scholarly journals A study of feto-maternal outcome in bleeding per vaginum in first trimester of pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1191
Author(s):  
Jaydeep J. Bhatu ◽  
Darshil S. Prajapati
Keyword(s):  
Vaginal Bleeding ◽  
Local Population ◽  
Previous History ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Maternal Complications ◽  
History Of ◽  
Threatened Abortion ◽  
Degree Of Association ◽  
In Pregnancy

Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly.

Progestogens for treatment and prevention of pregnancy disorders

2010 ◽  
Vol 3 (3) ◽  
Author(s):  
Adolf E. Schindler
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
First Trimester ◽  
Study Groups ◽  
Treatment And Prevention ◽  
Maternal Immune System ◽  
Hydroxyprogesterone Caproate ◽  
History Of ◽  
Threatened Abortion ◽  
In Pregnancy

AbstractProgesterone appears to be the dominant hormone not only establishing a proper secretory endometrial development but also adequate decidualization to establish pregnancy and sustain pregnancy development. Progesterone is the natural immunoregulator to control the maternal immune system and not to reject the allogeneic fetus. There are two sources of progesterone: corpus luteum first and placenta later. Three progestogens can be used in pregnancy: (i) progesterone (per os, intravaginal and intramuscular), (ii) dydrogesterone (per os), and (iii) 17α-hydroxyprogesterone caproate (intramuscular). There are three indications, for which these progestogens can be clinically used either for treatment or prevention: (i) first trimester threatened and recurrent (habitual) abortion, (ii) premature labor/premature birth, and (iii) pre-eclampsia (hypertension in pregnancy). The available data are limited and only partially randomized. In threatened abortion the use of progesterone, dydrogesterone and 17α-hydroxyprogesterone caproate leads to a significant improved outcome, when at the time of threatened abortion a viable fetus has been ascertained by ultrasound. For prevention of recurrent abortion there are also some data indicating a significant effect compared with women without progestogen treatment. Prevention of preterm birth by progestogens (progesterone vaginally, orally and 17α-hydroxyprogesterone caproate intramuscularly) was significantly effective. The main study groups include pregnant women with a previous history of premature birth. However, also in women with shortened cervix use of progesterone seems to be helpful. The studies done so far in women with risk factors for pre-eclampsia or established pre-eclampsia were based on parenteral progesterone application. However, new studies are urgently needed.

Previous induced abortion and ante-natal depression in primiparae: preliminary report of a survey of mental health in pregnancy

1978 ◽  
Vol 8 (4) ◽  
pp. 711-715 ◽  
Author(s):  
R. Kumar ◽  
Kay Robson
Keyword(s):  
Mental Health ◽  
Preliminary Report ◽  
Previous History ◽  
First Trimester ◽  
Induced Abortion ◽  
Depression And Anxiety ◽  
History Of ◽  
Expectant Mothers ◽  
Clinically Significant ◽  
In Pregnancy

SynopsisOne hundred and nineteen primiparae, who were routinely attending ante-natal clinics, were interviewed repeatedly between the 12th and 36th weeks of their pregnancies. The incidence of depression was highest in the first trimester and, overall, about a fifth of the sample was found to be suffering from clinically significant neurotic disturbances. In a proportion of these expectant mothers there was an association between depression and anxiety early in pregnancy and a previous history of induced abortion; this phenomenon may reflect a reactivation of mourning which was previously suppressed.

SIGNIFICANCE OF ULTRASOUND IN CLINICALLY DIAGNOSED CAUSES OF VAGINAL BLEEDING IN FIRST TRIMESTER PREGNANCY

2021 ◽  
pp. 74-75
Author(s):  
Amit Shankhwar ◽  
Prem Siddharth Tripathi ◽  
Saurabh Atram ◽  
Pankaj Kujur ◽  
Prakhar Nigam ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Imaging Modality ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Incomplete Abortion ◽  
Trimester Pregnancy ◽  
Highly Sensitive ◽  
History Of ◽  
Threatened Abortion

Background: (1) Nearly one-fourth (20-25%) of all pregnant women present with history of vaginal bleeding during the rst trimester . Ultrasound imaging plays an important role in determining the causes of vaginal bleeding during rst trimester of pregnancy. Aims & Objectives:To evaluate the signicance of ultrasound in clinically diagnosed causes of vaginal bleeding in rst trimester pregnancy. Methods: 100 women with vaginal bleeding during rst trimester of pregnancy with clinical diagnosis were evaluated by ultrasonography [USG] and interpretation was compared. Results: Among these 100 cases, threatened abortion was the commonest cause of bleeding (30%) followed by incomplete abortion. Disparity was found between clinical diagnosis of rst trimester vaginal bleed and ultrasound diagnosis. Ultrasound is highly sensitive and specic in diagnosing all causes of rst trimester vaginal bleed including ectopic pregnancy. Conclusion: With good diagnostic performance, USG proves to be an important imaging modality in determining the causes of vaginal bleeding during rst trimester of pregnancy and thus provides an aid for clinicians in better management of patients.

SIGNIFICANCE OF ULTRASOUND IN CLINICALLY DIAGNOSED CAUSES OF VAGINAL BLEEDING IN FIRST TRIMESTER PREGNANCY

2021 ◽  
pp. 39-40
Author(s):  
Amit Shankhwar ◽  
Prem Siddharth Tripathi ◽  
Saurabh Atram ◽  
Pankaj Kujur ◽  
Prakhar Nigam ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Imaging Modality ◽  
First Trimester ◽  
First Trimester Pregnancy ◽  
Incomplete Abortion ◽  
Trimester Pregnancy ◽  
Highly Sensitive ◽  
History Of ◽  
Threatened Abortion

Background: Nearly one-fourth (20-25%) of all pregnant women present with history of vaginal bleeding during the rst trimester (1). Ultrasound imaging plays an important role in determining the causes of vaginal bleeding during rst trimester of pregnancy. Aims & Objectives: To evaluate the signicance of ultrasound in clinically diagnosed causes of vaginal bleeding in rst trimester pregnancy. Methods: 100 women with vaginal bleeding during rst trimester of pregnancy with clinical diagnosis were evaluated by ultrasonography [USG] and interpretation was compared. Results: Among these 100 cases, threatened abortion was the commonest cause of bleeding (30%) followed by incomplete abortion. Disparity was found between clinical diagnosis of rst trimester vaginal bleed and ultrasound diagnosis. Ultrasound is highly sensitive and specic in diagnosing all causes of rst trimester vaginal bleed including ectopic pregnancy. Conclusion: With good diagnostic performance, USG proves to be an important imaging modality in determining the causes of vaginal bleeding during rst trimester of pregnancy and thus provides an aid for clinicians in better management of patients.

scholarly journals Gestational Diabetes Mellitus: Clinical Characteristics and Perinatal Outcomes in a Multiethnic Population of North Italy

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
M. Caputo ◽  
V. Bullara ◽  
C. Mele ◽  
M. T. Samà ◽  
M. Zavattaro ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Clinical Characteristics ◽  
Insulin Treatment ◽  
Dietary Habits ◽  
Nutrition Transition ◽  
Previous History ◽  
Perinatal Outcomes ◽  
Nutritional Intervention ◽  
Maternal Complications ◽  
History Of

Aim. To evaluate clinical characteristics and perinatal outcomes in a heterogeneous population of Caucasians born in Italy and High Migration Pressure Countries (HMPC) women with GDM living in Piedmont, North Italy. Methods. We retrospectively analyzed data from 586 women referring to our unit (2015–2020). Epidemiological (age and country of origin) and clinical-metabolic features (height, weight, family history of DM, parity, previous history of GDM, OGTT results, and GDM treatment) were collected. The database of certificates of care at delivery was consulted in relation to neonatal/maternal complications (rates of caesarean sections, APGAR score, fetal malformations, and neonatal anthropometry). Results. 43.2% of women came from HMPC; they were younger p < 0.0001 and required insulin treatment more frequently than Caucasian women born in Italy (χ2 = 17.8, p = 0.007 ). Higher fasting and 120-minute OGTT levels and gestational BMI increased the risk of insulin treatment (OGTT T0: OR = 1.04, CI 95% 1.016–1.060, p = 0.005 ; OGTT T120: OR = 1.01, CI 95% 1.002–1.020, p = 0.02 ; BMI: OR = 1.089, CI 95% 1.051–1.129, p < 0.0001 ). Moreover, two or more diagnostic OGTT glucose levels doubled the risk of insulin therapy (OR = 2.03, IC 95% 1.145–3.612, p = 0.016 ). We did not find any association between ethnicities and neonatal/maternal complications. Conclusions. In our multiethnic GDM population, the need for intensive care and insulin treatment is high in HPMC women although the frequency of adverse peripartum and newborn outcomes does not vary among ethnic groups. The need for insulin therapy should be related to different genetic backgrounds, dietary habits, and Nutrition Transition phenomena. Thus, nutritional intervention and insulin treatment need to be tailored.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

Placental massive perivillous fibrinoid deposition is associated with adverse pregnancy outcomes: a clinicopathological study of 12 cases

2016 ◽  
Vol 5 (1) ◽  
pp. 35-39
Author(s):  
Maili Qi ◽  
Kenneth Tou En Chang ◽  
Derrick Wen Quan Lian ◽  
Chong Kiat Khoo ◽  
Kok Hian Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Local Population ◽  
Fetal Loss ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Special Focus ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Abstract Introduction: Massive perivillous fibrinoid deposition (MPFD) is a very rare placental condition characterized by abnormally extensive fibrinoid deposition in the placental villous parenchyma. The aim of this study is to document clinical and pathological features with special focus on pregnancy outcomes of this condition in consecutive cases of MPFD in our local population. Methods: This is a retrospective clinico-pathological study of cases affected by MPFD over the period January 2010–July 2014 in our hospital. We document clinical features (including perinatal outcome and subsequent pregnancies) and placental pathological characteristics. Results: Twelve cases of MPFD were identified among 3640 placentas (0.33%). There was no identified recurrence. The affected infants had adverse outcomes, including intrauterine growth restriction (IUGR) (75%), preterm birth (58.3%), and fetal loss (25%). A high frequency of reduced PAPP-A in the first trimester (25%), and concurrent gestational hypertension or pre-eclampsia (25%) was noted. Conclusion: MPFD is associated with adverse perinatal outcomes. Further research to better understand its pathogenesis and to improve clinical diagnosis and management is warranted.

scholarly journals Different Sonographic Faces of Ectopic Pregnancy

2017 ◽  
Vol 7 ◽  
pp. 6 ◽  
Author(s):  
Charu Chanana ◽  
Nishant Gupta ◽  
Itisha Bansal ◽  
Kusum Hooda ◽  
Pranav Sharma ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Vaginal Bleeding ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Pictorial Essay ◽  
History Of ◽  
Clinical Signs And Symptoms

Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

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