scholarly journals Preterm and term rupture of the amniotic sac in the third trimester: outcomes for mother and child

2021 ◽  
Vol 12 (4) ◽  
pp. 12-19
Author(s):  
E. V. Enkova ◽  
A. S. Fomina ◽  
V. V. Enkova ◽  
O. V. Khoperskaya
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Neonatal Intensive Care ◽  
Latency Period ◽  
Breech Presentation ◽  
Maternity Hospital ◽  
Third Trimester ◽  
The Third ◽  
Prelabor Rupture Of Membranes

Objective: To evaluate the characteristics of women in labor and pregnancy outcomes at different gestational periods with preterm prelabor rupture of membranes (PPROM) and preterm rupture of membranes (PROM) in the third trimester of pregnancy.Materials and Methods: The study included pregnant women in the third trimester, at the gestation period of 28-41.6 weeks of pregnancy, divided into groups of PROM and PPROM: 173 (80.8%) and 41 (19.2%) pregnant women, respectively.Results: It was found that PPROM is associated with a significantly lower gestational age, higher levels of C-reactive protein, and higher body temperature upon admission to the maternity hospital (P <0.05). Breech presentation and history of cesarean section were significantly associated with PPROM (P < 0.05), rather than PROM. The PPROM group had a significantly longer latency period compared to the PROM group, in which the latency period increased with a lower gestational age (28–31.6 weeks). A significantly higher rate of admission to the neonatal intensive care unit (NICU) was observed in the PPROM group compared to the PROM group. Also, at the gestational age of 28-31.6 weeks, a significantly higher rate of admission to the NICU was revealed compared to the gestational age of 32-36. 6 weeks (P < 0.05).Conclusions: The purpose of this retrospective study was to evaluate the characteristics of women in labor and pregnancy outcomes at different gestational periods with PPROM and PROM in the third trimester of pregnancy.

The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Disease Activity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Third Trimester ◽  
Low Disease Activity ◽  
The Third ◽  
Observational Prospective Cohort Study ◽  
Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio &gt; 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

scholarly journals Correlation study between increased fetal movement during the third trimester and neonatal outcome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Stress Test ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Third Trimester ◽  
The Third ◽  
Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

scholarly journals Effectiveness of Prenatal Tdap Immunization in the Prevention of Infant Pertussis in the United States

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S68-S68
Author(s):  
Sylvia Becker-Dreps ◽  
Anne M Butler ◽  
Leah J McGrath ◽  
Kim A Boggess ◽  
David J Weber ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Gestational Age ◽  
Clinical Effectiveness ◽  
The United States ◽  
Optimal Timing ◽  
Third Trimester ◽  
The Third ◽  
Control And Prevention ◽  
Insurance Claims Data

Abstract Background The Centers for Disease Control and Prevention recommends that all pregnant women in the United States receive tetanus-diphtheria-acellular pertussis (Tdap) immunization to prevent infant pertussis. While the vaccine may be administered at any time during pregnancy, the recommendations define administration at 27 to 36 weeks of gestation as optimal timing to prevent infant pertussis. These recommendations were primarily based on immunogenicity studies. The objective of this study was to examine the clinical effectiveness of prenatal Tdap, and to understand whether effectiveness varies by gestational age at immunization. Methods We performed a nationwide cohort study of pregnant women with deliveries in 2010–2014 and their infants. Commercial insurance claims data were used to identify receipt of Tdap immunization in the pregnant women, and hospitalizations and outpatient visits for pertussis in their infants until 18 months of age. To address the difficulties in diagnosing pertussis, we also employed a “probable pertussis” definition, as an inpatient or outpatient diagnosis of pertussis, plus antibiotic treatment with a macrolide or trimethoprim/sulfamethoxazole within 7 days of diagnosis. Pertussis occurrence was compared between infants of mothers who received prenatal Tdap (overall, and stratified by gestational age at administration) and infants of unvaccinated mothers. Results There were 675,167 mother–infant pairs included in the cohort. Among infants whose mothers received Tdap at any time during pregnancy, the rate of pertussis hospitalization was 50% lower (adjusted hazards ratio (HR) = 0.50, 95% CI: 0.23, 1.09), and the rate of probable pertussis was 42% lower (HR = 0.58, 95% CI: 0.38, 0.89) than infants of unimmunized mothers. Pertussis rates were also lower for infants whose mothers received prenatal Tdap during the third trimester. Infants whose mothers received Tdap before the third trimester also tended to have lower rates of pertussis, but these estimates were imprecise. Conclusion Infants of mothers who received prenatal Tdap experienced half the rate of pertussis as compared with infants of unimmunized mothers. Our results do not provide evidence to support changing the currently recommended timing of Tdap administration in pregnancy. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; A. M. Butler, Astra Zeneca: Consultant, Support to institution; Amgen: Grant Investigator, Investigator initiated grant to institution; &#x2028;D. J. Weber, Merck: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium; Pfizer: Consultant, Consulting fee; J. B. Layton, Merck: Member of Center for Pharmacoepidemiology, Support to institution; GlaxoSmithKline: Member of Center for Pharmacoepidemiology, Support to institution; UCB Biosciences: Member of Center for Pharmacoepidemiology, Support to institution

scholarly journals FETAL TRANSVERSE CEREBELLAR DIAMETER MEASUREMENT;

2018 ◽  
Vol 21 (05) ◽  
pp. 888-891
Author(s):  
Anjum Afshan ◽  
Shabnam Nadeem ◽  
Shabnam Shamim Asim
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Normal Growth ◽  
Maternity Hospital ◽  
Accurate Estimation ◽  
P Value ◽  
Diameter Measurement ◽  
Third Trimester ◽  
The Third ◽  
The Mean

Objective: To determine the accuracy of fetal transverse cerebellar diametermeasurement in the prediction of gestational age in growth restricted fetuses. Material andmethods: This controlled was conducted at Sobhraj Maternity Hospital, Karachi from July 2012to June 2013. A total of 100 pregnant women in the third trimester of pregnancy satisfying theeligibility criteria were included. Among these 50 were fetuses with normal fetal growth and50 growth restricted fetuses. Results: The mean transverse cerebellar diameter in the fetusesshowing normal growth was not statistically different from the mean transverse cerebellardiameter in the growth restricted fetuses (p-value = 0.219). Conclusions: Transverse cerebellardiameter measurement can be used reliably for accurate estimation of gestational age in growthrestricted fetuses.

scholarly journals A Prospective Study of the Relationship Between Sleep Quality and Depression in Pregnancy

2022 ◽  
pp. 201010582110685
Author(s):  
Cassandra Chan ◽  
Shi Hui Poon ◽  
Tze-Ern Chua ◽  
Nurul Syaza Razali ◽  
Kok Hian Tan ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Prospective Study ◽  
Pregnant Women ◽  
Depression Scale ◽  
Antenatal Depression ◽  
Maternity Hospital ◽  
Poor Sleep ◽  
Third Trimester ◽  
The Third ◽  
The Relationship

Objective Poor sleep and depression are common problems during pregnancy, but there has been little investigation into the association between them. This prospective study aims to examine the relationship between sleep quality and depression during pregnancy. Methods Pregnant women under 14 weeks’ gestation attending routine outpatient antenatal care in Singapore’s largest maternity hospital were recruited between 2012 and 2014. Women with multiple pregnancies and deemed at high risk of miscarriage were excluded. Six hundred and forty participants completed the Pittsburgh Sleep Quality Index (PSQI) and Edinburgh Postnatal Depression Scale (EPDS) at the three trimesters during pregnancy. Results Mean PSQI score was highest in the third visit, suggesting poorer quality sleep in the late third trimester compared to other trimesters. 15.6% of participants at each time point fulfilled the criteria for antenatal depression according to the EPDS cut-off score > 14. PSQI scores were significantly correlated with EPDS scores, and also prospectively predicted EPDS scores in all three trimesters. Conclusion Sleep quality in Singaporean pregnant women was poorest in the third trimester, and was associated with the development of depressive symptoms. With more than 1 in 10 women having antenatal depression, interventions targeting sleep quality might be particularly beneficial.

Midwifery Care for Pregnant Women With Back Pain Discomfort in Trimester III Pregnancy at the Karunia Birth Clinic, Sidoarjo.

Academia Open ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Anggraeni Kriswidya Putri ◽  
Hanik Machfudloh
Keyword(s):  
Back Pain ◽  
Data Collection ◽  
Pregnant Women ◽  
Gestational Age ◽  
Analysis Data ◽  
Second Trimester ◽  
Third Trimester ◽  
Midwifery Care ◽  
The Third ◽  
Maternity Clinic

Pregnancy is a process that begins with the unification of spermatozoa with ovum called fertilization and then continued with implantation. Normal pregnancies generally last for 9 months, and are divided into the first 3 trimesters 1-12 weeks, the second trimester 13-27 weeks, the third trimester 28-40 weeks. Various complaints felt by pregnant women, one of which is back pain that causes pregnant women discomfort. This aerikel was written taken from the place of Maternity Clinic Karunia Sidoarjo on January 05, 2020. The way of data collection is by means of anamnesa, examination of analysis, data then documenting by comparing between the data that has been obtained with existing theories. Mrs. .m 40 weeks gestational age, with complaints of physiological back pain with good maternal and fetal conditions.

scholarly journals Hemoglobin Concentration and Pregnancy Outcomes: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Bunyarit Sukrat ◽  
Chumpon Wilasrusmee ◽  
Boonying Siribumrungwong ◽  
Mark McEvoy ◽  
Chusak Okascharoen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
First Trimester ◽  
Third Trimester ◽  
The Third

Objective. To conduct a systematic review and meta-analysis of hemoglobin effect on the pregnancy outcomes.Methods. We searched MEDLINE and SCOPUS from January 1, 1990 to April 10, 2011. Observational studies addressing association between hemoglobin and adverse pregnancy outcomes were selected. Two reviewers independently extracted data. A mixed logistic regression was applied to assess the effects of hemoglobin on preterm birth, low birth weight, and small for gestational age.Results. Seventeen studies were included in poolings. Hemoglobin below 11 g/dL was, respectively, 1.10 (95% CI: 1.02–1.19), 1.17 (95% CI: 1.03–1.32), and 1.14 (95% CI: 1.05–1.24) times higher risk of preterm birth, low birth weight, and small for gestational age than normal hemoglobin in the first trimester. In the third trimester, hemoglobin below 11 g/dL was 1.30 (95% CI: 1.08–1.58) times higher risk of low birth weight. Hemoglobin above 14 g/dL in third trimester decreased the risk of preterm term with ORs of 0.50 (95% CI: 0.26–0.97), but it might be affected by publication bias.Conclusions. Our review suggests that hemoglobin below 11 g/dl increases the risk of preterm birth, low birth weight, and small gestational age in the first trimester and the risk of low birth weight in the third trimester.

scholarly journals Influence of Sampling Time on Salivary Oestriol Concentrations in Pregnant Women

1984 ◽  
Vol 21 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Paulette E Cusick ◽  
Peter L Truran ◽  
Graham F Read ◽  
William C Alston
Keyword(s):  
At Risk ◽  
Pregnant Women ◽  
Gestational Age ◽  
Early Morning ◽  
Sampling Time ◽  
Sample Collection ◽  
Third Trimester ◽  
Normal Range ◽  
The Third ◽  
The Difference

Saliva specimens were collected at weekly intervals during the third trimester of 61 uncomplicated pregnancies. Oestriol concentrations, measured in samples collected in the early morning from fasting, recumbent subjects, were used to construct a provisional normal range. This proved to be higher than the corresponding normal range reported from another laboratory applying the same method to samples obtained at random from a different population of ambulant subjects. Interlaboratory variation in the assay of salivary oestriol was not sufficient to account for the difference in normal range. It is concluded that consideration should be given to the timing of sample collection if salivary oestriol concentration is to be monitored as a possible means of assessing fetoplacental function. A normal range for salivary oestriol concentration versus gestational age obtained from women sampled randomly may not be appropriate for monitoring patients with ‘at-risk’ pregnancies who are normally bed-rested.

scholarly journals The course of ankylosing spondylitis during pregnancy: intermediate data of a prospective follow-up

2019 ◽  
Vol 13 (2) ◽  
pp. 61-72 ◽  
Author(s):  
O. A. Krichevskaya ◽  
Z. M. Gandaloeva ◽  
A. B. Demina ◽  
T. V. Dubinina
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Pregnant Women ◽  
Functional Status ◽  
Gestational Age ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third

The onset of ankylosing spondylitis (AS) more frequently occurs at the end of the third decade of life, which corresponds to the time of marriage and the birth of the first child and determines the relevance of a study of the interaction of AS and pregnancy.Objective: to describe the clinical presentations of AS and its therapy during pregnancy and to study AS activity dynamics and the patients' functional status during gestation.Patients and methods. The investigation enrolled 19 pregnant women who met the 1984 modified New York AS criteria. The mean age of the women was 32.2±1.1 years; their mean age at the onset of AS was 22.6±3.1 years; the duration of the disease was 147±20.7 months. The patients visited their physician at 10–11, 20–21, and 31–32 weeks of pregnancy. The investigators determined AS activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) and functional status by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) was used to assess enthesitis.Results and discussion. At the time of conception, 78.9% of the patients had inflammatory back pain with an intensity of 2.2±0.4 on a numerical rating scale; during pregnancy, 95% of the pregnant women experienced pain, its intensity increased by the second trimester (4.6±0.7) and remained at this level in the third trimester (p<0.05 between the month of conception and the second and third trimesters). By the third trimester, the nature of the pain changed: 55.5 and 61.1% of the patients reported reduced pain at rest and after exercise, respectively. The frequency and severity of enthesitis increased with gestational age: the MASES scores were higher in the third trimester (2.3±0.5) than that in the first-trimester (0.4±0.22; p<0.05). The frequency of extra-axial and extra-skeletal manifestations did not increase during gestation. Coxitis was detected in 27.8% of the pregnant women.The BASDAI increased from the time of conception (1.7±0.3) to the second trimester (3.3±0.5; p<0.05) and remained at this level in the third trimester. Multiple regression analysis revealed that the predictors of BASDAI levels in the third trimester were BASDAI scores (R2 =0.7) and back pain (R2 =0.9) at the time of conception, the use of biological agents 3 months before gestation (R2 =0.7) with their cumulative impact. Throughout pregnancy, the BASDAI was determined by a set of factors: the severity of pain in the back (β=0.6) and entheses (β=0.3) and weakness (β=0.6). By the end of the first trimester, the increased BASDAI scores were provided mainly by the higher level of general weakness (by 68.5%) and back pain (by 24.1%). In the second trimester, the higher BASDAI was due to the increased severity of enthesitis (by 30.7%) and back pain (by 27%).There were no changes in ASDAS-C-reactive protein (ASDAS-CRP), but there was its upward tendency in the second trimester as compared with the beginning of pregnancy. The BASMI did not change significantly (1.3±0.9; 1.8±0.2; 2.1±0.3, respectively, for trimesters). The BASFI increased by the third trimester (3.9±0.7) versus the first trimester (1.4±0.3; p<0.05).In the third trimester, this rise was due to difficulties in performing the actions related to both AS activity and pregnancy (forward bends; questions 1, 2, and 4).According to the trimesters, 31.6, 73.7, and 66.7% of the pregnant women took nonsteroidal anti-inflammatory drugs. The need for glucocorticoids was noted in 22% of patients in the second trimester and in 53% in the third trimester.Conclusion. The clinical activity of AS is increased by the second trimester of pregnancy and remains moderate and high until the end of gestation. The activity of AS at the time of conception can determine the activity of the disease throughout pregnancy. In the third trimester, mechanical back pain becomes concurrent in half of the patients. Functional impairments increase with gestational age, and this is due to both the activity of AS and pregnancy itself in the third trimester. 

scholarly journals Transient accelerations of fetal heart rate analyzed by computerized cardiotocography in the third trimester of pregnancy

2014 ◽  
Vol 60 (3) ◽  
pp. 270-275
Author(s):  
Ana Luisa Fernandes Lauletta ◽  
Roseli Mieko Yamamoto Nomura ◽  
Seizo Miyadahira ◽  
Rossana Pulcineli Vieira Francisco ◽  
Marcelo Zugaib
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Fetal Heart ◽  
Third Trimester ◽  
The Third ◽  
Before And After ◽  
Gestational Week ◽  
A Prospective Study ◽  
Low Risk Women ◽  
Singleton Pregnancies

Objective: the aim of this study was to investigate the patterns of transient FHR accelerations (10 bpm and 15 bpm) in the third trimester of pregnancy, comparing the occurrence of this event before and after the 32nd gestational week. Methods: This is a prospective study comparing the results of the computerized cardiotocography of 46 low-risk women with singleton pregnancies, maternal age between 18 and 40 years, gestational age between 28 and 40 weeks, absence of maternal morbidity and adequate fetal growth according to ultrasound. Computed Cardiotocography (8002 Sonicaid System and Fetal Care System) was performed for 30 minutes to analyze the variables of FHR. Results: twenty-three pregnant women underwent cardiotocography before 32 weeks (mean = 29.9 weeks, SD = 1.4 weeks) and were compared with 23 pregnant women who were examined after 32 weeks (mean = 36.3 weeks, SD = 2.5 weeks). Regarding the characteristics of FHR, fetuses evaluated between 32 1/7 weeks and 40 weeks showed a significantly greater number of accelerations above 15 bpm (median = 5, variation 0-18) than the group of pregnant women from 28 to 32 weeks (median = 4, variation 0 to 10; P = 0.048). There was a significant positive correlation between the number of accelerations above 15 bpm and the gestational age at examination (rho = 0.33; P = 0.026). Conclusion: computerized cardiotocography showed an association regarding the number of transient accelerations greater than 15 bpm in the assessment of both periods before and after 32 weeks of gestational age, suggesting the influence of the maturation of the fetal autonomic nervous system with pregnancy progression.

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