scholarly journals Preeclampsia prediction –First trimester screening markers

2021 ◽  
Vol 8 (2) ◽  
pp. 223-229
Author(s):  
Kaliki Hymavathi ◽  
Bhaavya Paturi ◽  
Duvvuru Akshitha ◽  
K Sravya
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
First Trimester ◽  
Screening Tools ◽  
Early Prediction ◽  
Creatinine Ratio ◽  
Spot Urine ◽  
Maternal Urine ◽  
Urine Albumin

Preeclampsia is a multi-system disorder manifested primarily by hypertension and proteinuria during second half of pregnancy. It is a major cause of maternal morbidity and mortality worldwide. Despite decades of research into the condition, the ability of clinicians to predict preeclampsia prior to the onset of symptoms has not improved significantly. In this review we will look at potential biomarkers for early prediction and diagnosis of preeclampsia. To evaluate the efficacy of different biochemical and biophysical markers in the early weeks of gestation as screening tools for early prediction of preeclampsia. This hospital-based prospective observational study conducted on 52 pregnant women, at less than 13 weeks of gestation were recruited. Maternal urine microalbumin, urinary albumin to creatinine ratio, and USG uterine artery PI levels were analyzed among the pregnant women who subsequently developed PE and compare with those who did not develop PE. Methods used for the detection of markers are: immunoturbidimetric method for urine albumin, modified kinetic Jaffe reaction without deproteinization for Urine creatinine and Uterine artery Doppler velocimetry was done by PHILIPS HD11XE transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer. In the present study, spot urine microalbumin and spot urine albumin to creatinine ratio (UACR) at 11-13 were significantly higher in women who developed PE subsequently when compared to nonpreeclamptic women.(P<0.0001). The mean levels of 1st and 2nd-trimester uterine artery PI significantly high in women who subsequently developed PE when compared to those who did not develop preeclampsia (P<0.0001). Study results showed a strong association between gestational age at delivery and neonatal outcome (neonatal birth weight and APGAR) with preeclampsia. The maternal urine microalbumin, albumin to creatinine ratio, and uterine artery PI found to have good sensitivity and specificity for early prediction of PE. Study concluded that the women who are prone to develop PE subsequently, had high levels of MAP, UAPI, microalbuminuria and urine albumin to creatinine ratio than the normotensive women. In our setting, MAP, UAPI, microalbuminuria, and UACR markers appeared to be better screening modalities. The combination of biochemical markers with the biophysical markers, demographic characteristics, and other novel markers will establish the effective screening models for early prediction of PE. Early identification of high-risk cases will offer an opportunity for prophylactic therapy, such as Low- dose Aspirin in selected groups of high-risk women screened in the first trimester, thus improving the maternal and perinatal outcome.

scholarly journals Potential screening strategies for early prediction of pre-eclampsia

2021 ◽  
Vol 10 (4) ◽  
pp. 1436
Author(s):  
Hymavathi K. ◽  
Sandhya Rani Davuluru ◽  
Sameera Shaik ◽  
Sahithi Kaviti
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Uterine Artery ◽  
Strong Association ◽  
First Trimester ◽  
Maternal Serum ◽  
Screening Tools ◽  
Early Prediction ◽  
Inhibin A ◽  
Study Results

Background: This study was conducted to evaluate the efficacy of different biochemical and biophysical markers in the early weeks of gestation as screening tools for early prediction of preeclampsia.Methods: This hospital-based prospective observational study conducted on 52 pregnant women, at less than 13 weeks of gestation were recruited. Maternal serum inhibin A and USG uterine artery PI levels were analyzed among the pregnant women who subsequently developed PE and compare with those who did not develop PE. Methods used for the detection of markers were: chemiluminescence immunoassay (CLIA) for serum inhibin A levels, and uterine artery Doppler velocimetry was done by PHILIPS HD11XE transabdominal ultrasound machine using a 4-6 MHz probe with the same sonographer.Results: The present study revealed a significant rise of inhibin A in preeclamptic women when compared to normotensive women (p<0.0001). The mean levels of 1st and 2nd trimester uterine artery PI significantly high in women who subsequently developed PE when compared to those who did not develop preeclampsia (p<0.0001). Study results showed a strong association between gestational age at delivery and neonatal outcome (neonatal birth weight and APGAR) with preeclampsia. The maternal serum inhibin A, and uterine artery PI found to have good sensitivity and specificity for early prediction of PE.Conclusions: Study concluded that the women who are prone to develop PE subsequently, had high levels of MAP, UAPI, inhibin A. In our setting, MAP, UAPI, inhibin A, appeared to be better screening modalities. Combination of the biochemical markers with the biophysical markers, demographic characteristics, and other novel markers will establish the effective screening models for early prediction of PE. Early identification of high-risk cases will offer an opportunity for prophylactic therapy, such as Low- dose Aspirin in selected groups of high-risk women screened in the first trimester, thus improving the maternal and perinatal outcome.

scholarly journals Determination of Urinary Calcium/Creatinine Ratio in a Spot Sample of Urine For Early Prediction of Pre-Eclampsia

2014 ◽  
Vol 41 (2) ◽  
pp. 20-22 ◽  
Author(s):  
SY Moni ◽  
KM Ahmed ◽  
F Siddika ◽  
A Habib ◽  
N Ara ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urine Sample ◽  
Urinary Calcium ◽  
Early Prediction ◽  
Creatinine Ratio ◽  
Receiver Operator Curve ◽  
Predictive Values ◽  
Spot Urine ◽  
Single Urine Sample ◽  
Operator Curve

Based on the fact that urinary hypocalciuria in pre-eclampsia this study was designed to determine the predictive value of calcium to creatinine ratio in a spot urine sample in second trimester of pregnancy. The calcium to creatinine ratio Calcium/creatinine ratio has been considered for early detection of pre-eclamptic toxaemia (PET). So for the diagnosis of PET we try to investigate the relation of urinary calcium, urinary creatinine, urinary calcium/creatinine ratio. For this purpose total number of 60 healthy gravid and clinically suspected PET women of 20-28 weeks of pregnancy having age ranged from, 17-39 years were selected. On these 30 healthy pregnant women urinary calcium/creatinine ratio was within normal range and On the other hand urinary calcium/creatinine ratio in PET women was significantly decreased on the clinically diagnosed 30 PET women. These observations suggest that low calcium/creatinine ratio help in early prediction of PET .The result expressed by receiver operator curve analytic tecnique. Using the receiver operator curve a cut off level of 0.225 the calcium to creatinine ratio was chosen for prediction of PET. Twenty Two out of 30 woman had a calcium/creatinine ratio equal or less than 0.225. Thirty who had remained normotensive 13 had calcium/creatinine ratio equal or less than 0.225. This level thus yielded a 75% sensitivity and 65% specificity. Positive and negative predictive values 68.2% and 72.2% were calculated respectively, at this cut-off point. In conclusion a spot single urine sample calcium/creatinine ratio may be an effective method for screening pregnant women for detection of pre-eclampsia. DOI: http://dx.doi.org/10.3329/bmj.v41i2.18796 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 20-22

scholarly journals Public-health risks from tea drinking: Fluoride exposure

2021 ◽  
pp. 140349482199028
Author(s):  
Nimisha Krishnankutty ◽  
Tina Storgaard Jensen ◽  
Jeannett Kjær ◽  
Jan Stener Jørgensen ◽  
Flemming Nielsen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Direct Method ◽  
Fluoride Concentration ◽  
First Trimester ◽  
Tea Consumption ◽  
Spot Urine ◽  
Fluoride Exposure ◽  
Tea Infusions ◽  
Tea Drinking ◽  
New Evidence

Aims: Due to new evidence on fluoride neurotoxicity during early life, this study examined maternal exposure to fluoride through tea consumption in a low-fluoride region and measured fluoride releases from commercially available teas (tea bags and loose teas) to determine the need to limit fluoride exposure. Methods: Maternal urine fluoride (MUF) concentrations were measured in spot urine samples ( N=118) from first-trimester pregnant women and in prepared tea infusions made with deionised water from 33 brand teas and 57 loose-tea products, as determined by the direct method of using a fluoride-selective electrode. Results: The fluoride concentration in the local drinking water supplies ranged from 0.10 to 0.18 mg/L, and the creatinine-adjusted MUF ranged from 0.09 to 1.57 mg/L. Seventeen per cent of the women were daily tea drinkers, and their MUFs were higher than those with no consumption ( p=0.002). The fluoride concentration from tea bags ranged from 0.34 to 2.67 mg/L, while loose teas showed 0.72–4.50 mg/L (black), 0.56–1.58 mg/L (oolong), 1.28–1.50 mg/L (green), and 0.33–1.17 mg/L (white tea). Conclusions: Fluoride exposure among pregnant women increases with tea consumption, with likely risks of developmental neurotoxicity to their children. As the fluoride release from tea varies widely, the fluoride concentration should be indicated on tea packages in order to allow consumers to make informed decisions on minimising their fluoride exposure.

Spot urine protein creatinine ratio compared with dipstick proteinuria as a primary screening tool for renal disease in a community setting

2021 ◽  
Author(s):  
Michael Abel Alao ◽  
Asinobi OA ◽  
Ibrahim OR ◽  
Lagunju IA
Keyword(s):  
High Risk ◽  
Kidney Disease ◽  
Renal Disease ◽  
Screening Tool ◽  
Healthy Children ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Primary Screening ◽  
Dipstick Urinalysis

Abstract Background Although, the use of manual dipstick urinalysis for proteinuria has been a common practice, the Kidney Disease Improving Global Outcomes (KDIGO) guideline on screening for chronic renal disease least advocate it use. Besides, several studies have assessed the performance of dipstick urinary in screening for proteinuria to be inaccurate, unreliable with a poor predictive values. The goal of this study was to determine and compare the presence of significant proteinuria (SP) in high-risk African children using the spot urine protein creatinine ratio (UPr/UCr) as a primary screening tool besides dipstick proteinuria screening. Methods This cross-sectional study involved 1,316 apparently healthy children recruited through a multi-stage sampling technique in Ogbomoso land, Nigeria. We performed a dipstick urinalysis on early-morning urine samples. Urinary protein content was determined using a turbidimetric method and Jaffe’s reaction to measure the urinary creatinine concentration. Statistical analysis was performed using the IBM Statistical Package for Social Sciences (SPSS)TM, Version 23.0 for Windows. Results The prevalence of SP using spot UPr/UCr (≥ 0.2) and dipstick proteinuria screening (≥1+) were 18% and 0.8%, respectively (p<0.001). Of the 224 subjects determined to have SP using UPr/UCr, the females (140; 20.1%) had a higher proportion compared to males (84; 15.4% -p=0.032). Nephrotic range proteinuria was detected in nine out of 10 subjects (90%) using UPr/UCr but in only three out of ten (30%) using the urinary dipstick method. The biserial correlation coefficient (r= 0.092; p=0.001) and inter-rater-agreement (Cohen’s Kappa = 0.01) were poor, and the McNemar’s test result was (p<0.001). Conclusion The UPr/UCr ratio technique appeared to perform better than dipstick urinalysis as a primary screening tool for renal disease. Hence, it may be adopted for early detection of SP as a kidney disease marker especially among the high risk population.

scholarly journals First Trimester Uterine Artery Doppler in Early prediction of Preeclampsia

2021 ◽  
Vol 6 (5) ◽  
pp. 281-285
Author(s):  
S.A. Saad ◽  
A. A. Shedeed ◽  
A.S. Soliman ◽  
M.M.R. Elgendy
Keyword(s):  
Uterine Artery ◽  
First Trimester ◽  
Early Prediction ◽  
Uterine Artery Doppler

scholarly journals Cohort profile: targeted antenatal screening for haemoglobinopathies in Basel

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035735
Author(s):  
Gabriela Amstad Bencaiova ◽  
Franziska Geissler ◽  
Irene Hoesli
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
Iron Status ◽  
First Trimester ◽  
High Risk Group ◽  
University Hospital ◽  
Pregnancy Cohort ◽  
Haemoglobin Variant ◽  
Adverse Pregnancy

PurposeThe pregnancy cohort was established to examine the prevalence and variety of haemoglobinopathies in a high-risk group of pregnant women.ParticipantsThe pregnancy cohort is located in the Department of Obstetrics and Antenatal Care, University Hospital of Basel. The pregnant women were recruited in the first trimester between June 2015 and May 2019. Family origin questionnaires were used to screen pregnant women for the risk of a haemoglobin variant. Based on the questionnaire, pregnant women were divided into two groups: women with a high risk and women with a low risk of a haemoglobin variant. In women with a high risk, red blood cell indices, iron status and chromatography were conducted.Findings to date1785 pregnant women were recruited. Out of the 1785 women, 929 were identified as a part of the high-risk group. Due to the missing data of 74 pregnant women with a high risk, the final analysis was conducted in the remaining 855 women. The prevalence of haemoglobinopathies in the high-risk group was 14.5% (124/855).Future plansThis cohort will be used to: (1) implement the screening in prenatal care in Basel; (2) recommend the screening among pregnant women with a high risk of a haemoglobin variant in Switzerland; (3) improve prenatal and neonatal care in patients with a haemoglobin variant; (4) examine adverse pregnancy outcomes in women with a haemoglobin variant and (5) reduce maternal and neonatal morbidity and mortality in the future.Trial registration numberClinicalTrials.gov Registry (NCT04029142).

Features of the sexual life during pregnancy

2012 ◽  
Vol 19 (2) ◽  
pp. 67-74 ◽  
Author(s):  
Jelena ISAJEVA ◽  
Mindaugas ŠILKŪNAS ◽  
Gražina Stanislava DRĄSUTIENĖ ◽  
Daiva BARTKEVIČIENĖ
Keyword(s):  
High Risk ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Sexual Intercourse ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Education Level ◽  
Active Group ◽  
Sexual Life ◽  
Sexually Active

Background. The aim of our study was to evaluate Vilnius and Vilnius Region women’s knowledge about sexual intercourse during pregnancy. Materials and methods. The study included 94 women who were in the Center Affiliate of VUH Santariskiu Clinics after delivery. The women were interviewed using a questionnaire. They were divided in three groups by levels of education. Results. The study showed that 83% of pregnant women had sexual intercourse during pregnancy. 55.1% had coitus several times a month. The first trimester was the most frequent period of sexual intercourse (52.6%). 22.6% of pregnant women were at high risk of miscarriage and 61.9% of them have had sexual intercourse. The frequency of miscarriage in the sexually active group was 17.9% and in the non-active group it was 50% (p < 0.05). All women who reported frequent sexual intercourse were not at threat for miscarriage compared to incidence of miscarriage of those 13 (22%) women who reported infrequent intercourse (p = 0.019). 79.8% of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes. 20.2% of the women thought that intercourse during pregnancy was safe. 63.8% of pregnant women were not asked by doctors during pregnancy about their sexual life. Conclusions. The majority (79.8%) of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes but even 83% of pregnant women had sexual intercourse during pregnancy. There were no statistical differences between women with different education level. Pregnant women were rarely asked by doctors about their sexual life.

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