scholarly journals Mifepristone-misoprostol combination in medical termination of early pregnancy

2018 ◽  
Vol 7 (3) ◽  
pp. 1035
Author(s):  
Devdatt Laxman Pitale
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
Contraceptive Methods ◽  
Incomplete Abortion ◽  
Medical Termination ◽  
Products Of Conception ◽  
Surgical Methods ◽  
Unwanted Pregnancies

Background: Unplanned and unwanted pregnancies are common worldwide despite of the medical advancements and wider availability of contraceptive methods. The development of safe, effective, inexpensive, nonsurgical methods of abortion is thus highly desirable. Objective of present study was to evaluate the effectiveness of Mifepristone 200 mg orally followed by Misoprostol 800 µg intravaginally 48 hours later in women undergoing medical termination of early pregnancy (up to 63 days of gestational age).Methods: The present study included 100 pregnant women requesting termination of pregnancy in first trimester attending the department of Obstetrics and Gynecology. Women with gestational age up to 63 days from the first day of the last menstrual period with previous regular cycles were studied. Patients without medical or surgical contraindications to Mifepristone and Misoprostol were included.Results: Majority of the pregnant women belonged to the age group between 20-30 years. 30% of these women were nulliparous and 70 % were multiparous. The period of gestation varied from 35-63 days.90% of the patients had complete abortion and 10% had incomplete abortion. All the patients expelled the products of conception within 24 hours of prostaglandin administration. The adverse effects reported were nausea reported by 30%, vomiting by 5 %and diarrhea by 2% of the cases. None of the patients reported excess bleeding at the time of abortion, hospitalization or blood transfusion. This regimen has the effectiveness of complete abortion rate with few side effects.Conclusions: The Mifepristone- Misoprostol combination offers an effective, acceptable, out-patient procedure and an alternative to surgical methods of abortion in medical termination of early pregnancy (up to 63 days of gestation).

Establishment of Early Pregnancy Related Thyroid Hormone Models and Reference Intervals for Pregnant Women in China Based on Real World Data

2021 ◽  
Vol 53 (04) ◽  
pp. 272-279
Author(s):  
Chaochao Ma ◽  
Xiaoqi Li ◽  
Lixin Liu ◽  
Xinqi Cheng ◽  
Fang Xue ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Dynamic Change ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Stimulating Hormone

AbstractThyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.

scholarly journals THE STUDY OF EFFICACY OF SUBLINGUAL MISOPROSTOL IN TERMINATION OF EARLY PREGNANCY

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Arti Kumari ◽  
Usha Kumari ◽  
Anupama Sinha
Keyword(s):  
Side Effects ◽  
Spontaneous Abortion ◽  
Early Pregnancy ◽  
Gestational Age ◽  
High Efficacy ◽  
Missed Abortion ◽  
Pregnancy Failure ◽  
Products Of Conception ◽  
Early Pregnancy Failure ◽  
Sublingual Misoprostol

Introduction: Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol’s use in early pregnancy failure is varied and dose and route are not well established. AIM: To study the efficacy of sublingual misoprostol in causing expulsion of products of conception in early pregnancy failure. Methods: Women with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were included in the study. Tablet Misoprostol 600 mcg was given six hourly sublingually for 3 doses. All observations were noted and analyzed. Results: Mean gestational age was 7.946+1.2 weeks. Mean induction abortion interval was 18.241+1.2 hours. Women with gestational age six to eight weeks had least mean induction-abortion interval time of 17.38+2.86. Mean dose required was 1560mcg. Efficacy of protocol was 92.85% in achieving complete abortion. Conclusion: The regime had 92.85% efficacy, acceptability (90%) and few side effects. Thus by using a lower dose and appropriate interval between two doses (six hours), the side effects were lessened with high efficacy. Keywords: Efficacy, Missed Abortion, Misoprostol.

scholarly journals The possibility of modifications methods of determine volume of amniotic fluid

2016 ◽  
Vol 65 (3) ◽  
pp. 12-17
Author(s):  
Viktor A Mudrov
Keyword(s):  
Body Mass Index ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
First Trimester ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Pregnancy And Childbirth ◽  
Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of methods for determining the expected volume of amniotic fluid. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 300 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, Group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected volume of amniotic fluid were used the subjective method, the Chamberlain’s and Phelan’s methods. The error in determining volume of amniotic fluid by the existing methods exceeds 10 %, that defined need of creation of a quantitative method. On the basis of mathematical and 3d-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: VAF = IAF × М × π / GA2, where IAF - index of amniotic fluid (mm), M - fetal weight (g), GA - gestational age (weeks). Through a comprehensive analysis of anthropometric research of the pregnant women defined formula’s volume of amniotic fluid: V = 0,017 × HUF × (AC - 25 × BMI / GA)2 - М, where GA - gestational age (weeks), AC - abdominal circumference of the pregnant women (cm), BMI - body mass index for Quetelet in the first trimester of pregnancy (kg/m2), HUF - height of an uterine fundus (cm), M - the estimated fetal weight (g). In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3 %, anthropometric formula error does not exceed 10,2 %. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine volume of amniotic fluid in II and III trimester of pregnancy.

O-234 Using serum metabolomics to identify biomarkers of viable early, intrauterine pregnancy: an untargeted 1H NMR-based approach

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Hill ◽  
M Phelan ◽  
A Horne ◽  
K Gemzell-Danielsson ◽  
N Tempest ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
1H Nmr ◽  
Early Pregnancy ◽  
Pregnancy Outcomes ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies ◽  
Twin Pregnancies

Abstract Study question Which metabolites are associated with a viable intrauterine pregnancy (VIUP) when compared to other early pregnancy outcomes (failed intrauterine and ectopic pregnancies)? Summary answer Serum levels of four metabolites (phenylalanine, alanine, glutamate and glutamine) were significantly altered in VIUPs compared to other early pregnancy outcomes. What is known already Around 10% of all intrauterine pregnancies are lost in the first trimester. A further 1-2% of pregnancies are located outside the endometrial cavity; these ectopic pregnancies are the leading cause of maternal mortality in the first trimester of gestation. Early miscarriages may also cause significant morbidity when bleeding or infection occurs. The symptoms of miscarriages and ectopic pregnancy are often similar (pain and bleeding), however, such symptoms are also common in VIUPs. To date, no biomarkers have been identified to differentiate VIUPs from non-viable and ectopic pregnancies. Study design, size, duration This is a prospective cohort study that included 332 pregnant women at less than ten weeks of gestation, who attended the early pregnancy assessment unit (EPAU) at Liverpool Women’s Hospital with pain and/or bleeding. Participants/materials, setting, methods Blood samples were collected from the 332 pregnant women prior to final clinical diagnosis of pregnancy outcome. Serum samples were subjected to NMR metabolomics profiling (14 spectra that did not meet the recommended minimum reporting standards were removed from subsequent analysis). 1D 1H-NMR spectra were acquired at 37 °C on a 700 MHz spectrometer. Relative metabolite abundances underwent statistical analysis using MetaboAnalyst 5.0 (p-value FDR adjusted). Main results and the role of chance Final pregnancy outcomes were as follows: one hydatidiform mole (0.3%), 48 ectopic pregnancies (14.4%), three pregnancies of unknown location (PULs, 0.9%), 78 failed pregnancies of unknown location (FPULs, 23.4%), 47 miscarriages (14.1%), two vanishing twin pregnancies (0.6%) and 153 VIUPs (45.8%). Due to small sample numbers, the hydatidiform mole, PULs and vanishing twin pregnancies were excluded from further analysis. To compare VIUPs to other pregnancy outcomes, ectopic pregnancies, FPULs and miscarriages were grouped together. Univariate analysis of serum metabolite concentrations identified four metabolites (phenylalanine, alanine, glutamate and glutamine) as significantly different in VIUPs compared to other pregnancy outcomes. Multivariate partial least squared discriminant analysis provided only weak correlation between the serum metabolome and pregnancy outcome. In summary, we have identified differences in the metabolome of women with VIUPs compared to other common pregnancy outcomes, which may provide diagnostic utility. Limitations, reasons for caution In this study, women with VIUPs presented with pain and/or bleeding. The presence of symptoms may influence the metabolome of this group versus VIUPs without symptoms, thus limiting the translation of our findings. Furthermore, environmental factors were not controlled (e.g. fasting status), making it likely that cohort heterogeneity was enhanced. Wider implications of the findings This study identifies a metabolite profile associated with VIUPs. These findings may be useful in the development of a diagnostic test to confirm VIUPs and thus exclude potentially life-threatening pregnancy outcomes. Such a test would be invaluable in clinical emergencies. Trial registration number NA

Hazards of vaccination in pregnancy

1973 ◽  
Vol 11 (4) ◽  
pp. 13-15
Keyword(s):  
Pregnant Women ◽  
Yellow Fever ◽  
Early Pregnancy ◽  
First Trimester ◽  
Childbearing Age ◽  
Department Of Health ◽  
Chemical Agents ◽  
Women And Girls ◽  
Yellow Fever Vaccination ◽  
In Pregnancy

With the effects of certain chemical agents and rubella in mind, most authorities advise caution in the use of all vaccines during pregnancy and especially during the first trimester. The booklet issued by the Department of Health and Social Security1 lists pregnancy as a contra-indication to rubella, smallpox and polio vaccinations, with certain provisions, and the manufacturers’ literature adds yellow fever vaccination. Pregnant women wishing to travel obviously pose a problem. Neither the doctor nor the patient may be aware of an early pregnancy and this is always a hazard when vaccinating women and girls of childbearing age. However, apart from rubella and smallpox vaccinations, the risks are hypothetical.

scholarly journals Early pregnancy reference intervals; 29 serum analytes from 4 to 12 weeks’ gestation in naturally conceived and uncomplicated pregnancies resulting in live births

2019 ◽  
Vol 57 (12) ◽  
pp. 1956-1967 ◽  
Author(s):  
Jesper Friis Petersen ◽  
Lennart J. Friis-Hansen ◽  
Andreas Kryger Jensen ◽  
Anders Nyboe Andersen ◽  
Ellen C.L. Løkkegaard
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Clinical Chemistry ◽  
Clinical Care ◽  
Local Population ◽  
First Trimester ◽  
Reference Intervals ◽  
Specific Reference ◽  
Cancer Antigen 125 ◽  
Serum Samples

Abstract Background Pregnancy introduces major physiological changes that also alter biochemical analytes. Maternal and perinatal health can be optimized by early intervention and therefore, pregnancy-specific reference intervals (RIs) for the local population are warranted. While the second and third trimester-specific changes are well described, the first trimester is less well characterized. We therefore wanted to facilitate early detection of abnormalities by generating first trimester reference values for 29 common analytes. Methods In a prospective early pregnancy (PEP) cohort (2016–2017), 203 pregnant women were recruited from 4 to 8 weeks’ gestation. Consecutive blood samples were drawn every 2 weeks until an ongoing second trimester pregnancy (n = 164) or a miscarriage (n = 39) occurred. After exclusion of women with complicated pregnancies or deliveries (n = 42), 122 women were included. The serum samples collected at <6, 6–8, 8–10, 10–12 and >12 weeks’ gestation were analyzed for 29 common analytes. Subsequently the RIs were calculated according to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommendations (2.5–97.5th percentiles) and compared with the conventional RIs for non-pregnant women. Results Human chorionic gonadotropin (hCG), progesterone (P4), estradiol (E2), pregnancy-associated plasma protein A (PAPP-A), cancer antigen 125 (CA125), thyroid stimulating hormone (TSH), creatinine (CREA) and albumin (ALB) showed an early pregnancy-dependent change compared with conventional limits. For ALB the change was seen at 5.5 weeks’ gestation. Conclusions We report gestational age-specific RIs available from the early part of the first trimester applicable to everyday clinical care of pregnant women. Well-known alterations of RIs seen in later trimesters are also observed in the first.

Gestational age-specific reference intervals for 15 biochemical measurands during normal pregnancy in China

2017 ◽  
Vol 55 (4) ◽  
pp. 446-452 ◽  
Author(s):  
Yanpeng Dai ◽  
Junjie Liu ◽  
Enwu Yuan ◽  
Yushan Li ◽  
Quanxian Wang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Parametric Method ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Reference Intervals ◽  
Specific Reference ◽  
Gamma Glutamyl Transpeptidase ◽  
Cross Sectional ◽  
Laboratory Results

Aims Physiological changes that occur during pregnancy can influence biochemical parameters. Therefore, using reference intervals based on specimens from non-pregnant women to interpret laboratory results during pregnancy may be inappropriate. This study aimed to establish the essential reference intervals for a range of analytes during pregnancy. Methods A cross-sectional study was performed in 13,656 healthy pregnant and 2634 non-pregnant women. Fifteen biochemical measurands relating to renal and hepatic function were analysed using an Olympus AU5400 analyzer (Olympus, Tokyo, Japan). All the laboratory results were checked for outliers using Dixon’s test. Reference intervals were established using a non-parametric method. Results Alanine aminotransferase, aspartate aminotransferase, albumin, cholinesterase, creatinine, direct bilirubin, gamma-glutamyl transpeptidase, total bilirubin, total bile acid and total protein showed a decrease during the whole gestational period, while alkaline phosphatase and uric acid increased. Urea nitrogen, β2-microglobulin and cystatin-C fell significantly during the first trimester and then remained relatively stable until third trimester. Reference intervals of all the measurands during normal pregnancy have been established. Conclusions The reference intervals established here can be adopted in other clinical laboratories after appropriate validation. We verified the importance, for some measurands, of partitioning by gestational age when establishing reference intervals during pregnancy.

scholarly journals Fetal haemoglobin and alpha 1 microglobulin as biochemical markers in predicting preeclampsia in late first trimester and early second trimester of pregnancy

2018 ◽  
Vol 7 (8) ◽  
pp. 3226 ◽  
Author(s):  
S. Vijaya ◽  
M. Mahalakshmi ◽  
I. Inbapriyanka
Keyword(s):  
Oxidative Stress ◽  
Pregnant Women ◽  
Gestational Age ◽  
Subsequent Development ◽  
Fetal Hemoglobin ◽  
First Trimester ◽  
Antioxidant Property ◽  
Maternal Blood ◽  
Fetal Haemoglobin ◽  
System Disorder

Background: Preeclampsia is a multi system disorder with placenta as the organ of origin and maternal endothelium being the organ of target.  According to recent studies, the cell free haemoglobin induces oxidative stress mediated damage to the blood placenta barrier with consequently elevated levels of HbF in maternal blood. Alpha 1 microglobulin is an endogenous protein with antioxidant property, present in elevated levels in maternal blood in response to oxidative stress. This fact forms the basis for our study. The objective of the present study was to establish association between high levels of fetal hemoglobin and alpha 1 microglobulin in plasma of pregnant women between 10 to 16 weeks of gestational age and subsequent development of preeclampsia.Methods: This was a prospective cohort study undertaken in the Department of Obstetrics and Gynaecology, ISO -KGH, between December 2016 to November 2017. A total of 100 pregnant women were included in the study after getting informed written consent. Both primigravida and multigravida, belonging to age group of 20 to 35 years (singleton/ multiple) between 10 to 16 weeks GA and with BMI between 16 to 35 kg/m2 were included in the study. A woman with Diabetes mellitus, Hypertension, Renal disease, Epilepsy and Vascular disorders were excluded from the study.Results: The cut off value for alpha 1 microglobulin was 1.86ng/ml and the cut off value of fetal haemoglobin was 1.92ng/ml above which the pregnant women develop preeclampsia.Conclusions: Higher values of fetal hemoglobin and alpha 1 microglobulin in pregnant women between 10 to 16 weeks gestational age positively correlates with development of preeclampsia in those women.

scholarly journals Assessment of Thyroid Function in Early Pregnancy

2018 ◽  
Vol 19 (2) ◽  
pp. 98
Author(s):  
Mohammad Saifur Rahman ◽  
Sadia Sultana ◽  
Ayesha Nazneen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Correct Diagnosis ◽  
First Trimester ◽  
Military Hospital ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Cross Sectional ◽  
In Pregnancy

<p><strong>Objectives:  </strong>Thyroid disorders are commonly observed in pregnancy. Thyroid hormones play an important role in embryogenesis and fetal development. The fetus is completely dependent on the mother for thyroid hormone in first trimester. About 10% of all pregnant women can be affected by thyroid disorders during pregnancy. Thyroid function abnormalities in pregnancy are a challenge for the concerned physicians.  The objective of this study was to assess the maternal thyroid function in first trimester of pregnancy.</p><p><strong>Patients and Methods: </strong>A descriptive cross sectional study was carried out at the Combined Military Hospital (CMH), Dhaka over a period of one year from January 2013 to December 2013 to see the serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, thyroid antibodies level and common thyroid disorders in pregnancy. A total of 138 pregnant women in their first trimester (up to 12 weeks) of pregnancy with an age range of 18-35 years were enrolled in this study. Pregnant women with known thyroid disorder and on treatment and pregnancy more than three months were excluded. Measurement of serum FT<sub>3</sub>, FT<sub>4</sub>, TSH, Anti TPO-Ab and Anti TG-Ab were done in each patient at the time of enrolment. Ultrasonography of each patient was done for confirmation of pregnancy and correlation of gestational age.</p><p><strong>Results:  </strong>Among 138 pregnant women, subclinical hypothyroidism was detected in 10 (7.2%) patients and subclinical hyperthyroidism was detected in 3 (2.2%) patients. Mean difference of the investigation findings were not statistically significant among primi and multi gravida. TPO-Ab and TG-Ab difference were statistically significant between two age groups.</p><p><strong>Conclusion: </strong>Subclinical thyroid disorders are fairly high among pregnant women. Correct diagnosis in early pregnancy and prompt treatment will bring an excellent prognosis for both mother and offspring.</p><p>Bangladesh J. Nuclear Med. 19(2): 98-102, July 2016</p>

scholarly journals Relative Risk Assessment of Intrauterine Infection of the Fetus During Cytomegalovirus Infection in Early Pregnancy

2019 ◽  
Vol 4 (3) ◽  
pp. 45-51 ◽  
Author(s):  
K. K. Petrova
Keyword(s):  
Risk Assessment ◽  
Relative Risk ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Cmv Infection ◽  
Significant Difference ◽  
First Trimester Of Pregnancy ◽  
Relative Risk Assessment

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of  choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.

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