A CASE REPORT ON IMPACT OF PRE-GESTATIONAL DIABETES MELLITUS ON PREGNANCY OUTCOME IN A WOMEN WITH BAD OBSTETRIC HISTORY

Background Perinatal and neonatal mortality remains a challenge in the care of pregnant women worldwide, particularly for those who had a history of adverse outcome in previous pregnancies. Bad Obstetric History implies previous unfavorable fetal outcome in terms of two or more consecutive spontaneous abortion, H/O intrauterine fetal death, intrauterine growth restriction, stillbirth, early neonatal death and/or congenital anomalies. Age, obesity and high parity have been shown to be independent risk factors for recurrent pregnancy loss and stillbirths. About 3 to 10% of pregnancies are complicated by glycemic control abnormalities. The main underlying cause is lethal embryonic malformations due to glucose teratogenicity at high levels if diabetes is poorly controlled in the periconceptional period and first trimester.

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Intrauterine growth restriction: antenatal diagnosis and fetal outcome

Annals of King Edward Medical University ◽

10.21649/akemu.v11i4.1104 ◽

2016 ◽

Vol 11 (4) ◽

Author(s):

Lubna Amin ◽

Shaheena Asif

Keyword(s):

Risk Factors ◽

Clinical Assessment ◽

Intrauterine Growth Restriction ◽

Antenatal Diagnosis ◽

Previous History ◽

Fetal Outcome ◽

Growth Restriction ◽

Intrauterine Growth ◽

History Of ◽

Pregnancy Weight

The following study was conducted in the Department of Obstetrics and Gynecology Jinnah hospital Lahore to identify women with risk factors for IUGR (Intrauterine growth restriction: Antenatal diagnosis and foetal outcome.)on clinical assessment and ultrasound and to co -relate antenatal diagnosis with fetal outcome. Fifty (50) patients were picked on basis of risk factor. Fourteen (28%) had SFH less than expected for gestation. Eleven (22%) had hypertension, Nine (18%) had previous history of SGA babies. Other risk factors were diabetes mellitus, pre-pregnancy weight less than 50 kg and smoking. On ultrasound 18 (39.63%) of patients were diagnosed as IUGR while 28 (60.48%) were diagnosed as non IUGR. Among IUGR babies 66.24% had asymmetrical while 33.76% had symmetrical IUGR. 39.53% babies were suspected of IUGR on SFH, and 28% of IUGR babies were suspected on ultrasound, as outcome measure 25% of babies had birth weight less than 10th percentile after delivery. It was concluded that for antenatal diagn osis of IUGR sonographic assessment is more precise than clinical assessment.

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Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

Zeitschrift für Geburtshilfe und Neonatologie ◽

10.1055/a-1382-8787 ◽

2021 ◽

Vol 225 (02) ◽

pp. 125-128

Author(s):

Hasan Eroğlu ◽

Nazan Vanlı Tonyalı ◽

Gokcen Orgul ◽

Derya Biriken ◽

Aykan Yucel ◽

...

Keyword(s):

Intrauterine Growth Restriction ◽

Final Analysis ◽

First Trimester ◽

Maternal Serum ◽

Growth Restriction ◽

Control Group ◽

Aneuploidy Screening ◽

Intrauterine Growth ◽

Potential Marker ◽

The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

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Pregnancy outcomes of women with and without a history of anorexia nervosa

Psychological Medicine ◽

10.1017/s0033291712000414 ◽

2012 ◽

Vol 42 (12) ◽

pp. 2651-2660 ◽

Cited By ~ 11

Author(s):

J. M. Eagles ◽

A. J. Lee ◽

E. Amalraj Raja ◽

H. R. Millar ◽

S. Bhattacharya

Keyword(s):

Anorexia Nervosa ◽

Pregnancy Outcomes ◽

Intrauterine Growth Restriction ◽

Maternal Body Mass Index ◽

Intrauterine Growth ◽

North East ◽

Increased Risk ◽

History Of ◽

Obstetric Services ◽

Adverse Pregnancy

BackgroundWhen women have a history of anorexia nervosa (AN), the advice given about becoming pregnant, and about the management of pregnancies, has usually been cautious. This study compared the pregnancy outcomes of women with and without a history of AN.MethodWomen with a confirmed diagnosis of AN who had presented to psychiatric services in North East Scotland from 1965 to 2007 were identified. Those women with a pregnancy recorded in the Aberdeen Maternal and Neonatal Databank (AMND) were each matched by age, parity and year of delivery of their first baby with five women with no history of AN. Maternal and foetal outcomes were compared between these two groups of women. Comparisons were also made between the mothers with a history of AN and all other women in the AMND.ResultsA total of 134 women with a history of AN delivered 230 babies and the 670 matched women delivered 1144 babies. Mothers with AN delivered lighter babies but this difference did not persist after adjusting for maternal body mass index (BMI) in early pregnancy. Standardized birthweight (SBW) scores suggested that the AN mothers were more likely to produce babies with intrauterine growth restriction (IUGR) [relative risk (RR) 1.54, 95% confidence interval (CI) 1.11–2.13]. AN mothers were more likely to experience antepartum haemorrhage (RR 1.70, 95% CI 1.09–2.65).ConclusionsMothers with a history of AN are at increased risk of adverse pregnancy outcomes. The magnitude of these risks is relatively small and should be appraised holistically by psychiatric and obstetric services.

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Antiphosphatidylserine/prothrombin Antibodies in Antiphospholipid Syndrome with Intrauterine Growth Restriction and Preeclampsia

The Journal of Rheumatology ◽

10.3899/jrheum.170751 ◽

2018 ◽

Vol 45 (9) ◽

pp. 1263-1272 ◽

Cited By ~ 10

Author(s):

Valentina Canti ◽

Stefania Del Rosso ◽

Marta Tonello ◽

Roberta Lucianò ◽

Ariela Hoxha ◽

...

Keyword(s):

Antiphospholipid Syndrome ◽

Lupus Erythematosus ◽

Pregnancy Complications ◽

Intrauterine Growth Restriction ◽

Late Pregnancy ◽

Additional Treatment ◽

Growth Restriction ◽

Intrauterine Fetal Death ◽

Thrombotic Risk ◽

Intrauterine Growth

Objective.Antibodies that recognize the phosphatidylserine/prothrombin complex (antiphosphatidylserine/prothrombin antibodies; aPS/PT) might reveal enhanced thrombotic risk in patients with systemic lupus erythematosus. Little is known about their association with pregnancy complications in the antiphospholipid syndrome (APS).Methods.We enrolled 55 patients with APS who were seeking pregnancy in 2 Italian hospitals. Antiphospholipid antibodies (aPL), including anticardiolipin antibodies, anti-β2-glycoprotein I antibodies, lupus-like anticoagulant, and aPS/PT antibodies were assessed, and the patients were prospectively followed for 24 months.Results.There were 65% (36/55) of the APS patients who had aPS/PT antibodies. Forty-seven pregnancies were followed, including 33 of aPS/PT+ patients. Forty-one of the 47 patients (87%) who initiated a pregnancy eventually gave birth to a child. The pregnancy duration and the mean newborn weight at delivery were significantly lower in aPS/PT+ than in aPS/PT− patients (33.1 ± 4.7 vs 36.2 ± 3.4 wks of gestation, respectively, and 2058 ± 964 g vs 2784 ± 746 g, respectively, p < 0.05). Late pregnancy complications, including intrauterine fetal death, preterm delivery, preeclampsia, and intrauterine growth restriction (IUGR), were more frequent in aPS/PT+ patients, independent of the therapy. Titers of aPS/PT IgG were significantly inversely correlated with the neonatal weight at delivery. Vascular injury, as reflected by thrombosis, fibrinoid necrosis, ischemic and hemorrhagic areas, and presence of chorangiomas characterized the IUGR placentas in the presence of aPS/PT.Conclusion.The aPS/PT antibodies might represent markers of aPL-related pregnancy complications, IUGR/preeclampsia in particular, and could help identify beforehand patients who may require additional treatment.

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First trimester uterine artery Doppler and subsequent intrauterine growth restriction and preterm birth

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.09.085 ◽

2004 ◽

Vol 191 (6) ◽

pp. S22

Author(s):

Lorraine Dugoff ◽

John Hobbins ◽

Vincent Faber ◽

Fergal Malone ◽

Michael Belfort ◽

...

Keyword(s):

Preterm Birth ◽

Intrauterine Growth Restriction ◽

Uterine Artery ◽

First Trimester ◽

Growth Restriction ◽

Uterine Artery Doppler ◽

Intrauterine Growth

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Differential Effects of Maternal Heroin and Methadone Use on Birthweight

PEDIATRICS ◽

10.1542/peds.58.5.681 ◽

1976 ◽

Vol 58 (5) ◽

pp. 681-685

Author(s):

Stephen R. Kandall ◽

Susan Albin ◽

Joyce Lowinson ◽

Beatrice Berle ◽

Arthur I. Eidelman ◽

...

Keyword(s):

Fetal Growth ◽

Growth Retardation ◽

Intrauterine Growth Retardation ◽

Methadone Maintenance ◽

First Trimester ◽

Control Group ◽

Fetal Growth Retardation ◽

Intrauterine Growth ◽

Methadone Dosage ◽

History Of

An analysis of birthweights of 337 neonates in relation to history of maternal narcotic usage was undertaken Mean birthweight of infants born to mothers abusing heroin during the pregnancy was 2,490 gm, an effect primarily of intrauterine growth retardation. Low mean birthweight (2,615 gm) was also seen in infants born to mothers who had abused heroin only prior to this pregnancy, and mothers who had used both heroin and methadone during the pregnancy (2,535 gm). Infants born to mothers on methadone maintenance during the pregnancy had significantly higher mean birthweights (2,961 gm), but lower than the control group (3,176 gm). A highly significant relationship was observed between maternal methadone dosage in the first trimester and birthweight, i.e., the higher the dosage, the larger the infant. Heroin causes fetal growth retardation, an effect which may persist beyond the period of addiction. Methadone may promote fetal growth in a dose-related fashion after maternal use of heroin.

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Maternal Risk Factors of Placenta Praevia and Its Effects on Maternal and Fetal Outcome

Bangladesh Medical Journal ◽

10.3329/bmj.v48i2.51259 ◽

2019 ◽

Vol 48 (2) ◽

pp. 7-12

Author(s):

Alpana Adhikary ◽

Anwara Begum ◽

Fahmida Sharmin Joty ◽

Nihar Ranjan Sarker ◽

Rifat Sultana

Keyword(s):

Risk Factors ◽

Maternal Age ◽

Advanced Maternal Age ◽

Fetal Outcome ◽

Placenta Praevia ◽

Maternal Risk Factors ◽

High Parity ◽

Maternal Risk ◽

Antepartum Haemorrhage ◽

History Of

Placenta praevia is one of the most serious obstetric emergencies, which continues to be an important contributor to perinatal mortality and is responsible for leading maternal and infant morbidity. Very few data on etiology of placenta praevia are available till now. This study aims to explore the maternal risk factors related to occurrence of placenta praevia and its effects on maternal and fetal outcome. This cross-sectional observational study was carried out among 3279 obstetrics patients admitted in labour ward in the Department of Obstetrics and Gynecology, Sher-e-Bangla Medical College Hospital from January to December 2006. Out of 3279 obstetrics patients 93 placenta praevia cases were identified purposively as study subjects. The patients of placenta praevia were selected either diagnosed clinically by painless antepartum haemorrhage or asymptomatic placenta praevia diagnosed by ultrasonography irrespective of age, gestational age, parity, booking status. Pregnant woman admitted with painful antepartum haemorrhage were excluded from the study. With the ethical approval from the Institutional Ethical Committee (IEC), patients were selected after taking their written consent. A structured questionnaire and a chick list were designed with considering all the variables of interest. Out of 93 respondents, 73.88% were associated with risk factors in addition to advanced maternal age and high parity. Among them 24.73%, 33.33% and 7.52% had history of previous caesarean section (CS), MR and abortion and both CS & abortion previously. Patients aged above 30 years were 47% and 35.48% were in their 5th gravid and more; whereas, 31.18% patients were asymptomatic, 68.82% patients presented with varying degree of vaginal bleeding, among them 12.08% were in shock. Active management at presentation was done on 76.34% patients and 23.66% were managed expectantly. CS was done o 82.79% patients and only 17.2% were delivered vaginally. Case fatality rate was 1.07% and about 22% perinatal death was recorded, majority belonged to low birth weight (<1500 gm). About 10% patients required caesarean hysterectomy, 3.22% required bladder repair. Advanced maternal age, high parity, history of previous CS and abortion found to be common with the subsequent development of placenta praevia. Proper diagnosis, early referral and expectant management of patients will reduce prematurity, thereby improvised foetal outcome but to improve maternal outcome rate of primary CS have to be reduced and increase practice of contraception among women of reproductive age. Bangladesh Med J. 2019 May; 48 (2): 7-12

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Maternal and perinatal outcomes of hyperthyroidsm in pregnancy at Dr. Cipto Mangunkusumo Hospital, Jakarta, period of January 2015 - December 2016

Majalah Obstetri & Ginekologi ◽

10.20473/mog.v29i12021.36-40 ◽

2021 ◽

Vol 29 (1) ◽

pp. 36

Author(s):

Fita Maulina ◽

M Adya F F Dilmy ◽

Ali Sungkar

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Intrauterine Growth Restriction ◽

Fetal Death ◽

Perinatal Outcomes ◽

Growth Restriction ◽

Intrauterine Fetal Death ◽

Adequate Treatment ◽

Intrauterine Growth ◽

In Pregnancy

Objectives: To report maternal and perinatal outcomes of hyperthyroidsm in pregnancy.Case Report: There were 3622 cases of delivering pregnant women during the period of the study. From this number, the prevalence of pregnant women with hyperthyroid was 0.2 %. We reported 9 cases of hyperthyroid in pregnancy. The number of pregnancy complication and outcome on pregnant women with hyperthyroidism were preterm labor (44%) and preeclampsia (22%), both were found in group of mother who did taking antihyperthyroid therapy. In those who did not take antihyperthyroid therapy 11% had spontaneous abortion and 11% had preterm delivery. Fetal complications were intrauterine growth restriction (11%) and intrauterine fetal death (23%), both of these complication were on the group who did not take antihyperthyroid. On the contrary, 44% babies were born with normal birthweight in group who took antihyperthyroid.Conclusion: There were differences noted between the group that took adequate treatment and the group that did not take antihyperthyroid. The incidence of intrauterine growth restriction and intrauterine fetal death were high in group that did not took antihyperthyroid therapy but the incidence of preterm delivery as the maternal complication was high in group that did take the antihyperthyroid therapy.

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