Pregnancy and Women’s Health Care International Journal最新文献

{"title":"An investigation of experiences of pregnancy and childbirth during the first 9 months of the SARS-CoV-2 pandemic","authors":"T. Teoh, S. Munro","doi":"10.1370/afm.20.s1.2778","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2778","url":null,"abstract":"Context: The COVID-19 pandemic has globally affected the pregnancy experience. Studies on mental health during the pandemic have reported increased rates of depression and anxiety among pregnant individuals compared to pre-pandemic levels. Maternity providers must carefully consider the context of pregnant individuals’ needs and wellbeing during the pandemic in order to create patient -centered changes affecting their care. Objective: To investigate pregnant peop les’ experiences of pregnancy and labour during the first nine months of the COVID-19 pandemic. Study Design: This is a qualitative study involving semi-structured virtual interviews to explore experiences of pregnancy and labour in the COVID-19 pandemic. Ethical approval was given by the Children’s and Women’s Research Ethics Board. Recruitment was through snowball, theoretical, and purposeful sampling methods. Analysis was guided by Grounded Theory techniques, and utilized an inductive approach to build a conceptual framework describing participants’ experiences. Setting or Dataset: Participants were recruited from urban and suburban areas in the province of British Columbia (BC), Canada. Population studied: Included participants were planning to deliver in BC, 18 years or older, and English-speaking. Results: Seventeen participants were enrolled in the study from June 2020 to January 2021. Participants’ descriptions of pregnancy and birth during the COVID-19 pandemic focused on several common themes. Participants expressed uncertainty on how the pandemic would impact their pregnancies, and confusion around recommendations affecting their care. Many had envisioned a pregnancy surrounded by people, and instead were left isolated with the removal of social activities. This isolation was furthered by restrictions in in-person prenatal visits. Several concerns were raised on the limits of virtual care. Participants encountered difficulties when opening their ‘social bubbles’, and created several interventions to minimize risk while preserving social connection. Participants shared examples of ‘silver linings’ of their experiences, along with expressions of gratitude. Conclusions: Pregnant individuals experienced disruptions in their expectations of pregnancy milestones and in their ability to remain supported throughout the pregnancy during the COVID-19 pandemic. Our findings support prioritizing in-person interactions and a need for clear and consistent messaging on policies affecting their care.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77829996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-centered care…? provider perspectives on contraceptive counseling for latina/x patients","authors":"Diana N. Carvajal","doi":"10.1370/afm.20.s1.2674","DOIUrl":"https://doi.org/10.1370/afm.20.s1.2674","url":null,"abstract":"Context: The IOM defines patient- centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” A patient -centered approach of contraceptive care focuses on equity and urges clinicians to meet a person’s needs across the care continuum with trust -building, quality care, and access provision. Research shows Latina/x patients desire a patient-centered approach to counseling focused on their preferences and free of racial/ethnic-based bias. Whether this approach occurs often or at all, is uncertain. Objectives: To explore provider: 1) perspectives of their counseling practices with Latina/x patients within the context of patient-centered contraceptive care (PCCC); 2) perceptions of barriers to the provision of PCCC. Study Design & Analysis: Qualitative using a semi-structured guide based on foundational research and a PCCC conceptual framework. Researchers coded each transcript using a directed content analysis approach to develop a coding scheme, identify themes and draw conclusions – with attention to major concepts of Reproductive Justice theory. Setting & Population: Twenty-five physicians (MD/DO) and nurse practitioners recruited from 4 specialties (Family Medicine, Internal Medicine, Pediatrics, OB/GYN) who provide contraceptive care to Latina/x patients in Baltimore, MD. Results: Providers’ described a counseling approach focused on pregnancy prevention. Most described using a tiered-effectiveness model even as they often identified the importance of PCCC and its main tenets. Providers also described limited self-efficacy and low cultural humility in the delivery of PCCC. Time constraints, patient-provider language discordance, patient insurance status, patient misconceptions about contraception and low health literacy were described as barriers to providing PCCC for Latinx patients. Conclusions: Providers have knowledge of PCCC and express its value for healthcare delivery but have limited integration of it in their practices with Latina/x patients. Providers seem to experience a tension between an expressed desire to provide PCCC and paradigms that prioritize pregnancy prevention over patient preferences. Putting PCCC","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"707 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74761975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding and Gestational Diabetes: Overview in México","authors":"B. R. Aguilar Uscanga","doi":"10.53902/pwhcij.2022.02.000513","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000513","url":null,"abstract":"Gestational diabetes mellitus is defined as glucose intolerance first detected during pregnancy. Maternal obesity and gestational diabetes mellitus have been associated with more difficulties in the establishment and duration of breastfeeding among mothers with gestational diabetes mellitus who have a body mass index above their healthy, normal weight counterparts; plus the large number of social and economic factors that prevent the establishment of satisfactory breastfeeding, makes it essential to provide systematic support, especially in the first days of life, remembering that breastfeeding in turn reduces the risk of diabetes in women. Mexico is a middle-high income Latin American country; studies conducted in metropolitan areas with larger populations indicate that exclusive breastfeeding is often initiated, but it is difficult to continue it; together with the increase in the prevalence of obesity and diabetes mellitus in the population, it is of great importance to integrate maternal and child nutrition policies focused on the prevention of obesity and chronic diseases, as well as practices that contribute to the promotion and support to mothers to achieve successful breastfeeding, at least during the first 6 months of life.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83167134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving and addressing lymphocytes response against SARS-CoV-2 and its variants with intralveolar BCG administration","authors":"Nicola G Carretti MD","doi":"10.53902/pwhcij.2022.02.000510","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000510","url":null,"abstract":"Bacillus Calmette Guerin administered by the aerosol route may locally elicit and increase T1 lymphocyte response in pulmonary alveoli, which are the main target of SARS-2-CoV-2 and its variants, thus preventing and anticipating the virus attack. This may lead to a decrease of the most severe forms of the disease considered as an acute autoimmune virus inducted disease. The lymphocyte response may start to work before and regardless of anti-CoVid vaccination.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74356508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy And Safety of Nifuratel-Nystatin in The Treatment of Mixed Vaginitis, in Pregnant Women From Quindío, 2013-2017. Randomized Clinical Trial","authors":"Franklin J Espitia De La Hoz","doi":"10.53902/pwhcij.2021.01.000508","DOIUrl":"https://doi.org/10.53902/pwhcij.2021.01.000508","url":null,"abstract":"Introduction: Women with abnormal vaginal discharge usually suffer from bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonas vaginitis (TV) or any combination of these. Objective: To compare the efficacy and safety of the combination nifuratel-nystatin with metronidazole -nystatin in the treatment of mixed vaginitis in pregnant women, and its adverse effects. Materials and methods: Randomized, double-blind, parallel-group clinical trial in 153 pregnant women, diagnosed with mixed vaginitis; in a complex private medical institution in Armenia (Colombia), between 2013 and 2017. The patients were randomized 1:1 to receive a daily intravginal egg for six days: nifuratel (500mg) - nystatin (200,000 IU) (Group \"A\") and metronidazole (500mg) - nystatin (100,000 IU) (Group \"B\"). A follow-up of the healing of symptoms was determined at one week and an evaluation of the microbiological negativization at one month. Safety was assessed based on reports of adverse events. Descriptive statistics were used. Results: The mean age of the population was 27.59±3.71 years. The mean gestational age in group \"A\" was 18.56±2.87 weeks compared to 19.57±2.95 weeks in group \"B\" (p=0.87). The clinical cure rates at 7 days in group \"A\" were 84.61% vs. 81.33% in group \"B\", (p=0.91) The microbiological negativization at one month was 91.02% in group \"A\" vs. 86.66% in group \"B\", (p=0,072) The recurrence rate was 1.28% in group \"A\" vs. 5.33% in group \"B\", (p=0.37) Adverse events were present in the metronidazole-nystatin group, which were mild and self-limited. Conclusion: Both drugs have comparable efficacy and similar safety results in the treatment of mixed vaginitis in pregnant women; therefore, they can be used interchangeably. Studies in larger populations with a control group and random assignment are required to provide better evidence regarding this management.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88054465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy And Safety of Nifuratel-Nystatin in The Treatment of Mixed Vaginitis, in Pregnant Women From Quindío, 2013-2017. Randomized Clinical Trial","authors":"F. D. L. De La Hoz","doi":"10.53902/pwhcij.2022.02.000508","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000508","url":null,"abstract":"Introduction: Women with abnormal vaginal discharge usually suffer from bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), trichomonas vaginitis (TV) or any combination of these. Objective: To compare the efficacy and safety of the combination nifuratel-nystatin with metronidazole -nystatin in the treatment of mixed vaginitis in pregnant women, and its adverse effects. Materials and methods: Randomized, double-blind, parallel-group clinical trial in 153 pregnant women, diagnosed with mixed vaginitis; in a complex private medical institution in Armenia (Colombia), between 2013 and 2017. The patients were randomized 1:1 to receive a daily intravginal egg for six days: nifuratel (500mg) - nystatin (200,000 IU) (Group \"A\") and metronidazole (500mg) - nystatin (100,000 IU) (Group \"B\"). A follow-up of the healing of symptoms was determined at one week and an evaluation of the microbiological negativization at one month. Safety was assessed based on reports of adverse events. Descriptive statistics were used. Results: The mean age of the population was 27.59±3.71 years. The mean gestational age in group \"A\" was 18.56±2.87 weeks compared to 19.57±2.95 weeks in group \"B\" (p=0.87). The clinical cure rates at 7 days in group \"A\" were 84.61% vs. 81.33% in group \"B\", (p=0.91) The microbiological negativization at one month was 91.02% in group \"A\" vs. 86.66% in group \"B\", (p=0,072) The recurrence rate was 1.28% in group \"A\" vs. 5.33% in group \"B\", (p=0.37) Adverse events were present in the metronidazole-nystatin group, which were mild and self-limited. Conclusion: Both drugs have comparable efficacy and similar safety results in the treatment of mixed vaginitis in pregnant women; therefore, they can be used interchangeably. Studies in larger populations with a control group and random assignment are required to provide better evidence regarding this management.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76088362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Concept of Clinical Endometriosis: A Paradigm Shift in Africa","authors":"Bamgboye M Afolabi","doi":"10.53902/pwhcij.2022.02.000509","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000509","url":null,"abstract":"The clinical symptoms of endometriosis, an illness characterized by ectopic endometrium (glands and stroma) outside the uterus, are mainly dysmenorrhea, dyspareunia, cyclic urinary symptoms and infertility. Although imaging modalities such as pelvic ultrasound can identify and localize endometriotic deposits in the ovary (endometrioma) and in bladder wall, diagnosis of the disease is impossible where such imaging modalities are unavailable or where clinicians are not trained to clinically diagnose endometriosis during consultation. Especially in sub-Saharan Africa, clinicians should be familiar with certain predisposing risk factors for endometriosis such as early age at menarche, shorter menstrual length and low body mass index. Delay in the diagnosis of endometriosis not only prolongs the duration of suffering, pain and discomfort but also lowers quality of life and increases cost of treatment. This article focuses on how gynecologists and clinicians in sub-Saharan Africa can easily identify the symptomatology of endometriosis. Clinical presentations of endometriosis in Black African women may not be different from presentations among Caucasian women. Though a confusing illness for the patient and for the clinician, at least, African gynecologists, clinicians and general practitioners can have a suspicion of endometriosis when a Black African woman presents with a combination of infertility, pelvic pain, dysmenorrhea and dyspareunia. This article discusses various conditions associated with endometriosis in adolescent women and in women in child-bearing age group.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76594152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Lesions in the Central Nervous System Based on Neurosonography and Magnetic Resonance in Fetus with Isolated Congenital Heart Defects. A Systematic Review","authors":"Saulo Molina Giraldo","doi":"10.53902/pwhcij.2022.02.000512","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000512","url":null,"abstract":"Introduction: Congenitalheartdefectsrepresentoneofthemainmalformationsdiagnosed prenatally. These are a major cause of neuro developmental disorders and it has even been proposed that structural brain alteration is found from early stages of fetal development. Objective: The objective of this study was to review the existing evidence of prenatal diagnosis of structural braina lterations found in fetal brain magnetic resonance imaging and neurosonography in fetus with isolated congenital heart defect. Materials and Methods: A search of Pubmed, Science Direct, Clinical Key and EBSCO databases was conducted in order to review study cases of fetuses with congenital heart defect between 18 and 37 week with Doppler ultrasonography, neurosonography and /or fetal brain magnetic resonance imaging. Results: A total of 16 articles were selected and it was found that the fetuses with congenital heart defect present structural neurological alterations from intrauterine life showed by neurosonography and fetal brain magnetic resonance imaging. Conclusion: The evidence emphasizes on the importance of studying in detail the central nervous system of fetuses with congenital heart defect and the relationship between structural brain alterations and neurodevelopmental disorders impairment since prenatal stages.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85501742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and Benefits of HRT Versus ERT in Order to Separate HRT from ERT","authors":"J. Onwude","doi":"10.53902/pwhcij.2022.02.000511","DOIUrl":"https://doi.org/10.53902/pwhcij.2022.02.000511","url":null,"abstract":"Aim: While the benefits of Hormone Replace Therapy (HRT) and Estrogen Replace Therapy (ERT) might overlap, their risks have to be separated particularly with regard to breast cancer. The risks of HRT are mainly Coronary Heart Disease (CHD) and Breast cancer. The main risk of ERT is the incidence of strokes which can be avoided by not using an oral estrogen but an Intra-uterine contraceptive but reducing the risk of endometrial cancer in women with a womb. Methods: Studies that randomized peri-menopausal and menopausal women to either HRT or ERT versus placebo and one study that included similar women followed up prospectively for the incidence of the development of Alzheimer’s Dementia (AD). Results: The significant risks of HRT included CHD, stroke and pulmonary embolism. The risk of breast cancer only really existed after long term follow-up [(annualized incidence, 0.45% vs 0.36%; Hazard Ratio (HR) 1.28)]. The significant risks of ERT only included strokes. There was a lower risk of breast cancer in the long term [HR 0.77, 95% CI 0.62–0.95; p=0.02]. Conclusions: In women with a uterus, where HRT instead of ERT is mandated, the oral progestogen of HRT can be replaced by intrauterine device loaded with a Progestogen. Similarly, the oral Estrogen of HRT and ERT can be replaced by Estrogen sources like the patch, gel or implants that bypass the liver and bypass potential problems like strokes and pulmonary embolism.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"305 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83446028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspareunia in Climacteric Women: What should we know?","authors":"A. Belardo","doi":"10.53902/pwhcij.2021.01.000503","DOIUrl":"https://doi.org/10.53902/pwhcij.2021.01.000503","url":null,"abstract":"Dyspareunia is a common, but little-known, chronic problem, described as persistent or recurring pain that occurs during sexual intercourse.1 It is a multifactorial pathology that involves psychological, biological and social factors. The incidence of dyspareunia is difficult to determine because women do not usually resort to consultation. The prevalence is around 10% of women of childbearing age and 45% of postmenopausal women.2 Estrogen deficiency can lead to vaginal atrophy, the symptoms of which include vaginal dryness as well as dyspareunia.","PeriodicalId":20389,"journal":{"name":"Pregnancy and Women’s Health Care International Journal","volume":"2002 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82878855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}