Impact of TSH during the first trimester of pregnancy in obstetric and fetal complications: Usefulness of 2.5 mIU/l cut-off value

Twin pregnancies are increasing due to the rise in mothers’ childbearing age and have a higher risk of fetal growth restriction (FGR) and prematurity. Therefore, early prediction of these events is important. Our aim was to analyze in the first trimester of pregnancy a possible association between antioxidants, including melatonin, in maternal plasma and the development of fetal complications in twin pregnancies. A single-center, prospective, and observational study was performed in 104 twin-pregnant women. A blood sample was extracted between the 9th and the 11th week of gestation, and plasma was obtained. Antioxidants (thiols, reduced glutathione, phenolic compounds, catalase, superoxide dismutase) and oxidative damage biomarkers (carbonyl groups and malondialdehyde) were assessed by spectrophotometry, and global scores were calculated from these parameters (Antiox-S, Prooxy-S). Melatonin and cortisol were evaluated by a competitive immunoassay. In the first trimester of pregnancy, Antiox-S was significantly lower in women who developed FGR compared to those with normal fetal growth; plasma melatonin was significantly lower in women with preterm compared to those with full-term births and exhibited a positive correlation with birth weight. Maternal cortisol showed a negative correlation with birth weight. We conclude that, for twin gestations, maternal plasma antioxidant status and melatonin could be potential biomarkers to be included in algorithms to predict FGR and preterm labor.

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Management of Symptomatic Gallbladder Lithiasic Disease During Pregnancy

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2014.018 ◽

2018 ◽

Vol 1 (2) ◽

pp. 147-152

Author(s):

R. Pinilla ◽

E. Romero ◽

L. Rojas ◽

N. Claros

Keyword(s):

Medical Treatment ◽

Hospital Stay ◽

Case Series ◽

First Trimester ◽

Fetal Mortality ◽

Case Series Study ◽

Fetal Complications ◽

Average Operative Time ◽

First Trimester Of Pregnancy ◽

The Mean

The objective of this research was to determine the type of management of symptomatic gallbladder lithiasic disease (GLD) in the Obrero Hospital No. 1, Bolivia. A Case Series study design from January to December 2013 was conducted. The prevalence of GLD in pregnant patients was 4.2% (18 patients), of which 12 (66.7%) were operated and 6 patients (33.3%) subjected to medical treatment. The mean age was 28.83 years (SD± 5.328). The preoperative diagnoses were acute or exacerbated GLD in 12 cases (66.6%), acute pancreatitis of lithiasic origin in 3 (16.7%) and obstructive jaundice due to choledocholithiasis in 3 cases (16.7%). The mean gestational age was 16.83 weeks (SD± 8.155). During the first trimester of pregnancy 5 cases (27.7%) were observed; during the second quarter 10 cases (55.6%) and 3 cases (16.7%) during the third trimester. Only 3 cases (16.6%) were nulliparous. Average leukocyte count was 10632 x mm³ (SD± 2748.038), and 66% had leukocytosis and left deviation. Of the 12 operated, 10 laparoscopic cholecystectomy were described and in two cases also bile duct exploration was performed. Balanced general anesthesia was used in 10 cases (83.4%), in one TIVA (total intravenous anaesthesia) (8.3%) and one spinal (8.3%). The pneumoperitoneum always performed with open Hasson technique. The average operative time was 47.5 minutes (SD± 16.989) and hospital stay of 5.44 days (SD± 3.568). Comparing stay, patients undergoing surgery have a longer hospital stay compared with those who received medical treatment (6.16 vs. 4 days). No fetal complications occurred, including maternal and fetal mortality or premature contractions requiring treatment. Laparoscopic surgery appears to be a safe option and may be the form of treatment when the GLD is persistently symptomatic, preferably during the second trimester of pregnancy.

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Catheter Directed Thrombolysis for Deep Vein Thrombosis during the First Trimester of Pregnancy: Two Case Reports

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2008.58.2.127 ◽

2008 ◽

Vol 58 (2) ◽

pp. 127

Author(s):

Kum Rae Kim ◽

Won Kyu Park ◽

Jae Woon Kim ◽

Woo Hyung Kwun ◽

Bo Yang Suh ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Case Reports ◽

First Trimester ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

First Trimester Of Pregnancy ◽

Deep Vein

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FRACTIONAL DETERMINATIONS OF URINARY 17-KETOSTEROIDS IN HYPEREMESIS GRAVIDARUM

Acta Endocrinologica ◽

10.1530/acta.0.0410123 ◽

1962 ◽

Vol 41 (1) ◽

pp. 123-128 ◽

Cited By ~ 6

Author(s):

Pentti A. Järvinen ◽

Sykkö Pesonen ◽

Pirkko Väänänen

Keyword(s):

Hyperemesis Gravidarum ◽

First Trimester ◽

Control Group ◽

Before And After ◽

Daily Urine ◽

First Trimester Of Pregnancy ◽

The Difference

ABSTRACT The fractional determination of 17-ketosteroids in the daily urine was performed in nine cases of hyperemesis gravidarum and in four control cases, in the first trimester of pregnancy both before and after corticotrophin administration. The excretion of total 17-KS is similar in the two groups. Only in the hyperemesis group does the excretion of total 17-KS increase significantly after corticotrophin administration. The fractional determination reveals no difference between the two groups of patients with regard to the values of the fractions U (unidentified 17-KS), A (androsterone) and Rest (11-oxygenated 17-KS). The excretion of dehydroepiandrosterone is significantly higher in the hyperemesis group than in the control group. The excretion of androstanolone seems to be lower in the hyperemesis group than in the control group, but the difference is not statistically significant. The differences in the correlation between dehydroepiandrosterone and androstanolone in the two groups is significant. The high excretion of dehydroepiandrosterone and low excretion of androstanolone in cases of hyperemesis gravidarum is a sign of adrenal dysfunction.

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