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

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.

2021 ◽  
Vol 10 (19) ◽  
pp. 4495
Author(s):  
Panwad Harn-a-morn ◽  
Prapai Dejkhamron ◽  
Theera Tongsong ◽  
Suchaya Luewan

Objective: The primary objectives of this study are to compare the rates of preterm birth; fetal growth restriction and low birth weight between the following groups: (1) pregnant women treated for thyrotoxicosis and low-risk pregnancies; (2) between pregnant women with thyrotoxicosis with no need of medication and low-risk pregnancies; and (3) between those treated with MMI and PTU. Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups; the outcomes of various subgroups of the thyrotoxicosis group were also compared. Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls; the women of the thyrotoxicosis group had significantly higher rates of low birth weight (LBW) (23.7% vs. 17.7%; p: 0.036), preterm birth (19.3% vs. 12.3%; p: 0.007), preeclampsia (8.5% vs. 4.4%; p: 0.019) and cesarean section (21.5% vs. 16.0%; p: 0.046). In the thyrotoxicosis group; 67; 127; and 158 patients were treated with MMI; PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI; and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications. Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes; whereas the patients treated with MMI or PTU had comparable adverse outcomes.


2020 ◽  
Author(s):  
Negin Jaafar ◽  
Lars Henning Pedersen ◽  
Olav Bjørn Petersen ◽  
Lone Hvidman

AbstractIntroductionQuickening, the first sensation of fetal movements, is an important milestone for pregnant women. Information on the expected gestational age at quickening may reduce anxiety and prevent delayed detection of intrauterine demise but the available data are from the 1980s before the emergence of modern ultrasound techniques.Materials and methodsProspective observational study on nulliparous women blinded for placental location in two hospitals in Denmark. The pregnant women were enrolled at the time of nuchal translucency scan, placental location was determined at time of second trimester scanning.. The women were blinded to placenta location before time of quickening. Time of quickening were reported by 122 women, 65 with an anterior and 57 with a posterior placenta. Thirteen women had a BMI >30 (10.7%).ResultsThe mean gestational age for quickening was 19 + 0 weeks for nulliparous women. The timing depended on placental site; women with an anterior placenta experienced quickening 6.4 days later than the women with a posterior placenta. BMI > 30 was associated with a later time of quickening.ConclusionsAnterior placental location is associated with delay in experience of fetal movements of 6.4 days and this may further be delayed in women with a BMI>30.


Author(s):  
I. L. Okoroiwu ◽  
Jane Ugochi Chinedu-Madu ◽  
Emmanuel Ifeanyi Obeagu ◽  
C. C. N. Vincent ◽  
O. M. T. B. Ochiabuto ◽  
...  

The study was done to determine iron status, haemoglobin and protein levels of pregnant women in owerri metropolis. A total of 100 pregnant women were recruited for this study. The mean Hb levels in group 1, group 2, and group 3· were 12.00±1.68g/dl, 10.06±1.J4g/dl and 10.96±1.19g/dl respectively. The mean Serum ferritin level of group 1 was 67.00±88.38ng/ml, group 2, 52.48±52.47ng/ml and group 3, 51.26±48.70ng/ml. The mean Serum iron in group 1, 2 and 3 were 46.72±16.41 g/dl, 79.59±63.24 g/dl and 83.35±53.04 g/dl respectively. In group 1, 2 and 3 the mean results. ( g/dl) of TIBC were 295.58 ± 109.53, 324.06 ± 178.00 and 319.88 ± 92.95 and % T.S (%) were 18.78 ± 11.77,26.59 ± 19.40 and 17.97 ± 10.87 percent respectively. The mean total protein was group 1,6.83±l1.77g/dl, group 2,6.39±0.70g/dl and group 3, 6.39 ±0.98 g/dl while the mean albumin (g/dl) in group 1, 2 and 3 were 4.84±0.47, 4.13±0.28 and 4.14±0.29 respectively. The mean values of globulin (g/dl) were 1.98 ± 0.91, 2.29 ± 0.87 and 1.89 ± 0.90 in groups 1, 2 and 3 respectively. As gestational age increased; serum ferritin, total protein, and albumin levels decreased while serum" iron and TIBC increased. The differences in the mean results between the groups were statistically significant (p<0.05) while % T.S and globulin levels when compared showed no significant difference (p>0.05). Iron status showed no statistical difference with increasing parity (p>0.05). However, from this study iron deficiency anaemia was most prevalent in second trimester; hence iron status estimation should be an integral part of routine antenatal care test during second trimester of each pregnancy for proper assessment and management of iron deficiency anaemia in pregnancy.


2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yunyun Liu ◽  
Xiaosha Jing ◽  
Lingling Xing ◽  
Sha Liu ◽  
Jianlong Liu ◽  
...  

Background: We aimed to assess the clinical application of noninvasive prenatal screening (NIPS) based on second-trimester ultrasonographic soft markers (USMs) in low-risk pregnant women.Methods: Data of pregnant women between April 2015 and December 2019 were retrospectively analyzed. Pregnant women [age at expected date of confinement (EDC) of &lt;35 years; low risks for trisomy 21 (T21) and trisomy 18 (T18) based on maternal serum screening; presenting second-trimester USMs (7 types)] who successfully underwent NIPS and had available follow-up information were included in our study. Cases with positive NIPS results were prenatally diagnosed. All patients were followed up for 6 months to 2 years after NIPS, and their clinical outcomes were obtained. Subgroup analyses were performed according to the different USMs.Results: NIPS suggested that among a total of 10,023 cases, 37 (0.37%) were at high risk of aneuploidy, including 4 T21, 6 trisomy 13 (T13), and 27 sex chromosome abnormalities (SCA). Ten cases with aneuploidy (0.10%) were confirmed by prenatal diagnosis, consisting of two T21 and eight SCA. The eight fetuses with SCA consisted of one monosomy X, two XXY, one XXXY, one XXX, one XYY, and two mosaicisms. T21 was detected in one fetus with absent or hypoplastic nasal bone and one fetus with echogenic intracardiac focus (EICF). SCA was detected in five fetuses with EICF, two fetuses with multiple soft markers, and one fetus with echogenic bowel. The positive rate of chromosomal aneuploidy was significantly higher in fetuses with absent or hypoplastic nasal bone (6.25 vs. 0.10%, p = 0.017), echogenic bowel (3.7 vs. 0.10%, p = 0.029), and multiple soft markers (0.678 vs. 0.10%, p = 0.045) than in the total fetuses. The positive predictive values (PPVs) of NIPS in these three groups were 100%, 50%, and 100%, respectively. EICF accounted for 93.25% (9,346/10,023) of the study population, whereas the PPV of NIPS was only 20%.Conclusion: NIPS is an advanced screening test for low-risk pregnant women. In the 10,023 pregnant women sampled, SCA were more common than autosomal trisomy, and EICF was the most frequent USM but the least predictive aneuploidy. Further aneuploidy evaluation is suggested for low-risk pregnant women whose ultrasound indicates absent or hypoplastic nasal bone, echogenic bowel, or multiple soft markers. NIPS can serve as a second-line complementary screening for these women.


2016 ◽  
Vol 33 (2) ◽  
pp. 79-85
Author(s):  
Fahmida Naz Mustafa

Objective: The objective of the study was to measure the proportion of GDM in antenatal outdoor of a hospital, to find out the mean gestational period at which most delivery occurred in GDM and to assess the perinatal outcome.Study design : It was a prospective analytical study conducted in BSMMU, from March,2010 to February,2011.Method: 1489 pregnant women, not known to be diabetic previously, were selected by consecutive sampling in first trimester from Obstetrics outdoor, BSMMU. Their FBS and blood glucose 2hrs after 75gm oral glucose were recorded. We investigated blood glucose in first, second and third trimester in the same pregnant women for screening GDM. Cut off GDM values in fasting stage was e” 6.1mmol/l and 2 hrs after 75gm oral glucose was e” 7.8mmol/l .Result: The proportion of GDM in Obstetrics Outdoor of BSMMU was 6.85%. The mean gestational period at which delivery occurred was lower in GDM ( 36.9 ± 2.2 wks ) than that in non-GDM (39 ± 1.6 wks ) .The most common (31.4%) gestational week during delivery in GDM was 37 completed weeks. Birth weight of 40.2% babies were in the range of 2.5kg to 3.0kg, 31.4% in the range of 3.1 to 3.5 kg and 1% neonate died after birth in GDM.Conclusion: Presently GDM is diagnosed early. The mean gestational period at delivery in GDM is 36.9±2.2 wks. Majority neonatal birth weight is of normal range. Neonatal mortality rate is not increased and is not significantly different from non-GDM women.J Bangladesh Coll Phys Surg 2015; 33(2): 79-85


Author(s):  
Gaitree K. Baldewsingh ◽  
Jeffrey K. Wickliffe ◽  
Edward D. van Eer ◽  
Arti Shankar ◽  
Ashna D. Hindori-Mohangoo ◽  
...  

Prenatal mercury (Hg) exposure was determined in a sub-cohort of the Caribbean Consortium for Environmental and Occupational Health’s environmental epidemiologic prospective cohort study of pregnant women living in Suriname’s interior. The associations between Hg exposure, low birth weight (LBW, <2500 g) and preterm birth (PTB, <37 weeks) were explored. Correlation analysis, Fisher’s exact test and logistic regression analyses were conducted to evaluate the associations between maternal hair Hg levels and birth weight, LBW and PTB, and between potential confounders, LBW and PTB, respectively. Among 204 singleton births were 198 live births, five stillbirths and one miscarriage. The mean participant age was 26 years; 15.7% of participants had PTBs and 8.1% delivered a child with a LBW. The median hair Hg level was 3.48 μg/g hair. Low hair Hg exposure, based on lowest tertile < 2.34 μg/g, was associated with LBW (OR = 7.2; 95% CI 1.5–35.6; p = 0.015); this association was independent of maternal age, ethnic background, household income and village location, and no correlation was found between hair Hg and PTB. Young maternal age was associated with PTB (RR = 5.09, 95% CI: 1.92–13.85; p = 0.0004) while maternal age was not associated with hair Hg or LBW. The impact of prenatal Hg exposure on pediatric neurodevelopment is currently being evaluated in the infant sub-cohort.


1977 ◽  
Vol 85 (3) ◽  
pp. 636-643 ◽  
Author(s):  
H. Svan ◽  
K. Hall ◽  
M. Ritzén ◽  
K. Takano ◽  
A. Skottner

ABSTRACT Somatomedin A by radioreceptor assay and somatomedin B by radioimmunoassay were measured in serum from women immediately after parturition and from their newborns. The mean levels of somatomedin A in both mothers (0.54 U/ml) and infants (0.50 U/ml) were significantly decreased compared to a reference group consisting of 21 non-pregnant women (0.91 U/ml). There was no difference between the mothers and their children. The mean somatomedin B value in serum from the mothers (63.9 μg/ml) was above that found in non-pregnant women (19.2 μg/ml) and the mean value in cord blood and serum from the infants (7.1 μg/ml) was below it. A positive correlation was noted between somatomedin A and B in cord blood; r = 0.78. The combined somatomedin A and B values in cord blood were positively correlated to birth weight (r = 0.51, P < 0.05).


2015 ◽  
Vol 43 (1) ◽  
Author(s):  
Ghada Bourjeily ◽  
Patrizia Curran ◽  
Kristen Butterfield ◽  
Hasina Maredia ◽  
Marshall Carpenter ◽  
...  

AbstractObstructive sleep apnea (OSA) is associated with placenta-mediated adverse clinical outcomes. We aimed at comparing placenta-secreted proteins, such as first and second trimester Down syndrome screening markers which have been linked to preeclampsia, and markers of angiogenesis in pregnant women with OSA, and pregnant controls at low risk for OSA.A case-control study of pregnant women with OSA and controls at low risk for OSA was performed. Levels of first and second trimester markers were reported as multiple of median (MoM), and adjusted for body mass index (BMI). Stored samples were tested for markers of angiogenesis and adjusted for gestational age, BMI, and chronic hypertension.A total of 24 women with OSA and 166 controls had screening markers. BMI was higher in cases compared to controls, P=0.01. MoM levels of placenta associated plasma protein-A (PAPP-A) were significantly lower in cases versus controls, even after adjusting for BMI (0.52 IQR 0.48 vs. 1.01 IQR 0.63, P=0.009). The ratio of soluble vascular endothelial growth factor receptor 1 to placental growth factor was significantly higher in cases than controls, even after adjusting for confounders (4.42 IQR 2.52 vs. 2.93 IQR 2.01, P=0.009).Circulating placenta-secreted glycoproteins and markers of angiogenesis are altered in pregnant women with OSA.


2018 ◽  
Vol 9 (1) ◽  
pp. 22-28
Author(s):  
Shiffin Rijvi ◽  
Sharmin Abbasi ◽  
Anuradha Karmakar ◽  
Sehereen Farhad Siddiqua ◽  
Farhana Dewan

Background: Maternal weight gain is influenced by several trends in perinatal health that are of great public health concern. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growthObjective: To determine the relationship between maternal weight gain and birth weight of baby at term.Methodology : A cross sectional observational study was carried among 50 pregnant women at term were admitted in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College hospital during the period of January 2014 to July 2014. Data were collected pre-designed data collection sheet.Results: This study found maximum (36%) were age group 21-25 years followed by 28% were 20 years, 24% were 26-30 years, 8% were 31-35 years and only 4% were 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI <18.5, 15 cases (30%) had a BMI 18.5- 24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Weight increased there was a corresponding increase in the mean birth weight and this relationship was statistically significant (<0.05).Conclusion: This study shows maternal weight gain significantly increased birth weight of the baby at term. Maternal weight should continue to be given importance in monitoring the health of pregnancies and bioelectrical impedance analysis and arm measurements should be further investigated as another simple way to track appropriate body composition changes across gestation, especially in resource-limited settings. Although challenging, public health efforts should continue working to improve the nutritional status of women of reproductive age before they conceive as an apparent way to improve birth outcomes.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 22-28


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