25 hydroxycholicalciferol levels during Pregnancy in Rural and Urban Population of South India

2021 ◽  
Vol 12 (2) ◽  
pp. 1590-1596
Author(s):  
Julie Christy A ◽  
Saraswathi Perumal ◽  
Sumathy G

Maternal 25 dihydroxycholecalciferol is the storage form the vitamin D. It gets activated to 1,25, Dihydroxycholecalciferol (vitamin D3) in the kidneys. Pregnancy increases requirement for the vitamin D3. The 1,25 dihydroxycholecalciferol is produced by the fetal kidneys from maternal sources of 25 dihydroxycholecalciferol. Vitamin D3 is essential for intestinal calcium absorption and bone mineralization in fetus.104 venous blood samples were used to study 25 hydroxycholecalciferol and serum calcium levels. Experimental group involved venous blood samples from 100 ANC between 20-40 years. In the first trimester rural ANC cases had an average 25 hydroxycholecalciferol level of 50.9ng/ml. In Urban participants the average was 31.6nmol/L. Second Trimester ANC in rural sector had an average of 54nmol/L and in urban average was 45nmol/L. In third trimester rural participants had an average of 61nmol/L, urban participants had 28nmol/L. The urban participants in all the three trimesters had 25 hydroxycholecalciferol insufficiency. 25 hydroxycholecalciferol deficiency is higher percentage in first trimester, gradually reduces in second trimester and reaches towards normal limits in third trimester. The placental secretion compensates for the homeostasis and maintenance of normal calcium levels and during third trimester. Active fetal bone mineralization occurs in third trimester.

2021 ◽  
Vol 12 (4) ◽  
pp. 2330-2334
Author(s):  
Julie Christy A ◽  
Saraswathi Perumal ◽  
Sumathy G

Vitamin D deficiency has been reported worldwide. It has been reported at suboptimal levels in gestation. The levels vary during various trimesters of pregnancy. This article focuses on the gestation week wise variations observed in the serum cholecalciferol levels during gestation. 100 venous blood samples were collected from singleton, non-smoking pregnancies. The samples were collected in the summer and winter seasons during various weeks of pregnancy. The samples were collected randomly in patients who were not supplemented with vitamin D. The serum cholecalciferol levels were observed to be deficient during the first trimester (below<30 ng/ml), there was an increase in the vitamin D levels in the second trimester (levels<30 ng/ml). During the third trimester, the levels increased gradually. The ratio of cases deficient during the first trimester was higher when compared to the second and third trimesters. The serum cholecalciferol levels remain deficient due to the foetal organogenesis in the first trimester. The serum 25 hydroxy cholecalciferol levels are compensated with the development of the placenta. During the second trimester, it gradually increases and reaches sufficient limits during the third trimester.


2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.


2021 ◽  
Author(s):  
Zuoxi He ◽  
Chuan Xie ◽  
Xiaorong Qi ◽  
Zhengjun Hu ◽  
Yuedong He

Abstract ObjectiveCervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer.MethodsThis study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records. ResultsThe study comprised 40 patients with clinical cancer stages of ⅠA1 (1/40, 2.5%); ⅠB1 (15/40, 37.5%); IB2 (10/40, 25%); ⅡA (12/40, 30%); and ⅡB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. Ten of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs 90.91%, P =0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparing the 2 groups were not significantly different. ConclusionsIn the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer did not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.


2019 ◽  
Author(s):  
Veronique Schiffer ◽  
Laura Evers ◽  
Sander de Haas ◽  
Chahinda Ghossein ◽  
Salwan Al-Nasiry ◽  
...  

Abstract Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed.Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.75 (95% CI: 0.67-0.83) and 0.49 (95% CI: 0.46-0.53) in the first trimester to 0.52 (95% CI: 0.48-0.56, p=0.003) and 0.40 (95% CI: 0.38-0.42, p=0.080) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.510) and 0.36 (95% CI: 0.35-0.37, p=0.307) in the third trimester, respectively. In parallel, PSV altered from 0.24 m/s (95% CI: 0.17-0.31 m/s) to 0.28 m/s (95% CI: 0.22-0.34 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.21-0.28 m/s, p=0.919) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.76, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349).Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI and RI were found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.


2011 ◽  
Vol 106 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
R. K. Marwaha ◽  
N. Tandon ◽  
S. Chopra ◽  
N. Agarwal ◽  
M. K. Garg ◽  
...  

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.


2019 ◽  
Vol 105 (4) ◽  
pp. e1085-e1092
Author(s):  
Mengdi Lu ◽  
Bruce W Hollis ◽  
Vincent J Carey ◽  
Nancy Laranjo ◽  
Ravinder J Singh ◽  
...  

Abstract Context Vitamin D (VD) deficiency in pregnancy and the neonatal period has impacts on childhood outcomes. Maternal VD sufficiency is crucial for sufficiency in the neonate, though the effect of early versus late pregnancy 25-hydroxy-vitamin D (25(OH)D) levels on neonatal levels is unknown. Furthermore, chemiluminescence immunoassays (CLIAs) are widely used, though their validity in measuring 25(OH)D specifically in cord blood specimens has not been established. Objective To assess the validity of a CLIA in the measurement of cord blood 25(OH)D and to evaluate maternal determinants of neonatal 25(OH)D, including early versus late pregnancy 25(OH)D levels. Design This is an ancillary analysis from the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a randomized, double-blinded, placebo-controlled study. Participants and Intervention A total of 881 pregnant women at high risk of having offspring asthma were randomized to receive VD supplementation or placebo. Serum samples were collected from mothers in early and late pregnancy and from offspring cord blood at birth. 25(OH)D levels were assayed by CLIA in all maternal and offspring samples and by LC-MS/MS in all offspring samples and a subset of 200 maternal third trimester samples. Results Cord blood 25(OH)D levels were higher as measured by CLIA (mean 37.13 ng/mL [SD 18.30]) than by LC-MS/MS (mean 23.54 ng/mL [SD 11.99]), with a mean positive bias of 13.54 ng/mL (SD 12.92) by Bland-Altman analysis. This positive bias in measurement by CLIA was not observed in maternal samples. Third trimester 25(OH)D was a positive determinant of neonatal 25(OH)D levels. Conclusion Chemiluminescence immunoassays overestimate 25(OH)D levels in human cord blood samples, an effect not observed in maternal blood samples. The quantification of 25(OH)D by CLIA should therefore not be considered valid when assayed in cord blood samples. Third trimester, but not first trimester, maternal 25(OH)D is one of several determinants of neonatal 25(OH)D status.


1970 ◽  
Vol 29 (6) ◽  
Author(s):  
Salva MN ◽  
Chandni Gupta ◽  
Arvind Kumar Pandey ◽  
Nitesh Kumar ◽  
Sushma R Kotian ◽  
...  

Background: Intestine plays a major role for the normal growth of the fetus during the prenatal period. The process of the embryonic development is not quantified histologically. Therefore the main aim of the study was to measure the thickness of all part of the wall of the small intestine that are mucosa, submucosa and muscularis externa and to look for the appearance of the Brunner’s glands and Peyer’s patches in the submucosa of duodenum and ileum.Methods: The present study was carried out on 30 fetuses of gestational ages ranging from 11-36 weeks. Ten fetuses from each trimester were used in the study. Fetal small intestine were dissected carefully, and were separated as duodenum, jejunum & ileum and fixed in formalin solution. The tissue was processed for histology and then slides were stained with Haematoxylin and Eosin. The microscopic features were noted using light microscope.Results: The thickness of the mucosa, submucosa and the muscularis externa was observed to be increased in first trimester, decreased in the second trimester and again increased in the third trimester, which could be because of the increase cell turnover and the arrangement of the collagen fibers as to support the mucosa and the muscularis externa.Conclusion: Thus, the knowledge of the histogenesis and histomorphometry of the human fetal small intestine is crucial for the adult gastroenterologist to appreciate, because of the potential for these early life events to affect the responsiveness of the intestine to physiological or pathological challenges in later life. 


Author(s):  
Süleyman Akarsu ◽  
Filiz Akbiyik ◽  
Eda Karaismailoglu ◽  
Zeliha Gunnur Dikmen

AbstractThyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.


2019 ◽  
Vol 1 (1) ◽  
pp. 12-22
Author(s):  
Applonia Leo Obi

Abstract: DMF-T and OHIS index for pregnant women. Pregnancy is a physiological process that causes changes in a woman's body both physically and psychologically. During pregnancy physiological changes occur which are often accompanied by changes in attitude and behavior. The health behavior of pregnant women also has a very big influence on herself and the fetus. This research is a descriptive method. This study aims to determine the rates of DMF-T and OHIS in pregnant women at Oesapa Health Center, Kupang City. Sampling by accidental sampling technique, amounting to 97 pregnant women who visited the MCH polyclinic at the Kupang Oesapa Health Center. The results based on DMF-T figures show that the high prevalence of dental caries in the second-trimester pregnant women group (36.0%) than in the third trimester of pregnancy (28.8%) while OHIS most respondents in the second-trimester pregnancy (36, 1%) had an OHI-S index in the medium category with a ratio of trimester 3 there were 23 people (23.7%) and first trimester around 19 people (19.6%). It was concluded that the DMF-T index of pregnant women in the working area of ​​the Kupang City Oesapa health center was mostly carious and most of the pregnant women examined had caries of more than 4 teeth per person and all pregnant women who were examined for dental and oral hygiene levels showed moderate criteria. Abstrak: Indeks DMF-T dan OHIS pada Ibu Hamil. Kehamilan merupakan suatu proses fisiologis yang menimbulkan perubahan pada tubuh wanita baik fisik maupun psikis. Pada masa kehamilan terjadi perubahan fisiologis yang sering disertai dengan perubahan sikap dan perilaku. perilaku  kesehatan  ibu  hamil  juga  memiliki  pengaruh yang  sangat  besar  bagi  dirinya  sendiri  dan  janin. Penelitian ini adalah metode deskriptif. Penelitian ini bertujuan untuk mengetahui  angka DMF-T dan OHIS pada ibu hamil di Puskesmas Oesapa Kota Kupang. Pengambilan sampel dengan teknik accidental sampling, berjumlah 97 ibu hamil yang berkunjung ke poli KIA di Puskesmas Oesapa Kota Kupang. Hasil penelitian berdasarkan Angka DMF-T menunjukkan bahwa tingginya prevalensi karies gigi pada kelompok ibu hamil  trimester kehamilan kedua (36,0%) dari pada trimester kehamilan ke tiga (28,8%) sedangkan OHIS sebagian besar responden pada kehamilan trimester 2 (36,1%) memiliki indek OHI-S pada kategori sedang dengan perbandingan trimester 3 ada 23 orang (23,7%) dan trimester I sekitar 19 orang (19,6%). Disimpulkan bahwa indeks DMF-T ibu hamil diwilayah kerja puskesmas Oesapa Kota Kupang sebagian besar berkaries dan sebagian besar ibu hamil yang diperiksa mempunyai karies lebih dari 4 gigi per orang dan semua ibu hamil yang diperiksa tingkat kebersihan gigi dan mulutnya menunjukkan kriteria sedang.


Author(s):  
Maryam Hasani ◽  
Afsaneh Keramat ◽  
Raziyeh Maasoumi ◽  
Maryam Farjamfar ◽  
Masud Yunesian ◽  
...  

Objectives: Sexual life may change during pregnancy. Due to negative attitudes toward having sex, unpleasant feeling, and fear of several issues, women might avoid vaginal intercourse during pregnancy. Therefore, the present systematic review aimed to investigate the frequency of vaginal intercourse in pregnancy. Materials and Methods: Comprehensive literature review was conducted to find the relevant articles published (from December 1990 to April 2018) on the issue including observational studies (e.g., cross-sectional and cohort studies) that certainly determined the mean frequency of vaginal sex throughout pregnancy. In this regard, online international databases such as ISI, PubMed, Scopus, Cochrane, and Google Scholar were independently explored and checked by two authors. Duplicate articles were removed by the EndNote X7 Reference Manager. The results were analyzed using RevMan 5.3 software. The P < 0.05 was considered significant. Results: Totally, after excluding the duplicate and irrelevant articles based on having the mean frequency of vaginal intercourse during pregnancy, 13 articles were obtained. The range of vaginal intercourse frequency varied from 6.01 to 21 times every month pre-pregnancy, 3.67-9.87 times monthly in the first trimester, 2.78-7.21 times monthly in the second trimester, and 1.35-5.9 times monthly in the third trimester. Five out of the 13 selected articles reporting the mean and standard deviation were entered the current meta-analysis. The frequency of vaginal intercourse was obtained 7.75 (7.13-8.38) times monthly prior to pregnancy, 4.16 (3.86-4.46) times in the first trimester, 6.37 (5.60-7.14) times monthly in the second trimester, and 1.81 (1.49-2.13) times monthly in the third trimester. Conclusions: Generally, the frequency of vaginal intercourse decreased in the first trimester while increasing in the second trimester. However, a sharp decline was observed between the second and third trimesters of pregnancy.


Sign in / Sign up

Export Citation Format

Share Document