scholarly journals PECULIARITIES OF PREGNANCY COURSE IN WOMEN WITH CONCOMITANT OBESITY WHO TAKE THERAPEUTIC AND PROPHYLACTIC COMPLEX AIMED TO PREVENT PREECLAMPSIA

2021 ◽  
Vol 21 (2) ◽  
pp. 51-56
Author(s):  
M. M. Zelinka-Khobzey
Keyword(s):  
High Risk ◽  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
High Efficiency ◽  
Risk Group ◽  
High Risk Group ◽  
Overweight And Obesity ◽  
Obese Women ◽  
Women Of Childbearing Age ◽  
Childbearing Age

The rapid growth in the incidence of overweight and obesity among women of childbearing age is posing specific issues related to their pregnancy, thereupon choosing adequate and effective tactics for the prevention of preeclampsia in women with concomitant obesity who are at high risk group for this complication is of undoubted relevance. The aim of this study is to assess the occurrence and characteristic of obstetric and prenatal complications in women with concomitant obesity, who receive therapeutic and prophylactic complex designed to prevent the development of preeclampsia. We studied the course of pregnancy of 255 women, who were divided into 3 groups according to the class of obesity, and then, in turn, were subdivided into subgroups taking into account the presence of preeclampsia and the therapeutic and prophylactic complex course. The high efficiency of the therapeutic and prophylactic complex including L-arginine and diosmin for obese women enables to reduce the manifestations of endothelial dysfunction, the occurrence of preeclampsia and its severe forms; to lower down the occurrence of other complications during the pregnancy (risks of premature birth, placental insufficiency, distress and foetal growth retardation); to avoid perinatal mortality and improve the condition of the foetus. Applying this pathogenetically grounded therapeutic and prophylactic complex we elaborated (acetylsalicylic acid, L-arginine, calcium supplements and semisynthetic diosmin) to prevent the occurrence of preeclampsia in pregnant women with concomitant obesity, who are at high-risk group, promotes the reduction of occurrence and intensity of obstetric and prenatal complications resulted from endothelial dysfunction. We can suggest the therapeutic and prophylactic complex for pregnant women with concomitant obesity as effective therapy because no cases of severe and early preeclampsia have been registered.

scholarly journals Screening for Coxiella burnetii infection during pregnancy: pros and cons according to the Wilson and Jungner criteria

2012 ◽  
Vol 17 (3) ◽  
Author(s):  
J M Munster ◽  
L M Steggerda ◽  
A C Leenders ◽  
J G Aarnoudse ◽  
E Hak
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Risk Group ◽  
High Risk Group ◽  
Routine Screening ◽  
Maternal Complications ◽  
Clinical Consequences ◽  
Pros And Cons

In Europe the incidence of human Q fever has dramatically increased over the previous years. Untreated infections with Coxiella burnetii, the causal agent of Q fever, have been associated with both obstetric and maternal complications. The majority of pregnant women with a C. burnetii infection remain asymptomatic, hence screening could be of value to prevent unwanted outcomes in this high-risk group. We applied the updated Wilson and Jungner criteria to review the evidence for routine screening for C. burnetii infection during pregnancy. Since much uncertainty remains about the incidence, clinical consequences, diagnostics and treatment of C. burnetii infection during pregnancy, routine screening for C. burnetii infection during pregnancy should not be recommended. Rigorous studies to assess the effectiveness of C. burnetii screening are warranted.

scholarly journals Cohort profile: targeted antenatal screening for haemoglobinopathies in Basel

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035735
Author(s):  
Gabriela Amstad Bencaiova ◽  
Franziska Geissler ◽  
Irene Hoesli
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
Iron Status ◽  
First Trimester ◽  
High Risk Group ◽  
University Hospital ◽  
Pregnancy Cohort ◽  
Haemoglobin Variant ◽  
Adverse Pregnancy

PurposeThe pregnancy cohort was established to examine the prevalence and variety of haemoglobinopathies in a high-risk group of pregnant women.ParticipantsThe pregnancy cohort is located in the Department of Obstetrics and Antenatal Care, University Hospital of Basel. The pregnant women were recruited in the first trimester between June 2015 and May 2019. Family origin questionnaires were used to screen pregnant women for the risk of a haemoglobin variant. Based on the questionnaire, pregnant women were divided into two groups: women with a high risk and women with a low risk of a haemoglobin variant. In women with a high risk, red blood cell indices, iron status and chromatography were conducted.Findings to date1785 pregnant women were recruited. Out of the 1785 women, 929 were identified as a part of the high-risk group. Due to the missing data of 74 pregnant women with a high risk, the final analysis was conducted in the remaining 855 women. The prevalence of haemoglobinopathies in the high-risk group was 14.5% (124/855).Future plansThis cohort will be used to: (1) implement the screening in prenatal care in Basel; (2) recommend the screening among pregnant women with a high risk of a haemoglobin variant in Switzerland; (3) improve prenatal and neonatal care in patients with a haemoglobin variant; (4) examine adverse pregnancy outcomes in women with a haemoglobin variant and (5) reduce maternal and neonatal morbidity and mortality in the future.Trial registration numberClinicalTrials.gov Registry (NCT04029142).

scholarly journals Ultrasound elastography capabilities in studying uterine cerviх state in pregnant women of high-risk group in the first trimester of pregnancy

2016 ◽  
Vol 97 (4) ◽  
pp. 656-661
Author(s):  
M G Tukhbatullin ◽  
K V Yanakova
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Chromosomal Abnormality ◽  
Chromosomal Abnormalities ◽  
Ultrasound Examination ◽  
Risk Group ◽  
First Trimester ◽  
High Risk Group ◽  
Control Group ◽  
Significant Difference

Aim. To study capabilities of quantitative elastographic study to assess the elasticity of the uterine cervix in women with a fetal chromosomal abnormality in the first trimester of pregnancy.Methods. 230 pregnant women of high-risk group at 11-13.6 weeks of pregnancy (parietal-coccygeal length 45-84 mm) were included in this study. The first group consisted of 213 women without fetal pathology. The second group included 17 women, in whose fetuses different chromosomal abnormalities were detected. In ultrasound examination of pregnant women in the I trimester of pregnancy, in addition to standard methods of examination, quantitative cervical elastography was performed.Results. According to results of quantitative elastography in 14 (82.35%) out of 17 pregnant women (second group) one or another degree of the cervical tissue softening was found, and 3 (17.64%) pregnant women with fetal chromosomal pathology had stiff cervix (all 3 cases with Down syndrome). In the control group in 10 (4.7%) of 213 pregnant women relatively soft cervix was identified, and in 203 (95.3%) women cervical density was higher than the myometrial density. A statistically significant difference between the indices of SWE-Ratio in groups was revealed. Quantitative elastography, as a diagnostic test predicting the risk of miscarriage due to chromosomal abnormalities, has a high sensitivity (84.38%) and even higher specificity (95.26%) of negative predictive value 97.57%.Conclusion. Quantitative elastography reveals a significant decrease in the cervical elasticity (softening) in pregnant women with fetal chromosomal abnormality in the I trimester of pregnancy, which allows us to recommend this method of ultrasound examination as an additional marker for early diagnosis of miscarriage due to fetal chromosomal abnormality.

scholarly journals Thrombophilia in obstetric practice

2021 ◽  
Vol 99 (1) ◽  
pp. 15-20
Author(s):  
A. P. Melnikov ◽  
M. G. Kashchuk ◽  
K. N. Ahvlediani ◽  
I. N. Bokarev
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
High Probability ◽  
Risk Group ◽  
High Risk Group ◽  
Thromboembolic Complications ◽  
Spontaneous Thrombosis ◽  
Obstetric Practice ◽  
Very High

The rate of thromboembolic complications associated with thrombophilia is very high; therefore the detection of thrombophilia mutations in the high-risk group of patients is important for the prevention of morbidity, mortality and obstetric losses. The problem of thrombophilia is dealt with by doctors of various specialties: laboratory stuff, geneticists, vascular surgeons, hematologists, neurologists, cardiologists and obstetricians-gynecologists. At the same time, patients with spontaneous thrombosis are followed-up for years without proper examination for thrombophilia. Considering that pregnancy is a condition associated with a high probability of re-thrombosis, it is advisable to determine the cause and tactics of management and treatment of pregnant women as early as possible during the period of pregnancy.

Anxiety during Pregnancy at the Time of the Gulf War: Comparison of Anxiety of Israeli Women with Normal Pregnancies and Those with “At-Risk” Pregnancies

1993 ◽  
Vol 72 (2) ◽  
pp. 600-602 ◽  
Author(s):  
Deborah Lieberman ◽  
Shaul Harel
Keyword(s):  
At Risk ◽  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
Gulf War ◽  
High Risk Group

81 pregnant women were interviewed at the time of the Gulf War. One group was interviewed before the missile attacks began in Israel, and the second group during the period of the attacks. Of the women interviewed, 53 women had “high-risk” pregnancies and 28 had normal pregnancies. Despite the hypothesis that women with “at-risk” pregnancies would report a greater rise in anxiety during the missile attacks, it was found that the women with normal pregnancies reported a significantly greater rise in anxiety during missile attacks. It is suggested that the already-stressed “high-risk” group “shut out” the additional anxiety generated by the dangers from the missile attacks.

scholarly journals Risk of acquiring listeriosis from consumption of chicken offal among high risk group

2020 ◽  
Vol 16 (1) ◽  
pp. 59-63
Author(s):  
Ga Yarn Wai ◽  
John Yew Huat Tang ◽  
Nadiawati Alias ◽  
Chee Hao Kuan ◽  
Sur Guat Goh ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Women Elderly ◽  
Room Temperature ◽  
Risk Group ◽  
High Risk Group ◽  
Inoculum Size ◽  
Danger Zone ◽  
Listeria Infection ◽  
Foodborne Infection

Listeria monocytogenes causes mild foodborne infection in healthy adults but serious complication in high risk group such as infant, pregnant women, immunocompromised and elderly. This study aims to estimate the probability of infection based on the survivability of L. monocytogenes in chicken offal, particularly chicken liver, gizzard and heart. A total of 20 µl of L. monocytogenes with inoculum size of 9.02 log CFU/ml was spiked on the chicken offal and stored at room temperature (28oC) for 0, 1, 3, and 6 h. This experimental design was aimed to simulate the contaminated chicken offal stored at temperature danger zone. It was found that chicken offal supported the growth of L. monocytogenes that it significantly grows at 3 and 6 h incubation. Risk assessment was performed by combining this result with the data from our previous studies as well as data from government agencies and other studies. Dose-response model was used to estimate the probability of listeria infection per year. Immunocompromised was the highest risk group, followed by pregnant women, elderly and general population with probability of infection per year estimated at 3.78 x 10-3, 1.76 x 10-4, 5.68 x 10-8 and 5.75 x 10-9, respectively. It can be concluded that high risk group requires extra caution in their food consumption in order to prevent listeriosis which can result in serious complication and death.

scholarly journals Improved gestational diabetes screening protocol

2021 ◽  
Vol 2 (1) ◽  
pp. 87-96
Author(s):  
Miguel Calero Rojas ◽  
Aurora Jurado Roger ◽  
Marta Gutiérrez Grúa ◽  
Lourdes de la Peña Carretero ◽  
Victoria Romero Sotomayor ◽  
...  
Keyword(s):  
High Risk ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Risk Group ◽  
Challenge Test ◽  
Area Under The Curve ◽  
High Risk Group ◽  
Low Risk ◽  
Oral Glucose ◽  
Diagnostic Validity

Abstract Objectives This work aimed to assess the diagnostic validity of two approaches for the screening of gestational diabetes mellitus (GDM) with less discomfort for pregnant women. Methods A prospective diagnostic validation study was conducted with 2007 pregnant women. According to risk factors for GDM, women were classified into high-risk and low-risk groups. The current diagnostic procedure, based on oral glucose overload, was followed; simultaneously HbA1c was tested and an algorithm combining both biomarkers was applied. Results In the low-risk group, the Glucose challenge test (GCT) showed a higher area under the curve (AUC 0.953; 95% CI 0.915–0.992) than the HbA1c test (0.688; 95% CI 0.541–0.834). The best GCT cut-off, 153.5 mg/dL (8.52 mmol/L), showed higher diagnostic validity than that for HbA1c, 28 mmol/mol (4.75%), and that the algorithm using both tests. In the high-risk group, the GCT showed better diagnostic performance than the HbA1c and the algorithm; the optimal GCT cut-offs were higher than those recommended in current protocols. 13th week: GCT AUC 0.882 (95% CI 0.843–0.921), HbA1c AUC 0.624 (95% CI 0.562–0.686), GCT cut-off 140.5 mg/dL (7.8 mmol/L), HbA1c cut-off 33 mmol/mol (5.15%). 24th week: GCT AUC 0.944 (95% CI 0.925–0.962), HbA1c AUC 0.642 (95% CI 0.575–0.709), GCT cut-off, 145.5 mg/dL (8.08 mmol/L), HbA1c cut-off 29 mmol/mol (4.85%). Conclusions The GDM diagnostic approach using as the first step the GCT with higher cut-offs showed the best diagnostic validity. Applying these thresholds, 55.6 and 13.7% of 100 g. Oral glucose overloads would have been avoided in low-risk and high-risk pregnant women.

scholarly journals Comparison of universal screening with targeted high-risk case finding for diagnosis of thyroid disorders

2016 ◽  
Vol 174 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Sima Nazarpour ◽  
Fahimeh Ramezani Tehrani ◽  
Masoumeh Simbar ◽  
Maryam Tohidi ◽  
Hamid AlaviMajd ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Pregnant Women ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Risk Group ◽  
Case Finding ◽  
High Risk Group ◽  
Thyroid Status ◽  
High Risk Case

ObjectiveDebate about the need for universal screening of thyroid dysfunction in pregnancy is ongoing. The present study aimed to compare universal screening with targeted high-risk case findings for early diagnosis of thyroid disorders in Iranian pregnant women.Study designThis cross-sectional prospective study was carried out on 1600 pregnant women in their first trimester. A checklist, including all related risk factors recommended by The American Thyroid Association, was completed for all participants. Serum concentrations of thyroxine (T4), T-uptake, TSH and thyroid peroxidase antibody (TPOAb) were measured and thyroid status was documented, based on hormonal measurements and clinical examinations.ResultsThere were 656 women (44.3%) that had at least one risk factor for thyroid diseases and were eligible for the targeted high-risk case finding (high-risk group) approach, while 55.7% had no risk factors (low-risk group). Using the universal screening approach, there were 974 women (65.8%) with normal thyroid status and 506 participants (34.2%) with thyroid disturbances, including overt hyperthyroidism (0.7%), overt hypothyroidism (1.1%), subclinical hypothyroidism (30.1%; positive TPOAb (5.5%) and negative TPOAb (24.6%); and euthyroid and positive TPOAb (2.3%). Of women with thyroid dysfunction, 64.4% were in the high-risk group and 35.6% were in the low-risk group (P<0.0001).ConclusionsThe targeted high-risk case finding approach overlooks about one-third of pregnant women with thyroid dysfunction. If ongoing prospective trials provide evidence on the efficacy of treating subclinical hypothyroidism in pregnancy, in populations with a low prevalence of presumed risk factors, the targeted high-risk case finding approach will be proven inefficient.

scholarly journals Predictive values of ultrasound-based scoring system in morbidly adherent placenta for high risk group

2018 ◽  
Vol 7 (11) ◽  
pp. 4426
Author(s):  
Abd El-Naser Abd El-Gaber Ali ◽  
Ahmed AM. Mohammad ◽  
Mustafa M. Khodry ◽  
Khaled M. Abdallah ◽  
Ahmed M. Abbas
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
Elective Cesarean Section ◽  
Predictive Values ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Sensitivity Specificity

Background: The objective of the present study was to find out the predictive values of an ultrasound-based scoring system in diagnosis of morbidly adherent placenta (MAP) for high risk group. Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt.Methods: 63 full term pregnant women (≥37 weeks of gestation) with high risk of morbidly adherent placenta underwent elective cesarean section. Placental assessment by 2 D ultrasound based on ultrasound scoring system in morbidly adherent placenta, these data were recorded for further comparison with intraoperative data for degree of placental adherence.Results: Incidence of MAP was 7.93% (4.76% had a focal form and 3.17% had a complete form of accreta). As regarding to scoring system, 82.5 of cases had a low risk (< 5), 9.5% had a moderate risk (6-7) and 7.93% had a high risk (8-12) of development of morbidly adherent placenta with p value <0.0001. The sensitivity, specificity, positive and negative predictive values of the US scoring system for morbidly adherent placenta were (92.3%, 94.1%, 87.453% and 98.2%) respectively.Conclusions: Ultrasound based scoring system had a high predictive value (sensitivity, specificity, positive and negative predictive values) in diagnosis of morbidly adherent placenta for pregnant women have any risk factors for developing MAP.

scholarly journals Cara Persalinan Dan Terjadinya Komplikasi Persalinan Berdasarkan Tingkat Risiko Kehamilan Menurut Skor Poedji Rochjati Di Praktik Mandiri Bidan F Banjarmasin

2019 ◽  
Vol 10 (2) ◽  
pp. 783-794
Author(s):  
Nur Lathifah ◽  
Fitri Yuliana
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
High Risk Group ◽  
Risk Level ◽  
Pregnancy Risk ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Labor Complications ◽  
Very High

Latar Belakang: Salah satu cara untuk menurunkan angka kesakitan dan kematian ibu dengan pendekatan risiko pada ibu hamil. Deteksi risiko dapat dilakukan oleh bidan dengan skor Poedji Roechayati. Di praktik Mandiri Bidan (PMB) F hal ini telah dilaksanakan. Berdasarkan data terakhir pada bulan Mei  2019, dari 48 orang ibu hamil yang berkunjung ke PMB F didapatkan 18 orang (37,5%) kelompok risiko tinggi (KRT) dan 3 orang (6,25%) kelompok risiko sangat tinggi (KRST), di  tahun 2018, terdapat 21% kasus komplikasi persalinan.Tujuan: Menganalisa hubungan antara tingkat risiko ibu hamil dengan kejadian komplikasi persalinan dan juga cara persalinannya.Metode: . Metode penelitian kuantitatif dengan rancangan penelitian Cross Sectional. Populasi penelitian ini adalah semua ibu bersalin di PMB F pada tahun 2017 s.d juni 2019 sebanyak 90 orang dengan tehnik sampling jenuh. Data dianalisis menggunakan uji Chi Squere.Hasil: Dari 90 orang sampel yang diteliti 60 orang (66,7%) yang termasuk kelompok ibu hamil risiko tinggi (KRT). Ibu dengan cara persalinan normal sebanyak 73 orang (81,1%). Ibu yang mengalami komplikasi pada saat persalinan sebanyak 32 orang (35,6%) dari 90 sampel dan komplikasi ini banyak terjadi pada kelompok risiko tinggi (23 orang) dan kelompok risiko sangat tinggi (7 orang).  Simpulan: Ada hubungan yang signifikan antara Komplikasi persalinan dengan tingkat risiko ibu hamil dan tidak ada hubungan cara persalinan dengan tingkat risiko ibu hamil. Kata Kunci: Cara Persalinan, Komplikasi Persalinan, Tingkat Risiko Kehamilan Background: One way to reduce maternal morbidity and mortality with a risk approach for pregnant women. Risk detection can be done by midwives with Poedji Roechayati scores. In practice the Mandiri Midwife (PMB) F this has been carried out. Based on the latest data in May 2019, out of 48 pregnant women visiting PMB F, there were 18 people (37.5%) high risk group (KRT) and 3 people (6.25%) very high risk group (KRST), in 2018, there were 21% of cases of childbirth complications.Objective: To analyze the relationship between the risk level of pregnant women with the incidence of labor complications and also the mode of delivery.Method: . Quantitative research methods with cross sectional research design. The population of this study were all women giving birth at PMB F in 2017 to June 2019, as many as 90 people with saturated sampling techniques. Data were analyzed using the Chi Squere test.Results: Of the 90 samples studied, 60 (66.7%) were included in the high risk group of pregnant women (KRT). Mothers by normal delivery were 73 people (81.1%). Mothers who experienced complications at the time of delivery were 32 people (35.6%) from 90 samples and this complication mostly occurred in the high risk group (23 people) and the very high risk group (7 people).Conclusion: There is a significant relationship between the complications of childbirth with the level of risk of pregnant women and there is no relationship between the way of delivery and the risk of pregnant women. Keywords: Delivery Method, Labor Complications, Pregnancy Risk Level

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