scholarly journals Docosahexaenoic Acid Supplementation Early in Pregnancy May Prevent Deep Placentation Disorders

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Jorge A. Carvajal

Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction). Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids) rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA) supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction.

2019 ◽  
Vol 2 (2) ◽  
pp. 35-41
Author(s):  
Michelle J. Wang ◽  
Michelle Y. Lu ◽  
Elizabeth B. Ausbeck ◽  
Lorie M. Harper

Snakebites in pregnancy can result in significant maternal and fetal harm; however, the literature to guide management of this rare obstetric complication remains limited. We describe our approach to envenomation in pregnancy based on the currently available evidence. A 27-year-old G2P1 female presented at 27 weeks’ gestation after suffering a copperhead snakebite. She received antivenom and antenatal steroids without adverse maternal or fetal event. Antenatal testing was reassuring throughout admission, and she was discharged home with plans for close outpatient surveillance. She later developed preterm premature rupture of membranes and preterm labor, with delivery of a live infant at 33 weeks’ gestation. The risk of adverse maternal and fetal outcomes following snake envenomation in pregnancy may warrant closer antenatal surveillance than has been previously described.


2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Joohee Choi ◽  
Jeong Woo Park ◽  
Byoung Jae Kim ◽  
Ye-Jin Choi ◽  
Jong Hee Hwang ◽  
...  

AbstractTo compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.: The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ariel T. Levy ◽  
Melissa A. Yurkanin ◽  
Lauren A. Plante

AbstractFetal head entrapment by a uterine scar or adhesion is a rare obstetric complication. We present a case of a uterine constriction diagnosed in pregnancy that resulted in confinement of the fetal head to the lower uterine segment. The developing fetus ultimately suffered growth restriction of the head and was delivered after the mother experienced preterm premature rupture of membranes (PROM). Severe adhesions of the lower uterine segment were confirmed during the patient’s classical cesarean section.


Author(s):  
I.V. Komarova, A.A. Nikiforenko, A.V. Fedunyak

Literature reports of placental mosaicism, including trisomy 22, were analyzed. The chance of correlation of placental aneuploidy with fetus aneuploidy, also the probability of complications in pregnancy and fetal growth restriction and postnatal patients growth in the cases of confined placental mosaicism, were demonstrated. The case of prenatal diagnosis of confined placental mosaicism of trisomy 22 with favorable outcome is presented. The necessity of cytogenic assay of amniocytes and fetal lymphocytes in the case of placental heteroploidy diagnosis was emphasized.


2019 ◽  
Vol 79 (08) ◽  
pp. 813-833 ◽  
Author(s):  
Richard Berger ◽  
Harald Abele ◽  
Franz Bahlmann ◽  
Ivonne Bedei ◽  
Klaus Doubek ◽  
...  

Abstract Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.


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