scholarly journals Ivf versus spontan singleton pregnancies fetal and maternal outcomes in a tertiary care hospital

2018 ◽  
Vol 5 (3) ◽  
pp. 3583-3587
Author(s):  
Erbil Çakar ◽  
Meral Meryem Yavuz ◽  
Tayfun Kutlu ◽  
Habibe Ayvacı Taşan ◽  
Ebru Cogendez ◽  
...  
Keyword(s):  
Placental Abruption ◽  
Gestational Hypertension ◽  
Placenta Previa ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Study Group ◽  
Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
Cholestasis Of Pregnancy ◽  
Singleton Pregnancies

Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) versus naturally (spontaneously) concieved age and parity matched group of singleton pregnants. Methods: Two hundred and sixteen singleton pregnancies aged between 18-45 years old were included in this study.  Among all study group, 106 cases were ICSI pregnancies (study group) and 110 cases were spontaneously concieved singleton pregnancies (control group).  Pregnancy outcome parameters were: the incidence of chronic hypertension, preeclampsia, gestational hypertension, placenta previa, placental abruption, preterm birth, intrahepatic cholestasis of pregnancy, gestational diabetes, preterm premature rupture of membranes, caesarean delivery. Results: There were no differences in terms of maternal age, BMI, gravidity, parity, gestational weeks at birth and birth weight between ICSI and spontaneously concieved pregnancy groups. Placental abruption, gestational diabetes and cesarean section rates were significantly higher in ICSI pregnancies than spontaneously conceived pregnancies (4.7% vs 0%, 21.7% vs 11.8% and 82.1% vs 68.2%, respectively). There wereno statistically significant differences in terms of chronic hypertension, preeclampsia, gestational hypertension, preterm labor, placenta previa, intrahepatic cholestasis of pregnancy, preterm and term premature rupture of the membranes. Conclusion: ICSI pregnancies have higher adverse perinatal outcomes than spontaneously conceived singleton pregnancies which were matched with age and parity. That’s why ICSI pregnancies should be given a detailed counseling about the adverse perinatal outcomes and should be followed up more carefully through the pregnancy.

STUDY ON THE EFFECT OF ADVANCED MATERNAL AGE AT OBSTETRIC AND PERINATAL LEVEL

2021 ◽  
pp. 60-62
Author(s):  
Juliya John ◽  
Aswath Kumar ◽  
Saley Daniel
Keyword(s):  
Caesarean Section ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Gestational Hypertension ◽  
Preterm Labour ◽  
Perinatal Outcomes ◽  
Advanced Maternal Age ◽  
Control Group ◽  
Study Group ◽  
Adverse Perinatal Outcomes

INTRODUCTION: Advanced maternal age is commonly considered to be 35 years or older. The association between adverse perinatal outcomes and advanced maternal age has been a matter of controversy in several studies. While some researchers have noted an increased rate of adverse pregnancy outcomes in women older than 35 years, others have failed to nd any association between advanced maternal age and adverse perinatal outcomes. This discordance in conclusions could be attributed to the heterogeneity of study populations, differences in the denition of pregnancy outcomes, and failure to adjust for potential confounders. Therefore, we aimed to investigate the impact of advanced maternal age on obstetric and perinatal outcomes in this study. MATERIALS AND METHODS: The study was carried out among the patients who presented to the labour ward. This is a prospective observational study. The demographic data of these women, gestational age at time of delivery and complication during pregnancy are noted. They will be followed up till discharge and mode of delivery, perinatal outcome and any intrapartum and postpartum complications will be recorded in the research proforma. Sample Size: 252. RESULTS: Though there were higher incidence of Gestational hypertension, PROM, Preterm labour, placenta previa, Malpresentation, Multiple Pregnancy, FGR and treatment taken for infertility among the study group when compared to control group, their statistical signicance could not be established. There was also higher incidence of caesarean section (50.8%) and Operative vaginal delivery (2.6%) in the study group. There was no statistically signicant weight difference among the babies born to mothers in case and control group. CONCLUSION: Pregnant women of Advanced Maternal Age is thought about with great concern among the doctors as well as patients. In this study, there is an increased incidence of antenatal complications like Gestational Diabetes Mellitus, Gestational Hypertension, Caesarean Section and Preterm labour in women aged more than 35 years compared to the women of age 20 to 35 years.

scholarly journals Clinical Significance of Preterm Singleton Pregnancies Complicated by Placental Abruption following Preterm Premature Rupture of Membranes Compared with Those without p-PROM

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Shunji Suzuki
Keyword(s):  
Placental Abruption ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Crude Odds Ratio ◽  
Preterm Premature Rupture ◽  
Emergency Cesarean ◽  
Maternal And Neonatal Outcomes ◽  
Singleton Pregnancies

The purpose of this paper was to examine the obstetric and neonatal outcomes of preterm singleton pregnancies complicated by placental abruption following preterm premature rupture of membranes (p-PROM) compared with those without p-PROM. We reviewed the obstetric records of 95 singleton deliveries complicated by placental abruption at 22–36 weeks’ gestation. The incidence of placental abruption in singleton pregnancies with p-PROM was 4.7%, and the crude odds ratio of placental abruption for women following p-PROM was 6.50 (P<0.01). Of the 95 cases of placental abruption in preterm singleton deliveries, 64 cases (67.4%) occurred without p-PROM and 31 cases (32.6%) occurred following p-PROM. The incidence of histological chorioamnionitis stage III in the patients following p-PROM was significantly higher than that in the patients without p-PROM (P=0.02). The rate of emergency Cesarean deliveries associated with nonreassuring fetal status (NRFS) in the patients following p-PROM was significantly lower than that in the patients without p-PROM. However, there were no significant differences in the maternal and neonatal outcomes between the patients with and without p-PROM. Although p-PROM may be one of important risk factors for placental abruption associated with chorioamnionitis, it may not influence the perinatal outcomes in preterm placental abruption.

scholarly journals Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 667
Author(s):  
Kjerstine Breintoft ◽  
Regitze Pinnerup ◽  
Tine Brink Henriksen ◽  
Dorte Rytter ◽  
Niels Uldbjerg ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Section ◽  
Placental Abruption ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcome ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Increased Risk ◽  
Spontaneous Hemoperitoneum ◽  
In Pregnancy

Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study

2020 ◽  
Vol 48 (4) ◽  
pp. 317-321
Author(s):  
Rodney McLaren ◽  
Bharati Kalgi ◽  
Chima Ndubizu ◽  
Peter Homel ◽  
Shoshana Haberman ◽  
...  
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Repeated Measures ◽  
Adverse Outcome ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Doppler Velocity ◽  
Chronic Hypertension ◽  
Adverse Perinatal Outcomes

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

scholarly journals Perinatal Outcomes of Twin Pregnancies With Preterm Premature Rupture of the Membranes at 24–34 Weeks’ Gestation

2021 ◽  
Author(s):  
Shuwei Zhou ◽  
Yajun Yang ◽  
XiaoYan Zhang ◽  
Xiaoling Mu ◽  
Quan Quan ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Factors Associated ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.

Placental massive perivillous fibrinoid deposition is associated with adverse pregnancy outcomes: a clinicopathological study of 12 cases

2016 ◽  
Vol 5 (1) ◽  
pp. 35-39
Author(s):  
Maili Qi ◽  
Kenneth Tou En Chang ◽  
Derrick Wen Quan Lian ◽  
Chong Kiat Khoo ◽  
Kok Hian Tan
Keyword(s):  
Pregnancy Outcomes ◽  
Gestational Hypertension ◽  
Local Population ◽  
Fetal Loss ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Special Focus ◽  
Adverse Perinatal Outcomes ◽  
Adverse Pregnancy

Abstract Introduction: Massive perivillous fibrinoid deposition (MPFD) is a very rare placental condition characterized by abnormally extensive fibrinoid deposition in the placental villous parenchyma. The aim of this study is to document clinical and pathological features with special focus on pregnancy outcomes of this condition in consecutive cases of MPFD in our local population. Methods: This is a retrospective clinico-pathological study of cases affected by MPFD over the period January 2010–July 2014 in our hospital. We document clinical features (including perinatal outcome and subsequent pregnancies) and placental pathological characteristics. Results: Twelve cases of MPFD were identified among 3640 placentas (0.33%). There was no identified recurrence. The affected infants had adverse outcomes, including intrauterine growth restriction (IUGR) (75%), preterm birth (58.3%), and fetal loss (25%). A high frequency of reduced PAPP-A in the first trimester (25%), and concurrent gestational hypertension or pre-eclampsia (25%) was noted. Conclusion: MPFD is associated with adverse perinatal outcomes. Further research to better understand its pathogenesis and to improve clinical diagnosis and management is warranted.

Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications

2020 ◽  
Vol 48 (4) ◽  
pp. 322-328
Author(s):  
Rinat Gabbay-Benziv ◽  
Eran Ashwal ◽  
Eran Hadar ◽  
Amir Aviram ◽  
Yariv Yogev ◽  
...  
Keyword(s):  
Pregnancy Complications ◽  
Placental Abruption ◽  
Gestational Hypertension ◽  
Medical Center ◽  
Cohort Analysis ◽  
Interpregnancy Interval ◽  
Delivery Outcome ◽  
Retrospective Cohort Analysis ◽  
Increase Risk ◽  
Singleton Pregnancies

AbstractObjectiveThe aim of this study was to investigate the effect of short or long interpregnancy interval (IPI) with placental mediated pregnancy complications after already complicated first delivery.MethodsWe performed a retrospective cohort analysis of all women with singleton pregnancies who delivered their first three consecutive deliveries in one university-affiliated medical center (1994–2013). Placental mediated complications included placental abruption, small for gestational age, preeclampsia, gestational hypertension, or preterm delivery. Following first complicated delivery, IPI was compared stratified by second delivery outcome. Following two complicated deliveries, IPI was compared stratified by third delivery outcome. IPI was evaluated as continuous or categorical variable (>18, 18–60, >60 months). Related samples Cochrans’ Q test and Mann-Whitney analysis were used as appropriate.ResultsOverall, 4310 women entered analysis. Of them, 18.3%, 10.5%, and 9.3% had complicated first, second, and third delivery, consecutively. Evaluated continuously, longer IPI, but not short IPI, was associated with higher rates of complicated second delivery. Stratified to categories, IPI had no effect on recurrent complications evaluated separately or as composite.ConclusionOur results suggest that long IPI may increase risk for placental mediated pregnancy complications. Further studies are needed to evaluate this effect.

scholarly journals Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34–36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

2020 ◽  
Vol 42 (11) ◽  
pp. 717-725
Author(s):  
Malú Flôres Ferraz ◽  
Thaísa De Souza Lima ◽  
Sarah Moura Cintra ◽  
Edward Araujo Júnior ◽  
Caetano Galvão Petrini ◽  
...  
Keyword(s):  
Gestational Age ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Management Group ◽  
Group I ◽  
Adverse Perinatal Outcomes ◽  
Group Ii

Abstract Objective To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p < 0.001), latency time (20.9 versus 33.6 hours, p = 0.001), and gestational age at delivery (36.5 versus 37.2 weeks, p = 0.025). There were no significant associations between the groups and the presence of adverse perinatal outcomes. Gestational age at diagnosis was the only significant predictor of adverse composite outcome (x2 [1] = 3.1, p = 0.0001, R2 Nagelkerke = 0.138). Conclusion There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes.

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