Is there a Need for Own Median Calculation in the Second Trimester Biochemical Markers Screening?

2017 ◽  
Vol 68 (5) ◽  
pp. 1070-1072
Author(s):  
Dan Navolan ◽  
Mirela Nicolov ◽  
Simona Vladareanu ◽  
Ioana Ciohat ◽  
Marius Craina ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Biochemical Markers ◽  
Biochemical Marker ◽  
Second Trimester ◽  
Established Method ◽  
Crown Rump Length ◽  
The Difference ◽  
Fetal Aneuploidies ◽  
Singleton Pregnancies

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.

Weight of Pregnant Women and their Influence on Second Trimester Biochemical Markers

2018 ◽  
Vol 69 (2) ◽  
pp. 529-532
Author(s):  
Florin Szasz ◽  
Codrina Levai ◽  
Dan Navolan ◽  
Simona Farcas ◽  
Nicoleta Andreescu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Biochemical Markers ◽  
Smoking Status ◽  
Inverse Correlation ◽  
First Trimester ◽  
Second Trimester ◽  
Absolute Value ◽  
Long Time ◽  
Fetal Aneuploidies ◽  
First Trimester Ultrasound

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.

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 ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Cigarette Smoke ◽  
Chorionic Gonadotropin ◽  
Reference Values ◽  
Biochemical Markers ◽  
Smoking Status ◽  
Active Smoking ◽  
Second Trimester ◽  
Harmful Effects

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.

scholarly journals Evaluation of prenatal changes in fetal cardiac morphology and function in maternal diabetes mellitus using a novel fetal speckle-tracking analysis: a prospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong Wang ◽  
Caixia Liu ◽  
Xinyu Liu ◽  
Ying Zhang ◽  
Yu Wang
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Pregnant Women ◽  
Gestational Age ◽  
Speckle Tracking ◽  
Control Group ◽  
Second Trimester ◽  
Cardiac Morphology ◽  
Sphericity Index ◽  
And Function

Abstract Background Due to metabolic changes in the second trimester and the increasing number of pregnant women with obesity and advanced maternal age, the incidence of gestational diabetes mellitus (GDM) remains high. This study aimed to evaluate the effects of GDM on fetal cardiac morphology and function, and to determine whether these changes increase with increasing estimated fetal weight (EFW). Methods Fifty-eight women with GDM (GDM group) and 58 women with a healthy pregnancy (control group) were included in this prospective observational cohort study. Each group included subgroups of 31 pregnant women with a gestational age between 24+0 weeks and 27+6 weeks as well as 27 pregnant women with a gestational age between 28+0 weeks and 40+0 weeks. For all fetuses, a cine of 2–3 s in the four-chamber view was obtained, and online speckle-tracking analysis was performed using the GE Automatic Fetal Heart Assessment Tool (fetal HQ; General Electric Healthcare Ultrasound, Zipf, Austria) to measure the global sphericity index (GSI), global longitudinal strain (GLS), fractional area change (FAC), 24-segment sphericity index (SI), and 24-segment end-diastolic diameter of the left ventricle (LV) and right ventricle (RV). Data were analyzed using the independent t-test and Wilcoxon rank-sum test, as applicable. Results The GDM group (mean HbA1c value was 5.3 ± 0.57 mmol/L) showed a lower GSI value than the control group (1.21 vs. 1.27, P = 0.000), which indicated a rounder shape of the heart. In addition, fetuses in the GDM group demonstrated significant impairment in cardiac function compared to those in the control group (LV-GLS: -18.26% vs. -22.70%, RV-GLS: -18.52% vs. -22.74%, LV-FAC: 35.30% vs. 42.36%, RV-FAC: 30.89% vs. 36.80%; P = 0.000 for all). Subgroup analyses according to gestational age (24+0–27+6 weeks and 28+0–40+0 weeks) showed that the statistical differences were retained between the GDM and control groups in each subgroup. Conclusions Fetuses of women with GDM present with signs of biventricular systolic dysfunction according to deformation analysis using fetal HQ. Additionally, the heart had a rounder shape in the GDM group than in the control group. This study showed that fetal HQ can be used to assess fetal cardiac morphology and function easily and quickly, and the effects of GDM on fetal cardiac morphology and function appeared from the second trimester. Thus, whether earlier and stricter clinical intervention was necessary remained to be further studied. Furthermore, future studies will need to supplement the effects of blood glucose levels on GLS, FAC, GSI, and 24-segment SI. Additionally, the long-term follow-up after birth should also be improved to observe the influence of changes in the indicators on the prognosis.

scholarly journals The Effect of Down Syndrome Biochemical Markers on Predicting Severity of Preeclampsia

2020 ◽  
Author(s):  
AYSE OZBAN
Keyword(s):  
Down Syndrome ◽  
Pregnant Women ◽  
Biochemical Markers ◽  
First Trimester ◽  
Maternal Serum ◽  
Screening Tests ◽  
Second Trimester ◽  
Study Results ◽  
Second Trimester Screening ◽  
Trimester Screening

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.

scholarly journals Time of quickening is associated with the placental site and BMI in nulliparous women

2020 ◽  
Author(s):  
Negin Jaafar ◽  
Lars Henning Pedersen ◽  
Olav Bjørn Petersen ◽  
Lone Hvidman
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Prospective Observational Study ◽  
Nuchal Translucency ◽  
Second Trimester ◽  
Nulliparous Women ◽  
Placental Site ◽  
Fetal Movements ◽  
The Mean ◽  
Important Milestone

AbstractIntroductionQuickening, the first sensation of fetal movements, is an important milestone for pregnant women. Information on the expected gestational age at quickening may reduce anxiety and prevent delayed detection of intrauterine demise but the available data are from the 1980s before the emergence of modern ultrasound techniques.Materials and methodsProspective observational study on nulliparous women blinded for placental location in two hospitals in Denmark. The pregnant women were enrolled at the time of nuchal translucency scan, placental location was determined at time of second trimester scanning.. The women were blinded to placenta location before time of quickening. Time of quickening were reported by 122 women, 65 with an anterior and 57 with a posterior placenta. Thirteen women had a BMI >30 (10.7%).ResultsThe mean gestational age for quickening was 19 + 0 weeks for nulliparous women. The timing depended on placental site; women with an anterior placenta experienced quickening 6.4 days later than the women with a posterior placenta. BMI > 30 was associated with a later time of quickening.ConclusionsAnterior placental location is associated with delay in experience of fetal movements of 6.4 days and this may further be delayed in women with a BMI>30.

The effect of ear acupressure medicine at the “Shen Men” point on the nausea and vomiting during pregnancy

2021 ◽  
Vol 15 (5) ◽  
pp. 1774-1779
Author(s):  
Sanaz Nehbandani ◽  
Hajar Salehi ◽  
Khadije Rezaie Keikhaie ◽  
Hossein Rashki Ghalenow ◽  
Fatemeh Mirzaie ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Intervention Group ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Health Clinics ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Mean ◽  
The Difference

Introduction & Objective: Nausea and vomiting during pregnancy is one of the most common gastrointestinal disorders that more than 85% of pregnant women experience. However, controlling and treating this complication is still one of the most important issues in antenatal care. Therefore, the aim of this study was to investigate the effect of ear acupressure at Shen Men point on relieving nausea, vomiting and retching during pregnancy. Materials and Methods: In this quasi-experimental study, 100 pregnant women with a gestational age of less than 16 weeks attending the health clinics of Zabol city during 2019-2020 were studied in two control and intervention groups (n = 50 in each group). The samples in the intervention group were trained to apply pressure on their ears’ Shen Men point with the thumb for three minutes three times a day (morning, noon, and night), for a duration of one month. At the end of second and fourth weeks, the data were collected using the Rhodes index form and then, were analyzed by SPSS software version 22. Results: According to the results, there was no significant difference between the two groups in terms of age, gestational age, occupation and education. The difference in the mean scores of nausea, vomiting and retching was not statistically significant between the control and intervention groups before the study. But four weeks after the study, a significant difference was observed in the mean scores of vomiting, nausea and retching between the two groups, so that the mean scores of vomiting, nausea and retching were significantly lower in the intervention group than in the control group. Conclusion: The ear acupressure medicine at the Shen men point can be used as a non-invasive, safe and inexpensive method to relieve nausea, vomiting and retching during pregnancy. Keywords: Acupressure medicine, Shen Men, Vomiting, Pregnancy, Nausea, Retching, Rhodosis

ESTIMATE GESTATIONAL AGE ACCORDING TO FETAL CROWN RUMP LENGTH ON ECHOGRAPHY

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Tran Danh Cuong ◽  
Nguyen Hai Long ◽  
Ngo Toan Anh ◽  
Nguyen Thi Thu Huong ◽  
Le Pham Sy Cuong ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Pregnant Women ◽  
Linear Equation ◽  
Gestational Age ◽  
Menstrual Period ◽  
Last Menstrual Period ◽  
Obstetrics And Gynecology ◽  
National Hospital ◽  
Crown Rump Length ◽  
The Mean

Objectives: Development of descriptive table of gestational age (GA) based on fetal crown rump length (CRL) in Vietnam. Methods: This study was conducted at the Center for Prenatal Diagnosis, National Hospital Obstetrics and Gynecology. Gestational age based on the first day of last menstrual period (LMP) ranges from 10 weeks to 14 weeks and 6 days. Pregnant women who are healthy, have regular menstrual periods, have not used hormonal drugs or assisted reproductive methods before. Have ultrasound measured the length of the crown-rump of the embryo based on the mandatory criteria. Data were analysed using SPSS 20.0 software. Results: 1008 singleton fetuses that met criteria, were predicted GA according to LMP. There were 1008 fetal crown rump length recorded. The mean CRL was 59.95 ± 6.79 (mm), the mean gestational age according to KCC was: 12.13 ± 0.75 (weeks). Gestational age was linearly correlated with fetal crown rump length according to the equation: CRL = 6.602+ GAx 4.398 and GA= 8.889 + CRLx 0.54. Conclusion: Gestational age can be calculated based on fetal crown rump length index by linear equation: GA = 8.889 + CRLx 0.54. The equations can be applied to calculate gestational age in ultrasound practice in Vietnam.

Early pregnancy serum neopterin concentrations predict spontaneous preterm birth in asymptomatic pregnant women

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Dan Bogdan Navolan ◽  
Simona Vladareanu ◽  
Imad Lahdou ◽  
Ioana Ciohat ◽  
Christian Kleist ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Odds Ratio ◽  
Considerable Increase ◽  
Second Trimester ◽  
Spontaneous Preterm Birth ◽  
Serum Neopterin

AbstractTo investigate if early pregnancy serum neopterin concentrations (EPSN) could predict spontaneous preterm birth (SPB).EPSN was measured in 92 sera collected from 46 pregnant women with birth at term and 40 sera from 20 pregnant women with preterm birth. Two sera were collected for each case: in the first and early second trimester.EPSN concentrations correlate with gestational age (ρ=0.275, P=0.001), a correlation which was present in both groups: term and preterm birth. EPSN were higher in pregnancies with SPB compared with normal pregnancies (6.27±1.03 vs. 6.04±0.15, P=0.039). Patients with SPB showed a considerable increase of EPSN in the second trimester compared with patients with birth at term (7.30±1.53 vs. 6.16±0.23, P=0.043). A sharper increase was found in the group with SPB before 32 weeks of pregnancy (wp) (9.83±4.36 vs. 6.16±0.23, P=0.016). Pregnant women with an early second trimester serum neopterin value of above 8 nmol/L are associated with a risk of SPB before 32 wp (odds ratio=14.4, P=0.01) and of SPB before 34 wp (odds ratio=3.6, P=0.05), respectively.EPSN increases with the gestational age and predicts SPB in asymptomatic pregnant women.

scholarly journals Examining the predictive accuracy of metabolomics for small-for-gestational-age babies: a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031238 ◽  
Author(s):  
Debora Farias Batista Leite ◽  
Aude-Claire Morillon ◽  
Elias F Melo Júnior ◽  
Renato T Souza ◽  
Fergus P McCarthy ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Predictive Accuracy ◽  
Grey Literature ◽  
Synthesis Methods ◽  
Significant Heterogeneity ◽  
Second Trimester ◽  
Case Control Studies ◽  
Eligibility Criteria

IntroductionTo date, there is no robust enough test to predict small-for-gestational-age (SGA) infants, who are at increased lifelong risk of morbidity and mortality.ObjectiveTo determine the accuracy of metabolomics in predicting SGA babies and elucidate which metabolites are predictive of this condition.Data sourcesTwo independent researchers explored 11 electronic databases and grey literature in February 2018 and November 2018, covering publications from 1998 to 2018. Both researchers performed data extraction and quality assessment independently. A third researcher resolved discrepancies.Study eligibility criteriaCohort or nested case–control studies were included which investigated pregnant women and performed metabolomics analysis to evaluate SGA infants. The primary outcome was birth weight <10th centile—as a surrogate for fetal growth restriction—by population-based or customised charts.Study appraisal and synthesis methodsTwo independent researchers extracted data on study design, obstetric variables and sampling, metabolomics technique, chemical class of metabolites, and prediction accuracy measures. Authors were contacted to provide additional data when necessary.ResultsA total of 9181 references were retrieved. Of these, 273 were duplicate, 8760 were removed by title or abstract, and 133 were excluded by full-text content. Thus, 15 studies were included. Only two studies used the fifth centile as a cut-off, and most reports sampled second-trimester pregnant women. Liquid chromatography coupled to mass spectrometry was the most common metabolomics approach. Untargeted studies in the second trimester provided the largest number of predictive metabolites, using maternal blood or hair. Fatty acids, phosphosphingolipids and amino acids were the most prevalent predictive chemical subclasses.Conclusions and implicationsSignificant heterogeneity of participant characteristics and methods employed among studies precluded a meta-analysis. Compounds related to lipid metabolism should be validated up to the second trimester in different settings.PROSPERO registration numberCRD42018089985.

scholarly journals Maternal Serum Levels of Alpha Tumour Necrotic Factor, Interleukin 10, Interleukin 6 and Interleukin 4 in Malaria Infected Pregnant Women Based on Their Gestational Age in Southeast, Nigeria

2020 ◽  
pp. 64-70
Author(s):  
Obeagu, Emmanuel Ifeanyi ◽  
Esimai, Bessie Nonyelum ◽  
Ekelozie, Ifeoma Stella ◽  
Asogwa Eucharia Ijego ◽  
Amaeze Augustine Amaeze ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
First Trimester ◽  
Interleukin 10 ◽  
Interleukin 4 ◽  
Second Trimester ◽  
Third Trimester ◽  
Tnf Α ◽  
Significant Difference ◽  
Tumour Necrotic Factor

Malaria has been reported as a condition caused by infestation with Plasmodium parasite species, is a major public health problem globally especially in developing countries like Nigeria. This study was carried out in Federal Medical Centre Umuahia in Abia State, Nigeria. A study was done to determine the maternal serumlevels of alpha tumour necrotic factor, interleukin 10, interleukin 6and interleukin 4 in malaria infected pregnant women based on their gestational age in Southeast, Nigeria. A total of 150 subjects between the ages of 18-45 years were recruited for the study comprising of fifty (50) subjects each of the 3 trimesters. Commercial ELISA Kit by MELSIN Medical Co Limited was used to measure all the cytokines. The results of Table 1 showed no significant difference of TNF-α (p=0.346), IL-10 (p=0.059), IL-6 (p=0.811) and IL-4 (p=0.257) of malaria infected pregnant women at first trimester and second trimester respectively. The results of Table 2 showed no significant difference of TNF-α (p=0.642), IL-10 (p=0.678), IL-6 (p=0.551) and IL-4 (p=0.280) of malaria infected pregnant women at first trimester and third trimester respectively. The results of Table 2 showed no significant difference of TNF-α (p=0.062), IL-10 (p=0.016), IL-6 (p=0.352) and IL-4 (p=0.914) of malaria infected pregnant women at first trimester and third trimester respectively. The study showed no changes in the cytokines studied among the malaria infected pregnant women based on gestational ages except when IL-10 was compared between the subjects on second trimester and third trimester. This study shows that malaria infection does not changes these cytokines in pregnant women based on gestational ages except the il-10 when compared at second trimester and third trimester but changes when compared at other trimesters.

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