singleton pregnancies
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2022 ◽  
Vol 12 ◽  
Author(s):  
Hanxiang Sun ◽  
Yang Liu ◽  
Shijia Huang ◽  
Xiaosong Liu ◽  
Guohua Li ◽  
...  

ObjectiveTo study the association between pre-pregnancy body mass index (BMI) and adverse maternal and neonatal outcomes of singleton pregnancies after assisted reproductive technology (ART).MethodsThis hospital-based retrospective cohort study of women with live singleton births through ART in China from January 2015 to August 2020 included 3043 Chinese women. According to the latest BMI classification standard of Asian women, the women included in this study were classified as underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2), and obese (BMI ≥27.5 kg/m2). We compared the risk of adverse outcomes of different pre-pregnancy BMI values of women with singleton pregnancies conceived through ART. We used Logistic regression analysis to estimate the associations between pre-pregnancy BMI and adverse perinatal and neonatal outcomes.ResultsOur findings showed that women who were overweight or obese before pregnancy through ART are more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia, regardless of whether confounding factors are adjusted. Moreover, pre-pregnancy obesity was more associated with a higher risk of these adverse outcomes than pre-pregnancy overweight. In addition, neonates from women who had obesity before pregnancy through ART were more likely to have macrosomia; adjusted odds ratios and 95% confidence intervals were 3.004 (1.693-5.330).ConclusionsOur research showed that women who had pre-pregnancy overweight or obesity with singleton pregnancies through ART were more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia. Moreover, neonates from women who had obesity before pregnancy were more likely to have macrosomia.


2022 ◽  
pp. 1-7
Author(s):  
Murat Cagan ◽  
Ummuhan Okuducu ◽  
Hanife Guler Donmez ◽  
Mehmet Sinan Beksac

BACKGROUND: The rates of pregnancy losses (PLs) are increased by maternal risk factors such as autoimmune disorders (AD) and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. OBJECTIVE: To evaluate singleton PLs before gestational week (gw) 22 among patients with AD and MTHFR polymorphisms. METHODS: Totally, 1108 singleton pregnancies in 243 women were categorized as: 1) 148 pregnancies in 33 patients with AD, 2) 316 pregnancies in 66 patients with MTHFR polymorphisms, 3) 644 pregnancies in 144 patients with AD +MTHFR polymorphisms. PLs were classified into subgroups: a) Chemical Pregnancy(CP), b) Blighted Ovum(BO), c) gw ⩽ 10, d) gw11–14 e) gw15–22, f) Ectopic Pregnancy(EP), g) Trophoblastic Disease(TD). Obstetric histories were compared using Beksac Obstetrics Index (BOI): [number of living child + (π/10)]/gravida. RESULTS: PL rates before gw22 were 39.2% (58/148), 33.2% (105/316), and 36.3% (234/644) in AD, MTHFR, and AD +MTHFR groups, respectively (p= 0.421). The rate of Pre-Prenatal Screening Period fetal losses (CP + BO + gw ⩽ 10 fetal losses + EP + TD) were 84.8%, 75.9%, and 77.8% in AD, MTHFR, and AD +MTHFR, respectively (p= 0.264). Gravidity ⩽ 4 versus those with gravidity ⩾ 5 had statistically significant differences in BOI (p< 0.001). CONCLUSIONS: PL rate before gw22 among singleton pregnancies with AD and/or MTHFR polymorphisms was 35.8%. The clinical findings seem to be more complicated in patients with gravidity ⩾ 5.


2022 ◽  
Vol 78 (01) ◽  
pp. 6612-2022
Author(s):  
MONICA PROBO ◽  
ALESSIO COTTICELLI ◽  
ROBERTA BUCCI ◽  
MASSIMO FAUSTINI ◽  
JASMINE FUSI ◽  
...  

The Teramana goat is an at-risk breed, needing population protection and programs to increase their numbers. The first step for a population increase is the best management of reproduction, leading to an as high as possible number of healthy and viable kids born. To this purpose, beside the optimization of mating, the best possible management of pregnancy and parturition is mandatory. The goat is a prolific farm animal in which single, double, or triple ovulations can occur, leading to singleton, twin or triple pregnancies, and the birth of multiple kids. Twins and triplets are associated to increased risk for perinatal mortality and need a special surveillance and possible assistance at birth. Knowledge of the number of fetuses that have to be delivered from each goat could be a practical tool for a better management of parturition. Among the methods to define the number of fetuses in the goat, the measurement of blood progesterone (P4) concentrations have provided inconsistent results. Therefore, the present study was aimed to assess the possible association between the maternal concentrations of plasma P4 and cortisol (C), two hormones possibly associated to the number of fetuses, measured only once at about two to one week before parturition in Teramana goats, and the number of fetuses. The results, obtained from 23 does, showed that both plasma P4 and C are higher in does bearing multiple fetuses than does with singleton pregnancies. However, the single measurement of plasma C, but not P4, two to one week before the expected parturition in the Teramana goat is useful to distinguish between does bearing singleton and triplet pregnancies for a better surveillance and assistance at delivery. Therefore, it could represent a tool for the best management of reproduction in a breed population at risk for extinction.


2022 ◽  
Vol 226 (1) ◽  
pp. S436
Author(s):  
Moti Gulersen ◽  
David Krantz ◽  
Xueying Li ◽  
Alexandra Peyser ◽  
Randi Goldman ◽  
...  

2022 ◽  
Vol 226 (1) ◽  
pp. S260
Author(s):  
Moti Gulersen ◽  
Erez Lenchner ◽  
Amos Grunebaum ◽  
Frank A. Chervenak ◽  
Eran Bornstein

Author(s):  
Long Hai Nguyen ◽  

Objective: To examine the sensitivity and specificity of different thresholds of nuchal translucency in diagnosis of chromosomal defects. Study Design: This is a longitudinal study of pregnant women have first trimester screening and ultrasound in center of diagnostic antenatal of national hospital of obstetrics and gynecology. A follow-up was made to identify, in all singleton pregnancies in both group of which fetal karyotyping was made and group of normal fetuses. The threshold for nuchal translucency was divided in to above the 95th percentile, the 99th percentile, the 3.0mm and 2.5 MoM of nuchal translucency. The sensitivity and specificity ware calculated in order to diagnosis the chromosomal abbreviation. Results: The research identified 2645 fetuses, 743 amniocentesis (28%). There is 32.4% fetus has NT ≥ the 95th percentile, 28.6% ≥ 2.5mm percentile, 22.3% ≥ 3.0mm, 16.6% above 2.5 MoM. The fetal karyotype was abnormal in 157 (5.8%) pregnancies. The popular conditions were found including trisomy 21(52.2%). Then structural rearrangements occupied 31.2%. Other chromosomes like 13,18,21 occupied 12.7%. The abnormal of sex chromosome was smallest proportion with only 3.8%. At the 95th percentile of nuchal translucency has the highest sensitivity in detection of chromosomal defects (99.4%) but the threshold 2.5mm has a better detection rate (20.4%). The cut off 3.0mm has a better positive prediction rate (22.3%) but could detect less defects (only 132/157 abbreviation). The threshold 2.5xMoM had the highest specificity (86.4%) but lowest sensitivity (only 65%). Conclusion: In fetuses with increased nuchal translucency, more than a half of the chromosomally abnormal group is affected by defects other than trisomy 21 (52.2%). Using threshold 2.5mm helps detect more 23 chromosomal defects in comparison with the threshold 3.0mm and it had the highest average of sensitivity and specificity (87.25%).


2021 ◽  
Vol 3 (3) ◽  
pp. 78-82
Author(s):  
Gülnaz Şahin ◽  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Erol Tavmergen

Objective: We aimed to evaluate the obstetric and neonatal outcomes of singleton pregnancies at risk for preterm birth (PTB) following assisted reproductive treatments and underwent cervical cerclage placement. Material and methods: A total of 42 women with singleton pregnancies following ART who underwent cerclage between 2009-2021 were included in this retrospective study.  Indications of the cerclage procedure, gestational age at cerclage placement and delivery, neonatal birthweight, and requirement for admission to the neonatal unit of newborns were evaluated. Results: Of those cerclage placement performed in women with a history of second-trimester loss (19%), women with suspected cervical insufficiency according to pre-pregnancy evaluation (52.4%), women with the unicornuate uterus (4.8%), women with cervical shortening/or suspicious changes on ultrasonography (11.9%), and women with detection of cervical dilatation/shortening beyond 20 weeks of gestation (11.9%). Of the total group, 7.1% resulted in late miscarriages, while the remaining 92.9% ended with a live birth with mean gestational age at delivery of 37.0±2.5 weeks. Of those live births, 92.3% (36/39) delivered at >34 weeks and %74.4 (29/39) delivered at term. Except one neonatal death due to extremely PTB at 26th weeks, all infants were discharged from the hospital with well condition. Conclusion: ART pregnancies are evaluated as a special group as having a higher PTB risk at baseline. Cerclage may be considered in broader indications for suspected cervical insufficiency in these pregnancies. There is need for further studies on the effectiveness of cerclage in these ART pregnancies with suspected cervical insufficiency based on different criterions used.


2021 ◽  
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
Junko Kasai ◽  
...  

Abstract Background: To investigate whether false-positive early gestational diabetes mellitus (GDM) women can be managed similarly as normal glucose tolerance (NGT) women.Methods: This retrospective study was conducted at a tertiary care center in Japan. Pregnancy and neonate outcomes of 117 singleton pregnancies with false-positive early GDM and 1774 singleton pregnancies with NGT who delivered after 22 weeks of gestation were compared. GDM was diagnosed according to the IADPSG criteria (patients having one or more of the following: fasting plasma glucose ≥ 92 mg/dL and a 75 g oral glucose tolerance test (OGTT) value ≥180 mg/dL at 1 h, or ≥153 mg/dL at 2 h). Pregnant women diagnosed with GDM in early pregnancy who did not meet the diagnostic criteria on the second OGTT were defined as having false-positive early GDM. Women with false-positive early GDM did not receive any therapeutic intervention during gestation.Results: Maternal age, pre-pregnancy BMI, and gestational weight gain were significantly higher in the false-positive GDM group than the NGT group. No significant differences were found in pregnancy outcomes, including gestational age, birth weight, large for gestational age rate, and cesarean delivery rate. Except for neonatal hypoglycemia rate, no significant differences were found in neonatal outcomes.Conclusions: There were no clinically significant differences between early GDM false-positive women exhibiting GDM patterns only during early pregnancy and NGT women. False-positive early GDM women can be managed similarly as NGT women, suggesting that WHO diagnostic guidelines, applying the IADPSG criteria during early pregnancy, need revision.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Beatriz Fernandez-Rodriguez ◽  
Ana Roche Gomez ◽  
Blanca Sofia Jimenez Moreno ◽  
Concepción de Alba ◽  
Alberto Galindo ◽  
...  

Abstract Objectives Smoking during pregnancy is a leading and modifiable risk factor for fetal growth restriction (FGR) and low birthweight (<10th centile). We studied the effects of smoking in the development of early and late FGR or low birthweight, as well as in uteroplacental and fetoplacental hemodynamics of growth-restricted fetuses. Methods Retrospective cohort study of 5,537 consecutive singleton pregnancies delivered at ≤34 + 0 (“early delivery” group, n=95) and >34 + 0 (“late delivery” group, n=5,442) weeks of gestation. Each group was divided into smokers and non-smokers. Prenatal diagnosis of FGR was based on customized fetal growth standards and fetal Doppler, and postnatal birthweight was assessed using the Olsen newborn chart. Results There were 15/95 (15.8%) and 602/5,442 (11.1%) smokers in the early and late delivery groups, respectively. In early deliveries, FGR was diagnosed in 3/15 (20%) of smokers and in 20/80 (25%) of non-smokers (p=0.68). We also found no differences in birthweights and hemodynamics. In late deliveres, FGR was detected in 30/602 (5%) smokers and 64/4,840 (1.3%) non-smokers (p<0.001). Birthweights <3rd centile and <10th centile were more common in smokers vs. non-smokers: 38/602 (6.3%) vs. 87/4,840 (1.8%) and 89/602 (14.8%) vs. 288/4,840 (6%), respectively (all p<0.01). Fetal Doppler of late FGR showed slightly higher umbilical artery resistances in smokers. Conclusions Smoking in pregnancy is associated with FGR, low birthweight and higher umbilical artery Doppler resistances after 34 weeks of gestation, but we could not confirm this association in earlier deliveries.


Author(s):  
Athena Souka ◽  
Vasiliki Areti Maritsa ◽  
Makarios Eleftheriades

Introduction: To compare the effect of a policy of screening for spontaneous preterm delivery (SPD) by transvaginal cervical length (CL) measurement versus a no screening policy in the prevention of severe prematurity. Methods: Retrospective study on low risk singleton pregnancies examined at 20-24 weeks. Two cohorts one with SPD screening and the other without screening were matched using propensity analysis to create the study groups. Women with short CL were treated with vaginal progesterone and/or cervical cerclage/pessary. The outcomes examined were SPD<32 weeks (SPD 32) and SPD between 20 and 32 weeks (SPD 20-32). Results: Screening for SPD was associated with a significant reduction in the rate of SPD at less than 32 weeks (0.3% vs 0.8%, p=0.001 in the screened and no screened pregnancies respectively) and in the rate of SPD 20-32 (0.3% vs 0.9%, p=0.005 in the screened and no screened pregnancies respectively). After adjusting for maternal age, parity, body mass index, smoking and mode of conception, the screening group had significantly lower hazard for SPD 20-32 (HR=0.36, 95% CI: 0.18-0.75, p=0.006) and SPD32 (HR=0.39, 95% CI: 0.19-0.82, p=0.013). Conclusion: Screening for SPD by transvaginal CL measurement in mid pregnancy may reduce the incidence of severe prematurity in low risk singleton pregnancies.


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