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Alternative Therapies in Health and... Jun 2024To analyze the intervention effects of targeted nursing based on goal management theory on pregnancy outcomes, blood pressure, postpartum self-efficacy, and quality of...
OBJECTIVE
To analyze the intervention effects of targeted nursing based on goal management theory on pregnancy outcomes, blood pressure, postpartum self-efficacy, and quality of life in patients with preeclampsia.
METHODS
We retrospectively analyzed 90 cases of preeclampsia admitted to Huzhou Maternity & Child Health Care Hospital from January 2022 to June 2023. All patients met the complete inclusion criteria. They were divided into 2 groups based on different nursing interventions: the control group (n = 45) received routine nursing interventions, and the observation group (n = 45) received targeted nursing based on goal management theory. Pregnancy outcomes, blood pressure, postpartum self-efficacy, and quality of life were compared between the 2 groups.
RESULTS
The incidence of adverse pregnancy outcomes was 28.89% in the control group and was significantly lower in the observation group at 11.11% (P < .001). Before intervention, there were no significant differences in systolic blood pressure and diastolic blood pressure between the 2 groups (P > .05). After intervention, the systolic blood pressure and diastolic blood pressure were significantly lower in the observation group than in the control group (P < .001). Before intervention, there was no significant difference in Breastfeeding Self-Efficacy Scale scores between the 2 groups (P > .05). After intervention, the Breastfeeding Self-Efficacy Scale scores were significantly higher in the observation group than in the control group (P < .001). Before intervention, there was no significant difference in the Short Form 36 Health Survey scores between the 2 groups (P > .05). After intervention, the Short Form 36 Health Survey scores were significantly higher in the observation group than in the control group (P < .001).
CONCLUSION
Compared with routine nursing, targeted nursing based on goal management theory had superior intervention effects on preeclampsia. It can further alleviate patients' blood pressure, promote postpartum self-efficacy, improve quality of life, and reduce the risk of adverse pregnancy outcomes. It is worthy of clinical application and promotion.
PubMed: 38940806
DOI: No ID Found -
Annals of Agricultural and... Jun 2024Women in pathological pregnancy are a group of patients especially exposed to the risk of occurrence of psychological complications. The aim of the study was assessment...
INTRODUCTION AND OBJECTIVE
Women in pathological pregnancy are a group of patients especially exposed to the risk of occurrence of psychological complications. The aim of the study was assessment of the risk of depressive and anxiety disorders, and the relationship between the intensity of symptoms and social support.
MATERIAL AND METHODS
The study group were 300 patients hospitalized in the Department of Pathology of Pregnancy. The study was conducted using the State-Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Inventory of Socially Supportive Behaviours (ISSB), and an author-constructed socio-demographic questionnaire.
RESULTS
The level of State Anxiety (STAI) was higher in respondents from the study group, compared to the control group. The level of anxiety (HADS-A) was higher in the control group than in women from the study group. The level of social informational support was higher in those from the control group, compared to those from the study group. The level of emotional support was lower in respondents from the study group, compared to those from the control group. Instrumental support negatively correlated with the symptoms of depression among women in physiological pregnancy. The lack of evaluative support statistically significantly correlated with anxiety among women hospitalized before labour.
CONCLUSIONS
The results obtained suggest the necessity for the substantive preparation of medical and psychological staff employed in departments of pathology of pregnancy to provide proper emotional and informational support for hospitalized women.
Topics: Humans; Female; Pregnancy; Adult; Social Support; Depression; Anxiety; Cross-Sectional Studies; Young Adult; Pregnancy Complications; Surveys and Questionnaires
PubMed: 38940110
DOI: 10.26444/aaem/183424 -
Journal of Global Health Jun 2024Malaria infection during pregnancy is associated with an increased risk of maternal death, as well as adverse birth outcomes. Intermittent preventive treatment in...
BACKGROUND
Malaria infection during pregnancy is associated with an increased risk of maternal death, as well as adverse birth outcomes. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is known to improve pregnancy outcomes. However, the coverage of IPTp-SP in antenatal care (ANC) in sub-Saharan Africa remains well below the target. This study aims to estimate to what extent malaria service readiness affects the uptake of IPTp-SP during ANC visits in sub-Saharan African countries.
METHODS
This study included 3267 pregnant women attending ANC for the first time and 2797 pregnant women who had attended ANC more than a month ago in six sub-Saharan African countries. The readiness of malaria services at each institution includes four indicators: the presence of IPTp-SP guidelines, SP availability, integration of IPTp-SP service into ANC, and provider training on IPTp-SP. The outcome variable indicates whether a pregnant woman received IPTp-SP at her current ANC visit. A modified Poisson regression model estimated the associations between malaria service readiness and IPTp-SP uptake for women eligible for the first and subsequent doses.
RESULTS
For women eligible for their first dose, visiting an institution with available SP was associated with an increased probability of receiving IPTp-SP (risk ratio (RR) = 1.43; 95% confidence interval (CI) = 1.22 to 1.67, P < 0.001). For women who were eligible for their next dose, the availability of SP (RR = 1.17; 95% CI = 1.04 to 1.32, P = 0.008) and integration of IPTp-SP service into ANC (RR = 1.82; 95% CI = 1.21 to 2.74, P = 0.004) in the institution were associated with increased likelihood of IPTp-SP uptake. Counterfactual predictions indicated that enhanced provider training could boost IPTp-SP uptake in high-uptake countries, while better SP availability and IPTp-SP integration into ANC would significantly impact low-uptake countries.
CONCLUSIONS
For better IPTp-SP coverage, strategies should be customised. High uptake countries should focus on provider training, while low uptake ones should ensure IPTp-SP availability and service integration.
Topics: Humans; Female; Pregnancy; Antimalarials; Africa South of the Sahara; Pyrimethamine; Sulfadoxine; Malaria; Pregnancy Complications, Parasitic; Adult; Drug Combinations; Prenatal Care; Young Adult; Adolescent; Patient Acceptance of Health Care
PubMed: 38939971
DOI: 10.7189/jogh.14.04112 -
JACC. Advances Jan 2024Hypertensive disorders of pregnancy (HDP) can be classified into gestational hypertension, preeclampsia (PRE), and chronic hypertension with superimposed preeclampsia...
BACKGROUND
Hypertensive disorders of pregnancy (HDP) can be classified into gestational hypertension, preeclampsia (PRE), and chronic hypertension with superimposed preeclampsia (SPE).
OBJECTIVES
The purpose of this study was to retrospectively examine the echocardiographic differences in biventricular structure and function in 3 HDP groups of women in comparison to normotensive pregnant controls.
METHODS
Women with an echocardiogram during or within the first year of pregnancy were identified within our integrated health network. Exclusion criteria included age <18 years, diagnosis of pulmonary embolism, malignancy, autoimmune disease, and structural heart disease.
RESULTS
We identified a total of 706 subjects (cases: n = 427, normotensive controls: n = 279). Cases were divided into 3 groups: gestational hypertension (n = 57), PRE (n = 291), and SPE (n = 79). In adjusted analyses, echocardiographic parameters demonstrated a graded difference in left ventricular (LV) mass index, relative wall thickness, mitral inflow E, mitral inflow A, septal e', lateral e', E/e', left atrial volume index, tricuspid velocity, and lateral e' velocities with the most profound findings noted in the SPE group. Specifically, adjusted LV mass index (adjusted β = 14.45, 95% CI: 9.00-19.90) and E/e' (adjusted β = 2.97, 95% CI: 2.27-3.68) was highest in the SPE group in comparison to controls ( < 0.001).
CONCLUSIONS
LV remodeling and diastolic filling abnormalities are more common in HDP and are most evident in SPE and PRE. Echocardiography during or immediately after pregnancy may be useful in these high-risk women to identify these abnormalities. The long-term implications of these echocardiographic abnormalities require further study.
PubMed: 38939814
DOI: 10.1016/j.jacadv.2023.100725 -
JACC. Advances Apr 2024Exposure to ionizing radiation is an inherent occupational health hazard in clinical cardiology. Health risks have been reported previously, including predilection to... (Review)
Review
Exposure to ionizing radiation is an inherent occupational health hazard in clinical cardiology. Health risks have been reported previously, including predilection to cancer. In addition, orthopedic injury due to prolonged wearing of heavy protective lead aprons, which are mandatory to reduce radiation risk, have been extensively documented. Cardiology as a specialty has grown with rising volumes of increasingly complex procedures. This includes electrophysiological, coronary, and structural intervention, advanced heart failure/transplant management, and diagnostic imaging. Both the operator as well imaging specialists are exposed to radiation, particularly in structural interventions where interventional cardiologists and structural imagers work closely. Increasingly, women interested in cardiology may deselect the field due to radiation concerns. This expert document highlights the risks of radiation exposure in cardiology, including practical tips within various subspecialty fields such as interventional/structural cardiology, electrophysiology, imaging, advanced heart failure, and pediatric cardiology.
PubMed: 38939686
DOI: 10.1016/j.jacadv.2024.100863 -
JACC. Advances Apr 2024Maternal mortality is a major public health crisis in the United States. Cardiovascular disease (CVD) is a leading cause of maternal mortality and morbidity. Labor and... (Review)
Review
Maternal mortality is a major public health crisis in the United States. Cardiovascular disease (CVD) is a leading cause of maternal mortality and morbidity. Labor and delivery is a vulnerable time for pregnant individuals with CVD but there is significant heterogeneity in the management of labor and delivery in high-risk patients due in part to paucity of high-quality randomized data. The authors have convened a multidisciplinary panel of cardio-obstetrics experts including cardiologists, obstetricians and maternal fetal medicine physicians, critical care physicians, and anesthesiologists to provide a practical approach to the management of labor and delivery in high-risk individuals with CVD. This expert panel will review key elements of management from mode, timing, and location of delivery to use of invasive monitoring, cardiac devices, and mechanical circulatory support.
PubMed: 38939671
DOI: 10.1016/j.jacadv.2024.100901 -
Frontiers in Public Health 2024The concept of race is prevalent in medical, nursing, and public health literature. Clinicians often incorporate race into diagnostics, prognostic tools, and treatment...
The concept of race is prevalent in medical, nursing, and public health literature. Clinicians often incorporate race into diagnostics, prognostic tools, and treatment guidelines. An example is the recently heavily debated use of race and ethnicity in the Vaginal Birth After Cesarean (VBAC) calculator. In this case, the critics argued that the use of race in this calculator implied that race confers immutable characteristics that affect the ability of women to give birth vaginally after a c-section. This debate is co-occurring as research continues to highlight the racial disparities in health outcomes, such as high maternal mortality among Black women compared to other racial groups in the United States. As the healthcare system contemplates the necessity of utilizing race-a social and political construct, to monitor health outcomes, it has sparked more questions about incorporating race into clinical algorithms, including pulmonary tests, kidney function tests, pharmacotherapies, and genetic testing. This paper critically examines the argument against the race-based Vaginal Birth After Cesarean (VBAC) calculator, shedding light on its implications. Moreover, it delves into the detrimental effects of normalizing race as a biological variable, which hinders progress in improving health outcomes and equity.
Topics: Humans; Female; Pregnancy; Algorithms; United States; Maternal Health; Racial Groups; Cesarean Section
PubMed: 38939564
DOI: 10.3389/fpubh.2024.1417429 -
Wellcome Open Research 2021When the Avon Longitudinal Study of Parents and Children (ALSPAC) was planned, it was assumed that the clinical obstetric data would be easily accessible from the newly...
BACKGROUND
When the Avon Longitudinal Study of Parents and Children (ALSPAC) was planned, it was assumed that the clinical obstetric data would be easily accessible from the newly developed National Health Service computerised 'STORK' system. Pilot studies, however, showed that, although fairly accurate in regard to aspects of labour and delivery, it was, at the time (1990-2), inadequate for identifying the full antenatal and postnatal details of clinical complications and treatments of the women in the Study.
METHODS
A scheme was therefore developed to train research staff to find and abstract relevant details from clinical records onto proformas designed for the purpose. Extracting such data proved very time consuming (up to six hours for complicated pregnancies) and consequently expensive. Funding for the enterprise was obtained piecemeal using specific focussed grants to extract data for subsamples of the Study, including a random sample to serve as controls.
RESULTS
To date, detailed records have been completed for 8369 pregnancies, and a further 5336 (13,705 in total) have complete details on specific prenatal areas, including serial measures of maternal blood pressure, proteinuria and weight. In this Data Note we describe the information abstracted from the obstetric medical records concerning the mother during pregnancy, labour, delivery and the first two weeks of the puerperium. Information abstracted relating to the fetus (including fetal monitoring, presentation, method of delivery) and neonate (signs of asphyxia, resuscitation, treatment and well-being) have been described in a further Data Note.
CONCLUSIONS
These data add depth to ALSPAC concerning ways in which the signs and symptoms, procedures and treatments of the mother prenatally, intrapartum and postnatally, may impact on the long-term health and development of both mother and child. They augment the data collected from the mothers' questionnaires (described elsewhere) and the 'STORK' digital hospital data.
PubMed: 38939328
DOI: 10.12688/wellcomeopenres.16603.2 -
Biochemistry and Biophysics Reports Sep 2024Zika virus represents the primary cause of infection during pregnancy and can lead to various neurological disorders such as microcephaly and Guillain-Barré syndrome...
Zika virus represents the primary cause of infection during pregnancy and can lead to various neurological disorders such as microcephaly and Guillain-Barré syndrome affecting both children and adults. This infection is also associated with urological and nephrological problems. So far, evidence of mosquito-borne Zika virus infection has been reported in a total of 89 countries and territories. However, surveillance efforts primarily concentrate on outbreaks that this virus can cause, yet the measures implemented are typically limited. Currently, there are no specific treatments or vaccines designed for the prevention or treatment of Zika virus infection or its associated disease. The development of effective therapeutic agents presents an urgent need. Importantly, an alternative for advancing the discovery of new molecules could be dermaseptins, a family of antimicrobial peptides known for their potential antiviral properties. In this study, we carried out the synthesis of dermaseptins and their analogs and subsequently assessed the bioactivity tests against Zika virus (ZIKV PF13) of dermaseptins B2 and S4 and their derivatives. The cytotoxicity of these peptides was investigated on HMC3 cell line and HeLa cells by CellTiter-Glo® Luminescent Cell Viability Assay. Thereafter, we evaluated the antiviral activity caused by the action of our dermaseptins on the viral envelope using the Fluorescence Activated Cell Sorting (FACS). The cytotoxicity of our molecules was concentration-dependent at microgram concentrations Expect for dermaseptin B2 and its derivative which present no toxicity against HeLa and HMC3 cell lines. It was observed that all tested analogs from S4 family exhibited antiviral activity with low concentrations ranging from 3 to 12.5 μg/ml , unlike the native B2 and its derivative which increased the infectivity. Pre-incubating of dermaseptins with ZIKV PF13 before infection revealed that these derivatives inhibit the initial stages of virus infection. In summary, these results suggest that dermaseptins could serve as novel lead structures for the development of potent antiviral agents against Zika virus infections.
PubMed: 38939125
DOI: 10.1016/j.bbrep.2024.101747 -
JACC. Advances Jul 2023
PubMed: 38938999
DOI: 10.1016/j.jacadv.2023.100433