Adverse perinatal outcomes in patient with chronic hypertension by insurance type

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

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Adverse Perinatal Outcomes and Risk Factors for Preeclampsia in Women With Chronic Hypertension

Hypertension ◽

10.1161/hypertensionaha.107.107565 ◽

2008 ◽

Vol 51 (4) ◽

pp. 1002-1009 ◽

Cited By ~ 158

Author(s):

Lucy C. Chappell ◽

Stephen Enye ◽

Paul Seed ◽

Annette L. Briley ◽

Lucilla Poston ◽

...

Keyword(s):

Risk Factors ◽

Perinatal Outcomes ◽

Chronic Hypertension ◽

Adverse Perinatal Outcomes

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Role of umbilical artery Doppler velocimetry in predicting the adverse perinatal outcomes in hypertensive disorder of pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174409 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4382

Author(s):

Jyoti Yadav ◽

Mala Shukla ◽

P. K. Jain ◽

Devender Kumar

Keyword(s):

Predictive Value ◽

Perinatal Outcome ◽

Umbilical Artery ◽

Perinatal Outcomes ◽

Chronic Hypertension ◽

Hypertensive Disorder ◽

Umbilical Artery Doppler ◽

Hypertensive Disorder Of Pregnancy ◽

Adverse Perinatal Outcomes ◽

Group B

Background: Early detection of fetoplacental compromise with Umbilical Artery Doppler indices and to know the predictive value of each indices in predicting perinatal outcome and interventional strategies in these patients.Methods: The present prospective study was conducted on 200 women with hypertensive disorder of pregnancy. Umbilical artery doppler evaluation done in all the patients at (28-32) weeks, (33-36) weeks and (37-40) weeks of gestation and more frequently in those patients having deranged Doppler. Patients divided into two groups women with abnormal Umbilical artery indices (group B) and normal indices (group A). Perinatal outcome of both the groups were compared, analyzed statistically using Chi-square test. Multiple pregnancy, chronic hypertension, fetal congenital anomalies, systemic disease and those lost to follow up till delivery were excluded from study.Results: A total of 200 pregnant women with hypertensive disorder, 64% were primgravida. Abnormal umbilical artery indices seen in 36%. Adverse outcome was seen in 88.88% patients of group B. Statistically significantly higher rate of caeserian section, induction of labour, Preterm delivery, fetal growth restriction, NICU admission, NICU stay >48hrs were seen in group B. In all indices Umbilical artery PI had highest Sensitivity (84.21%), positive predictive value (88.88%) and accuracy (90%).Conclusions: Umbilical artery PI is the most reliable to predict adverse perinatal outcomes and help in appropriate timing of intervention to improve perinatal outcome.

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95: Are adverse perinatal outcomes (APOs) in chronic hypertension (CHTN) mostly related to superimposed preeclampsia (PE)?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.10.113 ◽

2012 ◽

Vol 206 (1) ◽

pp. S57

Author(s):

Baha Sibai ◽

Matthew Koch ◽

Salvio Freire ◽

Joao Luiz Pinto e Silva ◽

Marilza Vieira Cunha Rudge ◽

...

Keyword(s):

Perinatal Outcomes ◽

Chronic Hypertension ◽

Adverse Perinatal Outcomes

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Ivf versus spontan singleton pregnancies fetal and maternal outcomes in a tertiary care hospital

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v5i3.04 ◽

2018 ◽

Vol 5 (3) ◽

pp. 3583-3587

Author(s):

Erbil Çakar ◽

Meral Meryem Yavuz ◽

Tayfun Kutlu ◽

Habibe Ayvacı Taşan ◽

Ebru Cogendez ◽

...

Keyword(s):

Placental Abruption ◽

Gestational Hypertension ◽

Placenta Previa ◽

Perinatal Outcomes ◽

Chronic Hypertension ◽

Study Group ◽

Premature Rupture ◽

Adverse Perinatal Outcomes ◽

Cholestasis Of Pregnancy ◽

Singleton Pregnancies

Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) versus naturally (spontaneously) concieved age and parity matched group of singleton pregnants. Methods: Two hundred and sixteen singleton pregnancies aged between 18-45 years old were included in this study. Among all study group, 106 cases were ICSI pregnancies (study group) and 110 cases were spontaneously concieved singleton pregnancies (control group). Pregnancy outcome parameters were: the incidence of chronic hypertension, preeclampsia, gestational hypertension, placenta previa, placental abruption, preterm birth, intrahepatic cholestasis of pregnancy, gestational diabetes, preterm premature rupture of membranes, caesarean delivery. Results: There were no differences in terms of maternal age, BMI, gravidity, parity, gestational weeks at birth and birth weight between ICSI and spontaneously concieved pregnancy groups. Placental abruption, gestational diabetes and cesarean section rates were significantly higher in ICSI pregnancies than spontaneously conceived pregnancies (4.7% vs 0%, 21.7% vs 11.8% and 82.1% vs 68.2%, respectively). There wereno statistically significant differences in terms of chronic hypertension, preeclampsia, gestational hypertension, preterm labor, placenta previa, intrahepatic cholestasis of pregnancy, preterm and term premature rupture of the membranes. Conclusion: ICSI pregnancies have higher adverse perinatal outcomes than spontaneously conceived singleton pregnancies which were matched with age and parity. That’s why ICSI pregnancies should be given a detailed counseling about the adverse perinatal outcomes and should be followed up more carefully through the pregnancy.

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Chronic hypertension in pregnancy stratified by first trimester blood pressure control and adverse perinatal outcomes: a prospective observational study

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.14132 ◽

2021 ◽

Author(s):

Dan Dumitrascu‐Biris ◽

Diane Nzelu ◽

Theodore Dassios ◽

Kypros Nicolaides ◽

Nikos A Kametas

Keyword(s):

Blood Pressure ◽

Observational Study ◽

Prospective Observational Study ◽

Perinatal Outcomes ◽

Pressure Control ◽

First Trimester ◽

Chronic Hypertension ◽

Hypertension In Pregnancy ◽

Adverse Perinatal Outcomes ◽

In Pregnancy

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Faculty Opinions recommendation of Intrauterine Zika virus infection of pregnant immunocompetent mice models transplacental transmission and adverse perinatal outcomes.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727327812.793534615 ◽

2017 ◽

Author(s):

Philippe Le Bouteiller

Keyword(s):

Virus Infection ◽

Zika Virus ◽

Perinatal Outcomes ◽

Transplacental Transmission ◽

Zika Virus Infection ◽

Adverse Perinatal Outcomes ◽

Immunocompetent Mice

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Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽

10.3390/v13050853 ◽

2021 ◽

Vol 13 (5) ◽

pp. 853

Author(s):

Sara Cruz Melguizo ◽

María Luisa de la Cruz Conty ◽

Paola Carmona Payán ◽

Alejandra Abascal-Saiz ◽

Pilar Pintando Recarte ◽

...

Keyword(s):

Pregnant Women ◽

Perinatal Outcomes ◽

Preterm Births ◽

Hypertensive Disorder ◽

Obstetric Emergency ◽

Increased Risk ◽

Emergency Group ◽

Adverse Perinatal Outcomes ◽

Maternal Disease ◽

The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

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Fetal movement counting is associated with the reduction of delayed maternal reaction after perceiving decreased fetal movements: a prospective study

Scientific Reports ◽

10.1038/s41598-021-90240-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Shigeki Koshida ◽

Shinsuke Tokoro ◽

Daisuke Katsura ◽

Shunichiro Tsuji ◽

Takashi Murakami ◽

...

Keyword(s):

Pregnant Women ◽

Maternal Behavior ◽

Multivariable Analysis ◽

Perinatal Outcomes ◽

Fetal Movement ◽

Post Intervention ◽

Fetal Movements ◽

Adverse Perinatal Outcomes ◽

The Impact ◽

Maternal Reaction

AbstractMaternal perception of decreased fetal movement is associated with adverse perinatal outcomes. Although there have been several studies on interventions related to the fetal movements count, most focused on adverse perinatal outcomes, and little is known about the impact of the fetal movement count on maternal behavior after the perception of decreased fetal movement. We investigated the impact of the daily fetal movement count on maternal behavior after the perception of decreased fetal movement and on the stillbirth rate in this prospective population-based study. Pregnant women in Shiga prefecture of Japan were asked to count the time of 10 fetal movements from 34 weeks of gestation. We analyzed 101 stillbirths after the intervention compared to 121 stillbirths before the intervention. In multivariable analysis, maternal delayed visit to a health care provider after the perception of decreased fetal movement significantly reduced after the intervention (aOR 0.31, 95% CI 0.11–0.83). Our regional stillbirth rates in the pre-intervention and post-intervention periods were 3.06 and 2.70 per 1000 births, respectively. Informing pregnant women about the fetal movement count was associated with a reduction in delayed maternal reaction after the perception of decreased fetal movement, which might reduce stillbirths.

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