A Dissertation that is being submitted for an MMed in Obstetrics and Gynaecology in partial fulfilment of the FCOG (SA) Part II 07 April 2015 / Objectives: The main objective of this study was to characterise women who presented at Chris Hani Baragwanath Academic Hospital (CHBAH) between 12 and 20 weeks for termination of pregnancy (TOP). Secondary objectives were to determine time to abortion, compare sonar gestational age to gestational age by dates and reasons for late presentation. Method: This was a prospective cohort study of women over the age of 18 who were referred to CHBAH for second trimester TOP between August 2012 and May 2013. The exclusion criteria were pregnancies more advanced than 20 weeks gestation. Data was collected from the medical file and by interview. Demographics and reasons to terminate were extracted from the files. Outcome variables included bleeding, pain, and time to abortion. Results: One hundred and ninety one women (91.39%) aborted. The median age of women was 25.00 (IQR=21.00-31.00), range (18-43). Women older than 25 years were 33% less likely to abort than women less than 25 years of age. Ninety nine women (47.14%) bled severely. One woman had a uterine perforation following evacuation of the uterus. The median gestational age by sonar was14.71 (IQR=13.86-16.14), range (13.00-20.00). The median gestational age by dates was13.57 (IQR=12.29-15.00), range (4.14-26.28). One hundred and thirty five women (63.98%) had an MVA for RPOC using analgesia following medical induction. Two women (0.95%) needed hysterotomy following failed TOP. The median time to abortion was 11.50(IQR=8.67-17.92), range (3.50-69.33) and incidence rate of 0.5 per hour or 1 per 2hours. Conclusion: The majority of women (91%) aborted within 72 hours following medical induction with less complication rate and short induction to abortion time. This affirm misoprostol efficacy as the suitable drug for conducting second trimester medical TOP. / MT2016

Orientador: Anderson Marliere Navarro / Banca: Conrado Milani Coutinho / Banca: Rose Mary Zumstein Georgetto Naal / Resumo: Objetivo: Verificar o perfil de selênio e zinco total em gestantes eutróficas,com sobrepeso e obesas. Metodologia: Foi realizado um estudo transversalcom 126 mulheres entre o segundo e terceiro trimestres gestacional. Asparticipantes, foram classificadas segundo estado nutricional pelo critério deAtalah, como: gestante eutrófica, sobrepeso e obesa. Foram avaliados osmarcadores selênio e zinco no plasma e no eritrócito. Foram realizadasmedidas antropométricas e avaliação do consumo alimentar. Asparticipantes foram subdivididas segundo o índice de massa corporal, sendoGrupo Controle (GC): 42 participantes gestantes eutróficas; GrupoSobrepeso (GS): 42 participantes gestantes com sobrepeso; Grupo obeso(GO): 42 participantes gestantes obesas. Foram realizados testesestatísticos para testar a igualdade entre os grupos, testes paramétricos eassociação entre estado nutricional e valores de Se e Zn plasmático eeritrocitário, considerando diferenças significativas o valor de p<0,05.Resultados: Não houve diferença significativa entre os três grupos emrelação aos valores médios de zinco no plasma (GC, 53±7 mg/dl; GS, 57±8g/dl; GO, 55±6 g/ dl) e selênio no plasma (GC 45 ± 12 mg/L; GS, 48±12mg/L; GO, 43±6 μg/L) e não houve diferença significativa nos valores médiosentre os três grupos para zinco no eritrócito (GC, 11±3 g/ml; GS, 10±3mg/ml; OG, 10±2 g/ml) e selênio no eritrócito (GC, 64±17 μg/L; GS de 63±17mg/L; GO, 60±13 mg/L). Conclusão: O presente ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Objective: To evaluate the profile of total selenium and zinc in eutrophic,overweight and obese women. Methodology: A cross-sectional study wascarried out in 126 either gestational period women, being them eithereutrophic or obese pregnant women. Biochemical markers wereassessed: total zinc and selenium, in addition to anthropometricmeasurements and food intake. Participants will be divided according tobody mass index, the control group (CG) of: 42 eutrophic pregnantparticipants; group (OG) of: 42 overweight pregnant women; and group(OWG) of: 42 obese pregnant women. Statistical tests for equalitybetween groups, parametric tests and the association between BMI andprofile of Se and Zn were performed, considering significant differencesthe value of p <0.05. Results: There was no significant difference betweenthe three groups regarding the average values of zinc in plasma (CG,53±7 μg/dl; OWG, 57± 8 µg/dl; OG, 55±6 µg/dl) and selenium plasma (CG,45±12 µg/L; OWG, 48±12 µg/L, OG, 43±6µ g/L) and there was nosignificant difference in mean values between the three groups for zinc inthe erythrocyte (CG, 11±3 µg/ml; OWG, 10±3 µg/ml; OG, 10±2 µg/ml) andselenium in erythrocytes (CG 64±17µg/L; OWG of 63±17 µg/L; OG 60±13µg/L). Conclusion: The present study demonstrated the presence ofdeficiency of the micronutrients zinc and selenium in all groups ofpregnant women, with and without overweight and obesity. However, morestudies are needed to better u... (Complete abstract click electronic access below) / Mestre

Thesis (M Med.(Family Medicine))--University of Limpopo, 2008. / Objective: To determine what proportion of pregnant women attending antenatal care in Mecklenburg Hospital eat soil. Study Design: A cross-sectional descriptive study was conducted at Mecklenburg Hospital. Results: A total 273 pregnant women participated in the study, of which 85% eat soil. The majority (74%) were single, mean age of 26 years. About seventy-eight percent had secondary education. Most of the women were unemployed. The majority of women believed that soil eating gives energy, taste nice, makes women feel strong, and makes stomach feel full. The other reason given by these women is that soil eating protects unborn baby from poison, gives nutrients to unborn baby, prevent prolonged labor, stops morning sickness. Conclusion: We conclude that the majority of pregnant women seen at Mecklenburg Hospital eat soil. There was not direct relationship between education level and nutritional reasons for eating soil. Furthermore, fetal and maternal reasons for eating soil were not associated with education level.

Thesis (Ph. D.)--Rutgers University, 2009. / "Graduate Program in Toxicology." Includes bibliographical references (p. 62-72).

Thesis (Ph.D.) -- University of Texas at Arlington, 2008.

Objective: Pregnancy has been recognized as a risk factor for severe pandemic influenza illness and this “vulnerable” group is suggested to be heightened alertness to the disease by WHO. This systemic review aims to identify the factors affecting the uptake of influenza vaccination among pregnant women as the immunization uptake among this particular group of population is low or suboptimal worldwide. Methods: Systematic literature reviews were conducted by using MEDLINE and PubMed with the key words: “influenza vaccination uptake” and “pregnant women” in the period of January 2004 to January 2013. It was further supplemented by a manual search for literatures and articles on the WHO website, Centers for Disease Control and Prevention (CDC) website, Google Scholar, and reference lists of reviews captured by initial searches. Results: Of the 222 articles identified, 10 studies were found to be relevant in this system literature review. Influenza vaccine coverage among pregnant women was highly diverse (6.2-76%) among the 10 studies. Overall, pregnant women were more likely to take the vaccination against influenza if they: (1) believed the benefits of the vaccine outweighed the potential barriers, (2) believed the influenza was severe and they were highly susceptible to the disease, and (3) were influenced by the positive cues to action such as recommendation from health care professionals and the experience of the influenza vaccination uptake. Conclusion: Overall, greater emphasis on vaccine effectiveness and safety, and the recommendation from health care providers is needed to increase the number of pregnant women influenza immunization in the future public health campaigns. / published_or_final_version / Medicine / Master / Master of Public Health

Despite the World Health Organization identifying pregnant women as the highest priority group for seasonal influenza vaccination, many pregnant women remain unaware of the recommendation and have substantial concerns about the adverse effects of the vaccine on them and their unborn foetuses. Few interventions have been conducted to improve influenza vaccine uptake among pregnant women. Among these studies, the results are inconsistent and the quality is generally low. Brief education has been previously shown to improve women’s health practices during pregnancy. An open-label randomized control trial was conducted to assess the effect of providing brief education on influenza vaccine uptake among pregnant women. A total of 163 unvaccinated pregnant women in at least their second trimester were recruited from antenatal clinics of four public hospitals in Hong Kong. They were randomized to receive standard care or a one-to-one brief education session that provided an overview of the safety and benefits of the vaccine to both pregnant women and their foetuses. Participants were followed up by telephone at two to three weeks postpartum to ascertain vaccination status. The primary study outcome was the influenza vaccine uptake rate and the second study outcomes were the proportion of participants initiating discussion about influenza vaccine with their health care providers, the proportion attempting to be vaccinated, and their knowledge of influenza infection and vaccination. A total of 163 participants were recruited with 155 (95%) participants completing follow-up. The overall influenza vaccine uptake rate was 17.8%. When compared with those receiving standard care, the vaccination rate was higher among participants who received the intervention (23.5% vs. 12.2%; p=0.06). In addition, the increase in the rate of self-initiated discussion with HCPs before and after the intervention was significantly higher in intervention group (26.7% vs. 9.3%; p<0.001) but not in standard care group (13.3% vs. 8%; p=0.481). Among participants who did not receive influenza vaccine, pregnant women in intervention group were substantially more likely to have made an unsuccessful attempt to be vaccinated (39.3% vs. 9.2%; p<0.001). Almost one-third of the pregnant women who had attempted to receive the vaccine (n=13) reported they received advice against vaccination during pregnancy from HCPs. If participants had not been advised against influenza vaccine and were successfully vaccinated, the overall difference in the vaccine uptake rate between the two treatment groups would have been statistically significant (34.6% vs. 18.3%; p=0.02). Brief education can be one strategy to improve vaccination uptake rates among pregnant women. In addition, it is clear from this and other studies that recommendations from HCPs substantially influence vaccination behaviours among pregnant women, both positively and negatively. Therefore, multicomponent approaches should be considered in future vaccination programmes and the synergistic effect of both brief education and HCP recommendations should be further evaluated. / published_or_final_version / Nursing Studies / Master / Master of Philosophy

Not available / text

Not available / text

Not available / text