Oligohydramnion in the First Half of Pregnancy in the Fetuses with Congenital Abnormalities: Ultrasound Diagnostics and Obstetric Outcomes

2021 ◽  
Vol 76 (4) ◽  
pp. 341-350
Author(s):  
Sergey M. Voevodin ◽  
Tatiana V. Shemanaeva ◽  
Alyona V. Serova
Keyword(s):  
Amniotic Fluid ◽  
Congenital Malformations ◽  
Fetal Death ◽  
Congenital Abnormalities ◽  
Neonatal Period ◽  
Perinatal Outcomes ◽  
Main Group ◽  
Obstetric Outcomes ◽  
Fetal Abnormalities ◽  
4D Ultrasound

Background.Oligohydramnion in the first half of pregnancy, combined with congenital abnormalities in the fetus has objective difficulties in diagnosis. The morphology features and type of defects associated with oligohydramnion, which manifests in the first half of pregnancy, are not sufficiently studied at the present stage. Aims to evaluate the clinical significance of diagnosing oligohydramnion in the first half of pregnancy in women with congenital fetal malformations. Materials and methods.The analysis of the course of pregnancy and perinatal outcomes in 77 women with low water content in combination with congenital malformations of the fetus and 72 patients with a normal amount of amniotic fluid and no congenital malformations of the fetus was performed. The patients of the main group were divided into two subgroups depending on the severity of oligohydramnion: the 1st subgroup (n = 54) patients with severe oligohydramnion and the 2nd subgroup (n = 23) patients with moderate oligohydramnion. The amount of amniotic fluid was determined by 3D/4D ultrasound (1321 weeks of gestation) and the structure of fetal abnormalities associated with oligohydramnion was analyzed. We evaluated perinatal outcomes in women with congenital malformations of the fetus in combination with oligohydramnion and the effect of its severity on the outcome of pregnancy. Results.In the main group (n = 77), fetal abnormalities were detected in patients: urinary system 39 (50.6%), respiratory system 4 (5.2%), heart 1 (1.3%), chromosomal and genetic abnormalities 14 (18.2%), central nervous system 3 (3.9%), osseous system 3 (3.9%), multiple 13 (16.9%). In the main group (n = 77), pregnancy was terminated for medical indications in 47 (61%) cases, in 6 (7.8%) spontaneous miscarriage occurred, in 5 (6.5%) antenatal fetal death. 19 (24.7%) children were born alive, and surgical treatment in the neonatal period was required in 8 (10.4%) cases. In the 1st subgroup (n = 54) in 53 (98.1%) cases, there was a loss of the fetus, in 1 (1.9%) the newborn died on the 9th day. In the 2nd subgroup (n = 23), fetal death occurred in 5 (21.7%) cases, 18 (78.3%) children were born alive, and 8 (44.4%) newborns were operated on in the neonatal period. In the control group, all pregnancies ended with the birth of healthy children. A decrease in ultrasound imaging of internal organs in the fetus was observed when a pregnant woman was obese (BMI more than 35). Conclusions.Oligohydramnion in the first half of pregnancy in combination with fetal malformation should be considered an extremely unfavorable clinical sign for the prognosis of pregnancy and the health of the fetus and newborn. 3D/4D ultrasound scanning allows you to reliably determine oligohydramnion in the first half of pregnancy, and the degree of its severity to assume the nature of complications.

scholarly journals STRUCTURE OF SURGICAL ABNORMALITY IN NEWBORNS OF THE NIZHNY NOVGOROD REGION

2019 ◽  
Vol 8 (4) ◽  
pp. 33-38
Author(s):  
I. Yu. Karpova ◽  
V. V. Parshikov ◽  
E. A. Rozhdenkin ◽  
G. B. Batanov ◽  
V. E. Pivikov ◽  
...  
Keyword(s):  
Congenital Malformations ◽  
Birth Rate ◽  
Congenital Abnormalities ◽  
Neonatal Period ◽  
Initial Therapy ◽  
Surgical Pathology ◽  
Adequate Treatment ◽  
Medical University ◽  
The City ◽  
Nizhny Novgorod Region

Introduction.A tendency to the decline in birth rate and reduced number of diseases of the neonatal period has been lately observed in the Nizhny Novgorod region.Materials and methods. 494 neonates with a surgical pathology aged from the frst hours to several weeks were treated in hospitals serving as clinical bases for the Volga Research Medical University from 2013 to 2017. 305 (62%) boys and 189 (38%) girls were observed. The majority of children (88%) were taken to surgical departments from maternity homes and perinatal centers of the city and region. 62 (12%) of children were hospitalized following the referral from local pediatricians. Admitted patients had a clinical and instrumental examination and initial therapy that stabilized their conditions and prepared them for surgeries.Results. Congenital malformations (CM) were diagnosed in 330 (67%) children only. According to analysis of diseases related to the neonatal period, purulent and septic processes were found in 104 (21%) patients. Surgeries were performed in children aged from day 1 to several months of life.Conclusion. Modern antenatal diagnostics and complex examination of newborns in the neonatal period enable timely detection of congenital abnormalities and initiation of adequate treatment.

Engineering tissue for the fetus: stem cells and matrix signalling

2014 ◽  
Vol 42 (3) ◽  
pp. 631-635 ◽  
Author(s):  
Paolo De Coppi
Keyword(s):  
Stem Cells ◽  
Amniotic Fluid ◽  
Congenital Malformation ◽  
Congenital Malformations ◽  
Adult Stem Cells ◽  
Neonatal Period ◽  
Amniotic Fluid Stem Cells ◽  
The Future ◽  
Causes Of Disease ◽  
Functional Replacement

Congenital malformations are major causes of disease and death during the first years of life and, most of the time, functional replacement of the missing or damaged organs remains an unmet clinical need. Particularly relevant for the treatment of congenital malformation would be to collect the stem cells at diagnosis, before birth, to be able to intervene during the gestation or in the neonatal period. Human AFSCs (amniotic fluid stem cells), which have characteristics intermediate between those of embryonic and adult stem cells, have been isolated. c-Kit+Lin− cells derived from amniotic fluid display a multilineage haemopoietic potential and they can be easily reprogrammed to a pluripotent status. Although, in the future, we hope to use cells derived from the amniotic fluid, we and others have proved recently that simple organs such as the trachea can be engineered using adult progenitors utilizing decellularized cadaveric matrices. A similar approach could be used in the future for more complex organs such as the muscles, intestines or lungs.

Perinatal outcomes with isolated oligohydramnios at term pregnancy

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Mariña Naveiro-Fuentes ◽  
Alberto Puertas Prieto ◽  
Rocío Sánchez Ruíz ◽  
María Paz Carrillo Badillo ◽  
Francisco Montoya Ventoso ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Umbilical Artery ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Induction Of Labor ◽  
Obstetric Outcomes ◽  
Term Pregnancy ◽  
Neonatal Birth Weight ◽  
Blood Ph ◽  
Discharge Status

AbstractAims:To compare the outcomes of term gestations with oligohydramnios in the absence of other underlying disorders and term gestations with normal amniotic fluid.Methods:A retrospective analysis of obstetric outcomes in 27,708 term pregnancies. We compared three groups: labor induced because of oligohydramnios, spontaneous onset of labor with normal amniotic fluid, and labor induced because of late term pregnancy with normal amniotic fluid. We excluded pregnancies with maternal or fetal diseases or disorders potentially related with amniotic fluid alterations. The main outcome measures were mode of delivery, neonatal birth weight, umbilical artery blood pH, Apgar scores and neonatal discharge status.Results:Compared to spontaneous labor, induction of labor because of oligohydramnios was associated with a higher risk of cesarean delivery and small size of the fetus for gestational age (SGA). Compared to induction because of late term pregnancy there were no significant differences in neonatal, although neonates had a higher risk of being SGA.Conclusion:The only perinatal outcome for which the risk was higher in term pregnancies with isolated oligohydramnios was SGA. The systematic induction of labor in these pregnancies should be questioned.

Distinct features of youth-onset primary antiphospholipid syndrome

Lupus ◽  
2021 ◽  
pp. 096120332110380
Author(s):  
Carla Baleeiro Silva ◽  
Camila SC Duran ◽  
Flavio Signorelli ◽  
Gustavo GM Balbi ◽  
Eloisa Bonfá ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Fetal Death ◽  
Early Recognition ◽  
Disease Onset ◽  
Obstetric Outcomes ◽  
Premature Delivery ◽  
Primary Antiphospholipid Syndrome ◽  
Adult Onset ◽  
Increased Risk ◽  
Onset Group

Background Characteristics of primary APS (PAPS) in the youth population have never been studied. In contrast with children, pregnancy is genuinely relevant in the youth age, and understanding clinical characteristics of PAPS patients within this specific age stratum may also provide insights regarding the well-known risk of poor obstetric outcomes during the adolescence. Objective To evaluate clinical and laboratory characteristics of patients with youth-onset PAPS (15–24 years) and compare them with adult-onset PAPS (over 24 years old). Methods This was a cross-sectional study derived from two rheumatology outpatient clinics. Patients who fulfilled Sidney criteria and who were 15 years of age or older at disease onset were included. Secondary APS patients were excluded. We subdivided patients into two groups: youth- (15–24 years) and adult-onset (over 24 years) and compared them regarding demographic characteristics, criteria and non-criteria manifestations, cardiovascular risk factors, and aPL status. For the pregnancy outcomes analysis, ever-pregnant patients were divided in three groups: youth-onset, early adult-onset (25–34 years), and late adult-onset (35–49 years). Results A total of 250 consecutive PAPS patients were included. Groups had a comparable female and Caucasian distribution. We found a similar disease duration (14.0±7.9 vs 17.0±10.1 years, p = 0.079) and similar rates of thrombotic arterial (34.2% vs. 42.0%, p = 0.250) and venous events (69.7% vs. 69.5%, p = 0.975) between them. Skin ulcers were more frequent in the youth-onset group (17.1% vs. 4.0%, p = 0.001), whereas nephropathy was less common (1.3% vs. 8.0%, p = 0.039). No differences were observed for the other criteria and non-criteria manifestations. The adult-onset group presented more frequently with hypertension ( p = 0.002), hyperlipidemia ( p = 0.008), and smoking ( p = 0.003). The youth-onset group presented a higher frequency of obstetric events as the first manifestation of PAPS (30.3% vs. 21.7%, p = 0.005), with worse pregnancy outcomes, namely, fetal death (58.5% vs. 46.4% vs. 24.1%, p = 0.012) and premature delivery (35.8% vs. 19.0% vs. 10.3%, p = 0.016). Of note, all groups had a comparable number of pregnancies (2.81±2.52 vs 2.74±2.07, p = 0.899). Conclusion This study provides novel evidence that youth-onset PAPS presents a higher frequency of obstetric complications as its first manifestation, with an increased risk of fetal death and preterm delivery. Early recognition of this condition by obstetricians is essential to improve prognosis.

The Early Diagnosis of Congenital Abnormalities

PEDIATRICS ◽  
1964 ◽  
Vol 34 (5) ◽  
pp. 744-745
Author(s):  
RUSTIN MCINTOSH
Keyword(s):  
Early Diagnosis ◽  
Early Identification ◽  
Congenital Abnormalities ◽  
Neonatal Period ◽  
Congenital Defects ◽  
Children's Hospitals ◽  
Children’S Hospitals ◽  
Alder Hey

This is a gem of a book—small, compact, sparkling, a bit expensive for its size. It reflects the growing interest in congenital defects and the realization that early identification is the key to successful correction in an increasing number and variety of anomalies. The author, consultant pediatrician to Alder Hey and Olive Mount Children's Hospitals in Liverpool, addresses himself to obstetrician and pediatrician alike, placing special emphasis on the conditions which can be recognized or suspected during the four weeks preceding birth and in the neonatal period.

Fertility Treatments and the Risk of Preterm Birth Among Women with Subfertility: A Linked-Data Retrospective Cohort Study

2021 ◽  
Author(s):  
Jessica N Sanders ◽  
Sara E Simonsen ◽  
Christina A Porucznik ◽  
Ahmad O Hammoud ◽  
Ken Smith ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Birth ◽  
In Vitro Fertilization ◽  
Retrospective Cohort ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Birth Certificates ◽  
Vitro Fertilization ◽  
Fertility Treatments

Abstract Background: In vitro fertilization (IVF) births contribute to a considerable proportion of preterm birth (PTB) each year. However, there is no formal surveillance of adverse perinatal outcomes for less invasive fertility treatments. The study objective was to determine the effect of fertility treatment (in vitro fertilization, intrauterine insemination, usually with ovulation drugs (IUI), or ovulation drugs alone) on preterm birth, compared to no treatment in subfertile women.Methods: The Fertility Experiences Study (FES) is a retrospective cohort study conducted at the University of Utah between April 2010 and September 2012. Women with a history of primary subfertility self-reported treatment data via survey and interviews. Participant data were linked to birth certificates and fetal death records to asses for perinatal outcomes, particularly preterm birth.Results: A total 487 birth certificates and 3 fetal death records were linked as first births for study participants who completed questionnaires. Among linked births, 19% had a PTB. After adjustment for maternal age, paternal age, maternal education, annual income, religious affiliation, female or male fertility diagnosis, and duration of subfertility, the odds ratios and 95% confidence intervals (CI) for PTB were 2.17 (CI: 0.99, 4.75) for births conceived using ovulation drugs, 3.17 (CI: 1.4, 7.19) for neonates conceived using IUI and 4.24 (CI: 2.05, 8.77) for neonates conceived by IVF, compared to women with subfertility who used no treatment during the month of conception. A reported diagnosis of female factor infertility increased the adjusted odds of having a PTB 2.99 (CI: 1.5, 5.97). Duration of pregnancy attempt was not independently associated with PTB. In restricting analyses to singleton gestation, odds ratios remained elevated but were not significant for any type of treatment.Conclusion: IVF, IUI, and ovulation drugs were all associated with a higher incidence of preterm birth and low birth weight, predominantly related to multiple gestation births.

Review of Modern Management of the Rh Problem, by John T. Queenan, M.D. New York: Harper and Row (Hoeber Medical Division), 1967, 318 pp., $12.50

PEDIATRICS ◽  
1968 ◽  
Vol 42 (2) ◽  
pp. 379-379
Author(s):  
Thomas E. Cone
Keyword(s):  
New York ◽  
Amniotic Fluid ◽  
Fetal Death ◽  
Modern Management ◽  
Medical Division

Pity the busy practicing obstetrician who tries to keep up with the latest on the management of the "Rh problem" in his practice. Whereas once, there were only two Rh types, Rh positive and Rh negative, now there are more than two dozen, of which at least six can cause problems, though most rather rarely. And, there is a 20% danger of fetal death which may now be foretold by pigment changes in the amniotic fluid. So amniocentesis is an important prognostic measure.

scholarly journals Fetal death: an extreme manifestation of maternal anti-fetal rejection

2017 ◽  
Vol 45 (7) ◽  
Author(s):  
Kia Lannaman ◽  
Roberto Romero ◽  
Tinnakorn Chaiworapongsa ◽  
Yeon Mee Kim ◽  
Steven J. Korzeniewski ◽  
...  
Keyword(s):  
Cohort Study ◽  
Amniotic Fluid ◽  
Study Design ◽  
Fetal Death ◽  
Unknown Etiology ◽  
Amniotic Cavity ◽  
Inflammatory Lesions ◽  
Esi Ms ◽  
Chemokine Ligand ◽  
Placental Inflammation

AbstractObjective:The aim of this study was to determine the association between chronic placental inflammation and amniotic fluid (AF) markers of maternal anti-fetal rejection as well as the presence of microorganisms in the AF fluid of patients with fetal death.Study Design:This cohort study included 40 patients with fetal death whose placentas were examined for chronic inflammatory lesions and whose AF chemokine ligand (CXCL)10 and interleukin (IL)-6 concentrations were determined by immunoassays. AF was processed for bacteria, mycoplasmas and viruses using cultivation and molecular microbiologic techniques (i.e. PCR-ESI/MS).Results:(1) The most prevalent placental findings were maternal vascular underperfusion (63.2%, 24/38), followed by chronic inflammatory lesions (57.9%, 22/38); (2) chronic chorioamnionitis (18/38) was three times more frequent than villitis of unknown etiology (6/38); (3) an elevated AF CXCL10 concentration (above the 95Conclusion:In women with unexplained fetal death, there is an association between elevated AF CXCL10 and chronic placental inflammatory lesions. Therefore, we conclude that a subset of patients with fetal death may have endured a breakdown of maternal-fetal tolerance, which cannot be attributed to microorganisms in the amniotic cavity.

scholarly journals Title: Application of a physiotherapy protocol to women during the active phase of labour improves obstetric outcomes: a randomized clinical trial.

2021 ◽  
Author(s):  
LICIA SANTANA ◽  
Rubneide Gallo ◽  
Silvana Quintana ◽  
Geraldo Duarte ◽  
Cristine Homsi Ferreira ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Labour Pain ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Phase Duration ◽  
Intention To Treat ◽  
Reference Centre ◽  
Care Protocol

Objective: To evaluate the effectiveness of a non-pharmacological childbirth care protocol in women in the active phase of labour in improving obstetric and perinatal outcomes. Design: Randomized trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Setting: Reference Centre of Women’s Health of Ribeirão Preto–MATER, São Paulo, Brazil. Methods: Eighty low-risk primiparous women at the end of pregnancy and beginning of the active phase of labour were randomized to experimental group (EG) (n=40) or control group (CG) (n=40). Women in EG received four interventions: ambulation at 4 to 6 cm of cervical dilation; alternative maternal positions associated with TENS at 6 to 7 cm, and a warm shower bath at >7 cm. The CG received only routine obstetric. Main outcome measures: The length of the active phase of labour, the expulsive phase duration, and the prevalence of labour dystocia assessed by the partograph. Results: The parturients who received the sequential non-pharmacological protocol had a shorter length of the active phase of labour (CG=444 minutes; EG=373 minutes; p=0,02), presented rupture of membranes later in labour (CG=7cm; EG=8cm; p<0,01), requested pharmacological analgesia with more significant cervical dilatation (CG=5cm; EG=8cm; p<0,01) and had lower labour dystocia rates than the patients in the CG. Conclusion: The implementation of a sequential non-pharmacological protocol has the potential in decreased and delayed use of pharmacological analgesia, duration of the active phase of labour and dystocia rates. Keywords: length of labour, labour pain, dystocia, randomized controlled trial, non-pharmacological resources, pharmacological analgesia. Trial registration: NCT01601860 Link: https://clinicaltrials.gov/ct2/show/NCT01601860

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