scholarly journals Comparative study between vaginal natural progesterone and oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy

2020 ◽  
Vol 9 (8) ◽  
pp. 3330
Author(s):  
Nermeen M. Hefila ◽  
Tarek A. Karkour ◽  
Sara M. Elghareeb ◽  
Tamer M. Abdeldaiem
Keyword(s):  
Uterine Fibroid ◽  
Gestational Age ◽  
Uterine Fibroids ◽  
Pregnant Females ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Red Degeneration ◽  
In Pregnancy ◽  
Natural Progesterone

Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality. Objective of this study was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups, Group A: twenty-five treated by vaginal natural progesterone, Group B: twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: Results showed that there were no statistically significant differences as regards age, obstetric history (gravidity and parity), number, Site, grade and size of the fibroid. There was a significant difference between the two studied groups, regarding the acute abdominal pain, it occurred to only 3 cases (12%) in Group A, versus to 16 cases (64%) in Group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in Group A, while in Group B it occurred to 15 cases (60%).Conclusions: Vaginal natural micronized progesterone is more effective than oral dydrogesterone in prevention of red degeneration of uterine fibroid in pregnancy with fewer complications. Vaginal natural progesterone daily dose of 200 mg is recommended to all pregnant females with uterine fibroids.

Early versus delayed cord clamping in term neonates.

2021 ◽  
Vol 28 (05) ◽  
pp. 656-660
Author(s):  
Samina Mumtaz ◽  
Shagufta Tabassum ◽  
Saima Afzal
Keyword(s):  
Gestational Age ◽  
Controlled Trial ◽  
Hemoglobin Level ◽  
Delayed Cord Clamping ◽  
Term Neonates ◽  
Cord Clamping ◽  
Significant Difference ◽  
Early Cord Clamping ◽  
Group A ◽  
Group B

Objective: To compare mean hemoglobin levels of neonates after early and late cord clamping. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics & Gynaecology at Nishtar Hospital Multan. Period: June 2019 to December 2019. Material & Methods: A total of 60 women booked and unbooked were included in study. Selected patients randomized into group A and B, each group comprising of 30 patients depending upon the envelope with assigned treatment (either early or delayed cord clamping) picked up by the patient. Results: In present study, two groups were made. Group A consisted of 30 neonates in whom early cord clamping was done while in group B delayed clamping was done in 30 neonates. Mean age of mothers was 28.4±0.4 vs. 28.6±0.5 years in group A and B respectively. There were 25 mothers (83.3%) in group A and 21 mothers (70%) in group B between 25–30 years. There were 5 mothers (16.7%) in group A and 8 mothers (26.7%) in group B between 31–35 years of age. While none of the mother in group A and 1 mother (3.3%) in group B was between 36–40 years of age. Mean parity of the mothers was 1.1±0.2 vs. 1.4±0.2 in group A and B respectively. Eight mothers (85.4%) in group A and 7 mothers (82.5%) in group B were primipara. While 22 mothers (14.6%) in group A and 23 mothers in group B (17.5%) were para 1–3. Gestational age was 37–38 weeks in 13(43.3%) vs. 19(63.3%) women in group A and B respectively. While there were 17(56.7%) vs. 11(36.7%) women in group A and B respectively of the gestational age 39–40 weeks. Pre-delivery maternal mean hemoglobin levels was 11.9±0.1 gm/dl vs. 12.3±0.1 gm/dl in group A and B respectively. Pre-delivery maternal hemoglobin levels were 10–10.9 g/dl in 2 mothers (6.7%) vs. 1 mother (3.3%) in group A and B respectively. Neonatal mean hemoglobin levels were 16.8±0.2 g/dl vs. 17.7±0.1 g/dl in group A and B respectively. Out of the 31 booked mothers, neonatal mean hemoglobin level was 16.8±0.2 g/dl vs. 17.9±0.1 g/dl in group A and B respectively. While out of the 29 unbooked mothers, neonatal mean hemoglobin level was 16.7±0.2 g/dl vs. 17.5±0.1 g/dl in group A and B respectively. When compared the neonatal mean hemoglobin levels, there was significant difference between mean hemoglobin levels of neonates between the two groups (p=0.000). Conclusion: Delayed cord clamping in term neonates for a minimum of 2 minutes at birth is beneficial to the newborn in terms of improved hemoglobin levels. There is no significant difference seen in pre-delivery maternal hemoglobin levels and neonatal hemoglobin either in delayed cord clamping group or in early cord clamping group.

scholarly journals The Effect of Artemisinin-based Combination Therapy (ACT) Antimalaria Drugs on Liver Enzymes in Pregnancy

2019 ◽  
pp. 1-6
Author(s):  
Ajibade Oluwagbenga Oyeyemi ◽  
Ayobola Abimbola Sonuga
Keyword(s):  
Pregnant Women ◽  
Malaria Parasite ◽  
Harmful Effect ◽  
Antenatal Clinic ◽  
Significant Difference ◽  
Group A ◽  
Student’S T ◽  
Group B ◽  
And Control ◽  
In Pregnancy

Aims: Artemisinin-based Combination Therapies (ACTs) are employed as first-line agents in malaria chemotherapy. This study is aimed at assessing the effects of ACTs on renal function of pregnant women. Study Design: Comparative study. Place and Duration of Study: Pregnant women aged 18 to 50 years were recruited from antenatal clinic of Obstetrics and Gynecology Department of Ekiti State Hospital, Ado Ekiti, Nigeria between 2016 and 2018 Methodology: One hundred and eighty pregnant women were grouped into three which include:  Sixty pregnant women with malaria parasite on ACT drugs (Group A), sixty pregnant women with malaria parasite not on ACT drugs (Group B), sixty pregnant women without malaria parasite (Group C/control). Plasma Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT) and Lactate Dehydrogenase (LDH) activities were evaluated by standard methods. The data collected were analyzed using one-way analysis of variance (ANOVA) and Student’s t test to compare the data between the test groups and control. Results: Results showed there was a significant decrease (P=.05) in Body Mass Index in the pregnant women with malaria on ACT and those that were not on ACT when compared with control (24.1± 0.32 versus (25+ 2.30 vs 27± 1.62). A significant increase (P=.05) occurred in the levels of ALP,AST, ALT and LDH  in pregnant women with malaria not on ACT drugs when compared the control (168.45±0.19, 10.0±0.27, 8.19±0.25, 4.5±0.21) versus (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19),while no significant difference occurred in the levels of ALP,AST, ALT and LDH in pregnant women with malaria on ACT when compared with control (141.60±0.78, 8.02±0.32, 6.10±0.30, 2.75+ 0.20) vs (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19). Conclusion: Normal therapeutic dose of ACT has no harmful effect on the liver in pregnancy.

scholarly journals Increase of PlGF (Placental Growth Factor) Level After Administration of Dydrogesterone in Pregnancy

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Dewi Karlina Rusly
Keyword(s):  
Folic Acid ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Study Population ◽  
The Mean ◽  
Group B ◽  
In Pregnancy

<p><strong>Aim:</strong> To observe the effect of Dydrogesterone administration in pregnancy on PlGF level</p><p><strong>Methods:</strong> This is a randomized controlled clinical trial. Study population has been divided into two groups. Group A consists of 20 women who receive only Folic acid 5 mg a day for 4 weeks time. Group B consists of 20 women who receive Dydrogesterone 2x10 mg a day and Folic acid 5 mg a day for 4 weeks. PlGF has been measured twice. First measurement was done before drug administration, while the second measurement has been done during 18<sup>th</sup> weeks of pregnancy. The changes on PlGF level before and after treatment from each group has been analyzed using SPSS 17.</p><p><strong>Results:</strong> 40 pregnant women have been recruited for this study. There are no differences based on the patient’s age, number of pregnancy and parity, gestational age and body weight between each group.  The mean levels of PlGF in both groups before intervention shows no significant difference (p = 0091 or p&gt; 0.05), 40.80 pg/mL vs.  25.95 pg / mL. The mean levels of PlGF in group A after 4 weeks administration of Folic acid is 89.60 pg / mL. It shows the escalation of 48.8 pg / mL. The elevation of PlGF level in group A shows significant difference (p = 0.000 or p &lt;0.05) after 4 weeks Folic acid treatment.The mean levels of PlGF in group B after 4 weeks administration of Dydrogesterone and Folic acid is 212.15 pg / mL. It shows the escalation of 186.20 pg / mL. The elevation of PlGF level in group B shows significant difference (p = 0.000 or p &lt;0.05) after 4 weeks Dydrogesterone and Folic acid treatment.</p><p><strong>Conclusion:</strong> Dydrogesterone treatment can increase the level of PlGF.</p>

scholarly journals Antibiotic prophylaxis before skin incision versus after cord clamping in the prevention of maternal and neonatal infectious morbidity after cesarean section

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W H Eltantawy ◽  
K M Labib ◽  
A M Farag
Keyword(s):  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Gestational Age ◽  
Skin Incision ◽  
Infectious Morbidity ◽  
Cord Clamping ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background the purpose of antibiotic prophylaxis in surgical procedures is not to sterilize tissues but to reduce colonisation pressure of microorganisms introduced at the time of the operation to a level that can be overcome by the patient’s immune system. Aim of the study to compare the effects of antibiotic prophylaxis administered in cesarean section preoperatively versus after neonatal cord clamp on postoperative infectious complications for both the mother and the neonate. Patients and Methods This comparative study was carried out between August 2017 and February 2018, at Ain Shams maternity hospital and Al-Galaa teaching hospital, a prospective randomized control comparativestudy of 874 pregnant ladies undergoing cesarean section after obtaining the approval of the local ethical committee and a fully-informed written consent. Results Of 874 pregnant ladies undergoing cesarean section, mean gestational age in group A (38.71±1.09); while in group B mean gestational age (38.86±1.06). In group A, wound infection 8 cases (1.6%), endometritis 25 cases (5.7%), UTI 18 case (4.1%). In group B, wound infection 16 cases (3.7%), endometritis 35 cases (8%), UTI 28 case (6.4%). No cases suffered from early or long term neonatal complications. Conclusion there is no significant difference between timing of antibiotic either before skin incision or after cord clamping, however there are risk factors that increase the maternal, fetal infectious morbidity as high BMI, low gestational age, previous section, general anaesthesia.

scholarly journals COMPARACIÓN DEL ESTADIO FETAL OBTENIDO POSTMORTEM MEDIANTE DOS METODOS ANTROPOMETRICOS. Comparación del estadio fetal obtenido postmortem mediante dos metodos antropometricos

2016 ◽  
Vol 3 (1) ◽  
pp. 37-48
Author(s):  
Mirta M Aliendo ◽  
Emanuel Repetto
Keyword(s):  
Gestational Age ◽  
Abdominal Circumference ◽  
Post Mortem ◽  
Crown Rump Length ◽  
Significant Difference ◽  
Group A ◽  
Para Determinar ◽  
Group B ◽  
Fetal Stage

En la etapa fetal se observa un rápido incremento de la masa corporal y de todas las dimensiones. La literatura evidencia discrepancias sobre los criterios para determinar el estadio fetal post-mortem, en relación a los parámetros morfométricos utilizados, por lo que nuestro objetivo fue comparar la medición morfológica directa (vertex-coxis, tabla de Hansmann) con la ultrasonografía (medición del fémur), para establecer el grado de confiabilidad en la determinación post-mortem del estadío fetal. Se utilizaron 120 fetos: 1) grupo A (60 fetos) estadificado ecográficamente y 2) grupo B (60 fetos) estadificado por tabla de Hansmann. A ambos grupos se le realizaron múltiples mediciones siguiendo parámetros probados según la literatura internacional. Se utilizó calibre de precisión. Parámetros evaluados: longitud vertex-coxis, circunferencia cefálica, diámetro cefálico occipito-frontal, biparietal, longitud mentón-vertex, perímetro toráxico-transverso, circunferencia abdomi-nal y longitudes de brazo, antebrazo, mano, muslo, pierna y pie. Estos valores fueron agrupados por semanas, obteniéndose la media y aplicándose la prueba t de Student. Los resultados demostraron que la diferencia entre los parámetros medidos en el grupo A y en el grupo B eran significativas en todas las semanas, por lo que se observa disparidad en la determinación del estadio fetal por ecografía y los registros correspondientes a la medición vertex-coxis (tabla de Hansmann) postmortem. Concluímos que los resultados obtenidos por ambas modalidades de medición son diferentes para una misma edad gestacional y, por ende, resultaría más apropiado referirse a fetos con ciertas dimensiones según alguno de estos parámetros que a “edad gestacional”.In fetal stage, body mass and measurements quickly increase. Scientific literature shows differences on the criteria to determine the post-mortem fetal stage, depending on morphometric parameters. Our objective was to compare both methods, direct morphologic measures (crown-rump length, Hansmann table) and ultrasonography (femur measurement), to establish their reliability on post-mortem determination of fetal age. One hundred and twenty fetuses were studied: 1) group A (60 fetuses) sonographically staged and 2) group B (60 fetuses) staged according to Hansmann table. Many measurements were performed on both groups, following internationally determined parameters. We used a precision gauge. Considered parameters were: crown-rump length, head circumference, occipito-frontal diameter, bi-parietal length, chin-vertex length, thoracic transverse perimeter, abdominal circumference, arm, forearm, hand, thigh, leg and foot lengths. Obtained information was grouped by weeks. We calculated the data mean and significant difference was managed by Student t-test. Results demonstrated significant difference in the considered parameters between group A and B, and then, to determine the fetal age.We conclude that results obtained by both measuring modalities were different for the same gestational age, and therefore, it should be more appropriate to consider fetuses by measures obtained following certain parameters than by “gestational age”.

scholarly journals Evaluation of Creatine Kinase, Lactate Dehydrogenase, and Amylase Concentrations in Umbilical Blood of Preterm Infants after Long-Term Tocolysis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka
Keyword(s):  
Creatine Kinase ◽  
Birth Weight ◽  
Lactate Dehydrogenase ◽  
Preterm Infants ◽  
Gestational Age ◽  
Umbilical Blood ◽  
Significant Difference ◽  
Group A ◽  
Group B

Creatine kinase (CK), lactate dehydrogenase (LDH), and amylase levels of preterm infants following long-term tocolysis in pregnant women are limited. The objective of this study was to determine if the tocolytic therapy affects CK, LDH, and amylase levels in the umbilical blood. This study included 215 preterm infants born to women treated with and without ritodrine hydrochloride. CK, LDH, and amylase levels in the umbilical blood at delivery were determined. Infants were divided according to the ritodrine tocolysis, as follows: Group A (n=91), not exposed to ritodrine; Group B (n=44), IV ritodrine for <1 week; Group C (n=80), IV ritodrine for ≥1 week. The CK concentration in cord blood of Group C (198.8±14.2 IU/L) was significantly higher in comparison with Group A (155.0±7.3 IU/L,P<0.05). There was no significant difference in LDH and amylase levels in the three groups. The CK significantly correlated with gestational age (r=0.42,P<0.01) and birth weight (r=0.38,P<0.01). LDH and amylase levels did not change with gestational age nor birth weight. In conclusion, long-term ritodrine tocolysis leads to increased umbilical blood CK level.

scholarly journals Pulmonary Recruitment Strategy in Preterm Neonates < 29 Weeks of Gestational Age to Reduce the Need for Intubation in the Delivery Room

2019 ◽  
Vol 36 (S 02) ◽  
pp. S115-S119 ◽  
Author(s):  
Flavia Petrillo ◽  
Luigia Valenzano ◽  
Caterina Franco ◽  
Giovanna Calò ◽  
Domenico Dentico ◽  
...  
Keyword(s):  
Gestational Age ◽  
Face Mask ◽  
Delivery Room ◽  
Recruitment Strategy ◽  
Chest Compressions ◽  
Epinephrine Administration ◽  
Sustained Inflation ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background The application of noninvasive ventilation (NIV) modalities from birth in the delivery room (DR) during fetal–neonatal transition reduces the need for invasive mechanical ventilation, mortality, and bronchopulmonary dysplasia (BPD). The use of a RAM nasal cannula (RAM NC) in the DR for resuscitation results in less need for intubation, chest compressions, and epinephrine administration when compared with using a face mask for PPV in the DR. Objective To evaluate the need for endotracheal intubation in the DR among extremely low gestational age neonates treated at birth with sustained inflation (SI) followed by a nasal continuous positive airway pressure (NCPAP) (range: 6–8 cm of H2O) delivered through the RAM NC. Study Design A retrospective study was conducted to compare the use of NIV techniques in the DR and the need for intubation in the DR in premature infants 23 to 28 weeks' gestational age from December 2016 to July 2018 (group A). These data were compared with those of premature inborn infants with similar GA born between April 2015 and November 2016 (group B). In the DR, immediately after birth, neonates in group A received SI through RAM NC followed by CPAP ranging from 6 to 8 cm H2O, whereas the neonates in group B were treated in the DR with SI administered through a face mask followed by the application of CPAP of 5 cm H2O delivered through a nasopharyngeal tube. Results A total of 65 preterm infants 23 to 28 weeks of gestational age, 31 in group A and 34 in group B, were included in the study. The percentage of neonates intubated in the DR was significantly lower in group A (p < 0.008). In both groups, no neonates died in the DR, and no one required epinephrine and/or chest compressions. For those neonates who did not require intubation in the DR, there was no significant difference in the average FiO2 on arrival in the neonatal intensive care unit, rate of intubation within 24 hours, and use of surfactant. The incidence of BPD was similar in the two groups. Only one infant in group A developed moderate BPD, and no one needed oxygen and/or ventilatory assistance at discharge. Mortality was similar in the two groups, with a slight prevalence in group B (27.7 vs. 19.2%). Conclusion SI with RAM NC followed by NCPAP ranging from 6 to 8 cm H2O, administered with RAM NC resulted in a significant reduction of intubation in the DR.

scholarly journals Steroid Metabolome in the Umbilical Cord: Is It Necessary To Differentiate Between Arterial and Venous Blood?

2014 ◽  
pp. 115-126 ◽  
Author(s):  
A. PAŠKOVÁ ◽  
A. PAŘÍZEK ◽  
M. HILL ◽  
M. VELÍKOVÁ ◽  
J. KUBÁTOVÁ ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Venous Blood ◽  
Umbilical Blood ◽  
Group A ◽  
Group B ◽  
Steroid Conjugates ◽  
In Pregnancy

Steroids are important markers in pregnancy. Although estimating their levels separately in umbilical arterial (UA) and venous blood (UV) enable more precise insights into the functioning fetoplacental unit compared to using mixed umbilical blood (UM), selective aspiration of UA and UV is technically more demanding than collecting UM. We measured the levels of 67 unconjugated steroids and steroid polar conjugates in UA and UV using GC-MS in 80 women giving birth within weeks 28 to 42 of gestation. The samples were sorted into three groups: women entering labor within weeks 28-32 (group A, n=19), weeks 33-37 (group B, n=19), and weeks 38-42 (group C, n=42) of gestation, respectively. The preterm labors were due to pathologies unrelated to steroid status. Most unconjugated steroids exhibited pronounced arteriovenous differences (AVD). The AVD were less distinct in more stable steroid conjugates. Most steroids positively correlate with gestational age, but unconjugated 5β-reduced pregnanes show negative correlations, as do testosterone and androstenediol, substrates for the placental synthesis of estrogens. Tight correlations between steroids in UA and UV indicate that steroid measurements in UA, UV and UM can be accurately derived from each other, which is important for the diagnostics of steroid related diseases in newborns.

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