scholarly journals Relative Risk Assessment of Intrauterine Infection of the Fetus During Cytomegalovirus Infection in Early Pregnancy

2019 ◽  
Vol 4 (3) ◽  
pp. 45-51 ◽  
Author(s):  
K. K. Petrova
Keyword(s):  
Risk Assessment ◽  
Relative Risk ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Cmv Infection ◽  
Significant Difference ◽  
First Trimester Of Pregnancy ◽  
Relative Risk Assessment

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of  choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.

SHOULD A FIRST-TRIMESTER RISK ASSESSMENT FOR PRE-ECLAMPSIA BE ROUTINELY OFFERED?

2013 ◽  
Vol 24 (2) ◽  
pp. 129-133
Author(s):  
MAURO PARRA-CORDERO
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Pregnant Women ◽  
Expert Opinion ◽  
First Trimester ◽  
Good Evidence ◽  
Point Of View ◽  
Health Policies ◽  
Public Health Policies ◽  
First Trimester Of Pregnancy

From a scientific point of view, the answer to the question might be quite straightforward in favour of routinely screening all pregnant women for pre-eclampsia (PE) during the first trimester of pregnancy. However, irrespective of the large amount of good evidence and expert opinion favourable for universally screening for obstetric syndromes, such as PE, public health policies do not always align with pure clinical science.

scholarly journals Assessment of the choroidal structure in pregnant women in the first trimester

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keiko Azuma ◽  
Atsushi Okubo ◽  
Takafumi Suzuki ◽  
Nozomi Igarashi ◽  
Yoko Nomura ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Choroidal Thickness ◽  
Linear Mixed Model ◽  
First Trimester ◽  
Study Groups ◽  
Enhanced Depth Imaging ◽  
Significant Difference ◽  
Luminal Area ◽  
Choroidal Structure ◽  
First Trimester Of Pregnancy

AbstractWe investigated the anatomical differences in the choroidal structure between pregnant women in the first trimester of pregnancy and age-matched healthy nonpregnant women using enhanced depth imaging optical coherence tomography (EDI-OCT) and choroidal binarization analysis. The main parameters measured in the two study groups, namely, pregnant women in the first trimester and healthy nonpregnant women, were choroidal thickness and the choroidal luminal area. Binarization of the EDI-OCT images from each patient was performed, and the choroidal vascularity index (CVI) was calculated. The correlations between the baseline characteristics of the subjects and the CVI were investigated using linear mixed model analysis. As a result, there was no statistically significant difference in the mean age, best-corrected visual acuity, axial length, central retinal thickness, subfoveal choroidal thickness, systolic blood pressure (BP), or diastolic BP between the two study groups. Conversely, a significant difference was observed in the CVI (P = 0.012) between the two groups. The multivariate analysis identified a significant correlation between the CVI and the systolic BP (P = 0.0044, linear mixed test). Taken together, a larger choroidal luminal area was associated with a higher systolic BP, especially in the first trimester of pregnancy. Our findings may provide further insight into the choroidal changes that occur during pregnancy.

scholarly journals Effectiveness of Evidence-Based Measures on Nausea and Vomiting during First Trimester of Pregnancy

2021 ◽  
Vol 3 (4) ◽  
pp. 9
Author(s):  
Asmaa I. Marak ◽  
Mona A. El-Sheikh ◽  
Eman M. S. Ahmed
Keyword(s):  
Pregnant Women ◽  
Lifestyle Modification ◽  
First Trimester ◽  
Maternity Hospital ◽  
Nausea And Vomiting ◽  
Evidence Based ◽  
Herbal Therapy ◽  
Sample Mean ◽  
Significant Difference ◽  
First Trimester Of Pregnancy

Context: Nausea and vomiting are the most common pregnancy symptoms that negatively affect many pregnant women. Severity varies from mild distaste for certain foods to more severe vomiting. Aim: The present study aimed to examine the effectiveness of applying evidence-based measures on nausea and vomiting during the first trimester of pregnancy. Methods: A quasi-experimental (pre/post-test) design was used. The study was conducted at the antenatal clinics at Ain Shams University Maternity Hospital. A purposive sample of forty-seven pregnant women was included in this study. All women received the evidence-based intervention. Data were collected using three tools. A structured interviewing questionnaire, pregnancy symptoms inventory (PSI), and weekly follow-up record. In addition to Arabic Evidence-based guide for alleviating nausea and vomiting during the first trimester of pregnancy. All pregnant women that suffered from nausea and vomiting followed the evidence-based guidelines designed by the researcher that involved instructions related to lifestyle modification. Besides, one of the following: herbal therapy, acupressure, and aromatherapy to relieve nausea and vomiting. Results: The study sample mean age was 28.1±6.42, with a mean gestational age of 9.43 ±3.88. 72% of them used nothing to overcome nausea and vomiting, while 18% used medication, and only 10% used a lifestyle modification before intervention. All women adopt lifestyle modification; 72.3% use herbal therapy after the intervention. The present study demonstrates a highly significant difference between responses before and after the intervention related to nausea and vomiting (p 0.004). There is a significant association between the evidence-based measure used and the relief of nausea and vomiting at p<0.01. Conclusion: The current study concluded that evidence-based measures positively alleviated nausea and vomiting during the first trimester of pregnancy. A leaflet or booklet about evidence-based measures for alleviating minor discomforts during pregnancy as a hospital protocol for guiding nurses in the application is strongly recommended.

scholarly journals Current practices of management of maternal and congenital Cytomegalovirus infection during pregnancy after a maternal primary infection occurring in first trimester of pregnancy: Systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261011
Author(s):  
Claire Périllaud-Dubois ◽  
Drifa Belhadi ◽  
Cédric Laouénan ◽  
Laurent Mandelbrot ◽  
Olivier Picone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Primary Infection ◽  
First Trimester ◽  
Secondary Outcome ◽  
Cmv Infection ◽  
Congenital Cmv Infection ◽  
First Trimester Of Pregnancy ◽  
Congenital Cmv ◽  
Current Practices

Introduction Congenital CMV infection is the first worldwide cause of congenital viral infection but systematic screening of pregnant women and newborns for CMV is still debated in many countries. Objectives This systematic review aims to provide the state of the art on current practices concerning management of maternal and congenital CMV infection during pregnancy, after maternal primary infection (PI) in first trimester of pregnancy. Data sources Electronically searches on databases and hand searches in grey literature. Study eligibility criteria and participants Primary outcome was listing biological, imaging, and therapeutic management interventions in two distinct populations: population 1 are pregnant women with PI, before or without amniocentesis; population 2 are pregnant women with congenitally infected fetuses (after positive amniocentesis). Secondary outcome was pregnancy outcome in population 2. Results Out of 4,134 studies identified, a total of 31 studies were analyzed, with 3,325 pregnant women in population 1 and 1,021 pregnant women in population 2, from 7 countries (Belgium, France, Germany, Israel, Italy, Spain and USA). In population 1, ultrasound (US) examination frequency was 0.75/month, amniocentesis in 82% cases, maternal viremia in 14% and preventive treatment with hyperimmune globulins (HIG) or valaciclovir in respectively 14% and 4% women. In population 2, US examination frequency was 1.5/month, magnetic resonance imaging (MRI) in 44% cases at 32 weeks gestation (WG), fetal blood sampling (FBS) in 24% at 28 WG, and curative treatment with HIG or valaciclovir in respectively 9% and 8% patients. Conclusions This systematic review illustrates management of maternal and congenital CMV during pregnancy in published and non-published literature, in absence of international consensus. Systematic review registration PROSPERO CRD42019124342

scholarly journals Oxidative Stress Markers in Early Pregnancy Loss: A Case-Control Study

2018 ◽  
Vol 7 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Shahnaz Torkzahrani ◽  
Padideh Janati Ataei ◽  
Mehdi Hedayati ◽  
Soheila Khodakarim ◽  
Zohre Sheikhan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Uric Acid ◽  
Pregnant Women ◽  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Pregnancy Loss ◽  
First Trimester ◽  
Demographic Characteristics ◽  
Early Pregnancy Loss ◽  
First Trimester Of Pregnancy

Objectives: Evidence suggests that oxidative stress (OS) plays a prominent role in the pathophysiology of pregnancy complications in women. The present study was conducted to determine the levels of OS markers in early pregnancy loss and to compare the results with those in healthy pregnant women. Materials and Methods: A total of 32 women with early pregnancy loss and 32 healthy women in the first trimester of pregnancy, with similar demographic characteristics entered this study as the cases and controls. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), uric acid, and bilirubin levels were determined in both groups. The data obtained were then analyzed and compared between the groups using the independent samples t test and Mann-Whitney U test. Results: The 2 groups matched in terms of personal-demographic characteristics including mother’s age, father’s age, gravidity, and body mass index (BMI). MDA levels increased significantly in the women with spontaneous abortion compared to the healthy pregnant women (4.35±1.47 vs. 3.42±1.68 µM/L; P=0.026) and TAC decreased significantly in the cases compared to the healthy controls (552.34±212.79 vs. 1003.23±1168.68 U/mL; P=0.040). Uric acid and bilirubin levels did not differ between the groups. Conclusions: The results of this study provides further evidence on the effect of increased OS on the incidence of early spontaneous abortion in the first trimester of pregnancy. High serum MDA levels and low TAC during pregnancy were 2 risk factors for spontaneous abortion. The present findings support the hypothesis that OS plays a key role in the etiopathogenesis of spontaneous abortion. Further studies are required for assessing the preventive role of antioxidant therapy in this complication.

scholarly journals DISTURBANCE OF THE PROGESTERONE AND ITS METABOLITES SYNTHESIS IN THE DEVELOPMENT OF NEUROLOGICAL DISORDERS IN CHILDREN AFTER CYTOMEGALOVIRUS INFECTION DURING PREGNANCY

2018 ◽  
Vol 3 (4) ◽  
pp. 78-84
Author(s):  
I. V. Dovzhikova ◽  
I. A. Andrievskaya ◽  
N. A. Ishutina ◽  
I. N. Gorikov ◽  
S. V. Medvedeva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neurological Disorders ◽  
First Trimester ◽  
Neurological Dysfunction ◽  
Viral Agent ◽  
Cmv Infection ◽  
First Trimester Of Pregnancy ◽  
Latent Disease ◽  
One Year ◽  
The Impact

Cytomegalovirus (CMV) infection is one of the causes of congenital neurological disorders and the virus itself is the most common viral  agent causing an imbalance in the production of placenta  progesterone and its neuroactive metabolites – allopregnenolone and 5α-dihydroprogesterone. The aim was to evaluate the concentration  of progesterone and its metabolites – 5α-dihydroprogesterone and  allopregnenolone – in placenta during exacerbation of CMV infection  in the first trimester of pregnancy, and the impact of these  disturbances on the development of neurological disorders in children. We examined 30 pregnant women with exacerbation of  CMV infection in the first trimester of pregnancy and 30 pregnant  women with latent disease; and later their newborns. The enzyme  immunoassay was used to determine  concentration of progesterone  in placenta; the histochemical method – to determine 5α-dihydroprogesterone and allopregnenolone. Newborns underwent  neurosonography studies. Exacerbation of CMV infection in the first  trimester of pregnancy decreased progesterone in placenta by 1.3  times, 5α-dihydroprogesterone – by 1.73 times and allopregnenolone – by 2 times. Ultrasound examination of the brain  showed ventriculomegaly, periventricular ischemia, and pseudocysts  in newborns up to one year from mothers with exacerbation of CMV  during pregnancy. Later, minimal brain dysfunctions were manifested by motor disorders, increased general, vegetative excitability, and a  tendency to digestive and sleep disorders. The data obtained  indicate that the exacerbation of CMV infection in the first trimester  of pregnancy is interrelated with a decrease in the concentration of progesterone and its metabolites (5α-dihydroprogesterone, allopregnenolone) in the placenta and development of neurological dysfunction in newborns.

scholarly journals Cohort profile: effect of malaria in early pregnancy on fetal growth in Benin (RECIPAL preconceptional cohort)

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019014 ◽  
Author(s):  
Manfred Accrombessi ◽  
Emmanuel Yovo ◽  
Gilles Cottrell ◽  
Gino Agbota ◽  
Agnès Gartner ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Early Pregnancy ◽  
First Trimester ◽  
Reproductive Age ◽  
Health Determinants ◽  
Women Of Reproductive Age ◽  
High Prevalence ◽  
First Trimester Of Pregnancy

PurposeREtard de Croissance Intra-uterin et PALudisme (RECIPAL) is an original preconceptional cohort designed to assess the consequences of malaria during the first trimester of pregnancy, which is a poorly investigated period in Africa and during which malaria may be detrimental to the fetus.ParticipantsFor this purpose, a total of 1214 women of reproductive age living in Sô-Ava and Akassato districts (south Benin) were followed up monthly from June 2014 to December 2016 until 411 of them became pregnant. A large range of health determinants was collected both before and during pregnancy from the first weeks of gestation to delivery. Five Doppler ultrasound scans were performed for early dating of the pregnancy and longitudinal fetal growth assessment.Findings to datePregnant women were identified at a mean of 6.9 weeks of gestation (wg). Preliminary results confirmed the high prevalence of malaria in the first trimester of pregnancy, with more than 25.4% of women presenting at least one microscopic malarial infection during this period. Most infections occurred before six wg. The prevalence of low birth weight, small birth weight for gestational age (according to INTERGROWTH-21st charts) and preterm birth was 9.3%, 18.3% and 12.6%, respectively.Future plansREtard de Croissance Intra-uterin et PALudisme (RECIPAL) represents at this time a unique resource that will provide information on multiple infectious (including malaria), biological, nutritional and environmental determinants in relation to health outcomes in women of reproductive age, pregnant women and their newborns. It will contribute to better define future recommendations for the prevention of malaria in early pregnancy and maternal malnutrition in Africa. It confirms that it is possible to constitute a preconceptional pregnancy cohort in Africa and provides valuable information for researchers starting cohorts in the future.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan
Keyword(s):  
Pregnant Women ◽  
Ambulatory Care ◽  
National Level ◽  
Mainland China ◽  
Antibiotic Use ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fetal Safety ◽  
First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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