Role of cervicovaginal β-hCG in prediction of preterm delivery: a prospective observational study

Background: The World Health Organization (WHO) factsheet revealed that 15 million babies are born too early every year and almost 1 million children die each year due to complications of preterm birth. The objective of this study was to determine whether cervicovaginal β-hCG level can be used as predictor of preterm delivery in asymptomatic high-risk pregnant women at 24-34 weeks gestation age.Methods: This was prospective observational study. Total 134 asymptomatic pregnant women were taken for study who had at least one risk factor for preterm delivery at 24-34 weeks gestation age. Cervicovaginal secretion was collected and β-hCG level was measured by chemiluminescent immunoassay.Results: Out of 134 cases, 42.5% had preterm delivery and 57.5% had term delivery. Mean cervicovaginal β-hCG level (mIU/ml) in preterm delivery group was 39.38±19.66 and term delivery group was 21.86±11.18. Cervicovaginal β-hCG level was significantly higher in preterm group compare to term group demonstrating significant association of raised β-hCG with preterm group (p value <0.001). ROC curve analysis was done to find out best cut off value of cervicovaginal β-hCG for prediction of preterm delivery and optimal cut off value was 36.45 mIU/ml. The optimal cut off value for cervicovaginal β-hCG (36.45 mIU/ml) gave sensitivity 71.9%, specificity 81.8%, positive predictive value 74.5%, negative predictive value 79.7% and diagnostic accuracy of 77.6% for prediction of preterm delivery.Conclusions: Cervicovaginal β-hCG can be used as sensitive and specific biomarker of prediction of preterm delivery in asymptomatic high-risk women.

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Does the Addition of Serum PAPP-A and β-hCG Improve the Predictive Value of Uterine Artery Pulsatility Index for Preeclampsia at 11–14 Weeks of Gestation? A Prospective Observational Study

The Journal of Obstetrics and Gynecology of India ◽

10.1007/s13224-020-01420-7 ◽

2021 ◽

Author(s):

Zeba Khanam ◽

Pratima Mittal ◽

Jyotsna Suri

Keyword(s):

Observational Study ◽

Predictive Value ◽

Pulsatility Index ◽

Uterine Artery ◽

Prospective Observational Study ◽

Β Hcg

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Serum Angiopoietin-1/Angiopoietin-2 at 16-18 Weeks of Gestation to Predict Preeclampsia

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.2021793 ◽

2021 ◽

Author(s):

Vorapong Phupong ◽

Patau Tanbirojn ◽

Ruangsak Lertkhachonsuk

Keyword(s):

Observational Study ◽

Positive Predictive Value ◽

Pregnant Women ◽

Predictive Value ◽

Prospective Observational Study ◽

Predictive Values ◽

Early Onset Preeclampsia ◽

Angiopoietin 2 ◽

Sensitivity Specificity ◽

Angiopoietin 1

Objective: To determine whether serum angiopoietin-1/angiopoietin-2 ratio can predict preeclampsia in women at 16–18 weeks of gestation, or not.Material and Methods: This was a prospective observational study that was conducted in pregnant women with gestational age of 16-18 weeks. Serum angiopoietin-1 and angiopoietin-2 levels were acquired. The predictive values of these tests were calculated.Results: Data from 269 pregnant women were analyzed. Twenty-two cases developed preeclampsia, and five of these cases had early onset preeclampsia. When the angiopoietin-1/angiopoietin-2 ratio was above 6.2, the sensitivity, specificity, positive predictive value and negative predictive values to predict preeclampsia were 50.0%, 72.9%, 14.1% and 94.2%, respectively. When angiopoietin-1 was used to predict preeclampsia, the sensitivity, specificity, positive predictive value and negative predictive values were 59.1%, 65.2%, 13.1% and 94.7%, respectively. When angiopoietin-2 was used to predict preeclampsia, the sensitivity, specificity, positive predictive value and negative predictive values were 63.6%, 50.2%, 10.2% and 93.9%, respectively.Conclusion: This study demonstrated that serum angiopoietin-1/angiopoietin-2 ratio at 16-18 weeks of gestation was not effective in predicting preeclampsia. However, angiopoietin-2 may be used to predict preeclampsia.

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Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0502 ◽

2020 ◽

Vol 33 (5) ◽

pp. 653-659

Author(s):

Jia Song ◽

Yun Cui ◽

Chunxia Wang ◽

Jiaying Dou ◽

Huijie Miao ◽

...

Keyword(s):

Septic Shock ◽

Thyroid Hormone ◽

Observational Study ◽

Hospital Mortality ◽

Predictive Value ◽

Prospective Observational Study ◽

Threshold Value ◽

Nonthyroidal Illness ◽

Hormone Levels ◽

Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

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Efficiency of non-invasive prenatal screening in pregnant women at advanced maternal age

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03570-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hui Zhu ◽

Xiaoxiao Jin ◽

Yuqing Xu ◽

Weihua Zhang ◽

Xiaodan Liu ◽

...

Keyword(s):

High Risk ◽

Pregnant Women ◽

Predictive Value ◽

Trisomy 21 ◽

Maternal Age ◽

Prenatal Screening ◽

Advanced Maternal Age ◽

Youden Index ◽

Non Invasive ◽

Sensitivity Specificity

Abstract Background Non-invasive prenatal screening (NIPS) is widely used as the alternative choice for pregnant women at high-risk of fetal aneuploidy. However, whether NIPS has a good detective efficiency for pregnant women at advanced maternal age (AMA) has not been fully studied especially in Chinese women. Methods Twenty-nine thousand three hundred forty-three pregnant women at AMA with singleton pregnancy who received NIPS and followed-up were recruited. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), receiver operating characteristic (ROC) curves and the Youden Index for detecting fetal chromosomal aneuploidies were analyzed. The relationship between maternal age and common fetal chromosomal aneuploidy was observed. Results The sensitivity, specificity, PPV, NPV of NIPS for detecting fetal trisomy 21 were 99.11, 99.96, 90.98, and 100%, respectively. These same parameters for detecting fetal trisomy 18 were 100, 99.94, 67.92, and 100%, respectively. Finally, these parameters for detecting trisomy 13 were 100, 99.96, 27.78, and 100%, respectively. The prevalence of fetal trisomy 21 increased exponentially with maternal age. The high-risk percentage incidence rate of fetal trisomy 21 was significantly higher in the pregnant women at 37 years old or above than that in pregnant women at 35 to 37 years old. (Youden index = 37). Conclusion It is indicated that NIPS is an effective prenatal screening method for pregnant women at AMA.

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Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm10071487 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1487

Author(s):

Isabel Añón-Oñate ◽

Rafael Cáliz-Cáliz ◽

Carmen Rosa-Garrido ◽

María José Pérez-Galán ◽

Susana Quirosa-Flores ◽

...

Keyword(s):

High Risk ◽

Observational Study ◽

Medical Care ◽

Pregnant Women ◽

Rheumatic Diseases ◽

Absolute Risk ◽

University Hospital ◽

Obstetric Outcomes ◽

Number Needed To Treat ◽

Foetal Death

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

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Evaluation of gastric contents using ultrasound in full-term pregnant women fasted for 8 h: a prospective observational study

Journal of Anesthesia ◽

10.1007/s00540-021-03019-2 ◽

2021 ◽

Author(s):

Khaled Sarhan ◽

Ahmed Hasanin ◽

Ramy Melad ◽

Reham Fouad ◽

Hany Elhadi ◽

...

Keyword(s):

Observational Study ◽

Pregnant Women ◽

Prospective Observational Study ◽

Full Term ◽

Gastric Contents

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Continuous Monitoring of Lactate Using Intravascular Microdialysis in High-Risk Cardiac Surgery: A Prospective Observational Study

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2016.04.013 ◽

2017 ◽

Vol 31 (1) ◽

pp. 37-44 ◽

Cited By ~ 5

Author(s):

Pavel I. Lenkin ◽

Alexey A. Smetkin ◽

Ayyaz Hussain ◽

Andrey I. Lenkin ◽

Konstantin V. Paromov ◽

...

Keyword(s):

Cardiac Surgery ◽

High Risk ◽

Observational Study ◽

Continuous Monitoring ◽

Prospective Observational Study

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Which Clinical Scoring Systems Are Most Useful in Showing Severity in COVID-19 Patients?

10.21203/rs.3.rs-362665/v1 ◽

2021 ◽

Author(s):

Ishak San ◽

Emin Gemcioglu ◽

Salih Baser ◽

Nuray Yilmaz Cakmak ◽

Abdulsamet Erden ◽

...

Keyword(s):

High Risk ◽

Clinical Outcomes ◽

Predictive Value ◽

Independent Predictor ◽

Severe Disease ◽

Scoring Systems ◽

High Risk Group ◽

World Health ◽

Severe Group ◽

Clinical Scoring

Abstract IntroductionIn this study, we compare the predictive value of clinical scoring systems that are already in use in patients with COVID-19, including the BCRSS, qSOFA, SOFA, MuLBSTA and HScore, for determining the severity of the disease. Our aim in this study is to determine which scoring system is most useful in determining disease severity and to guide clinicians.Materials and MethodsWe classified the patients into two groups according to the stage of the disease (severe and non-severe) by using the slightly modified and adopted interim guidance of the World Health Organization. Severe cases were divided into a group of surviving patients and a deceased group according to the prognosis. According to admission values, the BCRSS, qSOFA, SOFA, MuLBSTA, and HScore were evaluated at admission using the worst parameters available in the first 24 hours.ResultsOf the 417 patients included in our study, 46 (11%) were in the severe group, while 371 (89%) were in the non-severe group. Of these 417 patients, 230 (55.2%) were men. The median (IQR) age of all patients was 44 (25) years. In multivariate logistic regression analyses, BRCSS in the highest tertile (HR: 6.1, 95% CI: 2.105–17.674, p = 0.001) was determined as an independent predictor of severe disease in cases of COVID-19. In multivariate analyses, qSOFA was also found to be an independent predictor of severe COVID-19 (HR: 4.757, 95% CI: 1.438–15.730, p = 0.011). The area under the curve (AUC) of the BRCSS, qSOFA, SOFA, MuLBSTA, and HScore was 0.977, 0.961, 0.958, 0.860, and 0.698, respectively.ConclusionCalculation of the BRCSS and qSOFA at the time of hospital admission can predict critical clinical outcomes in patients with COVID-19, and their predictive value is superior to that of HScore, MuLBSTA, and SOFA. With early identification of the high-risk group using BRCSS and qSOFA, early interventions for high-risk patients can improve clinical outcomes in COVID-19.

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DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i3.40529 ◽

2021 ◽

pp. 141-144

Author(s):

DURGA PRASAD THAMMISETTY ◽

DIVITI RANGANAYAKULU ◽

DEVANNA NAYAKANTI

Keyword(s):

Observational Study ◽

Drug Interactions ◽

Hospital Stay ◽

Prospective Observational Study ◽

Tertiary Care ◽

World Health ◽

Care Hospital ◽

Drug Related Problems ◽

Stroke Patients ◽

Prescribing Indicators

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.

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