scholarly journals Differences in Sexual Function Between Trimesters During Pregnancy: An Observational Study

Author(s):  
Sunullah Soysal ◽  
Abdullah Sarioz ◽  
Umran Kilincdemir Turgut ◽  
Gokce Anik Ilhan ◽  
Yusuf Arman ◽  
...  

<p><strong>OBJECTIVE:</strong> The aim of this study was to evaluate differences in sexual function between trimesters, and factors (in addition to pregnancy) that influence sexual function during pregnancy.</p><p><strong>STUDY DESIGN:</strong> This observational study was conducted at a tertiary referral center with 372 pregnant women. Seventy-two of the women did not complete the questionnaire (rejections or missing data) and the overall response rate was 80.6%. Among the remaining women, 43 of them excluded due to depression. Beck Depression Inventory was used to evaluate depression. Index of female sexual function questionnaire was used to assess sexual function. Index of female sexual function had a total and six sub-domain scores which assess the quality and frequency of sexual intercourse, desire, overall satisfaction, ability to achieve orgasm, and degree of clitoral sensation (c.sensation).</p><p><strong>RESULTS:</strong> Total index of female sexual function and quality, satisfaction, orgasm, and c.sensation sub-domain scores were lowest in the third trimester. Older age, lower level of education, and lower level of income negatively affected total index of female sexual function scores. Quality scores were lowest in older women and women with lower education. Frequency scores were highest during the second trimester. Desire scores were highest in women aged between 18 and 25 years, in women who were newly married (1-3 years), and during the second trimester. Satisfaction scores were lowest in women older than 35 years, and highest in newly married women. Orgasm scores were highest in women aged 18-25 years, in newly married women. </p><p><strong>CONCLUSIONS:</strong> Sexual function in women during the third trimester of pregnancy is generally affected negatively.</p>

Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 240 ◽  
Author(s):  
Samy Hanafy ◽  
Neveen E. Srour ◽  
Taymour Mostafa

Background Pregnancy is a special period in the life of women characterised by physical, hormonal and psychological changes that, in conjugation with social and cultural influences, could affect women’s sexuality as well as couples’ sexual relationships. This cross-sectional study aimed to evaluate female sexual dysfunction (FSD) among the three pregnancy trimesters. Methods: A total of 300 healthy heterosexual pregnant Egyptian women with stable marital relationships were included. The Female Sexual Function Index (FSFI) questionnaire was used as a standard method for measuring female sexual function in each pregnancy trimester. Results: There was no significant relationship between FSD and women’s education, work, gravidity and parity. The incidence of FSD demonstrated significant alterations throughout pregnancy, being 68% in the first trimester, decreasing in the second trimester to 51% and increasing to 72% in the third trimester. Sexual desire decreased in the first trimester, was variable in the second trimester and decreased at the end of the third trimester (3.5 ± 1.2, 3.7 ± 1.2 and 3.4 ± 1.1 respectively). Sexual satisfaction declined significantly in the first trimester compared with the second and the third trimesters (4.2 ± 1.1, 4.8 ± 0.8 and 4.6 ± 1.0 respectively). Scores for the arousal, lubrication and orgasm domains were significantly decreased in the third trimester, where pain was increased in the second trimester compared with the first and third trimesters. Conclusion: Female sexual function is affected during pregnancy, with a significant change in all Female Sexual Function Index domains, especially in the first and third trimesters.


2009 ◽  
Vol 2 (3) ◽  
pp. 121-122 ◽  
Author(s):  
Kate Bramham ◽  
David Makanjuola ◽  
Wael Hussein ◽  
Debra Cafful ◽  
Hassan Shehata

The role of cystatin C (Cys-C) as a marker of glomerular filtration rate (GFR) in pregnancy is undetermined. Measurements of Cys-C and creatinine (Cr) were taken at 14–17+6, 18–23+6, 27–31+6 weeks' gestation, at delivery and 2–6 weeks postpartum in a prospective observational study of 27 women. There was no difference between Cys-C levels in early and late second trimester, but they were significantly higher in early third trimester ( P < 0.001) than second trimester, despite no concurrent increase in Cr. Cys-C was also significantly higher at delivery than at all other times in pregnancy ( P < 0.001) and fell to postpartum values higher than second trimester measurements ( P < 0.01), but lower than delivery ( P<0.001). In conclusion, changes in Cys-C may be influenced by pregnancy-related changes in glomerular filtration and therefore we would advise against their use as a marker of GFR in pregnancy.


2021 ◽  
Author(s):  
Fatemeh Sarhaddi ◽  
Iman Azimi ◽  
Anna Axelin ◽  
Hannakaisa Niela-Vilen ◽  
Pasi Liljeberg ◽  
...  

BACKGROUND Heart rate variability (HRV) is a non-invasive method reflecting autonomic nervous system (ANS) regulations. Altered HRV is associated with adverse mental or physical health complications. ANS also has a central role in physiological adaption during pregnancy causing normal changes in HRV. OBJECTIVE Assessing trends in heart rate (HR) and HRV parameters as a non-invasive method for remote maternal health monitoring during pregnancy and three months postpartum. METHODS Fifty-eight pregnant women were monitored using an Internet-of-Things (IoT)-based remote monitoring system during pregnancy and 3-months postpartum. Pregnant women were asked to continuously wear Gear sport smartwatch to monitor their HR and HRV. In addition, a cross-platform mobile application was utilized for collecting pregnancy-related information. The trends of HR and HRV parameters were extracted using reliable data. We also analyzed the trends of normalized HRV parameters based on HR to remove the effect of HR changes on HRV trends. Finally, we exploited hierarchical linear mixed models to analyze the trends of HR, HRV, and normalized HRV parameters. RESULTS HR increased significantly during the second trimester (P<.001) and decreased significantly during the third trimester (P<.01). Time-domain HRV parameters, average normal interbeat intervals (AVNN), standard deviation of normal interbeat intervals (SDNN), root mean square of the successive difference of normal interbeat intervals (RMSSD), normalized SDNN (nSDNN), and normalized RMSSD (nRMSSD) decreased significantly during the second trimester (P<.001) then increased significantly during the third trimester (P<.01). Some of the frequency domain parameters, low-frequency power (LF), high-frequency power (HF), and normalized HF (nHF) decreased significantly during the second trimester (P<.01), and HF increased significantly during the third trimester (P<.01). In the postpartum period, nRMSSD decreased (P<.05), and the LF to HF ratio (LF/HF) increased significantly (P<.01). CONCLUSIONS Our study showed that HR increased and HRV parameters decreased as the pregnancy proceeded, and the values returned to normal after the delivery. Moreover, our results show that HR started to decrease while time-domain HRV parameters and HF started to increase during the third trimester. Our results also demonstrate the possibility of continuous HRV monitoring in everyday life settings.


2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.


2021 ◽  
Author(s):  
Wenqian Lu ◽  
Mingjuan Luo ◽  
Xiangnan Fang ◽  
Rong Zhang ◽  
Mengyang Tang ◽  
...  

Abstract Background: Gestational diabetes mellitus (GDM), one of the most common pregnancy complications, can lead to morbidity and mortality in both the mother and the infant. Metabolomics has provided new insights into the pathology of GDM and systemic analysis of GDM with metabolites is required for providing more clues for GDM diagnosis and mechanism research. This study aims to reveal metabolic differences between normal pregnant women and GDM patients in the second- and third-trimester stages and to confirm the clinical relevance of these new findings.Methods: Metabolites were quantitated with the serum samples of 200 healthy pregnant women and 200 GDM women in the second trimester, 199 normal controls, and 199 GDM patients in the third trimester. Both function and pathway analyses were applied to explore biological roles involved in the two sets of metabolites. Then the trimester stage-specific GDM metabolite biomarkers were identified by combining machine learning approaches, and the logistic regression models were constructed to evaluate predictive efficiency. Finally, the weighted gene co-expression network analysis method was used to further capture the associations between metabolite modules with biomarkers and clinical indices. Results: This study revealed that 57 differentially expressed metabolites (DEMs) were discovered in the second-trimester group, among which the most significant one was 3-methyl-2-oxovaleric acid. Similarly, 72 DEMs were found in the third-trimester group, and the most significant metabolites were ketoleucine and alpha-ketoisovaleric acid. These DEMs were mainly involved in the metabolism pathway of amino acids, fatty acids and bile acids. The logistic regression models for selected metabolite biomarkers achieved the area under the curve values of 0.807 and 0.81 for the second- and third-trimester groups. Furthermore, significant associations were found between DEMs/biomarkers and GDM-related indices. Conclusions: Metabolic differences between healthy pregnant women and GDM patients were found. Associations between biomarkers and clinical indices were also investigated, which may provide insights into pathology of GDM.


2021 ◽  
Author(s):  
Zuoxi He ◽  
Chuan Xie ◽  
Xiaorong Qi ◽  
Zhengjun Hu ◽  
Yuedong He

Abstract ObjectiveCervical cancer diagnosed during pregnancy is a rare event, and data regarding efficacy of cancer treatment during pregnancy is limited. This study aimed to assess the safety of continuation of the pregnancy for mother and fetus when concomitantly diagnosed with cervical cancer.MethodsThis study retrospectively analyzed all cervical cancer patients diagnosed while pregnant or immediately postpartum, inclusive from Jan 2010 to June 2019 at our institute. Patient clinical details and follow-up were obtained from hospital records. ResultsThe study comprised 40 patients with clinical cancer stages of ⅠA1 (1/40, 2.5%); ⅠB1 (15/40, 37.5%); IB2 (10/40, 25%); ⅡA (12/40, 30%); and ⅡB (2/40, 5%). There were 38 patients diagnosed during pregnancy, and 2 diagnosed in the postpartum period. Of the 38 patients, 17 were diagnosed in the first trimester, 13 in the second trimester, and 8 in the third trimester. Ten of 38 patients (26.3%) continued their pregnancy after learning of their diagnosis; 7 (70%) in the third trimester and 3 (30%) in the second trimester. The mean time from diagnosis to surgery in the patients who continued their pregnancy was 52.7 days, which was statistically significantly greater than the termination of pregnancy group (52.7 vs 16.3 days, P < 0.01). Notably, there was no survival difference between the 2 groups (100% vs 90.91%, P =0.54), and none of the pregnant women who ultimately died had delayed treatment due to pregnancy. Similarly, the surgical estimated blood loss and operative duration comparing the 2 groups were not significantly different. ConclusionsIn the present study, the gestational age of pregnancy at the time of initial diagnosis of cervical cancer was an important determinant in the disease management. Continuation of the pregnancy when diagnosed with cervical cancer did not affect the oncologic outcome of the mother nor increase either surgical or obstetric complications. Additionally, the use of neoadjuvant chemotherapy did not threaten the health of the fetus. These results may be useful in counseling patients facing the diagnosis of cervical cancer during pregnancy.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Mengyang Tang ◽  
Mingjuan Luo ◽  
Wenqian Lu ◽  
Rong Zhang ◽  
Wei Liang ◽  
...  

Abstract Objective Inflammation-related factors have been shown to play a significant role throughout pregnancy. In this study, we aimed to explore the relationships between selected inflammatory cytokines and gestational diabetes (GDM) in Chinese pregnant women. Design and methods This was a 1:1 matched case–control study that included 200 pairs of subjects in the second trimester and 130 pairs of subjects in the third trimester. Serum levels of nerve growth factor (NGF), Interleukin-6 (IL-6), leptin, Interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-α) and Interleukin-1beta (IL-1β) were measured by enzyme immunoassay. The associations of these inflammatory factors with metabolic parameters were analysed. Results In the second trimester, GDM patients had higher NGF levels and lower IL-8 levels than did normal controls (P < 0.001 and P = 0.015, respectively). However, in the third trimester, only lower leptin levels were observed in the GDM group (P = 0.031). Additionally, in the second trimester, NGF levels were not only positively associated with fasting, 1-h and 2-h glucose levels and the area under curve of glucose, but also positively related to insulin sensitivity and secretion, as suggested by fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment index of β-cell secretion (HOMA-β) (all P < 0.05). Moreover, IL-6 and leptin levels were positively correlated with HOMA-IR and HOMA-β, and TNF-α levels were positively related to HOMA-IR (all P < 0.05). Except for the relationships between NGF and HOMA-β and TNF-α and HOMA-IR, the other correlations still existed even after adjusting for confounding factors (all P < 0.05). Conclusion In addition to the positive associations of IL-6 and leptin with insulin resistance and secretion, NGF was higher in the GDM patients and strongly linked to glucose metabolism, insulin resistance and pancreatic β cell function in Chinese pregnant women in the second trimester.


Author(s):  
Emmanuel S. Swai ◽  
Abdu A. Hayghaimo ◽  
Ayubu A. Hassan ◽  
Bartholomeo S. Mhina

Information on the level of foetal wastage in slaughtered cattle in Tanzania is limited. A three-month observational study (April – June 2014) of animals slaughtered at the Tanga abattoir in Tanga region, Tanzania was carried out to determine the number of pregnant cows slaughtered. The total number of cattle slaughtered during the study period was 3643, representing a monthly kill average of 1214 and a daily kill average of 40. Over 98% of the cattle presented to the abattoir for slaughter were local breed (Tanzania shorthorn zebu) and most were above 3 years of age. Improved breeds of cattle represented only 1.3% of all slaughters. Of the cattle slaughtered, 2256 (61.9%) were female and 1387 (38.1%) were male. A total of 655 slaughtered cows were pregnant, representing a foetal wastage of 29.1%. Of the 655 recovered foetuses, 333 (50.8%) were male and 322 (49.2%) were female. Of the recovered foetuses, 25.8% were recovered in the first, 42.7% in the second and 31.6% in the third trimester. This study indicates cases of significant foetal losses, negatively impacting future replacement stock as a result of the slaughter of pregnant animals. The indiscriminate slaughter of pregnant cows suggests that existing animal welfare legislation is not sufficiently enforced and routine veterinary ante-mortem inspection of trade animals is failing to prevent the high level of foetal wastage.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Alec Szlachta-McGinn ◽  
Alexandra Aserlind ◽  
Lunthita Duthely ◽  
Sean Oldak ◽  
Ruchi Babriwala ◽  
...  

Background. The CDC and ACOG have issued guidelines for HIV screening in pregnancy for patients living in areas with high prevalence of HIV in order to minimize perinatal vertical transmission. There is a lack of data examining providers’ compliance with these guidelines in at-risk patient populations in the United States. Objective. To evaluate if HIV screening in pregnant women was performed according to guidelines at a large, urban, tertiary care medical center in South Florida. Study Design. A retrospective review was performed on 1270 prenatal and intrapartum records from women who delivered a live infant in 2015 at a single institution. Demographic and outcome data were chart abstracted and analyzed using arithmetic means and standard deviations. Results. Of the 1270 patients who met inclusion criteria, 1090 patients initiated prenatal care in the first or second trimester and delivered in the third trimester. 1000 (91.7%) patients were screened in the first or second trimester; however, only 822 (82.2%) of these were retested in the third trimester during prenatal care. Among the 178 patients lacking a third trimester test, 159 (89.3%) received rapid HIV testing upon admission for delivery. Of the 1090 patients who initiated prenatal care in the first or second trimester and delivered in the third trimester, 982 (90.1%) were screened in accordance with recommended guidelines. Of the 1270 patients initiating care in any trimester, 24 (1.9%) had no documented prenatal HIV test during prenatal care, however 22 (91.7%) had a rapid HIV test on admission for delivery. Two (0.16%) patients were not tested prenatally or prior to delivery. Conclusion. Despite 99.8% of women having at least one HIV screening test during pregnancy, there is room for improvement in routine prenatal screening in both early pregnancy and third trimester prior to onset of labor in this high-risk population.


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