Background Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management.Methods We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups.
Summary Background Infections are among the leading causes of maternal mortality and morbidity. The Global Maternal Sepsis and Neonatal Initiative, launched in 2016 by WHO and partners, sought to reduce the burden of maternal infections and sepsis and was the basis upon which the Global Maternal Sepsis Study (GLOSS) was implemented in 2017. In this Article, we aimed to describe the availability of facility resources and services and to analyse their association with maternal outcomes. Methods GLOSS was a facility-based, prospective, 1-week inception cohort study implemented in 713 health-care facilities in 52 countries and included 2850 hospitalised pregnant or recently pregnant women with suspected or confirmed infections. All women admitted for or in hospital with suspected or confirmed infections during pregnancy, childbirth, post partum, or post abortion at any of the participating facilities between Nov 28 and Dec 4 were eligible for inclusion. In this study, we included all GLOSS participating facilities that collected facility-level data (446 of 713 facilities). We used data obtained from individual forms completed for each enrolled woman and their newborn babies by trained researchers who checked the medical records and from facility forms completed by hospital administrators for each participating facility. We described facilities according to country income level, compliance with providing core clinical interventions and services according to women's needs and reported availability, and severity of infection-related maternal outcomes. We used a logistic multilevel mixed model for assessing the association between facility characteristics and infection-related maternal outcomes. Findings We included 446 facilities from 46 countries that enrolled 2560 women. We found a high availability of most services and resources needed for obstetric care and infection prevention. We found increased odds for severe maternal outcomes among women enrolled during the post-partum or post-abortion period from facilities located in low-income countries (adjusted odds ratio 1·84 [95% CI 1·05–3·22]) and among women enrolled during pregnancy or childbirth from non-urban facilities (adjusted odds ratio 2·44 [1·02–5·85]). Despite compliance being high overall, it was low with regards to measuring respiratory rate (85 [24%] of 355 facilities) and measuring pulse oximetry (184 [57%] of 325 facilities). Interpretation While health-care facilities caring for pregnant and recently pregnant women with suspected or confirmed infections have access to a wide range of resources and interventions, worse maternal outcomes are seen among recently pregnant women located in low-income countries than among those in higher-income countries; this trend is similar for pregnant women. Compliance with cost-effective clinical practices and timely care of women with particular individual characteristics can potentially improve infection...
IntroductionReproductive health is characterized by the condition of the woman in association with the course of pregnancy and childbirth. In this case, the absence of disease plays a fundamental role. Unfortunately, conditions that can negatively impact reproductive health and cause deterioration of pregnancy and delivery outcomes are frequent in women of reproductive age. Antiphospholipid syndrome (APS) is one of the leading conditions that can negatively affect reproductive health and lead to various complications in pregnancy including fetal loss.Materials and methodsWe assessed the effectiveness of pre-conception preparing, including traditional therapy of APS in conjunction with system enzyme therapy (SET) and plasmapheresis sessions. We conducted a study in two groups: women with APS and pre-conception preparing (n = 49) and the control group were women without pre-conception preparing (n = 46).ResultsThe effect of pre-conception preparing in women with APS was assessed by the course and outcome of pregnancy. The total number of women with complications of pregnancy were 39.1% lower in the study group compared to the control group. Risk of miscarriage in the basic group observed 68.7 % less frequently compared to the control group. The frequency of pre-eclampsia was 63.5 % less in the study group compared to the control group. We observed significantly lower rates of placental insufficiency in the study group and the difference in this parameter reached 65.2%. The risk of pre-term birth was 59.4 % lower in the study group compared to the control group.ConclusionWe concluded that pre-conception preparing in women with APS increases the possibility of physiological course pregnancy. Pre-conception preparing reduces the incidence of miscarriage, pre-term labor, and the development of pre-eclampsia, and placental insufficiency.
The study features of bone tissue mineral density and their correlation with blood levels of calcium, magnesium and non-organic phosphorus in young pregnant women. Clinical and ambulatory examination of 120 pregnant women of ages 16-25 was made. Estimation of bone tissue mineral density and blood levels of calcium, phosphorus and magnesium was performed during the pregnancy stage of 12 to 28 weeks. Among young pregnant women during II trimester, rate of osteopenic syndrome amounts to 17.5%, including osteoporosis of 1.7%. Development of osteopenic syndrome is attributed to general blood calcium deficiency. Development of osteopenic syndrome in young pregnant women is associated with decreased dietary consumption of calcium (owing to exclusion of milk products). Bone tissue mineral density is directly correlated with blood plasma levels of calcium.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.