scholarly journals SONOGRAPHIC EVALUATION OF FETAL GROWTH IN THE THIRD TRIMESTER OF LOW RISK PREGNANCY: A RANDOMIZED TRIAL

2020 ◽  
Author(s):  
Catarina Policiano ◽  
Jorge Mendes ◽  
Andreia Fonseca ◽  
Joana Barros ◽  
Sara Vargas ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Fetal Growth ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Control Group ◽  
Study Group ◽  
Close Monitoring ◽  
Operating Characteristics ◽  
Vaginal Deliveries ◽  
The Impact

Objective To evaluate the accuracy of 35-37 weeks‘ ultrasound for fetal growth restriction (FGR) detection and the impact of 30th-33rd weeks vs 35th-37th weeks ultrasound on perinatal outcomes. Design A prospective randomized trial Setting Tertiary referral hospital in Portugal. Population Low risk pregnant women Methods We enrolled 1061 women: 513 in the control group (ultrasound at 30th-33rd weeks) and 548 in the study group (with an additional ultrasound at 35th-37th weeks). FGR was defined as an estimated fetal weight (EFW) below 10th percentile. We calculated the overall accuracy of the 35-37 weeks’ ultrasound and compared perinatal outcomes between both groups. Main outcome measure Detection of late FGR Results The ultrasound at 35-37 weeks had an overall accuracy of FGR screening of 94%. Spearman’s correlation coefficient between EFW and birthweight centile was higher for at 35-37 weeks’ ultrasound (ρ = 0.75) compared with 30-33 weeks’ ultrasound (ρ = 0.44). The study group had a lower rate of operative vaginal deliveries (24.4% vs 39.3%, p = 0.005) and cesarean deliveries for nonreassuring fetal status (16.8% vs 38.8%, p < 0.001). For FGR prediction, the area under the receiver-operating characteristics curve of EFW centile at 35-37 weeks’ ultrasound was 0.90 (95% CI, 0.86-0.95). Conclusions A later ultrasound (35-37 weeks) had a higher correlation between EFW and birthweight centiles and was associated with a lower rate of cesarean and operative deliveries for nonreassuring fetal status compared to an earlier ultrasound, which reinforces that antenatal identification of FGR allows close monitoring and appropriate management.

scholarly journals The Adverse Impact of Maternal Obesity on Intrapartum and Perinatal Outcomes

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Dimuthu Vinayagam ◽  
Edwin Chandraharan
Keyword(s):  
Maternal Obesity ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Control Analysis ◽  
Class Iii ◽  
Retrospective Case ◽  
Increased Risk ◽  
The Impact ◽  
Intrapartum Outcomes

Background. Confidential enquiries into maternal deaths in the UK have repeatedly highlighted increased maternal morbidity and mortality associated with maternal obesity. Objective. To determine the impact of increased body mass index (BMI) on intrapartum outcomes. Materials and Methods. A retrospective case-control analysis of intrapartum outcomes of the study group (100 women), with a BMI above 40 kg/m2 (class III Obesity) at booking and a control group (100 women) with a booking BMI between 20 and 25 kg/m2 was performed. Results. A statistically significant increase in delivery by caesarean section (OR 2.32, 95% CI 1.26–4.29), minor and major postpartum haemorrhage (OR 5.93, 95% CI 2.34–11.98, OR 16.11, 95% CI 2.08–125.09, resp.), perineal trauma (OR 2.59, 95% CI 1.44–4.69), and fetal macrosomia (OR 3.11, 95% CI 1.25–7.79) was noted in the study group. Babies also had an increased risk of having a lower APGAR scores in the study group as compared to the control group (OR 3.09, 95% CI 1.07–8.94). Conclusion. Women with a BMI > 40 kg/m2 experience increased incidence of intrapartum complications and hence, input of skilled birth attendants during labour is essential to improve intrapartum outcomes.

scholarly journals How Did Prenatal Education Impact Women’s Perception of Pregnancy and Postnatal Life in a Romanian Population

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 581
Author(s):  
Anca Maria Balasoiu ◽  
Octavian Gabriel Olaru ◽  
Romina Marina Sima ◽  
Liana Ples
Keyword(s):  
Prenatal Care ◽  
Newborn Care ◽  
Control Group ◽  
Postnatal Life ◽  
Study Group ◽  
Prenatal Education ◽  
Questionnaire Online ◽  
A Prospective Study ◽  
The Impact ◽  
Official Information

Background and Objectives: Prenatal education represents an important part of maternal prenatal care in Western countries. In Romania, prenatal education is of recent interest but there is no official information about prenatal courses and their impact on prenatal care and patients in Romania. Material and methods: A prospective study based on the STROBE statement was designed in order to assess the prenatal education delivered in our unit. The study group included women who gave birth at Bucur Maternity, “Saint. John” Hospital, Bucharest, Romania and attended the prenatal courses, compared with a control group (women who gave birth in our unit but did not attend the prenatal lecture). Patients’ perception about the impact of prenatal education was collected by applying a questionnaire. Results: The analysis included 89 women who fulfilled the questionnaire online. In our study, 62 women (69.7%) attended the prenatal education classes and represented the study group while 27 women (30.3%) constituted the control group. Women who attended the prenatal lecture recognized the utility of the topic regarding newborn care (90.3%), while women from the control group did not consider it useful (n = 55.6%), χ2 = 18.412, p < 0.001. Patients from the study group admitted the importance of the topics (93.5%) from the lectures about breast feeding, while the percentage of these women from the control group is significantly lower (55.6%) χ2 = 27.867, p < 0.001. Conclusions: The benefits of prenatal education were recognized by women who attended the prenatal lecture, while women who did not participate underestimated the utility of the topics. Further actions are required to inform mothers about the necessity of antenatal education.

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

2010 ◽  
Vol 13 (5) ◽  
pp. 501-507 ◽  
Author(s):  
Ali Gedikbasi ◽  
Alpaslan Akyol ◽  
Gokhan Yildirim ◽  
Ali Ekiz ◽  
Ahmet Gul ◽  
...  
Keyword(s):  
Gestational Age ◽  
Statistical Significance ◽  
Expectant Management ◽  
Control Group ◽  
Study Group ◽  
Preliminary Evaluation ◽  
Gestational Age At Birth ◽  
The Impact ◽  
Twin Pregnancies ◽  
Age At Birth

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n= 429; 2137g and 34.71 weeks), DC study group,n= 37; 2117g (p= .338) and 33.97 weeks (p= .311), and DC study group with major malformations,n= 30; 2019g (p= .289) and 33.3 weeks (p= .01), and showed only significance for gestational age. There was no statistical significance between MC control group,n= 86; 2097g and 34.93 weeks, and MC study group,n= 18; 2237g (p= .338), and 34.42 weeks (p= .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

scholarly journals Risk factors for third- and fourth-degree perineal tears during vaginal delivery

2011 ◽  
Vol 25 (1) ◽  
pp. 2
Author(s):  
Leonard Juul ◽  
Gerhard B. Theron
Keyword(s):  
Risk Factors ◽  
Shoulder Dystocia ◽  
Control Group ◽  
Study Group ◽  
Tertiary Referral Hospital ◽  
Retrospective Case ◽  
Fourth Degree ◽  
Perineal Tears ◽  
Vaginal Deliveries ◽  
Hiv Negative

<strong>Objective</strong>. To identify risk factors for thirdand fourth-degree perineal tears, so as to anticipate and intervene in order to prevent this complication that can severely affect a woman’s quality of life. The study design was a retrospective case control study. <strong>Method</strong>. Ninety-three cases of third- and fourth-degree perineal tears were identified from the birth register of a tertiary referral hospital (Tygerberg Hospital). One hundred and nine patients with normal vaginal deliveries in the same time period were used as control group. <strong>Results</strong>. An analysis of the results revealed that there were no significant differences between cases and controls with regards to age, body mass index (BMI), gestation at delivery, duration of second stage, episiotomy and birth weight. However, there were significantly more primigravidas, assisted deliveries (forceps and vacuum), occipitoposterior positions, HIV negative patients and shoulder dystocia in the study group. <strong>Conclusions</strong>. Antenatal risk factors for thirdand fourth-degree tears are difficult to identify. However, intrapartum occipitoposterior and assisted deliveries, especially in the primigravid patient, should warn the obstetrician/ midwife about the risk of a severe tear. A restrictive episiotomy policy should be practiced. Shoulder dystocia was invariably associated with third- and fourth-degree tears in this study. The higher incidence of HIV negative patients in the study group requires further research.

scholarly journals Hemostasis in Infertile Patients Participating in Assisted Reproduction Programmes

Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 6-11
Author(s):  
A.O. Godzoeva ◽  
◽  
I.E. Zazerskaya ◽  
V.S. Vlasov ◽  
T.V. Vavilova ◽  
...  
Keyword(s):  
Reproductive Technologies ◽  
Control Group ◽  
Study Group ◽  
Study Objective ◽  
Hemostasis System ◽  
Fibrin Monomer ◽  
Study Results ◽  
Venous Thromboembolic Events ◽  
The Impact ◽  
Infertile Patients

Study Objective: To evaluate the impact of multifollicular ovarian stimulation in in vitro fertilisation (IVF) programmes on hemostasis. Study Design: perspective comparative study. Materials and Methods. The study included 68 patients divided into two groups: study group (n = 36) — infertile patients; control group (n = 32) — healthy non-pregnant women of reproductive age. The protocol with gonadotrophin releasing hormone antagonists was used for ovulation stimulation. Hemostasis system in study patients was evaluated in 2 weeks after embryos were transferred to uterus; in control group — on day 20–22 of menstrual period. For the study group, we evaluated clotting test parameters of hemostasis system, D-dimers (D-d) and fibrin monomer (FM). Study Results. We have not found statistically significant differences between hemostasis screening results of study groups. We have identified increase in pro-coagulatory properties of blood in the study group patients: increase in FM and D-d (р < 0.0001 in both cases). There is an association between study parameters and pregnancy (p < 0.001) and no association with obesity, age and infertility. Conclusion. In IVF programme, FM and D-d levels rise, evidencing hypercoagulation development. An increase in FM levels was even more significant and can be used as an early and specific fibrogenesis marker. Keywords: assisted reproductive technologies, fibrin monomer, D-dimer, hypercoagulation, venous thromboembolic events.

scholarly journals The Impact of Pre-emptive Large Dose of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly. A Randomized Control Study

2021 ◽  
Author(s):  
Henryk Liszka ◽  
Małgorzata Zając ◽  
Artur Gądek
Keyword(s):  
Total Knee Arthroplasty ◽  
Single Dose ◽  
Knee Arthroplasty ◽  
Opioid Analgesic ◽  
Control Group ◽  
Study Group ◽  
Intensity Level ◽  
Old Patients ◽  
Total Knee ◽  
The Impact

Abstract Background The aim of the study was to assess whether administration of gabapentin and methylprednisolone as “pre-emptive analgesia” in a group of patients above 65 years of age would be effective in complex pain management therapy following total knee arthroplasty (TKA). Material and Methods One hundred seventy, above 65 years old patients were qualified for the study, and 10 patients were excluded due to clinical situation. One hundred sixty patients were double-blind randomized into two groups: the study (eighty patients) and controls (eighty patients). The study group received as “pre-emptive” analgesia a single dose of 300 mg oral gabapentin and 125 mg intravenous methylprednisolone, while the others placebo. Perioperatively, all the patients received opioid and nonopioid analgesic agents calculated for 1 kg of body weight. We measured the levels of inflammatory markers (leukocytosis, C-reactive protein - CRP), pain intensity level at rest (numerical rating scale - NRS), the life parameters and all complications. Results Following administration of gabapentin and methylprednisolone as “pre-emptive” analgesia CRP values being lower on all postoperative days ( 1, 2 days - p<0,00001, 3 day – p=000538), leukocytosis on day 2 (p<0,0086) and 3 (p<0,00042), the NRS score at rest 6, 12 (p<0,000001), 18 (p<0,00004) and 24 (p=0,005569) hours postoperatively . Methylprednisolone with gabapentin significantly decreased the dose of parenteral opioid preparations (p=0,000006). The duration time of analgesia was significantly longer in study group (p<0,000001). No infectious complications were observed; in the control group, one patient manifested transient ischaemic attack (TIA). Conclusion The use of gabapentin and methylprednisolone at a single dose decreases the level of postoperative pain on the day of surgery, the dose of opioid analgesic preparations, the level of inflammatory parameters without infectious processes.

The Impact of Episiotomy on Adverse Perinatal Outcomes in Operative Vaginal Deliveries [40J]

2020 ◽  
Vol 135 ◽  
pp. 113s
Author(s):  
Sarah N. Owens ◽  
Sydney Marie Thayer ◽  
Keenan Yanit ◽  
Bharti Garg ◽  
Aaron B. Caughey
Keyword(s):  
Perinatal Outcomes ◽  
Vaginal Deliveries ◽  
Adverse Perinatal Outcomes ◽  
The Impact

Comparison of adverse perinatal outcomes after single-needle and double-needle CVS techniques

2017 ◽  
Vol 45 (2) ◽  
Author(s):  
Cenk Gezer ◽  
Atalay Ekin ◽  
Gokhan Goynumer ◽  
Kaan Pakay ◽  
Hicran Acar ◽  
...  
Keyword(s):  
Significant Risk ◽  
Perinatal Outcomes ◽  
Invasive Procedure ◽  
Significant Risk Factor ◽  
Adverse Outcomes ◽  
Control Group ◽  
Needle Technique ◽  
Adverse Perinatal Outcomes ◽  
Chorion Villus ◽  
The Impact

AbstractObjective:To determine the impact of the chorion villus sampling (CVS) technique on adverse perinatal outcomes.Methods:In this case-control study, 412 women who underwent CVS at 11–14 weeks of gestation and 231 women who did not undergo any invasive procedure were retrospectively evaluated. The women in the CVS group were further divided into two groups according to the use of single-needle technique (n=148) vs. double-needle technique (n=264). The adverse outcomes were compared between controls and the two CVS groups, and regression analysis was used to determine the significance of independent contribution.Results:The rate of preeclampsia for the control group was 2.2%, for the double-needle group was 3% and for the single-needle group was 8.1%. CVS with single-needle technique was found to be an independent and statistically significant risk factor for preeclampsia [odds ratio (OR)=2.1, 95% confidence interval (CI); 1.4–2.7, P=0.008].Conclusion:The risk of preeclampsia after CVS appears to be increased with single-needle technique compared with double-needle technique.

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