scholarly journals Risk assessment of preterm birth through identification and stratification of pregnancies using a real-time scoring algorithm

2021 ◽  
Vol 9 ◽  
pp. 205031212098672
Author(s):  
Lisa BE Shields ◽  
Clayton Weymouth ◽  
Kevin L Bramer ◽  
Scott Robinson ◽  
Donna McGee ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Real Time ◽  
First Trimester ◽  
Operating Characteristics ◽  
Early Care ◽  
Likelihood Ratios ◽  
Third Trimester ◽  
Predictive Values ◽  
Scoring Algorithm

Introduction: Preterm birth poses a significant challenge. This study evaluated a real-time scoring algorithm to identify and stratify pregnancies to indicate preterm birth. Methods: All claims data of pregnant women were reviewed between 1 January 2014 and 31 October 2018 in Kentucky. Results: A total of 29,166 unique women who were matched to a live newborn were documented, with the pregnancy identified during the first trimester in 54.1% of women. Negative predictive values, sensitivity, and positive likelihood ratios increased from the first to third trimesters as pregnant women who were matched to a live newborn had more visits with their physicians. The area under the receiving-operating characteristics curve on test data classifying preterm birth was 0.59 for pregnancies identified during the first trimester, 0.62 for pregnancies identified in the second trimester, and 0.73 for pregnancies identified in the third trimester. Conclusions: This study presents a real-time scoring algorithm of indicating preterm birth in the first trimester of gestation which permits stratification of pregnancies to provide more efficient early care management.

scholarly journals Radioimmunoassay of plasma ouabain in healthy and pregnant individuals

2000 ◽  
Vol 165 (3) ◽  
pp. 669-677 ◽  
Author(s):  
O Vakkuri ◽  
SS Arnason ◽  
A Pouta ◽  
O Vuolteenaho ◽  
J Leppaluoto
Keyword(s):  
Pregnant Women ◽  
Human Plasma ◽  
High Performance ◽  
Chemical Nature ◽  
Solid Phase ◽  
Plasma Concentrations ◽  
First Trimester ◽  
Plasma Samples ◽  
Third Trimester ◽  
Endogenous Substances

Ouabain was recently isolated from human plasma, bovine hypothalamus and bovine adrenal in attempts to identify endogenous substances inhibiting the cell membrane sodium pump. A number of radioimmunoassays have been developed in order to study the clinical significance of ouabain. The results have been controversial with regard to the presence and chemical nature of plasma ouabain-like immunoreactivity. We have now measured ouabain in healthy and pregnant individuals using solid-phase extraction of plasma samples followed by a new radioimmunoassay with the extraordinary sensitivity of at least 2 fmol/tube (5 pmol/l). Plasma extracts, a previously isolated human plasma ouabain-like compound and bovine hypothalamic inhibitory factor displaced the tracer in parallel and eluted identically with ouabain in high-performance liquid chromatography. Plasma ouabain immunoreactivity was found to be much lower than reported previously: 12.6+/-1.3 pmol/l in healthy men (mean+/-s.e., n=20) and 9.4+/-0.7 pmol/l in women (n=14). In pregnant women (n=28) plasma ouabain concentration was 16.3+/-4.0 pmol/l during the first trimester, 18.8+/-4.3 pmol/l during the second trimester and 24.3+/-4.0 pmol/l during the third trimester (all P<0.01 compared with non-pregnant women). Plasma ouabain 3-5 days after the delivery was 13.6+/-1.1 pmol/l (n=10, P<0.05-0.01 compared with second and third trimesters). The pregnancy-related changes in the plasma concentrations of ouabain resembled those of cortisol. Therefore cortisol was measured from the same plasma samples and a significant positive correlation was found (r=0.512, P=0.006). The similar profiles of plasma ouabain and cortisol during pregnancy and their rapid decreases postpartum are consistent with the adrenal cortical origin of ouabain and also show that the secretions of these hormones are possibly under the control of same factors.

scholarly journals Sonographic Assessment of Complex Ultrasound Morphology in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 414
Author(s):  
Artur Czekierdowski ◽  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Tomasz Kluz ◽  
Tomasz Łoziński ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Risk Model ◽  
Malignant Tumors ◽  
Scoring Systems ◽  
Subjective Assessment ◽  
Risk Level ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Simple Rules

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate.

scholarly journals Changes in fatty acid levels (saturated, monounsaturated and polyunsaturated) during pregnancy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Estefania Aparicio ◽  
Carla Martín-Grau ◽  
Carmen Hernández-Martinez ◽  
Nuria Voltas ◽  
Josefa Canals ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Arachidonic Acid ◽  
Fatty Acid ◽  
Docosahexaenoic Acid ◽  
Serum Concentration ◽  
Eicosapentaenoic Acid ◽  
Pregnant Women ◽  
First Trimester ◽  
Third Trimester ◽  
Total N

Abstract Background During pregnancy a high amount of fatty acids (FA) is necessary to meet foetus demands, which vary during gestation. The present study describes the changes in maternal fatty acid concentrations during pregnancy in a sample of pregnant women. Methods This is a longitudinal study of 479 pregnant women who were monitored from the first trimester to third trimester of pregnancy. Data on maternal characteristics were recorded and a serum sample was collected in each trimester. The fatty acid profile (saturated (SFA: total, lauric acid, myristic acid, palmitic acid, stearic acid), monounsaturated (MUFA: total, palmitoleic acid, oleic acid) and polyunsaturated fatty acids (PUFA: total omega-6 (n-6), linoleic acid, dihomo-γ-linolenic acid, arachidonic acid (AA), total omega-3 (n-3), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)) was analysed with a gas chromatography-mass spectrometry combination. Results From the first trimester to third trimester of pregnancy, a significant increase in total SFA, total MUFA and total n-6 PUFA was found. (p < 0.001). Nevertheless, the serum concentration of arachidonic acid (AA), eicosapentaenoic acid (EPA) and total n-3 PUFA decreased during gestation (p < 0.001). A statistically non-significant result was observed for the docosahexaenoic acid (DHA) serum concentration between the first and third trimesters of pregnancy. Significant correlations were observed between each total fatty acid concentrations of the first and third trimesters. Conclusion The circulating serum concentration of SFA, MUFA and n-6 PUFA increases during pregnancy, whereas essential fatty acids such as AA and EPA decrease, and DHA remains unchanged. Further research is necessary to understand the role played by FA throughout gestation.

The effect of placental elasticity on intraoperative bleeding in pregnant women with previous cesarean section

2020 ◽  
Vol 48 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Harun Egemen Tolunay ◽  
Hasan Eroğlu ◽  
Onur Kaya ◽  
Dilek Şahin ◽  
Aykan Yücel
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Real Time ◽  
Strain Ratio ◽  
Tissue Elasticity ◽  
Previous Cesarean Section ◽  
Third Trimester ◽  
Intraoperative Bleeding ◽  
Tissue Elastography ◽  
Previous Cesarean

AbstractBackgroundWe aimed to evaluate the efficiency of placental elasticity in predicting the amount of intraoperative bleeding via real-time tissue elastography technique.MethodsPregnant women in the third trimester of pregnancy who had planned delivery via cesarean section due to the recurrent cesareans were enrolled in the research (n = 78). Elastographic measurements of placental tissues of all cases were carried out by real-time elastographic ultrasonography. It is a tissue elastography software (Esaote MyLabSeven) that uses a 8-1-MHz multifrequency AC2541 Probe.ResultsA significant relationship was found between placental elasticity and intraoperative bleeding. There was a significant correlation between alterations in the preoperative and postoperative hemoglobin (Hb) and hematocrit (Hct) levels and placental strain ratio (SR) (P < 0.001, r: 0.831; P < 0.001, r: 0.733, respectively).ConclusionThese findings may reflect an alteration at the tissue elasticity level. We hope that the use of real-time elastographic ultrasonography technique may give an idea about the amount of bleeding during the cesarean section.

scholarly journals Thrombin Generation in Chinese Pregnant Women and the Effect of Insulin Use on Thrombin Generation in Patients with GDM

2019 ◽  
Vol 25 ◽  
pp. 107602961986349
Author(s):  
Feng Dong ◽  
Longhao Wang ◽  
Chengbin Wang
Keyword(s):  
Blood Glucose ◽  
Pregnant Women ◽  
Thrombin Generation ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
Control Blood Glucose ◽  
Normal Ranges ◽  
Increased Risk ◽  
Significant Difference

Pregnancy is a hypercoagulable state associated with an increased risk of venous thrombosis. Calibrated automated thrombogram (CAT) is a test to monitor the thrombin generation (TG), a laboratory marker of thrombosis risk, and increases during normal pregnancy, but it is still unclear whether TG is related to the use of insulin in pregnant women with gestational diabetes mellitus (GDM). We performed thrombin generation by CAT on 135 normal pregnant women, including 43 in first trimester, 32 in second trimester, 60 in third trimester, respectively; 68 pregnant women with GDM were also enrolled, 19 patients with GDM using insulin to control blood glucose and 49 patients control their blood glucose through diet and exercise with noninsulin treatment. The overall CAT parameters were calculated using descriptive statistics method with mean ± standard deviation. Mean endogenous thrombin potential, peak thrombin generation, and StartTail time increased significantly with the pregnancy. There was no significant difference in TG test parameters except StartTail time( P = .003) in insulin-treated GDM group when compared to those without insulin in the GDM group. The normal ranges for CAT parameters in pregnant women were determined. Thrombin generation increased significantly in first trimester and remains stable in second and third trimester. The use of insulin in patient with GDM did not affect thrombin generation test. Our study helps to establish the reference range of thrombin generation in Chinese normal pregnant population and provide more basis to predict the risk of thrombus complicating during pregnancy.

scholarly journals P21 PBPK modeling in pregnancy: achievements, shortcomings and future perspectives

2019 ◽  
Vol 104 (6) ◽  
pp. e25.2-e25
Author(s):  
A Dallmann ◽  
P Mian ◽  
P Annaert ◽  
M Pfister ◽  
K Allegaert ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pbpk Model ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Model Verification ◽  
Pbpk Modeling ◽  
Third Trimester ◽  
The Past ◽  
Pbpk Models

BackgroundPhysiologically-based pharmacokinetic (PBPK) models are considered a promising approach to better characterize and anticipate the effect of physiological changes on pharmacokinetics in pregnant women. Consequently, multiple pregnancy PBPK models have been developed and verified over the past years. Using acetaminophen (paracetamol) as example, PBPK modeling can provide specific insights into the expected pharmacokinetic changes throughout pregnancy.MethodsTo obtain an overview of pregnancy PBPK models, the scientific literature was systematically screened for publications with a focus on pharmaceutical applications using relevant keywords. Additionally, a pregnancy PBPK model for acetaminophen was developed with the Open Systems Pharmacology software suite (www.open-systems-pharmacology.org) following an established workflow. After model verification around gestational week 30, the model was scaled to earlier stages of pregnancy and molar dose fractions converted to acetaminophen metabolites were estimated for each trimester.ResultsOver the past years, more than 60 different pregnancy PBPK models for more than have 40 drugs been published. More than 70% of these models were developed for the third trimester, while few models have been applied to the first trimester. The developed PBPK model for acetaminophen indicated that the median dose fraction of acetaminophen converted to the reactive metabolite N-acetyl-p-benzoquinonimine (NAPQI) was 11%, 9.0% and 8.2% in the first, second and third trimester, respectively, while for non-pregnant women a value of 7.7% was simulated.ConclusionWhile the overall availability and quality of pregnancy PBPK models is varying considerably, the efforts to establish such models are promising in that they reflect an increased awareness of the necessity to better characterize pharmacokinetics during pregnancy. This is illustrated by the developed PBPK model for acetaminophen where information on NAPQI-formation in vivo is hitherto lacking. Although PBPK models are not a substitute for clinical trials, they constitute an important tool for clinicians in case of missing or incomplete information.Disclosure(s)Nothing to disclose

Gestation specific reference intervals for thyroid function tests in pregnancy

2016 ◽  
Vol 54 (8) ◽  
Author(s):  
Süleyman Akarsu ◽  
Filiz Akbiyik ◽  
Eda Karaismailoglu ◽  
Zeliha Gunnur Dikmen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
First Trimester ◽  
Reference Intervals ◽  
Specific Reference ◽  
Thyroid Function Tests ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Function Tests

AbstractThyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.

The results of the examination of cervical-vaginal microbiota in pregnant women with threatened preterm birth using a real-time polymerase chain reaction

2018 ◽  
Vol 11_2018 ◽  
pp. 50-59 ◽  
Author(s):  
Dobrokhotova Yu.E. Dobrokhotova ◽  
Bondarenko K.R. Bondarenko ◽  
Gushchin A.E. Gushchin ◽  
Rumyantseva T.A. Rumyantseva ◽  
Dolgova T.V. Dolgova ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Real Time ◽  
Vaginal Microbiota ◽  
Chain Reaction ◽  
Polymerase Chain

scholarly journals Indeks DMF-T dan OHIS pada Ibu Hamil

2019 ◽  
Vol 1 (1) ◽  
pp. 12-22
Author(s):  
Applonia Leo Obi
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Sampling Technique ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
High Prevalence ◽  
Second Trimester Pregnancy ◽  
And Behavior ◽  
Descriptive Method

Abstract: DMF-T and OHIS index for pregnant women. Pregnancy is a physiological process that causes changes in a woman's body both physically and psychologically. During pregnancy physiological changes occur which are often accompanied by changes in attitude and behavior. The health behavior of pregnant women also has a very big influence on herself and the fetus. This research is a descriptive method. This study aims to determine the rates of DMF-T and OHIS in pregnant women at Oesapa Health Center, Kupang City. Sampling by accidental sampling technique, amounting to 97 pregnant women who visited the MCH polyclinic at the Kupang Oesapa Health Center. The results based on DMF-T figures show that the high prevalence of dental caries in the second-trimester pregnant women group (36.0%) than in the third trimester of pregnancy (28.8%) while OHIS most respondents in the second-trimester pregnancy (36, 1%) had an OHI-S index in the medium category with a ratio of trimester 3 there were 23 people (23.7%) and first trimester around 19 people (19.6%). It was concluded that the DMF-T index of pregnant women in the working area of ​​the Kupang City Oesapa health center was mostly carious and most of the pregnant women examined had caries of more than 4 teeth per person and all pregnant women who were examined for dental and oral hygiene levels showed moderate criteria. Abstrak: Indeks DMF-T dan OHIS pada Ibu Hamil. Kehamilan merupakan suatu proses fisiologis yang menimbulkan perubahan pada tubuh wanita baik fisik maupun psikis. Pada masa kehamilan terjadi perubahan fisiologis yang sering disertai dengan perubahan sikap dan perilaku. perilaku  kesehatan  ibu  hamil  juga  memiliki  pengaruh yang  sangat  besar  bagi  dirinya  sendiri  dan  janin. Penelitian ini adalah metode deskriptif. Penelitian ini bertujuan untuk mengetahui  angka DMF-T dan OHIS pada ibu hamil di Puskesmas Oesapa Kota Kupang. Pengambilan sampel dengan teknik accidental sampling, berjumlah 97 ibu hamil yang berkunjung ke poli KIA di Puskesmas Oesapa Kota Kupang. Hasil penelitian berdasarkan Angka DMF-T menunjukkan bahwa tingginya prevalensi karies gigi pada kelompok ibu hamil  trimester kehamilan kedua (36,0%) dari pada trimester kehamilan ke tiga (28,8%) sedangkan OHIS sebagian besar responden pada kehamilan trimester 2 (36,1%) memiliki indek OHI-S pada kategori sedang dengan perbandingan trimester 3 ada 23 orang (23,7%) dan trimester I sekitar 19 orang (19,6%). Disimpulkan bahwa indeks DMF-T ibu hamil diwilayah kerja puskesmas Oesapa Kota Kupang sebagian besar berkaries dan sebagian besar ibu hamil yang diperiksa mempunyai karies lebih dari 4 gigi per orang dan semua ibu hamil yang diperiksa tingkat kebersihan gigi dan mulutnya menunjukkan kriteria sedang.

Sign in / Sign up

Export Citation Format

Share Document