Violeta Mladenovic, Milica Dimitrijevic-Stojanovic, Djuro Macut and Aleksandar Djukic
Pregnancy is a period marked by profound changes in a woman’s hormonal status and metabolism, including the development of a carbohydrate-intolerant state. Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.
The aim of this study was to estimate and analyse the parameters of glycaemic control during pregnancy. We stratified patients into the following three groups according to OGTT results: normal glucose tolerance (NTG), gestational impaired glucose tolerance (GIGT) and GDM.
We investigated 92 pregnant women, diagnosed with vital and desired pregnancy up to 12 weeks of gestation, who had signed informed consent forms. Among them, 7 pregnant women had a spontaneous abortion, while 8 pregnant women dropped out, so a total of 77 pregnant women completed the trial. Most of the women examined had no risk factors (48%), while 35% of the women had one risk factor. The current study demonstrates that normal glucose tolerance was shown in 59 (76.6%) participants, while some form of glucose intolerance (GIGT or GDM) was shown in 18 (23.4%) patients. Our findings revealed an increase in glucose intolerance with advancing pregnancy (in the second and third trimester). In conclusion, we demonstrate that the difference in the quality of glycaemic control during pregnancy is manifested in the second and third trimester, until it manifests in the first trimester. These findings underpin the clinical significance of discovering GDM.
Hormonal changes and metabolic needs during pregnancy result in profound changes in biochemical parameters of thyroid function, especially if there is preexsisting autoimmune thyroid disease (AITD). Normal thyroid function is important in order to ensure the best outcome. Many changes in the functioning of the thyroid gland occur during pregnancy, and some diseases of thyroid gland can affect both mother and fetus. Hypothyroidism is the most serious disorder that occurs during pregnancy and can go unnoticed as a „non-specifi c” problem. Hypothyroidism arises from the reduced ability of the gland to adapt to the increased needs during pregnancy. Mild thyroid dysfunction of mothers in the fi rst trimester, which does not threaten during the pregnancy, can damage the psychomotor development of the child. Measurement of TSH is the most practical, simple and cost- eff ective screening test for thyroid dysfunction. It is necessary to apply the trimester-specifi c TSH reference values to correctly interpreted thyroid function during pregnancy. Th e presence of TPOAb is confi rmation of existence of AITD, and predicts increased risk of developing subclinical hypothyroidism (SH). Preconceptional education and adequate diagnosis and treatment of thyroid dysfunction in early pregnancy are of great importance, in order to prevent complications during pregnancy and off spring. Current data indicate an increase in pregnancy loss, gestational diabetes, gestational hypertension, pre-eclampsia and preterm delivery in women with SH in pregnancy. Th e control of thyroid disease reduce complications of pregnancy.
Overcoming psychosocial barriers to maternal exercise: intervention strategies to improve participation and adherence
Poor adherence to physical activity programmes during pregnancy is a serious national issue, one that has detrimental effects on a large percentage of the population. Not only does a lack of activity result in a decrease in quality of life for women during term, but the effects can carry over well after pregnancy, potentially leading to increased morbidity and mortality. What's more, reduced prenatal activity can cause adverse effects on the foetus, with impairments seen in physical health as well as cognition. Accordingly, the purpose of this paper is twofold: first, to examine the socio-demographic data and psychosocial influences that modify exercise behaviours in pregnant women and, second, to make recommendations as to effective intervention strategies that can be adopted by health and fitness professionals to help improve maternal exercise participation and adherence.
Blagovest K. Pehlivanov, Georgi I. Amaliev, Maria L. Malinova and Ilia G. Amaliev
A rare case of a 32-year-old patient with simultaneous bilateral isthmic tubal pregnancy. A 32-year-old woman with a 3-year history of primary infertility was admitted with light vaginal bleeding and mild abdominal pain. She was 41 days after her last menstruation and 23 day after intrauterine insemination with her husband’s sperm. Clomiphene citrate (CC) was used for the induction of ovulation. In cases of ectopic pregnancy with ovulation induced by CC, doctors must be aware of the possibility of bilaterality.
Florina Ruţa, Monica Tarcea, Victoria Stere, Zoltan Abram and Călin Avram
Exposure to smoking during pregnancy is known to be one of the main modifiable risk factors, which threatens maternal and child health. Along with this factor, are not to be neglected also other risk factors belonging to lifestyle sphere, such as alcohol, sedentary, irregular daily meal serving plan, lack of knowledge.
Main objective is identification of behavioral risk factors during pregnancy in a group of recently given birth women, hospitalized in three maternities of Tirgu Mures County.
Aleksandra Łata, Barbara Baranowska and Piotr Węgrzyn
Introduction. The midwife profession is an independent profession, entitled to provide part of the services of gynaecology and obstetrics. Women whose pregnancy goes in a physiological way may benefit from midwife-led services as part of the benefits refunded by the National Health Fund. This model makes it possible to maintain continuity of care, considered a beneficial solution in the area of mother and child health.
Aim. Determination of the scale of the phenomenon of midwife-led antenatal care in Poland and comparison of groups of women actively using the Internet who chose midwife-led or doctor-led antenatal care.
Material and methods. The survey was carried out in February-March 2018. The research tool was an electronic questionnaire. Questions regarding socio-demographic factors of pregnancy, antenatal education, labour, intervention during labour and labour experience described by women-Internet users were used for the purpose of the analysis. The Chi-square test of independence, the Fisher’s Exact Test and the Mann-Whitney U test were used to develop the results.
Results and conclusions. The prenatal care of midwives is not a common phenomenon in Poland. Groups of women who decide on a different form of midwife-led or doctor-led antenatal care differ mainly in the material situation. Women choosing midwifeled antenatal care more often attend antenatal classes and prepare a birth plan. In order to popularize the model of antenatal care provided by midwives, attempts should be made to study the motivation of women who decide on an alternative antenatal care.
Joanna Kozłowiec, Monika Kozłowiec and Piotr Książek
Introduction. Performance management is a crucial concept in the broader field of human resource management. In accordance with its principles, in defining a professional role, its aim must be included. In addition, key results areas and crucial competencies must be stated. The professional role of a nurse with regard to pregnancy and pre-natal care, is defined by way of the set of functions fulfilled. The role of a midwife and her competencies are, however, in this situation, much broader.
Aim. The aim of the conducted research was to determine the roles played by both nursing and midwifery staff in ensuring a healthy pregnancy and delivery by way of their patients' assessment.
Material and methods. The research was conducted in the Obstetrics and Gynaecology unit, in the Regional Specialist Hospital in Biała Podlaska, and it involved 40 pregnant women.
Results and discussion. Our study reveals that what the subject women need the most from the nursing and midwifery staff, is emotional support. What is more, the dominant majority connects their expectations as to the fulfilment of the roles played by nursing and midwifery staff to an increase in information support.
Conclusion. The obtained results allow a defining of the aim of the professional roles of nurses and midwives in supporting and assisting the pregnant, as well as identifying their key results areas and crucial competencies from the patients' point of view. In comparing our own study results to that involving patients' opinions (gained by way of a study conducted in the obstetrics and gynaecology unit, by the quality care assessment section of the Regional Specialist Hospital in Biała Podlaska), it can be stated that there is continuous positive growth in the quality of service provided by nurses and midwives.
Paweł Golubka, Agnieszka Wańkowicz, Marian Przylepa, Marek Gogacz, Ivan Golubka, Kristiana Golubka, Dominik Dłuski, Wiktoria Golubka and Dorota Darmochwał-Kolarz
Introduction. Uterine fibroids are the most frequent benign tumors affecting sexual organs in women. It is estimated that they affect 20% of the female population, with the frequency in pregnant women ranging between 0.1-5%. In spite of the progress in the field of medicine, the actual cause of uterine fibroids has yet to be discovered.
Aim. Analysis of the recent methods of dealing with uterine fibroids during pregnancy.
Material and methods. A review of literature about dealing with pregnant, lying-in and parturient women suffering from uterine fibroids.
Results. The research studies by Aydeniz, Vergani, Rice showed that cesarean sections are much more frequent in pregnant women with uterine fibroids than in control group (52.9% vs 27.9%; 23% vs 12%; 35.1% vs 21.5%). However, it was shown that the rate of cesarean sections was much higher in women with uterine fibroids located in the lower part of the uterus than in the fundus uteri (respectively 39% and 18%). Also, the rate increased when the diameter of the fibroid exceeded 5 cm, unlike in case of those smaller than 5 cm (respectively 35% and 17%).
Conclusions. 1. The number of cesarean sections in women with uterine fibroids is higher than in control group. 2. The frequency of cesarean sections in pregnancies with uterine fibroids depends on their position and size. 3. There is no relationship between the number of complications and the amount of fibroids in pregnant women. 4. There is no agreement concerning the recommendations for removing the fibroid during cesarean section.
Artur Wdowiak, Grzegorz Bakalczuk, Elwira Dadej, Anita Wdowiak, Michał Filip, Edyta Wdowiak, Magdalena Lewicka and Magdalena Sulima
Pregnancy is a woman’s physiological state, covering the period from conception to birth. It is an important time in the life of every woman and the child’s father. Often, the parents-to-be find the new situation difficult. Childbirth classes may prove helpful during pregnancy and childbirth for mothers and fathers. The aim of the study was to evaluate the effect of antenatal classes on parturition, according to the assessment of patients. The study was conducted at the Cardinal Stefan Wyszynski Provincial Specialist University Hospital in Lublin at the maternity ward on a group of 155 patients by means of diagnostic survey. The survey, by which the research material was collected, has been developed with the author’s own method. It has been shown that education and age of the participants influence the decision to use the services of childbirth education classes. Furthermore, the knowledge of breathing techniques, the use of birthing facilities, development of a plan for parturition and knowledge of methods of pain relief of childbirth have no impact on its duration. It was also shown that it is important to use relevant childbirth positions.
Monika Cendrowska-Pinkosz, Iwona Łuszczewska-Sierakowska, Wojciech Dworzański, Marek Tomaszewski, Magdalena Krauze, Agnieszka Magdalena Grzebalska, Barbara Madej-Czerwonka and Franciszek Burdan
Caffeine (120 mg/kg) was administered intragastrically to pregnant rats daily on gestational days 8-21. An increase in serum concentration of glucose and total protein was found in animals, which were given caffeine. The protein content proved to be highly significant in the experimental group of animals. The control group showed a negative interdependence between body weight gain and glucose concentration. No correlation was found between body weight gain and total protein concentration, yet the glucose concentration significantly influenced the total protein concentration in this group of animals. Among animals which received caffeine, correlations between total protein and glucose concentrations were observed. The analysis did not show that the glucose or total protein concentration significantly influenced the body weight gain of pregnant female rats in the experimental group. The research conducted suggests the possibility of modulating effects of caffeine on adaptive processes during pregnancy.