Does Active Smoking Influence the Second Trimester Biochemical Markers Concentrations?

2017 ◽  
Vol 68 (10) ◽  
pp. 2234-2236
Author(s):  
Dan Navolan ◽  
Florin Birsasteanu ◽  
Adrian Carabineanu ◽  
Octavian Cretu ◽  
Diana Liana Badiu ◽  
...  

Cigarette smoke contains over 7000 different substances some of them exerting harmful effects on embryo and pregnant woman. Nowadays 15 % of adult people and around 10-15% of pregnant women smoke. Previous studies showed that cigarette smoke compounds could exert pharmacodinamic effects and influence some of the second trimester biochemical markers concentration. Therefore there is a need to adjust the reference values of second trimester markers depending of the smoker status. The aim of our study was to analyse which of the markers are influenced by smoking and whether the software used to calculate the risk for aneuploidies is able to counterbalance this influence. Alpha-fetoprotein (AFP), chorionic gonadotropin hormone (hCG) and free estriol (uE3) values were measured in second trimester sera of 1242 pregnant women: 1089 non-smokers and 153 smokers. Only hCG second trimester values were influenced by smoking whereas AFP and uE3 values were not. The correction of medians according to the smoking status was able to counterbalance this effect.

2018 ◽  
Vol 69 (2) ◽  
pp. 529-532
Author(s):  
Florin Szasz ◽  
Codrina Levai ◽  
Dan Navolan ◽  
Simona Farcas ◽  
Nicoleta Andreescu ◽  
...  

Fetal aneuploidies screening was based for a long time on ultrasonographic and biochemical markers measurement. The risk calculated in accordance with second trimester biochemical markers (STBM) values relies on calculation of corrected MoM values. MoM (multiple of Medians) signify the deviation of a measured value from the expected value (Median). The Median is measured at the same gestational age in pregnancies which involve healthy fetuses. The correction of MoM includes an adjustment for certain parameters that influence the STBM value: demographical (ethnicity), behavioral (smoking status, weight), and others (mode of conceiving, etc.). In our article we aim to analyze: (1) the accuracy of software to calculate STBM corrected MoM values, (2) the effect of weight of pregnant women on STBM and (3) the capability of software to counterbalance this influence. Pregnant women (n=1242) were screened for aneuploidies based on an integrated test: first trimester ultrasound and STBM (AFP, hCG and uE3). The absolute value, multiple of median (MoM) and corrected multiple of median (MoMc) values were 33.94�0.45, 1.04�0.12 and 0.98�0.01 for AFP, 22530�477, 0.87�0.01 and 0.85�0.01 for hCG, respectively 0.97�0.03, 0.99�0.01 and 0.98�0.01 for uE3. The weight of pregnant women inversely correlates with absolute and MoM AFP, hCG and uE3 values. No correlation was found with AFP and hCG MoMc values. A very weak inverse correlation was found between weight and uE3 corrected MoM values. Our study confirms that there is a difference between provider and own calculated hCG MoMc values. The weight of pregnant women inversely correlates with STBM values. The software used for aneuploidies risk evaluation corrects the influence of weight of pregnant women, but a minimal influence on uE3 corrected MoM values is still present.


2017 ◽  
Vol 68 (5) ◽  
pp. 1070-1072
Author(s):  
Dan Navolan ◽  
Mirela Nicolov ◽  
Simona Vladareanu ◽  
Ioana Ciohat ◽  
Marius Craina ◽  
...  

Screening of fetal aneuploidies in early pregnancy is a well-established method in the materno-fetal medicine. The aim of our study was to analyze if the medians recommended by the manufacturers are adequate to perform an accurate screening or if there is a need for own laboratory medians calculation in second trimester biochemical marker screening.Sera were collected between 14 wp and 22 wp from 3374 singleton pregnancies. We analyzed three second trimester biochemical markers (AFP, hCG and free Estriol) concentration in all pregnant women and in a subgroup of pregnant women in which gestational age was determined based on crown-rump length. Our results showed that for all biochemical markers the difference between the manufacturer and the own calculated median was lower than 10% excepting the hCG value in the group of pregnant women in which the gestational age was determined on basis of crown-rump-length. Our results show it is recommended to replace the values of the median for hCG measurement with the own laboratory calculated medians. This does not seem to be necessary in the case of AFP and free Estriol measurement.


2020 ◽  
Author(s):  
AYSE OZBAN

Abstract Objective: This study aims to determine whether it is possible to predict preeclampsia by comparing postpartum results and test results of the pregnant women diagnosed with preeclampsia, whose first and/or second trimester screening tests were accessible, and to demonstrate the predictability of severity and week of onset.Background: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies.Method: 135 patients were diagnosed with preeclampsia and their first and/or second trimester screening tests were accessible, and 366 control participants gave birth to a healthy baby between 37-41 weeks after standard follow-up period for pregnancy and their screening tests were also accessible.Results: The study results show that the first trimester maternal serum PAPP-A level is significantly low in preeclamptic pregnant women, and that the second trimester maternal serum AFP and hCG levels are significantly high and uE3 levels are significantly low The results also suggest that the first and second trimester Down syndrome biochemical markers can be used in preeclampsia screening.Conclusion: Among these markers, uE3 is the parameter which affects the possibility of preeclampsia the most. However, the first and second trimester Down syndrome biochemical markers are not effective in predicting the severity and onset week of preeclampsia.


2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Eva Martínez Franco ◽  
Helena Vallverdú Cartié ◽  
Montserrat Margarit Verano ◽  
José Ramón Méndez Paredes ◽  
Pere Gris Garriga ◽  
...  

Abstract The term mucocele is simply defined as the macroscopic description of an appendix that is grossly distended by intraluminal accumulation of mucoid material. Its incidence ranges from 0.2% to 0.7% of all appendectomies and during pregnancy it is even less frequent. After a mucocele diagnosis, the selection of an adequate surgical method is, in general, very important. But during pregnancy it is an even more complicated decision because of the lack of experience and evidence on elective surgical treatments in pregnant women. We present a commentary based on a case of a low-grade appendiceal mucinous neoplasm of the appendix, found on an appendectomy specimen because of a mucocele in a second trimester pregnant woman.


2020 ◽  
Vol 5 (6) ◽  
pp. 88-94
Author(s):  
N. A. Abdullaeva ◽  
◽  
V. I Cherepova ◽  
O. L. Tovazhnyanska ◽  
V. V. Lazurenko

Extragenital pathology during pregnancy and childbirth occupies a leading place in maternal mortality and perinatal pathology. One of the main ways to maintain the health of mother and child is to identify somatic diseases in pregnant women and timely treat them. Nervous system diseases that occur in pregnant women are mainly epilepsy, multiple sclerosis, brain tumors, cerebrovascular disorders, although remain poorly understood, but require immediate decisions to prolong pregnancy, obstetric tactics during childbirth, conservative or conservative surgery. The pathology of cerebral vessels (arterial aneurysms and arteriovenous malformations) also remains an urgent problem, despite many years of experience in their diagnosis and treatment. The sudden development of symptoms, severity of clinical manifestations and high mortality in rupture of an aneurysm or arteriovenous malformation of cerebral vessels determine the urgency of this problem and increased interest in its study, especially in pregnant women. Material and methods. The paper presents a clinical case of arteriovenous malformation in a 25-year-old pregnant woman, her treatment and delivery. Results and discussion. Arteriovenous malformation is considered a congenital cerebrovascular pathology, which is accompanied by a sudden rupture of abnormal vessels with the development of hemorrhagic stroke, without specific clinical symptoms and precursors, which complicates lifelong diagnosis. Endovascular embolization during pregnancy saved the lives of women and children. An effective result was obtained after neurosurgical treatment of arteriovenous malformation in a pregnant woman in the second trimester of pregnancy (17 weeks), which allowed to bring the pregnancy to the physiological time of delivery. Taking into account the complex neurological pathology, neurosurgery, which requires the exclusion of a powerful period of childbirth, a pregnant woman gave birth by cesarean section at 38 weeks of pregnancy. Conclusion. An effective result was obtained after neurosurgical treatment of arteriovenous malformation in a pregnant woman in the second trimester of pregnancy, which allowed to bring the pregnancy to the physiological time of delivery. The obtained results indicated the possibility of full-term pregnancy, reduction of maternal and perinatal morbidity and mortality in pregnant women with arteriovenous malformation with timely preventive and curative measures with timely referral of pregnant women to the perinatal center on the basis of a multidisciplinary clinical institution to prevent complications


2020 ◽  
Vol 73 (3) ◽  
pp. 494-497
Author(s):  
Tamara G. Romanenko ◽  
Olha M. Sulimenko

The aim: To reduce the frequency and severity of preeclampsia, to improve obstetrical and perinatal outcomes in women with multiple pregnancy after assisted reproduction by the development and implementation of the preventive algorithm with biochemical markers of endothelial dysfunction prospective analysis. Materials and methods: Clinical and laboratory prospective analysis of 54 cases of twins in women, treated from infertility with assisted reproductive technologies (ART), using the method of intracytoplasmic sperm injection (ICSI) and frozen embryos transfer, have been made. It was proven, that women with multiple pregnancy are always in a high risk group of placental dysfunction (PD) and preeclampsia (PE). Depending on the treatment algorithm and preventive measures, 2 groups of patients were formed. Group I included 29 pregnant women with twins, managed in accordance with developed recommendations. We didn’t find evidence-based European guidelines, that would recommend routine prescription of progesterone to improve chorion invasion and further placentation in such group of patients, but in order to prevent endothelial dysfunction and to decrease the incidence and severity of preeclampsia, placental abnormalities and intrauterine growth restriction (IUGR), we proposed the following algorithm: – micronized progesterone 200 mg vaginally (PV), as soon as pregnancy was diagnosed by positive hCG-test, till 16 weeks of pregnancy, angioprotector diosmin 600 mg once daily orally (PO), 2 courses: from 8 till 12 and from 16 till 20 weeks of gestation, antiaggregant – acetylsalicylic acid 150 mg from 12 till 36 weeks of gestation. Group II included 25 pregnant women with twins after the same ART procedures, who have not received above mentioned treatment. Plasma concentrations of PlGF, sFlt-1 and the ratio of sFlt-1/PlGF in the second trimester were investigated in both groups of women in order to assess the effectiveness of proposed preventive measures. Results: Usage of preventive algorithm has shown the reduction of PE incidences in 26%, PD in 28.1%, IUGR in 35%, prematurity by 23% and fetal distress in 18%, that led to improvement of obstetrical and perinatal outcomes in I group of women with multiple pregnancies after ART-treated infertility, compared with group II (p<0.05). The evaluation of PlGF, sFlt-1 plasma concentrations and the ratio of sFlt-1/PlGF in the second trimester of pregnancy reflected the effectiveness of our method in women with twins after ART. The level of PlGF in the study group was higher (186.5 ± 12 vs 154.2 ± 10.7; p<0.05), and the level of sFlt-1 was lower (1523.1 ± 40.3 vs 1835.3 ± 33.6; p <0.05). Results of sFlt-1/PlGF ratio analysis in the I group also showed effectiveness of the method proposed (20.3 ± 3.1 vs 28.1 ± 2.2; p<0.05). Conclusions: The observed results suggest, that pregnant women with twins after ART-treated infertility are in a high-risk group of PE, PD and IUGR of one or both fetuses. Implementation of the proposed preventive algorithm allows to reduce the incidence of PE, obstetrical and perinatal complications in this group of patients, and can be widely used in clinical practice. Evaluation and prospective assessment of biochemical markers, such as PlGF, sFlt-1 and sFlt-1/PIGF ratio, in the second trimester of pregnancy in the target groups may likely predict the development of PE and its severity.


2019 ◽  
Vol 20 (-1) ◽  
pp. 98-98
Author(s):  
Dursun Erol Afsin ◽  
◽  
Bugra Kerget ◽  
Elif Yilmazel Ucar ◽  
Leyla Saglam ◽  
...  

2019 ◽  
Vol 1 (1) ◽  
pp. 28-38
Author(s):  
Paulena Fao Lei ◽  
Emma Krisyudhanti ◽  
Christina Ngadilah ◽  
Applonia Leo Obi

Abstract: Dental Caries Status, Status of Dental and Oral Hygiene and Gingivitis Status of Pregnant Women Trimester I and II. Pregnancy is an event that is often encountered in a woman's life because pregnant women are one group that is vulnerable to dental and oral diseases. The purpose of this study: to determine the status of dental caries, the status of dental and oral hygiene, and the status of gingivitis for first and second-trimester pregnant women in Tarus Health Center, Kupang Regency. The research method used is descriptive. sampling with an accidental sampling technique totaling 73 pregnant women who came to the health center Tarus. The results of the study in the first trimester - the average pregnant woman experienced 4 carious teeth included in the medium category, and the second trimester the average pregnant woman had 4 carious teeth including the moderate category. The level of dental and oral hygiene of trimester I and II pregnant women includes moderate criteria with an average of 2.2, the status of gingivitis for first-trimester pregnant women (38.7%) who have moderate gingivitis, and trimester II has mild gingivitis (45, 2%). the frequency of brushing teeth twice a day but the time used is still not right and the average pregnant woman never uses dental floss. While gargling habits use more cold water, and for a balanced diet consume more acidic foods and pregnant women trimester I and II control the health of their teeth and mouth only when sick. It was concluded that the dental caries status of pregnant women trimester I and II included in the moderate category, the status of dental and oral hygiene criteria of moderate and gingivitis status of pregnant women for trimester I including moderate inflammation and trimester II mild inflammation, and maintenance of dental and oral health of pregnant women was not optimal because there are still many pregnant women who ignore oral and dental hygiene. Abstrak: Status Karies Gigi, Status Kebersihan Gigi dan Mulut dan Status Gingivitis Ibu Hamil Trimester I dan II. Kehamilan merupakan suatu peristiwa yang sering di jumpai dalam kehidupan seorang wanita, sebab wanita hamil merupakan salah satu kelompok yang rentan terhadap penyakit gigi dan mulut. Tujuan penelitian : untuk mengetahui status karies gigi, status kebersihan gigi dan mulut  dan status gingivitis ibu hamil trimester I dan II di Puskesmas Tarus Kabupaten Kupang. Metode penelitian yang digunakan adalah deskriptif. pengambilan sampel dengan teknik accidental sampling berjumlah 73 ibu hamil yang datang di Puskesmas Tarus. Hasil penelitian pada trimester I rata – rata ibu hamil mengalami 4 gigi berkaries termasuk kategori sedang, dan trimester II rata – rata ibu hamil mengalami 4 gigi berkaries termasuk kategori sedang. Tingkat kebersihan gigi dan mulut ibu hamil trimester I dan II termasuk kriteria sedang dengan rata – rata 2,2, status gingivitis ibu hamil trimester I sebanyak (38,7%) yang mengalami gingivitis sedang, dan trimester II mengalami gingivitis ringan sebanyak (45,2%). frekuensi menyikat gigi 2 kali sehari tetapi waktu yang digunakan masih belum tepat dan rata – rata ibu hamil tidak pernah menggunakan benang gigi. Sedangkan kebiasaan berkumur lebih banyak menggunakan air dingin, dan untuk diet seimbang lebih banyak mengkonsumsi makanan yang bersifat asam dan ibu hamil trimester I dan II mengontrol kesehatan gigi dan mulutnya hanya ketika sakit. Disimpulkan bahwa status karies gigi ibu hamil trimester I dan II termasuk kategori sedang, status kebersihan gigi dan mulut kriteria sedang dan status gingivitis ibu hamil untuk trimester I termasuk inflamasi sedang dan trimester II inflamasi ringan, serta pemeliharaan kesehatan gigi dan mulut ibu hamil belum maksimal karena masih banyak ibu hamil yang mengabaikan kebersihan gigi dan mulut.


2020 ◽  
pp. 41-53
Author(s):  
E. N. Nenashkina ◽  
Yu. P. Potekhina ◽  
E. S. Tregubova ◽  
V. O. Belash

Introduction. Changes occuring in a woman′s organism during pregnancy are genetically programmed and have a physiological adaptive character. The range of these changes affect all organism systems and is caused by the need to sustain the mother and the fetus; and the changes severity is causedby gestational age, number of fetuses and individual reserve possibilities of the motherorganism. The development of pregnancy is accompanied by a number of regular structural and functional changes in the woman′s organism, which in turn can serve as a background or cause for the formation of somatic dysfunctions, the level of manifestation and severity of which depend on the compensatory capabilities of the female organism.The goal of research was to study the occurrence frequency of somatic dysfunction in pregnant women at different stages of pregnancy and to compare it with anatomical and physiological changes in the woman′s organism.Materials and methods. It was examined 162 healthy pregnant women aged 25 to 45 years, with a gestation period of 7 to 37 weeks. The average age was 33±2,1 year, the proportion of the first-time mothers was 62 %. The distribution of women by trimester of pregnancy was as follows: I trimester — 42 people, II trimester — 60 people, III trimester — 60 people. There were no statistically significant differences in the age of the subjects in these three groups (p>0,05). The study lasted from February 2019 to March 2020. Each patient was examined by an osteopath during the initial treatment.Results. A statistically significant increase in the incidence of somatic dysfunctions (SD) of the thoracic region (p<0,05) and the pelvic region (p<0,001) was found from the first to the third trimester of pregnancy. SD of the lumbar region appeared only in the second trimester, and in the third trimester the occurrence frequency of these SD has not changed. It is these three regions that experience the most pronounced structural and functional changes, which are increasing with the pregnancy development. The most significant changes occur in the pelvic region, both in its structural component (bones, joints, muscles, ligaments) and in the visceral component (growing uterus). In addition, the most significant changes in blood and lymph circulation occur in the pelvic region. According to our observations, somatic dysfunctions of the pelvic region occurred in 7,1 % of the examined patients in the first trimester, in 25 % — in the second trimester, and in 63,3 % — in the third trimester. Among local SD, there is a statistically significant increase in the occurrence frequency of SD of the thoracic diaphragm, the pubic joint and impaired mobility of the uterus (p<0,01) with an increase in the duration of pregnancy, which is natural. As the size of the uterus increases, there is a decrease in the mobility of the thoracic diaphragm, which is most pronounced in the 3rd trimester. The pubic joint undergoes increasing stress and structural and functional restructuring as pregnancy progresses. There was a statistically significant difference (p<0,01) in the representation of dominant somatic dysfunctions depending on the duration of pregnancy, the predominance in the 3rd trimester of pregnancy in most women (63,3 %) of the dominant SD of the pelvic region.Conclusion. The functional changes occurring in the body of a pregnant woman have not only specific characteristics associated with the period of pregnancy, but also serve as a background condition that predisposes to the formation of specific somatic dysfunctions. As pregnancy progresses, the somatic dysfunctions of the pelvic and thoracic regions come to the fore; these SD are most likely associated with changes in the postural balance of a pregnant woman, due to changes in anatomically-topographic relationships due to the growth of the pregnant uterus. 


2018 ◽  
Vol 69 (3) ◽  
pp. 674-677
Author(s):  
Irina Negru ◽  
Delia Hinganu ◽  
Marius Valeriu Hinganu ◽  
Catalin Pricop ◽  
Virgil Bulimar ◽  
...  

Ureterohydronephrosis is a urological disease that can affect pregnant women in any trimester, but it also occur physiologically in the second trimester. The study included a group of 119 pregnant women diagnosed with ureterohydronephrosis. The diagnostic difficulties of the urological pathology in pregnancy are outweighed by the contribution of the biochemical assessment of patients, correlated with non-invasive imaging investigations. The results of the study highlight the peculiarities of these investigations in this group of patients and the possibilities of differential diagnosis.


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