Evolving pattern of fetal movements throughout a healthy pregnancy

2021 ◽  
Vol 14 (5) ◽  
pp. e243349
Author(s):  
Lauren O'Connell ◽  
Alexander E P Heazell
Keyword(s):  
Placental Abruption ◽  
Normal Growth ◽  
Male Infant ◽  
First Trimester ◽  
Healthy Pregnancy ◽  
Continuous Record ◽  
Fetal Movements ◽  
Fetal Activity ◽  
History Of ◽  
Detailed Record

A 31-year-old woman with a history of stillbirth due to placental abruption at 29 weeks’ gestation and one first trimester miscarriage documented a continuous record of her perceived fetal movements from 28 to 38 weeks’ gestation. Repeated ultrasound examinations confirmed a viable pregnancy, with normal growth, liquor volume and Doppler profile. She delivered a healthy male infant at 38 weeks and 3 days’ gestation. The data collected give a detailed record of fetal activity in a healthy pregnancy. Perceived fetal activity increased as pregnancy progressed and was greatest in the evenings. We also found that clusters of movements, which have previously been reported as protective against stillbirth, were felt earlier on in pregnancy.

ANALYSIS AND EVALUATION OF FIRST TRIMESTER BLEEDING – A RETROSPECTIVE STUDY

2021 ◽  
pp. 39-40
Author(s):  
Augusti Mary Priyanka A Joseph Stalin ◽  
C R Anuradha ◽  
Ranoji Shinde
Keyword(s):  
Retrospective Study ◽  
Pregnant Women ◽  
First Trimester ◽  
Close Monitoring ◽  
Healthy Pregnancy ◽  
Appropriate Treatment ◽  
Improve Pregnancy Outcome ◽  
History Of ◽  
Threatened Abortion ◽  
One Year

Introduction : About one fourth of pregnant women present with bleeding in the rst trimester .The four major sources of nontraumatic bleeding in early pregnancy are ectopic pregnancy, miscarriage (threatened, inevitable, incomplete, complete), implantation of the pregnancy, cervical, vaginal, or uterine pathology (eg, polyps, inammation/infection, trophoblastic disease). Although 50% of cases presenting with vaginal bleeding continue to have a normal healthy pregnancy, but the maternal anxiety about risk of miscarriage should be assessed and counselled. The present study is an overview of etiologies and evaluation of bleeding upto 12 weeks of gestational age. Aim:To evaluate the incidence and etiology of rst trimester bleeding. Objective: To correlate the association between rst trimester bleeding and miscarriage. Methodology:A retrospective study among pregnant women with rst trimester bleeding was conducted for a period of 1 year at Chettinad hospital and Research Institute.Detailed History taking and pelvic examination was done for 139 patients.Specic blood investigation along with Transvaginal USG probe 3-5 MHz was performed and appropriate treatment was given. Results: Out of 900 pregnant women attending the out patient (OP) over a period of one year, 139 patients presented with rst trimester bleeding , incidence being 15.44%. The present study suggest that 41.007% women had miscarriage following rst trimester bleeding . It is depicted that 20.14% of women had history of previous abortions and 12.23% had history of bleeding in previous pregnancy. The major cause of bleeding in the rst trimester in our study was threatened abortion (32.37%). Conclusion :We conclude that the present study helps in giving appropriate treatment to women presenting with rst trimester bleeding . Ultrasonography plays a key role in the diagnosis of cause of bleed . Early care and close monitoring will inevitably improve pregnancy outcome .

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

scholarly journals Sirenomelia: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asiyeh Shojaee ◽  
Firooze Ronnasian ◽  
Mahdiyeh Behnam ◽  
Mansoor Salehi
Keyword(s):  
Case Reports ◽  
Three Dimensional ◽  
First Trimester ◽  
Mendelian Inheritance ◽  
Lower Limbs ◽  
Congenital Deformity ◽  
White Family ◽  
Her Family ◽  
Caudal Regression ◽  
History Of

AbstractBackgroundSirenomelia, also called mermaid syndrome, is a rare lethal multi-system congenital deformity with an incidence of one in 60,000–70,000 pregnancies. Sirenomelia is mainly characterized by the fusion of lower limbs and is widely associated with severe urogenital and gastrointestinal malformations. The presence of a single umbilical artery derived from the vitelline artery is the main anatomical feature distinguishing sirenomelia from caudal regression syndrome. First-trimester diagnosis of this disorder and induced abortion may be the safest medical option. In this report, two cases of sirenomelia that occurred in an white family will be discussed.Case presentationWe report two white cases of sirenomelia occurring in a 31-year-old multigravid pregnant woman. In the first pregnancy (18 weeks of gestation) abortion was performed, but in the third pregnancy (32 weeks) the stillborn baby was delivered by spontaneous vaginal birth. In the second and fourth pregnancies, however, she gave birth to normal babies. Three-dimensional ultrasound imaging showed fusion of the lower limbs. Neither she nor any member of her family had a history of diabetes. In terms of other risk factors, she had no history of exposure to teratogenic agents during her pregnancy. Also, her marriage was non-consanguineous.ConclusionThis report suggests the existence of a genetic background in this mother with a Mendelian inheritance pattern of 50% second-generation incidence in her offspring.

Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

Progestogens for treatment and prevention of pregnancy disorders

2010 ◽  
Vol 3 (3) ◽  
Author(s):  
Adolf E. Schindler
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
First Trimester ◽  
Study Groups ◽  
Treatment And Prevention ◽  
Maternal Immune System ◽  
Hydroxyprogesterone Caproate ◽  
History Of ◽  
Threatened Abortion ◽  
In Pregnancy

AbstractProgesterone appears to be the dominant hormone not only establishing a proper secretory endometrial development but also adequate decidualization to establish pregnancy and sustain pregnancy development. Progesterone is the natural immunoregulator to control the maternal immune system and not to reject the allogeneic fetus. There are two sources of progesterone: corpus luteum first and placenta later. Three progestogens can be used in pregnancy: (i) progesterone (per os, intravaginal and intramuscular), (ii) dydrogesterone (per os), and (iii) 17α-hydroxyprogesterone caproate (intramuscular). There are three indications, for which these progestogens can be clinically used either for treatment or prevention: (i) first trimester threatened and recurrent (habitual) abortion, (ii) premature labor/premature birth, and (iii) pre-eclampsia (hypertension in pregnancy). The available data are limited and only partially randomized. In threatened abortion the use of progesterone, dydrogesterone and 17α-hydroxyprogesterone caproate leads to a significant improved outcome, when at the time of threatened abortion a viable fetus has been ascertained by ultrasound. For prevention of recurrent abortion there are also some data indicating a significant effect compared with women without progestogen treatment. Prevention of preterm birth by progestogens (progesterone vaginally, orally and 17α-hydroxyprogesterone caproate intramuscularly) was significantly effective. The main study groups include pregnant women with a previous history of premature birth. However, also in women with shortened cervix use of progesterone seems to be helpful. The studies done so far in women with risk factors for pre-eclampsia or established pre-eclampsia were based on parenteral progesterone application. However, new studies are urgently needed.

Differential Effects of Maternal Heroin and Methadone Use on Birthweight

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 681-685
Author(s):  
Stephen R. Kandall ◽  
Susan Albin ◽  
Joyce Lowinson ◽  
Beatrice Berle ◽  
Arthur I. Eidelman ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Methadone Maintenance ◽  
First Trimester ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Intrauterine Growth ◽  
Methadone Dosage ◽  
History Of

An analysis of birthweights of 337 neonates in relation to history of maternal narcotic usage was undertaken Mean birthweight of infants born to mothers abusing heroin during the pregnancy was 2,490 gm, an effect primarily of intrauterine growth retardation. Low mean birthweight (2,615 gm) was also seen in infants born to mothers who had abused heroin only prior to this pregnancy, and mothers who had used both heroin and methadone during the pregnancy (2,535 gm). Infants born to mothers on methadone maintenance during the pregnancy had significantly higher mean birthweights (2,961 gm), but lower than the control group (3,176 gm). A highly significant relationship was observed between maternal methadone dosage in the first trimester and birthweight, i.e., the higher the dosage, the larger the infant. Heroin causes fetal growth retardation, an effect which may persist beyond the period of addiction. Methadone may promote fetal growth in a dose-related fashion after maternal use of heroin.

Metoclopramide-Induced Methemoglobinemia

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 364-366
Author(s):  
Gregory L. Kearns ◽  
Debra H. Fiser
Keyword(s):  
Methylene Blue ◽  
Gastroesophageal Reflux ◽  
Respiratory Distress ◽  
Reductase Activity ◽  
Male Infant ◽  
Clinical Findings ◽  
Oxyhemoglobin Saturation ◽  
History Of ◽  
Motor Restlessness ◽  
Hemoglobin M

The case of a 3-week-old male infant is described. After receiving an iatrogenic overdose of metoclopramide (1.0 mg/kg every six hours) throughout a 36-hour period for the treatment of suspected gastroesophageal reflux, he became cyanotic, lethargic, and irritable, he fed poorly, and he had diarrhea and respiratory distress. Methemoglobinemia (20.5%) and reduced oxyhemoglobin saturation (79%) were identified. The patient had an excellent clinical response following a single IV dose of methylene blue. Subsequently, methemoglobin reductase activity was normal and there was no measurable hemoglobin M. The diagnosis of methemoglobinemia should be considered in any infant receiving large doses of metoclopramide who has clinical findings of cyanosis, ashen color, or a history of lethargy and/or motor restlessness.

Fatal Intracranial Hemorrhage in a Normal Infant Secondary to Vitamin K Deficiency

PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 562-564
Author(s):  
PETER A. LANE ◽  
WILLIAM E. HATHAWAY ◽  
JOHN H. GITHENS ◽  
RICHARD D. KRUGMAN ◽  
DONNA A. ROSENBERG
Keyword(s):  
Vitamin K ◽  
Correct Diagnosis ◽  
Fatal Case ◽  
Male Infant ◽  
Hemorrhagic Disease ◽  
Normal Infant ◽  
Vitamin K Deficiency ◽  
Hospital Emergency Room ◽  
History Of ◽  
K Deficiency

Since the initiation of routine vitamin K prophylaxis in newborns, the incidence of hemorrhagic disease of the newborn has been dramatically decreased. Recently there have been suggestions in the literature that prophylaxis may be unnecessary.1-4 We report here a fatal case of vitamin K deficiency in an otherwise healthy 1-month-old who did not receive prophylaxis. This case is illustrative because the child was initially thought to have suffered nonaccidental trauma. In addition, the correct diagnosis was confirmed, retrospectively, after vitamin K administration, with new assays for vitamin K-deficient prothrombin. CASE REPORT This 4-week-old male infant was seen at a community hospital emergency room with a one-day history of irritability, poor feeding, and decreased responsiveness without fever.

GUIDANCE IN MATERNAL AND INFANT CARE TWO MONTHS BEFORE AND AFTER THE BIRTH OF THE FIRST-BORN

PEDIATRICS ◽  
1948 ◽  
Vol 2 (2) ◽  
pp. 200-206
Author(s):  
AUGUSTA STUART CLAY
Keyword(s):  
Normal Growth ◽  
Point Of View ◽  
High School Education ◽  
Pediatric Care ◽  
New Haven ◽  
Private Physician ◽  
Healthy Pregnancy ◽  
Before And After ◽  
Haven Hospital ◽  
Made In

THIS study was made in the belief that family living and growth can be healthier if parents understand how mother and baby develop and what they need. Eleven mothers were visited weekly for two months before and after the birth of their firstborn to discover what guidance they wanted, what was offered, and what additional guidance was needed. The writer secured their cooperation by agreeing to work with them as a consultant, to interpret their point of view to the doctor, to explain medical instructions when permitted, and to teach the normal growth processes of mother and baby. Ten mothers were registered in the prenatal clinics of the New Haven Hospital; the eleventh had a private physician. They had no recorded problems beyond the needs of healthy pregnancy and they wanted to participate. Eight husbands agreed to take part in the study. The other three were overseas, but their wives reported for them. Backgrounds varied; 20 of the 22 had had college or high school education; all were between 18 and 32. None dropped out, and after the four months all asked for continued guidance. Cases were too few and the study too brief for statistical evidence. But problems were uncovered which needed to be considered and which have largely been neglected in routine obstetric and pediatric care. These parents wanted to learn—not in classes, but in the privacy of home—how to care for mother and baby without disrupting their accustomed way of living. All wanted the care and interest of one doctor for mother and one for baby. However, six women and five men preferred to talk with a consultant who was not a doctor, but who was affiliated with their doctors. The doctors seemed too busy for "little things" and "family affairs," and they saw so many doctors that they all seemed strangers. Once they felt sure that the consultant's interest was in themselves rather than in teaching them, they set the pace and pattern in the conference. There was no questionnaire, no probing, no set procedure. If they had any immediate interests or problems: job, move, presents, trips, in-laws, illness—these were discussed before they talked of pregnancy and baby.

CONGENITAL PITRESSIN RESISTANT DIABETES INSIPIDUS OF RENAL ORIGIN

PEDIATRICS ◽  
1955 ◽  
Vol 15 (3) ◽  
pp. 298-372
Author(s):  
William B. Macdonald
Keyword(s):  
Diabetes Insipidus ◽  
Extracellular Fluid ◽  
Male Infant ◽  
Renal Tubules ◽  
Post Mortem ◽  
Water Metabolism ◽  
History Of ◽  
Renal Clearances ◽  
Renal Function Tests ◽  
Renal Origin

1) The history of a male infant who presented soon after birth with features of failure to gain weight, dehydration and pyrexia of obscure origin, has been described. A diagnosis of pitressin resistant diabetes insipidus was made. 2) Renal function tests and post-mortem examination, including microdissection of the kidney, indicates that the basic defect in water metabolism was a functional inability of the distal renal tubules to respond to antidiuretic hormone. 3) Consequent dehydration was insufficient to cause circulatory collapse, but affected renal clearances. 4) There was evidence of increased catabolism and poor protein utilisation. 5) Hyperosmolarity of the extracellular fluid was accompanied by a rise in body temperature, probably due to a depression of sweat gland activity. 6) Post-mortem evidence suggests that infants with pitressin resistant diabetes insipidus should be investigated for cystine storage disease.

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