Nanotechnology, the art of engineering structures on a molecular level, offers the opportunity to implement new strategies for the diagnosis and management of pregnancy-related disorders. This review aims to summarize the current state of nanotechnology in obstetrics and cancer in pregnancy, focusing on existing and potential applications, and provides insights on safety and future directions. A systematic and comprehensive literature assessment was performed, querying the following databases: PubMed/Medline, Scopus, and Endbase. The databases were searched from their inception to 22 March 2022. Five independent reviewers screened the items and extracted those which were more pertinent within the scope of this review. Although nanotechnology has been on the bench for many years, most of the studies in obstetrics are preclinical. Ongoing research spans from the development of diagnostic tools, including optimized strategies to selectively confine contrast agents in the maternal bloodstream and approaches to improve diagnostics tests to be used in obstetrics, to the synthesis of innovative delivery nanosystems for therapeutic interventions. Using nanotechnology to achieve spatial and temporal control over the delivery of therapeutic agents (e.g., commonly used drugs, more recently defined formulations, or gene therapy-based approaches) offers significant advantages, including the possibility to target specific cells/tissues of interest (e.g., the maternal bloodstream, uterus wall, or fetal compartment). This characteristic of nanotechnology-driven therapy reduces side effects and the amount of therapeutic agent used. However, nanotoxicology appears to be a significant obstacle to adopting these technologies in clinical therapeutic praxis. Further research is needed in order to improve these techniques, as they have tremendous potential to improve the accuracy of the tests applied in clinical praxis. This review showed the increasing interest in nanotechnology applications in obstetrics disorders and pregnancy-related pathologies to improve the diagnostic algorithms, monitor pregnancy-related diseases, and implement new treatment strategies.

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Nanotechnologies in Obstetrics and Cancer during Pregnancy: A Narrative Review

Background Danger signs in pregnancy can warn of maternal health problems. In developing African countries, including Ethiopia, the rate of maternal mortality is high. There is little knowledge of danger signs during pregnancy and their associated factors at the community level in the study area. Methods A community-based, cross-sectional study was conducted to assess knowledge about danger signs among pregnant women in Hosanna Zuria Kebeles between 30 June and 30 July 2021. A simple random sampling method was used to select eligible pregnant women. The sample size was proportionally allocated based on the number of pregnant women in each kebele. Data were collected in face-to-face interviews using a pretested questionnaire. The descriptive results were presented as proportions, whereas the analytic results were presented as adjusted odds ratios (AOR). Results The prevalence of good knowledge of danger signs in pregnancy was 259/410 (63.2%, 95% confidence interval (CI) 58.3–67.8). The most common known danger signs during pregnancy were severe vaginal bleeding (n = 227, 55.4%), followed by blurred vision (n = 224, 54.6%). In the multivariable analysis, the age of the respondent (AOR = 3.29, 95% CI 1.15–9.38), the tertiary education of the mother (AOR = 5.40, 95% CI 2.56–11.34), and the number of live births (AOR = 3.95, 95% CI 2.08–7.48) were statistically significant factors. Conclusion There was an adequate prevalence of knowledge of danger signs in pregnancy among pregnant mothers compared with different studies in Ethiopia and different countries. Advanced maternal age, the respondent's level of education, and the number of live births were found to be independent determining factors for the level of knowledge on danger signs in pregnancy among pregnant mothers. Health facilities and healthcare providers should focus on antenatal care and the age and parity of the mother when giving information about danger signs in pregnancy. The Ministry of Health should provide reproductive health services in rural areas and encourage education for women. Further studies need to be conducted and include danger signs in the three trimesters using a qualitative study design.

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Knowledge of danger signs in pregnancy and their associated factors among pregnant women in Hosanna Town, Hadiya Zone, southern Ethiopia

Abstract Background Mother's awareness of obstetric danger signs is the degree of a pregnant woman to fully utilize her knowledge of the signs and symptoms of complications of pregnancy, which helps the mother and family to seek medical help immediately. High maternal and infant mortality rates in developing countries are due to a combination of a lack of quality, resources and access to health services coupled with mother’s lack of awareness. The purpose of this study was to collect current empirical studies to describe the pregnant women awareness about the obstetric danger sign in developing country. Method This review employed the Prisma-ScR checklist. The articles searched in four electronic databases (Scopus, CINAHL, Science Direct, Google Scholar). Variables that used to search the articles (pregnant woman, knowledge, awareness, danger signs pregnancy). The Framework used to review is PICOS. Result The results of the article found 20 studies which met inclusion criteria. The determinants were high educational status, more pregnancy experience, more ANC visit, and labour in the health facility. Conclusion The level of awareness is low to medium, only some have fair awareness, in which related to determinant. The recommended effective strategy is to improve the ANC program by assess the risk of obstetric danger sign promptly, assess the barrier of health seeking related to the family support, i.e. the husband and the elderly. Additionally, use MCH handbook or mobile application to record the ANC visit and communicate with the family. 

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Pregnant woman awareness of obstetric danger signs in developing country: systematic review

Abstract Introduction : - Maternal mortality is inadmissibly high. About two hundred ninety five thousand mothers lost their life due to pregnancy, delivery and their consequences in 2017 worldwide, in which Sub-Saharan Africa only comprised for about two-thirds of the losses. Inadequate knowledge regarding obstetrics danger signs among mothers and families in poor resource countries is among chief contributing factors for death of mothers. Little is known about the current knowledge of Obstetrics danger signs and influencing factors in Hargeisa, Somaliland. Objective : - To assess the level of knowledge of obstetrics danger signs and associated factors among pregnant women attending ANC in Hargeisa town health institutions, Somaliland. Methods and Materials : - Facility based cross sectional study design was used to collect data, among 222 pregnant women attending ANC in selected MCHs in Hargeisa town, Somaliland, July 2022. Eight MCHs were selected by simple random sampling. The sample size was proportionally allocated the selected MCHs based on the number previous month ANC attendees. Systematic random sampling was employed to approach study subjects. A pretested structured interviewer administered questionnaire used to collect the data. Data were checked, cleaned, entered and analyzed using SPSS V. 25. Bivariate and multivariate analysis was performed. Results : - A total of 222 pregnant women were participated in the study, with 100% response rate. Only 25.3% were knowledgeable about obstetrics danger signs. Educational status of the women and spouse, access to media, health educations given, and place of birth were significantly associated with knowledge of obstetrics danger signs among pregnant women attending ANC in health institutions in Hargeisa. Vaginal bleeding was most frequently mentioned obstetrics danger sign. Conclusion : - Large proportion of mothers were not knowledgeable about obstetrics danger signs. These mothers are more likely to delay in deciding to seek care. Increasing knowledge or awareness of key obstetrics danger signs need to be given focus as it makes women and their families ready for prompt and appropriate decisions and measures if obstetrics dangers occur. 

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Knowledge of Obstetric Danger Signs and Associated Factors among Pregnant Women Attending Antenatal Care in Hargeisa Town Health Institutions, Somaliland: A Cross sectional Study

Objective: This systematic review and meta-analysis will investigate the pooled knowledge level of obstetric danger signs and related factors among African women. Design: Systematic review and meta-analysis incorporating cross-sectional, case–control, and cohort study designs. Methods: Studies published with full texts in English language from the beginning to the present will be searched in the PubMed/MEDLINE, Cumulative Index to Nursing & Allied Health Literature, African Journals Online, and Google Scholar databases. Checklists from the Joanna Briggs Institute will be used to assess the quality of the studies’ methodology. Data extraction, critical appraisal, and screening of all retrieved articles will be conducted by two independent reviewers. Statistical analysis will be performed using the STATA-14 and Review Manager 5.3 (RevMan 5.3) software packages. A random effect will be employed to demonstrate pooled estimates of knowledge among women. For determinants of knowledge, an effect size with a 95% confidence interval will be analyzed. Protocol Registration: This systematic review and meta-analysis protocol was registered in PROSPERO with the registration ID and link as follows: CRD42022379085; CRD register@york.ac.ukhttps://www.york.ac.uk/inst/crd Discussion: Women who are more knowledgeable about obstetric danger signs are more likely to seek emergency care on time, closely attend antenatal care, and be better prepared for labor and any complications, which reduces both maternal and child mortality. This analysis will provide evidence of the pooled prevalence of knowledge of obstetric danger signs among African women, as well as contributing factors.

https://journals.sagepub.com/doi/pdf/10.1177/20503121231178102

A systematic review and meta-analysis protocol on knowledge of obstetric danger signs and associated factors among women in Africa

The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

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Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study.

Sonam Yoezer

Papers

Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study.