scholarly journals Role of Maternal Serum Glycodelin as Predictor of Ectopic Pregnancy in First Trimester

2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
First Trimester ◽  
Maternal Serum ◽  
Intrauterine Pregnancy ◽  
Receiver Operator Curve Analysis ◽  
Medical City ◽  
First Trimester Of Pregnancy ◽  
Control Study

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

Vitamine D en het risico op ASS

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Huub F.J. Savelkoul
Keyword(s):  
Vitamin D ◽  
Serum Levels ◽  
First Trimester ◽  
Autism Spectrum ◽  
Maternal Serum ◽  
Immune Reactivity ◽  
Anti Oxidant ◽  
First Trimester Of Pregnancy ◽  
Spectrum Disorders

Autism spectrum disorders (ASD) is a heterogeneous group of behavioral disorders in which a disturbed immune reactivity can contribute to the etiology. In retrospective research we found an association between the risk to develop ASD and the month of birth with a peak in July pointing at a possible decreased exposure to sunlight during the first two semesters of pregnancy. This could point to an important role of vitamin D which has important anti-inflammatory and anti-oxidant activities and thereby regulates the proper functioning of the immune system in these individuals. Maternal serum levels of vitamin D double during the first trimester of pregnancy and therefore decreased exposure to sunlight resulting in diminished levels of vitamin D production can be an important risk factor for the development of ASD. However, there is a need for more integrated multidisciplinary studies in families where all siblings are also studied to elucidate the contribution of their genetic risk factors.

THE ROLE OF ACTIVIN A AND FOLLISTATIN IN THE DIFFERENTIATION BETWEEN VIABLE INTRAUTERINE PREGNANCY FROM MISSED MISCARRIAGE AND ECTOPIC PREGNANCY

2019 ◽  
pp. 197-202
Author(s):  
ESRAA HAMEED HUMADI AL-MAINI ◽  
ISRAA TAILB ABD AL-KADIR ◽  
RAWNAQ ALI AL-SAADI
Keyword(s):  
Ectopic Pregnancy ◽  
First Trimester ◽  
Activin A ◽  
Intrauterine Pregnancy ◽  
Good Ability ◽  
Lower Accuracy ◽  
Significant Difference ◽  
Group B ◽  
Age Range

Objective: The objective of the study was to investigate the role of activin A and follistatin (FS) in the differentiation between viable intrauterine pregnancy from missed miscarriage and ectopic pregnancy (EP). Study Design: This was a case–control study. Setting: This study was conducted at the Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital, from February 2017 to October 2017. Patients and Methods: The study included 90 pregnant women, aged from 21 to 40 years old in their the first trimester attending the outpatient and inpatient clinic with single fetal pregnancy with a gestational age range between 6th and 8th weeks, they were divided into three groups; Group A: Includes 30 cases with uncomplicated pregnancies in their first trimester, Group B: Includes 30 cases diagnosed as missed miscarriages, and Group C: Includes 30 cases diagnosed as EPs. Results: There was no significant difference in the maternal age and body mass index between the three groups, β-human chorionic gonadotropin, activin A, FS, and their ratio were significantly higher in the healthy intrauterine pregnancy compared to missed miscarriage and EP. Activin A and activin A/FS ratio had an excellent ability to discriminate EP from healthy intrauterine pregnancy, while FS alone had good ability to discriminate between EP and intrauterine pregnancy. Activin A had fair ability to discriminate missed miscarriage from intra healthy uterine pregnancy, while both FS and activin A/FS ratio had poor ability to differentiate missed miscarriage and intrauterine pregnancy. Conclusion: Activin A can be used with high accuracy as a biomarker for EP and missed miscarriage, FS alone, and activin A/FS ratio is a possible biomarker, but it offers lower accuracy compared to activin A alone.

scholarly journals Role of transabdominal ultrasound in detection of ectopic pregnancy

2016 ◽  
Vol 12 (1) ◽  
pp. 1-4
Author(s):  
Narayan Bikram Thapa ◽  
Yam Prasad Dwa
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
Adnexal Mass ◽  
First Trimester ◽  
Clinical Profile ◽  
Ultrasound Diagnosis ◽  
Transabdominal Ultrasound ◽  
Transabdominal Ultrasonography ◽  
First Trimester Ultrasound

Background & Objectives: Ectopic pregnancy is one of the common medical emergencies encountered in the clinical practice. Confirmation of diagnosis is usually done by urine pregnancy test and transabdominal sonography. Thus, the present study is carried out to determine the role of transabdominal ultrasonography in the diagnosis of ectopic pregnancy by comparing the ultrasonography findings with that of operative and histopathology and to evaluate clinical profile of the women with confirmed ectopic pregnancy. Materials & Methods: Transabdominal ultrasound record of patients referred for first trimester ultrasound, from January 2008 to December 2015, at radiology department of Kist medial college teaching hospital were reviewed to identify patients with ectopic pregnancy. Among these patients those who underwent surgery and histopathology confirmed ectopic pregnancies were identified and their medical records were retrieved. Ultrasound and clinical profile were recorded and statistically analyzed. Results: There were 19 patients with ultrasound diagnosis of ectopic pregnancy among 1480 first trimester ultrasound record. Among these patients, ectopic pregnancy was confirmed on 18 patients. Ultrasound diagnosis included adnexal mass with pelvic fluid in 15 (83.3%) patients and pelvic fluid without adnexal mass in 4 (16.7%) patients. The study result revealed that sensitivity of transabdominal ultrasonography was 100% and specificity was 99.9%. Positive predictive value and negative predictive value of transabdominal ultrasonography was 94% and 100%.Conclusion: The transabdominal ultrasound accurately diagnose ruptured ectopic pregnancy.JCMS Nepal. 2016;12(1):1-4.

scholarly journals Diagnosis and management of ectopic pregnancy

2021 ◽  
Vol 16 (1) ◽  
pp. 73-78
Author(s):  
Catalina Diana STANICA ◽  
◽  
Adrian NEACSU ◽  
Romina Marina SIMA ◽  
Raluca Gabriela IOAN ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
First Trimester ◽  
Point Of View ◽  
Patient Comfort ◽  
Maternal Deaths ◽  
Hospitalization Period ◽  
Substantial Progress ◽  
First Trimester Of Pregnancy ◽  
Control Study ◽  
Made In

Recently, substantial progress has been made in diagnosis and treatment, complicated ectopic pregnancy is a not negligible cause of maternal mortality, being the leading cause of maternal death in the first trimester of pregnancy and responsible for 6% of maternal deaths. The aim of this study is to evaluate patients with ectopic pregnancy from a clinical, paraclinical and therapeutic point of view and to compare the influence of the management on hospitalization days and the preservation of patients fertility. This paper presents a prospective case-control study for 65 patients, who have been diagnosed serologically and ultrasonically. In the group of patients studied, 25% patients were treated with methotrexate, 65% were required surgical treatment, 4% required surgical and medical treatment, and 2% the management of expectation. Laparoscopy significantly reduces the hospitalization period, contributing decisively to the rapid reintegration into society, increasing patient comfort, an excellent mental tone that promotes earlier healing, the number of complications decreases.

scholarly journals The role of pregnancy-associated plasma protein-a level in the first trimester of pregnancy and clinical outcome in an urban referral centre

2019 ◽  
Vol 8 (10) ◽  
pp. 3884
Author(s):  
Lavanya T. ◽  
Premalatha R. ◽  
Nandita A. Thakkar ◽  
Latha Jawahar ◽  
Priya Kannappa Rajendran ◽  
...  
Keyword(s):  
Predictive Value ◽  
Case Control Study ◽  
Mode Of Delivery ◽  
Protein A ◽  
First Trimester ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
First Trimester Of Pregnancy ◽  
Control Study

Background: Estimation of serum PAPP-A levels studied predictability for adverse perinatal outcome. This case control study tries to establish the association between low PAPP-A levels among the pregnant woman and adverse maternal foetal outcome.Methods: This is an case-control study during 2017-2018 in the women delivered at Department of OBG at Mehta Hospitals. Women delivered in the labour room  had a first trimester screening of PAPP-A level were explained, taken informed consent, questionnaire which include detailed antenatal history, mode of delivery and baby data.  Depending upon outcome, the subjects are classified as case group or control group, out of the study sample of 264 subjects, 88 patients who had complications were taken as cases and 176 patients with no complications taken as control were undertaken.Results: Low PAPP-A level (<0.5 MoM) showed high incidence of PIH and preeclampsia, followed by IUGR and Preterm. PAPP-A level >0.5 MoM, normal outcome is more than the adverse outcome. The difference in the PAPP-A levels is statistically significant. In women with low PAPP A level, low birth weight found statistically significant when compared with <0.5 PAPP A level. The sensitivity of PAPP A levels in identifying the complicated outcomes was 17.04%.The specificity was 98.85%. The positive predictive value of predicting the complications was 88.23% and negative predictive value of 70.44%.Conclusions: The low PAPP-A levels confirmed during first trimester of pregnancy is associated with adverse maternal and foetal outcome such as PIH, preeclampsia, preterm, IUGR and LBW.

Increased secretory sphingomyelinase activity in the first trimester of pregnancy in women later developing preeclampsia: a nested case-control study

2016 ◽  
Vol 397 (3) ◽  
pp. 269-279 ◽  
Author(s):  
Víctor Rodríguez-Sureda ◽  
Francesca Crovetto ◽  
Stefania Triunfo ◽  
Olga Sánchez ◽  
Fátima Crispi ◽  
...  
Keyword(s):  
Plasma Cholesterol ◽  
First Trimester ◽  
Endothelial Damage ◽  
Biologically Active ◽  
Control Groups ◽  
Potential Biomarker ◽  
Circulating Markers ◽  
First Trimester Of Pregnancy ◽  
Nested Case Control ◽  
Control Study

Abstract The pathogenic basis of abnormal placentation and dysfunction in preeclampsia (PE) is highly complex and incompletely understood. Secretory sphyngomyelinase activity (S-ASM) was analyzed in plasma samples from 158 pregnant women developing PE and 112 healthy pregnant controls. Serum PlGF, sFlt-1, s-Endoglin and sVCAM were measured. Results showed S-ASM activity to be higher in women who later developed PE than in those with uncomplicated pregnancies (40.6% and 28.8% higher in the late- and early-onset groups, respectively). Plasma S-ASM activity correlated significantly with circulating markers of endothelial damage in the late-PE group (endoglin and sVCAM-1), with plasma cholesterol and total lipid levels. However, these significant associations were not observed in the early-PE or control groups. This work provides the first evidence of significantly elevated circulating S-ASM activity in the first trimester of pregnancy in women who go on to develop PE; thus, it may be deduced that the circulating form of ASM is biologically active in PE and could contribute to promoting endothelial dysfunction and cardiovascular programming. Plasma S-ASM measurement may have clinical relevance as a further potential biomarker contributing to the earliest identification of women at risk of developing preeclampsia.

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