Oral pathologies seen in pregnant and non-pregnant women

SummaryThe oral health status of a hundred pregnant women and that of one hundred non-pregnant women attending an antenatal clinic and gynaecological clinic respectively at Korle Bu Teaching Hospital was assessed for some common oral pathologies. The doctors and other health personnel managing the pregnant women were also quizzed to ascertain knowledge of any of these conditions. The aim was to find out if any oral condition was particularly prevalent in the pregnant women but not in the non-pregnant women. Our study confirms that in these women, pregnancy has an effect on the oral health status. However this effect is more likely due to the physiological changes associated with pregnancy than any other specific factors. Some oral conditions already present may be influenced by the hormonal changes, which in some cases exacerbate or ameliorate minor oral pathologies. Our findings were similar to that in other studies. However health workers who deal with the pregnant women in these clinics are less aware of these conditions and hence do not usually give any advice.     

应用FQ-PCR及ELISA技术诊断孕妇巨细胞病毒感染的研究

目的探讨荧光定量聚合酶链反应(FQ-PCR)及ELISA检测孕妇血清的CMV-DNA、抗CMV-IgM、抗CMV-IgG在诊断CMV感染中的意义.方法用FQ-PCR和EISA同时检测168例孕妇血清标本的CMV-DNA、抗CMV-IgM、抗CMV-IgG.结果CMV-DNA阳性57例(33.9%),CMV-IgM阳性11例(6.6%),CMV-IgG阳性152例(90.5%),三种检测结果间比较有显著性差异(P＜0.01).结论FQ-PCR检测CMV-DNA灵敏度高,可作为CMV感染的筛选指标.ELISA检测抗CMV-IgM的灵敏度低,仍是CMV现症感染的指标.因此,联合FQ-PCR、ELISA测CMV-DNA、抗CMV-IgM及抗CMV-IgG对筛选CMV感染及判断是否现症感染意义较大.     

Susceptibility to rubella among pregnant women and the serological evidence of congenital rubella in newborn babies at Colombo South Teaching Hospital

OBJECTIVE: To determine the susceptibility to rubella infection in early pregnancy and the incidence of seropositivity of cord blood for rubella specific IgM among the newborn babies at Colombo South Teaching Hospital. METHODS: 1000 cord blood samples and 500 maternal blood samples from pregnant women before the 16th week of gestation were taken from the labour room and the antenatal clinic of the University Unit, Colombo South Teaching Hospital during the period of February 1999 to February 2001. These samples were tested for rubella specific IgM and IgG antibodies by ELISA. A detailed questionnaire was filled during the time of sampling. RESULTS: Of the 500 antenatal blood samples 82% were positive for rubella specific IgG. 373(75%) women gave a history of vaccination against rubella before their present pregnancy. Among the vaccinated 2(0.5%) were negative for IgG antibodies by ELISA. Out of 127 unvaccinated women 12(9%) gave a history of past infection with rubella and of this 3(25%) were seronegative for rubella specific IgG. 18% of pregnant women at 16 weeks of gestation were at risk of giving birth to a baby with congenital rubella syndrome. Among the tested 1000 cord blood samples three were seropositive (0.3%) for rubella specific IgM. CONCLUSIONS: A significant proportion of pregnant women were susceptible to rubella infection in the studied population. The present strategy of selective rubella vaccination should be reconsidered if we are to get closer to eliminating rubella syndrome in Sri Lanka.     

Periodontal status and oral hygiene practices of pregnant and non-pregnant women

One hundred pregnant and another hundred non-pregnant women aged between 16-45 years attending the outpatient clinic of the department of Obstetrics and Gynaecology of Korle-Bu Teaching Hospital were examined and their periodontal status assessed using the Community Periodontal Index for Treatment Needs (CPITN). Selection was by convenient sampling. Only second and third trimester pregnant women were included in the study. Results were recorded using World Health Organization (WHO) standard oral health assessment form and analysed using SPSS for Windows. Overall there was a higher incidence of gingival bleeding or worse score among the pregnant (89%) than the non-pregnant women (61%). This was the case in each of the three age groups considered. Among the non-pregnant women the mean number of sextants with healthy gingivae was above 3.5 in all age groups with an average of 3.78. The mean for second trimester pregnant women was 1.55 and third trimester 2.73. The mean number sextants with bleeding gingivae was 0.698 among the non-pregnant women, whilst that for second trimester and third trimester women were 3.20 and 1.96 respectively. The commonest method of oral hygiene among both the pregnant and non-pregnant women was a combination of the use of chewing stick and toothbrush with paste. The second commonest method was chewing stick alone among the pregnant women and among the non-pregnant women toothbrushing with paste. The mean number of sextants with gingival bleeding among the second trimester pregnant women was consistently high (> 3) irrespective of the method of oral hygiene used. The level of gingival bleeding during pregnancy is not significantly affected by any of the methods of oral hygiene used (p < 0.05) which is higher during the second trimester compared with the third trimester of pregnancy.     

Gentamicin serum half-life: a comparison between pregnant and non-pregnant women

The serum half-life of gentamicin following an intravenous dose was compared between 19 pregnant women (28-34 weeks of pregnancy) with premature rupture of the membranes and 17 non-pregnant women with pelvic inflammatory disease, the groups being age and weight matched. A significant reduction of gentamicin half-life was found in the pregnant group.     

Treatment of uncomplicated urinary tract infection in non-pregnant women

A study of placebo treatment of acute symptomatic urinary tract infection in non-pregnant women showed that about 80% obtained sterile urine spontaneously within 5 months. About one-half of these had recurrent infection within a year.     

Cervical cytology during pregnancy--comparison with non-pregnant women and management of pregnant women with abnormal cytology

To clarify the clinical significance of uterine cervical cytology during pregnancy, we analyzed the incidence of cervical cytology and its accuracy. Of the 1,593 pregnant women underwent cervical cytology, the patients with abnormal cytology were followed up and performed histological confirmation on colposcopic biopsy specimen. An incidence of abnormal cytology and cervical neoplasm during pregnancy were 1.63% (26 cases) and 0.82% (13 cases), respectively. The incidence of abnormal cytology in the pregnant women was significantly higher than that (0.9%) in mass-screened, non-pregnant 214,375 women under the age of 45 years (P < 0.001). There was no significant difference of the incidence of cervical neoplasm between in the pregnant women and in mass-screened, non-pregnant women (0.82% vs. 0.46%). The accuracy of cervical cytology during pregnancy was 45.0% and this was not significantly different from that (27.6%) in the mass-screened, non-pregnant women. Since, cervical screening cytology for uterine cervical cancer in the pregnant women as shown in this study, has an equal effectiveness to that in the mass-screened non-pregnant women, routine cervical cytology is highly recommended to performed during pregnancy. In addition, management of pregnant women with abnormal cytology was discussed in this article.     

孕妇TORCH感染情况的调查分析

目的了解本地区孕妇感染TORCH（TOX RUV CMV HSV）的情况。方法采用ELISA的方法对来我院就诊的3650例孕妇进行TORCH-IgM的检测。结果妊娠妇女检测TOX RUV CMV HSV-1 HSV-2的阳性率分别为0．98％、7．2％、15．6％、4．5％、8．6％。结论本地区妊娠妇女CMV感染比较高，应及早对育龄妇女进行TORCH的筛查，做好优生优育工作，提高人口出生素质。     

孕妇TORCH感染情况的调查分析

目的了解本地区孕妇感染TORCH（TOX RUV CMV HSV）的情况。方法采用ELISA的方法对来我院就诊的3650例孕妇进行TORCH-IgM的检测。结果妊娠妇女检测TOX RUV CMV HSV-1 HSV-2的阳性率分别为0．98％、7．2％、15．6％、4．5％、8．6％。结论本地区妊娠妇女CMV感染比较高,应及早对育龄妇女进行TORCH的筛查,做好优生优育工作,提高人口出生素质。     

孕妇TORCH感染情况的调查分析

目的 了解本地区孕妇感染TORCH(TOX RUV CMV HSV)的情况.方法 采用ELISA的方法 对来我院就诊的3650例孕妇进行TORCH-lgM的检测.结果 妊娠妇女检测TOX RUV CMV HSV-1 HSV-2的阳性率分别为0.98%、7.2%、15.6%、4.5%、8.6%.结论 本地区妊娠妇女CMV感染比较高,应及早对育龄妇女进行TORCH的筛查,做好优生优育工作,提高人口出生素质.     

孕妇巨细胞病毒不同感染形式对母婴免疫状态的影响

①目的 探讨孕妇巨细胞病毒（CMV）不同感染形式对母婴免疫状态的影响.②方法 对门诊产前检查的孕妇行CMV血清IgG和IgM筛查,对IgG（＋）和/或IgM（＋）者分娩前采集孕妇静脉血,检测CMV IgM抗体.根据检测结果分为原发感染组、复发感染组和对照组.各组新生儿出生后采集脐静脉血,检测CMV IgM抗体.各组孕妇及新生儿检测免疫学指标IL-2、IFN-γ和IL-4.③结果 原发感染组孕妇与对照组相比IL-2、IL-4显著降低（P＜0.05）;原发感染组新生儿与对照组相比IL-2水平显著降低;垂直传播组新生儿IL-2、IFN-γ和IL-4水平均显著低于对照组（P＜0.05）.④结论 孕妇CMV原发感染可降低其机体的免疫力;新生儿先天感染及其母亲原发感染CMV可使其免疫状态受到抑制.     

HIV infection seroprevalence and risk factor study among pregnant women attending the Antenatal Clinic at the University Hospital of the West Indies,Kingston, Jamaica

The objectives of this study were to determine the seroprevalence and risk factors for Human Immunodeficiency Virus (HIV) infection among the antenatal clinic population at the University Hospital of the West Indies (UHWI). Pregnant mothers (4186) attending antenatal clinic at the UHWI were screened for HIV infection between September, 1998, and October, 2000. Tests were performed with the use of Abbott enzyme immunoassay (EIA) kits for the detection of antibodies to HIV 1 and 2. Demographic characteristics and risk factor assessments were performed using a questionnaire for all positive cases and four randomly selected negative controls matched by age to each positive case. Twenty-one women were found to be HIV positive. Nineteen of these women were not previously aware that they were HIV-positive. The seroprevalence of HIV infection among antenatal mothers was 0.5%. The mean age of cases was 29.3 +/- 4.6 years. There was no significant difference between cases and controls with regards to parity, socio-economic status and educational achievement. Women residing in urban Kingston and St Andrew (Odds ratio (OR) 5, 95% confidence interval (CI) 1.4, 18), as well as those with a higher number of lifetime sexual partners (OR 1.42, 95% CI 1.13, 1.79) and those with previous sexually transmitted diseases (OR 3.4, 95% CI 1.1, 10.6) were at greater risk for HIV infection. In contrast, women who commenced coitus at a later age were at less risk of becoming infected (OR 0.79, 95% CI 0.6, 0.97). This study demonstrates a low seroprevalence of HIV in the UHWI antenatal population compared to the reported seroprevalence of 2%-8% in pregnant women in Latin America and the Caribbean. The results from this study emphasize the continuing need for voluntary HIV testing and HIV/AIDS educational campaign for this vulnerable group.