Feto-Maternal Consequences of Obesity in Pregnancy

Introduction: Potential ill effects of obesity in pregnancy pose a challenge encompassing many comorbidities that threaten the life and require special attention. Pregnancy is the most crucial event for women surrounded with multiple complexities. Obesity during pregnancy leads to life threatening events for mother as well as fetus. Purpose of the present study was to identify the feto-maternal outcomes of obesity during pregnancy. Methodology: An observational cross-section design was used. Non-probability convenient sampling was done to collect data from 170 women. Data related to predominated maternal problem during pregnancy and fetus birth was collected. Ethical considerations were followed. Data was analyzed through SPSS (version 24.0). Results: Findings revealed multiple consequences of obesity on both mother and fetus. Obesity was considered as a mainstay of feto-maternal complications and findings revealed a significant association (p-value <0.05). Conclusion: Obesity is a signal for many adverse feto-maternal outcomes during pregnancy that poses a challenge for both mother and fetus. It is concluded from this study that there is ample need to educate mothers regarding the hazardous consequences of obesity in pregnancy. Keywords: Fetus, Maternal, Consequences, Obesity, Pregnancy

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Long-term consequences of obesity in pregnancy for the mother

Maternal Obesity ◽

10.1017/cbo9780511782466.009 ◽

2012 ◽

pp. 81-86

Author(s):

Andrea Deierlein ◽

Anna Maria Siega-Riz

Keyword(s):

Obesity In Pregnancy ◽

Long Term Consequences ◽

In Pregnancy ◽

Consequences Of Obesity

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Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170470 ◽

2017 ◽

Vol 6 (3) ◽

pp. 781

Author(s):

Radha K. R. ◽

Nishu Sugunan ◽

Resmy C. R.

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

Universal Screening ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Maternal Complications ◽

Cross Sectional ◽

Neonatal Hypothyroidism ◽

In Pregnancy

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

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Obstetric and neonatal outcomes of the pregnancies complicated with thrombocytopenia

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194843 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4276

Author(s):

Pratima Kumari ◽

Saurabh V. Bhangale ◽

Asmita N. Patil

Keyword(s):

Statistical Significance ◽

Tertiary Care ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

P Value ◽

Blood Product Transfusion ◽

Maternal Complications ◽

Common Cause ◽

Gestational Thrombocytopenia ◽

In Pregnancy

Background: Thrombocytopenia is second most common hematological abnormality in pregnancy after anemia (Incidence 8-10%). The aim of this study is to observe the obstetric and neonatal outcomes of pregnancies complicated with thrombocytopenia and to compare its maternal and fetal outcomes.Methods: The prospective observational study was conducted at tertiary care institute over period of one and half year and 100 cases of thrombocytopenia in present pregnancy were included after fulfilling inclusion and exclusion criteria and obtaining written informed valid consent. Complete history, physical examination and relevant investigations of the patient were documented. Patients were followed up to delivery and outcomes (obstetric, maternal, fetal, neonatal) were studied. The data obtained for all the patients was analyzed with SPSS (SPSS Inc, Chicago) software packages. Statistical comparisons were performed with Pearson’s Chi- square where appropriate with p-value of <0.05 considered statistically significant.Results: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia in (25%) cases followed by preeclampsia (20%). Most cases (94%) were diagnosed in antepartum period out of which most (58%) at >37 weeks of gestation. Most (53%) had moderate thrombocytopenia. Incidence of maternal complications was statically significant (P-value 0.038) with most common complication being caesarian section site oozing (9%) followed by placental abruption (4%). There was no statistical significance in degree of thrombocytopenia and need for blood and blood product transfusion (P-value 0.67). Only (2%) neonates of thrombocytopenic mothers had thrombocytopenia and both required treatment.Conclusions: Most common cause of thrombocytopenia in pregnancy was gestational thrombocytopenia with uneventful pregnancy and perinatal outcomes. Few severe cases associated with medical or systematic causes leads to serious catastrophic events which can be avoided by increasing antenatal surveillance and appropriate management by multidisciplinary team of obstetrician, hematologist, anesthesiologist, neonatologist and physician.

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NT-proBNP Levels and Obesity in Pregnancy

Case Medical Research ◽

10.31525/ct1-nct04049136 ◽

2019 ◽

Author(s):

Keyword(s):

Obesity In Pregnancy ◽

In Pregnancy

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Diabetes and Obesity in Pregnancy: From Patients to Molecular Mechanisms

Current Vascular Pharmacology ◽

10.2174/157016111902201230093444 ◽

2020 ◽

Vol 19 (2) ◽

pp. 111-112

Author(s):

Luis Sobrevia

Keyword(s):

Molecular Mechanisms ◽

Obesity In Pregnancy ◽

Diabetes And Obesity ◽

In Pregnancy

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Clinicians’ Knowledge and Attitudes About Delirium Detection and Management

Innovation in Aging ◽

10.1093/geroni/igaa057.1676 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 519-520

Author(s):

Priyanka Shrestha ◽

Erica Husser ◽

Diane Berish ◽

Long Ngo ◽

Marie Boltz ◽

...

Keyword(s):

Rating Scale ◽

P Value ◽

Clinical Implementation ◽

Chi Square ◽

Response Options ◽

Knowledge And Attitudes ◽

Point Rating Scale ◽

Life Threatening ◽

Strongly Agree ◽

High Level

Abstract Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patient and increased workload for the clinician. As a part of an NIH funded study testing a rapid two-step delirium identification protocol at two hospitals in the U.S. (one urban and one rural), clinicians completed a 12-item survey to assess their knowledge and attitudes about delirium and their confidence in preventing and managing delirium. Survey response options followed a 5-point rating scale (strongly disagree, disagree, undecided, agree, strongly agree). The sample for this analysis included 399 clinicians (MDs=53; RNs=235; CNAs=111). Chi-square was used to test for group differences between clinician types. Less than half of the clinicians reported agreeing with the statement, “delirium is largely preventable” (MDs: 47%; RN: 44%; CNA: 41%, p-value=0.021). MDs and RNs indicated a high level of confidence in recognizing delirium while CNAs endorsed lower levels of confidence (MDs: 87%; RN: 81%; CNA: 65%, p-value=0.001). All types of clinicians reported lower confidence in managing delirium (MDs: 29%; RN: 36%; CNA: 44%, p-value=0.117). 47% of CNAs and 37% of RNs agreed there is a need for additional training in caring for persons with delirium while only 21% of MDs agreed (p = 0.031). Understanding how different types of clinicians think and feel about delirium will inform training and communication initiatives, clinical implementation, and research on best practices for delirium identification and management.

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Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

Journal of Medical Case Reports ◽

10.1186/s13256-021-02892-5 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Yuya Kato ◽

Yoshikazu Ogawa ◽

Teiji Tominaga

Keyword(s):

Pituitary Apoplexy ◽

Clinical Symptoms ◽

Case Series ◽

Optimal Timing ◽

Presenting Symptoms ◽

Pathological Evaluation ◽

Mother And Child ◽

Life Threatening ◽

In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

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Thyroid storm in the second stage of labour: a case report

BMJ Case Reports ◽

10.1136/bcr-2021-243159 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243159

Author(s):

Yudianto Budi Saroyo ◽

Achmad Kemal Harzif ◽

Beryliana Maya Anisa ◽

Fistyanisa Elya Charilda

Keyword(s):

Treatment Guidelines ◽

Thyroid Storm ◽

Lung Oedema ◽

Second Stage ◽

Second Stage Of Labour ◽

Failure Treatment ◽

Life Threatening ◽

Thyroid Hormone Levels ◽

Peripartum Period ◽

In Pregnancy

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.

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