scholarly journals Evaluation of Pregnancy Outcomes in Women with Hypertension Disorders of Pregnancy

2021 ◽  
Vol 15 (10) ◽  
pp. 3420-3422
Author(s):  
Kalsoom Essa Bhattani ◽  
Shumaila Khawaja Khail ◽  
Kashif Ali Samin ◽  
Zubaida Khanum Wazir ◽  
Mobashara Ghulam Muhammad ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Postpartum Hemorrhage ◽  
Health Centre ◽  
Mode Of Delivery ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Hypertensive Disorders

Background and Aim: Globally, hypertension disorder is the most common disorder in pregnancy. It complicates 6–10% of pregnancies with a major contribution to the worldwide maternal mortality rate. The aim of the current study was to evaluate the pregnancy outcomes in women with Hypertension disorders. Materials and Methods: This cross-sectional study was carried out on women with hypertension disorders enrolled in the department of Gynecology, Mardan Women Hospital, Sheikh Maltoon Town, Mardan and Family Health Centre, Peshawar from March 2021 to August 2021. Demographic details such as age, gestational age, parity, intrapartum, early postpartum complications such as perinatal outcomes and mode of delivery, and antepartum were recorded from each individual. Chi-square test was used for comparing the composite adverse outcomes such as preterm birth, postpartum hemorrhage, abrupt placenta, and mortality rate. SPSS version 20 was used for data analysis. Results: Of the total 2357 pregnant women, about 146 (6.2%) women had hypertensive disorders of pregnancy. The mean age of 146 pregnant women was 29.45±4.67 years with an age range from 17 to 43 years. About 37 (25.3%) women had no perinatal and maternal complications. Out of 109 pregnant women, the prevalence of eclampsia, preeclampsia, and pregnancy-induced hypertension were 8 (7.3%), 44 (40.4%), and 57 (52.3%) respectively. Based on gestational age, preterm (24-36 weeks) and term (>37 weeks) were 35 (32.1%) and 74 (67.9%) respectively. Other maternal complications were Abruption Placentae, Postpartum hemorrhage (PPH), Renal Failure., Pulmonary Edema, Disseminated intravascular coagulation (DIC), and Maternal Death. Conclusion: Our study found hypertension disorders as a significant medical disorder in pregnant women. However, neonatal outcomes and pregnancy outcomes were significantly smooth in more than 50% of pregnant women. Keywords: Hypertensive disorders of pregnancy, Pre-eclampsia, Eclampsia.

Machine learning approaches to predict gestational age in normal and complicated pregnancies via urinary metabolomics analysis

2021 ◽  
Author(s):  
Takafumi Yamauchi ◽  
Daisuke Ochi ◽  
Naomi Matsukawa ◽  
Daisuke Saigusa ◽  
Mami Ishikuro ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Urinary Metabolites ◽  
Normal Pregnancy ◽  
Urinary Metabolite ◽  
Learning Approaches ◽  
Hypertensive Disorders Of Pregnancy ◽  
Spontaneous Preterm Birth ◽  
Hypertensive Disorders ◽  
Pregnancy Status

Abstract The elucidation of dynamic metabolomic changes during gestation is particularly important for the development of methods to evaluate pregnancy status or achieve earlier detection of pregnancy-related complications. Some studies have constructed models to evaluate pregnancy status and predict gestational age using omics data from blood biospecimens; however, less invasive methods are desired. Here we propose a model to predict gestational age, using urinary metabolite information. In our prospective cohort study, we collected 2,741 urine samples from 187 healthy pregnant women, 23 patients with hypertensive disorders of pregnancy, and 14 patients with spontaneous preterm birth. Using gas chromatography-tandem mass spectrometry, we identified 184 urinary metabolites that showed dynamic systematic changes in healthy pregnant women according to gestational age. A model to predict gestational age during normal pregnancy progression was constructed; the correlation coefficient between actual and predicted weeks of gestation was 0.86. The predicted gestational ages of cases with hypertensive disorders of pregnancy exhibited significant progression, compared with actual gestational ages. This is the first study to predict gestational age in normal and complicated pregnancies by using urinary metabolite information. Minimally invasive urinary metabolomics might facilitate changes in the prediction of gestational age in various clinical settings.

scholarly journals Maternal Complications and Adverse Pregnancy Outcomes among Pregnant Women who Acquired Asymptomatic Bacteriuria in Addis Ababa, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ketema Bizuwork Gebremedhin ◽  
Haile Alemayehu ◽  
Girmay Medhin ◽  
Wondwossen Amogne ◽  
Tadesse Eguale
Keyword(s):  
Pregnant Women ◽  
Correlation Coefficient ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Addis Ababa ◽  
Asymptomatic Bacteriuria ◽  
Adverse Pregnancy Outcomes ◽  
Maternal Complications ◽  
Adverse Pregnancy

In this study, we aimed to document adverse pregnancy outcomes and maternal complications among pregnant women who acquired asymptomatic bacteriuria in Addis Ababa, Ethiopia. We used hospital-based prospective cohort study design in which we followed 44 pregnant women with asymptomatic bacteriuria confirmed by urine culture result of ≥105cfu/ml of urine. We documented adverse pregnancy outcomes and maternal complications in terms of frequency, percentage, mean, and standard deviation. Additionally, we used Pearson’s correlation coefficient to investigate associations of selected variables with perinatal death as one of adverse pregnancy outcomes. Of the 44 pregnant women enrolled in the study, complete data was collected from 43 participants with one lost to follow-up. Six (14%) of women developed fever and were treated with antibiotic during pregnancy, 26 (60.5%) delivered with cesarean section, two (4.3%) perinatal deaths within seven days of delivery, one miscarriage, and 4 (9.3%) newborns were found underweight. The mean birth weight of the newborns was 3.1   kg ± 0.60 . Almost half 21(48.8%) were born before 37 weeks of gestational age. Fourteen (32.6%) of newborns were born asphyxiated. Twenty-two (51.2%) of newborns developed early neonatal fever within 48 hours of delivery and treated with antibiotic. Correlation coefficient analysis revealed that weight and gestational age of newborns at birth, Apgar score at 1st and 5th minutes of birth and miscarriage were positively correlated and significantly associated with perinatal death. The occurrence of unsought pregnancy outcomes were frequent, and substantial number of pregnant women developed maternal complications. Therefore, screening pregnant women for asymptomatic bacteriuria and treating may reduce the possible maternal complications and adverse pregnancy outcomes.

scholarly journals Study of liver function tests in hypertensive disorders of pregnancy

2018 ◽  
Vol 7 (3) ◽  
pp. 1212
Author(s):  
Radhika Pusuloori ◽  
K. Dilzith Arora
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Liver Function Tests ◽  
Risk Category ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Hypertensive Disorders ◽  
Maternal Morbidity And Mortality ◽  
Set Up ◽  
A Prospective Study

Background: Hypertensive disorders of pregnancy with spectrum complications is one among leading causes of feto-maternal morbidity and mortality especially when its associated with HELLP syndrome.Methods: The present prospective study was conducted over a period of three years in the department of obstetrics and gynecology at Chalmeda Anandarao Institute of Medical Sciences, Karimnagar, Telangana from January 2008 to January 2009. This is a prospective study on 50 pregnant women with 28-40 weeks of gestation with diastolic BP ≥110 mm Hg recorded 6 hours apart.Results: This is a prospective study on 50 pregnant women with 28-40 weeks of gestation with diastolic BP≥110 mm Hg recorded 6 hours apart. Severe pre eclampsia was seen in younger age group ˂25 years. In patients with raised LFTs unbooked cases were more (64%) showing complications are more in unbooked cases. Renal complications are seen in 16% of the total cases and in 28% of the cases with raised LFTs. In overall study group number of primi gravid were 50% and multi were 27%. Incidence of severe pre eclampsia was 78% in overall cases. In patients with raised LFTs the incidence was 30 (88%).Conclusions: Detection of increased LFTs in cases of severe pre-eclampsia is a risk category, associated with increased rate of feto-maternal complications, compared to severe pre-eclampsia with normal LFTs. Such cases need special attention with early detection and referral to higher centre with better facilities of NICU set up to reduce the complications and mortality.

scholarly journals Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil

2022 ◽  
Vol 40 ◽  
Author(s):  
Antônio José Ledo Alves da Cunha ◽  
Karina Bilda de Castro Rezende ◽  
Maria Elisabeth Lopes Moreira ◽  
Silvana Granado Nogueira da Gama ◽  
Maria do Carmo Leal
Keyword(s):  
Data Analysis ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Maternal Education ◽  
Mode Of Delivery ◽  
Immune Deficiency Syndrome ◽  
Antenatal Corticosteroids ◽  
Maternal Complications ◽  
Mortality And Morbidity

ABSTRACT Objective: To estimate the rate of the use of antenatal corticosteroids (ANC) among pregnant women and to identify the conditions associated with their non-use in Brazil. Methods: Secondary data analysis from “Birth in Brazil”, a national hospital-based survey carried out in 2011–2012 on childbirth and birth. The sample was characterized regarding maternal age, marital status and maternal education, parity, mode of delivery and place of residence. The association of ANC use with gestational age and type of delivery was analyzed. The studied maternal complications were the presence of hypertension, pre-eclampsia/eclampsia, and pyelonephritis, infection by the HIV virus or acquired immune deficiency syndrome. Results: 2,623 pregnant women with less than 37 weeks of gestational age were identified, and, of these, 835 (31.8%) received ANC. The frequency of ANC use was higher among women with gestational ages between 26–34 weeks (481 cases; 48.73%). In pregnancies with less than 37 weeks, the use of ANC was 23.9% in spontaneous deliveries, 20.6% in induced deliveries and 43.8% among those who did not go into labor. The variables vaginal delivery (OR 2.5; 95%CI 1.8–3.4) and living in the countryside were associated with not using ANC, and the occurrence of pre-eclampsia/eclampsia (OR 1.8; 95%CI 1.2–2.9) was associated with the use of ANC. Conclusions: The use of ANC among Brazilian pregnant women was low. Interventions to increase its use are necessary and can contribute to reduce neonatal mortality and morbidity. ANC should be promoted in pregnancies of less than 37 weeks, especially in cases of vaginal delivery and for those living in the countryside.

scholarly journals Perinatal Outcome in Women with Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Gezehagn Endeshaw ◽  
Yifru Berhan
Keyword(s):  
Cohort Study ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Low Income ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Mode Of Delivery ◽  
Significant Proportion ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Background. Hypertensive disorders of pregnancy (HDP) are multisystem diseases known to increase the risk of perinatal mortality worldwide, with a significant proportion of these deaths occurring in low income countries. However, little is known about the obstetric and treatment predictors of perinatal mortality in women with HDP. Methods. A retrospective cohort study design was used to include 1015 hypertensive pregnant women who gave birth to 1110 babies between 2008 and 2013 in three university teaching hospitals. Bivariate and multivariate regression models were used to estimate the associations between selected predictor variables and perinatal mortality taking the onset of HDP illness to death or discharge from the hospital as the time period. Results. There were 322 perinatal deaths resulting in a perinatal mortality rate (PMR) of 290/1000 total births. The proportion of stillbirths was more than 4-fold higher than early neonatal deaths (81% versus 19%). The multivariate analysis demonstrated that multiparity (OR, 1.6; 95% CI, 1.12–228), grand multiparity (OR, 2.8; 95% CI, 1.55–4.92), preterm (OR, 1.5; 95% CI, 1.02–2.35) and very preterm gestational age (OR, 7.7; 95% CI, 5.26–11.20), lack of antenatal care (OR, 2.0; 95% CI, 1.43–2.67), having eclampsia (OR, 4.1; 95% CI, 2.85–6.04), antepartum or before (OR, 6.6; 95% CI, 3.40–12.75) and intrapartum onset of HDP (OR, 4.0; 95% CI, 1.99–8.04), raised SGOT level (OR, 2.3; 95% CI, 1.30–3.91), vaginal delivery (OR, 5.3; 95% CI, 2.93–9.54), low fetal birth weight (OR, 4.3; 95% CI, 2.56–7.23), and maternal death (OR, 12.8; 95% CI, 2.99–54.49) were independent predictors of perinatal mortality. Conclusion. This study showed that the PMR of HDP was among the highest in the world. Parity, gestational age, type and onset of HDP, mode of delivery, birthweight, and maternal outcome were strong predictors of perinatal mortality.

scholarly journals Machine learning approaches to predict gestational age in normal and complicated pregnancies via urinary metabolomics analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takafumi Yamauchi ◽  
Daisuke Ochi ◽  
Naomi Matsukawa ◽  
Daisuke Saigusa ◽  
Mami Ishikuro ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Urinary Metabolites ◽  
Normal Pregnancy ◽  
Urinary Metabolite ◽  
Learning Approaches ◽  
Hypertensive Disorders Of Pregnancy ◽  
Spontaneous Preterm Birth ◽  
Hypertensive Disorders ◽  
Pregnancy Status

AbstractThe elucidation of dynamic metabolomic changes during gestation is particularly important for the development of methods to evaluate pregnancy status or achieve earlier detection of pregnancy-related complications. Some studies have constructed models to evaluate pregnancy status and predict gestational age using omics data from blood biospecimens; however, less invasive methods are desired. Here we propose a model to predict gestational age, using urinary metabolite information. In our prospective cohort study, we collected 2741 urine samples from 187 healthy pregnant women, 23 patients with hypertensive disorders of pregnancy, and 14 patients with spontaneous preterm birth. Using gas chromatography-tandem mass spectrometry, we identified 184 urinary metabolites that showed dynamic systematic changes in healthy pregnant women according to gestational age. A model to predict gestational age during normal pregnancy progression was constructed; the correlation coefficient between actual and predicted weeks of gestation was 0.86. The predicted gestational ages of cases with hypertensive disorders of pregnancy exhibited significant progression, compared with actual gestational ages. This is the first study to predict gestational age in normal and complicated pregnancies by using urinary metabolite information. Minimally invasive urinary metabolomics might facilitate changes in the prediction of gestational age in various clinical settings.

EPIDEMIOLOGICAL AND ETIOLOGICAL PROFILE OF IUFD: A PROSPECTIVE STUDY AT TERTIARY CARE CENTRE

2021 ◽  
pp. 31-34
Author(s):  
Deepali Jain ◽  
Uma Jain ◽  
Japhia David
Keyword(s):  
Gestational Age ◽  
Fetal Death ◽  
Health Centre ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
National Level ◽  
Health Indicators ◽  
Fetal Mortality ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre

Introduction:- IUFD occurrence without warning in a previously normal pregnancy is really a challenge to obstetrician and distressing situation for parents. It becomes crucial to identify specic probable cause of fetal death, to prevent the re-occurance and get the corrective measures. Prenatal mortality is still of one of the top most health indicators in measuring the quality and impact of health services in developing countries Still birth is a useful index to measure the values of antenatal and intranatal care. To decrease the fetal mortality rate, evaluation, documentation and audit of the etiology and the associated risk factors for stillbirth is required. Material and method :- The present study aims at studying the various causes related to IUFD. Prospective observational study conducted on 112 patients at Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.) for 18 months. All those cases who were diagnosed as intrauterine dead fetus at the time of admission with gestational age >24 weeks pregnancy were included in the study. All those investigation available at the centre of mother and father were noted and details were taken. Epidemiological evaluation of causes of fetal death was done. Record of the method of induction and mode of delivery taken. RESULTS :-Total 112 cases found during the study period were included . We found maximum cases unbooked - 71.43%, which were mainly emergency admissions. Majority of the IUFD cases- 77.67% were found to lie in the age group of 20-30 yrs, most of them were primigravida 62.5%., maximum cases of IUFD were of the gestational age 31-35 weeks- 47.32%. Hypertensive disorder of pregnancy- 23.3 % cases were found to be the major associated cause followed by Antepartum Haemorrhage 11.5%, Severe anaemia 15.1%, diabetes- 14.2% jaundice - 9.8%. congenital anomaly- 9.8%. Oligohydromnios- 8.9% and IUGR were also found to be associated with IUFD, forming an indirect reason. 39.29% cases were unexplained. 86.6% cases delivered vaginally. 10.7% cases had to undergo LSCS and only 2.68% cases underwent laparotomy for rupture uterus. 11.61% cases were of macerated IUFD baby indicating long term neglected IUFD. 39.78% and 38.39% IUFD were of 2.0-2.5 kg and 1.5-2.0 kg. This show strong corelation with LBW and IUGR. CONCLUSION:- Unexplained cases, hypertensive disorder, anemia and diabetes were the major causes for IUFD. In spite of advances in diagnostic and therapeutic modalities a major cause of fetal death remain unexplained because of poverty, illiteracy, unawareness and inaccessibility of a health centre. Undoubtedly, continued surveillance of stillbirth rates is wanted for both high- and low-risk pregnancies at a state and national level.

Maternal Serum EG-VEGF as A First Trimester Predictor of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2021 ◽  
Author(s):  
Shiyu Zeng ◽  
Ling Yu ◽  
Yiling Ding ◽  
Mengyuan Yang
Keyword(s):  
Cohort Study ◽  
Growth Factor ◽  
Prediction Model ◽  
Pregnant Women ◽  
Predictive Value ◽  
Prospective Cohort ◽  
First Trimester ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Sensitivity Specificity

Abstract Background This study aims to explore whether plasma endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in the first trimester can be used as a predictor of hypertensive disorders of pregnancy (HDP), and compare it with placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) to evaluate its prediction of HDP value. Methods This is a prospective cohort study that records the medical history of the pregnant women included in the study at 11–13 weeks’ gestation, and analyzes serum biochemical markers including EG-VEGF, PIGF, sFlt-1 and sFlt-1/PIGF. The predictive values of these tests were determined. We used the receiver operating characteristic (ROC) curve to find the optimal cut-off value for each biomarker and compare the operating characteristics (sensitivity, specificity). Logistic regression analysis was used to create a prediction model for HDP based on maternal characteristics and maternal biochemistry. Results Data were obtained from 205 pregnant women. 17 cases were diagnosed with HDP, the incidence rate was 8.2% (17/205). Women who developed HDP had a significantly higher body mass index (BMI) and mean arterial pressure (MAP). Serum EG-VEGF levels in the first trimester are significantly higher in pregnant women with HDP. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value(NPV) of serum EG-VEGF levels more than 227.83 pg/ml for predicting HDP were 43%, 93%, 86% and 62%, respectively. We established a prediction model in the first trimester include maternal BMI, MAP, and EG-VEGF, with an AUC of 0.8861 (95%CI: 0.7905–0.9818), which is better than using EG-VEGF alone (AUC: 0.66). Conclusion This study demonstrated that serum EG-VEGF is a promising biomarker for predicting HDP in the first trimester. It has better predictive performance compared with the currently used biomarkers like PIGF and sFlt-1. Combining maternal clinical characteristics and biochemical tests at 11–13 weeks can effectively identify women at high risk of HDP.

Sign in / Sign up

Export Citation Format

Share Document