tenaga kesehatan agar dapat memberikan penyuluhan kepada ibu hamil untuk meningkatkan pengetahuan
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Dissertations / Theses on the topic "Antenatal"

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Nolan, Mary Louise. "Empowerment and antenatal education." Thesis, University of Birmingham, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366168.

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Lubbe, Zoe Odette Eloise. "Training on attachment as part of antenatal programmes : the perceptions of antenatal programme presenters." Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60379.

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Attachment refers to a strong emotional bond with special people in a person?s life, in whose presence the person experiences pleasure, joy and comfort in times of stress. The first attachment in life is commonly formed between an infant and primary caregiver, which is usually the mother. The caregiving provided by the mother or caregiver will determine whether a secure or insecure attachment pattern is formed. Attachment theory indicates that this first attachment forms the basis for a cognitive representation, the so-called internal working model, which becomes part of the person?s personality and forms the foundation of the person?s perception of the self and the world as well as of all future interpersonal relationships. As infancy is a sensitive period for the development of attachment, the prenatal period could be an appropriate time to educate expecting mothers about the importance of secure attachment and their role in the development thereof. The researcher therefore wished to explore whether antenatal programmes could be used as a platform for teaching expecting mothers about attachment. As a starting point, the goal of this study was to explore the perceptions of antenatal programme presenters on including training on attachment into antenatal programmes. The study was based on a qualitative research approach, and applied research as the type of research. A collective case study research design was adopted and data was collected by means of semi-structured interviews that were conducted with a sample of ten presenters of antenatal programmes in the Tshwane district. The participants were selected by means of purposive sampling. Data was analysed according to methods for qualitative data analysis, and relevant ethical considerations were followed during the study. The research findings indicate that the participants were aware of the importance and benefits of secure attachment and that they had a positive attitude towards the inclusion of training on attachment into antenatal programmes. They were eager to receive training on attachment and to adapt their programmes to include training on attachment. The researcher concludes that it would be feasible and beneficial to include training on attachment into antenatal programmes, and to train antenatal programme presenters for this purpose. The provision of training on attachment to nurses and raising awareness of attachment in the private and public health care sectors could facilitate greater knowledge of attachment for expecting mothers. Further research in diverse settings, such as in private and public clinics and hospitals in different geographical areas, is recommended.
Mini Dissertation (MA)--University of Pretoria, 2016.
Social Work and Criminology
MA
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Gauer, Philippe. "Aspects ethiques du diagnostic antenatal." Nancy 1, 1988. http://www.theses.fr/1988NAN11115.

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MATIKOLA, LINGIAH DEENANATH. "Diagnostic antenatal des epanchements intrathoraciques." Lyon 1, 1989. http://www.theses.fr/1989LYO1M229.

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Majoko, Franz. "Assessing Antenatal Care in Rural Zimbabwe." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6018.

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Draper, J. "An experiment in community antenatal care." Thesis, University of Cambridge, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598641.

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Olsson, Pia. "Antenatal midwifery consultations : a qualitative study." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96903.

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GIRARD, BRUNO. "Diagnostic antenatal de la toxoplasmose congenitale." Nantes, 1990. http://www.theses.fr/1990NANT001M.

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Miedzybrodzka, Zofia Helena. "Antenatal carrier screening for cystic fibrosis." Thesis, University of Aberdeen, 1995. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU541313.

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This thesis explores the advantages and disadvantages of various aspects of antenatal carrier screening for cystic fibrosis, taking into account both psychological and economic factors. It also provides information specific to the implementation of screening within Grampian region. Following the introductory literature review, a population genetic study of CF in Grampian region is described. In addition to giving information about the incidence and prevalence of the disease itself, the relative frequencies of the common CF mutations are detailed. Next, there is an assessment of different molecular methods for CF mutation detection. The remainder of the thesis comprises a comparative evaluation of two different approaches to antenatal CF carrier screening, namely step-wise (disclosure) and couple (non-disclosure) testing. The evaluation covers both psychological and economic aspects of screening. Grampian was found to have a higher prevalence of the common CF mutation F508 than the southern Scottish population. Thus testing for the four commonest mutations allows detection of 92% of carriers. The use of multiplex ARMS, dot-blotting and a deletion/digest/PAGE method were compared. The multiplex ARMS system was sensitive, specific and robust, and required less labour than the other methods. Step-wise antenatal carrier screening was found to be associated with transiently high levels of anxiety amongst carriers, which dissipates when a negative partner's result is received. For the majority of screenees who will test negative, couple screening is associated with more anxiety and false reassurance. Step-wise screening was found to be slightly less expensive than couple screening. When asked to state their preferred method, more women chose step-wise than couple screening.
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Crudo, Ariann. "Antenatal Glucocorticoid Treatment and the Epigenome." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119336.

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In late gestation, fetal endogenous glucocorticoids increase exponentially. This dramatic increase in glucocorticoids acts to mature several organ systems. As a result, synthetic glucocorticoids (sGCs) are administered to pregnant women at risk of delivering pre-term (>10% of all pregnancies). While this treatment is highly effective in the fetal lung, little is known concerning its long-term consequences in humans. Animal studies have demonstrated that offspring prenatally exposed to sGCs are at risk of behavioral abnormalities and modifications in hypothalamic-pituitary-adrenal (HPA) axis and endocrine function; this involves long-term changes in gene expression. Given that the effects of antenatal sGC exposure are stable, long lasting and can manifest across generations, in concert with the fact that early life exposure has the ability to modify the epigenome of offspring, we now hypothesize that epigenetic mechanisms are the route by which sGC permanently modifies behavior and endocrine function in offspring. DNA methylation is a covalent modification of DNA, which plays an essential role in generating stable changes in gene expression. For this reason, the impact of late gestational development and antenatal sGC treatment on global methylation has been investigated. Our results demonstrated organ-specific changes in global methylation, which occur following the endogenous cortisol surge. Further, we noted that these modifications in global methylation could be prematurely initiated by intrauterine exposure to sGC. However, long-term, these sGC-induced global DNA methylation changes are further altered, and these changes are present into adulthood and persist in the next generation. Further, our data indicated that prenatal sGC exposure impacts the expression of several key genes involved in epigenetic regulation.Determining the genome-wide fetal epigenetic landscape was of critical importance to begin to elucidate the mechanisms by which glucocorticoid exposure in late gestation generates its long-term consequences. High-density promoter microarrays identified the fetal hippocampal promoter regions that exhibited differential DNA methylation and Histone-3-lysine-9 (H3K9) acetylation. Our results indicated that the fetal glucocorticoid surge is partially responsible for significantly modifying promoter methylation in a large number of genes. Further, we observed that antenatal sGC exposure significantly impacts DNA methylation and H3K9 acetylation in the fetal hippocampus. The impact of elevated fetal glucocorticoid exposure was further investigated using genome-wide transcription arrays. We noted that exposure to excess glucocorticoids in late gestation substantially altered the mRNA levels of a broad number of genes. Further, we identified fetal hippocampal promoter regulatory regions, in which the glucocorticoid receptor (GR) is bound during late gestational development and following antenatal sGC therapy. Considering the extensive clinical use of antenatal sGC therapy, the data within this thesis are essential, as they provide an understanding of the long-term epigenetic consequences of such a treatment, in a relevant animal model. Further, it advances our knowledge of fetal programming and the underlying mechanisms associated with antenatal sGC treatment.
À la fin de la gestation, les niveaux de glucocorticoïdes endogènes fœtaux augmentent de façon exponentielle. Cette augmentation spectaculaire des glucocorticoïdes agit sur la maturation de nombreux organes. En conséquence, des glucocorticoïdes de synthèse (sGC) sont administrés aux femmes enceintes qui risquent d'accoucher avant terme (>10% des grossesses). Tandis que ce traitement est hautement efficace pour la maturation pulmonaire du fœtus, peu de choses sont connues quant à ses conséquences sur le long terme chez l'homme. Des études chez l'animal ont montré que la progéniture exposée aux sGC pendant la gestation présentait un risque de développer des anomalies de comportement et des modifications dans l'axe hypothalamo-hypophyso-surrénalien (HPA) ainsi que dans les fonctions endocrines; ceci impliquant des changements à long terme de l'expression génique. De plus, Il a été montré que les effets de l'exposition anténatale aux sGC étaient stables, durables et pouvaient se manifester à travers plusieurs générations. Il a récemment été établit que l'exposition au début de la vie avait la capacité de modifier l'épigénome de la descendance. Une unique étude a montré que les sGC pouvaient augmenter l'expression génique dans le foie fœtal par le biais d'une déméthylation de l'ADN des promoteurs. Ainsi, nous avons proposé que des mécanismes épigénétiques pouvaient représenter une voie par laquelle les sGC modifient de façon permanente le comportement et les fonctions endocrines de la progéniture. La méthylation de l'ADN est une modification covalente de l'ADN qui joue un rôle essentiel dans la mise en place de changements stables de l'expression génique. Pour cette raison, l'impact du traitement aux sGC lors du développement gestationnel tardif et anténatal sur les niveaux de méthylation globale a été examiné. Nos résultats montrent des changements dans la méthylation globale spécifiques aux organes, qui se produisent après la poussée de cortisol endogène. De plus, nous avons noté que ces modifications de méthylation globale pouvaient être initiées prématurément par l'exposition intra-utérine aux sGC. Cependant, à long terme, ces changements de méthylation globale, induits par les sGC, sont altérés et ces changements sont présents à l'âge adulte et persistent dans la génération suivante. Par ailleurs, nos données indiquent que l'exposition prénatale aux sGC a un impact sur l'expression de plusieurs gènes clés de la régulation épigénétique. Déterminer le paysage épigénétique à l'échelle du génome entier revêtait une importance capitale pour commencer à élucider les mécanismes par lesquels l'exposition aux glucocorticoïdes en fin de gestation pouvait induire des conséquences à long terme. Des micropuces à haute densité des promoteurs ont permis d'identifier les régions des promoteurs dans l'hippocampe fœtal qui présentaient des différences de méthylation de l'ADN et de l'acétylation de la lysine 9 des histones 3 (H3K9). Nos résultats indiquent que la poussée de glucocorticoïdes fœtaux est partiellement responsable des modifications significatives de la méthylation des promoteurs d'un grand nombre de gènes. De plus, nous avons observé que l'exposition anténatale aux sGC avait un impact significatif sur la méthylation de l'ADN et l'acétylation de H3K9 dans l'hippocampe fœtal. L'impact de l'exposition à des niveaux élevés de glucocorticoïdes fœtaux a été étudié plus avant en utilisant des puces de transcription du génome entier. Nous avons noté que l'exposition à un excès de glucocorticoïdes altérait considérablement les niveaux d'expression génique, et ces changements d'expression sont associés aux niveaux de méthylation de l'ADN de leurs promoteurs. D'autre part, nous avons identifié des régions régulatrices dans les promoteurs dans l'hippocampe fœtal, dans lesquelles GR se lie lors de la gestation tardive et de la thérapie anténatale aux sGC.
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Books on the topic "Antenatal"

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Alexander, Jo, Valerie Levy, and Sarah Roch, eds. Antenatal Care. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3.

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Valentina, Collington, Kroll Debra, and South Bank University. Distance Learning Centre., eds. Antenatal care. London: Distance Learning Centre, South Bank University, 1992.

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1939-, Hall Marion, ed. Antenatal care. London: Baillière Tindall, 1990.

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Royal College of Midwives Trust. Learning, Research & Practice Development Department., ed. Antenatal care. London: Royal College of Midwives Trust, 2004.

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Royal College of Midwives (Great Britain), ed. Antenatal investigations. Cheshire, England: Books for Midwives Press, 1995.

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Royal College of Midwives (Great Britain), ed. Antenatal investigations. Cheshire, England: Books for Midwives Press, 1994.

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Pearson, Virginia. Antenatal ultrasound scanning. Bristol: Health Care Evaluation Unit, Department ofEpidemiology and Public Health Medicine, University of Bristol, 1994.

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Wyldes, Mike. Community antenatal care handbook. 2nd ed. Solihull: West Midlands Perinatal Audit, Solihull Hospital, 1997.

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Wyldes, Mike. Community antenatal care handbook. Solihull: Regional Perinatal Audit, West Midlands RHA, 1992.

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Chamberlain, Geoffrey. ABC of antenatal care. London: British Medical Journal, 1992.

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Book chapters on the topic "Antenatal"

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Murphy-Black, Tricia. "Antenatal education." In Antenatal Care, 88–104. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_6.

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Shorney, Joyce. "Preconception care — the embryo of health promotion." In Antenatal Care, 1–19. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_1.

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Currell, Rosemary. "The organisation of midwifery care." In Antenatal Care, 20–41. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_2.

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Methven, Rosemary C. "The antenatal booking interview." In Antenatal Care, 42–57. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_3.

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Alexander, Jo. "Antenatal preparation of the breasts for breastfeeding." In Antenatal Care, 58–72. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_4.

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Plant, Moira. "Maternal alcohol and tobacco use during pregnancy." In Antenatal Care, 73–87. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_5.

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Proud, Jean. "Ultrasound — the midwife’s role." In Antenatal Care, 105–19. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_7.

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Prince, Joyce, and Margaret Adams. "The psychology of pregnancy." In Antenatal Care, 120–33. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_8.

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Spillman, Jane. "Multiple births — parents’ anxieties and the realities." In Antenatal Care, 134–48. London: Macmillan Education UK, 1990. http://dx.doi.org/10.1007/978-1-349-20974-3_9.

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Kovacs, Gab, and Paula Briggs. "Antenatal Care." In Lectures in Obstetrics, Gynaecology and Women’s Health, 101–3. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-14863-2_20.

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Conference papers on the topic "Antenatal"

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Wautier, J. L., Y. Gruel, B. Boizard, J. P. Caen, F. Daffos, and F. Forestier. "ANTENATAL DIAGNOSIS OF THROMBOPATHY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644271.

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We previously determined platelet antigens and glycoproteins in the human fetus after 19 weeks of intrauterine life (Blood 68, 488-92,1986). These results obtained in fetuses with normal platelets allowed us to do the first attempt of antenatal diagnosis in Glanzmann thrombasthenia. The fetal propositus was tested with monoclonal (AP2, AP3) or polyclonalantibodies (IgGL) directed against GPIIbllla or platelets antigen (PLA1, Leka). The foetus was found to be heterozygous for GT and similar results were foundafter his birth.Grey platelet syndrome is a rare congenital platelet defect caracterized by an alpha granule deficiency and is transmitted on the dominant feature. To be able to detect this abnormality before birth we have measured the platelet content of alpha granules.The amount of Beta thromboglobulin (gTG) at 18 weeks of intrauterine life was32±4.3 mg/109 platelets in normal platelets (adults 60 mg/10^ platelets). The foetus of the mother with grey platelet syndrome was sampled at 19 weeks when the mother was under platelet transfusion and the platelets were studied by electron microscopy and for their BTG content. The platelet morphologyshowed the presence of alpha granules and the $TG content was in the range of the control fetuses (42mg/109 platelets). The baby was born after artificial delivery under platelet transfusion. These results showed that the antenatal diagnosis of thrombopathies is feasible and can permit a therapy to avoid dramatic haemorrhage during pregnancy or delivery.
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Salsabilla, Dinda Anindita, Hanung Prasetya, and Bhisma Murti. "The Effect of Unplanned Pregnancy on Antenatal Depression: A Meta-Analysis." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.116.

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ABSTRACT Background: Family planning is a potential strategy for the prevention of postpartum depression. Women who report unintended pregnancies during prenatal care must be educated of their increased risk, even if they do not exhibit antenatal depressive symptoms. This study aimed to examine the effect of unplanned pregnancy on antenatal depression. Subjects and Method: This was a meta-analysis and systematic review toward unplanned pregnancy and antenatal depression. The study was conducted by selected published articles from 2010 to 2020 in Google Scholar, PubMed, and Springer Link electronic databases. “unplanned pregnancy” AND “antenatal depression” OR “risk factor” AND “antenatal depression” OR “antenatal depression” AND “cross sectional” AND “EPDS” AND “adjusted odd ratio” keywords were used to collected the articles. The inclusion criteria were full text, using cross-sectional study, and reporting adjusted odd ratio. The articles were analyzed using PRISMA guidelines and Revman 5.3. Results: 7 articles were reported that unplanned pregnancy escalated the risk of antenatal depression (aOR= 2.32; 95% CI=1.86 to 2.90; p<0.001). Conclusion: Unplanned pregnancy escalates the risk of antenatal depression. Keywords: unplanned pregnancy, depression, pregnancy Correspondence: Dinda Anindita Salsabilla. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: dindaaninditasalsa@gmail.com. Mobile: 081249007525. DOI: https://doi.org/10.26911/the7thicph.03.116
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Lestari, Yayuk Puji, and Farida Kartini. "Antenatal Service Quality: A Scoping Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.31.

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ABSTRACT Background: Maternal mortality rate (MMR) is an indicator of the success of health development in a country. The World Health Organization (WHO) has issued a series of new recommendations to improve the quality of antenatal care to reduce the risk of birth and pregnancy complications and provide a positive pregnancy experience. This study aimed to review the antenatal service quality. Subjects and Method: This was a scoping review using an electronic bibliographic database method. Articles were collected from 5 databases, namely Science Direct, PubMed, EBSCO, Wiley, and ProQuest. This study was carried out systematically from 2009 to 2019. The articles used in this scoping review were described in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flowchart. Results: Based on 10 articles out of 190 articles according to inclusion criteria, the review results showed that the quality of antenatal care was divided into physical examinations and supporting examinations carried out in antenatal care services, suggestions and infrastructure in antenatal care services, and availability of health personnel in antenatal care services. Conclusion: The quality of antenatal care services is strongly influenced by the standard of the equipment used, the standard of examination, facilities and infrastructure and the availability of health personnel. Keywords: quality, antenatal care, scoping review Correspondence: Yayuk Puji Lestari. Universitas ‘Aisyiyah Yogyakarta. Jl. Ringroad Barat No.63, Mlangi Nogotirto, Gamping, Rice Field Area, Nogotirto, Kec. Gamping, Sleman Regency 55592, Yogyakarta Special Region. Email: yayuk.pujilestari1892@gmail.com. Mobile : 085349033588. DOI: https://doi.org/10.26911/the7thicph.03.31
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Al Ibrahim, Abdullah A., Ibrahim Aqel, Sawsan Al Obaidly, Najat Khenyab, Najah Al Jenahi, Zeena Al Mansori, and Mariam El Bolushi. "Antenatal Idiopathic Polyhydramnios: Then what?" In Qatar Foundation Annual Research Conference Proceedings. Hamad bin Khalifa University Press (HBKU Press), 2016. http://dx.doi.org/10.5339/qfarc.2016.hbpp2371.

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Rassi, D. "Antenatal fetal magnetocardiography using SQUID's." In IEE Colloquium on `Magnets in Medicine - Hazards and Health Care'. IEE, 1995. http://dx.doi.org/10.1049/ic:19951001.

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Ribeiro, Eduardo Teixeira da Silva, Rafaela Motta Pereira, Guilherme Ribeiro Ramires de Jesus, and Jose Paulo Pereira Junior. "Diagnóstico antenatal cisto hepático congênito." In 47º Congresso da SGORJ e Trocando Ideias XXVI. Zeppelini Editorial e Comunicação, 2023. http://dx.doi.org/10.5327/jbg-2965-3711-2023133s1066.

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Introdução: O cisto hepático congênito é uma condição rara e assintomática em lactentes e crianças. Geralmente, é diagnosticado como um achado incidental durante exames de ultrassom pré-natal de rotina. Os cistos hepáticos congênitos são caracterizados como estruturas uniloculares preenchidas por líquido, com aspecto anecoico e reforço acústico posterior na ultrassonografia. As septações observadas correspondem a ductos biliares e vasos sanguíneos. Os principais diagnósticos diferenciais incluem cisto de colédoco, cistos renais e cistos ovarianos. Descrição do caso: Relatou-se o caso de uma paciente de 26 anos, no terceiro trimestre de sua terceira gestação, que foi encaminhada para um serviço de medicina fetal devido à suspeita de um cisto abdominal observado em um exame de ultrassom. A ultrassonografia mostrou uma imagem cística septada, sem fluxo detectável ao Doppler colorido, localizada no fígado e medindo 32 × 31 × 30 mm. Uma ressonância magnética fetal foi solicitada, confirmando a presença de uma formação cística septada no lobo direito do fígado, com medidas de 31 × 34 × 28 mm, e ausência da vesícula biliar. Exames de acompanhamento subsequente demonstraram crescimento progressivo do cisto. No exame realizado com 41 semanas de gestação, o cisto hepático septado media 69 × 34 × 46 mm, e o crescimento fetal estava dentro dos parâmetros normais. O parto foi induzido com prostaglandina, resultando no nascimento de um recém-nascido do sexo feminino, com apresentação cefálica, Apgar 9/9 e peso de 3.110 g. Não foram observadas malformações aparentes. No primeiro dia de vida, foram realizados exames de ultrassonografia abdominal e tomografia computadorizada com contraste, que confirmaram os achados de uma lesão cística hepática primária provável, medindo 85 × 58 × 38 mm. Os exames de função hepática estavam normais. A paciente foi avaliada por uma equipe de cirurgia pediátrica e genética, foi realizado o cariótipo fetal e foi programado o seguimento ambulatorial. Discussão: O manejo dos cistos hepáticos congênitos é geralmente conservador, com monitoramento periódico por meio de ultrassonografias para garantir a estabilidade da lesão, especialmente em cistos grandes (≥4 cm de diâmetro). A maioria dos cistos hepáticos simples é benigna e tende a se resolver espontaneamente. No entanto, uma pequena parcela de cistos, especialmente aqueles de grandes dimensões, pode apresentar complicações, como obstrução das vias biliares e potencial de malignidade.
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Fuada, Noviati, and Nurhandayani Utami. "Program Evaluation of Antenatal Classes." In 1st International Conference on Health. SCITEPRESS - Science and Technology Publications, 2019. http://dx.doi.org/10.5220/0009571801650172.

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Pamungkasari, Eti Poncorini, and Bhisma Murti. "Factors Affecting the Use of Antenatal Care in Semarang, Central Java: Application of Health Belief Model." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.117.

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ABSTRACT Background: In the field of health-care education, theories and models help us to explain and predict behaviors to conduct effective health-care educational programs for changing behaviors. The Health Belief Model (HBM) contains several primary concepts by which individuals evaluate themselves to take action to change their behaviors, including antenatal care uptake in pregnant women. This study aimed to examine factors affecting the use of antenatal care. Subjects and Method: A cross sectional study was carried out in Semarang, Central Java, from June to August 2020. A sample of 250 pregnant women was selected by simple random sampling. The dependent variable was antenatal care. The independent variables were attitude, knowledge, information, self-efficacy, perceived seriousness, perceived susceptibility, perceived barrier, perceived benefit, cues to action, husband support, and facilities. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Complete antenatal care increased with strong support (OR= 38.97; 95% CI= 3.19 to 476.53; p= 0.004), high knowledge (OR= 16.44; 95% CI= 2.54 to 106.60; p= 0.003), positive attitude (OR= 29.88; 95% CI= 2.88 to 309.92; p= 0.004), high information toward antenatal care (OR= 31.42; 95% CI= 4.07 to 242.41; p= 0.001), strong self-efficacy (OR= 7.85; 95% CI= 1.50 40.99; p= 0.015), strong cues to action (OR= 11.97; 95% CI= 2.01 to 71.36; p= 0.006), high perceived seriousness (OR= 32.99; 95% CI= 3.93 to 276.98; p= 0.001), high perceived susceptibility (OR= 24.29; 95% CI= 2.50 to 235.78; p= 0.006), high perceived benefit (OR= 30.43; 95% CI= 2.99 to 308.80; p= 0.004), high perceived barrier (OR= 0.07; 95% CI= 0.01 to 0.57; p= 0.013) and complete facilities (OR= 63.52; 95% CI= 3.62 to 1115.08; p= 0.005). Conclusion: Complete antenatal care increases with strong support, high knowledge, positive attitude, high information toward antenatal care, strong self-efficacy, strong cues to action, high perceived seriousness, high perceived susceptibility, high perceived benefit, high perceived barrier and complete facilities. Keywords: antenatal care, health facility, Health Belief Model Correspondence: Widyawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: widyawatichin1412@gmail.com. Mobile: +6285742919076. DOI: https://doi.org/10.26911/the7thicph.03.117
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Zukrufiana, Ilma Ratih, Herlin Fitriani Kurniawati, and Anjarwati. "Antenatal Care Experience in Adolescent Pregnancy." In 5th Universitas Ahmad Dahlan Public Health Conference (UPHEC 2019). Paris, France: Atlantis Press, 2020. http://dx.doi.org/10.2991/ahsr.k.200311.045.

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Vaz and Pereira. "A Telematic Based Antenatal Care Demonstrator." In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.594775.

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Reports on the topic "Antenatal"

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Kern, Nora, and Anthony Herndon. Antenatal hydronephrosis (2): further imaging, diagnosis and management. BJUI Knowledge, March 2022. http://dx.doi.org/10.18591/bjuik.0671.v2.

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Kern, Nora, and Anthony Herndon. Antenatal hydronephrosis (1): postnatal evaluation and initial management. BJUI Knowledge, March 2022. http://dx.doi.org/10.18591/bjuik.0278.v2.

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Birungi, Harriet. Adapting focused antenatal care: Lessons from three African countries. Population Council, 2008. http://dx.doi.org/10.31899/rh14.1018.

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Ciapponi, Agustín. Does group antenatal care improve outcomes for women and their babies? SUPPORT, 2016. http://dx.doi.org/10.30846/161015.

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Antenatal care is one of the key preventive health services used around the world, usually involving one-to-one visits with a care provider (midwife, obstetrician or general practitioner). Group antenatal care is a potentially useful alternative strategy.
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Dudley, Lilian D., and Charles Shey Wiysonge. Does giving women their own case notes to carry in pregnancy improve maternal care? SUPPORT, 2016. http://dx.doi.org/10.30846/160804.

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Improvements in antenatal care have included changes to traditional practices in order to improve womens’ experiences of antenatal care and the clinical outcomes of maternity care. One such change has been giving women their own clinical case notes to carry throughout their pregnancy in order to enable women to participate in the decision making regarding their healthcare, and to improve the availability of the records when needed.
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Warren, Charlotte, and Annie Mwangi. Integrating tuberculosis case finding and treatment into focused antenatal care in Kenya. Population Council, 2008. http://dx.doi.org/10.31899/rh4.1106.

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Birungi, Harriet, and Washington Onyango-Ouma. Acceptability and sustainability of the WHO focused antenatal care package in Kenya. Population Council, 2006. http://dx.doi.org/10.31899/rh4.1177.

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Balk, Ethan M., Kristin J. Konnyu, Wangnan Cao, Monika Reddy Bhuma, Valery A. Danilack, Gaelen P. Adam, Kristen A. Matteson, and Alex Friedman Peahl. Schedule of Visits and Televisits for Routine Antenatal Care: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), June 2022. http://dx.doi.org/10.23970/ahrqepccer257.

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Background. The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine plan a new evidence-based joint consensus statement to address the preferred visit schedule and the use of televisits for routine antenatal care. This systematic review will support the consensus statement. Methods. We searched PubMed®, Cochrane databases, Embase®, CINAHL®, ClinicalTrials.gov, PsycINFO®, and SocINDEX from inception through February 12, 2022. We included comparative studies from high-income countries that evaluated the frequency of scheduled routine antenatal visits or the inclusion of routine televisits, and qualitative studies addressing these two topics. We evaluated strength of evidence for 15 outcomes prioritized by stakeholders. Results. Ten studies evaluated scheduled number of routine visits and seven studies evaluated televisits. Nine qualitative studies also addressed these topics. Studies evaluated a wide range of reduced and traditional visit schedules and approaches to incorporating televisits. In comparisons of fewer to standard number of scheduled antenatal visits, moderate strength evidence did not find differences for gestational age at birth (4 studies), being small for gestational age (3 studies), Apgar score (5 studies), or neonatal intensive care unit (NICU) admissions (5 studies). Low strength evidence did not find differences in maternal anxiety (3 studies), preterm births (3 studies), and low birth weight (4 studies). Qualitative studies suggest that providers believe fewer routine visits may be more convenient for patients and may free up clinic time to provide additional care for patients with high-risk pregnancies, but both patients and providers had concerns about potential lesser care with fewer visits. In comparisons of hybrid (televisits and in-person) versus in-person only visits, low strength evidence did not find differences in preterm births (4 studies) or NICU admissions (3 studies), but did suggest greater satisfaction with hybrid visits (2 studies). Qualitative studies suggested patients and providers were open to reduced schedules and televisits for routine antenatal care, but importantly, patients and providers had concerns about quality of care, and providers and clinic leadership had suggestions on how to best implement practice changes. Conclusion. The evidence base is relatively sparse, with insufficient evidence for numerous prioritized outcomes. Studies were heterogeneous in the care models employed. Where there was sufficient evidence to make conclusions, studies did not find significant differences in harms to mother or baby between alternative models, but evidence suggested greater satisfaction with care with hybrid visits. Qualitative evidence suggests diverse barriers and facilitators to uptake of reduced visit schedules or televisits for routine antenatal care. Given the shortcomings of the evidence base, considerations other than proof of differences in outcomes may need to be considered regarding implications for clinical practice. New studies are needed to evaluate prioritized outcomes and potential differential effects among different populations or settings.
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9

Yeika, Eugene, Erica L. Kocher, and Carrie Ngongo. Integrating Noncommunicable Diseases into Antenatal Care in Cameroon: A Triangulated Qualitative Analysis. RTI Press, January 2024. http://dx.doi.org/10.3768/rtipress.2024.rr.0051.2401.

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Noncommunicable diseases (NCDs) have important implications for pregnancy outcomes and the subsequent health of women and their children. The aim of this study is to determine the status of NCD and maternal health program integration, identify barriers to integration, and explore what would be required to deepen integration of NCD care into antenatal care in Cameroon. We used two methods of data collection and synthesis: a desk review of policy documents and protocols and a series of key informant interviews with health system experts and managers working in public, private, and faith-based health facilities at central, regional, and district levels. Although screening for blood glucose and blood pressure occurs during antenatal care, post-diagnosis management is not well-integrated and often requires referral to specialists in higher-level health facilities. Key barriers to integration include lack of guidelines for the management of NCDs, financial constraints for facilities and patients, and shortages of health workers, medications, and supplies for laboratory investigations. Further integration of services for NCDs during pregnancy will require national guidelines backed up by system-wide strengthening of health information systems, insurance coverage, supply chain management, and human resource capacity, particularly in remote areas.
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Zamorano, Natalia, and Cristian Herrera. Can community-based intervention packages reduce maternal and neonatal morbidity and mortality? SUPPORT, 2017. http://dx.doi.org/10.30846/170115.

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In the last three decades, rates of neonatal mortality in low-income countries have declined much more slowly than the rates of infant and maternal mortality. A significant proportion of these deaths could potentially be addressed by community-based intervention packages, which are defined as delivering more than one intervention via different sets of strategies that include additional training of outreach workers, building community-support, community mobilization, antenatal and postnatal home visitation, training of traditional birth attendants, antenatal and delivery home visitation, and home-based neonatal care and treatment; usually supplemented by strengthening linkages with local health systems.
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