scholarly journals Perinatal risks at the repeated caesarean section and vaginal delivery in women with a uterine scar

2014 ◽  
Vol 18 (2 (70)) ◽  
Author(s):  
O. V. Kravchenko ◽  
V. A. Varvus
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Genital Tract ◽  
Vaginal Birth ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Perinatal Pathology ◽  
Uterine Scar ◽  
Perinatal Risks ◽  
In Pregnancy

251 pregnant women were under observation with a uterine scar after previously performed cesarean section. 225 women were operated one more time. 26 women had delivery through natural genital tract (10 % of the pregnant women with a uterine scare). It was established that the delivery occurred physiologically due to the correct assessment of risk factors for vaginal birth in women with a uterine scar. The presence of uterine scar in the lower segment does not significantly affect the nature and duration of labor. An increased fetal weight at vaginal birth in women with a uterine scar to 300g does not increase obstetric and perinatal complications. Thus, the study has shown that an increase of complications such as placentation in the scar and scar failure is high risk of maternal and perinatal pathology in pregnancy with a uterine scar.

scholarly journals Cholestatic hepatosis in pregnant women: pathogenesis, symptoms, therapy.

2003 ◽  
Vol 52 (1) ◽  
pp. 13-19
Author(s):  
Natalia V. Deryabina ◽  
Eduard K. Ailamazyan ◽  
V. А. Voinov
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Optimal Conditions ◽  
Perinatal Complications ◽  
Therapeutic Treatment ◽  
Laboratory Parameters ◽  
Perinatal Pathology ◽  
In Pregnancy ◽  
Management Tactics

This work studies causes, risk factors, features of the course and outcomes in 103 pregnant women with cholestatic hepatosis. The problem is significant due to the increased frequency of failure to carry the term and of perinatal pathology. Management tactics and methods for treating pregnant women with this pathology were developed. An analysis of the results indicated that including in complex therapeutic treatment of cholestatic hepatosis in pregnancy plasmapheresis and haemosorbtion increases the effectiveness of the treatment provided, improves clinico-laboratory parameters and aids to create optimal conditions for the prolongation of pregnancy and the reduction of perinatal complications.

Prophylaxis of obstetric and perinatal pathology at women with pathological increase of body weight during pregnancy

2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Pregnant Women ◽  
Key Words ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Fetoplacental Complex ◽  
The Right ◽  
Selection Of

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.

scholarly journals Sleep Disorders in Pregnancy

2021 ◽  
Author(s):  
Patrizia Moretti ◽  
Giulia Menculini ◽  
Lucia Gonfia
Keyword(s):  
Risk Factors ◽  
Circadian Rhythms ◽  
Pregnant Women ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Pharmacological Treatments ◽  
Mother And Child ◽  
Physiological Sleep ◽  
In Pregnancy

Sleep disturbances and changes in circadian rhythms are commonly observed in pregnant women. These disorders can result from anatomical, physiological, psychological, and hormonal alterations that can influence sleeping during this phase. Sleep disorders during pregnancy can be responsible for detrimental effects on both mother and foetus. In this chapter we will focus on the epidemiology of sleep disorders, physiological sleep mechanisms and their alterations during pregnancy, as well as on risk factors for sleep disorders in pregnancy. We will then focus of the most frequent sleep disorders during pregnancy, also considering eventual adverse implications for both mother and child, prognosis, and possible pharmacological and non-pharmacological treatments.

scholarly journals Knowledge and Practices of Pregnant Women regarding Oral Health in A Tertiary Care Hospital in Nepal

2019 ◽  
Vol 57 (217) ◽  
Author(s):  
Neha Gupta ◽  
Manisha Chhetry
Keyword(s):  
Oral Health ◽  
Pregnant Women ◽  
Dental Care ◽  
Dental Health ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Perinatal Complications ◽  
Institutional Review ◽  
In Pregnancy

Introduction: Poor dental hygiene has been associated with various perinatal complications in studiesdone worldwide but few studies in Nepal have explored the knowledge of pregnant ladies regardingdental hygiene. The aim of the study was to know the knowledge and practices of pregnant womenregarding oral health in a tertiary care center in Nepal. Methods: A qualitative study was carried out in Nobel Medical College and Teaching Hospital fromJanuary 15, 2018 to June 15, 2018 after approval from the Institutional Review Committee of NobelMedical College. Convenience sampling was done. Fifty pregnant women admitted in antenatalward were interviewed regarding their knowledge of dental care in pregnancy, the common dentalproblems they faced and the treatment taken. A predesigned proforma was used and results wereanalyzed using SPSS version 17. Results: Twenty two (44%) patients reported dental problems during pregnancy. Bleeding gumswas seen in 7 (14%) and toothache in 7 (14%) were commonly reported dental problems. Forty seven(94%) patients acknowledged that routine dental care was needed for health, only 6 (12%) wereaware that poor dental health could affect baby weight. Oral health not seen as priority in 24 (48%)was the main barrier to seeking dental care in pregnancy followed by costs of treatment in 18 (36%)and safety concerns in pregnancy in 8 (16%) cases. Conclusions: Though dental problems were a common occurrence in pregnancy, utilization ofservices was low for the same. The participants reported significant barriers to obtaining dental careincluding lack of knowledge about the importance of maternal oral health and the treatment costs.

scholarly journals Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Durray Shahwar A. Khan ◽  
La-Raib Hamid ◽  
Anna Ali ◽  
Rehana A. Salam ◽  
Nadeem Zuberi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pregnant Women ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
The Mean ◽  
In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

The possibility of high-precision ultrasound diagnosis of placenta ingrowth into the uterine scar after cesarean section

2020 ◽  
Author(s):  
V.N. Demidov, A.I. Gus, T.A. Yarygina
Keyword(s):  
Statistical Analysis ◽  
Cesarean Section ◽  
Pregnant Women ◽  
High Precision ◽  
Ultrasound Examination ◽  
Placenta Previa ◽  
Ultrasound Diagnosis ◽  
Lower Segment ◽  
Uterine Scar

Our statistical analysis, based on ultrasound examination of 7069 pregnant women, showed that both in the absence and in the presence of a scar on the uterus in the region of its lower segment, the placenta in the 3rd trimester of pregnancy was located extremely rarely, only in 0.1%. It was either primarily located in other parts of the uterus, or migrated from the lower segment of the uterus towards the bottom. In the case of the location of the placenta in this area, its ingrowth was not observed only in 2.3% of women. The main ultrasound signs of ingrowth of the placenta into the scar was the absence of its migration, as well as the presence of a combination of placenta previa with its localization in the scar zone. From the data obtained, it follows that the sensitivity of ultrasound diagnosis of placental accreta was 97.7%, and the specificity was 99.9%. According to our data, ingrown placenta in most cases can be delivered as early as 14–19 weeks, and the time spent on detecting this pathology usually does not exceed one minute.

scholarly journals 315. Prenatal Hepatitis C Viral (HCV) Screening Practices and HCV-Associated Fetal, Neonatal and Pregnancy Outcomes in a Large Regional Healthcare System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S167-S167
Author(s):  
Tripti Adhikari ◽  
Rachel Scott ◽  
Utsav Timalsina ◽  
Ariunzaya Amgalan ◽  
Shari L Sawney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Behavioral Health ◽  
Healthcare System ◽  
Categorical Variables ◽  
Opioid Use ◽  
Screening Practices ◽  
Hcv Screening ◽  
In Pregnancy

Abstract Background Prevalence of HCV in pregnancy is 0.1–3.6%. AASLD and IDSA now recommend HCV screening in pregnancy although CDC, USPSTF, or ACOG still do not—though HCV can be perinatally transmitted and carries associated complications for the mother and fetus. Our study objectives were to analyze prenatal HCV screening practices at a large regional healthcare system and the prevalence of HCV-associated maternal and fetal/neonatal outcomes. Methods We performed a nested propensity score (PS) case–control study of pregnant women who tested HCV Ab+ in a cross-sectional study of women presenting for prenatal care at a large regional healthcare system from January 17 to December 18. We collected retrospective EHR data, including state of residency, HCV Ab, RNA, care engagement, HCV risk factors, comorbidities, maternal and fetal/neonatal morbidity, and neonatal HCV testing (when available). Mixed and generalized linear models were used to examine differences in continuous and categorical variables, respectively, between cases and controls Results 14,363 women were seen for prenatal care; 4,891 (34%) were HCV tested, 75 (1.5%) tested HCV Ab+. Demographic and comorbidity data are shown in Table 1. HCV Ab+ cases had more co-morbidities, including obesity, heart disease, opioid use, and behavioral health issues compared with the controls. HCV risk factors included IVDU (64%) and tattoos (24%) (Figure 1). Neither past/current pregnancy-related complications nor fetal or neonatal adverse events (Figure 2) were statistically significantly different except for cholestasis in HCV Ab+ cases (5.3 vs. 0%, P = 0.04). Conclusion Our study showed only one-third of pregnant women are currently HCV screened in our health system. Universal screening would likely increase the number of HCV-infected women identified. Early HCV detection, repeated testing, and behavioral health intervention of those at high-risk may decrease further horizontal and vertical transmission of HCV in pregnancy. Disclosures All authors: No reported disclosures.

Evaluating serum elastin levels in striae gravidarum

2019 ◽  
Vol 45 (1) ◽  
pp. 76-82
Author(s):  
Beril Gürlek ◽  
Ülkü Mete Ural ◽  
Sibel Tuğcugil ◽  
Medeni Arpa ◽  
Özgür Önal
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Prospective Observational Study ◽  
Personal Characteristics ◽  
Active Phase ◽  
Controlled Trials ◽  
Blood Samples ◽  
Associated Risk Factors ◽  
Striae Gravidarum ◽  
In Pregnancy

Abstract Objective Striae gravidarum (SG) is the most common dermatological defect in pregnancy leading to cosmetic anxiety with unknown etiopathogenesis. The aim of the study was to analyze the relation between serum elastin levels and striae and identify possible independent associated risk factors. Materials and methods This was a prospective observational study. In total, 138 primipara pregnant women were examined before delivery. Participants were separated into two groups according to the presence of SG. Striae assessment was performed according to Davey score. Before the active phase of labor patients were physically examined and blood samples were collected. Personal characteristics, features of birth, skin findings and serum elastin levels were compared between groups. Results Term pregnant women with SG had significantly higher serum elastin levels than those without SG (99.46 ± 32.92 vs. 88.36 ± 19.12, respectively; p = 0.018). Conclusions Serum elastin levels were increased in women with SG. However, the newly synthesized elastin may not be functional as it is thin and disorganized. Therefore, increased elastin production may not prevent the formation of striae. This finding may provide an impetus to explore the pathomechanisms of striae. Further controlled trials are warranted to determine the clinical significance of serum elastin levels in the formation of SG.

scholarly journals Assessment of prevalence and risk factors for anaemia in pregnant women attending Karnataka institute of medical sciences, outpatient department, Hubballi, Karnataka, India

2020 ◽  
Vol 7 (5) ◽  
pp. 1916
Author(s):  
Dattatraya D. Bant ◽  
Shiv Kumar
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Pregnant Women ◽  
Low Income ◽  
Factors Influencing ◽  
History Of ◽  
Iron And Folic Acid ◽  
Anaemia In Pregnancy ◽  
Inter Pregnancy Interval ◽  
In Pregnancy

Background: Anaemia in pregnancy is one of the major causes of maternal morbidity and mortality in India and world. Anaemia in pregnancy continues to be a problem in spite of national programs for its prevention and control. It accounts for 1/5th of maternal deaths worldwide and 16% in India and is the major factor responsible for low birth weight, abortions, premature birth, and post-partum haemorrhage. Hence determining the status and factors influencing anaemia among pregnant women is essential to treat and prevent the same. Objective of this study was to assess the prevalence and risk factors associated with anaemia among pregnant women.Methods: A cross sectional study was conducted among 200 pregnant women attending for antenatal care at KIMS OPD from 3rd June to 4th July. A pretested, semi-structured questionnaire was applied to collect data. Haemoglobin estimation was done by Sahli’s method.Results: Prevalence of anaemia among pregnant women was found to be 81%; majority had moderate anaemia 57%. The mean age of pregnant women in the study is 24.55 years and 46.5% belong to lower socioeconomic status, 43% lived in joint families. Factors influencing anaemia were multi-parity, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake.Conclusions: In the present study, the prevalence of anaemia among pregnant women was found to be very high i.e., 81% especially among illiterates, low income groups, multiparous women, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake. 

scholarly journals Mutations in transcription factor as rare causes of diabetes in pregnancy

2019 ◽  
Vol 22 (3) ◽  
pp. 274-280 ◽  
Author(s):  
Natalia A. Zubkova ◽  
Fatima F. Burumkulova ◽  
Vasily A. Petrukhin ◽  
Margarita A. Plechanova ◽  
Anton E. Panov ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Glycemic Control ◽  
Pregnant Women ◽  
Clinical Characteristics ◽  
Diabetes In Pregnancy ◽  
Perinatal Complications ◽  
Nuclear Factors ◽  
Hepatocyte Nuclear Factors ◽  
Hnf1a Gene ◽  
In Pregnancy

MODY1 and MODY3 represent rare causes of diabetes in pregnancy. Establishing a molecular diagnosis of MODY1 or MODY3 during pregnancy may be important for minimizing risk of perinatal complications and for improving glycemic control after pregnancy. The objective of the study was to evaluate the contribution of mutations in HNF4A and HNF1A genes in development of diabetes in pregnancy and to describe clinical characteristics of diabetes in pregnancy associated with these mutations. 230 pregnant women (20-43 years) with different type of glucose intolerance complicated during their current pregnancy were included in the study. A custom NGS panel targeting 28 diabetes causative genes was used for sequencing. Heterozygous mutations in HNF4A and HNF1A genes were detected in 3% of cases. Mutations p.I271T in HNF4A gene and p.L148F, p.Y265C, p.G288W in HNF1A gene were novel. This study includes a description of patients with pregnancy diabetes due to mutations in hepatocyte nuclear factors.

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