scholarly journals Treatment of Primary Fetal Hydrothorax with OK-432 (Picibanil): Outcome in 14 Fetuses and a Review of the Literature

2015 ◽  
Vol 37 (4) ◽  
pp. 259-266 ◽  
Author(s):  
Brooke O''Brien ◽  
Greg Kesby ◽  
Robert Ogle ◽  
Ingrid Rieger ◽  
Jon A. Hyett
Keyword(s):  
Birth Weight ◽  
Perinatal Outcomes ◽  
Therapeutic Interventions ◽  
Review Of The Literature ◽  
Normal Range ◽  
Average Survival ◽  
Alfred Hospital ◽  
Uncommon Condition ◽  
The Mean ◽  
Ages And Stages Questionnaires

Background: Primary fetal hydrothorax (PFHT) is an uncommon condition with an estimated prevalence of 1 in 10,000/15,000 pregnancies. Therapeutic interventions include thoracocentesis, thoraco-amniotic shunting (TAS), and pleurodesis using OK-432. Methods: A review of the literature was performed to identify all cases of PFHT treated with TAS and OK-432. All cases of PFHT referred to the Fetal Maternal Unit at Royal Prince Alfred Hospital between 2002 and 2012 were retrospectively reviewed. In the cohort of fetuses treated with OK-432, the main perinatal outcomes evaluated were termination of pregnancy, live birth, neonatal death, and fetal death in utero. Secondary outcomes included gestational age (GA) at diagnosis, GA at treatment, GA at resolution, birth weight, and GA at birth. The development of the children was screened using the Ages and Stages Questionnaires, Version 3 (ASQ-3, 2009). Results: Primary hydrothorax was diagnosed in 31 fetuses, of which 14 had treatment with OK-432. One pregnancy terminated after treatment with OK-432. Survival was 85% (11/13): 100% in fetuses treated with OK-432 without hydrops, and 78% in those treated with hydrops. This compares well to the cases of TAS in the literature with an average survival of 63%: 85% in fetuses without hydrops and 55% with hydrops. The mean GA at birth was 36+4 weeks and mean birth weight 3,007 g. Eight of the 9 children screened with ASQ-3 scored well within the normal range. Conclusion: OK-432 appears to be a valid treatment option in fetuses with PFHT, particularly in those diagnosed at early GAs.

scholarly journals Maternal risk factors and perinatal outcomes in fetal growth restriction using obstetric Doppler in South Kerala, India

2018 ◽  
Vol 8 (1) ◽  
pp. 6
Author(s):  
Heera Shenoy T. ◽  
Sonia X. James ◽  
Sheela Shenoy T.
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
P Value ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
The Mean

Background: Fetal Growth Restriction (FGR) is the single largest contributing factor to perinatal morbidity in non-anomalous foetuses. Synonymous with Intrauterine Growth Restriction (IUGR), it is defined as an estimated fetal weight less than the10th percentile. Obstetric Doppler has helped in early detection and timely intervention in babies with FGR with significant improvements in perinatal outcomes.  Hence, authors evaluated the maternal risk factors and diagnosis-delivery intervals and perinatal outcomes in FGR using Doppler.Methods: This research conducted in a tertiary care hospital in South Kerala included 82 pregnant women who gave birth to neonates with birth weight less than the 10th percentile over a period of1 year (Jan 1, 2017-Dec 31, 2017). Socio-demographic, maternal risk, Diagnosis- delivery interval in FGR and neonatal morbidities were studied.Results: Mean GA at diagnosis in weeks was 34.29 and 35.19 respectively for abnormal and normal Doppler respectively (p value-0.032). The mean birthweight in Doppler abnormal FGR was 272.34 g lesser than in Doppler normal group (p value-0.001). Growth restricted low birth weight neonates had Doppler   pattern abnormalities (p value-0.0009). FGR <3rd percentile and AFI <5 had abnormal Doppler (OR:6.7). Abnormal biophysical profile (OR:14) and Non-Reactive NST (OR:3.5) correlated with abnormal Doppler. Growth restricted with normal Doppler had shorter NICU stays than with abnormalities (p value-0.003). Term FGR went home early than early preterm. (p value-0.001).Conclusions: Abnormal Doppler velocimetry is significantly associated with earlier FGR detection, shorter decision- delivery interval, reduction in the mean birthweight and longer NICU stay. Hence, Umbilical artery Doppler and Cerebroplacental index is an integral part of in-utero fetal surveillance to identify impending fetal hypoxia, appropriate management, optimising the timing of delivery and improve perinatal health in FGR.

scholarly journals Correlation of Brain Derived Neurotrophic Factors (BDNF) With Maternal and Perinatal Outcome in Preeclampsia

2021 ◽  
Vol 5 (2) ◽  
pp. 148-160
Author(s):  
Mayuliani Mayuliani ◽  
Yusrawati Yusrawati ◽  
Defrin Defrin
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Neurotrophic Factors ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Birth Length ◽  
Weak Correlation ◽  
Bdnf Level ◽  
The Mean

Objective: To analyze the correlation between BDNF and maternal and perinatal outcomes in preeclampsia.Methods: This was an observational analytic study with a cross-sectional design on 73 pregnant women with preeclampsia. The study began in January 2020 to June 2020 in the Obstetrics and Gynecology Department of Dr M. Djamil Hospital Padang.Results: The mean BDNF levels of pregnant women with preeclampsia were 519.9± 325.4 pg/ml. The correlation between BDNF and systolic blood pressure, diastolic blood pressure, and Mean Arterial Pressure was negatively correlated (r = -0.145, -0.1, and -0.218), with a weak correlation. There was no statistically significant relationship between BDNF and systolic blood pressure, diastolic blood pressure, and mean arterial pressure (p> 0.05). BDNF correlation with infant birth weight and the birth length was positively correlated (0.196 and 0.205) with a weak correlation. The correlation between BDNF level and Apgar score was negatively correlated (-0.039 and -0.054) with a weak correlation. There was no statistically significant correlation between BDNF with birth weight, birth length, and Apgar score (p> 0.05).Conclusion: The mean BDNF level in preeclampsia was lower than normal pregnancy, there was a negative correlation between BDNF levels and maternal outcomes in preeclampsia with a weak correlation. There was a positive correlation between BDNF levels and perinatal outcomes (birth weight and birth length) in preeclampsia and there was a negative correlation between BDNF levels and Apgar score in preeclampsia with a weak correlation.Keywords: Brain Derived Neurotrophic Factors, Preeclampsia, Maternal Outcome, Perinatal Outcome

scholarly journals Comparison of the Pregnancy Characteristics and Outcomes Between Syrian Immigrants and Local Turkish Women: Large Cohort Multicenter Study

2021 ◽  
Author(s):  
Seçil Karaca Kurtulmuş ◽  
Ebru Sahin Gulec ◽  
Esra Bahar Gur
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Large Cohort ◽  
Health Policies ◽  
Turkish Women ◽  
Large Cohort Study ◽  
The Mean ◽  
Adolescent Pregnancies ◽  
Different Characteristics

Objective: The aim of the present study is to compare Syrian immigrants and local Turkish women in terms of pregnancy characteristics and its outcomes. Methods: In a large cohort, multicenter, retrospective study, we obtained data from births that occurred in three hospitals in the Metropolitan Municipality of Izmir and Aydin Province between October 1, 2009 and June 1, 2019. We compared 11036 Syrian immigrants and local Turkish women in terms of their demographic features, perinatal, and neonatal outcomes. Results: Pregnant women were significantly younger, and the number of adolescent pregnancies (maternal age<19) was significantly higher in the Syrian immigrant group (p<0.01, and p<0.01, respectively). The number of previous pregnancies was higher among Syrian immigrant pregnant women (p<0.01). Cesarean Section (C/S) and interventional delivery rates were higher in Turkish pregnant women, and C/S delivery indications were significantly different between the groups (p<0.05, and p<0.01, respectively). Preterm birth rates (<37 gestational weeks) were higher in the Syrian immigrants, whereas the rates of low birth weight (LBW) (<2500 gr) were higher in the Turkish women (p<0.05, and p<0.05, respectively). Also, the mean newborn birth weight and head circumference of the newborns were higher in the Turkish women, whereas the birth length of newborns was higher in the Syrian immigrants (p<0.01, p<0.01, and p<0.01, respectively). Conclusion: In the present study, compared to local Turkish pregnant women, pregnancy characteristics and the perinatal outcomes of the Syrian immigrant women and their neonates had different characteristics. Moreover, the types and indications of delivery of Syrian immigrants differed from those of Turkish pregnant women. The findings of our large cohort study can contribute to the improvement of health policies in Turkey and other countries hosting Syrian immigrants.

scholarly journals Gestational and Neonatal Outcomes of a New Three-Step Procedure for Emergency Cerclage

2021 ◽  
Author(s):  
Manuel Gómez Castellano ◽  
Lorena Sabonet Morente ◽  
Ernesto González Mesa ◽  
Jesús S Jiménez Lopez
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
University Hospital ◽  
Cervical Dilatation ◽  
Step Procedure ◽  
The Mean ◽  
Infant Birth

Abstract Background: The objective of our study was to evaluate a new technique for emergency cerclage performed in a cohort of patients with cervical incompetence in the second trimester of pregnancy. Design: Prospective observational study in Regional university hospital. Population: Twenty-four pregnant women at 15 to 24 weeks gestation with cervical dilatation and bursa prolapseMethods: Depending on the clinical condition of the patient, a new emergency cerclage was performed with a technical consisting of a first cerclage in a purse-string and a second occlusive cerclage located inferiorly to the first one. The technique ended with the performance of a cervical cleisis, depending on the presence or absence of prolapse of the vaginal bag. This procedure is called the Three-Step Procedure for Emergency Cerclage (TSEC). Outcome measure: The latency period to deliveryResults: Latency from procedure to delivery, pregnancy duration, infant birth weight, rate of premature amniorrhexis. The mean latency from procedure to delivery was 14 weeks + 6 days, the mean weight of the newborns was 2550 g, and the mean age at delivery was 35 weeks. The neonatal survival rate was 95.8%. The rate of premature amniorrhexis <34 weeks was 8.3% (two cases) with successful perinatal outcomes. There were significant differences (p < 0.05) between groups when we sub-divided the cohort in terms of history of conization, preterm delivery, and bursal prolapse. The multivariate regression model showed that best predictor variables for latency to delivery were cervical dilatation at diagnosis, the use of the three step cerclage, cervical length after the procedure, and gestational age at diagnosis.Conclusion: The excellent results obtained with the TSEC procedure in terms of the latency from procedure to delivery, gestational age at delivery, birth weight, and few reported complications, highlight the importance of collecting new data on this promising novel procedure.

Immunologic Assessment of Patients Treated with Bovine Fibrin as a Hemostatic Agent

1996 ◽  
Vol 76 (06) ◽  
pp. 0925-0931 ◽  
Author(s):  
John F Carroll ◽  
Keith A Moskowitz ◽  
Niloo M Edwards ◽  
Thomas J Hickey ◽  
Eric A Rose ◽  
...  
Keyword(s):  
Coagulation Factors ◽  
Allergic Reactions ◽  
Factor V ◽  
Normal Range ◽  
Serum Samples ◽  
Human Fibrinogen ◽  
Bovine Thrombin ◽  
Thrombotic Complications ◽  
The Mean ◽  
Clinically Significant

SummaryTwenty-one cardiothoracic surgical patients have been treated with fibrin as a topical hemostatic/sealing agent, prepared from bovine fibrinogen clotted with bovine thrombin. Serum samples have been collected before treatment with fibrin and postoperatively between 1 and 9 days, 3 and 12 weeks, and 6 and 8 months. The titers of anti-bovine fibrinogen antibodies, measured by ELISA specific for immunoglobulins IgG or IgM, increased to maximal values after about 8 or 6 weeks, respectively. After 8 months, IgG titers were on average 20-fold lower than the mean maximal value, while IgM titers returned to the normal range. IgG was the predominant anti-bovine fibrinogen immunoglobulin as documented by ELISA, affinity chromatography and electrophoresis. Anti-bovine fibrinogen antibodies present in patients reacted readily with bovine fibrinogen, but did not cross-react with human fibrinogen as measured by ELISA or by immunoelectrophoresis. A significant amount of antibodies against bovine thrombin and factor V has been found, many cross-reacting with the human counterparts. No hemorrhagic or thrombotic complications, or clinically significant allergic reactions, occurred in any patient, in spite of antibody presence against some bovine and human coagulation factors. The treatment of patients with bovine fibrin, without induction of immunologic response against human fibrinogen, appeared to be an effective topical hemostatic/sealing measure.

Influence of Acute Myocardial Infarction and rt-PA Therapy on Circulating Fibrinogen

1993 ◽  
Vol 69 (04) ◽  
pp. 321-327 ◽  
Author(s):  
E Seifried ◽  
M Oethinger ◽  
P Tanswell ◽  
E Hoegee-de Nobel ◽  
W Nieuwenhuizen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Agent ◽  
Degradation Products ◽  
Maximum Plasma ◽  
Normal Range ◽  
Fibrinogen Degradation Products ◽  
Fibrin Degradation Products ◽  
Rebound Phenomenon ◽  
The Mean

SummaryIn 12 patients treated with 100 mg rt-PA/3 h for acute myocardial infarction (AMI), serial fibrinogen levels were measured with the Clauss clotting rate assay (“functional fibrinogen”) and with a new enzyme immunoassay for immunologically intact fibrinogen (“intact fibrinogen”). Levels of functional and “intact fibrinogen” were strikingly different: functional levels were higher at baseline; showed a more pronounced breakdown during rt-PA therapy; and a rebound phenomenon which was not seen for “intact fibrinogen”. The ratio of functional to “intact fibrinogen” was calculated for each individual patient and each time point. The mean ratio (n = 12) was 1.6 at baseline, 1.0 at 90 min, and increased markedly between 8 and 24 h to a maximum of 2.1 (p <0.01), indicating that functionality of circulating fibrinogen changes during AMI and subsequent thrombolytic therapy. The increased ratio of functional to “intact fibrinogen” seems to reflect a more functional fibrinogen at baseline and following rt-PA infusion. This is in keeping with data that the relative amount of fast clotting “intact HMW fibrinogen” of total fibrinogen is increased in initial phase of AMI. The data suggest that about 20% of HMW fibrinogen are converted to partly degraded fibrinogen during rt-PA infusion. The rebound phenomenon exhibited by functional fibrinogen may result from newly synthesized fibrinogen with a high proportion of HMW fibrinogen with its known higher degree of phosphorylation. Fibrinogen- and fibrin degradation products were within normal range at baseline. Upon infusion of the thrombolytic agent, maximum median levels of 5.88 μg/ml and 5.28 μg/ml, respectively, were measured at 90 min. Maximum plasma fibrinogen degradation products represented only 4% of lost “intact fibrinogen”, but they correlatedstrongly and linearly with the extent of “intact fibrinogen” degradation (r = 0.82, p <0.01). In contrast, no correlation was seen between breakdown of “intact fibrinogen” and corresponding levels of fibrin degradation products. We conclude from our data that the ratio of functional to immunologically “intact fibrinogen” may serve as an important index for functionality of fibrinogen and select patients at high risk for early reocclusion. Only a small proportion of degraded functional and “intact fibrinogen”, respectively, is recovered as fibrinogen degradation products. There seems to be a strong correlation between the degree of elevation of fibrinogen degradation products and the intensity of the systemic lytic state, i.e. fibrinogen degradation.

Kaolin-Activated Euglobulin Lysis Time (KELT)

1979 ◽  
Author(s):  
H Greig
Keyword(s):  
No Value ◽  
Clinical Assessment ◽  
Fibrinolytic Activity ◽  
Factor Xii ◽  
Plasminogen Activation ◽  
Normal Range ◽  
Control Subjects ◽  
Lysis Time ◽  
Euglobulin Lysis Time ◽  
The Mean

The most commonly used test for clinical assessment of fibrinolytic activity is the Euglobulin Lysis Time (ELT). However the normal range is very wide, the long times are inconvenient and detection of inhibition is impossible. An attempt has been made to utilise the acceleration of the ELT when kaolin is present, to devise a test with shorter times, a narrower normal range, and better precision. The Euglobulin lysis time was carried out by a modification of the method of NILSSON and OLOW, after precipitation of the euglobulin in the absence of kaolin (ELT) and in the presence of 1 mg. kaolin/ml. plasma (KELT). In 14 control subjects the mean, SD, and range for the ELT were 168.6’, 54.6’, 84-290’; the corresponding values for the KELT were 60.3’, 8.3’ and 46-74’. However, it was found that there was no correlation between the ELT value and the corresponding KELT (’r’ = -0.021); on the contrary, the longer the ELT, the greater the shortening produced by kaolin and there is a direct correlation between the ELT and the shortening of the lysis time by kaolin; ’r’ = 0.988. It is concluded that the KELT has no value as a clinical measure of fibrinolytic activity; further, the results suggest that kaolin may remove an inhibitor(s) of plasminogen activation as well as initiating Factor XII - mediated plasminogen activation.

Assessment of nutritional status of students of medical institute according to the blood biochemical parameters

2020 ◽  
pp. 55-63
Author(s):  
Rofail Rakhmanov ◽  
Elena Bogomolova ◽  
Mariya Shaposhnikova ◽  
Mariya Sapozhnikova
Keyword(s):  
Nutritional Status ◽  
Lower Boundary ◽  
Density Lipoprotein ◽  
Blood Parameters ◽  
Medical Institute ◽  
Specific Situation ◽  
Mathematical Methods ◽  
Normal Range ◽  
Mean Values ◽  
The Mean

The biochemical blood parameters characterizing the students ’nutritional status were evaluated: protein, lipid, carbohydrate metabolism, a number of minerals. The mean values, errors of the mean, median (Me), boundary (Q) and the range of 25–75 percentiles were determined. In 9.1 % of students and 28.6 % of students, the total protein was increased. Creatinine in men was in the upper normal range, in women — at the upper limit of normal, of which 46.2 % was higher than normal. The interval Q25–75 of uric acid in students is determined in the lower normal zone. In 40.0 % of men, decreased high-density lipoprotein cholesterol (Q25–75 corresponded to 1.15–1.79), in women — below normal, Q25–75 5 was 1.3–1.5, decreased in 73.3 %. Me and Q25–75 iron were in the lower normal range; 14.1 % of men and 13.2 % of women are below normal. Me sodium and potassium at the level of the lower boundary of the norm, Q25–75 in the lower zone of the norm: in 16.0 % and 15.4 % of students the levels are reduced. Calcium is slightly above the lower limit of the norm, Q25–75–2.1–2.24, indicating an insufficient intake in the whole group; 25.0 % are below normal. The border of the 25th percentile of magnesium is at the level of the lower border of the norm, in 19.2 % it is reduced. 7.2 % lack of chlorine. Phosphorus is normal, but Q25–75 is in the upper zone; 17.9 % increased. Biochemical markers can identify individuals with metabolic disorders of nutrients. Statistical indicators — the median, the boundaries of 25–75 quartiles and their scope characterize the metabolism of macronutrients and minerals in the group and subgroups of students. Laboratory and mathematical methods can provide a basis for identifying the specific causes of these changes. For this, you can use the questionnaire method of studying the nutrition of students, possibly using the developed questionnaires for a specific situation.

HPV Prevalence and its Association with Perinatal Outcomes among Singleton Mothers: Analysis of Pregnancy Risk Assessment and Monitoring System (PRAMS) Data, 2004-2011

2019 ◽  
Vol 15 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Harpriya Kaur ◽  
Delf Schmidt-Grimminger ◽  
Baojiang Chen ◽  
K.M. Monirul Islam ◽  
Steven W. Remmenga ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Monitoring System ◽  
Large Population ◽  
Perinatal Outcomes ◽  
Hpv Infection ◽  
Adverse Outcomes ◽  
P Value ◽  
Pregnancy Risk

Background: Pregnancy may increase the risk of Human Papillomavirus (HPV) infection because of pregnancy induced immune suppression. The objective of this study was to use a large population-based dataset to estimate the prevalence of HPV infection and its association with adverse outcomes among pregnant women. Methods: We analyzed Pregnancy Risk Monitoring System data from 2004-2011 (N=26,085) to estimate the self-reported HPV infection. Survey logistic procedures were used to examine the relationship between HPV infection and adverse perinatal outcomes. Results: Approximately 1.4% of women were estimated to have HPV infection during their pregnancy. The prevalence of adverse outcomes in this sample was preterm birth (8.4%), preeclampsia (7.5%), low birth weight (6.3%) and premature rupture of membranes (2.8%). Compared to women without HPV infection, HPV infection positive women were much more likely to have had other infections such as chlamydia (9.23% vs. 2.12%, p-value <.0001), Group B Strep (21.7% vs. 10.04%, p-value <.0001), and herpes (7.17% vs. 1.07%, p-value <.0001). After adjusting for other risk factors including other infections, HPV infection was significantly associated with low birth weight (OR: 1.94, 95% CI: 1.14-3.30). Conclusion: The study indicated a potential association between HPV infection and low birth weight. Because pregnant women with HPV infection are at higher risk of other infections, future research may focus on the roles of co-infection in the development of adverse perinatal effects.

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