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Articles 1 - 30 of 31
Full-Text Articles in Obstetrics and Gynecology
The Knowledge, Experiences, And Barriers Associated With Male Involvement In Family Planning At Lal Qila, District Dir (Lower), Kpk, Pakistan: A Descriptive Exploratory Study, Jalal Khan
Theses & Dissertations
Background: Pakistan is one of the world’s most populous countries with a high growth rate. The overgrowth in population negatively affects the country’s socioeconomic progress in many aspects, like education, housing, employment, and health. Family Planning (FP) is the best way to reduce the fertility rate and control population overgrowth through contraception. FP positively impacts the mother's health and the productive results of every pregnancy.
Purpose: This study aims to explore the knowledge, experiences, and barriers associated with male involvement in family planning.
Method: A qualitative exploratory design was used with a purposive sampling technique to explore the perceptions of …
Quality Of Life And Sexual Function Of Women With Endometriosis At The Aga Khan University Hospital Nairobi, Edna Mohere Chacha
Quality Of Life And Sexual Function Of Women With Endometriosis At The Aga Khan University Hospital Nairobi, Edna Mohere Chacha
Theses & Dissertations
Introduction: Endometriosis is a benign, chronic condition that affects up to ten percent of women of childbearing age. It’s marked by the presence of endometrial tissue outside the uterine cavity (Giudice, 2010). It is a health condition with wide-ranging and pervasive sequelae making it a significant health concern requiring appropriate action (Rush & Misajon, 2018). We observed that there was a paucity of data relating to how endometriosis impacted on female sexual function and quality of life in sub-Saharan Africa, Kenya included.
Objectives: The primary goal of this empirical investigation was to determine the quality of life of women who …
Placental Histopathological Changes In Covid-19 And Their Associated Effects On Adverse Pregnancy Outcomes, Eric Mugambi
Placental Histopathological Changes In Covid-19 And Their Associated Effects On Adverse Pregnancy Outcomes, Eric Mugambi
Theses & Dissertations
Introduction: Coronavirus disease (COVID-19) is a significant cause of morbidity and mortality among pregnant women. Pregnant women infected with SARS-CoV-2 are at a greater risk of pre-eclampsia/eclampsia, non-iatrogenic preterm birth, stillbirth, and small for gestational age infants/fetal growth restriction (SGA/FGR), which share a common placental etiology. Placental histopathological changes attributed to COVID-19 have been demonstrated but there is a knowledge gap in how these changes impact pregnancy outcomes particularly those of placental origin.
Objectives: To investigate if there is an association between placental histopathology (maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), acute and chronic inflammatory pathology, and other findings …
Perceptions And Attitudes Of Physicians And Midwives Towards Patient Safety At The Maternity Department Of A Tertiary Teaching Hospital In Kenya: A Mixed Method Study, Albert Kiretia Gichuki
Perceptions And Attitudes Of Physicians And Midwives Towards Patient Safety At The Maternity Department Of A Tertiary Teaching Hospital In Kenya: A Mixed Method Study, Albert Kiretia Gichuki
Theses & Dissertations
Introduction: The maternal mortality ratio (MMR) has declined across the world over the last 17 years. This has been attributed to more women delivering in health facilities with trained birth attendants. Despite this there is still a high maternal mortality rate with over 86% of the mortalities occurring in Sub-Saharan Africa and South East Asia. This has led to increased focus on improving quality of care and patient safety in the health facilities. A positive safety culture, which is the product of individual and group values, attitudes, perceptions and patterns of behaviour that determine the commitment to an organization’s safety …
Determinants Of The Uptake Of Prenatal Aneuploidy Screening Among Pregnant Women At The Aga Khan University Hospital, Nairobi, Kenya, Duncan Ndegwa
Determinants Of The Uptake Of Prenatal Aneuploidy Screening Among Pregnant Women At The Aga Khan University Hospital, Nairobi, Kenya, Duncan Ndegwa
Theses & Dissertations
INTRODUCTION: Aneuploidies present with an abnormal copy number of chromosomes. Majority are lethal with only a handful carrying on to term and beyond in pregnancy. Its currently recommended that all pregnant women be offered screening for aneuploidies. This is to facilitate pregnant women make informed choices regarding their pregnancies. At present the current uptake rate of aneuploidy screening in Kenya is unknown. The purpose of this study this study was to determine whether pregnant women are aware of aneuploidy screening, the uptake rate of screening and the determinants of screening at a tertiary private healthcare facility in Nairobi, Kenya.
METHODS: …
Association Between Third Trimester Cerebro-Placental Ratio And Adverse Outcomes In Appropriate For Gestational Age Foetuses, Morris Wabacha Kimani
Association Between Third Trimester Cerebro-Placental Ratio And Adverse Outcomes In Appropriate For Gestational Age Foetuses, Morris Wabacha Kimani
Theses & Dissertations
Background: Small for gestational age (SGA) fetuses are at increased risk of adverse outcomes and appropriate vigilance is put in place in terms of antenatal and intrapartum surveillance. Appropriate for gestational age (AGA) fetuses have a lower incidence of adverse outcomes, although majority of these outcomes occur in this cohort. AGA fetuses can fail to reach their genetic growth potential due to placental insufficiency and 25 % have actually been found to have placental histological features of chronic hypoxia. Therefore, there is need to use other methods of screening for adverse perinatal outcomes apart from estimated fetal weight (EFW), with …
Efficacy Of Nerve Blocks On Immediate Post Caesarean Delivery Functionality, Dorothy Makena
Efficacy Of Nerve Blocks On Immediate Post Caesarean Delivery Functionality, Dorothy Makena
Theses & Dissertations
Introduction; Caesarean section is becoming increasingly common and is one of the most performed procedures globally. It is a major surgery accompanied by moderate to severe pain. Pain impacts negatively on functionality of the mother in terms of daily activities like self-care, newborn care and mobility. A post caesarean section mother therefore requires effective and safe pain relief to improve functionality, for effective breastfeeding and to reduce the risk of venous thromboembolism. Abdominal plane nerve blocks have been studied widely in the recent past and have been shown to be effective as part of multimodal post caesarean analgesia. This study …
Uptake And Determinants Of Cervical Cancer Screening Among Health Care Workers In Aga Khan University Hospital, Nairobi Kenya., Doreen Moraa Osoro
Uptake And Determinants Of Cervical Cancer Screening Among Health Care Workers In Aga Khan University Hospital, Nairobi Kenya., Doreen Moraa Osoro
Theses & Dissertations
Background: The cancer burden has been rising globally. The reported incidence of cervical cancer is 13.1 / 100,000 globally and 40 / 100,000 in Kenya. Up to 88% of all cervical cancer deaths have been reported in lower to middle-income countries. In comparison, developed countries had up to two to four times lower rates of cervical cancer incidence and mortality. The burden of cancers attributable to carcinogenic infections has potentially modifiable risk factors, for which prevention tools already exist. There is a gap in the implementation of evidence-based interventions including primary prevention with the HPV vaccine and secondary prevention with …
Planned Delivery At 37 Weeks Gestation Versus Expectant Management For Non-Severe Chronic Hypertension, A Systematic Review., Jackson Njuguna
Planned Delivery At 37 Weeks Gestation Versus Expectant Management For Non-Severe Chronic Hypertension, A Systematic Review., Jackson Njuguna
Theses & Dissertations
Background: Chronic hypertension is independently associated with an increased incidence of adverse maternal and perinatal outcomes. Delayed delivery carries maternal risks, while early delivery increases fetal risk, so appropriate timing is important. The optimal timing of delivery for women with this condition has not been adequately addressed by the available literature.
Objective: To review the literature that assesses the benefits and risks of a policy of planned delivery versus expectant management in pregnant women with non-severe chronic hypertension at 37 weeks gestation. Our primary outcomes were composite maternal outcome (super-imposed pre-eclampsia, placental abruption, maternal admission to intensive care unit and …
Assessment Of Activity Levels And Perceived Barriers Or Facilitators To Physical Activity In Pregnancy At Aga Khan University Hospital, Nairobi, Kenya, Zoya Virji Lalani
Assessment Of Activity Levels And Perceived Barriers Or Facilitators To Physical Activity In Pregnancy At Aga Khan University Hospital, Nairobi, Kenya, Zoya Virji Lalani
Theses & Dissertations
Introduction: Physical activity (PA) during pregnancy significantly reduces the risk of pregnancy related complications and positively influences maternal health and wellbeing. The American College of Obstetricians and Gynaecologists (ACOG) recommends that pregnant women can exercise moderately for 30 minutes on most days of the week, however no study has ever examined the extent to which Kenyan women are meeting these recommendations. Furthermore, attitudes and perceptions of pregnant women towards PA shape their eventual behaviour. Whilst these influencing factors have not been explored, understanding them is essential for implementing effective interventions to improve exercise participation antenatally.
Objectives: This study examined …
The Burden Of Urinary Incontinence Among African Diabetic And Non-Diabetic Women Seeking Care At The Aga Khan University Hospital, Nairobi, Martin Kimemia Mbuthia
The Burden Of Urinary Incontinence Among African Diabetic And Non-Diabetic Women Seeking Care At The Aga Khan University Hospital, Nairobi, Martin Kimemia Mbuthia
Theses & Dissertations
Introduction: Female urinary incontinence is a common and chronic condition with devastating psychosocial effects. It can occur at any age and is specifically more common in older women. It has a prevalence of up to 55% depending on the age-group and the target population studied. About 9% of adults globally have diabetes and a greater number live in LMICs. Diabetes is twice as prevalent in blacks and three to four times higher in South-Asian populations compared to Caucasian populations. In women with Type 2 DM, urinary incontinence is 30% to 70% more common than among women with normal glucose levels. …
Long Term Health Related Quality Of Life Following Uterine Fibroid Embolization At Aga Khan University Hospital, Nairobi, Michael Muthoka Kioko
Long Term Health Related Quality Of Life Following Uterine Fibroid Embolization At Aga Khan University Hospital, Nairobi, Michael Muthoka Kioko
Theses & Dissertations
Background: Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. Most of the studies have demonstrated an improvement in the quality of life over a short to intermediate period. We carried out this study to assess the long-term quality of life following uterine fibroid embolization in a predominantly black population. There are no identified studies locally or in Africa addressing this issue whereas studies done elsewhere indicate a probable increased fibroid disease burden among black women.
Objectives: Our objectives in …
The Association Of Maternal Sociodemographic Factors With Stress In Pregnancy, Maheshwari Andhavarapu
The Association Of Maternal Sociodemographic Factors With Stress In Pregnancy, Maheshwari Andhavarapu
Theses & Dissertations
Introduction: Antenatal stress has been linked to maternal morbidity and preterm birth (PTB). One of the pathophysiological processes leading to PTB is thought to be via activation of the hypothalamus-pituitary-adrenal axis resulting in cortisol production. Hair cortisol has recently been shown to be a stress marker in the pregnant and non-pregnant population. Some determinants of hair cortisol have also been studied but more research is needed in this area, especially in pregnancy. Understanding the risk factors of antenatal stress may guide institution of preventative or screening measures to reduce the risk of adverse birth outcomes. As the effect of stress …
Burnout Among Medical Residents; Their Impressions Of Its Impact On Patient Care And Coping Mechanisms, Elizabeth Ochola
Burnout Among Medical Residents; Their Impressions Of Its Impact On Patient Care And Coping Mechanisms, Elizabeth Ochola
Theses & Dissertations
Introduction: Burnout is a syndrome that occurs as a result of chronic workplace stress that has not been successfully managed. This global definition is given by the International Classification of Diseases; 11th edition. The ICD-11 further characterizes burnout using three dimensions: Emotional exhaustion described as feelings of energy depletion or exhaustion; depersonalization described as; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and low personal accomplishments seen as reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and is not applied to describe experiences in other areas of life. …
Timing And Factors That Contribute To The Decision Making Process On The Mode Of Delivery After One Previous Casearean Section., Sylvia Nyanyu Mruttu
Timing And Factors That Contribute To The Decision Making Process On The Mode Of Delivery After One Previous Casearean Section., Sylvia Nyanyu Mruttu
Theses & Dissertations
Background: The rates of caesarean sections have continued to rise despite public and professional concern. This has continually increased the proportion of the obstetric population with a history of previous caesarean delivery. These women may be offered either elective repeat caesarean section (ERCS) or planned vaginal birth after caesarean delivery (VBAC). This study aimed to identify the timing, level of knowledge and factors that influence the decision-making.
Objectives: The primary objective was to elicit the factors that contribute to women to choose VBAC or ERCS. The secondary objectives were to determine the timing of this decision, measure the level of …
Comparison Of Vaginal Microbiota In Women With Spontaneous Preterm Labour Versus Those With Term Labour, Edgar Gulavi
Comparison Of Vaginal Microbiota In Women With Spontaneous Preterm Labour Versus Those With Term Labour, Edgar Gulavi
Theses & Dissertations
Background: Preterm birth presents a challenge on a global scale with a disease burden that is on the rise. It is a leading cause of perinatal morbidity and mortality worldwide with approximately 15 million preterm births every year. Kenya has a 12% preterm birth rate with about 190,000 babies born preterm every year. The female lower genital tract bacterial community plays a vital role in maternal and neonatal health. An association between altered vaginal microbial composition and preterm birth has been demonstrated in previous studies. However, findings in terms of composition and diversity of these bacteria across the few studies …
Quality Of Life And Its Determinants In Subfertile Patients Seeking Fertility Care At Two Urban Fertility Centres In Nairobi, Lawrence Makoha Sikuku
Quality Of Life And Its Determinants In Subfertile Patients Seeking Fertility Care At Two Urban Fertility Centres In Nairobi, Lawrence Makoha Sikuku
Theses & Dissertations
Introduction: Subfertility affects one in six couples worldwide with devastating psychosocial consequences impacting on quality of life (QoL). Assessment of QoL and institution of appropriate interventions in subfertility patients complements clinical management by reducing the psycho-social effects of subfertility and its treatment. No local or regional data exist on impact of subfertility on QoL using a fertility-specific QoL assessment tool.
Objective: The study sought to determine the QoL of subfertile patients seeking fertility care at two urban fertility centres in Nairobi using the Fertility Quality of Life (FertiQoL) tool.
Methods: This was a cross sectional study. Subfertile women of reproductive …
Relationship Between Gestational Diabetes And A Positive Depression Screen, Onegarach Herbert Ozelle
Relationship Between Gestational Diabetes And A Positive Depression Screen, Onegarach Herbert Ozelle
Theses & Dissertations
Introduction: Gestational diabetes mellitus (GDM) and its treatment have a marked effect on women’s lives consequently aggravating psychosocial disruptions of a normal pregnancy. The demand for behavioural adaptation as well as postulated biological interactions are likely to increase the risk of maternal depression in GDM patients. There is however inadequate literature concerning the relationship between GDM and depression.
Objective: To compare the proportion of women with GDM who screen positive for depression and the proportion of women without GDM who screen positive for depression at the Aga Khan University Hospital, Nairobi. Socio-demographic factors associated with a positive depression screen were …
Women And Maternal Health Care Providers’ Perceptions, Beliefs And Attitudes Towards Use Of Epidural Analgesia For Labour Pain Relief, Stella Njenga
Women And Maternal Health Care Providers’ Perceptions, Beliefs And Attitudes Towards Use Of Epidural Analgesia For Labour Pain Relief, Stella Njenga
Theses & Dissertations
Background: Epidural analgesia (EA) is considered the gold standard for relief of labour pains due to its effectiveness, safety and flexibility of use. There is a disparity of utilization between high and low & middle income countries with lack of knowledge and resources implicated. Aga Khan University Hospital Nairobi is a well-resourced facility with a well-established EA service. This study explores the perceptions, beliefs and attitudes of women seen at the facility towards EA and how these affect their decision to use the method. It also explores health care providers’ views on the method and how they influence the women’s …
Difference In The Level Of Utilization And Determinants Of Preconception Care Among Pregnant Women In Aga Khan University Hospital And Maragua Level Four Hospital., Joan Okemo
Theses & Dissertations
Background: Preconception care (PCC) is an important form of primary health care that aims to identify risks, offer patient education and evidence based interventions prior to conception in order to improve maternal and fetal short and long term health outcomes. Despite the benefits of PCC, the global levels of utilization are still low, more so in developing countries and in the rural settings. This study aimed to determine the difference in the level and determinants of PCC in both urban and rural settings in Kenya.
Objectives: The primary objective of this study was to compare PCC among pregnant women in …
Prevalence Of Positive Depression Screen Among Post Miscarriage Women At The Aga Khan University Hospital, Steve Kyende Mutiso
Prevalence Of Positive Depression Screen Among Post Miscarriage Women At The Aga Khan University Hospital, Steve Kyende Mutiso
Theses & Dissertations
Introduction: Miscarriages are a common pregnancy complication affecting about 10-15% of pregnancies. Miscarriages may be associated with a myriad psychiatric morbidity at various timelines after the event. Depression has been shown to affect about 10-20% of all women following a miscarriage. However, no data exists in the local setting informing on the prevalence of post-miscarriage depression.
Objective: To determine the prevalence of positive depression screen among post-miscarriage women at the Aga Khan University hospital, Nairobi.
Methods: The study was cross-sectional in design. Patients who had a miscarriage were recruited at the post-miscarriage clinic review at the gynecology clinics …
Association Between Female Sexual Dysfunction And Fertility Among Women Of Reproductive Age At The Aga Khan University Hospital, Nairobi., Felix Mwembi Oindi
Association Between Female Sexual Dysfunction And Fertility Among Women Of Reproductive Age At The Aga Khan University Hospital, Nairobi., Felix Mwembi Oindi
Theses & Dissertations
Introduction: Sexual function plays an essential role in the bio-psychosocial wellbeing and quality of life of women and disturbances in sexual functioning often result in significant stress. Sexual dysfunction in women is a highly prevalent condition affecting up to 43% of women. Subfertility being a common problem affecting up to 20% of the population, causes significant psychosocial distress which might adversely affect sexual functioning and vice versa. However, despite the high prevalence of both conditions, little has been studied on the effects of subfertility on sexual functioning especially in sub-Saharan Africa.
Objectives: This study primarily compared the prevalence …
Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure
Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure
Theses & Dissertations
Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …
The Rise And Fall Of The Bovine Corpus Luteum, Heather Talbott
The Rise And Fall Of The Bovine Corpus Luteum, Heather Talbott
Theses & Dissertations
This dissertation describes a study of the mechanisms regulating the genesis and subsequent involution of the temporary endocrine structure, the corpus luteum (CL), through the use of a bovine model. The CL is essential for maintaining a suitable uterine environment for embryo implantation and early development through secretion of the steroid hormone progesterone. The “Rise and Fall” of the CL occurs within each estrous cycle whereby the CL must form from the ruptured follicle, secrete sufficient progesterone for uterine maturation, and at the end of the cycle (or pregnancy) regress to allow new follicular development. During the rise of the …
Maternal Inflammatory Markers In The Diagnosis Of Chorioamnionitis And Prediction Of Neonatal Sepsis In Preterm Pre-Labour Rupture Of Membranes: A Systematic Review, Angela Koech Etyang
Maternal Inflammatory Markers In The Diagnosis Of Chorioamnionitis And Prediction Of Neonatal Sepsis In Preterm Pre-Labour Rupture Of Membranes: A Systematic Review, Angela Koech Etyang
Theses & Dissertations
Background: There is no consensus on the potential role of inflammatory markers in identifying chorioamnionitis in women with Preterm Pre-labour Rupture of Membranes (PPROM) or in predicting Early Onset Neonatal Sepsis (EONS) in their neonates.
Objectives: To perform a quantitative review on the accuracy of maternal C reactive protein (CRP), Procalcitonin (PCT) and Interleukin 6 (IL6) in the diagnosis of Histological Chorioamnionitis and/or Funisitis (HCA/Funisitis) and their role in the prediction of EONS in PPROM.
Methods: MEDLINE, EMBASE and The Cochrane Library databases were searched from inception to October 2015, for studies where these markers were assessed against a reference …
Association Of 24-32wk Maternal Triglyceride Levels And Neonatal Birth Weight At The Aga Khan University Hospital, Demetrius Mududa Omondi
Association Of 24-32wk Maternal Triglyceride Levels And Neonatal Birth Weight At The Aga Khan University Hospital, Demetrius Mududa Omondi
Theses & Dissertations
Introduction: The association of neonatal birth weight and mid-term maternal lipid levels has been demonstrated in several studies with elevated serum triglyceride levels shown to be a strong predictor of the large for gestational age baby/ fetal macrosomia. Maternal diabetes remains the strongest risk factor for developing a LGA/macrosomic baby explained by the Pederson hypothesis. However non-diabetic macrosomia is still an obstetric dilemma with the attendant fetal and maternal complications. This phenomenon could be explained by altered maternal lipid metabolism as lipids have been shown to be important for normal fetal growth and development.
Objective: Our primary objective was to …
Association Between Immediate Postnatal Anaemia And Risk Of Developing Postpartum Depression At The Aga Khan University Hospital: A Cohort Study, John Ndungu Kimani
Association Between Immediate Postnatal Anaemia And Risk Of Developing Postpartum Depression At The Aga Khan University Hospital: A Cohort Study, John Ndungu Kimani
Theses & Dissertations
Introduction: Postpartum depression has significant burden on obstetric psychopathology. While risk factors for the same have been extensively studied, most of this studies have focused on the role of psychosocial factors. Data on the role of physiological variables such as anaemia and role of obstetric complications in postpartum depression is now emerging. There are still gaps in literature regarding the same in developing countries and in Africa.
Primary Objective: To determine the association between low postnatal hemoglobin and postpartum depression
Secondary Objective: To determine the association between obstetric complication specifically postpartum hemorrhage, operative delivery and NICU/NHDU admission and postpartum depression. …
One Year Symptom Severity And Health-Related Quality Of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation, Charles Muriuki Mariara
One Year Symptom Severity And Health-Related Quality Of Life Changes Among Patients Undergoing Uterine Fibroid Embolisation, Charles Muriuki Mariara
Theses & Dissertations
Background: The main aim of treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in women with significant fibroid burden and large uterine volumes is not clear.
Objective: To determine the change in symptom severity and health-related quality of life among patients who have undergone uterine fibroid embolisation for treatment of symptomatic uterine fibroids.
Setting: Aga Khan University Hospital, Nairobi
Methods: A prospective before and after study (observational) of patients undergoing uterine fibroid embolisation. Prior to embolisation, study participants underwent …
Association Between Parity And Rubella Seropositivity Among Older Reproductive-Age Women, Ibtisam Salim Awadh
Association Between Parity And Rubella Seropositivity Among Older Reproductive-Age Women, Ibtisam Salim Awadh
Theses & Dissertations
Background: Rubella virus when it infects a non-pregnant adult or child usually causes a mild febrile rash illness. However, infection in the first 12 weeks of pregnancy causes miscarriages, stillbirths or foetal anomalies known as congenital rubella syndrome (CRS). Factors associated with rubella immunity include age and parity. No studies have been done to isolate the association of parity independent of age.
Objectives: To determine the seroprevalence of rubella IgG antibodies among nulliparous and multiparous women of the same age-group attending various clinics in Aga Khan University Hospital, Nairobi,
Design: A cross-sectional study of women attending a tertiary hospital, Nairobi, …
Association Between Elevated Third Trimester Maternal Haemoglobin And Neonatal Gestational Age Adjusted Birth Weight, Bob Otieno Achila
Association Between Elevated Third Trimester Maternal Haemoglobin And Neonatal Gestational Age Adjusted Birth Weight, Bob Otieno Achila
Theses & Dissertations
Background: Women tend to have lower haemoglobin compared to men due to menstrual blood losses. This is often compounded by nutritional deficiencies. There is a further drop in haemoglobin during pregnancy due to red cell dilution. Pregnancy itself places a huge demand on maternal iron stores. High haemoglobin may reflect haemoconcentration due to a failure of the normal physiological expansion in plasma volume. Iron excess has also been associated with free-radical damage. In current practice, high maternal haemoglobin in pregnancy is often not given as much attention as anaemia. This study examines the association between high maternal haemoglobin in the …