scholarly journals Urinary Nephrin and Podocalyxin Levels as Predictors of Pre-eclampsia in High-Risk Pregnant Women

Folia Medica ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 948-957
Author(s):  
Irena Kostovska ◽  
Katerina Tosheska Trajkovska ◽  
Ognen Kostovski ◽  
Danica Labudovic

Introduction: Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria. Damage of podocyte cells has been reported in pre-eclamptic women, thus podocyte specific proteins such as nephrin and podocalyxin could be useful biomarkers in PE. Aim: To investigate the role of urinary nephrin (u-nephrin) and urinary podocalyxin (u-PDX) levels in predicting PE in women with a high-risk pregnancy. Materials and methods: We included 101 pregnant women in this study and allocated them into three groups: group 1 included pregnant women at high risk of developing PE (n=41), group 2 - pregnant women with PE (n=30), and group 3 was the controls including healthy pregnant women (n=30). The inclusion criteria for women with PE were de novo hypertension >140/90 mm Hg, proteinuria >300 mg/24 hours, and presence of edema after 20 weeks of gestation, while the exclusion criteria were a history of renal diseases and pregnant women younger than 18. Inclusion criteria for the group of women with a high-risk pregnancy was gestational week >15, a history of PE in a previous pregnancy, pre-existing diabetes type 1 or 2, pre-existing hypertension, multiple gestations, prior placental abruption, obesity women, nulliparity, maternal age >35 years, and a family history of PE. The study was conducted from March 2016 to May 2017 in the Medical Faculty at the Institute of Medical and Experimental Biochemistry in Skopje. Urine samples were used to measure the nephrin and podocalyxin levels using immunoenzyme assay, creatinine and microalbumin. Blood samples were collected for biochemical analyses. Results: U-nephrin levels were elevated in 96.7% of women with PE, and 73% of women with a high-risk pregnancy. U-PDX levels were elevated in 63% of the women with PE and 100% of the women with a high-risk pregnancy. U-nephrin and u-PDX levels were significantly increased in women with a high-risk pregnancy and women with PE compared with a control group (p<0.001). A significant difference was found between the subgroups of pregnant women classified according to gestational age in their u-nephrin and u-PDX levels. There was a significant positive correlation between the levels of both markers and glomerular filtration rate, and significant negative correlation between the levels of both markers and gestational age. ROC analysis revealed that the cut-off value of 304.6 ng/ml of u-nephrin had a sensitivity (Se) of 96.7%, specificity (Sp) of 96.7% (for both Se and Sp 95% confidence interval (CI) 82.8-99.9), while the cut-off value of 59.5 ng/ml of u-PDX had a sensitivity of 100% and Sp of 93.3% (Se - 95% CI 88.4-100, Sp - 95% CI 77.9-99.2), in distinguishing women with PE and healthy pregnancies. Both markers showed excellent clinical utility (CUI&ge;0.81), for u-nephrin (CUI+ and CUI&minus; is 0.934), for u-PDX (CUI+ is 0.938; CUI&minus; is 0.933). Conclusions: U-nephrin and U-PDX levels could be useful as predictors of PE in women with a high-risk pregnancy.

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.


2020 ◽  
pp. 19-27
Author(s):  
L. V. Tsallagova ◽  
L. V. Maisuradze ◽  
S. V. Sagkaeva ◽  
T. I. Tsidaeva

Summary. Purpose of research. Development of a method for prevention of placental insuffi ciency (PN) in high-risk pregnancy in women of the Republic of North Ossetia-Alania (RSO-A) with the complex use of antihypoxant limontar and ozone therapy (OT). Material and methods. Observations were made of 75 pregnant residents of RSO-A with diagnosed PN, whose average age was 32,6 ± 8,14 years. Using a simple randomization method, 3 groups were formed: in the main group (OG), patients received prevention of PN by using OT and antihypoxant limontar; in the comparison group (GS), only limontar; in the control group (KG), pregnant women did not receive prevention of PN. All patients observed before and after PN prevention were examined for placental lactogen and estriol, ultrasound of the fetoplacental complex (FPC), Doppler examination of the uterine blood fl ow and ultrasound examination of the placenta structure, and morphological examination of the placenta. Results. Based on identifi ed pathogenetic mechanisms of the disorders in the system “mother — placenta — fetus” are defined by a high clinical effi cacy of combined pharmaco-ozone therapy (CT) in the prevention of PN in pregnant women at risk, which was manifested by the lack of progression of PN, whereas in GS, where patients received only pharmacotherapy with limontar, progression was noted in 31,8 % of cases, in KG, where there was no prevention, is 56 %. Conclusion. In the present study, the positive effect of OT and antihypoxant limontar on the processes of microcirculation, metabolism, and adaptation of the body, which provides a signifi cant reduction in the frequency of pregnancy complications, increasing the adaptive capabilities of the fetus and improving perinatal outcomes.


2020 ◽  
Vol 30 (1) ◽  
pp. 1-14
Author(s):  
Ayun Sriatmi ◽  
Sri Suwitri ◽  
Zahroh Shaluhiyah ◽  
Sri Achadi Nugraheni

Abstract The inability of pregnant women to identify and recognize danger signs of pregnancy indicates the lack of knowledge, attitudes and perceptions of mothers about healthy pregnancies which has an impact on the low practices of prevention of high risk of pregnancy. Pregnant Women Class Program (KIH) which is held is not optimal because of the low presence of pregnant women for various reasons. The aim of study to determine the effect of the KIH-Virtual model on the practice of preventing high risk of pregnancy. This is a quasi-experimental study with case-control approach. The population is pregnant women in Semarang City. The total sample was 60 mothers for the intervention group and 61 mothers for control group. The independent variable is KIH-Virtual intervention and dependent variable is the practice of preventing high risk pregnancy (covering 7 dimensions). Data collection through interviews and observations with four times measurements (pretest, posttest 1,2,3). Partial analysis using independent-T test and Paired test. Simultaneous analysis with Linear-Mixed-Model. Statistically, there were differences in the practice of preventing high risk pregnancy between intervention groups and control at the last measurement (p<0.05). Although both groups experienced an increase in scores at each measurement stage, it was evident in the intervention group that the increase was higher for all dimensions of practice. The highest increase in the effect of interventions on communication and collaboration practices was followed by health status monitoring practices. Daily self-care practices and lifestyle practices are the dimensions with the lowest intervention effect. Virtual-KIH influences the practice of pregnant women in the prevention of high risk of pregnancy and is able to improve the practice better than conventional models that have been underway. Abstrak  Ketidakmampuan ibu hamil mengidentifikasi dan mengenali tanda bahaya kehamilan mengindikasikan rendahnya pengetahuan, sikap dan persepsi ibu tentang kehamilan sehat, yang berdampak pada rendahnya praktik pencegahan risiko tinggi kehamilan. Program Kelas Ibu Hamil (KIH) yang diselenggarakan belum optimal karena terkendala rendahnya kehadiran ibu hamil dengan berbagai alasannya. Tujuan penelitian menganalisis pengaruh model KIH Virtual terhadap praktik pencegahan risiko tinggi kehamilan. Penelitian ini merupakan penelitian quasi experimental dengan pendekatan kasus-kontrol. Populasi adalah ibu hamil di Kota Semarang. Jumlah sampel 60 ibu untuk kelompok intervensi dan 61 ibu untuk kelompok kontrol. Variabel bebas yaitu intervensi KIH Virtual dan variabel terikatnya yaitu praktik pencegahan risiko tinggi kehamilan (meliputi 7 dimensi). Pengumpulan data melalui wawancara dan observasi dengan 4 kali pengukuran (pretest, posttest-1,2,3). Analisis parsial menggunakan uji beda independen dan berpasangan. Analisis simultan dengan Linear-Mixed-Model. Secara statistik ada perbedaan praktik pencegahan risiko tinggi kehamilan antara kelompok intervensi dengan kontrol pada pengukuran terakhir (p<0,05). Meski kedua kelompok mengalami peningkatan skor pada setiap tahap pengukuran, namun terbukti pada kelompok intervensi peningkatannya lebih tinggi untuk semua dimensi praktik. Peningkatan tertinggi efek intervensi pada praktik komunikasi dan kerjasama, diikuti praktik pemantauan status kesehatan. Praktik perawatan diri sehari-hari dan praktik gaya hidup merupakan dimensi praktik dengan efek intervensi terendah. KIH Virtual memengaruhi praktik ibu hamil dalam pencegahan risiko tinggi kehamilan dan mampu meningkatkan praktik tersebut dengan lebih baik dibandingkan model konvensional yang selama ini berlangsung.  


Author(s):  
Narendra Vaghela

Introduction: In normal married couple or married women pregnancy is normal physiological condition and not a high-risk condition. Most of the pregnancies have happy outcome with good health of both foetus and mother whereas some pregnancies are complicated by problems with mother’s health, the health of the foetus or complications unique to pregnancy. Like these kinds of complicated pregnancies are group as “high risk” for developing problems and having a poor outcome. In comparing to the normal pregnancy High-risk pregnancy is one of greater risk to the mother or her fetus. A High risk (at risk) pregnancy cases there is increased in risk of morbidity or mortality before or after delivery where the mother, fetus, or neonate. At the time of pregnancy, a high-risk pregnancy is grouped in which past reproductive performance or maternal environment presents a significant risk to foetus such as premature birth, small for date infant, full term with low reservoir or still births and early neonatal death. For pregnant women identification of at high risk for these complicated pregnancies with poor outcome is fundamental to antenatal care. The risk factors which include high risk pregnancy are existing medical conditions such as HIV positive, Diabetes mellitus and BP as well as maternal obesity, multiple births and young or old age. A number of biological and social factors such as age, social class, parity and past obstetric history, occupation and psycho social factors and nutritional status that influence the perinatal outcome during pregnancy. Aim: The main aim of this study is to pregnancy outcome in various high-risk pregnancies. Material and Methods: This study was prospective study in which total 100 high risk and 100 low risk caesarean cases were done.  In all the cases married women were included with the age from 20 to 40 years old having gestational age of more than 28 wks and underwent Caeserian section (Emergency/elective). In this study both IPD and OPD patients were included.  In IPD cases in general had minimum of two antenatal check-ups. At the time of admission detail history of patients was taken including age, address and occupation, menstrual history, obstetrical history regarding gravity, parity abortion, number of term & preterm labours, any history of previous CS, indication for CS and intra-operative complication. For all the patients scoring was done as low risk and high risk cases by modified Coopland’s Scoring System.  In the case of cesarean section Breast feeding was stated after 4 hours. Detailed information and history of neonatal complication and perinatal outcome was also recorded using predesigned and pretested proforma. Result: In this study to total 100 high risks as a study group and 100 low risks as a control group caesarean case with perinatal outcome was recorded. 42% and 30% of the study and control group respectively had low birth weight baby. In the high risk group, 3% had neonatal death while in control group there was 0% respectively. 38% babies in this study group and 17% babies in the control group had mild to severe depression and Apgar score below 6-4. Conclusion:  This study showed pregnancy complications and related perinatal morbidity as risk factors impacting on neonatal outcome. If mother had access to appropriate and timely healthcare during pregnancy majority of maternal morbidities could be prevented.  Hence proper care and timely referral can have a positive impact in lowering the perinatal mortality and morbidity and possibly better maternal outcome. Keywords: Pregnancy outcome, High risk pregnancy, Perinatal outcome, Coopland scoring, Caesarian section


Author(s):  
Tutik Setyowati ◽  
Erni Nuryan ◽  
Suharto . ◽  
Ismi Rajiani

Background: This research aimed to identify the effectiveness of One Nursing Student One Client (OSOC) Assistance in decreasing high-risk pregnancy as an effort to   accelerate the decline in maternal and infant mortality rates.Methods: The research design employed the post test-only control group design method, where the high-risk pregnant women are accompanied by one student one client. After supervision has been completed, the results were then compared with the control group that has been given high-risk leaflet prevention for pregnant women. Mann Whitney Test is used to test the difference statistically.Results: The results of high-risk statistical analysis of hypertension obtained results p = 0.000 (P <0.05), anemia p = 0.001 (P <0.05), swollen extremity p = 0.040 (P <0.05) which means there is   a very significant different average value of high-risk pregnancy between the control group and the experimental group. This indicates that OSOC counseling is effective in reducing high-risk pregnancies of positive urine protein to negative urine protein in Blora City Community Health Center compared with leaflets to control groups. Further, counseling at high risk of swollen extremity was obtained p = 0. 114 (P> 0.05) which mean there was no difference of the mean value of high pregnancy risk of swollen extremity between the control and experiment group.Conclusion: One nursing student one client assistance is effective in reducing high-risk of the third trimester pregnancy women suffering from hypertension, anemia and positive urine proteins. K eywords: mentoring one nursing student one client, high-risk pregnancy


2020 ◽  
Vol 3 (1) ◽  
pp. 18
Author(s):  
Ika Parmawati ◽  
Ayyu Sandhi ◽  
Wenny Artanty Nisman ◽  
Wiwin Lismidiati ◽  
Anik Rustiyaningsih ◽  
...  

Maternal death rate is one of the important health development indicators. Indonesian maternal mortality is still high due to both direct and indirect causes that occur during pregnancy and childbirth. High-risk pregnancy can present complications for both the mother and fetus, and demands early detection. Early detection requires involvement of the community, health cadre, medical officers, and government. There is a need to increase the community health cadre competency in the detection of pregnancy complications, especially high-risk pregnancy knowledge. This study used a quasi-experimental design without control group to determine the effect of training regarding pregnancy complications on community health worker’s knowledge in Wijimulyo, Nanggulan, Kulon Progo, Yogyakarta in October 2018. The research subjects were community health cadre workers chosen by purposive random sampling. There were 43 research subjects who were given pretests, training about complications of pregnancy, and posttests. The instrument used was a knowledge questionnaire about complications during pregnancy that consisted of 23 items with reliability of 0.865. There was significant difference between community health cadre’s knowledge about complications of pregnancy at pretest and posttest. These results indicate that training about pregnancy complications increases the knowledge of community health cadre workers concerning complications of pregnancy. Further research is needed to assess community health cadre’s skills in making early detection of pregnancy complications.


Author(s):  
Ashok Rupraoji Jadhao ◽  
Mahendra D. Gawade ◽  
Suresh N. Ughade

Background: All pregnant women, by virtue of their pregnancy status, face some level of maternal risk. Some pregnancies are complicated by problems associated with mother’s health. Most maternal morbidities could be prevented if mother had access to appropriate and timely healthcare during pregnancy. Study was intended to find out prevalence of high risk pregnancy and pregnancy outcome among them in rural area of Nagpur district, Central India.Methods: Community based observational descriptive study was conducted on consecutive sample of 214 pregnant women, who had 20 weeks and above gestational period.Results: Prevalence of high risk pregnancy observed was 33.64% (95% CI 27.31%-39.97%). Caesarean section (OR=7.63, 95% CI=4.04-14.40, P=0.0001) and birth weight less than 2500gm (OR= 3.47, 95% CI=1.47-8.20, P=0.003) were significantly associated with high risk pregnancy. Mode of delivery caesarean section had strong relationship with previous history of caesarean section (OR=37.53, 95% CI=8.64-163.05, P=0.0001) and mothers height less than or equal to 140cm (OR=8.87, 95% CI=1.02-77.32, P = 0.0183). Pregnancy outcome low birth weight was significantly associated with oligohyramnios (OR = 8.45, 95 % CI=1.61-44.48, P=0.003) and history of caesarean section (OR=2.67, 95 % CI=1.01-7.07, P = 0.041).Conclusions: Prevalence of high risk pregnancy was almost one-third in pregnant women in rural area of central India. Mode of delivery caesarean section and birth weight less than 2500gm was significantly associated with high risk pregnancy. History of caesarean section and height less than or equal to 140 cm influence the outcome of pregnancy i.e. caesarean section. Birth weight, LBW (Low Birth Weight) was associated with history of caesarean section and oligohyramnios.


Author(s):  
Daniel Liando Daniel Liando ◽  
IMS Murah Manoe ◽  
Eddy R Moeljono

Objective: To compare the effectiveness of rectal misoprostol administration to the amount of blood loss in 4th stage of labor at high risk pregnancy. Method: We recruited all pregnant women with high risk criteria including anemia, age  35 years old, or the number of pregnancies  4. Women would deliver appropriate to standard procedure of normal delivery. After that, we gave 400-mcg tablet of misoprostol rectally in treatment group. To count the amount of blood loss during 4th stage of labor, we put the underpad. Result: The amount of blood loss in 4th stage of labor in the treatment group was 201.1 (SD 80.3) ml less than the control group (285.9 (SD 93.2) ml). The result showed that the administration of 400-mcg misoprostol tablet rectally immediately after the birth of the placenta at high risk pregnancy impacted significantly to reduce the amount of blood loss in 4th stage of labor (p


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.


2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.


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