Study On Diagnosis And Management Strategies On Heterotopic Pregnancy

Abstract Objective The aims of this study were to analysis the clinical characteristics of women with heterotopic pregnancy (HP) following embryo transfer (ET) and explore the early predictors for pregnancy outcomes.Methods This retrospective study reviewed patients with HP following assisted reproductive technology (ART) in our institution between January 2013 and December 2020. The relationships between pregnancy outcomes and general features, ultrasonic characteristics and different treatment modality were analyzed by logistic regression analysis.Results Fourty patients were identified, including 27 with tubal HP, 7 interstitial HP and 6 cornual HP. The most frequent manifestations before diagnosis was vaginal bleeding (30.0%), while 7 patients (17.5%) had no symptoms before diagnosis. The mean gestational age at symptom onset was 44.8 ± 8.6 days (range 27–68). Gestational age at diagnosis was 49.4 ± 7.6 days (range 29–68). Among these cases, twenty-nine patients of HP were accurately diagnosed by transvaginal ultrasonography (TVS). Hence, the sensitivity of TVS for detecting HP was 72.5% (29/40). Eleven patients received expectant management, while 29 patients underwent laparotomy (13/29) or laparoscopy (16/29) surgery. Gestational age at surgery day was 51.0±8.6 days (range 33–67). Live births occurred for 18 patients in the surgery group, 3 of whom delivered preterm. Additionally, the miscarriage rate was lower for patients with IUP cardiac activity (16.7% vs. 90.0%) than patients without IUP cardiac activity at HP diagnosis (P < 0.001). Further by logistic regression analysis, an IUP with cardiac activity at HP diagnosis was identified as an independent factors of pregnancy outcome (P<0.001).Conclusions Symptoms combined with routine TVS scans could reduce misdiagnosis and facilitate the diagnosis of HP. An IUP with cardiac activity at HP diagnosis as predictors for a favorable prognosis of HP. Prompt surgical intervention after diagnosis may minimize the incidence of abortion of IUP.

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Impact of prematurity and the CTG repeat length on outcomes in congenital myotonic dystrophy

10.21203/rs.3.rs-24158/v2 ◽

2020 ◽

Author(s):

Yu Saito ◽

Kenta Matsumura ◽

Misao Kageyama ◽

Yuichi Kato ◽

Eiji Ohta ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Predictive Model ◽

Myotonic Dystrophy ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Multivariate Logistic Regression Analysis ◽

Repeat Length ◽

Congenital Myotonic Dystrophy ◽

Ctg Repeat

Abstract Objective: Patients with congenital myotonic dystrophy (CDM) tend to be born preterm. Although the CDM severity generally depends on the CTG repeat length, prematurity may also affect the prognosis in patients with CDM. Given that preterm birth is expected to increase the risk of CDM in newborns, we investigated the outcomes of newborns with CDM according to gestational age to assess prematurity and the CTG repeat length for predicting prognosis. Results: We assessed the outcomes of 54 infants with CDM using data collected from our hospitals and previously published studies. The patients were divided into mild and severe groups based on clinical outcomes. Multivariate logistic regression analysis was performed to estimate odds ratios (ORs) for CDM prognosis according to gestational age and the CTG repeat length and to construct a predictive model. Logistic regression analysis showed both the CTG repeat and gestational age were significantly associated with severe outcomes in patients with CDM (OR:150.24, 95% CI: 5.97–3778.14; p = .0023 and OR: 0.73, 95% CI: 0.58–0.93; p = .0094, respectively). This predictive model for CDM prognosis exhibited good sensitivity (63%) and specificity (86%). Both prematurity and the CTG repeat length were significantly associated with the CDM severity.

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Impact of prematurity and the CTG repeat length on outcomes in congenital myotonic dystrophy

10.21203/rs.3.rs-24158/v3 ◽

2020 ◽

Author(s):

Yu Saito ◽

Kenta Matsumura ◽

Misao Kageyama ◽

Yuichi Kato ◽

Eiji Ohta ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Predictive Model ◽

Myotonic Dystrophy ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Repeat Length ◽

Congenital Myotonic Dystrophy ◽

Using Data ◽

Ctg Repeat

Abstract Objective: Patients with congenital myotonic dystrophy (CDM) tend to be born preterm. Although the CDM severity generally depends on the CTG repeat length, prematurity may also affect the prognosis in patients with CDM. Given that preterm birth is expected to increase the risk of CDM in newborns, we investigated the outcomes of newborns with CDM according to gestational age to assess prematurity and the CTG repeat length for predicting prognosis. Results: We assessed the outcomes of 54 infants with CDM using data collected from our hospitals and previously published studies. The patients were divided into mild and severe groups based on clinical outcomes. Logistic regression analysis was performed to estimate odds ratios (ORs) for CDM prognosis according to gestational age and the CTG repeat length and to construct a predictive model. Logistic regression analysis showed both the CTG repeat and gestational age were significantly associated with severe outcomes in patients with CDM (OR: 32.27, 95% CI: 3.45–300.7; p = .002 and OR: 0.73, 95% CI: 0.58–0.93; p = .0094, respectively). This predictive model for CDM prognosis exhibited good sensitivity (63%) and specificity (86%). Both prematurity and the CTG repeat length were significantly associated with the CDM severity.

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D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03224-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Huiling Xu ◽

Shumin Qiu ◽

Xiaojing Chen ◽

Suqin Zhu ◽

Yan Sun ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Logistic Regression Analysis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hormone Replacement ◽

Implantation Rate ◽

Blastocyst Transfer ◽

Miscarriage Rate

Abstract Background There is no definitive evidence about the suitable timing to transfer blastocysts formed and cryopreserved on day 6 (D6 blastocysts) in frozen-thawed embryo transfer (FET) cycles. This study aimed to investigate the suitable timing to transfer D6 blastocysts in FET cycles and to identify factors affecting clinical pregnancy rate (CPR) and early miscarriage rate (EMR) in FET cycles with blastocysts. Methods This retrospective cohort study included 1788 FET cycles with blastocysts. There were 518 cycles with D6 blastocysts, and 1270 cycles with blastocysts formed and cryopreserved on day 5 (D5 blastocysts) (D5 group). According to the blastocyst transfer timing, the cycles with D6 blastocysts were divided into cycles with D6 blastocysts transferred on day 5 (D6-on-D5 group, 103 cycles) and cycles with D6 blastocysts transferred on day 6 (D6-on-D6 group, 415 cycles). The chi-square test, independent t-test or Mann-Whitney test, and logistic regression analysis were used for data analysis. Results The CPR and implantation rate (IR) were significantly higher in the D6-on-D5 group than in the D6-on-D6 group (55.3% vs. 37.3%, 44.8% vs. 32.6%, P < 0.01). The CPR and IR were significantly higher in the D5 group than in the D6-on-D5 group (66.0% vs. 55.3%, 62.1% vs. 44.8%, P < 0.05), and the EMR was significantly lower in the D5 group than in the D6-on-D5 group (11.2% vs. 21.1%, P < 0.05). Logistic regression analysis demonstrated that transfer D6 blastocysts on day 5, instead of day 6, could significantly increase the CPR (odds ratio[OR]: 2.031, 95% confidence interval (CI): 1.296–3.182, P = 0.002). FET cycles with D6 blastocysts transferred on day 5 had a higher EMR than those with D5 blastocysts (OR: 2.165, 95% CI: 1.040–4.506, P = 0.039). Hormone replacement therapy (HRT) cycles exhibited a higher EMR than natural cycles (OR: 1.953, 95% CI: 1.254–3.043, P = 0.003), while no difference was observed in the CPR (P > 0.05). Conclusions These results indicate that the suitable timing to transfer D6 blastocysts in FET cycles may be day 5, and D6 blastocyst transfer on day 6 in FET cycles should be avoided. D6 blastocysts transfer and HRT cycles may be associated with a higher EMR.

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Y chromosome polymorphisms may contribute to an increased risk of male-induced unexplained recurrent miscarriage

Bioscience Reports ◽

10.1042/bsr20160528 ◽

2017 ◽

Vol 37 (2) ◽

Cited By ~ 2

Author(s):

Yan Wang ◽

Gang Li ◽

Man-Zhen Zuo ◽

Jun-Hua Fang ◽

Hai-Rong Li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Y Chromosome ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Recurrent Miscarriage ◽

Control Group ◽

Case Group ◽

Unexplained Recurrent Miscarriage

The present study aims to explore the relationship between the Y chromosome polymorphisms (1qh+, inv(9), 9qh+, 16qh+, group D/G, Yqh– and Yqh+) and the risk of unexplained recurrent miscarriage (URM). A total of 507 couples with URM were recruited as case group and 465 healthy couples as control group. The Y chromosome polymorphisms of the male individuals were analysed with the G-banding technique, and the results of the chromosome G-banding analysis were determined using the International Naming Standards of Human Genetics (ISCN). Logistic regression analysis was used to analyse the risk factors for URM. The detection rate of Y chromosome polymorphisms in the case group (12.03%) was higher than that in the control group (2.15%). Y chromosome polymorphisms were detected at significantly higher rates in the case group than in the control group. Using the normal Y chromosomes in individuals of the case group as reference, the partners of their counterparts were more likely to experience miscarriage. The couples who were Y chromosome-polymorphism carriers had shorter gestational age, increased frequency of URM and longer average interval between pregnancies. The results of logistic regression analysis revealed that Y chromosome polymorphisms, shorter gestational age, a higher frequency of miscarriage and longer pregnancy interval were independent risk factors for URM. Y chromosome polymorphisms may be associated with the risk of URM and may play an important role in the development of URM.

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Correlation between ventriculomegaly on prenatal magnetic resonance imaging and the need for postnatal ventricular shunt placement

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.1.peds08328 ◽

2009 ◽

Vol 3 (5) ◽

pp. 365-370 ◽

Cited By ~ 3

Author(s):

Todd C. Hankinson ◽

Monique Vanaman ◽

Peter Kan ◽

Sherelle Laifer-Narin ◽

Robert DeLaPaz ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Mr Imaging ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Imaging Studies ◽

Fetal Sex ◽

Shunt Placement ◽

Imaging Time ◽

Cns Anomalies

Object Pediatric neurosurgeons are increasingly called on to provide prognostic data regarding the antenatal diagnosis of ventriculomegaly. This study was designed to determine if there is a correlation between prenatal MR imaging results and the need for ventricular shunt placement during the neonatal period. Methods The authors retrospectively reviewed the prenatal MR imaging data of 38 consecutive patients who had been referred for neurosurgical consultation following the diagnosis of ventriculomegaly. The outcome measure was placement of a ventricular shunt. Assessed parameters included prenatal atrial diameter (AD), gestational age at MR imaging, time between imaging studies, presence of concomitant CNS anomalies, laterality of ventriculomegaly, fetal sex, and temporal evolution of ventriculomegaly. Logistic regression analysis was completed with the calculation of appropriate ORs and 95% CIs. Results Six patients (16%) required shunt placement, all with an AD ≥ 20 mm (mean 23.8 mm) at the time of imaging. Eight patients had presented with an AD ≥ 20 mm. Atrial diameter was the only presenting feature that correlated with shunt placement (OR 1.58, 95% CI 1.10–2.25, p = 0.01). Logistic regression analysis revealed no statistical correlation between the need for ventricular shunting and gestational age at MR imaging, time between imaging studies, fetal sex, presence of additional CNS anomalies, and laterality of the ventriculomegaly. Conclusions When assessed using MR imaging, an AD ≥ 20 mm at any gestational age is highly associated with the need for postnatal shunting. Patients with concomitant CNS anomalies did not require shunts at a greater rate than those with isolated ventriculomegaly. Further studies are required to assess the long-term outcome of this patient population.

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Functional outcomes at 2 years of age following treatment for posthemorrhagic hydrocephalus of prematurity: what do we know at the time of consult?

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.12.peds19381 ◽

2020 ◽

Vol 25 (5) ◽

pp. 453-461 ◽

Cited By ~ 2

Author(s):

Samuel G. McClugage ◽

Nicholas M. B. Laskay ◽

Brian N. Donahue ◽

Anastasia Arynchyna ◽

Kathrin Zimmerman ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Visual Impairment ◽

Premature Infants ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Functional Outcomes ◽

Independent Predictor ◽

Posthemorrhagic Hydrocephalus ◽

Grade Iii

OBJECTIVEPosthemorrhagic hydrocephalus of prematurity remains a significant problem in preterm infants. In the literature, there is a scarcity of data on the early disease process, when neurosurgeons are typically consulted for recommendations on treatment. Here, the authors sought to evaluate functional outcomes in premature infants at 2 years of age following treatment for posthemorrhagic hydrocephalus. Their goal was to determine the relationship between factors identifiable at the time of the initial neurosurgical consult and outcomes of patients when they are 2 years of age.METHODSThe authors performed a retrospective chart review of premature infants treated for intraventricular hemorrhage (IVH) of prematurity (grade III and IV) between 2003 and 2014. Information from three time points (birth, first neurosurgical consult, and 2 years of age) was collected on each patient. Logistic regression analysis was performed to determine the association between variables known at the time of the first neurosurgical consult and each of the outcome variables.RESULTSOne hundred thirty patients were selected for analysis. At 2 years of age, 16% of the patients had died, 88% had cerebral palsy/developmental delay (CP), 48% were nonverbal, 55% were nonambulatory, 33% had epilepsy, and 41% had visual impairment. In the logistic regression analysis, IVH grade was an independent predictor of CP (p = 0.004), which had an estimated probability of occurrence of 74% in grade III and 96% in grade IV. Sepsis at or before the time of consult was an independent predictor of visual impairment (p = 0.024), which had an estimated probability of 58%. IVH grade was an independent predictor of epilepsy (p = 0.026), which had an estimated probability of 18% in grade III and 43% in grade IV. The IVH grade was also an independent predictor of verbal function (p = 0.007), which had an estimated probability of 68% in grade III versus 41% in grade IV. A higher weeks gestational age (WGA) at birth was an independent predictor of the ability to ambulate (p = 0.0014), which had an estimated probability of 15% at 22 WGA and up to 98% at 36 WGA. The need for oscillating ventilation at consult was an independent predictor of death before 2 years of age (p = 0.001), which had an estimated probability of 42% in patients needing oscillating ventilation versus 13% in those who did not.CONCLUSIONSIVH grade was consistently an independent predictor of functional outcomes at 2 years. Gestational age at birth, sepsis, and the need for oscillating ventilation may also predict worse functional outcomes.

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RISK FACTORS OF PREECLAMPSIA WITH SEVERE FEATURES AND ITS COMPLICATIONS

Indonesian Midwifery and Health Sciences Journal ◽

10.20473/imhsj.v5i1.2021.29-37 ◽

2021 ◽

Vol 5 (1) ◽

pp. 29

Author(s):

Eka Suci Wulandari ◽

Ernawati Ernawati ◽

Djohar Nuswantoro

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Multiple Logistic Regression Analysis ◽

Severe Preeclampsia ◽

Control Group ◽

P Value ◽

Multiple Logistic Regression

Abstract.Background : The maternal mortality rate in Indonesia is dominated by preeclampsia as the second highest cause after bleeding. Several predictors can be categorized as risk factors that can be used to increase alertness in the care of pregnant women with severe preeclampsia to avoid complications. The purpose of this study was to study the relationship between risk factors for severe preeclampsia and its complications. Methods: This study used an observational analytic method with a case control design. The sampling technique is simple random sampling. The number of samples in this study were 80 samples, with 40 samples in each group. The case group was severe preeclampsia with one complication and the control group was severe preeclampsia without complications. Statistical analysis used was chi square and multiple logistic regression analysis. Results: The results showed that there was a significant relationship between age variables (p value = 0.001 < 0.05; OR = 5.318; CI = 2.118 – 13,356), BMI (p value = 0.002 < 0.05; OR = 6.000; CI = 1.958 – 18.384 ) and gestational age (p value = 0.039 < 0.05; OR = 2.636; CI = 1.040 – 6.685). Multiple logistic regression analysis showed that BMI (p = 0.003), age (p = 0.001) and gestational age (p = 0.048) were variables included in the final modeling of the regression analysis with the incidence of severe preeclampsia complications. Conclusion: BMI is the variable that has the strongest relationship with the incidence of severe preeclampsia complications.

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Impact of prematurity and the CTG repeat length on outcomes in congenital myotonic dystrophy

10.21203/rs.3.rs-24158/v1 ◽

2020 ◽

Author(s):

Yu Saito ◽

Kenta Matsumura ◽

Misao Kageyama ◽

Yuichi Kato ◽

Eiji Ohta ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Predictive Model ◽

Myotonic Dystrophy ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Multivariate Logistic Regression Analysis ◽

Repeat Length ◽

Congenital Myotonic Dystrophy ◽

Ctg Repeat

Abstract Objective: Approximately half of patients with congenital myotonic dystrophy (CDM) are born preterm. Although the CDM severity depends on the CTG repeat length, prematurity may also affect the prognosis in patients with CDM. Given that preterm birth is expected to increase the risk of CDM in newborns, we investigated the outcomes of newborns with CDM according to gestational age to assess prematurity and the CTG repeat length for predicting prognosis. Results: We assessed the outcomes of 54 infants with CDM using data collected from our hospitals and previously published studies. The patients were divided into mild and severe groups based on clinical outcomes. Multivariate logistic regression analysis was performed to estimate odds ratios (ORs) for CDM prognosis according to gestational age and the CTG repeat length and to construct a predictive model. Logistic regression analysis showed both the CTG repeat and gestational age were significantly associated with severe outcomes in patients with CDM (OR: 45.17, 95% CI: 3.22–633.24; p = .0047 and OR: 0.73, 95% CI: 0.59–0.91; p = .0043, respectively). This predictive model for CDM prognosis exhibited good sensitivity (67%) and specificity (86%). Both prematurity and the CTG repeat length were significantly associated with the CDM severity.

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Surgical site infections following caesarean sections at Emirati teaching hospital: Incidence and implicated factors

Scientific Reports ◽

10.1038/s41598-020-75582-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Munther S. Alnajjar ◽

Dalia A. Alashker

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

United Arab Emirates ◽

Logistic Regression Analysis ◽

Gestational Age ◽

Multivariate Logistic Regression Analysis ◽

Surgical Site Infections ◽

Multivariate Logistic Regression ◽

Post Discharge ◽

Increased Risk

Abstract The rate of delivery by caesarean sections is increasing globally and, therefore, the incidence of post-caesarean surgical site infections (SSIs) is probably also going to rise. The aim of the present study was to determine the incidence of SSIs after caesarean operations and to explore the factors associated with an increased risk of post-caesarean SSIs. A retrospective study was performed to assess all women who underwent caesarean sections from January 2016 to December 2017 at Al Ain Hospital in the United Arab Emirates (UAE). Backward multivariate logistic regression analysis was utilized to specify the variables that were significantly and independently connected with the development of post-caesarean SSIs. In total, 807 women underwent caesarean deliveries at the study site hospital during the two-year study period (January 2016–December 2017). Post-operative SSI was detected in 11 (1.4%) of the women who underwent caesarean operations. Of these, 11 (100%) women were diagnosed post-discharge, within 30 days after the date of the surgery. Multivariate logistic regression analysis showed that increased gestational age (P = 0.045) was significantly and independently associated with the development of post-caesarean SSI. Increased gestational age was found to be an independent predictor of post-caesarean SSIs. This identified risk factor should inform targeted health care policies to reduce the rate of SSIs.

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ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

Jurnal Penelitian Kebidanan & Kespro ◽

10.36656/jpk2r.v2i1.178 ◽

2019 ◽

Vol 2 (1) ◽

pp. 27-33

Author(s):

Megawati Sinambela ◽

Evi Erianty Hasibuan

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Logistic Regression Analysis ◽

Care Service ◽

Multivariate Logistic Regression Analysis ◽

Bivariate Analysis ◽

Cross Sectional ◽

The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

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