scholarly journals Microbial pathogens in urogenital infection in pregnant women

2019 ◽  
pp. 13-20
Author(s):  
A. V. Karaulov ◽  
M. S. Afanasiev ◽  
Yu. V. Nesvizhsky ◽  
S. S. Afanasiev ◽  
E. A. Voropaeva ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Pregnancy Termination ◽  
Clinical Manifestations ◽  
Microbial Pathogens ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cervical Canal ◽  
Type I ◽  
Urogenital Infection ◽  
In Pregnancy

Introduction. Chronic and latent infections are often activated during pregnancy.Aim - to asses the pathogenetic role of microbial pathogens in urogenital tract infection (UTI) in pregnant women.Materials and methods. 89 pregnant women underwent general clinical examination, examination of smears from urethra, vagina, cervical canal; bacteriological analysis of vaginal contents; enzyme-linked immunosorbent assay, polymerase chain reaction and determination of specific antibodies for verification of herpes simplex virus (HSV) type I and II, cytomegalovirus (CMV), Epstein-Barr (EBV) and UTI pathogens in pregnant women in blood and mucosal scrapes.Results. Prevalence of Herpesviridae was revealed (90-100% -EBV, HSV type I and II, CMV); in 41% of cases - bacterial pathogens, in 57% of cases - Mycoplasma, Ureaplasma.Discussion. In preterm birth and pregnancy termination mycoplasma and ureaplasma were more often revealed, and in pregnancy termination - association of HSV type I and II in comparison with urgent birth; in the last equally often - HSV type I and association of HSV type I and II; in urgent birth (infection) more often - HSV type I, than association of HSV type I and II; in preterm birth more often - HSV type I, than the association of HSV types I and II, and less often than combination of HSV type I and association of HSV types I and II in pregnancy termination; in the last, the association of HSV types I and II is more common than HSV type I. Increase of TLRs genes expression levels depends on HSV type I less than from association of HSV types I and II, less than from combination of HSV type I and association of HSV types I and II (it determines the clinical manifestations of genital herpes).Conclusion. Microbial pathogens determine the character of pregnancy course, and HSV types I and II- are the triggers of the infectious process, prognosing its course.

DISCRIMINANT ANALYSIS IN ESTABLISHING THE RELATIONSHIP OF PATHOGENETIC MECHANISMS OF GESTATIONAL COMPLICATIONS IN UROGENITAL INFECTION IN PREGNANT WOMEN

2020 ◽  
Vol 65 (7) ◽  
pp. 443-453
Author(s):  
A. V. Karaulov ◽  
S. S. Afanasiev ◽  
A. M. Zatevalov ◽  
Yu. V. Nesvizhsky ◽  
E. A. Voropaeva ◽  
...  
Keyword(s):  
Herpes Simplex ◽  
Pregnant Women ◽  
Mucosal Immunity ◽  
Mutual Influence ◽  
Pregnancy Termination ◽  
Clinical Manifestations ◽  
Type I ◽  
Infectious Process ◽  
Urogenital Infection ◽  
Simplex Virus

The aim of the work - to establish the interconnection and interdependence of toll-like mediated pathogenetic mechanisms of urogenital infection in pregnant women from the position of epigenomics. Using discriminant analysis in 89 patients with urogenital infection in pregnant women for the first time was established a reliable evidence-based relationship and interdependence between mucosal immunity, the severity of the infectious process, clinical manifestations, symptoms of miscarriage in the background of simultaneous development of the infectious process and pregnancy. For urgent delivery (infection), urgent childbirth (infection and clinical manifestation) and premature birth, mucosal immunity determines the severity of anti-infective resistance (with increasing mucosal immunity oppression of infectious process and clinical manifestations is logged , and its decrease increases the severity of infection process and clinical manifestations); the inhibition of mucosal immunity prevails over its hyperreaction (inhibition of mucosal immunity is determined by the physiological immunodepression in response to the development of pregnancy, as well as in response to herpes virus infection when activated); the severity of the infectious process depends on the severity of clinical manifestations and symptoms of miscarriage. During miscarriage mucosal immunity provides the pathophysiological course of infectious process and the clinical manifestations and development of symptoms of misacrriage; increasing levels of mucosal immunity to hyperreaction contributes to the development of symptoms of abortion and miscarriage; not registered mutual influence of oppression, mucosal immunity and its hyperreaction; the severity of the infectious process does not depend on the severity of clinical signs and symptoms of miscarriage. In urgent childbirth (infection), the oppression of mucosal immunity does not affect the severity of clinical manifestations, symptoms of abortion and the infectious process. In urgent or premature birth, and termination of pregnancy, the oppression of mucosal immunity affects the severity of clinical manifestations, the severity of the infectious process and the symptoms of abortion; the severity of clinical manifestations and the severity of the symptoms of abortion are interrelated. In urgent birth (infection) mucosal immunity overreaction affects the severity of clinical manifestations, symptoms of miscarriage and infection; in case of term and preterm labour overreaction mucosal immunity on the severity of infection and symptoms of abortion and does not affect the severity of clinical manifestations and at the termination of a pregnancy mucosal immunity on the severity of the infectious process and does not affect the severity of clinical signs and symptoms of abortion. The levels of mucosal immunity inhibition, its hyperreaction, clinical manifestations, symptoms of pregnancy termination and the severity of the infectious process do not depend on the type of herpes simplex virus. In the absence of infection with herpes simplex virus in patients with urogenital infections of pregnant women, there is no mutual influence and the relationship between the oppression of mucosal immunity and hyperreaction of mucosal immunity, the oppression of mucosal immunity prevails over its hyperreaction. With increasing mucosal immunity oppression, increased anti-infectious resistance of the body (the decreased activity of the infectious process), and with its decrease decreased (increased activity of the infectious process). Hyperreaction of mucosal immunity influenced the severity of pregnancy termination symptoms, clinical manifestations and infectious process, and also determined the severity of pregnancy termination symptoms. The severity of the infectious process and clinical manifestations influenced the symptoms of abortion. The severity of the infectious process did not affect the clinical manifestations. During infection with herpes simplex virus type I or type I and II on the background prevalence of oppression mucosal immunity over hyperreaction mucosal immunity, the presence of relationships between them, and the impact of mucosal immunity on the severity of the infectious process and the clinical manifestations increase mucosal immunity has been shown to decrease the severity of infection and clinical manifestations (reduction of anti-infective resistance), while reducing mucosal immunity the severity of infection and clinical manifestations increased. Hyperreaction of mucosal immunity influenced the severity of pregnancy termination symptoms and determined the severity of pregnancy termination symptoms. The severity of the infectious process and clinical manifestations influenced the symptoms of abortion. The severity of clinical manifestations reflects the severity of the infectious process. In type I and type II of pregnancy, the level of mucosal immunity determines the anti-infectious resistance of the body in urogenital infection of pregnant women. Inhibition of mucosal immunity and its hyperreactions are interrelated, have an impact on each other, as a result of their integral interaction, increasing the levels of mucosal immunity leads to a decrease in the severity of clinical manifestations and the infectious process, reducing the levels of mucosal immunity contributes to the manifestation of clinical manifestations, as well as increasing the severity of the infectious process. Hyperreaction of mucosal immunity affects the severity of symptoms of abortion, infection and clinical manifestations. The infectious process and clinical manifestations determine the severity of the symptoms of abortion. In type III and type IV of pregnancy course, there is no mutual influence of mucosal immunity oppression and its hyperreaction. The levels of indicators of mucosal immunity oppression and its hyperreaction are interrelated; the increase in the severity of mucosal immunity oppression is accompanied by a decrease in clinical manifestations and severity of the infectious process and vice versa. Hyperreaction of mucosal immunity affects the severity of symptoms of abortion, infection and clinical manifestations. The infectious process determines the severity of the symptoms of abortion and clinical manifestations, acting as a leading component of gestational complications in urogenital infection of pregnant women. In the III type of pregnancy course oppression of mucosal immunity does not affect the severity of symptoms of miscarriage. In the IV type of pregnancy course, the levels of mucosal immunity oppression prevail over the indicators of mucosal immunity hyperreaction, which is due to the integral interaction of physiological inhibition of immunological reactivity of the organism in response to pregnancy and inhibition of immunological reactivity of the organism, accompanying the activation of infectious process of viral genesis. Hyperreaction of mucosal immunity determines the symptoms of abortion.

scholarly journals Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m3320 ◽  
Author(s):  
John Allotey ◽  
Elena Stallings ◽  
Mercedes Bonet ◽  
Magnus Yap ◽  
Shaunak Chatterjee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intensive Care ◽  
Preterm Birth ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
In Pregnancy

Abstract Objective To determine the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed coronavirus disease 2019 (covid-19). Design Living systematic review and meta-analysis. Data sources Medline, Embase, Cochrane database, WHO COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 26 June 2020, along with preprint servers, social media, and reference lists. Study selection Cohort studies reporting the rates, clinical manifestations (symptoms, laboratory and radiological findings), risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed covid-19. Data extraction At least two researchers independently extracted the data and assessed study quality. Random effects meta-analysis was performed, with estimates pooled as odds ratios and proportions with 95% confidence intervals. All analyses will be updated regularly. Results 77 studies were included. Overall, 10% (95% confidence interval 7% to14%; 28 studies, 11 432 women) of pregnant and recently pregnant women attending or admitted to hospital for any reason were diagnosed as having suspected or confirmed covid-19. The most common clinical manifestations of covid-19 in pregnancy were fever (40%) and cough (39%). Compared with non-pregnant women of reproductive age, pregnant and recently pregnant women with covid-19 were less likely to report symptoms of fever (odds ratio 0.43, 95% confidence interval 0.22 to 0.85; I 2 =74%; 5 studies; 80 521 women) and myalgia (0.48, 0.45 to 0.51; I 2 =0%; 3 studies; 80 409 women) and were more likely to need admission to an intensive care unit (1.62, 1.33 to 1.96; I 2 =0%) and invasive ventilation (1.88, 1.36 to 2.60; I 2 =0%; 4 studies, 91 606 women). 73 pregnant women (0.1%, 26 studies, 11 580 women) with confirmed covid-19 died from any cause. Increased maternal age (1.78, 1.25 to 2.55; I 2 =9%; 4 studies; 1058 women), high body mass index (2.38, 1.67 to 3.39; I 2 =0%; 3 studies; 877 women), chronic hypertension (2.0, 1.14 to 3.48; I 2 =0%; 2 studies; 858 women), and pre-existing diabetes (2.51, 1.31 to 4.80; I 2 =12%; 2 studies; 858 women) were associated with severe covid-19 in pregnancy. Pre-existing maternal comorbidity was a risk factor for admission to an intensive care unit (4.21, 1.06 to 16.72; I 2 =0%; 2 studies; 320 women) and invasive ventilation (4.48, 1.40 to 14.37; I 2 =0%; 2 studies; 313 women). Spontaneous preterm birth rate was 6% (95% confidence interval 3% to 9%; I 2 =55%; 10 studies; 870 women) in women with covid-19. The odds of any preterm birth (3.01, 95% confidence interval 1.16 to 7.85; I 2 =1%; 2 studies; 339 women) was high in pregnant women with covid-19 compared with those without the disease. A quarter of all neonates born to mothers with covid-19 were admitted to the neonatal unit (25%) and were at increased risk of admission (odds ratio 3.13, 95% confidence interval 2.05 to 4.78, I 2 =not estimable; 1 study, 1121 neonates) than those born to mothers without covid-19. Conclusion Pregnant and recently pregnant women are less likely to manifest covid-19 related symptoms of fever and myalgia than non-pregnant women of reproductive age and are potentially more likely to need intensive care treatment for covid-19. Pre-existing comorbidities, high maternal age, and high body mass index seem to be risk factors for severe covid-19. Preterm birth rates are high in pregnant women with covid-19 than in pregnant women without the disease. Systematic review registration PROSPERO CRD42020178076. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

Vitamins for the First 1000 Days: Preparing for Life

2012 ◽  
Vol 82 (5) ◽  
pp. 342-347 ◽  
Author(s):  
Ibrahim Elmadfa ◽  
Alexa L. Meyer
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Young Children ◽  
Pregnant Women ◽  
Bone Mineralization ◽  
Type I ◽  
Lactation Performance ◽  
Balanced Diet ◽  
Diabetes Mellitus Type I ◽  
In Pregnancy

Vitamins are essential nutrients for many body functions and particularly important during growth. Adequate supply in pregnancy and in early infancy is therefore crucial, but there is still a lack of knowledge about the needed amounts of vitamins of children older than six months and also during pregnancy. Recommendations for intake levels are generally derived by extrapolation from data for infants based in turn on the contents in breast milk and those for adults. A vitamin of particular importance in pregnancy is folic acid due to its role in the development of the brain and nerve system and the prevention of fetal neural tube defects (NTD). Mandatory fortification of flour and certain other grain products in many countries has been associated with a reduction in NTD incidence. However, other deficiencies or suboptimal status of B vitamins, especially B6 and B12 have been repeatedly reported in pregnant women also in high-income countries. Vitamin A is one of the three most critical micronutrients globally and pregnant women and young children are especially vulnerable to deficiencies. Night blindness, anemia, and immunodeficiency are major consequences of inadequate supply in these populations. Much attention has recently been accorded vitamin D that is also critical in pregnant women and young children for instance because of its involvement in bone mineralization but also its more recently discovered immune-modulating function that is thought to prevent development of autoimmune diseases like diabetes mellitus type I. A healthy balanced diet provides the best basis for optimal pregnancy outcome, lactation performance, and complementary feeding. However, supplements or fortified foods may be needed to cover the high requirements especially of critical vitamins such as vitamin D and folic acid and to correct unfavorable dietary patterns in women or to adapt foods to the needs of young children.

scholarly journals PENINGKATAN KESEHATAN PERIODONTAL IBU HAMIL DALAM UPAYA MENGURANGI RESIKO BAYI DENGAN BERAT BADAN LAHIR RENDAH

2020 ◽  
Vol 4 (2) ◽  
pp. 275
Author(s):  
I KOMANG EVAN WIJAKSANA ◽  
Lambang Bargowo ◽  
Shafira Kurnia Supandi
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Community Service ◽  
Periodontal Diseases ◽  
Oral Care ◽  
Pregnancy Rates ◽  
Dental Visit ◽  
Periodontal Tissue ◽  
Knowledge And Skills ◽  
In Pregnancy

During the Covid-19 pandemic, there was an increase in pregnancy rates in East Java. Besides efforts to suppress pregnancy rates, it is also necessary to ensure the health of the mother and fetus in order to be born healthy. The prevalence of periodontal diseases in pregnant women is high, while the dental visit of pregnant women is low. Periodontal disease is one of the risk factors of preterm birth as well as low-birth-weight (LBW) infants. In this community service, socialization held through lecture methods, QnA, discussion and self-practice procedures to maintain oral health procedures. The goal is to improve pregnant women's knowledge of the importance of dental and oral care, especially periodontal tissue during pregnancy and enhance skills of pregnant women in detecting early symptoms of periodontal diseases and to perform oral dental care independently at home. The knowledge and skills of pregnant women can be improved during this community service. By healthy periodontal tissue and teeth, it is expected that the risk of LBW infants and also preterm birth can be decreased.abstrakSelama masa pandemi Covid-19, terjadi peningkatan tingkat kehamilan di Jawa Timur. Selain usaha menekan tingkat kehamilan, perlu juga dipastikan kesehatan ibu dan janin agar lahir dengan sehat. Prevalensi kelainan periodontal pada ibu hamil tinggi sementara kunjungan ibu hamil ke dokter gigi rendah. Penyakit periodontal merupakan salah satu faktor resiko bayi lahir prematur dan juga berat badan lahir rendah (BBLR). Dalam pengabdian masyarakat ini dilakukan sosialisasi melalui metode ceramah, tanya jawab, diskusi dan praktek mandiri prosedur menjaga kesehatan rongga mulut. Tujuannya adalah meningkatkan pengetahuan ibu hamil mengenai pentingnya perawatan gigi dan mulut khususnya jaringan periodontal selama kehamilan dan meningkatnya ketrampilan ibu hamil dalam mendeteksi gejala awal kelainan periodontal dan cara melakukan perawatan gigi mulut mandiri di rumah. Pada pengabdian masyarakat ini pengetahuan dan ketrampilan ibu hamil dapat ditingkatkan. dengan jaringan periodontal dan gigi serta rongga mulut yang sehat, diharapkan resiko BBLR maupun kelahiran prematur dapat diturunkan.

RELATIONSHIP OF MATERNAL VITAMIN B12 STATUS IN PREGNANCY WITH PRETERM BIRTH AND MATERNAL HEALTH RISKS

2020 ◽  
pp. 32-38
Author(s):  
VICTORIA LAZAROVA SPASOVA ◽  
LILIA IVANOVA KOLEVA ◽  
MARIETA ANTONOVA POPOVA ◽  
VALENTINA BOYANOVA PETKOVA ◽  
MILEN VENTZISLAVOV DIMITROV
Keyword(s):  
Preterm Birth ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Inverse Association ◽  
Maternal Vitamin ◽  
B12 Deficiency ◽  
The Impact ◽  
In Pregnancy

Vitamin B12 is known to be vital for cell growth and population during pregnancy. This retrospective and prospective case−control study was aimed to disclose a health risk for pregnant women with vitamin B12 deficiency, as well as the one of the preterm birth. The main tasks set and performed in this research were as follows: to compare the obstetrics anamnesis between the women who gave birth on term and women who gave birth before term; to find the prevalence of vitamin B12 insufficiency in pregnancy; to determine its association with preterm birth and low birth weight; to examine its association with spontaneous abortions, and to investigate its relationship with obesity and hemoglobin levels in pregnant women. The conducted investigation involved 107 women who gave birth before the 37th week of gestation and 101 women who gave birth after the 37th week of gestation at the outpatient clinic of the University Hospital "Maichin Dom" in Bulgaria. Our study revealed a correlation between maternal vitamin B12 deficiency, overweight and low hemoglobin level. Our results showed no significant correlation between serum vitamin B12 level and the risk of preterm birth. However, we found an inverse association between vitamin B12 level and overweight before pregnancy and at the time of giving birth. As well there was confirmed the strong connection between meat consumption and vitamin B12 level. The paper emphasizes that the deficiency of the vitamin occurs most likely in the women with inadequate diets. Such a deficiency is actually confirmed to have serious health consequences for pregnant women and their offspring. Therefore further profound and numerous studies should be performed to properly assess the correlation between vitamin B12 and preterm birth, as well as to understand better the impact of vitamin B12 over pregnant women. Key words: vitamin B12, preterm birth, pregnancy, overweight, hemoglobin.

Angiogenin and Hemoxygenase in Pregnancy

Angiology ◽  
2011 ◽  
Vol 63 (3) ◽  
pp. 194-198 ◽  
Author(s):  
Velore J. Karthikeyan ◽  
Gregory Y. H. Lip ◽  
Sabah Baghdadi ◽  
Deirdre A. Lane ◽  
D. Gareth Beevers ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Endothelial Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cell Physiology ◽  
Vascular Endothelial ◽  
Abnormal Growth ◽  
Von Willebrand ◽  
Endothelial Growth Factor ◽  
Willebrand Factor ◽  
In Pregnancy

The pathophysiology of hypertension and preeclampsia involves angiogenesis and endothelial damage/dysfunction, as shown by abnormal growth factors (vascular endothelial growth factor [VEGF], and its receptor sFlt-1) and von Willebrand factor (vWf) in the plasma. Angiogenin and hemoxygenase are abnormal in hypertension and angiogenesis but data on pregnancy are scant. We hypothesized altered angiogenin and hemoxygenase in 38 hypertensive pregnant women (HTPW) compared to 38 normotensive pregnant women (NTPW) and 50 nonpregnant controls (NonPCs). Plasma markers were measured by enzyme-linked immunosorbent assay (ELISA). Hypertensive pregnant women had lower VEGF than NonPCs ( P < .01), vWf was raised in both pregnant groups ( P < .01), but sFlt-1 was no different. Both angiogenin and hemoxygenase were lower in NTPW compared to NonPCs (both p<0.02). In both pregnancy groups, angiogenin correlated with vWf ( r > .33, P < .05), but in NonPCs this was not significant ( r = .13, P = .367). These changes may reflect differences in endothelial cell physiology and pathology in the hypertension in pregnancy.

scholarly journals Type I Arnold-Chiari malformation with bronchiectasis, respiratory failure, and sleep disordered breathing: a case report

2013 ◽  
Vol 8 ◽  
Author(s):  
Raffaele Campisi ◽  
Nicola Ciancio ◽  
Laura Bivona ◽  
Annalisa Di Maria ◽  
Giuseppe Di Maria
Keyword(s):  
Respiratory Failure ◽  
Chiari Malformation ◽  
Sleep Disordered Breathing ◽  
Clinical Manifestations ◽  
Low Flow ◽  
Cervical Canal ◽  
Type I ◽  
Arnold Chiari Malformation ◽  
Pulmonary Manifestations ◽  
Disordered Breathing

Arnold Chiari Malformation (ACM) is defined as a condition where part of the cerebellar tissue herniates into the cervical canal toward the medulla and spinal cord resulting in a number of clinical manifestations. Type I ACM consists of variable displacement of the medulla throughout the formamen magnum into the cervical canal, with prominent cerebellar herniation. Type I ACM is characterized by symptoms related to the compression of craniovertebral junction, including ataxia, dysphagia, nistagmus, headache, dizziness, and sleep disordered breathing. We report a case of a life-long nonsmoker, 54 years old woman who presented these symptoms associated with bronchiectasis secondary to recurrent inhalation pneumonia, hypercapnic respiratory failure, and central sleep apnea (CSA). CSA was first unsuccessfully treated with nocturnal c-PAP. The subsequent treatment with low flow oxygen led to breathing pattern stabilization with resolution of CSA and related clinical symptoms during sleep. We suggest that in patients with type I ACM the presence of pulmonary manifestations aggravating other respiratory disturbances including sleep disordered breathing (SDB) should be actively investigated. The early diagnosis is desirable in order to avoid serious and/or poorly reversible damages.

scholarly journals Drug-induced cytolytic syndrome in pregnancy: clinical and biochemical diagnostic criteria

2016 ◽  
Vol 65 (6) ◽  
pp. 28-35
Author(s):  
Irina V Borisova
Keyword(s):  
Pregnant Women ◽  
Hormone Therapy ◽  
Clinical Manifestations ◽  
First Trimester ◽  
Gamma Glutamyl Transpeptidase ◽  
Drug Induced ◽  
Planning Stage ◽  
Protein Levels ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

The aim of the study was evaluation of clinical and laboratory manifestations of drug-induced cytolytic syndrome in pregnancy. In the research group included 62 pregnant women with drug-induced liver injury (DILI) in the first trimester of pregnancy. These pregnant women received hormone therapy at the planning stage and/or during pregnancy for the prevention and treatment of miscarriage and had clinical and biochemical manifestations of cytolytic syndrome. Pregnancy after IVF and ovulation induction was in 60.8% of cases. Hormone therapy for pregnant patients received long-term, 85% of pregnant women used estrogen and progestin drugs. DILI during pregnancy characterized by low-symptom or asymptomatic clinical manifestations. DILI manifested cytolytic biochemical syndrome, in which there is isolated increase of transaminase levels, in some cases accompanied by increased level of gamma glutamyl transpeptidase, liver glutamate dehydrogenase and decreased total protein levels, in the first place due to the albumin fraction.

scholarly journals A Study on Fundus changes in Pregnancy-induced hypertension: A Four-year Observation

2021 ◽  
Vol 4 (2) ◽  
pp. 162
Author(s):  
Elluru Pandu Rangaiah ◽  
Madhavi Latha Gangisetty ◽  
Sandhya K ◽  
Latha A ◽  
Meena Syed
Keyword(s):  
Pregnant Women ◽  
Pregnancy Termination ◽  
Renal Diseases ◽  
Hypertensive Retinopathy ◽  
Pregnancy Induced Hypertension ◽  
Important Indicator ◽  
Positive Correlation ◽  
Induced Hypertension ◽  
Changes In Pregnancy ◽  
In Pregnancy

Introduction: Hypertensive disorders complicate 5-10% in all pregnant and together form the deadly triad and hemorrhage and heart disease that contribute greatly to maternal morbidity or mortality. This study aims to identify retinal changes in pregnancy-induced hypertension and analyze the association between retinal changes and hypertension severity. Method: A total of 100 pregnant admitted with pregnancy-induced hypertension(PIH) were included. Patients with pre-existing hypertension, diabetes mellitus, and renal diseases were excluded from the study. The vision, anterior segment, and Fundus were examined. Result: Higher number of PIH were recorded in the 21-30 years age group. Fifty-four pregnant women suffered from mild preeclampsia, 40 pregnant women with severe preeclampsia, and six pregnant women with eclampsia with seizures. 41% of pregnant had normal fundus, and 24% of pregnant had hypertensive retinopathy. Whereas grade 2,3, and 4 retinopathy was observed in 22%, 6%, and 2% of pregnant women. Two percent of pregnants had macular edema, and 3% had central serous retinopathy. No association was observed between the fundus findings with age/gravida. Whereas a significant positive correlation was observed between the fundus findings and hypertension severity (P < 0.001). Conclusion: Overall, 54% of pregnants were recorded with hypertensive retinopathy. A positive correlation was observed between fundus changes with the hypertension severity. This study reports the importance of routine fundus examination in pregnant with hypertension. Retinal change during pregnancy is an important indicator to decide the pregnancy termination or any other opt.

scholarly journals 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 ◽  
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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