Elimination of marginal and partial placenta previa from clinical perspective: is it rational?

2020 ◽  
Author(s):  
Shilei Bi ◽  
Lizi Zhang ◽  
Zhijian Wang ◽  
Jingsi Chen ◽  
Jingman Tang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Classification Method ◽  
Clinical Perspective ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy

Abstract Background We aimed to evaluate the difference between the effects of three categories of classifications of placenta previa (PP) on maternal and neonatal outcomes. Methods This study was conducted in the Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University and Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, between January 2009 and 2018. The three categories of PP were the four-classification (low-lying, marginal, partial, and complete PP), three-classification (low-lying, “marpartial,” and complete PP), and two-classification (low-lying PP and PP) methods. We performed multivariate analysis to determine the effects of these classifications on maternal and neonatal outcomes. Results There were 4490 singleton pregnancies complicated with PP, of which 466, 1233, 140, and 2651 were low-lying, marginal, partial, and complete PP, respectively. As per the four-classification method, compared with women with low-lying PP, women with complete PP had a risk of placenta accrete spectrum, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and perinatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classification method, PP was the risk factor for most of the adverse maternal and perinatal outcomes. Conclusions Complete and low-lying PP were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classification method may be practical from the ultrasound and clinical perspective.

scholarly journals Effect of types of placenta previa on maternal and neonatal outcomes: A 10-year retrospective cohort study

2021 ◽  
Author(s):  
Shilei Bi ◽  
Lizi Zhang ◽  
Zhijian Wang ◽  
Jingsi Chen ◽  
Jingman Tang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Multivariate Logistic Regression Analysis ◽  
Neonatal Outcomes ◽  
Classification Method ◽  
Different Types ◽  
Maternal And Neonatal Outcomes

Abstract Purpose: Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes.Methods: This study was conducted in The Third Affiliated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classified into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classified PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classification of PP into three types, for the first time, which included low-lying placenta, “marpartial” (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes.Results: In total, 4490 singleton pregnancies were complicated with PP. In the four-classification method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classification method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta.Conclusion: Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classification of PP may be practical from the clinical perspective.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

Maternal and Neonatal Outcomes in 89 Patients with Takayasu Arteritis (TA): Comparison Before and After the TA Diagnosis

2015 ◽  
Vol 42 (10) ◽  
pp. 1861-1864 ◽  
Author(s):  
Ana Paula Luppino Assad ◽  
Thiago Ferreira da Silva ◽  
Eloisa Bonfa ◽  
Rosa Maria R. Pereira
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Takayasu Arteritis ◽  
Disease Diagnosis ◽  
Fetal Outcome ◽  
Neonatal Outcomes ◽  
Healthy Controls ◽  
American College Of Rheumatology ◽  
Before And After ◽  
Maternal And Neonatal Outcomes

Objective.To evaluate maternal and neonatal outcomes in patients before and after a diagnosis of Takayasu arteritis (TA).Methods.Patients diagnosed with TA according to the American College of Rheumatology criteria were selected from the Vasculitis Outpatient Clinic of the Rheumatology Division. Healthy female staff members of this hospital of similar age and educational level were selected as the controls. The disease data were obtained from an ongoing electronic database protocol. A standardized questionnaire, emphasizing gestational history, was applied to both groups. The prevalence of fetomaternal complications and disease variables were evaluated between the groups and a statistical analysis was performed.Results.A total of 89 patients with TA (156 pregnancies) and 89 healthy controls (181 pregnancies) were evaluated. There were 75.6% pregnancies that occurred before the TA diagnosis (pre-TA group) and 24.3% after (post-TA group). In the pre-TA group, higher rates of hypertension (HTN; 27.1% vs 3.9%, p < 0.001), low birth weight (16.8% vs 6.5%, p = 0.012), and perinatal mortality (7.9% vs 0.7%, p = 0.003) were observed compared with healthy controls. The frequency of abortions and the average number of children were similar in both groups (p > 0.05). Further comparison of the pre- and post-TA groups revealed similar rates of HTN, abortion, and low birth weight, and higher rates of Cesarean delivery (p = 0.002), prematurity (p < 0.001), and infection (p = 0.045) in the latter group.Conclusion.Our study identified that patients with TA, even before the disease diagnosis, have a worse fetal outcome that is most likely associated with high rates of HTN. TA was identified as an additional differential diagnosis for HTN in pregnancy.

scholarly journals Chlamydia trachomatis Screening and Treatment in Pregnancy to Reduce Adverse Pregnancy and Neonatal Outcomes: A Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Kristina N. Adachi ◽  
Karin Nielsen-Saines ◽  
Jeffrey D. Klausner
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Middle Income ◽  
Infant Outcomes ◽  
Adverse Pregnancy

Chlamydial trachomatis infection has been associated with adverse pregnancy and neonatal outcomes such as premature rupture of membranes, preterm birth, low birth weight, conjunctivitis, and pneumonia in infants. This review evaluates existing literature to determine potential benefits of antenatal screening and treatment of C. trachomatis in preventing adverse outcomes. A literature search revealed 1824 studies with 156 full-text articles reviewed. Fifteen studies were selected after fulfilling inclusion criteria. Eight studies focused on chlamydial screening and treatment to prevent adverse pregnancy outcomes such as premature rupture of membranes, preterm birth, low birth weight, growth restriction leading to small for gestational age infants, and neonatal death. Seven studies focused on the effects of chlamydial screening and treatment on adverse infant outcomes such as chlamydial infection including positive mucosal cultures, pneumonia, and conjunctivitis. Given the heterogeneity of those studies, this focused review was exclusively qualitative in nature. When viewed collectively, 13 of 15 studies provided some degree of support that antenatal chlamydial screening and treatment interventions may lead to decreased adverse pregnancy and infant outcomes. However, notable limitations of these individual studies also highlight the need for further, updated research in this area, particularly from low and middle-income settings.

scholarly journals Pregnancy and Delivery with Cardiac Disease in Dr. Soetomo Hospital 2018

2021 ◽  
Vol 2 (2) ◽  
pp. 61-66
Author(s):  
Ana Puji Rahayu ◽  
Khanisyah Erza Gumilar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cardiac Disease ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Number Of Patients ◽  
Pregnancy And Delivery ◽  
Maternal And Neonatal Outcomes ◽  
In Pregnancy

Background: Cardiac disease is one of the non obstetric problems causing mortality both in pregnancy and labor due to the complications. Preventions for the complications have not been implemented, thus the number of patients which have cardiac disease with complications and perinatal outcome with low birth weight is still high. Objective : To identify maternal and neonatal outcome of pregnant women with cardiac disease in dr. Soetomo Surabaya hospital in 2018. Method: Descriptive retrospective study using medical records in dr. Soetomo Surabaya hospital 2018. Result: We found 1433 pregnancy cases with 51 (3,6 %) patients were having cardiac disease and included in this research. The most common maternal complication was pulmonary hypertension 16 cases. A dead case was found 1 case (1,9 %) with eissenmenger syndrome. We found the perinatal outcome of 30 babies (58.8%) born with a weight of 2500 gram and under. There are 7 patients with cardiac disease that have been corrected (13,7%). Among those 7 patients, 6 had a perinatal outcome with a birth weight of more than 2500 gram. Conclusion : Most pregnant patients with cardiac disease in dr. Soetomo Surabaya hospital 2018 are already having some complications with perinatal outcomes of low birth weight. Therefore, management of cardiac disease in pregnancy to prevent complications by means of preconception counseling, good antenatal care, and appropriate referrels are still needed to improve the quality of maternal and neonatal outcomes.

scholarly journals Comparison of Maternal and Neonatal Outcomes in Teenage and Reproductive Age Pregnancy at Tertiary Hospital in West Java, Indonesia

2021 ◽  
Vol 9 (B) ◽  
pp. 1080-1084
Author(s):  
Windi Nurdiawan ◽  
Ahmad Raihan Hidayat Koto ◽  
Zulvayanti Zulvayanti ◽  
Nur Atik ◽  
Hadi Susiarno ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Teenage Mothers ◽  
Neonatal Outcomes ◽  
Reproductive Age ◽  
West Java ◽  
Risk Pregnancy ◽  
Low Birth Weight Babies ◽  
Maternal And Neonatal Outcomes

Aim: This study was aimed to compare the maternal and neonatal outcomes among teenage and reproductive-age pregnancies. Patients and methods: This was a cross-sectional study of pregnant mothers in Hasan Sadikin General Hospital, the tertiary referral hospital in West Java, Indonesia. Patients who gave birth during January 2015-December 2018 were included and divided into two groups (teenage and reproductive-age pregnancy). Their medical record data then were evaluated to compare both maternal and neonatal outcomes. Results: The incidence of teenage pregnancy was 10.05%. A total of 3810 patients were recruited. The teenage mothers were 522 subjects and reproductive-age mothers were 3288 subjects. The incidence of eclampsia (5.2% vs 1.9%, p<0.001), anaemia (18.4% vs 14.9%, p=0.040), and preterm delivery (27.2% vs 18.6%, p<0.001) were more frequent in teenage pregnancies. Teenage mothers also had a higher percentage of low-birth-weight babies (42.3% vs 36.2%, p=0.007). Conclusion: Teenage pregnancies also had a higher risk of eclampsia, anaemia, preterm delivery, and having low-birth-weight babies. More efforts to prevent teenage and high-risk pregnancy are needed, especially in rural areas.

Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study

2020 ◽  
Author(s):  
Wenjie Qing ◽  
Linda Li ◽  
Alyssia Venna ◽  
Jie Zhou
Keyword(s):  
Risk Factor ◽  
Neonatal Intensive Care ◽  
Independent Risk Factor ◽  
Placenta Previa ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Life Threatening ◽  
Gestational Week ◽  
Maternal And Neonatal Outcomes ◽  
The Relationship

Abstract BACKGROUND Placenta previa can be a serious, life-threatening obstetric complication that causes painless but potentially catastrophic bleeding. It is unclear as to whether the frequency of antepartum hemorrhage (APH) relative to the specific gestational week in placenta previa will lead to negative perinatal outcomes. The purpose of the present study was to determine the relationship between APH and gestational week number, and to ascertain the different perinatal outcomes in women with placenta previa. METHODS This was a multi-center, retrospective study in which we enrolled all women with placenta previa between October of 2015 and September of 2018. Patients with placenta previa were divided into two groups: women with APH and women without APH. RESULTS A total of 247 patients were included in this study: 121 women with APH and 126 women without. The incidence of APH was 49.0% (121/247). The mean bleeding frequency was 2.2 ± 1.3 (mean ± SD), with the majority having experienced a one-time bleeding episode (36.4%, 44/121), followed by 26.4% with 2 episodes (32/121), and 23.1% with 3 (28/121). The APH was distinct in every gestational-week category, with bleeding occurring at 31.4 ± 3.3 weeks, ranging from 24 to 37 gestational weeks. The incidence of bleeding varied from 2.6–14.6%, with the highest incidence at 32 gestational weeks. Patients categorized as having complete placental coverage included a greater number of women experiencing bleeding than women who did not bleed (72.9% vs 47.4%, P < 0.001), indicating that a complete placenta was an independent risk factor for APH (odds rations [OR], 4.17; 95% confidence interval [CI], 1.805–9.634). In addition, although APH did not augment the rates of hysterectomy (6.6% vs 7.1%, P = 0.869), it was associated with critical neonatal outcomes that included lower weight, lower Apgar score at 1 minute, preterm age, and more frequent neonatal intensive care unit admissions (P < 0.05). CONCLUSIONS The gestational week and frequency of each APH varied in patients with placenta previa and might result in an increase in adverse maternal and neonatal outcomes. The 32nd gestational week appeared to be the most precarious time—exhibiting the highest incidence of bleeding—and we consider complete placenta previa to be an independent risk factor for APH.

scholarly journals Adverse effects of endometriosis on pregnancy: a case-control study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mayo Miura ◽  
Takafumi Ushida ◽  
Kenji Imai ◽  
Jingwen Wang ◽  
Yoshinori Moriyama ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Placenta Previa ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes ◽  
Non Surgical Treatment ◽  
Control Study

Abstract Background Endometriosis is a common disease occurring in 1–2% of all women of reproductive age. Although there is increasing evidence on the association between endometriosis and adverse perinatal outcomes, little is known about the effect of pre-pregnancy treatments for endometriosis on subsequent perinatal outcomes. Thus, this study aimed to evaluate maternal and neonatal outcomes in pregnant women with endometriosis and to investigate whether pre-pregnancy surgical treatment would affect these outcomes. Methods This case-control study included 2769 patients who gave birth at Nagoya University Hospital located in Japan between 2010 and 2017. Maternal and neonatal outcomes were compared between the endometriosis group (n = 80) and the control group (n = 2689). The endometriosis group was further divided into two groups: patients with a history of surgical treatment such as cystectomy for ovarian endometriosis, ablation or excision of endometriotic implants, or adhesiolysis (surgical treatment group, n = 49) and those treated with only medications or without any treatment (non-surgical treatment group, n = 31). Results In the univariate analysis, placenta previa and postpartum hemorrhage were significantly increased in the endometriosis group compared to the control group (12.5% vs. 4.1%, p <  0.01 and 27.5% vs. 18.2%, p = 0.04, respectively). In the multivariate analysis, endometriosis significantly increased the odds ratio (OR) for placenta previa (adjusted OR, 3.19; 95% confidence interval [CI], 1.56–6.50, p <  0.01) but not for postpartum hemorrhage (adjusted OR, 1.14; 95% CI, 0.66–1.98, p = 0.64). Other maternal and neonatal outcomes were similar between the two groups. In patients with endometriosis, patients in the surgical treatment group were significantly associated with an increased risk of placenta previa (OR. 4.62; 95% CI, 2.11–10.10, p <  0.01); however, patients in the non-surgical treatment group were not associated with a high risk (OR, 1.63; 95% CI, 0.19–6.59, p = 0.36). Additionally, other maternal and neonatal outcomes were similar between the two groups. Conclusion Women who have had surgical treatment for their endometriosis appear to have a higher risk for placenta previa. This may be due to the more severe stage of endometriosis often found in these patients. However, clinicians should be alert to this potential increased risk and manage these patients accordingly.

scholarly journals Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City

2021 ◽  
Vol 19 (1) ◽  
pp. 280
Author(s):  
Reyna Sámano ◽  
Gabriela Chico-Barba ◽  
María Eugenia Flores-Quijano ◽  
Estela Godínez-Martínez ◽  
Hugo Martínez-Rojano ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Protective Factor ◽  
Neonatal Outcomes ◽  
Physical Growth ◽  
Gestational Weight ◽  
Maternal And Neonatal Outcomes

During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.

scholarly journals The relationship between birth intervals and adverse maternal and neonatal outcomes in six low and lower-middle income countries

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Melissa Bauserman ◽  
Kayla Nowak ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Death ◽  
Very Low Birth Weight ◽  
Neonatal Outcomes ◽  
Middle Income ◽  
Maternal Characteristics ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

Abstract Background Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes. Methods We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6–17 months (short), 18–36 months (reference), 37–60 months, and 61–180 months (long). We used non-parametric tests for maternal characteristics, and multivariable logistic regression models for outcomes, controlling for differences in baseline characteristics. Results We evaluated 181,782 women from sites in the Democratic Republic of Congo, Zambia, Kenya, Guatemala, India, and Pakistan. Women with short IDI varied by site, from 3% in the Zambia site to 20% in the Pakistan site. Relative to a 18–36 month IDI, women with short IDI had increased risk of neonatal death (RR = 1.89 [1.74, 2.05]), stillbirth (RR = 1.70 [1.56, 1.86]), low birth weight (RR = 1.38 [1.32, 1.44]), and very low birth weight (RR = 2.35 [2.10, 2.62]). Relative to a 18–36 month IDI, women with IDI of 37–60 months had an increased risk of maternal death (RR 1.40 [1.05, 1.88]), stillbirth (RR 1.14 [1.08, 1.22]), and very low birth weight (RR 1.10 [1.01, 1.21]). Relative to a 18–36 month IDI, women with long IDI had increased risk of maternal death (RR 1.54 [1.10, 2.16]), neonatal death (RR = 1.25 [1.14, 1.38]), stillbirth (RR = 1.50 [1.38, 1.62]), low birth weight (RR = 1.22 [1.17, 1.27]), and very low birth weight (RR = 1.47 [1.32,1.64]). Short and long IDIs were also associated with increased risk of obstructed labor, hemorrhage, hypertensive disorders, fetal malposition, infection, hospitalization, preterm delivery, and neonatal hospitalization. Conclusions IDI varies by site. When compared to 18–36 month IDI, women with both short IDI and long IDI had increased risk of adverse maternal and neonatal outcomes. Trial registration The MNHR is registered at NCT01073475.

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