FETAL AND MATERNAL CONSEQUENCES OF PREGNANCIES CONCEIVED USING ART

2014 ◽  
Vol 25 (3-4) ◽  
pp. 281-294
Author(s):  
CATHERINE E. M. AIKEN ◽  
JEREMY C. BROCKELSBY
Keyword(s):  
Pregnancy Outcomes ◽  
Large Scale ◽  
Reproductive Technology ◽  
Maternal Outcomes ◽  
Perinatal Complications ◽  
Adverse Impacts ◽  
The Us ◽  
Fetal Complications ◽  
Adverse Pregnancy ◽  
Singleton Pregnancies

Artificial reproductive technology (ART) was first introduced to clinical practice in the late 1970s1 and has subsequently resulted in approximately 5 million births worldwide2. Globally, the rates of assisted conceptions continue to rise3. In 2011, approximately 1.5% of all pregnancies in the US were conceived using ART4. Since its introduction, much interest has been generated regarding the effects of ART on the developing fetus and potential adverse impacts on the health of the mother. In particular, early studies suggested an increase in fetal genetic and structural anomalies, and a high risk of perinatal complications. As experience with pregnancies conceived using ART has increased worldwide and more data regarding the outcomes of ART-conceived pregnancies have been reported, many of the initial worries have been shown to be unfounded. However, concern still exists regarding whether any adverse fetal and maternal outcomes result from the use of this technology. Many studies have reported higher risks of fetal complications following the use of ART including an increase in perinatal mortality, even in singleton pregnancies5,6. However, interpretation of these data are far from simple and it is important to consider that observations of higher rates of complications do not equate to a causal relationship between adverse pregnancy outcomes and the use of ART7. There are multiple confounding factors that may account for these associations, many of which are difficult to control for in large-scale studies.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

scholarly journals Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013-2018

2020 ◽  
Author(s):  
Chunyun Li ◽  
Huihui Zeng ◽  
Xin Ding ◽  
Yi Chen ◽  
Xiaowei Liu ◽  
...  
Keyword(s):  
Large Scale ◽  
Clinical Manifestations ◽  
Positive Culture ◽  
Maternity Hospital ◽  
Health Concern ◽  
Cns Infection ◽  
Perinatal Complications ◽  
Adverse Pregnancy ◽  
Beijing China

Abstract Background: Listeriosis is a rare but severe foodborne infectious disease. Perinatal listeriosis is often associated with septicemia, central nervous system (CNS) infection, and serious adverse pregnancy outcomes (miscarriage and neonate death). Here we report the characteristics and outcomes of perinatal listeriosis cases treated over 6 years at Beijing Obstetrics and Gynecology Hospital (BOGH), the largest maternity hospital in China. Methods: We retrospectively reviewed the records of laboratory-confirmed, pregnancy-associated listeriosis cases treated from January 1, 2013 to December 31, 2018. The clinical manifestations, laboratory results, perinatal complications and outcomes (post-natal follow-up of 6 months) were investigated. Results: In BOGH, 12 perinatal listeriosis cases were diagnosed based on Listeria monocytogenes positive culture, including 10 single pregnancies and 2 twin pregnancies. The corresponding incidence of pregnancy-associated listeriosis was 13.7/100,000 deliveries. Among those cases, four pregnant women and four newborns had septicemia, and two of the neonates with septicemia also suffered CNS infection. All the maternal patients recovered. Two inevitable miscarriages and four fetal stillbirths occurred. Of the eight delivered newborns, six survived, and two died within 2 days from birth. None of the survivors had neurological sequelae during a 6-month follow-up. The overall feto-neonatal fatality rate was 57.1%; notably, this rate was 100% for infections occurring during the second trimester of pregnancy and only 14.3% for those occurring in the third trimester. Conclusions: Perinatal listeriosis is associated with high feto-neonatal mortality, and thus, a public health concern. Additional large-scale studies are needed to strengthen the epidemiological understanding of listeriosis in China.

Association Between First-Trimester Subchorionic Hematomas and Adverse Pregnancy Outcomes After 20 Weeks of Gestation in Singleton Pregnancies

2019 ◽  
Vol 134 (4) ◽  
pp. 863-868 ◽  
Author(s):  
Mackenzie N. Naert ◽  
Alberto Muniz Rodriguez ◽  
Hanaa Khadraoui ◽  
Mariam Naqvi ◽  
Nathan S. Fox
Keyword(s):  
Pregnancy Outcomes ◽  
First Trimester ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Pregnancy ◽  
Singleton Pregnancies

scholarly journals Viral Infections in Pregnancy: A Focus on Ebola Virus

2018 ◽  
Vol 24 (9) ◽  
pp. 993-998 ◽  
Author(s):  
Nicole S. Olgun
Keyword(s):  
Viral Infection ◽  
Pregnancy Outcomes ◽  
Ebola Virus ◽  
Viral Infections ◽  
Adverse Pregnancy Outcomes ◽  
Adverse Impacts ◽  
Vaginal Secretions ◽  
Experimental Therapies ◽  
Changing Roles ◽  
Adverse Pregnancy

During gestation, the immune response of the placenta to viruses and other pathogens plays an important role in determining a pregnant woman’s vulnerability toward infectious diseases. Located at the maternalfetal interface, trophoblast cells serve to minimize the spread of viruses between the host and developing fetus through an intricate system of innate antiviral immune signaling. Adverse pregnancy outcomes, ranging from learning disabilities to preterm birth and fetal death, are all documented results of a viral breach in the placental barrier. Viral infections during pregnancy can also be spread through blood and vaginal secretions, and during the post-natal period, via breast milk. Thus, even in the absence of vertical transmission of viral infection to the fetus, maternal health can still be compromised and threaten the pregnancy. The most common viral DNA isolates found in gestation are adenovirus, cytomegalovirus, and enterovirus. However, with the recent pandemic of Ebola virus, and the first documented case of a neonate to survive due to experimental therapies in 2017, it is becoming increasingly apparent that the changing roles and impacts of viral infection during pregnancy needs to be better understood, while strategies to minimize adverse pregnancy outcomes need to be identified. This review focuses on the adverse impacts of viral infection during gestation, with an emphasis on Ebola virus.

scholarly journals Listeria Placental Infection

mBio ◽  
2017 ◽  
Vol 8 (3) ◽  
Author(s):  
José A. Vázquez-Boland ◽  
Emilia Krypotou ◽  
Mariela Scortti
Keyword(s):  
Pregnancy Outcomes ◽  
Bacterial Infections ◽  
Medical Intervention ◽  
Neonatal Infections ◽  
Nonhuman Primate Model ◽  
Primate Model ◽  
Food Borne ◽  
Fetal Complications ◽  
Adverse Pregnancy ◽  
Transplacental Infection

ABSTRACT The Gram-positive facultative intracellular bacterium Listeria monocytogenes is the causative agent of listeriosis, a severe food-borne infection. Pregnant women are at risk of contracting listeriosis, which can potentially lead to miscarriage, stillbirth, preterm birth, and congenital neonatal infections. While other systemic bacterial infections may result in adverse pregnancy outcomes at comparable frequencies, L. monocytogenes has particular notoriety because fetal complications largely occur in the absence of overt illness in the mother, delaying medical intervention. Here, we briefly review the pathophysiology and mechanisms of maternofetal listeriosis, discussed in light of a recent mBio report on Listeria transplacental infection in a nonhuman primate model.

scholarly journals A Comparison of Vitamin E Status and Associated Pregnancy Outcomes in Maternal–Infant Dyads between a Nigerian and a United States Population

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1300
Author(s):  
Caleb Cave ◽  
Corrine Hanson ◽  
Marina Schumacher ◽  
Elizabeth Lyden ◽  
Jeremy Furtado ◽  
...  
Keyword(s):  
United States ◽  
Vitamin E ◽  
Health Outcomes ◽  
Cord Blood ◽  
Fetal Growth ◽  
Pregnancy Outcomes ◽  
Mode Of Delivery ◽  
The Us ◽  
Adverse Pregnancy ◽  
Vitamin E Status

Oxidative stress is associated with adverse pregnancy outcomes, and vitamin E has powerful anti-oxidant properties with the potential to impact health outcomes. Tocopherol isomers of vitamin E differ in their ability to modulate inflammation and vary in concentration in diets containing high proportions of processed versus unprocessed foods. The purpose of this study was to compare vitamin E status and associated pregnancy outcomes (mode of delivery, chorioamnionitis, APGARs (measure of appearance, pulse, grimace, activity, respiration), gestational age at delivery, and fetal growth) between maternal–infant dyads in a developed and a developing nation to identify potentially modifiable differences that may impact pregnancy and neonatal outcomes and provide a way to improve maternal and neonatal health. Plasma tocopherol levels were evaluated in 189 Midwestern United States (US) mother–infant pairs and 99 Central Nigerian mother–infant pairs. Maternal and infant concentrations of α-, γ-, and δ-tocopherol were measured using HPLC with diode-array detection. Descriptive statistics were calculated and tocopherol concentrations were associated with clinical outcomes such as mode of delivery, chorioamnionitis, APGARS, and fetal growth. Alpha- and γ-tocopherol levels were higher in the US mothers, (alpha: 12,357.9 (175.23–34,687.75) vs. 8333.1 (1576.59–16,248.40) (mcg/L); p < 0.001) (gamma: 340.7 (224.59–4385.95) vs. 357.5 (66.36–1775.31) (mcg/L); p < 0.001), while δ-tocopherol levels were higher in the Nigerian mothers (delta: 261.7 (24.70–1324.71) vs. 368.9 (43.06–1886.47) (mcg/L); p < 0.001). US infants had higher γ-tocopherol levels than Nigerian infants (203.1 (42.53–1953.23) vs. 113.8 (0.00–823.00) (mcg/L); p < 0.001), while both the Nigerian mothers and infants had higher α:γ-tocopherol ratios (8.5 vs. 26.2, and 8.9 vs. 18.8, respectively; p < 0.001). Our results in both populations show associations between increased circulating γ-tocopherol and negative outcomes like Caesarian sections, in contrast to the associations with positive outcomes such as vaginal delivery seen with increased α:γ-tocopherol ratios. Growth was positively associated with α- and γ-tocopherols in cord blood in the US population, and with cord blood δ-tocopherols in the Nigerian population. Tocopherol levels likely impact health outcomes in pregnancy in a complicated metabolism across the maternal–fetal axis that appears to be potentially influenced by culture and available diet.

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