scholarly journals Elevated Circulating IL-1βand TNF-Alpha, and Unaltered IL-6 in First-Trimester Pregnancies Complicated by Threatened Abortion With an Adverse Outcome

2006 ◽  
Vol 2006 ◽  
pp. 1-6 ◽  
Author(s):  
Nicolaos Vitoratos ◽  
Constantinos Papadias ◽  
Emmanuel Economou ◽  
Evangelos Makrakis ◽  
Constantinos Panoulis ◽  
...  
Keyword(s):  
Gestational Age ◽  
Adverse Outcome ◽  
First Trimester ◽  
Wilcoxon Test ◽  
Successful Outcome ◽  
Tnf Alpha ◽  
Obstetric Outcome ◽  
Group A ◽  
Threatened Abortion ◽  
Admission Group

The purpose of the present study was to examine the profile of selected proinflammatory cytokines in maternal serum of first-trimester pregnancies complicated by threatened abortion (TACP) and its relevance to obstetric outcome. Serum levels of Th1-type cytokines interleukin-1β(IL-1β), tumor necrosis factor alpha (TNF-alpha), and Th2-type cytokine interleukin 6 (IL-6) were measured, by ELISA, in 22 women with TACP and adverse outcome at admission (group A) and compared with the corresponding levels of 31 gestational age-matched women with TACP and successful outcome at admission (group B1) and discharge (group B2) and 22 gestational age-matched women with first-trimester uncomplicated pregnancy (group C) who served as controls. Mann-Whitney U or Wilcoxon test was applied as appropriate to compare differences between groups. IL-1βand TNF-alpha were detected with significantly higher levels in group A, compared to all other groups. On the contrary, IL-6 levels were detected with no significant difference among all the other groups studied. It is concluded that in first-trimester TACP with adverse outcome, a distinct immune response, as reflected by elevated maternal IL-1β, TNF-alpha, and unaltered IL-6 levels, is relevant to a negative obstetric outcome.

Adverse Outcome of the First Trimester Gestational Age Discrepancy: A Cohort study

2020 ◽  
Vol 23 (09) ◽  
Author(s):  
Abdul Razzaq Oleiwi Jasim ◽  
Salam Geddoa ◽  
Fatima Aljassany
Keyword(s):  
Cohort Study ◽  
Gestational Age ◽  
Adverse Outcome ◽  
First Trimester ◽  
Age Discrepancy

Outcome of TRAP Sequence Treated in the First Trimester – A Ten-Year Single-Center Experience

2021 ◽  
Author(s):  
Eva Christin Weber ◽  
Florian Recker ◽  
Ingo Gottschalk ◽  
Brigitte Strizek ◽  
Annegret Geipel ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Adverse Outcome ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Death ◽  
Arterial Perfusion ◽  
Trap Sequence ◽  
Single Center Experience ◽  
Group A ◽  
Group B

Abstract Purpose To evaluate the outcome of first trimester intervention by intrafetal laser (IFL) in pregnancies complicated by twin reversed arterial perfusion (TRAP). Materials and Methods For a 10-year study period, all patients with TRAP diagnosed < 14.0 weeks of gestation were retrospectively analyzed for intrauterine course and outcome. Monoamniotic pregnancies were excluded. Patients were offered either intervention by IFL in the first trimester, expectant management, or termination of pregnancy (TOP). Adverse outcome was defined as either intrauterine death (IUD), neonatal death, or preterm birth. Results In 45 cases TRAP was diagnosed. 17 monoamniotics were excluded. The cohort was divided into two groups according to management. Group A: 24 cases underwent IFL and group B: 4 cases were managed expectantly. No patient opted for TOP. In group A, 70.8 % of pump twins were born alive, including one preterm delivery, and 29.2 % died within four days after the intervention. All 4 expectantly managed cases in group B had an adverse outcome (1 preterm delivery, 3 IUDs < 15.0 weeks). There were no neonatal deaths. In cases treated by IFL, a comparison of survivors and non-survivors identified no significant differences in gestational age at IFL or any of the assessed biometrical and functional parameters. There was a trend towards better outcome in the second half of the study period. Conclusion IFL in first trimester TRAP sequence is technically feasible but is associated with significant mortality, albeit less than previously reported. No risk stratification is possible using the investigated parameters. However, there seems to be a learning curve.

scholarly journals Histogenesis of suprarenal glands at different gestational age groups

2019 ◽  
Vol 10 (3) ◽  
pp. 37-43
Author(s):  
Ravindra Kumar Boddeti ◽  
Velichety Subhadra Devi
Keyword(s):  
Gestational Age ◽  
Age Groups ◽  
Outer Zone ◽  
First Trimester ◽  
Transitional Zone ◽  
Maternity Hospital ◽  
Zona Fasciculata ◽  
Suprarenal Gland ◽  
Suprarenal Glands ◽  
Group A

Background: The human foetal suprarenal gland is structurally variant from its adult counterpart. The most distinctive features of human foetal suprarenal gland and histologically unique foetal zone, was described first by Elliott and Armour in 1911. After the first trimester, the centrally located foetal zone accounts for most of the foetal adrenal mass. The outer zone of the foetal suprarenal gland is called the “definitive zone or neo cortex”; this zone likely gives rise to the adult adrenal glomerulosa. A third zone called “transitional zone”, lies just between the neocortex and foetal zone and is believed to develop into the zona fasciculata. Aims and Objectives: The current study was designed to study the histogenesis of suprarenal glands at different gestational age groups. Materials and Methods: Twenty-eight formalin preserved dead embryos and foetuses of both sexes, were obtained from the Govt. Maternity Hospital & S.V.Medical College, Tirupati, Andhra Pradesh, India. Specimens were grouped according to their gestational age groups (A,B,C,D) A= 0-12 weeks, B= 13-24 weeks, C= 25-36 weeks and D= more than 36 weeks of gestation. Specimens from group A were subjected to serial section as this group consists of embryos, and other groups were sectioned coronal and subjected to routine histological processing for H&E staining. Sections were observed for cellular details under light microscopy with 10X and 40X magnifications, and the same were photographed by microphotography. Results: Based upon the gestational age groups, histogenesis of the suprarenal gland was observed and correlated with the available literature, and the detailed results, discussion will be dealt at the time of discussion. Conclusions: Histological observation of the all the specimens observed in the present study are in agreement with those reported in the literature except that they appeared earlier in the present study than that reported in the literature. Capsule of suprarenal gland appeared at 12 weeks, sympatho-chromaffin bundles appeared before 6 weeks and zonation of cortex was observed at 8 weeks in the present study when compared to the time of appearance reported in the literature as 14 weeks, after 6 weeks and after 12 weeks respectively in the literature.

Titration of Antiplatelet Treatment in Pregnant Women at Risk of Preeclampsia

1998 ◽  
Vol 79 (04) ◽  
pp. 743-746 ◽  
Author(s):  
N. A. C. Clark ◽  
M. de Swiet ◽  
C. Nelson-Piercy ◽  
M. G. Elder ◽  
M. H. F. Sullivan
Keyword(s):  
Gestational Age ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Second Trimester ◽  
Antiplatelet Treatment ◽  
Medical Disorders ◽  
Increased Risk ◽  
Group A ◽  
Group B ◽  
Risk Of Preeclampsia

SummaryWe recruited 111 patients who were considered to be at significantly increased risk of preeclampsia on the basis of previous obstetric history or preexisting medical disorders. All patients were treated with low dose aspirin (75 mg/day) from the first occasion the patient attended the antenatal clinic, regardless of gestational age. If the maternal mean platelet volume (MPV) increased significantly (by >0.8 fl) from the baseline, antiplatelet treatment was increased. Five pregnancies were lost during the second trimester and 106 of the treated patients had live infants. The incidence of neonatal death (3/106 infants) was much lower than in the previous pregnancies in these patients (32/134 infants). Patients who were treated from the first trimester of pregnancy (group A, 89 patients) did substantially better than those treated from the second trimester (group B, 17 patients) as assessed by the incidence of pre-eclampsia or intrauterine growth restriction (IUGR), gestational age and birthweight at delivery. These data suggest that longitudinal monitoring of the MPV may identify the women who could benefit from increased antiplatelet treatment, and that antiplatelet treatment may be more effective when initiated in the first trimester rather than later in pregnancy.

Changes in total and free concentrations of steroid hormones in the plasma of women throughout pregnancy: effects of medroxyprogesterone acetate in the first trimester

1985 ◽  
Vol 107 (2) ◽  
pp. 293-300 ◽  
Author(s):  
D. L. Willcox ◽  
J. L. Yovich ◽  
S. C. McColm ◽  
L. H. Schmitt
Keyword(s):  
Steroid Hormones ◽  
Medroxyprogesterone Acetate ◽  
First Trimester ◽  
Abortion Rate ◽  
Uterine Bleeding ◽  
Risk Pregnancy ◽  
Group A ◽  
Threatened Abortion ◽  
Low Risk Pregnancy ◽  
Group B

ABSTRACT The total (protein-bound plus free) and free concentrations of progesterone, oestradiol-17β and cortisol were measured serially throughout pregnancy in the plasma of two groups of women whose pregnancies went to term. Group A (n = 53) experienced an uneventful low-risk pregnancy with a spontaneous abortion rate of 8·6%. Women in group B (n = 22) were treated orally with medroxyprogesterone acetate (MPA; 80–120 mg daily) until 18 weeks gestation for threatened abortion within the first 6 weeks of pregnancy. In both groups of women the proportion of each hormone circulating in the free or unbound form remained constant despite the overall increases which occurred in total circulating hormone concentrations as pregnancy progressed. The steroid hormonal profiles in the first half of pregnancy were similar in both groups of women. However, from weeks 20 to 40 total and free progesterone concentrations were significantly (P < 0·05 in each case) higher in group B compared with group A. Conversely, total and free oestradiol-17β concentrations were lower (P < 0·005 and P < 0·01 respectively) in group B. At this stage it is not known if these differences were attributable to the administration of MPA to women in group B or to altered placental steroidogenesis as a result of earlier uterine bleeding. J. Endocr. (1985) 107, 293–300

scholarly journals Efficacy of combination of tablet mifepristone and misoprostol for first trimester pregnancy termination at different gestational age

2017 ◽  
Vol 7 (1) ◽  
pp. 248
Author(s):  
Poonam Bhojwani ◽  
Pragati Meena ◽  
Gajendra Singh Verma
Keyword(s):  
Side Effects ◽  
Gestational Age ◽  
Pregnancy Termination ◽  
First Trimester ◽  
P Value ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Medical method of abortion is a safe, effective and affordable method for first trimester termination. However, nausea, vomiting, diarhoea, excess bleeding and incomplete abortion are known side effects. The aim of study was to compare the success rate of abortions in both groups, to compare the induction-abortion interval in both groups and to study the side effects of the drugs.Methods: This study was conducted in department of obstetrics and gynecology, NIMS Medical College, Jaipur, India during June 2017-August 2017. Total hundred cases were taken and divided into two groups. Group A was gestational age upto 49 days, Group B was gestational age 50-63 days. Both groups were given tab. mifepristone 200mg. followed by 48 hrs. by 4 tablets of tab misoprostol.Results: The results of the given regimen were highly successful and complete abortion was achieved in 96% and 94% in group A and group B respectively. The difference between two groups was statistically not significant (p value =0.64). Failure rates were seen in only 4% of group A and 6% of group B. Pain abdomen was seen in 16% of group A and 38% of group B patients. The difference between both groups was statistically significant (p value=0.02). Nausea was seen in 10% of group A and 30% of group B patients. The difference between both groups is statistically significant(p value=0.018).Conclusions: First trimester pregnancy can be successfully terminated with combination of mifepristone and misoprostol upto 63 days (9 weeks) of pregnancy.

First Trimester Bleeding: A Diagnostic Dilemma—Probing It with Ultrasound

2017 ◽  
Vol 2 (3) ◽  
pp. 117-124
Author(s):  
Pramod Kumar ◽  
Prashant Sinha ◽  
Deepanshu Gupta ◽  
Atul Mehrotra ◽  
Shobha Mukharjee ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Clinical Examination ◽  
Hydatidiform Mole ◽  
Uttar Pradesh ◽  
Clinical History ◽  
First Trimester ◽  
Teaching Hospitals ◽  
Successful Outcome ◽  
Diagnostic Dilemma ◽  
Threatened Abortion

ABSTRACT Objective The objective of our study was to evaluate the role of ultrasound in the evaluation of patients with first trimester bleeding and to prognosticate and predict the status of abnormal pregnancies. Materials and methods We studied 50 cases of pregnant women who presented with bleeding per vaginum during the first trimester between November 2015 and August 2016. The main sources of data for this study are patients from teaching hospitals attached to Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India. All patients referred to the Department of Radiodiagnosis with clinically suspected first trimester bleeding were evaluated with clinical history, clinical examination, and ultrasonography (USG). Ultrasonographic examination of patients was done using the following machines: (1) Phillips 350, (2) G.E. logiq V3, and (3) Toshiba 1000. Results Of the 50 cases of first trimester bleeding, 26 cases were diagnosed as threatened abortion clinically, out of which only 12 cases were confirmed. Ultrasound examination confirmed 12 cases of clinically suspected threatened abortions and aids in correctly diagnosing 8 cases that were missed on clinical examination. A total of 12 cases out of 18 threatened abortions continue to term gestation with a successful outcome of 66%. All cases of threatened abortion (n = 18), incomplete abortion (n = 10), missed abortion (n = 4), ectopic pregnancy (n = 4), inevitable abortion (n = 4), blighted ovum (n = 2), and hydatidiform mole (n = 2) were correctly diagnosed on USG. A total of 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%. Four out of five proved ectopic pregnancies were correctly diagnosed both on ultrasound and on clinical examination. Conclusion Ultrasound is noninvasive, nonionizing, without any proved harmful effects on the developing fetus and easily available method of investigation to assess the patients with first trimester bleeding, which is highly accurate in diagnosing the actual causes of bleeding and guides the clinician in choosing the appropriate line of management and prevents mismanagement of the cases. In the present study, 48 out of 50 cases were correctly diagnosed on ultrasound compared with 18 out of 50 cases on clinical diagnosis, with a disparity of 64%. How to cite this article Kumar P, Mehrotra A, Gupta D, Mukharjee S, Saket R, Sinha P. First Trimester Bleeding: A Diagnostic Dilemma—Probing It with Ultrasound. Int J Adv Integ Med Sci 2017;2(3):117-124.

Early fetal megacystis: Is it possible to predict the prognosis in the first trimester?

2018 ◽  
Vol 46 (9) ◽  
pp. 1035-1039 ◽  
Author(s):  
Ambra Iuculano ◽  
Cristina Peddes ◽  
Giovanni Monni
Keyword(s):  
Adverse Outcome ◽  
First Trimester ◽  
Ultrasound Scan ◽  
Best Management ◽  
Ultrasound Monitoring ◽  
Ultrasound Findings ◽  
Group A ◽  
Group B ◽  
Fetal Karyotype

Abstract Objective: To evaluate the best management of fetal megacystis diagnosed in the first trimester and define the prognosis and the most appropriate follow-up as early as possible. Methods: This is a retrospective study of first-trimester fetal megacystis diagnosed in pregnant women who performed a combined screening for fetal aneuploidy. Megacystis was defined as a longitudinal bladder diameter (LBD) greater than 7 mm. All fetuses were divided into two groups according to the LBD: Group A with LBD > 15 mm and Group B with LBD < 15 mm. The fetal karyotype and associated anomalies were evaluated. Ultrasound monitoring was performed every 2 weeks (a second ultrasound scan after 2 weeks from diagnosis and a third ultrasound scan 2 weeks after the second one). Results: Twenty-six cases were identified between 2011 and 2016; three cases of aneuploidy were excluded from the study. Of the remaining 23 cases, 11 were included in Group A and 12 in Group B. All Group A fetuses had an adverse outcome. In Group B: five (41.7%) cases had an adverse outcome and seven (58.3%) had a spontaneous resolution of megacystis. The ultrasound findings of both the ultrasound scans, the second and the third, were 100% concordant. Conclusion: An ultrasound scan performed 2 weeks after the megacystis diagnosis can predict the outcome in fetuses with an LBD < 15 mm as early as the end of the first trimester. The outcome of euploid fetuses with an LBD < 15 mm was favorable in 58.3% of the cases.

Perinatal outcomes in women affected by different types of headache disorders: A prospective cohort study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110292
Author(s):  
Isabella Neri ◽  
Daniela Menichini ◽  
Francesca Monari ◽  
Ludovica Spanò Bascio ◽  
Federico Banchelli ◽  
...  
Keyword(s):  
Migraine With Aura ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Migraine Without Aura ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Aneuploidy Screening ◽  
Type Headache

Objective This study aims to investigate pregnancy and perinatal outcomes in women with tension-type headache, migraine without aura and migraine with aura by comparing them to women without any headache disorders. Study design Prospective cohort study including singleton pregnancies attending the first trimester aneuploidy screening at the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them (224/515). Tension-type headache was diagnosed in 24.3% of the cases, while 14% suffered from migraine without aura and 5.2% from migraine with aura. Birthweight was significantly lower in women affected by migraine with aura respective to other groups, and a significantly higher rate of small for gestational age infants was found in tension-type headache (10.4%) and in migraine with aura (24.9%) groups respective to the others (p < 0.001). Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups (p = 0.012). Multivariate analysis showed that women presenting tension-type headache (OR 4.19, p = 0.004), migraine with aura (OR 5.37, p = 0.02), a uterine artery pulsatility index >90th centile (OR 3.66, p = 0.01), low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A) (OR 0.48, p = 0.05) and high MoM of Inhibin-A (OR 3.24, p = 0.03) at first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders. Conclusion Migraine with aura and tension type headache expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at first trimester. These women with headache disorders have an additional indication to undergo first trimester aneuploidy screening and would possibly benefit from specific interventions.

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