scholarly journals Comparison of uterine fibroids’ growth pattern during pregnancy according to fetal sex: an observational study

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Giovanni Delli Carpini ◽  
Valeria Verdecchia ◽  
Maria Papiccio ◽  
Camilla Grelloni ◽  
Andrea Ciavattini
Keyword(s):  
Observational Study ◽  
Uterine Fibroids ◽  
Serum Levels ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
Second Trimester ◽  
Third Trimester ◽  
Fetal Sex ◽  
Female Fetus ◽  
The Mean

Abstract Background To investigate the effect of fetal sex on fibroids’ growth during pregnancy according to the hCG serum levels Methods Observational study conducted from January 2007 to December 2016 on women with ultrasound identification of uterine fibroids who had a pregnancy within 1 year from diagnosis. The fibroids diameter was determined during the pre-pregnancy ultrasound, early first trimester (5–7 weeks), late first trimester (11–13 weeks), second trimester (19–21 weeks), and third trimester (31–33 weeks). The diameter growth was calculated in each interval between two ultrasounds. The hCG serum levels were determined both in early and late first trimester. The correlation between hCG levels and fibroid diameter was evaluated. Obstetric outcomes collected were gestational weeks at birth and the rate of cesarean section. Neonatal outcomes were birthweight and Apgar score at 1 min. Results Eighty-seven of the included women had a male fetus, and 70 had a female fetus. A progressive increase of fibroid diameter was observed from pre-pregnancy to second trimester for both fetal sexes. In third trimester, the mean ± SD fibroid diameter of female fetuses showed a slowdown, while the mean ± SD fibroid diameter of male fetuses continued to grow. Women carrying a female fetus presented a higher fibroid diameter in early first trimester (33.5 ± 13.3 mm vs 27.4 ± 11.0 mm, p < 0.01), late first trimester (40.2 ± 13.9 mm vs 34.6 ± 11.7 mm, p < 0.01), and second trimester (40.5 ± 14.9 mm vs 34.7 ± 10.3 mm, p < 0.01). The hCG serum levels resulted higher in women with a female fetus: 61406 (50554-71760) mU/ml vs 46016 (37160-56744) mU/ml (p < 0.01). A positive correlation between hCG levels and fibroid diameter was found both for male and female fetuses (male r = 0.77, 95% CI 0.71–0.82, p < 0.01 and female r = 0.82, 95% CI 0.76–0.86, p < 0.01). Conclusion Women with female fetus seem to have a higher growth of fibroids up to second trimester of pregnancy. This process may be mediated by the higher serum hCG levels found in women expecting a female fetus.

scholarly journals The Frequency of Vaginal Intercourse During Pregnancy: A Systematic and Meta-Analysis Stud

2018 ◽  
Vol 7 (1) ◽  
pp. 1-9
Author(s):  
Maryam Hasani ◽  
Afsaneh Keramat ◽  
Raziyeh Maasoumi ◽  
Maryam Farjamfar ◽  
Masud Yunesian ◽  
...  
Keyword(s):  
Meta Analysis ◽  
First Trimester ◽  
Sexual Life ◽  
Vaginal Intercourse ◽  
Second Trimester ◽  
Third Trimester ◽  
Mean Frequency ◽  
The Third ◽  
Reference Manager ◽  
The Mean

Objectives: Sexual life may change during pregnancy. Due to negative attitudes toward having sex, unpleasant feeling, and fear of several issues, women might avoid vaginal intercourse during pregnancy. Therefore, the present systematic review aimed to investigate the frequency of vaginal intercourse in pregnancy. Materials and Methods: Comprehensive literature review was conducted to find the relevant articles published (from December 1990 to April 2018) on the issue including observational studies (e.g., cross-sectional and cohort studies) that certainly determined the mean frequency of vaginal sex throughout pregnancy. In this regard, online international databases such as ISI, PubMed, Scopus, Cochrane, and Google Scholar were independently explored and checked by two authors. Duplicate articles were removed by the EndNote X7 Reference Manager. The results were analyzed using RevMan 5.3 software. The P < 0.05 was considered significant. Results: Totally, after excluding the duplicate and irrelevant articles based on having the mean frequency of vaginal intercourse during pregnancy, 13 articles were obtained. The range of vaginal intercourse frequency varied from 6.01 to 21 times every month pre-pregnancy, 3.67-9.87 times monthly in the first trimester, 2.78-7.21 times monthly in the second trimester, and 1.35-5.9 times monthly in the third trimester. Five out of the 13 selected articles reporting the mean and standard deviation were entered the current meta-analysis. The frequency of vaginal intercourse was obtained 7.75 (7.13-8.38) times monthly prior to pregnancy, 4.16 (3.86-4.46) times in the first trimester, 6.37 (5.60-7.14) times monthly in the second trimester, and 1.81 (1.49-2.13) times monthly in the third trimester. Conclusions: Generally, the frequency of vaginal intercourse decreased in the first trimester while increasing in the second trimester. However, a sharp decline was observed between the second and third trimesters of pregnancy.

scholarly journals Therapeutic levetiracetam monitoring during pregnancy: “mind the gap”

2019 ◽  
Vol 10 ◽  
pp. 204062231985165 ◽  
Author(s):  
Maya Berlin ◽  
Dana Barchel ◽  
Revital Gandelman-Marton ◽  
Nurit Brandriss ◽  
Ilan Blatt ◽  
...  
Keyword(s):  
Reference Range ◽  
Serum Levels ◽  
First Trimester ◽  
Second Trimester ◽  
Serum Concentrations ◽  
Third Trimester ◽  
The Third ◽  
Antiepileptic Medication ◽  
Apparent Clearance ◽  
Neurological Conditions

Background: Epilepsy is one of the most common chronic neurological conditions and its treatment during pregnancy is challenging. Levetiracetam (LEV) is an antiepileptic medication frequently used during pregnancy. Only a few small studies have been published on LEV monitoring during pregnancy, demonstrating decreased serum LEV levels during the first and second trimester; however, the most significant decrease was observed during the third trimester of pregnancy. In this study we aimed to evaluate LEV pharmacokinetics during different stages of pregnancy. Methods: We followed up and monitored serum levels of pregnant women treated with LEV for epilepsy. Results: Fifty-nine women with 66 pregnancies during the study period were included. The lowest raw LEV serum concentrations were observed during the first trimester. Compared with the pre-pregnancy period, raw serum concentration was lower by 5.76 mg/L [95% confidence interval (CI) (2.78, 8.75), p = 0.039] during the first trimester. Comparing the decrease in the first trimester with either the second or the third, no significant changes were observed ( p = 0.945, p = 0.866). Compared with pre-pregnancy measurements, apparent clearance was increased by 71.08 L/day [95%CI (16.34, 125.83), p = 0.011] during the first trimester. About 30% of LEV serum levels during pregnancy were below the laboratory quoted reference range. Conclusions: Raw LEV serum levels tend to decrease during pregnancy, mainly during the first trimester contrary to previous reports. Monitoring of LEV serum levels is essential upon planning pregnancy and thereafter if pre-pregnancy LEV levels are to be maintained. However, more studies are needed to assess the correlation with clinical outcome.

scholarly journals Study of Forced Expiratory Volume in First Second (FEV1) and Ratio of Forced Expiratory Volume in First Second and Forced Vital Capacity in Percentage (FEV1/FVC%) in Pregnant Women

2012 ◽  
Vol 2 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Dipok Kumar Sunyal ◽  
Md Ruhul Amin ◽  
Ayesha Yasmin ◽  
Golam Morshed Molla ◽  
Md Liakat Ali ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
First Trimester ◽  
Study Groups ◽  
Forced Expiratory Volume ◽  
P Value ◽  
Second Trimester ◽  
Third Trimester ◽  
The Mean

Background: A few data are available on the effects of pregnancy on pulmonary function in different countries. But no such established data are available in our country. So we designed this study in our population. Objectives: To observe the forced expiratory volume in first second (FEV1) and ratio of forced expiratory volume in first second and forced vital capacity (FEV1/FVC%) in different trimesters of normal pregnant women and to compare them with those of healthy non-pregnant women. Materials and Methods: This observational and analytical study was carried out in the department of Physiology, Dhaka Medical College during July 2004 to June 2005. Total 100 women aged from 25 to 35 years without any recent history of respiratory tract diseases were selected as study population. Among them, 75 normal pregnant women were taken as experimental and 25 healthy non-pregnant women were taken as control groups. The experimental group included 25 pregnant women in first trimester, 25 in second trimester and 25 in third trimester. Forced expiratory volume in first second (FEV1), ratio of percentage of forced expiratory volume in first second and forced vital capacity (FEV1/FVC%) were measured in pregnant and non-pregnant control women. The FEV1 and FEV1/FVC% were measured by using an ‘automatic spirometer’. Statistical analyses were done by unpaired Student’s ‘t’ test between the study groups and p value <0.05 was taken as significant.Results: The mean ± SD of measured values of FEV1 were 2.41 ± 0.87, 2.28 ± 0.59, 2.15 ± 0.74 and 1.89 ± 0.76 liters in non-pregnant women and in pregnant women during first trimester, second trimester and third trimester. The mean ± SD of measured values of FEV1/FVC% were 75.22 ± 16.77, 74.86 ± 11.06, 74.42 ± 17.43 and 71.81 ± 15.87% in nonpregnant women and in pregnant women during first trimester, second trimester and third trimester. Conclusion: The FEV1 and FEV1/FVC% were significantly lower in third trimester pregnant women than that of non-pregnant and first trimester of pregnant women and FEV1/FVC% gradually decreased from first to third trimester of pregnant women. DOI: http://dx.doi.org/10.3329/jemc.v2i1.11926 J Enam Med Col 2012; 2(1): 29-32

scholarly journals Central Corneal Thickness (CCT) Measurement in Each Trimester of Pregnancy: A Screening Parameter for a Healthy Eye During Pregnancy : A Prospective Study!

2015 ◽  
Vol 01 (01) ◽  
pp. 019-025
Author(s):  
Sruthi G. ◽  
Lalith Sundaram ◽  
Ranjakumar TC ◽  
Rahana Ashraf ◽  
Nimesha Alex
Keyword(s):  
Pregnant Women ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Corneal Edema ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Screening Parameter ◽  
The Mean

AIM: - To detect central corneal thickness (CCT) in each trimester of pregnancy. Purpose: To evaluate difference in measurement of central corneal thickness due to corneal changes in each trimester of pregnancy. METHOD: - 100 healthy pregnant women within age group ranging from 21 to 35 years were included in the study. Central corneal thickness (Ultrasound Pachymetry), Intra ocular pressure (Goldmann-Applanation Tonometer) was done. Changes in central corneal thickness (CCT) were calculated at 3 time periods: First trimester, Second trimester, Third trimester. Informed consent was taken from all patients. Patients had no systemic or ocular co-morbidities.All of the patients underwent comprehensive ophthalmologic examinations, including Refraction, Intraocular pressure (IOP), Anterior segment and Fundus examination. RESULTS: - The mean age was 25 years in the study group. The mean CCT in the second trimester of pregnancy was measured to be higher than first trimester by 1.67% &3.13% by third trimester in right eye & increase of 1.91% in second trimester & 3.03% in third trimester left eye.The results are statistically significant confirmed by ANOVA. CONCLUSION: - Changes during pregnancy causes corneal edema, which is observed in pregnant women resulting from increased water retention during pregnancy. Changes in corneal curvature, central, corneal thickness and steeping may also occur during pregnancy particularly during the second and third trimester. Most of the changes are reversible and resolved in the postpartum period or after cessation of breastfeeding. Awareness of the changes during pregnancy and routine screening during antenatal period should be improvised.

scholarly journals FETAL HEAD ANTHROPOMETRY: A CROSSSECTIONAL STUDY FROM KUMAUN REGION

2019 ◽  
Vol 27 (2) ◽  
Author(s):  
Anamika Jaiswal ◽  
Ankit Kaushik ◽  
AK Singh
Keyword(s):  
Gestational Age ◽  
First Trimester ◽  
P Value ◽  
Strong Positive Correlation ◽  
Second Trimester ◽  
Third Trimester ◽  
Fetal Head ◽  
Increase With Increase ◽  
Local Reference ◽  
The Mean

Introduction: Biparietal diameter (BPD) and head circumference (HC) are important for estimating gestational age (GA), monitoring fetal growth and to rule out congenital abnormalities. Western references using HC and BPD can lead to erroneous GA estimation, therefore regional reference is required. Aim: To measure HC and BPD in fetus at different GA, their relationship with GA and comparison of HC and BPD with expected HC and BPD by “Hadlock’s formula”. Material & Methods: CRL, HC and BPD were measured in 72 fetuses. Mean and standard deviation of HC and BPD were calculated for all fetuses and across three trimesters. The correlation of HC and BPD with GA was calculated and p value was derived. Hadlock’s HC and BPD were calculated for the gestational age. The observed HC and BPD in the study were compared with the Hadlock’s value to find out any difference between them Results: The mean HC of fetuses was 23.7 ± 8.58 cm. The mean HC in first trimester was 6.3 cm, 15.13 cm in second trimester and 30.8 cm in third trimester. The mean HC of fetuses according to Hadlock’s formula was 23.72 ± 8.80 cm. The mean Hadlock’s HC in first trimester was 5.6 cm, 14.92 cm in second trimester and 31.12 cm in third trimester. The mean BPD in the studied fetuses was 5.92 ± 2.24 cm. The mean BPD in first trimester was 1.7 cm, 4.8 cm in second trimester and 7.8 cm in third trimester. The mean Hadlock’s BPD was 6.33 ± 2.41 cm. The mean Hadlock’s BPD in first trimester was 1.6 cm, 4.4 cm in second trimester and 8.3 cm in third trimester. The mean HC of fetuses were nearly equal to mean Hadlock’s formula, while BPD of the study fetuses was less than mean Hadlock’s BPD. Both HC and BPD measured at different GA showed increase, with increase in GA and strong positive correlation and statistically significant association. Conclusion: This study had shown that while HC is nearly equal to Hadlock’s reference, BPD was less than Hadlock’s for GA, reflecting need of local reference data for accurate fetal age estimation.

scholarly journals Effect of Fetal Sex on Total Levels of Maternal Serum Testosterone

2014 ◽  
Vol 5 (2) ◽  
pp. 58 ◽  
Author(s):  
Ghulam Nabi ◽  
Tariq Aziz ◽  
Muhammad Amin ◽  
Ayaz Ali Khan
Keyword(s):  
Rural Areas ◽  
Serum Testosterone ◽  
Maternal Serum ◽  
Total Testosterone ◽  
Second Trimester ◽  
Single Male ◽  
Fetal Sex ◽  
Female Fetus ◽  
Fetal Effect ◽  
The Mean

The aim of this study was to find out the effect of fetal sex on maternal serum total testosterone level and its application for fetal sex determination.Forty healthy pregnant (second trimester) females were recruited in the study from rural areas of district Dir lower, Khyber Pakhtunkhwa, Pakistan, having complete antenatal record. Twenty of them were carrying single male fetuses and twenty female fetuses. The inclusions criteria were age (25 to 30), second trimester, absence of serious diseases, availability of antenatal record, no drug addiction and no exposure to pesticides.  Blood samples at 5 ml size were collected from each woman, serum was obtained and was assayed by Bio-check (USA) kit according to the manufacturer protocol.In male fetus group the mean and SD was 169±27.18 ng/dl and in female fetus group the Mean± SD was 166.6±30.47 ng/dl. There was nosignificant difference (P 0.1062) between the two groups at 95% confidence level.The results suggest that sex of the fetus has no association with maternal serum total testosterone among the study population-and should not be analyzed for sex determination. Further study with bigger sample size of different population groups in different gestational stages is needed to find the fetal effect on maternal serum testosterone because, increased level of testosterone in females can cause aggression, other behavioral changes, acnes and abrupt growth of pubic and axillary hairs.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Murat Akbas ◽  
Faik Mumtaz Koyuncu ◽  
Burcu Artunç-Ülkümen ◽  
Gökce Akbas
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Value Added ◽  
Shear Wave Elastography ◽  
Multiple Regression Model ◽  
Low Risk ◽  
Obstetric Outcomes ◽  
Second Trimester ◽  
The Mean ◽  
Random Measurements

AbstractObjectivesIncreased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes.MethodsA total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes.ResultsSecond-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043).ConclusionsOur results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight.

scholarly journals Serum cystatin is not a marker of glomerular filtration rate in pregnancy

2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata
Keyword(s):  
Glomerular Filtration Rate ◽  
Observational Study ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Prospective Observational Study ◽  
Second Trimester ◽  
Third Trimester ◽  
Serum Cystatin ◽  
In Pregnancy

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.

scholarly journals Infliximab clearance decreases in the second and third trimesters of pregnancy in inflammatory bowel disease

2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Interquartile Range ◽  
Therapeutic Drug ◽  
Population Pharmacokinetic ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Inflammatory Bowel

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.

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