scholarly journals Asthma in pregnancy – from immunology to clinical management

2010 ◽  
Vol 5 ◽  
Author(s):  
Lilla Tamási ◽  
Anikó Bohács ◽  
Ildikó Horváth ◽  
György Losonczy
Keyword(s):  
Fetal Growth ◽  
Clinical Management ◽  
Perinatal Outcomes ◽  
Asthma Severity ◽  
Chronic Medical Conditions ◽  
Uncontrolled Asthma ◽  
Immunological Mechanisms ◽  
Fetal Complications ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Asthma is one of the most common chronic medical conditions that may complicate pregnancy. Asthma influences the outcome of pregnancy and, vice versa, pregnancy affects asthma severity, but the underlying immunological mechanisms of this interaction are not fully understood. As a sign of pregnancy-induced immunotolerance, attenuation of allergic responses can be detected in controlled asthmatic pregnant patients; however non controlled asthmatic pregnant women show significant asthma-associated immune reactions that may, beside other factors, influence fetal growth. Generally, although uncontrolled asthma may increase the risk of adverse perinatal outcomes, women with well-controlled and adequately treated disease during pregnancy do not develop maternal or fetal complications.

scholarly journals Fetal growth standards for Chinese twin pregnancies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jianping Chen ◽  
Jun Zhang ◽  
Yang Liu ◽  
Xing Wei ◽  
Yingjun Yang ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Perinatal Outcomes ◽  
Growth Charts ◽  
Growth Standards ◽  
Growth Standard ◽  
Adverse Perinatal Outcomes ◽  
Chinese Twins ◽  
Twin Pregnancies

Abstract Background The common use of singleton fetal growth standard to access twin growth might lead to over-monitoring and treatment. We aimed to develop fetal growth standards for Chinese twins based on ultrasound measurements, and compare it with Zhang’s and other twin fetal growth charts. Methods A cohort of uncomplicated twin pregnancies were prospectively followed in 2014–2017. Smoothed estimates of fetal growth percentiles for both monochorionic (MC) and dichorionic (DC) twins were obtained using a linear mixed model. We also created growth charts for twins using a model-based approach proposed by Zhang et al. Our twin standards were compared with Hadlock’s (singleton) in predicting adverse perinatal outcomes. Results A total of 398 twin pregnancies were included, with 214 MC and 582 DC live-born twins. The MC twins were slightly lighter than the DC twins, with small differences throughout the gestation. Our ultrasound-based fetal weight standards were comparable to that using Zhang’s method. Compared with previous references/standards from the US, Brazil, Italy and UK, our twins had very similar 50th percentiles, but narrower ranges between the 5th and 95th or 10th and 90th percentiles. Compared with the Hadlock’s standard, the risks of neonatal death and adverse perinatal outcomes for small for gestational age (SGA) versus non-SGA were substantially elevated using our standards. Conclusions A normal fetal growth standard for Chinese twins was created. The differences between MC and DC twins were clinically insignificant. The 50th weight percentiles of the Chinese twins were identical to those in other races/ethnicities but the ranges were markedly narrower. Our standard performed much better than the Hadlock’s in predicting low birth weight infants associated with adverse perinatal outcomes in twin pregnancies. The present study also indicated that Zhang’s method is applicable to Chinese twins, and other areas may use Zhang’s method to generate their own curves for twins if deemed necessary.

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

Mild gestational hyperglycaemia as a risk factor for metabolic syndrome in pregnancy and adverse perinatal outcomes

2008 ◽  
Vol 24 (4) ◽  
pp. 324-330 ◽  
Author(s):  
Carlos Antonio Negrato ◽  
Lois Jovanovic ◽  
Marcos Antonio Tambascia ◽  
Iracema de Mattos Paranhos Calderon ◽  
Bruno Geloneze ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
Perinatal Outcomes ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Detection of Adverse Perinatal Outcomes at Term Delivery Using Ultrasound Estimated Percentile Weight at 35 Weeks of Gestation: Comparison of Five Fetal Growth Standards

2019 ◽  
Vol 47 (2) ◽  
pp. 104-114 ◽  
Author(s):  
Ricardo Savirón-Cornudella ◽  
Luis M. Esteban ◽  
Mauricio Tajada-Duaso ◽  
Sergio Castán-Mateo ◽  
Peña Dieste-Pérez ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Perinatal Outcomes ◽  
Growth Standards ◽  
Term Delivery ◽  
Adverse Perinatal Outcomes

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

scholarly journals Perinatal Outcomes of Fetuses with Early Growth Restriction, Late Growth Restriction, Small for Gestational Age, and Adequate for Gestational Age

2019 ◽  
Vol 41 (12) ◽  
pp. 688-696
Author(s):  
Quênya Antunes Silveira Inácio ◽  
Edward Araujo Júnior ◽  
Luciano Marcondes Machado Nardozza ◽  
Caetano Galvão Petrini ◽  
Victor Paranaíba Campos ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Fetal Growth ◽  
Gestational Age ◽  
Late Onset ◽  
Neonatal Resuscitation ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Adverse Perinatal Outcomes ◽  
Gestational Age At Birth ◽  
Age At Birth

Abstract Objective To evaluate the association between early-onset fetal growth restriction (FGR), late-onset FGR, small for gestational age (SGA) and adequate for gestational age (AGA) fetuses and adverse perinatal outcomes. Methods This was a retrospective longitudinal study in which 4 groups were evaluated: 1 — early-onset FGR (before 32 weeks) (n = 20), 2 — late-onset FGR (at or after 32 weeks) (n = 113), 3 — SGA (n = 59), 4 — AGA (n = 476). The Kaplan-Meier curve was used to compare the time from the diagnosis of FGR to birth. Logistic regression was used to determine the best predictors of adverse perinatal outcomes in fetuses with FGR and SGA. Results A longer time between the diagnosis and birth was observed for AGA than for late FGR fetuses (p < 0.001). The model including the type of FGR and the gestational age at birth was significant in predicting the risk of hospitalization in the neonatal intensive care unit (ICU) (p < 0.001). The model including only the type of FGR predicted the risk of needing neonatal resuscitation (p < 0.001), of respiratory distress (p < 0.001), and of birth at < 32, 34, and 37 weeks of gestation, respectively (p < 0.001). Conclusion Fetal growth restriction and SGA were associated with adverse perinatal outcomes. The type of FGR at the moment of diagnosis was an independent variable to predict respiratory distress and the need for neonatal resuscitation. The model including both the type of FGR and the gestational age at birth predicted the risk of needing neonatal ICU hospitalization.

scholarly journals Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Huijie Wang ◽  
Na Li ◽  
Huaqiong Huang
Keyword(s):  
Health Care ◽  
Medication Safety ◽  
Control Level ◽  
Perinatal Outcomes ◽  
Health Care Practitioner ◽  
Disease Assessment ◽  
Physiological Changes ◽  
Drug Compliance ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Asthma in pregnancy is a health issue of great concern. Physiological changes and drug compliance during pregnancy can affect asthma control in varying degrees, and the control level of asthma and the side effects of asthma medications are closely related to the adverse perinatal outcomes of mother and fetus. This article provides an update on the available literature regarding the alleviating or aggravating mechanism of asthma in pregnancy, diagnosis, disease assessment, and systematic management, to provide a new guidance for physician, obstetric joint doctor, and health care practitioner.

366: Placental volume measurements early in pregnancy predict adverse perinatal outcomes

2009 ◽  
Vol 201 (6) ◽  
pp. S142-S143 ◽  
Author(s):  
Nadav Schwartz ◽  
Jaclyn Coletta ◽  
Sindhu Srinivas ◽  
Cara Pessel ◽  
Ilan E. Timor ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Volume Measurements ◽  
Adverse Perinatal Outcomes ◽  
Placental Volume ◽  
In Pregnancy
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