scholarly journals Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

2019 ◽  
Vol 9 (1) ◽  
pp. 23
Author(s):  
Kiran Agarwal ◽  
Ritu . ◽  
Amrita Singh ◽  
Anjali Singh ◽  
Amrita Mishra
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
First Trimester ◽  
Growth Restriction ◽  
Antepartum Haemorrhage ◽  
Increased Risk ◽  
The Difference ◽  
Nicu Admission

Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups.

Early growth outcomes in very low birth weight infants with bronchopulmonary dysplasia or fetal growth restriction

2020 ◽  
Vol 88 (4) ◽  
pp. 601-604
Author(s):  
Jennifer Check ◽  
Elizabeth T. Jensen ◽  
Joseph A. Skelton ◽  
Walter T. Ambrosius ◽  
T. Michael O’Shea
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Very Low Birth Weight ◽  
Early Growth ◽  
Growth Restriction ◽  
Low Birth Weight Infants ◽  
Growth Outcomes

scholarly journals Maternal and Fetal Outcome in Antepartum Haemorrhage of Unknown Origin in Chennai, India

2021 ◽  
Vol 10 (31) ◽  
pp. 2481-2484
Author(s):  
Swetha Gulabi Gaddam ◽  
Vijithra Thangamani
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Unknown Origin ◽  
Study Group ◽  
Antepartum Haemorrhage ◽  
Increased Risk ◽  
Nicu Admission

BACKGROUND Antepartum haemorrhage of unknown origin (APHUO) being a diagnosis of exclusion, is a rare condition which poses dilemma in the management of pregnancy in terms of timing and mode of delivery. The purpose of this study was to evaluate antenatal factors associated with APHUO, clinical presentation and analyse its impact on pregnancy and its outcome. METHODS This is a retrospective study conducted over a period of two years in a tertiary care hospital. Pregnancy outcomes were compared between 41 cases who had APHUO versus 39 controls who never had history of bleeding in their antepartum period. Bleeding pattern, incidence of preterm labour, intra partum and postpartum complications, mode of delivery, birth weight, APGAR (appearance, pulse, grimace, activity, and respiration) score of the baby and neo-natal intensive care unit (NICU) admission were analysed. RESULTS Patients with APHUO had subclinical abruption and increased risk of preterm delivery. Intrapartum and postpartum complications were similar among both the groups. The average birth weight was much lesser in the study group, but the cause was attributed to prematurity. These findings were consistent with the previous studies. CONCLUSIONS APHUO is associated with subclinical abruption and increased risk of preterm labour. Hence the patient should be counselled for delivery at a tertiary care center with adequate neonatal care. Greater incidence of NICU admission and low birth weight were attributed to prematurity among the study group. Induction of labour at term in this group is of questionable value unless there is an associated obstetric indication. KEY WORDS APHUO, Preterm Labour, Sub Clinical Abruption, Low Birth Weight

scholarly journals PRETERM BIRTH AND FETAL GROWTH RESTRICTION IN HIV-INFECTED BRAZILIAN PREGNANT WOMEN

2015 ◽  
Vol 57 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Helena Lucia Barroso DOS REIS ◽  
Karina da Silva ARAUJO ◽  
Lilian Paula RIBEIRO ◽  
Daniel Ribeiro DA ROCHA ◽  
Drielli Petri ROSATO ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Hiv Infection ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Low Income ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Southeastern Brazil

Introduction: Maternal HIV infection and related co-morbidities may have two outstanding consequences to fetal health: mother-to-child transmission (MTCT) and adverse perinatal outcomes. After Brazilian success in reducing MTCT, the attention must now be diverted to the potentially increased risk for preterm birth (PTB) and intrauterine fetal growth restriction (IUGR). Objective: To determine the prevalence of PTB and IUGR in low income, antiretroviral users, publicly assisted, HIV-infected women and to verify its relation to the HIV infection stage. Patients and Methods: Out of 250 deliveries from HIV-infected mothers that delivered at a tertiary public university hospital in the city of Vitória, state of Espírito Santo, Southeastern Brazil, from November 2001 to May 2012, 74 single pregnancies were selected for study, with ultrasound validated gestational age (GA) and data on birth dimensions: fetal weight (FW), birth length (BL), head and abdominal circumferences (HC, AC). The data were extracted from clinical and pathological records, and the outcomes summarized as proportions of preterm birth (PTB, < 37 weeks), low birth weight (LBW, < 2500g) and small (SGA), adequate (AGA) and large (LGA) for GA, defined as having a value below, between or beyond the ±1.28 z/GA score, the usual clinical cut-off to demarcate the 10th and 90th percentiles. Results: PTB was observed in 17.5%, LBW in 20.2% and SGA FW, BL, HC and AC in 16.2%, 19.1%, 13.8%, and 17.4% respectively. The proportions in HIV-only and AIDS cases were: PTB: 5.9 versus 27.5%, LBW: 14.7% versus 25.0%, SGA BW: 17.6% versus 15.0%, BL: 6.0% versus 30.0%, HC: 9.0% versus 17.9%, and AC: 13.3% versus 21.2%; only SGA BL attained a significant difference. Out of 15 cases of LBW, eight (53.3%) were preterm only, four (26.7%) were SGA only, and three (20.0%) were both PTB and SGA cases. A concomitant presence of, at least, two SGA dimensions in the same fetus was frequent. Conclusions: The proportions of preterm birth and low birth weight were higher than the local and Brazilian prevalence and a trend was observed for higher proportions of SGA fetal dimensions than the expected population distribution in this small casuistry of newborn from the HIV-infected, low income, antiretroviral users, and publicly assisted pregnant women. A trend for higher prevalence of PTB, LBW and SGA fetal dimensions was also observed in infants born to mothers with AIDS compared to HIV-infected mothers without AIDS.

Critical Coarctation of the Aorta in Selective Fetal Growth Restriction and the Role of Coronary Stent Implantation

2020 ◽  
Vol 47 (10) ◽  
pp. 740-748
Author(s):  
Manon Gijtenbeek ◽  
Monique C. Haak ◽  
Arend D.J. ten Harkel ◽  
Regina Bökenkamp ◽  
Benedicte Eyskens ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Stent Implantation ◽  
Fetal Growth Restriction ◽  
Heart Defects ◽  
Coarctation Of The Aorta ◽  
Growth Restriction ◽  
Monochorionic Twins ◽  
Coronary Stent Implantation ◽  
Increased Risk

<b><i>Introduction:</i></b> Monochorionic twins are at increased risk of congenital heart defects (CHDs). Up to 26% have a birth weight &#x3c;1,500 g, a CHD requiring neonatal surgery, therefore, poses particular challenges. <b><i>Objective:</i></b> The aim of the study was to describe pregnancy characteristics, perinatal management, and outcome of monochorionic twins diagnosed with critical coarctation of the aorta (CoA). <b><i>Methods:</i></b> We included monochorionic twins diagnosed with critical CoA (2010–2019) at 2 tertiary referral centers, and we systematically reviewed the literature regarding CoA in monochorionic twins. <b><i>Results:</i></b> Seven neonates were included. All were the smaller twin of pregnancies complicated by selective fetal growth restriction. The median gestational age at birth was 32 weeks (28–34). Birth weight of affected twins ranged as 670–1,800 g. One neonate underwent coarctectomy at the age of 1 month (2,330 g). Six underwent stent implantation, performed between day 8 and 40, followed by definitive coarctectomy between 4 and 9 months in 4. All 7 developed normally, except for 1 child with neurodevelopmental delay. Three co-twins had pulmonary stenosis, of whom 1 required balloon valvuloplasty. The literature review revealed 10 cases of CoA, all in the smaller twin. Six cases detected in the first weeks after birth were treated with prostaglandins alone, by repeated transcatheter angioplasty or by surgical repair, with good outcome in 2 out of 6. <b><i>Conclusions:</i></b> CoA specifically affects the smaller twin of growth discordant monochorionic twin pairs. Stent implantation is a feasible bridging therapy to surgery in these low birth weight neonates.

scholarly journals Fetal growth restriction in a cohort of migrants in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliane Ankert ◽  
Tanja Groten ◽  
Mathias W. Pletz ◽  
Sasmita Mishra ◽  
Gregor Seliger ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Birth Outcomes ◽  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Caesarian Section ◽  
Growth Restriction ◽  
Delivery Mode

Abstract Background Migrant women may have an increased risk of adverse birth outcomes. This study analyses the occurrence of low birth weight, preterm birth and intrauterine growth restriction / fetal growth restriction (IUGR/FGR) in pregnant migrants. Method Cross-sectional study of 82 mother-child pairs of pregnant migrants attending medical care in Germany. Results The Median age was 27 years, 49% of patients were of oriental-asian ethnicity and median year of migration was 2015. At least one previous pregnancy was reported in 76% of patients, in 40% the delivery mode was caesarian section. Median gestational age was 39.7 weeks. Preterm birth occurred in 6.1% of pregnancies. Median gestational age for preterm birth was 32.3 weeks. Low birth weight (< 2500 g) occurred in 6.1%. Birth weights below the 10th percentile of birth weight for gestational age were observed in 8.5% of the total cohort. Conclusions Compared to German data no increased occurrence of low birth weight, preterm birth or IUGR/FGR was found. We note that the rate of caesarian section births was higher than in the general population for reasons yet to be identified. The authors propose stratification according to migration status for the national documentation of birth outcomes in Germany.

Loss of a close family member the year before or during pregnancy and the risk of placental abruption: a cohort study from Denmark and Sweden

2013 ◽  
Vol 44 (9) ◽  
pp. 1855-1866 ◽  
Author(s):  
K. D. László ◽  
C. V. Ananth ◽  
A. K. Wikström ◽  
T. Svensson ◽  
J. Li ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Placental Abruption ◽  
Maternal Stress ◽  
First Trimester ◽  
Growth Restriction ◽  
Chronic Hypertension ◽  
Increased Risk ◽  
First Trimester Of Pregnancy ◽  
Close Family

BackgroundMaternal stress during pregnancy is associated with a modestly increased risk of fetal growth restriction and pre-eclampsia. Since placental abruption shares similar pathophysiological mechanisms and risk factors with fetal growth restriction and pre-eclampsia, we hypothesized that maternal stress may be implicated in abruption risk. We investigated the association between maternal bereavement during pregnancy and placental abruption.MethodWe studied singleton births in Denmark (1978–2008) and Sweden (1973–2006) (n = 5 103 272). In nationwide registries, we obtained data on death of women's close family members (older children, siblings, parents, and partners), abruption and potential confounders.ResultsA total of 30 312 (6/1000) pregnancies in the cohort were diagnosed with placental abruption. Among normotensive women, death of a child the year before or during pregnancy was associated with a 54% increased odds of abruption [95% confidence interval (CI) 1.30–1.82]; the increased odds were restricted to women who lost a child the year before or during the first trimester in pregnancy. In the group with chronic hypertension, death of a child the year before or in the first trimester of pregnancy was associated with eight-fold increased odds of abruption (odds ratio 8.17, 95% CI 3.17–21.10). Death of other relatives was not associated with abruption risk.ConclusionsLoss of a child the year before or in the first trimester of pregnancy was associated with an increased risk of abruption, especially among women with chronic hypertension. Studies are needed to investigate the effect of less severe, but more frequent, sources of stress on placental abruption risk.

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