Adolescent pregnancy accounts for 11% of annual births worldwide according to WHO. The study analyzed obstetric outcomes of 3310 adolescent pregnant women in Mexico. The main complications were obstetric hemorrhage (13% of cases) and hypertensive disorders (8% of cases). Obstetric hemorrhage was more common in women aged 15-19, while hypertensive disorders were more frequent in women aged 9-14. No maternal deaths occurred. The cesarean section rate was 33%. Adolescent pregnancy carries increased risks, so addressing this public health issue could reduce maternal and infant mortality.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Teenagers are at risk of a range of adverse pregnancy outcomes, particularly preterm birth.
The reasons for this are complex and reflect a combination of adverse socioeconomic pressures and gynaecological and biological immaturity.
The obstetrician providing care for women in this age group should be aware of the potential challenges.
Studies have shown that delaying adolescent births could significantly lower population growth rates, potentially generating broad economic and social benefits, in addition to improving the health of adolescents.
A national target should be set to decrease the incidence of teenage pregnancy in our country .
Obstetricians should have a major role in such health education.
,
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Teenagers are at risk of a range of adverse pregnancy outcomes, particularly preterm birth.
The reasons for this are complex and reflect a combination of adverse socioeconomic pressures and gynaecological and biological immaturity.
The obstetrician providing care for women in this age group should be aware of the potential challenges.
Studies have shown that delaying adolescent births could significantly lower population growth rates, potentially generating broad economic and social benefits, in addition to improving the health of adolescents.
A national target should be set to decrease the incidence of teenage pregnancy in our country .
Obstetricians should have a major role in such health education.
,
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The effects of adolescent pregnancies on child health are discussed in this paper. In recent decades adolescent pregnancy has become an important health issue in many countries, both developed and developing. According to WHO data in 2010, there are nearly 1, 2 billion adolescents in the world, which consists of 20% of the world population. 85% of these adolescents live in developing countries. A pregnancy in adolescence, which is a period of transmission from childhood to adulthood with physical, psychological and social changes, has been a public health issue having an increasing importance. Individual, cultural, social, traditional or religious factors play a great role in adolescent pregnancies which are among risky pregnancies. In the related studies, it is obviously stated that adolescent pregnancies, compared to adult pregnancies, have a higher prevalence of health risks such as premature delivery, low birth weight newborn, neonatal complications, congenital anomaly, problems in mother-baby bonding and breastfeeding, baby negligence and abuse. As a result, it is clear that adolescent pregnancies have negative effects on the health of children. Both the society and the health professionals have major responsibilities on this subject. Careful prenatal and postnatal monitoring of pregnant adolescents and providing of necessary education and support would have positive effects on both mother and child health. In this review, we have discussed affects of adolescent pregnancy on the health of a baby.
Maternal & Infant Risks Regarding Extreme Age of PregnancyAI Publications
Background: Extremes of maternal age are of considerable clinical and public health concern as it plays an important role in infant and maternal health. This study aims to determine the effect of extreme maternal age at pregnancy on a mother and infant’s health. Methods: The study was a cross-sectional analytical observational study, conducted on a pediatric outpatient clinic at Teaching Hospital, with a purposive sample of 450 mothers. A structured questionnaire was designed, which included socio-demographic data, factors related to pregnancy care, and factors related to the infant. Results: The main maternal health problem during pregnancy was anemia and pregnancy induced hypertension with a statistically significant association between the mother’s age and maternal morbidity. The main causes of baby admission into hospital were diarrhea and acute respiratory diseases, with a statistical significant. Conclusion: There was an agonizing correlation between extreme maternal age and infant health. A serious collaborative effort must be done between social worker in health facilities and community, to rise up awareness about the suitable age of marriage and reproductive health.
Rate of Different Types of Abortion in Madinah Maternity and Children Hospita...Crimsonpublishers-IGRWH
Rate of Different Types of Abortion in Madinah Maternity and Children Hospital, Madinah, Saudi Arabia by Mohammad Othman in Investigations in Gynecology Research & Womens Health
Risk Factors and Pregnancy Outcome of Preterm Laboriosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in
Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of signifi cance was 0.05.
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in
Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of significance was 0.05.
Background: Data regarding Gestational Diabetes Mellitus (GDM) and Depression in Bangladesh are inadequate. Though we have sufficient information on depression and diabetes especially during pregnancy but information about depression and gestational diabetes and the consequences are very scanty in Bangladesh. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression, and the outcome of pregnancy. GDM effects fetal growth is well stablish but whether and how depression aggravates the condition was another specific objective to find out from this study. Mode of delivery, fetal morbidity and mortality and postpartum depression as a consequent was also tried to explore. Moreover this study focused on other principal social factors which might have infl uence over this condition
Adolescent pregnancy continues to be a grave problem in India not only from the obstetrical point of view but from the social and economical perspectives also. Complications of pregnancy and childbirth are the leading cause of mortality among women between the ages of 15 and 19 in the developing world.
Murgano 2019 Outcome of twin‐to‐twin transfusion syndrome in monochorionic mo...Võ Tá Sơn
Murgano 2019 Outcome of twin‐to‐twin transfusion syndrome in monochorionic monoamniotic twin pregnancies: a systematic review and meta‐analysis
Hội chứng truyền máu cho nhận trong song thai một bánh nhau, một buồng ối
BLACK LIVES MATTER:
The latest Abortion report issued from the CDC in 2014. Displays that Black women (14% of the US population) make up 29.6 % of the nations abortions.
The effects of adolescent pregnancies on child health are discussed in this paper. In recent decades adolescent pregnancy has become an important health issue in many countries, both developed and developing. According to WHO data in 2010, there are nearly 1, 2 billion adolescents in the world, which consists of 20% of the world population. 85% of these adolescents live in developing countries. A pregnancy in adolescence, which is a period of transmission from childhood to adulthood with physical, psychological and social changes, has been a public health issue having an increasing importance. Individual, cultural, social, traditional or religious factors play a great role in adolescent pregnancies which are among risky pregnancies. In the related studies, it is obviously stated that adolescent pregnancies, compared to adult pregnancies, have a higher prevalence of health risks such as premature delivery, low birth weight newborn, neonatal complications, congenital anomaly, problems in mother-baby bonding and breastfeeding, baby negligence and abuse. As a result, it is clear that adolescent pregnancies have negative effects on the health of children. Both the society and the health professionals have major responsibilities on this subject. Careful prenatal and postnatal monitoring of pregnant adolescents and providing of necessary education and support would have positive effects on both mother and child health. In this review, we have discussed affects of adolescent pregnancy on the health of a baby.
Maternal & Infant Risks Regarding Extreme Age of PregnancyAI Publications
Background: Extremes of maternal age are of considerable clinical and public health concern as it plays an important role in infant and maternal health. This study aims to determine the effect of extreme maternal age at pregnancy on a mother and infant’s health. Methods: The study was a cross-sectional analytical observational study, conducted on a pediatric outpatient clinic at Teaching Hospital, with a purposive sample of 450 mothers. A structured questionnaire was designed, which included socio-demographic data, factors related to pregnancy care, and factors related to the infant. Results: The main maternal health problem during pregnancy was anemia and pregnancy induced hypertension with a statistically significant association between the mother’s age and maternal morbidity. The main causes of baby admission into hospital were diarrhea and acute respiratory diseases, with a statistical significant. Conclusion: There was an agonizing correlation between extreme maternal age and infant health. A serious collaborative effort must be done between social worker in health facilities and community, to rise up awareness about the suitable age of marriage and reproductive health.
Rate of Different Types of Abortion in Madinah Maternity and Children Hospita...Crimsonpublishers-IGRWH
Rate of Different Types of Abortion in Madinah Maternity and Children Hospital, Madinah, Saudi Arabia by Mohammad Othman in Investigations in Gynecology Research & Womens Health
Risk Factors and Pregnancy Outcome of Preterm Laboriosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in
Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of signifi cance was 0.05.
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in
Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of significance was 0.05.
Background: Data regarding Gestational Diabetes Mellitus (GDM) and Depression in Bangladesh are inadequate. Though we have sufficient information on depression and diabetes especially during pregnancy but information about depression and gestational diabetes and the consequences are very scanty in Bangladesh. This comparative, longitudinal research study was done to better understand the relationship between gestational diabetes and depression, and the outcome of pregnancy. GDM effects fetal growth is well stablish but whether and how depression aggravates the condition was another specific objective to find out from this study. Mode of delivery, fetal morbidity and mortality and postpartum depression as a consequent was also tried to explore. Moreover this study focused on other principal social factors which might have infl uence over this condition
Adolescent pregnancy continues to be a grave problem in India not only from the obstetrical point of view but from the social and economical perspectives also. Complications of pregnancy and childbirth are the leading cause of mortality among women between the ages of 15 and 19 in the developing world.
Murgano 2019 Outcome of twin‐to‐twin transfusion syndrome in monochorionic mo...Võ Tá Sơn
Murgano 2019 Outcome of twin‐to‐twin transfusion syndrome in monochorionic monoamniotic twin pregnancies: a systematic review and meta‐analysis
Hội chứng truyền máu cho nhận trong song thai một bánh nhau, một buồng ối
BLACK LIVES MATTER:
The latest Abortion report issued from the CDC in 2014. Displays that Black women (14% of the US population) make up 29.6 % of the nations abortions.
Similar to maternal-morbidity-of-adolescent-pregnant-women.pdf (20)
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. 10
ORIGINAL research
CA Paniagua Coahuila et al. Moldovan Medical Journal. December 2021;64(6):10-12
Introduction
According to the World Health Organization (WHO),
an average of 16 million adolescents, between 15 and 19
years of age, account for 11% of annual births worldwide.
The WHO defines adolescence as the period of human de-
velopment between childhood and adulthood (early adoles-
cence: 10-14 years and late adolescence: 15-19 years) [1].
In Mexico, it is estimated that the adolescent population
represents just over 18% of the total population and 29%
of the population of childbearing age; the main biological
problem of adolescent pregnancy is the lack of maturity
for gestation. A determining factor of reproductive health
in adolescents is reflected in the first trimester, when there
is the importance of transgenerational events that make it
possible to reduce the main diseases that affect pregnancy,
such as diabetes, hypertension, cancer, preeclampsia, pre-
maturity, intrauterine growth restriction, etc. [2].
Complications during pregnancy and childbirth are the
second leading cause of mortality worldwide in this popula-
tion. In this regard, the WHO reports that 830 women die
daily from these complications and that 95% of them occur
https://doi.org/10.52418/moldovan-med-j.64-6.21.02
UDC: 618.3-053.6
Maternal morbidity of adolescent pregnant women
1
Carlos Arturo Paniagua Coahuila, 1
José Anaya Herrera, 2
Dulce Alejandra Alonso Lozano,
1
Lenny Piña Guerrero, 3
Raúl Alejandro Miranda Ojeda, *1,3
Hugo Mendieta Zerón
1
Obstetrics and Gynecology Department, Mónica Pretelini Sáenz Maternal-Perinatal Hospital, Toluca, Mexico
2
Gynecology and Obstetrics Hospital, Mother-Child Institute of the State of Mexico, Toluca, Mexico
3
Research Unit, Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Mexico
Authors’ ORCID iDs, academic degrees and contributions are available at the end of the article
*Corresponding author – Hugo Mendieta Zerón, e-mail: drmendietaz@yahoo.com
Manuscript received October 18, 2021; revised manuscript December 03, 2021; published online December 17, 2021
Abstract
Background: In Mexico, it is estimated that the adolescent population represents 29% of the population of childbearing age. The present study aimed to
analyze the obstetric results of 3310 adolescent pregnant women attended in a third level hospital.
Material and methods: All records of pregnant women aged 19 years or less up to the date of admission were analyzed at the Mónica Pretelini Saenz
Maternal Perinatal Hospital during the period from January 2018 to June 2020, with the following variables: age, pregnancy, resolution obstetric, severe
preeclampsia, preeclampsia and gestational hypertension.
Results: A total of 13874 pregnant women were attended, of which 3310 (24%) patients were adolescents. The overall frequency of obstetric complications
was 21%, including obstetric hemorrhage (13%) and hypertensive disorders of pregnancy (8%). Regarding postpartum obstetric hemorrhage events,
classified according to the Advanced Trauma Life Support shock scale, they were categorized as Grade 1 – 338 cases, Grade II – 76 cases, Grade III – 11
cases and Grade IV – 1 case. Hypertensive disorders of pregnancy highlight preeclampsia as the most frequent with a total of 97 cases, followed by 89
cases of severe preeclampsia, 58 cases of gestational hypertension, 14 cases of chronic hypertension and 3 cases of chronic hypertension with preeclampsia.
Conclusions: The main complications found in the Mexican pregnant adolescent population were obstetric hemorrhage, which was more frequent in
the population aged 15 to 19 years, and hypertensive disorders, which occurred more frequently in the population aged 9 to 14 years.
Key words: adolescence, maternal morbidity, preeclampsia.
Cite this article
Paniagua Coahuila CA, Anaya Herrera J, Alonso Lozano DA, Piña Guerrero L, Miranda Ojeda RA, Mendieta Zerón H. Maternal morbidity of adolescent
pregnant women. Mold Med J. 2021;64(6):10-12. https://doi.org/10.52418/moldovan-med-j.64-6.21.02.
---------------------------------------------------------------------------------------------------------------------------------------------------------
in developing countries [3]; in Latin America, almost half of
the female population has had at least one delivery before
the age of 20 years [4].
In the same line, the National Institute of Statistics,
Geography and Informatics (INEGI), in 2018 published the
data informing that in Mexico 17.5% of births are to teen-
age mothers; and teenage pregnancy continues to be one
of the main contributors to maternal and infant mortality.
Complications of pregnancy and childbirth are the leading
cause of death among girls aged 10-19 years worldwide [5,
6].
Adolescent mothers (aged 10-19 years) face higher risks
of eclampsia, puerperal endometritis, and systemic infec-
tions than women aged 20-24 years [4]. Besides, about 3.9
million unsafe abortions occur among girls aged 13 to 19
years each year, contributing to maternal mortality and
long-lasting health problems [7]. Also, the emotional, psy-
chological, and social needs of pregnant adolescents may be
greater than those of other women.
Early childbearing can increase risks for newborns as
well as for young mothers. In low- and middle-income
2. 11
ORIGINAL research CA Paniagua Coahuila et al. Moldovan Medical Journal. December 2021;64(6):10-12
countries, babies born to mothers younger than 19 years
face increased risks of low birth weight, preterm delivery,
and serious neonatal conditions [4]. In some settings, rapid
repeated pregnancy is common for young mothers, present-
ing additional risks to both mother and child [8].
Some research has concluded that these adverse events
are due to age, and even to biological immaturity that may
predispose very young mothers to subclinical infections; to
an increase in the production of prostaglandins, with a con-
sequent increase in the incidence of preterm delivery and
fetal growth restriction [9, 10]. The present study had the
purpose of analyzing the obstetric outcomes of adolescent
pregnant women attended in a third level hospital in Toluca,
Mexico.
Material and methods
This was a retrospective and descriptive study of patients
admitted to the Mónica Pretelini Sáenz Maternal Perinatal
Hospital (MPSMPH), Health Institute of the State of Mexico
(HISM), Toluca, Mexico.
All the records of pregnant women aged 19 years from
January 2018 to June 2020 were analyzed with the follow-
ing variables: age, gestation, obstetric resolution, severe pre-
eclampsia, preeclampsia, and gestational hypertension.
The present study followed the ethical principles of hu-
man research stipulated in the Declaration of Helsinki [11]
and was considered risk-free since only information from
the hospital databases was collected. The ethics committee
MPSMPH, approved the protocol (code: 2021-03-721).
The descriptive analysis was performed according to the
nature of the variables: continuous variables were expressed
as means and medians with standard deviation, while cate-
gorical variables were summarized as frequencies and per-
centages. Also, a measur were used for continuous variables.
All statistical analyses were performed using the SPS® pro-
gram, version 23.0.
Results
During the time of this survey, 13874 pregnant women
were attended in the MPSMPH, of which 3310 patients were
adolescents (24%). The median age was 17 years (range 9
to 19 years), 42.5% of the patients were between 17 and
18 years old, however, 908 patients were younger than 15
years old and there was a record of 4 patients aged 9 years.
59% (1952) resolved the pregnancy vaginally, 33% (1081)
through the abdominal route, and 8% (277) underwent
uterine evacuation.
The overall frequency of obstetric complications was
21%, including obstetric hemorrhage (13%) and hyperten-
sive disorders of pregnancy (8%); but there were no mater-
nal deaths. The diagnosis of hypertensive disorders of preg-
nancy was made according to the time of onset of clinical
data, gestational age of onset, and biochemical alterations.
The most frequent diagnosis was preeclampsia with a total
of 97 cases, followed by preeclampsia with a severity of 89
cases, gestational hypertension – 58 cases, chronic hyper-
tension with 14 cases, and chronic hypertension with added
preeclampsia with 3 cases. It should be noted that there were
no cases of eclampsia, as well as admissions to the Obstetric
Intensive Care Unit (O-ICU) with a total of 256 cases.
As for postpartum obstetric hemorrhage events, classi-
fied according to the Advanced Trauma Life Support shock
scale, they were categorized only according to the estimated
amount of loss: Grade I with a total of 338 cases, Grade II
with 76 cases, Grade III with 11 cases, and Grade IV with
only 1 case that was sent to the O-ICU.
Discussion
Compared to other Latin American countries, the tim-
ing of sexual debut in Mexico is later [12]. However, 15%
of our population were between 9 and 16 years old; thus, it
can be affirmed that there are indicative data that the sexual
life beginning of the Mexican population is moving to early
ages. The results of this study may be useful, for example,
to estimate at what age it is convenient to vaccinate young
people against human papillomavirus or to know when it
is the right time to include information on family planning
methods.
It was documented that the resolution of pregnancy
was 59% vaginally, which is consistent with the findings of
Amaya J. [9] and Fory JL. [10], where 33% of pregnancies
were resolved by cesarean section; disagreeing with a study
conducted in Nepal by Maharjan M. et al. [13], where they
studied 2050 pregnant adolescents and reported a cesarean
section rate of 11.9%, well below our results; the variation
could be because this study was conducted in a rural hospi-
tal. According to the Nepal Demographic Health Survey in
2016, the total cesarean section in adolescents constituted
24%; adolescent pregnancy is higher in South Asian coun-
tries due to the common practice of early marriage and the
social expectation of having a child soon after marriage.
Garcia-Salgado A. et al. in 2019 [14] mentioned that
adolescent pregnancy carries a five times higher risk of ma-
ternal mortality compared to adult pregnant women; how-
ever, at the MPSMPH adolescent maternal deaths in the
period from January 2018 to June 2020 were not confirmed;
attributing it to the interdisciplinary management of this
unit. The results of the present study show that adolescent
pregnancy is associated with complications due mainly to
obstetric hemorrhage and hypertensive disorders of preg-
nancy, these findings are consistent with those reported in
the literature consulted [10, 14-18].
Finally, eight percent of the pregnant adolescents pre-
sented hypertensive diseases; most frequently preeclampsia
(97) and preeclampsia with severity (89); studies show that
adolescents of younger ages (< 15 years) seem to be the most
prone to suffer from this complication [14, 17].
Although no statistically significant differences were
observed in the present study concerning the frequency of
threatened abortion, urinary tract infections, gestational
diabetes, and ectopic pregnancies, a higher frequency of
obstetric hemorrhage episodes were detected, representing
13% of pregnant adolescents, in agreement with studies con-
ducted in populations, such as Argentina, Guatemala, India,
Kenya, Pakistan and Zambia [17] and international, multi-
3. 12
ORIGINAL research
CA Paniagua Coahuila et al. Moldovan Medical Journal. December 2021;64(6):10-12
center registries from countries with limited resources [19].
Conclusions
The main complications encountered in Mexican preg-
nant adolescent population were obstetric hemorrhage,
which was more frequent in the population aged 15-19
years and hypertensive disorders, which occurred more fre-
quently in the population aged 9-14 years.
Current health programs have privileged the care of
children and the elderly, leaving the adolescent population
uncovered.
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Authors’ ORCID iDs and academic degrees
Carlos Arturo Paniagua Coahuila, MD, PhD, Professor – https://orcid.org/0000-0002-4551-0923
José Anaya Herrera, MD – https://orcid.org/0000-0002-1804-1017
Dulce Alejandra Alonso Lozano, MD – https://orcid.org/0000-0003-2023-0498
Lenny Piña Guerrero, PsychoD – https://orcid.org/0000-0003-4264-9089
Raúl Alejandro Miranda Ojeda, MD Student, Research Assistant – https://orcid.org/0000-0003-1896-9648
Hugo Mendieta Zerón, MD, PhD, Professor – https://orcid.org/0000-0003-3492-8950
Authors’ contribution
CAPC conceptualized the project and designed the research, collected the data and drafted the manuscript; JAH interpreted the data and drafted
the manuscript; DAAL interpreted the data, drafted the manuscript and revised the manuscript critically; LPG collected the data; RAMO
revised the manuscript critically; HMZ made statistical analysis, drafted the manuscript and revised the manuscript critically. All the authors
revised and approved the final version of the manuscript.
Funding
Self-funding.
Ethics approval and consent to participate
This study was approved by the Research Ethics Committee of Mónica Pretelini Sáenz Maternal-Perinatal Hospital, Toluca, Mexico (the protocol
code: 2021-03-721).
Conflict of interests
No competing interests were disclosed.