scholarly journals OP14.03: Ultrasound and Doppler evaluation at routine third trimester scan to detect late pregnancy large-for-gestational age fetuses (LGA) in (AGA) fetuses

2015 ◽  
Vol 46 ◽  
pp. 94-94
Author(s):  
M.A. Parra-Saavedra ◽  
S. Triunfo ◽  
F. Crovetto ◽  
E. Gratacós ◽  
F. Figueras
Keyword(s):  
Gestational Age ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Third Trimester ◽  
Doppler Evaluation

Abstract P176: Associations of Gestational Lipids and Apolipoproteins With Pregnancy Outcomes: The Hyperglycemia and Adverse Pregnancy Outcome Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Amanda M Perak ◽  
Alan Kuang ◽  
Nicola Lancki ◽  
Darwin R Labarthe ◽  
Svati H Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Obstetric Outcomes ◽  
Outcome Study ◽  
Adverse Pregnancy

Introduction: Gestational hyperlipidemia has traditionally been considered physiologic and benign, but the significance of inter-individual variation in lipid levels for maternal-fetal health are poorly understood. We examined associations of gestational lipids and apolipoproteins with adverse obstetric and neonatal outcomes. Methods: Data from the Hyperglycemia and Adverse Pregnancy Outcome Study were analyzed, including 1,813 mother-child dyads from 9 field centers in 6 countries: US (25%), Barbados (24%), UK (20%), China (16%), Thailand (8%), and Canada (7%). Fasting lipids and apolipoproteins were directly measured at a mean of 28 (range 23-34) weeks’ gestation. Cord blood was collected at delivery, neonatal anthropometrics were measured within 72 hours, and medical records were abstracted for obstetric outcomes. Logistic regression was utilized to test associations of lipids and apolipoproteins (per +1 SD; log-transformed if skewed) with pregnancy outcomes, adjusted for center, demographics, and maternal covariates such as BMI, blood pressure, and glycemia. Results: See Table for lipid and apolipoprotein levels in pregnant mothers. In fully adjusted models ( Table ), 1 SD higher log-triglycerides (i.e., ~2.7-fold higher triglyceride level) in late pregnancy was significantly associated with higher odds for preeclampsia (OR 1.53 [95% CI, 1.15-2.05]), large for gestational age infant (1.42 [1.21-1.67]), and infant insulin sensitivity <10 th percentile (1.25 [1.03-1.50]), but not with unplanned primary cesarean section or infant sum of skinfolds >90 th percentile. There were no significant associations of maternal HDL-C, LDL-C, or log-ApoB/A1 ratio with any outcome. Conclusion: Triglyceride levels in the latter half of pregnancy were uniquely associated with both maternal risks (preeclampsia) and neonatal risks (large for gestational age and insulin resistance), even after adjustment for maternal BMI, blood pressure, and glycemia.

scholarly journals Prediction of large‐for‐gestational‐age neonate by routine third‐trimester ultrasound

2019 ◽  
Vol 54 (3) ◽  
pp. 326-333 ◽  
Author(s):  
N. Khan ◽  
A. Ciobanu ◽  
T. Karampitsakos ◽  
R. Akolekar ◽  
K. H. Nicolaides
Keyword(s):  
Gestational Age ◽  
Large For Gestational Age ◽  
Third Trimester

scholarly journals Monitoring Foetus and Neonatal Outcomes in Patients With Current or Previous History of Hyperthyroidism

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A942-A942
Author(s):  
Lakshminarayanan Varadhan ◽  
Monzoor Quader ◽  
Ayat Mohamed ◽  
Julia Uffindell ◽  
Sa’adatu Usman ◽  
...  
Keyword(s):  
Gestational Age ◽  
Care Pathway ◽  
Previous History ◽  
Multidisciplinary Care ◽  
Thyroid Function Test ◽  
Large For Gestational Age ◽  
Third Trimester ◽  
Thyroid Status ◽  
Tertiary Referral Centre ◽  
History Of

Abstract Aim: Graves’ hyperthyroidism can be associated with persistent TSH-receptor antibody (TRAB) and need for anti-thyroid drugs (ATD) during pregnancy warranting careful monitoring during pregnancy and the neonatal period. The aim of this retrospective observational study was to assess the outcomes of babies born of women with current or previous history of hyperthyroidism. Method: All women with previous or current hyperthyroidism were reviewed in the joint antenatal-endocrine clinic. Neonatal alert was instituted for all patients with positive TRAB at 20 weeks and/or requiring ATD into third trimester and included serial growth scans in third trimester, fetal medicine(FM) scan, review of neonate by paediatrician, thyroid function test(TFT) for the neonate on day 2(D2) and further tests as needed. Results: Of the 56 patients treated over a 2 year period, 31 qualified for this study. Thyroid statuses of patients were: active hyperthyroidism at conception=20; Post radioactive iodine (RAI)=4; post thyroidectomy =2; hyperthyroidism in remission prenatally=5. 24 patients were TRAB positive at 20 weeks (Strongly positive(&gt;3xnormal) =10) & 7 were TRAB negative. 16 patients required ATD into 3rd trimester, of whom 11 required until delivery. Presence of any TRAB positivity did not statistically predict continuation or withdrawal of treatment. FM scan was normal in all patients (one patient had hydronephrosis which was deemed not related to thyroid status and resolved spontaneously after birth). Growth Scans were normal in 26 patients. One patient had a large for gestational age fetus which was not related to thyroid status (patient in Graves’ remission, TRAB weakly positive, normal FM scan, normal D2 and D14 TSH in the neonate). 4 patients had small for gestational age fetuses -2 had weakly positive and 1 strongly positive TRAB; all had normal FM scans; 1 neonate had high TSH at D2 and others normal; all neonates had normal TFT at D14. None of the neonates had clinical or biochemical hyperthyroidism on D2. 12 had high TSH on D2 - 10 normalized at D14; the other 2 were discussed with tertiary referral centre, no further medical treatment was advised and normalized spontaneously. 22 had high T4 at D2; at D14, 14 normalized, 4 had persistent high T4 but normal TSH (T4 data not available on 4 but all had normal TSH). Neonates born to mothers who were using ATD at time of delivery had higher probability of having high TSH at D2 compared to those who were not (8/11 vs 4/20, p&lt;0.005). This difference was not statistically significant based on use of ATD at onset of pregnancy (10/20 vs 2/11, p=0.08). Conclusion: Our study showed that no neonates developed overt hyperthyroidism. Use of ATD, especially in third trimester, could be associated with risk of transient biochemical hypothyroidism in neonate. A coordinated multidisciplinary care pathway is required to monitor and manage this complex cohort of patients and neonates.

scholarly journals Effect of Maternal Lipid Levels during Late Pregnancy on the Birth of Large for Gestational Age Newborns in a Tertiary Care Setting in Southern Sri Lanka

2018 ◽  
Author(s):  
Amarasingha Arachchige Dinusha Subhashini Amarasingha ◽  
Mohamed Fassy Fathima Nasrina ◽  
Ruwani Punyakanthi Hewawasam ◽  
Mawananehewa Aruna Devapriya De Silva ◽  
Mampitiya Arachchige Gayani Iresha
Keyword(s):  
Sri Lanka ◽  
Gestational Age ◽  
Care Setting ◽  
Tertiary Care ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Lipid Levels ◽  
Tertiary Care Setting

scholarly journals Correlation of HbA1c levels in late pregnancy with maternal and perinatal outcome in patients with gestational diabetes mellitus

2019 ◽  
Vol 8 (9) ◽  
pp. 3664
Author(s):  
Navjot Kaur ◽  
Poonam Goel ◽  
Reeti Mehra ◽  
Jasbinder Kaur
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Perinatal Outcome ◽  
Late Pregnancy ◽  
Large For Gestational Age ◽  
Third Trimester ◽  
Hba1c Levels

Background: Estimation of HbA1c in gestational diabetes mellitus patients is not being recommended by any societies/guidelines as studies regarding the role of HbA1c for monitoring of euglycemic control and predicting the maternal and perinatal outcomes in GDM patients (unlike overt diabetes) are conflicting and sparse.Methods: This was a prospective study with an aim to evaluate the role of HbA1c estimation in late pregnancy (early and late third trimester) for prediction of pregnancy outcomes in GDM patients. 53 patients with GDM (diagnosed before third trimester) were recruited for the study. HbA1c levels were estimated in late pregnancy (at 28-32 weeks and again repeated at 37 - 39 weeks or at the time of delivery). Correlation of HbA1c levels in third trimester with maternal and perinatal outcome was studied in patients with gestational diabetes mellitus and cut off taken was 5.8%.Results: Of the total 53 patients 54.7% had HbA1c levels <5.8% and 45.3% had HbA1c ≥5.8% done at 28-32 weeks. Also when HbA1c levels done at 37-39 weeks POG/ at the time of delivery, 52.8% patients had <5.8% and 47.2% had HbA1c ≥5.8%. Approximately one-fourth of the patients had HbA1c ≥ 5.8% even with normal blood sugar levels (euglycemic) control. There was statistically significant increased incidence of polyhydramnios, LGA (large for gestational age babies) and increased mean birth weight in patients with HbA1c ≥ 5.8%, done in late pregnancy. However there was no statistically significant difference in the incidence of preterm labour, gestational hypertension or preeclampsia, urinary tract infections, vulvovaginal infections, caesarean deliveries and postpartum haemorrhage in patients with HbA1c ≥5.8% compared to patients with HbA1c <5.8%.Conclusions: The study revealed that in patients of GDM with HbA1c levels ≥5.8% done in third trimester was statistically significantly associated with increased incidence of polyhydramnios, large for gestational age babies and increased mean birth weight when compared to patients with HbA1c <5.8%.

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