Management of menstrual hygiene, practices and perceptions among vulnerable Bharia women in Madhya Pradesh: A pilot survey

India has the highest proportion of adolescents and the highest adolescent pregnancy and childbirth rate in the tribal segment of the population. Very few studies have focused on the use of sanitary pad and quality of health care as menstrual hygiene practices. The data was collected among ‘Bharia’ women who identified as one of the particularly vulnerable tribal groups (PVTGs) in Madhya Pradesh. Towards comparing the use, source, and components of menstrual hygiene practices among adolescents and adult mothers, the sample included adolescent (10-19 years) and adult women 20-49 years of age. The relevant information was collected by trained female investigator with designed questionnaire from the respondents. Findings revealed that only 22.7% women are using sanitary pad during menstruation period in the studied tribe. It was seen the use of this absorbent (sanitary pad) for menstrual hygiene among the adolescents were found significantly higher (37.5%) than that of adult women (14.3%), whereas, the use of old cotton was found significantly higher (78.6%) among adult women. Awareness on menstrual hygiene about 50% adolescents and 64% adult women believed it is a curse of God. About 25% adolescents and 21.4% adult women believed menstruation is a natural process. The tribe has underprivileged menstrual hygiene practices owing to low awareness, illiteracy, and poverty. The special IEC education campaign with suitable strategy can be forced to optimum hygiene practices.

The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns

The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.

Antenatal Care Predicts Neonatal Mortality in Eastern Africa: A Systematic Review and Meta-analysis of Observational Studies

Background Sub-Saharan African countries, especially the Eastern region, present the dismal picture of neonatal mortality (NM) in the globe. The majority of these deaths could be avoided if effective health measures are provided throughout pregnancy and childbirth. Although antenatal care (ANC) is assumed as one of the viable interventions that contribute to neonatal survival, the effect of ANC on NM was not systematically analyzed in Eastern Africa. Thus, the study aimed to determine the pooled effect of ANC on NM in Eastern Africa. Methods PubMed, EMBASE, CINAHL, and HINARI databases were searched using appropriate keywords from January 1, 1990 to February 12, 2021. Independent authors selected eligible articles and extracted data. The risk of a bias assessment tool for nonrandomized studies was used to assess the quality of the study. Comprehensive meta-analysis version 2 was used for meta-analysis. The random-effect model was employed, and the outcome is expressed as a risk ratio with 95% confidence interval (CI). Results In total, 1149 studies were identified through database search, and only 27 studies were included in the meta-analysis. Having at least 1 ANC visit during pregnancy reduced the risk of neonatal death by 42% compared to their counterparts (RR = 0.58, 95% CI [0.47, 0.71]). The pooled prevalence of NM was 8.5% (95% CI [7.3, 9.6]), with NM rate of 46.3/1000 live births. Conclusion The study indicated that NM might be decreased even with a single ANC visit when compared to no visits. Scaling up ANC services through ANC promotion and tackling service-related barriers could potentially reduce NM in Eastern Africa.

Pregnancy and childbirth in women from among the indigenous minorities of the north in the context of urbanization

Data on the health status of the population of the indigenous small-numbered peoples of the North of Khanty and Mansi, who migrated to the city and changed the traditional nomadic way of life, are few and not systematized.The aim of the study was to study the course of pregnancy and childbirth among the indigenous peoples of the north who migrated and live in the city of Khanty-Mansiysk, Khanty-Mansiysk Autonomous Okrug-Yugra. An increase in the frequency of gynecological diseases was revealed: menstrual irregularities (in 38.5%), inflammatory diseases of the cervix (in 42.3%) and inflammatory diseases of the uterus (in 19.2%). Half of the observed women had gastritis (50%), cholecystitis (51.9%), every fourth cystitis (23.1%), anemia was diagnosed in every third in 30.8%. Pregnancy in women of the study cohort was often complicated by early toxicosis, anemia, gestational diabetes mellitus, threatening premature birth. Childbirth in pregnant women from among the indigenous small peoples of the north living in the city was complicated by anomalies in labor, indications for emergency operative delivery. This requires further study of the health status of the indigenous peoples of the north and the development of a health improvement program.Materials and methods. The course of pregnancy, childbirth and the postpartum period was retrospectively analyzed in 168 women selected by the continuous sampling method. Women from the Khanty and Mansi KMNS living in the village of Berezovo, in the camps and in Khanty-Mansiysk were examined. Statistical processing was performed in the software package SPSS, Statistica 8.0, as well as using the Microsoft Excel analysis package.Results. The results of the study showed that the least number of deviations in the state of health were among women from the number of KMNS living in the village and in the camps and leading a traditional nomadic lifestyle. The course of pregnancy rarely had complications and 100% of women ended in spontaneous labor on time.Conclusion. The urbanization of women from among the indigenous small-numbered peoples of the north has an adverse effect on the state of somatic and reproductive health, characterized by a high frequency of gynecological diseases, pregnancy complications, labor anomalies and operative delivery.

Long-term association of pregnancy and maternal brain structure: the Rotterdam Study

The peripartum period is the highest risk interval for the onset or exacerbation of psychiatric illness in women’s lives. Notably, pregnancy and childbirth have been associated with short-term structural and functional changes in the maternal human brain. Yet the long-term effects of pregnancy on maternal brain structure remain unknown. We investigated a large population-based cohort to examine the association between parity and brain structure. In total, 2,835 women (mean age 65.2 years; all free from dementia, stroke, and cortical brain infarcts) from the Rotterdam Study underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Associations of parity with global and lobar brain tissue volumes, white matter microstructure, and markers of vascular brain disease were examined using regression models. We found that parity was associated with a larger global gray matter volume (β = 0.14, 95% CI = 0.09–0.19), a finding that persisted following adjustment for sociodemographic factors. A non-significant dose-dependent relationship was observed between a higher number of childbirths and larger gray matter volume. The gray matter volume association with parity was globally proportional across lobes. No associations were found regarding white matter volume or integrity, nor with markers of cerebral small vessel disease. The current findings suggest that pregnancy and childbirth are associated with robust long-term changes in brain structure involving a larger global gray matter volume that persists for decades. Future studies are warranted to further investigate the mechanism and physiological relevance of these differences in brain morphology.

Experiencing pregnancy at an advanced maternal age in a private hospital

Objective: to describe the experiences of pregnant women at advanced maternal age assisted in a private hospital. Methods: a qualitative study, carried out with 17 women, by means of semi-structured interviews via telephone. The data was submitted to Thematic Content Analysis. Results: the participants were between 35 and 40 years old. Two categories emerged: Experiencing pregnancy as a couple and family: the preparation of the couple for pregnancy and childbirth (Pregnancy after 35 years old as an element of potentiality; Change in the family routine for the baby’s arrival) and Experiencing pregnancy and its changes: perceiving pregnancy as a healthy and calm experience (Change in emotional patterns related to the pregnancy process). Conclusion: experiencing pregnancy late in life was not a concern for women. Maturity and favorable socioeconomic conditions may have a protective influence on the course of healthy pregnancies in women attending the private health service.

Issues of safe correction of gastroduodenal symptoms during pregnancy

Extragenital diseases make a great effect on the complicated course of pregnancy and childbirth. The lack of pregravidar preparation and somatic diagnostics lead to miscarriage, preeclampsia, and placental disorders. Therefore, the development of various algorithms for the management of pregnant women suffering from diseases of the gastrointestinal tract and the safe correction of various gastroduodenal symptoms, which is sometimes characteristic of the gestation period, are relevant. The purpose of the study: evaluation and critical analysis of modern data in the field of diagnosis and safe correction of various gastroduodenal symptoms during pregnancy. Materials and methods. Collection of modern Russian and foreign literature sources on the correction of gastroduodenal pathology during pregnancy, generalization and critical analysis of this problem. Results. Heartburn, constipation, flatulence are the most common complaints during pregnancy. The causes of their occurrence are physiological features during gestation, aimed at the most favorable gestation of the fetus. The first-line preparations are alginates created on the basis of alginic acid of brown alga. Antacids have a number of disadvantages. Proton pump inhibitors are prescribed extremely rarely and cautiously during pregnancy. In case of constipation in pregnant women, it is recommended to prescribe lactulose preparations together with defoamers. Prebiotics perfectly regulate the work of the intestine. The etiology, mechanisms of occurrence, clinical symptoms, differential diagnosis and treatment of intrahepatic cholestasis of pregnant women were analyzed. Its possible prognoses and risks for the mother and fetus, the possibilities of diagnosis and correction are determined. Diseases of the gastrointestinal tract in pregnant women cause difficulties in diagnosis and treatment. For the most optimal course of pregnancy, there are sufficiently effective gastroenterological drugs recommended so that the effect of treatment is maximized and the side effect is minimized.

HUBUNGAN PENGETAHUAN DENGAN CAKUPAN K4 PADA IBU HAMIL DI PUSKESMAS SANGKUNUR

Antenatal Care (ANC) is a planned program in the form of observation, education and medical treatment for pregnant women to obtain a safe and satisfying process of pregnancy and childbirth. ANC visits should be done at least 4 times during pregnancy, namely K1 to K4, with a time distribution of at least 1 time in the first trimester (0-12 weeks of gestation), at least 1 time in the second trimester (12-24 weeks of gestation), and at least 2 times in the third trimester (24 weeks gestation - birth). This type of research is an analytic study with a cross sectional design. The population in this study were all 124 pregnant women in the final third semester of Sangkunur Health Center using simple random sampling of 95 people. Data obtained from the Sangkunur Health Center and through the results of interviews using a questionnaire. The data analysis method was analyzed by univariate, bivariate using the Chi-square test. Based on the results of statistical tests with the Chi-square test, it is known that there is a relationship between knowledge and K4 coverage in pregnant women (0.006 <0.05). It is recommended to Sangkunur Health Center to regularly provide outreach to pregnant women about the importance of conducting antenatal care visits in order to get antenatal care services so that pregnant women can visit health service places.

Pregnancy, childbirth and health of female labour migrants from Central Asia in Russia

The research note contains an analysis of data on health, pregnancy, and childbirth experience among female labour migrants arriving in Russia from Central Asia. Empirically, the study bases on the data of three surveys conducted in 2015, 2017, and 2020. In total, the surveys contain information on 2,028 migrants from Tajikistan, Kyrgyzstan, and Uzbekistan living in Russia. The analysis proves that with gradual feminization of labour migration from Central Asia, pregnancy and childbirth in a significant part of labour migrants take place in risky living conditions; the existing system of maternal health protection for migrants in Russia needs modernization. Compared to earlier studies on this topic, the survey data showed a higher proportion of female migrants who had got pregnant and gave birth in Russia along with a lower proportion of migrants who terminated pregnancy. These differences may indicate a change in the reproductive behaviour of women who come to work in Russia from the countries of Central Asia. The presented note shows the need for in-depth studies of the reproductive behaviour of labour migrants in Russia, as well as the development of national migration statistics, which should become gender sensitive.