Predictors of preeclampsia. Screening and prophylaxis in the I trimester of pregnancy

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 428-434
Author(s):  
Rushania I. Gabidullina ◽  
Albina V. Ganeeva ◽  
Tatiana N. Shigabutdinova

Aim. To examine the current state of the problem of the prediction of preeclampsia in early pregnancy. Materials and methods. The article provides an overview of publications based on search results in electronic resources PubMed, Elibrary, EMBASE and Google Scholar. Results. The currently known predictors of preeclampsia can be divided into biochemical and hemodynamic. A number of markers demonstrate prognostic value already in the early stages of gestation. To predict preeclampsia, algorithms are created. They include various combinations of its predictors and maternal risk factors. Conclusion. Prediction of preeclampsia is gradually moving from theory to practice. The instruments of its early forecasting before the gestational age of 14 weeks 6 days are becoming available. That opens up opportunities for targeted and timely prevention of preeclampsia.

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033296 ◽  
Author(s):  
Maria Ospina ◽  
Álvaro Román Osornio-Vargas ◽  
Charlene C Nielsen ◽  
Susan Crawford ◽  
Manoj Kumar ◽  
...  

ObjectiveUsing a summary measure of health inequalities, this study evaluated the distribution of adverse birth outcomes (ABO) and related maternal risk factors across area-level socioeconomic status (SES) gradients in urban and rural Alberta, Canada.DesignCross-sectional study using a validated perinatal clinical registry and an area-level SES.SettingThe study was conducted in Alberta, Canada. Data about ABO and related maternal risk factors were obtained from the Alberta Perinatal Health Program between 2006 and 2012. An area-level SES index derived from census data (2006) was linked to the postal code at delivery.ParticipantsWomen (n=3 30 957) having singleton live births with gestational age ≥22 weeks.Primary and secondary outcome measuresWe estimated concentration indexes to assess inequalities across SES gradients in both rural and urban areas (CIdxRand CIdxU, respectively) for spontaneous preterm birth (PTB), small for gestational age (SGA), large for gestational age (LGA), gestational hypertension, gestational diabetes, smoking and substance use during pregnancy and pre-pregnancy weight >91 kg.ResultsThe highest health inequalities disfavouring low SES groups were identified for substance abuse and smoking in rural areas (CIdxR−0.38 and −0.23, respectively). Medium inequalities were identified for LGA (CIdxR−0.08), pre-pregnancy weight >91 kg (CIdxR−0.07), substance use (CIdxU−0.15), smoking (CIdxU−0.14), gestational diabetes (CIdxU−0.10) and SGA (CIdxU−0.07). Low inequalities were identified for PTB (CIdxR−0.05; CIdxU−0.05) and gestational diabetes (CIdxR−0.04). Inequalities disfavouring high SES groups were identified for gestational hypertension (CIdxR+0.04), SGA (CIdxR+0.03) and LGA (CIdxU+0.03).ConclusionsABO and related maternal risk factors were unequally distributed across the socioeconomic gradient in urban–rural settings, with the greatest concentrations in lower SES groups of rural areas. Future research is needed on underlying mechanisms driving SES gradients in perinatal health across the rural–urban spectrum.


2010 ◽  
Vol 37 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Yusuke Inde ◽  
Misao Satomi ◽  
Nao Iwasaki ◽  
Shuichi Ono ◽  
Eriko Yamashita ◽  
...  

2019 ◽  
Vol 6 (5) ◽  
pp. 1845
Author(s):  
Sahana Giliyaru ◽  
Sahaya Nirmala S. ◽  
Adarsh E.

Background: This study was conducted to analyse the immediate outcome of late preterm babies and also to evaluate the various maternal risk factors in these babies so that close monitoring of these babies for the complications is done and immediate problems can be addressed.Methods: Prospective observational study done in level 3 NICU setting for 6 months. All babies born between 34-36/7 weeks are included in the study and they constitute the cases. Term (above 36 weeks 6 days gestation) newborns babies born during the study period are controls. Maternal history is taken in detail. Risk factors during pregnancy including maternal age, gravida, mode of delivery, medical conditions and birth details. Baby details like gestational age, sex, birth weight, and neonatal morbidities are recorded. The babies are either shifted to NICU or to mother’s side based depending on the baby’s condition. All of them are followed up till discharge.Results: 89 late preterm babies born in the hospital during the study period are included in the study. Out of 89 babies 45are females constituting 50.6% and 44are male babies constituting 49.4%. 20 (22.5%) babies had gestational age between 34-35 weeks.29 babies (32.5 %) had gestational age between 35-36 weeks and 40 babies (45%) are between 36-37 weeks of gestation. 47 babies (52.9%) have birth weight between 1.5-2.49 kg.42 babies (47.1%) have birth weight between 2.5-3.5 kg. The number of babies born by LSCS were 48 (54%) and 41 babies 46% are born through vaginal route.42 babies constituting 48.3% are appropriate for gestational age and 43 babies (49.4%) are small for gestationalage.34 (39.1%) babies required NICU admission and 55 (60.9%) babies did not require NICU admission. Among the maternal risk factors PIH was the commonest risk factor in 22babies (24.7 %), followed by PROM13 (14.6 %), oligohydramnios 6 (6.7 %) ,twin gestation 6 (6.7 %), MSAF 3 (3.4%), IDM 3 (3.4%), Antepartum hemorrhage 3 (3.4%), eclampsia 1 (1.1%) and maternal cardiac disease 1.1%. Neonatal morbidities are 25 late preterm babies had jaundice (28.7%) followed by RDS in 15 (17.2%), sepsis in 9 (10.3%), NEC 2 (2.3%), Hypoglycemia 5 (5.6%) late preterm babies required ventilation/ CPAP constituting 5.7%. Surfactant was used in 2 late preterm babies 2.3%. 87 babies (97.8%) got discharged and mortality is 2.2%.Conclusions: Late prematurity is associated with significant neonatal morbidity.


2018 ◽  
Vol 21 (04) ◽  
pp. 745-749
Author(s):  
Sikandar Ali Bhand ◽  
Farzana Sheikh ◽  
Abdul Rehman Siyal ◽  
Muhammad Akber Nizamani ◽  
Muhammad Saeed

… Objective: To determine the presenting features and assessment of the neonateswith hypoglycemia along with maternal and neonatal risk factors for hypoglycemia. Subjects &methods: All consecutive neonates with hypoglycemia admitted were included in the study.Demographic characteristics of the mothers and their babies, past medical history and illnessesduring pregnancy especially that, of diabetes mellitus and duration, details of the management oflabour and place of delivery, birth asphyxia as well as history of feeding prior to admission. All therisk factors and clinical features were documented. Results: From presenting features neonateswere most common temperature instability 32% of the neonates. Maternal risk factors were asMaternal diabetic mellitus, Intrapartum administration of glucose , Maternal drug uses as: (Betablockers, Oral hypoglycemic agents, Valproate), family history of metabolic disorder and withoutany factors with the percentage 13%, 17%, (15%, 08%, 07%) , 27% and 13% respectively.Neonatal risk factors of the patients were found low birth weight 49%, small gestational age 26%,macrosomia 11%, respiratory distress 32%, sepsis 20%, hypothermia 25%, congenital cardiacabnormalities 4%, endocrine disorder 4%, family history of metabolic disorder 7%, inborn errorsof metabolism 4%, rhesus hemolytic disease 5%, erythroblastosis fetalis 1%, inadequate feeding35% and neonates without factors were 6%. Conclusions: The risk factors associate withneonatal hypoglycemia are, low birth weight, small gestational age, macrodome, respiratorydistress, sepsis, hypothermia and inadequate feeding , and maternal risk factors associate toneonatal hypoglycemia was Eclampsia, Maternal diabetic mellitus, and maternal drug uses


2011 ◽  
Vol 51 (1) ◽  
pp. 52 ◽  
Author(s):  
Melani Rakhmi Mantu ◽  
Lelani Reniarti ◽  
Sjarif Hidajat Effendi

Background Small for gestational age (SGA) neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA) infants.Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE) tests and to study correlations between maternal risk factors and hearing loss in SGA neonates.Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression.Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE) results in the SGA group compared to the AGA group (P<0.001, Z=13.247). For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001). By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR) to he 4.34 (95% CI 2.52 to 7.49, P=0.001), meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group.Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to hearing loss in all newborns. [


2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.


2016 ◽  
Vol 65 (3) ◽  
pp. 283-286
Author(s):  
Claudiu Marginean ◽  
◽  
Lucian Puscasiu ◽  
Claudiu V. Molnar ◽  
Florin Rozsnyai ◽  
...  

The diagnosis of fetal cerebral hemorrhage (HCF) is less reported (0,9/1000 births) in comparison to the postpartum one. We presented 2 cases of fetal intraventricular hemorrhages diagnosed. Case 1: HCF diagnosed by ultrasound at the gestational age of 28 weeks and confirmed after birth by the presence of erythrocytes (significant number, pathological aspect) in the spinal fluid and by the modifications signaled by the transfontanellar ultrasound (severe internal hydrocephaly, minimum cerebral tissue). The death occurred after 24 hours postpartum (pathological exam: intraventricular cerebral hemorrhage). We mention the apparent lack of maternal risk factors, negative TORCH tests. Case 2: internal hydrocephaly at the age of 37 gestational weeks and confirmed in newborn (after cesarean section) by the clinical characteristic modifications, severe neurological impairment with modification at the transfontanellar ultrasound and the hemorrhagic and hypertensive aspect of the spinal fluid. We did not encounter maternal risk factors. Also, apparently, there were not any fetal risks: weight 2,820 grams at 37 gestational weeks, negative TORCH tests, negative cultures and CRP. The hydrocephaly had a progressive evolution imposing ventriculostomies and cysternotomies; the placement of a ventriculoperitoneal shunt during the third neurosurgical intervention improved the vital prognosis. Conclusions. The presence of hydrocephaly was a faithful ultrasound sign for the diagnosis of HCF. The evolution and the prognosis are influenced by the severity of hemorrhage and the gestational age. The survivors benefit from neurosurgical treatment. The multifactorial etiology, of the HCF incompletely elucidated leads to difficulties in establishing a target group of screening, in order to identify this lesion.


2021 ◽  
Vol 4 (1) ◽  
pp. 73
Author(s):  
Jianti Fina Lestari ◽  
Risa Etika ◽  
Pudji Lestari

Abstract Background: Low Birth Weight Babies (LBW) accounts for 60 - 80% of all neonatal deaths in the world. Not the only major predictor of mortality and morbidity in neonates, individuals with a history of LBW have a greater risk of experiencing various diseases such as hypertension, heart disease, and diabetes later in life. This systematic review study aims to identify maternal risk factors that contributing to LBW Method: Articles published between 2015 - 2020 in the Science Direct, Scopus and Cochrane library databases are systematically reviewed. Eleven articles that met the inclusion and exclusion criteria were included as samples for further review. Results regarding maternal risk factors for LBW events are synthesized systematically .Results: From the search results, there were 818 articles, after the screening process, the final results were 11 articles. Risk factors that are significantly related to LBW incidence in the article, are grouped in the subtheme, include: maternal age (<20 years, and each increase in age), parity (primipara and grandemultipara), low maternal upper arm circumference, hemoglobin levels less than 11 gr / dl, gestational age below 37 weeks, and complications during pregnancy. Conclusion: maternal age, parity, arm circumference, hemoglobin level, gestational age, and complications during pregnancy were significaly found to be maternal risk factors for LBW. 


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