A Case of Placental Abruption Complicated by Vaginal Trial of Labor in a Unicornuate Uterus

Unicornuate uterus has a low incidence,it is a congenital uterine developmental anomaly, it has many complications during pregnancy, and it is less common in pregnancy to term. This article retrospectively analyzes a case of unicornuate uterus with a full-term vaginal trial of labor and delivery with placental abruption resulting in neonatal asphyxia. We also present the typology of unicornuate uterus, diagnosis, and discuss the mode of delivery in the light of the literature, in order to raise awareness of this type of disease among medical professionals and reduce the occurrence of adverse pregnancy outcomes.

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Fertility and Pregnancy in Inflammatory Bowel Disease

10.2310/gastro.5419 ◽

2015 ◽

Author(s):

Aoibhlinn M. O’Toole ◽

Sonia Friedman

Keyword(s):

Pregnancy Outcomes ◽

Mode Of Delivery ◽

Reproductive Function ◽

Pregnant Patient ◽

Ileoanal Pouch ◽

Bowel Diseases ◽

Individualized Approach ◽

Inflammatory Bowel ◽

Adverse Pregnancy ◽

In Pregnancy

Inflammatory bowel diseases (IBDs) commonly affect women in their reproductive years; 25% of women with IBD become pregnant after the diagnosis. The relation of IBD to reproductive function often manifests in issues concerning fertility, antepartum pregnancy management, mode of delivery, and lactation as these can be influenced by disease activity, medications, perianal disease, and previous ileoanal pouch surgery. As disease location, activity, and complications can vary between patients, an individualized approach with multidisciplinary management is recommended. Pregnancy outcomes, recommended medication, nursing, managing IBD flares during pregnancy, and immune pathways are also discussed. Figures show issues discussed in preconception counseling and pregnancy guidelines. Tables list medication recommendations, Food and Drug Administration categories for the use of medications in pregnancy, adverse pregnancy outcomes PIANO registry, pregnancy and biological recommendations, thiopurine recommendations, safety of biologics in pregnancy, biologic guidelines, and sick pregnant patient recommendations. This review contains 2 highly rendered figures, 8 tables, and 29 references.

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Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0430 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Tanapak Wisetmongkolchai ◽

Fuanglada Tongprasert ◽

Kasemsri Srisupundit ◽

Suchaya Luewan ◽

Kuntharee Traisrisilp ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Loss Rate ◽

Fetal Loss ◽

Adverse Pregnancy Outcomes ◽

Expert Group ◽

Second Trimester ◽

Single Institution ◽

Adverse Pregnancy ◽

In Pregnancy ◽

Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

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Dengue in Pregnancy

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v34i1.56673 ◽

2019 ◽

Vol 34 (1) ◽

pp. 36-42

Author(s):

Sameena Chowdhury ◽

Sharmin Abbasi

Keyword(s):

Adverse Effects ◽

Dengue Fever ◽

Pregnancy Outcomes ◽

Adverse Outcomes ◽

Severe Dengue ◽

Management Guideline ◽

Serious Infection ◽

Adverse Pregnancy ◽

Day By Day ◽

In Pregnancy

Dengue fever during pregnancy is increasing day by day in Bangladesh. The knowledge of adverse effects on mother and neonate remains limited and there are also lack of management guideline in this regard. Mortality rate for severe dengue fever is 0.8–2.5%, and pregnancy should be considered as a coexisting risk factor for serious infection. However, the maternal and fetal outcomes not fully understood. Some review articles on outcomes of neonates born to mother with dengue fever was reported, and demonstrated that preterm birth and low birth weight were the most common adverse pregnancy outcomes; however, dengue fever was not significantly associated with these adverse outcomes, suggesting that symptomatic dengue fever may indicate risk. Other adverse effects such as stillbirth or postpartum hemorrhage (PPH) remain unclear. Therefore, we aimed to brief review of recent management guideline of OGSB about dengue fever in pregnancy. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 36-42

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COVID-19 and Adverse Pregnancy Outcome: A Systematic Review of 104 Cases

Journal of Clinical Medicine ◽

10.3390/jcm9113441 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3441

Author(s):

Ramy Abou Ghayda ◽

Han Li ◽

Keum Hwa Lee ◽

Hee Won Lee ◽

Sung Hwi Hong ◽

...

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcome ◽

Mode Of Delivery ◽

Maternal Mortality Ratio ◽

Case Series ◽

Neonatal Outcomes ◽

Treatment Modalities ◽

Adverse Pregnancy

(1) Background: Until now, several reports about pregnant women with confirmed coronavirus disease 2019 (COVID-19) have been published. However, there are no comprehensive systematic reviews collecting all case series studies on data regarding adverse pregnancy outcomes, especially association with treatment modalities. (2) Objective: We aimed to synthesize the most up-to-date and relevant available evidence on the outcomes of pregnant women with laboratory-confirmed infection with COVID-19. (3) Methods: PubMed, Scopus, MEDLINE, Google scholar, and Embase were explored for studies and papers regarding pregnant women with COVID-19, including obstetrical, perinatal, and neonatal outcomes and complications published from 1 January 2020 to 4 May 2020. Systematic review and search of the published literature was done using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). (4) Results: In total, 11 case series studies comprising 104 pregnant women with COVID-19 were included in our review. Fever (58.6%) and cough (30.7%) were the most common symptoms. Other symptoms included dyspnea (14.4%), chest discomfort (3.9%), sputum production (1.0%), sore throat (2.9%), and nasal obstruction (1.0%). Fifty-two patients (50.0%) eventually demonstrated abnormal chest CT, and of those with ground glass opacity (GGO), 23 (22.1%) were bilateral and 10 (9.6%) were unilateral. The most common treatment for COVID-19 was administration of antibiotics (25.9%) followed by antivirals (17.3%). Cesarean section was the mode of delivery for half of the women (50.0%), although no information was available for 28.8% of the cases. Regarding obstetrical and neonatal outcomes, fetal distress (13.5%), pre-labor rupture of membranes (9.6%), prematurity (8.7%), fetal death (4.8%), and abortion (2.9%) were reported. There are no positive results of neonatal infection by RT-PCR. (5) Conclusions: Although we have found that pregnancy with COVID-19 has significantly higher maternal mortality ratio compared to that of pregnancy without the disease, the evidence is too weak to state that COVID-19 results in poorer maternal outcome due to multiple factors. The number of COVID-19 pregnancy outcomes was not large enough to draw a conclusion and long-term outcomes are yet to be determined as the pandemic is still unfolding. Active and intensive follow-up is needed in order to provide robust data for future studies.

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Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre-eclampsia

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2010.02742.x ◽

2010 ◽

Vol 117 (13) ◽

pp. 1593-1598 ◽

Cited By ~ 98

Author(s):

AW Shand ◽

N Nassar ◽

P Von Dadelszen ◽

SM Innis ◽

TJ Green

Keyword(s):

Vitamin D ◽

High Risk ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Vitamin D Status ◽

Maternal Vitamin ◽

Adverse Pregnancy ◽

Maternal Vitamin D Status ◽

In Pregnancy

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Schistosomiasis among pregnant women in the Njombe-Penja health district, Littoral region of Cameroon: A cross sectional study

10.1101/661900 ◽

2019 ◽

Author(s):

Calvin Tonga ◽

Charlie Ngo Bayoi ◽

Flore Chanceline Tchanga ◽

Jacqueline Félicité Yengue ◽

Godlove Bunda Wepnje ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Haemoglobin Concentration ◽

Epidemiological Data ◽

Adverse Pregnancy Outcomes ◽

Health District ◽

Blood Levels ◽

Childbearing Age ◽

Adverse Pregnancy ◽

In Pregnancy

AbstractBackgroundSchistosomiasis is a Neglected Tropical Disease with endemic foci in Cameroon. Epidemiological data on schistosomiasis in pregnancy are scarce in the country. This study is about schistosomiasis among pregnant women in the Njombe-Penja health district, where schistosomiasis was reported since 1969.MethodologyOverall, 282 pregnant women were enrolled upon informed consent at first antenatal consultation. A questionnaire was administered to document socio-economic and obstetric information. Stool and terminal urine samples were collected and analysed using the Kato-Katz/formol-ether concentration techniques and centrifugation method respectively. Haemoglobin concentration was measured with finger prick blood, using a URIT-12® electronic haemoglobinometer.Principal findingsThe overall prevalence of schistosomiasis was 31.91%. Schistosoma guineensis, S. haematobium and S. mansoni infections were found in 0.35%, 04.96% and 28.01% of participants respectively. Co-infection with 2 species of Schistosoma was found in 04.44% of these women. The prevalence of schistosomiasis was significantly higher in younger women (≤20) and among residents of Njombe. All S. haematobium infected women were anemic and infection was associated with significantly lower haemoglobin levels (p=0.02).ConclusionThe prevalence of schistosomiasis is high in pregnant women of the Njombe-Penja health district, with possible adverse pregnancy outcomes. Female of childbearing age should be considered for mass drug administration.Author summaryPregnant women are known to be more vulnerable to infectious diseases and in their case, at least two lives are at risk. Although schistosomiasis remains a major public health issue in Cameroon, epidemiological data on schistosomiasis in pregnancy are scarce. These data are of high interest for informed decision-making. We examined stools and urines from 282 women of the Njombe-Penja Health district and measured their blood levels. Overall, 31.91% of women were infected, mostly younger ones and those living in the town of Njombe. Three species of Schistosoma parasite were identified. Women having urinary schistosomiasis had lower blood levels. These results show that the prevalence of schistosomiasis is high in pregnant women of Njombe. Also, because of the anemia it induces, the disease can lead to adverse pregnancy outcomes on the woman and her foetus. Treating female of childbearing age would cure the disease and prevent adverse outcomes.

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Pregnancy outcomes in sexually transmitted infections or human immunodeficiency viruses infected women at a tertiary care center: a retrospective study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20210573 ◽

2021 ◽

Vol 7 (2) ◽

pp. 229

Author(s):

Saradha K. P. ◽

Anitha Christy Stephen ◽

Vikram V. Huddar

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Tertiary Care ◽

Mode Of Delivery ◽

Adverse Pregnancy Outcomes ◽

Cd4 Count ◽

Clinical Staging ◽

Normal Delivery ◽

Adverse Pregnancy

Background: The natural history of HIV infection in early disease is not affected by pregnancy. In later stages there may be rapid disease progression leading to adverse pregnancy outcomes. Prevalence of HIV in India is 0.3% in pregnant women. With the advent of PPTCT, there have been a decline in the adverse pregnancy outcomes but still few adversities are reported. Aim of the study was to assess the various pregnancy outcomes in HIV positive women and the effects of antiretroviral therapy (ART).Methods: A retrospective analytical study conducted from July 2017-June 2019 on HIV infected pregnant women. Their maternal age, CD4 count at diagnosis of HIV, after postpartum, mode of delivery, birth weight and HIV status of baby were noted and analyzed. Results: 18 HIV infected pregnant women were included. Their mean age was 25.6 years. 12 patients were in 2nd trimester and the rest in 1st trimester. All were on triple-drug (TEL) regimen. Three were diagnosed with HIV prior to conception and were already on ART. Remaining were detected at the time of ANC visit. All cases fall under stage I WHO clinical staging. Out of the 18 pregnant, two delivered by LSCS and the rest by normal delivery. All were term deliveries, with mean birth weight of 2.82 kg. One HIV infected baby was born by LSCS. The mean CD4 count at the time of diagnosis of HIV was 389 and at postpartum was 508. Overall, there was seen to be an increase in CD4 count without any adverse effects during ART.Conclusions: Prompt HIV diagnosis and ART initiation during antenatal period can have good pregnancy outcome and thereby reducing transmission to children.

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Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis

PLoS Medicine ◽

10.1371/journal.pmed.1003856 ◽

2021 ◽

Vol 18 (11) ◽

pp. e1003856

Author(s):

Sophie Relph ◽

Trusha Patel ◽

Louisa Delaney ◽

Soha Sobhy ◽

Shakila Thangaratinam

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Preterm Birth ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Microvascular Disease ◽

Adverse Pregnancy ◽

In Pregnancy

Background The rise in the global prevalence of diabetes, particularly among younger people, has led to an increase in the number of pregnant women with preexisting diabetes, many of whom have diabetes-related microvascular complications. We aimed to estimate the magnitude of the risks of adverse pregnancy outcomes or disease progression in this population. Methods and findings We undertook a systematic review and meta-analysis on maternal and perinatal complications in women with type 1 or 2 diabetic microvascular disease and the risk factors for worsening of microvascular disease in pregnancy using a prospective protocol (PROSPERO CRD42017076647). We searched major databases (January 1990 to July 2021) for relevant cohort studies. Study quality was assessed using the Newcastle–Ottawa Scale. We summarized the findings as odds ratios (ORs) with 95% confidence intervals (CIs) using random effects meta-analysis. We included 56 cohort studies involving 12,819 pregnant women with diabetes; 40 from Europe and 9 from North America. Pregnant women with diabetic nephropathy were at greater risk of preeclampsia (OR 10.76, CI 6.43 to 17.99, p < 0.001), early (<34 weeks) (OR 6.90, 95% CI 3.38 to 14.06, p < 0.001) and any preterm birth (OR 4.48, CI 3.40 to 5.92, p < 0.001), and cesarean section (OR 3.04, CI 1.24 to 7.47, p = 0.015); their babies were at increased risk of perinatal death (OR 2.26, CI 1.07 to 4.75, p = 0.032), congenital abnormality (OR 2.71, CI 1.58 to 4.66, p < 0.001), small for gestational age (OR 16.89, CI 7.07 to 40.37, p < 0.001), and admission to neonatal unit (OR 2.59, CI 1.72 to 3.90, p < 0.001) than those without nephropathy. Diabetic retinopathy was associated with any preterm birth (OR 1.67, CI 1.27 to 2.20, p < 0.001) and preeclampsia (OR 2.20, CI 1.57 to 3.10, p < 0.001) but not other complications. The risks of onset or worsening of retinopathy were increased in women who were nulliparous (OR 1.75, 95% CI 1.28 to 2.40, p < 0.001), smokers (OR 2.31, 95% CI 1.25 to 4.27, p = 0.008), with existing proliferative disease (OR 2.12, 95% CI 1.11 to 4.04, p = 0.022), and longer duration of diabetes (weighted mean difference: 4.51 years, 95% CI 2.26 to 6.76, p < 0.001) than those without the risk factors. The main limitations of this analysis are the heterogeneity of definition of retinopathy and nephropathy and the inclusion of women both with type 1 and type 2 diabetes. Conclusions In pregnant women with diabetes, presence of nephropathy and/or retinopathy appear to further increase the risks of maternal complications.

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