scholarly journals Sonographic Estimated Fetal Weight among Diabetics at ≥ 34 Weeks and Composite Neonatal Morbidity

2018 ◽  
Vol 08 (02) ◽  
pp. e121-e127
Author(s):  
Leen Al-Hafez ◽  
Michael Pirics ◽  
Suneet Chauhan

Objectives The objective was to assess the composite neonatal morbidity (CNM) among diabetic women with sonographic estimated fetal weight (SEFW) at 10 to 90th versus >90th percentile for gestational age (GA). Study Design The inclusion criteria for this retrospective study were singleton pregnancies at 34 to 41 weeks, complicated by diabetes, and that had SEFW within 4 weeks of delivery. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Results Among the 140 cohorts that met the inclusion criteria, 72% had SEFW at 10th to 90th percentile for GA, and 28% at >90th percentile. Compared with women with diabetes with last SEFW at 10th to 90th percentile, those with estimate > 90th percentile for GA had a significantly higher rate of CNM (13 vs. 28%; OR, 2.65; 95% CI, 1.07–6.59). Among 109 diabetic women who labored, the rate of shoulder dystocia was significantly higher with SEFW at >90th percentile for GA than those at 10th to 90th percentile (25 vs. 2%; p = 0.002); the corresponding rate of CNM was 29 versus 10% (p = 0.02). Conclusion Among diabetic women with SEFW > 90th percentile for GA, CNM was significantly higher than in women with estimate at 10 to 90th percentile. Despite the increased risk of CNM, these newborns did not have long-term morbid sequela.

Author(s):  
Aria Wibawa ◽  
Amanda Rumondang

  Objective: To establish fetal biometry nomogram using percentilemethod based on normal population.   Methods: A descriptive retrospective study in order to establishfetal biometry nomogram using percentile method basedon normal population. Four fetal biometry measurement (BPD,HC, AC and FL) was collected from ultrasonography examinationresult in Fetomaternal Division Ultrasound Unit - AnggrekClinic and from medical record unit Dr. Cipto MangunkusumoGeneral Hospital, from January 2015 until April 2016. Databeing documented using case report form and being tabulatedusing Microsoft Excell 2011 Version 14.7.0 (161029). All datawere analyzed using SPSS 20.0 dan Matlab R2016a.   Results: There were 6169 pregnant women underwent fetalbiometry ultrasound within January 2015 - April 2016. Basedon inclusion criteria, 2798 (45%) were eligible as researchsample distributed from 12 until 42 wga. Due to evenly distributiondata, 2205 (78%) were distributed from 20 until 40 wgato develop fetal biometry nomogram. Most pregnant womenwere 28.9 years old (SD  5.74) in range of 21-30 (55%) yearsold. The youngest was 13 years old and the oldest was 45years old. Four fetal biometry were collected and distributedevenly using percentile method to establish fetal biometrynomogram. As for estimated fetal weight curve was developedby Hadlock C formula. Each biometry was calculated the 10th,50th and 90th centile curves according to gestational age. Thus,representing the fetal biometry and modified Hadlock C estimatedfetal weight nomogram based on normal population inJakarta.   Conclusion: Each biometry and modified Hadlock C estimated fetalweight were calculated in 10th, 50th and 90th centile curves accordingto gestational age represent fetal biometry nomogram based onnormal population in Jakarta. Keywords: biometry, estimated fetal weight formula, nomogram


2017 ◽  
Vol 34 (11) ◽  
pp. 1058-1064 ◽  
Author(s):  
Kam Szlachetka ◽  
Neil Seligman ◽  
Tara Lynch

Objective To determine if change in uterocervical angle (UCA) is associated with an increased rate of preterm birth (less than 37 weeks) for women with a short cervix. Study Design A retrospective study was performed from January 2013 to March 2016 of singleton pregnancies undergoing universal cervical length screening. The difference between the UCA for the first cervical length ≤ 2.5 cm and last recorded cervical length < 25 weeks was defined as the change in UCA. The primary outcome was the rate of preterm birth at < 37 weeks of gestation. Results A total of 176 women met the inclusion criteria. There was no difference in the rate of preterm birth at < 34 weeks (23.3 vs. 16.7%, p = 0.27) or at < 37 weeks (34.9 vs. 37.8%, p = 0.69) based on a change in UCA (i.e., decreased/no change or increased UCA). However, women with a final UCA ≥105 degrees had an increased risk of preterm birth at less than 34 weeks (24.2 vs. 6.8%, p = 0.01). Conclusion A change in UCA was not associated with an increased risk of preterm birth. Instead, a final absolute UCA ≥ 105 degrees measured < 25 weeks was associated with an increased risk of preterm birth at < 34 weeks of gestation for women with a short cervix ≤ 2.5 cm.


2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Fadi G. Mirza ◽  
Samuel T. Bauer ◽  
Anne Van der Veer ◽  
Lynn L. Simpson

AbstractFetuses with gastroschisis are at increased risk of intrauterine growth restriction (IUGR). However, there is a tendency for underestimation of fetal abdominal circumference and hence fetal weight, leading to overdiagnosis of IUGR. Our objective was to evaluate the accuracy of ultrasound for the prediction of being small for gestational age (SGA) at birth in these cases.A retrospective study of prenatally diagnosed cases of gastroschisis was conducted at a tertiary center. Fetal weight was estimated using the formula of Hadlock. IUGR was defined as an estimated fetal weight ≤10th percentile for gestational age. SGA at the time of birth was defined as a birth weight ≤10th percentile for gestational age. The incidence of IUGR on last ultrasound and that of SGA at birth were calculated, and the precision of ultrasound in predicting SGA was determined.IUGR was reported on the last ultrasound prior to delivery in 9/25 cases (36%). Postnatally, 13/25 newborns (52%) were SGA. All sonographically suspected cases of IUGR based on the last ultrasound were SGA at birth. The positive predictive value of the last ultrasound in identifying SGA was 100%.At least half of the infants affected by gastroschisis were SGA at birth. Sonographic estimation of fetal weight within 1 month of birth reliably predicted SGA in infants with gastroschisis.


Author(s):  
Gayathri S. Kumar ◽  
Jenna A. Beeler ◽  
Emma E. Seagle ◽  
Emily S. Jentes

AbstractSeveral studies describe the health of recently resettled refugee populations in the US beyond the first 8 months after arrival. This review summarizes the results of these studies. Scientific articles from five databases published from January 2008 to March 2019 were reviewed. Articles were included if study subjects included any of the top five US resettlement populations during 2008–2018 and if data described long-term physical health outcomes beyond the first 8 months after arrival in the US. Thirty-three studies met the inclusion criteria (1.5%). Refugee adults had higher odds of having a chronic disease compared with non-refugee immigrant adults, and an increased risk for diabetes compared with US-born controls. The most commonly reported chronic diseases among Iraqi, Somali, and Bhutanese refugee adults included diabetes and hypertension. Clinicians should consider screening and evaluating for chronic conditions in the early resettlement period. Further evaluations can build a more comprehensive, long-term health profile of resettled refugees to inform public health practice.


2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.


2016 ◽  
Vol 214 (1) ◽  
pp. S270
Author(s):  
Nathan S. Fox ◽  
Kathy C. Matthews ◽  
John Williamson ◽  
Simi Gupta ◽  
Jennifer Lam-Rachlin ◽  
...  

2018 ◽  
Vol 298 (6) ◽  
pp. 1123-1129
Author(s):  
Eran Ashwal ◽  
Alexandra Berezowsky ◽  
Sharon Orbach-Zinger ◽  
Nir Melamed ◽  
Amir Aviram ◽  
...  

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Sarina Meikle ◽  
Jenny Wu ◽  
David Bach ◽  
Marion Hofmann Bowman ◽  
Mark Norris ◽  
...  

Background: Bicuspid aortic valve (BAV) is associated with an increased risk of aortic dissection, but little is known about pregnancy-associated outcomes. Methods: ICD codes and a text recognition program (EMERSE) were used to identify women with BAV and pregnancy (2000-2018) at a single center. Charts were manually reviewed to confirm the diagnoses, echocardiographic data, co-morbidities, and outcomes. Inclusion criteria were congenital BAV pathology and pregnancy. Primary endpoints included expansion of aortic aneurysm and aortic dissection during pregnancy and up to 6 weeks post-partum. Results: We identified 622 women with diagnoses of BAV and pregnancy. After detailed review, 72 women (87 pregnancies) met inclusion criteria. Mean gestational age at delivery was 36.9 weeks. Ten (11.5%) patients had hypertensive disorders of pregnancy, 7 (8.0%) had gestational diabetes, and 25 (28.7%) were treated with beta-blockers. Two (2.3%) pregnancies had intra-uterine growth restriction. Vaginal deliveries occurred in 56.5% and cesarean section in 36.3%. No Type A or B aortic dissections occurred. During pregnancy, there were no significant changes in the aortic dimensions. Prior to pregnancy, 6 women had aortic measurements > 40mm (mean pre-pregnancy 40.8 ± 3.2 mm; mean post-pregnancy 42.5 ± 3.9 mm). In this higher-risk group, mean gestational age was 38.7 weeks, 4 (66.7%) had vaginal delivery, 1 (16.7%) had preeclampsia, 4 (66.7%) were treated with beta-blockers, and all breastfed. There were no delivery complications, no aortic dissections, and no maternal or fetal deaths. Conclusions: Women with BAV appear to be at relatively low risk for acute aortic dissection during pregnancy.


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