scholarly journals Follow-up and management of recurrent pregnancy losses due to massive perivillous fibrinoid deposition

2017 ◽  
Vol 11 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Mai He ◽  
Alison Migliori ◽  
Nisreen S Maari ◽  
Niharika D Mehta
Keyword(s):  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Retrospective Chart Review ◽  
Subsequent Pregnancy ◽  
Case Review ◽  
Placental Pathology ◽  
Recurrent Pregnancy Losses ◽  
Consecutive Pregnancy ◽  
Adverse Pregnancy

Massive perivillous fibrinoid deposition is a rare placental pathology associated with significant adverse pregnancy outcome and can recur. We provide a detailed case review of a woman through 10 of her pregnancies, including 8 consecutive pregnancy losses and 2 live births. We also conducted a retrospective chart review of all massive perivillous fibrinoid deposition placenta specimens at our institution over an eight-year period. A total of 42 cases of massive perivillous fibrinoid deposition were identified from 2007 to 2015, yielding an incidence of 0.16%. Recurrence was seen in subsequent pregnancy in eight out of nine (88.9%) cases with more than one specimen. The clinical characteristics, perinatal outcomes and α-feto protein level of the 42 cases are presented. Also, presented is a review of the literature discussing placental pathology, pathogenetic mechanisms and management of this condition.

scholarly journals Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia, Gujarat

2017 ◽  
Vol 6 (8) ◽  
pp. 3418
Author(s):  
Rohit Jain ◽  
Chintan Upadhyay ◽  
Latika Mehta ◽  
Bipin Nayak ◽  
Gaurav Desai
Keyword(s):  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Lactic Dehydrogenase ◽  
Fetal Outcome ◽  
Third Trimester ◽  
Medical College ◽  
Severity Of Disease ◽  
Still Births ◽  
Adverse Pregnancy ◽  
A Prospective Study

Background: Serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. This will help in making decision, about the management guidelines to the better the maternal and fetal outcome. Objective of present study was compare serum LDH levels in the normal pregnant women and in women with preeclampsia and eclampsia in ante-partum period and to study the association of maternal and perinatal outcomes with serum LDH levels.Methods: It is a prospective study done at Obstetrics and Gynecology department, GMERS medical college and civil hospital, Gandhinagar during August-September 2016. Participants were divided into four groups according to severity of disease and into three groups according to serum LDH level.Results: Mean level of LDH (IU/l) in Control, Mild pre-eclampsia, Severe pre-eclampsia & Eclampsia was 302.33, 398.56, 675.26 & 1589.85 respectively. Out of total 34 cases with LDH level >800 IU/L, 47.1% cases had ≥160 mm hg SBP & 52.9% had ≥110 mm hg DBP, mean gestational age and mean baby weight was 36.88 week and 1950 gm, mean apgar score at 10 min was 6.96, 47.1% had uneventful outcome, whereas 58.8% had neonatal complications and 5.9% had neonatal death. Almost 26.5% still births, 47.1% perinatal deaths.Conclusions: Higher serum LDH levels during pregnancy have significant association with severity of disease and maternal and fetal outcomes in patients of preeclampsia and eclampsia and can be considered as a supportive prognostic tool from early third trimester.

Vaginal delivery after laparotomic myomectomy during pregnancy

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Anna Garofalo ◽  
Paolo Petruzzelli ◽  
Michela Chiadò Fiorio Tin ◽  
Silvia Parisi ◽  
Giulia Garofalo ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Best Practice ◽  
Adverse Pregnancy Outcome ◽  
Case Reports ◽  
Rare Condition ◽  
Case Presentation ◽  
Feasible Option ◽  
Adverse Pregnancy

Abstract Background Symptomatic myomas during pregnancy are a rare condition that could however turn into an emergency because of torsion, necrosis, growth and compression leading to acute abdomen, potentially threating for pregnancy. Surgeons are usually reluctant to perform myomectomy during pregnancy because of an increased uterine blood flow and volume can give rise to a potential risk for haemorrhagic complications, while uterine manipulation can determine adverse pregnancy outcome. However, in some rare cases surgery is compulsory. Case presentation Here, we described a case of a successful laparotomic myomectomy performed during pregnancy at 11 weeks of gestation when an acute abdomen occurred. Surgery was followed by regular obstetrics follow-up ended with a spontaneous vaginal delivery with no pregnancy complications. Conclusion Although few case reports are described in literature, other authors have performed a myomectomy during pregnancy, and fewer cases have had a subsequent vaginal delivery, so that nowadays there is no clinical evidence on which to base best practice. This case shows that vaginal delivery after a laparotomic myomectomy performed during pregnancy, in selected cases, can be considered as a feasible option.

scholarly journals Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism

Diabetes Care ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. 381-392 ◽  
Author(s):  
Denise M. Scholtens ◽  
Alan Kuang ◽  
Lynn P. Lowe ◽  
Jill Hamilton ◽  
Jean M. Lawrence ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Follow Up Study ◽  
Adverse Pregnancy

Childbearing after age 35: its effect on early perinatal outcomes

1982 ◽  
Vol 14 (1) ◽  
pp. 69-80 ◽  
Author(s):  
Judith A. Fortney ◽  
J. E. Higgins ◽  
A. Diaz-Infante ◽  
F. Hefnawi ◽  
L. G. Lampe ◽  
...  
Keyword(s):  
Older Women ◽  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Good Health ◽  
Social Risk ◽  
Social Risk Factors ◽  
Developed Country ◽  
Age Related ◽  
Adverse Pregnancy

SummaryBirths to women aged 35 years and older are compared with births to women aged 20–34 in three hospitals, one each in Mexico, Egypt and Hungary. In the two developing countries, babies born to the older women had lower rates of survival until hospital discharge, and were more likely to have depressed 5-minute Apgar scores. They were not, however, more likely to be of low birth weight. The differences were statistically significant, and remained when several other variables were controlled. The variables controlled were known to be age-related and to influence pregnancy outcome.Hungary, the only developed country in the analysis, was quite different. Age had a significant influence on the weight of the infant, but not on survival or Apgar score. It seems therefore that when older women are in general good health and there are no concurrent social risk factors, advanced maternal age does not necessarily increase the risk of an adverse pregnancy outcome.

Mobile phone application use in pregnant women: does it make a difference? Usage and perinatal outcomes in China (Preprint)

2021 ◽  
Author(s):  
Puhong Zhang ◽  
Huan Chen ◽  
Jie Shang ◽  
Jun Ge ◽  
Huichen Zhang ◽  
...  
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Northern China ◽  
Mobile Phone Application ◽  
Adverse Pregnancy ◽  
And Child Health

BACKGROUND Maternal and child health (MCH) related mobile applications (apps) are becoming increasingly popular amongst pregnant women, however, few have demonstrated they lead to improvements in pregnancy outcomes. OBJECTIVE This study aimed to investigate the use of MCH apps amongst pregnant women and explore associations with pregnancy outcomes in China. METHODS A retrospective study was conducted in six maternal and child health hospitals in Northern China. Women who delivered a singleton baby greater than 28 weeks gestation in the study hospitals were sequentially recruited from postnatal wards during October 2017 to January 2018. Information was collected on self-reported MCH app use during their pregnancy, with clinical outcomes. Women were categorized as non-users of MCH apps, and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight <2500 grams, birth defects, stillbirth and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. RESULTS The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 457 (24.7%); intermittent 876 (47.4%); and continuous 517 (27.9%). Amongst app users, the most common reasons for app use were for health education (100.0%), self-monitoring (54.2%) and antenatal appointment reminders (43.2%). Non-users were older, with fewer years of education, lower incomes, and higher parity (P<0.01). No association was found between “any app” use and the CAPO (6.8% in non-users compared to 6.3% in any users, OR 0.77, 95% CI: 0.48-1.25). CONCLUSIONS Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. “Any app” use was not found associated with improved pregnancy outcomes, highlighting the needs for rigorous development and testing of apps before recommendation for use in clinical settings.

Small artery function 2 years postpartum in women with altered glycaemic distributions in their preceding pregnancy

2011 ◽  
Vol 122 (2) ◽  
pp. 53-61 ◽  
Author(s):  
Moulinath Banerjee ◽  
Simon G. Anderson ◽  
Rayaz A. Malik ◽  
Clare E. Austin ◽  
J. Kennedy Cruickshank
Keyword(s):  
Diabetes Mellitus ◽  
Adverse Pregnancy Outcome ◽  
Vascular Pathology ◽  
Control Group ◽  
Small Artery ◽  
Overweight Women ◽  
Adverse Pregnancy ◽  
Oxide Synthase

GDM (gestational diabetes mellitus) is associated with later adverse cardiovascular risk. The present study examined the relationship between glycaemia during pregnancy and small artery function and structures approx. 2 years postpartum. Women were originally enrolled in the HAPO (Hyperglycaemia and Adverse Pregnancy Outcome) study from which they were classified by their glycaemic distribution during pregnancy as controls (in the lower half of the distribution), UQ (upper quartile; in the UQ of the glycaemic distribution) or having had overt GDM. Subcutaneous arteries from a gluteal fat biopsy taken at follow-up 2 years later were examined using wire myography. Small artery structure, stiffness and vasoconstrictor responses were similar across groups. Maximal endothelium-dependent dilation in response to carbachol was impaired in arteries from both GDM (43.3%, n=8 and P=0.01) and UQ (51.7%, n=13 and P=0.04) women despite generally ‘normal’ current glycaemia (controls, 72.7% and n=8). Inhibition of NOS (nitric oxide synthase) significantly reduced maximum endothelium-dependent dilation in controls but had no effect on arteries from UQ and GDM women, suggesting impaired NOS activity in these groups. Endothelium-independent dilation was unaffected in arteries from previous GDM and UQ women when compared with the control group. Multiple regression analysis suggested that BMI (body mass index) at biopsy was the most potent factor independently associated with small artery function, with no effect of current glycaemia. Overweight women with either GDM or marginally raised glycaemia during pregnancy (our UQ group) had normal vascular structure and stiffness, but clearly detectable progressively impaired endothelium-dependent function at 2 years follow-up. These results suggest that vascular pathology, which may still be reversible, is detectable very early in women at risk of decline into Type 2 diabetes mellitus.

scholarly journals Cerebro-placental ratio as a prognostic factor of fetal outcome in women with hypertensive disorders complicating pregnancy during third trimester

2020 ◽  
Vol 9 (10) ◽  
pp. 4109
Author(s):  
Sahana K. ◽  
Suma K. B. ◽  
Nischay R.
Keyword(s):  
Perinatal Outcome ◽  
Adverse Pregnancy Outcome ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Adverse Outcomes ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders ◽  
Risk Pregnancy ◽  
Doppler Study ◽  
Adverse Pregnancy

Background: CPR is emerging as an important predictor of adverse pregnancy outcome and helps in management of high risk pregnancy. Therefore we undertook the study to find the correlation of CPR with perinatal outcomes in women with hypertensive disorder complicating during third trimester.Methods: 128 patients with hypertensive disorder of pregnancy, ≥32 weeks of singleton gestation, were randomly selected during their hospital visit. They were subjected to USG Doppler study to calculate MCA/UA pulsatility index-CPR. The CPR<1 was considered abnormal and >1 as normal. These results were compared with the perinatal outcome and adverse fetal outcome.Results: The present study revealed that the incidence of adverse outcomes like Apgar score <7 (36.5%), still birth (15.9%), NICU admission (69.8%) and LBW i.e. <2500 gm (68.3%) were significantly higher in abnormal CPR than normal CPR.Conclusions: Abnormal CPR is valuable in predicting the outcome of hypertensive disorders in pregnancy. CPR is an easy procedure which can be included in the routine antenatal sonographic evaluation to predict poor perinatal outcome and to detect or recognize those fetuses at risk.

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