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Mutia Nadra Maulida. "Effleurage Massage for Pain Relief in Pregnant Women." Conferences of Medical Sciences Dies Natalis Faculty of Medicine Universitas Sriwijaya 2, no. 1 (November 12, 2020): 185–97. http://dx.doi.org/10.32539/dies.v2i1.54.
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Pregnancy is an event that begins with conception and ends with the onset of labor. Pregnancy is divided into three trimesters, the first trimester (0-12 weeks), the second trimester (13-27 weeks), and the third trimester (28-40 weeks). During the pregnancy process will cause various changes in all body systems, both physiological changes and psychological changes that can cause discomfort to pregnant women. Physiological changes that often occur in pregnant women such as dyspnea, insomnia, gingivitis, frequent urination, pressure and discomfort in the perineum, back pain, constipation, varicose veins, fatigue, Braxton hicks contractions, leg cramps, ankle edema. Not only physiologically, changes in pregnant women also occur psychologically such as changes in mood and increased anxiety.One of the physiological changes that pregnant women often complain about is back pain. According to Ratih (2016), the results of research on pregnant women in various regions of Indonesia reached 60-80% of people who experience back pain in their pregnancy. The reported prevalence of back pain in pregnancy varies from 50% in the UK and Scandinavia to 70% in Australia. Back pain experienced by pregnant women will peak at week 24 to week 28, just before abdominal growth reaches its maximum point. Most back pain during pregnancy occurs due to changes in the spinal muscles, as much as 70%.Back pain in pregnant women can be treated both pharmacologically and non pharmacologically. One of the non-pharmacological therapies that can be given is Effleurage Massage, which provides a gentle, slow and uninterrupted massage on the back of pregnant women so that it can cause relaxation and reduce pain.
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Robinson, Helen, Philip Robinson, Michael D’Emden, and Kassam Mahomed. "Management of thyroid disease in pregnancy – Room for improvement in the first trimester." Obstetric Medicine 9, no. 3 (June 21, 2016): 126–29. http://dx.doi.org/10.1177/1753495x16629773.
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Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.
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Ghimire, Pramesh Raj, Gretchen Buck, Jackie Jackson, Emma Woolley, Rebekah Bowman, Louise Fox, Shirlena Gallagher, Malindey Sorrell, and Lorraine Dubois. "Impact of Antenatal Care on Perinatal Outcomes in New South Wales, Australia: A Decade-Long Regional Perspective." International Journal of Environmental Research and Public Health 20, no. 2 (January 5, 2023): 977. http://dx.doi.org/10.3390/ijerph20020977.
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Low birth weight (LBW) and preterm birth are adverse perinatal outcomes that pose a significant risk to a child’s healthy beginning. While antenatal care (ANC) is an established intervention for pregnancy care, little is understood about how the number and timing of ANC visits can impact these adverse health outcomes. This study aimed to examine the impact of the number and timing of ANC visits on LBW and preterm birth in a regional setting. A decade-long perinatal dataset related to singleton live births that took place in the Southern New South Wales Local Health District (SNSWLHD) was utilized. The outcomes of interest were LBW and preterm birth, and the exposure variables were based on the Australian pregnancy guidelines on the number and timing of ANC visits. A multivariable logistic regression was performed to measure the association between outcome and exposure while adjusting for potential confounders. A greater level of protection against LBW and preterm birth was observed among mothers who had an adequate number of visits, with early entry (first trimester) into ANC. The protective effect of an adequate number of ANC visits against LBW and preterm birth among mothers with late entry into ANC (third trimester) was found to be statistically non-significant.
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Beetham, Kassia S., Jemima G. Spathis, Samantha Hoffmann, Wendy J. Brown, Vicki Clifton, and Gregore I. Mielke. "Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women’s health." Women's Health 18 (January 2022): 174550572211423. http://dx.doi.org/10.1177/17455057221142357.
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Background: Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. Objectives: The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. Design: The study involved 1657 pregnant women from the Australian Longitudinal Study on Women’s Health, who completed surveys from 2006 to 2012 (aged 28–39 years). Methods: Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0–<33.3 MET.min/week), (2) Low (33.3–<500 MET.min/week), (3) Moderate (500–<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). Results: There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). Conclusion: Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety.
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Fealy, Shanna, Jenna Hollis, Julia Martin, Lucy Leigh, Christopher Oldmeadow, Clare E. Collins, Roger Smith, Shelley Wilkinson, and Alexis Hure. "Modeling the Predictive Value of Evidence-Based Referral Criteria to Support Healthy Gestational Weight Gain among an Australian Pregnancy Cohort." Nutrients 14, no. 2 (January 17, 2022): 381. http://dx.doi.org/10.3390/nu14020381.
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Globally, there has been a renewed focus on addressing gestational weight gain (GWG). In Australia, the Department of Health pregnancy care guidelines recommend women be offered routine weighing and receive brief nutritional and physical activity support during antenatal care visits. Women gaining weight outside the Institute of Medicine (IOM)’s weight gain reference values are further recommended to be referred to a dietitian. However, professional and organizational barriers, including an absence of weight gain referral pathways and limited workforce resources, exist with the translation and scaling of these recommendations into practice. This study aimed to explore patterns of GWG among a cohort of Australian pregnant women and to determine if pregnancy weight gains of above or below 2 kg or 5 kg in the second and third trimester can be used to predict total GWG outside recommendations. Sensitivity, specificity, negative, and positive likelihood ratios were calculated. The most predictive time point was 24 weeks’ gestation using the minimum weight change parameter of +/−2 kg, demonstrating reasonable sensitivity (0.81, 95% CI 0.61–0.83) and specificity (0.72, 95% CI 0.61–0.83), resulting in 55% (n = 72/131) of the cohort qualifying for dietetic referral. Given the current health service constraints, a review of dietetic services within maternity care is warranted.
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DODD, Jodie, Lauri O'BRIEN, and Judy COFFEY. "Misoprostol for second and third trimester termination of pregnancy: A review of practice at the Women's and Children's Hospital, Adelaide, Australia." Australian and New Zealand Journal of Obstetrics and Gynaecology 45, no. 1 (February 2005): 25–29. http://dx.doi.org/10.1111/j.1479-828x.2005.00338.x.
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Buchanan, Limin, Emi Anderson, Huilan Xu MBiostat, Philayrath Phongsavan, Chris Rissel, and Li Ming Wen. "Sources of information and the use of mobile applications for health and parenting information during pregnancy: Implications for health promotion." Health Informatics Journal 27, no. 3 (July 2021): 146045822110431. http://dx.doi.org/10.1177/14604582211043146.
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This study aims to examine the characteristics of pregnant women who used and intended to use mobile applications (apps) for health and parenting information. We used data from a randomised controlled trial, Communicating Healthy Beginnings Advice by Telephone (CHAT), conducted in Australia. Telephone surveys were conducted in 2017 to collect information on women’s demographic characteristics, sources of health and parenting information and willingness to use mobile apps. Multiple logistic regression was used to examine the associations of women’s socio-demographic backgrounds, their mobile apps usage and their willingness to use such apps. Data included 1155 pregnant women in their third trimester. Women from culturally and linguistically diverse backgrounds and with lower income appeared to have lower uptake of mobile apps despite high ownership of smart devices. Development of evidence-based and culturally-adapted mobile apps represent an important opportunity for healthcare providers to optimise maternal and birth outcomes.
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Pierce, Heather, Caroline S. E. Homer, Hannah G. Dahlen, and Jenny King. "Pregnancy-Related Lumbopelvic Pain: Listening to Australian Women." Nursing Research and Practice 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/387428.
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Objective. To investigate the prevalence and nature of lumbo-pelvic pain (LPP), that is experienced by women in the lumbar and/or sacro-iliac area and/or symphysis pubis during pregnancy.Design. Cross-sectional, descriptive study.Setting. An Australian public hospital antenatal clinic. Sample population: Women in their third trimester of pregnancy.Method. Women were recruited to the study as they presented for their antenatal appointment. A survey collected demographic data and was used to self report LPP. A pain diagram differentiated low back, pelvic girdle or combined pain. Closed and open ended questions explored the experiences of the women.Main Outcome Measures. The Visual Analogue Scale and the Oswestry Disability Index (Version 2.1a).Results. There was a high prevalence of self reported LPP during the pregnancy (71%). An association was found between the reporting of LPP, multiparity, and a previous history of LPP. The mean intensity score for usual pain was 6/10 and four out of five women reported disability associated with the condition. Most women (71%) had reported their symptoms to their maternity carer however only a small proportion of these women received intervention.Conclusion. LPP is a potentially significant health issue during pregnancy.
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Pereira, Lenore, Takako Tabata, and Matthew Petitt. "Cytomegalovirus infection and pathogenesis in the human placenta." Microbiology Australia 36, no. 4 (2015): 171. http://dx.doi.org/10.1071/ma15061.
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Human cytomegalovirus (HCMV) is the most common cause of congenital viral infection. Affected children can have permanent neurological complications, including hearing loss, visual impairment and mental retardation1–3. In Australia, 57% of women are seronegative and at risk for primary infection and transmission of virus to the fetus during pregnancy4. Despite its public health significance, the specific molecular and cellular basis of HCMV replication in the human placenta and pathogenesis associated with poor clinical outcome are unknown. Direct fetal infection is involved in severe cases of neuropathology and infection of the placenta can impair its development and functions resulting in a hypoxic environment5–8 and stillbirth6,9,10. Gestational age at the time of infection is an important determinant of outcome. The rates of virus transmission increase from 30% in first trimester to over 70% in third trimester suggesting different mechanisms for overcoming the placental barrier2. Remarkable insights into viral pathogenesis factors that function in the tissue environment have been gained by studying congenitally infected placentas and explants infected by clinical strains ex vivo. Together these studies revealed that direct infection of specialised placental cells and paracrine factors contribute to impaired development and functional defects.
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Di Ciaccio, Pietro R., Belinda Campbell, Kylie D. Mason, Mohamed Shanavas, Matthew Greenwood, Gareth P. Gregory, Renee Eslick, et al. "Lymphoma during Pregnancy: A Multicentre Study By the Australasian Lymphoma Alliance." Blood 138, Supplement 1 (November 5, 2021): 882. http://dx.doi.org/10.1182/blood-2021-150538.
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Abstract Introduction Lymphoma complicates approximately 1/6000 pregnancies (Pereg, Haematologica 2007), and presents challenges for the patient, her family, and medical professionals. This rare event raises unique therapeutic, social and ethical issues, with the welfare of both mother and unborn child to consider. There are challenges regarding symptom obfuscation, diagnosis delays and treatment delivery. In this retrospective study, we aimed to describe the experience, treatment patterns and outcomes of lymphoma in pregnancy in Australia and New Zealand. Methods We identified patients aged ≥18 diagnosed with lymphoma in pregnancy between 1 January 2009 and 31 December 2020 , across 11 institutions in Australia and New Zealand. We defined "lymphoma in pregnancy" as diagnoses occurring during pregnancy (antenatal cases) or the first 12 months after delivery (postpartum cases). Postpartum cases were included to account for the phenomenon of diagnostic delay during gestation due to deferral of diagnostic investigations and symptom obfuscation (de Haan, Lancet Oncol 2018). Overall survival was calculated by Kaplan-Meier methods from the date of diagnosis to death, with patients alive and lost to follow-up censored on the last day of follow-up. Results We identified 63 patients, 34 diagnosed antepartum and 29 diagnosed postpartum (Table 1). The most common diagnoses were classical Hodgkin lymphoma (HL) (35), followed by diffuse large B cell lymphoma (11) and primary mediastinal B cell lymphoma (6). The median age was 32 (range 23-42) years. Women diagnosed antepartum were more likely to be nulliparous (p=0.004). Of the postpartum cases, symptoms of malignancy first appeared during pregnancy in 24%. At diagnosis, 44% had advanced stage disease. 60% of women had PET as part of baseline staging, however only 8% underwent PET whilst pregnant, all during the second or third trimester. 83% of HL patients had adverse risk factors (mediastinal bulk >1/3 diameter, ESR>50mm/hr, >2 sites). ESR alone, which may be elevated physiologically in pregnancy, was the sole adverse risk factor for 9% of HL patients. Median days between diagnosis and treatment initiation were 14 (IQR 8-30) for antenatal patients and 21 (IQR 7-40) for postnatal. 19% of the antenatal cohort with aggressive lymphoma had treatment deferred/delayed explicitly due to pregnancy. The majority (89%) of antenatal patients were treated with ABVD (HL) or (R)CHOP/(R)EPOCH (NHL) whilst pregnant. 3 patients received first-line treatment divergent from standard (vinblastine for HL, interferon for indolent B-NHL and surgery for primary cutaneous ALCL). 37% received radiotherapy, although only 1 patient received it antenatally. Median follow up was 34 months. 5 year OS for HL was 83% (95%CI 54%-95%) and for DLBCL 74% (95%CI 30%-93%)(Figure 1). Seven patients died (4 from lymphoma, 2 treatment-related infection, 1 unknown). Discussion of elective termination of pregnancy was documented in 24 of 34 antenatal diagnoses, advised in 3 and performed in 2, both in the first trimester. Only 31 (49%) of 63 women had documented evidence of counselling regarding future fertility strategies. Of the 48 patients with available data, there were 45 live births, 2 elective terminations and 1 spontaneous abortion in the first trimester. The mean gestation at birth was significantly earlier and marginally preterm for antenatal diagnoses (mean 35.6wk v 38.2wk, p=0.002). 6 neonates (11%) were small for gestational age, 5 of whom were born to mothers diagnosed antenatally. 29% of neonates were admitted to neonatal intensive care or special care units. There were no cases of neonatal neutropenia, one case of sepsis of prematurity and one case of PJP infection in a term baby. Conclusion Lymphoma in pregnancy is rare and lacks a harmonised approach. We present a large multicentre cohort reflecting contemporary practice. Although standard therapy could be provided to most patients, delays in treatment and diagnosis were common, and most antenatally-diagnosed women did not receive optimal staging. Neonates in the antenatally-diagnosed group were more likely to be premature, however there are likely a number of confounders and causality cannot be presumed. There were no neonatal deaths. It is imperative to continue to report on data regarding lymphoma in pregnancy to inform optimal care in this setting. Figure 1 Figure 1. Disclosures Greenwood: Amgen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees; Servier: Membership on an entity's Board of Directors or advisory committees, Research Funding; Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. Gregory: Janssen: Consultancy; Novartis: Consultancy; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel fees, Speakers Bureau. Hamad: Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.
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Foo, Damien, Mohinder Sarna, Gavin Pereira, Hannah C. Moore, and Annette K. Regan. "Prenatal influenza vaccination and allergic and autoimmune diseases in childhood: A longitudinal, population-based linked cohort study." PLOS Medicine 19, no. 4 (April 5, 2022): e1003963. http://dx.doi.org/10.1371/journal.pmed.1003963.
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Background Few studies have evaluated the effect of maternal influenza vaccination on the development of allergic and autoimmune diseases in children beyond 6 months of age. We aimed to investigate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and subsequent diagnosis of allergic and autoimmune diseases. Methods and findings This longitudinal, population-based linked cohort study included 124,760 singleton, live-born children from 106,206 mothers in Western Australia (WA) born between April 2012 and July 2016, with up to 5 years of follow-up from birth. In our study cohort, 64,169 (51.4%) were male, 6,566 (5.3%) were Aboriginal and/or Torres Strait Islander children, and the mean age at the end of follow-up was 3.0 (standard deviation, 1.3) years. The exposure was receipt of seasonal IIV during pregnancy. The outcomes were diagnosis of an allergic or autoimmune disease, including asthma and anaphylaxis, identified from hospital and/or emergency department (ED) records. Inverse probability of treatment weights (IPTWs) accounted for baseline probability of vaccination by maternal age, Aboriginal and/or Torres Strait Islander status, socioeconomic status, body mass index, parity, medical conditions, pregnancy complications, prenatal smoking, and prenatal care. The models additionally adjusted for the Aboriginal and/or Torres Strait Islander status of the child. There were 14,396 (11.5%) maternally vaccinated children; 913 (6.3%) maternally vaccinated and 7,655 (6.9%) maternally unvaccinated children had a diagnosis of allergic or autoimmune disease, respectively. Overall, maternal influenza vaccination was not associated with diagnosis of an allergic or autoimmune disease (adjusted hazard ratio [aHR], 1.02; 95% confidence interval [CI], 0.95 to 1.09). In trimester-specific analyses, we identified a negative association between third trimester influenza vaccination and the diagnosis of asthma (n = 40; aHR, 0.70; 95% CI, 0.50 to 0.97) and anaphylaxis (n = 36; aHR, 0.67; 95% CI, 0.47 to 0.95).We did not capture outcomes diagnosed in a primary care setting; therefore, our findings are only generalizable to more severe events requiring hospitalization or presentation to the ED. Due to small cell sizes (i.e., <5), estimates could not be determined for all outcomes after stratification. Conclusions In this study, we observed no association between in utero exposure to influenza vaccine and diagnosis of allergic or autoimmune diseases. Although we identified a negative association of asthma and anaphylaxis diagnosis when seasonal IIV was administered later in pregnancy, additional studies are needed to confirm this. Overall, our findings support the safety of seasonal inactivated influenza vaccine during pregnancy in relation to allergic and autoimmune diseases in early childhood and support the continuation of current global maternal vaccine programs and policies.
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Dahham, Mariam T., Abd alkarim F. Omar, and Batol I. Dheeb. "Synergistic effect of tea tree oil on fungi causing vaginal thrush in pregnant women." Journal of Biotechnology Research Center 13, no. 2 (June 1, 2019): 35–44. http://dx.doi.org/10.24126/jobrc.2019.13.2.579.
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Background: Vulvovaginal candidiasis(VVC), or Vaginal thrush, is a vaginitis caused by the overgrowth of some opportunistic yeasts of the genus Candida spp. Australian Tea Tree Oil (TTO) is one of the most important essential oils that contain many compounds that are effective against many bacteria and fungi, which may match the effect of common antibiotics.
Objective: The aim of this study was to isolate and diagnose fungi that causing vaginal thrush, in pregnant women and to study the effect of (pregnancy and pregnancy sequence and age) on the rate of infection compared to non-pregnant, as well as to study the drug sensitivity of isolates towards a number of antifungal and compared that with the inhibitory effectiveness of tea tree oil.
Material and Methods: 75 vaginal swabs from pregnant women and 50 from non-pregnant women were collected at ages ranging from 17-65 years. The isolates were diagnosed using several methods, including the Vitek2 Compact system. 17 isolates were selected to study the inhibitory effect of ten antifungal agents, six of them were automatically tested by the Vitek 2 compact system, which contains a sensitivity test kit (AST-YS07 Card). The essential oil (TTO) was analyzed by GC-MS to detect its content of active compounds. The inhibitory effect of TTO was studied according to "Broth dilution" method to determine minimum inhibitory concentration (MIC) for it, the inhibitory effect of four concentrations of TTO (100%, 50%, 25%, 12.5 %) was also tested according to "well diffusion" method. This investigation also included a study of the mechanism of action (TTO).
RESULTS: The rate of infection among pregnant women was (41%) with the highest rate of infection during the third trimester of pregnancy, while the percentage of non-pregnant women was only 8%. Vaginal infection was also prevalent in the age group ranged between (17-29 years).The isolates showed resistance to (Ketoconazol, Terbinafine) while they were sensitive to (Nystatin, clotrimazol), as well as sensitive to all antifungal of (AST-YS07 Card). The analysis of the TTO using chromatogram showed that it contains 32 chemical compounds, most of them are monoterpene like (Terpinen-4-ol, 1, 8-Cineol). The MIC of TTO ranged between (4 - < 2 µl/ ml). The function of TTO is to destroy the structural structure of the cell membrane and change its permeability, thereby leakage of cellular components and cell death.
Conclusion: Pregnancy increases the rate of vaginal candidiasis in women, especially during the third trimester. TTO is highly effective in inhibiting the growth of opportunistic candida yeasts.
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Boyle, Jacqueline Anne, Suzanne Willey, Rebecca Blackmore, Christine East, Jacqueline McBride, Kylie Gray, Glenn Melvin, et al. "Improving Mental Health in Pregnancy for Refugee Women: Protocol for the Implementation and Evaluation of a Screening Program in Melbourne, Australia." JMIR Research Protocols 8, no. 8 (August 19, 2019): e13271. http://dx.doi.org/10.2196/13271.
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Background Identifying mental health disorders in migrant and refugee women during pregnancy provides an opportunity for interventions that may benefit women and their families. Evidence suggests that perinatal mental health disorders impact mother-infant attachment at critical times, which can affect child development. Postnatal depression resulting in suicide is one of the leading causes of maternal mortality postpartum. Routine screening of perinatal mental health is recommended to improve the identification of depression and anxiety and to facilitate early management. However, screening is poorly implemented into routine practice. This study is the first to investigate routine screening for perinatal mental health in a maternity setting designed for refugee women. This study will determine whether symptoms of depression and anxiety are more likely to be detected by the screening program compared with routine care and will evaluate the screening program’s feasibility and acceptability to women and health care providers (HCPs). Objective The objectives of this study are (1) to assess if refugee women are more likely to screen risk-positive for depression and anxiety than nonrefugee women, using the Edinburgh Postnatal Depression Scale (EPDS); (2) to assess if screening in pregnancy using the EPDS enables better detection of symptoms of depression and anxiety in refugee women than current routine care; (3) to determine if a screening program for perinatal mental health in a maternity setting designed for refugee women is acceptable to women; and (4) to evaluate the feasibility and acceptability of the perinatal mental health screening program from the perspective of HCPs (including the barriers and enablers to implementation). Methods This study uses an internationally recommended screening measure, the EPDS, and a locally developed psychosocial questionnaire, both administered in early pregnancy and again in the third trimester. These measures have been translated into the most common languages used by the women attending the clinic and are administered via an electronic platform (iCOPE). This platform automatically calculates the EPDS score and generates reports for the HCP and woman. A total of 119 refugee women and 155 nonrefugee women have been recruited to evaluate the screening program’s ability to detect depression and anxiety symptoms and will be compared with 34 refugee women receiving routine care. A subsample of women will participate in a qualitative assessment of the screening program’s acceptability and feasibility. Health service staff have been recruited to evaluate the integration of screening into maternity care. Results The recruitment is complete, and data collection and analysis are underway. Conclusions It is anticipated that screening will increase the identification and management of depression and anxiety symptoms in pregnancy. New information will be generated on how to implement such a program in feasible and acceptable ways that will improve health outcomes for refugee women. International Registered Report Identifier (IRRID) DERR1-10.2196/13271
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Sykes, S. D., E. R. Lumbers, K. G. Pringle, T. Zakar, G. A. Dekker, and C. T. Roberts. "306. PREDICTING GESTATIONAL DIABETES FROM MATERNAL ANGIOTENSIN II AND ANGIOTENSIN 1–7 LEVELS AT 15 WEEKS GESTATION." Reproduction, Fertility and Development 22, no. 9 (2010): 106. http://dx.doi.org/10.1071/srb10abs306.
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Gestational diabetes (GD), a pregnancy complication defined by glucose intolerance with onset during pregnancy, is a condition affecting 5.5%–8.8% of Australian pregnancies1. Untreated GD increases perinatal mortality and babies from GD pregnancies have an increased risk of diabetes and obesity, whilst mothers have an increased risk of type II diabetes later in life1. Circulating levels of angiotensin 1–7 (Ang1–7), a peptide of the renin angiotensin system, have been reported to be reduced in third trimester pregnancies with GD2. The effects of Ang1–7 generally oppose those of angiotensin II (AngII) and it is possible that in early gestation pro-angiogenic functions of AngII are counterbalanced by Ang1–7, causing placental insufficiency and pregnancy complications. We wanted to determine the predictive capability of AngII and Ang1–7, in early gestation, for GD. Healthy nulliparous pregnant women from the Adelaide SCOPE cohort with GD (n = 36) or serving as controls (n = 131) had both peptides measured at 15 weeks using an RIA (D. Casley, Prosearch Pty. Ltd.) on EDTA treated plasma. A predictive model was constructed using logistic regression and area under the curve after ROC analysis (AROC, Table 1). AngII did not change the model and was omitted. This model shows that for every one unit increase of Log (Ang1–7 pg/mL) peptide levels the odds of acquiring GD increase five times, suggesting that Ang1–7 levels in early gestation may be a better disease marker than those seen at late pregnancy. (1) Hoffman L, Nolan C, Wilson JD, et al., 1998. Gestational diabetes mellitus – management guidelines. The Australasian Diabetes in Pregnancy Society. Med. J. Aust. 169, 93–97.(2) Nogueira AI, Santos RAS, Simoes e Silva AC, et al., 2007. The pregnancy-induced increase of plasma angiotensin-(1–7) is blunted in gestational diabetes. Regul. Pep., 141, 55–60.
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Lee, Yu Qi, Eugenie R. Lumbers, Tracy L. Schumacher, Clare E. Collins, Kym M. Rae, and Kirsty G. Pringle. "Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort." Nutrients 13, no. 2 (February 9, 2021): 569. http://dx.doi.org/10.3390/nu13020569.
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Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.
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Anusha, Kaneshapillai, Usha Hettiaratchi, Dulani Gunasekera, Shamini Prathapan, and Guwani Liyanage. "Maternal Vitamin D Status and Its Effect on Vitamin D Levels in Early Infancy in a Tertiary Care Centre in Sri Lanka." International Journal of Endocrinology 2019 (July 9, 2019): 1–6. http://dx.doi.org/10.1155/2019/9017951.
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Epidemiologic studies from South Asian countries have reported vitamin D deficiency among all age groups. However, there is very little information on vitamin D levels, especially in the vulnerable populations (pregnant/breast feeding mother and infants) in Sri Lanka. More data on vitamin D status of such populations will be important for policy decisions to be made at a national level. Similarly, it will be valuable for healthcare programs in other countries (e.g., United States, Australia, Europe, and Canada) as Sri Lankans are a fast-growing migrant population to those countries. The purpose of this study was to investigate maternal vitamin D status and its effects on infants in a state sector tertiary care centre in Sri Lanka. This prospective cohort study was conducted on 140 healthy pregnant mothers in the third trimester (mean gestational age 39±1 weeks). Blood was collected for 25(OH)D and parathyroid hormone (PTH). Sun exposure and feeding patterns of the infants were recorded based on maternal reporting. Mean age of the infants at follow-up visit was 36±7 days. Vitamin D (25 (OH)D) deficiency (<25 nmol/L) was observed in 12% pregnant mothers, 5% lactating mothers, and 63% infants. Insufficiency (<50 nmol/L) was found in an additional 51% and 43% in pregnant and lactating mothers and 25% of infants. Mean 25(OH)D was higher in pregnant (46.4±17.5 nmol/L) and lactating (51.9±17.0 nmol/L) mothers than infants (28.1±13.7 nmol/L). Maternal vitamin D level during pregnancy was a significant risk factor (OR: 6.00, 95%CI: 1.522-23.655) for infant deficiency and insufficiency. Sun exposure of infants showed a significant positive correlation with vitamin D level (OR: 3.23, 95%CI: 1.19-8.68). In conclusion, the presence of Vitamin D deficiency/insufficiency is higher in infants compared to pregnant/lactating mothers. Low maternal 25(OH)D during pregnancy was a risk factor for deficiency in infants. Although majority of lactating mothers had sufficient vitamin D, most of their exclusively breastfed offspring were deficient.
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Salim, A., P. Handaya, G. H. Wiknjosastro, and B. Karsono. "Third trimester abdominal pregnancy." Ultrasound in Obstetrics and Gynecology 18 (October 2001): P72. http://dx.doi.org/10.1046/j.1469-0705.2001.abs27-38.x.
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Newfield, Emily. "Third-Trimester Pregnancy Complications." Primary Care: Clinics in Office Practice 39, no. 1 (March 2012): 95–113. http://dx.doi.org/10.1016/j.pop.2011.11.005.
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Olsson, Craig A., Primrose Letcher, Christopher J. Greenwood, Jennifer E. McIntosh, Sophie Barker, Catherine M. Olsson, Jacqui A. Macdonald, et al. "The Australian Temperament Project Generation 3 study: a population-based multigenerational prospective cohort study of socioemotional health and development." BMJ Open 12, no. 9 (September 2022): e061854. http://dx.doi.org/10.1136/bmjopen-2022-061854.
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PurposeThe Australian Temperament Project Generation 3 Study (ATPG3) was established to examine the extent to which offspring social and emotional development is shaped in the decades prior to conception, in parent and grandparent histories of psychosocial adjustment (eg, emotional regulation, relationship quality and prosociality) and maladjustment (eg, depressive symptoms, substance use and antisociality).ParticipantsThe Australian Temperament Project (ATP) commenced in 1983 as a population representative survey of the social and emotional health of 2443 young Australians (Generation 2: 4–8 months old) and their parents (Generation 1). Since then, families have been followed from infancy to young adulthood (16 waves). Between 2012 and 2018, the cohort was screened biannually for pregnancies (Generation 3), with assessments conducted in the third trimester of pregnancy, and at 8 weeks and 1 year postpartum.Findings to dateA total of 1167 offspring (607 female) born to 703 Generation 2 parents (400 mothers) were recruited into the ATPG3 Study. Findings to date highlight: (1) strong continuities in depressive symptoms and substance use from adolescence through to becoming a parent; (2) a role for persistent preconception mental health problems in risk for parent–child bonding difficulties, as well as infant emotional reactivity and behaviour problems; (3) the importance of secure attachments in adolescence in reducing long-term risk for postpartum mental health problems; and (4) the protective nature of perceived social support, both preconception and postpartum, in strengthening relationship quality and social support during the COVID-19 pandemic.Future plansAssessments of ATPG3 families in preschool and middle childhood are currently funded and underway. We intend to maintain the offspring cohort through childhood, adolescence, young adulthood and into parenthood. Data will be used to map preconception determinants of emotional health, and enhance approaches to population monitoring and targeted intervention over the life course and across generations.
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Noshiro, Kiwamu, Takeshi Umazume, Rifumi Hattori, Soromon Kataoka, Takashi Yamada, and Hidemichi Watari. "Hemoglobin Concentration during Early Pregnancy as an Accurate Predictor of Anemia during Late Pregnancy." Nutrients 14, no. 4 (February 17, 2022): 839. http://dx.doi.org/10.3390/nu14040839.
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It is undetermined which blood variables related to iron storage during the first trimester of pregnancy could efficiently predict anemia occurring during the third trimester. Red blood cell count (RBC), hemoglobin concentration, hematocrit, ferritin, iron, and total iron binding capacity (TIBC) were assessed longitudinally during the first, second, and third trimesters of 231 healthy Japanese women. None of the patients had anemia in the first trimester and none used iron supplementation before the second trimester blood test. Anemia was defined as hemoglobin (Hb) < 11 g/dL for the first trimester and Hb < 10.0 g/dL for the third trimester. Forty-seven (20%) women developed anemia in the third trimester. The first trimester RBC, Hb, hematocrit, and ferritin levels were significantly lower in women with third-trimester anemia than those without anemia. The first trimester hemoglobin level exhibited a greater area under the curve of the receiver operating characteristic curve for prediction of the third trimester anemia than other blood variables; the optimal cut-off (12.6 g/dL) of hemoglobin yielded a sensitivity of 83% (39/47). First trimester hemoglobin levels were significantly better predictors of anemia during the third trimester than the indices of iron storage, including serum iron, ferritin, and TIBC levels.
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Choi, Yong Hee, and Guisera Lee. "Uterine Torsion in Third Trimester Pregnancy." Korean Journal of Perinatology 27, no. 1 (2016): 67. http://dx.doi.org/10.14734/kjp.2016.27.1.67.
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MARTIN, U., C. DAVIES, S. HAYAVI, A. HARTLAND, and F. DUNNE. "Is normal pregnancy atherogenic?" Clinical Science 96, no. 4 (April 1, 1999): 421–25. http://dx.doi.org/10.1042/cs0960421.
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Serum cholesterol, triacylglycerols and low-density lipoprotein (LDL) subfractions were determined in 120 primagravid women during normal gestation (40 in each trimester) and in 20 non-pregnant age-matched controls. LDL subfractions were determined by PAGE, and an LDL score was calculated. The higher the score, the smaller the subfractions. The objective of the study was to determine the effects of the hyperlipidaemia, high oestrogen concentrations and insulin resistance known to exist in normal pregnancy on LDL subfraction formation. Pregnant women had an increased mean serum cholesterol concentration [5.78 (S.D. 1.09) mmol/l] in the first trimester compared with the non-pregnant controls [5.11 (0.77) mmol/l; P< 0.01]. The serum cholesterol concentration increased progressively throughout gestation to a mean of 8.14 (1.39) mmol/l in the third trimester (P< 0.001 compared with the second trimester). Triacylglycerol concentrations in the first trimester were similar to those of controls, and there was a non-significant increase by the second trimester to 1.32 (0.44) mmol/l. However, by the third trimester the mean triacylglycerol concentration had doubled [2.58 (0.98) mmol/l; P< 0.001 compared with the first and second trimester]. During gestation the LDL score increased dramatically, from 1.17 (0.39) during the first trimester to 2.01 (0.37) in the second trimester (P< 0.001) to 2.73 (0.48) in the third trimester (P< 0.001 compared with the second trimester). Thus an atherogenic lipid profile develops during normal gestation. The significance of these changes remains unclear, but thay may have important implications for mother and foetus.
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Braddick, Maxwell, Marion L. Woods, and Suji Prabhaharan. "Acute Q fever in third trimester pregnancy." BMJ Case Reports 14, no. 8 (August 2021): e242558. http://dx.doi.org/10.1136/bcr-2021-242558.
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A 29-year-old gravida 2 para 1 woman presented at 29 weeks gestation with fevers, back pain, thrombocytopenia and hepatitis. PCR testing of blood samples detected Coxiella burnetii and paired serology later confirmed the diagnosis of acute Q fever in pregnancy. The patient was treated empirically with oral clarithromycin and experienced a symptomatic and biochemical improvement. Therapy was changed to oral trimethoprim/sulphamethoxazole but was complicated by a delayed cutaneous reaction, prompting recommencement of clarithromycin. Therapy continued until delivery of a healthy girl at 39 weeks and 3 days. Q fever in pregnancy is likely under-reported and is associated with the development of chronic infection and obstetric complications. Treatment with clarithromycin is an alternative to trimethoprim/sulphamethoxazole in the setting of drug intolerance.
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Batool, Tahira, and M. Griffiths. "Heterotopic pregnancy presenting in the third trimester." Journal of Obstetrics and Gynaecology 13, no. 6 (January 1993): 447. http://dx.doi.org/10.3109/01443619309151737.
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Şentürk, Şenol, Nursel Dilek, Yeşim Bayoğlu Tekin, Sabri Çolak, Betül Gündoğdu, and Emine Seda Güvendağ Güven. "Pemphigoid Gestationis in a Third Trimester Pregnancy." Case Reports in Obstetrics and Gynecology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/127628.
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Pemphigoid gestationis (PG) is a rare vesiculobullous dermatosis of pregnancy. It is commonly seen in second or third trimester. The diagnosis is frequently made with direct immunofluorescence studies of perilesional skin. Prompt recognition and appropriate management may reduce morbidity of this disease. Herein we present a case of pemphigoid gestationis occurring in a 33-year-old primigravida woman with symptoms of generalized pruritus.
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Brown, Oliver, Neil Davidson, and John Palmer. "Cardioversion in the third trimester of pregnancy." Australian and New Zealand Journal of Obstetrics and Gynaecology 41, no. 2 (May 2001): 241–42. http://dx.doi.org/10.1111/j.1479-828x.2001.tb01222.x.
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Sen, G., J. S. Nagabhushan, and V. Joypaul. "Laparoscopic cholecystectomy in third trimester of pregnancy." Journal of Obstetrics and Gynaecology 22, no. 5 (January 2002): 556–57. http://dx.doi.org/10.1080/014436102760298863.
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Passarinho, R. M., E. Afonso, L. Reis, and I. Santos Silva. "Adnexal torsion in third trimester of pregnancy." Case Reports 2012, oct29 1 (October 29, 2012): bcr—2012–006755—bcr—2012–006755. http://dx.doi.org/10.1136/bcr-2012-006755.
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Schnatz, Peter F., and Sara Thaxton. "Parathyroidectomy in the Third Trimester of Pregnancy." Obstetrical & Gynecological Survey 60, no. 10 (October 2005): 672–82. http://dx.doi.org/10.1097/01.ogx.0000180889.23678.fb.
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Meydanli, M. Mutlu, Yusuf Üstün, and Omer T. Yalcin. "Pelvic Organ Prolapse Complicating Third Trimester Pregnancy." Gynecologic and Obstetric Investigation 61, no. 3 (2006): 133–34. http://dx.doi.org/10.1159/000090034.
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O'Donoghue, Keelin, Laura Giorgi, Valentina Pontello, Lucia Pasquini, and Sailesh Kumar. "Amniocentesis in the third trimester of pregnancy." Prenatal Diagnosis 27, no. 11 (2007): 1000–1004. http://dx.doi.org/10.1002/pd.1820.
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Samuel, George, Lydia Baltarowich, Kamelia Albujoq, Said Chaaban, Muhammad Usman, and Daniel Ouellette. "Acetaminophen Overdose in a Third Trimester Pregnancy." Chest 152, no. 4 (October 2017): A379. http://dx.doi.org/10.1016/j.chest.2017.08.405.
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Demain, Jeffrey G., and Paul A. Greenberger. "Exercise-Induced Anaphylaxis in Third Trimester Pregnancy." Journal of Allergy and Clinical Immunology: In Practice 8, no. 4 (April 2020): 1471. http://dx.doi.org/10.1016/j.jaip.2020.01.020.
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Jesudason, W. V., J. Murphy, and R. J. A. England. "Primary hyperparathyroidism in pregnancy." Journal of Laryngology & Otology 118, no. 11 (November 2004): 891–92. http://dx.doi.org/10.1258/0022215042703714.
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Primary hyperparathyroidism during pregnancy carries significant risks to both mother and fetus. Parathyroidectomy remains the only definitive treatment for the condition. The timing of surgery remains controversial, with ongoing debate regarding the safety of surgery during the third trimester. A case of symptomatic primary hyperparathyroidism treated by parathyroidectomy in the third trimester is described. The clinical features, investigations and treatment options are discussed.
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Morimoto, Kaori, and Luke O’Rourke. "Third Trimester Lower Extremity Lymphorrhea." Case Reports in Obstetrics and Gynecology 2021 (November 28, 2021): 1–5. http://dx.doi.org/10.1155/2021/3594923.
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Introduction. Lower extremity edema is one of the most common complaints among pregnant patients. However, there is no literature mentioning weeping edema (i.e., lymphorrhea) in a pregnant woman who has no concordant underlying renal and/or cardiac pathology. There is also a lack of evidence and recommendations regarding the therapeutic benefit and safety profile of diuretic use to treat profound pregnancy-associated edema. Herein, we present the case of 32-year-old female who presented with a significant lymphorrhea during the third trimester without cardiac or renal comorbidity and was successfully treated with torsemide. Case Report. We report a case of a 32-year-old multigravida patient pregnant with her third child and has two living full-term children (G3P2003). Her pregnancy was complicated by obesity, smoking (vape), and previous history of fetal growth restriction. The patient presented for routine prenatal care at 9-week gestation. She was diagnosed with chronic hypertension at 19 weeks of pregnancy based upon systolic blood pressure > 140 . Lifestyle modifications were recommended, but the patient did not comply. At her 31-week office visit, the patient presented with anasarca and clear, slightly viscous fluid seeping through the atraumatic skin of her lower extremities. Preeclampsia, renal, cardiac, vascular, and infectious complications were all ruled out. The patient responded positively to loop diuretic therapy. Torsemide was found to be far more beneficial than furosemide. The patient was induced at 37 weeks secondary to chronic hypertension requiring antihypertensive therapy. Delivery was uncomplicated. The patient gave birth to a healthy male with birth weight of 2,920 g via spontaneous vaginal delivery. Discussion. Pitting edema of lower limbs frequently occurs as a result of fluid overload and chronic venous insufficiency, and pregnancy is one of the known risk factors. Additionally, the blockage of lymphatic channel with the gravida uterus likely was the main contributing factor for her lymphorrhea. In this patient, the capillary hydrostatic pressure was likely accentuated due to hypertension, obesity, and vaping. Furosemide was minimally effective to alleviate her symptoms. Torsemide provided much more effective diuresis and symptom control. However, her symptoms persisted until delivery. Conclusion. Torsemide provided significant therapeutic benefit over furosemide in this patient without adverse maternal, fetal, or neonatal outcomes. Further study is needed to assess the safe use of loop diuretics in the pregnant population who suffers from significant lower extremity edema.
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Behluli, Edon, Gazmend Temaj, Mirsada Behluli, Anila Kamberi, Donika Dragidella, and Blerim Kamberi. "Korelacija bakterija Lactobacillus u slini i OHI, PI, GI i PBI indeksa u trudnica." Collegium antropologicum 46, no. 2 (2022): 121–28. http://dx.doi.org/10.5671/ca.46.2.6.
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Pregnancy is a completely new physiological condition that stimulates important protective forces of the future mother. The changes that occur in the body of the pregnant woman are hormonal, biochemical, anatomical, and histological which are manifested in the functions of all organs. This study included 66 pregnant women in their first pregnancy living in Pristina or coming from nearby places in Kosovo. It aimed at dermining the Oral Hygiene Index (OHI), Plaque Index (PI), Gingival index (GI) and Index of interdental gingival bleeding (PBI) in pregnant women in the first and third trimester of pregnancy. The amount of Lactobacillus in saliva was determined by the diagnostic test of CRT-bacteria. The results show that OHI value in the third trimester of pregnancy for (p = 0.000) was significantly higher than the value in the first trimester; IDP value in the third trimester of pregnancy for (p=0.000) was significantly higher than the first trimester value; GI value in the third trimester of pregnancy was significantly higher than in the first trimester p<0.01(p=0.006); PBI value in the third trimester of pregnancy was significantly higher than in the first trimester (p=0.000). A weak positive correlation was obtained between the OHI index and Lactobacillus in pregnant women in the first and third trimesters (p> 0.05). The correlation between IDP and the value Lactobacillus in pregnant women in the first and third trimesters showed a weak positive value (p> 0.05). The correlation between GI and the value of Lactobacillus in pregnant women in the first and third trimester showed a weak negative insignificant correlation for Spearman Rank Order R = –0.05 and p> 0.05. The results obtained from this study pointed at small differences in the examined parameters which are very important for early detection and timely prevention.
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Lao, Terence T., and Kar-Fai Tam. "Gestational diabetes diagnosed in third trimester pregnancy and pregnancy outcome." Acta Obstetricia et Gynecologica Scandinavica 80, no. 11 (November 2001): 1003–8. http://dx.doi.org/10.1034/j.1600-0412.2001.801106.x.
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Alhaj, A., T. Al-Saadi, and R. Dudley. "P.163 Endoscopic third ventriculostomy for VP shunt malfunction during the third trimester of pregnancy: illustrative case." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (June 2022): S50. http://dx.doi.org/10.1017/cjn.2022.245.
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Background: Endoscopic third ventriculostomy (ETV) is a successful procedure for treating noncommunicating hydrocephalus as an alternative to initial ventriculoperitoneal (VP) shunt placement and as a salvage procedure when a VP shunt fails. Physiological changes of pregnancy can lead to VP shunt failure and complicate the management of shunt malfunction, particularly in the third trimester. Methods: Case report: ETV was successfully used in the third trimester (31 weeks of gestation) of pregnancy for acute hydrocephalus due to VP shunt malfunction, and the patient went on to deliver a healthy baby at term; the patient remained well in the long-term follow-up. An English-language PubMed literature review revealed four cases of VP shunt failure successfully treated with an ETV in the first or second trimester but no such reports in the third trimester of pregnancy. Results: This case report adds to the sparse literature regarding the use of an ETV to treat VP shunt malfunction in the third trimester of pregnancy. This appears to be a unique first-time report of the use of an ETV during this specific challenging prenatal period. Conclusions: ETV appears to be a safe and effective alternative to VP shunt replacement in the late prenatal period of pregnancy in well-selected candidates.
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Korgozha, Maria A. "Women’s quality of life dynamics in postpartum period." Pediatrician (St. Petersburg) 8, no. 6 (December 28, 2017): 125–30. http://dx.doi.org/10.17816/ped86125-130.
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The article presents the results of the study of characteristics and dynamics of the women’s quality of life in the third trimester of pregnancy and six weeks after delivery. The study involved 240 women, patients of the Perinatal Center of Saint Petersburg State Pediatric Medical University, during the third trimester of pregnancy and six weeks after the delivery. Research subjects were divided into three study groups, depending on the presence and severity of negative emotional manifestations in women in the third trimester of pregnancy. It was revealed that the indicators of physical, mental and social functioning in women, who underwent negative emotional manifestations of different severity in the third trimester of pregnancy, are below the average population data. It is shown that the intensity of negative emotional manifestations in women in the third trimester of pregnancy does not affect the subjective assessment of the overall health and life status. The appearance of negative emotional manifestations of different severity in women in the third trimester of pregnancy significantly reduces the subjective assessment of pregnant women’s own physical functioning in the context of daily and professional activities. It was revealed that for women underwent mild negative emotional manifestations in the third trimester of pregnancy, the situation of labor is the most stressful and has a significant impact on the quality of life in the late postpartum period. This category of women is at risk and needs more thorough medical support and professional psychological assistance.
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G., Sruthi, Lalith Sundaram, Ranjakumar TC, Rahana Ashraf, and Nimesha Alex. "Central Corneal Thickness (CCT) Measurement in Each Trimester of Pregnancy: A Screening Parameter for a Healthy Eye During Pregnancy : A Prospective Study!" International Journal of Recent Surgical and Medical Sciences 01, no. 01 (December 2015): 019–25. http://dx.doi.org/10.1055/s-0039-1678628.
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AIM: - To detect central corneal thickness (CCT) in each trimester of pregnancy. Purpose: To evaluate difference in measurement of central corneal thickness due to corneal changes in each trimester of pregnancy. METHOD: - 100 healthy pregnant women within age group ranging from 21 to 35 years were included in the study. Central corneal thickness (Ultrasound Pachymetry), Intra ocular pressure (Goldmann-Applanation Tonometer) was done. Changes in central corneal thickness (CCT) were calculated at 3 time periods: First trimester, Second trimester, Third trimester. Informed consent was taken from all patients. Patients had no systemic or ocular co-morbidities.All of the patients underwent comprehensive ophthalmologic examinations, including Refraction, Intraocular pressure (IOP), Anterior segment and Fundus examination. RESULTS: - The mean age was 25 years in the study group. The mean CCT in the second trimester of pregnancy was measured to be higher than first trimester by 1.67% &3.13% by third trimester in right eye & increase of 1.91% in second trimester & 3.03% in third trimester left eye.The results are statistically significant confirmed by ANOVA. CONCLUSION: - Changes during pregnancy causes corneal edema, which is observed in pregnant women resulting from increased water retention during pregnancy. Changes in corneal curvature, central, corneal thickness and steeping may also occur during pregnancy particularly during the second and third trimester. Most of the changes are reversible and resolved in the postpartum period or after cessation of breastfeeding. Awareness of the changes during pregnancy and routine screening during antenatal period should be improvised.
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Hanafy, Samy, Neveen E. Srour, and Taymour Mostafa. "Female sexual dysfunction across the three pregnancy trimesters: an Egyptian study." Sexual Health 11, no. 3 (2014): 240. http://dx.doi.org/10.1071/sh13153.
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Background Pregnancy is a special period in the life of women characterised by physical, hormonal and psychological changes that, in conjugation with social and cultural influences, could affect women’s sexuality as well as couples’ sexual relationships. This cross-sectional study aimed to evaluate female sexual dysfunction (FSD) among the three pregnancy trimesters. Methods: A total of 300 healthy heterosexual pregnant Egyptian women with stable marital relationships were included. The Female Sexual Function Index (FSFI) questionnaire was used as a standard method for measuring female sexual function in each pregnancy trimester. Results: There was no significant relationship between FSD and women’s education, work, gravidity and parity. The incidence of FSD demonstrated significant alterations throughout pregnancy, being 68% in the first trimester, decreasing in the second trimester to 51% and increasing to 72% in the third trimester. Sexual desire decreased in the first trimester, was variable in the second trimester and decreased at the end of the third trimester (3.5 ± 1.2, 3.7 ± 1.2 and 3.4 ± 1.1 respectively). Sexual satisfaction declined significantly in the first trimester compared with the second and the third trimesters (4.2 ± 1.1, 4.8 ± 0.8 and 4.6 ± 1.0 respectively). Scores for the arousal, lubrication and orgasm domains were significantly decreased in the third trimester, where pain was increased in the second trimester compared with the first and third trimesters. Conclusion: Female sexual function is affected during pregnancy, with a significant change in all Female Sexual Function Index domains, especially in the first and third trimesters.
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Zou, Jiaojiao, Yanting Yang, Qian Wei, Yunhui Zhang, and Huijing Shi. "Longitudinal Association of Maternal Pre-Pregnancy BMI and Third-Trimester Glycemia with Early Life Growth of Offspring: A Prospective Study among GDM-Negative Pregnant Women." Nutrients 13, no. 11 (November 7, 2021): 3971. http://dx.doi.org/10.3390/nu13113971.
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Intrauterine modifiable maternal metabolic factors are essential to the early growth of offspring. The study sought to evaluate the associations of pre-pregnancy BMI and third-trimester fasting plasma glucose (FPG) with offspring growth outcomes within 24 months among GDM-negative pregnant women. Four hundred eighty-three mother –offspring dyads were included from the Shanghai Maternal-Child Pairs Cohort. The pregnant women were categorized into four mutually exclusive groups according to pre-pregnancy BMI as normal or overweight/obesity and third-trimester FPG as controlled or not controlled. Offspring growth in early life was indicated by the BAZ (BMI Z-score), catch-up growth, and overweight/obesity. Among those with controlled third-trimester FPG, pre-pregnancy overweight/obesity significantly increased offspring birth weight, BAZ, and risks of overweight/obesity (RR 1.83, 95% CI 1.23 to 2.73) within 24 months. Those who had uncontrolled third-trimester FPG had a reduced risk of offspring overweight/obesity within 24 months by 47%. The combination of pre-pregnancy overweight/obesity and maternal uncontrolled third-trimester FPG increased 5.24-fold risk of offspring catch-up growth within 24 months (p < 0.05). Maternal pre-pregnancy overweight/obesity and uncontrolled third-trimester glycemia among GDM-negative women both have adverse effects on offspring growth within 24 months. With the combination of increasing pre-pregnancy BMI and maternal third-trimester FPG, the possibility of offspring catch-up growth increases.
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Mehta, Varshil, Raghuram Pusukuru, and Babita Ghodke. "Association of Thyroid Stimulating Hormone and Lipid Profile in Pregnancy." Journal of Medical Research and Innovation 1, no. 2 (April 28, 2017): AU1—AU6. http://dx.doi.org/10.15419/jmri.50.
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Introduction: Thyroid hormones have significant functions in embryogenesis and fetal development. Evidence suggests that thyroid stimulating hormone (TSH) may exert extra-thyroidal effects and modify the profile of blood lipids. Aim: To determine the association between maternal blood lipid profile and thyroid stimulating hormone in second and third trimester of pregnancy. Methods & Materials: The present study was carried out at MGM Hospital, Navi Mumbai, India. 200 antenatal cases from October, 2012 to October 2014 were enrolled after taking an informed consent. The blood samples for Thyroid stimulating hormone and lipid profile were taken at 16th and 32nd weeks. Results: The mean TSH level in second trimester was 1.53 mIU/L, with a standard deviation of 1.147 mIU/L. In third trimester, the mean TSH level was increased to 2.60 mIU/L with a standard deviation of 0.836mIU/L. The t-stat value was found to be -10.649 (p < 0.001). In third trimester, TSH was negatively correlated with Cholesterol (r= -0.214, p < 0.01) and VLDL (r= -0.148, p < 0.05). Conclusion: TSH levels rises according to the gestational age, being higher in third trimester as compared to second trimester. There is a significant negative correlation between TSH levels and cholesterol & VLDL in third trimester of the pregnancy. Hence, TSH levels should be looked for, especially in third trimester, in order to keep the thyroid related problems in check.
Keywords: TSH, Lipid Profile, Pregnancy.
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Ummah, Dewi Afidatul, Gita Kostania, and Rosalina Rosalina. "Reminder dengan Short Message Service (SMS) Untuk Meningkatkan Kepatuhan Kunjungan K4 dan Kemampuan Deteksi Dini Tanda Bahaya Ibu Hamil Trimester III." Jurnal Kebidanan dan Kesehatan Tradisional 5, no. 2 (September 18, 2020): 94–103. http://dx.doi.org/10.37341/jkkt.v5i2.146.
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Background: Low K4 rate coverage and management of complications in pregnancy is a problem in Klaten, caused by lack of information and motivation in antenatal care. Short Message Service (SMS) can be used as a support intervention to increase information. This research aims to determine effects of SMS toward K4 compliance and screening danger sign ability among third trimester pregnancy in Wedi Public Health Center. Methods: type of research is a quasy experimental with post-test only non-equivalent control group. The sampling technique used Quota sampling, obtain 52 respondents in the third trimester of pregnancy. Data analysis techniques used Mann Whitney and Chi Square with a significance level of 0.05. Result: K4 compliance of pregnancy could be classified as disobedient of 59,6% and screening danger sign ability among third trimester pregnancy is considered relatively of 53.8%. SMS had a strong impact toward K4 compliance with a p value= 0,002 (p<0,05). SMS also affected screening danger sign ability among third trimester pregnancy with a p value = 0.001 (p<0.05). Conclusion: There is significant effects between SMS toward K4 compliance and screening danger sign ability among third trimester pregnancy in Wedi Pubic Health Center, Klaten Regency.
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Alza, Nurfaizah, and Ismarwati Ismarwati. "Faktor-faktor yang mempengaruhi kecemasan ibu hamil trimester III." Jurnal Kebidanan dan Keperawatan Aisyiyah 13, no. 1 (April 30, 2018): 1–6. http://dx.doi.org/10.31101/jkk.205.
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Abstract: The purpose of this study was to determine the factors thatinfluence on anxiety of pregnancy third trimester. This research is adescriptive cross-sectional design. The sampling technique used isconsecutive sampling with the total sample 61 respondents. The analysisused is independent t test. The results showed the factors that influenceon anxiety of pregnancy third trimester is the support of husband with ap value of 0,048 (p <0.05), while the age of mother, education level,occupation, gravidity and physical exercise can not be influence relatedto anxiety of pregnancy third trimester with p> 0,05. Conclusions factorsthat influence anxiety third trimester pregnant women isthe support ofhusband.
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Bérard, Anick, Jin-Ping Zhao, Irene Shui, and Susan Colilla. "Leflunomide use during pregnancy and the risk of adverse pregnancy outcomes." Annals of the Rheumatic Diseases 77, no. 4 (December 8, 2017): 500–509. http://dx.doi.org/10.1136/annrheumdis-2017-212078.
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ObjectivesLeflunomide is known to be embryotoxic and teratogenic in rodents. However, there is less evidence in humans. We quantified the risk of major congenital malformation (MCM), prematurity, low birth weight (LBW) and spontaneous abortion associated with leflunomide exposure during pregnancy in humans.MethodsFrom a cohort of 289 688 pregnancies in Montreal, Quebec, Canada, from 1998 to 2015, first-trimester leflunomide exposure and other antirheumatic drug exposures were studied for their association with MCM and spontaneous abortions. Also second or third-trimester leflunomide exposures were examined for associations with prematurity and LBW. Logistic regression model-based generalised estimating equations were used.Results51 pregnancies were exposed to leflunomide during the first trimester, and 21 during the second/third trimesters. Adjusting for potential confounders, use of leflunomide during the first trimester of pregnancy was not associated with the risk of MCM (adjusted OR (aOR) 0.97, 95% CI 0.81 to 1.16; 5 exposed cases). No association was found between second/third-trimester exposure to leflunomide and the risk of prematurity (aOR 4.03, 95% CI 0.91 to 17.85; 7 exposed cases) nor LBW (aOR 1.06, 95%CI 0.90 to 1.25; 8 exposed cases). Pregnancy exposure to leflunomide was also not associated with the risk of spontaneous abortion (aOR 1.09, 95% CI 0.90 to 1.32; 11 exposed cases).ConclusionsMaternal exposure to leflunomide during pregnancy was not associated with statistically significant increased risk of MCMs, prematurity, LBW or spontaneous abortions. However, given that relatively few women were exposed to leflunomide during pregnancy in this cohort, caution remains warranted.
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Aprilia Ningsih, Dewi, Sanisahhuri Sanisahhuri, and Dwi Mulyani. "The Relationship Of Knowledge With Sexual Behavior Pregnant Woman Trimester III In The Work Area Of Puskesmas Basuki Rahmad Bengkulu City." Jurnal Kebidanan Midwiferia 6, no. 1 (April 5, 2020): 32–37. http://dx.doi.org/10.21070/midwiferia.v6i1.451.
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Sexual intercourse will be better done in the third trimester because the physical and mental conditions of pregnant women support, of course with the right sexual position. This study aims to study the relationship of knowledge with sexual behavior of pregnant women in third trimester in the working area of Puskesmas Basuki Rahmad Bengkulu City.This study uses a cross sectional design. The population in this study were all pregnant women in the third trimester in the working area of the health center, basuki rahmad, bengkulu city. Sample appearance technique in this study uses purposive sampling. A sample of 35 third trimester pregnant women was obtained. data collection in this study uses a questionnaire.The results were obtained: 15 (42.9%) respondents had good knowledge, 24 (68.6%) respondents had sexual intercourse during the third trimester of pregnancy. There was a significant relationship between the knowledge of third trimester pregnant women with third trimester pregnant women sexual behavior. in the Puskesmas Basuki Rahmad Working Area, the City of Bengkulu with the category of moderate relations. To various parties, especially pregnant women in the third trimester to increase their knowledge about sexual relations during the third trimester of pregnancy and for health workers to improve the information provided to pregnant women both in terms of counseling and at the time of pregnancy examination.
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Vereş, Monica, Aurel Babeş, and Szidonia Lacziko. "Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight." Romanian Journal of Diabetes Nutrition and Metabolic Diseases 20, no. 3 (September 1, 2013): 259–65. http://dx.doi.org/10.2478/rjdnmd-2013-0024.
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Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.
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Mărginean, Claudiu, Marius-Vicea Calomfirescu, Radu Vlădăreanu, Daniel Mureşan, Liana Pleș, Iuliana Ceauşu, Ştefania Tudorache, et al. "Ultrasound screening in the third trimester of pregnancy." Obstetrica şi Ginecologia 3, no. 68 (2020): 112. http://dx.doi.org/10.26416/obsgin.68.3.2020.4007.
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Uleanya, Obiefula, Kate McCallin, Noor Khanem, and Sabahat Sabir. "Recurrent uterine rupture in third trimester of pregnancy." BMJ Case Reports 14, no. 8 (August 2021): e241987. http://dx.doi.org/10.1136/bcr-2021-241987.
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We report a case of recurrent upper segment uterine rupture in a 31-year-old woman at 32+5/40 weeks of gestation. She had fundal uterine rupture 3 years ago in her first pregnancy at 40 weeks of gestation. There was no history of uterine malformation or prior uterine surgery. However, we noted that she had had three laparoscopic procedures for endometriosis treatment. She was scheduled to have an elective repeat caesarean section at 34+6/40 weeks of gestation in the index pregnancy. Unfortunately, she presented at 32+5/40 weeks with features of acute abdomen and signs of fetal distress. She had a category 1 caesarean section and was found to have fundal uterine rupture at the same site. She had a smooth uneventful recovery following a timely intervention and discharged home on day 5 postoperatively in a good condition with her baby girl.