scholarly journals SLE during pregnancy, maternal and perinatal outcome in teritary hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 507 ◽  
Author(s):  
. Leelavathi ◽  
Nayana D. H. ◽  
Triveni Kondareddy ◽  
Kaytri S.
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Multidisciplinary Approach ◽  
High Rate ◽  
Therapeutic Interventions ◽  
Successful Management ◽  
Lupus Flare ◽  
Multisystem Involvement ◽  
Improved Outcomes ◽  
Child Bearing

Background: SLE is an autoimmune disease most frequently found in women of child bearing age and may co­exist with pregnancy. Its multisystem involvement and therapeutic interventions pose a high risk for both the mother and the foetus. Disease flares in pregnancy pose challenges with respect to distinguishing physiologic changes related to pregnancy from disease related manifestations. The present study analyzes the fetomaternal outcome of pregnant women with SLE.Methods: An analysis of fetomaternal outcome of pregnant women with SLE during April  2015 to May 2016 at JSS hospital.Results: During the period from April 2016 to May 2016, 3773 deliveries were conducted in the department. Eleven pregnant women with SLE were followed up during this period, giving an incidence of 0.29/1000 deliveries. A high rate of lupus flare during pregnancy was found in the current study. Even among women in remission for more than six months before pregnancy, the rate of lupus flare was not low (27%). Also other complications seen were pre-eclampsia 54.54%, HELLP syndrome in 9.09% , PPH in 50%, polyserositis seen in 9.09% and one maternal death was seen (9.09%). No neonate suffered from heart-blocker however there was 75 % NICU admissions among live borns.Conclusions: Advancing technology and better understanding of the maternal-foetal relationship in lupus have improved outcomes in lupus pregnancies over the last decade. The multisystem nature of the disease, the severity of the organ involvement needs to be assessed and a multidisciplinary approach is required for its diagnosis and successful management.

The Myometrium in Pregnant Women with Obesity

2020 ◽  
Vol 19 (2) ◽  
pp. 193-200
Author(s):  
Jorge A. Carvajal ◽  
Joaquín I. Oporto
Keyword(s):  
Pregnant Women ◽  
Public Health Problem ◽  
Oxytocin Receptor ◽  
High Rate ◽  
K Channel ◽  
Obese Women ◽  
Cesarean Sections ◽  
Cholesterol Levels ◽  
Myometrial Contractility ◽  
Lower Expression

: Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the resulting high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women, compared with that in nonobese women, is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, the disruptions of myometrial myocytes were reviewed in obese women during pregnancy that may explain the dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, a lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function, and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, at least partially explaining the higher rate of cesarean of sections in obese women.

scholarly journals Relationship between sleep-disordered breathing and perinatal outcome in pregnant women

2011 ◽  
Vol 25 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Sachiyo MIYAGAWA ◽  
Yoko EMORI ◽  
Atsuko KAWANO ◽  
Susumu SAKURAI ◽  
Takeshi TANIGAWA
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals Advances in Hepatitis E Virus Biology and Pathogenesis

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 267
Author(s):  
Shaoli Lin ◽  
Yan-Jin Zhang
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Case Fatality ◽  
Hepatitis E ◽  
Host Cells ◽  
High Rate ◽  
Rapid Progression ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Zoonotic Infections

Hepatitis E virus (HEV) is one of the causative agents for liver inflammation across the world. HEV is a positive-sense single-stranded RNA virus. Human HEV strains mainly belong to four major genotypes in the genus Orthohepevirus A, family Hepeviridae. Among the four genotypes, genotype 1 and 2 are obligate human pathogens, and genotype 3 and 4 cause zoonotic infections. HEV infection with genotype 1 and 2 mainly presents as acute and self-limiting hepatitis in young adults. However, HEV infection of pregnant women with genotype 1 strains can be exacerbated to fulminant hepatitis, resulting in a high rate of case fatality. As pregnant women maintain the balance of maternal-fetal tolerance and effective immunity against invading pathogens, HEV infection with genotype 1 might dysregulate the balance and cause the adverse outcome. Furthermore, HEV infection with genotype 3 can be chronic in immunocompromised patients, with rapid progression, which has been a challenge since it was reported years ago. The virus has a complex interaction with the host cells in downregulating antiviral factors and recruiting elements to generate a conducive environment of replication. The virus-cell interactions at an early stage might determine the consequence of the infection. In this review, advances in HEV virology, viral life cycle, viral interference with the immune response, and the pathogenesis in pregnant women are discussed, and perspectives on these aspects are presented.

scholarly journals Cesarean delivery on maternal request and its influencing factors in Chongqing, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruibin Deng ◽  
Xian Tang ◽  
Jiaxiu Liu ◽  
Yuwen Gao ◽  
Xiaoni Zhong
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
High Rate ◽  
Primiparous Woman ◽  
Personal Factors ◽  
Maternal Request ◽  
Primary Indication ◽  
Vaginal Deliveries

Abstract Background A high rate of cesarean delivery has become a cause of global concern. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. Accordingly, how to handle the CDMR rate in China remains an important issue. Methods Data were collected from a longitudinal follow-up study conducted in Chongqing, China, from 2018 to 2019. A structured questionnaire was administered to subjects for data collection. Basic information, including demographic characteristics, living habits, medical history, and follow-up data of pregnant women, as well as their families and society, was collected. Additionally, delivery outcomes were recorded. Logistic regression was performed to analyze the factors influencing CDMR. Results The rate of cesarean delivery in Chongqing, China was 36.01 %, and the CDMR rate was 8.42 %. Maternal request (23.38 %), fetal distress (22.73 %), and pregnancy complications (9.96 %) were the top three indications for cesarean delivery. Logistic regression analysis showed that older age (OR = 4.292, 95 % CI: 1.984–9.283) and being a primiparous woman (OR = 6.792, 95 % CI: 3.230-14.281) were risk factors for CDMR. In addition, CDMR was also associated with factors such as the tendency to choose cesarean delivery during late pregnancy (OR = 5.525, 95 % CI: 2.116–14.431), frequent contact with mothers who had undergone vaginal deliveries (OR = 0.547, 95 % CI: 0.311–0.961), and the recommendation of cesarean delivery by doctors (OR = 4.071, 95 % CI: 1.007–16.455). Conclusions “Maternal request” has become the primary indication for cesarean delivery. The occurrence of CDMR is related to both the personal factors of women during pregnancy and others. Medical institutions and obstetricians should continue popularizing delivery knowledge among pregnant women, enhancing their own professional knowledge about delivery, adhering to the standard indications for cesarean delivery, and providing pregnant women with adequate opportunities for attempting vaginal delivery.

scholarly journals Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1505
Author(s):  
Nirmala Bhandari ◽  
Anjali Gupta ◽  
Simmi Kharb ◽  
Meenakshi Chauhan
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Intracellular Enzyme ◽  
Potential Marker

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia.

scholarly journals Correlation of Doppler assessment of fetal aortic isthmus with perinatal outcome in intrauterine growth restriction

2018 ◽  
Vol 7 (9) ◽  
pp. 3780
Author(s):  
Bhoomika Tantuway ◽  
Y. M. Mala ◽  
Anju Garg ◽  
Reva Tripathi
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Additional Parameter ◽  
Intrauterine Death ◽  
Aortic Isthmus ◽  
Diastolic Velocity

Background: The objective of the present study was to find out association between aortic isthmus Doppler changes and perinatal outcome in growth restricted fetuses with placental insufficiency.Methods: It is a prospective case control study, cases were 43 pregnant women with fetal growth restriction (FGR) with abnormal umbilical artery (UA) Doppler while 43 pregnant women with FGR but normal UA doppler, matched with period of gestation were taken as control. The direction of blood flow in aortic isthmus studied which may be antegrade, absent or retrograde and correlation between qualitative parameters of umbilical artery, aortic isthmus and ductus venosus were studied. Quantitative parameters, PI and RI were also calculated. Patients were managed as per hospital protocols. Perinatal outcome and any adverse event e.g. stillbirth, neonatal death, respiratory distress syndrome, intensive care unit stay >14 days etc. was noted.Results: The number of intrauterine death (IUD) and still birth was increased in women with absent and retrograde flow in aortic isthmus, 66.7% and 71.4% respectively (p value <0.001). Retrograde blood flow in the aortic isthmus is consistently associated with absent or reverse end diastolic velocity in umbilical artery and ductus venosus.Conclusions: Doppler of aortic isthmus is an additional parameter to assess severity of FGR. It plays an important role in termination of preterm FGR fetuses.

scholarly journals Trends in maternal BMI, glycaemic control and perinatal outcome among type 1 diabetic pregnant women in 1989–2008

Diabetologia ◽  
2012 ◽  
Vol 55 (9) ◽  
pp. 2327-2334 ◽  
Author(s):  
M. Klemetti ◽  
M. Nuutila ◽  
M. Tikkanen ◽  
M. A. Kari ◽  
V. Hiilesmaa ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Maternal Bmi

scholarly journals Alloimmunization due to red cell antibodies in Rhesus positive Omani Pregnant Women: Maternal and Perinatal outcome

2015 ◽  
Vol 9 (2) ◽  
pp. 150 ◽  
Author(s):  
Vaidyanathan Gowri ◽  
Tamima Al-Dughaishi ◽  
IkhlassS Al-Rubkhi ◽  
Maymoona Al-Duhli ◽  
Yusra Al-Harrasi
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Red Cell

scholarly journals Results of the Toxoplasmosis Screening in 9311 Pregnant Women in a Tertiary Center in Turkey

2020 ◽  
Vol 25 (3) ◽  
pp. 332-338
Author(s):  
Özgür Koçak ◽  
Özgür Kan
Keyword(s):  
Pregnant Women ◽  
Acute Infection ◽  
Congenital Toxoplasmosis ◽  
Tertiary Hospital ◽  
High Rate ◽  
Central Anatolia ◽  
Confirmatory Test ◽  
Serological Examination ◽  
Tertiary Center ◽  
Avidity Test

Introduction: Toxoplasma gondii is an important parasite that can cause permanent sequelae to the fetus when infected during pregnancy in humans. Although the frequency of this parasite varies widely between countries, it is known that it is common in our country. The aim of this study was to determine the seroprevalence of toxoplasma in pregnant women admitted to a tertiary hospital in central Anatolia and to evaluate the pregnancy outcomes together with seroprevalence. Materials and Methods: A total of 9311 patients admitted to a tertiary hospital between January 2016 and December 2018 were included into the study. After serological examination, avidity test was performed in cases suggestive of acute infection. Amniocentesis was recommended to be performed by Polimeraze Chain Reaction (PCR) in patients with low avidity. Results: The frequency of Toxoplasma immunoglobulin (Ig) G and M seropositivity rates were 20.3% and 0.28%, respectively. Low avidity was found in approximately 27% of the patients with IgM positivity, and only 15.4% had low avidity by confirmatory test. One patient could not be reached during follow-up. PCR was performed in 4 patients whose low avidity value was confirmed by re-tests and all of their PCR results were reported negative. No cases of congenital toxoplasmosis were detected during the 3 years in our clinic. Conclusion: The inclusion of toxoplasma in routine screening programme is still controversial and differs between countries. Screening in areas with a high rate of toxoplasma, such as in our country, may be rational. If infection is detected, treatment may be recommended because it may reduce the transmission to the fetus.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

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