scholarly journals DISTURBANCE OF THE PROGESTERONE AND ITS METABOLITES SYNTHESIS IN THE DEVELOPMENT OF NEUROLOGICAL DISORDERS IN CHILDREN AFTER CYTOMEGALOVIRUS INFECTION DURING PREGNANCY

2018 ◽  
Vol 3 (4) ◽  
pp. 78-84
Author(s):  
I. V. Dovzhikova ◽  
I. A. Andrievskaya ◽  
N. A. Ishutina ◽  
I. N. Gorikov ◽  
S. V. Medvedeva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neurological Disorders ◽  
First Trimester ◽  
Neurological Dysfunction ◽  
Viral Agent ◽  
Cmv Infection ◽  
First Trimester Of Pregnancy ◽  
Latent Disease ◽  
One Year ◽  
The Impact

Cytomegalovirus (CMV) infection is one of the causes of congenital neurological disorders and the virus itself is the most common viral  agent causing an imbalance in the production of placenta  progesterone and its neuroactive metabolites – allopregnenolone and 5α-dihydroprogesterone. The aim was to evaluate the concentration  of progesterone and its metabolites – 5α-dihydroprogesterone and  allopregnenolone – in placenta during exacerbation of CMV infection  in the first trimester of pregnancy, and the impact of these  disturbances on the development of neurological disorders in children. We examined 30 pregnant women with exacerbation of  CMV infection in the first trimester of pregnancy and 30 pregnant  women with latent disease; and later their newborns. The enzyme  immunoassay was used to determine  concentration of progesterone  in placenta; the histochemical method – to determine 5α-dihydroprogesterone and allopregnenolone. Newborns underwent  neurosonography studies. Exacerbation of CMV infection in the first  trimester of pregnancy decreased progesterone in placenta by 1.3  times, 5α-dihydroprogesterone – by 1.73 times and allopregnenolone – by 2 times. Ultrasound examination of the brain  showed ventriculomegaly, periventricular ischemia, and pseudocysts  in newborns up to one year from mothers with exacerbation of CMV  during pregnancy. Later, minimal brain dysfunctions were manifested by motor disorders, increased general, vegetative excitability, and a  tendency to digestive and sleep disorders. The data obtained  indicate that the exacerbation of CMV infection in the first trimester  of pregnancy is interrelated with a decrease in the concentration of progesterone and its metabolites (5α-dihydroprogesterone, allopregnenolone) in the placenta and development of neurological dysfunction in newborns.

scholarly journals Relative Risk Assessment of Intrauterine Infection of the Fetus During Cytomegalovirus Infection in Early Pregnancy

2019 ◽  
Vol 4 (3) ◽  
pp. 45-51 ◽  
Author(s):  
K. K. Petrova
Keyword(s):  
Risk Assessment ◽  
Relative Risk ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Cmv Infection ◽  
Significant Difference ◽  
First Trimester Of Pregnancy ◽  
Relative Risk Assessment

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of  choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.

scholarly journals Current practices of management of maternal and congenital Cytomegalovirus infection during pregnancy after a maternal primary infection occurring in first trimester of pregnancy: Systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261011
Author(s):  
Claire Périllaud-Dubois ◽  
Drifa Belhadi ◽  
Cédric Laouénan ◽  
Laurent Mandelbrot ◽  
Olivier Picone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Primary Infection ◽  
First Trimester ◽  
Secondary Outcome ◽  
Cmv Infection ◽  
Congenital Cmv Infection ◽  
First Trimester Of Pregnancy ◽  
Congenital Cmv ◽  
Current Practices

Introduction Congenital CMV infection is the first worldwide cause of congenital viral infection but systematic screening of pregnant women and newborns for CMV is still debated in many countries. Objectives This systematic review aims to provide the state of the art on current practices concerning management of maternal and congenital CMV infection during pregnancy, after maternal primary infection (PI) in first trimester of pregnancy. Data sources Electronically searches on databases and hand searches in grey literature. Study eligibility criteria and participants Primary outcome was listing biological, imaging, and therapeutic management interventions in two distinct populations: population 1 are pregnant women with PI, before or without amniocentesis; population 2 are pregnant women with congenitally infected fetuses (after positive amniocentesis). Secondary outcome was pregnancy outcome in population 2. Results Out of 4,134 studies identified, a total of 31 studies were analyzed, with 3,325 pregnant women in population 1 and 1,021 pregnant women in population 2, from 7 countries (Belgium, France, Germany, Israel, Italy, Spain and USA). In population 1, ultrasound (US) examination frequency was 0.75/month, amniocentesis in 82% cases, maternal viremia in 14% and preventive treatment with hyperimmune globulins (HIG) or valaciclovir in respectively 14% and 4% women. In population 2, US examination frequency was 1.5/month, magnetic resonance imaging (MRI) in 44% cases at 32 weeks gestation (WG), fetal blood sampling (FBS) in 24% at 28 WG, and curative treatment with HIG or valaciclovir in respectively 9% and 8% patients. Conclusions This systematic review illustrates management of maternal and congenital CMV during pregnancy in published and non-published literature, in absence of international consensus. Systematic review registration PROSPERO CRD42019124342

scholarly journals Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 601
Author(s):  
Houyu Zhao ◽  
Mei Zhang ◽  
Jiaming Bian ◽  
Siyan Zhan
Keyword(s):  
Pregnant Women ◽  
Ambulatory Care ◽  
National Level ◽  
Mainland China ◽  
Antibiotic Use ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fetal Safety ◽  
First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

Evaluation of Thyroid Function in Pregnant Women Using Automated Immunoassays

2021 ◽  
Author(s):  
K Aaron Geno ◽  
Matthew S Reed ◽  
Mark A Cervinski ◽  
Robert D Nerenz
Keyword(s):  
Pregnant Women ◽  
Equilibrium Dialysis ◽  
Reference Interval ◽  
First Trimester ◽  
Reference Intervals ◽  
Free Thyroxine ◽  
Specific Reference ◽  
Childbearing Age ◽  
Thyroid Autoantibody ◽  
The Impact

Abstract Introduction Automated free thyroxine (FT4) immunoassays are widely available, but professional guidelines discourage their use in pregnant women due to theoretical under-recoveries attributed to increased thyroid hormone binding capacity and instead advocate the use of total T4 (TT4) or free thyroxine index (FTI). The impact of this recommendation on the classification of thyroid status in apparently euthyroid pregnant patients was evaluated. Methods After excluding specimens with thyroid autoantibody concentrations above reference limits, thyroid-stimulating hormone (TSH), FT4, TT4, and T-uptake were measured on the Roche Cobas® platform in remnant clinical specimens from at least 147 nonpregnant women of childbearing age and pregnant women at each trimester. Split-sample comparisons of FT4 as measured by the Cobas and equilibrium dialysis were performed. Results FT4 decreased with advancing gestational age by both immunoassay and equilibrium dialysis. TSH declined during the first trimester, remained constant in the second, and increased throughout the third, peaking just before delivery. Interpretation of TT4 concentrations using 1.5-times the nonpregnant reference interval classified 13.6% of first trimester specimens below the lower reference limit despite TSH concentrations within trimester-specific reference intervals. Five FTI results from 480 pregnant individuals (about 1.0%) fell outside the manufacturer’s reference interval. Conclusions Indirect FT4 immunoassay results interpreted in the context of trimester-specific reference intervals provide a practical and viable alternative to TT4 or FTI. Declining FT4 and increasing TSH concentrations near term suggest that declining FT4 is not an analytical artifact but represents a true physiological change in preparation for labor and delivery.

scholarly journals Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 795
Author(s):  
Mary M. Murphy ◽  
Kelly A. Higgins ◽  
Xiaoyu Bi ◽  
Leila M. Barraj
Keyword(s):  
Pregnant Women ◽  
Protein Intake ◽  
First Trimester ◽  
The United States ◽  
Limited Information ◽  
Health And Nutrition ◽  
Animal Source ◽  
Usual Intake ◽  
First Trimester Of Pregnancy ◽  
Using Data

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.

AYURVEDIC MANAGEMENT OF GARBHINI CHARDI (Emesis Gravidarum) WITH CHATURJATA CHOORNA (CHATURJATA POWDER) - A PILOT STUDY

2020 ◽  
Vol 8 (9) ◽  
pp. 4317-4323
Author(s):  
Priyanka 1 ◽  
Shreyes. S ◽  
Yogitha Bali M.R
Keyword(s):  
Pilot Study ◽  
Pregnant Women ◽  
First Trimester ◽  
Nausea And Vomiting ◽  
Morning Sickness ◽  
Excessive Salivation ◽  
First Trimester Of Pregnancy ◽  
Rice Water ◽  
Single Blind

Background: During pregnancy many demands are made by growing fetus, to meet these requirements maternal system has to undergo certain changes. Garbhinichardi (Emesis Gravidarum) is one among them and this has been termed as Gruhita Garbha Lakshanas (Immediate signs of conception) in Ayurvedic clas-sics. Approximately 80 % of pregnant women experience excessive salivation, nausea and vomiting during pregnancy, commonly known as “morning sickness”, which is seen frequently throughout the day. Design: This is single blind pilot study. 30 patients with complaints of Garbhinichardi (Emesis Gravidarum) in first trimester were included in this study. Patients were given Chaturjatachurna (Chatutjata powder)for a peri-od of 2 weeks in dose of 3gms thrice a day after meal with Anupana (Adjuvant) as Madhu (honey) of 5ml mixed with Tandulodaka (Raw rice water) Results: This pilot study showed statistically significant changes with Chaturjatachurna in reducing the complaints of pregnant women such as nausea (p<0.001), vomiting (p<0.001) and Aruchi (Anorexia) (p<0.001) in their first trimester of pregnancy. Conclusion: Chaturjata-churna was effective in the management of Garbhini Chardi (Emesis Gravidarum) and other symptoms in the first trimester of pregnancy.

scholarly journals Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon

2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Brazilian Amazon ◽  
First Trimester ◽  
Inflammatory Factors ◽  
Anthropometric Measures ◽  
First Trimester Of Pregnancy ◽  
Adverse Pregnancy ◽  
Angiopoietin 2

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.

scholarly journals Descriptive Study Analyzing Medical and Surgical Methods of Terminating First Trimester Pregnancy

2018 ◽  
Vol 4 (1) ◽  
pp. 1-5
Author(s):  
Bhaktabatsal Raut ◽  
Shreedhar Acharya
Keyword(s):  
Failure Rate ◽  
First Trimester ◽  
Medical Sciences ◽  
Trimester Abortion ◽  
Surgical Methods ◽  
Education Status ◽  
First Trimester Of Pregnancy ◽  
One Year ◽  
Long Acting ◽  
Post Abortion

INTRODUCTION: This study was conducted to analyze the medical and surgical methods of first trimester of pregnancy. MATERIAL AND METHODS: A hospital based retrospective study done at Lumbini Zonal Hospital, Butwal over the period of one year, where all the women who had first trimester abortion services were analyzed. Age, parity, education status, failure rates and post abortion contraception were analyzed.RESULTS: There were total of 478 women who had abortion services, of which 244 women had medical method of abortion. Among them 4.89% were teenagers and 11.29% were primigravida and 6.9% were uneducated. The failure rate for medical method was 9% and for surgical method was 1.7%. Most women at their post abortion period asked for condoms, followed by DMPA, IUD and OCP as a method of contraception.CONCLUSION: Failure rate of medical method was high and acceptance of long acting post abortion contraception was low.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, page: 1-5

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