The Role of Microbial Communities in Parturition: Is There Evidence of Association with Preterm Birth and Perinatal Morbidity and Mortality?

2012 ◽  
Vol 30 (08) ◽  
pp. 613-624 ◽  
Author(s):  
Radhika Ganu ◽  
Jun Ma ◽  
Kjersti Aagaard
Keyword(s):  
Preterm Birth ◽  
Microbial Communities ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity

scholarly journals Hemorrhage from Umbilical Cord Ulceration Identified on Real-Time Ultrasound in a Fetus with Duodenal Atresia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
William M. Curtin ◽  
Jaimie L. Maines ◽  
Christina T. DeAngelis ◽  
Niamh A. Condon ◽  
Serdar H. Ural ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Umbilical Cord ◽  
Intestinal Atresia ◽  
Duodenal Atresia ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Jejunal Atresia ◽  
Fetal Surveillance ◽  
High Index Of Suspicion

Umbilical cord ulceration has been associated with congenital upper intestinal (duodenal or jejunal) atresia and can lead to fatal fetal intrauterine hemorrhage. We report a case of spontaneous hemorrhage from the umbilical cord, incidentally noted at the time of ultrasound in a 33-week fetus with suspected duodenal atresia, in which immediate delivery resulted in a good outcome. Despite many reports in the literature of congenital upper intestinal atresia and its association with umbilical cord ulceration, the propensity for this lesion for fetal hemorrhage, and the resulting perinatal morbidity and mortality, there appears to be a gap in the dissemination of this knowledge. In fetuses with suspected congenital upper intestinal atresia, recognition of the entity of umbilical cord ulceration may be improved by ultrasound with special attention to the amount of Wharton’s jelly within the cord. Routine antepartum fetal surveillance may reduce perinatal morbidity and mortality from this condition. A high index of suspicion is needed to make the diagnosis of umbilical cord ulceration in association with congenital upper intestinal atresia. The role of amniotic fluid bile acids in the genesis of this disorder needs further study.

scholarly journals Possibilities for diagnosis and prediction of preterm labor at the present stage

2021 ◽  
Vol 102 (1) ◽  
pp. 47-59
Author(s):  
V A Mudrov ◽  
A M Ziganshin ◽  
A G Yashchuk ◽  
L A Dautova ◽  
R Sh Badranova
Keyword(s):  
Preterm Birth ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Modern World ◽  
Perinatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Risk Of Death ◽  
Premature Babies ◽  
Gynecology And Obstetrics

Preterm birth is one of the main causes of perinatal morbidity and mortality, which does not tend to decrease in rate. The risk of death in premature babies is 2535 times higher than that of full-term babies, and stillbirths are registered 813 times more often than in timely delivery. To date, there are no effective ways to prevent preterm birth. Therefore, the timeliness of therapy, which largely determines the outcome of pregnancy in general, depends on the effectiveness of assessing the likelihood of their development. At the International Federation of Gynecology and Obstetrics (FIGO) Congress (2018), preterm birth is identified as a problem that has not yet been solved at the current stage of science and technology development. The result of the unsolved problems is a situation wherein the modern world over the past 60 years there has been no decrease in the premature birth rate, which is 9.5% of births and annually ends with the birth of 15,000,000 premature babies. The study aimed to research modern methods of diagnosis and prediction of spontaneous preterm birth. An analytical method was used in the study: a detailed systematic analysis of modern domestic and foreign literature on the diagnosis and prognosis of preterm birth. We used eLibrary, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane Library bibliographic databases (until August 2020). The article deals with the diagnosis and prediction of preterm birth probability, which will optimize the management of patients from the risk group and, in the future, will reduce the rate of perinatal morbidity and mortality of premature babies. Despite a significant number of researches devoted to the study of possibilities for diagnosing and predicting spontaneous preterm birth, currently, there are no methods with absolute diagnostic value. Most -existing studies indicate that when assessing the probability of preterm birth, a comprehensive approach should be preferred taking into account the results of several main and additional methods.

scholarly journals Role of Ultrasound in Detection of Abruptio Placentae and its Clinical Correlation

2018 ◽  
Vol 8 (2) ◽  
pp. 35-39
Author(s):  
Sangeeta Devi Gurung ◽  
Junu Shrestha ◽  
Prakash Sharma
Keyword(s):  
Gestational Age ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Abruptio Placentae ◽  
Ultrasound Findings ◽  
Recorded Data ◽  
A Prospective Study ◽  
Singleton Pregnancies

Introduction: Abruptio placentae is one of the major complications in second half of pregnancy. It accounts for 0.4-1 % of all deliveries. With the advent of ultrasonography, though abruptio placentae has been diagnosed however the sensitivity is less. Those patients clinically suspicious of abruption placenta with negative ultrasound findings can have positive intrapartum findings suggestive of abruptio. Fetal outcome is associated with the gestational age. Preterm deliveries with abruption have higher incidence of perinatal morbidity and mortality as compared to term pregnancies.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara from July 2017 to July 2018. All the cases of more than twenty eight weeks gestation, singleton pregnancies without preexisting maternal medical diseases suspicious of abruption placentae were included in the study. Ultrasonological and intrapartum findings were recorded. Data was analyzed using SPSS (VERSION16).Results: Out of forty patients presented with per vaginal bleeding, sixteen were diagnosed as placental abruption either clinically or ultrasonographically. Only ten patients had positive ultrasound findings of retroplacental clot or subchorionic hemorrhage. Out of six patients with negative ultrasound findings, only four had positive Intrapartum findings suggestive of abruption placenta. The specificity (100%) of ultrasound in diagnosing abruption was more than the sensitivity (71.43%) and the accuracy was 75%.Conclusion: Ultrasound is less sensitive in diagnosing abruption placenta and the lesser the gestational age, the more in the increase in perinatal morbidity and mortality.

scholarly journals Infection and preterm birth

2008 ◽  
Vol 29 (4) ◽  
pp. 212
Author(s):  
Helen McDonald
Keyword(s):  
Preterm Birth ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Late Miscarriage

Preterm birth (PTB) before 37 weeks? gestation remains an important cause of perinatal morbidity and mortality, despite modern advances in obstetric and neonatal care. The causes of spontaneous PTB are multi-factorial; however, infection has been implicated as a significant cause of both PTB and late miscarriage, often with no visible signs or symptoms.

scholarly journals Preterm birth: from understanding of pathogenesis to pregnancy management

2019 ◽  
Vol 12 (4) ◽  
pp. 47-51
Author(s):  
V. S. Belousova ◽  
A. N. Strizhakov ◽  
E. V. Timokhina ◽  
O. A. Svitich ◽  
I. M. Bogomazova ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gene Polymorphism ◽  
Preterm Delivery ◽  
Inflammatory Cytokines ◽  
Morbidity And Mortality ◽  
Gestation Period ◽  
Perinatal Morbidity ◽  
Cytokine Gene ◽  
Cytokine Gene Polymorphism ◽  
Pro Inflammatory Cytokines

Preterm birth is an important issue in the current obstetrics as it is associated with perinatal morbidity and mortality. Today, most studies are aimed at understanding of the pathogenesis of preterm delivery. The known data on cytokine gene polymorphism indicate that in women with preterm birth, the presence of pro-inflammatory dominant alleles is typical. This may lead to increased production of pro-inflammatory cytokines in the utero-placental complex and may also initiate preterm delivery. At present, studies are under way to identify genes that determine the duration of the gestation period. A better understanding of the preterm birth pathogenesis is expected to help prevent this unfortunate outcome and decrease perinatal morbidity and mortality.

scholarly journals Preterm Delivery; Who Is at Risk?

2021 ◽  
Vol 10 (11) ◽  
pp. 2279
Author(s):  
Dvora Kluwgant ◽  
Tamar Wainstock ◽  
Eyal Sheiner ◽  
Gali Pariente
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Recurrent Pregnancy Loss ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Population Based ◽  
Perinatal Morbidity ◽  
Multiple Gestations ◽  
Extremely Preterm

Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

scholarly journals A birth population-based survey of preterm morbidity and mortality by gestational age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojing Guo ◽  
Xiaoqiong Li ◽  
Tingting Qi ◽  
Zhaojun Pan ◽  
Xiaoqin Zhu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Birth Defects ◽  
Gestational Age ◽  
Death Rate ◽  
Preterm Births ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

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