scholarly journals LABOR COURSE AND CONDITION OF NEWBORNS IN WOMEN WITH PLACENTAL DYSFUNCTION DUE TO GESTATIONAL ENDOTHELIOPATHY

World Science ◽  
2019 ◽  
Vol 2 (9(49)) ◽  
pp. 4-8
Author(s):  
V. V. Lazurenko ◽  
I. B. Borzenko ◽  
D. Yu. Tertyshnik

The purpose of the study is to evaluate the effect of placental dysfunction caused by gestational endotheliopathy on the course of labor and the condition of the newborn. The first group consisted of 70 patients with placental dysfunction with gestational endotheliopathy confirmed by laboratory-instrumental findings in the first trimester of pregnancy. The control group included 30 pregnant women with physiological gestational course. PD secondary to GE leads to preterm birth, fetal distress, increases the percentage of caesarean section, contributes to the delay of fetal growth and birth weight, poor infant status and perinatal complications.

2018 ◽  
pp. 14-18
Author(s):  
V.V. Kaminskyi ◽  
◽  
O.I. Zhdanovich ◽  
T.V. Kolomiychenko ◽  
A.D. Derkach ◽  
...  

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.


2012 ◽  
Vol 56 (9) ◽  
pp. 4800-4805 ◽  
Author(s):  
Catherine A. Koss ◽  
Dana C. Baras ◽  
Sandra D. Lane ◽  
Richard Aubry ◽  
Michele Marcus ◽  
...  

ABSTRACTTo assess whether treatment with metronidazole during pregnancy is associated with preterm birth, low birth weight, or major congenital anomalies, we conducted chart reviews and an analysis of electronic data from a cohort of women delivering at an urban New York State hospital. Of 2,829 singleton/mother pairs, 922 (32.6%) mothers were treated with metronidazole for clinical indications, 348 (12.3%) during the first trimester of pregnancy and 553 (19.5%) in the second or third trimester. There were 333 (11.8%) preterm births, 262 (9.3%) infants of low birth weight, and 52 infants (1.8%) with congenital anomalies. In multivariable analysis, no association was found between metronidazole treatment and preterm birth (odds ratio [OR], 1.02 [95% confidence interval [CI], 0.80 to 1.32]), low birth weight (OR, 1.05 [95% CI, 0.77 to 1.43]), or treatment in the first trimester and congenital anomalies (OR, 0.86 [0.30 to 2.45]). We found no association between metronidazole treatment during the first or later trimesters of pregnancy and preterm birth, low birth weight, or congenital anomalies.


Author(s):  
Shreyasi Karmakar ◽  
Sabyasachi Bid ◽  
Tapan Kumar Maiti

Background: The study was aimed to determine the mode of delivery, maternal outcome and perinatal outcome in prolonged pregnancy.Methods: It was a prospective observational study. Uncomplicated nulliparous singleton pregnancies who have completed 37 weeks of gestation were included in the study. Inclusion and exclusion criteria were strictly followed. Total 200 cases were divided into study group and control group. Those who have crossed their Estimated date of delivery (EDD) were compared with term pregnancies (not crossed their EDD).Results: The study group and control group consist of 114 and 86 women respectively. The incidence of caesarean section (64.04%), induction of labour (50.88%) is significantly higher in the study group. It also shows that the occurrence of caesarean section (63.79%) is more in post-dated pregnant women who underwent induction of labour. The most common indication for caesarean section was fetal distress in both groups. The commonest maternal complication was prolonged labour and perinatal complication was fetal distress in both groups. The incidence of low birth weight was significantly less in post-dated pregnancy.Conclusions: Our study suggests that the incidence of induction of labour and caesarean section is significantly higher in post-dated pregnancy. Although the mean birth weight baby is more in them, a definite policy should be recommended for optimum timing of intervention to avoid maternal and perinatal complications.


Author(s):  
Preeti Patil ◽  
Gayathri Karthik

Background: Conception by IVF has been associated with an increased incidence of several obstetrical and perinatal complications. IVF is associated with increased complications like OHSS (Ovarian Hyper Stimulation Syndrome), multiple pregnancies and thromboembolism, ectopic pregnancy, congenital malformations, and small for gestational age, low birth weight etc. This study is done to evaluate and compare the obstetric and perinatal complications between assisted reproduction and spontaneous conception. The objective of the present study was to evaluate and compare the maternal and neonatal outcome of IVF/ICSI conceived pregnancies with spontaneous conceived pregnancies.Methods: In this study 62 patients conceived with IVF/ICSI were taken as cases and 62 patients conceived spontaneously were taken as controls. The categorical data was analyzed using chi square test and results expressed by p value.Results: The incidence of multiple pregnancies among IVF/ICSI group is 33.8% and 1.6% in controls. IVF/ICSI conception when compared to spontaneous conception is associated with increased incidence of miscarriage (18% versus 1.6%), first trimester bleeding (18% versus 1.6%), cervical insufficiency (22.5% versus 0), PROM (11.3% versus 1.6%), preterm birth (33.8% verss 14.5%), caesarean section rates (71% vs 53%), low birth weight babies (44% vs 10.7%) and NICU admissions(33.3% vs 10.7%). The male: female ratio is higher in IVF/ICSI group.Conclusions: IVF/ICSI conceptions are associated with a significantly higher incidence of multiple pregnancies, miscarriage, prematurity, increased caesarean section rates, and increased male: female ratio.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e018360 ◽  
Author(s):  
Shao J Zhou ◽  
Karen Best ◽  
Robert Gibson ◽  
Andrew McPhee ◽  
Lisa Yelland ◽  
...  

IntroductionPreterm birth accounts for more than 85% of all perinatal complications and deaths. Seventy-five per cent of early preterm births (EPTBs) occur spontaneously and without identifiable risk factors. The need for a broadly applicable, effective strategy for primary prevention is paramount. Secondary outcomes from the docosahexaenoic acid (DHA) to Optimise Mother Infant Outcome trial showed that maternal supplementation until delivery with omega-3 (ω-3) long chain polyunsaturated fatty acid (LCPUFA), predominantly as DHA, resulted in a 50% reduction in the incidence of EPTB and an increase in the incidence of post-term induction or post-term prelabour caesarean section due to extended gestation. We aim to determine the effectiveness of supplementing the maternal diet with ω-3 LCPUFA until 34 weeks’ gestation on the incidence of EPTB.Methods and analysisThis is a multicentre, parallel group, randomised, blinded and controlled trial. Women less than 20 weeks’ gestation with a singleton or multiple pregnancy and able to give informed consent are eligible to participate. Women will be randomised to receive high DHA fish oil capsules or control capsules without DHA. Capsules will be taken from enrolment until 34 weeks’ gestation. The primary outcome is the incidence of EPTB, defined as delivery before 34 completed weeks’ gestation. Key secondary outcomes include length of gestation, incidence of post-term induction or prelabour caesarean section and spontaneous EPTB. The target sample size is 5540 women (2770 per group), which will provide 85% power to detect an absolute reduction in the incidence of preterm birth of 1.16% (from 2.45% to 1.29%) between the DHA and control group (two sided α=0.05). The primary analysis will be based on the intention-to-treat principle.Trial registration numberAustralia and New Zealand Clinical Trial Registry Number: 2613001142729; Pre-results.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
S. Iodice ◽  
M. Hoxha ◽  
L. Ferrari ◽  
I. F. Carbone ◽  
C. Anceschi ◽  
...  

Growing evidences have shown that particulate matter (PM) exposures during pregnancy are associated with impaired fetal development and adverse birth outcomes, possibly as a result of an exaggerated systemic oxidative stress and inflammation. Telomere length (TL) is strongly linked to biological age and is impacted by oxidative stress. We hypothesized that PM exposure during different time windows in the first trimester of pregnancy influences both mitochondrial DNA copy number (mtDNAcn), an established biomarker for oxidative stress, and TL. Maternal blood TL and mtDNAcn were analysed in 199 healthy pregnant women recruited at the 11th week of pregnancy by quantitative polymerase chain reaction. We also examined whether maternal mtDNAcn and TL were associated with fetal growth outcomes measured at the end of the first trimester of pregnancy (fetal heart rate, FHR; crown-rump length, CRL; and nuchal translucency, NT) and at delivery (birth weight, length, head circumference). The possible modifying effect of prepregnancy maternal body mass index was evaluated. PM10 exposure during the first pregnancy trimester was associated with an increased maternal mtDNAcn and a reduced TL. As regards ultrasound fetal outcomes, both FHR and CRL were positively associated with PM2.5, whereas the association with FHR was confirmed only when examining PM10 exposure. PM10 was also associated with a reduced birth weight. While no association was found between mtDNAcn and CRL, we found a negative relationship between mtDNAcn and fetal CRL only in overweight women, whereas normal-weight women exhibited a positive, albeit nonsignificant, association. As abnormalities of growth in utero have been associated with postnatal childhood and adulthood onset diseases and as PM is a widespread pollutant relevant to the large majority of the human population and obesity a rising risk factor, our results, if confirmed in a larger population, might represent an important contribution towards the development of more targeted public health strategies.


Author(s):  
Juhi Sisodia ◽  
Meena Samant

Background: The study of hypothyroidism in pregnancy was done with the aim of determining the effect of hypothyroidism on maternal and perinatal outcome. This study also aimed to decide whether universal screening of pregnant women for hypothyroidism is justified.Methods: A prospective observational study was done over a period of 1 year from October 2011 to September 2012, on pregnant women attending the OPD of Obs and Gynae department. Serum TSH is the most convenient and best test to diagnose hypothyroidism in pregnancy in first trimester. Ideal serum TSH level during pregnancy is 0.5-2.5µIU/ml in first trimester and 0.5-3µIU/ml in second and third trimester. First trimester booking visit is the ideal time for initial evaluation. Thereafter serum TSH should be measured at 6 weeks interval for necessary dose adjustments. Levothyroxine is the drug of choice. It should be started at 1.6-2µg/kg/day. If serum TSH is raised but fT4 is normal, treatment can be started with 25-75µg/day.Results: Inadequately treated hypothyroid pregnant women had higher incidence of maternal complications in comparison to adequately treated hypothyroid patients, like threatened abortion (11.1% vs 1.5%), antepartum hemorrhage (7.4% vs 1.5%), premature rupture of membrane (14.8% vs 3.0%), preterm labour (18.5% vs 1.5%), postpartum hemorrhage (9.3% vs 4.5%), anemia (16.7% vs 9.1%) and intrauterine death (9.3% vs 0%). Perinatal complications were also higher like fetal distress (33.3% vs 13.6%) and low birth weight (16.7% vs 4.5%).Incidence of caesarean section was higher in hypothyroid women in comparison to control group (29.2% vs 19.2%).Conclusions: This study shows that there is an association between inadequately treated hypothyroidism and adverse maternal and perinatal outcome. Those who were detected early and adequately treated had outcome similar to control group.


2019 ◽  
Vol 72 (1) ◽  
pp. 52-55
Author(s):  
Volodymyr I. Boiko ◽  
Alla V. Boychuk ◽  
Irina M. Nikitina ◽  
Tetyana V. Babar ◽  
Alesya V. Boiko ◽  
...  

Introduction: In order to evaluate the value of the Placenta Growth Factor (PlGF) in the developing the gestational complications during multiple pregnancies, a study of this indicator in serum of 320 pregnant women with multiple pregnancies in the first trimester, as well as 40 pregnant women with single pregnancy, constituted a control group. The aim: of the study is to investigate the effect of the placental growth factors on gestational process during multiple pregnancies. Materials and methods: A prospective study of maternity pregnancy in 320 females with multiple pregnancies was conducted, which comprised the main group of the subjects and 40 healthy women with unipolar pregnancy. The level of PlGF in serum was determined by solid phase enzyme analysis using monoclonal antibody sets in the first trimester of pregnancy. Indicators of the hemostasis system (vascular thrombocyte and coagulation link) were evaluated according to generally accepted methods. Dopplerometry of placental and fetal blood flow was performed in uterine arteries, arteries and umbilical cord veins, middle cerebral artery of the fetus. Results: Women with multiple pregnancies are at the risk of gestational complications - premature births in 67.8% (p <0.01), feto placental dysfunction, pre eclampsia - in 17.5% (p <0.05) cases. The revealed violations of the vascular thrombocyte and coagulation homeostasis in the first trimester of pregnancy are the main risk factors for early premature abortion. It has been shown that the low level of placental growth factor in serum of pregnant women with multiple pregnancies in the case of premature labor, feto placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg / ml) compared with the corresponding indicators for single-pregnancy (418.2 ± 10.4 pg / ml) is a prognostic marker for the development of gestational complications. Conclusions: Timely medical correction of gestational complications during multiple pregnancies with the use of micronized progesterone, low molecular weight heparins, angio protectants allowed prolonging the pregnancy with mono choric type of placentation by 3.2 weeks (up to 34.2 ± 2.4 weeks), and in the case of dichoric twins - to full-term pregnancy.


Antioxidants ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 269 ◽  
Author(s):  
David Ramiro-Cortijo ◽  
María de la Calle ◽  
Pilar Rodríguez-Rodríguez ◽  
Ángel L. López de Pablo ◽  
María R. López-Giménez ◽  
...  

Twin pregnancies are increasing due to the rise in mothers’ childbearing age and have a higher risk of fetal growth restriction (FGR) and prematurity. Therefore, early prediction of these events is important. Our aim was to analyze in the first trimester of pregnancy a possible association between antioxidants, including melatonin, in maternal plasma and the development of fetal complications in twin pregnancies. A single-center, prospective, and observational study was performed in 104 twin-pregnant women. A blood sample was extracted between the 9th and the 11th week of gestation, and plasma was obtained. Antioxidants (thiols, reduced glutathione, phenolic compounds, catalase, superoxide dismutase) and oxidative damage biomarkers (carbonyl groups and malondialdehyde) were assessed by spectrophotometry, and global scores were calculated from these parameters (Antiox-S, Prooxy-S). Melatonin and cortisol were evaluated by a competitive immunoassay. In the first trimester of pregnancy, Antiox-S was significantly lower in women who developed FGR compared to those with normal fetal growth; plasma melatonin was significantly lower in women with preterm compared to those with full-term births and exhibited a positive correlation with birth weight. Maternal cortisol showed a negative correlation with birth weight. We conclude that, for twin gestations, maternal plasma antioxidant status and melatonin could be potential biomarkers to be included in algorithms to predict FGR and preterm labor.


2019 ◽  
Vol 73 (10) ◽  
pp. 913-919 ◽  
Author(s):  
Julia C Bond ◽  
Amanda L Mancenido ◽  
Divya M Patil ◽  
Seth S Rowley ◽  
Jack Goldberg ◽  
...  

BackgroundThere are few published studies evaluating the impact of perinatal residence change on infant outcomes and whether these associations differ by socioeconomic status.MethodsWe conducted a population-based cohort study using Washington State birth certificate data from 2007 to 2014 to assess whether women who moved during the first trimester of pregnancy (n=28 011) had a higher risk of low birth weight, preterm birth and small for gestational age than women who did not move during the first trimester (n=112 367). ‘Non-first-trimester movers’ were frequency matched 4:1 to movers by year. We used generalised linear models to calculate risk ratios and risk differences adjusted for maternal age, race, marital status, parity, education, smoking, income and insurance payer for the birth. We also stratified analyses by variables related to socioeconomic status to see whether associations differed across socioeconomic strata.ResultsMoving in the first trimester was associated with an increased risk of low birth weight (6.4% vs 4.5%, adjusted risk ratio 1.37 (95% CI 1.29 to 1.45)) and preterm birth (9.1% vs 6.4%, adjusted risk ratio 1.42 (95% CI 1.36 to 1.49)) and a slight increased risk of small for gestational age (9.8% vs 8.7%, adjusted risk ratio 1.09 (95% CI 1.00 to 1.09)). Residence change was associated with low birth weight and preterm birth in all socioeconomic strata.ConclusionMoving during the first trimester of pregnancy may be a risk factor for adverse birth outcomes in US women. Healthcare providers may want to consider screening for plans to move and offering support.


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