Infectious Diseases in Obstetrics and Gynecology The latest articles from Hindawi © 2021 , Hindawi Limited . All rights reserved. Seroprevalence of Hepatitis A and Hepatitis E Viruses among Pregnant Women in Northern Iran Sat, 03 Jul 2021 07:05:00 +0000 Background. Hepatitis A (HAV) and hepatitis E viruses (HEV) are endemic in Iran and are known major causes of acute viral hepatitis. Also, during pregnancy, they are associated with severe outcomes. Therefore, it is vital to evaluate the antibody levels against HAV and HEV in pregnant women to avoid severe outcomes incidence. Study design and methods. A total of 247 pregnant women were enrolled in this prospective cross-sectional study. In addition to completing the questionnaire and interviewing all participants, the serum samples were tested for anti-HAV and anti-HEV IgG using the enzyme-linked immunosorbent assay (ELISA). The association between anti-HAV and anti-HEV antibodies status and risk factors was evaluated. Results. The mean age of patients was years. Anti-HAV antibody was found in 111 patients (44.9%), while anti-HEV antibody was detected in only two pregnant women (0.8%). The seroprevalence of HAV was inversely related to the level of education. There was no significant correlation between HAV antibody levels and age, marital status, residence location, and pregnancy trimesters. Conclusion. Considering many complications of these diseases in pregnancy, the detection of enteroviral hepatitis, especially HAV in pregnant women, is necessary, and therefore, proactive measures, such as promoting education, improving people awareness, and vaccination, are recommended. Farzin Sadeghi, Zahra Golchob, Maryam Javadian, Mohammad Barary, Parisa Sabbagh, Soheil Ebrahimpour, and Masomeh Bayani Copyright © 2021 Farzin Sadeghi et al. All rights reserved. Factors Associated with Malaria Preventive Measures among Pregnant Women in Guinea Fri, 02 Jul 2021 05:50:01 +0000 Background. Malaria control interventions have been scaled up, particularly those in pregnant women in Guinea. Despite that, coverage of key malaria preventive measure (MPM) indicators remains low. Therefore, it is vital to understand the reasons behind that, especially for the low coverage of sulfadoxine-pyrimethamine (SP) and long-lasting insecticide-treated bed nets (LLIN). Methods. We conducted a cross-sectional survey in nine district hospitals in Guinea. Pregnant women received for delivery were interviewed to collect sociodemographic and obstetrical parameters. Associated factors with MPMs were investigated through univariate analysis and classification and regression tree (CART). Results. A total of 2248 parturients participated in this study. Among pregnant women using mosquito nets (63.5% (61.4%, 65.5%)), only 41.2% (39.1%, 43.3%) had used it regularly during the last two weeks preceding delivery. Similarly, most pregnant women (57.9% (55.8%, 59.9%)) had received less than three doses of SP, and only a few pregnant women (23.9% (22.1%, 25.7%)) have benefited from full MPMs. Parturient’s age, marital status, time spent in residence, place of residence, level of education, distance from home to the health centre, health conditions, occupation, head of the household’s occupation, the presence of garbage and stagnant water in the neighbourhood, source of running water, and the number of pregnancies were significantly statistically associated with MPMs in pregnant women. However, the number of antenatal care visits (ANC), means of transportation used by the pregnant woman to accomplish ANCs, and stagnant water in the neighbourhood were the three preponderant factors. Conclusion. The low coverage of SP and LLINs among pregnant women requires revitalising some strategies, especially improving ANC coverage and more efforts to reduce inequalities in access to those services due to sociodemographic status. Education on the benefits of these MPMs should also be emphasised. Abdourahamane Diallo, Almamy Amara Touré, Abdoulaye Doumbouya, Aboubacar Sidiki Magassouba, Falaye Traoré, Mamady Cissé, Ibrahima Barry, Ibrahima Conté, Diao Cissé, Abdourahim Cissé, Gnoume Camara, Alpha Oumar Bérété, Alsény Yarie Camara, Naby Yaya Conté, and Abdoul Habib Beavogui Copyright © 2021 Abdourahamane Diallo et al. All rights reserved. Giant Condyloma Acuminata (Buschke-Lowenstein Tumor): Review of an Unusual Disease and Difficult to Manage Thu, 01 Jul 2021 04:20:00 +0000 Giant condyloma acuminatum (GCA) or Buschke-Loewenstein tumor is a rare disease, with an estimated prevalence of 0.1%. It was initially described in 1896 by Buschke and later in 1925 by Buschke and Loewenstein. Classic condyloma acuminata (CCA) and squamous cell carcinoma (SCC) were initially described as different entities. These three entities are currently considered to correspond to the same spectrum of different but not exclusive malignant transformations, associated with multiple risk factors such infection by human papilloma virus (HPV), immunodeficiencies, poor hygiene, multiple sexual partners, and chronic genital infections. HPV subtypes 6 and 11 are associated with 90% of GCA. It presents as a cauliflower-like tumor in the genital region with bad odor, bleeding, and local infection, differential diagnosis with multiple conditions should be considered, and sexually transmitted diseases should always be investigated. GCA has a higher rate of malignant transformation than CCA and tends to infiltrate adjacent soft tissues. The therapeutic approach is controversial but is considered that the resection with free edges is the gold standard and can be combined with adjuncts. The recurrence rate is high. Overall mortality is 21% and is associated with morbidity caused by recurrences. Imiquimod cream 5% has recently shown good results as monotherapy and in combination with ablative and surgical treatments. The quality of life is diminished in patients with this condition. In this review, we address the different aspects of this rare entity including the therapeutic approach. Jefferson F. Nieves-Condoy, Camilo L. Acuña-Pinzón, José L. Chavarría-Chavira, Diego Hinojosa-Ugarte, and Luis A. Zúñiga-Vázquez Copyright © 2021 Jefferson F. Nieves-Condoy et al. All rights reserved. Antibacterial and Antifungal Activity of the Human Endometrial Fluid during the Natural Cycle Wed, 16 Jun 2021 12:35:00 +0000 Purpose. Some microbiota patterns have been associated with favorable IVF prognosis and others with pathological conditions. The endometrial fluid aspirate (EFA) contains antibacterial proteins that are enriched in implantative IVF cycles, but the antimicrobial effect of EFA has not been addressed. We aimed to evaluate the antimicrobial activity of the human endometrial fluid during the natural cycle. Methods. EFA was obtained through an embryo transfer catheter in 38 women, aged 18-40 years, with regular cycles attending to a fertility clinic. The antimicrobial activity of EFAs was tested against two strains of Staphylococcus aureus; one strain each of Streptococcus agalactiae, Enterococcus faecalis, Escherichia coli, and Klebsiella pneumoniae; and three yeasts (Candida albicans, Candida glabrata, and Candida krusei). Results. All samples exhibited antibacterial activity against S. aureus. In addition, 32.4% of EFAs were active against one of the other microorganisms assayed, 16.2% against two, and 5.4% against four of them. In contrast, none exhibited antibacterial activity against E. coli or K. pneumoniae. The antimicrobial activity differs considerably between EFA samples, and we failed to observe a cycle-related pattern. Conclusions. EFA presented two antimicrobial activity patterns: (a) one common to all the samples, exhibiting activity against S. aureus and lack of activity against E. coli and K. pneumoniae, and (b) an individualized pattern, showing activity against some of the other microorganisms tested. The intensity of antibacterial activity differs between EFA samples. Our data suggest that the uterine microbiota is controlled by means of endometrial fluid components. Marta Bregón-Villahoz, Maria-Dolores Moragues, Inés Arrieta-Aguirre, Mikel Azkargorta, Lucía Lainz, Miren Diez-Zapirain, Maria Iglesias, Maria-Begoña Prieto, Ana Matorras, Antonia Exposito, Felix Elortza, and Roberto Matorras Copyright © 2021 Marta Bregón-Villahoz et al. All rights reserved. Neonatal Outcomes in Pregnant Women Infected with COVID-19 in Babol, North of Iran: A Retrospective Study with Short-Term Follow-Up Thu, 03 Jun 2021 12:50:01 +0000 During the coronavirus disease 2019 (COVID-19) pandemic, the number of pregnant women and neonates suffering from COVID-19 increased. However, there is a lack of evidence on clinical characteristics and neonatal outcomes in pregnant women with COVID-19. We evaluated short-term outcomes (4 weeks postdischarge) and symptoms in neonates born to mothers infected with COVID-19. In this retrospective cohort study, we included all neonates born to pregnant women with COVID-19 admitted to Ayatollah Rohani Hospital, Babol, Iran, from February 10 to May 20, 2020. Clinical features, treatments, and neonatal outcomes were measured. Eight neonates were included in the current study. The mean gestational age and birth weight of newborns were weeks (30₊6-40) and gr (1720-3900), respectively. Apgar score of the first and fifth minutes in all neonates was ≥8 and ≥9 out of 10, respectively. The most clinical presentations in symptomatic neonates were respiratory distress, tachypnea, vomiting, and feeding intolerance. This manifestation and high levels of serum C-reactive protein (CRP) in three infants are common in neonatal sepsis. The blood culture in all of them was negative. They have been successfully treated with our standard treatment. Our pregnant women showed a pattern of clinical characteristics and laboratory results similar to those described for nonpregnant COVID-19 infection. This study found no evidence of intrauterine or peripartum transmission of COVID-19 from mother to her child. Furthermore, the long-term outcomes of neonates need more study. Zahra Akbarian-Rad, Mohsen Haghshenas Mojaveri, Zinatossadat Bouzari, Farzin Sadeghi, Yousef Yahyapour, Mojgan Naeimi Rad, Somayeh Alizadeh, Soheil Ebrahimpour, Mahdi Sepidarkish, and Mostafa Javanian Copyright © 2021 Zahra Akbarian-Rad et al. All rights reserved. Detection of Anti-Toxoplasma gondii IgG and IgM Antibodies and Associated Risk Factors during Pregnancy in Southwest Iran Thu, 27 May 2021 13:05:00 +0000 Background. This research was aimed at evaluating the seroprevalence of acute and chronic Toxoplasma gondii (T. gondii) infection in pregnant women and related risk factors in southwest Iran. Methods. In this cross-sectional study, eighty-eight pregnant women were included from October 2019 to December 2019. The presence of anti-T. gondii IgM and IgG antibodies was measured using the enzyme-linked immunosorbent assay (ELISA). In addition, a questionnaire consisting of demographic information was completed for each subject. Results. The overall seroprevalence of T. gondii infection was estimated to be 34.09% (30/88). Of these, 1 (1.13%) and 29 (32.95%) samples were found positive for IgM and IgG, respectively. Regarding the risk factors, the consumption of raw/undercooked meat ( value = 0.007) and history of abortion ( value = 0.017) were significantly associated with IgG seroprevalence in pregnant women. Conclusion. The results showed that the pregnant women of southwest Iran might be moderately exposed to T. gondii. Since the risk of acute T. gondii infection in this susceptible group is very important, regular screening tests to diagnose the infection are recommended before pregnancy. Shahrzad Soltani, Ali Dalir Ghaffari, Mehdi Sagha Kahvaz, Mohamad Sabaghan, Marzieh Pashmforosh, and Masoud Foroutan Copyright © 2021 Shahrzad Soltani et al. All rights reserved. Adjustable Algorithmic Tool for Assessing the Effectiveness of Maternal Respiratory Syncytial Virus (RSV) Vaccination on Infant Mortality in Developing Countries Tue, 25 May 2021 17:05:00 +0000 Acute lower respiratory infection (ALRI) due to RSV is a common cause of global infant mortality, with most cases occurring in developing countries. Using data aggregated from priority countries as designated by the United States Agency for International Development’s (USAID) Maternal Child Health and Nutrition (MCHN) program, we created an adjustable algorithmic tool for visualizing the effectiveness of candidate maternal RSV vaccination on infant mortality. Country-specific estimates for disease burden and case fatality rates were computed based on established data. Country-specific RSV-ALRI incidence rates for infants 0-5 months were scaled based on the reported incidence rates for children 0-59 months. Using in-hospital mortality rates and predetermined “inflation factor,” we estimated the mortality of infants aged 0-5 months. Given implementation of a candidate maternal vaccination program, estimated reduction in infant RSV-ALRI incidence and mortality rates were calculated. User input is used to determine the coverage of the program and the efficacy of the vaccine. Using the generated algorithm, the overall reduction in infant mortality varied considerably depending on vaccine efficacy and distribution. Given a potential efficacy of 70% and a maternal distribution rate of 50% in every USAID MCHN priority country, annual RSV-ALRI-related infant mortality is estimated to be reduced by 14,862 cases. The absolute country-specific reduction is dependent on the number of live births; countries with the highest birth rates had the greatest impact on annual mortality reduction. The adjustable algorithm provides a standardized analytical tool in the evaluation of candidate maternal RSV vaccines. Ultimately, it can be used to guide public health initiatives, research funding, and policy implementation concerning the effectiveness of potential maternal RSV vaccination on reducing infant mortality. Rachel Cevigney, Christopher Leary, and Bernard Gonik Copyright © 2021 Rachel Cevigney et al. All rights reserved. Multiattribute Analysis of Trichomonas vaginalis Diagnostics and Its Correlation with Clinical Complaints and Contraceptive Methods in a Symptomatic Egyptian Cohort Fri, 30 Apr 2021 11:35:00 +0000 Background. Trichomonas vaginalis (T. vaginalis) infection has been long considered among the sexually transmitted diseases that possesses a clear effect on women’s health especially in the childbearing period. Methods. A 234 females of age range 18-45 years old attending the Gynecology and Obstetrics Outpatient Clinic of Kasr El Aini Hospitals were enrolled in a cross-sectional study. The taken vaginal swabs were subjected to wet mount microscopy, Giemsa stain, modified Diamond’s culture, and nested polymerase chain reaction (nPCR) amplification. Multiattribute and analytical hierarchy processes were conducted to detect laboratory utility. Univariate and multivariate analyses were done to detect the multiple risk factors that may be associated with Trichomonas infection. Results. Based on nPCR, the prevalence of trichomoniasis was 26.9%. Wet mount, Giemsa stain, and culture showed 100% specificity but of low sensitivity (28.57%, 28.57%, and 57.14%, respectively). On the multivariate analysis, nPCR showed the highest rank for diagnostic performance and culture had the lowest rank. For univariate analysis, there was a significant correlation between T. vaginalis infection and vaginal discharge, burning sensation, dyspareunia, and the use of intrauterine device (IUD) ( value < 0.05). Conclusion. The routine screening of trichomoniasis using nPCR was reliable, sensitive, and specific. Also, it could financially be considered a more suitable option in batch screening. Significant higher rates of infection were reported among IUD users compared to condom or hormonal-based methods. Marwa M. I. Ghallab, Doaa Alaa, and Salwa M. Morsy Copyright © 2021 Marwa M. I. Ghallab et al. All rights reserved. Seroprevalence and Risk Factors of Toxoplasma gondii Infection among Pregnant Women in Kumasi: A Cross-Sectional Study at a District-Level Hospital, Ghana Mon, 05 Apr 2021 06:50:00 +0000 Background. This study investigated the prevalence and risk factors of Toxoplasma gondii infection among pregnant women in a district-level hospital in Ghana and compared the diagnostic performance of the rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA) for T. gondii diagnosis. Method. This cross-sectional study included 400 consecutive consenting women in their first-trimester stage of pregnancy. A validated well-structured closed-ended questionnaire was used to collect sociodemographic data and possible risk factors of each participant. Blood samples were collected for analysis of T. gondii IgG and IgM using the commercial ELISA Kit and RDT. Results. Seroprevalence of toxoplasmosis was 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education (, 95% CI (1.1-3.1), and ) and contact with cats (, 95% CI (1.1-2.8), and ) were significant predictors of T. gondii infection, with the former being the only independent risk factor for T. gondii infection (, 95% CI (1.0-3.0), and ) by the ELISA method. The sensitivity, specificity, and area under the curve (AUC) of RDT-IgM against ELISA were 42.9%, 95.9%, and 0.694, respectively, whereas those of RDT-IgG were 31.0%, 91.2%, and 0.611, respectively. The diagnostic consistency between the two methods was fair for both RDT-IgM () and RDT-IgG ().Conclusion. The prevalence of T. gondii infection among pregnant women at Kumasi is 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education and contact with cats were the major risk factors of T. gondii infection. Using ELISA as the reference, the RDT used in this study for the diagnosis of T. gondii infection has low sensitivity, and therefore, it is unreliable. However, this finding does not invalidate all RDTs because there are several other brands of RDT with good sensitivity and specificity. Further studies to ascertain the performance of other commercially available RDT kits are needed. Bhavana Singh, Linda Batsa Debrah, Godfred Acheampong, and Alexander Yaw Debrah Copyright © 2021 Bhavana Singh et al. All rights reserved. Antimicrobial Susceptibility Patterns in Neisseria gonorrhoeae Isolated from South African Pregnant Women Sun, 28 Mar 2021 06:05:01 +0000 Background. Neisseria gonorrhoeae, a sexually transmitted infection, is associated with adverse pregnancy and neonatal outcomes. Emerging resistance towards various antibiotics has been observed globally. However, there is a lack of data on antimicrobial susceptibility patterns in N. gonorrhoeae isolated from pregnant women in our setting. This study fills in this gap in the literature. Methods. The study population included pregnant women, recruited from the antenatal clinic of the King Edward VIII hospital (KEH) in Durban. Endocervical swabs were obtained from 307 women. The swab was placed in Amies Charcoal media for culture assessments. Pure isolates of N. gonorrhoeae were subjected to antimicrobial susceptibility testing using the Etest™ method. The MIC values were assessed in accordance with the European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2019) breakpoints. Results. The prevalence of N. gonorrhoeae by culture was 1.9%. High MIC values to penicillin G (12-64 mg/L) indicating a resistant phenotype were observed for all isolates tested, with 50% of the isolates displaying complete resistance. Isolates with intermediate (1 mg/L) and resistance (1.9-32 mg/L) profiles to tetracycline were observed. Resistance to ciprofloxacin (1.16-3 mg/L) was also observed. Isolates displayed either dual or triple resistance to penicillin G, tetracycline, or ciprofloxacin. All isolates showed susceptibility to spectinomycin (>64 mg/L), azithromycin (1 mg/L), ceftriaxone (>0.125 mg/L), and cefixime (>0.125 mg/L). Conclusion. Despite lack of resistance to ceftriaxone and azithromycin, continuous surveillance for emerging patterns of resistance to these antibiotics is needed since they form part of the treatment guidelines. Glynis Oree, Meleshni Naicker, Hopolang Clifford Maise, Partson Tinarwo, and Nathlee Samantha Abbai Copyright © 2021 Glynis Oree et al. All rights reserved. Progression of CIN1/LSIL HPV Persistent of the Cervix: Actual Progression or CIN3 Coexistence Thu, 11 Mar 2021 03:20:01 +0000 Objective. The natural history of the CIN1 lesions is characterized by an elevated rate of spontaneous regression (80%), some authors recognize a capacity to progress to HSIL in 10% of cases, and other authors do not recognize the capacity of progression of LSIL (CIN1). This study was aimed to evaluate the incidence of progression to HSIL (CIN3) in women with a histological diagnosis of LSIL (CIN1). Furthermore, to this end, we studied the histological outcomes of cone specimens collected by the LEEP. Methods. All the data were retrospectively analyzed. All participants underwent a follow-up of 4 years, during which each woman underwent an HPV test and genotyping, cervical cytological sampling, or biopsy every six months. The endpoint was the histological confirmation of CIN3 lesions in any moment during follow-up. Results. Progression to CIN3 occurred in 7 cases (1,5%). Analyzing the histological exams of the cones of the 7 cases that progressed to CIN3, we found the coexistence of CIN1 and CIN3 lesions in all cases. Conclusion. After 4 years of follow-up, only 1.5% (7/475) of the women with LSIL developed CIN3, all within the first two years of follow-up, and were immediately treated. The most likely explanations for “progression” from LSIL to HSIL are (1) actual progression, (2) underdiagnosis of HSIL on initial biopsy, (3) overdiagnosis of HSIL on follow-up biopsy/cone, and (4) CIN3 arose de novo. Analyzing the histological exams of the cones of the 7 cases that progressed to high-grade, we found the coexistence of CIN1 and CIN3 lesions in all cases. Some recent studies have shown that a viral genotype corresponds to different lesions in the same cervix; therefore, CIN1 coexisting with CIN3 does not always indicate progression of CIN1. Other authors have doubted the capacity of LSIL to progress. Maria Teresa Bruno, Nazario Cassaro, Francesca Bica, and Sara Boemi Copyright © 2021 Maria Teresa Bruno et al. All rights reserved. Development of Pelvic Inflammatory Disease after Ectopic Removal Tue, 19 Jan 2021 13:50:01 +0000 Although ectopic pregnancy and pelvic inflammatory disease (PID) are separately commonly seen in practice, development of PID after surgical removal is rare. Here, we present the case of a 41-year-old female who was admitted for pelvic inflammatory disease diagnosed after laparoscopic salpingectomy for a ruptured ectopic pregnancy. Treatment required drainage of TOAs with interventional radiology and antibiotic treatment. This case report demonstrates how treatment of PID following ectopic pregnancy is complex and may require surgical- or radiology-guided drainage of infection in addition to common antibiotic treatment. Follow-up and duration of treatment are highlighted. Amanda Wang, Sema Hajmurad, Maryam Khan, and Sarah Villarreal Copyright © 2021 Amanda Wang et al. All rights reserved. Efficacy of Nucleotide/Nucleoside Analogues and Hepatitis B Immunoglobulin Therapy in Blocking Mother-to-Child Transmission of Hepatitis B in an Eastern Chinese Group Thu, 17 Dec 2020 13:20:00 +0000 The objective of this study was to investigate the efficacy and potential side-effects of nucleotide/nucleoside analogues and hepatitis B immunoglobulin injection of newborns in blocking mother-to-child transmission of hepatitis B virus in the middle and late pregnancy period. 238 cases of enrolled pregnant women were divided into the Telbivudine group, the Tenofovir group, the Lamivudine group, and the hepatitis B immunoglobulin (HBIG) group. Enrolled patients received corresponding therapies. Clinical and laboratory data were collected. Results showed that the levels of HBV DNA of the enrolled pregnant women in the Telbivudine, Tenofovir, and Lamivudine groups decreased rapidly after 12 weeks of drug intervention compared with those in the control. HBsAg positive rate in newborns and in children 24 weeks after birth was 0/60, 0/60, 0/60, 3/30, and 11/28 in the Telbivudine, Tenofovir, Lamivudine, HBIG, and control groups, respectively. No significant side-effects were identified after following up to 12 months after birth. Our results show that routine HBV vaccine plus HBIG injections is insufficient in blocking mother-to-child HBV transmission. Administration of nucleotide/nucleoside analogues or HBIG at pregnancy is suggested to maximize the blocking of vertical HBV transmission. Xiaojun Sun, Chengwei Wang, Bian Wang, Xiuzhen Yang, Hongtao Xu, Meilong Shen, and Kuichun Zhu Copyright © 2020 Xiaojun Sun et al. All rights reserved. Vertical Transmission of COVID-19 to the Neonate Mon, 16 Nov 2020 08:35:00 +0000 Objective. To estimate the incidence rate of vertical transmission of coronavirus disease 2019 (COVID-19) to the neonate during the third trimester. Study Design. We conducted a retrospective observational study of pregnant women diagnosed with COVID-19 during the third trimester, who delivered at Flushing Hospital Medical Centre (FHMC) or Jamaica Hospital Medical Centre (JHMC) between March 20, 2020, and April 30, 2020. The study participants were symptomatic pregnant women diagnosed with COVID-19 via positive SARS-CoV-2 RNA, real-time reverse transcription-polymerase chain reaction (SARS-CoV-2 rRT-PCR) test. Evidence of vertical transmission was assessed in the neonate via a SARS-CoV-2 rRT-PCR test, with nasopharyngeal swab samples collected on the neonates after 24 hours of birth. The exclusion criteria for this study were maternal or neonate records without SARS-CoV-2 rRT-PCR test results, neonates not delivered at FHMC or JHMC, and foetuses with suspected foetal anomalies or incomplete medical records. Results. We identified 19 symptomatic pregnant women diagnosed with COVID-19, including two women with twin pregnancies. Seven patients (36.8%) were delivered via cesarean. 12 patients (63.1%) presented in spontaneous labour, and 8 (38.1%) had preterm delivery. No maternal intensive care unit admission, maternal sepsis, or maternal mortality was observed. Twenty-one neonates were evaluated for COVID-19 after birth. SARS-CoV-2 rRT-PCR test results were negative in 100% of the neonates. Thirteen neonates (61.9%) were admitted to the neonatal intensive care unit. Prematurity was the most common cause of NICU admission 6 (46.1%), with a length of stay of days. No invasive mechanical ventilation, neonatal sepsis, or neonatal mortality was observed. Conclusion. In our cohort, symptomatic COVID-19 during the third trimester of pregnancy was not associated with vertical transmission to the neonate. Sindy C. Moreno, Justin To, Hajoon Chun, and Ivan M. Ngai Copyright © 2020 Sindy C. Moreno et al. All rights reserved. Improving Obstetric Provider Congenital Cytomegalovirus Knowledge and Practices Mon, 09 Nov 2020 13:50:01 +0000 Background. Congenital cytomegalovirus infection (cCMV) is the most common congenital infection. Antenatal education is proven to reduce cCMV risk. Little is known about obstetric provider knowledge and practice patterns around cCMV. Objectives. To evaluate obstetric provider knowledge and practice patterns regarding cCMV at baseline and again after a brief educational intervention. Methods. Obstetric providers () at a US academic community hospital were invited to complete a survey regarding their knowledge and practice patterns around cCMV. Providers attended a brief presentation about cCMV and later were invited to repeat the same survey. Univariate statistics were calculated for baseline data, and prepost intervention comparison analyses were conducted. Results. Baseline cCMV knowledge was low at 49% ( out of a possible 36, SD 6.4), with most providers (51%) reporting never counseling pregnant patients about cCMV. Post intervention, overall cCMV knowledge increased to 80% (, SD 4.1, ); provider intention to counsel about cCMV prevention increased to 100%. Conclusions. Obstetric provider knowledge about cCMV is low, which likely impacts their antenatal counseling. Educational initiatives to increase awareness about cCMV may increase antenatal education and thereby decrease the risk of cCMV. Megan H. Pesch, Carter Anderson, and Erika Mowers Copyright © 2020 Megan H. Pesch et al. All rights reserved. Chlamydia trachomatis Infection, when Treated during Pregnancy, Is Not Associated with Preterm Birth in an Urban Safety-Net Hospital Mon, 05 Oct 2020 17:20:00 +0000 Preterm birth is a major public health problem, occurring in more than half a million births per year in the United States. A number of maternal conditions have been recognized as risk factors for preterm birth, but for the majority of cases, the etiology is not completely understood. Chlamydia trachomatis is one of the most prevalent sexually transmitted infections in the world. However, its role in adverse pregnancy outcome in women is still debated. In order to determine if genitourinary tract infection with C. trachomatis during pregnancy was associated with preterm birth, we conducted a case-control study on women who delivered at Boston Medical Center, an urban “safety-net” hospital that serves a socioeconomically disadvantaged and racially diverse population. Women with known risk factors for preterm birth or immune suppression were excluded. Variables collected on enrolled subjects included demographics; diagnosis of C. trachomatis during or prior to pregnancy; tobacco, alcohol, and illicit substance use; gestational age; and birthweight and gender of the newborn. We also collected urine for chlamydia testing at the time of delivery and placental biopsies for nucleic acid amplification and histological studies. A total of 305 subjects were enrolled: 100 who delivered preterm and 205 who delivered full term. Among those subjects, we identified 19 cases of pregnancy-associated C. trachomatis infection: 6/100 preterm and 13/205 full term, a difference which was not statistically significant. Only two cases of untreated chlamydia infection were identified postpartum, and both occurred in women who delivered at term. We conclude that genitourinary tract infection with C. trachomatis during pregnancy, when appropriately treated, is not associated with preterm birth. Jessica Vercruysse, Samrawit Mekasha, Lisa Movilla Stropp, James Moroney, Xianbao He, Yanmei Liang, Olivera Vragovic, Eduardo Valle, Jennifer Ballard, Jeffrey Pudney, Wendy Kuohung, and Robin R. Ingalls Copyright © 2020 Jessica Vercruysse et al. All rights reserved. Malaria in Pregnancy in Endemic Regions of Colombia: High Frequency of Asymptomatic and Peri-Urban Infections in Pregnant Women with Malaria Thu, 20 Aug 2020 16:20:01 +0000 Background. Malaria in pregnancy (MiP) has been associated with adverse pregnancy outcomes. There is limited information on MiP in low transmission regions as Colombia. This study aimed to describe the epidemiology of MiP through active surveillance of infections by microscopy and polymerase chain reaction (PCR). Methods. A cross-sectional study was conducted between May 2016 and January 2017 in five municipalities (Apartadó, Turbo, El Bagre, Quibdó, and Tumaco) in Colombia. Pregnant women self-presenting at health centers for antenatal care visits, seeking medical care for suspected malaria, or delivery, were enrolled. Diagnosis of Plasmodium spp was made in peripheral and placental blood samples by microscopy and PCR. Results. A total of 787 pregnant women were enrolled; plasmodial infection was diagnosed by microscopy in 4.2% (95% CI 2.8-5.6; 33/787) or by nPCR in 5.3% (95% CI 3.8-6.9; 42/787) in peripheral blood. Most of the infections were caused by P. falciparum (78.5%), and 46% were afebrile (asymptomatic). Women in the first and second trimester of pregnancy were more likely to be infected (,). To live in the urban/peri-urban area (,), to have a history of malaria during last year (,), and the infrequent bed net usage (,) were associated with the infection. Pregnant infected women had a higher risk of anaemia (,) and fever (,).Conclusion. The screening for malaria during antenatal care in endemic areas of Colombia is highly recommended due to the potential adverse effects of Plasmodium spp. infection in pregnancy and as an important activity for the surveillance of asymptomatic infections in the control of malaria. Ana-María Vásquez, Lina Zuluaga-Idárraga, Margarita Arboleda, Luz-Yáned Usuga, Carolina Gallego-Marin, Alvaro Lasso, Luisa Carbal, Juan-Gabriel Piñeros-Jiménez, and Alberto Tobón-Castaño Copyright © 2020 Ana-María Vásquez et al. All rights reserved. Genotypic Variation in Trichomonas vaginalis Detected in South African Pregnant Women Wed, 05 Aug 2020 14:50:02 +0000 Background. Trichomonas vaginalis is the causative agent of trichomoniasis. The genetic characterisation of T. vaginalis isolates reveals significant genetic diversity in this organism. Data on the prevalence of different genotypes of T. vaginalis in South African populations is lacking. This study investigated the diversity of T. vaginalis in a pregnant population in South Africa. Methods. In this study, 362 pregnant women from the King Edward VIII Hospital in Durban, South Africa, provided vaginal swabs to be tested for the presence of T. vaginalis. T. vaginalis was detected using the TaqMan assay using commercially available primers and probes specific for this protozoan (Pr04646256_s1). The actin gene from T. vaginalis was amplified with gene-specific primers. The actin amplicons were digested with HindII, MseI, and RsaI, and the banding patterns were compared across the three digests for assignment of genotypes. Phylogenetic analysis was conducted using MEGA. Results. The prevalence of T. vaginalis in the study population was 12.9% (47/362). Genotype G was the most frequent genotype in our study population. Genotypes H and I were detected in one sample each. According to the multiple sequence alignments and phylogenetic analysis, a level of diversity was observed across and within genotypes. Four different single-nucleotide changes in the actin gene were detected. Sample TV358 (H genotype) contained a single amino acid substitution from glutamine to lysine. Sample TV184 (G genotype) contained a single amino acid substitution from glutamic acid to arginine. Sample TV357 (G genotype) contained two amino acid substitutions, arginine to leucine and glycine to aspartic acid. Conclusion. Three different genotypes were observed in the pregnant population. Diversity was observed across and within genotypes. The observed diversity can be challenging for future vaccine design and development of antigen-based rapid diagnostic tests for trichomoniasis. Rennisha Chetty, Nonkululeko Mabaso, and Nathlee Abbai Copyright © 2020 Rennisha Chetty et al. All rights reserved. Azithromycin in the Treatment of Preterm Prelabor Rupture of Membranes Demonstrates a Lower Risk of Chorioamnionitis and Postpartum Endometritis with an Equivalent Latency Period Compared with Erythromycin Antibiotic Regimens Thu, 09 Jul 2020 03:35:00 +0000 Objective. To determine if antibiotic regimens including azithromycin versus erythromycin has an impact on pregnancy latency and development of clinical chorioamnionitis in the context of preterm prelabor rupture of membranes. Study Design. We conducted a prospective observational cohort study and followed all women receiving antibiotic regimens including either azithromycin or erythromycin in the context of preterm prelabor rupture of membranes. Primary outcomes were the duration of pregnancy latency period and development of chorioamnionitis. Secondary outcomes included neonatal sepsis with positive blood culture, cesarean delivery, postpartum endometritis, and meconium-stained amniotic fluid. Results. This study included 310 patients, with 142 receiving the azithromycin regimen and 168 receiving the erythromycin regimen. Patients receiving the azithromycin regimen had a statistically significant advantage in overall rates of clinical chorioamnionitis (13.4% versus 25%, ), neonatal sepsis (4.9% versus 14.9%, ), and postpartum endometritis (14.8% versus 31%, ). In crude and adjusted models, when comparing the azithromycin group with the erythromycin group, a decreased risk was noted for the development of clinical chorioamnionitis, neonatal sepsis, and postpartum endometritis. Pregnancy latency by regimen was not significantly different in crude and adjusted models. Conclusion. Our study suggests that latency antibiotic regimens substituting azithromycin for erythromycin have lower rates and decreased risk of clinical chorioamnionitis, neonatal sepsis, and postpartum endometritis with no difference in pregnancy latency. Daniel Martingano, Shailini Singh, and Antonina Mitrofanova Copyright © 2020 Daniel Martingano et al. All rights reserved. Prevalence of Genotypes and Subtypes of Gardnerella vaginalis in South African Pregnant Women Thu, 02 Jul 2020 04:05:02 +0000 Background. Gardnerella vaginalis, a microorganism highly linked to bacterial vaginosis (BV), is understudied in terms of genotypic heterogeneity in South African populations. This study investigated the prevalence of G. vaginalis genotypes in BV-positive, BV-intermediate, and BV-negative South African pregnant women. Methods. The study population included pregnant women recruited from a public hospital in Durban, South Africa. The women provided self-collected vaginal swabs for BV diagnosis by Nugent scoring. For the genotyping assays, the 16S rRNA and sialidase A genes from BV-negative, BV-intermediate, and BV-positive samples were amplified with G. vaginalis-specific primers. The16S rRNA amplicon was digested with TaqI to generate genotyping profiles, and subtypes were determined by correlating BamHI and HindIII digestion profiles. Phylogenetic analysis was performed on the 16S rRNA and sialidase A sequences. The data analysis was performed with R Statistical Computing software, version 3.6.2. Results. Two different genotypes, GT1 and GT2, were detected. The most prevalent genotype was GT1. Four subtypes (1, 2B, 2AB, and 2C) were shown to be present. The most prevalent subtype was 2B, followed by subtypes 1, 2C, and 2AB. The phylogenetic analysis of the 16S rRNA showed the presence of 5 clusters. The tree displayed clusters which contained sequences from the same BV group with different genotypes and subtypes. Clusters with sequences from across the BV groups carrying the same genotype and subtype were present. Diversity of the sialidase A across BV groups and genotypes was observed. Finally, the study did not find a significant association () between reported symptoms of abnormal vaginal discharge and genotype harboured. Conclusion. This study provided the first report on the diversity of G. vaginalis in South African pregnant women. Diversity assessments of G. vaginalis with respect to genotypes and virulence factors may aid in a greater understanding of the pathogenesis of this microorganism. Kayla Pillay, Silondiwe Nzimande, Meleshni Naicker, Veron Ramsuran, Partson Tinarwo, and Nathlee Abbai Copyright © 2020 Kayla Pillay et al. All rights reserved. Hepatitis B Virus Infection and Its Determinants among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis Thu, 11 Jun 2020 15:35:01 +0000 Background. Hepatitis B virus (HBV) is an infectious and a global public health problem. The prevalence of HBV infection among pregnant women is between 2.3% and 7.9%. HBV infection during pregnancy is associated with prenatal transmission to the fetus. HBV has an effective vaccine which reduces up to 96% of the transmission. Although different studies were conducted in Ethiopia, none of them showed the national prevalence of HBV infection among pregnant women. Therefore, this study was conducted to determine the pooled prevalence of HBV and its associated factors in Ethiopia. Methods. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles. All observational published studies were retrieved using relevant search terms in Google Scholar, African Online Journal, CINAHL, and PubMed databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The statistics were used to test heterogeneity whereas Begg’s and Egger’s tests were used to assess publication bias. Odds ratio (OR) with a 95% confidence interval (CI) was presented using the forest plot. Results. A total of twenty-three studies were included in this systematic review and meta-analysis. The pooled prevalence of HBV in Ethiopia was 4.75% (95% CI: 4.06, 5.44). The subgroup analysis showed a higher prevalence of HBV infection among pregnant women in Gambella (7.9%) and the lowest in Southern Nations, Nationalities, and Peoples’ Region (SNNPR) (2.3%). Associated factors with HBV infection include history of multiple sexual partner ( (, 9.36)), blood transfusion history ( (, 10.04)), abortion history ( (, 6.09)), and history of body tattoo ( (, 5.17)). Conclusions. HBV infection among pregnant women is a common public health problem in Ethiopia. Multiple sexual partners, abortion history, blood transfusion history, and body tattoo were significantly associated with HBV infection. Policies and strategies should focus on factors identified in this study to improve the prevention of HBV among pregnant women. Addisu Alehegn Alemu, Liknaw Bewket Zeleke, Bewket Yesarah Aynalem, and Getachew Mullu Kassa Copyright © 2020 Addisu Alehegn Alemu et al. All rights reserved. Detection of Ureaplasma Biovars and Subtyping of Ureaplasma parvum among Women Referring to a University Hospital in Morocco Mon, 08 Jun 2020 01:20:01 +0000 Objectives. The aim of this study was to determine the prevalence of Ureaplasma biovars and Ureaplasma parvum (U. parvum) serovars, their associated risk factors, and genital STI-related symptoms. Methods. DNA obtained from cervical samples of 1053 women attending the department of Obstetrics and Gynecology and the laboratory of pathological anatomy of Hassan II university hospital of Fez, Morocco, was used to detect Ureaplasma biovars (U. urealyticum and U. parvum) and to subtype U. parvum by polymerase chain reaction (PCR). Results. Of the 1053 women examined, 25.4% (268/1053) were Ureaplasma positives. The rates of U. urealyticum and U. parvum were 12.1% (128/1053) and 7% (74/1053), respectively, and the copresence of these biovars was noted in 6.3% (66/1053) cases. The U. parvum subtyping revealed a predominance of the serovar 3/14 (61.4%). The association of demographics variables with Ureaplasma biovars was studied and shows that the age (“<30” years) seems to be a risk factor of Ureaplasma spp. and U. urealyticum carriage (OR 1.729, 95% CI [1.113-2.687] and OR 1.848, 95% CI [1.026-3.330], respectively). There was no difference in the prevalence of Ureaplasma type regarding symptoms. However, a significant association was found between U. parvum serovar 1 and infertility ().Conclusion. This first study conducted in Morocco provides an idea on Ureaplasma biovars and U. parvum serovars circulating in this region, their associated risk factors, and genital STI-related symptoms. Therefore, further studies are required to clarify and confirm the pathogenic role of these Ureaplasma species. Safae Karim, Chahrazed Bouchikhi, Abdelaziz Banani, Hinde E. L. Fatemi, Tiatou Souho, Sanaa Erraghay, and Bahia Bennani Copyright © 2020 Safae Karim et al. All rights reserved. The Role of Highly Active Antiretroviral Therapy (HAART) on Interleukin 17A (IL-17A) in Normotensive and Preeclamptic Black South African Women Sat, 30 May 2020 11:20:01 +0000 Introduction. Interleukin 17A has been implicated in the pathophysiology of both human immune deficiency virus and preeclampsia. This study evaluated serum levels of IL-17A based on pregnancy type, gestational age, HIV status, and duration of HAART. Material and Methods. A sample size of 250 was analysed: normotensives (; N) and preeclamptics (; PE). Normotensives were further stratified into HIV negative (), HAART-acute (), and HAART-chronic (). The PE group was divided into early onset (; EOPE) and late onset (; LOPE). The EOPE and LOPE groups were subdivided into HIV negative (), HAART-acute (), and HAART-chronic (). Analysis of IL-17A was performed using a multiple Bio-Plex immunoassay method. Results. Pregnancy type: the levels of IL-17A were increased in PE compared to N (). Gestational age: the levels of IL-17A were increased in EOPE compared to N group (). A significant increase in the levels of IL-17A in LOPE compared to N was observed (). HIV status: the levels of IL-17A were increased in PE compared to N () and in EOPE compared to N groups (). HAART duration: the concentration of IL-17A was increased in HAART-chronic PE compared to N groups (). There was also an increase in the levels of IL-17A in EOPE compared to N ().Conclusion. The study demonstrates that IL-17A is involved in the pathophysiology of PE and that in the presence of HIV infection, chronic HAART administration predisposes women to the development of EOPE. Wendy N. Phoswa, Thajasvarie Naicker, Veron Ramsuran, and Jagidesa Moodley Copyright © 2020 Wendy N. Phoswa et al. All rights reserved. A Need for Standardization of the Diagnosis and Treatment of Pelvic Inflammatory Disease: Pilot Study in an Outpatient Clinic in Quito, Ecuador Sat, 09 May 2020 16:50:01 +0000 Background. Pelvic inflammatory disease (PID) diagnosis is often challenging as well as its treatment. This study sought to characterize the diagnostic and therapeutic trend among physicians at the outpatient level, in Quito, Ecuador, where currently no nationwide screening or specific clinical guideline has been implemented on PID or its main microbiological agents. Methods. A retrospective analysis of medical records with pelvic inflammatory disease diagnosis in an outpatient clinic was performed. Electronic medical records from 2013 to 2018 with any pelvic inflammatory disease-related diagnoses were retrieved. Information with regard to age, sexually related risk factors, symptoms and physical exam findings, ancillary tests, method of diagnosis, and antibiotic regimens was extracted. Results. A total of 186 records were included. The most frequent clinical manifestations were vaginal discharge (47%) and pelvic pain (39%). In the physical examination, leucorrhea was the most frequent finding (47%), followed by lower abdominal tenderness (35%) and cervical motion tenderness in 51 patients (27%). A clinical diagnosis was established in 60% of patients, while 37% had a transvaginal sonography-guided diagnosis. Antibiotic treatment was prescribed with standard regimens in 3% of cases, while other regimens were used in 93% of patients. Additionally, an average of 1.9 drugs were prescribed per patient, with a range from 1 to 5, all in different combinations and dosages. Conclusions. No standardized methods of diagnosis or treatment were identifiable. These findings highlight the need for standardization of the diagnosis and treatment of PID attributed to chlamydial and gonococcal infections. Francisco Cueva, Andrés Caicedo, and Paula Hidalgo Copyright © 2020 Francisco Cueva et al. All rights reserved. HIV Screening During Pregnancy in a U.S. HIV Epicenter Thu, 07 May 2020 17:05:00 +0000 Background. The CDC and ACOG have issued guidelines for HIV screening in pregnancy for patients living in areas with high prevalence of HIV in order to minimize perinatal vertical transmission. There is a lack of data examining providers’ compliance with these guidelines in at-risk patient populations in the United States. Objective. To evaluate if HIV screening in pregnant women was performed according to guidelines at a large, urban, tertiary care medical center in South Florida. Study Design. A retrospective review was performed on 1270 prenatal and intrapartum records from women who delivered a live infant in 2015 at a single institution. Demographic and outcome data were chart abstracted and analyzed using arithmetic means and standard deviations. Results. Of the 1270 patients who met inclusion criteria, 1090 patients initiated prenatal care in the first or second trimester and delivered in the third trimester. 1000 (91.7%) patients were screened in the first or second trimester; however, only 822 (82.2%) of these were retested in the third trimester during prenatal care. Among the 178 patients lacking a third trimester test, 159 (89.3%) received rapid HIV testing upon admission for delivery. Of the 1090 patients who initiated prenatal care in the first or second trimester and delivered in the third trimester, 982 (90.1%) were screened in accordance with recommended guidelines. Of the 1270 patients initiating care in any trimester, 24 (1.9%) had no documented prenatal HIV test during prenatal care, however 22 (91.7%) had a rapid HIV test on admission for delivery. Two (0.16%) patients were not tested prenatally or prior to delivery. Conclusion. Despite 99.8% of women having at least one HIV screening test during pregnancy, there is room for improvement in routine prenatal screening in both early pregnancy and third trimester prior to onset of labor in this high-risk population. Alec Szlachta-McGinn, Alexandra Aserlind, Lunthita Duthely, Sean Oldak, Ruchi Babriwala, Emily Montgomerie, and JoNell Potter Copyright © 2020 Alec Szlachta-McGinn et al. All rights reserved. Phase I Study in Healthy Women of a Novel Antimycotic Vaginal Ovule Combining Econazole and Benzydamine Sat, 02 May 2020 06:05:00 +0000 Purpose. A novel fixed-dose combination of 150 mg of econazole with 6 mg of benzydamine formulated in vaginal ovules was investigated in a randomised, double-blind, four-parallel group, tolerability, and pharmacokinetic Phase I study in healthy women. Methods. The fixed-dose combination was compared to econazole and benzydamine single-drug formulations and with placebo after daily applications for 3 consecutive days. Safety and tolerability were evaluated recording the adverse drug reactions, local and general tolerability scores, clinical laboratory assays, and vital signs. Econazole, benzydamine, and its metabolite benzydamine N-oxide pharmacokinetics were investigated after single and multiple applications. Results. Local reactions were generally absent. Pruritus and pain at the application site were infrequently reported. According to the subjects’ evaluations, the overall tolerability of the ovules was rated as excellent or good. No significant effect of any treatment on laboratory parameters, vital signs, body weight, vaginal pH, or ECG was observed. Very low econazole, benzydamine, and benzydamine-N-oxide concentrations were measured in plasma, though quantifiable in almost all samples. Conclusion. The tested fixed-dose combination showed a good safety profile consistently with the known tolerability of both active substances. In addition, the confirmed low bioavailability of the drugs excludes the possibility of any accumulation effects and limits the risk of undesired systemic effects. This trial is registered at with the identifier NCT02720783 last updated on 07 February 2017. A. F. D. Di Stefano, M. M. Radicioni, A. Vaccani, G. Caccia, F. Focanti, E. Salvatori, F. Pelacchi, R. Picollo, M. T. Rosignoli, S. Olivieri, G. Bovi, and A. Comandini Copyright © 2020 A. F. D. Di Stefano et al. All rights reserved. Urinary Tract Infections among Indonesian Pregnant Women and Its Susceptibility Pattern Tue, 21 Apr 2020 16:35:00 +0000 Pregnant women are usually at risk of urinary tract infections (UTIs) such as asymptomatic bacteriuria. In the current multidrug-resistance era, appropriate diagnosis and treatment should be provided to avoid complications in pregnant women in developing countries, which have limited facilities, such as Indonesia. The aim of this study was to evaluate in vitro susceptibility tests. Urinary isolates were collected from 715 pregnant women who visited eight Community Health Centers in Jakarta, Indonesia, between 2015 and 2017. We identified bacterial uropathogens from samples that were positive for nitrite/leukocyte esterase (LE), using two types of VITEK cards. Since noncompliance among patients is a major problem, fosfomycin-trometamol 3 g single-dose sachets were given to the patients, and the side effects of the medication and neonatal outcomes were reported. Asymptomatic bacteriuria was found in 10.5% of the 715 pregnant women. Escherichia coli was the most common etiological factor (26.7%), followed by Klebsiella pneumoniae (20%), Streptococcus agalactiae (9.3%), Enterobacter cloacae (5.3%), Enterococcus faecalis (5.3%), Staphylococcus saprophyticus (4%), Acinetobacter baumannii (4%), and others. Out of 76 pregnant women who took fosfomycin-trometamol, two complained of diarrhea that subsided without medication and fever that responded to paracetamol. Neonatal outcomes showed 100% full-term and normal-weight babies. E. coli, including extended-spectrum beta-lactamase- (ESBL-) producing E. coli, was 100% susceptible to fosfomycin. Nitrite/LE test results are often used as evidence for empiric antibiotic administration for treating asymptomatic bacteriuria in pregnancy, but the diagnosis should be confirmed using culture tests. Based on in vitro susceptibility patterns and medication outcomes, fosfomycin-trometamol single dose could be administered to noncompliant UTI patients, including pregnant women. Yeva Rosana, Dwiana Ocviyanti, Melissa Halim, Friza Yossy Harlinda, Rahmah Amran, Wafridha Akbar, Matthew Billy, and Syadza Rhizky Putri Akhmad Copyright © 2020 Yeva Rosana et al. All rights reserved. Influence of Sexually Transmitted Infections in Pregnant Adolescents on Preterm Birth and Chorioamnionitis Wed, 25 Mar 2020 14:20:00 +0000 Background. Adolescents have an increased risk of preterm birth (PTB) and sexually transmitted infections (STIs). We examined the prevalence and impact of STIs (gonorrhea, chlamydia, and trichomonas) on PTB and chorioamnionitis in pregnant adolescents. Methods. This retrospective cohort study utilized the first pregnancy delivered at an urban hospital among old over a 5-year period. Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between STIs and PTB (<37 weeks) and chorioamnionitis identified by clinical or placental pathology criteria. Results. 739 deliveries were included. 18.8% () of births were preterm. The overall prevalence of STIs during pregnancy was 16.5% (Chlamydia trachomatis: 13.1%, ;Trichomonas vaginalis: 3.7%, ; and Neisseria gonorrheae: 3.1%, ). Detection of C. trachomatis, T. vaginalis, or N. gonorrheae was not associated with increased PTB. While infection with N. gonorrheae and C. trachomatis did not increase the likelihood of any chorioamnionitis, infection with T. vaginalis significantly increased the likelihood of any chorioamnionitis diagnosis (aPR 2.19, 95% CI 1.26-3.83). Conclusion. In this adolescent population with a high rate of PTB, in whom most received appropriate STI treatment, we did not find an association between STI during pregnancy and an increased rate of PTB. However, an infection with T. vaginalis was associated with an increased likelihood of chorioamnionitis. Early detection of STIs may prevent adverse pregnancy outcomes. Continued vigilance in STI screening during pregnancy, including consideration of universal Trichomonas vaginalis screening, is merited in this high-risk population. Esther Fuchs, Maggie Dwiggins, Erica Lokken, Jennifer A. Unger, and Linda O. Eckert Copyright © 2020 Esther Fuchs et al. All rights reserved. Factors Associated with Cervical Cancer Screening Uptake: Implications for the Health of Women in Jordan Sat, 21 Mar 2020 06:35:02 +0000 Purpose. The existing factors that influence cervical cancer screening uptake worldwide do not necessarily reflect the situation in Jordan. Therefore, the aim of this study was to determine the factors associated with cervical cancer screening uptake among Jordanian women. Methods. In this cross-sectional study, 500 married Jordanian women aged 21 to 65 years were recruited from eight nongovernmental organisations and community settings in Amman. Data were collected with a self-administered questionnaire regarding sociodemographic and reproductive data, a health utilisation data form, and scales on the perceived benefits of screening, perceived barriers to screening, perceived susceptibility to cervical cancer, and perceptions regarding the severity of cervical cancer. Descriptive statistics, multivariate logistic regressions, and independent -tests were used in the data analysis. Results. Among the 500 age-eligible women, only 156 (31.2%) had been screened for cervical cancer. Healthcare provider encouragement, years of marriage (,,), and use of the private healthcare sector (,,) were significant predictors of cervical cancer screening. Conclusion. Cervical cancer screening uptake among Jordanian women is significantly low; determining factors for the decision to undergo screening include encouragement from the healthcare provider, the number of years of marriage, and use of the private healthcare sector. To improve uptake, structured screening programmes need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Jordan. Suzanne Q. Al-amro, Muntaha K. Gharaibeh, and Arwa I. Oweis Copyright © 2020 Suzanne Q. Al-amro et al. All rights reserved. Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo Tue, 25 Feb 2020 15:50:01 +0000 Background. Gestational malaria is a major public health problem. It produces fetal complications such as low birth weight, perinatal mortality, and congenital malaria. The present study is aimed at determining the prevalence of congenital malaria and its neonatal complications in the city of Kisangani. Methods. We conducted a cross-sectional study in Kisangani from 1 January to 30 September 2018. Our study population was composed of 1248 newborns born in our study sites, during the period of our study. Just after their birth, we performed the thick drop smear in the placental print and in umbilical blood smear. Results. The prevalence of congenital malaria was 13.98%; 69.23% of newborns who contracted congenital malaria were from 18- to 34-year-old mothers, 53.85% from primiparous mothers, 92.31% from mothers who took intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine, all (100%) from mothers using the insecticide-treated mosquito nets and 7.69% from HIV-positive mothers. Low birth weight and perinatal mortality were recorded in 76.92% and 7.69% of congenital malaria cases, respectively. Intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine had no effect on congenital malaria (; OR: 0.8, 95% CI: 0.1651-3.8769) and on low birth weight (; OR: 1.2308, 95% CI: 0.0037-0.1464); however, it seemed to have protective effect against perinatal mortality (; OR: 0.0233, 95% CI: 0.0037-0.1464). Conclusion. Congenital malaria remains a major problem in stable malaria transmission area like Kisangani, and it is grafted by major perinatal complications, particularly low birth weight and perinatal mortality. We recommend an extended study to clarify the relationship between the outcome of pregnancy and the intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine. Labama Otuli Noël, Bosenge Nguma Jean-Didier, Maindo Alongo Mike-Antoine, Katenga Bosunga Gedeon, Mbo Mukonkole Jean-Paulin, Losimba Likwela Joris, and Manga Okenge Jean-Pascal Copyright © 2020 Labama Otuli Noël et al. All rights reserved.