Diagnosis of Placental Position by Early First-Trimester Ultrasound: A Pilot Study

2019 ◽  
Vol 26 (11) ◽  
pp. 1512-1518 ◽  
Author(s):  
Laura Detti ◽  
Jennifer C. Gordon ◽  
Mary E. Christiansen ◽  
Nicole A. Van de Velde ◽  
Ludwig Francillon ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cesarean Section ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Significant Difference ◽  
Gestational Sac ◽  
Twin Pregnancies ◽  
Anterior Posterior ◽  
First Trimester Ultrasound

Objective: Conventional wisdom is that placental location cannot be identified before 8 weeks’ gestation when the placenta first becomes hyperechogenic on ultrasound. We sought to evaluate whether placental location could be reliably diagnosed between 5 and 6 weeks’ gestation. Materials and Methods: This was a retrospective analysis of prospectively acquired data. Early placental location was diagnosed by evaluation of the embryonal and yolk sac position inside the gestational sac on transvaginal ultrasound. Placental position was described as anterior, posterior, fundal, or lateral. Early and mid-pregnancy placental locations were compared and coded as being the same, having migrated to an adjacent surface, or being on an opposite surface. Results: A total of 111 patients met study criteria, providing 141 placental locations, comprising 85 singleton and reduced pregnancies and 28 dichorionic twin pregnancies. The most common placental location was anterior in both singleton and twin/triplet pregnancies. Placental location at the mid-pregnancy ultrasound was consistent with early pregnancy location in 100% of cases, with 79.5% (112/141) being on the same surface and 20.5% (29/141) having expanded onto an adjacent surface. Placental location was not associated with pregnancy outcome, although our study may have been underpowered to detect a significant difference. Conclusions: Placental location diagnosed at 5 to 6 weeks’ gestation is consistent with the location on mid-pregnancy ultrasound. Excluding the presence of an ectopic, cornual, or cesarean section scar and uterine subseptation pregnancy in early first trimester would allow a more effective tailoring of pregnancy follow-up.

scholarly journals A retrospective study of efficacy and cost efficiency of medical vs. surgical management of abortions in first trimester

2021 ◽  
Vol 10 (9) ◽  
pp. 3429
Author(s):  
Meetangi Agarwal ◽  
Sailatha Ramanujam ◽  
Anuradha C. Ramachandran
Keyword(s):  
Success Rate ◽  
Pregnancy Termination ◽  
Transvaginal Ultrasound ◽  
Cost Effective ◽  
Medical Abortion ◽  
First Trimester ◽  
Observational Research ◽  
Medical Termination ◽  
Significant Difference

Background: The aim of the study was to assess and comparatively evaluate the efficacy of different methods of first trimester abortions (medical, surgical) in terms of its safety, cost and effectiveness.Methods: We present a retrospective observational research study done at Chettinad hospital and research institute, Kelambakkam Chennai which included a total of 70 patients of first trimester abortions, in the period from June 2019 to June 2020. 55 patients were offered medical treatment (MTOP) and were followed up with a repeat scan after 2 weeks. In cases of failed medical abortion patient underwent curettage. Though, in some cases after an attempt at medical abortion, if the products didn’t expel at all within 48 hours, dilatation and evacuation was offered. Transvaginal ultrasound was performed to confirm the success of the treatment. In 15 cases who presented with incomplete abortion, surgical treatment (STOP) was offered. The outcomes considered were successful complete abortions, failed medical abortions, side effects and complications including blood transfusion.Results: The baseline characteristics of women were similar in both the groups like mean age, parity, history of previous termination of pregnancy (TOP). The success rate in MTOP was 67.2% and in STOP 100%.The amount of bleeding experienced was moderate to heavy in MTOP and minimal to moderate in STOP.37 women who underwent only medical termination who returned for the 2-week follow-up, the rate of complete pregnancy termination was 94% and for the remaining 2 women surgical intervention was required. In the surgical group, at the 2-week follow up, no woman underwent a repeat vacuum aspiration with an efficacy of 100%. No significant difference was found in the mean total cost for the medical and surgical groups after adding the subsequent costs (including additional manual vacuum evacuation).Conclusions: Medical termination of abortion should be preferred over surgical termination as it is safer, cost effective, with fewer complications and high success rate. 

The Effect of Reflexology on Lactation in Women Who Had Cesarean Section: A Randomized Controlled Pilot Study

2021 ◽  
pp. 1-8
Author(s):  
Sevde Aksu ◽  
Pelin Palas Karaca
Keyword(s):  
Pilot Study ◽  
Cesarean Section ◽  
Intervention Group ◽  
Control Group ◽  
Breast Pain ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Right ◽  
Documentation Tool ◽  
And Control

<b><i>Aim:</i></b> The research was conducted as a randomized controlled pilot study to evaluate the effects of reflexology on lactation in mothers who delivered by cesarean section (CS). <b><i>Methods:</i></b> A single-blind randomized controlled experimental study was conducted with a total of 60 postpartum women in the reflexology application (<i>n</i> = 30) and control groups (<i>n</i> = 30). After the CS, the mothers in the control group were given approximately 3-h routine nursing care after recovering from the effects of anesthesia; the introductory information form was applied, and the Breastfeeding Charting System and Documentation Tool (LATCH) and visual analog scale (VAS) for the signs of the onset of lactation were implemented on the first and second days. Reflexology was applied to the women in the intervention group after an average of 3 h following the mother’s condition had become stable and she had recovered from the effects of anesthesia. Reflexology was applied a total of 20 min – 10 min for the right foot, 10 min for the left foot – twice a day with 8-h intervals on the first and second days after CS. After the last reflexology application, the LATCH and VAS for the signs of the onset of lactation were applied. <b><i>Results:</i></b> Of the women, 70% breastfed their babies within 60 min after delivery; 46.7% of the mothers received breastfeeding training and 81.7% needed support for breastfeeding after the CS. The LATCH breastfeeding scores of the women in the intervention group on both days were significantly higher compared to those of the women in the control group (<i>p</i> &#x3c; 0.001). On the first day after the CS, apart from breast pain, there was no significant difference between the two groups in terms of breast heat and breast tension (<i>p</i> &#x3e; 0.05). On the second day after the CS, apart from breast tension, there was no significant difference between the groups in terms of breast heat and breast pain (<i>p</i> &#x3c; 0.05). In the study, women in the intervention group were found to have higher scores in terms of all three symptoms compared to the control group (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> In the study, it was determined that LATCH scores and signs of the onset of breastfeeding increased in the mothers who received reflexology after CS.

When diamniotic twins suddenly become monoamniotic twins: spontaneous septostomy of the dividing membrane

2021 ◽  
Vol 14 (7) ◽  
pp. e243513
Author(s):  
Angela Vidal ◽  
Cristina Nastasia ◽  
Markus Hodel ◽  
Joachim Kohl
Keyword(s):  
Twin Pregnancy ◽  
Rare Condition ◽  
First Trimester ◽  
Sonographic Diagnosis ◽  
Sudden Failure ◽  
Reliable Diagnosis ◽  
Accepted Standard ◽  
Perinatal Management ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound

In twin pregnancies, amnionicity and chorionicity are crucial as they strongly determine prenatal and perinatal management. First trimester ultrasound allows a highly reliable diagnosis of amnionicity and chorionicity, making it an internationally accepted standard in antenatal care. However, in rare cases, amnionicity can change from diamniotic to monoamniotic throughout pregnancy, substantially impacting perinatal management. We report the case of a confirmed monochorionic diamniotic twin pregnancy with a diagnosis of spontaneous septostomy of the dividing membrane (SSDM) at 28 weeks of gestation, resulting in a pseudomonoamniotic pregnancy. Even though SSDM is a rare condition and its sonographic diagnosis might be challenging, it should be considered if, in a known diamniotic pregnancy, there is a sudden failure to visualise the intertwin membrane truly separating both twins.

First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Tanya Maric ◽  
Natasha Singh ◽  
Keith Duncan ◽  
Guy J. Thorpe-Beeston ◽  
Makrina D. Savvidou
Keyword(s):  
Fetal Growth ◽  
Case Control Study ◽  
Subsequent Development ◽  
First Trimester ◽  
Case Control ◽  
Retrospective Case ◽  
Crown Rump Length ◽  
Significant Difference ◽  
Twin Pregnancies ◽  
Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

scholarly journals Aromatherapy with ylang ylang for anxiety and self-esteem: a pilot study

2014 ◽  
Vol 48 (3) ◽  
pp. 492-499 ◽  
Author(s):  
Juliana Rizzo Gnatta ◽  
Patricia Petrone Piason ◽  
Cristiane de Lion Botero Couto Lopes ◽  
Noemi Marisa Brunet Rogenski ◽  
Maria Júlia Paes da Silva
Keyword(s):  
Pilot Study ◽  
Essential Oil ◽  
Self Esteem ◽  
Physiological Parameters ◽  
Post Intervention ◽  
Temperature Method ◽  
Significant Difference ◽  
Perception Of Self ◽  
Cutaneous Application

Objective: To verify if the use of ylang ylang essential oil by cutaneous application or inhalation alters the anxiety and self-esteem perception and physiological parameters as blood pressure and temperature. Method : A pilot study with 34 professionals from a nursing group randomized in three groups: one received the ylang ylang essential oil by cutaneous application, the second received through inhalation and the third (placebo) received the ylang ylang essence through cutaneous application. The assessment was done by an Anxiety Inventory (IDATE) and the Dela Coleta self-esteem scale, applied on baseline, after 30, 60 and 90 days and after 15 days post-intervention (follow up). Results : In the pre and post-intervention intergroup analysis, there was a significant difference in self-esteem for the three groups (p values: G1=0.014; G2=0.016; G3=0.038). There were no differences in the analysis between groups for anxiety or for physiological parameters. Conclusion : It was found significant alterations only to the intergroup perception of self-esteem for the three groups.


OP11.02: Sensitivity of first trimester ultrasound in detecting fetal structural malformations in twin pregnancies

2014 ◽  
Vol 44 (S1) ◽  
pp. 93-93
Author(s):  
F. D'Antonio ◽  
M. Morlando ◽  
A. Khalil ◽  
A.T. Papageorghiou ◽  
B. Thilaganathan ◽  
...  
Keyword(s):  
First Trimester ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound

scholarly journals Sensitivity of first-trimester ultrasound in the detection of congenital anomalies in twin pregnancies: population study and systematic review

2016 ◽  
Vol 95 (12) ◽  
pp. 1359-1367 ◽  
Author(s):  
Francesco D'Antonio ◽  
Alessandra Familiari ◽  
Basky Thilaganathan ◽  
Aris T. Papageorghiou ◽  
Lamberto Manzoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Population Study ◽  
Congenital Anomalies ◽  
First Trimester ◽  
Twin Pregnancies ◽  
First Trimester Ultrasound

scholarly journals Effectiveness of Online Training and Supervisor Feedback on Safe Eating and Drinking Practices for Individuals With Developmental Disabilities

2020 ◽  
Vol 58 (2) ◽  
pp. 111-125
Author(s):  
Emaley McCulloch ◽  
Audra Cuckler ◽  
Elise Valdes ◽  
M. Courtney Hughes
Keyword(s):  
Pilot Study ◽  
Developmental Disabilities ◽  
Online Training ◽  
Direct Care ◽  
Follow Up Study ◽  
Significant Difference ◽  
The Impact

Abstract Dysphagia is common in individuals with developmental disabilities. Little research exists on the impact of trainings aimed at improving Direct Care Staff's (DCS) use of safe eating and drinking practices. This article presents two studies using pre-and postexperimental design, evaluating online training to improve DCSs' knowledge and ability to identify nonadherence to diet orders. A pilot study (n = 18) informed improvements to the intervention. The follow-up study (n = 64) compared those receiving training with those receiving training plus supervisor feedback. There was no significant difference between groups after training. Both groups increased in knowledge and identification of nonadherence to diet orders. Online training may be an effective tool for training DCS in safe eating and drinking practices.

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