Background Schistosomiasis is a highly prevalent parasitic disease that can lead to adverse maternal and perinatal outcomes. To our knowledge, there has been no systematic review and meta-analysis of schistosomiasis during pregnancy. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant published studies were searched in international databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar), from their inception until May 31, 2020. The retrieved studies were assessed for quality using the Modified Newcastle-Ottawa Scale. OpenMeta Analyst software was used for the statistical analysis. Results Thirty-two studies enrolling 21024 pregnant women were included in this meta-analysis. All 32 of these studies were conducted in Africa. Of these studies, 19, 11, and 2 investigated S. mansoni, S. haematobium, and combined S. mansoni and S. haematobium infections, respectively. The pooled prevalence estimate of schistosomiasis during pregnancy was 13.2% (95 CI 11.0–15.4). A random model was used because of high heterogeneity (Q = 99.14; P < 0.001). In subgroup analyses, the pooled prevalence estimate of S. haematobium was significantly higher than the pooled prevalence estimates of S. mansoni [22.5% (95% CI 1.6–43.5) vs 8.7% (95% CI 6.0–11.3, P = 0.016), respectively]. The results of meta-regression analyses showed a non-significant difference in the prevalence of schistosomiasis during pregnancy according to the study sample sizes and year of publication. Only six studies evaluated the association between schistosomiasis during pregnancy and anemia. Schistosomiasis was associated with anemia in these six studies (OR = 3.02, 95% = 1.25‒7.28, P = 0.014). Conclusion The present meta-analysis suggests that schistosomiasis during pregnancy is an existing health problem. This meta-analysis also highlights the lack of data on the determinants and outcomes of schistosomiasis during pregnancy. Preventive measures are needed and could be part of antenatal care in areas endemic with schistosomiasis.
Background The association between previous spontaneous abortion and preeclampsia is not yet fully understood. The current study was conducted to assess the association between previous spontaneous abortion and preeclampsia among pregnant women in Sudan. Methods A case–control study (involving 180 women in each study group) was conducted at Saad Abuelela Hospital, Khartoum, Sudan. The cases were pregnant women with preeclampsia, while the control group included healthy pregnant women. The participants’ sociodemographic, obstetric, and clinical characteristics were assessed via a questionnaire. Results There was no significant difference in the age, parity, education level, employment status, blood group, body mass index, and hemoglobin level between the patient and control groups. Forty (22.2%) women with preeclampsia and 68 (37.8%) women in the control group had a history of spontaneous abortion (p = 0.001). Multivariate logistic regression analysis (adjusted) revealed that women with a history of spontaneous abortion had a lower risk of preeclampsia than those without a history of spontaneous abortion [adjusted odds ratio (AOR) = 0.44, 95% confidence interval (CI) = 0.26‒0.73]. However, women with a history of preeclampsia had a higher risk of recurrence of preeclampsia (AOR = 1.92, 95% CI = 1.11‒3.32). Conclusion The present study revealed that previous spontaneous abortion reduced the risk of preeclampsia by 59.0%.
Background Maternal undernutrition is a global health challenge, and it is associated with significant maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and the factors associated with undernutrition among pregnant women in Sudan. Methods A cross-sectional study was carried out in Saad Abuelela Hospital in Khartoum, Sudan, from June to December 2019. Sociodemographic and obstetric characteristics were collected through a questionnaire. Mid-upper arm circumference was measured. Undernutrition was defined as a mid-upper arm circumference of <23 cm. Multiple logistic regression was used to assess the factors associated with maternal undernutrition. Results Of 1801 pregnant women, 226 (12.5%) were undernourished. Multivariable analysis revealed that ≤2 antenatal care clinic visits (adjusted OR [AOR]=3.06, 95% CI 1.68 to 5.58) was associated with undernutrition. Age (AOR=0.90, 95% CI 0.87 to 0.94) and haemoglobin levels (AOR=0.81, 95% CI 0.67 to 0.97) were negatively associated with undernutrition. There was no association between parity, education, interpregnancy interval, occupation and maternal undernutrition. Conclusions Our findings indicated that 12.5% of the pregnant women in Khartoum were undernourished. More effort and action are need to improve the counselling and future inclusion of a supplemental food supply for undernourished pregnant women.
Cesarean delivery is needed (indicated) for many reasons such as failure to progress, cephalopelvic disproportion, antepartum hemorrhage, preeclampsia, and repeated cesareans. The increase of the cesarean delivery rate is accompanied with an increase in the maternal and perinatal morbidities and increase in maternal mortality such as complications of anesthesia, injury to the nearby structure, respiratory distress syndrome, childhood allergy and childhood obesity. Vaginal delivery after cesarean section (VBAC) is one of the tools that aimed to reduce the rate of cesarean delivery. Here in this chapter we would like to highlight the different guidelines for VBAC, the success rate of VBAC, the determinant of the success rate, maternal and perinatal outcomes of VBAC. Then the arena of using oxytocic drugs in VBAC is discussed in details too.
Background and Objectives: Vast data have been published recently on the association between periodontitis and preterm birth (PB). However, these studies have shown inconsistent results. Few of them were conducted in Africa, and data has not been published on the association between periodontitis and PB in Sudan. Materials and Methods: A case-control study was conducted at the Omdurman maternity hospital in Sudan from February through October 2021. The cases were women with spontaneous PB (<37 weeks), and healthy women with TB (37–42 weeks) were the controls. Questionnaires (demographics, medical and obstetric factors) were completed through face-to-face interviews. Periodontitis was diagnosed by the Community Periodontal Index as: “bleeding on probing and a pocket depth of ≥3 mm and clinical attachment loss of ≥6 mm, calculus with plaque deposits, and gingival recession”. Multivariate regression analysis was performed with PB as the dependent variable. Results: One hundred sixty-five women were enrolled in each arm of the study. The age, parity and body mass index did not significantly differ between the women with PB and those with TB. Compared with the controls, a significantly higher number of women with PB had periodontitis (50/165 (30.3%) vs. 30/165 (18.2%), p = 0.011). The association between periodontitis and PB was significant. Women who had periodontitis had double the odds of having PB compared to women who had no periodontitis (adjusted Odd Ratio = 2.05, 95% Confidence Interval = 1.20–3.52). Moreover, the haemoglobin level (adjusted Odd Ratio = 0.67, 95% Confidence Interval = 0.51–0.88) was inversely associated with PB. Conclusion: The study results indicate that periodontitis and low haemoglobin were strongly associated with PB. Preventive measures, including the use of periodontitis screening and the prevention of anaemia, are needed to reduce PB in this setting.
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