Is there an association between the vaginal microbiome and first trimester miscarriage? A prospective observational study

BACKGROUND Early pregnancy failure is stated as noncompatible, intrauterine pregnancy with either an empty gestational sac or a gestational sac that contains an embryo or fetus which does not have any fetal cardiac activity in the initial 12 weeks of the pregnancy. In the assessment of early pregnancy, ultrasound plays a significant role. METHODS A prospective observational study was conducted in a tertiary care hospital between May 2019 and April 2020 among 500 pregnant females fulfilling the inclusion and exclusion criteria. Patient follow up was done by weekly telephonic calls until completing 12 weeks gestation or reporting miscarriage. Also, all patients were followed by the recommended routine ultrasound (US) scanning with or without emergency visits. RESULTS In our study period, 500 women fulfilling the inclusion criteria were included in our study. Out of whom, 85 (17.5 %) women had an early pregnancy failure (before 12 weeks). There was significantly lower mean gestational sac diameter (GSD), crown to rump length (CRL), fetal heart rate (FHR), and P-value < 0.001 in women who experienced early pregnancy failure. In pregnancies where the GSD, CRL, and FHR were below the 5th percentile, early pregnancy failure was a more prone outcome. All pregnancies with FHR below 75 beats per minute ended in failure in the present study. When FHR was less than 128 beats per minute, there was enormous rise in the frequency of pregnancy failure. By comparison, yolk sac diameter (YSD) was a less significant predictor of early pregnancy failure. CONCLUSIONS First-trimester ultrasonographic estimations help in predicting early abortion. Risk appraisal tables dependent on combinations of abnormal parameters could significantly help in identifying abnormal pregnancy from normal pregnancy and could improve prediction rates. KEYWORDS Early Pregnancy Failure, Prediction, Transvaginal Ultrasonography, Ultrasonography

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Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

Obstetrics & Gynecology Science ◽

10.5468/ogs.2017.60.2.154 ◽

2017 ◽

Vol 60 (2) ◽

pp. 154 ◽

Cited By ~ 13

Author(s):

Kyung Uk Sung ◽

Jeong A Roh ◽

Kyung Jin Eoh ◽

Eui Hyeok Kim

Keyword(s):

Growth Factor ◽

Observational Study ◽

Plasma Protein ◽

Gestational Age ◽

Small For Gestational Age ◽

Prospective Observational Study ◽

Protein A ◽

First Trimester ◽

Maternal Serum ◽

Placental Growth Factor

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Review of Prediabetes and Hypertensive Disorders of Pregnancy

American Journal of Perinatology ◽

10.1055/s-0039-1698831 ◽

2019 ◽

Author(s):

Nicholas W. Carris ◽

Chinedu K. Nwabuobi ◽

Weiwei He ◽

Krystal Bullers ◽

Roneé E. Wilson ◽

...

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

Hemoglobin A1c ◽

Statistical Significance ◽

First Trimester ◽

Retrospective Observational Study ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Obesity And Diabetes ◽

The Impact

AbstractObesity and diabetes increase hypertensive disorders of pregnancy (HDP) risk, thus preventive interventions are heavily studied. How pregestational prediabetes and related interventions impact HDP risk is less characterized. Therefore, we searched and reviewed the literature to assess the impact on HDP risk of prediabetes and varied interventions. We identified 297 citations related to pregnancy, prediabetes, and early pregnancy interventions. We also reviewed the references and citations of included articles. We included five studies assessing HDP outcomes in women with first trimester hemoglobin A1c in the prediabetes range (5.7–6.4%). One prospective observational study demonstrated first trimester hemoglobin A1c (5.9–6.4%) is associated with increased HDP risk, while another prospective observational study and one retrospective observational study had similar trends without statistical significance. A small and underpowered randomized controlled trial demonstrated initiating gestational diabetes mellitus treatment (i.e., diet, monitoring, ± insulin) in response to first trimester hemoglobin A1c (5.7–6.4%) did not statistically reduce HDP compared with standard care. One retrospective observational study suggested metformin, when started early, may reduce HDP risk in patients with prediabetes. Pregestational prediabetes appears to increase HDP risk. Interventions (i.e., metformin, diet/glucose monitoring, and/or exercise) to reduce HDP risk require additional study with long-term follow-up.

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