scholarly journals Optimization of monitoring of contractile uterus activity and fetus status in women with the threat of preterm birth

2021 ◽  
pp. 32-34
Author(s):  
S.V. Korovai ◽  
I.V. Lakhno ◽  
O.V. Gryshchenko ◽  
K.V. Drogovoz ◽  
Y.S. Blazhko ◽  
...  
Keyword(s):  
At Risk ◽  
Preterm Birth ◽  
Diagnostic Accuracy ◽  
Pregnant Women ◽  
Sensitivity And Specificity ◽  
Comparison Group ◽  
Fetal Distress ◽  
Uterine Activity ◽  
Non Invasive ◽  
Group I

Research objective: to study the use of uterine activity and variables of acceleration capacity (AC) and deceleration capacity (DC) in uterine contractile activity and fetal well-being monitoring in women at risk of preterm birth.Materials and methods. 292 pregnant women were included in the prospective study. All involved women underwent ultrasound cervicometry at 16 weeks. 124 pregnant women with a “short cervix” of the III (main) group were observed in the dynamics, as well as uterine activity and fetal AC/DC at 26, 32 and 38 weeks of gestation, and during labor were studied. In 112 women of group II the variables of fetal AC/DC were detected at these terms of pregnancy. They were monitored via conventional cardiotocography during labor. 56 pregnant women in group I with normal cervicometry were monitored.Results. Sensitivity and specificity of the diagnosis of the threatened preterm birth in the main group was 97.30% and 94.74% respectively. Diagnostic accuracy in the case of uterine activity according to fetal non-invasive electrocardiography was 96.18%. Sensitivity and specificity of the diagnosis of the threatened preterm birth in the comparison group were significantly lower: 89.29% and 87.80% respectively. The diagnostic accuracy was 88.41%.Patients in all clinical groups at 26 weeks had low AC/DC values. However, later in women of group I was found highest AC/DC level. AC/DC values in patients with risk of preterm birth were reduced compared with controls (p < 0.05). Sensitivity and specificity of the diagnosis of fetal distress if AC/DC was used were 91.67% and 99.12% respectively. Diagnostic accuracy of the test was 98.41%. In the comparison group the sensitivity was 77.78%, and the specificity was 89.22%. Diagnostic accuracy of intranatal cardiotocography was 86.82%.Conclusions. Uterine activity extracted from the maternal abdominal signal can significantly improve the diagnosis of the threatenedpreterm delivery. Patients at risk of preterm birth have a delayed fetal neurological, which leads to fetal distress. AC/DC variables obtained via fetal non-invasive electrocardiography allow increasing the accuracy of fetal distress diagnosis.

scholarly journals Rapid diagnostic test for antenatal syphilis screening in low-income and middle-income countries: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018132 ◽  
Author(s):  
Carmen Phang Romero Casas ◽  
Marrissa Martyn-St James ◽  
Jean Hamilton ◽  
Daniel S Marinho ◽  
Rodolfo Castro ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Pregnant Women ◽  
Sensitivity And Specificity ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Antenatal Clinics

ObjectivesTo undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women.MethodsFive electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women. Methodological quality was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). A bivariate meta-analysis was undertaken to generate pooled estimates of diagnostic parameters. Results were presented using a coupled forest plot of sensitivity and specificity and a scatter plot.ResultsThe methodological quality of the five included studies with regards to risk of bias and applicability concern judgements was either low or unclear. One study was judged as high risk of bias for patient selection due to exclusion of pregnant women with a previous history of syphilis, and one study was judged at high risk of bias for study flow and timing as not all patients were included in the analysis. Five studies contributed to the meta-analysis, providing a pooled sensitivity and specificity for ICS of 0.85 (95% CrI: 0.73 to 0.92) and 0.98 (95% CrI: 0.95 to 0.99), respectively.ConclusionsThis review and meta-analysis observed that rapid ICS POC tests have a high sensitivity and specificity when performed in pregnant women at antenatal clinics. However, the methodological quality of the existing evidence base should be taken into consideration when interpreting these results.PROSPERO registration numberCRD42016036335.

A Stress Coping App for Hospitalized Pregnant Women at Risk for Preterm Birth

2017 ◽  
Vol 42 (5) ◽  
pp. 257-262 ◽  
Author(s):  
Nancy Jallo ◽  
Leroy R. Thacker ◽  
Victoria Menzies ◽  
Predrag Stojanovic ◽  
Dace S. Svikis
Keyword(s):  
At Risk ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Stress Coping

Performance of Serum Glypican 3 in Diagnosis of Hepatocellular Carcinoma: A meta-analysis

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Dahai Xu ◽  
Chang Su ◽  
Liang Sun ◽  
Yuanyuan Gao ◽  
Youjun Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Web Of Science ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Positive Control ◽  
Cochrane Library ◽  
Non Invasive

Introduction and aim. Serum glypican-3 (GPC3) has been explored as a non-invasive biomarker of hepatocellular carcinoma (HCC). However, controversy remains on its diagnostic accuracy. Therefore, we aimed to conduct a systematic review and metaanalysis to evaluate the differential diagnostic accuracy of serum GPC3 between HCC and liver cirrhosis (LC) cases. Material and methods. After the strict filtering and screening of studies from NCBI, PUBMED, Clinical Trials, Cochrane library, Embase, Prospero and Web of Science databases, 11 studies were selected. All studies provided the sensitivity and specificity of GPC3 and the alpha-fetoprotein (AFP) in the HCC and LC diagnosis. The sensitivity and specificity, and the area under the receiver operating characteristic curve (AUC) were determined and compared between GPC3 and AFP, which was set as a positive control. Results. Pooled sensitivity (95% CI) and specificity (95% CI) were 0.55 (0.52-0.58) and 0.58 (0.54-0.61) for GPC3, 0.54 (0.51-0.57) and 0.83 (0.80-0.85) for AFP, and 0.85 (0.81-0.89) and 0.79 (0.73-0.84) for GPC3 + AFP, respectively. The AUCs of GPC3, AFP and GPC3 + AFP were 0.7793, 0.7867 and 0.9366, respectively. GPC3 had a nearly similar sensitivity as AFP, while the specificity and AUC of GPC3 was lower than that of AFP. The combination of GPC3 and AFP yielded a better sensitivity and AUC than GPC3 or AFP. Conclusion. Serum GPC3 is inferior to AFP in the differential diagnosis between HCC and LC. However, the combination of GPC3 and AFP exhibited a much better performance.

scholarly journals Specific Characteristics of Bioelectric Activity of the Brain in Women with Placental Dysfunction Considering the Type of Psychological Component of Gestation Dominant

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Nataliya Henyk ◽  
Nataliya Yakumchuk
Keyword(s):  
Pregnant Women ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Gestational Hypertension ◽  
Fetal Distress ◽  
Main Group ◽  
Software Complex ◽  
Placental Dysfunction ◽  
Psychological Component ◽  
Attitude Test

 The study of the influence of the autonomic nervous system on the course of pregnancy, childbirth and fetal state remains relevant. Changes in the parameters of electroencephalography may be detected long before the onset of clinical symptoms in the complicated course of pregnancy.  The objective of the research was to evaluate electroencephalography in women with placental dysfunction and gestational complications taking into account the type of psychological component of gestation dominant.  Materials and methods. Electroencephalography was performed in 60 pregnant women at the age of 19 to 45 years with gestational hypertension and fetal distress during pregnancy. The main group included 40 patients, who were stratified according to the type of psychological component of gestation dominant: 10 patients with euphoric type, 20 pregnant women with anxious and depressive type, 10 patients with hypogestognostic type. The comparison group comprised 20 patients with optimal type of psychological component of gestation dominant and normal course of the first half of pregnancy. The assessment of psychological component of gestation dominant was carried out according to the method proposed by Dobriakov I.V. - "Pregnant woman attitude test". Registrations, spectral and coherent analysis of electroencephalography were performed using BrainTest-24 hardware and software complex.  \textbf{Results and discussion. }Electroencephalography of the patients of the comparison group was in line with current concepts regarding the physiological norm. In the main group, there were the following changes in electroencephalography: non-sinusoidal forms of alpha-oscillations (77.5%), high index of fast rhythms, flashes of spike waves under load, disturbances of the frontal occipital gradient with the focus on the anterior sections of the hemispheres.  Conclusions. The use of electroencephalography in women with different types of psychological component of gestation dominant in case of progressive placental dysfunction and preeclampsia on its background allows identifying characteristic changes, modifying the program of therapeutic measures, differentiating obstetric tactics and terms of delivery.

scholarly journals Effect of Clinical and Subclinical Hypothyroidism on Fetal Outcomes among Pregnant Women: A Sub-Specialty Department Experience

2021 ◽  
Vol 7 (1) ◽  
pp. 29-32
Author(s):  
Farzana Sharmin ◽  
Mahfuja Asma ◽  
Khandaker Shehneela Tasnim ◽  
Afzal Momin ◽  
Shimul Akhter ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Apgar Score ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Fetal Outcomes ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Medical University

Background: Hypothyroidism can effect on the fetal outcomes during pregnancy. Objective: The purpose of the present study was to compare the effects of clical and subclinical hypothyroidism on fetal outcomes among pregnant women. Methodology: This cohort study was conducted in the Feto-Maternal Department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from a period of 6 months dated from September 2019 to February 2020. All cases of the clinical and sub-clinical hypothyroid pregnant women admitted in this department. Fetal outcomes of clinical and sub-clinical hypothyroid pregnant women during delivery were recorded. Findings of the cases recorded carefully. Result: A total number of 75 patients were recruited for this study who were divided in to two group designated as group I or sub clinical hypothyroidism and group II or clinical hypothyroidism. Fetal distress was 22(51.1%) cases in group I and 9(33.3%) cases in group II. The fetal outcome of the study patients had observed that 8(27.6%) and 12(80.0%) of the baby had low (<2.5 kg) birth weight in group I and group II' respectively. In group I most (62.1%) of the baby APGAR score was >7 and 11(73.3%) cases had < 6 APGAR score at 1st minute. Majority of the study patients had >7 APGAR score at 5 min in both groups which was 25(86.2%) and 12(80.0%) in group I and group II respectively. Conclusion: In conclusion there is a significant difference found in overt and sub-clinical hypothyroidism considering fetal stress, IUD and prematurity. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 29-32

scholarly journals Hepatitis B e Antigen (HBeAg) Rapid Test and Alanine Aminotransferase Level–Based Algorithm to Identify Pregnant Women at Risk of HBV Mother-to-Child Transmission: The ANRS 12345 TA PROHM Study

2020 ◽  
Vol 71 (10) ◽  
pp. e587-e593 ◽  
Author(s):  
Olivier Segeral ◽  
Bunnet Dim ◽  
Christine Durier ◽  
Sophearot Prak ◽  
Kearena Chhim ◽  
...  
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Sensitivity And Specificity ◽  
Alanine Aminotransferase ◽  
Rapid Test ◽  
Perinatal Transmission ◽  
Hbv Dna ◽  
Dna Quantification ◽  
Low Middle Income Countries

Abstract Background The paucity of hepatitis B virus (HBV) DNA measurement in low-/middle-income countries hinders the identification of HBV-infected pregnant women at risk of perinatal transmission. This study evaluates the validity of an algorithm selecting HBeAg-positive women and HBeAg-negative women with alanine aminotransferase (ALT) ≥40 IU/L as a predictor of high HBV DNA level. Methods All women with reactive samples for hepatitis B surface antigen (HBsAg) were assessed with an SD BIOLINE HBeAg rapid test and HBV DNA quantification was performed. Validities of HBeAg and of the algorithm to identify HBV DNA &gt;2 thresholds (5.3 and 7.3 log10 IU/mL) were evaluated. Results For the 515 HBsAg-positive women, median age was 29 years, 92 (17.9%) were HBeAg positive, 47 (9.1%) were HBeAg negative with ALT ≥40 IU/L, and 144 (28.0%) had an HBV DNA &gt;5.3 log10 IU/mL. Sensitivity and specificity of HBeAg were 61.8% and 99.2% for HBV DNA &gt;5.3 log10 IU/mL and 81.3% and 96.7% for HBV DNA &gt;7.3 log10 IU/mL. For the algorithm, sensitivity and specificity were 79.2% and 93.3% for HBV DNA level &gt;5.3 log10 IU/mL and 92.7% and 88.1% for HBV DNA &gt;7.3 log10 IU/mL. The AUCs for the algorithm (0.92 and 0.94 for HBV DNA &gt;5.3 and 7.3, respectively) were significantly greater (P &lt; .001) than the AUCs for HBeAg (0.81 and 0.89 for HBV DNA &gt;5.3 and 7.3, respectively). Conclusions An algorithm using HBeAg and ALT level could be an effective strategy to identify HBV-infected pregnant women at risk of perinatal transmission in countries where HBV DNA quantification is not routinely available.

Fetus arrest of development at prematurely born pregnancy: diagnostics and prophylaxis of perinatal pathology

2017 ◽  
pp. 124-126
Author(s):  
V.I. Boyko ◽  
◽  
O.I. Butenko ◽  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Fetoplacental Complex ◽  
Adaptive Agent ◽  
Threatened Abortion ◽  
Early Preterm Birth ◽  
Structural Mechanisms

The objective: to reduce the frequency of perinatal complications at pregnant women with a fetus arrest of development the pregnant at prematurely born pregnancy by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. prospective research was conducted, we surveyed 120 patients, among which 90 pregnant women with syndrome of an arrest of development of a fetus who were divided by method of casual choice into two groups. Results. The use of the proposed treatment and preventive methods in pregnant women with premature birth at FGR allowed to significantly reduce the incidence of threatened abortion and placental dysfunction 1.3 times, genital tract disorders microbiocenosis 1.4 times, premature rupture of membranes by 1.4 times, the severity FGR syndrome 1.6 times, fetal distress is 1.3 times, 1.2 times of the COP, severe asphyxia in 3 times, intra-amniotic infection is 1.5 times, to change the structure of preterm birth (to prevent early preterm birth in 22–28 weeks). The overall incidence of infants in the early neonatal period, these pregnant women was significantly reduced by 1.3 times (p<0.05), but there were no perinatal loss. Conclusion. The received results: when using the technique of complex correction developed by us the dizadaptation of disturbances in fetoplacental complex at women who received algorithm offered by us, all structural mechanisms of adaptation of placenta which allow to keep morphometric and diffuse indicators of vorsine tree at level with firmness compensations that is the most important adaptive agent which allows to support vital activity of fetus turn on and to prevent development of serious degree of delay of its development. Key words: fetus arrest of development, prematurely born pregnancy, diagnostics, prophylaxis.

scholarly journals Prevention of the fetoplacental complex disorders in women at risk and the risk of preterm birth (Literature review)

2021 ◽  
Vol 2 ◽  
pp. 32-36
Author(s):  
O.V. Laba
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Placental Abruption ◽  
Reproductive Potential ◽  
Fetal Distress ◽  
Smoking During Pregnancy ◽  
Complex Disorders ◽  
Placental Dysfunction ◽  
Fetoplacental Complex ◽  
The Impact

The obstetrician-gynaecologist practitioners consider a woman’s health from her reproductive potential support standpoint, and the problem of miscarriage is considered as one of the most important health problems in the world. The difficulty in solving the premature birth problem is the presence of many factors and preconditions that determine the risks of miscarriage. The article provides an overview of current international guidelines for assessing the root causes and preconditions for preterm birth. The problem of preterm birth risks is discussed, taking into account both the socio-economic living conditions of pregnant women and the factors that accompany the formation of the pathogenesis of preterm birth (placental dysfunction). There were examination and evaluation of the clinical significance of the factors that can lead to dysfunction of the fetoplacental complex (partial placental abruption, low placentation, placental dysfunction, premature placental maturation, placental malnutrition/hypertrophy, polyhydramnios/dehydration, placental abruption syndrome and growth retardation syndrome, fetal-placental blood flow, acute/chronic fetal distress). It was noted that hemodynamic disorders in the placenta depend on both the nature and duration of adverse factors. Those factors are pregnancy in unfavourable terms for the birth of children (up to 18 and after 40 years), high frequency of extragenital pathology, complicated reproductive history, genital infectious diseases (chlamydial infections, trichomoniasis, urogenital mycoplasmosis), smoking during pregnancy, the impact of environmental and economical character.Attention is paid to the hemodynamic disorders assessment (vascularization of the lower uterus) in pregnant women and determination of their role in the fetoplacental dysfunction development. The role of the hemodynamic disorders in the placenta is considered as the morphological and biochemical adaptive reactions abnormality. 

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