Preconception-Health-Related Attitudes of Bulgarian Women of Reproductive Age

Management of Endocrinopathies During Pregnancy: A Systematic Review

Uncertainty surrounds the efficacy and security of several medications in treating endocrinopathies, such as gestational diabetes mellitus (GDM) in individuals whose normal glucose levels cannot be maintained by diet and exercise alone. To improve pregnancy results for GDM individuals, the present review is conducted to measure the effectiveness of several antidiabetic medications for glucose management. Up until 2024, we looked through PubMed and Google Scholar. Patients with GDM were enrolled in randomized controlled studies that examined several medications. Using the Cochrane risk of bias method, we obtained the pertinent data and evaluated the bias probability. To determine the odds ratio and the surface of the cumulative ranking function of the maternal and neonatal consequences of various therapies in GDM individuals, we first performed pair-wise meta-assessments and subsequently used a systematic review. Macrosomia, higher gestational ages, infant hypoglycemia, and birth weight are the neonatal outcomes. Glycohemoglobin (HbA1c), and pregnancy-induced hypertension (PIH) are the maternal outcomes. This thorough analysis of 25 trial designs found that metformin had fewer cases of macrosomia, higher gestational ages, infant hypoglycemia, and decreased birth weight when compared to glyburide. Metformin was found to be the fastest way to control blood sugar levels in individuals with GDM, whereas glyburide was found to be the most successful medicine for the same purpose.

Midwives' Knowledge and Attitudes Regarding Perinatal Care for Women With Disabilities

INTRODUCTION

Women with disabilities (WWD) face significant barriers to accessing quality perinatal care, resulting in adverse outcomes for mothers and newborns. Midwives are crucial in providing this care, but their knowledge and attitudes can impact the quality of services delivered. This study aims to examine midwives' knowledge and attitudes toward perinatal care for WWD and identify factors influencing these aspects.

METHODS

A cross-sectional study was conducted from January to April 2023, involving 149 midwives from various healthcare settings. Data were collected using a self-administered questionnaire addressing demographics, knowledge, attitudes, and perceived barriers related to perinatal care for WWD. Descriptive statistics and non-parametric tests were used for analysis, with a significance level set at 0.05.

RESULTS

The sample comprised predominantly female midwives (146, 98%), with a mean age of 33.7 years and a mean of 9.8 years of work experience. Only 48 (32.2%) reported workplaces equipped for perinatal care for WWD. Most participants rated the perinatal care services in Greece for WWD as moderate (87, 58.4%) and believed that the medical staff's knowledge in this area was insufficient (148, 99.3%). The mean knowledge score was 35 points out of 100, indicating a low level of knowledge. Key barriers included the lack of adapted services (148, 99.3%) and insufficient infrastructure (143, 96%). Despite these challenges, 142 (95.3%) midwives supported the right of WWD to have children. Significant correlations were found between higher knowledge scores and less specialized attitudes, while more perceived barriers correlated with a greater need for further education.

CONCLUSIONS

This study highlights the urgent need for improved education and training programs for midwives to enhance their knowledge and attitudes toward perinatal care for WWD. Addressing educational and structural barriers is essential to provide equitable and high-quality care. Policymakers should prioritize creating inclusive healthcare environments and support ongoing professional development for midwives.

Therapeutic Value of Low-Dose Acetylsalicylic Acid for the Prevention of Preeclampsia in High-Risk Bulgarian Women

Introduction Preeclampsia (PE) is a syndrome that affects pregnant women after 20 weeks of gestation and involves numerous organ systems. Screening for PE is essential to prevent complications and guide management. Some existing guidelines for screening have limitations in terms of detection rates and false positives. The aim of this study is to assess the therapeutic value of low-dose acetylsalicylic acid (ASA) for the prevention of PE in high-risk Bulgarian women. Methodology A prospective cohort research was carried out, encompassing women who were recruited from several routine consultations, such as booking, scanning, and regular prenatal visits. We utilized the purposive sampling technique to carefully choose potential participants. The study was conducted by a maternal-fetal medicine center located in Plovdiv, Bulgaria. The data-gathering period spanned from January 2018 to November 2020. At the appointment, the following procedures were conducted: 1) recording history; 2) assessing height, weight, and blood pressure; 3) collecting blood specimens for biochemical markers; and 4) ultrasound examination. Results A total sample size of 1,383 individuals was categorized into two distinct groups: high-risk patients (n = 506) and low-risk patients (n = 877). The mean uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP) ratios were all greater in high-risk group women (p < 0.05). The data revealed that a significant number of high-risk women failed to adhere to the prescribed dosage or regular use of ASA as recommended by their doctor. There were only 384 (75.9%) high-risk women who took low-dose ASA regularly. Conclusion The findings emphasize the importance of personalized prenatal care and early risk assessment to improve maternal and fetal outcomes. Therefore, it is crucial to educate pregnant women, considering the benefits and risks of low-dose ASA when appropriately indicated.

Overcoming Recurrent Miscarriages in a 35-Year-Old Female With Thrombophilia

Thrombophilias, which include both hereditary and acquired illnesses, are a range of abnormalities that make persons more prone to developing thromboembolism. Thrombophilic conditions carry significant dangers during pregnancy, such as miscarriage in early pregnancy, intrauterine growth restriction, abruptio placenta, and preeclampsia. According to compiled statistics, an average of 15%-20% of pregnancies end in miscarriage. While the risk of miscarriage in a first pregnancy is 11%, this risk increases to between 13% and 17% in subsequent pregnancies, and after the third miscarriage, it reaches 38%. This research article presents a detailed case report that focuses on a patient who has experienced three previous failed pregnancies. The patient's genetic analysis indicates that she has two copies of a mutated version of the methylenetetrahydrofolate reductase (MTHFR) gene (Ala222Val) and a variation in the plasminogen activator inhibitor 1 (PAI-1) gene known as 4G/5G. In addition, an evaluation of immunological characteristics revealed increased amounts of natural killer (NK) cells with enhanced activity, along with the identification of embryotoxins in a blood test that suppress embryotoxicity in a blood test, assisted by DNA isolation and real-time polymerase chain reaction (PCR) DNA analysis.

A comparative analysis of the sexual culture and behavior of nursing students from the Medical University of Plovdiv in the period 2009-2019

INTRODUCTION

Population reproduction and family planning are highly dependent on sexual culture and sexual behavior. In this study, we seek to determine whether, over a ten-year period from 2009 to 2019, there have been any changes in the sexual culture of nursing students in relation to the knowledge of risk factors for unintended pregnancies and subsequent abortions.