Protein Z in normal pregnancy

2005 ◽  
Vol 93 (04) ◽  
pp. 706-709 ◽  
Author(s):  
Ruth Stiller ◽  
Malgorzata Roos ◽  
Roland Zimmermann ◽  
Katharina Quack Loetscher
Keyword(s):  
First Trimester ◽  
Normal Pregnancy ◽  
Progressive Increase ◽  
Cross Sectional Study ◽  
Factor X ◽  
Clotting Factors ◽  
Protein Z ◽  
Cross Sectional ◽  
Fibrinolytic Proteins ◽  
Adverse Pregnancy

SummaryChanges in the coagulation and fibrinolytic systems during pregnancy lead to a higher risk of thromboembolism. These changes include the increase of many clotting factors, as well as a significant fall in activity of fibrinolytic proteins, such as protein C. Protein Z is a vitamin-K-dependent plasma glycoprotein and inhibits the activation of factor X by serving as a cofactor to a plasma proteinase inhibitor. Protein Z deficiency has recently been reported in women with unexplained early fetal losses, and antibodies to protein Z can contribute to adverse pregnancy outcomes. The aim of this study was to determine the range of protein Z in normal pregnancies at different gestational weeks in a cross-sectional and a longitudinal setting. In the longitudinal study we found a 20% increase (p=0.006) of protein Z from first trimester to delivery and a 30% decrease (p<0.0001) 6 to 12 weeks after delivery. In the cross-sectional study these findings were reproducible. In summary, our data show a progressive increase in protein Z levels with gestational age in normal pregnancies and a return to normal levels around 6 to 12 weeks postpartum. The normal increase of protein Z during pregnancy may balance the increase of clotting factors to protect pregnant women from thrombosis.

scholarly journals MMP-9 Level Comparation between Spontaneous Abortion and Normal Pregnancy

2012 ◽  
Vol 4 (3) ◽  
pp. 174
Author(s):  
Aloysius Suryawan ◽  
Johanes C Mose ◽  
Budi Handono
Keyword(s):  
Pregnant Women ◽  
Spontaneous Abortion ◽  
Fetal Death ◽  
Embryo Implantation ◽  
Obstetric Care ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Cross Sectional

BACKGROUND: Abortion remains a problem in the obstetric care as it is one of the causes of maternal and fetal death. Bleeding or miscarriage threat in the first trimester comprises 20% to 25% of all pregnant women, and 50% of them will end as spontaneous abortion. The major cause of maternal death in abortion is hemorrhage. Some recent studies have indicated that MMP-9 is important in the process of embryo implantation into the endometrium and spontaneous abortion occurs when there is an overwhelming increase of MMP-9. This data indicate the importance of a further research to elucidate the role of MMP-9 in spontaneous abortion.METHODS: This was a cross sectional study, included 70 pregnant women with gestational age <20 weeks who came for examination and treatment at the Department of Obstetrics and Gynecology, Medical Faculty of Padjadjaran University/Hasan Sadikin Hospital, Bandung. RESULTS: There were differences in the MMP-9 levels in spontaneous abortion compared to normal pregnancy and MMP-9 had a cut-off point >1221.7 with the sensitivity of 48.6% specificity of 80%, and accuracy of 60.9%.SUMMARY: The MMP-9 level in spontaneous abortion was higher than in normal pregnancy.KEYWORDS: MMP-9, spontaneous abortion, normal pregnancy

Plasma and 24-h NOxand cGMP during normal pregnancy and preeclampsia in women on a reduced NOxdiet

1999 ◽  
Vol 277 (1) ◽  
pp. F48-F57 ◽  
Author(s):  
Kirk P. Conrad ◽  
Laurie J. Kerchner ◽  
Monique D. Mosher
Keyword(s):  
First Trimester ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Whole Body ◽  
No Production ◽  
Maternal Circulation ◽  
Cross Sectional ◽  
Endogenous Production ◽  
Normal Human ◽  
Nitrate And Nitrite

We tested the hypothesis that nitric oxide (NO) biosynthesis increases during normal human pregnancy and decreases in preeclampsia. The major metabolites of NO, nitrate and nitrite (NOx), were measured in both the plasma and 24-h urine of women subjected to a reduced NOxdiet. In this way, the plasma and urinary levels mainly reflected endogenous production rather than dietary intake. Moreover, we assessed cGMP, a second messenger of NO, in the same samples. Both NOxand cGMP assays were validated in our laboratory. We first conducted a cross-sectional study of nonpregnant women ( n = 15), normal pregnant women in the first ( n = 9), second ( n = 17) and third ( n = 22) trimesters, as well as women with preeclampsia ( n = 15) and transient hypertension of pregnancy ( n= 7). We also performed a serial study in the same women ( n = 9) before, during, and after pregnancy. Taken together, the results of the two investigations suggested marked increases in cGMP production especially during the first trimester when the maternal circulation is rapidly vasodilating. In contrast, whole body NO production as estimated by the plasma level and urinary excretion of NOxwas not elevated during the first trimester. Finally, unequivocal demonstration of reduced NO biosynthesis in preeclampsia was not forthcoming.

Anti-β2-glycoprotein I antibodies are associated with pregnancy loss in women with the lupus anticoagulant

2006 ◽  
Vol 95 (05) ◽  
pp. 796-801 ◽  
Author(s):  
Thomas Sailer ◽  
Claudia Zoghlami ◽  
Christine Kurz ◽  
Helmut Rumpold ◽  
Peter Quehenberger ◽  
...  
Keyword(s):  
Lupus Anticoagulant ◽  
Pregnancy Loss ◽  
Fetal Loss ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Anticardiolipin Antibodies ◽  
Cross Sectional ◽  
Glycoprotein I ◽  
Increased Risk

SummaryThe presence of lupus anticoagulant (LA) predisposes to fetal loss and to venous and arterial thrombosis; however, a subgroup of women is unaffected by pregnancy loss. Currently, no predictive markers are available for the identification of women positive for LA at increased risk for pregnancy loss. It was the aim of our study to investigate whether increased anti-β2-GPI-antibodies predict pregnancy loss in women positive for LA. We performed a cross-sectional study in a cohort of 39 women with persistent LA, who had in total 111 pregnancies. Fifteen women had exclusively normal pregnancies (30 pregnancies) and 24 women had pregnancy losses (81 pregnancies). Anti-β2-GPI-antibodies were determined using a semiquantitative enzyme linked immunoassay (QUANTA Lite™ β2 GPI IgG and IgM; Inova Diagnostics). Increased levels of anti-β2-GPI antibodies were significantly associated with pregnancy loss [odds ratio (OR) 9.6, 95% confidence interval (CI) 1.6 – 56.4].This risk was even higher in the subgroup of women (n=16) with more than two miscarriages or fetal loss after the first trimester [OR 13.1, 95% CI 1.4 – 126.3]. There was no significant association between anticardiolipin antibodies and pregnancy loss [OR 3.5, 95% CI 0.7 – 17.6].The coexistence of anti-β2-GPI and anticardiolipin antibodies was also predictive for pregnancy loss [OR 6.1, 95%CI 1.3 – 29.7]. Interestingly, the prevalence of thrombosis was similar between women with normal pregnancy (87%) and those with pregnancy loss (75%). We conclude that increased levels of anti-β2-GPI antibodies are predictive for pregnancy loss among women positive for LA, and that prophylactic treatment should be considered in these women even without a history of previous pregnancy loss.

scholarly journals Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan
Keyword(s):  
Pregnant Women ◽  
Ambulatory Care ◽  
National Level ◽  
Mainland China ◽  
Antibiotic Use ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fetal Safety ◽  
First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

scholarly journals The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Batul Birjandi ◽  
Fahimeh Ramezani Tehrani ◽  
Atieh Amouzegar ◽  
Maryam Tohidi ◽  
Razieh Bidhendi Yarandi ◽  
...  
Keyword(s):  
Thyroid Autoimmunity ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Population Based Study ◽  
History Of ◽  
Autoimmune Condition ◽  
Biochemical Measurements ◽  
Adverse Pregnancy ◽  
Adjusted Logistic Regression

Abstract Background Thyroid autoimmunity(TAI) is the most prevalent autoimmune condition in women of fertile age. There are increasing data regarding the association of thyroid dysfunction and thyroid autoimmunity with adverse pregnancy outcomes but there is no consensus regarding infertility and TPOAb positivity; thus we aimed to evaluate the association between thyroid TPOAb positivity and infertility in females and males in a population-based study (TTS). Methods Cross-sectional study of 3197 female and male participants in Tehran Thyroid Study (TTS) at the framework of the Tehran Lipid and Glucose Study (TLGS). Data included biochemical measurements and a self-administered questionnaire. Results A total of 12,823 cases in phase 4, 3719 cases (2108 female and 1611 male) were analyzed. The mean TSH of the infertile female and male was 2.52 ± 2.68 μIU/ml and 3.24 ± 10.26 μIU/ml respectively. The TPO median(IQR) of women with and without a history of infertility were 6.05 (3.30–13.96)and 6.04 (3.17–11.15);(P = 0.613), they were 5.08 (3.20–125.68) and 5.31 (3.93–125.68);(P = 0.490) in male participants, respectively. Results of crude and adjusted logistic regression analysis of the development of infertility by thyroid function and TPOAb, except for fT4 in male subjects, depicted no association between infertility and other variables in both crude and adjusted models. Conclusion Based on the result, thyroid autoimmunity was not associated with infertility in both females and males.

scholarly journals Knowledge and attitude of pregnant women towards preeclampsia and its associated factors in South Gondar Zone, Northwest Ethiopia: a multi‐center facility‐based cross‐sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maru Mekie ◽  
Dagne Addisu ◽  
Minale Bezie ◽  
Abenezer Melkie ◽  
Dejen Getaneh ◽  
...  
Keyword(s):  
Associated Factors ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
Knowledge And Attitude ◽  
Study Participants ◽  
South Gondar

Abstract Background Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide. It is one of the top five maternal mortality causes and responsible for 16 % of direct maternal death in Ethiopia. Little is known about the level of knowledge and attitude towards preeclampsia in Ethiopia. This study was designed to assess the knowledge and attitude towards preeclampsia and its associated factors in South Gondar, Northwest Ethiopia. Methods A multicenter facility-based cross-sectional study was implemented in four selected hospitals of South Gondar Zone among 423 pregnant women. Multistage random sampling and systematic random sampling techniques were used to select the study sites and the study participants respectively. Data were entered in EpiData version 3.1 while cleaned and analyzed by Statistical Package for Social Sciences (SPSS) version 23. Descriptive and inferential statistics were performed. Adjusted odds ratio with 95 % confidence interval were used to identify the significance of the association between the level of knowledge on preeclampsia and its predictors. Results In this study, 118 (28.8 %), 120 (29.3 %) of the study participants had good knowledge and a positive attitude towards preeclampsia respectively. The likelihood of having good knowledge on preeclampsia was found to be low among women with no education (AOR = 0.22, 95 % CI (0.06, 0.85)), one antenatal care visit (ANC) (AOR = 0.13, 95 % CI (0.03, 0.59)). Whereas, those who booked for ANC in the first trimester (AOR = 6.59, 95 % CI (1.43, 30.33)), gave the last birth at a health facility (AOR = 2.61, 955 CI (1.03, 6.61)), and experienced a complication during previous births (AOR = 3.67, 95 % CI (1.78, 7.57)) were more likely to be knowledgeable on preeclampsia. Conclusions No formal education and not attending four ANC visits were associated with poor knowledge of preeclampsia. While participants who visited health facilities during the first trimester, who gave birth at health facilities, and those who experienced a complication in previous births were more likely to be knowledgeable on preeclampsia. Improving the numbers of ANC visits and encouraging facility delivery are important measures to improve women’s knowledge on preeclampsia. Health education regarding preeclampsia risk factors, symptoms, and complications shall be emphasized.

scholarly journals Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi
Keyword(s):  
Sri Lanka ◽  
Data Collection ◽  
Pregnant Women ◽  
Associated Factors ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.

scholarly journals Tinnitus: The Sound of Stress?

2018 ◽  
Vol 14 (1) ◽  
pp. 264-269 ◽  
Author(s):  
Patricia Ciminelli ◽  
Sergio Machado ◽  
Manoela Palmeira ◽  
Mauro Giovanni Carta ◽  
Sarah Cristina Beirith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Progressive Increase ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Mean Values ◽  
Subjective Tinnitus ◽  
Stress Symptoms ◽  
The Impact

Background: Emotional stress is frequently associated with otologic symptoms as tinnitus and dizziness. Stress can contribute to the beginning or worsening of tinnitus. Objective: The objective of the study is to evaluate the presence of stress symptoms in patients with chronic, subjective tinnitus, and correlate its presence to annoyance associated with tinnitus. Methods: This is a cross-sectional study. One hundred and eighty patients with chronic, subjective tinnitus were included. Patients answered the Tinnitus Handicap Inventory (THI) to evaluate the impact of tinnitus in the quality of life and answered the Lipp's inventory symptoms of stress for adults (ISSL). The data obtained was organized using Excel® 2010, mean values, linear regression and p-value were calculated. Results: Of the 180 patients included in the study, 117 (65%) had stress symptoms, 52 of the 117 (44%) were in the resistance phase and 23 of the 117 (20%) in the exhaustion phase, the remaining was in the alert phase. There was a clear progressive increase in stress as THI raised, with more impact of tinnitus in quality of life. Conclusion: The presence of stress symptoms, measured by ISSL was observed in most of our patients with chronic subjective tinnitus, specially in the resistance and exhaustion phases and it is directly associated with tinnitus annoyance.

scholarly journals Fetal foot length for assessment of gestational age: a cross sectional study

2021 ◽  
Vol 10 (8) ◽  
pp. 3153
Author(s):  
Vaibhav Sharma ◽  
Ruchi Saxena ◽  
Priyanka Gaur
Keyword(s):  
Gestational Age ◽  
Abdominal Ultrasound ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Foot Length ◽  
Adverse Pregnancy ◽  
The Relationship ◽  
Singleton Pregnancies

Background: Fetal age actually begins at conception and an equivalent term is conceptional age. Uncertain gestational age (GA) has been associated with adverse pregnancy outcomes independent of maternal characteristics. The objective was to evaluate the accuracy of fetal foot length (FFL) in estimation of gestational age.Methods: It was a cross sectional study. Trans abdominal ultrasound on 150 pregnant women with normal singleton pregnancies between 16 to 40 weeks was done to measure FFL. The relationship between GA and FFL was analysed by simple linear regression.Results: A linear relationship was demonstrated between FFL and GA. (GA (in weeks)=7.490+0.393×FFL (in mm)) with significant correlation (r=0.985, p<0.001).Conclusions: Ultrasonographic measurement of FFL is a reliable indicator of gestational age and can be a useful alternative to estimate GA when other routine biometric parameters are not conclusive.

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