Journal articles on the topic 'Pregnancy advice literature'
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Yam, Charmaine, Vilija Jokubaitis, Kerstin Hellwig, and Ruth Dobson. "MS, pregnancy and COVID-19." Multiple Sclerosis Journal 26, no. 10 (August 17, 2020): 1137–46. http://dx.doi.org/10.1177/1352458520949152.
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Concerns regarding infection with the novel coronavirus SARS-CoV-2 leading to COVID-19 are particularly marked for pregnant women with autoimmune diseases such as multiple sclerosis (MS). There is currently a relative paucity of information to guide advice given to and the clinical management of these individuals. Much of the limited available data around COVID-19 and pregnancy derives from the obstetric literature, and as such, neurologists may not be familiar with the general principles underlying current advice. In this article, we discuss the impact of potential infection on the pregnant woman, the impact on her baby, the impact of the current pandemic on antenatal care, and the interaction between COVID-19, MS and pregnancy. This review provides a framework for neurologists to use to guide the individualised advice given to both pregnant women with MS, and those women with MS who are considering pregnancy. This includes evidence derived from previous novel coronavirus infections, and emerging evidence from the current pandemic.
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Midgley, Georgia, Hayley Smithers-Sheedy, Sarah McIntyre, Nadia Badawi, John Keogh, and Cheryl A. Jones. "Congenital Cytomegalovirus Prevention, Awareness and Policy Recommendations - A Scoping Study." Infectious Disorders - Drug Targets 20, no. 3 (July 20, 2020): 291–302. http://dx.doi.org/10.2174/1871526518666181009093725.
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Background: Congenital cytomegalovirus (cCMV) is known to cause childhood deafness, neurodevelopmental disability and death. Simple hygiene precautions are effective in reducing maternal risk of CMV infection. Objective: To review i) awareness of CMV infection and available primary prevention strategies both in the community and amongst health professionals ii) available cCMV information sources in the literature, grey literature and published professional guidelines. Methods: Scoping study to i) identify literature pertaining to cCMV awareness amongst parents and health professionals using MedLine and CINAHL databases via EBSCO ii) review one high income country’s guidelines and recommendations regarding cCMV infection and pregnancy (example country Australia) iii) grey literature for parental information. Results: Worldwide awareness of cCMV and of available prevention strategies amongst women and health professionals are poor. Findings internationally suggest at least half of maternity care health professionals do not routinely provide advice to women regarding simple hygiene precautions that can reduce their risk of infection during pregnancy. Though information resources regarding cCMV are available, they are frequently not included within general healthy pregnancy advice and require individuals to search for ‘congenital cytomegalovirus’. Conclusion: cCMV is a preventable cause of serious congenital disability and death. Prevention opportunities are being missed because most women are not aware of cCMV or how to reduce their risk of infection in pregnancy, in part due to poor health professional awareness. New strategies to disseminate cCMV information to the community and to support health professionals to embed cCMV advice within routine pregnancy counselling is required.
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Wiersma, Thomas K., Marijn C. Visschedijk, Nanne K. de Boer, Marjolijn N. Lub-de Hooge, Jelmer R. Prins, Daan J. Touw, and Paola Mian. "The Effect of Pregnancy and Inflammatory Bowel Disease on the Pharmacokinetics of Drugs Related to Inflammatory Bowel Disease—A Systematic Literature Review." Pharmaceutics 14, no. 6 (June 11, 2022): 1241. http://dx.doi.org/10.3390/pharmaceutics14061241.
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Due to ethical and practical reasons, a knowledge gap exists on the pharmacokinetics (PK) of inflammatory bowel disease (IBD)-related drugs in pregnant women with IBD. Before evidence-based dosing can be proposed, insight into the PK has to be gained to optimize drug therapy for both mother and fetus. This systematic review aimed to describe the effect of pregnancy and IBD on the PK of drugs used for IBD. One aminosalicylate study, two thiopurine studies and twelve studies with biologicals were included. Most drugs within these groups presented data over multiple moments before, during and after pregnancy, except for mesalazine, ustekinumab and golimumab. The studies for mesalazine, ustekinumab and golimumab did not provide enough data to demonstrate an effect of pregnancy on concentration and PK parameters. Therefore, no evidence-based dosing advice was given. The 6-thioguanine nucleotide levels decreased during pregnancy to 61% compared to pre-pregnancy levels. The potentially toxic metabolite 6-methylmercaptopurine (6-MMP) increased to maximal 209% of the pre-pregnancy levels. Although the PK of the thiopurines changed throughout pregnancy, no evidence-based dosing advice was provided. One study suggested that caution should be exercised when the thiopurine dose is adjusted, due to shunting 6-MMP levels. For the biologicals, infliximab levels increased, adalimumab stayed relatively stable and vedolizumab levels tended to decrease during pregnancy. Although the PK of the biologicals changed throughout pregnancy, no evidence-based dosing advice for biologicals was provided. Other drugs retrieved from the literature search were mesalazine, ustekinumab and golimumab. We conclude that limited studies have been performed on PK parameters during pregnancy for drugs used in IBD. Therefore, more extensive research to determine the values of PK parameters is warranted. After gathering the PK data, evidence-based dosing regimens can be developed.
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Rodgers, Ornaith. "“Relinquish the reins”: Persuasion and consensus in the discourse of pregnancy and childbirth advice literature." Women and Birth 28, no. 1 (March 2015): 40–46. http://dx.doi.org/10.1016/j.wombi.2014.10.005.
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Dobson, Ruth, Pooja Dassan, Megan Roberts, Gavin Giovannoni, Catherine Nelson-Piercy, and Peter A. Brex. "UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines." Practical Neurology 19, no. 2 (January 5, 2019): 106–14. http://dx.doi.org/10.1136/practneurol-2018-002060.
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Multiple sclerosis (MS) is more common in women than men and is most commonly diagnosed in early adulthood; thus, many patients will not have completed their families at the time of diagnosis. There is increasing awareness of the importance of early treatment in preventing long-term disability in MS. Delaying treatment until women with MS have completed their families can lead to the development of irreversible disability in at least some cases. It is therefore important to discuss family planning and pregnancy proactively. However, to date there is limited evidence to inform such discussions. We set out to develop consensus guidelines for the treatment of MS in pregnancy to encourage and facilitate discussions in this important area. The guidelines draw on available evidence from drug-specific pregnancy registers and published literature and have been scored by a panel of experts from a variety of disciplines using modified Delphi criteria. They cover prepregnancy counselling, management during pregnancy, delivery and anaesthetic options, postpartum advice and specific advice regarding currently licensed disease-modifying drugs. As the complexity and range of available disease-modifying drugs increase, further data gathering via a UK-wide MS pregnancy register is recommended.
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Mansfield, Phyllis Kernoff. "Midlife Childbearing: Strategies for Informed Decisionmaking." Psychology of Women Quarterly 12, no. 4 (December 1988): 445–60. http://dx.doi.org/10.1111/j.1471-6402.1988.tb00977.x.
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More and more women in the United States are choosing to delay motherhood until their 30s or even 40s. Yet traditional medical advice warns against midlife pregnancy, predicting a variety of adverse reproductive outcomes associated with “advanced maternal age.” Assignment to a high-risk category may result in heightened feelings of concern about pregnancy complications among midlife mothers. Because it is possible that increased emotionality during pregnancy may itself give rise to various childbearing complications, some middle-aged women may become victims of iatrogenic stress during pregnancy. This article first examines critically the medical literature describing the relationship between maternal age and pregnancy outcomes and finds little support for the medical pessimism. Next, the article describes the literature that explores the links between heightened emotionality during pregnancy and various negative outcomes and suggests that, despite serious methodological flaws, there is some evidence that fear-induced stress during pregnancy may place certain middle-aged women at higher risk for complications. Finally, strategies for improved decisionmaking and for enhancing the pregnancy experience of midlife women are proposed.
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Cox, Jessica. "The ‘most Sacred of Duties’1: Maternal Ideals and Discourses of Authority in Victorian Breastfeeding Advice." Journal of Victorian Culture 25, no. 2 (January 8, 2020): 223–39. http://dx.doi.org/10.1093/jvcult/vcz065.
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Abstract The maternal role and its associated practices were subject to much scrutiny throughout the Victorian period. Whilst motherhood was seen as the natural destiny of the (respectable) woman, mothers were nonetheless deemed in need of strict guidance on how best to raise their offspring. This was offered in an extensive range of advice and conduct books, via newspapers, journals, and fiction, and from medical practitioners, and covered pregnancy, childbirth, and all aspects of care for babies and young children. This article considers Victorian advice on infant feeding, focusing in particular on the various strategies deployed to encourage mothers to breastfeed. Advice literature for mothers frequently invoked patriarchal – religious, medical, and (pseudo-) scientific – authority, in line with broader Victorian discourses on femininity. Much of this advice was produced by, or drew on, the authority of (male) medical practitioners, whilst comparatively little emphasis was placed on maternal experience as a source of expertise. Set within the wider historical context of shifting trends in infant feeding, this article analyses the various persuasive techniques employed by the authors of advice literature, which ultimately served as an attempt to control women’s maternal behaviours and to suppress their own maternal authority.
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Jouanne, Marie, Sarah Oddoux, Antoine Noël, and Anne Sophie Voisin-Chiret. "Nutrient Requirements during Pregnancy and Lactation." Nutrients 13, no. 2 (February 21, 2021): 692. http://dx.doi.org/10.3390/nu13020692.
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A woman’s nutritional status during pregnancy and breastfeeding is not only critical for her health, but also for that of future generations. Nutritional requirements during pregnancy differ considerably from those of non-pregnant women. Thus, a personalized approach to nutritional advice is recommended. Currently, some countries recommend routine supplementation for all pregnant women, while others recommend supplements only when necessary. Maternal physiological adaptations, as well as nutritional requirements during pregnancy and lactation, will be reviewed in the literature examining the impacts of dietary changes. All of these data have been studied deeply to facilitate a discussion on dietary supplement use and the recommended doses of nutrients during pregnancy and lactation. The aim of this review is to evaluate the knowledge in the scientific literature on the current recommendations for the intake of the most common micronutrients and omega-3 fatty acids during pregnancy and lactation in the United States, Canada, and Europe. Taking into account these considerations, we examine minerals, vitamins, and omega-3 fatty acid requirements. Finally, we conclude by discussing the potential benefits of each form of supplementation.
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Edgley, Alison, and Julie Roberts. "Love, Fear, and Disgust: Deconstructing Masculinities and Affective Embodiment in Pregnancy Guides for Men." Men and Masculinities 24, no. 4 (February 3, 2021): 652–70. http://dx.doi.org/10.1177/1097184x21990711.
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Employing a material discursive approach, this article deconstructs advice within published guides to pregnancy and birth written by men for men. We deconstruct the representation of feelings and emotions in men during this period rejecting essentialist and social constructionist views of gendered emotionality. We find the texts are saturated with emotional advice, which is ambivalent and resorts to forms of essentialism that obscure male vulnerabilities and leave male forms of power intact. While men can expect to feel love, fear, and disgust, the case for male calm and stoicism is reconstructed, threatening dire consequences if he fails. Our study makes a unique contribution to our understanding of the affective assemblage that accompanies men who are now expected to care during pregnancy, labor, and birth. Men are constructed as having an embodied experience that cannot be admitted to, ensuring that hegemonic masculine understandings reinforce gendered constructions of care, caring and emotions during pregnancy, labor and birth.
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Davidoff, Christopher L., Anna Lo Presti, Jeffrey M. Rogers, Mary Simons, Nazih N. A. Assaad, Marcus Andrew Stoodley, and Michael Kerin Morgan. "Risk of First Hemorrhage of Brain Arteriovenous Malformations During Pregnancy: A Systematic Review of the Literature." Neurosurgery 85, no. 5 (May 31, 2019): E806—E814. http://dx.doi.org/10.1093/neuros/nyz175.
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Abstract BACKGROUND Recommendations on the management of brain arteriovenous malformations (bAVM) with respect to pregnancy are based upon conflicting literature. OBJECTIVE To systematically review the reported risk and annualized rate of first intracranial hemorrhage (ICH) from bAVM during pregnancy and puerperium. METHODS MEDLINE, EMBASE, and Scopus databases were searched for relevant articles in English published before April 2018. Studies providing a quantitative risk of ICH in bAVM during pregnancy were eligible. RESULTS From 7 initially eligible studies, 3 studies met the criteria for providing quantitative risk of first ICH bAVM during pregnancy. Data from 47 bAVM ICH during pregnancy across 4 cohorts were extracted for analysis. Due to differences in methodology and definitions of exposure period, it was not appropriate to combine the cases. The annualized risk of first ICH during pregnancy for these 4 cohorts was 3.0% (95% confidence interval [CI]: 1.7-5.2%); 3.5% (95% CI: 2.4-4.5%); 8.6% (95% CI: 1.8-25%); and 30% (95% CI: 18-49%). Only the last result from the last cohort could be considered significantly increased in comparison with the nonpregnant period (relative rate 6.8, 95% CI: 3.6-13). The limited number of eligible studies and variability in results highlighted the need for enhanced rigor of future research. CONCLUSION There is no conclusive evidence of an increased risk of first hemorrhage during pregnancy from bAVM. Because advice to women with bAVM may influence the management of pregnancy or bAVM with significant consequences, we believe that a retrospective multicenter, case crossover study is urgently required.
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Chung, Eric, and Gerald B. Brock. "Cryptorchidism and its impact on male fertility: a state of art review of current literature." Canadian Urological Association Journal 5, no. 3 (April 4, 2013): 210. http://dx.doi.org/10.5489/cuaj.645.
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Cryptorchidism is associated with impairment of germ cellmaturation and subsequent infertility in adulthood. The presentreport details common scenarios of referral of men with prior historyof cryptorchidism and orchidopexy seeking advice for infertility,and examines the association between cyrptorchidism and maleinfertility. The increase in the understanding of the hormonalprofiles and patho-physiological changes in germ cell maturationin cryptorchid boys may potentially change our approach andmanagement strategies. Improvement in sperm retrieval techniquesand micromanipulation techniques, such as intracytoplasmic sperminjection, has led to excellent fertilization and pregnancy outcomesof treatment cycles.
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Orban, N., E. Maughan, and N. Bleach. "Pregnancy-induced rhinitis." Rhinology journal 51, no. 2 (June 1, 2013): 111–19. http://dx.doi.org/10.4193/rhino12.045.
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Background: Pregnancy-induced rhinitis (PIR) is often misclassified and under-diagnosed. There is currently no cure or optimum symptomatic treatment. Objective: To summarize current knowledge of PIR and assess evidence supporting treatment options. Type of review: Structured literature search. SEARCH STRATEGY AND EVALUATION METHOD: Review of English-language articles addressing evidence for aetiology, classification, differential diagnosis or treatment options for PIR. Comparisons to management of other types of rhinitis in pregnancy are also considered. Results: Incidence and prevalence of PIR vary widely between studies. Hormonal changes have a presumed aetiological role, although present evidence is scanty. Smoking appears to be the only agreed identifiable risk factor. Distinction between PIR and other types of rhinitis in pregnancy, especially allergic rhinitis, is important as effective treatments differ. Management of PIR focuses on minimal intervention required for symptom relief. Conclusions: Although PIR is temporary, its impact on patients` quality of life can be profound. Advice and conservative treatment provide the mainstay of clinical management. None of the currently available medical options offer an ideal solution. Any potential benefit gained should be balanced against risks to the foetus. Clarifying the definition of this separate category of rhinitis will lead to better recognition, with prompt and appropriate treatment.
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Beezhold, J. N., D. Fagard, and C. Harabajiu. "Valproate used during pregnancy: What should be done?" European Psychiatry 41, S1 (April 2017): S419. http://dx.doi.org/10.1016/j.eurpsy.2017.01.375.
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BackgroundSodium valproate can cause serious developmental disorders in unborn babies if taken while pregnant, especially in the first trimester.AimTo review recent literature and advice or treatment for women who have or are using valproate whilst pregnant.DesignLiterature review.MethodsLiterature review using Pubmed with search terms: ‘bipolar’; ‘pregnant’; ‘valproate’ and following up references.ResultsThere are several small methodologically flawed studies that attempt to address this question and will be reprised. Three key population register studies found high rates of malformations. A retrospective study of longer-term outcomes found high rates of developmental issues. There are several relevant treatment guidelines, including from the National Institute for Health and Clinical Excellence (NICE). There is a 40% risk of developmental disorder, a 10% risk of congenital malformations and a 3% risk of IQ deterioration.ConclusionsAvoid valproate in women of childbearing age if at all possible, and consider effective contraception if used. If already pregnant then consider, with involvement from the patient, stopping or minimizing the dose of sodium valproate. Assess the risks and benefits of using sodium valproate during pregnancy versus stopping the treatment for the first trimester as symptoms of the disorder may return. Seek advice from a perinatal psychiatrist. Add 5 mg of folic acid daily for the remainder of the pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Rosiou, Konstantina, and Christian P. Selinger. "Obstetric Considerations in Pregnant Women with Crohn’s Disease." Journal of Clinical Medicine 12, no. 2 (January 15, 2023): 684. http://dx.doi.org/10.3390/jcm12020684.
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Crohn’s disease affects many women of childbearing age. Fecundity rates are often lower than in the general population due to reduced fertility during active inflammation, effects of pelvic surgery or voluntary childlessness. Many women have concerns regarding the effects of pregnancy on their Crohn’s, any potential effect of medication on the fetus, and passing on Crohn’s disease to the offspring. International guidelines on reproduction for women with Crohn’s disease provide evidence-based advice to patients and health care professionals. There is an increasing literature on the safety of advanced medication for Crohn’s disease during pregnancy. This review article therefore focuses on obstetric considerations beyond medication safety. We provide information on fertility, factors affecting pregnancy and fetal outcomes, obstetric complications, factors influencing mode of delivery, management of intestinal stomas during pregnancy and general considerations around breast feeding.
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Aoyama, Tomoko, Donglai Li, and Jacquie Lindsay Bay. "Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region." Nutrients 14, no. 6 (March 18, 2022): 1288. http://dx.doi.org/10.3390/nu14061288.
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Nutrition and weight gain during pregnancy can influence the life-course health of offspring. Clinical practice guidelines play an important role in ensuring appropriate nutrition and weight gain among pregnant women. This study aims to identify clinical practice guidelines on gestational weight gain and/or maternal nutrition across the Asia-Pacific region and to determine the quality of the guidelines and variability in the recommendations. Through a systematic search of grey literature from 38 Asia-Pacific countries, 23 published guidelines were obtained. Of these, 10 eligible clinical practice guidelines reporting nutrition- or/and weight-related recommendations for pregnant women were selected and reviewed. Guideline quality was determined using the Assessment of Guidelines for Research Evaluation II (AGREE II) instrument. Of the 10 guidelines, 90% were classified as low-quality in the AGREE II appraisal. Several variations were found with respect to recommendations on gestational weight gain, including those specific to Asian populations. The recommendations on dietary advice, additional energy intake, and nutritional supplementation during pregnancy were varied. Clinical practice guidelines on weight gain and nutrition in pregnancy across the Asia-Pacific region are generally of poor quality, reflecting significant variation, and need to be improved to ensure pregnant women receive appropriate advice. (PROSPERO registration no. CRD42021291395).
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Burzyńska, Katarzyna. "Misreading Moll’s Virginal Body in A Chaste Maid in Cheapside." Interdisciplinary Literary Studies 24, no. 4 (November 1, 2022): 491–511. http://dx.doi.org/10.5325/intelitestud.24.4.0491.
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ABSTRACT This article investigates the early modern fluidity of pregnancy and instability of the reproductive health discourse in order to reconsider Moll’s “green-sickness,” her embodiment and agency in A Chaste Maid in Cheapside. Taking an (eco)feminist and phenomenological perspective, I argue that Moll has been misdiagnosed by both the play’s characters and critics who failed to recognize her sexual responsiveness to a suitor of her choice. In what follows I look at Middleton’s treatment of contemporary medical knowledge on female health, pregnancy, and labor in order to illuminate a pervasive erasure of female sexual agency in the period. Although Middleton’s characters follow contemporary medical advice, they use it chaotically, contributing to a momentary collapse of virgin/whore, fertile/barren labels—capturing a sex-gender system in flux. The play’s glimpse into maids’ realities problematizes rather than confirms the precepts of humoral medicine.
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Adesomo, Adebayo, Veronica Gonzalez-Brown, and Kara M. Rood. "Infective Endocarditis as a Complication of Intravenous Drug Use in Pregnancy: A Retrospective Case Series and Literature Review." American Journal of Perinatology Reports 10, no. 03 (July 2020): e288-e293. http://dx.doi.org/10.1055/s-0040-1716732.
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Abstract Objective An increase in opioid use disorder and subsequent intravenous drug use has led to an increase in sequalae that may complicate pregnancy, such as infective endocarditis. Infective endocarditis has the potential for significant maternal and neonatal morbidity and mortality. We sought to examine the management considerations and clinical implications of intravenous drug use-related infective endocarditis in pregnancy from our center's experience. Study Design Retrospective study of management of pregnancies complicated by infective endocarditis as a result of active intravenous drug use at an academic tertiary care hospital from January 2012 through December 2019. Results Twelve women with active intravenous drug use histories were identified as having clinical and echocardiographic features consistent with infective endocarditis. Six women were discharged against medical advice and did not complete the full course of recommended antibiotic regimen. Eight women were started or continued on opioid agonist therapy during their hospitalization. Four neonates required neonatal intensive care unit admission for pharmacologic treatment for neonatal abstinence syndrome. Conclusion Management of intravenous drug use-associated infective endocarditis in pregnancy involves more than treating the acute condition. In pregnant women with opioid use disorder and infective endocarditis, addiction and chronic psychosocial conditions need to be addressed to optimize care.
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Ramos, S. Freitas, D. Cruz E Sousa, B. Jesus, J. Martins Correia, M. I. Fonseca Marinho Vaz Soares, and J. Mendes. "“It is natural so it must be safe!”: Cannabis use during pregnancy, an update." European Psychiatry 64, S1 (April 2021): S833. http://dx.doi.org/10.1192/j.eurpsy.2021.2201.
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IntroductionRates of cannabis use among pregnant women have been increasing. Psychiatrists may be required to provide counselling regarding marijuana use in pregnancy for their patients.ObjectivesTo produce an up-to-date review of cannabis effects on pregnancy and the offspring.MethodsWe performed a non-systematic review of the literature apropos a clinical case.ResultsA 31-years-old, 22-weeks pregnant woman presented with severe anxiety, panic attacks and insomnia which she managed solely with cannabis. She had been previously treated with antidepressants and benzodiazepines with symptom remission but had suspended before her pregnancy without medical advice. She believed medication was more harmful to the baby than her cannabis use. There is little perception of risk concerning cannabis use in pregnant woman. Information on cannabis use is less likely to be obtained from healthcare providers than from anecdotal experiences, Internet searching and advice from friends and family. Prenatal use of cannabis has been associated with anaemia in the mother, whereas in the offspring it is associated with reduction in birth weight and greater likelihood of placement in intensive care units. There is insufficient evidence to support an association between marijuana use and any specific congenital abnormality, but also to demonstrate its safety.ConclusionsIt is essential for psychiatrists to have up-to-date knowledge of the effects of cannabis on the pregnancy and the offspring to properly counsel their patients. However, the effects of cannabis on maternal and foetal outcomes remain generally unknown. With rising numbers of female users, there is urgent need for further research.DisclosureNo significant relationships.
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Hinton, Lisa, Alison Chisholm, Beth Jakubowski, Sheila Greenfield, Katherine L. Tucker, Richard J. McManus, and Louise Locock. "“You Probably Won’t Notice Any Symptoms”: Blood Pressure in Pregnancy—Discourses of Contested Expertise in an Era of Self-Care and Responsibilization." Qualitative Health Research 31, no. 9 (June 11, 2021): 1632–44. http://dx.doi.org/10.1177/10497323211003067.
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Pregnancy is not a disease or illness, but requires clinical surveillance as life-threatening complications can develop. Preeclampsia, one such potentially serious complication, puts both mother and baby at risk. Self-monitoring blood pressure in the general population is well established, and its potential in pregnancy is currently being explored. In the context of self-monitoring, the information and guidance given to women regarding hypertension, and the literature they themselves seek out during pregnancy, are vital to perceptions of disease risk and subsequent responses to, and management of, any symptoms. Drawing on online, offline, official, and unofficial sources of information, discourses are examined to provide analysis of how self-responsibilization is reflected in contemporary information, advice, and guidance drawn from multiple sources. A paradox emerges between the paternalistic and lay discourses that seek to challenge and regain control. Findings are discussed in the context of Foucault’s governmentality and medical power.
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Ahuja, Maninder. "Bed Rest in Pregnancy and Its Related Complications: Is It Needed?" Journal of South Asian Federation of Obstetrics and Gynaecology 4, no. 3 (2012): 147–50. http://dx.doi.org/10.5005/jp-journals-10006-1199.
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ABSTRACT For centuries it is common myth to advice bed rest during pregnancy. At the least pretext bed rest is advised by family members and by health care providers also. But review of literature and RCT shows that in reality bed rest does not alter the course of pregnancy in various complications. Role of bed rest has been examined in singleton, twin and triplet pregnancies but was not found useful. Prolonged bed rest is rather harmful as it causes increased calcium excretion, loss of muscle mass, financial loss and increased psychological rest for the pregnant woman and her family. Moderate exercise is advisable throughout pregnancy to maintain tone of muscles and range of movements. So till we have more proof we should be cautious in advising pregnant patients about bed rest. It can be limited activity where we feel it is not advisable to overexert her. How to cite this article Ahuja M. Bed Rest in Pregnancy and Its Related Complications: Is It Needed?. J South Asian Feder Obst Gynae 2012;4(3):147-150.
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Okafor, Uchenna Benedine, and Daniel Ter Goon. "Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review." Healthcare 9, no. 5 (May 19, 2021): 609. http://dx.doi.org/10.3390/healthcare9050609.
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Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.
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Bajaj, Archana Dhawan. "A self-study on identification of etiology of Anemia in pregnancy." Indian Journal of Obstetrics and Gynecology Research 9, no. 4 (November 15, 2022): 537–40. http://dx.doi.org/10.18231/j.ijogr.2022.102.
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Anemia in medical literature could be defined as when levels of hemoglobin are below two standard derivation of the mean for age and gender of patients. During pregnancy many women lacks the sufficient amount of iron which is needed for 2 & 3 trimesters due to significant changes in increase in volume of blood to support the growth of baby, person could suffer from anemia. Based on several researches conducted it have been stated that anemia is one of the most common complications which could occur in pregnancy.A systemic self-study was planned to determine and review the possible cause of Anemia during pregnancy. With the application of electronic databases we searched PubMed, Google Scholar, Web of Science, Clinical Trial Gov, Medline Plus, health line, John Hopkins Medicine which were published in English language. This systemic self-study have reviewed the facts which were published earlier to determine the cause of anemia during pregnancy. Vast analysis was made to determine the cause of anemia during pregnancy.We observed and concluded the fact that anemia during pregnancy occurs due to iron and folate deficiency. In more than 50 percent of studies conducted in pregnant women, we observed that one who have less adequate diet and did not received any prenatal iron and folate supplement have the chances to suffer from iron deficiency and folate deficiency anemia.We conclude by delivery of very important message that adequate iron and folate intake is very crucial for both mother and child during pregnancy. Healthcare professionals must provide proper nutritional advice and essential supplementation which is required at their first consultation with mother’s which lowers and minimalizes the risk of anemia related complications in future.
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Lacombe-Duncan, Ashley, Nazanin Andalibi, Lee Roosevelt, and Emma Weinstein-Levey. "Minority stress theory applied to conception, pregnancy, and pregnancy loss: A qualitative study examining LGBTQ+ people’s experiences." PLOS ONE 17, no. 7 (July 26, 2022): e0271945. http://dx.doi.org/10.1371/journal.pone.0271945.
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Many lesbian, gay, bisexual, transgender (trans), queer, and other sexual and gender minority (LGBTQ+) people desire to conceive children. Yet, LGBTQ+ peoples’ experiences are scant in reproductive health literature, particularly around pregnancy loss—a stigmatized and distressing pregnancy outcome. Informed by minority stress theory, this qualitative study aimed to explore the experiences of multi-level stigma and resilience among LGBTQ+ people in the context of conception, pregnancy, and loss. Seventeen semi-structured individual interviews (25–70 minutes) were conducted (2019) with a purposive sample of LGBTQ+ people in the United States (U.S.) who had experienced pregnancy loss (n = 14) or in an intimate partnership in which a pregnancy was lost (n = 3) in the last two years. Transcribed interviews were analyzed thematically. Participants described the profound sadness of pregnancy loss due to unique challenges of LGBTQ+ conception. Multiple types of stigma manifested at intrapersonal (e.g., anticipated sexual stigma upon disclosure), interpersonal (e.g., unsolicited advice about conception decisions), and structural levels (e.g., differential requirements to access conception compared to heterosexual/cisgender couples). Resilience was also seen individually (e.g., purposeful disclosure of conception, pregnancy, and loss), relationally (e.g., connecting with other LGBTQ+ community members), and collectively (e.g., creating/engaging in LGBTQ+-specific conception, pregnancy, and loss online spaces). LGBTQ+ people experience minority stressors of multi-level stigmatization throughout the pregnancy process, which limits their access to social support after experiencing pregnancy loss. However, individual, relational, and collective resilience strategies abound in response. Thus, minority stress theory can also be applied to recognize strengths-based and affirming approaches to reproductive healthcare for LGBTQ+ people.
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Doyle, Ina-Merle, Brigitte Borrmann, Angelique Grosser, Oliver Razum, and Jacob Spallek. "Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis." Public Health Nutrition 20, no. 6 (November 17, 2016): 1009–28. http://dx.doi.org/10.1017/s1368980016002937.
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AbstractObjectiveTo identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence.DesignA systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle–Ottawa Scales.SettingHigh- and upper-middle-income countries.SubjectsPregnant or postpartum women reporting their dietary intake during pregnancy.ResultsSeventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail.ConclusionsThe framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.
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Akira, A., A. Deka, and D. Banayan. "“I heard the heartbeat”- Psychophysiological and Sociocultural Determinants in Pseudocyesis and Delusion of Pregnancy." European Psychiatry 65, S1 (June 2022): S235. http://dx.doi.org/10.1192/j.eurpsy.2022.608.
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Introduction Pseudocyesis and Delusion of Pregnancy are often conflated. Both presentations are associated with false beliefs of pregnancy in patients who are not pregnant. Pseudocyesis is associated with physiological changes of pregnancy such as amenorrhea, galactorrhea, abdominal distention, and hyperprolactinemia. Delusion of Pregnancy is not associated with physiological signs/changes. We describe a case to demonstrate the phenomenological and physiological differences between these entities and how these influence treatment considerations. Objectives 1.Phenomenology of Pseudocyesis vs Delusion of Pregnancy 2.Elucidate the physiological underpinnings of both 3.Treatment considerations Methods Comprehensive literature review following a 29-year-old-female with no known psychiatric history presenting to the emergency department with mixed complaints of twin-pregnancy, menorrhagia, and concern for threatened abortion. Psychiatry was consulted for decisional capacity to leave against-medical-advice due to concerns for ectopic pregnancy. Patient reported a recent ultrasound with fetal heartbeat and sensation of fetal “kicks”. She was concerned the menorrhagia was threatening her pregnancy. The patient appeared irritable, paranoid, endorsed ideas of reference and a fixed false belief that she was pregnant with twins, despite quantitative HCG, abdominal and transvaginal ultrasounds being negative. On examination, while there was vaginal bleeding, there were no stigmata of pregnancy. Results Diagnosis- Delusion of Pregnancy. Conclusions Delusion of Pregnancy have been associated with polythematic content. Pseudocyesis may be confounded by conditions such as abdominal neoplasms, leiomyoma, and endocrinologic changes (eg- hyperprolactinemia). Potent D2R antagonists carry increased risk of hyperprolactinemia and subsequent galactorrhea which may paradoxically exacerbate misattributions of pregnancy. Careful consideration of psychotropic choice is therefore needed in the management of these conditions. Disclosure No significant relationships.
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Grammatikopoulou, Maria G., Xenophon Theodoridis, Konstantinos Gkiouras, Maria Lampropoulou, Arianna Petalidou, Maria Patelida, Efrosini Tsirou, Constantina Papoutsakis, and Dimitrios G. Goulis. "Methodological quality of clinical practice guidelines for nutrition and weight gain during pregnancy: a systematic review." Nutrition Reviews 78, no. 7 (November 22, 2019): 546–62. http://dx.doi.org/10.1093/nutrit/nuz065.
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Abstract Context Ensuring a healthy pregnancy and achieving optimal gestational weight gain (GWG) are important for maternal and child health. Nevertheless, the nutritional advice provided during pregnancy is often conflicting, suggesting limited adherence to clinical practice guidelines (CPGs). Objective The aim of this review was to identify all CPGs on maternal nutrition and GWG and to critically appraise their methodological quality. Data Sources The MEDLINE/PubMed, Cochrane, Guidelines International Network, and BMJ Best Practice databases, along with gray literature, were searched from inception until February 2019 for CPGs and consensus, position, and practice papers. Study Selection Clinical practice guidelines published in English and containing advice on maternal nutrition or GWG were eligible. Data Extraction Two authors independently extracted data on items pertaining to maternal nutrition or GWG, and CPGs were appraised using the AGREE II instrument. Results Twenty-two CPGs were included. All scored adequately in the “scope” domain, but most were considered inadequate with regard to stakeholder involvement, rigor of development, applicability, and editorial independence. Many CPGs lacked patient or dietician involvement, and more than half did not disclose funding sources or conflicts of interest. Guidance on GWG was based mostly on Institute of Medicine thresholds, while nutrition recommendations appeared scattered and heterogeneous. Conclusion Despite the importance of maternal nutrition and the plethora of advising bodies publishing relevant guidance, there is room for substantial improvement in terms of development standards and content of nutritional recommendations. Systematic review registration PROSPERO registration number CRD42019120898.
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Pavlovsky, Carolina, Isabel Giere, and Germán Van Thillo. "Planned Pregnancy in a Chronic Myeloid Leukemia Patient in Molecular Remission." Case Reports in Hematology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/624590.
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Excellent response rates and a good quality of life have been observed since the introduction of tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) treatment. Consequently, some challenges began to appear in CML women in child-bearing age wishing to become pregnant. Currently, many women around the world are in stable major/complete molecular response MMR/CMR (MMR: <0.1% BCR-ABL/ABL and CMR: undetectable BCR-ABL mRNA by RQ-PCR transcript levels on the international scale). The condition of stable MMR/CMR is linked to a long-term virtual absence of progression to the accelerated and blastic phase and to the possibility of stopping the TKI treatment with the maintenance of a condition of CMR in a proportion of cases. Imatinib teratogenic and prescribing information prohibits the use of it during pregnancy. We describe the case of a 36-year-old female patient with CML in chronic phase who stopped imatinib after 2 years in major molecular response (MMR) to plan a pregnancy. Molecular monitoring by RQ-PCR was performed quarterly. She achieved a safe pregnancy and delivery maintaining an optimal molecular response throughout the pregnancy. Isolated literature reports have been described, but no formal advice has been described at present time.
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Baroni, Luciana, Silvia Goggi, Roseila Battaglino, Mario Berveglieri, Ilaria Fasan, Denise Filippin, Paul Griffith, et al. "Vegan Nutrition for Mothers and Children: Practical Tools for Healthcare Providers." Nutrients 11, no. 1 (December 20, 2018): 5. http://dx.doi.org/10.3390/nu11010005.
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As the number of subjects choosing vegan diets increases, healthcare providers must be prepared to give the best advice to vegan patients during all stages of life. A completely plant-based diet is suitable during pregnancy, lactation, infancy, and childhood, provided that it is well-planned. Balanced vegan diets meet energy requirements on a wide variety of plant foods and pay attention to some nutrients that may be critical, such as protein, fiber, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, and vitamin B12. This paper contains recommendations made by a panel of experts from the Scientific Society for Vegetarian Nutrition (SSNV) after examining the available literature concerning vegan diets during pregnancy, breastfeeding, infancy, and childhood. All healthcare professionals should follow an approach based on the available evidence in regard to the issue of vegan diets, as failing to do so may compromise the nutritional status of vegan patients in these delicate periods of life.
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Irmawati, Irmawati, Andi Nilawati Usman, Mardiana Ahmad, and Nur Aliya Arsyad. "HUSBAND SUPPORT IN PREGNANT WOMEN WHO TAKE FOLAMIL SUPPLEMENTS FOR INCREASING HEMOGLOBIN LEVELS: A LITERATURE REVIEW." Nurse and Health: Jurnal Keperawatan 11, no. 1 (June 29, 2022): 199–208. http://dx.doi.org/10.36720/nhjk.v11i1.315.
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Background: Folic acid deficiency in pregnancy will cause impaired maturation of erythrocyte nuclei, resulting in the appearance of red blood cells with abnormal shapes and sizes referred to as megaloblastic anemia, further impaired folic acid metabolism will cause impaired DNA replication and cell division processes, and this will affect the work of all cells of the body, including in iron metabolism.
Objectives: This study aims to determine the effect of husband support on pregnant women who consume phthalate supplements for increased hemoglobin levels.
Design: This research design is a systematic review to find and review articles from databases and theories that are descriptive.
Data Sources: Search for articles using the old version of the Mendeley application by entering the keyword "folic acid in pregnant women with inclusion criteria, namely the year of publication 2017-2021, English, full text and open access. There were 11 articles that were willing to be reviewed based on the inclusion criteria.
Review Methods: Systematic review method by filtering on the Mendeley website based on inclusion criteria, then collected and made a summary of the journal including the name of the researcher, year of publication of the journal, research title, method, and summary of results or findings. Summary of research journals are entered in table 1.
Results: From the search for articles, 4,463 articles were found. After filtering 9 eligible articles based on inclusion criteria, it was found that the level of folic acid consumption for pregnant women was still very low. Husband's support from the family can encourage pregnant women to be more enthusiastic in dealing with the changes that occur during pregnancy, including maintaining a healthy pregnancy through increased pregnancy visits and consumption of folic acid supplements. Pregnant women who receive attention and support from their husbands and families are more likely to accept and follow the advice given by health workers compared to pregnant women who receive less attention and support from their husbands and families.
Conclusion: Husband support in pregnant women who take Folamil supplements for the improvement of Haemoglobin is an important factor and has a very large influence on the health of pregnant women, so cooperation is needed between health workers and the family, especially the husband, in order to improve the health status of pregnant women.
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Bettiol, Alessandra, Niccolò Lombardi, Ettore Marconi, Giada Crescioli, Roberto Bonaiuti, Valentina Maggini, Eugenia Gallo, et al. "The Impact of Previous Pregnancy Loss on Lactating Behaviors and Use of Herbal Medicines during Breastfeeding: A Post Hoc Analysis of the Herbal Supplements in Breastfeeding InvesTigation (HaBIT)." Evidence-Based Complementary and Alternative Medicine 2018 (November 8, 2018): 1–7. http://dx.doi.org/10.1155/2018/1035875.
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Introduction. Complementary and alternative medicines (CAMs) are commonly used among lactating women, despite the poor knowledge of these products and of their safety. Perception of pregnancy- and breastfeeding-related difficulties and consequent use of CAMs may differ in bereaved women, by force of the distress related to previous loss, although no literature evidence is available. This Herbal supplements in Breastfeeding InvesTigation (HaBIT) post hoc analysis explored the impact of previous pregnancy loss on lactating behaviors and on use of CAMs during breastfeeding. Methods. A web-based survey was conducted among lactating women with no previous alive child, resident in Tuscany (Italy). Data on lactating behavior and on CAMs use were collected and evaluated among women with previous pregnancy loss as compared to control women. Results. Out of 476 women answering the questionnaire, 233 lactating women with one child were considered. Of them, 80 had history of pregnancy loss. Cesarean birth was significantly more frequent among women with history of pregnancy loss as compared to controls (41% versus 22%; p=0.004). Proportion, length of exclusive breastfeeding, and occurrence of breastfeeding-related complications were comparable among the two cohorts. More than half of women used CAMs during breastfeeding. Use of CAMs was more frequent among women with previous pregnancy loss (54% versus 68%; p=0.050), specifically considering herbal preparations (16% versus 30%; p=0.018). Major advisors for CAMs use were midwives. 18% and 23% of women without and with history of pregnancy loss declared no clear perception on CAMs efficacy and safety. Conclusion. Overcoming the social taboo of pregnancy loss and training healthcare professionals for an adequate management of the perinatal period are essential for an effective and safe care. Despite the common use and advice on CAMs use during breastfeeding, it is important to acknowledge that limited evidence supports their safety and efficacy during such critical period.
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Bauld, Linda, Hilary Graham, Lesley Sinclair, Kate Flemming, Felix Naughton, Allison Ford, Jennifer McKell, et al. "Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study." Health Technology Assessment 21, no. 36 (June 2017): 1–158. http://dx.doi.org/10.3310/hta21360.
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Background Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women’s significant others (SOs) and support from health-care professionals (HPs). Objectives To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking. Design Four parts: (1) a description of interventions in the UK for smoking cessation in pregnancy; (2) three systematic reviews (syntheses) of qualitative research of women’s, SOs’ and HPs’ views of smoking in pregnancy using meta-ethnography (interpretative approach for combining findings); (3) semistructured interviews with pregnant women, SOs and HPs, guided by the social–ecological framework (conceptualises behaviour as an outcome of individuals’ interactions with environment); and (4) identification of new/improved interventions for future testing. Setting Studies in reviews conducted in high-income countries. Qualitative research was conducted from October 2013 to December 2014 in two mixed urban/rural study sites: area A (Scotland) and area B (England). Participants Thirty-eight studies (1100 pregnant women) in 42 papers, nine studies (150 partners) in 14 papers and eight studies described in nine papers (190 HPs) included in reviews. Forty-one interviews with pregnant women, 32 interviews with pregnant women’s SOs and 28 individual/group interviews with 48 HPs were conducted. Main outcome measures The perceived barriers to, and facilitators of, smoking cessation in pregnancy and the identification of potential new/modified interventions. Results Syntheses identified smoking-related perceptions and experiences for pregnant women and SOs that were fluid and context dependent with the capacity to help or hinder smoking cessation. Themes were analysed in accordance with the social–ecological framework levels. From the analysis of the interviews, the themes that were central to cessation in pregnancy at an individual level, and that reflected the findings from the reviews, were perception of risk to baby, self-efficacy, influence of close relationships and smoking as a way of coping with stress. Overall, pregnant smokers were faced with more barriers than facilitators. At an interpersonal level, partners’ emotional and practical support, willingness to change smoking behaviour and role of smoking within relationships were important. Across the review and interviews of HPs, education to enhance knowledge and confidence in delivering information about smoking in pregnancy and the centrality of the client relationship, protection of which could be a factor in downplaying risks, were important. HPs acknowledged that they could best assist by providing support and understanding, and access to effective interventions, including an opt-out referral pathway to Stop Smoking Services, routine carbon monoxide screening, behavioural support and access to pharmacotherapy. Additional themes at community, organisational and societal levels were also identified. Limitations Limitations include a design grounded in qualitative studies, difficulties recruiting SOs, and local service configurations and recruitment processes that potentially skewed the sample. Conclusions Perceptions and experiences of barriers to and facilitators of smoking cessation in pregnancy are fluid and context dependent. Effective interventions for smoking cessation in pregnancy should take account of the interplay between the individual, interpersonal and environmental aspects of women’s lives. Future work Research focus: removing barriers to support, improving HPs’ capacity to offer accurate advice, and exploration of weight concerns and relapse prevention. Interventions focus: financial incentives, self-help and social network interventions. Study registration This study is registered as PROSPERO CRD42013004170. Funding The National Institute for Health Research Health Technology Assessment programme.
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Mekonnen, Berhanu Abebaw, Yadeta Dessie, Negga Baraki, Abdu Oumer, and Mehari Gebru. "Adherence to iron and folic acid supplementation and associated factors among antenatal care attendants in Northwest Ethiopia." International Journal of Public Health Science (IJPHS) 9, no. 1 (March 1, 2020): 20. http://dx.doi.org/10.11591/ijphs.v9i1.20385.
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<p>Iron and folic acid supplementation is the key approach for anemia prevention and control during pregnancy. In Ethiopia only <1% of pregnant mothers ingest the ideal number of tablets. Although, adherence is the most important challenge, literature is dearth and the predictors are undoubtedly recognized. Institution based quantitative cross sectional study design triangulated with qualitative methods was employed among 395 systematically selected pregnant mothers attending antenatal care in Debre Markos town, Ethiopia. Data were collected using interviewer administered structured questionnaire. Data were entered into Epi data and exported to SPSS software. Bivariate and multivariable Logistic regression with the 95% confidence interval was computed. P-value < 0.05 was declared as statistically significant. Eight in-depth interviews were conducted. The data were entered and analyzed using open code software. Adherence rate was 55.5% (95%CI, 50.5%-60.4%). Pregnant mothers who had; history of anemia during current pregnancy [AOR:7.9, 95%CI (4.44-14.01)], primary education (AOR:4.0, 95%CI (1.88-8.54)], secondary education and above (AOR:3.6, 95%CI (1.20-6.94)], good knowledge of iron and folic acid supplementation [AOR:2.1, 95%CI (1.24-3.56)], and early registration for antenatal care (AOR:1.8, 95%CI (1.06-3.11)] were predictors of iron and folic acid supplementation adherence. The rate of adherence was low. Getting medical advice and fear of illness if missed were the primary reasons that enforce mothers to take the tablets. Hence, improving mothers’ knowledge regarding overall aspects of the tablet through better advice, community teaching and the mass media at large, would improve adherence.</p>
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Reyes, Saúl, Mary Ramsay, Shamez Ladhani, Gayatri Amirthalingam, Neena Singh, Carlos Cores, joela Mathews, et al. "Protecting people with multiple sclerosis through vaccination." Practical Neurology 20, no. 6 (July 6, 2020): 435.1–445. http://dx.doi.org/10.1136/practneurol-2020-002527.
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Vaccination is one of the most effective and cost-efficient methods for protecting people with multiple sclerosis (MS) from infections. However, use of vaccines has often been problematic because of misguided concerns that they may exacerbate the disease and/or that some disease-modifying therapies may influence the immune response to immunisations and/or their safety. People with MS risk higher morbidity and mortality from vaccine-preventable infections. It is, therefore, important to address any patient’s reluctance to accept vaccination and to provide clear guidance for clinicians on which vaccinations to consider proactively. We have reviewed the current literature and provide recommendations regarding vaccines in adults with MS, including specific advice regarding vaccination safety in patients receiving—or going to receive—disease-modifying therapies, vaccination during pregnancy, pretravel counselling and patient education.
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Enwerem, Nkechi, Priscillia Okunji, Ntekim Oyonumo, and Amos Samson. "Momordica Charantia (Bitter Melon): Safety and Efficacy During Pregnancy and Lactation." International Journal of Studies in Nursing 3, no. 2 (January 3, 2018): 140. http://dx.doi.org/10.20849/ijsn.v3i2.454.
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Background: The leaf, fruit ,and bark of Momordica charantia (MC)(Common name. Bitter Melon). (Cucurbitaceae) has been used extensively in folk medicine as a remedy for diabetes. Biological and pharmacological activities attributed to different parts and extracts of these plants include anti-HIV, wound healing, anti-helmintic, anti-genotoxicity, larvicidal, antiviral, antimicrobial, anti-obesity, antifertility, anticancer, antidiabetes, antidiarrheal .In Nigeria, a decoction of the leaves or bark is used in folk medicine to manage diabetes. Pregnant and lactating women have been observed, consuming the extract of MC for its folkloric belief as an antidiabetic agent. But its potential for toxicity when administered during pregnancy, lactation and breast feeding has not been completely investigated. The present study was aimed to review the literature for evidence on the use, safety, efficacy and pharmacology of Momordica charantia during pregnancy and lactation.Methods: Seven electronic databases including the Napralert database were searched. Data were compiled based on the grade and evidence found.Results: There were no scientific evidence to support the use of Momordica charantia during pregnancy and lactation. However animal studies in both rodents and primates show that the plant extract, induce abortion. In males, seed extracts of M.charantia, showed indirect evidence of reduced availability of pituitary gonadotrophs necessary for spermatogenesis.Conclusion: Caution should be exercised with the use of Momordica charantia during pregnancy and lactation till human research is conducted to determine its safety. There is a need to be cautious when using preparations containing Momordica charantia. Implications for Nursing: Findings can be utilized by community health nurses and policy makers to advice on the use of Momordica charantia during pregnancy, lactation and in males in their reproductive life.
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Polasek, Thomas M., Matthew P. Doogue, and Tilenka R. J. Thynne. "Metformin treatment of type 2 diabetes mellitus in pregnancy: update on safety and efficacy." Therapeutic Advances in Drug Safety 9, no. 6 (April 25, 2018): 287–95. http://dx.doi.org/10.1177/2042098618769831.
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With the increasing prevalence of type 2 diabetes mellitus (T2DM) in women of childbearing age, prescribing antidiabetic medications in first-trimester pregnancy is becoming more common. Metformin treatment during this time is usually avoided in countries with well-resourced healthcare. This is based on historical concerns about safety to the foetus and the widespread availability of insulin. However, there is now increasing interest in the potential benefits of metformin in pregnant women with T2DM. In this commentary, the main evidence supporting metformin safety in pregnancy is summarized, with an emphasis on the first trimester. Based on a structured literature search, the recent randomized controlled trials comparing metformin and insulin are reviewed. We then show that prescribing advice for metformin in pregnancy is inconsistent and product information/package inserts (PI) are universally out of date. This causes confusion and pushes some women and their clinicians to change from metformin to insulin. The potential advantages of metformin in pregnant women with T2DM are then discussed, including oral dosing and improved acceptability, lower resource utilization and cost, decreased insulin requirements, less maternal weight gain and less risk of maternal and neonatal hypoglycaemia. The conclusion is that metformin is a cheap and efficacious antidiabetic medication for many pregnant women with T2DM, with reasonable evidence for safety. Drug information resources should be updated so that metformin can be considered more broadly in women with T2DM who present for antenatal care.
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Patil, Ashwini Ravindra, and Vishala Turlapati. "THE STUDY ON THE EFFICACY AND OUTCOME OF CHARAKOKTA GARBHINI PARICHARYA IN THE FIRST TRIMESTER OF PREGNANCY." International Journal of Research in Ayurveda and Pharmacy 13, no. 5 (October 15, 2022): 70–74. http://dx.doi.org/10.7897/2277-4343.1305126.
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Pregnancy is the most essential and critical part of every woman's life. Garbhini paricharya is nothing, but the care given to women during their pregnancy, mainly through ahara, vihara and vichara. So systematic examination, dietary and other advice are critical; this systematic supervision is called garbhini paricharya (Antenatal care). In Ayurveda, food is considered the best source of nourishment and medication for a pregnant woman. Ayurveda is described as month-wise Paricharya that helps in the development of the foetus and healthy growth and gives health and care to the mother. In Ayurveda, food is considered the best source of nourishment and medication for pregnant women. The main intention of advising garbhini paricharya is paripurnatya (providing growth of mother and foetus), anupaghata (pregnancy without complications), and sukhaprasava (for a healthy delivery and healthy child). The ancient Ayurvedic literature described in various Samhita; is not unique but also scientific as modern medical sciences. So antenatal care should be integrated, i.e., as per modern science and as described in Ayurveda. In this study, we took patients into two groups, Group A (Trial Group-30 patients) and Group B (Control Group- 30 patients) and gave them Ayurvedic garbhini paricharya in group A and folic acid supplement in group B. After the study, it is found that the incidence of first trimester ailments like fatigue, nausea, vomiting, and constipation shows a statistically significant advantage over the control group.
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Eggenhuizen, Geerke M., Attie Go, Maria P. H. Koster, Esther B. Baart, and Robert Jan Galjaard. "Confined placental mosaicism and the association with pregnancy outcome and fetal growth: a review of the literature." Human Reproduction Update 27, no. 5 (May 13, 2021): 885–903. http://dx.doi.org/10.1093/humupd/dmab009.
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Abstract BACKGROUND Chromosomal mosaicism can be detected in different stages of early life: in cleavage stage embryos, in blastocysts and biopsied cells from blastocysts during preimplantation genetic testing for aneuploidies (PGT-A) and later during prenatal testing, as well as after birth in cord blood. Mosaicism at all different stages can be associated with adverse pregnancy outcomes. There is an onward discussion about whether blastocysts diagnosed as chromosomally mosaic by PGT-A should be considered safe for transfer. An accurate diagnosis of mosaicism remains technically challenging and the fate of abnormal cells within an embryo remains largely unknown. However, if aneuploid cells persist in the extraembryonic tissues, they can give rise to confined placental mosaicism (CPM). Non-invasive prenatal testing (NIPT) uses cell-free (cf) DNA released from the placenta in maternal blood, facilitating the detection of CPM. In literature, conflicting evidence is found about whether CPM is associated with fetal growth restriction (FGR) and/or other pregnancy outcomes. This makes counselling for patients by clinicians challenging and more knowledge is needed for clinical decision and policy making. OBJECTIVE AND RATIONALE The objective of this review is to evaluate the association between CPM and prenatal growth and adverse pregnancy outcomes. All relevant literature has been reviewed in order to achieve an overview on merged results exploring the relation between CPM and FGR and other adverse pregnancy outcomes. SEARCH METHODS The following Medical Subject Headings (MESH) terms and all their synonyms were used: placental, trophoblast, cytotrophoblast, mosaicism, trisomy, fetal growth, birth weight, small for gestational age and fetal development. A search in Embase, PubMed, Medline Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases was conducted. Relevant articles published until 16 July 2020 were critically analyzed and discussed. OUTCOMES There were 823 articles found and screened based on their title/abstract. From these, 213 articles were selected and full text versions were obtained for a second selection, after which 70 publications were included and 328 cases (fetuses) were analyzed. For CPM in eight different chromosomes (of the total 14 analyzed), there was sufficient evidence that birth weight was often below the 5th percentile of fetal growth standards. FGR was reported in 71.7% of CPM cases and preterm birth (<37 weeks of delivery) was reported in 31.0% of cases. A high rate of structural fetal anomalies, 24.2%, in cases with CPM was also identified. High levels of mosaicism in CVS and presence of uniparental disomy (UPD) were significantly associated with adverse pregnancy outcomes. WIDER IMPLICATIONS Based on the literature, the advice to clinicians is to monitor fetal growth intensively from first trimester onwards in case of CPM, especially when chromosome 2, 3, 7, 13, 15, 16 and 22 are involved. In addition to this, it is advised to examine the fetuses thoroughly for structural fetal anomalies and raise awareness of a higher chance of (possibly extreme) premature birth. Despite prematurity in nearly a fifth of cases, the long-term follow-up of CPM life borns seems to be positive. More understanding of the biological mechanisms behind CPM will help in prioritizing embryos for transfer after the detection of mosaicism in embryos through PGT-A.
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Beluska-Turkan, Katrina, Renee Korczak, Beth Hartell, Kristin Moskal, Johanna Maukonen, Diane E. Alexander, Norman Salem, et al. "Nutritional Gaps and Supplementation in the First 1000 Days." Nutrients 11, no. 12 (November 27, 2019): 2891. http://dx.doi.org/10.3390/nu11122891.
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Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching 2020–2025 Dietary Guidelines for Americans (DGA) will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition. The purpose of this review is to summarize the nutrition and supplementation literature for the first 1000 days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Nutrition influencers, such as dietitians, obstetricians/gynecologists, and other relevant health professionals, should continue guiding supplement and food intake and work closely with expectant families and nutrition gatekeepers.
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Böhme Kristensen, Camilla, Mark Ide, Angus Forbes, and Koula Asimakopoulou. "Psychologically informed oral health interventions in pregnancy and type 2 diabetes: a scoping review protocol." BMJ Open 12, no. 9 (September 2022): e062591. http://dx.doi.org/10.1136/bmjopen-2022-062591.
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IntroductionPeriodontal health is becoming a recognised component in managing gestational diabetes. Gestational diabetes is characterised as raised blood glucose levels first discovered in pregnancy and managed similarly to type 2 diabetes. Currently, the standard intervention for gestational diabetes in the UK entails dietary modifications and physical activity interventions. However, considering the literature discussed in this review, it is argued that oral health advice and support should also become an integrated part of gestational diabetes management.ObjectiveThe objective of this scoping review is to map out psychologically informed oral health interventions in pregnancy and type 2 diabetes. This will inform the development of a new behavioural intervention to promote oral health-related behaviours in women with gestational diabetes. As no literature exists on oral health interventions in gestational diabetes, it was deemed appropriate to synthesise the evidence on oral health interventions designed for pregnant women and individuals with type 2 diabetes.MethodologyThe scoping review will be conducted using the Joanna Briggs Institute’s methodology for scoping reviews. Studies including pregnant women and individuals with type 2 diabetes over 18 years of age will be included. Only studies including a psychologically informed oral health intervention will be considered. The authors will consider experimental and quasi-experimental research designs. The Ovid Interface including EMBASE, Medline, Global Health, APA PsychInfo, Health Management Information, Maternity, Infant Care Database and the Cochrane Library will be used as information sources. The planned searches will commence on the week of the 25 July 2022. Only articles in Danish and English will be considered. The study selection will follow the Preferred Reporting Items for Scoping Reviews process. The data will be presented using narrative synthesis.Ethics and disseminationNo ethical approval is needed for this review. The results will be published in a relevant scientific journal.
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Amin, M. Ali Syamsuddin. "Communication Activities in Mitoni Events in Layansari Village (Study of Communication Ethnography Regarding Communication Activities at the Mitoni Event in Layansari Village, Gandrungmangu District, Cilacap Regency in requesting the safety of Mother and Child)." Budapest International Research and Critics Institute (BIRCI-Journal): Humanities and Social Sciences 3, no. 2 (May 8, 2020): 1289–96. http://dx.doi.org/10.33258/birci.v3i2.973.
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This research was intended to gives a deep about the communicating actifity mitoni event in Layansari village . As for focus problems divided by researchers into some sub micro problems that is the situation communicative, communicative events, and the act of communicative in mitoni event. The Methods used in this study was a qualitative methodology tradition ethnography communication. Research Informant amounted to 4 (four), 1 key informant and 3 suppored informants that selected by Purposive. Data collecting technique through in-depth interviews, non participants observation, study literature, internet searching, and documentation. Technique of data analysis is data Collection, Data Reduction, Data Display, Conclusion Veryfication. The results showed that the Communicative Situation, contained in mitoni event was conducted in the Layansari village at pregnant mother’s home. Communicative events in a mitoni as a cultural tradition which is carried out by pregnant woman that seven months pregnancy for entreating the safety of Mother and Child. Communicative Action in mitoni is an action which embodies the verbal and nonverbal behavior as an gratitude expression and entreating the safety. The conclusions of this study that the communication activity in mitoni event inherited from their ancestors by hereditary to embody respect for the ancestors and applying the safety of Mother and Child. The advice from researcher in order to always execute when a pregnant woman that seven months pregnancy in entreating the safety and also to conservating this culture.
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Phulkerd, Sirinya, Parichat Nakraksa, Ladda Mo-suwan, and Mark Lawrence. "Progress towards Achieving the Recommendations of the Commission on Ending Childhood Obesity: A Comprehensive Review and Analysis of Current Policies, Actions and Implementation Gaps in Thailand." Nutrients 13, no. 6 (June 3, 2021): 1927. http://dx.doi.org/10.3390/nu13061927.
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Despite a significant commitment to tackling childhood overweight and obesity, questions remain about the progress the Thai Government has made in implementing childhood obesity prevention policies and actions. This study aimed to review and assess the implementation of the government’s policies and actions for childhood obesity prevention in Thailand compared with the recommendations of the Commission on Ending Childhood Obesity and to identify the implementation gaps. Policy data were collected from governmental and NGO websites and publications and via direct contact with government officials. Stakeholder meetings were held to seek further information and advice on implementation gaps and to give recommendations. The analysis of each policy was conducted against pre-determined criteria formulated from literature assessments and stakeholder consultations. The policies and actions that were implemented by the Government were consistent with 33 broad policy actions and 55 specific policy actions. Preconception and pregnancy care was the policy area that was most implemented. Six broad policy actions were assessed as ‘high’ performance, these were: sugar-sweetened beverage taxation, nutrient labeling, nutrition guidance for preconception and pregnancy care, the International Code of Marketing of Breast-milk Substitutes, regulatory measures for supporting maternal breastfeeding, and regulations on the marketing of complementary foods and beverages. Policy coherence and monitoring and evaluation (M&E) were identified as major implementation gaps. Increasing the effectiveness of childhood obesity prevention in Thailand will require national immediate attention towards building infrastructure to enhance coherence among the policies and to put in place M&E mechanisms for each policy.
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Luigi, Gianluca Di, Angela D’Alfonso, and Gaspare Carta. "Seafood and Omega-3 Supplementation During Pregnancy and Lactation can be Considered Still Safe after Fukushima Nuclear Accident." Journal of Breastfeeding Biology 1, no. 1 (May 19, 2015): 1–7. http://dx.doi.org/10.14302/issn.2644-0105.jbfb-14-547.
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Background: Scientific research is constantly expanding our knowledge of nutritional needs in pregnancy and lactation. In June 2014 the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued draft-revised advice encouraging pregnant women, those who might become pregnant, breastfeeding mothers and young children to eat more fish, a total of least 8 ounces per week and to eat a variety of fish lower in mercury in particular anchovies, butterfish, catfish, clam, haddock (Atlantic), herring, mullet, oyster, perch (ocean), sardine, shad, trout (freshwater). However, the presence of radionuclides released from the damaged Fukushima Daiichi nuclear power plant in Pacific biota has aroused worldwide attention and concern. Objective and Methods: Evaluating all the scientific literature available after the Fukushima nuclear disaster, the aim of this review is to demonstrate the safety of seafood products and the use of omega-3 supplements potentially derived from contaminated radioactive fish. Results and Conclusions: There are no reasons to fear the amount of radiation in Japanese fish. The dose received from seafood consumption can be estimated to result in two additional fatal cancer cases per 10,000,000 similarly exposed people. The safest way to get omega-3 fatty acids during pregnancy is by taking a high-quality fish oil supplement, approved by a governing body that provides proof of quality such as the Council for Responsible Nutrition, the European Pharmocopeia Standard or the Norwegian Medicinal Standard and by the Food and Drug Administration or the Environmental Protection Agency 1, 2. Pregnant and breastfeeding women do not need to cut fish out of their diet completely, and it may be safely eaten up to three times per week safely 3.
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Ramaekers, Stefan, and Naomi Hodgson. "Parenting apps and the depoliticisation of the parent." Families, Relationships and Societies 9, no. 1 (March 1, 2020): 107–24. http://dx.doi.org/10.1332/204674319x15681326073976.
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In educational research, digital technology has received considerable attention, and in early childhood studies this has largely focused, understandably, on children. Our concern here is with the figure of the parent and on a specific digital technology ‐ apps designed for parents. While apps can be seen as a digital extension of existing information and advice that has proliferated in the turn to parenting, and exhibits many of the characteristics of the parenting culture ‐ for example, positioning parents as in need of education, drawing predominantly from developmental psychology and neuroscience ‐ the particular affordances of apps draw attention to a more profound shift in how we understand what it means to raise children today, particularly if we reassert the representational ‐ political, pedagogical ‐ dimension of the figure of the parent.This article considers the implications of parenting apps for the position of the parent in the parent‐child relationship. Key focuses in the critical sociological literature on the ‘parenting culture’ and the increasing digitisation of our daily lives are summarised to show how parenting apps can be seen as an extension of the instrumentalisation, scientisation and psychologisation identified therein. A pedagogical-philosophical register is introduced, however, informed by Stanley Cavell’s account of initiation in forms of life and Klaus Mollenhauer’s account of upbringing, that brings out the political aspect of the figure of the parent as a representative figure situated between child and world. With reference to a selection of apps aimed at the period from pregnancy to three years old, we illustrate how, while sharing similarities with the existing sources of information and advice for parents, parenting apps are distinctive due to the personalisation, visualisation and notion of community they offer. Hence, what appears as a politicisation of parents through a sociological lens is seen as a depoliticisation of parents through a pedagogical-philosophical lens.
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Zugravu, Corina, Andreea Petra, Valeria-Anca Pietroșel, Bianca-Margareta Mihai, Doina-Andrada Mihai, Roxana-Elena Bohîlțea, and Monica Tarcea. "Nutritional Interventions and Lifestyle Changing in Gestational Diabetes Mellitus Prevention: A Narrative Review." Sustainability 15, no. 2 (January 6, 2023): 1069. http://dx.doi.org/10.3390/su15021069.
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Background: Gestational diabetes mellitus (GDM) is the most common pregnancy complication, and its prevalence is increasing, as obesity is more prevalent in women at reproductive age. Food choices and patterns that might reduce incidence are of great importance, and the present review aims to offer a perspective on different types of nutritional interventions in GDM prevention. Methods: A literature review in the PubMed database was conducted in order to identify full-text, English, randomized control trials and observational clinical studies, published in the last 10 years, that are the most relevant to emphasize the usefulness of nutritional and lifestyle interventions in prevention of GDM. Results and discussions: Twenty-two articles met the inclusion criteria and were relevant for the search. Their outcomes were reported and analyzed. Dietary interventions were very heterogeneous, including general counselling of healthier eating patterns, recommendations to follow a Mediterranean dietary pattern or to choose low-glycemic-index foods, and dietary advice focusing on increasing consumption of some food groups or vitamin D or probiotics supplementations. Conclusions: Among these interventions, a moderate-intensity lifestyle intervention optimizing participants’ consumption of whole grains, vegetables, and fruits; portion control; lowering intake of ultra-processed food and simple sugars; and Mediterranean diet intervention were the most successful in reducing GDM incidence.
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Banga, Louise. "The microbiota of the vulva and vagina: Ways of washing to optimise the protective function of the vulvo-vaginal microbiota during pregnancy." New Zealand College of Midwives Journal 57 (December 1, 2021): 34–40. http://dx.doi.org/10.12784/nzcomjnl57.2021.5.34-40.
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Background: The microbiota of the vulva and vagina has a crucial protective function, which is important for all women and has particular significance in pregnancy. Yet this microbiota is part of a delicately balanced ecosystem, susceptible to extrinsic factors which include the simple matter of how women wash themselves. Clinical observation and anecdotal evidence indicate that women in Aotearoa New Zealand have washing practices that may compromise the naturally acidic vulvo-vaginal environment crucial to optimising the protective function of the microbiota. Aims: The aims of this review are: to determine if there is dissonance between how women are washing their vulva and vagina and recommended washing practices; and to raise awareness of the emerging significance of the vulvo-vaginal microbiota to women’s health, particularly in pregnancy. Method: A literature review was undertaken to discover what is reported (in the published literature) about the ways women wash themselves, products used, and their effect on the vulvo-vaginal microbiota. The evidence behind the “wash with water” recommendation was investigated. Findings: There is a lack of primary research on ways of vaginal washing used by women in Aotearoa New Zealand. Globally, women are routinely using a variety of products that include soap, anti-bacterial wipes, gels and baby wipes, and invasive vaginal washing practices such as douching, flannel scrubs and internal soap cleansing. All washing products, including gentle soap but excluding lactic-acid based gels, alter pH levels when used on either the vulva or the vagina. Washing practices that alter vaginal pH levels can cause a microbial shift into a sub-optimal state that compromises the protective function of the vulvo-vaginal microbiota and is more susceptible to bacterial vaginosis and group B streptococcus vaginal colonisation. The frequency and duration within suboptimal states may be predictors of risk. Conclusion: There is dissonance between the ways women wash their vulva and vagina, and evidence-based advice to just wash with water. The back-to-basics message “just wash with water” promotes a way of washing that optimises the protective function of the vulvo-vaginal microbiota, while also protecting the integrity of vulval skin, and supporting physiological self-cleaning of the vagina.
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Lynch, B. "OP0308-PARE PREGNANCY AND ARTHRITIS - A PATIENT EDUCATION PROGRAMME IN IRELAND." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 191.1–191. http://dx.doi.org/10.1136/annrheumdis-2020-eular.1214.
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Background:The relationship between pregnancy and arthritis is a complex one. Because of the variability of arthritic conditions, it is important for patients to get advice from their doctor or a specialist nurse before trying for a baby. There can be implications for medication regimes, while the pregnancy itself can also affect the inflammatory arthritis. In the postpartum period, other considerations include breastfeeding and the frequent return of flares.Through this education programme, Arthritis Ireland developed information resources primarily targeting women of child-bearing age. The multichannel campaign provided information about the wide range of issues of concern to women with inflammatory arthritis who are planning a family or are pregnant.Objectives:•To provide information and increase awareness around inflammatory arthritis and pregnancy;•To support women living with inflammatory arthritis through their illness and life journey;•To increase awareness of the work of Arthritis Ireland as a patient organisation.Methods:In developing and executing this education programme, Arthritis Ireland worked extensively with a team of healthcare professionals, who are regarded internationally as leaders in this field.A multi-channel approach was taken to the development, production and dissemination of information, with public information events, literature and a suite of videos developedUp to this point, there had not been any Irish-produced material on this subject. he topic was seen to be an important one and an issue of significant public health interest.The series of information talks on pregnancy and inflammatory arthritis was delivered by consultant rheumatologists and were held in cities around Ireland. The information booklet covered topics such as planning for a baby, medication and pregnancy, the role of the father, fertility, genetics, during the pregnancy, after the pregnancy and breastfeeding.Video was seen to be central to the success of the campaign. Working with the expert healthcare team, six information videos were developed around obstetrics, rheumatology, physiotherapy and occupational therapy. The videos were published and promoted across Arthritis Ireland’s social media channels and website.The capstone video featured a young mother who was diagnosed with JIA when she was two. Her story was an incredibly powerful testimony of overcoming and dealing with adversity and complex health issues.Results:This educational campaign was developed to meet a significant need in the health information landscape. While there are no little resources produced focusing on pregnancy and parenting, there wasn’t anything in Ireland which specifically addressed the needs of women and men with inflammatory arthritis who are looking to have a family. The materials produced are a valuable part of Arthritis Ireland’s canon of patient education materials.Conclusion:It is anticipated that the materials developed will have a long lifespan and will support prospective parents for several years to come. Central to the success of the project was the involvement of the expert healthcare teams. Their commitment to the project spoke volumes of its importance and the considerable need for the clearly communicated information, which the project provided.Ultimately, Arthritis Ireland has produced a suite of resources which will be referenced and used by patients, and will hopefully make a considerable impact on their quality of life.Acknowledgments:This patient education programme was supported by a grant from UCB.Disclosure of Interests:Brian Lynch Grant/research support from: Arthritis Ireland received a grant from MSD to develop this patient education programme. Brian Lynch has not benefited personally in any way.
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Worthington, Irene, Tamara Pringsheim, Marek J. Gawel, Jonathan Gladstone, Paul Cooper, Esma Dilli, Michel Aube, Elizabeth Leroux, and Werner J. Becker. "Canadian Headache Society Guideline: Acute Drug Therapy for Migraine Headache." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 40, S3 (September 2013): S1—S3. http://dx.doi.org/10.1017/s0317167100118943.
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ABSTRACT:Objectives:The primary objective of this guideline is to assist the practitioner in choosing an appropriate acute medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. It is focused on patients with episodic migraine (headache on < 14 days a month).Methods:A detailed search strategy was used to find relevant meta-analyses, systematic reviews and randomized double-blind controlled trials. Recommendations were graded with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, using a consensus group. In addition, a general literature review and expert consensus were used for aspects of acute therapy for which randomized controlled trials are not available.Results:Twelve acute medications received a strong recommendation for use in acute migraine therapy (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, ASA, ibuprofen, naproxen sodium, diclofenac potassium, and acetaminophen). Four received a weak recommendation for use (dihydroergotamine, ergotamine, codeine-containing combination analgesics, and tramadol-containing combination analgesics). Three of these were NOT recommended for routine use (ergotamine, and codeine- and tramadol-containing medications). Strong recommendations were made to avoid use of butorphanol and butalbital-containing medications. Metoclopramide and domperidone were strongly recommended for use where necessary. Our analysis also resulted in the formulation of eight general acute migraine treatment strategies. These were grouped into: 1) two mild-moderate attack strategies, 2) two moderate-severe attack or NSAID failure strategies, 3) three refractory migraine strategies, and 4) a vasoconstrictor unresponsive-contraindicated strategy. Additional strategies were developed for menstrual migraine, migraine during pregnancy, and migraine during lactation.Conclusion:This guideline provides evidence-based advice on acute pharmacological migraine therapy, and should be helpful to both health professionals and patients. The available medications have been organized into a series of strategies based on patient clinical features. These strategies may help practitioners make appropriate acute medication choices for patients with migraine.
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McKenzie, Gemma, Glenn Robert, and Elsa Montgomery. "Exploring the conceptualisation and study of freebirthing as a historical and social phenomenon: a meta-narrative review of diverse research traditions." Medical Humanities 46, no. 4 (May 2, 2020): 512–24. http://dx.doi.org/10.1136/medhum-2019-011786.
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Freebirthing is a clandestine practice whereby women intentionally give birth without healthcare professionals (HCPs) present in countries where there are medical facilities available to assist them. Women who make this decision are frequently subjected to stigma and condemnation, yet research on the phenomenon suggests that women’s motivations are often complex. The aim of this review was to explore how freebirth has been conceptualised over time in the English-language academic and grey literature. The meta-narrative methodology employed enables a phenomenon to be understood within and between differing research traditions, as well as against its social and historical context. Our research uncovered nine research traditions (nursing, autobiographical text with birthing philosophy, midwifery, activism, medicine, sociology, law and ethics, pregnancy and birth advice, and anthropology) originating from eight countries and spanning the years 1957–2018. Most of the texts were written by women, with the majority being non-empirical. Empirical studies on freebirth were usually qualitative, although there were a small number of quantitative medical and midwifery studies; these texts often focused on women’s motivations and highlighted a range of reasons as to why a woman would decide to give birth without HCPs present. Motivations frequently related to women’s previous negative maternity experiences and the type of maternity care available, for example medicalised and hospital-based. The use of the meta-narrative methodology allowed the origins of freebirth in 1950s America to be traced to present-day empirical studies of the phenomenon. This highlighted how the subject and the publication of literature relating to freebirth are embedded within their social and historical contexts. From its very inception, freebirth aligns with the medicalisation of childbirth, the position of women in society, the provision of maternity care and the way in which women experience maternity services.
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Earle, Sarah, Anisah Tariq, Carol Komaromy, Cathy E. Lloyd, M. Ali Karamat, Jackie Webb, and Paramjit S. Gill. "Preconception care for women with type 1 or type 2 diabetes mellitus: a mixed-methods study exploring uptake of preconception care." Health Technology Assessment 21, no. 14 (March 2017): 1–130. http://dx.doi.org/10.3310/hta21140.
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BackgroundDiabetes mellitus is a global health problem and one of the most common medical conditions in pregnancy. A wide range of modifiable risk factors are associated with diabetes mellitus in pregnancy, and it is widely acknowledged that preconception care (PCC) is beneficial for women with pre-existing diabetes mellitus. However, uptake of PCC services is low.ObjectivesTo systematically review qualitative research on PCC for women with pre-existing diabetes mellitus of childbearing age, identify facilitators of and barriers to uptake of PCC and establish themes and gaps in knowledge. Through qualitative interviews explore views on the provision of, and facilitators of and barriers to the uptake of, PCC.DesignMixed methods encompassing a systematic review and qualitative interviews.SettingTwo secondary care sites and 11 primary care sites.ParticipantsWomen of childbearing age with pre-existing type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) of white British or Pakistani origin.InterventionsNone.AnalysisA narrative synthesis of the literature using thematic analysis and a thematic analysis of the qualitative interview data using the method of constant comparison.ResultsEighteen qualitative studies were included in the systematic review and a quality appraisal was carried out using relevant criteria for qualitative research appraisal, including a narrative summary of study quality. Twelve interviews with women with pre-existing T1DM or T2DM were carried out. This fell short of the original aim of interviewing 48 women owing to challenges in recruitment, especially in primary care. A synthesis of these data shows that uptake of PCC is influenced by a range of factors, including the complexity of pregnancy planning, the skill and expertise of health professionals who provide care to women with diabetes mellitus, the role of health professionals in the delivery of PCC, and the quality of relationships between women and health professionals.LimitationsOwing to significant challenges with recruitment of participants, particularly in primary care, 12 interviews with women with pre-existing T1DM or T2DM were carried out, which fell short of the a priori sample size.ConclusionsReconceptualising PCC to place greater emphasis on pregnancy planning, fertility and contraception would lower some of the existing barriers to uptake of care. It is important to clarify who is responsible for the delivery of PCC to women with pre-existing diabetes mellitus and to ensure that the correct expertise is available so that opportunities for advice giving are maximised. Relationships between women and health professionals should be based on a partnership approach that encourages mutual trust and respect, focusing on positive change rather than negative outcomes.Future workFurther research is needed to investigate the views and experiences of stakeholders that commission, design and deliver PCC services for women with pre-existing diabetes mellitus; to explore experiences of women from minority or ethnically diverse backgrounds; to investigate the role of family support in contraception, pregnancy planning and PCC; and to investigate the management of diabetes mellitus in neonatal care and its role in breastfeeding.Study registrationThis study is registered as PROSPERO CRD42014015592 and ISRCTN12983949.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Ashraf, Safia, Memoona Ha nif, Muhammhad Abdul Aziz, Saba Akram, and Fouzia Khadim. "Association between Placenta Accreta and History of Previous C-Section and position of Placenta in Pregnant Women presenting at A Public Sector Hospital of Punjab, Pakistan: a cross-sectional analysis." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 71–73. http://dx.doi.org/10.53350/pjmhs2216771.
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Background: Placenta accreta is a rare and life threatening disease during pregnancy and causes must be sorted out for its early diagnosis and treatment. Aim: To find the association between placenta accreta and history of previous C-section in pregnant women. Methods: This analytical cross-sectional survey was conducted at Radiology department of DHQ teaching hospital Gujranwala from 1st January, 2022 to 31st March, 2022. A self-administered questionnaire was filled by the pregnant women at the gynecology and obstetrics outdoor department. Data was analyzed by using SPSS-Version 26. Results: AFI and age were found to be normally distributed while all other variables were non-normally distributed. Mean ± S.D of AFI was 10.75 ± 3.99 while mean ± S.D for age were 27.05 ± 3.90. Median ± IQR for gestational age of the study participants was 33.1 ± 8.98. While median ± IQR for body weight and heart rate of the study participants were 2052 ± 1632 and 147 ± 11 respectively. The association of the placenta accreta with history of C-Section was found to be highly statistically significant in our study (P=0.012). Conclusion: It was evident from our study that plecenta accreta was associated with history of C-Section hence the multiparous with history of C-Section should undergo repeated scans for early diagnosis of placenta previa and the patients also need to have a proper follow-up as per consultant’s advice. Key words: C-section, Placenta Accreta, Pregnancy.