scholarly journals The assessment of early and late gestational termination cases

2020 ◽  
Vol 28 (2) ◽  
pp. 82-88
Author(s):  
Serdar Kaya ◽  
Ferdi Vaizoğlu ◽  
Sezin Yakut Uzuner ◽  
Havva Serap Toru ◽  
Mehmet Şimşek ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Karyotype Analysis ◽  
Single Gene ◽  
Normal Karyotype ◽  
Singleton Pregnancy ◽  
Aneuploidy Screening ◽  
Structural Anomaly ◽  
Screening Programs ◽  
Study Results ◽  
Group 2

Objective We aimed to investigate the characteristics of early and late gestational termination cases by evaluating the cases underwent gestational termination in our clinic. Methods All pregnant women who had singleton pregnancy and underwent gestational termination due to fetal indications between January 2017 and December 2019 were included in the study. Results A total of 341 cases, of which 263 were with early gestational termination (Group 1) and 73 were with late gestational termination (Group 2) were included in the study. No difference was observed between the demographic characteristics of the groups. The ultrasonographic structural anomaly was observed in 273 (80.1%) of 341 cases and no structural anomaly was observed in 68 (19.9%) cases. Of the cases with structural anomaly, 200 (73%) had isolated system anomaly and 73 (26.7%) had multiple system anomaly. Karyotype analysis was performed in 68% of the cases, and chromosomal anomaly was found in 52.6% of them. Among the cases with normal karyotype analysis results, 22 cases had single gene disorder, of which mostly had thalassemia. While the incidence of structural anomaly was significantly high in the late termination cases (91% vs. 76.8%), the incidence of isolated cardiovascular anomaly was significantly high in the late termination cases similarly (37.5% vs. 13.8%). The autopsy was performed on 16.7% of the cases after termination and the findings were consistent with the prenatal ultrasonographic results in 86% of the cases, and additional findings were found in 22.4% of the cases in the autopsy. Conclusion When the late gestational terminations performed in our clinic are compared to the early gestational terminations, we believe that conducting ultrasonographic anomaly screening to all pregnant women including echocardiography even at a less rate, and also making screening programs in the early gestational periods such as aneuploidy screening easily accessible for all pregnant women may help to maintain maternal health by decreasing the rates of the cases with late gestational

scholarly journals A role of comprehensive cervix assessment in the first trimester of pregnancy for predicting preterm delivery

2020 ◽  
Vol 14 (2) ◽  
pp. 174-181
Author(s):  
V. G. Volkov ◽  
O. V. Chursina
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Diagnostic Value ◽  
Singleton Pregnancy ◽  
Group 4 ◽  
First Trimester Of Pregnancy ◽  
Group 3 ◽  
Group 2 ◽  
Delivery Term ◽  
Group 1

Aim: to improve efficacy of predicting preterm labor in the first trimester of pregnancy by combining diverse parameters of cervical ultrasound examination.Materials and methods. A prospective cohort study of 1517 women with uncomplicated pregnancy was performed. Inclusion criteria were: females underwent cervicometry at 11–14 weeks of gestation, singleton pregnancy, revealing no complaints at the onset of examination. All women were subdivided into four groups: Group 1 – 27 pregnant women with shortened cervix (less than 30 mm); Group 2 – 24 pregnant women without cervical gland area (СGA); Group 3 – 30 pregnant women with two risk factors (shortened cervix less than 30 mm and lacked СGA); Group 4 (control) consisted of 1436 pregnant women with cervix length exceeding 30 mm and presence of СGA.Results. Average delivery term in Group 1 was 35.7 weeks (95 % CI = 34.7–36.8), in Group 2 – 34.7 weeks (95 % CI = 33.59–35.0), in Group 3 – 33.23 weeks (95 % CI = 31.6–34.8), in Group 4 (control) – 38.11 weeks (95 % CI = 38.06–38.17). A significant moderate correlation (Rxy = 0.534) between shortened cervix, absence of СGA and delivery term was found (p < 0.001). A regression model consisting of cervical length and presence of СGA was simulated based upon 50.8 % factors underlying probability of preterm birth, revealing 42.6 % sensitivity, 99.1 % specificity, and 96.6 % overall diagnostic value. The area under the ROC curve was 0.902 ± 0.022 (95 % CI = 0.860–0.945). The data obtained reflect diverse biochemical changes such as collagen decomposition, altered glucosamine level and fluid amount within cervical tissues. Such processes result in shortened, softened and expanded (matured) cervix. Uncovering markers for preterm cervical maturation underlies a logical strategy to predict miscarriage.Conclusion. Untrasound cervical measurement in the first trimester of pregnancy allows for revealing valuable miscarriage predictors (shortened cervix and absence of GI). Risk assessment by combining diverse ultrasound cervix parameters would allow to improve overall predictive efficacy.

scholarly journals Late presentation of pregnant women with chromosomal abnormalities: A barrier to legal and safe abortions in Muslim majority countries

2018 ◽  
Vol 6 (4) ◽  
pp. 158-164
Author(s):  
Simin Taghavi ◽  
Hossein Alikhah ◽  
Mohammad Mirza-Aghazadeh-Attari ◽  
Sharareh Barband ◽  
Sahar Mohammadi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Chromosomal Abnormalities ◽  
Pregnancy Termination ◽  
Single Gene ◽  
Late Presentation ◽  
Chromosomal Anomalies ◽  
Cross Sectional ◽  
Screening Programs ◽  
Prenatal Diagnostic ◽  
Islamic Countries

Introduction: In Islamic countries, the prenatal diagnostic procedures are planned considering legal and religious limitations. We aimed to evaluate the indications of presentation and problems related to religious and legal limitations for presentation of Muslim parents for prenatal screening of chromosomal abnormalities. Methods: A cross-sectional study was performed on consecutive 920 pregnant women presenting for screening of congenital and chromosomal anomalies to Educational Medical Centers of Tabriz University of Medical Sciences, Tabriz, Iran, between 2011 and 2015. Previously prepared questionnaire forms were utilized for collection of information from patients and their medical records. Results: In total, 153 cases had an indication for amniocentesis, and this procedure revealed that 141 fetuses (92.2%) did not have any congenital abnormalities, but 12 cases (7.8%) had some sort of abnormality, requiring pregnancy termination. These cases included 8 fetuses (5.2%) with trisomy and four (2.6%) with single gene diseases. Of 12 patients, the justifications for pregnancy termination were issued for 7 women by the provincial Legal Medicine Organization. However, the remaining 5 patients could not obtain legal justifications for termination of their pregnancies, mostly because of late presentation, obligating them to choose illegal methods for pregnancy termination. Conclusion: Regarding the legal and religious limitation of pregnancy termination after 18th week in Islamic countries, it is highly recommended that the first trimester screening programs be performed in Islamic countries in order to obtain early decision-making.

Efficacy of intrauterine administration of autologous peripheral blood mononuclear cells prior to embryo transfer in patients with recurrent implantation failures in assisted reproductive technology programmes

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 28-33
Author(s):  
T S Amyan ◽  
S G Perminova ◽  
L V Krechetova ◽  
V V Vtorushina
Keyword(s):  
Embryo Transfer ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Peripheral Blood Mononuclear ◽  
Study Objective ◽  
Study Results ◽  
Blood Mononuclear Cells ◽  
History Of ◽  
Group 2

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

scholarly journals Pregnant Women Living with Obesity: A Cross-Sectional Observational Study of Dietary Quality and Pregnancy Outcomes

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1652
Author(s):  
Margaret Charnley ◽  
Lisa Newson ◽  
Andrew Weeks ◽  
Julie Abayomi
Keyword(s):  
Pregnant Women ◽  
Maternal Obesity ◽  
Maternal Nutrition ◽  
Saturated Fatty Acids ◽  
Poor Quality ◽  
Dietary Quality ◽  
Obstetric Outcomes ◽  
Dietary Intakes ◽  
Singleton Pregnancy ◽  
Cross Sectional

Good maternal nutrition is key to optimal maternal and foetal health. A poor-quality diet is often associated with obesity, and the prevalence and severity of maternal obesity has increased significantly in recent years. This study observed dietary intakes in pregnant women living with obesity and assessed the quality of their diet. In total, 140 women with a singleton pregnancy, aged > 18 years and BMI ≥ 35 kg/m2, were recruited from antenatal clinics, weighed and completed food diaries at 16-, 28- and 36-weeks’ gestation. Clinical data were recorded directly from the women’s medical records. Nutrient intake was determined using ‘MicrodietTM’, then compared to Dietary Reference Values (DRVs). Energy intakes were comparable with DRVs, but intakes of sugar and saturated fatty acids were significantly higher. Intake of fibre and several key micronutrients (Iron, Iodine, Folate and Vitamin D) were significantly low. Several adverse obstetric outcomes were higher than the general obstetric population. Women with obesity, often considered ‘over nourished’, may have diets deficient in essential micronutrients, often associated with poor obstetric outcomes. To address the intergenerational transmission of poor health via poor diets warrants a multi-disciplinary approach focusing away from ‘dieting’ onto positive messages, emphasising key nutrients required for good maternal and foetal health.

scholarly journals Routinization of prenatal screening with the non-invasive prenatal test: pregnant women’s perspectives

2021 ◽  
Author(s):  
Karuna R. M. van der Meij ◽  
Annabel Njio ◽  
Linda Martin ◽  
Janneke T. Gitsels-van der Wal ◽  
Mireille N. Bekker ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
Screening Program ◽  
Informed Choice ◽  
Aneuploidy Screening ◽  
Non Invasive ◽  
Fetal Aneuploidy ◽  
Societal Pressure ◽  
Prenatal Test

AbstractDue to the favorable test characteristics of the non-invasive prenatal test (NIPT) in the screening of fetal aneuploidy, there has been a strong and growing demand for implementation. In the Netherlands, NIPT is offered within a governmentally supported screening program as a first-tier screening test for all pregnant women (TRIDENT-2 study). However, concerns have been raised that the test’s favorable characteristics might lead to uncritical use, also referred to as routinization. This study addresses women’s perspectives on prenatal screening with NIPT by evaluating three aspects related to routinization: informed choice, freedom to choose and (personal and societal) perspectives on Down syndrome. Nationwide, a questionnaire was completed by 751 pregnant women after receiving counseling for prenatal screening. Of the respondents, the majority (75.5%) made an informed choice for prenatal screening as measured by the multidimensional measure of informed choice (MMIC). Education level and religious affiliation were significant predictors of informed choice. The main reason to accept screening was “seeking reassurance” (25.5%), and the main reason to decline was “every child is welcome” (30.6%). The majority of respondents (87.7%) did not perceive societal pressure to test. Differences between test-acceptors and test-decliners in personal and societal perspectives on Down syndrome were found. Our study revealed high rates of informed decision-making and perceived freedom to choose regarding fetal aneuploidy screening, suggesting that there is little reason for concern about routinization of NIPT based on the perspectives of Dutch pregnant women. Our findings highlight the importance of responsible implementation of NIPT within a national screening program.

scholarly journals Comparison between Enzyme Immunoassays Performed on Samples of Dried Blood and Serum for Toxoplasmosis Prenatal Screening: Population-based Study

2021 ◽  
Vol 43 (05) ◽  
pp. 351-356
Author(s):  
Bárbara Araújo Marques ◽  
Ericka Vianna Machado Carellos ◽  
Vânia Maria Novato Silva ◽  
Fernando Henrique Pereira ◽  
Maria Regina Lage Guerra ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Prenatal Screening ◽  
Dried Blood Spots ◽  
Population Based ◽  
Minas Gerais ◽  
Immunoglobulin M ◽  
Screening Tests ◽  
Reference Test ◽  
Screening Programs ◽  
Blood Spots

Abstract Objective Most prenatal screening programs for toxoplasmosis use immunoassays in serum samples of pregnant women. Few studies assess the accuracy of screening tests in dried blood spots, which are of easy collection, storage, and transportation. The goals of the present study are to determine the performance and evaluate the agreement between an immunoassay of dried blood spots and a reference test in the serum of pregnant women from a population-based prenatal screening program for toxoplasmosis in Brazil. Methods A cross-sectional study was performed to compare the immunoassays Imunoscreen Toxoplasmose IgM and Imunoscreen Toxoplasmose IgG (Mbiolog Diagnósticos, Ltda., Contagem, Minas Gerais, Brazil)in dried blood spots with the enzyme-linked fluorescent assay (ELFA, BioMérieux S.A., Lyon, France) reference standard in the serum of pregnant women from Minas Gerais Congenital Toxoplasmosis Control Program. Results The dried blood spot test was able to discriminate positive and negative results of pregnant women when compared with the reference test, with an accuracy of 98.2% for immunoglobulin G (IgG), and of 95.8% for immunoglobulin M (IgM). Conclusion Dried blood samples are easy to collect, store, and transport, and they have a good performance, making this a promising method for prenatal toxoplasmosis screening programs in countries with continental dimensions, limited resources, and a high prevalence of toxoplasmosis, as is the case of Brazil.

scholarly journals Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1505
Author(s):  
Nirmala Bhandari ◽  
Anjali Gupta ◽  
Simmi Kharb ◽  
Meenakshi Chauhan
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Intracellular Enzyme ◽  
Potential Marker

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia.

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

The effects of psychological counseling and acupressure based on couple therapy procedure for alleviation of vomiting and nausea in pregnant women in Iran country

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sahar Saadatnia ◽  
Azita Tiznobaik ◽  
Amir Saber
Keyword(s):  
Pregnant Women ◽  
Couple Therapy ◽  
Psychological Intervention ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Negative Effects ◽  
Psychological Counseling ◽  
Significant Difference ◽  
Group 2 ◽  
Short Time

Abstract Objectives Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. Methods Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. Results Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). Conclusions The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.

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