Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
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A researcher reviewed the January 1984-December 1986 birth and obstetrical records at the University of Nigeria Teaching Hospital in Enugu. During this period, the incidence rate for abruptio placentae was .44% (81/18,215). 56 of these cases were considered mild and 25 were severe. 15/81 cases did not have adequate antenatal care. 49.4% of the cases were in the 26-30 year old age group. The higher the parity of the women the higher the percentage of those with abruptio placentae, e.g., 3.7% for primigravidas and 33.3% for parity or = 5. The leading symptoms included tender uterus (87.7%), abdominal pain (85.2%), and vaginal bleeding (54.3%). Other symptoms included hypertension, shock, and proteinuria. Vaginal delivery accounted for 80.3% of the abruptio placentae births, while cesarean section accounted for 12.4%, vacuum extraction 3.7%, and breech delivery 3.7%. 91.4% of the patients required a blood transfusion with an average of 3 pints of blood/patient. 22.2% of the patients experienced severe postpartum hemorrhage as a result of uterine atony, coagulation failure, or puerperal sepsis. The perinatal mortality rate stood at 58%. None of the 15% of mothers who had severe abruptio placentae had a live infant. 16% of the infants were premature. Since most of the referred patients either did not have any antenatal care or had inadequate antenatal care, it appears that an appropriate measure to reduce the gravity of abruptio placentae would be a wider distribution of excellent antenatal and obstetric management in the rural areas.
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PMID:Abruptio placentae at the University of Nigeria Teaching Hospital, Enugu: a 3-year study. 280 22

Prenatal care aims to preserve the health of the fetus and mother. It screens for indications of illness or pregnancy-related complications and tries to prevent them from becoming emergencies. Sufficient referral services are needed for prenatal screening to be effective. Women and their families must be motivated to go to them promptly. Often prenatal care is the first time women receive any medical care. Thus, quality care is imperative so women will again request medical care when necessary. Prenatal care providers must ask women about signs and symptoms of placenta previa and placental abruptio. They should also tell them about the gravity of hemorrhaging in late pregnancy. Referral facilities must have operative capabilities and be able to provide adequate transfusion to treat severe hemorrhage. Health workers must prevent and treat anemia in pregnant women to improve their chances of recovery from blood loss; they must also measure blood pressure and periodically test for proteinuria and edema to diagnose preeclampsia, eclampsia, and hypertension. Health workers must screen women at high risk for cephalopelvic disproportion (e.g. by assessing, height, foot size, and age) and for a malpositioned fetus and multiple pregnancies (e.g. via abdominal examination). They must also educate mothers about the importance of hygienic delivery and provide sanitary delivery kits. Unhygienic delivery conditions and untreated sexually transmitted diseases (STDs) can cause puerperal sepsis. STDs can also have other adverse effects such as ectopic pregnancy and blindness, death, or retardation of the fetus/ infant. STD screening could prevent needless suffering in many women; 5-15% of pregnant women in some developing countries have syphilis. Prenatal care should include screening for urinary tract infections which can cause preterm delivery and low birth weight. Antibiotics can treat these infections. Some pregnant women have infectious diseases which may undetected without prenatal care.
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PMID:How prenatal care can improve maternal health. 1228 37