Pregnancy and delivery in advanced maternal age: epidemiologic aspects and prognosis

Introduction: Pregnancies in old age are a topical subject for both women and health professionals because of their increasing frequency. In Chad, pregnancy and childbirth in old age is a frequent phenomenon. So, we initiated this study to evaluate the prognosis of pregnancy and childbirth in old age. Patients and method: This was a descriptive prospective study about maternal and fetal prognosis of pregnancies in old age covering a period of 3 months, from 1st January to 31st March 2017. Were included in the study all parturient aged ≥ 35 years, a pregnancy age ≥ 28 years that have accepted to participate to this study. Results: During the study period we recorded 104 parturient with age ≥ 35 years among 8442 parturient giving a frequency of 1.23%. The average age was 36.7 years with extremes age of 35 and 45 years. Thirty five year-old were more represented with 45.2%. The majority of patients were married. The no uneducated had represented 75% of cases. The multiparous were more represented with 65.4%. Sixty-five (62.5%) did attended prenatal consultation. The pregnancy was at term for ninety-three (89.4%). The majority delivered by the vaginal route (87.5%). Hypertension was the most common complication with 12.8%. No maternal death has been reported. Fifty-eight newborns (53.7% had a birth weight between 3500-3999g. Thirty two newborns (29.6%). presented complications Perinatal asphyxia was the most common fetal complication with 8.3%. However, the perinatal death rate was 17.6%. Conclusion: Childbirth among women age ≥ 35 years is an infrequent phenomenon, with complications recorded that can be maternal or fetal.

Download Full-text

Association of coagulation dysfunction with cardiac injury among hospitalized patients with COVID-19

Scientific Reports ◽

10.1038/s41598-021-83822-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Liang Chen ◽

Wei Hu ◽

Xiaoxiao Guo ◽

Ping Zhao ◽

Jia Tang ◽

...

Keyword(s):

Hospital Mortality ◽

Clinical Outcomes ◽

Old Age ◽

Serum Ferritin ◽

Leukocyte Count ◽

Cardiac Injury ◽

Study Cohort ◽

Common Complication ◽

Coagulation Dysfunction ◽

D Dimer

AbstractCardiac injury is a common complication of the coronavirus disease 2019 (COVID-19), and is associated with adverse clinical outcomes. In this study, we aimed to reveal the association of cardiac injury with coagulation dysfunction. We enrolled 181 consecutive patients who were hospitalized with COVID-19, and studied the clinical characteristics and outcome of these patients. Cardiac biomarkers high-sensitivity troponin I (hs-cTnI), myohemoglobin and creatine kinase-myocardial band (CK-MB) were assessed in all patients. The clinical outcomes were defined as hospital discharge or death. The median age of the study cohort was 55 (IQR, 46–65) years, and 102 (56.4%) were males. Forty-two of the 181 patients (23.2%) had cardiac injury. Old age, high leukocyte count, and high levels of aspartate transaminase (AST), D-dimer and serum ferritin were significantly associated with cardiac injury. Multivariate regression analysis revealed old age and elevated D-dimer levels as being strong risk predictors of in-hospital mortality. Interleukin 6 (IL6) levels were comparable in patients with or without cardiac injury. Serial observations of coagulation parameters demonstrated highly synchronous alterations of D-dimer along with progression to cardiac injury. Cardiac injury is a common complication of COVID-19 and is an independent risk factor for in-hospital mortality. Old age, high leukocyte count, and high levels of AST, D-dimer and serum ferritin are significantly associated with cardiac injury, whereas IL6 are not. Therefore, the pathogenesis of cardiac injury in COVID-19 may be primarily due to coagulation dysfunction along with microvascular injury.

Download Full-text

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

Wiadomości Lekarskie ◽

10.36740/wlek202110210 ◽

2021 ◽

Vol 74 (10) ◽

pp. 2585-2587

Author(s):

Vitaliy V. Maliar

Keyword(s):

Vitamin D ◽

Blood Serum ◽

Pregnant Women ◽

Perinatal Outcomes ◽

Fetal Distress ◽

Test System ◽

Perinatal Complications ◽

Pregnancy And Childbirth ◽

Wide Range ◽

Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

Download Full-text

Antler growth in male roe deer in field hunting grounds in Vojvodina: Effect of age on trophy value

Glasnik Sumarskog fakulteta ◽

10.2298/gsf0694109g ◽

2006 ◽

pp. 109-122

Author(s):

Dragan Gacic

Keyword(s):

Old Age ◽

Representative Sample ◽

Roe Deer ◽

Age Groups ◽

Capreolus Capreolus ◽

Mean Values ◽

Antler Growth ◽

Study Results ◽

Effect Of Age ◽

Healthy Males

Antler growth in male roe deer (Capreolus capreolus L) was studied on the representative sample consisting of 546 trophies (227 from Backa and 319 from Banat) hunted in the period 19982005. No significant differences in antler characters and trophy values were noted between Backa and Banat (except weight of antlers for 5 year old males), and the data for both regions were pooled. Antler growth is a curvilinear function of age. Mean values of length, weight and volume of antlers, and total trophy score varied significantly between the males in different age groups. The study results prove that in Vojvodina field hunting grounds, healthy males attain the culmination in antler growth and trophy value at the age of six years but already after the age of seven years, they show the first sign of old age and decline.

Download Full-text

Analysis of Risk Factors and Perinatal Mortality Structure in Pregnant Patients with Diabetes Mellitus

Doctor Ru ◽

10.31550/1727-2378-2021-20-6-46-52 ◽

2021 ◽

Vol 20 (6) ◽

pp. 46-52

Author(s):

R.V. Kapustin ◽

◽

E.V. Kopteeva ◽

E.N. Alexeenkova ◽

E.M. Tsybuk ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Perinatal Mortality ◽

Perinatal Death ◽

Mode Of Delivery ◽

Overweight And Obesity ◽

Study Objective ◽

Study Materials ◽

Study Results ◽

Patients With Diabetes

Study Objective: To analyse risk factors and perinatal mortality structure in patients with various types of diabetes mellitus (DM) over the last 30 years in specialised settings. Study Design: retrospective single-site cohort study. Materials and Methods. We have studied 42 medical records containing cases of perinatal death of foetus or newborn in 1988–2018 in patients with DM1 (n = 20), DM2 (n = 10), gestational DM (n = 12). Study Results. The most common complication in pregnancy was preeclampsia combined with chronic placental insufficiency (47.6%). The most common risk factors of perinatal death were inadequate glycemic control in 1st trimester (69.0%), absence of preconception preparations (66.7%), preconception overweight and obesity (42.8%), and chronic arterial hypertension (28.6%). There were 38.1% antenatal deaths, 16.7% intranatal deaths, and 45.2% cases of postnatal mortality. The major causes of perinatal foetal mortality in 26.2% cases were placental disorders, 16.7% were associated with foetus growth retardation, diabetic fetopathy and respiratory distress syndrome. Conclusion. DM during pregnancy was associated with a higher risk of perinatal death. Timely preconception preparation, BMI normalization and a consolidated approach to term and mode of delivery can reduce the risk of perinatal mortality in women with various types of DM. Keywords: diabetes mellitus, gestational diabetes mellitus, perinatal mortality, stillbirth, obesity, preeclampsia

Download Full-text

PECULIARITIES OF THE RADIATION PATTERN OF THE BRAIN AND INTERNAL ORGANS OF NEWBORNS WHO UNDERWENT SEVERE PERINATAL ASPHYXIA AND UNDERWENT GENERAL THERAPEUTIC HYPOTHERMIA, ACCORDING TO THE PILOT STUDY RESULTS

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-1-30-35 ◽

2021 ◽

Vol 100 (1) ◽

pp. 30-35

Author(s):

N.S. Vorotyntseva ◽

◽

V.V. Orlova ◽

A.N. Motina ◽

A.D. Novikova ◽

...

Keyword(s):

Therapeutic Hypothermia ◽

Perinatal Asphyxia ◽

Control Group ◽

Internal Organs ◽

X Ray ◽

Abdominal Organs ◽

Study Results ◽

Negative Effect ◽

Chest X Ray ◽

The Brain

Objective of the research: to study the features of the radiological picture of the brain and internal organs of newborns with severe perinatal asphyxia, who underwent general therapeutic hypothermia (GTH). Materials and methods: the study included 116 newborns with severe perinatal asphyxia. GTH was performed in 72 patients (group 1), 44 children did not receive hypothermia in the 2 (control) group. In the first 6 hours of life, children of groups 1 and 2 underwent ultrasound of the brain and abdominal organs and chest x-ray. The complex ultrasound scan was repeated at 3–5, 7–10, 14–16 and 21–28 days. Repeated chest x-ray was carried out strictly according to the indications. Results: GTH reduced the incidence of organic brain lesions by 18% in children with severe perinatal asphyxia (p0,05). The study revealed a number of undesirable consequences associated with GTH. Transient effusion into the abdominal and thoracic cavities was diagnosed by ultrasound in 8 (11%) patients after hypothermia, while there were no such changes in children in the control group (p<0,05). X-ray of the chest in newborns who received GTH during the first 14 days revealed edematous-hemorrhagic changes in the lungs more often than in patients of the control group – 55 (76%) and 24 (55%), respectively (p<0,05). Conclusions: GTH effectively prevented the development of severe post-hypoxic changes in the brain. The negative effect of hypothermia on microcirculation was manifested by the development of effusion into the serous cavities and edematous-hemorrhagic syndrome.

Download Full-text

Immediate Outcome of Mechanically Ventilated Neonates: Experience from a Tertiary Care Hospital

BIRDEM Medical Journal ◽

10.3329/birdem.v6i1.28406 ◽

2016 ◽

Vol 6 (1) ◽

pp. 22-25

Author(s):

Amrita Lal Halder ◽

Md Abdul Baki ◽

Nazmun Nahar ◽

Tahmina Begum

Keyword(s):

Mechanical Ventilation ◽

Intensive Care ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Cause Of Death ◽

Distress Syndrome ◽

Perinatal Asphyxia ◽

Common Reason ◽

Fatality Rate ◽

Common Complication

Background: A large number of neonates in intensive care unit require mechanical ventilation due to various disease conditions. There has been a dramatic fall in neonatal mortality in developed countries with the advent of mechanical ventilation and the concept of neonatal intensive care. But still fatality rate is very high in developing countries. So, this study or was done to identify the immediate hospital outcome of the neonates who required mechanical ventilation.Methods: This study was done in Special Care Baby Unit, BIRDEM General Hospital from July 2009 to June 2010. All neonates requiring mechanical ventilation during the study period were prospectively enrolled in this study. During the time of mechanical ventilation neonates were followed up to observe any complication till discharge or death.Results: Total 37 neonates were enrolled in the study. Among them 27 (73%) were preterm and 30 (81%) were low birth weight. Respiratory distress syndrome was the most common reason for ventilation accounting for 17 (45.9%) cases. The other indications were perinatal asphyxia (9, 24.3%), congenital pneumonia (5, 13.5%), septicemia (5, 13.5%) and meconium aspiration syndrome (1, 2.7%). The most common complication during the period of ventilation was septicemia (14, 37.8%). Other complication included pneumothorax (6, 16.2%), acute renal failure (5, 13.3%), pneumonia (5, 13.3%), pulmonary hemorrhage (3, 8.1%), intraventricular hemorrhage (2, 5.4%) and heart failure (2, 5.4%). The fatality rate was 38% and most of the infant died of perinatal asphyxia (5, 35.7%), septicemia (4, 28.5%), respiratory distress syndrome (3, 21.5%) and congenital pneumonia (2, 14.3%).Conclusion: Respiratory distress syndrome was the most common reason for mechanical ventilation followed by perinatal asphyxia and septicemia. Most common complication during mechanical ventilation was septicemia which was also a common cause of death. Another important cause of death was perinatal asphyxiaBirdem Med J 2016; 6(1): 22-25

Download Full-text

Heterogeneous effects of old age on human muscle oxidative capacity in vivo: a systematic review and meta-analysis

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0195 ◽

2016 ◽

Vol 41 (11) ◽

pp. 1137-1145 ◽

Cited By ~ 10

Author(s):

Liam F. Fitzgerald ◽

Anita D. Christie ◽

Jane A. Kent

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Old Age ◽

Meta Analysis ◽

Oxidative Capacity ◽

Muscle Group ◽

Resonance Spectroscopy ◽

Muscle Oxidative Capacity ◽

Study Results

Despite intensive efforts to understand the extent to which skeletal muscle mitochondrial capacity changes in older humans, the answer to this important question remains unclear. To determine what the preponderance of evidence from in vivo studies suggests, we conducted a systematic review and meta-analysis of the effects of age on muscle oxidative capacity as measured noninvasively by magnetic resonance spectroscopy. A secondary aim was to examine potential moderators contributing to differences in results across studies, including muscle group, physical activity status, and sex. Candidate papers were identified from PubMed searches (n = 3561 papers) and the reference lists of relevant papers. Standardized effects (Hedges’ g) were calculated for age and each moderator using data from the 22 studies that met the inclusion criteria (n = 28 effects). Effects were coded as positive when older (age, ≥55 years) adults had higher muscle oxidative capacity than younger (age, 20–45 years) adults. The overall effect of age on oxidative capacity was positive (g = 0.171, p < 0.001), indicating modestly greater oxidative capacity in old. Notably, there was significant heterogeneity in this result (Q = 245.8, p < 0.001; I2 = ∼70%–90%). Muscle group, physical activity, and sex were all significant moderators of oxidative capacity (p ≤ 0.029). This analysis indicates that the current body of literature does not support a de facto decrease of in vivo muscle oxidative capacity in old age. The heterogeneity of study results and identification of significant moderators provide clarity regarding apparent discrepancies in the literature, and indicate the importance of accounting for these variables when examining purported age-related differences in muscle oxidative capacity.

Download Full-text

Epidemiology of congenital malformations of the central nervous system in (a) Aberdeen and (b) Scotland

Journal of Biosocial Science ◽

10.1017/s0021932000009585 ◽

1974 ◽

Vol 6 (2) ◽

pp. 113-137 ◽

Cited By ~ 33

Author(s):

Dugald Baird

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Death Rate ◽

Perinatal Death ◽

Social Classes ◽

Stillbirth Rate ◽

Sequence Of Events ◽

Perinatal Death Rate ◽

The Central Nervous System ◽

Cns Malformations

SummaryThe incidence of anencephalus and other malformations of the central nervous system (CNS) is much higher in the United Kingdom than in other countries of Western Europe which were not industrialized to the same extent. In the UK the incidence is highest in the unskilled manual occupational group, especially in the large cities of the North of England, Scotland and Northern Ireland. Standards of living have been low in these areas for many years and deteriorated sharply at the time of the worldwide industrial depression from 1928 to 1934. The population tended to be stunted in stature and to show other signs of chronic malnutrition.The cohort of women born in these years had an unusually high stillbirth rate from anencephalus (and from all other CNS malformations) from about 1946 onwards. It was highest in the early 1960s when these women were at the peak of their reproductive activity. This suggests that the severe malnutrition to which they were subjected before and soon after birth resulted in severe damage, which reduced their reproductive efficiency as demonstrated by the unusually high perinatal death rate from all CNS malformations. Not surprisingly the death rate rose sooner, lasted longer and reached a higher level in social classes IV and V than in social classes I and II. Other evidence of damage was an increase in the incidence of low birth weight babies with a corresponding increase in the perinatal death rate from this cause.In Scotland the stillbirth rate from anencephalus was approximately 2·1 per 1000 in 1948–49, 3·4 at its highest point between 1961 and 1963 and 2·1 in 1968, by which time the women born in the years of the depression had completed their childbearing. A teratogen acting during a particular period of time could not provide a satisfactory explanation for this sequence of events.

Download Full-text

Features of pregnancy and delivery in minors female in a metropolis (by the example of St. Petersburg)

Journal of obstetrics and women s diseases ◽

10.17816/jowd63336-43 ◽

2014 ◽

Vol 63 (3) ◽

pp. 36-43

Author(s):

Yevgeniy Sergeyevich Mikhaylin ◽

Lada Anatolyevna Ivanova ◽

Aleksey Gennadyevich Savitskiy ◽

Larisa Pavlovna Zhibura ◽

Anna Gennadyevna Minina

Keyword(s):

Premature Labor ◽

Fetal Hypoxia ◽

Disease Exacerbation ◽

Uterine Activity ◽

Pregnancy And Childbirth ◽

The Poor ◽

Physiological Phenomenon ◽

Pregnancy And Delivery ◽

Somatic Diseases ◽

Preterm Rupture Of Membranes

The article presents a retrospective analysis of peculiarities of pregnancy and childbirth in 483 pregnant women minors, representing 15 % of all juveniles who have given birth in St. Petersburg from 2004 to 2013. Among somatic diseases prevailed kidney disease exacerbation during pregnancy, cardiovascular diseases, diseases of the gastrointestinal tract, eyes and skin. Among the complications of pregnancy among minors prevailed preeclampsia, threating of premature labor, anemia and chronic placental insufficiency. Among the complications of childbirth - preterm rupture of membranes, weakness of uterine activity and fetal hypoxia. Cesarean section was mainly carried out by emergency indications during childbirth. The above analysis basically confirms the literature data about the poor physical health and a lot of complications in pregnancy and childbirth in minors in metropolis because pregnancy is not a normal physiological phenomenon for minors.

Download Full-text

Assessment of Perinatal Mortality in a Tertiary Care Hospital by Using Wigglesworth Classification

Bangladesh Journal of Child Health ◽

10.3329/bjch.v31i1.6072 ◽

1970 ◽

pp. 32-39

Author(s):

Lutfun Nahar Begum ◽

Kishwar Azad ◽

Shahida Akhter ◽

Nazmun Nahar ◽

Abu Hasan Md Abdullah

Keyword(s):

Child Health ◽

Key Words ◽

Causes Of Death ◽

Tertiary Care Hospital ◽

Perinatal Death ◽

Perinatal Asphyxia ◽

Tertiary Care ◽

Hospital Setting ◽

Care Hospital ◽

Perinatal Deaths

Objective: To determine the causes of perinatal death using Wigglesworth classification and to assess the feasibility of using Wigglesworth classification in a tertiary care hospital setting. Methods: All live and stillborn babies delivered at BIRDEM over a 5 yr period(from January 2000 to December 2004) were recorded. Perinatal deaths of that period were analysed according to Wigglesworth classification Results: According to Wigglesworth classification, majority of deaths were in the group "macerated stillbirths" (63.5%). Perinatal asphyxia was responsible for 13.6% of deaths, lethal congenital malformation was found in 11.2% and immaturity and "others" each accounted for 6.1%. Conclusion: Macerated stillbirth and asphyxia were the two leading causes of death at BIRDEM and Wigglesworth classification has been found to be feasible in BIRDEM for categorising perinatal deaths retrospectively. Key words: Perinatal death; Wigglesworth classification DOI: 10.3329/bjch.v31i1.6072 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 32-39

Download Full-text