scholarly journals The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns

2022 ◽  
Vol 10 (1) ◽  
pp. 176
Author(s):  
Irina Anatolyevna Andrievskaya ◽  
Irina Valentinovna Zhukovets ◽  
Inna Victorovna Dovzhikova ◽  
Nataliya Alexandrovna Ishutina ◽  
Ksenia Konstantinovna Petrova
Keyword(s):  
Neonatal Period ◽  
Recurrent Infection ◽  
First Trimester ◽  
Placental Insufficiency ◽  
Igg Antibodies ◽  
Pregnancy And Childbirth ◽  
Serological Status ◽  
Anemia In Pregnancy ◽  
In Pregnancy ◽  
Hsv 1

The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.

scholarly journals How I treat anemia in pregnancy: iron, cobalamin, and folate

Blood ◽  
2017 ◽  
Vol 129 (8) ◽  
pp. 940-949 ◽  
Author(s):  
Maureen M. Achebe ◽  
Anat Gafter-Gvili
Keyword(s):  
Iron Deficiency ◽  
First Trimester ◽  
Cobalamin Deficiency ◽  
Iron Treatment ◽  
Iron Deficient ◽  
Iv Iron ◽  
Anemia In Pregnancy ◽  
Surgery Rates ◽  
Global Health Problem ◽  
In Pregnancy

AbstractAnemia of pregnancy, an important risk factor for fetal and maternal morbidity, is considered a global health problem, affecting almost 50% of pregnant women. In this article, diagnosis and management of iron, cobalamin, and folate deficiencies, the most frequent causes of anemia in pregnancy, are discussed. Three clinical cases are considered. Iron deficiency is the most common cause. Laboratory tests defining iron deficiency, the recognition of developmental delays and cognitive abnormalities in iron-deficient neonates, and literature addressing the efficacy and safety of IV iron in pregnancy are reviewed. An algorithm is proposed to help clinicians diagnose and treat iron deficiency, recommending oral iron in the first trimester and IV iron later. Association of folate deficiency with neural tube defects and impact of fortification programs are discussed. With increased obesity and bariatric surgery rates, prevalence of cobalamin deficiency in pregnancy is rising. Low maternal cobalamin may be associated with fetal growth retardation, fetal insulin resistance, and excess adiposity. The importance of treating cobalamin deficiency in pregnancy is considered. A case of malarial anemia emphasizes the complex relationship between iron deficiency, iron treatment, and malaria infection in endemic areas; the heightened impact of combined etiologies on anemia severity is highlighted.

scholarly journals An evidence-based definition of anemia for singleton, uncomplicated pregnancies

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262436
Author(s):  
Amanda C. Zofkie ◽  
W. Holt Garner ◽  
Rachel C. Schell ◽  
Alexandra S. Ragsdale ◽  
Donald D. McIntire ◽  
...  
Keyword(s):  
United States ◽  
Private Hospital ◽  
Short Interval ◽  
First Trimester ◽  
Public Hospitals ◽  
Multiple Gestation ◽  
The Public ◽  
Anemia In Pregnancy ◽  
Definition Of ◽  
In Pregnancy

Background The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student’s t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix.

scholarly journals Upaya Deteksi Dini Risiko Tinggi Kehamilan Ditentukan Oleh Pengetahuan Dan Pemeriksaan Kehamilan Di Pulau Osi

2019 ◽  
Vol 1 (4) ◽  
pp. 265-268
Author(s):  
Arindiah Puspo Windari ◽  
Sri Ayu Lohy
Keyword(s):  
High Risk ◽  
First Trimester ◽  
Health Care Facilities ◽  
Second Trimester ◽  
Maternal Deaths ◽  
Adequate Treatment ◽  
Pregnancy And Childbirth ◽  
Risk Pregnancy ◽  
Care Facilities ◽  
In Pregnancy

The most common cause of maternal death is bleeding (30.3%), followed by hypertension in pregnancy (27.1%), infection (7%). Other causes, 45%, are quite large, including non-obstetric causes. High maternal mortality is also caused by the high number of unexpected pregnancies. Approximately 65% of pregnancies still occur because "4 too" associated with pregnancies "too young (less than 20 years)," too old: (more than 35 years), "too often (pregnancy interval less than 2 years," too many”(more than 3 children). Most maternal deaths can be prevented if adequate treatment is provided in health care facilities. Time and transportation factors are very decisive in referring to high-risk cases. Therefore, detection of risk factors in mothers is good by personnel. Health and society is one of the important efforts in preventing death and morbidity. To avoid the risk of complications in pregnancy and childbirth, every pregnant woman needs at least 4 antenatal care, namely once in the first trimester (0-12 weeks gestation), one times in the second trimester (12-24 weeks of gestation), and twice in the second trimester third steer (24 weeks gestation until delivery). Keywords: Early Detection Of High Risk Pregnancy, Pregnancy Test.

scholarly journals Role of Reticulocyte Parameters in Anemia of First Trimester Pregnancy: A Single Center Observational Study

2020 ◽  
Vol 12 (01) ◽  
pp. 15-19
Author(s):  
Utpal Kumar ◽  
Harish Chandra ◽  
Arvind Kumar Gupta ◽  
Neha Singh ◽  
Jaya Chaturvedi
Keyword(s):  
Serum Ferritin ◽  
First Trimester ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Roc Curve Analysis ◽  
Early Therapy ◽  
Pregnant Females ◽  
Fetal Complications ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Abstract Introduction The diagnosis of anemia in pregnancy should be early to prevent complications to mother and baby. It should be simple and safe, and therefore feasibility of reticulocyte parameters may prove beneficial in this regard. Newer reticulocyte parameters have not been studied extensively especially in pregnancy. The present study was conducted to evaluate reticulocyte hemoglobin content (Ret-He), immature reticulocyte fraction, and reticulocyte count and to compare them with serum ferritin, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in assessment anemia in pregnancy. Material and Methods Prospective study included first trimester pregnant females where hemoglobin, MCV, and MCH were categorized and statistically analyzed with serum ferritin and reticulocyte parameters. Results The study included 155 first trimester pregnant females showing statistical difference in Ret-He between all categories of hemoglobin and MCV (p < 0.05). ROC curve analysis using MCV < 83 fl and MCH <27 pg showed that area under curve for Ret-He at cutoff of 27.8 ng/mL was 0.93 (95% confidence interval 0.90–0.98, sensitivity 93%, specificity 83%). The cutoff of 27.2 ng/mL Ret-He for the diagnosis of iron deficiency anemia has specificity of 86%, sensitivity 71%, positive predictive value 0.39, and likelihood ratio of 5.1. Conclusion Ret-He is a feasible and easily available parameter which may be helpful in differentiating between microcytic hypochromic and normocytic normochromic anemia along with frank and borderline anemia in first trimester pregnant females. This in turn is essential to initiate an early therapy so as to prevent the maternal and fetal complications.

Anemia in pregnancy: characteristics in Szabolcs-Szatmár-Bereg County, Hungary

2010 ◽  
Vol 151 (33) ◽  
pp. 1347-1352 ◽  
Author(s):  
László Szerafin ◽  
János Jakó
Keyword(s):  
Anemia In Pregnancy ◽  
In Pregnancy

Terhesség során az anaemia napjainkban is a leggyakoribb belgyógyászati elváltozások közé tartozik. Az anya és az utód számára egyaránt számos káros következménnyel járhat. Célkitűzés: A szerzők vizsgálták a Szabolcs-Szatmár-Bereg megyében 2008-ban szült nők vérképadatai (hemoglobin, átlagos vörösvértest-térfogat), szérum ferritinszintje és a terhességi kor, a várandósok életkora, az iskolázottság, az előző terhességek száma, a vetélések és koraszülések gyakorisága közötti összefüggéseket. Módszer: A szerzők a megyei, 2008-as védőnői nyilvántartások adatait elemezték. Eredmények: A vérszegénység előfordulásának aránya az I. trimeszterben 2,54%, a másodikban 0,71%, a harmadikban 1,87% volt, és szignifikánsan gyakoribbnak bizonyult a fiatalkorúak (10,30%), az alacsony iskolai végzettségűek (5,55%), a második vagy többedik terhességüket viselők (2,56%) között. A vetélések arányában nem volt különbség, de a koraszülés gyakoribb volt az anaemiás terhesek között (7,14%, vs. 5,46%). Minden vizsgált csoportban az anaemiások számánál jelentősen magasabb volt a normálisnál alacsonyabb átlagos vörösvértest-térfogattal jellemezhető vérképek aránya (6,06–22,88%), ami az esetek döntő többségében kórosan csökkent vasraktárra utal. (Ferritinszint-meghatározás csak az esetek 2,42%-ában történt, ezek között viszont 93,1%-ban kórosan alacsony értéket mértek!) Következtetések: A szerzők a többségükben (latens) vashiányos, jóval ritkábban vashiányos anaemiás várandós esetek kapcsán felhívják a figyelmet a fiatalkorú, alacsony iskolázottságú, illetve többedszer szülő terhesek gondozásának kiemelt fontosságára, valamint már a várandósság korai szakaszában a vérkép helyes értelmezésére, a megfelelő vaspótlás időben történő elkezdésére, sőt, a vasraktárak még fogamzás előtti feltöltésének szükségességére. Ehhez az irodalmi adatok alapján ajánlásokat fogalmaznak meg.

scholarly journals High burden of anemia among pregnant women in Tanzania: a call to address its determinants

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bruno F. Sunguya ◽  
Yue Ge ◽  
Linda Mlunde ◽  
Rose Mpembeni ◽  
Germana Leyna ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Pregnant Women ◽  
Reproductive Age ◽  
Gis Mapping ◽  
Demographic And Health Surveys ◽  
Health Coverage ◽  
Nutritional Knowledge ◽  
Women Of Reproductive Age ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Abstract Background Anemia in pregnancy is behind a significant burden of maternal mortality and poor birth outcomes globally. Efforts to address it need evidence on trends and its pertinent factors as they vary from one area to another. Methods We pooled data of 23,203 women of reproductive age whose hemoglobin levels were measured from two Tanzania Demographic and Health Surveys (TDHS). Of them, 2,194 women were pregnant. Analyses employed descriptive analyses to determine the burden of anemia, its characteristics, and severity; GIS mapping to determine the regional changes of anemia between 2005 and 2015; and logistic regression to determine the remaining determinants of anemia among pregnant women using Stata 15. Results The burden of anemia among pregnant women in Tanzania has remained unprecedently high, and varies between regions. There was no significant decline of anemia in general between the two periods after adjusting for individual, households, reproductive, and child characteristics [AOR = 0.964, 95% CI = 0.774–1.202, p = 0.747). Anemia is currently prevalent in 57% of pregnant women in Tanzania. The prevalence is more likely to be higher among women aged 15–19 years than those aged between 20–34 years. It is more likely to be prevalent among those within large families, with no formal education, food insecurity, lack of health insurance, had no antimalaria during pregnancy, and had low frequency of ANC attendance. On the other hand, delivery in a health facility may be potentially protective against anemia. Conclusions Anemia in pregnancy remained persistently high and prevalent among 57% of pregnant women in Tanzania. Efforts to address anemia are crucial and need to be focused in regions with increasing burden of anemia among pregnant women. It is imperative to address important risk factors such as food insecurity, strengthening universal health coverage, empowering women of reproductive age with education and especially nutritional knowledge and advocating for early antenatal booking, attendance, and facility delivery.

EXPRESS: Method dependent variation in TSH and FT4 reference intervals in pregnancy: a systematic review

2021 ◽  
pp. 000456322110269
Author(s):  
O E Okosieme ◽  
Medha Agrawal ◽  
Danyal Usman ◽  
Carol Evans
Keyword(s):  
Systematic Review ◽  
Reference Interval ◽  
First Trimester ◽  
Reference Intervals ◽  
Assay Method ◽  
Specific Reference ◽  
Upper Limits ◽  
Wide Range ◽  
Assay Methods ◽  
In Pregnancy

Background: Gestational TSH and FT4 reference intervals may differ according to assay method but the extent of variation is unclear and has not been systematically evaluated. We conducted a systematic review of published studies on TSH and FT4 reference intervals in pregnancy. Our aim was to quantify method-related differences in gestation reference intervals, across four commonly used assay methods, Abbott, Beckman, Roche, and Siemens. Methods: We searched the literature for relevant studies, published between January 2000 and December 2020, in healthy pregnant women without thyroid antibodies or disease. For each study, we extracted trimester-specific reference intervals (2.5–97.5 percentiles) for TSH and FT4 as well as the manufacturer provided reference interval for the corresponding non-pregnant population. Results: TSH reference intervals showed a wide range of study-to-study differences with upper limits ranging from 2.33 to 8.30 mU/L. FT4 lower limits ranged from 4.40–13.93 pmol/L, with consistently lower reference intervals observed with the Beckman method. Differences between non-pregnant and first trimester reference intervals were highly variable, and for most studies the TSH upper limit in the first trimester could not be predicted or extrapolated from non-pregnant values. Conclusions: Our study confirms significant intra and inter-method disparities in gestational thyroid hormone reference intervals. The relationship between pregnant and non-pregnant values is inconsistent and does not support the existing practice in some laboratories of extrapolating gestation references from non-pregnant values. Laboratories should invest in deriving method-specific gestation reference intervals for their population.

scholarly journals Elevated Circulating and Placental SPINT2 Is Associated with Placental Dysfunction

2021 ◽  
Vol 22 (14) ◽  
pp. 7467
Author(s):  
Ciara N. Murphy ◽  
Susan P. Walker ◽  
Teresa M. MacDonald ◽  
Emerson Keenan ◽  
Natalie J. Hannan ◽  
...  
Keyword(s):  
Stem Cells ◽  
First Trimester ◽  
Placental Insufficiency ◽  
Human Trophoblast ◽  
Trophoblast Stem Cells ◽  
Placental Dysfunction ◽  
Foetal Growth Restriction ◽  
Term Delivery ◽  
Placental Disease ◽  
Prospective Cohorts

Biomarkers for placental dysfunction are currently lacking. We recently identified SPINT1 as a novel biomarker; SPINT2 is a functionally related placental protease inhibitor. This study aimed to characterise SPINT2 expression in placental insufficiency. Circulating SPINT2 was assessed in three prospective cohorts, collected at the following: (1) term delivery (n = 227), (2) 36 weeks (n = 364), and (3) 24–34 weeks’ (n = 294) gestation. SPINT2 was also measured in the plasma and placentas of women with established placental disease at preterm (<34 weeks) delivery. Using first-trimester human trophoblast stem cells, SPINT2 expression was assessed in hypoxia/normoxia (1% vs. 8% O2), and following inflammatory cytokine treatment (TNFa, IL-6). Placental SPINT2 mRNA was measured in a rat model of late-gestational foetal growth restriction. At 36 weeks, circulating SPINT2 was elevated in patients who later developed preeclampsia (p = 0.028; median = 2233 pg/mL vs. controls, median = 1644 pg/mL), or delivered a small-for-gestational-age infant (p = 0.002; median = 2109 pg/mL vs. controls, median = 1614 pg/mL). SPINT2 was elevated in the placentas of patients who required delivery for preterm preeclampsia (p = 0.025). Though inflammatory cytokines had no effect, hypoxia increased SPINT2 in cytotrophoblast stem cells, and its expression was elevated in the placental labyrinth of growth-restricted rats. These findings suggest elevated SPINT2 is associated with placental insufficiency.

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