International Journal of Maternal and Fetal Health

Barriers to Accessing Prenatal Care: Experience in the Chiclayo Health Network, 2024

Clara Milena Palma-García — 2025-11-09

Objective: To determine the access barriers to prenatal care in the Chiclayo Health Network during 2024. Materials and methods: A non-experimental, correlational, and cross-sectional study was carried out. A total of 426 pregnant women who received prenatal care in the Chiclayo Health Network participated. Non-probability convenience sampling was used, and the Index of Barriers to Access to Care (ABCI) questionnaire, composed of 28 items on a five-point Likert scale, was applied. Means, proportions, and correlations were analyzed using the Spearman's (Rho) test using SPSS version 22. Results: The main access barrier identified was difficulty scheduling timely appointments for prenatal care (94.1%). Transportation limitations and travel expenses were also reported (69.5%), as well as difficulties in recognizing the importance of prenatal care (78.8%). Differences by place of care were statistically significant (p ≤ 0.005). Despite the aforementioned difficulties, the wait time for care was not considered long by most pregnant women. Conclusion: The main access barriers identified are related to appointment scheduling, transportation, and available financial resources. It is recommended that equity strategies in prenatal services be strengthened, improving organization, geographic access, and financial support for pregnant women in vulnerable situations.

Atherogenic Indices in cases of idiopathic preterm premature rupture of membranes and healthy pregnant controls: A Comparative Study

Shanmuga Priya Kirubalenin — 2025-11-19

Objective: To evaluate and compare atherogenic indices in women with idiopathic Preterm Premature Rupture of Membranes (pPROM) and gestational age matched healthy pregnant controls. Material and methods: In the Departments of Biochemistry and Obstetrics & Gynecology at UCMS & GTBH-Delhi, a cross-sectional comparative pilot study was carried out from August 2023 to July 2024. The study comprised 60 participants: 30 women with idiopathic pPROM (26-34 weeks gestation) and 30 controls with uncomplicated pregnancies who were matched for gestational age. We computed the following atherogenic indices: non-HDL-C, Lipoprotein Combined Index (LCI), LDL-C/HDL-C, TC/HDL-C, Atherogenic Coefficient (AC) and Atherogenic Index of Plasma (AIP) and analysed the data. Results: HDL-C levels were lower in idiopathic pPROM group. TC, TG, and LDL-C levels were higher in cases of idiopathic pPROM group. CRP levels were also higher in cases of idiopathic pPROM group, indicating increased systemic inflammation. All atherogenic indices except non-HDL-C were significantly elevated in the idiopathic pPROM group. Conclusion: Compared to healthy pregnant age-matched controls, women with idiopathic pPROM had a significantly pro-atherogenic lipid profile, elevated atherogenic indices and a higher inflammatory milieu. These findings also suggest a potential mechanism that links dyslipidaemia with proinflammatory state with membrane weakening, and ultimately resulting in premature rupture of membranes. Thus, these women require closer monitoring for timely interventions to alleviate adverse outcomes.

Effects of prenatal support on perceived stress and immune response in the postpartum period: a cross-sectional study in Uruguay

Pablo Lores — 2025-11-20

Objective: The aim of this study was to analyze the influence of CPN participation on perceived stress and salivary IgA levels during the immediate postpartum period. Material and methods: A cross-sectional study was conducted in a private healthcare institution in Uruguay, including 84 women in the immediate postpartum period. Perceived stress was assessed using the PSS-10 and PSS-14 scales, and saliva samples were collected for IgA quantification by indirect ELISA. Results: Participation in CPN was associated with moderately lower levels of perceived stress (p=0,0216 for PSS-10 y p=0,0221 for PSS-14), although no significant differences were observed in IgA concentrations between groups. Nevertheless, a trend toward lower IgA levels in the presence of high stress was identified, which appeared less pronounced among women who attended CPN. Conclusions: These findings suggest that CPN may play an indirect protective role by mitigating the impact of stress on maternal immunity during the postpartum period.

Academic adaptation of obstetrics students during the COVID-19 pandemic: Virtual study modality

Jhodith Jhovana Puente-Ayala — 2025-11-12

Objective: To analyze the process of academic adaptation of obstetrics students at the National University Hermilio Valdizán (UNHV) regarding the transition from face-to-face to virtual education during the COVID-19 pandemic. Materials and Methods: The research was quantitative, non-experimental, cross-sectional, and descriptive. The population consisted of 45 third- and fourth-year students of the Obstetrics program at the UNHV, who answered a questionnaire. Results: The findings showed low attendance in both modalities, limited teacher support, and diverse applications of methodological strategies. Likewise, difficulties were identified in access to digital resources and a significant digital gap, especially among third-year students. Despite these limitations, frequent use of virtual learning environments was observed. Conclusion: Academic adaptation was conditioned by structural, technological, and pedagogical factors that affected the professional training of the students.

Usefulness and Efficacy of Antiplatelet Agents in COVID-19: A Critical Review of the Evidence

Javier Rubén Rovar-Brandán — 2025-11-02

Objective: To review the available scientific evidence on the efficacy and safety of antiplatelet therapy in adult patients with COVID-19, with particular emphasis on its impact on mortality and thrombotic events. Material and Methods: A literature review was conducted including observational studies, clinical trials, and systematic reviews published between 2020 and 2024, involving adult patients diagnosed with COVID-19, both in-hospital and out-of-hospital settings. Searches were performed in PubMed, Embase, Health Systems Evidence, Cochrane, LILACS, and Scielo databases. The selected articles were assessed according to the quality criteria established by the CASPE template and the levels of evidence and grades of recommendation from the Joanna Briggs Institute (JBI). Results: Out of 121 articles, 40 were selected for full-text review, and 13 met the inclusion criteria. Among these were 4 systematic reviews, 8 cohort studies, and 1 randomized controlled trial (RCT). Findings indicate that the use of antiplatelet agents, particularly acetylsalicylic acid, may slightly reduce the incidence of thrombotic events, although evidence regarding its effect on mortality is limited and heterogeneous. Meta-analyses of RCTs showed that antiplatelet therapy reduces major thrombotic events (RR 0.86–0.90), does not affect mortality (RR 0.95–1.0), and increases the risk of major bleeding (RR/OR 1.62–1.68). Observational studies reported variable results regarding mortality, ICU admission, and need for mechanical ventilation. Conclusions: Antiplatelet agents may help prevent thrombotic events in COVID-19, especially when administered early or in high-risk patients. Their effect on mortality and other outcomes is heterogeneous and does not allow for conclusive recommendations. Further multicenter randomized controlled trials are needed to define which patients may benefit most, as well as optimal dosing, timing, and duration.

Pancreatic Neuroendocrine Tumor with Hepatic Metastases in a Pregnant Patient: A Case Report and Literature Review

Victor Hugo Vargas-Guzmán — 2025-10-29

Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms accounting for less than 2% of digestive tumors, with an estimated incidence of 0.32 per 100,000 person-years. Their diagnosis during pregnancy is unusual and poses significant challenges for therapeutic decision-making due to restrictions in diagnostic studies and treatment options. This case report presents a third-trimester pregnant patient with a well-differentiated pancreatic neuroendocrine tumor and multiple liver metastases, who initially manifested with glycemic dysregulation and nonspecific symptoms such as nausea and vomiting. Liver metastases were first identified through ultrasound, while the primary tumor was detected in the pancreatic body by magnetic resonance imaging and Octreoscan. Biochemical parameters remained within normal ranges. This case highlights the complexity of diagnosis and treatment, as well as the importance of multidisciplinary management.