Pregnancy is a period full of changes. The perception of life values by the woman and her partner are varied, changes in the life style are encountered and their roles in the life are also altered. The pregnant woman feels that nothing will be like before. She is very sensitive and also easily vulnerable. Contrastingly to the routine prenatal care, prenatal psychology searches for answering questions what the feelings in the pregnancy are in terms of the psychosocial situation, and what the impacts of this course on the newborn condition after the delivery are. The scope of the work is aimed at the importance and forms of the prenatal attachment, course and its impact on the newborn. The targets of the Diploma Work entitled "Effects of the psychosomatic situation of pregnant women on the child prenatal development" are as follows: 1) to assess the pregnant woman psychosomatic situation, 2) to evaluate the influence of psychosomatic situation on prenatal development of child 3) to determine the measure of the pregnant woman (dis)comfort throughout three trimesters and 4) to evaluate the newborn condition after the delivery. Thirty pregnant women were addressed. Fifteen women reflected on the proposal and agreed with completing an anonymous standardized scale. The respondents were contacted within a period of February 2017 to February 2018. The research sample group included the women and their newborns. The choice was intentional. The women completed the Freybergh scale, which is focused on monitoring the psychosocial situation of pregnant women. It comprised 70 questions divided into seven categories. They were answered through the mediation of a compiled web reference at http://mail.scac.cz/mrIWeb/mrIWeb.dll?I.Project=V31_TEHOTENSTVI_PORIZOVANI. The statistically processed results indicated the measure of the deprivationof pregnant women in particular trimesters and condition of the newborn after the delivery based on the pregnancy experienced. The Atlas programme was employed for the qualitative research to develop an anchored statement. From the sample group of 15 women and their 405 answers, 2% of answers were recorded corresponding to an intermediate degree of deprivation. Every respondent suffered frommild deprivation. The results of the present study will find their applications particularly to branches of prenatal psychology and gynaecology. They will serve as pilot results for a CEP project planned.

The aim of the study was to investigate the knowledge and utilisation of antenatal care (ANC) services by pregnant women at a clinic in Ekurhuleni. A quantitative, descriptive correlational study was carried out on 90 eligible pregnant women. Data were collected with a self-administered questionnaire and analysed with the help of a statistician using the Epi Info version 7 computer program. The results of the study indicate that most women initiated ANC later than the recommendations by the World Health Organization (WHO). Over half of the respondents had overall good knowledge of ANC, but lacked knowledge of medication and screening tests done during pregnancy, some danger signs during pregnancy and of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC were current employment status, number of children, transport costs to clinic and number of antenatal visits. / Department of Health Studies / M.A. (Public Health)

No description available.

A imunização materna com a vacina acelular para pertussis (dTpa) é uma intervenção adicional que visa fornecer proteção aos recém-nascidos (RN). No entanto, tem sido relatado que altos níveis de anticorpos adquiridos por transferência placentária podem afetar adversamente a resposta imune desses RN após a imunização ativa, devido ao mascaramento antigênico. Neste estudo, avaliamos a aquisição passiva neonatal de anticorpos específicos para pertussis e sua influência na resposta imune celular dos neonatos. A casuística foi composta por gestantes vacinadas com a vacina dTpa (grupo caso, n=66) ou por gestantes que não receberam a vacina (grupo controle, n=101). As concentrações de anticorpos IgG séricos específicos para Bordetella pertussis total (Bp), toxina pertussis (PT), hemaglutinina filamentosa (FHA) e pertactina (PRN) foram quantificadas em soro materno e de cordão umbilical de seu respectivo RN, e as concentrações de anticorpos IgA específicos para Bp e PT foram dosadas nas amostras de colostro por meio de ensaio imunoenzimático. A responsividade dos linfócitos do sangue neonatal foi avaliada após estimulação ex vivo com Bp inativada por citometria de fluxo com o intuito de detectar a proliferação, produção de citocinas e fenótipo de ativação dos linfócitos T em um contexto de altas concentrações de IgG específicas adquiridas após a vacinação materna. As concentrações de anticorpos IgG anti-Bp, PT, FHA e PRN foram maiores nas amostras de soro materno e de cordão umbilical do grupo caso quando comparadas ao grupo controle (p < 0,0001), com índices de correlação positivos em ambos os grupos para todos os antígenos estudados (p < 0,0001). As vacinações realizadas entre 26 e 31 semanas de gestação foram associadas com as melhores taxas de transferência placentária, embora índices significativamente menores foram detectados no grupo caso (p < 0,01). As concentrações de anticorpos IgA anti-Bp e anti-PT no colostro não foram afetadas pelo estado vacinal da parturiente. Os ensaios de cultura celular revelaram que os RN responderam ao estímulo com Bp, com maior expressão de CD40L, CD69 e proliferação de células T CD4, em comparação com células não estimuladas. Também foi observada uma menor resposta Th1, enquanto a resposta Th2 foi preservada, em comparação com os adultos, mas sem diferenças entre os grupos de neonatos em nenhum dos parâmetros estudados. Nossos resultados indicam que níveis mais altos de anticorpos IgG específicos para B. pertussis no soro dos RN após a vacinação materna não afetam a resposta imune neonatal mediada por células / Maternal immunization with pertussis acellular vaccine (Tdap) is an additional intervention that provides protection to newborns. However, it has been reported that high antibody levels acquired via placental transfer may adversely affect the immune response of newborns after active immunization due to epitope masking. In this study, we evaluated neonatal passive acquisition of pertussis-specific antibodies and their influence on the neonatal cell-mediated immune response. The sample consisted of pregnant women vaccinated with the Tdap vaccine (case group, n=66) or pregnant women who received no vaccine (control group n=101). Whole-cell Bordetella pertussis (Bp), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN)-specific serum IgG concentrations were quantified in paired maternal-cord sera, and Bp- and PT-specific IgA concentrations were evaluated in colostrum samples by immunoenzymatic assay. Ex vivo neonatal blood lymphocyte responsiveness after inactivated Bp stimulation was assessed using flow cytometry to detect the proliferation, cytokine production and activation phenotype of T lymphocytes in the context of high specific IgG concentrations acquired after maternal vaccination. Anti-Bp, PT, FHA and PRN IgG antibody concentrations in maternal and cord serum samples from case group were higher than those in control group (p < 0.0001), with positive correlation indexes in both groups for all pertussis antigens (p < 0.0001). Vaccinations performed between 26 and 31 gestation weeks were associated with the best placental transfer ratios, although significantly lower ratios were detected in case group (p < 0.01). Anti-Bp and anti-PT IgA concentrations in colostrum were not affected by vaccine status. Cell culture assays revealed that newborns responded to Bp stimulation with higher expression of CD40L CD69 and CD4+ T cell proliferation compared to unstimulated cells. It was also observed a lower Th1 response, while a preserved Th2 response compared to adults, but there were no differences between neonatal groups for any of the studied parameters. Our results indicate that higher pertussis-specific IgG levels in newborn sera after maternal vaccination do not affect the neonatal cell-mediated immune response

A imunização materna com a vacina acelular para pertussis (dTpa) é uma intervenção adicional que visa fornecer proteção aos recém-nascidos (RN). No entanto, tem sido relatado que altos níveis de anticorpos adquiridos por transferência placentária podem afetar adversamente a resposta imune desses RN após a imunização ativa, devido ao mascaramento antigênico. Neste estudo, avaliamos a aquisição passiva neonatal de anticorpos específicos para pertussis e sua influência na resposta imune celular dos neonatos. A casuística foi composta por gestantes vacinadas com a vacina dTpa (grupo caso, n=66) ou por gestantes que não receberam a vacina (grupo controle, n=101). As concentrações de anticorpos IgG séricos específicos para Bordetella pertussis total (Bp), toxina pertussis (PT), hemaglutinina filamentosa (FHA) e pertactina (PRN) foram quantificadas em soro materno e de cordão umbilical de seu respectivo RN, e as concentrações de anticorpos IgA específicos para Bp e PT foram dosadas nas amostras de colostro por meio de ensaio imunoenzimático. A responsividade dos linfócitos do sangue neonatal foi avaliada após estimulação ex vivo com Bp inativada por citometria de fluxo com o intuito de detectar a proliferação, produção de citocinas e fenótipo de ativação dos linfócitos T em um contexto de altas concentrações de IgG específicas adquiridas após a vacinação materna. As concentrações de anticorpos IgG anti-Bp, PT, FHA e PRN foram maiores nas amostras de soro materno e de cordão umbilical do grupo caso quando comparadas ao grupo controle (p < 0,0001), com índices de correlação positivos em ambos os grupos para todos os antígenos estudados (p < 0,0001). As vacinações realizadas entre 26 e 31 semanas de gestação foram associadas com as melhores taxas de transferência placentária, embora índices significativamente menores foram detectados no grupo caso (p < 0,01). As concentrações de anticorpos IgA anti-Bp e anti-PT no colostro não foram afetadas pelo estado vacinal da parturiente. Os ensaios de cultura celular revelaram que os RN responderam ao estímulo com Bp, com maior expressão de CD40L, CD69 e proliferação de células T CD4, em comparação com células não estimuladas. Também foi observada uma menor resposta Th1, enquanto a resposta Th2 foi preservada, em comparação com os adultos, mas sem diferenças entre os grupos de neonatos em nenhum dos parâmetros estudados. Nossos resultados indicam que níveis mais altos de anticorpos IgG específicos para B. pertussis no soro dos RN após a vacinação materna não afetam a resposta imune neonatal mediada por células / Maternal immunization with pertussis acellular vaccine (Tdap) is an additional intervention that provides protection to newborns. However, it has been reported that high antibody levels acquired via placental transfer may adversely affect the immune response of newborns after active immunization due to epitope masking. In this study, we evaluated neonatal passive acquisition of pertussis-specific antibodies and their influence on the neonatal cell-mediated immune response. The sample consisted of pregnant women vaccinated with the Tdap vaccine (case group, n=66) or pregnant women who received no vaccine (control group n=101). Whole-cell Bordetella pertussis (Bp), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN)-specific serum IgG concentrations were quantified in paired maternal-cord sera, and Bp- and PT-specific IgA concentrations were evaluated in colostrum samples by immunoenzymatic assay. Ex vivo neonatal blood lymphocyte responsiveness after inactivated Bp stimulation was assessed using flow cytometry to detect the proliferation, cytokine production and activation phenotype of T lymphocytes in the context of high specific IgG concentrations acquired after maternal vaccination. Anti-Bp, PT, FHA and PRN IgG antibody concentrations in maternal and cord serum samples from case group were higher than those in control group (p < 0.0001), with positive correlation indexes in both groups for all pertussis antigens (p < 0.0001). Vaccinations performed between 26 and 31 gestation weeks were associated with the best placental transfer ratios, although significantly lower ratios were detected in case group (p < 0.01). Anti-Bp and anti-PT IgA concentrations in colostrum were not affected by vaccine status. Cell culture assays revealed that newborns responded to Bp stimulation with higher expression of CD40L CD69 and CD4+ T cell proliferation compared to unstimulated cells. It was also observed a lower Th1 response, while a preserved Th2 response compared to adults, but there were no differences between neonatal groups for any of the studied parameters. Our results indicate that higher pertussis-specific IgG levels in newborn sera after maternal vaccination do not affect the neonatal cell-mediated immune response

In Uganda, there are an estimated 200,000 women suffering from obstetric fistula, with 1,900 new cases expected annually. These figures, combined with a persistently high maternal mortality rate, have led to an international discourse that claims the solution to improving maternal health outcomes is facility-based delivery with a skilled birth attendant. In accord with this discourse, the Ugandan government criminalized traditional birth attendants in 2010. In this study, I examine the lived experience of traditional birth attendants and women who have suffered from an obstetric fistula in eastern Uganda. Using data collected from open-ended, semi-structured interviews, focus groups, and participant-observation, I describe the biocultural determinants of obstetric fistula. Based on findings, I argue that although emergency obstetric care is critical to prevent obstetric fistula in cases of obstructed labor, the criminalization of the locally constructed system of care, TBAs, serves as yet another layer of structural violence in the lives of rural, poor women. Results demonstrate how political-economic and cultural determinants of obstetric fistula are minimized in favor of a Western prescribed, bio-medical solution, which is heavily resource dependent. This solution is promoted through a political economy of hope fueled by the obstetric imaginary, or the enthusiastic belief in Western-style biomedical obstetric care’s ability to deliver positive health outcomes for women and infants regardless of local context and constraints. Recommendations include increased obstetric fistula treatment facilities with improved communication from medical staff, decriminalization of traditional birth attendants and renewed training programs, and engaging local populations in maternal health discourse to ensure culturally competent programs. / Graduation date: 2013

Fetal Alcohol Syndrome (FAS) is a preventable cause of mental retardation and is the severest category within Fetal Alcohol Spectrum Disorder (FASD). As gestational alcohol exposure affects fetal cognitive functioning, children with FAS present with intellectual deficits. Unfortunately FASD prevalence rates are increasing amongst infants and school-going children. The main goal of this study was to compare the neurodevelopmental subscales of infants diagnosed with FAS, Partial FAS and non- FAS. Seventy-four infants with confirmed FAS, Partial FAS or Non- FAS diagnoses were assessed using the Griffiths Mental Developmental Scale. Development assessed at 7-12 and 17-29 months of age showed that, regardless of a FAS, PFAS or Non-FAS diagnosis, all infants performed weaker at their assessment at 17-29 months. The Subscales significantly affected included Personal-Social, Eye- Hand Coordination and Performance. The infants with FAS and PFAS displayed the most marked developmental delays. From this study it can be concluded that there are definite neurodevelopmental profiles for infant's diagnosed with FAS, PFAS and/or Non-FAS, highlighting the significant impact of prenatal alcohol exposure on various aspects of infant development. / Social work / M.Diac.

The aim of the study was to determine factors contributing to late booking amongst pregnant women at Ekurhuleni health district in order to offer recommendations for enhancing early booking. Interpretative phenomenological analysis design was used. Data were collected using semi-structured individual face-to-face interviews from 20 purposively selected pregnant women. Each interview was audio recorded and lasted between 45-60 minutes. Fields notes were taken to triangulate data collection method. Audio recorded interviews were transcribed verbatim. Data were thematically analysed using Interpretative Phenomenological Analysis framework for data analysis. Results indicate that healthcare service related factors such as human resources, infrastructure and the type of service rendered at the clinic contribute to late bookings. Client related factors such as socioeconomic status, cultural beliefs and knowledge deficit also contribute to late bookings. Recommendations are made addressing both healthcare service and client related factors in order to enhance early booking among pregnant woman at Ekurhuleni district. / Health Studies / M.A. (Nursing science)

The purpose of the study is to determine the barriers to utilisation of antenatal care services among pregnant women in Omaheke Region - Namibia. A quantitative, cross-sectional descriptive research was followed, and a structured questionnaire was used to obtain information from study participants. One hundred and ten (110) women of child-bearing age between 18 to 49 years who visited Gobabis District Hospital in Omaheke Region for deliveries (full-term) or kept for postnatal care purposes were selected. A questionnaire with open-ended and closed-ended questions was designed using a Likert scale to gather information. SPSS software was used to generate descriptive statistics. Results indicated that the majority of respondents (39%) who attended antenatal care services, fell within the age range of 18-21 years. Participants demonstrated higher knowledge of the recommended number of antenatal care visits and of the importance of antenatal care services. Transport money and cost, long distances to health facilities, desirability, unplanned or unwanted pregnancy, and limited transportation options are the barriers that contribute to low utilisation of antenatal care services among pregnant women in Omaheke Region. Recommendations for deployment of more qualified midwives at rural antenatal clinics, building more antenatal care clinics in the region and creation of community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services in the Region. It is anticipated that this research will contribute to the promotion and utilisation of antenatal care services among pregnant women in Omaheke Region. / Health Studies / M. P. H.

The registered midwives are engaged in continuous health education lessons In antenatal visits, discouraging antenatal clients from using hannful traditional and cultural practices in an attempt to preserve pregnancy to tenn. Despite the registered midwives' efforts, the clients continue to use hannful cultural methods, which are life-threatening to both the mother and the foetus In utero. The prenatal clients perceive the registered midwives as not being sensitive to their culture. The results of this study revealed that health education in antenatal clinics should be collaborative: that is, the people who have influence over the clients' pregnancy, like me mother-in-law, the traditional practitioners, cUents and their family members, should be involved by the midwives during the preparation of pregnancy lessons and health education lessons on how to preserve pregnancy to term according to· scientifically proven methods. / Health Studies / M.A. (Health Studies)