scholarly journals The Association between Abnormal Vaginal Flora and Cytological Evidence of HPV with Prematurity in High-Risk Pregnant Women

2019 ◽  
pp. 1
Author(s):  
Alana Dantas Freire ◽  
Ada Isa Custódio ◽  
José Queiroz Filho ◽  
Janaína Crispim Freitas ◽  
Ana Katherine Gonçalves ◽  
...  
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Pap Smear ◽  
Statistical Significance ◽  
Prevalence Ratio ◽  
Vaginal Flora ◽  
Abnormal Cytology ◽  
Cytological Evidence ◽  
Abnormal Vaginal Flora

<p><strong>Objective:</strong> To evaluate the association between abnormal vaginal flora and cytological evidence of HPV with prematurity in high-risk pregnant women. <br /><strong></strong></p><p><strong>Study design:</strong> A prospective cohort study was designed with high-risk pregnant women who delivered singletons between 20-42 gestational weeks between January to November 2018. Vaginal specimens were collected to obtain material from the upper lateral vaginal vault and cervix for direct microscopic examination of vaginal contents and preparation of Gram-stained and pap smear slides. Potential determinants of infection were assessed using the chi-square test. Poisson regression was used to determine the prevalence ratio and 95% confidence interval of the association between the vaginal flora and cytology with prematurity and a p &lt;0.05 was considered as statistical significance. <br /><strong></strong></p><p><strong>Results:</strong> A total of 68 pap smear and high vaginal swab samples were collected from high-risk pregnant women with a mean age of 30.3 years. There were 26 (38.2%) cases of abnormal vaginal flora and 6 (8.8%) of HPV-induced cytological abnormalities. The preterm delivery rate was comparable between women with normal and abnormal vaginal flora (11.9% vs. 11.5%, prevalence ratio 1.0 [95% confidence interval: 0.8-1.2], aPR 1.0 [95% confidence interval: 0.8-1.2]) and between women with and without abnormal cytology (16.7% vs. 11.3%, prevalence ratio 0.9 [95% confidence interval: 0.6-1.4], aPR 0.9 [95% confidence interval: 0.6-1.4]). <br /><strong></strong></p><p><strong>Conclusions:</strong> We determined no association between abnormal cytology or altered vaginal flora in high-risk pregnancy in terms of overall preterm birth rate.</p>

scholarly journals Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 213
Author(s):  
Bogdan Marian Sorohan ◽  
Andreea Andronesi ◽  
Gener Ismail ◽  
Roxana Jurubita ◽  
Bogdan Obrisca ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Cumulative Risk ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Clinical Predictors ◽  
Mean Time

Background and Objectives: Pregnant women with chronic kidney disease (CKD) are at high risk of adverse maternal and fetal outcomes. Preeclampsia (PE) superimposed on CKD is estimated to occur in 21%–79% of pregnancies. Both conditions share common features such as proteinuria and hypertension, making differential diagnosis difficult. Objective: The aim of this study was to evaluate the incidence and the clinical-biological predictors of preeclampsia in pregnant women with CKD. Material and Methods: We retrospectively analyzed 34 pregnant women with pre-existing CKD admitted to our department between 2008 and 2017. Results: Among the 34 patients, 19 (55.8%) developed PE and the mean time of occurrence was 31.26 ± 2.68 weeks of gestation. The median value of 24-h proteinuria at referral was 0.87 g/day (interquartile range 0.42–1.50) and 47.1% of patients had proteinuria of ≥1 g/day. Patients with PE tended to be more hypertensive, with a more decreased renal function at referral and had significantly higher proteinuria (1.30 vs. 0.63 g/day, p = 0.02). Cox multivariate analysis revealed that proteinuria ≥1 g/day at referral and pre-existing hypertension were independently associated with PE (adjusted hazard ratio = 4.10, 95% confidence interval: 1.52–11.02, p = 0.005, adjusted hazard ratio = 2.62, 95% confidence interval: 1.01–6.77, p = 0.04, respectively). The cumulative risk of PE was significantly higher in pregnant women with proteinuria ≥1 g/day at referral (log-rank, p = 0.003). Proteinuria ≥ 1 g/day at referral and pre-exiting hypertension predicted PE development with accuracies of 73.5% and 64.7%, respectively. Conclusions: Pregnant patients with pre-existing CKD are at high risk of developing preeclampsia, while proteinuria ≥ 1 g/day at referral and pre-existing hypertension were independent predictors of superimposed preeclampsia.

Potential coverage of circulating HPV types by current and developing vaccines in a group of women in Bosnia and Herzegovina with abnormal Pap smears

2015 ◽  
Vol 143 (12) ◽  
pp. 2604-2612
Author(s):  
I. SALIMOVIĆ-BEŠIĆ ◽  
M. HUKIĆ
Keyword(s):  
High Risk ◽  
Bosnia And Herzegovina ◽  
Pap Smear ◽  
Multiple Infections ◽  
Pap Smears ◽  
Abnormal Cytology ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Cervical Disease ◽  
Hpv 18

SUMMARYThe objectives of this study were to identify human papillomavirus (HPV) genotypes in a group of Bosnian-Herzegovinian women with abnormal cytology and to assess their potential coverage by vaccines. HPVs were identified by multiplex real-time PCR test (HPV High Risk Typing Real-TM; Sacace Biotechnologies, Italy) of 105 women with an abnormal cervical Pap smear and positive high-risk (HR) HPV DNA screening test. The most common genotypes in the study were HPV-16 (32·6%, 48/147), HPV-31 (14·3%, 21/147), HPV-51 (9·5%, 14/147) and HPV-18 (7·5%, 11/147). The overall frequency of HR HPV-16 and/or HPV-18, covered by currently available vaccines [Gardasil® (Merck & Co., USA) and Cervarix®; (GlaxoSmithKline, UK)] was lower than the overall frequency of other HPVs detected in the study (40·1%, 59/174,P= 0·017). Group prevalence of HR HPVs targeted by a nine-valent vaccine in development (code-named V503) was higher than total frequency of other HPVs detected (68·0%, 100/147,P< 0·001). Development of cervical cytological abnormalities was independent of the presence of multiple infections (χ2= 0·598,P= 0·741). Compared to other HPVs, dependence of cervical diagnosis and HPV-16, -18 (P= 0·008) and HPV-16, -18, -31 (P= 0·008) infections were observed. Vaccines targeting HR HPV-16, -18 and -31 might be an important tool in the prevention of cervical disease in Bosnia and Herzegovina.

scholarly journals Prevalence of premature rupture of membrane and its associated factors among pregnant women in Ethiopia: A systematic review and meta-analysis

2021 ◽  
Vol 9 ◽  
pp. 205031212110539
Author(s):  
Getahun Tiruye ◽  
Kassiye Shiferaw ◽  
Abera Kenay Tura ◽  
Adera Debella ◽  
Abdulbasit Musa
Keyword(s):  
Confidence Interval ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Associated Factors ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Premature Rupture ◽  
History Of ◽  
Tract Infections

Background: Premature rupture of the membrane is a serious public health problem, especially in low- and middle-income countries with significant maternal and perinatal morbidity and mortality. Despite its substantial contributions to feto-maternal complications, the burden of premature rupture of the membrane was not systematically analyzed in Ethiopia. Hence, this review aimed to identify the burden of premature rupture of the membrane and associated factors among pregnant women in Ethiopia. Methods: PubMed/Medline, Scopus, and African journal online databases and Google Scholar were searched for articles published in the English language. Independent review authors selected and screened studies. Appraisal for methodological quality of studies was conducted using the Joanna Briggs Institute assessment checklist. RevMan 5.3 software was used for meta-analysis. The I2 statistical significance and Egger’s test were used to assess heterogeneity and publication bias, respectively. Results: The pooled prevalence of premature rupture of the membrane among pregnant women in Ethiopia was 9.2% (95% confidence interval = 5.0, 16.4). Factors significantly associated with premature rupture of the membrane were no antenatal care visit (odds ratio = 2.87, confidence interval = 1.34, 6.14), history of premature rupture of the membrane (odds ratio = 4.09, 95% confidence interval = 2.82, 5.91), history of abortion (odds ratio = 3.13, confidence interval = 1.63, 6.01), abnormal vaginal discharge (odds ratio = 6.78, confidence interval = 4.11, 11.16), and urinary tract infection (odds ratio = 3.04, confidence interval = 1.21, 7.63). Conclusion: Nearly one in ten pregnancies in Ethiopia encounters premature rupture of the membrane complications. The finding highlights improving antenatal care utilization, thus preventing or treating urinary and reproductive tract infections, and tailored interventions for pregnant women with a history of premature rupture of the membrane or abortion contribute to reduced premature rupture of the membrane.

scholarly journals Bacterial vaginosis in pregnancy and early labour using Nugent scoring and the implication on foetal outcome

2020 ◽  
Vol 54 (1) ◽  
pp. 10-16
Author(s):  
Adewale O. Sule-Odu ◽  
Adedayo A. Oluwole ◽  
Adebayo A. Akadri ◽  
Babatunde A. Andu ◽  
Adeniyi K. Akiseku ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Vaginal Flora ◽  
Vaginal Microflora ◽  
Early Labour ◽  
Foetal Outcome ◽  
Antenatal Clinics ◽  
Prospective Longitudinal ◽  
Abnormal Vaginal Flora ◽  
In Pregnancy

Background: To compare the pattern of vaginal microflora during pregnancy with pattern in early labour using Nugent scoring and determine the effect of these changes on fetal outcome. Design: A prospective longitudinal study. Setting and Population: Pregnant women attending antenatal clinics of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between June 2017 and May 2018. Methods: Consenting pregnant women who attended antenatal clinics were recruited. Vaginal secretions were obtained for Nugent scoring during pregnancy and at presentation in labour. Main Outcome Measures: Prevalence of abnormal vaginal flora in pregnancy and early labour, birth outcome, birth weight, gestational age at delivery, APGAR scores, need for neonatal ward admission. Results: Sixty-seven (33.3%) of pregnant women had abnormal flora which was consistent with bacterial vaginosis.At the presentation of these women in labour, 14.4% of them had bacterial vaginosis thus indicating a significant reduction in abnormal vaginal flora in labour compared to the proportion of abnormal flora in antenatal period(P<0.001). There were no significant differences in the fetal outcomes of mothers with bacterial vaginosis when compared with those with normal vaginal flora (P-value >0.05). Conclusions: Persistence of abnormal vaginal microflora from pregnancy till early labour did not seem to be associated with poorer foetal outcomes when compared with women with normal vaginal microflora in labour. The possibility of persistent infection or re-infection before labour may justify the need for re-evaluation of vaginal smears in the late third trimester to allow for prompt treatment before the onset of labour. Keywords: Bacterial vaginosis, foetal outcome, Lactobacillus, pregnancy, vaginal microflora. Funding: This research work was sponsored by the Tertiary Education Trust Fund, Nigeria (TETFund) with referencenumber OOU/IBR/010.

Dual and multiple trisomies: analysis of 38 cases from 13 thousand karyotyped embryos and fetuses

2017 ◽  
pp. 109-115
Author(s):  
N.P. Veropotvelyan ◽  
Keyword(s):  
Prenatal Diagnosis ◽  
High Risk ◽  
Pregnant Women ◽  
Maternal Age ◽  
Chromosomal Abnormalities ◽  
Chorionic Villus ◽  
Primary Group ◽  
Chorionic Villus Sampling ◽  
Missed Abortion ◽  
Reproductive Losses

The study presents data of different authors, as well as its own data on the frequency of multiple trisomies among the early reproductive losses in the I trimester of pregnancy and live fetuses in pregnant women at high risk of chromosomal abnormalities (CA) in I and II trimesters of gestation. The objective: determining the frequency of occurrence of double (DT) and multiple trisomies (MT) among the early reproductive losses in the I trimester of pregnancy and live fetuses in pregnant women at high risk of occurrence of HA in I and II trimesters of gestation; establishment of the most common combinations of diesel fuel and the timing of their deaths compared with single regular trisomy; comparative assessment materinskogo age with single, double and multiple trisomies. Patients and methods. During the period from 1997 to 2016, the first (primary) group of products in 1808 the concept of missed abortion (ST) of I trimester was formed from women who live in Dnepropetrovsk, Zaporozhye, Kirovograd, Cherkasy, Kherson, Mykolaiv regions. The average term of the ST was 8±3 weeks. The average age of women was 29±2 years. The second group (control) consisted of 1572 sample product concepts received during medical abortion in women (mostly residents of Krivoy Rog) in the period of 5-11 weeks of pregnancy, the average age was 32 years. The third group was made prenatally karyotyped fruits (n = 9689) pregnant women with high risk of HA of the above regions of Ukraine, directed the Centre to invasive prenatal diagnosis for individual indications: maternal age, changes in the fetus by ultrasound (characteristic malformations and echo markers HA) and high risk of HA on the results of the combined prenatal screening I and II trimesters. From 11 th to 14 th week of pregnancy, chorionic villus sampling was performed (n=1329), with the 16th week – platsentotsentez (n=2240), 18 th and 24 th week – amniocentesis (n=6120). Results. A comparative evaluation of maternal age and the prevalence anembriony among multiple trisomies. Analyzed 13,069 karyotyped embryonic and fetal I-II trimester of which have found 40 cases of multiple trisomies – 31 cases in the group in 1808 missed abortion (2.84% of total HA), 3 cases including 1 572 induced medabortov and 7 cases during 9689 prenatal research (0.51% of HA). Determined to share the double trisomies preembrionalny, fetal, early, middle and late periods of fetal development. Conclusion. There were no significant differences either in terms of destruction of single and multiple trisomies or in maternal age or in fractions anembrionalnyh pregnancies in these groups. Key words: multiple trisomies, double trisomy, missed abortion, prenatal diagnosis.

scholarly journals Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Gashaw Garedew Woldeamanuel
Keyword(s):  
Pregnant Women ◽  
Health Surveys ◽  
Educational Inequality ◽  
Statistical Significance ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Obesity Prevalence ◽  
Urban Rural ◽  
Prevalence Of Obesity ◽  
Health Organization

Abstract Background The growing rates of obesity in developing countries are alarming. There is a paucity of evidence about disparities of obesity in Lesotho. This study examined socioeconomic and area-based inequalities in obesity among non-pregnant women in Lesotho. Methods Data were extracted from the 2004, 2009 and 2014 Lesotho Demographic and Health Surveys (LDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. Obesity prevalence was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, simple and complex as well as relative and absolute summary measures were calculated. A 95% confidence interval was used to measure statistical significance of findings. Results We noticed substantial wealth-driven (D = -21.10, 95% CI; − 25.94, − 16.26), subnational region (PAR = -11.82, 95%CI; − 16.09, − 7.55) and urban-rural (− 9.82, 95% CI; − 13.65, − 5.99) inequalities in obesity prevalence without the inequalities improved over time in all the studied years. However, we did not identify educational inequality in obesity. Conclusions Wealth-driven and geographical inequalities was identified in Lesotho in all the studied time periods while education related inequalities did not appear during the same time period. All population groups in the country need to be reached with interventions to reduce the burden of obesity in the country.

scholarly journals High susceptibility to varicella among urban and rural pregnant women in South India: a brief report

2021 ◽  
Vol 149 ◽  
Author(s):  
Leeberk Raja Inbaraj ◽  
Sindhulina Chandrasingh ◽  
Nalini Arun Kumar ◽  
Jothi Suchitra ◽  
Abi Manesh
Keyword(s):  
Pregnant Women ◽  
South India ◽  
Significant Proportion ◽  
Prevalence Ratio ◽  
Epidemiological Studies ◽  
Lethal Outcome ◽  
Factors Associated ◽  
Rural And Urban ◽  
History Of ◽  
Secondary Hospital

Abstract Varicella infection during pregnancy has serious and/or difficult implications and in some cases lethal outcome. Though epidemiological studies in developing countries reveal that a significant proportion of patients may remain susceptible during pregnancy, such an estimate of susceptible women is not known in India. We designed this study to study the prevalence and factors associated with susceptibility to varicella among rural and urban pregnant women in South India. We prospectively recruited 430 pregnant women and analysed their serum varicella IgG antibodies as surrogates for protection. We estimated seroprevalence, the validity of self-reported history of chickenpox and factors associated with varicella susceptibility. We found 23 (95% CI 19.1–27.3) of women were susceptible. Nearly a quarter (22.2%) of the susceptible women had a history of exposure to chickenpox anytime in the past or during the current pregnancy. Self-reported history of varicella had a positive predictive value of 82.4%. Negative history of chickenpox (adjusted prevalence ratio (PR) 1.85, 95% CI 1.15–3.0) and receiving antenatal care from a rural secondary hospital (adjusted PR 4.08, 95% CI 2.1–7.65) were significantly associated with susceptibility. We conclude that high varicella susceptibility rates during pregnancy were noted and self-reported history of varicella may not be a reliable surrogate for protection.

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