Aim: The study examined the policies, systems, and procedures for pregnancy registration in 10 local government units (LGUs) within Quezon Province, a Universal Health Care (UHC) implementation site in Calabarzon.

Methods: This descriptive, cross-sectional study employed a mixed quantitative and qualitative design to examine the policy environment and identify gaps in pregnancy registration in Quezon Province as a UHC implementation site. Key informant interviews, focus group discussions, and surveys were conducted to identify factors that either facilitate or impede the timing of pregnancy registration.

Results: Analysis revealed deficiencies in the current pregnancy registration process. Key findings indicate that women with four or more pregnancies, or those with three or more childbirths, are more likely to delay seeking antenatal care (ANC) at healthcare facilities. Conversely, women who acknowledge significant barriers to accessing ANC tend to have a lower odds of experiencing delays. These barriers include health system-related issues, accessibility issues, and sociodemographic factors.

Conclusion: The findings underscore the need to implement comprehensive policies aimed at institutionalizing and enhancing the pregnancy registration process. A streamlined and accessible process can significantly improve healthcare access for pregnant women, particularly in underserved communities. This, in turn, can foster an environment where expectant mothers receive timely prenatal care, education, and support throughout their pregnancy journey.

Aims: The place of residence influences the occurrence of adverse birth outcomes, and understanding disparities in adverse birth outcomes between rural and urban areas is crucial for designing targeted interventions and improving maternal and neonatal health outcomes.

Methods: A scoping review using five databases, including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, PubMed, and Web of Science, was conducted to evaluate the association between the place of residence (rural and urban areas) and adverse birth outcomes.

Results: A total of 15 studies met the inclusion criteria and were included in this review. Nine adverse birth outcomes (preterm birth, low birth weight, small for gestational age, perinatal death, stillbirth, neonatal death, large for gestational age, cesarean section, and miscarriage) were reported to have higher rates in rural versus urban communities.

Conclusions: Inadequate access to antenatal care services and limited healthcare facilities were identified as potential factors contributing to the higher likelihood of adverse birth outcomes in rural areas. Targeted interventions tailored to the specific challenges faced by rural communities should be implemented to ensure equitable access to healthcare services and optimal maternal and neonatal health.

Aim: We introduced the use of paracervical block in combination with intravenous pentazocine and thiopental sodium for evacuation of first-trimester miscarriage or abortion, with the hypothesis that this regimen would reduce thiopental sodium dosage and its side effects compared with using intravenous anesthesia alone.

Methods: We retrospectively reviewed cases of singleton miscarriage or abortion before 12 weeks of gestation, classified into Group IV (intravenous anesthesia only) and Group IV+PB (intravenous anesthesia and paracervical block), from February 2019 to August 2022. The primary outcome was thiopental sodium dosage, and secondary outcomes were the need for prolonged hospitalization and incidence of nausea or vomiting.

Results: Seventy-six and 97 cases were included in Group IV and Group IV+PB, respectively. The amount of thiopental sodium was significantly lower in Group IV+PB (mean: 260±107 mg) than in Group IV (mean: 287±102 mg) (P=0.047). Regarding the need for prolonged hospitalization and incidence of nausea or vomiting, results were comparable between the two groups.

Conclusions: The combination of intravenous anesthesia and paracervical block effectively reduced the amount of anesthesia administered. This approach holds promise for enabling smoother pain relief, promoting early postoperative ambulation, and reducing side effects during evacuation procedures for first-trimester miscarriage or abortion.

Introduction: Recently, pregnancy and lactation-related osteoporosis has been the focus of research because age at delivery has been increasing in developed countries and osteoporosis reduce a mother's quality of life. This study aimed to investigate bone mineral density (BMD) in women at delivery and one-month postpartum using radiofrequency echographic multi-spectrometry (REMS) and to determine the clinical factors affecting BMD.

Materials and methods: Seventeen women with singleton term pregnancies who cared at Keio University Hospital between November 1 and December 31, 2022, were included. We measured the estimated BMD (eBMD) of the right femoral neck using REMS at delivery and one-month postpartum. We evaluated the association between eBMD and maternal clinical characteristics.

Results: Postpartum eBMD (0.68±0.06 g/cm²) was significantly higher than antepartum eBMD (0.66±0.06 g/cm²) (P=0.02). There was a positive correlation between pre-pregnancy body mass index (BMI) and antepartum eBMD (ρ=0.85, P<0.01). Antepartum and postpartum eBMDs were significantly lower in multiparous women than in nulliparous women (both P=0.04). Calcium intake and breastfeeding did not affect postpartum eBMD.

Conclusion: eBMD increases at the one month postpartum compared to that at delivery. Pre-pregnancy BMI is crucial for maintaining BMD during pregnancy and lactation, emphasizing the importance of pre-conception care.