scholarly journals FOLATE METABOLISM IMPAIRMENT IN SMOKING PREGNANT WOMEN

2013 ◽  
Vol 62 (2) ◽  
pp. 34-42
Author(s):  
Tatyana Valeryevna Semenova ◽  
Yuliya Pavlovna Milyutina ◽  
Aleksandr Vartanovich Arutyunyan ◽  
Olga Nikolayevna Arzhanova
Keyword(s):  
Plasma Level ◽  
Pregnant Women ◽  
Homocysteine Level ◽  
Late Pregnancy ◽  
Folate Metabolism ◽  
Premature Delivery ◽  
Essential Condition ◽  
Delivery Outcome ◽  
Pregnancy And Delivery ◽  
High Smoking Rate

Tobacco smoking is one of the pressing issues of public health. Russia ranks among the countries with a very high smoking rate. Smoking frequency among pregnant women in St. Petersburg is about 26.4%, among which 18.9% of the women smoke every day, and the rest 7.5% of them on the occasion. Complications from pregnancy (threatening miscarriage, premature delivery, anaemia) and from labour and delivery (labour abnormalities) in the smoking women occurs at almost twice the rate in those non-smoking, threatening miscarriage and anaemia notably having a more severe clinical picture and being more reluctant to the therapy. Smoking is one of the risk factors of hyperhomocysteinemia, which is in turn a marker of the folate metabolism impairment in the organism. It has been shown that homocysteine plasma level increases in the smoking pregnant women. Besides, a significant decrease in folate plasma level has been found in the same women. It is a folate deficiency that most of all raises homocysteine level in blood plasma. It has been proved that elevated homocysteine level has a direct toxic effect on the endothelium. Microthrombosis and microcirculation loss result in a series of obstetric complications. In late pregnancy, hyperhomocysteinemia causes chronic fetoplacental insufficiency and chronic intrauterine hypoxia. Therefore, many complications from pregnancy, such as gestosis and fetoplacental insufficiency, are associated with hyperhomocysteinemia, which is most probably caused by the smoking derived folate metabolism impairment. Supplementary folate and vitamin B complex therapy may possibly improve the pregnancy and delivery outcome in the pregnant women with high homocysteine plasma level. This, however, requires supportive clinical trials. Smoking cessation at birth spacing and prevention of hyperhomocysteinemia must be an essential condition for favourable prognosis for pregnancy.

scholarly journals Effect and Safety of Iron Supplementation on Mild Thalassemia Complicated by Iron Deficiency in Late Pregnancy

2021 ◽  
Vol 5 (6) ◽  
pp. 15-18
Author(s):  
Yanchuan Li ◽  
Yanfeng Liu ◽  
Xue Li ◽  
Limin Hou
Keyword(s):  
Iron Deficiency ◽  
Hemorrhagic Shock ◽  
Pregnant Women ◽  
Research Group ◽  
Iron Supplementation ◽  
Late Pregnancy ◽  
Premature Delivery ◽  
Control Group ◽  
Significant Difference ◽  
Intrapartum Hemorrhage

Aim: To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy. Methods: 376 patients with mild thalassemia complicated by iron deficiency in late pregnancy treated in our hospital from July 2019 to June 2021 were selected and recruited in the research group, and 200 normal pregnant women treated in the same period were selected and recruited in the control group. Hemoglobin (Hb), reticulocyte blood, red blood protein (RET he) level, ferritin (SF) level, soluble transferrin receptor (sTfR) level, adverse maternal and infant outcomes, etc. were analyzed. Results: There was no significant difference in the levels of SF, Hb, RET he and sTfR between the two groups before treatment. After treatment, the levels of SF, Hb, RET he and sTfR in the research group were significantly improved, which was statistically significant compared with the control group. The frequencies of intrapartum hemorrhage, premature delivery, stillbirth, hemorrhagic shock, and neonatal asphyxia in the research group were 289±47.88, 36 (9.57%), 0 (0.00%), 25 (6.65%), and 6 (1.26%), respectively. The frequencies of intrapartum hemorrhage, premature delivery, stillbirth, hemorrhagic shock, and neonatal asphyxia in the control group were 284 ± 46.99, 7 (3.50%), 0 (0.00%), 6 (3.00%), and 0 (0.00%), respectively. There were significant differences in preterm delivery and hemorrhagic shock, and there was no significant difference in other delivery outcomes. Conclusions: Under the premise of strictly controlling the iron reserve in pregnant women, continuous medication until the end of delivery may be conducive to the control of maternal thalassemia complicated by iron deficiency and the improvement of pregnancy outcome.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Test System ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Wide Range ◽  
Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

Fibrin monomer complex in normal pregnant women: a potential thrombotic marker in pregnancy

2007 ◽  
Vol 44 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Hiroaki Onishi ◽  
Kimiko Kaniyu ◽  
Mitsutoshi Iwashita ◽  
Asashi Tanaka ◽  
Takashi Watanabe
Keyword(s):  
Pregnant Women ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Reference Ranges ◽  
Vein Thrombosis ◽  
Fibrin Monomer ◽  
Potential Marker ◽  
Deep Vein ◽  
Positive Results ◽  
In Pregnancy

Background: Pregnancy represents a major risk factor for deep vein thrombosis (DVT). Most coagulation/fibrinolysis markers currently utilized change during pregnancy, and therefore they cannot accurately evaluate thrombotic events in pregnancy because the rate of false positive results is high. Fibrin monomer complex (FMC) has recently become widely available for diagnosing DVT. The present study examined whether FMC is suitable for evaluating thrombotic status in pregnancy. Methods: Concentrations of FMC and other haemostatic markers were investigated in 87 pregnant women without major complications at early, mid- or late pregnancy. FMC concentrations were also measured in 127 normal non-pregnant women, and in one woman who developed DVT after delivery. Results: In normal pregnant women, FMC concentrations were unchanged during early or mid-pregnancy and slightly elevated during late pregnancy. Concentrations were within reference range in most cases, and none exceeded the cut-off value for DVT. In contrast, thrombin-antithrombin complex (TAT) and D-dimer (DD) concentrations were significantly elevated in late pregnancy, and median values exceeded reference ranges. The DVT case displayed significantly elevated FMC concentrations. Conclusions: Changes in FMC concentrations during normal pregnancy are minimal compared with other haemostatic markers. Because the rate of false positivity is lower, FMC could be a potential marker of thrombotic status in pregnancy rather than TAT and DD.

Concentrations of progesterone and oestradiol-17β after administration of a 3β-hydroxysteroid dehydrogenase inhibitor to sheep in late pregnancy

1987 ◽  
Vol 113 (1) ◽  
pp. 97-101 ◽  
Author(s):  
M. J. Taylor
Keyword(s):  
Plasma Concentrations ◽  
Late Pregnancy ◽  
Hydroxysteroid Dehydrogenase ◽  
Premature Delivery ◽  
Plasma Progesterone ◽  
Twofold Increase ◽  
Rapid Fall

ABSTRACT An inhibitor of 3β-hydroxysteroid dehydrogenase (3β-HSD) activity was administered to sheep in late pregnancy. A rapid fall in plasma progesterone concentrations followed, associated with premature delivery by all animals 44±3 h (s.e.m.) after administration of inhibitor. A significant (about twofold) increase in plasma concentrations of oestradiol-17β was detected immediately before delivery. These results demonstrate, in contrast to previous reports, that 3β-HSD inhibitors have the capacity consistently to induce premature delivery associated with increased oestrogen release in sheep. J. Endocr. (1987) 113, 97–101

scholarly journals A Novel Nomogram for Predicting the Risk of Premature Delivery Based on the Thyroid Function in Pregnant Women

2022 ◽  
Vol 12 ◽  
Author(s):  
Yu Meng ◽  
Jing Lin ◽  
Jianxia Fan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Premature Delivery ◽  
Multivariable Logistic Regression Analysis ◽  
Decision Curve Analysis ◽  
Cutoff Values ◽  
Lemeshow Test ◽  
Maternal Thyroid

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 &gt; 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

scholarly journals The impact of levothyroxine exposure on delivery outcome in hypothyroid pregnant women (PETAL study): A five-year retrospective cohort study

2021 ◽  
pp. 1753495X2110641
Author(s):  
Diana Oprea ◽  
Nadine Sauvé ◽  
Jean-Charles Pasquier
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Singleton Pregnancy ◽  
Delivery Outcome ◽  
The Impact

Background Hypothyroidism affects 3% of pregnant women, and to date, no studies have addressed the impact levothyroxine-treated hypothyroidism on delivery outcome. Methods This retrospective cohort study was conducted among 750 women with a singleton pregnancy who gave birth between 2015 and 2019. Delivery modes were compared between 250 hypothyroid women exposed to levothyroxine and 500 euthyroid control women. The aim of this study was to determine the impact of levothyroxine exposure on delivery outcome. Results Multiple logistic regression showed no significant association between exposure to levothyroxine and the overall rate of caesarean delivery (aOR 1.1; 95% CI 0.8 to 1.6). Mean TSH concentrations were significantly higher throughout the pregnancy in hypothyroid women despite levothyroxine treatment. Maternal and neonatal outcomes in both groups were not different. Conclusion Hypothyroidism treated with levothyroxine during pregnancy according to local guidelines is not a significant risk factor for caesarean delivery.

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