The Different Outcomes in Pregnant Women with Severe Features of Preeclampsia between New Onset Hypertension Group and Pre-Existing Hypertension Group

2021 ◽  
Vol 104 (6) ◽  
pp. 951-958

Background: There are extensive evidence that preeclampsia is the reason for many maternal and perinatal morbidities. However, there are no previous study on the different outcomes in severe preeclamptic women between new onset hypertension and chronic hypertension. Objective: To compare the rate of low Apgar score at 5 minutes and other adverse pregnancy outcomes of preeclamptic women with severe features between those who had new onset hypertension in pregnancy and those with chronic hypertension before pregnancy. Materials and Methods: A retrospective cohort study was conducted. The medical records of pregnant women diagnosed with preeclampsia with severe features and delivered at Chonburi Hospital between January 2017 and June 2020 were reviewed. The authors categorized these pregnant women into two groups, new onset hypertension and chronic hypertension. Descriptive statistics were used for the data analyses. Results: Of the 526 women diagnosed with preeclampsia with severe features, 290 met the inclusion and exclusion criteria. Eighty-nine had superimposed preeclampsia on chronic hypertension and 201 patients had new onset hypertension. The rate of low Apgar score at 5 minutes was not statistically different between the two groups (p=0.258). The incidence of impaired liver function and HELLP syndrome were increased in the new onset hypertension group at 18.9% versus 6.7% (p=0.008) and 9.5% versus 1.1% (p=0.010), respectively. Conclusion: There was no significant difference in the rate of low Apgar score between the two groups. Regarding the severity of maternal outcomes, new onset preeclampsia with severe features seems to be more severe than superimposed preeclampsia on chronic hypertension. Keywords: Low Apgar score; Preeclampsia with severe features; Chronic hypertension; Superimposed preeclampsia; Pregnancy outcomes

Author(s):  
Sai Deepthi Chikicherla ◽  
V. Sitalakshmi

Background: Bacterial vaginosis is an extremely prevalent vaginal condition and one of the causes of vaginitis among both pregnant and non pregnant women and associated with severe sequelae. Fifty percent of the women are asymptomatic. Current studies have found that the prevalence of BV ranges from 15% to 30% among non-pregnant women and 10% to 41% among pregnant women.Methods: This is a prospective study conducted among 150 pregnant women who attended the antenatal outpatient and inpatient clinic in the Department of Obstetrics and Gynaecology at Narayana Medical College and Hospital, Nellore over a period of two years from Oct 2016 to Oct 2018. Obstetric cases fulfilling the inclusion and exclusion criteria were enrolled in the study by convenient sampling technique. They were followed till the outcome of pregnancy. The data was subjected to usual statistical analysis by employing the chi-square tests.Results: Prevalence of the bacterial vaginosis was 20% in the present study. BV was significantly (p<0.05) associated with preterm delivery, PPROM, low birth weight, low APGAR and neonatal jaundice. Neonatal sepsis and congenital abnormalities showed no statistically significant difference (p>0.05) between BV positive and negative women.Conclusions: Considering the vast spectrum of maternal and fetal morbidity associated with this infection, and the availability of rapid inexpensive diagnostic tests it may be prudent to screen BV in pregnancy, so that it may be treated early and hence prevent the adverse pregnancy outcomes.


Author(s):  
Murat Cagan ◽  
Atakan Tanacan ◽  
Hanife Guler Donmez ◽  
Erdem Fadiloglu ◽  
Canan Unal ◽  
...  

Abstract Objective To evaluate the obstetric outcomes of singleton high-risk pregnancies with a small size uterine fibroid. Methods This retrospective cohort study was conducted among 172 high-risk pregnant women who were followed-up by a single surgeon between 2016 and 2019. Pregnant women with preconceptionally diagnosed small size (< 5 cm) single uterine fibroids (n = 25) were compared with pregnant women without uterine fibroids (n = 147) in terms of obstetric outcomes. Results There was no statistically significant difference between the groups in terms of adverse pregnancy outcomes. The size of the fibroids was increased in 60% of the cases, and the growth percentage of the fibroids was 25% during pregnancy. Intrapartum and short-term complication was not observed in women who underwent cesarean myomectomy. Conclusion Small size uterine fibroids seem to have no adverse effect on pregnancy outcomes even in high-risk pregnancies, and cesarean myomectomy may be safely performed in properly selected cases.


2013 ◽  
Vol 68 (11) ◽  
pp. 22-25 ◽  
Author(s):  
V. S. Chulkov ◽  
N. K. Vereina ◽  
S. P. Sinitsyn ◽  
V. F. Dolgushina

Aim: to assess of the relationship of clinical and molecular genetic factors in the course and outcome of pregnancy in different forms of hypertension in pregnant women. Patients and methods: a total of 125 pregnant women who were divided into the following groups: with chronic hypertension (n =45), with gestational hypertension (n =20), with pre-eclampsia (n =10), superimposed preeclampsia upon chronic hypertension (n =15) and 35 women without hypertension in control group. Results: in pregnant women with chronic hypertension and superimposed preeclampsia upon chronic hypertension were observed higher incidence of overweight and obesity, smoking before pregnancy and family history of hypertension and thrombosis, the course and outcomes of pregnancy characterized by higher frequency of obstetric complications, higher frequency of polymorphisms of genes identified the renin-angiotensin system, folate cycle and endothelial function. Conclusions: Molecular-genetic factors, combined with the factors of cardiovascular risk may make some contribution to the phenotypic realization of pregnancy complications and adverse pregnancy outcomes in pregnant women with different forms of hypertension. 


2020 ◽  
Author(s):  
Zhiheng Guo ◽  
Yanhong Shan ◽  
Caifeng Xiu ◽  
Yi Yang ◽  
Shu Zheng ◽  
...  

Abstract Background Gestational diabetes mellitus (GDM) is a common pregnancy-induced metabolic complication worldwide. At present, a variety of strategies for diagnosis and management of GDM have been recommended. Our aim is to investigate the clinical features and pregnancy outcomes among women in whom a first-trimester fasting glucose value (≥ 5.10 mmol/L but < 7.0 mmol/L) was detected and a 2-h 75-g oral glucose tolerance test (OGTT) between 24–28 weeks was negative.Methods This is a prospective cohort study of women who registered and delivered between June 2016 and November 2019 at First Hospital, Jilin University. Pregnant women who met the inclusion criteria were categorized as normal first-trimester fasting plasma glucose(FPG)(< 5.10 mmol/L) and first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L).Outcomes included weeks at time of delivery, neonatal birth weight, Apgar score at 1 min, Apgar score at 5 min, prevalence of macrosomia, hypertensive disorders of pregnancy ,primary cesarean delivery, preterm delivery ,premature rupture of membranes and sillbirth or neonatal death were compared after women who developed gestational diabetes mellitus (GDM) were excluded.Results In our population of 2124 eligible subjects, pregnant women with first-trimester fasting hyperglycemia (≥ 5.10 mmol/L but < 7 mmol/L) constituted 20.8% of the total study population and accounted for 27.6% of subsequent GDM diagnosis. The other 1683 had a normal first-trimester FPG (< 5.1 mmol/L), accounting for 11.6% of all subsequent GDM diagnosis (p < 0.01).After excluding women with a diagnosis of GDM between 24 and 28 weeks of gestation, we observed no significant difference between groups for adverse maternal and prenatal outcomes.Conclusion More than two thirds of first-trimester fasting hyperglycemia pregnant women will have a normal OGTT performed at 24–28 week and of these women whom in no increased risk of adverse pregnancy outcomes have been identified.


2021 ◽  
Vol 12 ◽  
pp. 215013272110343
Author(s):  
Sewitemariam Desalegn Andarge ◽  
Abriham Sheferaw Areba ◽  
Robel Hussen Kabthymer ◽  
Miheret Tesfu Legesse ◽  
Girum Gebremeskel Kanno

Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.


2014 ◽  
Vol 34 (5) ◽  
pp. 445-459 ◽  
Author(s):  
S Mozaffari ◽  
AH Abdolghaffari ◽  
S Nikfar ◽  
M Abdollahi

Several studies have indicated the harmful effect of flare-up periods in pregnant women with inflammatory bowel disease (IBD) on their newborns. Therefore, an effective and safe medical treatment during pregnancy is of great concern in IBD patients. The aim of this study was to perform a meta-analysis on the outcomes of thiopurines use and a systematic review of antitumor necrosis factor (anti-TNF) drugs used during pregnancy in women with IBD. The results of cohorts evaluating the safety of anti-TNF drugs during pregnancy up to July 2013 were collected and analyzed. In the meta-analysis, a total of 312 pregnant women with IBD who used thiopurines were compared with 1149 controls (women with IBD who were not treated with any medication and women who were exposed to drugs other than thiopurines) to evaluate the drug effect on different pregnancy outcomes, including prematurity, low birth weight, congenital abnormalities, spontaneous abortion, and neonatal adverse outcomes. Results of statistical analysis demonstrated that congenital abnormalities were increased significantly in thiopurine-exposed group in comparison with control group who did not receive any medicine for IBD treatment. The summary odds ratio was 2.95 with 95% confidence interval = 1.03–8.43 ( p = 0.04). We observed no significant differences in occurrence of other adverse pregnancy outcomes between compared groups. The results of cohorts evaluated the safety of anti-TNF drugs during pregnancy demonstrated no increase in occurrence of adverse pregnancy outcomes in comparison with controls except for the significant decrease in gestational age of newborns of drug-exposed mothers in one trial. In conclusion, a benefit–risk ratio should be considered in prescribing or continuing medicinal therapy during pregnancy of IBD patients.


2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.


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