scholarly journals OC22.06: Third trimester weight discordance cut-offs and perinatal mortality in twins: the STORK multiple pregnancy cohort

2013 ◽  
Vol 42 (s1) ◽  
pp. 45-46
Author(s):  
F. D'Antonio ◽  
A. Khalil ◽  
T. Dias ◽  
A. Bhide ◽  
B. Thilaganathan
Keyword(s):  
Perinatal Mortality ◽  
Multiple Pregnancy ◽  
Third Trimester ◽  
Pregnancy Cohort

scholarly journals PP.12 Weight Discordance and Perinatal Mortality in Twins: The Stork Multiple Pregnancy Cohort

2013 ◽  
Vol 98 (Suppl 1) ◽  
pp. A85.2-A85
Author(s):  
F D’Antonio ◽  
A Khalil ◽  
T Dias ◽  
A Bhide ◽  
B Thilaganathan
Keyword(s):  
Perinatal Mortality ◽  
Multiple Pregnancy ◽  
Pregnancy Cohort

Preterm labour in multiple pregnancies

1993 ◽  
Vol 5 (2) ◽  
pp. 105-119 ◽  
Author(s):  
James P Neilson ◽  
Caroline A Crowther
Keyword(s):  
Perinatal Mortality ◽  
Preterm Labour ◽  
Multiple Pregnancy ◽  
High Rate ◽  
Fetal Malformation ◽  
Multiple Pregnancies ◽  
Neonatal Deaths ◽  
Late Abortion ◽  
Early Neonatal Deaths ◽  
Singleton Pregnancies

Multiple pregnancy is associated with a high rate of perinatal loss – mainly due to preterm labour but with important contributions from fetal malformation, intrauterine growth retardation and twin-twin transfusion syndrome. The overall perinatal mortality rate is consistently around six times that of singleton pregnancies but the rate rises progressively with the number of fetuses. Rates of 63,164,200,214 and 416 per 1000 births have been recently reported for twins, triplets, quadruplets, quintuplets and sextuplets respectively. In addition to these alarming figures, it should be emphasized that the restricted concept of perinatal mortality obscures the real extent of loss. If we include late abortion (after 20 weeks), late neonatal deaths and deaths in infancy from perinatal causes, as well as the usual indices of perinatal mortality (stillbirths and early neonatal deaths) we find that the total loss rate from twin pregnancy alone doubles and may be close to 10%. Although the rate of loss from multiple pregnancies is now substantially higher than that associated with the pregnancies of diabetic women, the challenge of multiple pregnancy has not been met with the same commitment or organisation of specialized perinatal services as has diabetes.

scholarly journals Pregnancy outcome with hepatitis E infection

2019 ◽  
Vol 8 (2) ◽  
pp. 467
Author(s):  
Niranjan M. Mayadeo ◽  
Sachi N. Shah
Keyword(s):  
Early Diagnosis ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Care Hospital ◽  
Third Trimester ◽  
Institutional Ethics ◽  
Foetal Monitoring ◽  
Severity Of The Disease ◽  
Supportive Management

Background: Hepatitis E is usually a self-limited viral infection in men and non-pregnant women, but during pregnancy it is associated with high maternal and perinatal mortality. This needs to be studied for early diagnosis and better management.Methods: The study commenced after the approval of Institutional Ethics Committee. This was a retrospective cum prospective observational study conducted in the Department of Obstetrics and Gynaecology and Department of Medical Intensive Care Unit in present tertiary care hospital between February 2012 and July 2017. An analysis of 120 cases was made over a period of five years.Results: In this study the incidence of pregnant patients with hepatitis E was 3.09 per 1000 deliveries. It was found that majority of the patients which were diagnosed with hepatitis E were young and belonged to the age group of 21-25 years. Most of the affected patients were primigravida with increasing severity of the disease in their third trimester. The maternal morbidity was 51% with a mortality rate of 20%. The percentage of still birth was 25.64% with increased incidence of preterm deliveries and poor perinatal outcome.Conclusions: Early diagnosis and rapid management of the complications such as correction of abnormal coagulation and supportive management is the best treatment available at present. ICU admission and with strict maternal and foetal monitoring can help improve the outcome and thereby reducing the maternal and perinatal mortality.

scholarly journals P21 PBPK modeling in pregnancy: achievements, shortcomings and future perspectives

2019 ◽  
Vol 104 (6) ◽  
pp. e25.2-e25
Author(s):  
A Dallmann ◽  
P Mian ◽  
P Annaert ◽  
M Pfister ◽  
K Allegaert ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pbpk Model ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Model Verification ◽  
Pbpk Modeling ◽  
Third Trimester ◽  
The Past ◽  
Pbpk Models

BackgroundPhysiologically-based pharmacokinetic (PBPK) models are considered a promising approach to better characterize and anticipate the effect of physiological changes on pharmacokinetics in pregnant women. Consequently, multiple pregnancy PBPK models have been developed and verified over the past years. Using acetaminophen (paracetamol) as example, PBPK modeling can provide specific insights into the expected pharmacokinetic changes throughout pregnancy.MethodsTo obtain an overview of pregnancy PBPK models, the scientific literature was systematically screened for publications with a focus on pharmaceutical applications using relevant keywords. Additionally, a pregnancy PBPK model for acetaminophen was developed with the Open Systems Pharmacology software suite (www.open-systems-pharmacology.org) following an established workflow. After model verification around gestational week 30, the model was scaled to earlier stages of pregnancy and molar dose fractions converted to acetaminophen metabolites were estimated for each trimester.ResultsOver the past years, more than 60 different pregnancy PBPK models for more than have 40 drugs been published. More than 70% of these models were developed for the third trimester, while few models have been applied to the first trimester. The developed PBPK model for acetaminophen indicated that the median dose fraction of acetaminophen converted to the reactive metabolite N-acetyl-p-benzoquinonimine (NAPQI) was 11%, 9.0% and 8.2% in the first, second and third trimester, respectively, while for non-pregnant women a value of 7.7% was simulated.ConclusionWhile the overall availability and quality of pregnancy PBPK models is varying considerably, the efforts to establish such models are promising in that they reflect an increased awareness of the necessity to better characterize pharmacokinetics during pregnancy. This is illustrated by the developed PBPK model for acetaminophen where information on NAPQI-formation in vivo is hitherto lacking. Although PBPK models are not a substitute for clinical trials, they constitute an important tool for clinicians in case of missing or incomplete information.Disclosure(s)Nothing to disclose

scholarly journals OC22.04: Twin actual birthweight discordance and adverse pregnancy outcome: the STORK multiple pregnancy cohort

2012 ◽  
Vol 40 (S1) ◽  
pp. 45-45
Author(s):  
F. D'Antonio ◽  
T. D. Dias ◽  
S. Pescarini ◽  
A. Bhide ◽  
B. Thilaganathan
Keyword(s):  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Multiple Pregnancy ◽  
Pregnancy Cohort ◽  
Adverse Pregnancy

scholarly journals Comparative study of vaginal delivery and caesarean section in antepartum eclampsia at tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 457 ◽  
Author(s):  
Priti Kumari ◽  
Sipra Singh ◽  
Salma Khatun ◽  
. Shashikar
Keyword(s):  
Caesarean Section ◽  
Perinatal Mortality ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Fetal Outcome ◽  
Sudden Onset ◽  
Care Hospital ◽  
Maternal Complications

Background: Eclampsia is characterized by the sudden onset of generalized tonic clonic seizures. Eclampsia is usually preceded by a history of the pre-eclampsia but rarely arises in a woman with minimally increased blood pressure and no proteinuria. Eclampsia most commonly occurs in the third trimester, though rarely eclampsia may occur before 20 wks in molar or multiple pregnancy. The aim of the study was to compare maternal and fetal outcome in antepartum eclampsia when terminated by vaginal delivery and caesarean section.Methods: 50 women with eclampsia attending emergency department OBG department of Katihar Medical College, Katihar were collected from Feb 2015 to Sep 2016. Depending upon the mode of delivery, they were divided into two groups, CD group where caesarean section was performed and VD group where vaginal delivery was performed.Results: Of the 50 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried was carried in 60%.Maternal complications in CD group was 35% and 80% in VD group (p<0.001).The incidence of live births, still birth and neonatal death was 85%, 15%, 0% in CD group and 60%, 40%, 10% in VD group. The corrected perinatal mortality was 50%.Conclusions: Timely caesarean section reduces maternal and perinatal mortality and improves their outcome in antepartum eclampsia.

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