Asian Journal of Pregnancy and Childbirth

Objectives: To solve the sexual health problems among young women aged 20-39 years by using a PLISSIT model in rural Sindh Karachi Pakistan. 

Material and Methods: This Quasi-experiment will carry in the primary health care center of Sindh Karachi, Pakistan. One primary healthcare center will be randomly selected as an intervention group and another center will be selected as control from all primary healthcare centers in Karachi. Intervention and control groups both will have socio-demographic characteristics. The population will be post-married women of age 20 to 39 years.  Eligible participants will be randomly selected into control or intervention groups by applying the Balanced Blocked Randomizing method.  For estimating sample size a confidence level of 95%, with a power of 80%, and with a dropout rate of 15%, will be used in open epi online software. This led to about 40 participants in each group of intervention and the control group will be the sample size. An adapted questionnaire (tool) called the female sexual functioning index (FSFI) from an Iranian study will be used in the study. Permission has been taken through email from the corresponding author. The questionnaire of FSFI is a validated and reliable measurement for assessing female sexual problems.

Analysis Plan: For the statistical analysis, SPSS version 20 will be used and data will be shown in the form of mean and standard deviation. For the comparison of scores between and within the groups, the Pair T-test and repeated measure of variance (ANOVA) will be used. The results will be considered significant for all statistical analyses if P < 0.05.

Conclusion: In conclusion, the PLISSIT model and using the FSFI questionnaire, this study aims to contribute valuable insights into addressing and potentially solving sexual health problems among young women in rural Sindh, Karachi, Pakistan. The findings obtained from this research have the potential to inform future interventions and strategies aimed at improving the sexual well-being of this population.

One of the major accomplishments of modern obstetrics over the past fifty years in high-income countries has been the decrease in stillbirths, which went from rates as high as 50 per 1000 births to approximately 5 per 1000 births these days. The infant mortality rate has decreased in relation to post-term pregnancies, diabetes, hypoxia, Rh illness, hypertension, placental abruption, and all infections, including syphilis. Several term deliveries have occurred throughout the intrapartum phase as a result of this achievement. In high-income countries, the antepartum stage currently accounts for the majority of preterm stillbirths. Stillbirth rates in many low- and middle-income countries now are comparable to those in high-income countries fifty years ago, especially in the parts of those countries with the weakest health systems. An important distinction between stillbirths in high-income countries and other places is the majority of late preterm, term, and intrapartum deaths in low-resource countries. These stillbirths ought to be rather straightforward to prevent with the use of proven risk assessment techniques and early delivery, typically by Cesarean section. This article discusses a thorough six-paper investigation of stillbirths, focusing on low- and middle-income countries. One of the inferences is that even though a sum of interventions have shown to be effective in lowering stillbirth rates, the potential for a significant and long-lasting decline in stillbirth rates won't be attained unless there is an effective health system in which these interventions can be put into practice.

The goal is to encourage good medical practices so that the emotional and psychological stigma associated with the common occurrence of infertility related to endometriosis in females of reproductive age may be adequately treated simultaneously with the fundamental cause. The failure of a male and female partner to conceive following frequent, unprotected sexual activity for a period of 12 months is a fairly strict definition of infertility. As a result of the fact that 85% of women are seen to become pregnant within a year of engaging in regular, unprotected sexual activity, the length is significant and commonly stressed in this context. The remaining 15% of couples may encounter a variety of obstacles to conceiving, and those issues are what spark this entire discussion about infertility. The presence of endometrial tissue outside of the uterine cavity is referred to as endometriosis. In the event that the female does not engage in sexual activity to conceive, it typically lines the uterine cavity and is shed off during the monthly menstrual cycle. Endometriosis is diagnosed only on the basis of histology, with the criteria focused on finding endometrial glands and stroma anywhere beyond the uterine cavity. The presence of endometrial tissue outside of the uterine cavity is referred to as endometriosis. In the event that the female does not engage in sexual activity to conceive, it typically lines the uterine cavity and is shed off during the monthly menstrual cycle. Endometriosis is diagnosed only on the basis of histology, with the criteria focused on finding endometrial glands and stroma anywhere beyond the uterine cavity.

Background: The advancement in science has brought about better medicines and preventive measures hence improved quality of life leading to higher life expectancy. This has also lead to advancement in assisted reproductive technology (ART) such as In vitro fertilization (IVF) which is helping women of advanced maternal age to conceive however this has a lot of ethical issues to consider.

Aim: The aim of this paper is to look at those aged ≥ 60 years who had live births and the ethical issues surrounding these births.

Methods and Materials: This is a retrospective cross-sectional study of cases reports of elderly women who delivered live babies. Journals, newspapers and magazines including on-line media from credible sites reporting women aged ≥60 years who had live babies globally were analyzed.

Results: There were 75 elderly women worldwide that had live births ever.  Majority (99.7%) of the women were within the youngest old age group ranging from 60-74 years while 96% had  IVF with primary infertility  without children from either partners seen in 55.6% of cases . Ethical issues identified include medical health challenges associated with advanced maternal age and those associated with ART which includes:  the unnatural means of conception, inequitable access to the intervention due to its high cost, lack of regulatory body, safety of the procedure, and fate of the embryos, surrogacy, sex selection, gamete donation and reproductive tourism. India had the highest number of women consisting of 18.7% of the study population while Nigeria had the highest number in Africa with 5.3% of the women. Ukraine was the most visited country for reproductive tourism, while Switzerland was the county whose women undertook reproductive tourism most.

Conclusion: The ethical considerations regarding child birth in elderly women that is those above 60 years are several and can be biological, social or religious. Legal rules guiding ART vary from country to country. The decision to bear children is a fundamental human reproductive right but the actualization takes critical assessment by competent specialists. There is need for uniform regulations and legislation worldwide to assist these women who were not able to achieve conception at a younger age.

Aims: Hyperthyroidism occurs due to overproduction of thyroid hormone. We aim to investigate the relationship of VASA and IFITM3 with hyperthyroidism by demonstrating immunolocalization at the stage of diestrus in hyperthyroid rat ovaries.

Materials and Methods: To induce hyperthyroidism, rats were given 250 ug/kg/day of L-thyroxine by subcutaneous injection for 21 days. The control group was a saline solution injected only. Ovarian tissues of euthanized rats were removed after cardiac blood was collected.

Results: It was determined that VASA is intensely expressed in oocytes and theca layers of growing follicles, and IFITM3 is strongly expressed in germinal epithelium and oocytes.

Conclusion: The intense expression of VASA is most likely due to the abundant ATP in the mitochondria of the oocyte cytoplasm. The effect of VASA and IFITM3 expressions in hyperthyroidic ovary compared to the control group shows the link between hyperthyroidism and follicle development.

Aims: One of the most significant causes of infertility in men and women are chromosomal abnormalities. There is a growing trend of postponing family planning so that couples want to have children in the later years of reproductive age, more precisely in the middle or late thirties. For this reason, we aimed to investigate the age, frequency, and types of significant cytogenetic abnormalities among infertile couples.

Study Design:  Retrospective study.

Place and Duration of Study: 142 couples (284 patients) were referred to the Center for Genetics of the Faculty of Medicine in Sarajevo between 2018 - 2022.

Methodology: The research included 284 respondents aged 20 to 54 with infertility. Karyotyping was performed on peripheral blood lymphocytes using the Giemsa trypsin banding (GTG) technique.

Results: The highest frequency of infertility was observed in the couples group aged 30-39 years. Chromosomal aberrations were found in 8 (2.8%) couples with infertility. Out of 160 cases of primary infertility, aberrant karyotypes were recorded in five patients, and three aberrant karyotypes were recorded out of 124 patients diagnosed with secondary infertility.  Compared to numerical aberration, the most common type of chromosome was a structural aberration. In both types of infertility, a structural aberration of chromosome 9 inversion was recorded.

Conclusion: The frequency of chromosomal abnormalities and the age of couples with infertility suggest that cytogenetic analysis is essential for the timely detection of the infertility cause. It has special significance for couples who decide to have assisted fertilization.

The aim of this study is the comparative analysis of breast milk and commercial infant milk sold in Aguata LGA. Breast milk and four infant milk (SME GOLD, Peak milk, MY BOY and Lactogen) were purchased from different sellers within Aguata metropolies. The proximate analysis were determined using standard AOAC method. The results of this study showed that the milk contained the following nutrients: in terms of moisture content, breast milk contain 11.40%, Peak milk 22.40%, Lactogen milk 11.60, My boy milk 17.40% and SME Gold milk 19.20%. Fat content were breast 12.50%, Peak milk 13.50, Lactogen milk 20.10, My boy milk 21.00% and SME Gold milk 12.80%. Crude fiber were breast milk 27.60%, Peak milk 32.00%, Lactogen milk 31.00%, My boy milk 30.00% and SME Gold milk 33.00%, Ash content were breast milk 22.20%, Peak milk 30.00%, Lactogen milk 40.00%, My boy milk 43.00% and SME Gold milk 34.00%, Protein content were breast milk 0.29%, Peak milk 0.29%, Lactogen milk 0.28%, My boy milk 0.31% and SME Gold        milk 0.29%. Carbohydrate content were breast milk 22.00%, Peak milk 2.00%, Lactogen milk 16.91%, My boy milk 6.99% and SME Gold milk 0.70% .The Breast milk is the best nutrition for infant growth and development, and is also rich in antibodies that provide the first source of adaptive immunity in a newborn’s intestinal tract. For healthy newborns whose mothers are unable to provide sufficient breast milk, the current option of choice is infant formula.

Aims: Perinatal women might have a negative experience with childbirth owing to the coronavirus disease 2019 (COVID-19) pandemic, and their parenting attitudes or mental state could be affected. We used an Internet survey to clarify the experiences of women who gave birth during the COVID-19 pandemic.

Study Design: Quantitative descriptive research.

Place and Duration of Study: Four maternal and child health facilities at a prefecture of Tohoku region from August 14, 2021, to May 29, 2022.

Methodology: We used an Internet-based questionnaire survey. A total of 103 mothers of children undergoing checkups between three- to four-month and 1.5-year were included in our analysis. Descriptive statistics were obtained from participants’ basic information and free answers were compiled regarding their experiences with childbirth during COVID-19.

Results: The surveyed women believed that the pandemic’s main effect was the inability of family members to be present during their health checkups. Owing to the pandemic, 42 women (40.8%) were severely stressed during their pregnancy as they could not see their families outside the prefecture or go out freely. Additionally, most women were denied or restricted family attendance and care during childbirth. Even after leaving the hospital, they could not seek consultation regarding their health and childcare, had to manage childcare and housework alone, refrained from going out owing to the fear of infection, and felt anxious and lonely. Some women appreciated the medical staff, stating that they were dependable and available to talk to, while others reported that the nurses were strict and overbearing. Participants demanded not only that nurses provide infection control measures but also psychological care.

Conclusion: Women experienced anxiety, loneliness, and isolation owing to COVID-19-related restrictions and feared for their own and their children’s health. Following discharge from the hospital, childcare support should be provided by healthcare professionals.

Background: Teenage pregnancy is a global societal issue with significant public health implications. Both developed and developing nations are affected, although developing nations like Ghana are more likely to have it. The explored the factors associated with teenage pregnancy in the Ahafo Ano South East District of Ghana.

Methods: The study employed qualitative method. An exploratory study design was used to determine the factors that influence the prevalence of teenage pregnancy in Ahafo Ano South-East District. A purposive sampling method was used to select 45 participants for the study. Data were collected by using one on one interview and focus group discussion. Four mixed focus group discussions comprising five people in a group were conducted. Face to face interview was done for the other 25 participants and analysis done with NVivo.

Results: The findings revealed that early marriage, poor knowledge and use of family planning, peer influence and social media were the main factors that influenced teenage pregnancy. On support systems available, the study revealed that most of the participants had support from their families, the friends and health workers to deal with their challenges. Support systems are ways adopted by the teenage mothers with pregnancy to reduce their burden of the condition on the young mothers. On effects of teenage pregnancy, the following findings emerged: school dropout, child abuse, drug abuse and economic hardship were the main effects of teenage pregnancy.

Conclusion: The study concludes that if the above challenges are not addressed by providing social support and adequate health services, sex education, girls after delivery will find it very difficult to reintegrate themselves into their families and communities. The government through the Ministry of Health should provide free medical care to the teenage pregnant girls to prevent further complications associated with the pregnancy.

Background: The extent to which available antenatal care (ANC) services and its delivery is perceived to be of goodquality among ANC attendees, remains key in achieving effective utilization, compliance and desirable outcomes with interventions.

Objective: To assess and compare availability of material resources and supplies, perception and satisfaction with quality of services delivery among women accessing ANC at public and private secondary health facilities in Anambra, Nigeria.

Materials and Methods: The study was a comparative, cross-sectional analytical study involving pregnant women attending ANC clinic in public and private secondary health facilities in Anambra state. Multi-stage random sampling technique was used to select all eligible and consenting subjects. Data were collected using pretested, semi-structured, interviewer-administered, questionnaire and observation checklist. Data obtained were analyzed using IBM/SPSS version 22.Association between variables were tested using Chi-square and Binary logistic regression.

Results: The overall satisfaction on the quality of ANC received by clients from the private healthcare facilities were significantly more likely to use the centre for ANC again 93 (77.5%) compared to public healthcare facilities studied 79 (65.8%). Also, clients from the private healthcare facilities were significantly more likely to recommend the centre to someone 80 (66.7%) compared to public healthcare facilities studied 64 (53.3%). Occupation of spouse (p = 0.042) and parity (p <0.001) were the socio-demographic determinants of overall perception of quality of ANC.Re-registration and recommending facility to someone, were the predictors.

Conclusions: There was availability of functional material resources and supplies. The overall perception and satisfaction with quality of ANC services was good. Stakeholder are to sustainavailability of material resources, quality of delivery and periodic feedback from clients.

Background: Pregnancy is an important process in the life cycle that gives rise to offspring to ensure continuity of life. However, due to unwanted pregnancies, some women resort to an abortion, which may or may not be safe. Given the health risk associated with unsafe abortion, the World Health Organization firmly supports Comprehensive Abortion Care (CAC) as a best practice since it offers access to both safe abortion and post-abortion care. It is important to note that, a significant proportion of unsafe abortions occur among students in developing countries.

Aim: To assess the knowledge and attitude towards Comprehensive Abortion Care (CAC) among female students at the University for Development Studies, Ghana.

Methods: The study is quantitative with a descriptive cross-sectional survey design. A multistage sampling technique was used to select 384 female students from various departments for inclusion. Both descriptive and inferential statistical analysis was done using Statistical Package for Social Science (SPSS) software, version 25. Based on some selected demographic factors of respondents, a one-way analysis of variance (One way ANOVA) was done to assess whether there were any differences in the respondents' knowledge and attitudes about comprehensive abortion care.

Results: The results showed that more than half of the respondents, 59.6% (n = 229) had poor knowledge of comprehensive abortion care. Only 31.5% (n = 121) of students knew that an abortion can be done if the pregnancy is as a result of rape and 36.7% (n = 141) of students knew incest as a legal criterion for abortion in the current study. A one-way ANOVA test revealed a statistically significant difference in knowledge on students’ levels of study [F _{(3, 380)} = 53.429, p =.000] and age [F _{(3, 380)} = 3.615, p =.013]. A follow-up post hoc analysis (α= .05) showed that students in their fourth year of study had higher knowledge than those in their third year [MD = 5.614, p = .000], second year [MD = 7.348, p = .000] and first year [MD = 6.893, p = .000]. In terms of age, students between 26 – 30 years had a significantly higher knowledge than all the other age groups. Finally, the mean score of 13.94 (SD = 3.072) revealed a negative attitude towards CAC; where 52.6% (n = 202) had a negative attitude whilst 47.4% (n = 182) had a positive attitude towards comprehensive abortion care.

Conclusion: Overall, this finding from the study indicates the respondents have had limited knowledge and a negative attitude towards comprehensive abortion care. Therefore, educational campaigns focused on increasing knowledge of comprehensive abortion care and destigmatizing abortion should be targeted at female students in tertiary institutions.

Ethno-medically, pineapple is used as abortifacient. Moreover, pineapple juice was found to have utero tonic effect in vitro just like Oxytocin, but in vivo research, bred at 10 days (second trimester in albino rats) showed no abortifacient effect. Therefore, this research was set up to investigate the trimester effect of the juice using albino rats. A total of 74 albino rats were used. Twenty one rats were used for toxicity testing, 40 female albino rats of 12 weeks of age and 13 males of 14 weeks of age were used for in vivo investigations. The males were kept in 13 cages. The rats were acclimatized for one week. The female rats’ estrus were induced using peanut extract (Luchis estrus milk) at a dose of 800mg/kg body weight. Three females picked at random were introduced to each male albino rat for impregnation. The male in cage 6 had very high libido and was given 4 females to impregnate. Twelve female rats each divided into 3 groups of 4 were used to study each trimester effect while the remaining 4 impregnated rats served as control for the three trimester treatment groups. Breeding was confirmed through vaginal cytology. In all the trimesters, the treatments were: 250mg/kg, 500mg/kg and 1000mg/kg body weight (graded doses) of pineapple juice. The control was given 2ml/kg body weight of distilled water. Five days post breeding, graded doses of pineapple juice were given to first trimester treatment groups and control group. Second trimester groups were given graded doses of pineapple juice just as in first trimester at day 10 while third trimester treatment groups were treated just as in first and second trimester at day 20 post conception. Furthermore, 20 days post conception, blood for hematology (in heparinized bottles) and serology (in test tubes) were collected through the ocular vein of the median cantus in first trimester treatment groups and control. Then, the rats in first trimester treatment group and control were sacrificed. The result obtained showed that in the first trimester treatment group, the embryos were resorbed/aborted in female rats treated with 500mg/kg and 1000mg/kg respectively but stunted in rats treated with 250mg/kg. Conclusion: high doses of pineapple juice caused abortion. But low dose caused stunting of the growth of the fetus. This could be why some women experience the stunting of the growth of their fetuses which most often elongates the gestation period.

Aim: Sickle cell disease is a public health problem with a global spread. As a hereditary disease, sickle cell disease comes with many complications, including anemia. With the increasing incidence of Sickle cell disease in Ghana, the study assessed students' knowledge, attitude, and belief about the disease.

Methods: A descriptive cross-sectional design was used in the study. A systematic sampling technique was used to select 386 participants. A questionnaire was used to gather the data in four selected schools. Data were analyzed using SPSS.

Results: About 47% of the participants were 18-20 years old. The study found that 81% of the participants have heard about Sickle cell disease. A few of them (11.66%) could tell their sickle cell status. In the case of curability of the disease, 31% believed that sickle cell disease is curable. The majority, 48.70%, would seek spiritual intervention to treat Sickle cell disease. Participants provided different explanations for the cause of sickle cell including the belief that sickle cell disease is transmitted at birth (72.28%), sexual intercourse (20.21%), airborne (3.37%), food (1.5%), and spiritual (13.47%). About 88.34% had not been screened for sickle cell disease, and the reasons assigned included not falling sick easily (22.22%), not considering it as necessary (14.53%), and the fear of testing positive (13.11%).

Conclusion: There was fair knowledge of Sickle Cell Disease, with few knowing their status. There were statistically significant associations between class, the course of study, and knowledge of Sickle Cell Disease. Some of the beliefs regarding the transmission of the disease include; Sickle Cell Disease is transmitted at birth, through sexual intercourse, and airborne.

Background: Major antepartum depression is associated with multisystemic symptoms, functional impairment, obstetric complications and even maternal mortality secondary to suicide if not promptly treated.

Aims: To determine the prevalence of antepartum depression among pregnant women attending antenatal clinic in the Rivers State University Teaching Hospital so that the affected patients could be promptly identified and managed, thereby averting the negative effects of the condition on the unborn child, mother and the family.

Methodology: This was a cross sectional study carried out in the antenatal clinic of the Rivers State University Teaching Hospital over a period of four months. A total of 163 antenatal patients who met the inclusion criteria were selected using the systematic random sampling method. Data on socio-demographic, obstetrics and medical information were obtained with semi-structured interviewer-administered questionnaire. Screening for depression was done using the Edinburgh Postnatal Depression Scale (EPDS). A score of 10 and above on EPDS was considered depression. Data were analysed with SPSS version 23 and a p-value of less than 0.05 was considered significant. 

Results: The mean age of the participants was 29.1±4.53 years with an age range of 20-40 years. The highest proportion (43.6%) of the participants were 26-30 years. The majority of the participants were married (87.1%), from monogamous families (73.6%) and had tertiary level of education (67.5%), majority were within the high social class (56.4%), and did not experience intimate partner violence (92.6%). The prevalence of depression was 44.8%.

Conclusion: The prevalence of antenatal depression in Rivers State University Teaching Hospital was high underscoring the urgent need for introduction of universal screening for the disease in each trimester.

Respiratory distress, intraventricular haemorrhage, necrotizing enterocolitis, hypothermia are few of the neonatal threats associated with preterm delivery. Antenatal steroids are given to pregnancy women who are at risk of delivery before 37weeks to prevent these complications in their babies. Dexamethasone and Betamethasone are the corticosteroids that have proven effective for fetal maturation. The average birth weight of extremely preterm, very preterm, moderate preterm and late preterm babies was 648.75 g, 1573 g, 1828.7 g and 2462.58 g respectively. This is a retrospective study where we have reported the administration of antenatal steroids in mother with impending preterm delivery and have discussed various factors associated with it including average NICU stay of the preterm babies, gender and average weight of the babies, outcome and gravidity of the mother.

Aim: Early Antenatal Care initiation among first-time mothers is crucial for the health of both the baby and mother. Unfavorable birth outcomes are mostly associated with late initiation of antenatal care that is designed to prevent complications associated with childbirth. This study examined the factors that influence antenatal care practices among first-time mothers within Tamale Metropolis.

Methods: The study design was cross-sectional and the study approach was mixed method. A simple random sampling technique was used to select the health facilities. The data collection techniques were survey and interview and the tools were questionnaire and interview guide. Data were analyzed using Statistical Package for Social Sciences version 20, and thematic content analysis for quantitative and qualitative data respectively.

Results: Results showed that 80% of first-time mothers visited the centers for antenatal care services more than four times. Factors influencing antenatal care patronage include the distance from facilities, support from family, and the educational level of pregnant women. Again, the majority of first-time mothers who patronized antenatal care services throughout their respective pregnancy terms delivered full-term babies. The age of the respondents was significantly associated with antenatal care attendance, while the presence of a significant correlation between occupation and patronage of antenatal care services.

Conclusion: The study thus recommends that all stakeholders in health, including frontline health providers, should emphasize the effectiveness of adequate antenatal care attendance and the need for early initiation. Additionally, Ghana Health Service needs to develop programs to strengthen Focus antenatal care and counseling on birth preparedness.

The study is aimed at investigating Perceptions and Experiences of Pregnant Women about Routine Human Immunodeficiency Virus Counselling and Testing in Tertiary Hospitals in Rivers State. Qualitative and quantitative research designs were used for the study. Two objectives and two research questions guided the study. A sample size of 200 pregnant women was used for the quantitative study while depth interviews were held with 10 pregnant women who tested for HIV at antenatal clinics (ANC), as well as four (4) healthcare workers involved in routine HIV counselling and testing. The instrument was subjected to a reliability test and a reliability coefficient of 0.85 was obtained. Data were analysed using the content analysis approach and simple percentages. The qualitative section of the study was divided into attitude of husbands, attitude of healthcare workers, fear of death for being HIV positive and suicidal tendency subthemes. The findings of the study revealed that 5% of the respondents were between 18 - 25years, 55% were between 26-30 years, 35% were between 31-36years while 5% were 37years and above. The result further revealed that HIV counselling and testing is well received and acceptable for most pregnant women. Most women were aware of routine antenatal HIV testing before registering for ANC services. The women indicated that they had learnt about HIV testing and its benefits through various community education activities, mass media and during their previous pregnancies. During ANC services, most health care workers were over stressed by the large numbers of women waiting for HIV testing. This was noticed to have downplayed or reduced the quality of counselling services, thereby affecting the quality of prevention of mother to child transmission services. Also, routine HIV counselling and testing in tertiary hospitals in River State is very important and necessary but should not be made compulsory. The study concluded that routine counselling and testing will enable individuals to make informed choices regarding the HIV test and take appropriate action. Therefore, the study recommended that routine counselling and testing facilities should be made available in all antenatal units of the hospitals.

Background: Labour pain is regarded as the most intense pain experienced by women; yet, the degree of labour pain varies. The severity of labour pain is seldom assessed or addressed in low-resource settings.

Aim: To evaluate the perceptions and experiences of labour pain among postpartum mothers in public health facilities in Rivers State.

Study Design: A mixed method (convergent parallel) study design was used.

Methods: The qualitative and quantitative aspects involved 26 purposively and 194 consecutively selected postpartum mothers. The qualitative aspect (perception) involving in-depth interviews and thematic analysis was performed using Atlas.ti software version 23. The quantitative aspect (experience) employed an interviewer-administered semi-structured questionnaire and Visual Analogue Scale (VAS) pain tool to obtain sociodemographic information, antenatal data and assess labour pain experience. Labour pain VAS ≥6 was considered severe.  The proportion with severe labour pain was determined and associated factors were uncovered using a Chi-square test. The significance level was p-value<0.05.

Results: Of the 26 postpartum mothers interviewed, two themes emerged: labour pain perception and pain relief. Of the 194 postpartum mothers recruited, 137(70.6%) experienced severe labour pains. Prelabour expectation of labour pain severity, mode of delivery, labour augmentation and pain relief modality significantly influenced labour pain experience.

Conclusion and Recommendation: Women perceived labour pain as severe during childbirth. Pain relief was strongly desired by postpartum mothers and influenced labour pain perception. Postpartum mothers’ perceptions of labour pain were predominantly convergent with their experience. There is a need for a uniform labour pain relief policy and improved pain assessment and support for women in labour in Nigeria.

Introduction: Postdated pregnancies have been shown for centuries in several studies of having increased risk to the mother and their fetus when compared to term pregnancies with complications increasing with increase in gestational age beyond 40 weeks. The purpose of this study was to determine the factors influencing early neonatal adverse outcomes among women with postdate pregnancies delivering at Kampala International University Teaching Hospital.

Methods: A quantitative cross-sectional study employed simple random sampling among 108 pregnant postdated mothers admitted in labour in maternity ward at Kampala International University Teaching Hospital.

Results: From total respondents, 58 (53.7%) mothers had babies with neonatal complications with confidence interval of (53.4–61.6). Majority 14 (24.1%) of women revealed that they had meconium aspiration while the least 3 (5.2%) had Low birth weight complications.Statistically significantly factors associated with early neonatal adverse outcomes among women with postdated pregnancies at Kampala International University Teaching Hospital included age group 25 – 29 years of age (OR =5.73: 95%CI, 2.31-28.4: P<0.001), no educational background (OR=3.29: 95%CI, 1.94–5.57: P<0.001), being a single women (OR=2.61: 95%CI, 0.77–8.85: P=<0.001), smoking (OR=4.36: 95%CI, 3.18-29.63: P=<0.001), gravity of 4 and above (OR=7.93: 95%CI, 0.55–38.33: P<0.001), ANC between 1 to 2 times (OR=3.81: 95%CI, 0.57–29.01: P=0.004), and previous postdated pregnancy (OR=10.47: 95%CI, 7.69–14.26: P=<0.001).

Conclusion: In conclusion, with good antenatal care and multidisciplinary approach, HIV-infected women can ensure quality care of mothers and newborns.

Background: The Apgar score is a recognized and practical way to report a newborn infant's condition at 1^st and 5^th minutes after birth and their reaction to resuscitation, if necessary; nonetheless, it has been improperly used to forecast specific negative neurologic outcomes.

Aim of the Study: To identify the most frequent maternal risk factors associated with low Apgar scores among newborns and evaluate the effect of neonatal sex, type of delivery, mothers’ age on Apgar score at Al-Batool Teaching Hospital in Mosul.

Methodology: This study used a cross-sectional Hospital based study design to achieve the study objectives. The data was obtained and collected from 93 maternal and neonatal record files for the mothers who delivered at Al-Batool Teaching Hospital for the period from 1^st May 31^st June 2023 with a simple random sampling method was used. All maternity data for women and full-term newborns, regardless of the delivery method, meet the inclusion criteria for this study. All maternal files involving home births, premature births, and referrals from other facilities following deliveries were disqualified. The information was gathered and examined by researchers.

Results: The current study involved 93 full term neonates; 58 were males and 35 were females with male: female ratio of 1.65:1. Of them 35 (37.6%) neonates delivered by normal vaginal delivery while the remaining 58 (62.4%) delivered through cesarean section. The mean Apgar score at 1 min was 5.311±2.274 while at 5 min. was 7.462± 1.891 and the mean maternal age was 27.57± as 5.942 years. The commonest risk factors found was obstructed labor with mean Apgar score of 3.381±1.687 at 1 min and 6.142±1.768 at 5 min, followed by previous 2 CS and meconium stained liquor. Neonates with no maternal risks had mean Apgar score of 8.285±0.755 at 1 min and 9.571±0.534 at 5 min. The statistical difference between Apgar score at 1 and 5 min was significant for each of males and females while the difference between males and females was not significant at each of 1 and 5 min. The mean Apgar score at 5 min was significantly higher than that at 1 min for those with maternal risk the difference between those with maternal risk and those with no maternal risk was statistically significant for both at 1 min and 5 min. Furthermore, mean Apgar score at 5 min was significantly higher than that at 1 min for normal vaginal delivery and cesarean section while the difference between Apgar score in normal vaginal delivery and cesarean section at each of 1 and 5 min was not significant. The Apgar scores for at both 1 and 5 min were not significantly correlated with the mothers’ ages.

Conclusions: Mothers who had obstructed labor, had newborns with low Apgar score. At both 1 and 5 minutes, there was a statistically significant difference between the groups with and without maternal risk. The difference in the Apgar score at 1 and 5 minutes for male and female newborns and between those who delivered vaginally normally and via cesarean section was not statistically significant.

Background: Dizygotic twin pregnancies present unique challenges and implications for maternal and neonatal health. In Bangladesh, with its rapidly changing socio-economic landscape and rich cultural traditions, there is a need to explore the prevalence and outcomes of such pregnancies.

Objective: This study aimed to determine the prevalence of dizygotic twin pregnancies in Bangladesh, evaluate associated maternal and neonatal health outcomes, and understand the influence of socio-cultural, economic, and healthcare-related factors.

Methods: A cross-sectional study involving 384 participants with dizygotic twin pregnancies was conducted across urban and rural regions of Bangladesh. Data were collected using structured questionnaires, in-depth interviews, and focus group discussions. Chi-square tests were employed to ascertain associations.

Results: The prevalence of dizygotic twin pregnancies was 1.7%, with a slightly higher rate in urban (1.9%) compared to rural areas (1.5%). Socio-cultural practices positively influenced maternal outcomes (p=0.021), while higher household income was associated with reduced neonatal complications (p=0.011). Regular antenatal care visits significantly reduced maternal complications (p=0.0038).

Conclusion: Dizygotic twin pregnancies in Bangladesh are influenced by a blend of genetic, socio-cultural, and economic factors. The importance of consistent antenatal care and socio-economic stability in ensuring optimal pregnancy outcomes was emphasized. This study underscores the need for tailored healthcare strategies and community engagement to support maternal and neonatal health in the context of twin pregnancies.

Objective: Advanced obstetric care in pregnancy with chronic kidney disease (CKD) has improved the perinatal outcomes. However, preterm delivery associated with high cost implications and perinatal morbidity is a matter of concern in these women. Better understanding of the risk factors for preterm delivery in these women may further help to improve the outcome by targeted interventions. The objective of our study was to evaluate the maternal and fetal outcomes and identify the risk factors for induced preterm delivery in pregnancy with CKD.

Study Design: It was a retrospective analysis of 57 pregnant women with CKD. Various biochemical and clinical factors were compared between these women with induced preterm delivery and term delivery to find out associated risk factors. P value <0.05 was considered as statistically significant.

Results: Out of 57 women, 39.59%(n=22) had term delivery, 57.89%(n=33) preterm and 3.50%(n=2) women underwent medical termination of pregnancy. The mean age (26.55±4.04 vs 27.36±4.02 years, p=0.46) and body mass index (24.91±3.23 vs 25.48±3.43 kg/m², p=0.53) were similar among term vs preterm group.  Primary glomerulonephritis was commonest cause of CKD in both groups. In term group, 68.2% were stage 1, 27.3% stage 2, 4.5% stage 3 and none of the patient were in stage 4 and 5. In preterm group, 48.5% were stage 1, 3.5% stage 2, 30.3% stage 3 CKD. All women in stage 4 (12.1%) and stage 5 (6.1%) had preterm births. Anaemia (4.5% vs 33.4%, p=0.018) and hypertension (31.8% vs 72.7%, p=0.003) were significantly more in preterm as compared to term group. On univariate analysis, CKD stage ³3(OR 15, 95% CI 1.8-127.4), uric acid (OR 1.7, 95% CI 1.15-2.44), anaemia (OR 10.50,95%CI 1.2-88.5) and hypertension (OR 5.71,95%CI 1.75-18.5) were significant predictors of induced preterm delivery. On multivariate analysis, hypertension and stage of CKD were significant risk factors for induced preterm delivery.

Conclusion: Conception in earlier stage of CKD, correction of anaemia in first trimester and control of hypertension are to be especially focused during preconception counselling and antenatal care of patients with CKD. Early detection of risk factors and timely intervention may reduce induced preterm delivery and improve maternal and fetal outcomes.

Objective: This study aimed to conduct a comparative analysis of neonatal outcomes and the underlying socio-cultural determinants of premature childbirth in urban and rural settings of Bangladesh.

Methods: A cross-sectional study was carried out involving 1,000 pregnant women (500 each from urban and rural areas). Data was collected via structured interviews and medical record reviews, focusing on socio-demographics, neonatal outcomes, traditional childbirth practices, and access to health care.

Results: Urban regions reported a higher incidence of premature births (22%) compared to rural settings (15%). Traditional childbirth practices were more prevalent in rural areas (76%) than urban ones (58%). Despite better healthcare access in urban regions, with 89% of women attending at least four antenatal visits, rural areas lagged at 67%, with 52% citing distance as a major barrier.

Conclusion: Both urban and rural areas in Bangladesh present unique challenges influencing neonatal outcomes, with socio-cultural determinants playing a pivotal role. Addressing these disparities demands a comprehensive approach that incorporates culturally-sensitive strategies, enhanced healthcare facilities, and community awareness initiatives.

Aim: To determine stillbirth rate and identifiable predictors from a sample of deliveries in our setting.

Study Design: A retrospective analysis of a cross-sectional dataset.

Place and Duration of Study: Study was conducted at the Federal Medical Centre Yenagoa (FMCY), Bayelsa State, Nigeria using data collected between July 2020 and April 2021.

Methodology: A cross-sectional dataset of 584 births at the FMCY was analysed. Variables included in the data were women’s age, level of education, booking status, parity, number of fetuses, onset of labour, mode of delivery, urgency of CS, fetal maturity, fetal lie, fetal presentation, fetal sex, birth weight categories and stillbirth or live birth. Stillbirth was defined as a baby born at ≥ 28 completed weeks of gestation or weighing ≥ 1000 grams with no signs of life. Data was analysed using IBM SPSS Statistics version 25.

Results: Of the 584 births during the study period, 53 were stillbirths giving a prevalence of 9.1% and stillbirth rate of 90.8/1000 total births. Unbooked status conferred >4 times higher odd of stillbirth (AOR = 4.36; 95% CI = 2.13 – 8.93; pValue < 0.001) relative to a booked status. Relative to delivery by pre-labour caesarean section, odd of stillbirth was about 8.3 times and 15.9 times higher among women in spontaneous labour (AOR = 8.30; 95% CI = 2.27 – 30.36; pValue = 0.001) and women with induced labour (AOR = 15.91; 95% CI = 2.03 – 125.06; pValue = 0.009) respectively. Post-term gestation had 16 times significantly higher odd of stillbirth (AOR = 15.74; 95% CI = 1.35 – 183.91; pValue = 0.028) relative to term gestation.

Conclusion: This study establishes an unbooked status and post-term gestation as predictors of stillbirth in our setting. It also underscores the need to include the status of the fetus at presentation in labour (alive or IUFD) in data collection and analysis when studying the role of labour in incidence of stillbirth.

Background: Pregnancy complications present significant health challenges, particularly in nations like Bangladesh where access to maternal healthcare varies. This study aimed to provide an epidemiological analysis of major pregnancy complications among Bangladeshi women, offering insights into trends, risk factors, and outcomes.

Methods: A cross-sectional design was utilized, encompassing a sample size of 3,832 women. The study focused on identifying the trends over recent years, examining various risk factors, and contrasting complications between urban and rural settings. Data was subjected to chi-square tests to determine significance.

Results: The prevalence of major pregnancy complications remained stable over the years. Significant risk factors identified include age (both <20 and >35), low socioeconomic status, having more than three previous pregnancies, inadequate prenatal visits, and poor nutritional status. A statistically significant disparity in complications was evident between urban (50.0%) and rural (56.3%) settings.

Conclusion: The persistent prevalence of pregnancy complications among Bangladeshi women underscores the crucial need for targeted healthcare interventions. Recognizing and addressing the salient risk factors and bridging the urban-rural divide are imperative steps towards improving maternal health outcomes in the nation.

Background: The best time to clamp the umbilical cord has been disputed for decades, and definitions differ "Early" cord clamping (ECC) occurs before one minute after birth (about 15-30 seconds), whereas "delayed" cord clamping (DCC) occurs after one minute or when cord pulsations have stopped Doctors and midwives have traditionally defined ECC as malpractice, associated with danger and harm to both mother and newborn, and There is strong evidence that early cord clamping causes neonatal hypovolemia, anemia, and poor iron reserves.

Objectives: To determine the levels of newborn hemoglobin and serum ferritin at birth and three months after delivery in infants who had their umbilical cord clamped for 60 seconds. And to determine the levels of newborn hemoglobin and serum ferritin at birth and three months after birth in infants who had their umbilical cord clamped within 30 seconds.

Subjective and Methods: A randomized controlled trial was conducted in Benghazi Medical Center from June 2021 to March 2022 for 300 pregnant women who were admitted for elective cesarean section: 150 (the control group) received early cord clamping, and 150 (the study group) received delayed cord clamping.

Conclusion: Delay Cord Clamping provides considerable health benefits to term infants; it has been shown to lessen the risk of anemia in babies as young as three months old. Delay Cord Clamping (DCC) in term infants was feasible and safe, and there should be no hesitation in implementing this procedure routinely. Delay cord clamp is beneficial for the Apgar score of babies.

Background: The purpose of the study was to assess the use of emergency contraceptives among female trainee nurses in Ghana using Nursing and Midwifery Training College, Dunkwa-On-Offin as a case study.

Methods: The study employed a case study design. A structured questionnaire was used, which took data on knowledge, perception and use of emergency contraceptives among female nursing students. Descriptive, bivariate, and logistic regression analysis techniques were used to analyze the data, and the level of significance was set at 0.05. Data were analysed with SPSS version 23.

Results: The results showed that majority of the respondents 215 (58.9%) were familiar with the purpose of family planning. Again, an overwhelming majority of the respondents (81.1%) said they had heard about emergency contraceptive and had their information from the health workers. It was agreed by the majority (55.9%) that emergency contraceptives were safe for users, hence positive perception about emergency contraceptive. The usage rate for emergency contraceptive use among the respondents was 63.0%. Age of the respondents was found to be statistically significant OR 0.21(CI; 0.43-1.12; p-value=0.000). Also, marital status and level/class were significant (p-value=0.001) and p-value=0.000 respectively.

Conclusion: The study concludes that if students are educated on when and how to use emergency contraceptive, the knowledge, perception and usage will help reduce unwanted pregnancies among female nursing students in Ghana. There is the need for service providers either at the facilities or pharmacies to provide adequate information about emergency contraceptive.

Background: Prenatal care is pivotal for maternal and neonatal outcomes, yet its accessibility remains disproportionately limited in rural Bangladesh. This study assesses the efficacy of health interventions aimed at bolstering prenatal care accessibility from a gynecological and obstetrical perspective.

Methods: Using a mixed-methods approach, a sample of 1,876 participants was selected to gauge baseline prenatal care access, the nature and reach of health interventions, post-intervention access levels, and existing barriers. Data collection encompassed both quantitative tools and qualitative interviews, analyzed using chi-square tests and thematic analysis respectively.

Results: Prior to interventions, 43% had no access, 37% had limited access, and only 20% had adequate access to prenatal services. Post-intervention data reflected a significant shift with 65% reporting adequate access (p<0.001). Three primary health interventions, namely community-based programs, birth attendant training, and health awareness campaigns, yielded distinct impacts. However, despite the improvements, geographical constraints, socio-cultural beliefs, and limited healthcare infrastructure persisted as predominant barriers.

Conclusion: Targeted health interventions significantly enhance prenatal care accessibility in rural Bangladesh. However, to achieve a comprehensive improvement in maternal healthcare, it is imperative to address deeply rooted systemic and cultural challenges that impede seamless access.

Pregnant Indian women have a high Vitamin D deficiency prevalence (approx. 90%). Mounting evidence suggests that Vitamin D may be essential for maintaining healthy glucose homeostasis.

Aims: We aimed to determine the relationship between the GDM risks and maternal concentrations of Vitamin D in early pregnancy.

Settings and Design: An observational study was performed on 114 healthy pregnant women in their first antenatal (<twelve weeks) visit during a regular antenatal check-up at the Department of Obstetrics and Gynaecology, Rajarajeshwari Medical College and Hospital, Bangalore, India.

Methods and Materials: Venous plasma total Vitamin D concentration was evaluated with the help of tandem LC-MS/MS (liquid chromatography-mass spectrophotometry). A screening OGCT (oral glucose challenge test) was performed during the first visit and OGCT was repeated in mid-pregnancy between (24-28 weeks). Applying DIPSI criteria, gestational diabetes mellitus was identified and confirmed.

Results: Of 114 women, 54 (47.3%) were obese, 25 (21.9%) were overweight, 19 (16.6%) were normal weight, and 16 (14%) were underweight. A statistically considerable correlation was seen between Vitamin D status and OGCT (ϰ2= 57/07, p=0.01). The mean OGCT levels were higher in Vitamin D deficiency patients, which showed a statistically significant difference among the group (p=0.001). No statistically considerable correlation was seen between OGCT and BMI (ϰ2= 10.85, p=0.093).

Conclusions: Increased GDM risk might be linked to low plasma total Vitamin D concentrations in early pregnancy.

The goal of this study is to determine how beneficial each of these treatment options could be in assisting women to have a safe pregnancy free from worry about problems. The term "cervical insufficiency" describes the uterine cervix's failure to hold the fetus in place in the absence of any vigorous uterine contractions or labor. Only 0.5% of women, or 1 in 2000, are affected by this extremely rare illness. But when it does, there will undoubtedly be a more complicated etiology and pathogenetic mechanism at play. A rare anatomical or functional cervix deficiency called cervical insufficiency causes labor to start spontaneously or without any discomfort, which results in deliveries. It affects one in every 2000 women and typically starts during the beginning of the second and third trimester. Numerous studies have been conducted to find a cure for cervical insufficiency since it invariably results in preterm labor. In order to entirely prevent this citation, bed rest, water, and rigorous limitation on all forms of intense work are now regarded to be effective. However, it's still important to consider what could be done to completely avoid this circumstance.

This article review explains the challenges and barriers to Facility-based Respectful Maternity Care worldwide. Although respectful maternity care (RMC) is an important component of quality care, many factors act as barriers to the same. However, it is considered a critical standard of care for women and newborns. Respectful maternity care means care organized and provided to all women that preserve their dignity, privacy, and confidentiality, ensures freedom from harm and abuse, and enables informed choice and ongoing support during labor and delivery (WHO 2018).