Repeated Measurement of Crown-Rump Length at 9 and 11-13 Weeks' Gestation: Association with Adverse Pregnancy Outcome

2015 ◽  
Vol 38 (4) ◽  
pp. 262-268 ◽  
Author(s):  
Masamitsu Nakamura ◽  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Hiroko Takita ◽  
Shoko Hamada ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fetal Growth ◽  
Gestational Age ◽  
Chromosomal Abnormalities ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Trisomy 18 ◽  
Crown Rump Length ◽  
Adverse Pregnancy ◽  
In Pregnancy

Aims: To clarify whether ultrasonographic measurements of crown-rump length (CRL) at 11-13 weeks - based on the number of gestational days determined using the CRL at 9 weeks - can predict fetal prognosis. Methods: A prospective cohort study was conducted to evaluate the association between fetal growth in the first trimester and fetal prognosis. Fetal growth in the first trimester was evaluated measuring CRLs at 11-13 weeks determined using the CRL at 9 weeks. The subjects were divided into short CRL (s-CRL) and normal CRL (n-CRL). The prognoses were compared between the two groups. Results: A total of 126 patients in the s-CRL group and 1,130 patients in the n-CRL group were enrolled. Abortion occurred in 7.1% of s-CRL and 0.9% of n-CRL subjects (p < 0.001). Among the patients with chromosomal abnormalities, the incidence of trisomy 18 was significantly greater in s-CRL (4.8 vs. 0.1%, p < 0.001). Without abortion, placental weight, frequency of small for gestational age (SGA) and birth weight in s-CRL were significantly higher than those in the n-CRL group (12.8 vs. 3.6%, p < 0.001). Conclusions: Measuring CRL at 9 weeks is useful for determining gestational days prior to measuring CRL at 11-13 weeks. After reconfirming the gestational age at 9 weeks, measuring CRL at 11-13 weeks is useful for predicting the incidence of trisomy 18 as well as SGA later in pregnancy.

scholarly journals Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049075
Author(s):  
Dionne V Gootjes ◽  
Anke G Posthumus ◽  
Vincent W V Jaddoe ◽  
Eric A P Steegers
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Preterm Birth ◽  
Fetal Growth ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Neighbourhood Deprivation ◽  
Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

scholarly journals Ultrasound Assessment of Twin Reversed Arterial Perfusion Sequence for the Prediction of Adverse Pregnancy Outcomes in the First Trimester

2021 ◽  
Author(s):  
Ying Tang ◽  
Yan Zeng ◽  
Taizhu Yang ◽  
Pan Yang ◽  
Shan Bao ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
University Hospital ◽  
Intrauterine Death ◽  
Crown Rump Length ◽  
Arterial Perfusion ◽  
Adverse Pregnancy ◽  
Twin Reversed Arterial Perfusion

Abstract ObjectivesTo investigate twin reversed arterial perfusion (TRAP) sequence for the prediction of TRAP-related adverse pregnancy outcomes at the gestational age of 11-14 weeks. MethodsPregnant women in the first trimester diagnosed with TRAP were recruited at West China Second University Hospital from January 2015 to June 2018. Systematic screening for the pump twin’s crown-rump length (CRL) and acardiac twin’s upper pole-rump length (URL) was conducted using ultrasonic detection. The (CRL-URL)/CRL and URL/CRL ratios were used to assess the pregnancy outcomes for the pump twin. ResultsTwenty-one pregnant women aged 21–39 years with a gestation of 11-14 weeks were recruited. TRAP was diagnosed on average (± standard deviation [SD]) at pregnancy week 13.1 ± 0.18. The pump twins’ mean (± SD) CRL was 6.65 ± 1.1 cm. The incidence of intrauterine death for the pump twins was 19.0% (n=4), the miscarriage rate was 14.3% (n=3), and the live birth rate was 66.7% (n=14). The (CRL-URL)/CRL ratios between the non-survival (intrauterine death and miscarriage) and survival groups significantly differed (0.33 ± 0.08 vs. 0.58 ± 0.08, p < 0.05). Similarly, the URL/CRL ratios between the non-survival and survival groups significantly differed (0.67 ± 0.08 vs. 0.42 ± 0.08, p < 0.05). ConclusionsThe (CRL-URL)/CRL and URL/CRL ratios were valuable indicators for determining pregnancy outcomes of pump twins with TRAP at an early gestational age.

scholarly journals A COMPARATIVE STUDY OF MATERNAL OUTCOME IN FIRST-TRIMESTER VAGINAL BLEEDING IN THE DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY, SMS MEDICAL COLLEGE, JAIPUR

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Savita Meena ◽  
Suniti Verma ◽  
R N Sehra ◽  
Suman Choudhary
Keyword(s):  
Gestational Age ◽  
Vaginal Bleeding ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Control Group ◽  
Case Group ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: The outcome of ongoing pregnancies after first trimester vaginal bleeding is of relevance to women and obstetricians for planning antenatal care and clinical interventions in pregnancy. Hence, this study was conducted to identify the risks associated with first trimester bleed which may facilitate decision making regarding mode, place and timing of delivery during management, which may improve maternal and neonatal outcome. Methods: Hospital based comparative prospective study conducted at Department of Obstetrics and Gynaecology, SMS Medical College & associated Hospitals, Jaipur. Results: APH was found in 4 (8.00%) patients of case group and nil in control group. So, APH was found to be more in the case group than control group but was statistically not significant. Pre-eclampsia was found in 4 (8.00%) in case group and 3 (6.00%) in control group with statistically insignificant difference between the two groups.  26 (52.00%) delivered at the gestational age of ?37 weeks, whereas only 8 (16%) of control group delivered at ?37 weeks. So, the gestational age at delivery of control group subjects was found to be higher as compared to case group subjects and the difference was statistically significant (p=0.001). Conclusion: Threatened miscarriage in early pregnancy increases the risk of adverse pregnancy outcome. In our study, these patients were found to be at an increased risk of preterm delivery, PPROM. Keywords: PROM, Miscarriage, Gestational age

scholarly journals Demographic, Clinical and Microbiological Characteristics of Maternity Patients: A Canadian Clinical Cohort Study

2002 ◽  
Vol 13 (5) ◽  
pp. 311-318 ◽  
Author(s):  
Wanda M Wenman ◽  
Ivanna V Tataryn ◽  
Michel R Joffres ◽  
Rachelle Pearson ◽  
Michael GA Grace ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Postsecondary Education ◽  
Gestational Age ◽  
Mycoplasma Hominis ◽  
First Trimester ◽  
Clinical Cohort ◽  
Microbiological Characteristics ◽  
Adverse Pregnancy ◽  
One Year

OBJECTIVE: To determine the demographic, clinical and microbiological characteristics of a representative Canadian obstetrical population.DESIGN: A one-year cohort study of all maternity patients who were followed to delivery, using detailed patient questionnaires containing more than 60 demographic and clinical variables, and three microbiological evaluations during gestation - first trimester, 26 to 30 weeks, and labour and delivery. Outcome measurements included birth weight and gestational age.SETTING: Labour and delivery suites of all office obstetrical practices affiliated with a single hospital.POPULATION STUDIED: A consecutive sample of pregnant women in the study practices during one year were eligible for enrolment; 2237 consecutive patients were approached for consent, 2047 enrolled and 1811 completed the study through delivery.RESULTS: The average patient was white, married and 29 years of age. Slightly more than half of the patients had postsecondary education, but 10% fell below the national poverty line for income. Frequency of factors linked to adverse pregnancy outcomes included cigarette smoking (19%), alcohol ingestion (18%), previously having had a premature infant (7%), and maternal diabetes (2%). Overall prevalence of genital microbes variously implicated in prematurity was 37% for ureaplasma, 11% for group B streptococcus and 4% forMycoplasma hominis. Prevalence of bacterial vaginosis was 14%. The median gestational age for the cohort was 39 weeks, with 7% of infants born less than 37 weeks' gestation. Mean birth weight was 3415 g.CONCLUSIONS: The present clinical cohort represents demographic and medical characteristics of the Canadian obstetrical population. The birth outcomes are consistent with national data. This database provides valuable information about a general obstetrical population that is managed by a universal health care system.

Pregnancy-Associated Infections

2019 ◽  
Author(s):  
Anna Riddell ◽  
Michael Millar
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Hepatitis B ◽  
Bacterial Vaginosis ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
In Pregnancy

An important consideration in pregnancy is the relationship between infection in the mother and the developing foetus. Infections can indirectly impact the foetus through effects on the mother, for example, maternal urinary tract infection is associated with preterm birth, or can infect the foetus. Routes of infection can be ascending from the birth canal through the cervical os, transplacentally, or rarely, contiguously. The effect on the mother is also important: pregnancy is considered an immunosuppressive state and the growing foetus causes significant mechanical and physiological changes. Although the first trimester is the key developmental phase for the growing foetus, during the third trimester the mother is more susceptible to severe respiratory infection and some viral infections such as varicella zoster virus (VZV), due to the mechanical changes produced by the growing foetus. There is a paucity of evidence supporting the safety of drugs in pregnancy. Use of any medicinal drug in pregnancy, including antibiotics, requires good reasons. The optimum choice of antibiotics depends on the trimester of the pregnancy. In general, beta-lactams are safe and tetracyclines should be avoided throughout pregnancy. Nitrofurantoin is safe until after thirty-five weeks gestation and trimethoprim should be avoided in the first trimester but is safe otherwise (perhaps with folic acid supplementation if < 20 weeks). Specific patterns of colonization and infection of the genitourinary tract can be associated with an increased risk of an adverse pregnancy outcome, particularly preterm birth. Sexually transmitted diseases such as gonorrhoea and chlamydia are associated with an increased risk of spontaneous preterm birth, which may extend to infection in the pre-conception period. Bacterial vaginosis is an abnormal pattern of vaginal colonization and is also linked with an increased risk of preterm birth. The US Center for Disease Control recommends screening all pregnant women for chlamydia, gonorrhoea, syphilis, HIV, and hepatitis B, symptomatic women for trichomonas and genital herpes, women considered at high risk of preterm birth for bacterial vaginosis, and women at high risk of blood-borne virus infection for hepatitis C. Treatment is administered to reduce the risk of an adverse pregnancy outcome (syphilis, gonorrhoea, chlamydia, trichomonas, and bacterial vaginosis) or to prevent transmission to the infant (herpes, HIV, hepatitis B, and C).

Coronavirus disease 2019 (COVID-19) and Pregnancy: A narrative review

2021 ◽  
Vol 17 ◽  
Author(s):  
Mandana Zafari ◽  
Mohammad Taha Saadati Rad ◽  
Fatemeh Mohseni
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Adverse Pregnancy Outcome ◽  
Fetal Distress ◽  
Large For Gestational Age ◽  
Rapid Heart Rate ◽  
Disciplinary Expertise ◽  
Adverse Pregnancy ◽  
Viral Respiratory ◽  
In Pregnancy

: A novel viral respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-C0V-2), is responsible for a pandemic situation in the world. Pregnant women are susceptible against this virus due to physiologic changes of immunologic system. Some adverse pregnancy outcome such as; death, still birth, preeclampsia, intra uterine fetal distress may increase in infected pregnant women. Infected women should be isolated and investigated and they should admit in a designated hospital with adequate facilities and multi-disciplinary expertise to manage them. Some adverse neonatal complication such as; Small for Gestational Age, Large for Gestational Age, shortness of breath, thrombocytopenia with abnormal liver function, rapid heart rate, vomiting and pneumothorax may increase in affected neonate. This study reviews the problems and guidelines of covid-19 in pregnancy. The limitation of this study was; we didn’t conduct systematic review among studies were done in pregnancy and COVID 19.

scholarly journals Frontomaxillary Facial Angle Measurement in Screening for Trisomy 18 at 11 + 0 to 13 + 6 Weeks of Pregnancy: A Double-Centre Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Bartosz Czuba ◽  
Wojciech Cnota ◽  
Agata Wloch ◽  
Piotr Wegrzyn ◽  
Krzysztof Sodowski ◽  
...  
Keyword(s):  
Final Analysis ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Angle Measurement ◽  
Trisomy 18 ◽  
Crown Rump Length ◽  
Beta Hcg ◽  
Large Populations ◽  
Trimester Screening ◽  
Independent Marker

Objective. The aim of this study was to evaluate the effectiveness of prenatal screening for trisomy 18 with the use of the frontomaxillary facial angle (FMF angle) measurement.Material and Methods. The study involved 1751 singleton pregnancies at 11–13 + 6 weeks, examined between 2007 and 2011. Serum PAPP-A and free beta-hCG levels were assessed, and crown-rump length, nuchal translucency, and FMF angle were measured in all patients. 1350 fetuses with known follow-up were included in the final analysis.Results. Highly significant (P<0.01) negative correlation between the CRL and the FMF angle was found. There were 30 fetuses with trisomy 18. FMF angle was highly significantly larger (P<0.0001) in fetuses with trisomy 18 as compared to chromosomally normal fetuses. Two models of first trimester screening were compared: Model 1 based on maternal age, NT, and first trimester biochemistry test (DR 80–85% and FPR 0.3–0.6%), and Model 2 = Model 1 + FMF angle measurement (DR 87.3–93.3% and FPR 0.8–1.3%).Conclusions. The use of FMF angle measurement increases the effectiveness of the screening for trisomy 18. Introduction of the FMF angle as an independent marker for fetal trisomy 18 risk requires further prospective research in large populations.

Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome

2002 ◽  
Vol 22 (9) ◽  
pp. 778-782 ◽  
Author(s):  
Yuval Yaron ◽  
Sigal Heifetz ◽  
Yifat Ochshorn ◽  
Ofer Lehavi ◽  
Avi Orr-Urtreger
Keyword(s):  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Adverse Pregnancy

Cancer in pregnancy and the risk of adverse pregnancy and neonatal outcomes: a nationwide cohort study

2021 ◽  
Author(s):  
Iben Katinka Greiber ◽  
Jakob Hansen Viuff ◽  
Lene Mellemkjær ◽  
Cristel Sørensen Hjortshøj ◽  
Øjvind Lidegaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Neonatal Outcomes ◽  
Cancer In Pregnancy ◽  
Adverse Pregnancy ◽  
In Pregnancy
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