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

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.

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

Acta biomedica scientifica ◽

10.29413/abs.2019-4.3.6 ◽

2019 ◽

Vol 4 (3) ◽

pp. 45-51 ◽

Cited By ~ 1

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.

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Association between serum soluble fms-like tyrosine kinase-1 and the central choroidal thickness during pregnancy: a prospective study

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2021-000888 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000888

Author(s):

Takafumi Suzuki ◽

Tatsuya Inoue ◽

Nozomi Igarashi ◽

Chisato Agata ◽

Atsushi Okubo ◽

...

Keyword(s):

Tyrosine Kinase ◽

Prospective Study ◽

Postpartum Period ◽

Choroidal Thickness ◽

Mixed Model ◽

Linear Mixed Model ◽

Structural Parameters ◽

Enhanced Depth Imaging ◽

Third Trimester ◽

Significant Difference

ObjectiveTo investigate the association between serum soluble fms-like tyrosine kinase-1 (sFlt-1) and the choroidal structure during the pregnancy.Methods and analysisThis prospective study enrolled 24 eyes of 12 consecutive healthy pregnant women. Each participant was evaluated during the first, second and third trimester of pregnancy and the postpartum period. The central choroidal thickness (CCT) and Choroidal Vascular Index (CVI) were measured using enhanced depth-imaging optical coherence tomography. Moreover, serum sFlt-1 and vascular endothelial growth factor (VEGF) concentrations were measured manually using ELISA. The association between choroidal structural parameters and serum sFlt-1/VEGF was analysed using a linear mixed model.ResultsThe CCT was significantly thicker in the second and third trimester than the postpartum period (p<0.05). In contrast, there was no significant difference in the CVI throughout pregnancy or the postpartum period. Serum sFlt-1 levels were significantly higher during pregnancy than the postpartum period (p<0.05), whereas the serum VEGF levels were significantly lower during pregnancy than the postpartum period (p<0.05). Furthermore, serum sFlt-1 levels were significantly associated with CCT throughout pregnancy (p=0.011, linear mixed model). On the contrary, sFlt-1 levels was not associated with the CVI during the pregnancy.ConclusionOur results suggest that serum sFlt-1 might have an influence on the choroidal thickness during the pregnancy.

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

Evidence-Based Nursing Research ◽

10.47104/ebnrojs3.v3i4.225 ◽

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.

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CHOROIDAL THICKNESS, MACULAR THICKNESS, RETINAL NERVE FIBER LAYER THICKNESS BY OCT IN NON-PREGNANT, PREGNANT AND POST MENOPAUSAL WOMEN

QJM ◽

10.1093/qjmed/hcab109.024 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Sherif Zaki ◽

Thanaa Helmy ◽

Hisham Samy ◽

Nariman Fathy

Keyword(s):

Pregnant Women ◽

Choroidal Thickness ◽

Study Groups ◽

Fiber Layer ◽

Pregnant Females ◽

Rnfl Thickness ◽

Menopausal Women ◽

Significant Difference ◽

Ophthalmologic Examination ◽

Post Menopausal

Abstract PURPOSE To evaluate the macular, retinal nerve fiber layer (RNFL) and choroidal thickness alterations by using spectral-domain optical coherence tomography (SD-OCT) in postmenopausal, pregnant and non-pregnant women. PATIENTS AND METHODS A comparative study included a total of 42 eyes (Right eye) of 42 healthy females in the period from march 2019 to September 2019 divided into 3 groups: a) Non pregnant women. b) Pregnant women.c) Postmenopausal women. Each subject underwent a comprehensive ophthalmologic examination. Following this detailed ophthalmologic examination, the Rs 3000 Nidek Japan OCT device was used for the assessment choroidal, macular and RNFL Thickness. RESULTS The mean age of non-pregnant females was 29.64 ±3.13, mean age of pregnant females was 28.93 ±3.89 and of postmenopausal women was 53.86 ± 1.75. There was no significant difference in all macular quadrants in the 3 study groups. Choroidal thickness was statistically significant thicker in healthy pregnant females (333.36 ±44.42) than in healthy non pregnant (326.93±31.50) and significantly thinner in healthy post-menopausal women (282.64±28.04) than healthy non pregnant females. There was no significant difference in RNFL thickness between the 3 study groups. CONCLUSION Oct has evolved over the past decade as one of the most important ancillary tests in ophthalmic practice. Pregnancy hormones may lead to an increase in fluid volume in many tissues of the body. There was no statistically significant difference in macular thickness and RNFL thickness between the 3 study groups. Choroidal thickness was statistically significant thicker in healthy pregnant than in healthy non pregnant and significant thinner in healthy post-menopausal women than healthy non pregnant.

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Optic nerve head cupping in glaucomatous and non-glaucomatous optic neuropathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312161 ◽

2018 ◽

Vol 103 (3) ◽

pp. 374-378 ◽

Cited By ~ 4

Author(s):

Masoud Aghsaei Fard ◽

Sasan Moghimi ◽

Alireza Sahraian ◽

Robert Ritch

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Optic Nerve Head ◽

Axial Length ◽

Choroidal Thickness ◽

Linear Mixed Model ◽

Enhanced Depth Imaging ◽

Glaucomatous Optic Neuropathy ◽

Peripapillary Choroidal Thickness ◽

Significant Difference

BackgroundEnlargement of optic disc cupping is seen both in glaucoma and in neurological disorders. We used enhanced depth imaging with spectral-domain optical coherence tomography to differentiate glaucoma from non-glaucomatous optic neuropathy.MethodsThe optic discs were scanned in this prospective comparative study, and the lamina cribrosa (LC) thickness and anterior laminar depth (ALD) in the central, superior and inferior optic nerve head, and peripapillary choroidal thicknesses, were measured.ResultsThere were 31 eyes of 31 patients with severe glaucoma and 33 eyes of 19 patients with non-glaucomatous cupping. Eyes of 29 healthy controls were also enrolled. There was no significant difference in the cup-to-disc ratio and in the average peripapillary nerve fibre layer thickness between the glaucoma and non-glaucomatous cupping groups (p>0.99). The average peripapillary choroidal thickness was thinner in glaucoma eyes than in the control eyes after adjusting for age and axial length. Glaucomatous and non-glaucomatous eyes had greater ALD and thinner LC than the control eyes (p<0.001 for both). ALDs of glaucoma eyes were deeper than non-glaucomatous eyes (p=0.01 for central ALD) when age, axial length and peripapillary choroidal thickness were included in the linear mixed model. Prelaminar thickness and LC thickness of glaucoma eyes were not different from non-glaucomatous eyes after adjusting.ConclusionDeeper ALD was observed in glaucoma than non-glaucomatous cupping after adjusting for choroidal thickness.

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Correlation Between Choroidal Structure and Smoking in Eyes With Central Serous Chorioretinopathy

10.21203/rs.3.rs-121708/v1 ◽

2020 ◽

Author(s):

Tatsuya Inoue ◽

Kazuyoshi Okawa ◽

Ryo Asaoka ◽

Keiko Azuma ◽

Ryo Obata ◽

...

Keyword(s):

Central Serous Chorioretinopathy ◽

Choroidal Thickness ◽

Smoking Habit ◽

Spherical Equivalent ◽

Optimal Model ◽

Significant Difference ◽

Luminal Area ◽

History Of ◽

Choroidal Structure ◽

Smoking Group

Abstract A smoking habit is associated with central serous chorioretinopathy (CSC). Although CSC is caused by an abnormal circulation of the choroid, how smoking habit affects the choroid remains elusive. Therefore, to investigate the effect of smoking on the choroidal structure in patients with CSC, the current study analyzed two important choroidal morphological parameters in 75 consecutive CSC patients with/without a smoking habit; i.e., subfoveal choroidal thickness [SFCT] and the choroidal vascular index (CVI), the ratio of the luminal area to the total choroidal area. The results demonstrated that although other baseline parameters (age or refractive error expressed by the spherical equivalent [SE]) was not different between the smoking group and the non-smoking group, the SFCT was thicker in smoking group compared with non-smoking group (382.0 ± 68.2 μm vs. 339.3 ± 52.3 μm, p = 0.0038). No significant difference was observed in the CVI (p = 0.32). The optimal model for SFCT included the variables of age, SE and a history of smoking among the baseline parameters. Additionally, increased pack years was associated with increased SFCT. Taken together, cigarette smoking is associated with an increased SFCT in patients with CSC. Thicker choroid in smoking CSC patients may be an important modulator of the disease.

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CORRELATION OF VITAMIN B12 WITH THYROID HORMONES IN ANEMIC PREGNANT WOMEN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i9.1406 ◽

2020 ◽

Vol 4 (9) ◽

Author(s):

Monika Mandrai ◽

Shreya Nigoskar

Keyword(s):

Thyroid Hormones ◽

Vitamin B12 ◽

Pregnant Women ◽

Serum Vitamin ◽

First Trimester ◽

Study Groups ◽

Serum Samples ◽

Medical College ◽

Group I ◽

Significant Difference

Introduction: Thyroid hormones are required for normal development as well as regulating metabolism in the adult. A decreased thyroid hormone adversely affects erythropoietic system causes anemia. Our objective was to assess the relationship between serum vitamin B12 levels and thyroid function in anemic pregnant women. Aim: The Aim and objective of the study was to compare the vitamin B12 with thyroid hormones in anemic pregnant women. Materials & Methods: Study consisted of 50 subjects from OPD/IPD Index Medical College & Research Center, INDORE, MADHYA PRADESH, India. The study groups were divided into Group I-25 anemic pregnant women and Group II-25 Non – anemic pregnant women. The serum samples were collected from each subject and levels of different biochemical parameters were estimated. Result: were noted. On comparing values in vitamin B 12 and thyroid hormones , among two groups, a significant difference (p<0.005) was found between few of them. Conclusion: Screening of vitamin B12 levels in first trimester itself will be beneficial to prevent the complications of pregnancy. Further, hypothyroidism also present. So, early diagnosis of these deficiencies will be useful to start giving supplements to avoid unwanted effects in pregnancy.

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

Antibiotics ◽

10.3390/antibiotics10050601 ◽

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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Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012

Nutrients ◽

10.3390/nu13030795 ◽

2021 ◽

Vol 13 (3) ◽

pp. 795

Author(s):

Mary M. Murphy ◽

Kelly A. Higgins ◽

Xiaoyu Bi ◽

Leila M. Barraj

Keyword(s):

Pregnant Women ◽

Protein Intake ◽

First Trimester ◽

The United States ◽

Limited Information ◽

Health And Nutrition ◽

Animal Source ◽

Usual Intake ◽

First Trimester Of Pregnancy ◽

Using Data

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.

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The role of the platelet profile in the prediction of gestational diabetes

10.51271/kmj-0012 ◽

2021 ◽

pp. 50-54

Keyword(s):

Body Mass Index ◽

Blood Glucose ◽

Gestational Diabetes ◽

Pregnant Women ◽

Body Mass ◽

First Trimester ◽

Oral Glucose ◽

Mean Corpuscular Hemoglobin ◽

Lymphocyte Ratio ◽

Significant Difference

Objective: In our study, the results of oral glucose tolerance test (OGTT) and other hemogram parameters of pregnant women with and without gestational diabetes mellitus (GDM) were compared. The aim of our study is to investigate the benefit of these parameters in predicting GDM risk. Material and Method: The study was planned as a descriptive, retrospective and cross-sectional study. It was included 218 pregnant women who applied to the Gynecology and Obstetrics Clinic of Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital between January 01, 2019 and January 31, 2020. It was examined complete blood count parameters, ultrasound findings, complete urinalysis, first trimester blood glucose, body mass index, age, and gravide parameters the patients we included in the study. The results were analyzed retrospectively and was evaluated the statistical significance relationship with gestational diabetes. Results: There was no statistically significant difference in age, body mass index (BMI), obesity status and number of gravida between the pregnant women who were examined and those without GDM (p> 0.05). The hemoglobin, platelet count, mean platelet volume (MPV), mean corpuscular volume (MCV), mean corpuscular hemoglobine (MCH), and mean corpuscular hemoglobin concentration (MCHC) values, and neutrophil, lymphocyte, monocyte and basophil counts, urine density and femur length were statistically significant. There was no difference (p> 0.05). No statistically significant difference was found in terms of neutrophile lymphocyte ratio (NLR), neutrophile monocyte ratio (NMR), platelet lymphocyte ratio (PLR), monocyte eosinophil ratio (MER), platelet MPV ratio (PMPVR), and platelet neutrophile ratio (PNR) values (p> 0.05) Conclusion: HbA1c, hematocrit and blood glucose in the first trimester may be predictors of GDM. In addition, we think that further studies are needed in a prospective design in more patients in terms of others parameters.

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