scholarly journals The Effect of Fat Emulsion Intralipid Infusion on Reproductive Outcome for Women with Unexplained First Trimester Habitual Abortion

2021 ◽  
pp. 276-283
Author(s):  
Mahmoud Abd Alsattar Al Mohasseb ◽  
Eltahera Mohsen Goda
Keyword(s):  
First Trimester ◽  
University Hospital ◽  
Second Trimester ◽  
Group Iii ◽  
Live Births ◽  
Habitual Abortion ◽  
Low Dose Aspirin ◽  
History Of ◽  
Group A ◽  
Maternal And Neonatal Outcomes

Objectives: To study the effect of the use of intralipid in management of women suffering from unexplained first trimester habitual abortion. Methods: The study was a prospective cohort study, which conducted in Tanta university Hospital; Egypt. It included 93 women with history of two or more unexplained recurrent abortion in the first trimester. They were divided into three groups: group Ι received only intralipid, group II received low molecular weight heparin (LMWH) and low dose aspirin, and group III served as controls and received only saline as placebo. The patients were followed up until continuation of pregnancy into the second trimester. Occurrence of complication and pregnancy outcomes were evaluated. Results: Ninety three women were included. After treatment, more pregnancy continued into the second trimester, more live births and less numbers of abortions in group A and B in comparison with group C (p=0.008, 0.008 and 0.035) respectively. Maternal and neonatal outcomes were comparable in all studied regimens. Conclusions: Management of women with unexplained first trimester habitual abortion (before 14 weeks) with intralipid or LMWH with small dose of aspirin may increase the proportion of pregnancy continued into the second trimester, more live births and less numbers of abortions. However, LMWH is more superior to the intralipid but with more side effect.

Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

scholarly journals Effectiveness of misoprostol for induction of first and early second trimester spontaneous miscarriages in parous women

2018 ◽  
Vol 7 (11) ◽  
pp. 4512
Author(s):  
Tamima Al-Dughaishi ◽  
Amjad Hamed Al-Haddabi ◽  
Mussab Mussab Mubarak Hamed Al-Jabri ◽  
Vaidyanathan Gowri
Keyword(s):  
Success Rate ◽  
First Trimester ◽  
University Hospital ◽  
Second Trimester ◽  
Sultan Qaboos University ◽  
Dilatation And Curettage ◽  
Dilation And Curettage ◽  
Medical Termination ◽  
Surgical Evacuation ◽  
Incomplete Miscarriage

Background: Medical termination of missed miscarriage and incomplete miscarriage with misoprostol, are an alternative to surgical evacuation (dilatation and curettage). This study aimed to evaluate the effectiveness of misoprostol in highly parous woman for incomplete and missed miscarriage.Methods: This was a retrospective study was conducted in two different time lines (2010 and 2014). All patients admitted to the Sultan Qaboos University hospital, Muscat, Oman, for the management of first-trimester miscarriages (missed and incomplete types) during the study period were included. Some women were moved to dilation and curettage even after misoprostol. The effect of gravidity and parity on those women in whom misoprostol was not effective was studied.Results: The overall success rate of misoprostol for the management was 62.14% in 2010 and 53.8% 2014. In nulliparous woman the success rate of misoprostol was slightly higher than parous women. There was no apparent effect of gravidity and parity of ≥ 5 or ≥ 5 on the success of misoprostol.Conclusions: Misoprostol reduced the rate of surgical evacuation among the study subjects. In highly parous and multigravid women (≥ para 5 and gravida ≥5) the success was not significantly different compared to less parous women.

scholarly journals PREDICTORS OF POOR PROGNOSIS IN PREGNANT WOMEN WITH COVID-19: A PROSPECTIVE COHORT STUDY IN THE MATERNITY MOTHER AND CHILD UNIVERSITY HOSPITAL OF CASABLANCA MOROCCO

2021 ◽  
Vol 9 (10) ◽  
pp. 735-741
Author(s):  
Lamrissi A. ◽  
◽  
Midyani H. ◽  
Khalloufi C. ◽  
Jalal M. ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Death Rate ◽  
Poor Prognosis ◽  
First Trimester ◽  
University Hospital ◽  
Maternity Unit ◽  
Second Trimester ◽  
Third Trimester ◽  
High Prevalence ◽  
Mother And Child

Objective: We aim to study the clinicalcharacteristics, the evolution of COVID-19 on pregnant women and survival factors. Study design: Its a prospective cohortstudy in a large tertiary maternity unit within the Mother and Child University Hospital Ibn Rochd of Casablanca with an average annual birth of over 6950 births. We prospectively collected and analyzed data for a cohort of 40 pregnant patients tested positive for COVID-19 between January 2020 and December 2020 inclusive to assess the effect of COVID-19 on pregnancy. Results: Forty pregnant patients testedpositive for COVID-19, 36 patients gave birth and 4 patients died pregnant. The severity of the symptoms ranged from mild in 20/40 (50%) of the patients, moderate in 7/40 (17,5%), and severe in 13/40 (32,5%). Thirteen of our patients were admitted to invasive care units, six were in their third trimester, and seven in their second trimester nine were intubated and ventilated prior to delivery and three of them required Extracorporeal membrane oxygenation. Among these patients intubated only two survived. Most common comorbidities were gestational diabetes 4/40 (10 %), asthma 4/40 (10 %), preeclampsia 7/40 (17,5%). Of the 40 pregnant patients 31 (77,5%) were in their third trimester, 8 (20%) women in their second trimester, and one in her first trimester. Of the 36 patients who delivered, 12/36 (33,3 %) were preterm delivered by elective C-sections. The death rate was 17,5% (7/40). Conclusion: COVID-19 is associated with high prevalence of preterm birth, caesarean section, and a high mortality rate.

scholarly journals Mathieu repair in distal penile hypospadias with or without stent

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Sajid Hameed Dar ◽  
Nabila Talat ◽  
Muhammad Afzal Sheikh
Keyword(s):  
Urinary Retention ◽  
Major Complication ◽  
First Trimester ◽  
Paediatric Surgery ◽  
Chi Square ◽  
Indwelling Catheter ◽  
History Of ◽  
Group A ◽  
Group B ◽  
Complications Rate

Objective: To compare the outcome of two techniques for repair of distal penile hypospadias: Mathieu`s repair with and without stent. Study Design: Prospective observational descriptive study. Place and duration: Department of Paediatric Surgery, Mayo Hospital, Lahore from September 2000 to September 2002. Material and methods: Sixty boys were randomly assigned the two groups of thirty boys each. Detailed scrutiny of procedure done and analyses of the clinical outcome made prospectively. Results: A total of sixty patients were treated in two separate groups. All the boys had Mathieu`s repair done for distal hypospadias. In group A stent/ indwelling catheter was used for 7-8 days while in group B no stent was used. Stratification was done using Chi square test. Median age was 4 years and most of them belonged to low socioeconomic class (61.6%). A high percentage (48.3% were born to mothers of age ranging from 30-40 years. Sixteen (26.66%) patients had a family history of hypospadias. Only twelve mothers (2 0%) gave a positive history of drug intake in first trimester. Sixteen (26.66%) patients had associated anomalies of undescended testis / inguinal hernia. Twenty four (40%) patients were brought because of the abnormal appearance of the child`s penis while their stream (21.66%) and dysuria (25%) were presenting complaints of two other major groups. Mathieu`s repair was done in all cases with group A. Thirty boys (50%) having a stent post operatively and the group B thirty boys (50%) were without stent. Total complications rate is 46.66% with group a showing eight cases (26.66%) and group B having twenty (66.66%) cases with compliec. Major complication in group B was urinary retention in eleven cases (36.66%) while no patient had retention in group A. overall twenty six (86.66%) in group A and twenty one (70%) in group B showed satisfactory results. Conclusion: Mathieu`s repair without stent has been advantage of shorter hospital stay but a fair proportion of patients (36.66%) having urinary retention calls for further studies on a larger scale.

scholarly journals Changes of Partial Pressure of Carbon Dioxide in Arterial Blood (PaCO2) and Respiratory Rate (RR) in Pregnant Women

2008 ◽  
Vol 10 (Number 1) ◽  
pp. 10-15
Author(s):  
D K Sunyal ◽  
Md. R Amin ◽  
MH Md. R ◽  
GM Kibria ◽  
G M Molla ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Pregnant Women ◽  
Respiratory Rate ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Arterial Blood ◽  
Significant Difference ◽  
History Of

In the present study the partial pressure of carbon dioxide in arterial blood (PaC0:1 and respiratory rate (RR) were studied in pregnant and non-pregnant women in Dhaka city. Far this purpose a total 32 women for PaCO)and 100 women for RR with age ranging front 25 ...ears le 35 years without any recent history of respiratory diseases were selected. Normal pregnant women were taken as e.yperimental group and healthy nor-pregnant ...omen as return!. Data was collected during first trimester. second trimester and third trimester in pregnant women and also nompregnant women. The PaCOrwas determined by using 'EASY BLOOD GAS .0TO INALMER" and RR was recorded. The PaCO, and RR during different trimesters of pregnant .rumen were compared with that of non-pregnant 11.1101. Statistical analysis was drum with .tudents '1' rest. The PeCOr was significantly lower in first trimester, second trimester and third (rimester of pregnant women than that of non-pregnant women. Similarly, RR was significantly higher in first trimester. second trimester and third trimester of pregnant women than that of nonpregnant women. Again RR was significantly higher in third trimester than in first trimester and second trimester of pregnant women. There were no statistically significant difference of PaCO, among first trimester. second trimester and third trimester of pregnant women. Similarly, there were no statistically significant difference of RR between first trimester and second trimester of pregnant women. It may be concluded from the study that the progressively decreased PaCO• and increased RR throughout Me pregnancy were most likely MP be related to the effect of progesterone-induced hyperventilation. Hypermfilation in pregnancy is due to hypersensitivity of respiratory centre. Due to hyperventilation there is expel out of CO, miming decrease in PaC0r and increase in RR during pregnancy.

scholarly journals Comparative study between intravaginal misoprostol and extra-amniotic instillation of ethacridine lactacte for second trimester abortion

2017 ◽  
Vol 6 (6) ◽  
pp. 2575
Author(s):  
Suryaprakash Jagdevappa Karande ◽  
Meena Shantanu Gunjotikar
Keyword(s):  
Side Effects ◽  
Pregnancy Termination ◽  
First Trimester ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Ethacridine Lactate ◽  
Second Trimester Pregnancy ◽  
Group A ◽  
Second Trimester Abortion ◽  
Group B

Background: The methods of terminating pregnancy in the first trimester are simple, safe and effective. Factors like lack of knowledge about availability of MTP services, ignorance, denial of pregnancy, fear of society may account for decrease in number of first trimester abortions. The aims of the present study were to compare the efficacy, induction abortion interval and side effects of intravaginal misoprostol with extra amniotic installation of ethacridine lactate for second trimester abortion.Methods: 60 women coming to MTP clinics requesting second trimester pregnancy termination between 12 to 20 weeks were selected. Detail history and examination was carried out in each patient. They divided into two groups, Group A (30) intravaginal misoprostol 400 initially followed by 400 micrograns every 6 hourly if required. Group B (30) extra-amniotic 0.1% ethacridine lactate 150 cc.Results: In Group A success rate was 100% while in Group B it was 76.66%, which is highly statistically significant (P< 0.01). Mean I – A interval in Group A was 14.58+5.25 hours was highly significantly less than in Group B, it was 33.91 + 3.97 hours (p<0.0001). In Group A complete abortion has occurred in 28 cases (93.33%) and in Group B in 12 cases (52.17%).Conclusions: We conclude that, as compared to extra-amniotic instillation of ethacridinelactate intravaginal misoprostol is the preferred regimen in second trimester abortion because of its high efficacy, shorter induction abortion interval, high incidence of completeness of abortion, low incidence of side effects and better tolerance by the patient. 

Optimal timing to screen for asymptomatic bacteriuria during pregnancy: first vs. second trimester

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lisa-Marie Langermans ◽  
Wilfried Cools ◽  
Ingrid Van Limbergen ◽  
Leonardo Gucciardo ◽  
Gilles Faron
Keyword(s):  
Preterm Delivery ◽  
Cohort Analysis ◽  
Asymptomatic Bacteriuria ◽  
First Trimester ◽  
University Hospital ◽  
Optimal Timing ◽  
Main Question ◽  
Second Trimester ◽  
Urinary Culture ◽  
The Moment

Abstract Objectives Although current guidelines advice to screen for asymptomatic bacteriuria during pregnancy, little is known about the best moment of testing. The goal of this study is to analyze the optimal timing (first vs. second trimester) to screen for asymptomatic bacteriuria during pregnancy. Methods A retrospective cohort analysis, comparing patients that were screened for asymptomatic bacteriuria in the first vs. second trimester was performed. The main question was to compare the rate of positive urinary culture in both trimesters. Study included patients all followed a prenatal consultation at the University Hospital of Brussels between 2012 and 2017. Other outcomes considered were the nature of identified germs, treatments, possible risk and confounding factors (age, BMI, gravidity-parity-abortus [GPA], type of conception, ethnicity, education, prior urinary tract infection (UTI), diabetes, hypertension, prior preterm delivery and sickle cell disease) and complications (UTI, preterm delivery, preterm rupture of the membranes and chorio-amnionitis). Results A total of 2,005 consecutive files were reviewed, 655 concerned patients screened during the first trimester group and 1,350 in the second trimester group. Asymptomatic bacteriuria was present in only 71 cases (3.54%), 23 in the first trimester group (3.50%) and 48 in the second trimester group (3.55%). Escherichia coli was the most frequently identified germ (37 cases (1.8%), 14 in the first trimester group and 23 in the second trimester group). Our logistic regression analysis shows no statistical difference according to the moment the urinary culture was done for the presence of asymptomatic bacteriuria (E. coli or others), for its association with hospitalization for pyelonephritis, preterm contractions, preterm pre-labor rupture of the membranes (PPROM) and/or preterm delivery. Conclusions If recommendations remain to screen for asymptomatic bacteriuria at least once during pregnancy, this study indicates that the moment of testing (first vs. second trimester) has no clinical impact on obstetrical outcomes.

scholarly journals Comparing the first trimester and second trimester fifty grams oral glucose tolerance test values in gestational diabetes mellitus

2021 ◽  
pp. 1-9
Author(s):  
Hasan Turan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Early Period ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Second Trimester ◽  
Glucose Levels ◽  
History Of

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels <140 mg/ dl and plasma glucose levels between 140 mg/dl and 200mg/dl, GDM group plasma glucose levels ≥200 mg/dl. First trimester and second-trimester OGTT values and possible risk factors for GDM (age, gravida, parity, number of abortions, smoking, a previous GDM history, etc.) were compared between non-GDM and GDM groups. Results: GDM, diagnosed in 4.5% (7) in the first trimester (between 8th and 14th weeks) and 6.5% (10) second trimester, was detected in 11% (17) of 153 pregnant women in the present study. GDM, diagnosed in 41.2% (7 patients) in the first trimester and 58.8% (10 patients) second trimester, was found with a higher rate in pregnant women over 30 years (p=0.000 <0.05). The mean fasting blood glucose (FBG) level was 96 mg/dl in the GDM group and 83 mg/dl in the non-GDM group, with a statistically sig- nificant difference, which existed (p<0.05). The mean 50 g OGTT value was 170 mg/ dl in pregnant women diagnosed with GDM in the first trimester, and it was 140 mg/dl in those diagnosed in the second trimester, with this difference was considered statis- tically different (p<0.05). Age, parity, a family history of DM, FBG, a previous GDM his- tory, gravida, a previous macrosomia history, and a previous history of preeclampsia were determined as risk factors that significantly increase the risk of GDM (p<0.05). The half of patients was diagnosed with GDM in the early period of pregnancy. In the present study, 41.2% of cases were diagnosed in the first trimester and 58.8% in the second trimester. In general, the patients diagnosed in the first trimester were those being under risk in terms of GDM. According to the present study, it is recommended that the pregnant women should be scanned for GDM in the early period. Conclusion: With screening tests to be applied to risky groups in early pregnancy, a significant number of cases with GDM recently be detected on time. Thereby, mater- nal and fetal morbidity and mortality rates might be considerably reduced thanks to providing proper treatments and regular monitoring. Furthermore, for obtaining spe- cific data concerning the factors with potential influence on the risk of GDM, further studies on this topic need to be performed.

scholarly journals First Trimester Uterine Rupture: A Case Report and Literature Review

2020 ◽  
Vol 17 (8) ◽  
pp. 2976
Author(s):  
Fabiana Cecchini ◽  
Alice Tassi ◽  
Ambrogio P. Londero ◽  
Giovanni Baccarini ◽  
Lorenza Driul ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Case Reports ◽  
Good Condition ◽  
First Trimester ◽  
Emergency Laparotomy ◽  
Cesarean Scar Pregnancy ◽  
Spontaneous Uterine Rupture ◽  
History Of ◽  
Group A ◽  
English Articles

The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. Methods: A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. Results: A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. Conclusion: According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.

First-trimester low-dose prednisolone in refractory antiphospholipid antibody–related pregnancy loss

Blood ◽  
2011 ◽  
Vol 117 (25) ◽  
pp. 6948-6951 ◽  
Author(s):  
Kate Bramham ◽  
Mari Thomas ◽  
Catherine Nelson-Piercy ◽  
Munther Khamashta ◽  
Beverley J. Hunt
Keyword(s):  
Antiphospholipid Antibodies ◽  
Maternal Morbidity ◽  
Pregnancy Loss ◽  
Conventional Treatment ◽  
Low Dose ◽  
First Trimester ◽  
Antiphospholipid Antibody ◽  
Live Births ◽  
Positive Pregnancy Test ◽  
History Of

Abstract The objective of this study was to assess pregnancy outcome in women with a history of refractory antiphospholipid antibody–associated pregnancy loss(es) who were treated with early low-dose prednisolone in addition to aspirin and heparin. Eighteen women with antiphospholipid antibodies who had refractory pregnancy loss(es) were given prednisolone (10 mg) from the time of their positive pregnancy test to 14 weeks' gestation. Before low-dose prednisolone was given as treatment, 4 (4%) of 97 pregnancies had resulted in live births. Among 23 pregnancies supplemented with prednisolone, 9 women had 14 live births (61%), including 8 uncomplicated pregnancies. The remainder were complicated by preterm delivery, preeclampsia, and/or small-for-gestational-age infants. There were 8 first-trimester miscarriages and 1 ectopic pregnancy. There were no fetal deaths after 10 weeks' gestation and no evidence of maternal morbidity. The addition of first-trimester low-dose prednisolone to conventional treatment is worthy of further assessment in the management of refractory antiphospholipid antibody–related pregnancy loss(es), although complications remain elevated.

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