scholarly journals A prospective observational study to determine the utility of placental laterality for prediction of preeclampsia in pregnancy

2020 ◽  
Vol 9 (4) ◽  
pp. 1664
Author(s):  
Anshul Rana ◽  
Rama Thakur ◽  
Rohini Rao
Keyword(s):  
Mode Of Delivery ◽  
Previous History ◽  
Significant Risk ◽  
P Value ◽  
Large Sample Size ◽  
Multisystem Disorder ◽  
Fetal Outcomes ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
In Pregnancy

Background: Preeclampsia is a multisystem disorder of unknown aetiology and recently its link with placental laterality has been explored. The objective of this study was to find the association of placental laterality with maternal and fetal outcomes in pregnancy. Study also determined the predictive ability of placenta laterality for the development of hypertension in pregnancy.Methods: A prospective observational cohort study was conducted on 200 pregnant women. Routine investigations and doppler analysis were done. Placenta position was categorized into central and lateral. Maternal and fetal outcomes were recorded. The data was entered in MS excel spreadsheet and analysis was done using statistical package for social sciences (SPSS) version 21.0. A p value of < 0.05 was considered statistically significant.Results: Study found no significant association of placental laterality with hypertension in pregnancy. Various fetal complications, birth weight, Apgar scores and NICU admission were comparable among women with central or lateral placenta (p > 0.05). Even the maternal outcomes like mode of delivery, onset of labor, indication of labor induction and caesarean deliveries were comparable among women with central or lateral placenta (p > 0.05). On applying univariate logistic regression analysis, previous history of hypertension in pregnancy was a significant risk factor for development of preeclampsia with odds ratio of 168.43 (p < 0.05).Conclusions: It can be concluded that the maternal and fetal outcomes are independent of the placenta laterality. The doppler characteristics and placenta laterality did not show any increased risk for hypertension in pregnancy. However future studies are recommended with large sample size including more women with diagnosed hypertension in the pregnancy so that a better association can be derived with placenta laterality and doppler characteristics.

scholarly journals Perinatal outcome in hypertensive disorder of pregnancy in a rural community of Haryana

2019 ◽  
Vol 6 (10) ◽  
pp. 4267
Author(s):  
Bharti . ◽  
Sumit Chawla
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Statistical Tests ◽  
Mode Of Delivery ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
In Pregnancy

Background: Pregnancy in hypertension may complicate pregnancies with variable incidence among different settings. Pregnancies complicated with hypertensive disorders are associated with increased risk of adverse fetal, neonatal and maternal outcome including preterm birth, intrauterine growth retardation (IUGR), perinatal death etc. The present study was undertaken to study the perinatal outcome of hypertension in pregnancy in a rural block of Haryana.Methods: This cross-sectional study was carried out in the all the 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Pregnancy outcome was followed-up by contacting the health worker of respective sub-center or mother. Information regarding stillbirth, abortion, maturity, birth weight, mode of delivery and early neonatal death was collected. Appropriate statistical tests were used for analysis.Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Hypertension in pregnancy is significantly associated with premature births still births (6.7% vs 1.4%; p=0.003), low birth weight (26.7% vs 4.9%; p=0.000) and early neonatal deaths (8.3% vs 2.8%; p=0.017).Conclusions: Perinatal mortality is significantly high in mothers with hypertensive disorders. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

scholarly journals Intimate partner violence among postpartum women at a teaching hospital in Nigeria’s Federal Capital City: pattern and materno-fetal outcomes

2020 ◽  
Vol 14 ◽  
pp. 263349412092834
Author(s):  
Godwin O. Akaba ◽  
Habiba I. Abdullahi
Keyword(s):  
Intimate Partner Violence ◽  
Teaching Hospital ◽  
Partner Violence ◽  
Intimate Partner ◽  
Sexual Partners ◽  
Postpartum Women ◽  
Fetal Outcomes ◽  
The Past ◽  
Increased Risk ◽  
In Pregnancy

Background: Intimate partner violence is an important public health and human rights issue. Previous studies have considered intimate partner violence in pregnancy mainly among pregnant women attending antenatal clinics thereby missing out a few who may encounter this problem in late pregnancy or just before delivery. This study had the objective of ascertaining the prevalence, pattern of intimate partner violence, and associated materno-fetal outcomes. Method: This was a cross-sectional study conducted between January 2017 and June 2017 among postpartum mothers at a Nigerian Teaching Hospital just before being discharged home. The abuse assessment score was adapted and used to interview women regarding possible intimate partner violence experiences within the past 1 year and during the pregnancy after obtaining written consent. Results: Out of 349 postpartum women interviewed, 102/349 (29.2%) experienced intimate partner violence in the past 1 year, while 18/349 (5.2%) of intimate partner violence occurred in the index pregnancy. Sexual partners were the main perpetuators of intimate partner violence, 67/102 (65.7%), while 35/102 (34.3%) were by someone else other than their sexual partners. Among those abused in the current pregnancy, 10/18 (55.6%) were abused once and the remaining 8/18 (44.4%) were abused more than once. Intimate partner violence was associated with higher chances of cesarean section ( p = 0.001), increased risk of lesser birth weight babies ( p = 0.014), and maternal complications in pregnancy ( p = 0.030). Conclusion: The prevalence of intimate partner violence in pregnancy in Abuja is high with associated poor materno-fetal outcomes. Enforcing existing legislations and screening for intimate partner violence during routine antenatal care may help reduce its prevalence and ensure a positive pregnancy experience for Nigerian women.

Behcet’s disease and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 12 million births

2019 ◽  
Vol 47 (4) ◽  
pp. 381-387 ◽  
Author(s):  
Seohyuk Lee ◽  
Nicholas Czuzoj-Shulman ◽  
Haim Arie Abenhaim
Keyword(s):  
Venous Thromboembolism ◽  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
The United States ◽  
Population Based ◽  
Fetal Outcomes ◽  
Behcet's Disease ◽  
Increased Risk ◽  
In Pregnancy

AbstractBackgroundBehcet’s disease (BD) is a rare, multi-systemic inflammatory disorder for which only limited and contradictory data exists in the context of pregnancy. Our objective was to estimate the prevalence of BD in pregnancy and to evaluate maternal and fetal outcomes associated with pregnant women living with BD.MethodsUsing the 1999–2013 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from the United States, we performed a population-based retrospective cohort study consisting of pregnancies that occurred during this time period. ICD-9 codes were used to identify delivery admissions to women with or without BD. Multivariate logistic regression was used to estimate the adjusted effects of BD on maternal and fetal outcomes.ResultsAmong the 12,592,676 pregnancies in our cohort, 144 were to women with BD, for an overall prevalence of 1.14 cases/100,000 births between 1999 and 2013. Over the study period, the prevalence of BD rose from 0.5 to 2.4/100,000 births. Women with BD demonstrated a two-fold greater frequency of non-delivery hospital admissions during pregnancy, and were more likely to be Caucasian, have private medical insurance, be of the upper income quartiles, and deliver at an urban teaching hospital. Women with BD were at greater risk for preterm labor and postpartum venous thromboembolism, while their newborns were more likely to be born premature.ConclusionBD-associated pregnancies are increasing in prevalence and are associated with a greater risk for adverse maternal and fetal outcomes in pregnancy. Appropriate thromboprophylaxis during pregnancy should be considered given the increased risk for venous thromboembolism.

scholarly journals HIV Antibody Seroprevalence and Determinants Amongst Antenatal Clients in a Tertiary Hospital in the Niger Delta

2018 ◽  
Vol 14 (9) ◽  
pp. 300
Author(s):  
Kotingo E.L. ◽  
Allagoa D.O.B.
Keyword(s):  
Hiv Infection ◽  
Sex Education ◽  
Significant Risk ◽  
Data Entry ◽  
Public Health Problem ◽  
Sexual Partners ◽  
P Value ◽  
Cross Sectional ◽  
Multiple Sexual Partners ◽  
In Pregnancy

Background: The pandemicity of the human immunodeficiency virus (HIV) has continued to be a ‘medical quagmire,’ one of the most serious global catastrophe and public health problem that plagues the world today. Objectives: To determine the seroprevalence and clinico-epidemiological correlates of HIV infection in pregnancy. Methodology: This is a descriptive cross sectional study. Two hundred and twenty (220) consecutive healthy pregnant women attending the antenatal booking clinic of the hospital who met the inclusion criteria were recruited. Data was collected via a questionnaire. Data entry and analysis was done using SPSS (statistical package forsocial sciences) 22 statistical package (SPSS Inc., Illinois, U.S.A). P value less than 0.05 was taken as being significant. Results: Of the 220 women, 4.6% (n=10) were seropositive for HIV antibodies. Multiple sexual partners was the significant risk factors for HIV seropositivity (p<0.05). There was no significant association with respect to tattoo/scarification marks, female circumcision, previous blood transfusion, intravenous drug abuse or sharing of sharps, previous surgery, episiotomies or dilatation and curettage (p>0.05). Conclusion: The high endemicity of HIV infection in this study justifies the need for routine screening in pregnancy to identify and institute treatment of the infection promptly as this will reduce the mother to child transmission of the virus. Sex education on the dangers of multiple sexual partners or sexual promiscuity, availability of barrier methods of contraception and patronage, more efforts/interventions by relevant agencies, high sense of vigilance amongst others are very vital to curtailing this global pandemic in our society.

scholarly journals RELATIONSHIP BETWEEN OBESITY, TWIN-PREGNANCY AND PREVIOUS HISTORY OF PREECLAMPSIA WITH PREECLAMPSIA

2021 ◽  
Vol 5 (3) ◽  
pp. 307
Author(s):  
Riani Widia Parantika ◽  
Gatut Hardianto ◽  
Muhammad Miftahussurur ◽  
Wahyul Anis
Keyword(s):  
Risk Factors ◽  
Previous History ◽  
Significant Risk ◽  
Multiple Pregnancies ◽  
Chi Square ◽  
Exact Test ◽  
Pregnancy And Childbirth ◽  
Increased Risk ◽  
History Of ◽  
Risk Of Preeclampsia

Background: Preeclampsia can threaten the health of the mother and fetus during pregnancy and childbirth, besides that it also increases the risk of long-term complications and has the potential to cause death. The incidence of preeclampsia at the RSUD Engku Haji Daud Tanjung Uban showed an increase in the last three years, namely the occurrence from 2017 as many as 23 cases to 56 cases in 2019. The condition of preeclampsia can worsen quickly and without warning, for that, it must be detected and managed appropriately. This study aimed to identify the association of obesity, multiple pregnancies, and previous history of preeclampsia with the incidence of preeclampsia in maternity women. Methods: This study uses a case-control study design. Performed on women giving birth in the period January – December 2019, consisting of 56 cases and 112 controls. Maternal women with preeclampsia were cases and women who were not diagnosed with preeclampsia were controls. The data was obtained from the respondents' medical records, then analyzed using the Chi-Square test or Fisher's Exact test with a value of = 0,05. Results: Obesity was associated with an increased risk of preeclampsia (OR= 4,746, 95% CI 2,381-9,460; P=0,000). Multiple pregnancies were associated with a significantly increased risk of preeclampsia (OR=15,857, 95% CI 1,899-132,384; P=0,002). Likewise, a previous history of preeclampsia was associated with a markedly increased risk of preeclampsia (OR=99,000, 95% CI 22,057-444,343; P=0,000). Conclusion: Based on these data, it was found that obesity, multiple pregnancies, and previous history of preeclampsia were significant risk factors for the occurrence of preeclampsia. It is important to identify risk factors for preeclampsia early, so that appropriate management can be carried out, to prevent complications.

scholarly journals Correlation of different obstetrical factors with hemoglobin level in pregnant females.

2020 ◽  
Vol 27 (03) ◽  
pp. 625-630
Author(s):  
Iffat Imran ◽  
Nusrat Zareen Bashir ◽  
Umber - Fatima ◽  
Imran Nazir ◽  
Rizwan Rasul Khan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mode Of Delivery ◽  
Sampling Technique ◽  
Hemoglobin Level ◽  
P Value ◽  
Pregnant Females ◽  
History Of ◽  
Anemia In Pregnancy ◽  
Inter Pregnancy Interval ◽  
In Pregnancy

Objectives: To assess the correlation of different obstetrical factors with the hemoglobin level in multiparous pregnant females in Taif KSA. Anemia in pregnancy is a multifactorial phenomenon, among which obstetrical factors like parity, previous H/O abortions, inter pregnancy interval, mode of delivery etc are frequently associated. Study Design: Observational study. Setting: Outpatient department in King Faisal Hospital (KFH), Taif, Saudi Arabia. Period: 1st June 2018 and 31st August 2018. Material & Methods: Conducted in 200 pregnant women by random sampling technique. Hemoglobin value and all patient’s data was noted. All data was fed to SPSS version 23.0 and statistically analyzed using chi square test for qualitative and student’s t test for quantitative data. Results: The study was conducted in 200 patients that showed that there was no statistically significant association of increasing parity, inter pregnancy interval, mode of delivery (NVD or Cesarean section) & history of anemia and PPH in preceding pregnancy with the Hemoglobin level. While history of previous abortion is associated and a risk factor for anemia in pregnancy, 50% with history of 01 previous abortion had anemia while 100% of the cases with history of 02 previous abortions had moderate anemia. (Table-II). This association was observed statistically significant with p value of 0.001. Conclusion: This study concluded that anemia is a predictable as well as preventable entity. Obstetrical factors may be the contributory factors of anemia in pregnancy. Health education awareness programs, regular antenatal visits and iron supplements can be helpful to improve heath of pregnant women.

scholarly journals Assessment of the Neutrophil Lymphocyte Ratio and Mean Platelet Volume in Pregnancy

2020 ◽  
Vol 5 (1) ◽  
pp. 85-93
Author(s):  
Rendy Singgih ◽  
Yohanes Firmansyah
Keyword(s):  
Roc Curve ◽  
Mean Platelet Volume ◽  
Statistical Tests ◽  
P Value ◽  
Platelet Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Hypertension In Pregnancy ◽  
The Mean ◽  
In Pregnancy

Abstract Introduction:  Hypertension in pregnancy is a common complication that affects maternal and fetal morbidity and mortality. Comprehensive handling is needed to overcome the incidence of hypertension in pregnancy so that it does not get worse. The use of inflammatory markers is widely used as a predictor of the incidence of hypertension in pregnancy, especially preeclampsia. Neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) values are believed to predict the incidence of hypertension in pregnancy. Aim of study: The purpose of this study was to determine the ability of both the NLR and MPV values to predict the incidence of hypertension in pregnancy. Methods: This research is an analytic observational study using secondary data from medical records. The data were taken from the Cimacan Regional Hospital from January to December 2019. The variables were then tested statistically to see the difference in the mean. If there are significant results, the predictor's ability will be tested again with the ROC curve test. Results: The results of statistical tests between the normotensive pregnancy group and pregnancy with hypertension showed that the mean difference was significant in the NLR variable with P-value of 0.004 and MPV with a P-value of 0.005. Then the NLR and MPV values were tested again by the ROC Curve method. The AUC results on the NLR variable (AUC: 0.562 / p-value: 0.022) and MPV (AUC: 0.560 / p-value: 0.022). Conclusion: Although NLR and MPV had differences mean between the two groups, their ability to predict pregnancy with hypertension was very low.   Keywords: Pregnancy; Hypertension; Preeclampsia; NLR; MPV.

scholarly journals Influence of severity of total bile acids and mode of delivery on the perinatal outcomes in intrahepatic cholestasis of pregnancy

2021 ◽  
Author(s):  
Chengcai Kong ◽  
Fenglin Mei ◽  
Pingping Xue ◽  
Jingyun Cao ◽  
Yong Li ◽  
...  
Keyword(s):  
Bile Acids ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Intrahepatic Cholestasis ◽  
Mode Of Delivery ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Abstract To assess the associations between mode of delivery and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP) based on the severity of maternal hypercholanemia. A hospital-based retrospective cohort study was performed between January 1, 2015, and December 31, 2019. Among the 177 women with mild total bile acids, 123 (69.5%) had a vaginal delivery and 54 (30.5%) underwent a cesarean delivery, of which 42 (23.7%) were planned and 12 (6.8%) were unplanned. Among the 50 severe ICP women, 13 (26.0%) had a vaginal delivery and 37 (74.0%) underwent a cesarean delivery, of which 26 (52.0%) were planned and 11 (22.0%) were unplanned. Severe ICP was associated with an increased risk of preterm delivery (P < 0.001), low birthweight (P=0.001), and neonatal intensive care unit admission (P < 0.001). Women with severe ICP (aOR, 5.017; 95% CI 1.848–13.622), planned cesarean delivery (aOR, 5.444; 95%CI 1.723–17.203), or unplanned cesarean delivery (aOR, 5.792; 95%CI 1.384–24.236) had increased risks of adverse fetal outcomes compared to controls. Both planned and unplanned cesarean delivery are associated with a higher incidence of adverse fetal outcomes and severe ICP than vaginal delivery.

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