European Journal of Molecular & Clinical Medicine

Background: Standard assessment of renal function in pregnancy is by measurement of
serum creatinine concentration yet normal gestational ranges have not been established.
The aim of this systematic review was to define the difference in serum creatinine in a
healthy pregnancy compared with concentrations in non-pregnant women to facilitate
identification of abnormal kidney function in pregnancy.
Materials and Methods: The study was performed on 70 pregnant women. Out of which
35 women were pregnancy induced hypertensive and 35 were normal pregnant women.
Results: The result showed significantly high blood pressure (SBP-197.21±21.7 VS
187.28±8.69, DBP 124.36±9.41 VS 99.2±6.28) and Blood urea (42.31 ±7.81 mg% VS
41.30±9.29 mg%), serum creatinine (3.45 ±1.19 mg% VS 3.18±1.38 mg%), serum uric
acid level (9.89±3.16 mg% VS 7.34±0.9 mg%) in pregnancy induced hypertensive
women compares to normal pregnant women. In the present study, in pre-eclampsia,
there is elevation of serum uric acid and serum creatinine elevated values are
statistically significant.
Conclusion: There is a renal derangement of parameters in preeclampsia so it may be
advised to renal function test to confirm involvement of renal dysfunctions.
Measurement of renal function Test could be used as a biochemical indicator in
pregnancy induced hypertensive women.

Background:Health & nutritional status of mother during & before pregnancy is
considered to be strongly associated with pregnancy outcomes. Poor nutritional status
& inadequate intake of food in pregnancy not only affect women’s health but also effect
birth weight & development of infant. The present study was conducting to analyse the
outcomes of maternal nutrition on infant's birth weight.
Material and methods: The present cross-sectional study was conducted among 350
pregnant women. Socio-demographic characteristics and obstetrics information of the
pregnant women were collected using pretested questionnaires. Anthropometric
measurements were carried out using appropriate measuring instruments. All statistical
analyses were performed using SPSS version 20. Multiple linear regressions analysis
was also performed to explore independent effects of maternal factors. A p value< 0.05
was considered to be significant.
Results: In this study, the mean weight and height of pregnant women were 63.25kg and
156.32cm, respectively. Overall, the mean pre-pregnancy BMI of the study participants
was 24.43kg/m2. The study also revealed that the mean weight gain of the mothers was
9.45kg, within the weight gain range of 4–16kg. The mean maternal hemoglobin level
was 11.76g/dL. Moreover, the mean total serum cholesterol level of the mothers was
187.32mg/dL. Maternal blood sample analysis also revealed that the mean total serum
protein level was 5.70g/dL, with 81.42% and 18.58% of women having total protein
level less than 6.7 g/dL and between 6.7 and 8.7 g/dL, respectively. In multivariate
linear regression analysis, birth weight was significantly associated with parity,
maternal BMI, weight gain during pregnancy, hemoglobin level.
Conclusion: The present study concluded that birth weight was significantly associated
with parity, maternal BMI, weight gain during pregnancy, hemoglobin level. Therefore,
nutritional status of the pregnant women should be improved to reduce the risk of low
birth weight.

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Background: Measurement of serum free T4 concentrations and TSH is helpful in
assessing thyroid function. During the first trimester of pregnancy, free T4 levels
measured by analog immunoassays may be unreliable, as measurements using 2
different assays were not reproducible. The present study was conducted to assess
thyroid functions in early pregnancy.
Materials & Methods:
Results: Age group 18- 21 years had 28, 22-25 years had 25, 26- 29 years had 20 and 30-
33 years had 7 patients. Subclinical hypothyroidism was seen in 20, euthyroidism in 4,
overt hypothyroidismin 8, subclinical hyperthyroidism in 45 and overt hyperthyroidism
in 3. The mean TSH (mIU/l) in subclinical hypothyroidism was 4.31, in euthyroidism
was 1.48, in overt hypothyroidism was 10.32, in subclinical hyperthyroidism was 0.016
and in overt hyperthyroidism was 0.06. The mean FT3(pg/ml) level in subclinical
hypothyroidism, euthyroidism, overt hypothyroidism, subclinical hyperthyroidism and
overt hyperthyroidism was 4.08, 3.94, 1.54, 4.2 and 7.52 respectively. The mean
S.FT4(ng/dl) level in subclinical hypothyroidism, euthyroidism, overt hypothyroidism,
subclinical hyperthyroidism and overt hyperthyroidism was 1.20, 1.28, 0.48, 1.6 and 4.2
respectively.
Conclusion: The high prevalence of thyroid disorders in pregnant women makes it
necessary to screen all the pregnant women in early pregnancy.

Fetal growth restriction (FGR) is a pathological condition in which a fetus has not achieved his genetic growth potential, regardless of fetal size (1) Worldwide FGR is observed in about 24% of newborns; approximately 30million infants suffer from FGR every year. The burden of FGR is concentrated mainly in Asia which accounts for nearly 75% of all affected infants. National neonatal perinatal database of India reported the incidence of FGR to be 9.65% among hospital born live birth infants. Study was conducted for all cases with clinical/ Sonological term FGR admitted under department of OBG. A detailed history as per questioner will be taken with general physical examination and investigations will be done as per requirement. The accumulated data was evaluated and statistically analyzed. In the present study 70 patients with term gestation with FGR were recruited. Maternal (74.28%) was the commonest cause followed by Idiopathic (11.43) and Placental (10%) and Fetal (4.29%) causes. Among Maternal causes Pre Eclampsia was found to be in 50% cases. Most of the patients (50.7%) required caesarean section. A total of 9 (12.86%) neonate had birth weight of <1.5 kg, 48.6% had Birth weight between 1.6 to 1.9kg, 38.5% had birth weight between 2-2.4kg and 95.8% had asymmetrical FGR, 4.2% were symmetrical. 26 (40%) neonates had morbidity with 17(24.3%) neonatal mortality with Respiratory distress syndrome (41.18%) being most common cause. No Maternal Mortality.

Background:Cardiac disease is an important cause of maternal mortality and morbidity
both in ante partum and postpartum period. The overall incidence of heart disease in
pregnancy is <1%. Objective of present study was to determine maternal outcome in
pregnant women with heart diseases in terms of fetal complication, maternal
complication and Mode of delivery. Aims: The aim of this study is to evaluate the
influence of biological factors inPerinatal Outcome in Heart Disease Complicating
Pregnancy.
Materials and Methods: This study wasconducted between January 2018 to
Decmber2021,ina tertiary care centre, SVIMS, Sri Padmavathi Medical college for
women. It is a retrospective observational study. Sample size is 55.
Results: In the present study, age distribution varied from 20-40 yrs. majority of women
(52.72%) are in the age group 20-25 years, followed by 23.63% in the age group of 26-30
years, 12.72% in the age group 31-35 years and 1.81% in the age group 36-40 years.
90.90% of cases are booked cases and 9.10% of cases are booked cases.
Conclusion: Preconceptional counselling, accurate risk assessment, regular antenatal
checkups,prevention, early recognition and aggressive treatment of complications
during pregnancy are crucial in reducing themorbidity. Surgical correction of the
cardiac lesion prior to pregnancy is associated with better pregnancy outcome.

Background: Acute Kidney Injury (AKI) is the sudden loss of renal function. Multiple causes of AKI exist that include those that afflict the general population, and those that are associated with pregnancy. AKI in pregnancy is of particular challenge as there are physiological alterations of renal function in pregnancy. The diagnosis is by abnormalities of renal function tests in addition to the abnormalities reflecting underlying pathologies. Management depends on underlying causes and the prognosis can often be positive.
Material and methods: We present three cases of AKI in pregnancy, their evaluation and management.
Results: The first patient had AKI due to septic abortion and was treated by dialysis. The second patient had AKI due to preeclampsia with severe features and was treated by termination of pregnancy and multiple anti-hypertensives. The third patient had AKI due to hyperemesis gravidarum and was treated aggressively with fluids and anti-emetics.
Conclusion: Early recognition and initiation of appropriate therapy can lead to favourable outcomes in AKI.

Background: Asthma attack is the most common respiratory symptom observed and is of great concern. Throughout the world asthma cases are increasing during pregnancy. The major issue is that the control levels of asthma is changing during pregnancy so the management is a little difficult during pregnancy.
Objective: The present study was undertaken to observe the prevalence of asthma and respiratory symptoms during pregnancy.
Materials and methods: 40 pregnant women attending OPD in the hospital were part of the study after obtaining the written informed consent. Confidentiality of the data was maintained. Willing pregnant women were included in the study. Pregnant women with any other complications severe were excluded from the study. Respiratory symptoms were examined during the general physical examination by an expert physician.
Results: The age group of the participants ranges from 22-30 years. 25% of individuals have asthma. 37.5% of individuals have wheeze without cold, 15% of individuals have nasal allergies. 27.5% have shortness of breath. 5% of individuals have a history of smoking. 15% of individuals are currently under the medication for asthma.
Conclusion: The present study results explained that wheezing without cold and shortness of breath are the most common respiratory symptoms during pregnancy. Further detailed studies with a higher sample size are recommended to understand better the respiratory symptoms during pregnancy.

Background: Preeclampsia isa state of insulin resistance. Insulin resistance features like
Hypertension, hyperinsulinemia, glucose intolerance, and lipid abnormalities are
associated with pregnancy-induced Hypertension.
Aimsandobjectivesofthestudy:
1. Tostudyinsulinresistanceinwomenwith pre-eclampsia.
2. TocompareandevaluatetheroleofmeasuringIR amongwomenwith
preeclampsiaandnormalpregnancy.
Methodology: AProspectiveandobservational one year study conducted in
GovernmentGeneralHospital.Kurnool. Atotalof 50Womenwith
preeclampsiaand50women withnormalpregnancy. Women were instructed for 12hrs
overnight fasting about 2ml of venous blood was collected in a
fluorideethylenediaminetetraacetic acid vial using proper aseptic precautions. Plasma
was separated by centrifugationand usedforestimationof
plasmaglucoseandplasmainsulinlevels. Values are presented as mean ± standard deviation
(SD) and the statistical analysis was done using SPSS 17.0software. Student’s unpaired ttest
was used for comparison of parameters between two groups. The p-value
oflessthan0.05was consideredas statistically significant.

Background: The objectives is to Screening of all the antenatal pregnant women for
thyroid dysfunction, To study the maternal and fetal noutcome in pregnancy thyroid
dysfunction, To provide adequate treatment and there by reduce adverse outcome,
Follow up of cases six weeks post partum.
Materials and Methods: Prospective, observational study. 110 patients were included.
The study was conducted at Department of Obstetrics and Gynecology (OBG), Modern
Govt MaternityHopsital, Petlaburz attached to Osmania Medical College, Hyderabad,
Telangana, India during the period from 1st December 2019 to 30th June 2021.Mothers
attending for ante-natal check-up and having either a detected or documented thyroid
dysfunction. An Institutional Ethics Committee approval was obtained. Written
informed consent was obtained from all the study participants. The mothers during
their first visit were included for detailed history, clinical examination and blood
investigations as follows.
Results: No age related influence in the presence of thyroid dysfunction, there was no
statistical significance. it was observed that 68% of abortions were in primigravida, it
was found that with increase in gravida abortion rate was less. the mode od delivery
had no significant variations in both hypo/hyperthyroidism. it was noted that
subclinical hypothyrid and overt hypothroid cases resulted in more preterm deliveries
than hyperthyroid patients.the study showed no significance difference in newborn
thyroxine levels among thyroid dysfunction groups.
Conclusion: The study showed that thyroid dysfunction is more among the pregnant
women. Hypothyroidism is the major thyroid dysfunction among the antenatal women.
The women with thyroid dysfunction had more incidents of adverse outcomes of
pregnancy like increased abortion rates, caesarean deliveries on the mothers and
preterm babies and lbw on the newborn.

Background: In pregnancy, anaemia has a significant impact on the health of fetus as
well as that of mother. It is one of the leading causes responsible for maternal and
perinatal morbidity and mortality. The objectives of the study are to find out the effect
of severe anaemia on women in labour affecting maternal and fetal outcome.
Materials and Methods: This a prospective case control study undertaken in the
Department of Obstetrics and Gynaecology, Govt Maternity Hospital, Petlaburz
attached to Osmania Medical College, Hyderabad. The period of study was from 1st
December 2019 to 31st December 2021.There were a total of 160 study subjects, 80 cases
of severe anaemia (Hb<7gm %) and 80 non anaemic controls (Hb≥ 11gm %).
Results: Low socio economic status (86.25%), inadequate antenatal care (38.75%),
multiparity (71.25%) and no iron supplementation (52.5%) were associated with severe
anaemia cases. Microcytic hypochromic anaemia was more prevalent (76.25%),
suggesting nutritional inadequacies as a cause of anaemia. It was seen that the incidence
of preterm labour (22.5%), atonic PPH (2.5%), sub involution of the uterus (2.5%),
CCF (1.25%), abruptio placentae (1.25%) and maternal mortality (1.25%) was more in
cases of severe anaemia than in the control group. Adverse fetal outcome in the form of
preterm birth (22.5%), low birth weight babies (41.25%), IUGR (13.75%), birth
asphyxia (11.25%), and perinatal mortality (11.25%) was more in the anaemic group
than the controls.

Background:To determine the number of women with asymptomatic bacteriuria
(Group A) and the number of women with symptomatic bacteriuria (Group B) (Group
B). To identify the most common pathogenic organism in women with asymptomatic
bacteriuria. To compare the outcomes of pregnancies in groups A and B (maternal and
foetal morbidity).
Materials and Methods: Pregnant women visiting the antenatal clinic of the Department
of Obstetrics and Gynecology in Govt Medical College/General Hospital Suryapet for
the first time in 20 weeks to 36 weeks were the subjects of this prospective study.
Results: The study included 250 pregnant women starting at 20 weeks of gestation.
Urine culture and sensitivity testing were performed to check for asymptomatic
bacteriuria. Asymptomatic bacteriuria was found in 8.8 percent of the study population.
E.Coli was the most common pathogen, accounting for 63.63 percent of all cases.
Asymptomatic bacteriuria was associated with increased maternal morbidity (18.18
percent ). Those who did not have asymptomatic bacteriuria had lower morbidity (9.1
percent ). Fetal morbidity was higher (21.4 percent) in kids whose mothers had
asymptomatic bacteriuria than in those whose mothers did not have silent bacteriuria
(9.3 percent ). Preterm labour was the most prevalent maternal morbidity (18.18
percent), while low birth weight was the most common foetal morbidity (18.18 percent ).
There was no maternal or foetal death.

Objective: To study the Feto maternal outcome of Covid-19 in Pregnancy.
Methodology: This is a retrospective study done on 53 pregnant patients who tested positive
for SARS-CoV-2 and were delivered in D. Y. Patil Hospital, Kolhapur from April 2020 to
July 2020. Maternal and fetal characteristics and the outcome of Covid-19 infection in
pregnancy was studied.
Results: Among the 53 patients, 49 patients (92%) were asymptomatic. Remaining presented
with fever, sore throat, cough. 69% were primigravida and 30% were multigravida. 66%
underwent LSCS while 28% were delivered normally. In majority, LSCS was done for
oligohydramnios and fetal distress. All the patients were discharged after negative swab
report and no maternal death was reported. About 32% of neonates required NICU admission
for hyperbilirubinemia, pneumonia and sepsis. There was no neonatal death and none of the
neonates turned out to be positive for covid-19.
Conclusion: The severity of SARS-CoV-2 was seen to be mild to moderate in pregnant
women. Majority of the women infected with coronavirus disease were asymptomatic. The
risk of vertical transmission to the neonate was also found to be low. Oligohydramnios and
fetal distress were commonly seen in the patients, pointing towards the lack of antenatal
follow up visits due to restricted mobility in the covid era.

Background &Method: To evaluate the maternal outcomes through ABG index and its
influence on new-borns through Apgar scoring. Role of arterial blood gas values and their
implications to patient management.A total of 130 women with PIH syndrome were treated in
Department of Obstetrics and Gynaecology of IMCHRC, Indore, over a period of 12 months
Result:In this study, 66.10% PIH patients improved by conservative management, whereas
33.88% required ventilatory support of which 5.08% died on mechanical ventilation.
Amongst which maximum patients which succumbed showed decompensated metabolic
acidosis at 0 hr ABG.In this study, the mean pH value, PO2, HCO3 in severe PIH cases were
lower than the mild PIH cases, whereas the mean PCO2 and BE levels in severe PIH cases
were higher than the mild PIH cases. Therefore, with the exerbation of the disease,the
differences of indexes from normal values became larger.

Background: Pre-pregnancy obesity is strongly associated with certain pregnancy
complications and perinatal conditions. Placental structure and function are important
for maternal and fetal health both during and after pregnancy. The aim of this study to
evaluate the effect of prelabour body mass index on the mode of delivery.
Materials and Methods: An hospital-based prospective study involving pregnant women
at term (33-37 weeks) admitted to gynaecology ward in district hospital Dholpur,
Rajasthan, India during one-year period. A total of 120 cases in the age group of 18-40
years included in the study. Patients were classified into 3 categories based on their first
trimester BMI. Category I included normal women (BMI 20- 24.9 kg/m2), Category II
included overweight women (BMI 25-29.9 kg/m2) and detailed history and clinical
examination including general physical, obstetrical and systemic examinations.
Category III included obese women (BMI >30 kg/m2). Data were analysed statistically
by Chi-square test of the dependence of variables and a p-value of less than 0.05 was
considered as statistically significant.
Results: Under anthropometric parameters, the differences in mean age, mean weight,
mean height and mean BMI among the three categories women were statistically
significant (p<0.001**), In this study, it was observed that overweight and obese women
were slightly older and short in stature when compared with women with normal BMI.
There was increased incidence of antepartum complications in Category III women as
compared to Category II and Category I women. The difference in the onset of labour
as well as mode of delivery among the three categories was statistically significant
(p<0.05*).
Conclusion: As obesity is a modifiable risk factor all attempts should be made to
maintain a normal BMI in women of childbearing age. Pre–pregnancy counselling,
health programme and appropriate multidisciplinary management should be done.

Background &Method: The present study was conducted with an aim to study incidence of patients with recurrent pregnancy loss with respect to antenatal patient &to identify the various etiological factorsin the Department of Obstetrics and Gynecology, M.G.M Medical College and M.Y Hospital, Indore. In this period 14564 antenatal patients were admitted both in routine and emergency hours of which 5660 were high risk pregnancies. 89 patients had recurrent pregnancy loss. Of these 62 patients selected. These patients were randomly selected including all age groups, parity, socioeconomic and educational status.

Aim: To determine the demographic profile of pregnant females with COVID-19 infection.
The outcome and prognosis in pregnant women with COVID-19 infection was also
evaluated.
Method and material:The study included 38 pregnant women with COVID-19 infection and
hospital admission for at least 24 hours. Cause of admission was classified as obstetric and
COVID-19-related. All the patients were COVID positive and were referred from other
centres/ hospital to this facility andwas admitted to this hospital for delivery. Primary
outcomes included maternal admission to intensive care unit (ICU), COVID-19 pneumonia,
maternal mortality. The information on socio-demographic factors, pre-gestational chronic
diseases (including cardiac, renal, endocrine, psychiatric, hematologic and autoimmune
disease, cancer and HIV)and mode of delivery was collected.
Results:The mean age of the patients was 28.8±6.2 years. The mode of delivery for
60.5%patients(23) was normal vaginal delivery and lower segmentcaesarean section in
39.5%(15) patients.94.7%(36) patients were asymptomatic in the present study. Maximum
patients in the present studywere hospitalized for 3-5 days.
Conclusion: COVID-19 infection was associated with higher rates of caesarean section in
pregnant women. However, COVID-19 cannot be considered as an indication for
caesareansectiondelivery. Patients with increased age have more days of hospitalization than
younger patient.

Background: Severe acute maternal morbidity has long-term ill effects on socioeconomic
condition and health of the females including excessive financial burden post-treatment
which may last lifelong to the desertion of females after hysterectomy considering the
inability to reproduce.
Aims: The present clinical trial was carried out to assess the incidence and various causes
leading to SAMM. Also, the trial was aimed at factors associated with the instance of nearmiss
cases or SAMM.
Materials and Methods: 82 SAMM cases and 4 maternal deaths were evaluated based on
the WHO criteria. The data were maternal deaths, demographic data, complications
encountered, gestational age at the time of SAMM, SAMM event time from admission
time, ICU admission, and associated organ failure/dysfunction. The collected data were
subjected to statistical evaluation and the results were formulated.
Results: Maternal death resulted from abdominal pain in 75% (n=3) and breathlessness in
25% (n=1) female. The disorders associated with SAMM were surgical cause,
haemorrhage, hypertension, indirect causes, and medical conditions respectively in 1.21%
(n=1), 32.92% (n=27), 63.41% 9n=52), 2.43% (n=2), and 18.29% (n=15) females. The
etiology of 4 deaths was due to 50% (n=2) deaths each from cardiac and respiratory
etiology in females with the gestational age of 30.10±2.14 weeks and 25.7±1.3 years of age.
Near-miss cases were 34.14% (n=28) due to compromised transport facility.
Conclusion: The present study concludes that severe acute maternal morbidity affects
significant females and is the leading cause of maternal death. The most common factor
associated with SAMM is in the present study was hypertension leading to morbidity
followed by hemorrhage, whereas, leading causes for morbidity were respiratory and
cardiac causes.

GENERALIZED DLE: Patients with generalized discoid lupus erythematosus are at a higher risk of progressing to systemic disease than those with a localized variant. Pregnancy is one of the factors that can trigger lupus erythematosus. There are only one case report published in online search that presented generalized discoid lupus erythematosus in pregnancy. We report a case of 24 year old female patient with 31-32 weeks of gestational age complained blackreddish patches accompanied by fine scales, slightly itchy and a little painful on the forehead,
cheeks, bridge of the nose, chin, ears, neck, chest, stomach, back, upper and lower extremities since ± 2 months before. ANA profile with positive result. The results of histopathologicaland dermoscopyexamination suitable with discoid lupus erythematosus. Results of the internal medicine department revealed a diagnosis of systemic lupus erythematosus. CONCLUSION:Management of DLE aims to improve general condition of patient, control the lesions, prevent of the development of further lesions; fetal growth abnormalities; preterm birth; neonatal lupus and fetal death.

To evaluate the maternal, fetal and neonatal complications in pregnant women with Covid-19 infection. Setting and design: A prospective descriptive study was carried out in Basrah Teaching Hospital, Iraq during the period 15/3/2020 till 1/11/2020. There were 135 infected pregnant women with Covid-19. The maternal information's were obtained included Age, parity, residence, travel history, gestational age at time of diagnosis. The pregnancy measures of interest were evaluated according to the severity of the disease, medical disease, history of antepartum hemorrhage, mode of delivery, type of delivery, post-natal complication and admission to
intensive care unit and maternal death. The neonatal outcomes of interest were fetal weight, neonatal Apgar
score, admission to neonatal intensive care unit and neonatal death. Results: The mild type of the disease was common (41.48%) in comparison to severe conditions (17.77%).

Purpose: To study indicators of central and peripheral hemodynamics in pregnant women with obesity of varying severity at a gestational age of 36-38 weeks.
Materials and Methods: To study hemodynamic parameters (heart rate, SDD, UI, SI, OPSS, CR, LVMI) in pregnant women with obesity of varying severity, 127 pregnant women (I, main group) aged from 23 to 34 years were selected obesity of varying severity with gestational age 36-38 weeks. The second (control) group consisted of 28 pregnant women of the same age and gestational age with normal body weight (body mass index from 19 to 24.9 kg / m2). The groups were identical in age, gestational age, which allowed for an objective and comparative assessment.

There are still many pregnant women and their families who are unable to do early detection of high risk pregnancies. The purpose of this study was to develop a family empowerment model for the early detection ability of high-risk pregnancies.An explanatory survey research with a cross sectional study approach. The study population was the family of pregnant women in the Surabaya area who were taken using the rule of thumb with a sample size of 120 respondents using systematic random sampling. The latent variables in this study are personal factors, cognitive behavior, resource factors, interpersonal, basic values (Fillial Values), commitment, and family ability in early detection of high risk pregnancies, as measured by using a questionnaire. Latent variables that affect family empowerment consist of data analysis using Structural Equation Modeling (SEM) -Partial Least Squares (PLS).The results showed that the family empowerment model for the early detection ability of high-risk pregnancy was a fit model. This refers to the results of the goodness of fit test. Personal factors towards interpersonal (T statistics = 10,301; P = 0,000), interpersonal towards Fillial Value (T statistics = 13,501; P = 0,000), Fillial Value for commitment (T statistics = 9,495; P = 0,000), family commitment to early detection ability of high risk pregnancy (T statistics = 3,840; P = 0,000).The results of this study provide information about family empowerment models in high-risk pregnancies so that they can be used as a reference in preparing midwifery care plans in cases of maternal emergencies for high-risk pregnant women.

Background:Gestational diabetes mellitus (GDM) becomes common cases over the globe. GDM prevalence is counted as 1-3% out of all pregnancies in the west and 90% of them are complicated by diabetes. GDM is related with the increasing of maternal risk and short-time or long-term perinatal complication.GDM incidents in Indonesia are identified around 1,9-3,6% and around 40-60% women, who ever experienced with GDM, on the further observation after labouring will have diabtes melitus or glucose tolerance disorder. This research is aimed to identify the mother’s experience in GDM self-management.
Methods: This research is a qualitative research with phenomenology approach. This research was conducted on October 2018 – June 2019. The data were collected by employing interview that supported by documentation study over 8 mothers who had GDM interview and 3 midwives in charge at the KIA poly service. The data were analyzed by using thematic analysis.
Results: Qualitative analysis resulted five themes that cover nutrition management, education, glucose monitoring, sports and medication. The results showed that pregnancy mother tried to control the eating pattern as suggested by the health-workers. The mothers should conduct routine glucose controlling, perform physical activity, such as regular walk, perform house works or pregnancy workout. The appropriate medication during the pregnancy involves insulin.
Conclusion: This research reveals mothers’ experiences in GDM self-management in terms of lifestyle. The result of the research could be a valuable guidance in developing comprehensive self-management service, by considering more on mother’s self-management. The necessities of more effective GDM counceling is required to ensure clear understanding about principal self-management for pregnant mothers, hence it could help mother in enhancing adaptation and ability in dealing with GDM. Besides, it could increase the alert towards the risks on pregnancy with diabetes mellitus. Hence screening examination on diabetes melitus.
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GDM prevalence is counted as 1-3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% 3% out of all pregnancies in the west and 90% of them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the incre of them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increof them are complicated by diabetes. GDM is related with the increasing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk asing of maternal risk and and short short -time or long time or longtime or longtime or longtime or long time or longtime or long time or long-term perinatal complication perinatal complication perinatal complicationperinatal complicationperinatal complication perinatal complicationperinatal complicationperinatal complicationperinatal complication perinatal complication .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia .GDM incidents in Indonesia are are are identified around 1,9 identified around 1,9 identified around 1,9 identified around 1,9 identified around 1,9identified around 1,9 identified around 1,9 -3,6% 3,6% and around 40 and around 40 and around 40 and around 40 and around 40and around 40 and around 40 -60% 60% 60% women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with women, who ever experienced with GDM, GDM, on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melituson the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus on the further observation after labouring will have diabtes melitus or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance or glucose tolerance disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self disorder. This research is aimed to identify the mother’s experience in GDM self -management.management.management.management. management.management.management.management.Methods: Methods: This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This research is a qualitative with phenomenology approach. This This This research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 research was conducted on October 2018 – June 2019. June 2019. June 2019. June 2019. June 2019. The da The da ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected ta were collected by by employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM employing interview that supported by documentation study over 8 mothers who had GDM interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by interview and 3 midwives in charge at the KIA poly service. The data were analyzed by using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis. using thematic analysis.Results:Results:Results: Results: Results: Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resultedQualitative analysis resulted Qualitative analysis resulted Qualitative analysis resultedQualitative analysis resulted five themes five themesfive themesfive themes five themesfive themesfive themesfive themes that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, that cover nutrition management, education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy education, glucose monitoring, sports and medication. The results showed that pregnancy mother tried mother tried mother tried mother tried mother tried mother tried mother tried mother tried mother tried to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating to control the eating pattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the health pattern as suggested by the healthpattern as suggested by the health pattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the healthpattern as suggested by the health pattern as suggested by the health-workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers workers. The mothers should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose should conduct routine glucose controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular controlling, perform physical activity, such as regular walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the walk, perform house works or pregnancy workout. The appropriate medication during the pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin. pregnancy involves insulin.Conclusion:Conclusion: Conclusion:Conclusion: Conclusion: Conclusion:Conclusion: This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self This research reveals mothers’ experiences in GDM self -management in termmanagement in term management in term management in termmanagement in termmanagement in termmanagement in term management in termmanagement in term s of lifestyle. of lifestyle. of lifestyle. of lifestyle. of lifestyle. of lifestyle. The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing The result of the research could be a valuable guidance in developing comprehensive selfcomprehensive self comprehensive self comprehensive selfcomprehensive selfcomprehensive selfcomprehensive selfcomprehensive self comprehensive selfcomprehensive self comprehensive self -management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self management service, by considering more on mother’s self 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considering more on mother’s self -management. 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The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. The necessities of more effective GDM counceling is required to ensure clear management. 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Pregnancy-reference levels of Subclinic hypothyroidism (SCH), along with normal level of serum thyroxine, are called high thyroid stimulation hormone level (TSH).
Autoimmune Thyroiditis is also common in patients of subclinical hypothyroidism. Subclinical Hypothyroidism in pregnancy is the cause of some adverse obstetric consequences. Changes in the metabolism of thyroid hormones during pregnancy needs to be kept in mind, while diagnosing thyroid abnormalities. There is a jump in the obstetric and neonatal results, like preterm delivery, miscarriage, fetal growth restriction, preeclampsia, gestational diabetes mellitus, low birth weight, abruptio placentae and poor Apgar scores at birth. Treatment with Cevothyroxine therapy may help reduce some of these adverse effects, however there is restricted evidence to provision it. The behavior of subclinical hypothyroidism should target maternal TSH concentrations of less than 2.5mIU/L. However there is a lack of recommendation for the official starting dose of levothyroxine. So, individualised low doses of levothyroxine can be started and thereafter titred to the maintain the TSH in the target level

The aim of our study was to retrospectively examine the history of childbirth and the quality of primary care for bleeding and evaluate the prescribed rehabilitation measures for women who have suffered postpartum hemorrhage and massive bleeding. The materials and methods of the study were 242 birth histories with postpartum hemorrhage for the last 6 years (2013-2018) in the city maternity hospital of Bukhara. The average age of the patients was 26.7 ± 1.2 years. The obstetric pathology leading to bleeding mainly consists of uterus hypotonia - 143 (59.1) and large fetus - 68 (28.1), and preeclampsia and DIOV are equal amounts - 33 (13.64). Only about 20% of women who had postpartum hemorrhage underwent early rehabilitation in the form of prescribing contraceptives.The aim of the research was to study the effectiveness of modern principles of stopping postpartum obstetric bleeding. From 127 cases of bleeding in 101 women (79.5%) the childbirth were with the operational method. With the development of blood loss was renderedstepwise ways to stop bleeding. During hemostasis of the bleeding, ligatures were imposed on the ovarian arteries and the ascending branch of the uterine artery for ischemicization of the uterus, which was effective in 30 (30%) women, and in 114 (89.7%) women managed to achieve organ-sparing tactics.

Purpose:This study was aimed to analyze the correlation of food security status and household food expenditure to nutritional status on pregnant women.
Research Methodology:This study was an observational study with crossectional design, conducted in PuskesmasWonosobo, Lampung Province, Indonesia on May 2020 - Augustus 2020. All of pregnant women who get Antenatal Care (ANC) on Puskesmas were carried out as samples. Food security status and household food expenditure data were measure by anamnesis and questionnaire. Nutritional status was asses by mid-upper arm circumference (MUAC) of pregnant women. Data was collected and then analyzed using SPSS 21 application.
Results:A total of 53 pregnant women, with age distribution on range of <18 years &>35 years (20 women) and 20-35 years (33 women) were analyzed in this study. Statistical analysis (Chi-Square) show the pregnant womens in malnutrition status with food insecurity were 3 women (75%) while pregnant women in good nutrition status with food insecurity only 3 women (6.1%) (p = 0.003). Correlation between house hold expenditure to nutritional status was analyzed by chi-square test, the result show all of pregnant women in malnutrition status (4 women) have lower house hold expenditure (p = 0.001).
Conclusion:This study clearly shows that more food security and level of household food expenditure will affect on nutritional status of pregnant women.

Purpose:This study was aimed to analyze the correlation of food security status and household food expenditure to nutritional status on pregnant women.This study was aimed to identify the significant effect of the determinants factor of maternal health and incidence of maternal death.
Research Methodology:This study was an observational study with cross sectional design, Thisstudy was conducted in Province Lampung, Indonesia, in 2020. Population of this research consisted of situation maternal health in provience Lampung. Sampel in this study are report of bacis health and SDGs series: districts/city readiness from 13 districts and 2 cities in Province Lampung. The studied indicators either were evaluated of environtment, health behavior, and health service for ech districts/city. Data was collected and then analyzed using SmartPLS application.
Results:The environment determinant in this study was determined to water quality and sanitation. Health behaviour determinant indicator was assessed by ANC adherence and labor operator while indicator of health service determinants were access of health service, care of maternal complication, health insurance. All of determinants have significant correlation to maternal health by T- value and p value were (T= 2.201 ; p= 0.028), (T= 2.467 ; p= 0.012), (T=2.737 ; p=0.006), respectively dor environment, health behaviour, and health service determinants. Refer to the result above which are schematized in Figure 1, it can be learned that environment, health behavior and health services present strong effets to maternal health.
Conclusion:This study results show clearly there are correlation of variable determinants; environment, health behavior, and health service to affect maternal healthby the pathways.

Background: A sudden decline of renal function occurring during pregnancy or postpartum is defined as Pregnancy-related acute kidney injury (PRAKI) includes all the causes not only the obstetric one. The incidence and etiology of PRAKI varies greatly between different regions. Data for the prevalence and prognosis cannot be interpreted without taking into account the geographic and economic context of the country in which they have been obtained. In developed countries, obstetric AKI has become a rare complication of pregnancy. However, in developing countries, AKI remains a frequent and grave complication of pregnancy. Aim: to demonstrate the demographic, clinical and laboratory characteristic of the pregnant women with AKI. Materials and Methods: A Cross-sectional study was carried out among pregnant women who were admitted to obstetrics & gynecology department in collaboration with nephrology unit in internal medicine department during a six months. This study is a part of a large study on the prevalence and outcome of AKI in pregnancy by the same authors in the same center that will be published soon. The demographic, clinical and laboratory data was obtained and analyzed
Results: During the period of the study, a total of 4130 obstetric cases were admitted to the hospital. In total, 33 patients met the diagnostic criteria of pregnancy related acute kidney injury. The mean age of the patients was 29 ± 4.58 years, and gestational age was 31.46 ± 6.34 weeks. Eleven of the 33 women (21%) were primiparous and twelve of them (79%) were multipara. There was a significant findings between the patients who were suffering from hypertensive disorders of pregnancy (Group 1) and who didn’t suffer (Group 2) as regarding low hemoglobin level and low arterial blood pressure and in group 2, while group 1 showed higher uric acid level and low albumin level with a significant finding.

This article details the condition of newborn babies from mothers with epilepsy.
The frequency and nature of epilepsy in children born to mothers with epilepsy are
described. Risk factors for the development of epilepsy in children born to mothers with
epilepsy were determined.

BACKGROUND: The primary function of amniotic fluid is protection of the growing foetus while providing nutrition. A considerable amount of research has been conducted to evaluate interventions to improve amniotic fluid index and the subsequent impact on foetal growth restriction and oligohydramnios. However, there isn't any conclusive evidence hence this study aims to compare the effect of oral amino acid supplements and intravenous infusions in pregnancies with oligohydramnios and foetal growth restriction. 
AIM: To compare the effect of oral amino acid supplementation vs intravenous amino acid infusion on amniotic fluid index and perinatal outcome in pregnancy complicated by oligohydramnios and foetal growth restriction
OBJECTIVES: To compare the effectiveness of oral amino acid supplementation vs intravenous amino acid infusion in pregnancy having oligohydramnios and foetal growth restriction. To study the increase in amniotic fluid index in pregnancy with foetal weight gain. To study the interval growth rate of baby after two weeks and four weeks of therapy.
MATERIAL AND METHOD: This Semi experimental study will be conducted in Department of Obstetrics and Gynaecology, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha. A total of 104 clinically and sonographically proven cases of foetal growth restriction & Oligohydramnios in third trimester attending antenatal clinic or admitted in wards, fulfilling the exclusion and inclusion criteria will be comprise the study groups. After providing oral supplements or intravenous infusions arbitrarily, repeat ultrasonography will be done after two weeks and four weeks of therapy.
EXPECTED RESULTS: We compare from our results the effect of oral amino acid supplementation vs intravenous amino acid infusion on amniotic fluid index and perinatal outcome in pregnancies complicated by oligohydramnios and foetal growth restriction.

Objectives: This paper points to verify the influences of motherly exposure the basic air depressions off infant mortality. For further investigation of these relationships, we used vital registry data to retroactively build (2907) deaths occurred between 2009 and 2013 at Children's Medical City Hospital for children younger than one year and (1167) of them less than a month Previous investigates have concerned air contamination in raised mortality and disease, mainly in the aged populace and childish person. Extra in recent times, relations with death in newborns then through several generative reproductive effects have also been registered
The purpose from such study is to analysis the relationship relating revealing to open-air pollution for the period of gestation then infant mortality, airborne contamination is linked to poor pregnancy.
Elevation indication has exposed that population’s physical and mental health be able to be influenced air study by several contaminations.
Then, this investigate
Purposes to examine the correlate between air pollutions (O3, SO2, NO2, CO, Pb, PM2.5 or PM10) and Born prematurely. For the interval period (2009-2013).
Method: Totally Infant mortality information besides child birth information since (first January 2009 to end December 2013) be there recorded Children’s Hospital in Medical City in Baghdad Iraq
And Daily data on air quality from The Iraqi Ministry of Health and the Environment, The reality of the environment report (2010 ...) report on the status of the status of the Iraqi Environment

The aim was to study the prevalence and risk factors of dental disease development in
pregnant women living in different Uzbekistan regions. The prevalence and intensity of dental
caries among pregnant women are 1.3 times higher in the Urgenchdistrict of the Khorezm
region compared to the Kibray district of the Tashkent region. These figures increase with
each subsequent pregnancy. The same pattern is observed for periodontal and oral mucosa
diseases. The most significant medical and biological factors contributing to the development
of dental diseases in pregnant women were age, several pregnancies, intergenerational period,
course and terms of pregnancy, the presence of extragenital diseases. Among medical and
social risk factors, the most significant were education, living conditions, oral hygiene,
sanitary culture, and medical activity of pregnant women.

Pregnancy conceived with assisted reproductive technologies (ART) has a higher risk of maternal and perinatal complications, and the overall risk of adverse outcomes requiring extended obstetric care has not been thoroughly studied. The review is devoted to the actual problem of the health status of children born after IVF. A systematic review of the health indicators of children conceived with IVF after the neonatal period was carried out versus natural, conceived.

Abstract. The aim of this study was to examine the impact of obesity in pregnant women in
the development of preeclampsia. All women were divided into 2 groups: the study group
included women with obesity (n=120) and the control group of pregnant women with
physiological course of pregnancy without obesity (n=60).

Abstract. Insufficient supply of pregnant women with micronutrients leads to the
development of a number of congenital malformations of the fetus. In order to study the
multivitamin-mineral complexes application’s effect on pregnant women during
pregnancy, and on intrauterine fetal growth and development. Was revealed that a
deficiency of bioelements and vitamins in mothers is a common cause of intrauterine
growth retardation, serious violations of organs and systems functioning. So, it is indicates
integrated approach significance in the treatment of microelementosis in pregnant.

Study objective is to study the influence of early pregnancy BMI on neonatal birth weight. To Study the association between gestational weight gain and neonatal birth weight. An observational correlational study, consisting of 1031 pregnant women, with singleton uncomplicated pregnancy, booked at Krishna Institute of Medical Sciences, Karad before 12 weeks of pregnancy, conducted between June 2014 to December 2015. After getting written informed consent from the patient, patients included in the study. Those who developed any complication during the study were excluded. With rising BMI, weight gain in pregnancy is greatly increased. Maternal pregnancy BMI has a positive association with the birth weight of neonatal. Lower BMI is significantly linked to a relatively low weight gain lower birth weight.

This study was undertaken to determine the effectiveness of two anti-hypertensive drugs: oral Nifedipine and oral Labetalol in cases of extreme preeclampsia in terms of their side effect profile, BP regulation, time taken to lower BP, and number of doses required. The objective of the study was to calculate the time required to reduce the blood pressure to the target level of 90 / 100 mmHg diastolic and less than 160mmHg systolic.In the labetalol group the mean SBP before treatment was 158mm of Hg which was reduced to 140 mm of Hg. The decline rate in the labetalol group was 11.77%. This study proved that labetalol reduces the BP more effectively than nifedipine and also has minimal side effects with less frequent dosing schedule as compared to nifedipine thus indicating that labetalol is better than nifedipine in lowering the BP in cases of preeclampsia.

Background: In new pandemic, the probable effects of COVID-19 pneumonia on pregnant woman and their infant is one of new critical challenge for health care. Here we presented clinical symptoms, laboratory findings and outcome of COVID-19 pneumonia in pregnant woman. Methods: In a case series study, from 15 Feb to 15 June 2020, all women with RT-PCR COVID-19 who referred to two hospitals (Taleghani and Qods Hospital) affiliated to Arak University of Medical Sciences were selected. The epidemiological and demographic variables, laboratory test and outcomes obtained from patient’s medical records. Results: In this case series, we presented thirteen confirmed COVID-19 pregnant women. Their mean age was 34.6 (S.D.: 5.9) years and the mean gestational age was 32.4 (S.D.: 7.3) weeks. Most of patient didn’t show any maternal complication and intrauterine vertical transmission. The large number of pregnant women had normal HRCT and also in terms of laboratory most of the patients had normal laboratory tests. Amniotic fluids, cord blood, the throat swab of neonate in our pregnant woman with delivery were tested for COVID-19 and all of them were negative. Conclusion: The COVID-19 mothers and their infant didn’t have higher risk for morbidity and mortality and this virus didn’t associate with intrauterine vertical transmission.