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Dec 2024 DOI 10.14302/issn.2379-7835.ijn-24-5352
C. Katusi GodfreyCorresponding author
Introduction Adolescent pregnancy has become a global health concern in recent years, with maintaining dietary diversity being essential to ensure the health of both the mother and fetus. This study aimed to understand the dietary diversity and nutritional status among pregnant adolescents attending antenatal clinic and identify the factors influencing these outcomes. Methodology A hospital based cross-sectional study was done at St Francis Regional Referral Hospital at Ifakara, Tanzania. A total of 131 adolescent pregnant women consented to participate. Data was obtained using questionnaire and 24-hour dietary recall. Results The study revealed that 93.1% (n=122) of adolescent pregnant women met the minimum dietary diversity score based on 24-hour recall period. Similar proportions were observed for age group but vary significantly with the number of children born (p< 0.001), marital status (p = 0.032) and education level (p< 0.001). Additionally, 93.9% (n=123) of adolescent pregnant women had a normal Mid-Upper Arm Circumference (MUAC) and 6.1% (n=8) were undernourished. Similar proportions were observed across age, number of children born, marital status, education status, and occupation. Conclusion Most adolescent pregnant women in this study achieved adequate dietary diversity. However, socio-demographic factors such as age, marital status, and education, as well as challenges like illness and loss of appetite, influenced their dietary diversity and overall nutritional status. Future research should adopt a community-based longitudinal approach to better understand these factors and provide a more comprehensive understanding on the dietary patterns of adolescent pregnant women.
Jul 2023 DOI 10.14302/issn.2994-6743.ijstd-23-4641
C. Hughes VirginiaCorresponding author
Syphilis is caused by the bacterium Treponema pallidum and is transmitted from human to human through sexual contact. Congenital syphilis (CS) occurs when the mother transmits the infection to the fetus. Clinical manifestations of CS include anemia, hepatosplenomegaly, blindness, deafness, meningitis, and deformities in bone structure. The number of cases of CS have increased over the past decade in the United States according to the CDC. A study was conducted correlating the number of Medicaid enrollees in 2020, the number of uninsured persons in 2020, and the number of cases of COVID-19 in 2020 to cases of CS in the United States in 2021. A Spearman rank correlation analysis was done using SPSS. Results were statistically significant for all three pairs of variables with positive correlations; Medicaid enrollment and CS cases (r = 0.735, P<.05), uninsured persons with CS cases (r = 0.713, P<.05), COVID-19 cases and CS cases (r = 0.689, P<.05). Reasons for the increase in CS cases are multifactorial, including variations in state laws regarding syphilis screening in the prenatal period, differences in provider processes for persons on Medicaid, persons uninsured, and restrictions to accessing healthcare providers during the COVID-19 pandemic. Future studies should include questionnaires and interviews with women on their experiences during prenatal visits in regards to syphilis screening, particularly women covered by Medicaid, and surveys completed by healthcare providers to gain insight and to identify factors that affect a woman not being tested for syphilis during her pregnancy.
Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4117
Wu JianqingCorresponding author
Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA
Several mRNA vaccines are used on the population in the U.S. I started predicting the dangers of mRNA vaccines before March 2021 and update my findings periodically. My prior model study enabled me to identify many flaws in clinical trials, side-effect evaluation methods and mechanism studies, and I also considered consistent failure in predicting drug side effects in the past and systematic failure of FDA in keeping out dangerous drugs from market. I found that the risks of vaccination cannot be determined by experiments alone and must be determined by using a combination of methods. By studying mRNA expression dynamics and kinetics, I predict that vaccination with mRNA vaccines may increase cancer risks, multiple organ failure risks, earlier death risks, genome alteration speeds by one or more mechanisms, alter the normal selection process for viral evolution resulting in more virulent viruses, and aggravate chronic diseases or cause healed diseases to relapse. Two root problems are practical inability to control expression sites and severe adverse reactions from repeated vaccination. Based on mRNA bio-distribution, the mRNA mainly strikes the liver and other vital organs, and poses grave dangers to persons whose vascular functional reserves are relatively small, or whose vascular systems are temporarily burdened by other causes such as viral infections or life activities. If an mRNA vaccine is administered on a pregnant woman by second or booster shots, spike protein synthesis in fetus brain disrupts the highly regulated protein synthesis processes, resulting in potential brain damages. In less than a year, most of my early predicted damages are being materialized or are on the track to hit the population. In this update, I present a benefits-and-risks map to show how the number of deaths caused by mRNA vaccines is grossly underestimated and why claimed benefits like 95% effectiveness rate and 90% death rate reduction are meaningless and misleading.
Dec 2020 DOI 10.14302/issn.2641-5518.jcci-20-3636
El Guindi WaelCorresponding author
Department of Obstetrics and Gynecology, Franck Joly Hospital, Saint-Laurent-du-Maroni, France
Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.
Jul 2020 DOI 10.14302/issn.2328-0182.japst-20-3472
Abedulla Khan KayamkaniCorresponding author
Department of Clinical Pharmacy & Pharmacology, IbnSina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia.
Introduction An adequate nutrition pattern is of major importance for one’s health and well-being, especially during pregnancy when a woman undergoes major biological, physical, psychological and social transformations. Macronutrient and micronutrient deficiencies predispose the fetus to preterm birth, neural tube defects, and low birth weight for gestational age. This study was conducted to determine the nutrition awareness of women in childbearing age in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviors and pregnancy. Methods A cross-sectional study was conducted on based on our conceptualization of nutrition awareness and questionnaire based studies of a face-to-face interview. The participants were women with age group of 17 years to 45 years participate in studies in Jeddah city. Data collection procedures A Semi-structured questionnaires prepared in English language were translated in to Arabic and then translated back to English to check for consistency. The questionnaires were pretested Human ethical committee; the questions assessed respondents’ nutrition knowledge. Results and Discussion Different questions were asked to 175 selected pregnant women to be included in this study assess knowledge of pregnant mothers on nutrition and determinant factors in the study area. Most of the respondents (34.85.2%) were in 19-25 years of age group.69.1 % (n=121) women says they pay attention to the number of soft drinks they drink each day. There would be fascinating to study awareness of specific nutrients and related issues, like consumption folic acid, non-vegetarian diet, minerals and life style such as mental stress and physical exercise.
Feb 2020 DOI 10.14302/issn.2577-2279.ijha-20-3178
Ahmed Abdelrahman NuggedAlla MotazCorresponding author
University of Kassala-Sudan, Faculty of Medicine and Health Sciences, Head Department of Anatomy
Background In recent years great attention has been focused on the structural and histological structures of the placenta and the umbilical cord due to their vital roles in fetal development and neonatal survival. While extensive studies have been documented in this area in the developed world, there is very little published information about the morphological variations that occur in human placenta in Sudan. Therefore, this study was designed to evaluate the structural variations in placental indices and its relation to neonatal outcome. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018. Results Mean placental indices for weight, diameter and thickness were 515.51 g, 18.80 cm and 2.43 cm respectively. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. Neonatal weight correlated significantly with placental weight, neonatal length and neonatal head circumference (P < 0.000). On the contrary, neonatal weight had no significant correlation with placental thickness and diameter Conclusion In this study, there was a strong relationship between the placenta and the fetus suggesting that the well-being of the fetus is highly dependent on the placenta since it serves as a link between the mother and the fetus.
Jun 2019 DOI 10.14302/issn.2640-690X.jfm-19-2767
Venkateshwari AnanthapurCorresponding author
Institute of Genetics and Hospital for Genetic Diseases, Osmania University, Hyderabad, Telangana, India
Recurrent pregnancy loss is an important reproductive issue with a heterogeneous etiology where two or more consecutive abortions occur before 20 weeks of gestation. Approximately 15% of all clinically recognized pregnancies result in miscarriage with an incidence of 1 in 300 cases. Couples, who experience repeated pregnancy loss before three months of gestation, mostly have fetuses with chromosomal aneuploids. A non-consanguineous couple with a married life of 4 years was referred to the Institute with a clinical history of three first trimester abortions. Karyotype analysis revealed a balanced autosomal translocation between chromosomes 4 and 6 with 46, XX, t (4;6)(q35; q22) karyotype in the female and normal 46, XY in the male partner. Therefore, the siblings and the couple were suggested for extended genetic counseling. Interestingly, similar translocation was seen in her father and three sisters, whereas her mother and elder sister showed a normal chromosomal constitution, indicating the paternal inheritance.
Nov 2018 DOI 10.14302/issn.2997-2086.jfs-18-2245
Clarizio KatharineCorresponding author
PGY-2 Obstetrics and Gynecology; University of Illinois College of Medicine - Peoria, IL; OSF St. Francis Hospital, Peoria, IL.
Congenital pulmonary airway malformation (CPAM) can often be noted on fetal ultrasound. When a CPAM is noted in the face of fetal hydrops, the outcome is dismal. Surgical interventions and administration of antenatal steroids can be considered for treatment, but in hydropic fetuses these interventions are not always successful. We present a case of CPAM with severe fetal hydrops that underwent steroid administration and multiple intrauterine surgical interventions, which resulted in an excellent neonatal outcome.
Jun 2018
Depres JanCorresponding author
Department of Obstetrics and Gynecology, Division Woman and Child, University Hospital Gasthuisberg.
Our study aims to help researchers calculate resources based on a rat breeding colony for experiments on fetal lung development. The Wistar rat is commonly used in experimental research. In the context of fetal lung studies, the nitrofen rat is a model for pulmonary hypoplasia and congenital diaphragmatic hernia. Data needed to calculate resources for new experiments are not easily available. We prospectively acquired data on the reproductive performance and fetal outcome of 314 consecutive virgin Wistar dams in our fetal lung research breeding colony. We define the impact of breeding conditions on rat fertility and evaluate different methods to diagnose early rat gestation. Effects of nitrofen exposure as well as fetal surgery in terms of prenatal mortality and gross anatomical parameters of lung development are quantified in nitrofen-exposed and -unexposed fetuses from embryonic day 19 to 21 in 12h intervals. A reduced mating interval (1h) provides a great degree of experimental control with feasible pregnancy rates and a large litter size. Nitrofen exposure, as well as fetal surgery, depict high fetal survival rates. Fetal lung findings were very reproducible and could allow for reduction of animals utilized within experimental groups.
Dec 2017 DOI 10.14302/issn.2997-2086.jfs-17-1846
Amin RuchiCorresponding author
Pediatric Surgery, Children’s Hospital of Wisconsin
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.
Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1784
Minakshi RohillaCorresponding author
Objective: Mullerian anomalies of the female genital tract are rare and unicornuate uterus is one such variant: it may present with a rudimentary horn with or without a communication. Pregnancy is rare in a non communicating horn and majority of them end up in rupture during first trimester. The ones which progress to fetal viability are around 10 % and may end up in catastrophic hemorrhage with fetal loss at any time. Case report: We hereby report a rare case of unruptured rudimentary horn pregnancy associated with placenta accreta and delivery of a live born fetus at 34 weeks period of gestation. Around ten cases of such an association have been reported in the past. Conclusion: Diagnosis of pregnancy in a non communicating horn of a unicornuate uterus is challenging especially at term. High index of suspicion and timely delivery of a live fetus has major role in achieving best maternal and neonatal outcome.
Sep 2017 DOI 10.14302/issn.2574-4526.jddd-17-1776
Augoulea AretiCorresponding author
Department of Obstetrics and Gynecology, National and Kapodestrian University of Athens, Medical School,, Aretaieio Hospital, 76 Vas. Sofias Ave, GR-11528, Athens, Greece
Objectives: The rate of morbid obesity among women of reproductive age continues to rise worldwide. Surgical treatment remains the most effective mean to face it. Anatomical, physiological and nutritional modifications lead to several challenges for pregnancy after bariatric procedures. In spite of routine supplementation after bariatric surgery, vitamin and mineral deficiency frequently appear in bariatric pregnancies. The aim of this review is to summarize the existing data on the prevalence and management of nutritional deficiencies in pregnancy after bariatric surgery. Methodology: A comprehensive search of Pubmed Database was conducted for English-language studies using a list of key words. Results: The most common post-operative deficiencies in pregnancy include iron, vitamin B12, folate, vitamin D and magnesium deficiency. Less common are selenium, vitamin A, vitamin B6 and vitamin C deficiency. Finally, copper, vitamin K, vitamin B1, vitamin E and albumin deficiencies are considered to be relatively rare. Conclusions: Pregnancy after bariatric surgery has been proven to be safe for both the mother and the fetus. However, there is still the risk of significant nutritional deficiencies with adverse effects on pregnancy and lactation. As a result, a thorough customized nutritional assessment is mandatory for every woman in reproductive age who has undergone a bariatric operation, with strict regular follow-up during pregnancy and lactation.
Aug 2017 DOI 10.14302/issn.2997-2086.jfs-17-1663
Knezevich MichelleCorresponding author
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Fetal surgery is the newest surgical specialty with a compelling history. The development of fetal surgery began in primates and lambs and, in its most basic form, was first performed in humans in 1965. Since its introduction, the field has expanded and changed dramatically. Several of these changes have involved the ethical aspect of fetal surgery. This field conflicts with the Hippocratic oath mantra of “first do no harm” as one of the patients, the mother, receives no benefit from these procedures. The ethical dilemma resulted in stringent inclusion and exclusion criteria for fetal operations. Initially, fetal surgery was only indicated for life-threatening conditions of the fetus but is now offered in some disease processes to improve quality of life for the child. As the field has matured, it has grown to encompass numerous different types of fetal interventions. Similar to other areas of surgery, the trend has been to migrate from more invasive to less invasive procedures. Currently, some of these therapies are performed entirely percutaneously. Theoretically, this trend would improve outcomes for both the mother and fetus. While this has generally proven true, there are some important exceptions to this rule. Finally, as the field continues to evolve, much research is being performed looking at possible new types of fetal interventions. Some of these procedures, such as fetal stem cell therapy and fetal gene therapy, could change the face of modern medicine.
Feb 2017 DOI 10.14302/issn.2997-2086.jfs-16-1098
Burjonrappa SathyaprasadCorresponding author
Department of Pediatric Surgery, Winthrop University Hospital, Mineola, NY 11501
We report a twin gestation with one fetus afflicted by a left sided Extra-Lobar Sequestration (ELS) in a morbidly obese mother. The ELS was complicated by a left pleural effusion in the second trimester unresponsive to maternal steroid administration. We discuss the need for repeat shunt placement, in the setting of maternal morbid obesity and twin gestation. Shunt replacement was necessary secondary to dislodgement. Delivery at 34 weeks gestation was followed by successful surgical removal of the ELS. At one year follow up the infant has complete expansion of the left lung with no morbidity.