scholarly journals Decidualization of Endometriosis in a Cohort of IVF-Mediated Pregnancies

Author(s):  
Francesca FILIPPI ◽  
Laura BENAGLIA ◽  
Federica ALAGNA ◽  
Irene LA VECCHIA ◽  
Rossella BIANCARDI ◽  
...  

Abstract Decidualization is the process of endometrial change in pregnancy, a phenomenon that can involve also ovarian endometriomas. However, the frequency of this event remains unknown. In addition, there is no evidence on the decidualization of deep invasive endometriosis (DIE). To shed more light on this issue, we prospectively recruited women with ovarian endometriomas or DIE who underwent IVF. They were subsequently excluded if they did not become pregnant or if they had a miscarriage. The evaluation was repeated in 5 time points during pregnancy and post-partum. The primary outcome was the rate of decidualized endometriomas at 11-13 weeks’ gestation. Data from 45 endometriomas and 15 nodules were available for data analyses. At the 11-13 weeks’ ultrasound, endometriomas’ decidualization was observed in seven cases, corresponding to 16% (95%CI: 8-29%). Subsequent assessments in pregnancy failed to identify any additional case. DIE also underwent significant changes during pregnancy. An increase in mean diameter (at least 50%), an increase in color score or both were documented in seven, eight and five cases, respectively. In conclusion, decidualization of ovarian endometriomas in IVF pregnancies is common. DIE may also undergo decidualization, but further evidence is needed for a robust and shared definition of this process.

2018 ◽  
Vol 1 (19) ◽  
pp. 22
Author(s):  
Iulia Filipescu ◽  
Mihai Berteanu ◽  
George Alexandru Filipescu ◽  
Radu Vlădăreanu

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1450.2-1450
Author(s):  
H. Bjørngaard ◽  
H. Koksvik ◽  
B. Jakobsen ◽  
M. Wallenius

Background:Treat to target is a goal, also in pregnant women with Rheumatoid arthritis (1). There is increasing evidence on safe use with TNF inhibitors during pregnancy. Adjusted use of TNF inhibitors preconception and throughout pregnancy may stabilize disease activity and prevent flares (2). Low disease activity is also beneficial for the fetus.Objectives:To study the use of TNF-inhibitors among women with Rheumatic arthritis during and after pregnancy.Methods:RevNatus is a Norwegian, nationwide quality register that monitors treatment of inflammatory rheumatic diseases before, during and after pregnancy. Data from RevNatus in the period October 2017 to October 2019 was used to map the use of all types of TNF inhibitors among 208 women with rheumatoid arthritis, diagnosed by the ACR/EULAR criteria. The use of medication was reported at the time of visit in outpatient clinic. The frequency of use of TNF inhibitors registered at seven timepoints from pre-pregnancy to twelve months after delivery.Results:The use of medication was reported at each visit for all the women with rheumatoid arthritis. Most of the women were not using TNF inhibitors before and beyond conception. Most of the women continuing TNF inhibitors beyond conception used certolizumab or etanercept. Adalimumab and infliximab were used in pregnancy (tabell 1).Tabell 1.certoliz-umabetane-rceptadalim-umabgolim-umabinflixi-mabNo TNF-inhibitorBefore pregnancyn=10521% (22)9% (10)3% (3)1% (1)66% (69)1.trimestern=8119% (15)10% (8)71% (58)2.trimestern=8810% (9)10% (9)80% (70)3.trimestern=9111% (10)5% (5)83% (76)6 weeks post partum n=9622% (21)13% (13)1% (1)1% (1)63% (60)6 months post partum n=8824% (21)18% (16)4% (4)1% (1)53% (46)12 months post partum n=8421% (18)17% (15)7% (6)2% (2)53% (43)Conclusion:Most of the women with rheumatic arthritis were not treated with TNF inhibitors before or in pregnancy. Women with rheumatic arthritis that continuing treatment with TNF inhibitors through pregnancy were using certilozumab and etanercept.References:[1]Gotestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. 2016;75(5):795-810.[2]van den Brandt S, Zbinden A, Baeten D, Villiger PM, Ostensen M, Forger F. Risk factors for flare and treatment of disease flares during pregnancy in rheumatoid arthritis and axial spondyloarthritis patients. Arthritis Res Ther. 2017;19(1):64.Disclosure of Interests:None declared


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Arpan Patel ◽  
Athira Unnikrishnan ◽  
Martina Murphy ◽  
Robert Egerman ◽  
Sarah Wheeler ◽  
...  

Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity. We present a case of a patient who was safely on both eculizumab and modest prophylactic anticoagulation for 6 weeks post-partum.


1976 ◽  
Vol 98 (2) ◽  
pp. 297-302 ◽  
Author(s):  
K. G. T. Hollands ◽  
K. C. Goel

The general concept of the mean diameter of the disperse phase of an aerosol system, first introduced by Mugele and Evans in 1951, has proven to be a very useful one. In this concept, the proper mean diameter, xp,q, is characterized by a single pair of indices, p and q, which are dependent on the actual type of aerosol system under consideration. This paper re-examines the validity of this concept of mean diameter in heat and mass transfer aerosol systems. The concept is found to be applicable only under a very narrow range of conditions. Attention is then given to a more general definition of a mean diameter, applicable to aerosol heat or mass exchangers. Analyses of these devices shows that the more general mean diameter is a function of the capacity rate ratio, R, and effectiveness of the heat exchanger, ε. Solutions to the governing equations have permitted the mean diameter to be presented graphically as a function of these variables. These solutions are given for two types of particle size distributions, the Rosin-Rammler and the log-probability, and for both parallel-flow and counter-flow heat exchangers. The solutions are, however, restricted to cases where the resistance to heat or mass transfer lies exclusively in the continuous phase.


2020 ◽  
Vol 5 (02) ◽  
pp. 80-88
Author(s):  
Lilis Sumardiani

Introduction :antenatal care is an examination of pregnant women both physically and mentally as well as saving mothers and children in pregnancy, childbirth and the puerperium, so that they post partum healthy and normal not only physically but also mentallyMethod : The study was conducted by distributing questionnaires to pregnant women with emesis gravidarum. Data analysis using univariants for frequency distribution. Result : The results showed an overview of knowledge of pregnant women with good knowledge of 13 people (65%), sufficient knowledge of 5 people (25%) and lack of knowledge of 1 person (5%) while lacking knowledge of pregnant women who did not comply did 1 pregnancy check up (5) %). overall obedient pregnant women undergo pregnancy examinations aged <20 years 7 people (35%), 20-30 years there are 7 people (35%) and there are 4 people> 35 years (20%). while those aged <20 years who are not compliant pregnant women do pregnancy examinations 2 people (10%). pregnant women about compliance with antenatal care namely, support from the husband is very good there are 12 people (60%), good 4 people (20%) and enough 4 people (40%). 20%), the middle economy there are 13 people (65%), and the low economy 4 people (20%), while the economy is lacking in pregnant women who do not comply with one pregnancy checkup (5%). parity, shows that the total number of pregnant women regarding compliance with antenatal care is, that has children who live 1 times 4 people (20%), the number of children who live 2-5 times 11 people (55%), and the number of children who live> 5 times 5 people (25%) while parity, in pregnant women who do not comply with pregnancy examination 1 person (5%) Duscussion:From this study it can be concluded that knowledge, age, husband support, economy and parity in pregnant women regarding compliance with antenatal care in the Klinik Pratama Santa Elisabeth Medan is said to be a minority who are disobedient and more who are obedient do ANC visits


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
William H Marshall ◽  
Stephen Gee ◽  
Woobeen Lim ◽  
Elisa A Bradley ◽  
Lauren Lastinger ◽  
...  

Introduction: Pregnancy is contraindicated in women with pulmonary hypertension (PH), yet many still decide to pursue pregnancy. Hypothesis: We hypothesized improved maternal mortality with PH at our center’s cardio-obstetrics program and sought to identify factors to estimate the risk of major adverse cardiac events (MACE). Methods: Pregnant women with right ventricular systolic pressure (RVSP) ≥35 mmHg or tricuspid regurgitant velocity > 2.8 m/s on transthoracic echocardiogram (TTE) were identified. Women with intermediate to high probability PH by ESC criteria (TTE or catheterization, n = 70) were classified using the 6 th World Society of PH definitions. Results: In 70 women with PH (30 ± 6 years-old, RVSP 52 ± 16 mmHg) there were 12 (17%) with WHO Group 1 PH, 45 (64%) with Group 2 PH, 4 (6%) with Group 3 PH and 9 (13%) with Group 5 PH (Figure A). Baseline characteristics were similar except: Group 1 PH had 83% on prostacyclin (PC) therapy, higher RVSP (78 ± 20 mmHg vs. Groups 2 (46 ± 9), 3 (44 ± 2 mmHg) and 5 PH (48 ± 10mmHg), p<0.01), and compared to Group 2 PH, more Group 1 PH women were diagnosed pre-pregnancy (9 (75%) vs. 12 (27%), p = 0.01) and had cardio-obstetrics care (10 (83%) vs. 16 (36%), p < 0.01) (Figure B - E). There were no peripartum deaths, however 3 (4.3%) women with Group 2 PH had late mortality (7 ± 4 months post-partum). MACE occurred in 24 (34%) women and was more likely in those with: NYHA FC ≥ 2 (95% CI 4.7-57, p < 0.01), pre-eclampsia (95% CI 1.2-13, p = 0.03), RVSP >50 mmHg (95% CI 1.3-10, p = 0.02) and LVEF <50% (95% CI 1.1-8.8, p = 0.04) (Figure F). Preterm birth occurred in 32 (49%) pregnancies, with no neonatal mortality. Conclusion: To conclude, in a large single center cohort we report 100% 1-year survival in Groups 1, 3, and 5 PH, with most Group 1 PH patients on PC therapy and under cardio-obstetrics care. We identify Group 2 PH as an under-recognized group for adverse outcomes in pregnancy, with NYHA FC, pre-eclampsia, RVSP >50 mmHg and LVEF <50% associated with increased MACE.


2021 ◽  
pp. 40-41
Author(s):  
Vasudha Rani ◽  
Punam Kumari

Pregnancy is a nature's gift of humanity for procreation and continuation of its race. This gift is however fraught with several complications and has potential threat to the mother and the foetus. When pregnancy is compounded by endocrine disorders such as hypothyroidism, the potential for maternal and foetal adverse outcomes can be immense. While a lot of attention has been focused on the adverse foetal outcomes consequent to hypothyroidism, attention is also being gradually directed towards the adverse maternal outcomes of this disorder. Role of antibody positivity in inuencing outcomes in a euthyroid woman, also needs further clarication. Prompt diagnosis and treatment of hypothyroidism in pregnancy is very essential. Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal. Since women with hypothyroidism during pregnancy, especially of the autoimmune variety might have a are up of the disorder post-partum, or might continue to require thyroxine replacement post-partum, adequate follow-up is mandatory. While targeted case nding is generally practised, recent evidence seems to indicate that universal screening might be a better option. In conclusion, routine screening, early conrmation of diagnosis and prompt treatment allied with regular post-partum follow up, is required to ensure favourable maternal and foetal outcomes.


Author(s):  
Mukarromatul Khoiroh ◽  
Nurul Azizah

Postpartum hemorrhage is bleeding that occurs after the birth of the baby, placenta, and 2 hours after the placenta is born. One of the causes is anemia. Research in 2015, 60% of 100 mothers giving birth at RSIA Kirana Taman Sidoarjo experienced postpartum hemorrhage. The aim of the study was to determine the relationship of anemia in pregnancy with the incidence of postpartum hemorrhage in labor mothers. The study design used an analytical survey with a retrospective method. The population of 206 maternity mothers was taken with simple random sampling technique as many as 136 samples in August 2017. Data were analyzed by Chi Square statistical test with 0.05. The results showed that postpartum hemorrhage was more experienced by mothers with anemia (66.7%) than  those without anemia (26.2%). While those who did not experience postpartum hemorrhage were more experienced by mothers who were not anemic (73.8%) than those who were anemic (33.3%). Chi square test results  (p=0.000  <0.05),  which means there is a relationship  of anemia in pregnancy with the incidence of postpartum hemorrhage in labor mothers. Conclusions of the study were the relationship of anemia in pregnancy with the  incidence  of postpartum hemorrhage in labor mothers. It is expected that midwives and doctors conduct early detection of anemia so that appropriate care can be carried out.


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