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Sample records for activation clinical pregnancy

  1. Lupus Activity in Pregnancy

    Clowse, Megan E. B.

    2007-01-01

    Pregnancy in a woman with Systemic Lupus Erythematosus (SLE) can be complicated by both lupus activity and pregnancy mishaps. The majority of recent studies demonstrate an increase in lupus activity during pregnancy, perhaps exacerbated by hormonal shifts required to maintain pregnancy. Increased lupus activity, in turn, prompts an elevated risk for poor pregnancy outcomes, including stillbirth, preterm birth, low birth weight, and preeclamspsia. Fortunately, the majority of pregnancies in wo...

  2. The Clinical and Ultrasonic Study of Clinically Suspected Ectopic Pregnancy: Laying Emphasis on 15 proven Ectopic Pregnancies

    Ectopic preganacies are unsuccessful pregnancies that result from implantation of fertilized ovum occurring in an aberrant area. Aside from an emergency case, the early diagnosis of ectopic pregnancy is very difficult particularly in a case with insidious onset and mild clinical manifestations. Early diagnosis not only reduces the danger, but also simplifies the management of ectopic pregnancy. Ultrasonography has been an indispensable diagnostic tool in Obstetrics and Gynecology. In the authors' experience, clinical suspected ectopic pregnancy was one of the common indications for performing ultrasonography. Since Kobayashi at al. reported the appearances of ectopic pregnancy utilizing bistable B-scan ultrasonography, the ultrasonic findings of ectopic pregnancy have been reported by many authors. But, its accuracy and reliability in the diagnosis of ectopic pregnancy are still open to controversy. The authors studied 65 cases of clinically suspected ectopic pregnancy with Picker 80 L gray scale ultrasonography from Aug. 1982 to June. 1983. There were 29 confirmed cases, of which 15 were proved to have ectopic pregnancy and 14 were proved to have diseases other than ectopic pregnancy by surgical and histopathological study or by laparoscopy and follow up study. 29 confirmed cases were reviewed. The results were as follows: 1. Among 15 ectopic pregnancies, there were 12 ampullary pregnancies, 2 isthmic pregnancies and 1 interstitial pregnancy. Among 14 cases of no ectopic pregnancy, there were 5 intrauterine pregnancies, 3 myoma uteri, 2 P.I.D., and 1 case of dermoid cyst, cystic teratoma, H-mole and tubal hematoma due to previous tuball ligation, respectively. 2. The age distribution of ectopic pregnancy was from 22 to 41 years. The common clinical manifestations of ectopic pregnancy were lower abdominal pain (73.3%), vaginal spotting or bleeding (73.3%) and amenorrhea (66.7%). 3. Positive result of urine immunologic pregnancy test was 28.6% in ectopic pregnancy

  3. The Clinical and Ultrasonic Study of Clinically Suspected Ectopic Pregnancy: Laying Emphasis on 15 proven Ectopic Pregnancies

    Byun, Myung Ho; Chung, Yung Sun [Chonnam National University College of Medicine, Gwangju (Korea, Republic of)

    2010-05-15

    Ectopic preganacies are unsuccessful pregnancies that result from implantation of fertilized ovum occurring in an aberrant area. Aside from an emergency case, the early diagnosis of ectopic pregnancy is very difficult particularly in a case with insidious onset and mild clinical manifestations. Early diagnosis not only reduces the danger, but also simplifies the management of ectopic pregnancy. Ultrasonography has been an indispensable diagnostic tool in Obstetrics and Gynecology. In the authors' experience, clinical suspected ectopic pregnancy was one of the common indications for performing ultrasonography. Since Kobayashi at al. reported the appearances of ectopic pregnancy utilizing bistable B-scan ultrasonography, the ultrasonic findings of ectopic pregnancy have been reported by many authors. But, its accuracy and reliability in the diagnosis of ectopic pregnancy are still open to controversy. The authors studied 65 cases of clinically suspected ectopic pregnancy with Picker 80 L gray scale ultrasonography from Aug. 1982 to June. 1983. There were 29 confirmed cases, of which 15 were proved to have ectopic pregnancy and 14 were proved to have diseases other than ectopic pregnancy by surgical and histopathological study or by laparoscopy and follow up study. 29 confirmed cases were reviewed. The results were as follows: 1. Among 15 ectopic pregnancies, there were 12 ampullary pregnancies, 2 isthmic pregnancies and 1 interstitial pregnancy. Among 14 cases of no ectopic pregnancy, there were 5 intrauterine pregnancies, 3 myoma uteri, 2 P.I.D., and 1 case of dermoid cyst, cystic teratoma, H-mole and tubal hematoma due to previous tuball ligation, respectively. 2. The age distribution of ectopic pregnancy was from 22 to 41 years. The common clinical manifestations of ectopic pregnancy were lower abdominal pain (73.3%), vaginal spotting or bleeding (73.3%) and amenorrhea (66.7%). 3. Positive result of urine immunologic pregnancy test was 28.6% in ectopic

  4. Clinical management of pregnancy in cats.

    Root Kustritz, Margaret V

    2006-07-01

    Average gestation length in domestic cats is 65.6 days, with a range of 52-74 days. Average reported litter size is 4.0 kittens per litter; litter size is not correlated with number of matings in a given estrus. Superfecundation is common in domestic cats; superfetation never has been definitively proven to occur. Eclampsia may occur during pregnancy in queens, with non-specific clinical signs. Ectopic pregnancy and uterine torsion have been reported. Pregnancy loss may be due to infectious causes, including bacteria, viruses or protozoa, or non-infectious causes, such as hypoluteoidism and chromosome errors. PMID:16620942

  5. ORAL HEALTH DURING PREGNANCY AND THE CLINIC APPEARANCE OF PREGNANCY TUMOR (Case Report)

    Kılınç, Gülser; Koca, Hakan

    2015-01-01

    The aim of this case report is to introduce pregnancy tumors and to emphasize the importance of oral health during pregnancy. Pregnant patient within 34th week of her pregnancy applied our clinic for tuberance and bleeding problems in her gingiva. In her oral examination  she was diagnosed with pregnancy tumor. Oral hygiene education was taught to the patient and appropriate dental treatment was made. Bad oral hygiene and increased hormanal levels have an important role in the etiology of pre...

  6. Clinical study of cardiac diseases during pregnancy

    Amitha Vijay Kamat

    2016-03-01

    Conclusions: Cardiac diseases in pregnancy constitute high risk pregnancy and require special attention during antepartum, intrapartum and postpartum period. Rheumatic heart disease was the major contribution of cardiac diseases in pregnancy and is seen to be associated with increased maternal morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 855-859

  7. Clinical Study on Acute Pancreatitis in Pregnancy in 26 Cases

    Cheng Qihui; Zhang Xiping; Ding Xianfeng

    2012-01-01

    Aim. This paper investigated the pathogenesis and treatment strategies of acute pancreatitis (AP) in pregnancy. Methods. We analyzed retrospectively the characteristics, auxiliary diagnosis, treatment strategies, and clinical outcomes of 26 cases of patients with AP in pregnancy. Results. All patients were cured finally. (1) Nine cases of 22 mild acute pancreatitis (MAP) patients selected automatic termination of pregnancy because of the unsatisfied therapeutic efficacy or those patients' req...

  8. Triploid pregnancies, genetic and clinical features of 158 cases

    Joergensen, Mette W; Niemann, Isa; Rasmussen, Anders A;

    2014-01-01

    OBJECTIVE: The purpose of this study was to analyze the correlation between the genetic constitution and the phenotype in triploid pregnancies. STUDY DESIGN: One hundred fifty-eight triploid pregnancies were identified in hospitals in Western Denmark from April 1986 to April 2010. Clinical data and...

  9. TREATMENT OF HYPERTENSION IN PREGNANCY: GUIDELINES AND CLINICAL EXPERIENCE

    O. V. Gaisenok

    2015-09-01

    Full Text Available Topical issues of the treatment of hypertension in pregnancy are presented. Examples from clinical practice are discussed as well as possible medical treatment of hypertension in pregnant women taking into account actual recommendations.

  10. Summary of International Guidelines for Physical Activity Following Pregnancy

    Evenson, Kelly R.; Mottola, Michelle F.; Owe, Katrine M.; Rousham, Emily K.; Brown, Wendy J.

    2014-01-01

    Postpartum physical activity can improve mood, maintain cardiorespiratory fitness, improve weight control, promote weight loss, and reduce depression and anxiety. This review summarizes current guidelines for postpartum physical activity worldwide. PubMed (MedLINE) was searched for country-specific government and clinical guidelines on physical activity following pregnancy through the year 2013. Only the most recent guideline was included in the review. An abstraction form facilitated extract...

  11. Pregnancy

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde; Group, Multidisciplinary Guideline Development

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  12. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World

    Evenson, Kelly R.; Barakat Carballo, Ruben; Brown, Wendy J.; Dargent-Molina, Patricia; Haruna, Megumi; Mikkelsen, Ellen M.; Mottola, Michelle F.; Owe, Katrine M.; Rousham, Emily K; Yeo, SeonAe

    2014-01-01

    Women attain numerous benefits from physical activity during pregnancy. However, due to physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most rece...

  13. Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes.

    Tedeschi, Sara K; Guan, Hongshu; Fine, Alexander; Costenbader, Karen H; Bermas, Bonnie

    2016-07-01

    Systemic lupus erythematosus (SLE) is a disease of reproductive-age women, and thus questions regarding how disease influences pregnancy outcomes arise. We investigated whether five specific types of SLE activity during the 6 months before conception or during pregnancy (nephritis, cytopenias, skin disease, arthritis, serositis) were associated with adverse pregnancy outcomes. We performed a retrospective cohort study of pregnancy outcomes among women with SLE at the Brigham and Women's Hospital Lupus Center. Adverse pregnancy outcomes included pre-eclampsia, pre-term delivery, elective termination due to SLE, spontaneous miscarriage at weeks 12-20, and stillbirth. SLE and obstetric history, laboratories, and medications were obtained from electronic medical records. Generalized linear mixed models adjusting for potential confounders were used to identify predictors of any adverse pregnancy outcome. Most pregnancies resulted in a live term delivery (76.5 %). After adjustment for Hispanic ethnicity, prior adverse pregnancy outcome and medication use 6 months before conception, nephritis during pregnancy (odds ratio (OR) 3.6, 95 % confidence interval (CI) 1.0-12.8), cytopenias during pregnancy (OR 3.9, 95 % CI 1.3-11.4), and serositis during pregnancy (OR 5.9, 95 % CI 1.0-34.0) were significantly associated with adverse pregnancy outcome. Specific types of SLE disease activity during pregnancy were related to adverse pregnancy outcome. Nephritis, cytopenias, and serositis carried a higher risk of adverse pregnancy outcome, suggesting that these abnormalities should be carefully monitored during pregnancy. PMID:27166627

  14. Predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care.

    Huntington, S. E.; Thorne, C.; Bansi, L. K.; Anderson, J.; Newell, M. L.; Taylor, G P; Pillay, D.; Hill, T; Tookey, P A; Sabin, C.A.; UK Collaborative HIV Cohort Study and the National Stu

    2013-01-01

    OBJECTIVES: To describe predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care. METHODS: Data were obtained through the linkage of two separate studies: the UK Collaborative HIV Cohort study (UK CHIC), a cohort of adults attending 13 large HIV clinics; and the National Study of HIV in Pregnancy and Childhood (NSHPC), a national surveillance study of HIV-positive pregnant women. Pregnancy incidence was measured using the proportion of wo...

  15. Associations between pregnancy-associated glycoproteins and pregnancy outcomes, milk yield, parity, and clinical diseases in high-producing dairy cows.

    Mercadante, P M; Ribeiro, E S; Risco, C; Ealy, A D

    2016-04-01

    Pregnancy-associated glycoproteins (PAG) are produced by the ruminant placenta and secreted into the maternal circulation throughout pregnancy. The extent to which circulating PAG concentrations predict pregnancy outcomes was examined herein. Also, associations between circulating PAG concentrations and various production parameters and clinical diseases were evaluated. Lactating primiparous and multiparous Holstein cows (n=345) were bred via timed artificial insemination using a standard Ovsynch protocol. Pregnancy was diagnosed by transrectal ultrasonography at d 32, 46, and 74 of gestation. Blood was harvested at d 32 to determine plasma concentrations of PAG and progesterone. Cows pregnant at d 32 that subsequently lost their pregnancy at d 46 and 74 had reduced PAG concentrations. Both artificial insemination service number and parity were associated with plasma PAG concentrations. Concentration of PAG in plasma was greater for cows pregnant from their second or later breeding than those pregnant from the first breeding postpartum, and was increased for primiparous compared with multiparous. In addition, cows with greater milk yield had increased plasma PAG concentrations. No association was detected between body condition score and plasma PAG concentrations. Cows that experienced clinical metritis, metabolic problems, or left displacement abomasum in the early postpartum period preceding breeding had greater plasma PAG concentrations than cows not experiencing these clinical diseases. Also, cows with multiple clinical diseases had increased odds of pregnancy loss when compared with cows not experiencing clinical diseases. Odds ratio testing detected a tendency in the relationship between reduced milk yield and increased pregnancy loss. Collectively, these associations illustrate one feature of the early developing placenta that may predict pregnancy outcomes in dairy cattle. It is unclear if plasma PAG are actively involved with mediating pregnancy outcomes

  16. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

    Amudha

    2015-07-01

    Full Text Available OBJECTIVES: The objective of the present study is to analyse the incidence of preterm labour, intrapartum complications, incidence of operative delivery both vaginal and cesarean and indications for such interventions. METHODOLOGY: A total of 150 cases of twin pregnancy were analyzed between the period of September 2012 to February 2014. These cases were stud ied with respect to period of gestation at the onset of labour, fetal presentations at the onset of labour, route and mode of delivery, indications in cases of cesarean delivery, intrapartum complications and delivery interval between twins. OBSERVATIONS A ND RESULTS: In the present study there was increased incidence of preterm labour (52.6%, fetal malpresentations (43.3%, operative vaginal delivery (29.5%, cesarean delivery (17.3%. CONCLUSION: In this study it is observed that above mentioned labour ev ents and complications double up in the event of a twin pregnancy. Regular antenatal visits, planned delivery and anticipation and identification of complications will help for better pregnancy outcome.

  17. Experiences of physical activity during pregnancy in Danish nulliparous women with a physically active life before pregnancy. A qualitative study

    Hegaard, Hanne Kristine; Kjaergaard, Hanne; Damm, Peter P; Petersson, Kerstin; Dykes, Anna-Karin

    2010-01-01

    National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study was...... to elucidate experiences and views of leisure time physical activity during pregnancy in nulliparous women who were physically active prior to their pregnancy....

  18. Clinical characteristics and outcome of cancer diagnosed during pregnancy

    Shim, Min Hee; Mok, Chi-Won; Chang, Kylie Hae-Jin; Sung, Ji-Hee; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2016-01-01

    Objective The aim of this study is to describe the clinical characteristics and outcome of cancer diagnosed during pregnancy. Methods This is a retrospective cohort study of women who were diagnosed with cancer during pregnancy at a tertiary academic hospital between 1995 and 2013. Maternal characteristics, gestational age at diagnosis, and type, stage, symptoms and signs of cancer for each patient were retrieved from the medical records. The cancer treatment, pregnancy management and the subsequent perinatal and maternal outcomes for each cancer were assessed. Results A total of 87 women were diagnosed with cancer during pregnancy (172.6 cases per 100,000 deliveries). The most common cancer was breast cancer (n=20), followed by gastrointestinal (n=17), hematologic (n=13), thyroid (n=11), central nervous system (n=7), cervical (n=7), ovarian (n=5), lung (n=3), and other cancers (n=4). Eighteen (20.7%) patients terminated their pregnancies. In the 69 (79.3%) patients who maintained their pregnancies, one patient miscarried and 34 patients delivered preterm. Of the preterm babies, 24 (70.6%) were admitted to the neonatal intensive care unit and 3 (8.8%) of those expired. The maternal mortality rate was 31.0%, with highest rate seen with lung cancers (66.7%), followed by gastrointestinal (50.0%), central nervous system (50.0%), hematologic (30.8%), breast (25.0%), ovarian (20.0%) cervical (14.3%), and thyroid cancers (0%). Conclusion The clinical characteristics and outcome of cancer during pregnancy were highly variable depending on the type of cancer. However, timely diagnosis and appropriate management of cancer during pregnancy may improve both maternal and neonatal outcome. PMID:26866029

  19. Myasthenia gravis and pregnancy: clinical implications and neonatal outcome

    Estanol Bruno

    2004-11-01

    Full Text Available Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasthenia gravis. Retrospective chart review of pregnant patients with myasthenia gravis, followed at the National Institute of Perinatology in Mexico City over an 8-year period. Data was abstracted from the medical records on the clinical course during pregnancy, delivery and neonatal outcome. Results From January 1, 1996 to December 31, 2003 18 patients with myasthenia gravis were identified and included in the study. The mean ± SD maternal age was 27.4 ± 4.0 years. During pregnancy 2 women (11% had an improvement in the clinical symptoms of myasthenia gravis, 7 women (39% had clinical worsening of the condition of 9 other patients (50% remained clinically unchanged. Nine patients delivered vaginally, 8 delivered by cesarean section and 1 pregnancy ended in fetal loss. Seventeen infants were born at mean ± SD gestational age of 37.5 ± 3.0 weeks and a mean birth weight of 2710 ± 73 g. Only one infant presented with transient neonatal myasthenia gravis. No congenital anomalies were identified in any of the newborns. Conclusions The clinical course of myasthenia gravis during pregnancy is variable, with a significant proportion of patients experiencing worsening of the clinical symptoms. However, neonatal transient myasthenia was uncommon in our patient population.

  20. Telomerase activity in pregnancy complications (Review).

    Fragkiadaki, Persefoni; Tsoukalas, Dimitrios; Fragkiadoulaki, Irini; Psycharakis, Christos; Nikitovic, Dragana; Spandidos, Demetrios A; Tsatsakis, Aristides M

    2016-07-01

    Telomeres are specific DNA regions positioned at the ends of chromosomes and composed of functional non-coding repeats. Upon cell division, the telomeres decrease in length by a preordained amount. When the telomeres become critically short, cells lose the ability to divide and enter a specific functioning mode designated as 'cellular senescence'. However, human tissues express an enzyme that deters the shrinking of the telomeres, the telomerase. Due to its ability to maintain telomere length, the telomerase slows down and possibly suspends the aging of the cells. In regard to this, solid evidence demonstrates that female human fertility decreases with increased maternal age and that various adverse factors, including alterations in telomerase activity, can contribute to age-associated infertility in women. The fact that telomerase activity is regulated in a time- and location-dependent manner in both embryo and placental tissues, highlights it potential importance to the successful completion of pregnancy. Since maternal age is a crucial determining factor for the success of in vitro and in vivo fertilization, numerous studies have focused on telomerase activity and its correlation with mammalian fertilization, as well as the following cleavage and pre-implantation developmental processes. Associations between telomerase activity and pregnancy complications have been previously observed. Our aim in this review was to summarize and critically discuss evidence correlating telomerase activity with pregnancy complications. PMID:27175856

  1. Telomerase activity in pregnancy complications (Review)

    FRAGKIADAKI, PERSEFONI; TSOUKALAS, DIMITRIOS; FRAGKIADOULAKI, IRINI; PSYCHARAKIS, CHRISTOS; NIKITOVIC, DRAGANA; SPANDIDOS, DEMETRIOS A.; TSATSAKIS, ARISTIDES M.

    2016-01-01

    Telomeres are specific DNA regions positioned at the ends of chromosomes and composed of functional non-coding repeats. Upon cell division, the telomeres decrease in length by a preordained amount. When the telomeres become critically short, cells lose the ability to divide and enter a specific functioning mode designated as 'cellular senescence'. However, human tissues express an enzyme that deters the shrinking of the telomeres, the telomerase. Due to its ability to maintain telomere length, the telomerase slows down and possibly suspends the aging of the cells. In regard to this, solid evidence demonstrates that female human fertility decreases with increased maternal age and that various adverse factors, including alterations in telomerase activity, can contribute to age-associated infertility in women. The fact that telomerase activity is regulated in a time- and location-dependent manner in both embryo and placental tissues, highlights it potential importance to the successful completion of pregnancy. Since maternal age is a crucial determining factor for the success of in vitro and in vivo fertilization, numerous studies have focused on telomerase activity and its correlation with mammalian fertilization, as well as the following cleavage and pre-implantation developmental processes. Associations between telomerase activity and pregnancy complications have been previously observed. Our aim in this review was to summarize and critically discuss evidence correlating telomerase activity with pregnancy complications. PMID:27175856

  2. Antiretroviral Therapy Initiation Before, During, or After Pregnancy in HIV-1-Infected Women: Maternal Virologic, Immunologic, and Clinical Response

    Melekhin, Vlada V.; Shepherd, Bryan E.; Stinnette, Samuel E.; Peter F Rebeiro; Gema Barkanic; Raffanti, Stephen P.; Sterling, Timothy R

    2009-01-01

    BACKGROUND: Pregnancy has been associated with a decreased risk of HIV disease progression in the highly active antiretroviral therapy (HAART) era. The effect of timing of HAART initiation relative to pregnancy on maternal virologic, immunologic and clinical outcomes has not been assessed. METHODS: We conducted a retrospective cohort study from 1997-2005 among 112 pregnant HIV-infected women who started HAART before (N = 12), during (N = 70) or after pregnancy (N = 30). RESULTS: Women initiat...

  3. Clinical Analysis of 45 Cases of Caesarean Scar Pregnancy

    Hong SHI; Ai-hua FANG; Qin-fang CHEN

    2008-01-01

    Objective To summarize the clinical characteristics of caesarean scar pregnancy and to investigate its treatment.Methods Clinical case records of 45 cases of caesarean scar pregnancy from June 2003 to September 2007 were reviewed.The characteristics and management of cases were analyzed.Results The women's average age was 32.8±5.1 years.All cases had amenorrhoea.and 27 cases had vaginal bleeding from spotting to morderate.Seven cases were misdiagnosed as normal early intrauterine pregnancy or inevitable miscarriage before dilation and curettage(D & C).In case of massive bleeding,caesarean scar pregnancy was diagnosed after D & C.Bleeding was controlled and uterus was conserved in 6 cases,and 1 case underwent hysterectomy because of uncontrollable bleeding.The remaining 38 cases had ultrasound scan,which indicated scar pregnancy before primary treatment.Eight cases were primarily treated with dilation and curettage,in which only 2 cases had slight bleeding in the operation and no further treatment.Nineteen cases were primarily treated with dilation and curettage after uterine artery embolization.in which 17 cases needed no further treatment and had no complications.The success rate was 89.4%(17/19).Eleven cases were primarity treated with trichosanthin 1.2 mg intramuscular.No one encountered massive bleeding,but 7 cases of these 11 cases needed extra treatment.Conclusion Caesarean scar pregnancy must be cautious of,especially in cases of inevitable miscarriage.Dilation and curettage followed uterine artery embolization can be used as the primary treatment for caesarean scar pregnancy.

  4. Myasthenia gravis and pregnancy: clinical implications and neonatal outcome

    Estanol Bruno; Salinas Vicente; Hernández-Ronquillo Lizbeth; Téllez-Zenteno José F; da Silva Orlando

    2004-01-01

    Abstract Background The myasthenia gravis is twice as common in women as in men and frequently affects young women in the second and third decades of life, overlapping with the childbearing years. Generally, during pregnancy in one third of patients the disease exacerbates, whereas in two thirds it remains clinically unchanged. Complete remission can occur in some patients. Methods To describe the clinical course, delivery and neonatal outcome of 18 pregnant women with the diagnosis of myasth...

  5. Is interstitial pregnancy clinically different from cornual pregnancy? A case report.

    Sargin, Mehmet Akif; Tug, Niyazi; Ayas, Selçuk; Yassa, Murat

    2015-04-01

    Interstitial pregnancy is a rare form of ectopic pregnancy with significant risk for morbidity. A 32-year-old woman, was brought to the emergency department with severe abdominal pain and syncope. There was no history of menolipsis and usage of any contraceptive methods. Serum ß hCG arrival was 11224 IU/L. Trans-vaginal ultrasound scan showed an empty uterus with a displaced 16 × 26 mm gestation sac on the left corn of the uterine cavity which surrounded by a thin myometrium. Free abdominal fluid and coagulum were also detected in the cul-de-sac. She was haemodynamically unstable. A ruptured ectopic pregnancy was diagnosed in the left uterine cornu during emergency laparotomy. Cornual resection was performed. Interstitial and cornual pregnancies should be considered as two different clinical situations. It is important to enhance the clinician's suspicion about interstitial/cornual pregnancy. Thus, more detailed examination by transvaginal ultrasonography may contribute for accurate localization and diagnosis. PMID:26023605

  6. Pregnancy loss: French clinical practice guidelines.

    Huchon, C; Deffieux, X; Beucher, G; Capmas, P; Carcopino, X; Costedoat-Chalumeau, N; Delabaere, A; Gallot, V; Iraola, E; Lavoue, V; Legendre, G; Lejeune-Saada, V; Leveque, J; Nedellec, S; Nizard, J; Quibel, T; Subtil, D; Vialard, F; Lemery, D

    2016-06-01

    In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements TPO) and anti-thyroglobulin (anti-Tg) antibodies (Grade A), vitamin deficiencies (B9, B12) (Grade C), hyperhomocysteinaemia (Grade C), hyperprolactinaemia (Grade B), diminished ovarian reserve (Grade C), and a uterine malformation or an acquired uterine abnormality amenable to surgical treatment (Grade C). The treatment options recommended for women with a missed early miscarriage are vacuum aspiration (Grade A) or misoprostol (Grade B); and the treatment options recommended for women with an incomplete early miscarriage are vacuum aspiration (Grade A) or expectant management (Grade A). In the absence of both chorioamnionitis and rupture of the membranes, women with a threatened late miscarriage and an open cervix, with or without protrusion of the amniotic sac into the vagina, should receive McDonald cerclage, tocolysis with indomethacin, and antibiotics (Grade C). Among women with a threatened late miscarriage and an isolated undilated shortened cervix (<25mm on ultrasound), cerclage is only indicated for those with a history of either late miscarriage or preterm delivery (Grade A). Among women with a threatened late miscarriage, an isolated undilated shortened cervix (<25mm on ultrasound) and no uterine contractions, daily treatment with vaginal progesterone up to 34 weeks of gestation is recommended (Grade A). Hysteroscopic section of the septum is recommended for women with a uterine septum and a history of late miscarriage (Grade C). Correction of acquired abnormalities of the uterine cavity (e.g. polyps, myomas, synechiae) is recommended after three early or late miscarriages (Grade C). Prophylactic cerclage is recommended for women with a history of three late miscarriages or preterm deliveries (Grade B). Low-dose aspirin and low-molecular-weight heparin at a preventive dose are recommended for

  7. Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment and Epidemiology

    Grear, Karrie E; Bushnell, Cheryl D.

    2013-01-01

    Stroke is a neurological emergency that carries a risk of morbidity and mortality. Recent studies have shown that the incidence of stroke, while rare, is increasing in pregnant females. In this review, stroke and other vasculopathies in the pregnant and post-partum female are examined. A discussion of the symptoms and clinical presentation of stroke is provided, as well as the current guideline for treatment of stroke in pregnancy. Finally, the data illustrating the recent increases in stroke...

  8. Clinical course of ectopic pregnancy: A single-center experience

    Aqueela Ayaz; Sameh Emam; Mian Usman Farooq

    2013-01-01

    OBJECTIVES: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. MATERIALS AND METHODS: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome...

  9. Activation of the Maternal Immune System During Pregnancy Alters Behavioral Development of Rhesus Monkey Offspring

    Bauman, Melissa D.; Iosif, Ana-Maria; Smith, Stephen E. P.; Bregere, Catherine; Amaral, David G.; Patterson, Paul H.

    2014-01-01

    Background: Maternal infection during pregnancy is associated with an increased risk of schizophrenia and autism in the offspring. Supporting this correlation, experimentally activating the maternal immune system during pregnancy in rodents produces offspring with abnormal brain and behavioral development. We have developed a nonhuman primate model to bridge the gap between clinical populations and rodent models of maternal immune activation (MIA). Methods: A modified form of the ...

  10. Energy Expenditure of Selected Household Activities during Pregnancy

    Chasan-Taber, Lisa; Freedson, Patty S.; Roberts, Dawn E.; Schmidt, Michael D.; Fragala, Maren S.

    2007-01-01

    Accurately measuring pregnancy physical activity is critical to assess the percentage of pregnant women meeting the American College of Obstetricians and Gynecologists (ACOG) guidelines. In addition, valid assessment of pregnancy physical activity is important for epidemiologic studies assessing the relationship between physical activity and…

  11. Relationship between Daily Physical Activity During Last Month of Pregnancy and Pregnancy Outcome

    Koushkie Jahromi, M; Namavar Jahromi, B; Hojjati, S.

    2011-01-01

    Background Previous researchers have evaluated the influence of physical exercise or physical activity on pregnancy outcome, but the influence of daily physical activities in details including energy expenditure, biomechanical load and exercise before and during pregnancy have remained unclear. This study evaluates the relationship between daily physical activities as a biomechanical load and energy expenditure and physical exercise during household activities with birth weight, type of deliv...

  12. Clinical presentation and management of diabetes mellitus in pregnancy

    Al-Azemi N

    2013-12-01

    Full Text Available Nasser Al-Azemi,1 Michael F Diejomaoh,1,2 Elisavet Angelaki,1 Asiya T Mohammed2 1Maternity Hospital, Shuwaikh, Kuwait; 2Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Safat, Kuwait Objective: To evaluate the clinical presentation, management, and the outcome of diabetes mellitus in pregnancy. Methods: One hundred seventy-one patients with diabetes mellitus admitted between September 1, 2006, and June 30, 2008, to the labor room at Maternity Hospital in Kuwait for induction of labor made up the study population; while an equivalent number of patients without medical complications who also were admitted for induction of labor made up the control group. The patients were assessed at admission, and their medical data were extracted. The study and control patients were monitored through labor/puerperium, and the outcome was documented. Results: Gestational diabetes mellitus was diagnosed in 71.9% of the study patients, a past history of diabetes mellitus was recorded in 81.34% of the study patients, and 49.2% of the patients were admitted at 8–12 weeks of gestation for diabetic control. The mean weight gained in pregnancy was significantly higher for control patients (11.52±5.643 versus [vs] 9.90±5.757 kg/m2; P<0.009, and the body mass index of study patients was higher (32.00±6.160 vs 28.20±5.885 kg/m2; P<0.0001. Of the study population, 64.3% of the patients were managed with diet and increased physical activity and 35.7% with insulin, diet, and increased physical activity. The incidences of maternal morbidity in both study and control groups were comparable, and the incidence of preeclampsia was low, at 2.3%. The gestational age at delivery was higher in the control group (39.02±1.834 weeks vs 38.62±1.773 weeks; P<0.0001, and the percentage of cesarean deliveries was higher in the study population (44.4% vs 33.3%; P=0.046. The Apgar scores of the both groups were comparable and in the normal range, and the

  13. Clinical analysis of laparoscopic surgery for ectopic pregnancy with shock

    Yan-qin YOU

    2013-05-01

    Full Text Available Objective  To investigate the efficacy of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock. Methods  The clinical data of 48 patients with hemorrhagic shock as a result of ectopic pregnancy, admitted to General Hospital of PLA from Jan. 2005 to June 2012, were analyzed retrospectively. Among them, 25 underwent laparoscopic surgery and 23 received traditional laparotomy. The preoperative, intra-operative and post-operative conditions were compared between the two groups. Results  The intraperitoneal hemorrhage and HCG recovery time were 2465.2±712.6ml and 6.8±2.3d respectively in laparoscopic group, and 2716.7±954.9ml and 7.2±2.8d respectively in laparotomy group, and there was no significant difference between two groups. The operation time, postoperative exsufflation time and length of hospital stay were 53.1±36.3min, 1.2±0.4d and 2.8±1.4d respectively in laparoscopic surgery group, and 127.0±21.4min, 2.3±0.6d and 4.6±2.2d respectively in laparotomy group, and the difference between two groups was significant (P<0.05. Conclusion  Laparoscopic surgery is worthy of popularization for ectopic pregnancy complicated by shock due to its minimal invasion, short operation time and earlier postoperative recovery.

  14. The relation between self-esteem, sexual activity, and pregnancy.

    Robinson, R B; Frank, D I

    1994-01-01

    This study examined self-esteem in relation to sexual behaviors which often result in teen pregnancy. A sample of 141 male and 172 female adolescents of racial diversity was surveyed to elicit levels of self-esteem, sexual activity, pregnancy and fatherhood status. The Coopersmith Self-Esteem Inventory was used as well to elicit qualitative data about self-esteem, demographics, and sexual activity. Analysis revealed no differences in the self-esteem of males vs. females. Further, sexual activity or virginity was not related to self-esteem in either males or females. Pregnant teens did not have different levels of self-esteem from the nonpregnant. However, males who had fathered a child had lower self-esteem than did nonfathers. The findings support a multifocused approach to sex education for pregnancy prevention and also emphasize a need to include males in both pregnancy prevention efforts as well as in further research on teen pregnancy. PMID:8036980

  15. Experiences of counselling on physical activity during pregnancy Gestational diabetes mellitus : screening and pregnancy outcomes

    Lindqvist, Maria

    2016-01-01

    Background Overweight and obesity are global health problems with several adverse health effects that threaten public health. In Sweden, almost four of ten pregnant women are overweight or obese, conditions that are associated with adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), a metabolic disorder that complicates pregnancy. Globally, physical inactivity is the fourth leading risk factor for mortality. The recommendation for physical activity (i.e., ≥150 minutes/w...

  16. Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia: The Folic Acid Clinical Trial Study

    Shi Wu Wen

    2013-01-01

    Full Text Available Preeclampsia (PE is hypertension with proteinuria that develops during pregnancy and affects at least 5% of pregnancies. The Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia: the Folic Acid Clinical Trial (FACT aims to recruit 3,656 high risk women to evaluate a new prevention strategy for PE: supplementation of folic acid throughout pregnancy. Pregnant women with increased risk of developing PE presenting to a trial participating center between 80/7 and 166/7 weeks of gestation are randomized in a 1 : 1 ratio to folic acid 4.0 mg or placebo after written consent is obtained. Intent-to-treat population will be analyzed. The FACT study was funded by the Canadian Institutes of Health Research in 2009, and regulatory approval from Health Canada was obtained in 2010. A web-based randomization system and electronic data collection system provide the platform for participating centers to randomize their eligible participants and enter data in real time. To date we have twenty participating Canadian centers, of which eighteen are actively recruiting, and seven participating Australian centers, of which two are actively recruiting. Recruitment in Argentina, UK, Netherlands, Brazil, West Indies, and United States is expected to begin by the second or third quarter of 2013. This trial is registered with NCT01355159.

  17. Physical activity and weight gain during pregnancy

    Haakstad, Lene Annette Hagen

    2010-01-01

    A low level of daily PA and regular recreational exercise was shown in the present study of pregnant women in Oslo. There was a decline in exercise intensity, duration and frequency from before pregnancy and throughout the course of pregnancy. Walking was the most common exercise mode. The results of the multivariate analysis showed that women who decreased regular exercise in the 3rd trimester had higher weight gain and reported to have no social role models with respect to ex...

  18. Clinical course of ectopic pregnancy: A single-center experience

    Aqueela Ayaz

    2013-01-01

    Full Text Available Objectives: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP in a general hospital. Materials and Methods: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007. Results: Out of total 7564 pregnancies, 44 (0.58% patients were diagnosed as EP. Out of 44, 22 (50% patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%, and 21 (48% had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%, abdominal pain (39, 88.6%, and tenderness (38, 86%. Previous pelvic surgery (13, 29.5%, infertility treatment (11, 25%, and pelvic inflammatory disease (10, 22.7% were the common predisposing factors. Twenty-five (57% presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%. No mortality was observed. Conclusion: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  19. The clinical value of serum uric acid levels in hypertensive diseases of pregnancy

    Oral, Baha; Güney, Mehmet; MANDAL, Tanju; Özbaşar, Demir

    1999-01-01

    The aim of our study was to evaluate the clinical utility of serum uric acid measurements in the hypertensive diseases of pregnancy. We performed a case-control study to assess the clinical utility of .serum uric acid measurements in women with hypertensive diseases of pregnancy. We identified 201 women who had serum uric acid measurements at term and categorized them into five diagnostic groups: transient hypertension at pregnancy (n=29), preeclampsia (n=42), chronic hypertension (n=28), chr...

  20. Serum adenosine deaminase and its isoenzyme activities in pregnancy

    Göksel Bahadır

    2011-12-01

    .314, p<0.05 and trisomy 18 risk (p<0.05 in the triple test. ADA (p<0.05 and ADA-2 (p<0.05 activities were slightly significantly correlated with gestational age, while there was no significant correlation between ADA-1 activity and gestational age. Conclusion: Serum ADA activity may be useful for clinical diagnosis and observation of high-risk pregnancies in which cell-mediated immunity has been altered.

  1. Physical activity, health-related quality of life and depression during pregnancy

    Tendais, Iva; Figueiredo, Bárbara; Mota, Jorge; Conde, Ana

    2011-01-01

    This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased aft...

  2. Physical activity, health-related quality of life and depression during pregnancy

    Iva Tendais; Bárbara Figueiredo; Jorge Mota; Ana Conde

    2011-01-01

    This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self-reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased aft...

  3. Pregnancy-Related Systemic Lupus Erythematosus: Clinical Features, Outcome and Risk Factors of Disease Flares — A Case Control Study

    Huaxia Yang; Hui Liu; Dong Xu; Lidan Zhao; Qian Wang; Xiaomei Leng; Wenjie Zheng; Fengchun Zhang; Fulin Tang; Xuan Zhang

    2014-01-01

    OBJECTIVE: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL). METHODS: Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. RESULTS: PRL cases were divided into active (a-PRL) (n = 82, 53.0%) and stable lupus (s-PRL) (n = 73, 47.0%). Compared with nonpregnant active female systemic lu...

  4. The Pregnancy-Associated Glycoproteins: Biochemical Aspects and Clinical Application for Pregnancy Follow-up

    Melo De Sousa, Noelita; O. Barbato; Bella, Amina; Alvarez Oxiley, Andrea Vivian; Sulon, J.; Debenedetti, A.; Beckers, Jean-François

    2007-01-01

    Pregnancy diagnosis is an important part in reproduction management of ruminants. In the last years, a large polymorphic family of placenta-expressed proteins has been discovered in ruminant species and used for pregnancy diagnosis. Members of this family are named pregnancy-associated glycoproteins (PAG), being synthesized in the mono- and binucleate cells of the ruminant’s trophectoderm. Part of them are released in the maternal blood circulation where they can be assayed by different labor...

  5. Management approach for recurrent spontaneous pneumothorax in consecutive pregnancies based on clinical and radiographic findings

    Dixson George R

    2006-10-01

    Full Text Available Abstract Objective To describe management and clinical features observed in a patient's seven spontaneous pneumothoraces that developed during two consecutive pregnancies involving both hemithoraces. Materials and methods A 21 year old former smoker developed three spontaneous left pneumothoraces in the index pregnancy, having already experienced four right pneumothorax events in a prior pregnancy at age 19. Results Chest tubes were required in several (but not all hospitalizations during these two pregnancies. Following her fourth right pneumothorax, thoracoscopic excision of right apical lung blebs and mechanical pleurodesis was performed. The series of left pneumothoraces culminated in mini-thoracotomy and thoracoscopically directed mechanical pleurodesis. For both pregnancies unassisted vaginal delivery was performed with no adverse perinatal sequelae. With the exception of multiple pneumothoraces, there were no additional pregnancy complications. Conclusion Spontaneous pneumothorax in pregnancy is believed to be a rare phenomenon, yet the exact incidence is unknown. Here we present the first known case of multiple spontaneous pneumothoraces in two consecutive pregnancies involving both hemithoraces. Clinical management coordinated with obstetrics and surgical teams facilitated a satisfactory outcome for both pregnancies. The diagnosis of pneumothorax should be contemplated in any pregnant patient with dyspnea and chest pain, followed by radiographic confirmation.

  6. Dancing through pregnancy: activity guidelines for professional and recreational dancers.

    Sanders, Sarah G

    2008-01-01

    Over the past few years the benefits of exercise during pregnancy have become appreciated. Much attention has been given to common forms of exercise, such as aerobic dance, swimming, cycling and running. The effects of professional and recreational dance during pregnancy, such as ballet or flamenco, for example, have not been explored. Many studies, however, address issues relevant to dance. The purpose of this article is to delineate as clearly as possible what dance activities are safe and even possibly beneficial for the mother and her baby, as well as those activities and levels of exertion that should be avoided. PMID:19618574

  7. Clinical Significance of Detection of Serum TBA and ALP in Diagnosis of Intrahepatic Cholestasis of Pregnancy

    To investigate the clinical value of serum total bile acid (TBA) and alkaline phosphatase (ALP) in diagnosis of intahrpatic cholestasis of pregnancy (ICP), the serum levels of TBA, ALP and cholyglycine (CG) in 47 cases with intahrpatic cholestasis of pregnancy and 60 normal pregnant women were tested by biochemistry analysis and radioimmunoassay. The results showed that the serum levels of TBA and ALP in patients with intahrpatic cholestasis of pregnancy were significantly higher than that of normal pregnancy women. There was a positively correlation between TBA and ALP with CG. The combined determination of serum TBA and ALP could be useful in the diagnosis of intahrpatic cholestasis of pregnancy. Automatic biochemistry analysis of TBA and ALP is more simple and rapid than CG detected by radioimmunoassay,and it is suitable for clinical laboratory application. (authors)

  8. Clinical observation of interventional treatment for tubal pregnancy

    Objective: To investigate a new method to of conservative treatment of treat tubal pregnancy. Methods: 20 cases of tubal pregnancy were treated by two conservative methods. Among them, 10 cases received single dose 5-fluorouracil perfusion through the super selective catheterization for uterus artery. Others took RU486 orally and received intra-muscular injection of testosterone. Results: Hospitalization was shorter, less salpingectomy was recommended, and blood HCG decreased faster in interventional group, than in control group. Conclusion: The 5-fluorouracil interventional treatment had its advantages for tubal pregnancy

  9. Effect of short-term physical exercise on foetal heart rate and uterine activity in normal and abnormal pregnancies.

    Rauramo, I

    1987-01-01

    The response of a short-term submaximal bicycle ergometer test on foetal heart rate (FHR) and on uterine activity was studied in 61 pregnant women between pregnancy weeks 32 and 40. 28 of the women had uncomplicated pregnancies, 13 were hypertensive, 11 were diabetic, and 9 had intrahepatic cholestasis of pregnancy. After exercise, FHR declined in healthy subjects in pregnancy weeks past 35, whereas no significant change was found in such subjects before week 35 of pregnancy. Analysis of variance revealed a difference of FHR between subjects with umcomplicated and pre-eclamptic pregnancies in relation to time (p = 0.021). Exercise induced uterine contractions in hypertensive subjects. Foetal bradycardia was found in 2 healthy, in 2 pre-eclamptic, and in one cholestatic subject. In healthy pregnant women a non-reactive FHR with concomitant reduced FHR variability was found after exercise (P less than 0.01). The FHR variability of patients with pathologic pregnancies was less affected. These results suggest that, after a relatively strenuous short-term exercise, foetuses of mothers with uneventful pregnancies can be at risk of hypoxia in late pregnancy, but the clinical significance remains uncertain. PMID:3435001

  10. Clinical Presentation and Birth Outcomes Associated with Respiratory Syncytial Virus Infection in Pregnancy.

    Helen Y Chu

    Full Text Available Respiratory syncytial virus (RSV is the most important cause of viral pneumonia in children worldwide. A maternal vaccine may protect both the mother and infant from RSV illness. The epidemiology and clinical presentation of RSV in pregnant and postpartum women is not well-described.Data were collected from a prospective, randomized trial of influenza immunization in pregnant women in rural southern Nepal. Women were enrolled in their second trimester of pregnancy and followed until six months postpartum. Active weekly home-based surveillance for febrile respiratory illness was performed. Mid-nasal swabs collected with episodes of respiratory illness were tested for RSV by real-time polymerase chain reaction.RSV was detected in 14 (0.4% illness episodes in 3693 women over 3554 person-years of surveillance from 2011-2014. RSV incidence was 3.9/1000 person-years overall, and 11.8/1000 person-years between September and December. Seven (50% women sought care for RSV illness; none died. Of the 7 (50% illness episodes during pregnancy, all had live births with 2 (29% preterm births and a median birthweight of 3060 grams. This compares to 469 (13% preterm births and a median birthweight of 2790 grams in women without RSV during pregnancy. Of the 7 mothers with postpartum RSV infection, RSV was detected in 4 (57% of their infants.RSV was an uncommon cause of febrile respiratory illness in mothers during pregnancy in Nepal. These data will inform prevention and therapeutic strategies against RSV in resource-limited settings.

  11. [Denial of pregnancy and neonaticide: psychopathological and clinical features].

    Seigneurie, A-S; Limosin, F

    2012-11-01

    Pregnancy denial and neonaticide have recently received media coverage following a series of French cases of neonatal killing. Although it has been known for a long time that some women deny their pregnancy and may kill their newborns, there is still no consensus on the etiopathogenic factors involved in the denial of pregnancy occurrence. Even though neonaticide is often committed by young, poor, unmarried women with little or no prenatal care, it appears that denial of pregnancy is a heterogeneous condition associated with different psychological features. Societies are ambivalent with regard to mothers who killed their children and tend to lay the entire blame on them. Furthermore, there is a widespread lack of understanding among the public on these affairs, when birth control techniques and methods are widely available. The purpose of this article is to describe the different types of pregnancy denial and neonaticide and to review the still debated etiopathogenic hypotheses. The absence of the physical changes of pregnancy at the time of the denial such as cessation of menstruation, abdominal swelling or perception of foetal movements is also discussed. PMID:22939654

  12. Clinical characters of pregnancy complicated with epilepsy——with twenty cases reported

    Ma Liang-kun; Huang Yan; Yang Jian-qiu; Bian Xu-ming; Liu Jun-tao

    2012-01-01

    Objective: To explore the clinical characteristics and perinatal management of pregnancy complicated with epilepsy.Methods: Twenty patients of pregnancy complicated with epilepsy from January 1995 to December 2011 were analyzed retrospectively.Results: The incidence of pregnancy complicated with epilepsy was 0.08%.The average age was 29.2 ± 5.3 years and average gestational week was 37.9 ± 3.7 week.Fifteen patients were diagnosed with epilepsy before pregnancy.Two patients who stopped the antiepileptic drugs (AEDs) before pregnancy and five patients who continued the AEDs before and during pregnancy had good seizure control.The other seven patients who discontinued the AEDs had convulsive seizures during pregnancy.One patient has never been treated and had generalized tonic-clonic seizures frequently.Five patients experienced their first seizures during pregnancy.There were no obvious predisposing factors except for severe viral encephalitis in one patient.Fourteen patients had cesarean section.The preterm delivery rate,small for gestational age rate and perinatal mortality rate were 20%,20% and 5 % respectively.Follow up of the children born by the epilepsy mothers showed no mental retardation or epilepsy.Conclusions: Proper preconception planning and good compliance with antiepileptic drugs are essential for women with epilepsy to have favorable pregnancy outcome.The cooperation of obstetric,neurology and anaesthesia doctor is important for pregnant women with epilepsy.

  13. Unintended Pregnancy and Contraception Among Active Duty Servicewomen and Veterans

    Goyal, Vinita; Borrero, Sonya; Schwarz, Eleanor Bimla

    2011-01-01

    The number of women of childbearing age who are active duty service members or veterans of the U.S. military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector or through the Department of Veterans Affairs. This article reviews the current data on unintended pregnancy and prevalence of and barriers to contraceptive use among active duty and veteran women. Active duty servicewomen have high rates of unintended pre...

  14. A change from stimulatory to blocking antibody activity in Graves' disease during pregnancy

    Jones, BM; Kung, AWC

    1998-01-01

    Remission of Graves' disease (GD) during pregnancy with recrudescence after delivery is commonly observed. However, as pregnancy is associated with type 2 rather than type 1 cytokine production, a decrease in thyroid- stimulating antibody (TSAb) activity alone is unlikely to account for the remission during pregnancy. We hypothesized that a change in the antibody characteristics may occur as pregnancy advances. Fifteen women were studied in the first, second, and third trimesters of pregnancy...

  15. Clinical Significance of Monitoring Serum β-HCG in the Conservative Treatment of Ectopic Pregnancy

    To explore the clinical value of the serum β-HCG (human chorionic gonadotrophin) in the conservative treatment of ectopic pregnancy, the serum β-HCG levels in 118 patients with ectopic pregnancy were measured with RIA. The results showed that the serum β-HCG levels in patients with successful conservative treatment of ectopic pregnancy were all less than 200mIU/mL. The patients require a surgical treatment to reach <200mIU/mL serum β-HCG concentration were only 26.3%. There was significant difference between two groups (P<0.01). The monitoring of serum β-HCG was very useful in the diagnosis, the choice of treatment measures and the evaluation of conservative treatment effect of ectopic pregnancy. In the course of treatment of ectopic pregnancy, serum β-HCG is a good marker in determining the success or failure of treatment. (authors)

  16. The Use of Central Nervous System Active Drugs During Pregnancy

    Bengt Källén

    2013-10-01

    Full Text Available CNS-active drugs are used relatively often during pregnancy. Use during early pregnancy may increase the risk of a congenital malformation; use during the later part of pregnancy may be associated with preterm birth, intrauterine growth disturbances and neonatal morbidity. There is also a possibility that drug exposure can affect brain development with long-term neuropsychological harm as a result. This paper summarizes the literature on such drugs used during pregnancy: opioids, anticonvulsants, drugs used for Parkinson’s disease, neuroleptics, sedatives and hypnotics, antidepressants, psychostimulants, and some other CNS-active drugs. In addition to an overview of the literature, data from the Swedish Medical Birth Register (1996–2011 are presented. The exposure data are either based on midwife interviews towards the end of the first trimester or on linkage with a prescribed drug register. An association between malformations and maternal use of anticonvulsants and notably valproic acid is well known from the literature and also demonstrated in the present study. Some other associations between drug exposure and outcome were found.

  17. Profile of pregnancy in adolescence and related clinical-obstetric occurrences

    Maria Veraci Oliveira Queiroz

    2014-09-01

    Full Text Available The objective was to characterize the profile of adolescence pregnancy and its clinical and obstetric events. Descriptive, cross-sectional study, with quantitative approach, developed in a tertiary hospital in Fortaleza, CE, Brazil, with one hundred adolescent mothers, through interviews and registers from the medical records, from February to May, 2011. Data were analyzed by Statistical Package for the Social Science software, version 17.0. The majority lived with a partner who earned up to one minimum wage, had low education and unpaid occupational activity. Most of them also reported early sexual activity, and were primiparas. All of them had complete prenatal care, with an average number of 5.91 consultations. The percentage of uncomplicated births of newborns was 48.9%, being prematurity the most frequent (56.3%. It is necessary to have more encouragement to young mothers attending postnatal consultation and family planning, and to have access and learning contraceptive matters, making prevention to early pregnancy more effective.

  18. Brucellosis in pregnancy: clinical aspects and obstetric outcomes

    Gustavo Vilchez

    2015-09-01

    Conclusions: This is the largest series of brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes.

  19. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    Rutwa J. Chavda; Hardev B. Saini

    2014-01-01

    Background: Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. Methods: 200 pregnant subjects between 20 and 42 weeks of gestation, who were clinically suspected to have an abnormal amniotic fluid volume (oligohydramnios or polyhydramnios) were subjected to ultrasonographic (USG) assessment of amniotic fluid index. The subjects were closely monitored during pregnancy, labour and puerperium. Results: Ultrasonically, abnormal liquor volume was confirmed in 90-93...

  20. Epidemiology and clinical features of obsessive-compulsive disorder during pregnancy and postpartum period: a review

    Uguz, Faruk; Ayhan, Medine Gıynas

    2011-01-01

    In this study we reviewed the current literature on the epidemiology and clinical features of obsessive-compulsive disorder (OCD) during pregnancy and postpartum period. The available reports on this topic have significant limitations and heterogenous methods. However, the prevalence and incidence rates of OCD reported during these two reproductive periods are higher than the rates estimated in the general population. The most common obsessions in pregnancy and puerperium were contamination a...

  1. Clinical audit of foetomaternal outcome in pregnancies with fibroid uterus

    Background: Leiomyoma, myoma, leiomyoma or fibroids are synonymous terms. They may be present in as many as 1 in 5 women over age 35 years. If pregnancy is associated with fibroids, it leads to multiple complications. Objectives of this study were to evaluate the maternal and foetal outcome in women having pregnancy with fibroids in uterus and the complications associated with fibroids during the pregnancy. Methods: This descriptive study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from March 2009 to March 2010. Data were collected on proforma regarding demographic variables, obstetrical history, mode of delivery, maternal outcome, maternal complications, and foetal outcome. Mean and standard deviation was calculated for age, period of gestation, and obstetrical history. Frequency and percentages was calculated for booking status, maternal outcome, maternal complications and foetal outcome. Results: Thirty patients were included in this study who had pregnancy with fibroid. Normal delivery was achieved in 14 (46.66%) patients. Eight (26.67%) patients had caesarean section and eight (26.67%) had miscarriages. Seven (23.33%) patients had no complications while 8 (26.67%) had miscarriages, 8 (26.67%) had postpartum haemorrhage, 10 (33.33%) had preterm delivery, and 3 patients had ante-partum haemorrhage. Two (10%) patients had premature rupture off membranes and 1 patient (3.33%) had pain abdomen and technical difficulty during caesarean section. There were 12 (40%) healthy babies. Five (16.67%) babies delivered with morbidity but recovered. There were 4 (13.33%) intrauterine deaths and one early neonatal death. Conclusion: Fibroid in pregnancy, especially multiple intramural fibroids and fibroids larger than 10 Cm, cause miscarriage and preterm labour. (author)

  2. Unintended Pregnancy and Its Correlates among Female Attendees of Sexually Transmitted Disease Clinics in Eastern China

    Masahiro Kihara; Masako Ono-Kihara; Yun Xu; Jiezhe Yan; Gaofeng Cai; Xiaohong Pan; Qiaoqin Ma

    2013-01-01

    This study is to determine the prevalence of unintended pregnancy and its risk factors among the female attendees of sexually transmitted disease (STD) clinics in Zhejiang Province, China. A self-administered questionnaire survey of a cross-sectional design was administered to attendees at four STD clinics in 2007. Of the 313 female STD clinic attendees, 42.5% reported that they had at least one unintended pregnancy; the induced abortion rate was 39.0%. Over their lifetime, 12.1% responded “u...

  3. The clinical analyz of pregnancy terminastions with oksitosin/dinoproston (preeclamptic-nonpreeklamptic) term pregnancies

    ÇITIRKE, Ali; Küçükbaş, Mehmet; DAYICIOĞLU, Vedat

    2009-01-01

    Objective: The aim of our study is to compare the efficacy, safety and complications of pharmacological agents of Oxytocine and Dinoprostone and oxytocine + dinoprostone combination which are frequently used for cervical ripening and for labor induction in women with a gestational age of 37 weeks and over 37 weeks and an indication for termination of pregnancy. Materials and Methods: A total of 173 pregnant women with a gestational age of 37 weeks-and over 37 weeks were included into this stu...

  4. Clinical Pregnancy After Assisted Hatching Rate in Young women undergoing Intra Cytoplasmic Sperm Injection

    Mohammed Al-Sunaidi

    2012-01-01

    Full Text Available Problem statement: The ability of a blast cyst to hatch, or escape, from the Zona Pellucida (ZP that surrounds and protects the embryo during its first few days of development is one of many critical events that must occur for successful reproduction. Implantation of the embryo in the uterine lining is impossible unless hatching occurs. Hard or thick ZP will therefore impaire the implantation process and reduce the pregnancy rate. Approach: Retrospective analysis of patients' records who had ICSI cycles comparing pregnancy rate for women with and without assisted hatching between Jan and Dec 2010, this was to evaluate the overall effect of AH on pregnancy rates in younger women (less than 37 years old undergoing ICSI cycles at Mustasharak medical center, ABHA, Saudi Arabia. The studied population was divided into four different subgroups according to age and the differences in clinical pregnancy rate among the assisted hatching group and control group were calculated. Results: Clinical pregnancy rate was found to be significantly higher statistically in young women who underwent laser assisted hatching after ICSI. Conclusion: Laser assisted hatching has a positive impact on the clinical pregnancy rate following ICSI in young age group.

  5. Pregnancy incidence and correlates in a clinical trial preparedness study, North West Province South Africa.

    Candice M Chetty-Makkan

    Full Text Available INTRODUCTION: Women in HIV prevention trials often must typically agree to avoid pregnancy. Regardless, some become pregnant. Screening tools predicting pregnancy risk could maximize trial safety and efficiency. OBJECTIVES: We assessed incidence and correlates of pregnancy among women at high HIV risk. METHODS: We enrolled sexually-active, HIV-negative women into an observational cohort (2008-2011. At enrollment demographic, contraceptive, reproductive, pregnancy intention and behavioural data were collected. Women reported if one or both partners wanted or intended for the couple to become pregnant. We measured gender role beliefs using a locally validated eight-point index. We tested HIV and pregnancy, and inquired about sexually transmitted infection symptoms (STIs at enrollment and monthly. HIV testing included behavioural counselling and condom provision, but did not specifically counsel women to avoid pregnancy. Cox proportional hazard modelling evaluated the associations with pregnancy. The multivariate model included the following variables "Recent pregnancy attempts", "Gender Roles Beliefs", "Self-reported STIs" and "Age". RESULTS: We screened 1068 women and excluded (24.6%, 263/1068 who did not report risk behaviour. Non-pregnant, non-sterilized women aged 18-35 (median = 21 years enrolled (n = 438. Most women reported one partner (74.7% and a prior live birth (84.6%. Median follow-up time was 6 months (range 0.7-15.5. Pregnancy incidence was 25.1 per 100 women-years (n = 57 pregnancies. Conservative beliefs on gender roles (Adjusted Hazard Ratio (aHR 1.8; 95% confidence interval [CI] 1.1-2.9, recent pregnancy attempts (aHR 1.9; 95% CI 1.1-3.4 and baseline self-reported STI (aHR 2.5; 95% CI 1.4-4.4 were associated with increased incident pregnancy. Report of no pregnancy intention was associated with lowered pregnancy risk (aHR 0.3; 95% CI 0.1-0.7. CONCLUSIONS: We identified new and confirmed existing factors that can facilitate

  6. Physical activity, health-related quality of life and depression during pregnancy

    Iva Tendais

    2011-02-01

    Full Text Available This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL and depression over pregnancy. 56 healthy pregnant women self-reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased after conception, moderate leisure physical activity and work related physical activity remained stable over time. The prevalence of recommended physical activity was 39.3% and 12.5% in the 1st and 2nd trimesters of pregnancy respectively, and 14.3% pre-pregnancy. From the 1st to the 2nd pregnancy trimester, most physical HRQoL dimensions scores decreased and only mental component increased, independently of physical activity status. No changes in mean depression scores were observed. These data suggest that physical activity patterns change with pregnancy and that physical and mental components are differentially affected by pregnancy course, independently of physical activity status.

  7. Antiepileptic drug treatment in pregnancy: changes in drug disposition and their clinical implications.

    Tomson, Torbjörn; Landmark, Cecilie Johannessen; Battino, Dina

    2013-03-01

    Pregnancy is a state where pharmacokinetic changes are more pronounced and more rapid than during any other period of life. The consequences of such changes can be far reaching, not least in the management of epilepsy where the risks with uncontrolled seizures during pregnancy need to be balanced against potential teratogenic effects of antiepileptic drugs (AEDs). This article aims to review the literature on gestational effects on the pharmacokinetics of older and newer generation AEDs and discuss the implications for the treatment of epilepsy in women during pregnancy. Pregnancy can affect the pharmacokinetics of AEDs at any level from absorption, distribution, metabolism, to elimination. The effect varies depending on the type of AED. The most pronounced decline in serum concentrations is seen for AEDs that are eliminated by glucuronidation (UGT), in particular lamotrigine where the effect may be profound. Serum concentrations of AEDs that are cleared mainly through the kidneys, for example, levetiracetam, can also decline significantly. Some AEDs, such as carbamazepine seem to be affected only marginally by pregnancy. Data on pharmacokinetics during pregnancy are lacking completely for some of the newer generation AEDs: pregabalin, lacosamide, retigabine, and eslicarbazepine acetate. Where data are available, the effects of pregnancy on serum concentrations seem to vary considerably individually and are thus difficult to predict. Although large-scale systematic studies of the clinical relevance of the pharmacokinetic alterations are lacking, prospective and retrospective case series have reported an association between declining serum concentrations and deterioration in seizures control. The usefulness of routine monitoring of AED serum concentrations in pregnancy and of dose adjustments based on falling levels, are discussed in this review. We suggest that monitoring could be important, in particular when women have been titrated to the lowest effective AED

  8. Informative content of clinical symptoms of acute appendicitis in different terms of pregnancy

    Kutovoy A.B.

    2015-09-01

    Full Text Available With the purpose to evaluate diagnostic efficacy of some clinical symptoms of acute appendicitis 75 women in different terms of pregnancy were examined. Informative content of such symptoms as Kocher- Volkovich, Rovsing, Bartomje - Michelson, Sitkovsky, Gabay, Brendo, Michelson, Ivanov was studied. Pain syndrome was fixed in all examined women. Pain localization was various and depended on the pregnancy term. During the I trimester of pregnancy the most often pain was manifestated in epigastrium and right lower quadrant, rarely in other abdomen regions. In the II trimester in majority of cases pain occurred in right lower quadrant. During III trimester pain prevailed in right upper quadrant of abdomen. Analyzing informative component of researching symptoms there was noted significant decrease (р<0,05; р<0,01; р<0,001 of their diagnostic value with growth of pregnancy term. Therefore Kocher – Volkovich and Rovsing symptoms were the most informative in the I trimester of pregnancy. Diagnostic efficacy of Brendo(67,3%, Michelson(55,7%, Ivanov(59,6% symptoms was higher than that of Kocher – Volkovich (36,5%, Rovsing (28,8%, Sitkovsky (51,9%, Bartomje – Michelson (55,7% symptoms, their value was diminishing together with increase of pregnancy terms.

  9. Etiology, clinical features and outcome of fulminant hepatic failure in pregnancy

    Objective: To determine the etiology, clinical features and outcome of fulminant hepatic failure in pregnancy. Methods: An observational hospital based study was conducted at Isra University hospital Hyderabad from 1st March 2009 to 28th February 2010. Total 1192 obstetric patients were admitted in obstetrics and gynaecology department during this period, of whom 52 were with Fulminant hepatic failure in pregnancy and were included in this study. A pre-designed structured proforma was used. All patients had clinical history and underwent a physical examination. Routine laboratory tests, liver function tests and viral serology were performed in all cases. All results were analyzed on statistical software SPSS version 11. Frequencies and percentages were calculated, the final outcome was recorded. Results: Out of 52, 6(11.5%) presented in the first trimester, 4 (7.6%) in the second trimester and 42 (80.7%) were in their 3rd trimester of pregnancy. Etiology of the disease was Hepatitis E in 28(53.8%), Hepatitis B in 9 (17.3%), Hepatitis C in 7 (13.5%) HELLP syndrome in 7 (13.5%) and acute fatty liver of pregnancy in 1 (3.57%) case. Maternal mortality was 15(28.8%) and foetal mortality was 40 (77%). Only 12 (23.1%) new born remained alive. Conclusion: Fulminant hepatic failure in pregnancy has very high foetal and maternal mortality which is mostly due to viral hepatitis E. (author)

  10. Thyroid screening in pregnancy - a compulsory preventive activity

    Scrinic Olesea

    2015-08-01

    Full Text Available Obiectives: To assess the prevalence of thyroid dysfunction in a group of pregnant women, originating from Dobrogea region of southeastern Romania, considered to be an area without iodine deficiency, including the Black Sea area. Materials and methods: We enrolled 324 pregnant women in different trimesters of pregnancy. Each case was reviewed by a detailed madical history, clinical examination and by serum dosage of thyroid hormones: TSH, FT4, and the antithyroidperoxidase. They were evaluated by comparison with trimester -specific reference range for TSH recommended by American Thyroid Association, then the results were compared with those obtained using the manufacturers reference range. Abortion rate was also analysed. Results: The prevalence of thyroid dysfunction was different in all the 3 trimesters: subclinical hypothyroidism being the most frequently approx. 24% of all cases; 7% of pregnant women had overt hypothyroidism. Incidence of thyrotoxicosis in entire study cases was approx. 5.5%. The most frecvent thyroid autoimune disorders were Hashimoto thyroiditis: 42 % - I trimester, 26,6% in II trimester and about 12,5 % in III-trimester; Graves disease have an incidence of only 0,9 % (n=3.The difference between reference methods eluded a lower number of cases using manufactures reference range for TSH (P< 0,001, but higher for recommended trimester - specific TSH value, confirming the undervalueted hypothesis. The risk of misclassifying the hypothyroidism is between 3 %-8 %. Conclusion: Necessity for thyroid hormone dosage periodic/trimesterly/ in pregnancy is a preventive measure. The reference values for hormonal dosage requires trimester-specific assessment. The possibility of hormonal disorders during pregnancy is common. The need for specific therapy at diagnosis depends on the nature of hormonal disorder. Further precautions are needed in pregnant women with known autoimmune thyroid disorder or newly diagnosed

  11. Oral pyogenic granuloma (excluding pregnancy tumour)--a clinical analysis of 304 cases

    Zain, R. B.; Khoo, S. P.; Yeo, J. F.

    1995-01-01

    A clinical analysis of 304 cases of pyogenic granuloma (excluding pregnancy tumour) were obtained from the clinical evaluations submitted by clinicians while sending specimens for biopsy. The average age of the patients with pyogenic granuloma was 28.9 years with a peak age incidence in the second decade. More female patients were affected and the lesions present mainly in the Chinese. The majority of the lesions were ulcerated and pedunculated. The lesions had a mean diameter of 10.8 mm with...

  12. Pathological, clinical and biochemical investigation of naturally occurring pregnancy toxemia of sheep

    Kabakci N.; Yarim G.; Yarim M.; Duru O.; Yagci B.; Kisa U.

    2003-01-01

    A sick ewe in late pregnancy presented with clinical incoordination lipping, amaurosis, head tilt gait and nervous symptoms such as circling movements. A smell of ketones on the breath was detected. The sick animal died during clinical examination and, together with three more dead animals belonging to the same flock, was submitted to the laboratory for necropsy. The uteri of all pregnant animals contained late-term twin fetuses. The most prominent lesion was extensive fatty infiltration of t...

  13. Pathological, clinical and biochemical investigation of naturally occurring pregnancy toxemia of sheep

    Kabakci N.

    2003-01-01

    Full Text Available A sick ewe in late pregnancy presented with clinical incoordination lipping, amaurosis, head tilt gait and nervous symptoms such as circling movements. A smell of ketones on the breath was detected. The sick animal died during clinical examination and, together with three more dead animals belonging to the same flock, was submitted to the laboratory for necropsy. The uteri of all pregnant animals contained late-term twin fetuses. The most prominent lesion was extensive fatty infiltration of the liver. Massive lipidosis and lipid vacuoles were seen in sections of the livers. In three brains, there was prominent vacuolation in the white matter. Urine analysis revealed ketonuria in most of the suspected sheep from the same flock. Serum glucose, cholesterol, high density lipoprotein cholesterol, and blood urea nitrogen concentrations were lower (p£0.05 and serum triglycerides aspartate aminotransferase and alanine aminotransferase activities were higher (p£0.05 in these sheep than in the controls. After a change of diet and treatment, with glucose and dexamethasone serum glucose levels significantly increased (p£0.001 and urine ketone bodies decreased but the other biocemical differences remained.

  14. Sports and leisure time physical activity during pregnancy in nulliparous women

    Hegaard, Hanne Kristine; Damm, Peter; Hedegaard, Morten;

    2011-01-01

    increased from 6% to 29%. During the third trimester women performing competitive sports or moderate-to-heavy activities before pregnancy continued to have a higher level of physical activity than women with light activities or sedentary activities before pregnancy. In general the intensity and time spent...... included in the study at gestational week 33 from May 2004 to July 2005. Information was provided by self-administered questionnaires. Leisure time physical activity was categorised into four categories: competitive sport, moderate-to-heavy, light or sedentary. In this population of nulliparous women, 4......% participated in competitive sport, 25% in moderate-to-heavy activities, 66% in light activities, and 5% in sedentary activities in the year prior to pregnancy. Physical activity before pregnancy was statistically significantly associated with age, pre-pregnancy BMI, chronic diseases, number of years at school...

  15. Sonographic findings and clinical significance of uterine synechiae in pregnancy: Report of 6 cases

    We analyzed the sonograms of 6 cases with uterine synechiae in pregnancy. The diagnosis was based on the clinical and sonographic findings. Previous curret age during the artificial abortion and/or after the spontaneous abortion had been done in 5 cases (83.3%). In all cases, uterine synechia in pregnancy was recognized asintra-amniotic sheet containing hypoechoic central zone and an hyperechoic outer layers. Y-shaped splitting of thehyperechoic outer layers was seen against the uterine wall. The placenta extended along the sheet in 4 cases. Uterine synechiae in pregnancy should be distinguished from amniotic band syndrome by the characteristic snographic findings, and unwarranted abortion of normal fetus should be avoided

  16. FUNDUS CHANGES IN PREGNANCY INDUCED HYPERTENSION: A CLINICAL STUDY

    Rama Bharathi

    2015-01-01

    Full Text Available PURPOSE: To estimate the prevalence of fundus changes in Pregnancy Induced Hypertension (PIH and to find the correlation of the findings with the levels of hypertension and with the severity of the disease. METHODS: This was a hospital based cross section al study conducted over a period of one year from July 2012 to June 2013. 150 patients with diagnosed PIH and admission into wards at King George Hospital, Visakhapatnam, with 36 weeks period of gestation and above, were included in the study. Those with p re - existing hypertension, coexisting diabetes mellitus, severe anaemia, renal disease and ocular diseases like cataract or corneal opacities were excluded from the study. After taking consent and ocular history, anterior segment was evaluated. Pupils were dilated with 0.5% tropicamide eye drops and fundus examination was done with direct ophthalmoscope. Information like age, para, BP etc., was noted down from case sheets. RESULTS: Total number of patients studied was 150.Mean age was 23.06+ 3.03years. 105 ( 70% were primigravidae and 45(30% were multigravidae. Fundus findings were seen in 35 cases (23.33%. 26 (17.33% had Grade I changes, 1 (0.66% had grade II changes, 6 (3.9% had grade III changes 2 (1.3% had serous retinal detachment/grade - IV. The de gree of retinopathy was correlating with the severity of the disease and levels of hypertension. CONCLUSION: The prevalence of fundus changes in PIH is 23.33%. Most of the fundus changes in PIH are underdiagnosed. Timely ophthalmoscopy should be called for in all cases of PIH as it would affect the decision of induction of delivery, thereby preventing other complications.

  17. Red blood cell antibodies in pregnancy and their clinical consequences

    Nordvall, Maria; Dziegiel, Morten Hanefeld; Hegaard, Hanne Kristine;

    2009-01-01

    The objective was to determine clinical consequences of various specificities for the infant/fetus. The population was patients referred between 1998 and 2005 to the tertiary center because of detected red blood cell (RBC) alloimmunization. Altogether 455 infants were delivered by 390 alloimmunized...

  18. Endometrial thickness, Caucasian ethnicity, and age predict clinical pregnancy following fresh blastocyst embryo transfer: a retrospective cohort

    Santoro Nanette

    2009-04-01

    Full Text Available Abstract Background In-vitro fertilization (IVF with blastocyst as opposed to cleavage stage embryos has been advocated to improve success rates. Limited information exists on which to predict which patients undergoing blastocyst embryo transfer (BET will achieve pregnancy. This study's objective was to evaluate the predictive value of patient and cycle characteristics for clinical pregnancy following fresh BET. Methods This was a retrospective cohort study from 2003–2007 at an academic assisted reproductive program. 114 women with infertility underwent fresh IVF with embryo transfer. We studied patients undergoing transfer of embryos at the blastocyst stage of development. Our main outcome of interest was clinical pregnancy. Clinical pregnancy and its associations with patient characteristics (age, body mass index, FSH, ethnicity and cycle parameters (thickness of endometrial stripe, number eggs, available cleaving embryos, number blastocysts available, transferred, and cryopreserved, and embryo quality were examined using Student's T test and Mann-Whitney-U tests as appropriate. Multivariable logistic regression models were created to determine independent predictors of CP following BET. Receiver Operating Characteristic analyses were used to determine the optimal thickness of endometrial stripe for predicting clinical pregnancy. Results Patients achieving clinical pregnancy demonstrated a thicker endometrial stripe and were younger preceding embryo transfer. On multivariable logistic regression analyses, Caucasian ethnicity (OR 2.641, 95% CI 1.054–6.617, thickness of endometrial stripe, (OR 1.185, 95% CI 1.006–1.396 and age (OR 0.879, 95% CI 0.789–0.980 predicted clinical pregnancy. By receiver operating characteristic analysis, endometrial stripe ≥ 9.4 mm demonstrated a sensitivity of 83% for predicting clinical pregnancy following BET. Conclusion In a cohort of patients undergoing fresh BET, thicker endometrial stripe, Caucasian

  19. Longitudinal study on clinical and microbial analysis of periodontal status in pregnancy.

    Machado, Fernanda Campos; Cesar, Dionéia Evangelista; Apolônio, Ana Carolina Morais; Ribeiro, Luiz Claudio; Ribeiro, Rosangela Almeida

    2016-01-01

    This study was aimed to provide a longitudinal overview of the subgingival bacterial microbiome using fluorescence in situ hybridization (FISH) technique, in women in the second trimester of pregnancy (between 14 and 24 weeks), and 48 h and 8 weeks postpartum. Of 31 women evaluated during pregnancy, 24 returned for the 48-h and 18 for their 8-week exams postpartum. Probing depth (PD), bleeding on probing, clinical attachment level, and presence of calculus were recorded. Subgingival plaque samples were collected, and FISH was used to identify the numbers of eight periodontal pathogens. Friedman test was used to compare differences between follow-up examinations, followed by a multiple comparison test for a post hoc pairwise comparison. Clinically, a significantly greater number of teeth with PD = 4-5 mm were found during pregnancy than on postpartum examinations. Microbial analysis showed a statistically significant decrease in cell count over the study period for Prevotella nigrescens. P. intermedia, Campylobacter rectus, and Porphyromonas gingivalis also decrease, although not significantly, and Aggregatibacter actinomycetemcomitans increased. No significant changes were found for Fusobacterium nucleatum, Treponema denticola, or Tannerella forsythia. Our data demonstrate a change in the subgingival microbiota during pregnancy, at least for P. nigrescens. PMID:27556678

  20. Pregnancy-related systemic lupus erythematosus: clinical features, outcome and risk factors of disease flares--a case control study.

    Huaxia Yang

    Full Text Available OBJECTIVE: To investigate the clinical features, outcome, and risk factors of disease flares in patients with pregnancy-related lupus (PRL. METHODS: Medical charts of 155 consecutive PRL inpatients were systematically reviewed, including demographic data, clinical features, laboratory findings, treatment, complications, and outcome. RESULTS: PRL cases were divided into active (a-PRL (n = 82, 53.0% and stable lupus (s-PRL (n = 73, 47.0%. Compared with nonpregnant active female systemic lupus erythematosus (SLE patients, a-PRL including new-onset lupus (n-PRL and flare lupus (f-PRL (n = 41 respectively, had a higher incidence of renal and hematological involvement but less mucocutaneous and musculoskeletal involvement (p<0.05. The incidence of preeclampsia/eclampsia, fetal loss, and preterm birth were significantly higher in a-PRL than in s-PRL (p<0.05. Despite receiving a more vigorous glucocorticoid treatment, a-PRL mothers had a poorer prognosis (p<0.001. Five (6.1% of them died and 13 (15.9% developed severe irreversible organ failure, whereas none of these events was observed in the s-PRL group. Multivariate logistic analysis indicated that a history of lupus flares and serological activity (hypocomplementemia and/or anti-dsDNA positivity at the time of conception were associated with lupus flares in PRL mothers. CONCLUSIONS: SLE patients with a flare history and serological activity at the time of conception were at an increased risk of disease flares during pregnancy and puerperium. a-PRL patients were more prone to renal and hematological involvement, pregnancy complications, and a poorer prognosis despite more vigorous glucocorticoid treatment.

  1. Clinical impact of mild carbohydrate intolerance in pregnancy

    Jensen, Dorte Møller; Damm, P; Sørensen, B;

    2001-01-01

    . Information on oral glucose tolerance test results and clinical outcomes was collected from laboratory charts and medical records. RESULTS: The following outcomes increased significantly with increasing glucose values during the oral glucose tolerance test: shoulder dystocia, macrosomia, emergency cesarean...... section, assisted delivery, hypertension, and induction of labor. However, when corrections were made for other risk factors, hypertension and induction of labor were only marginally associated with glucose levels. CONCLUSION: In a group of nondiabetic pregnant women with risk factors for gestational...

  2. Recommendations of activity restriction in high-risk pregnancy scenarios

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas; Langhoff-Roos, Jens

    2015-01-01

    Abstract Aims: To describe specific recommendations of activity restriction, place of care, expected beneficial and adverse effects, and recommended antithrombotic prophylaxis in nine clinical scenarios. Methods: A national survey. All members of the Danish Society of Obstetrics and Gynaecology a...

  3. Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight

    Hegaard, Hanne Kristine; Pedersen, Bente K; Nielsen, Birgitte Bruun;

    2007-01-01

    It has been questioned whether leisure time physical activity (LTPA) during pregnancy is beneficial or deleterious to pregnancy outcome, and whether a sedentary lifestyle during pregnancy has a negative impact on pregnancy. Answers to these questions are of general interest, since some young wome...

  4. Involve young men in preventing teen pregnancy: draw them into your clinic.

    1998-08-01

    Although the majority of US male teenagers now believe pregnancy prevention is a male responsibility and are willing to use contraception, their actual contraceptive use is inconsistent. Moreover, teens are more likely to receive contraceptive information from the mass media or schools than from a health care provider. According to a national survey, only 32% of sexually experienced teen males and 17% of male virgins have received contraceptive information from a health care provider. Funding remains a significant obstacle to initiating reproductive health programs for young men. Thus, clinics must seek alternative funding resources, especially from foundations. A new US Urban Institute publication profiles 24 programs in 14 states that have effectively involved young men in pregnancy prevention and provided information on the male role in reproduction. Common features of these programs include coordination with existing community resources, attempts to reach young men in community settings where they congregate, and male outreach and clinic staff. PMID:12348578

  5. MR Imaging of Pregnancy Luteoma: a Case Report and Correlation with the Clinical Features

    Kao, Hung-Wen; Wu, Ching-Jiunn; Chung, Kuo-Teng; Wang, Sheng-Ru; Chen, Cheng-Yu

    2005-01-01

    We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findin...

  6. Profile of pregnancy in adolescence and related clinical-obstetric occurrences

    Maria Veraci Oliveira Queiroz; Eysler Gonçalves Maia Brasil; Caroline Magalhães de Alcântara; Maria da Glória Oliveira Carneiro

    2014-01-01

    The objective was to characterize the profile of adolescence pregnancy and its clinical and obstetric events. Descriptive, cross-sectional study, with quantitative approach, developed in a tertiary hospital in Fortaleza, CE, Brazil, with one hundred adolescent mothers, through interviews and registers from the medical records, from February to May, 2011. Data were analyzed by Statistical Package for the Social Science software, version 17.0. The majority lived with a partner who earned up to ...

  7. The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancyclinical effectiveness and safety until 2 years after delivery, with economic evaluation

    Cooper, Sue; Lewis, Sarah; Thornton, Jim; Marlow, Neil; Watts, Kim; Britton, John; Grainge, Matthew J.; Taggar, Jaspal; Essex, Holly; Parrott, Steve; Dickinson, Anne; Whitemore, Rachel; Coleman, Tim

    2014-01-01

    BACKGROUND: Smoking during pregnancy causes many adverse pregnancy and birth outcomes. Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants. OBJECTIVES: To compare (1) at delivery, the clinical effectiveness and cost-effectiveness for achieving biochemically validated smoking cessation of NRT patches wi...

  8. The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact.

    Boeuf, Phillipe; Drummer, Heidi E; Richards, Jack S; Scoullar, Michelle J L; Beeson, James G

    2016-01-01

    Zika virus (ZIKV) is a mosquito-borne flavivirus that has newly emerged as a significant global threat, especially to pregnancy. Recent major outbreaks in the Pacific and in Central and South America have been associated with an increased incidence of microcephaly and other abnormalities of the central nervous system in neonates. The causal link between ZIKV infection during pregnancy and microcephaly is now strongly supported. Over 2 billion people live in regions conducive to ZIKV transmission, with ~4 million infections in the Americas predicted for 2016. Given the scale of the current pandemic and the serious and long-term consequences of infection during pregnancy, the impact of ZIKV on health services and affected communities could be enormous. This further highlights the need for a rapid global public health and research response to ZIKV to limit and prevent its impact through the development of therapeutics, vaccines, and improved diagnostics. Here we review the epidemiology of ZIKV; the threat to pregnancy; the clinical consequences and broader impact of ZIKV infections; and the virus biology underpinning new interventions, diagnostics, and insights into the mechanisms of disease. PMID:27487767

  9. Stretch Marks of Pregnancy (Striae of Pregnancy)

    ... clinical tools newsletter | contact Share | Stretch Marks of Pregnancy (Striae of Pregnancy) Information for adults A A A Dark purple, ... pregnant women. Overview Striae gravidarum, stretch marks in pregnancy, occur in about 90% of all pregnant women. ...

  10. Pregnancy-Related Peritoneal Ectopic Decidua (Deciduosis: Morphological and Clinical Evaluation

    Filiz BOLAT

    2012-01-01

    Full Text Available Objective: Ectopic decidual reaction (deciduosis can be seen rarely on the peritoneum during laparotomy for a cesarean section for pregnancy, in addition to the ovary and cervix. The aim of this study was to evaluate the clinical, histopathological, immunohistochemical characteristics of ectopic decidua cases that were incidentally found in the peritoneum during a cesarean section.Material and Method: A total of seven cases where decidualization was found in the peritoneal biopsy taken during pregnancy at the Baskent University Medical Faculty Adana Teaching and Training Hospital Department of Pathology were included in this study. The clinical features of the cases were obtained from their clinical folders. The morphological findings were recorded and the peritoneal biopsies were analyzed with keratin Pan Ab-1, calretinin, vimentin, HMB-45 and progesterone receptor antibody for immunohistochemical analysis.Results: The mean age for the seven cases was 36±4.16. The gestational age was 33 to 39 (mean 37.2 weeks. Microscopic evaluation revealed decidualized cells that were large polygonal and eosinophilic, some with vacuolated cytoplasm, that formed small nodules under the mesothelium of the peritoneum in all cases. Immunohistochemical staining showed positive staining of the cell cytoplasm with vimentin and positive staining of the cell nucleus with the progesterone receptor antibody in the decidual cells. Calretinin, keratin and HMB-45 stains were negative.Conclusion: Pregnancy-related peritoneal deciduosis develops with the effect of progesterone in pregnancy. It disappears without complication in the postpartum period. Immunohistochemistry may help the differential diagnosis of peritoneal deciduosis where problems are experienced differentiating the case from malignant mesothelioma or metastatic tumor.

  11. Influence of medical treatment, smoking and disease activity on pregnancy outcomes in Crohn's disease

    Julsgaard, Mette; Nørgaard, Mette; Hvas, Christian Lodberg;

    2014-01-01

    Objective. Little is known about predictors for adverse pregnancy outcomes among women with Crohn’s disease (CD). In this population-based study, we examined pregnancy outcomes in CD stratified by medical treatment and smoking status while accounting for disease activity. Methods. In two Danish...... adverse pregnancy outcomes by different predictors. Results. Among 105 (80%) respondents, 55 (52%) reported taking medication during pregnancy. The majority (95%) were in disease remission. The children’s mean birth weight did not differ by maternal medical treatment. As expected, smoking was a predictor...

  12. MR imaging of pregnancy luteoma: a case report and correlation with the clinical features

    We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findings were closely correlated with the clinical presentation

  13. [Research activity in clinical biochemistry

    Jorgensen, H.L.; Larsen, B.; Ingwersen, P.;

    2008-01-01

    BACKGROUND: Quantitative bibliometric measurements of research activity are frequently used, e.g. for evaluating applicants for academic positions. The purpose of this investigation is to assess research activity within the medical speciality of Clinical Biochemistry by comparing it with a matched...... Clinical Biochemistry, 57 fulfilled the inclusion criteria. Each of these 57 was matched according to medical title with two randomly chosen specialists from other specialities, totaling 114. Using Medline and the Web of Science, the number of publications and the number of citations were then ascertained....... RESULTS: 25% of the 11,691 specialists held a PhD degree or doctoral degree, DMSci, (Clinical Biochemistry: 61%). The 171 specialists included in the study had 9,823 papers in Medline and 10,140 papers in the Web of Science. The number of Medline papers per specialist was 71 for Clinical Biochemistry...

  14. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team

    Olsen, S F; Secher, N J; Tabor, A; Weber, T; Walker, J J; Gluud, C

    2000-01-01

    To test the postulated preventive effects of dietary n-3 fatty acids on pre-term delivery, intrauterine growth retardation, and pregnancy induced hypertension.......To test the postulated preventive effects of dietary n-3 fatty acids on pre-term delivery, intrauterine growth retardation, and pregnancy induced hypertension....

  15. [Clinical practice recommendations for diabetes in pregnancy (Diabetes and Pregnancy Study Group of the Austrian Diabetes Association)].

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Weitgasser, Raimund; Lechleitner, Monika

    2016-04-01

    Twenty-six years ago the St. Vincent Declaration aimed for an achievement of a comparable pregnancy outcome in diabetic and non-diabetic women. However, current surveys clearly show that women with pre-gestational diabetes still feature a much higher risk of perinatal morbidity and even increased mortality. This fact is mostly ascribed to a persistently low rate of pregnancy planning and pre-pregnancy care with optimization of metabolic control prior to conception. In addition, obesity increases worldwide, contributing to a growing number of women with type 2 diabetes at a childbearing age, and a further deterioration in outcome in diabetic women. Development of diabetic embryopathy and fetopathy are known to be related to maternal glycemic control (target: normoglycemia and normal HbA1c, if possible without hypoglycemia). The risk for hypoglycemia is at its greatest in early pregnancy and decreases with the progression of pregnancy due to the hormonal changes leading to a marked increase of insulin resistance. Intensified insulin therapy with multiple daily insulin injections and pump treatment are equally effective in reaching good metabolic control during pregnancy. All women should be experienced in the management of their therapy and on stable glycemic control prior to the conception. In addition, thyroid dysfunction, hypertension as well as the presence of diabetic complications should be excluded before pregnancy or treated adequately in order to decrease the risk for a progression of complications during pregnancy as well as for maternal and fetal morbidity. PMID:27052227

  16. Platelet aggregation and serum adenosine deaminase (ADA) activity in pregnancy associated with diabetes, hypertension and HIV.

    Leal, Claudio A M; Leal, Daniela B R; Adefegha, Stephen A; Morsch, Vera M; da Silva, José E P; Rezer, João F P; Schrekker, Clarissa M L; Abdalla, Faida H; Schetinger, Maria R C

    2016-07-01

    Platelet aggregation and adenosine deaminase (ADA) activity were evaluated in pregnant women living with some disease conditions including hypertension, diabetes mellitus and human immunodeficiency virus infection. The subject population is consisted of 15 non-pregnant healthy women [control group (CG)], 15 women with normal pregnancy (NP), 7 women with hypertensive pregnancy (HP), 10 women with gestational diabetes mellitus (GDM) and 12 women with human immunodeficiency virus-infected pregnancy (HIP) groups. The aggregation of platelets was checked using an optical aggregometer, and serum ADA activity was determined using the colorimetric method. After the addition of 5 µM of agonist adenosine diphosphate, the percentage of platelet aggregation was significantly (p pregnancy and pregnancy-associated diseases suggest that platelet aggregation and ADA activity could serve as peripheral markers for the development of effective therapy in the maintenance of homeostasis and some inflammatory process in these pathophysiological conditions. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27273565

  17. Clinical significance of DVM and its prevalence in pre-gestational diabetes cases versus normal pregnancies

    Farideh Akhlaghi

    2015-06-01

    Full Text Available Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in such pregnancies. Delayed villous maturation of placental villi, which is one of the findings associated with pre-gestational diabetes increases the rate of perinatal mortality. There is limited literature regarding the delayed maturation of placental villous. This review included trials (randomized and non-randomized, cohort and case-control studies registered in Medline/PubMed database, from January 2001 to September 2012 that evaluated the clinical significance of delayed villous maturation and its prevalence in pre-gestational diabetic cases compared to normal pregnancies.It emphasizes that further studies with focus on possible clinical or ultrasound markers of placental delayed villous maturation, especially in a high risk-group such as women with pre-gestational diabetes mellitus are highly recommended.

  18. Does Father Absence Place Daughters at Special Risk for Early Sexual Activity and Teenage Pregnancy?

    Ellis, Bruce J.; Bates, John E.; Dodge, Kenneth A.; Fergusson, David M.; Horwood, L. John; Pettit, Gregory S.; Woodward, Lianne

    2003-01-01

    Longitudinal studies in two countries investigated impact of father absence on girls' early sexual activity (ESA) and teenage pregnancy. Findings indicated that greater exposure to father absence strongly related to elevated ESA and adolescent pregnancy risk. Elevated risk was not explained (U.S. sample) or only partly explained (New Zealand…

  19. Acute pancreatitis in pregnancy: a 6-year single center clinical experience

    LI Hua-ping; HUANG Ya-juan; CHEN Xuan

    2011-01-01

    Background The acute abdomen remains a challenge for all obstetricians and physicians who take part in the care of women in pregnancy.To add substantially to our understanding of acute pancreatitis (AP) in pregnancy,in particular affirming the increased risks for mother and fetus associated with AP,we explored features of clinical manifestation and the strategy of management of this disease during pregnancy,and its effects on maternal and fetal outcomes.Methods A retrospective review of medical records of all pregnant patients diagnosed with AP admitted to the Department of Obstetrics and Gynecology,Sixth People's Hospital Affiliated to Shanghai Jiao Tong University between 2005 and 2010 was performed.Information was collected from presentation,management,and outcome from medical records.Results There were 11 cases in 2010,accounting for 44% of 25 cases.Among these cases,mild AP (MAP) occurred in 15 cases (60%),while the rest cases were severe AP (SAP) (40%).The major etiology of AP in pregnancy was due to gallstone and cholecystitis.Clinical features together with elevation of the plasma concentrations of pancreatic enzymes were the cornerstones of diagnosis.Positive conservative treatment was taken in most of the cases (21 cases,84%) with a favorable outcome.Seven cases of critically ill patients were monitored in intensive care unit,and 4 patients underwent surgical interventions.As a result,all of 25 patients had better prognosis,no maternal death was observed.There were 8 preterm labors and 2 fetal losses,accounting for the perinatal mortality of 8%.Fetal malformation was not observed.Conclusions While a pregnant woman suffers acute abdominal pain,early diagnosis and severity assessment of AP are very important.Conservative comprehensive treatment with intensive care is recommended.Surgical intervention should be performed as late as possible.

  20. Clinical application of uterine artery embolization in treating uterine scar pregnancy

    Objective: To evaluate uterine artery embolization in treating uterine scar pregnancy. Methods: During the period from November 2007 to February 2010, 11 patients with uterine scar pregnancy were encountered in authors' hospital. All the patients had a history of lower uterine segment cesarean section. Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding. The other 7 patients received intravenous chemotherapy with MTX (0.4 mg/kg/day, every 5 days as a treatment course). Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding (blood loss ≥ 100 ml/hour) during the course of chemotherapy, while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease. The clinical results were analyzed. Results: Remarkable decrease in serum HCG was seen in all 11 patients after interventional management. The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization. The uterus together with intact fertility was successfully preserved in all 11 patients. Conclusion: For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding (blood loss ≥ 500 ml/24 h) and/or abnormal elevation of serum HCG (blood β-HCG ≥ 20000 IU/L), ectopic pregnancy with the mass diameter ≥ 5 cm, uterine artery embolization treatment is very safe and effective. This technique can well preserve female patient's uterus and fertility ability. It is of value to employ this treatment in clinical practice. (authors)

  1. Physical activity during pregnancy in normal-weight and obese women

    Renault, K; Nørgaard, K; Secher, N J;

    2012-01-01

    The objectives of this prospective study were to compare physical activity in 70 normal-weight women with a body mass index (BMI) 20-25 kg/m(2), and 70 obese with a BMI ≥ 30 kg/m(2), before and during pregnancy, and to compare compliance using the pedometer. Physical activity before pregnancy was...... assessed by questionnaires and during pregnancy by a pedometer worn on 7 consecutive days every 4th week. Obese women were less physically active than normal-weight women both before (p...

  2. Objectively measured physical activity during pregnancy: a study in obese and overweight women

    Rankin Judith

    2010-11-01

    Full Text Available Abstract Background Obese and overweight women may benefit from increased physical activity (PA during pregnancy. There is limited published data describing objectively measured PA in such women. Methods A longitudinal observational study of PA intensity, type and duration using objective and subjective measurement methods. Fifty five pregnant women with booking body mass index (BMI ≥ 25 kg/m2 were recruited from a hospital ultrasound clinic in North East England. 26 (47% were nulliparous and 22 (40% were obese (BMI ≥ 30 kg/m2. PA was measured by accelerometry and self report questionnaire at 13 weeks, 26 weeks and/or 36 weeks gestation. Outcome measures were daily duration of light, moderate or vigorous activity assessed by accelerometry; calculated overall PA energy expenditure, (PAEE, and PAEE within four domains of activity based on self report. Results At median 13 weeks gestation, women recorded a median 125 mins/day light activity and 35 mins/day moderate or vigorous activity (MVPA. 65% achieved the minimum recommended 30 mins/day MVPA. This proportion was maintained at 26 weeks (62% and 36 weeks (71%. Women achieving more than 30 mins/day MVPA in the first trimester showed a significant reduction in duration of MVPA by the third trimester (11 mins/day, p = 0.003. Walking, swimming and floor exercises were the most commonly reported recreational activities but their contribution to estimated energy expenditure was small. Conclusion Overweight and obese pregnant women can achieve and maintain recommended levels of PA throughout pregnancy. Interventions to promote PA should target changes in habitual activities at work and at home, and in particular walking.

  3. Physical Activity Patterns and Factors Related to Exercise during Pregnancy: A Cross Sectional Study

    Nascimento, Simony Lira; Surita, Fernanda Garanhani; Godoy, Ana Carolina; Kasawara, Karina Tamy; Morais, Sirlei Siani

    2015-01-01

    Objective To assess the physical activity levels of pregnant women and to examine the characteristics associated with the practice of exercise and the activities of daily living during pregnancy. Methods For this cross-sectional study, 1,279 women were recruited within 72 hours postpartum. They were interviewed about their socio-demographic data and obstetric history and were administered self-report questionnaires about exercise and daily physical activities during pregnancy. Data on the cur...

  4. Three-year follow-up of a randomised clinical trial of intravenous versus oral iron for anaemia in pregnancy

    Alhossain A. Khalafallah; Dennis, Amanda E.; Ogden, Kath; Robertson, Iain; Charlton, Ruth H; Bellette, Jackie M; Shady, Jessica L; Blesingk, Nep; Ball, Madeleine

    2012-01-01

    Background To date, there are no data available concerning the impact of iron therapy on the long-term well-being and health-related quality of life (HRQoL) in pregnancy. Objective To assess the long-term effect of iron therapy on HRQoL in pregnancy. Design This is a follow-up study conducted between January 2010 and January 2011 of an earlier randomised open-label clinical trial of intravenous and oral iron versus oral iron for pregnancy-related iron deficiency anaemia. We used a modified ve...

  5. A Randomized Clinical Trial of the Efficacy of KID21 Point (Youmen) Acupressure on Nausea and Vomiting of Pregnancy

    Naeimi Rad, Mojgan; Lamyian, Minoor; Heshmat, Reza; Jaafarabadi, Mohammad Asghari; Yazdani, Shahla

    2012-01-01

    Background Nausea and vomiting in pregnancy is a common complaint of nearly 50-80% of pregnant women. The problem begins around the 4th weeks of pregnancy and often stays up to the 12th weeks and may continue to the 16th week in a few patients. Objectives The aim of our study is to determine the effect of acupressure (on KID21 point) on nausea and vomiting of pregnancy. Materials and Methods This single blind clinical trial study was performed on 80 women with nausea and vomiting in the first...

  6. Clinical trial considerations on male contraception and collection of pregnancy information from female partners

    Banholzer Maria

    2012-06-01

    Full Text Available Abstract Background There is little guidance regarding the risk of exposure of pregnant women/ women of childbearing potential to genotoxic or teratogenic compounds via vaginal dose delivered through seminal fluid during sexual intercourse. Method We summarize current thinking and provide clinical trial considerations for a consistent approach to contraception for males exposed to genotoxic and/or teratogenic compounds or to compounds of unknown teratogenicity, and for collection of pregnancy data from their female partners. Results Where toxicity testing demonstrates genotoxic potential, condom use is required during exposure and for 5 terminal plasma half-lives plus 74 days (one human spermatogenesis cycle to avoid conception. For non-genotoxic small molecules and immunoglobulins with unknown teratogenic potential or without a no observed adverse effect level (NOAEL from embryo-fetal development (EFD studies and no minimal anticipated biological effect level (MABEL, condom use is recommended for males with pregnant partner/female partner of childbearing potential. For teratogenic small molecules with estimated seminal fluid concentration and a margin between projected maternal area under the curve (AUC and NOAEL AUC from EFD studies of ≥300 (≥100 for immunoglobulins or in the absence of a NOAEL with a margin between MABEL plasma concentration and maternal Cmax of ≥300 (≥10 for immunoglobulins, condom use is not required. However, condom use is required for margins below the thresholds previously indicated. For small molecules with available seminal fluid concentrations, condom use is required if margins are Pregnancy data should be proactively collected if pregnancy occurs during the condom use period required for males exposed to first-in-class molecules or to molecules with a target/class shown to be teratogenic, embryotoxic or fetotoxic in human or preclinical experiments. Conclusion These recommendations, based on a precaution

  7. Occupational activity during pregnancy based on the Polish Mother and Child Cohort Study

    Kinga Polańska

    2014-02-01

    Full Text Available Background: In Poland conditions related to or aggravated by the pregnancy, childbirth or the puerperium are one of the most common causes of sickness absence. The aim of the study was to analyze the occupational activity pattern during pregnancy and to evaluate the determinants of pregnancy-related temporary work disability confirmed by medical certificate. Materials and Methods: The presented analysis is based on data collected under the Polish Mother and Child Cohort Study. The study population consisted of 954 women who reported occupational activity during pregnancy. All women participating in the study were interviewed 3 times during pregnancy. Detail information on occupational activity during pregnancy and occupational stress, based on the Subjective Work Characteristics Questionnaire, was collected from all women. Results: The pregnant women had been issued medical certificate of temporary work disability because of conditions related to or aggravated by the pregnancy, childbirth or by the puerperium at 16 week of gestation on average and did not continue their activities until the end of pregnancy. The statistically significant determinants of receiving such medical certificate in the first trimester of pregnancy (≤ 12 weeks of pregnancy comprised poor health condition and complications during pregnancy (OR = 1.4; p = 0.01, lower education (OR = 2.4; p < 0.001, socio-economic status (OR = 9.6; p = 0.03, use of public transport to commute to work (OR = 2.7; p < 0.001, a longer work commute (OR = 1.4; p = 0.008 and a higher level of occupational stress (OR = 3.0; p < 0.01. Waitresses, nurses and saleswomen received medical certificate of temporary work disability in the first trimester of pregnancy more frequently than office workers (OR = 4.2; p = 0.005; OR = 3.3; p = 0.02; OR = 2.3; p < 0.001 respectively. Conclusions: It is crucial to develop the model of cooperation between occupational medicine physicians and gynecologists and a

  8. Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

    To, William W. K.; Wong, Margaret W. N.

    2012-01-01

    Objective To evaluate whether bone mineral density (BMD) changes in women engaged in active exercises during pregnancy would be different from non-exercising women. Methods Consecutive patients with singleton pregnancies who were engaged in active exercise training during pregnancy were prospectively recruited over a period of 6 months. Quantitative USG measurements of the os calcis BMD were performed at 14–20 weeks and at 36–38 weeks. These patients were compared to a control cohort of non-e...

  9. Physical activity, depressed mood and pregnancy worries in European obese pregnant women

    de Wit, Linda; Jelsma, Judith G M; van Poppel, Mireille N M;

    2015-01-01

    BACKGROUND: The purpose of this study was to examine the association between mental health status (i.e. depressed mood and pregnancy-related worries) and objectively measured physical activity levels in obese pregnant women from seven European countries. METHODS: Baseline data from the vitamin D...... scores indicative of depressed mood (<50) were reported by 27.1 % of the women and most frequently endorsed pregnancy-related worries pertained to own and the baby's health. Women with good well-being spent 85% more time in MVPA compared to women with a depressed mood (P = 0.03). No differences in MVPA...... levels were found for women with no, some, or many pregnancy worries. Depressed mood and pregnancy-related worries were not associated with sedentary behaviour. CONCLUSIONS: These findings suggest that in pregnant women who are obese, a depressed mood, but not pregnancy-related worries, may be associated...

  10. The Effect of Omega-3 Fatty Acid Supplementation on Maternal Depression during Pregnancy: A Double Blind Randomized Controlled Clinical Trial

    Kaviani, Maasumeh; Saniee, Laleh; Azima, Sara; Sharif, Farkhondeh; Sayadi, Mehrab

    2014-01-01

    Background: Depression is one of the most debilitating disorders during pregnancy and its recovery and treatment are among the concerns of obstetrics and gynecology experts. The present study aimed to determine the effect of omega-3 supplement on mild depression during pregnancy among primiparous women. Method: In this double-blind clinical trial, 80 primiparous women were randomly divided into 2 groups of omega-3 and placebo. The experimental group received 1 g omega-3 capsules for 6 weeks. ...

  11. Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics.

    Vrijkotte, Tanja; Schreuder, Ysbrand; Van Eijsden, Manon; Hutten, Barbara; Jansen, Eugene; Twickler, Marcel; Vissers, Maud

    2011-01-01

    Abstract Background/Objectives: Lipid disturbances during pregnancy may lead to early onset of metabolic diseases in the offspring. However, there is little knowledge on ethnic differences in lipid levels during pregnancy. We evaluated ethnic differences in non-fasting total cholesterol (TC) and triglyceride (TG) levels during early gestation and the role of demographics, behavioural factors and clinical characteristics. Subjects/Methods: Non-diabetic pregnant women (N=3025) fr...

  12. TLR-9 Activation Coupled To IL-10 Deficiency Induces Adverse Pregnancy Outcomes

    Thaxton, Jessica E.; Romero, Roberto; Sharma, Surendra

    2009-01-01

    Pregnancy outcome is severely compromised by intrauterine infections and inflammation. Although the pregnant uterine microenvironment is replete with innate immune cells and Toll-like receptor (TLR) expression, the mechanisms that facilitate adverse effects of their activation are largely unknown. Here we mimic the activation of TLR-9 with its pathogenic ligand hypomethylated CpG, and demonstrate that IL-10 proficiency protects against CpG-induced pregnancy complications. We show that fetal r...

  13. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women

    Rankin Judith; McParlin Catherine; Robson Stephen C; Bush Judith; Weir Zoe; Bell Ruth

    2010-01-01

    Abstract Background Whilst there has been increasing research interest in interventions which promote physical activity during pregnancy few studies have yielded detailed insights into the views and experiences of overweight and obese pregnant women themselves. The qualitative study described in this paper aimed to: (i) explore the views and experiences of overweight and obese pregnant women; and (ii) inform interventions which could promote the adoption of physical activity during pregnancy....

  14. Physical Activity during Pregnancy and Offspring Neurodevelopment and IQ in the First 4 Years of Life

    Domingues, Marlos R.; Matijasevich, Alicia; Barros, Aluísio J. D.; Santos, Iná S; Horta, Bernardo L; Hallal, Pedro C.

    2014-01-01

    Background Maternal physical activity during pregnancy could alter offspring's IQ and neurodevelopment in childhood. Methods Children belonging to a birth cohort were followed at 3, 12, 24 and 48 months of age. Physical activity during pregnancy was assessed retrospectively at birth. Neurodevelopment was evaluated by Battelle's Development Inventory (12, 24 and 48 months) and IQ by the Weschler's Intelligence Scale (48 months). Neurodevelopment was based on Battelles' (90th percentile) and al...

  15. Does physical activity during pregnancy adversely influence markers of the metabolic syndrome in adult offspring?

    Danielsen, Inge; Granström, Charlotta; Rytter, Dorte;

    2013-01-01

    It is unknown whether physical activity during pregnancy (PA) has long-term impact on the metabolic profile of the offspring. We investigated associations of PA with markers of the metabolic syndrome (MS) in 20y old offspring.......It is unknown whether physical activity during pregnancy (PA) has long-term impact on the metabolic profile of the offspring. We investigated associations of PA with markers of the metabolic syndrome (MS) in 20y old offspring....

  16. Strategies to Promote Physical Activity During Pregnancy: A Systematic Review of Intervention Evidence

    Pearce, Emily E.; Evenson, Kelly R.; Downs, Danielle Symons; Steckler, Allan

    2012-01-01

    Physical activity during pregnancy has been associated with significant health benefits, however most women in the United States do not meet current guidelines. This systematic review evaluates evidence for interventions to improve physical activity during pregnancy in order to identify best practices and inform future research. Electronic databases (PubMed, CINAHL, SportDISCUS, Embase, ERIC, Psych Info and ISI Web of Science) were searched in July 2011 for peer-reviewed journal articles. Stu...

  17. Hypertensive disorders of pregnancy: a systematic review of international clinical practice guidelines.

    Tessa E R Gillon

    Full Text Available Clinical practice guidelines (CPGs are developed to assist health care providers in decision-making. We systematically reviewed existing CPGs on the HDPs (hypertensive disorders of pregnancy to inform clinical practice.MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, Health Technology Assessments, and Database of Abstracts of Reviews of Effects (Ovid interface, Grey Matters, Google Scholar, and personal records were searched for CPGs on the HDPs (Jan/03 to Nov/13 in English, French, Dutch, or German. Of 13 CPGs identified, three were multinational and three developed for community/midwifery use. Length varied from 3-1188 pages and three guidelines did not formulate recommendations. Eight different grading systems were identified for assessing evidence quality and recommendation strength. No guideline scored ≧80% on every domain of the AGREE II, a tool for assessing guideline methodological quality; two CPGs did so for 5/6 domains. Consistency was seen for (i definitions of hypertension, proteinuria, chronic and gestational hypertension; (ii pre-eclampsia prevention for women at increased risk: calcium when intake is low and low-dose aspirin, but not vitamins C and E or diuretics; (iii antihypertensive treatment of severe hypertension; (iv MgSO4 for eclampsia and severe pre-eclampsia; (v antenatal corticosteroids at <34 wks when delivery is probable within 7 days; (vi delivery for women with severe pre-eclampsia pre-viability or pre-eclampsia at term; and (vii active management of the third stage of labour with oxytocin. Notable inconsistencies were in: (i definitions of pre-eclampsia and severe pre-eclampsia; (ii target BP for non-severe hypertension; (iii timing of delivery for women with pre-eclampsia and severe pre-eclampsia; (iv MgSO4 for non-severe pre-eclampsia, and (v postpartum maternal monitoring.Existing international HDP CPGs have areas of consistency with which clinicians and

  18. Physical activity, health-related quality of life and depression during pregnancy Atividade física, qualidade de vida e depressão durante a gravidez

    Iva Tendais; Bárbara Figueiredo; Jorge Mota; Ana Conde

    2011-01-01

    This study examines physical activity patterns among women, from pre-pregnancy to the second trimester of pregnancy, and the relationship between physical activity status based on physical activity guidelines and health-related quality of life (HRQoL) and depression over pregnancy. 56 healthy pregnant women self-reported physical activity, HRQoL and depression at 10-15 and 19-24 weeks of pregnancy and physical activity before pregnancy. Whereas vigorous leisure physical activity decreased aft...

  19. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

    2015-12-01

    Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health. PMID:26595585

  20. Committee Opinion No. 650 Summary: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

    2015-12-01

    Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health. PMID:26595580

  1. Adnexal torsion in a heterotopic pregnancy: a rare clinical entity with diagnostic dilemma

    Kirtirekha Mohapatra; Subhasri Mishra; Balaram Sahoo; Basudev Marandi; Rishika Sen; Sagarika N.

    2016-01-01

    Adnexal torsion is an uncommon cause of surgical emergency during pregnancy. Its incidence is 1 in 5000 pregnancies, occurring more frequently in the first trimester after ovarian hyper stimulation. Heterotopic pregnancy is also a rare entity and cause pain abdomen but without the classical symptom of bleeding per vaginum. Heterotopic pregnancy with adnexal torsion is extremely rare but increases the case fatality rate. Hence the differential diagnosis of pain abdomen during early pregnancy b...

  2. Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

    2015-01-01

    Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycem...

  3. Leisure-time physical activity in pregnancy and risk of postpartum depression: a prospective study in a large national birth cohort

    Strøm, Marin; Mortensen, Erik L; Halldorson, Thórhallur I;

    2009-01-01

    OBJECTIVE: To explore the association between physical activity during pregnancy and postpartum depression (PPD) in a large, prospective cohort. METHOD: Exposure information from the Danish National Birth Cohort, a large, prospective cohort with information on more than 100,000 pregnancies (1996......-2002), was linked to the Danish Psychiatric Central Register and the Danish Register for Medicinal Product Statistics for data on clinically identified cases of depression up to 1 year postpartum. A total of 70,866 women from the Danish National Birth Cohort were included in the analyses. Duration, frequency...... activity, against postpartum depression requiring antidepressant therapy. No protective effect could be detected on PPD leading to hospitalization....

  4. Pregnancy-Associated Heart Failure: A Comparison of Clinical Presentation and Outcome between Hypertensive Heart Failure of Pregnancy and Idiopathic Peripartum Cardiomyopathy.

    Ntobeko B A Ntusi

    Full Text Available There is controversy regarding the inclusion of patients with hypertension among cases of peripartum cardiomyopathy (PPCM, as the practice has contributed significantly to the discrepancy in reported characteristics of PPCM. We sought to determine whether hypertensive heart failure of pregnancy (HHFP (i.e., peripartum cardiac failure associated with any form of hypertension and PPCM have similar or different clinical features and outcome.We compared the time of onset of symptoms, clinical profile (including electrocardiographic [ECG] and echocardiographic features and outcome of patients with HHFP (n = 53; age 29.6 ± 6.6 years and PPCM (n = 30; age 31.5 ± 7.5 years. The onset of symptoms was postpartum in all PPCM patients, whereas it was antepartum in 85% of HHFP cases (p<0.001. PPCM was more significantly associated with the following features than HHFP (p<0.05: twin pregnancy, smoking, cardiomegaly with lower left ventricular ejection fraction on echocardiography, and longer QRS duration, QRS abnormalities, left atrial hypertrophy, left bundle branch block, T wave inversion and atrial fibrillation on ECG. By contrast, HHFP patients were significantly more likely (p<0.05 to have a family history of hypertension, hypertension and pre-eclampsia in a previous pregnancy, tachycardia at presentation on ECG, and left ventricular hypertrophy on echocardiography. Chronic heart failure, intra-cardiac thrombus and pulmonary hypertension were found significantly more commonly in PPCM than in HHFP (p<0.05. There were 5 deaths in the PPCM group compared to none among HHFP cases (p = 0.005 during follow-up.There are significant differences in the time of onset of heart failure, clinical, ECG and echocardiographic features, and outcome of HHFP compared to PPCM, indicating that the presence of hypertension in pregnancy-associated heart failure may not fit the case definition of idiopathic PPCM.

  5. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: a single-center study from India.

    Godara, Suraj M; Kute, Vivek B; Trivedi, Hargovind L; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Gumber, Vandana M

    2014-07-01

    Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34), early pregnancy (n = 10) and late pregnancy (n = 13). The cause of AKI included puerperal sepsis (63.1%), pregnancy-induced hypertension (PIH) (33.33%), post-abortion (22.80%), ante-partum hemorrhage (APH) (14%) and post-partum hemorrhage (PPH) (8%). Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial thromboplast in time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conservatively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality. PMID:24969215

  6. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: A single-center study from India

    Suraj M Godara

    2014-01-01

    Full Text Available Acute kidney injury (AKI is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34, early pregnancy (n = 10 and late pregnancy (n = 13. The cause of AKI included puerperal sepsis (63.1%, pregnancy-induced hypertension (PIH (33.33%, post-abortion (22.80%, ante-partum hemorrhage (APH (14% and post-partum hemorrhage (PPH (8%. Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial throm-boplastin time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conserva-tively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality.

  7. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women

    Rankin Judith

    2010-04-01

    Full Text Available Abstract Background Whilst there has been increasing research interest in interventions which promote physical activity during pregnancy few studies have yielded detailed insights into the views and experiences of overweight and obese pregnant women themselves. The qualitative study described in this paper aimed to: (i explore the views and experiences of overweight and obese pregnant women; and (ii inform interventions which could promote the adoption of physical activity during pregnancy. Methods The study was framed by a combined Subtle Realism and Theory of Planned Behaviour (TPB approach. This enabled us to examine the hypothetical pathway between beliefs and physical activity intentions within the context of day to day life. The study sample for the qualitative study was chosen by stratified, purposive sampling from a previous study of physical activity measurements in pregnancy. Research participants for the current study were recruited on the basis of Body Mass Index (BMI at booking and parity. Semi-structured, in-depth interviews were conducted with 14 overweight and obese pregnant women. Data analysis was undertaken using a Framework Approach and was informed by TPB. Results Healthy eating was often viewed as being of greater importance for the health of mother and baby than participation in physical activity. A commonly cited motivator for maintaining physical activity during pregnancy is an aid to reducing pregnancy-related weight gain. However, participants often described how they would wait until the postnatal period to try and lose weight. A wide range of barriers to physical activity during pregnancy were highlighted including both internal (physical and psychological and external (work, family, time and environmental. The study participants also lacked access to consistent information, advice and support on the benefits of physical activity during pregnancy. Conclusions Interventions to encourage recommended levels of physical

  8. Physical Activity and Pregnancy: Past and Present Evidence and Future Recommendations

    Symons Downs, Danielle; Chasan-Taber, Lisa; Evenson, Kelly R.; Leiferman, Jenn; Yeo, SeonAe

    2012-01-01

    Purpose: In this review, we provide researchers and practitioners with an overview of the physical activity and pregnancy literature to promote prenatal physical activity, improve measurement, further elucidate the role of activity in reducing maternal health complications, and inform future research. Method: We examined past and present physical…

  9. Clinical relevance of multiple antibody specificity testing in anti-phospholipid syndrome and recurrent pregnancy loss.

    Tebo, A E; Jaskowski, T D; Hill, H R; Branch, D W

    2008-12-01

    We wanted to evaluate whether testing for anti-phosholipid antibodies other than anti-cardiolipin (aCL) and anti-beta-2 glycoprotein I (abeta2GPI) immunoglobulin (Ig)G and IgM identifies patients with recurrent pregnancy loss (RPL) who may be positive for anti-phospholipid syndrome (APS). In a cross-sectional study comprising 62 patients with APS, 66 women with RPL, 50 healthy blood donors and 24 women with a history of successful pregnancies, we tested IgM and IgG antibodies to phosphatidic acid, phosphatidyl choline, phosphatidyl ethanolamine, phosphatidyl glycerol, phosphatidyl inositol and phosphatidyl serine with and without beta-2 glycoprotein I (beta2GPI) from a single manufacturer as well as aCL and abeta2GPI antibodies. Diagnostic accuracies of individual and combined anti-phospholipid (aPL) assays were assessed by computing sensitivities, specificities, positive predictive values and negative predictive values together with their 95% confidence intervals. There was a general trend for increased sensitivities in the presence of beta2GPI co-factor with significant effect for certain specificities. The overall combined sensitivity of the non-recommended aPL assays was not significantly higher than that of the aCL and aB2GPI tests. Multiple aPL specificities in RPL group is not significantly different from controls and therefore of no clinical significance. PMID:18826497

  10. Late presentation of hyperandrogenism in pregnancy: clinical features and differential diagnosis

    Das, Gautam; Eligar, Vinay S; Govindan, Jyothish; Rees, D. Aled

    2013-01-01

    Summary Background Hyperandrogenic states in pregnancy are rare but arise most commonly due to new-onset ovarian pathology in pregnancy. We describe the case of a young woman who presented in the latter half of her pregnancy with features of hyperandrogenism. We review the biochemical and imaging findings and discuss the differential diagnosis. Case presentation A 26-year-old woman presented in the later part of her pregnancy with widespread hirsutism. Biochemical testing confirmed hyperandro...

  11. Physical Activity Patterns and Factors Related to Exercise during Pregnancy: A Cross Sectional Study.

    Simony Lira Nascimento

    Full Text Available To assess the physical activity levels of pregnant women and to examine the characteristics associated with the practice of exercise and the activities of daily living during pregnancy.For this cross-sectional study, 1,279 women were recruited within 72 hours postpartum. They were interviewed about their socio-demographic data and obstetric history and were administered self-report questionnaires about exercise and daily physical activities during pregnancy. Data on the current pregnancy, labor, delivery, and newborn outcomes were collected from participants' medical records. To analyze factors related to the practice of exercise, we used the student t-test, X², and odds ratio (OR, with a corresponding 95% confident interval (CI, followed by a multiple logistic regression. The significance level was 5%.Compared to the pre-pregnancy period, the prevalence of physical activity among participants was lower throughout pregnancy (20.1% (p = 0.01. Half of the women interrupted practicing physical exercise due to pregnancy. The lowest prevalence of exercise was observed in the first (13.6% and third trimesters (13.4%. Less than half of women received exercise guidance during prenatal care meetings (47.4%. Walking was the most commonly reported exercise, followed by water aerobics. Factors positively associated with exercise practice were higher educational level (OR= 1.82; CI 95% 1.28-2.60, primiparity (OR=1.49; CI 95% 1.07-2.07, exercising before pregnancy (OR= 6.45; CI 95% 4.64-8.96, and exercise guidance during prenatal care (OR=2.54; CI 95% 1.80-3.57. Mildly intense exercise and domestic activities were most frequently reported among pregnant women. There were no differences in maternal and perinatal outcomes between active and sedentary pregnant women.The findings indicate that promoting physical activity remains a priority in public health policy, and women of childbearing age, especially those planning a pregnancy, should be encouraged to adopt

  12. Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention.

    Naing, Zin W; Scott, Gillian M; Shand, Antonia; Hamilton, Stuart T; van Zuylen, Wendy J; Basha, James; Hall, Beverly; Craig, Maria E; Rawlinson, William D

    2016-02-01

    Human cytomegalovirus (CMV) is under-recognised, despite being the leading infectious cause of congenital malformation, affecting ~0.3% of Australian live births. Approximately 11% of infants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital CMV infection may cause severe long-term sequelae, including progressive sensorineural hearing loss and developmental delay in 40-58% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal CMV infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for CMV-specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal CMV infection, amniocentesis with CMV-PCR performed on amniotic fluid, undertaken after 21-22 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital CMV infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed-onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. Recognition of the importance of CMV in pregnancy and in neonates is increasingly needed, particularly as therapeutic and preventive interventions expand for this serious problem. PMID:26391432

  13. Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: a review

    Hegaard, Hanne Kristine; Pedersen, Bente K; Nielsen, Birgitte Bruun; Damm, Peter

    2007-01-01

    It has been questioned whether leisure time physical activity (LTPA) during pregnancy is beneficial or deleterious to pregnancy outcome, and whether a sedentary lifestyle during pregnancy has a negative impact on pregnancy. Answers to these questions are of general interest, since some young women...... are very physically active during leisure time, while others have a sedentary lifestyle....

  14. Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study

    Santos, Paula Clara; Abreu, Sandra; Moreira, Carla; Santos, Rute; Ferreira, Margarida; Alves, Odete; Moreira, Pedro; Mota, Jorge

    2016-01-01

    Background Physical activity (PA) patterns during pregnancy have not been explored in depth and most previous studies lack assessment of variables such as type, frequency, duration and intensity of activity. Objectives This study had two goals: 1) to analyze PA patterns during pregnancy according to weekly time spent on different types of activity; and 2) to determine women’s perception about health care providers regarding PA advisement during pregnancy. Patients and Methods A longitudinal prospective study was carried out with a 118-pregnant women cohort. Participants were evaluated during all trimesters. Self-reported questionnaires were used to collect personal and obstetric data. Type, duration and frequency of PA were evaluated using the pregnancy physical activity questionnaire (PPAQ) and intensity levels were calculated. Repeated measure analysis of variance was performed to determine differences between trimesters, and Wilcoxon signed-rank test was performed when appropriate. Results A decrease in values of self-reported PA (MET.h.wk-1) was found from the first to the second and the first to the third trimester of pregnancy, respectively; total (270.91 vs 220.54 vs 210.35; P sport activities. Swimming was the most reported organized PA, reaching its highest proportion (12.7%) in the second trimester. Prenatal exercise classes were reported by 39.8% of women during the 3rd trimester. Pregnant women reported that PA was recommended by health professionals: 53.9% in the 1st trimester, 70.4% in the 2nd trimester and 56.8% in the 3rd trimester. Conclusions Self-reported PA decreased, especially from the first to the second trimester, in total, light and moderate intensity. Women spent most of their weekly time on domestic, occupational and leisure activities, except sport activities. There are some health care providers that do not recommend physical activity during pregnancy. PMID:27247788

  15. Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil

    Olsen, Sjurdur Frodi; Østerdal, M L; Salvig, J D;

    2007-01-01

    OBJECTIVE: To examine the effect of fish oil supplementation on duration of pregnancy, conditional on the woman's habitual fish intake. DESIGN: Multicentre 1:1 randomised clinical trial of effect of fish oil in a high-risk population of pregnant women in whom habitual fish intake was assessed at ...

  16. Factors predictive of clinical pregnancy in the first intrauterine insemination cycle of 306 couples with favourable female patient characteristics.

    Aydin, Yunus; Hassa, Hikmet; Oge, Tufan; Tokgoz, Vehbi Yavuz

    2013-12-01

    The objective of this study was to evaluate the factors predictive of clinical pregnancy in the first superovulation/intrauterine insemination (SO/IUI) cycle of couples with favourable female characteristics. We analyzed retrospectively the first SO/IUI cycle of 306 infertile couples with mild male factor infertility and unexplained infertility. The women had a favourable prognosis in terms of ovarian reserve. Univariate logistic regression analyses identified body mass index (BMI) [odds ratio (OR) = 0.9, P = 0.014], sperm concentration [OR = 1.007, P = 0.007] and inseminating motile sperm count (IMC) [OR = 1.007, P = 0.032] as significant predictive factors of clinical pregnancy. Multivariate logistic regression analysis identified BMI [OR = 0.87, P = 0.008] and sperm concentration [OR = 1.008, P = 0.011] as significant factors. Pregnant and non-pregnant groups did not differ significantly in terms of the age and smoking status of the woman, duration and type of infertility, length of the stimulation, total gonadotropin dosage or antral follicle count. Of the female characteristics investigated, BMI was the most significant predictive factor of clinical pregnancy in the first SO/IUI cycle of couples with unexplained or mild male factor infertility and favourable female characteristics. In overweight women, weight loss should be advised before starting SO/IUI. Sperm concentration and IMC were significant male predictive factors for clinical pregnancy in the first SO/IUI. PMID:24171641

  17. Unintended Pregnancy Prevention: Contraception

    ... Activities Assisted Reproductive Technology (ART) Depression Among Women Depression Treatment Resources Publications Maternal and Infant Health Pregnancy Complications Severe Maternal Morbidity Weight Gain During Pregnancy ...

  18. The stigmatisation of pregnancy: societal influences on pregnant women's physical activity Behaviour.

    van Mulken, Michelle R H; McAllister, Margaret; Lowe, John B

    2016-08-01

    Many women going through the major life transition of pregnancy experience decreases in physical activity behaviour, which may compromise maternal and infant health and wellbeing. Although research suggests that the social environment plays a large role in influencing women's physical activity behaviour, little is known about the association between societal attitudes and physical activity behaviour during the course of pregnancy. Through a qualitative longitudinal study, we explored women's physical activity experiences throughout pregnancy and how these were formed, supported and/or opposed by their social environment. This research included telephone interviews with 30 pregnant participants, recruited via a regional public hospital. Using a feminist standpoint analysis incorporating modern dialectics, three major tensions were identified, reflecting dominant societal discourses around physical activity and pregnancy: (1) engaging in physical activity and keeping the baby safe, (2) engaging in physical activity and obtaining social approval and (3) listening to oneself and to others. These findings present previously unrecognised opportunities for developing tailored and effective physical activity interventions among pregnant women. PMID:26967357

  19. Synthesis and Pregnancy Terminating Activity of 2-Aryl imidazo [2,1-a] isoquinolines

    2001-01-01

    Two 2-aryl imidazo [2,1-a] isoquinolines were synthesized and tested for pregnancy terminating activities. Both of them are new compounds and their structures were confirmed by IR, 1HNMR, MS and elemental analysis. They both showed high activities in NIH mice.

  20. Physical activity from menarche to first pregnancy and risk of breast cancer.

    Liu, Ying; Tobias, Deirdre K; Sturgeon, Kathleen M; Rosner, Bernard; Malik, Vasanti; Cespedes, Elizabeth; Joshi, Amit D; Eliassen, A Heather; Colditz, Graham A

    2016-09-15

    Breast tissue is particularly susceptible to exposures between menarche and first pregnancy, and a longer interval between these reproductive events is associated with elevated breast cancer risk. Physical activity during this time period may offset breast cancer risk, particularly for those at highest risk with longer menarche-to-first-pregnancy intervals. We used data from 65,576 parous women in the Nurses' Health Study II free of cancer in 1989 (baseline) and recalled their leisure-time physical activity at ages 12-34 in 1997. Current activity was collected at baseline and over follow-up. Relative risks (RRs) were estimated using multivariable Cox proportional hazards regression models. Between 1989 and 2011, 2,069 invasive breast cancer cases were identified. Total recreational activity between menarche and first pregnancy was not significantly associated with the risk of breast cancer. However, physical activity between menarche and first pregnancy was associated with significantly lower breast cancer risk among women in the highest category of a menarche-to first-pregnancy interval (≥20 years; RR for the highest versus the lowest quartile = 0.73, 95% confidence interval = 0.55-0.97; Ptrend  = 0.045; Pinteraction  = 0.048). This was not observed in women with a shorter interval. Physical activity between menarche and first pregnancy was associated with a lower risk of breast cancer among women with at least 20 years between these reproductive events. This may provide a modifiable factor that women can intervene on to mitigate their breast cancer risk associated with a longer interval. PMID:27130486

  1. Physical activity during pregnancy and offspring neurodevelopment and IQ in the first 4 years of life.

    Marlos R Domingues

    Full Text Available Maternal physical activity during pregnancy could alter offspring's IQ and neurodevelopment in childhood.Children belonging to a birth cohort were followed at 3, 12, 24 and 48 months of age. Physical activity during pregnancy was assessed retrospectively at birth. Neurodevelopment was evaluated by Battelle's Development Inventory (12, 24 and 48 months and IQ by the Weschler's Intelligence Scale (48 months. Neurodevelopment was based on Battelles' (90th percentile and also analyzed as a continuous outcome. IQ was analyzed as a continuous outcome. Potential confounders were: family income, mother's age, schooling, skin color, number of previous births and smoking; and newborns': preterm birth, sex and low birth weight.From birth to 48 months, sample size decreased from 4231 to 3792. Crude analysis showed that IQ at 48 months was slightly higher (5 points among children from active women. The Battelle's score at 12 and 24 months was higher among offspring from active mothers. After controlling for confounders, physical activity during pregnancy was positively associated to the Battelle's Inventory at 12 months IQ, however, at 48 months no association was observed.Physical activity during pregnancy does not seem to impair children's neurodevelopment and children from active mothers presented better performance at 12 months.

  2. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol

    Gomes, Mafalda; Matias, Alexandra [University of Porto, Faculty of Medicine, Porto (Portugal); Macedo, Filipe [SMIC, Porto (Portugal)

    2015-12-15

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting. (orig.)

  3. CLINICAL AND STATISTICAL STUDY OF PREGNANCY EVOLUTION ON MALFORMED UTERUS.PROGNOSTIC AND BIRTH MODALITIES

    Maria Chifan

    2011-05-01

    Full Text Available Our study aims to communicate the author’s experience concerning the pregnancy evolution at 316 women with various uterus malformations. At the beginning of this study, none of them was pregnant. The proportions of the various types of malformations encountered at the 316 cases were: septate uterus – 83%, arcuate uterus – 3%, bicornuate uterus – 3%, pseudounicorn – 3%, pseudodidelphys – 2%, “H” shaped – 1%, Rokitansky-Kuster-Hauser – 4%, uterine hypoplasia – 1%. The diagnosis was established clinically and para-clinically (non-pregnant women. The paraclinical methods that were used were: ecography at all the patients, hysterosalpyngography at 80% of the cases, hysteroscopy at 60% of the cases, RMN at 10% of the cases, celioscopy at 10% of the cases, the exam of the sexual chromatin and caryotype at 5% of the cases, hormonal dosage at 5% of the cases. The conventional as well as endoscopical surgery was performed with a successful rate of 67 – 82% pf the cases. The author concludes that uterine malformations precociously found benefit the best of surgical treatment, the difficult cases having the most reserved prognostic. The cause of reduced fertility in patients with endometriosis but patent fallopian tubes is not clear. In the mild stages of the disease a full course of hormonal suppression therapy should be the first therapeutic modality. In the advanced stages, a microsurgical approach, together with hormonal suppressive drugs, should be offered to the patients.

  4. Clinical, ultrasonography and haematology of aglepristone-induced mid-gestation pregnancy terminations in rabbits

    Gözde R. Özalp

    2013-02-01

    Full Text Available Aglepristone is a safe abortifacient in cats, dogs and rabbits. Although no serious side effects have been reported, there is no information available about the effects of the medicine on haematological parameters. For the first time clinical and ultrasonographic features and haematological profiles were evaluated in rabbits treated with aglepristone 15 and 16 days after mating. Ten healthy 10–14 month-old New Zealand White female rabbits were mated with fertile bucks and pregnancies were confirmed by ultrasound 15 days later. Of these, 5 does were treated with aglepristone (test group, n = 5 whilst the remaining five (control group, n = 5 were treated with a saline solution (0.9% NaCl. The treatment dose was 10 mg⁄kg body weight, administered subcutaneously once daily on two consecutive days (day 15 and 16 post mating. Ultrasonographic, clinical and haematological assessments were performed daily. Aglepristone treatment induced embryonic fluid resorptions without foetal death in mid-gestation terminations. Following ultrasonographic and haematological examinations, it was established that aglepristone is a safe abortifacient in rabbits.

  5. Clinical, ultrasonography and haematology of aglepristone-induced mid-gestation pregnancy terminations in rabbits

    Gözde R. Özalp

    2013-05-01

    Full Text Available Aglepristone is a safe abortifacient in cats, dogs and rabbits. Although no serious side effects have been reported, there is no information available about the effects of the medicine on haematological parameters. For the first time clinical and ultrasonographic features and haematological profiles were evaluated in rabbits treated with aglepristone 15 and 16 days after mating. Ten healthy 10–14 month-old New Zealand White female rabbits were mated with fertile bucks and pregnancies were confirmed by ultrasound 15 days later. Of these, 5 does were treated with aglepristone (test group, n = 5 whilst the remaining five (control group, n = 5 were treated with a saline solution (0.9% NaCl. The treatment dose was 10 mg⁄kg body weight, administered subcutaneously once daily on two consecutive days (day 15 and 16 post mating. Ultrasonographic, clinical and haematological assessments were performed daily. Aglepristone treatment induced embryonic fluid resorptions without foetal death in mid-gestation terminations. Following ultrasonographic and haematological examinations, it was established that aglepristone is a safe abortifacient in rabbits.

  6. The association between maltreatment in childhood and pre-pregnancy obesity in women attending an antenatal clinic in Australia.

    Katharine Hollingsworth

    Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.

  7. Clinical course and outcome of pregnancies in amenorrhoeic women with hyperprolactinaemia and pituitary tumours

    Seventeen term pregnancies occurred in 14 amenorrhoeic women with hyperprolactinaemia and radiological evidence of pituitary tumour. The abortion rate was high (32%). All but one of the term pregnancies occurred after ovulation-inducing treatment with human gonadotrophins and bromocriptine (four and 12 pregnancies respectively). Two of the 14 women had visual complications during pregnancy, but neither had serious residual visual impairment. Two patients had possible pituitary enlargement during pregnancy. Bromocriptine may be the most suitable primary treatment for many infertile women with prolactin-secreting tumours. Tumour complications during pregnancy are a definite risk, but most pregnancies went uneventfully to term. Patients with pituitary tumour should be carefully evaluated before starting ovulation-inducing treatment with bromocriptine alone, and they should be told of the possible risks and of the advantages and disadvantages of pretreatment with irradiation or surgery. Patients should be carefully monitored during pregnancy and have their visual fields checked frequently. If visual complications due to tumour enlargement occur during a pregnancy, reinstituting bromocriptine may be the treatment of choice. If this fails, other forms of treatment such as induction of labour, high-dose corticosteroid treatment, pituitary implantation of yttrium-90, or surgery may be effective. (author)

  8. Genotyping analysis for the 46 C/T polymorphism of coagulation factor XII and the involvement of factor XII activity in patients with recurrent pregnancy loss.

    Eriko Asano

    Full Text Available BACKGROUND: Established causes of recurrent pregnancy loss (RPL include antiphospholipid syndrome, uterine anomalies, parental chromosomal abnormalities, particularly translocations and abnormal embryonic karyotype. A systematic review concluded that coagulation factor XII (FXII deficiency was associated with RPL. However, it could not be established whether the 46 C/T SNP of FXII or low activity of FXII was a risk factor for RPL, because of the small sample size. METHODS AND FINDINGS: We conducted a cross-sectional and cohort study in 279 patients with two or more unexplained consecutive pregnancy losses and 100 fertile women. The association between the lupus anticoagulant (LA activity and FXII activity was examined. The frequency of the CC, CT and TT genotypes and the FXII activity were also compared between the patients and controls. Subsequent miscarriage rates among the CC, CT, TT genotypes and according to the FXII activity was examined. LA was associated with reduced FXII activity. The CT, but not the TT, genotype was confirmed to be a risk factor for RPL in the cross-sectional study using multivariate logistic regression analysis (OR, 2.8; 95% CI, 1.37-5.85. The plasma FXII activity in the patients was similar to that in the controls. Neither low FXII activity nor the CT genotype predicted the subsequent pregnancy outcome in the cohort study. On the other hand, and intermediate FXII activity level of 85-101% was predictive of subsequent miscarriage. CONCLUSIONS: Low FXII activity was not associated with RPL. The FXII gene was found to be one of the significant susceptibility genes for RPL, similar to the FV Leiden mutation. However, the clinical influence of the CT genotype might be relatively small, because the presence/absence of this genotype did not have any predictive value for the subsequent pregnancy outcome. This was the first study indicating the influence of FXII 46C/T on further pregnancy outcomes.

  9. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

    Sudha

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & ME THOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnios but not delivered at the facility were excluded. OBSERVATION: Incidence of polyhydramnios is 0.72% of the total antenatal cases, multiparous ie, 52% more than primiparous cases. Majority were unbooked (77.3% 63% were from rural set up. 76% belonged to low socio economic status. Majority 66% of the cases had their 1 st antenatal visit at term. Increased in cidence of operative delivery was seen in the study. Associated maternal factors found with polyhydramnios were gestation hypertension (8.4%, preeclampsia (2.9%, eclampsia (2.9%, anaemia (11%, twins (8.4%, malpresentation (5%, RH negative factor (3.7 %, and diabetes (1.9%. Fetal complication include prematurity 21.6%, IUFT 20.7%, congenital malformation 21.6%, cord prolapse 3.7%, birth asphyxia 1.9%. Most common congenital anomaly was anencephaly i.e., 11%. CONCLUSION : The study gives us the underst anding of the impact of polyhydramnios on the maternal and fetal outcome. Our study demonstrate s

  10. Sports and leisure-time physical activity in pregnancy and birth weight

    Hegaard, Hanne Kristine; Petersson, K; Hedegaard, M;

    2010-01-01

    We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hosp...

  11. The association between leisure time physical activity in the year before pregnancy and pre-eclampsia

    Hegaard, Hanne; Ottesen, Bent; Hedegaard, M; Petersson, K; Henriksen, T B; Damm, P; Dykes, A K

    2010-01-01

    In order to investigate the association between leisure time physical activity in the year before pregnancy and pre-eclampsia, stratifying for maternal BMI, a prospective study was carried out from 1996 to 1998. Pregnant women attending their first antenatal care visit, were invited to participate...

  12. Updates on Lupus and Pregnancy

    Buyon, Jill P.

    2009-01-01

    This review focuses on events subsequent to planning a pregnancy and addresses three components of concern for women with systemic lupus erythematosus: maternal, placental, and fetal. Flare rates are generally low for patients who are clinically stable at conception. For patients who have never had renal disease, there is no firm evidence that they will develop active renal disease simply due to being pregnant. For patients who begin pregnancy with an abnormal creatinine (> 2 mg/dl is ill adv...

  13. Clinical diagnostic value of combined determination of four serum markers (β-HCG, progesterone, VEGF, creatinekinase) for ectopic pregnancy before rupture

    Objective: To investigate the clinical diagnostic value of combined determination of 4 serum markers for unruptured ectopic pregnancy. Methods: Serum β-HCG, progesterone (P) (with RIA) vascular endothelial growth factor (VEGF) (with CLIA) and creatinekinase (CK) (with biochemical method) contents were determined twice (one day apart) in 50 subjects with suspected early ectopic pregnancy (before rupture) and 50 normal pregnant women. Results: Serum contents of β- HCG and P in the subjects with suspected ectopic pregnancy were significantly lower than those in the normal pregnant women (P0.05). Conclusion: Combined determination of those four markers were helpful for the early diagnosis of unruptured ectopic pregnancy. (authors)

  14. Adnexal torsion in a heterotopic pregnancy: a rare clinical entity with diagnostic dilemma

    Kirtirekha Mohapatra

    2016-01-01

    Full Text Available Adnexal torsion is an uncommon cause of surgical emergency during pregnancy. Its incidence is 1 in 5000 pregnancies, occurring more frequently in the first trimester after ovarian hyper stimulation. Heterotopic pregnancy is also a rare entity and cause pain abdomen but without the classical symptom of bleeding per vaginum. Heterotopic pregnancy with adnexal torsion is extremely rare but increases the case fatality rate. Hence the differential diagnosis of pain abdomen during early pregnancy both may be considered and it should not be forgotten that adnexal torsion may occur in absence of ovarian cyst. We report a case of adnexal torsion that was successfully managed by laparoscopy followed by laparotomy during pregnancy and diagnosed as a heterotopic pregnancy after getting the histopathological report. A 24-year-old G2P1 admitted to LR of SCBMCH at 4 weeks of GA with severe left abdominal pain and nausea for one day. Her vitals were stable. There was tenderness on the left iliac fossa with cervical motion tenderness and left POD fullness and tenderness, TAS visualized a foetus in utero with GA of 7 weeks and a hyperechoic mass of 6 x 6 cm on left side. Laparotomy done as the mass was gangrenous, enlarged and haemorhagic. Total salpingo oophorectomy of left side was done. Postoperative period was uneventful and managed with progesterone to continue the pregnancy. Histopathology report confirmed heterotopic pregnancy. This case suggests that clinicians should suspect both heterotopic pregnancy and adnexal torsion while evaluating pregnant patients with pain abdomen. [Int J Reprod Contracept Obstet Gynecol 2016; 5(1.000: 232-236

  15. Anti-bacterial activity of intermittent preventive treatment of malaria in pregnancy: comparative in vitro study of sulphadoxine-pyrimethamine, mefloquine, and azithromycin

    Mombo-Ngoma Ghyslain

    2010-10-01

    Full Text Available Abstract Background Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (SP is recommended for the prevention of malaria in pregnancy in sub-Saharan Africa. Increasing drug resistance necessitates the urgent evaluation of alternative drugs. Currently, the most promising candidates in clinical development are mefloquine and azithromycin. Besides the anti-malarial activity, SP is also a potent antibiotic and incurs significant anti-microbial activity when given as IPTp - though systematic clinical evaluation of this action is still lacking. Methods In this study, the intrinsic anti-bacterial activity of mefloquine and azithromycin was assessed in comparison to sulphadoxine-pyrimethamine against bacterial pathogens with clinical importance in pregnancy in a standard microdilution assay. Results SP was highly active against Staphylococcus aureus and Streptococcus pneumoniae. All tested Gram-positive bacteria, except Enterococcus faecalis, were sensitive to azithromycin. Additionally, azithromycin was active against Neisseria gonorrhoeae. Mefloquine showed good activity against pneumococci but lower in vitro action against all other tested pathogens. Conclusion These data indicate important differences in the spectrum of anti-bacterial activity for the evaluated anti-malarial drugs. Given the large scale use of IPTp in Africa, the need for prospective clinical trials evaluating the impact of antibiotic activity of anti-malarials on maternal and foetal health and on the risk of promoting specific drug resistance of bacterial pathogens is discussed.

  16. Depression and Anxiety During Pregnancy: Evaluating the Literature in Support of Clinical Risk-Benefit Decision-Making.

    Dalke, Katharine Baratz; Wenzel, Amy; Kim, Deborah R

    2016-06-01

    Depression and anxiety during pregnancy are common, and patients and providers are faced with complex decisions regarding various treatment modalities. A structured discussion of the risks and benefits of options with the patient and her support team is recommended to facilitate the decision-making process. This clinically focused review, with emphasis on the last 3 years of published study data, evaluates the major risk categories of medication treatments, namely pregnancy loss, physical malformations, growth impairment, behavioral teratogenicity, and neonatal toxicity. Nonpharmacological treatment options, including neuromodulation and psychotherapy, are also briefly reviewed. Specific recommendations, drawn from the literature and the authors' clinical experience, are also offered to help guide the clinician in decision-making. PMID:27091646

  17. Comparison of hemodynamic, biochemical and hematological parameters of healthy pregnant women in the third trimester of pregnancy and the active labor phase

    Flisser Ana

    2011-05-01

    Full Text Available Abstract Background Pregnancy is accompanied by several hemodynamic, biochemical and hematological changes which revert to normal values after labor. The mean values of these parameters have been reported for developed countries, but not for Mexican women. Furthermore, labor constitutes a stress situation, in which these factors may be altered. It is known that serologic increase of heat shock protein (Hsp 70 is associated with abnormal pregnancies, presenting very low level in normal pregnant women. Nevertheless, there are no studies where these measurements are compared in healthy pregnant women at their third trimester of pregnancy (3TP and the active labor phase (ActLP. Methods Seventy five healthy Mexican pregnant women were included. Hemodynamic, biochemical and hematological parameters were obtained in all cases, and serum Hsp70 levels were measured in a sample of 15 women at 3TP and at ActLP. Results Significant differences were found in most analysis performed and in Hsp70 concentration at 3TP as compared to ActLP, however all were within normal range in both conditions, supporting that only in pathological pregnancies Hsp70 is drastically increased. Conclusion Results obtained indicate that 3TP and ActLP have clinical similarities in normal pregnancies, therefore if abnormalities are found during 3TP, precautions should be taken before ActLP.

  18. Clinical Variables Affecting The Pregnancy Rate of Intracervical Insemination Using Cryopreserved Donor Spermatozoa: A Retrospective Study in China

    Xiao-Jun Chen; Li-Ping Wu; Hai-Lian Lan; Li Zhang; Yi-Min Zhu

    2012-01-01

    Background: The aim of this study was to investigate whether several clinical variables can affect the pregnancy rate of intracervical insemination (ICI) using cryopreserved donor spermatozoa. Materials and Methods: In this retrospective study, age, years of infertility, cervicitis, urinary luteinizing hormone (LH) surge, insemination number, uterus position, endometrial thickness and morphology, maximal follicle diameter, and the number of dominant follicles on the day of human chorionic gon...

  19. Clinical application of bilateral uterine arterial chemoembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy

    Objective: To investigate the clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to uterine scar pregnancy after cesarean section. Methods: Sixteen patients with massive hemorrhage due to cesarean scar pregnancy were enrolled in the study, the mean blood loss was (2 200 ± 1 400) ml. With Seldinger technique, abdominal angiography by using a pig-tail catheter was carried out. When bilateral uterine arterial bleeding was confirmed, selective or super-selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion of 5-Fu or methotrexate (MTX) together with gelatin sponge via the catheters was conducted. The clinical results were observed. Results: The technical success was achieved in all 16 patients. No recurrent bleeding occurred during a follow-up of 3-6 months. Conclusion: The emergency bilateral uterine arterial chemoembolization is a safe and effective treatment for massive hemorrhage due to cesarean scar pregnancy with no serious complications, therefore, this technique is worth being used in clinical practice. (authors)

  20. An historical and clinical review of the interaction of leprosy and pregnancy: a cycle to be broken.

    Duncan, M E

    1993-08-01

    Since earliest history the person with leprosy has been shut out from society. Laws have prohibited marriage and allowed divorce of those with leprosy. Segregation of the sufferer from the rest of society has been followed by separation of the sexes, and of leprous parents from their children. With the advent of antileprotic drugs, first dapsone then multidrug therapy (MDT), infection can be treated, individuals made non-infectious, and the pool of infection in the community reduced. The clinical signs of leprosy are due not to the degree of infection but to the immunological status of the host. Hormonal changes at puberty and in pregnancy can cause variation of the host's immune status. Pregnancy in women with leprosy is a hazardous undertaking. First appearance of leprosy, reactivation of the disease and relapse in 'cured' patients is likely to occur particularly in the third trimester of pregnancy. Leprosy reactions caused by variation in cell mediated and humoral immunity are triggered off by pregnancy: type 1 reaction (reversal reaction, RR) occurs post partum, while type 2 reaction (erythema nodosum leprosum, ENL) peaks in late pregnancy. Both types of reaction continue long into lactation. Neuritis with loss of both sensory and motor function is associated with relapse and reaction. Relapse, reaction and nerve damage, especially 'silent neuritis', with subsequent deformity and disability, occur not only in women on apparently effective treatment but also in those who have received MDT and have been released from treatment (RFT). To prevent disability, research is urgently needed into the mechanisms of early and late reaction and neuritis. Pregnancy is not only a trigger factor for reaction but an ideal in vivo model for research. Up to 20% of children born to mothers with leprosy may develop leprosy by puberty. While early leprosy in young children is self-healing, when marriage and childbearing take place at an early age the daughters of mothers with

  1. Dermatological Diseases Associated with Pregnancy: Pemphigoid Gestationis, Polymorphic Eruption of Pregnancy, Intrahepatic Cholestasis of Pregnancy, and Atopic Eruption of Pregnancy

    Christine Sävervall; Freja Lærke Sand; Simon Francis Thomsen

    2015-01-01

    Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.

  2. Clinical profile and obstetric outcome in pregnancies complicated by heart disease: a five year Indian rural experience

    Nilajkumar D. Bagde

    2013-02-01

    Full Text Available Background: Cardiac diseases are a major cause of morbidity and mortality in pregnant women in the developing world. This study illustrates the problem in rural India focusing on patterns of diseases, clinical features, and pregnancy outcome in these women. Methods: A retrospective analysis of five year data, from 2006 to 2010 for all patients admitted with cardiac disease in pregnancy. Results: Past history of heart disease was present in 70%. Rheumatic heart disease was predominant type in 83% and the chief complaint at admission was breathlessness in 44%. Mitral stenosis was the commonest lesion in 55% and mitral regurgitation with or without stenosis in 48%. Preeclampsia was seen in 20% and preterm labor in 10%. Spontaneous vaginal delivery was seen in 41% and cesarean in 20.6%. Conclusions: Heart disease in pregnancy is a high risk condition has a major impact on pregnancy. Associated obstetric complications along with lack of knowledge and ignorance regarding the pathology lead to unpleasant obstetric outcomes. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000: 52-57

  3. Physical activity during pregnancy in obese and normal-weight women as assessed by pedometer

    Renault, Kristina; Nørgaard, Kirsten; Andreasen, Kirsten Riis;

    2010-01-01

    OBJECTIVE: To compare physical activity as assessed by a pedometer in obese and normal-weight pregnant women at different gestational ages. To evaluate the use of a pedometer in pregnancy. DESIGN: Cross-sectional study. SETTING: Department of obstetrics and gynecology in a university hospital in...... Copenhagen. POPULATION: 338 pregnant women, 175 normal-weight women with body mass index (BMI) 20-25 kg/m(2) and 163 obese women with BMI > or = 30 kg/m(2). METHODS: Physical activity was assessed by a pedometer (Yamax Digiwalker SW-700/701) on seven consecutive days in six different groups: normal-weight or...... obese at gestational ages 11-13, 18-22, and 36-38, and expressed as median number of daily steps during a whole week, working days, and weekends. MAIN OUTCOME MEASURES: Relation between BMI and physical activity during pregnancy and compliance with wearing the pedometer. RESULTS: Noncompliance was more...

  4. Physical activity during pregnancy in obese and normal-weight women as assessed by pedometer

    Renault, Kristina; Nørgaard, Kirsten; Andreasen, Kirsten Riis;

    2010-01-01

    OBJECTIVE: To compare physical activity as assessed by a pedometer in obese and normal-weight pregnant women at different gestational ages. To evaluate the use of a pedometer in pregnancy. DESIGN: Cross-sectional study. SETTING: Department of obstetrics and gynecology in a university hospital in...... obese at gestational ages 11-13, 18-22, and 36-38, and expressed as median number of daily steps during a whole week, working days, and weekends. MAIN OUTCOME MEASURES: Relation between BMI and physical activity during pregnancy and compliance with wearing the pedometer. RESULTS: Noncompliance was more...... Copenhagen. POPULATION: 338 pregnant women, 175 normal-weight women with body mass index (BMI) 20-25 kg/m(2) and 163 obese women with BMI > or = 30 kg/m(2). METHODS: Physical activity was assessed by a pedometer (Yamax Digiwalker SW-700/701) on seven consecutive days in six different groups: normal-weight or...

  5. Impact of Surgical Varicocele Repair on Pregnancy Rate in Subfertile Men With Clinical Varicocele and Impaired Semen Quality: A Meta-Analysis of Randomized Clinical Trials

    Kim, Kyu Hyun; Lee, Joo Yong; Kang, Dong Hyuk; Lee, Hyungmin; Seo, Ju Tae; Cho, Kang Su

    2013-01-01

    Purpose To elucidate the impact of surgical varicocele repair on the pregnancy rate through new meta-analyses of randomized clinical trials that compared surgical varicocele repair and observation. Materials and Methods The PubMed and Embase online databases were searched for studies released before December 2012. References were manually reviewed, and two researchers independently extracted the data. To assess the quality of the studies, the Cochrane risk of bias as a quality assessment tool...

  6. Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy

    Yi Wang; Fan Yu; Li-Qin Zeng

    2015-01-01

    Ectopic pregnancy is commonly located in the fallopian tube. Nevertheless, two unusual types of ectopic pregnancy, intramural pregnancy and rudimentary horn pregnancy, seriously threaten maternal life. The diagnosis and treatment of these unusual implantation sites present a clinical challenge. In this study, we illustrated the two unusual types of ectopic pregnancy and summarized the current data regarding diagnosis and optimal treatment from our experience.

  7. Zika Virus and Pregnancy: A Review of the Literature and Clinical Considerations.

    Marrs, Caroline; Olson, Gayle; Saade, George; Hankins, Gary; Wen, Tony; Patel, Janak; Weaver, Scott

    2016-06-01

    The latest Zika virus (ZIKV) outbreak has reached epidemic proportions as it spreads throughout South and Central America. In November 2015, the Brazilian Ministry of Health reported a 20-fold increase in the number of cases of neonatal microcephaly, which corresponds geographically and temporally to the ZIKV outbreak. Case reports have provided some evidence of a causal link between maternal ZIKV infection, fetal microcephaly, and intracranial calcifications. The sparse data regarding ZIKV in pregnancy come solely from case reports and personal communications, and recommendations for management of ZIKV exposure during pregnancy are rapidly evolving. Our objective is to review and synthesize the current literature regarding ZIKV as it pertains to pregnancy and provide some assistance to clinicians who may have to manage a pregnant patient with potential exposure to ZIKV. We will also explore certain aspects of related viruses in pregnancy in hopes to shed light on this little-known topic. PMID:26939047

  8. Racial Disparities in Economic and Clinical Outcomes of Pregnancy Among Medicaid Recipients

    Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L.; Rust, George

    2013-01-01

    To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hosp...

  9. Effects of vitamin E supplementation on some pregnancy health indices: a randomized clinical trial

    Bastani P

    2011-06-01

    Full Text Available Parvin Bastani, Kobra Hamdi, Fatemeh Abasalizadeh, Nazli NavaliWomen's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranObjective: Available evidence about the role of supplementary vitamin E in normal pregnancy is inadequate. This study assessed the potential benefit of vitamin E supplementation on some pregnancy health indices.Methods: A 1:2 weighted simple randomization technique was used to allocate 104 eligible pregnant women to receive vitamin E and 168 women (control not to receive the drug. Treated women received capsules containing 400 IU vitamin E from week 14 of gestation to the end of the pregnancy.Results: Background variables including maternal age were found to be similarly distributed between the study groups. The rate of maternal and perinatal outcomes including Apgar score and birth weight did not differ significantly between groups. Preeclampsia occurred in 1% of treated women vs 1.78% of control women.Conclusion: Giving supplemental vitamin E from the second trimester of pregnancy did not appear to affect the risk of pregnancy outcomes and occurrence of preeclampsia.Keywords: antioxidants, vitamin E, pregnancy, supplementation, preeclampsia

  10. Racial disparities in economic and clinical outcomes of pregnancy among Medicaid recipients.

    Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L; Rust, George

    2013-10-01

    To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of $114 to $214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes. PMID:23065298

  11. Prevention of thrombosis in pregnancy: how practical are consensus derived clinical practice guidelines?

    Hayes-Ryan, D

    2012-11-01

    Thromboembolic disease (TED) has, for many years, consistently been identified as one of the leading causes of direct maternal mortality. In November 2009, the RCOG published a guideline on the prevention of TED that has been rapidly adopted by hospital trusts in the UK. The aim of our study was to determine the number and profile of women in our population that would require treatment with low molecular weight heparin (LMWH) and the cost implications of such treatment if these guidelines were implemented. A retrospective review of the first 100 women who delivered at the Coombe Women & Infants University Hospital (CWIUH) in 2010 was conducted and risk stratification applied at the relevant time points. A total of 51% were deemed to be at intermediate or high risk of TED at some point during pregnancy. In 35 of the 51 women (70%), this risk was attributable to factors such as age>35 years, parity≥3, BMI>30 kg\\/m2 or cigarette smoking. In our obstetric population, the percentage of women with these risk factors was: 25.5%, 8.5%, 19% and 16.7%, respectively. Implementation of this guideline would increase the hospital annual expenditure on LMWH by a factor of 17. The strategy of attributing risk by accumulating factors that individually have a low risk of TED and are prevalent in the population needs to be re-visited. The cost of implementation of these guidelines is not inconsiderable in the absence of data to indicate that clinical outcome is improved with their implementation.

  12. Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

    Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

    2016-05-01

    The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis. PMID:26651855

  13. Sexual activity among female teenagers: a comparison between two groups of middle class adolescents from a private clinic according to pregnancy status Atividade sexual em mulheres adolescentes: uma comparação entre dois grupos de adolescentes de classe média de clínica particular de acordo com estado gravídico

    Alexandre Faisal-Cury

    2008-09-01

    Full Text Available OBJECTIVES: to investigate patterns of sexual activity among teenagers. METHODS: a cross-sectional study was conducted between July 1998 and September 2000, among 117 sexually active female adolescents from a private clinic, in the city of the Osasco, State of São Paulo, Brazil. They were divided into two groups: one pregnant group (PG comprised 62 adolescents that were either pregnant (46 or had previously been pregnant (16; another group of 55 female adolescents that had never been pregnant (NPG. During consultations with these subjects, a physician conducted a semi-structured interview. Knowledge, attitudes and practices relating to sexual activity were evaluated. The comparison between the two groups was carried out using Student's t test, the chi-square test or Fisher's exact test. RESULTS: the two groups showed considerable similarities in terms of sexual behaviour, having engaged in the first sexual intercourse at the age of 15 and having had an average number of sexual partners of 1.5. Nevertheless, adolescents in the PG group had initiated sexual life earlier and tended to use less contraceptive methods during the first intercourse. Despite widespread knowledge of contraception, a large number of the adolescents did not use any contraceptive method during first sexual intercourse. In their current sexual life, an average of 81% of the participants referred to attaining orgasm. CONCLUSIONS: knowledge about contraceptive techniques is not enough to avoid unplanned pregnancies, suggesting the importance of investigating other psychosocial aspects of motherhood and maternal identity among teenagers.OBJETIVOS: investigar padrões de atividade sexual em adolescentes. MÉTODOS: estudo transversal realizado entre julho de 1998 e setembro de 2000, com 117 mulheres adolescentes sexualmente ativas oriundas de clínica privada, em Osasco, São Paulo, Brasil. Foram constituídos dois grupos: um grupo de grávidas (PG com 62 adolescentes que estavam

  14. The dermatoses of pregnancy

    Sachdeva Silonie

    2008-01-01

    Full Text Available The skin changes in pregnancy can be either physiological (hormonal, changes in pre-existing skin diseases or development of new pregnancy specific dermatoses. Pregnancy-specific skin dermatoses include an ill-defined heterogeneous group of pruritic skin eruptions which are seen only in pregnancy. These include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis and intrahepatic cholestasis of pregnancy. Atopic eruption of pregnancy is the most common of these disorders. Most skin eruptions resolve postpartum and require only symptomatic treatment. Antepartum surveillance is recommended for patients with pemphigoid gestationis and intrahepatic cholestasis of pregnancy as they carry fetal risk. This article deals with the classification, clinical features and treatment of the specific dermatoses of pregnancy.

  15. Metformin Treatment in Type 2 Diabetes in Pregnancy: An Active Controlled, Parallel-Group, Randomized, Open Label Study in Patients with Type 2 Diabetes in Pregnancy

    Jahan Ara Ainuddin

    2015-01-01

    Full Text Available Aims. To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. Methods. In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma. Results. Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain (P24 hours in metformin group (P<0.01. Significant reduction in cost of treatment was found in metformin group. Conclusion. Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.gov NCT01855763.

  16. Clinical Variables Affecting The Pregnancy Rate of Intracervical Insemination Using Cryopreserved Donor Spermatozoa:A Retrospective Study in China

    Xiao-Jun Chen

    2012-01-01

    Full Text Available Background: The aim of this study was to investigate whether several clinical variables can affectthe pregnancy rate of intracervical insemination (ICI using cryopreserved donor spermatozoa.Materials and Methods: In this retrospective study, age, years of infertility, cervicitis, urinaryluteinizing hormone (LH surge, insemination number, uterus position, endometrial thickness andmorphology, maximal follicle diameter, and the number of dominant follicles on the day of humanchorionic gonadotropin (HCG administration were retrospectively analyzed in 501 women whounderwent their first ICI cycle using cryopreserved donor spermatozoa.Results: Increased age, length of infertility (>5 years, retroverted uterine position, and endometrialthickness (14 mm were associated with lower rates of pregnancy.Conclusion: In older women with infertile periods longer than five years, especially those with aretroverted uterus, intrauterine insemination (IUI combined with ovarian stimulation should berecommended. In vitro fertilization with donor spermatozoa (IVFD should be offered earlier toachieve a much higher success rate.

  17. Duration of pregnancy in relation to fish oil supplementation and habitual fish intake: a randomised clinical trial with fish oil

    Olsen, SF; Østerdal, ML; Salvig, JD;

    2007-01-01

    OBJECTIVE: To examine the effect of fish oil supplementation on duration of pregnancy, conditional on the woman's habitual fish intake. DESIGN: Multicentre 1:1 randomised clinical trial of effect of fish oil in a high-risk population of pregnant women in whom habitual fish intake was assessed at...... suspicion of IUGR or threatening preeclampsia in the current pregnancy (group 3, n=106). Women were stratified into low, middle, or high fish consumers. METHODS: The intervention group received fish oil capsules providing 2.7 g long-chain n-3 fatty acids per day (n-3 poly unsaturated fatty acids (PUFA......)) from around week 20 (groups 1 and 2) or 6.3 g n-3 PUFA from week 33 (group 3). The control regimen was capsules with olive oil. Effect on timing of spontaneous delivery was examined by Cox regression, assuming elective delivery (occurring in 40%) as a censoring event. Analyses of effect of fish oil...

  18. Incomplete activation of peripheral blood dendritic cells during healthy human pregnancy.

    Della Bella, S; Giannelli, S; Cozzi, V; Signorelli, V; Cappelletti, M; Cetin, I; Villa, M L

    2011-05-01

    Successful pregnancy relies on the adaptation of immune responses that allow the fetus to grow and develop in the uterus despite being recognized by maternal immune cells. Dendritic cells (DCs) are central to the control of immune tolerance, and their state of activation at the maternal-decidual interface is critical to the feto-maternal immunological equilibrium. So far, the involvement of circulating DCs has been investigated poorly. Therefore, in this study we investigated whether, during healthy human pregnancy, peripheral blood DCs (PBDCs) undergo changes that may be relevant to the adaptation of maternal immune responses that allow fetal tolerance. In a cross-sectional study, we analysed PBDCs by six-colour flow cytometry on whole blood samples from 47 women during healthy pregnancy progression and 24 non-pregnant controls. We demonstrated that both myeloid and plasmacytoid PBDCs undergo a state of incomplete activation, more evident in the third trimester, characterized by increased expression of co-stimulatory molecules and cytokine production but lacking human leucocyte antigen (HLA)-DR up-regulation. To investigate the contribution of soluble circulating factors to this phenomenon, we also performed culture experiments showing that sera from pregnant women added to control DCs conditioned a similar incomplete activation that was associated with reduced DC allostimulatory capacity, supporting the in vivo relevance of our findings. We also obtained evidence that the glycoprotein hormone activin-A may contribute to DC incomplete activation. We suggest that the changes of PBDCs occurring during late pregnancy may aid the comprehension of the immune mechanisms operated by the maternal immune system to maintain fetal tolerance. PMID:21352205

  19. SELECTED PROFESSIONAL ACTIVATION INSTRUMENTS OF WOMEN DURING PREGNANCY AND CHILDBIRTH IN POLAND

    Anna Galik

    2015-01-01

    This article describes selected professional activation instruments of women during their pregnancy and after birth in Poland. An author indicates the main macroeconomic aggregates in the context of women's fertility and analysed available data in order to show the scale of the problem and identify a statistic picture of a woman who enters into motherhood. The article presents the situation of women, employed on the basis of the Labour Code, before and after childbirth in the context of curre...

  20. Pregnancy physical activity questionnaire (PPAQ): reliability and validity of Turkish version

    Çırak, Yasemin; Yılmaz, Gül Deniz; Demir, Yasemin Parlak; Dalkılınç, Murat; Yaman, Selen

    2015-01-01

    [Purpose] The aim of this study was to translate the Pregnancy Physical Activity Questionnaire into Turkish and test its reliability and validity among Turkish pregnant women. [Subjects and Methods] The subjects were 204 healthy, single pregnant women between the ages 18 and 40 who volunteered to participate in this study. Reliability was evaluated by measuring the one-week test-retest reliability with the intraclass correlation coefficient and Pearson’s correlation analysis. Concurrent valid...

  1. Feasibility and acceptability of a midwife-led intervention programme called 'Eat Well Keep Active' to encourage a healthy lifestyle in pregnancy

    Warren Lucie

    2012-04-01

    Full Text Available Abstract Background Eating a diet that is high in fat and sugar and having a sedentary lifestyle during pregnancy is understood to increase the risk of excessive gestational weight gain and obesity following the birth of the baby. However, there are no clinical guidelines in the UK on what is considered to be appropriate gestational weight gain. Indeed, clinical recommendations discourage the routine re-weighing of pregnant women, stating instead that women should be advised regarding their diet and activity levels, in order to prevent excessive weight gain. Pregnancy is seen as a time when many women may have an increased motivation to improve their lifestyle behaviours for the benefit of the fetus. However, it is evident that many women have difficulty in both maintaining a healthy balanced diet and remaining active through pregnancy. It would seem that midwives may be ideally placed to assist women to make and maintain healthier lifestyle choices during pregnancy. Methods/design This study will look at the feasibility and acceptability of a newly devised intervention programme called 'Eat Well Keep Active'. Participants will complete a questionnaire prior to the programme to obtain baseline data on food frequency, physical activity and to gauge their perception of personal ability to improve/maintain healthy lifestyle. The programme comprises client centred techniques; motivational interviewing and goal setting delivered early in pregnancy (12-16 weeks with the aim of supporting a healthy well balanced diet and either continuing or commencing appropriate levels of physical activity. Participants will then be followed up six weeks following the intervention with a one-to-one interview, and a further brief questionnaire. The interview will provide preliminary data regarding perceived effectiveness and acceptability of the 'Eat Well Keep Active' programme whilst the questionnaire will provide data regarding changes in the confidence of

  2. Outcome of pregnancy in the era of highly active antiretroviral: a 10-year experience in Southern Ireland

    J Joyce

    2012-11-01

    Full Text Available Introduction: Since the introduction of HAART the desire to become a mother in women with HIV has become a viable option due to the drastic reduction in vertical transmission. The aim of this study was to look at the epidemiology, clinical characteristics, and safety of antiretroviral drugs and rate of vertical transmission in our cohort in the Munster region, Ireland. Methods: We retrospectively reviewed all pregnant women with HIV who attended the ID clinic from January 2002 to April 2012. Patients’ demographics, pertinent laboratory data, and pharmacy records were reviewed and statistically analysed. Results: 105 HIV-positive women, with a total of 165 pregnancies, were seen from January 2002 to April 2012 at Cork University Hospital: 46 patients were previously known to be HIV-infected at their first pregnancy and 59 were diagnosed during antenatal screening (median of 32 week gestation at diagnosis. The median age at the time of pregnancy was 32 and the HIV transmission was 90% sexual: 39 women were from Europe/Asia and 66 were African; only two women were HCV co-infected and one was HBV co-infected. Of the patients diagnosed with HIV prior to pregnancy, 13 were on treatment, all of whom had no detectable virus at the start and during pregnancy. The median CD4+ at the start of pregnancy was 490 cells/µl. The median weeks of gestation at the start of HAART was 28 before 2006 and 20 after 2006, in accordance with National Guidelines. The HAART regime used was in line with current Guidelines. 18 pregnancies ended in miscarriage before week 12 gestation and 2 pregnancies resulted in intrauterine death at 28 weeks. 145 pregnancies progressed to delivery at full term but 10 infants were born before the 37th week, with one baby born at 23 weeks: 63 had SVD and 82 underwent C-section, of whom 12 emergency C-section due to prolonged membrane rupture. Most of the C-sections were planned due to obstetric reasons. 2 infants were born HIV+: in one

  3. Primum non nocere: how active management became modus operandi for intrahepatic cholestasis of pregnancy.

    Henderson, Cassandra E; Shah, Reena R; Gottimukkala, Sri; Ferreira, Khaldun K; Hamaoui, Abraham; Mercado, Ray

    2014-09-01

    The Royal College of Obstetrics and Gynecology does not endorse routine active management of intrahepatic cholestasis of pregnancy (ICP)-affected pregnancies. In contrast, the American College of Obstetricians and Gynecologists supports active management protocols for ICP. To investigate this controversy, we evaluated the evidence supporting ICP as a medical indication for early term delivery and the evolution of active management protocols for ICP. Sixteen articles published between 1986 and 2011 were identified. We created 2 groups based on whether obstetric care included active management. Group 1 comprised 6 uncontrolled reports without active management that were published between 1967 and 1983 that described high perinatal mortality rates that primarily were related to prematurity sequel. This group became the fundamental 'core' evidence for ICP-associated stillbirths and by extrapolation justification for active management. Group 2 was comprised of 10 reports in which the authors credited empirically adopted active management with the observed low stillbirth rates in ICP-affected pregnancies. Although the group 1 articles routinely are cited as evidence of ICP-associated stillbirth risk, the 1.2% stillbirth rate (4/331) in this group is similar to the background stillbirth rates of 1.1% (11/1000) and 0.6% (6/1000) in 1967 and 2011, respectively (P = .062 and P = .0614, respectively). Likewise, the stillbirth rates for articles in group 2 were similar to their respective national stillbirth rate. Nevertheless, group 2 articles have become the evidence-based support for active management. We found no evidence to support the practice of active management for ICP. PMID:24704063

  4. Clinical report: the joint obstetric and psychiatric management of phobic anxiety disorders in pregnancy.

    Patel, Roshni R; Hollins, Kathryn

    2015-01-01

    Women who struggle with distressing pregnancy-related phobic anxiety disorders are regularly encountered in maternity services, and their management poses particular challenges. Early identification is crucial in order to offer an opportunity to treat and manage their fears and enable a positive birth experience. In this article, women with different phobias (tokophobia, emetophobia and ante-cubital fossa phobia) describe their first pregnancy experience, and the ways in which the Chelsea and Westminster Hospital offered them joint maternity and psychiatric care. A multidisciplinary hospital-based approach can be effective in managing mental health problems in pregnancy. Despite maternal preconceptions and professional misgivings, this approach can work for women with phobias and enable a good birth experience and successful mother and infant bonding. The lead obstetrician for mental health and perinatal psychiatrist describe their roles in enabling successful outcomes for both the current and subsequent pregnancies. The case is made for training of maternity staff in both the identification of severe pregnancy phobias and the prompt referral for shared psychiatric and maternity care. Even if previous treatments have failed, adequate coping strategies for childbirth may be achieved in a short time frame. Long-term improvements in the phobia itself may also be found. PMID:25547323

  5. Cutaneous necrosis in pregnancy secondary to activated protein C resistance in hereditary angioedema.

    Perkins, W; Downie, I; Keefe, M; Chisholm, M

    1995-04-01

    A 26-year-old woman with hereditary angineurotic oedema (HAE) presented at 22 weeks gestation with severe cutaneous necrosis similar to that seen in coumarin skin necrosis. Protein S deficiency secondary to HAE and pregnancy was postulated. Treatment with heparin, C1-inhibitor concentrates, systemic steroids and surgical debridement resulted in a successful outcome for both mother and child. Subsequent investigations revealed normal levels of protein C, antithrombin III, total protein S, free protein S but reduced function protein S activity with evidence of activated protein C resistance. Cutaneous necrosis has not been reported in associated with activated protein C resistance previously and the possible mechanisms are discussed. PMID:7745572

  6. The Effects of Intravenous Hydration on Amniotic Fluid Volume and Pregnancy Outcomes in Women with Term Pregnancy and Oligohydramnios: A Randomized Clinical Trial

    Mahnaz Shahnazi

    2012-08-01

    Full Text Available Introduction: Amniotic fluid is an important factor in the prediction of fetal survival. The aim of this research was to evaluate the effects of intravenous hydration of mothers on amniotic fluid volume and in turn on pregnancy outcomes. Methods: The current single blind controlled clinical trial was conducted on 20 pregnant mothers with amniot-ic fluid index of lower or equal to 5 cm and gestational age of 37-41 weeks. The subjects were divided into two groups of case and control through simple random sampling. Am-niotic fluid index was measured in all participants. The case group received one liter of isotonic saline during 30 minutes by the bolus method. Reevaluations of amniotic fluid index in both groups were made 90 minutes after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid in-dex before and after treatment, respectively. Results: Hydration of mothers significantly increased the amniotic fluid index in the case group (mean change: 1.5 cm; 95%CI: 0.46 - 2.64; P = 0.01. The mean change of amniotic fluid index in the control group did not significantly increase (P = 0.06. The elevation of amniotic fluid index in the hydra-tion group (32% was significantly higher than the control group (1% (P = 0.03. Conclusion: In this study intravenous hydration increased amniotic fluid index of mothers with term pregnancy and oligohydramnios. Since it caused no complications for the moth-er and the fetus, it can be used as an effective method in management of oligohydramnios.

  7. Clinical significance of serum glycochlicacid detection in diagnosis of intrahepatic cholestasis of pregnancy

    Intrahepatic cholestasis of pregnancy (ICP) occurred in the middle and later phase of pregnancy. ICP had considerable effect on the perinatal babies. To further study the effect of serum glycochlicacid in diagnosis of ICP, serum glycochlicacid was measured by radio-immunoassay in normal pregnancy women and ICP pregnant women. The determination of alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were taken as contrast. Serum glycochlicacid is significantly higher (P < 0.01) in ICP pregnant women than in normal pregnant women. The positive rate of serum glycochlicacid was 100%, the positive rate of ALT was 80%, the positive rate of ALP was 40%. Serum glycochlicacid is the most sensitive serologic index in diagnosis of ICP

  8. Adolescent pregnancy.

    Short, J D; Slusher, I L

    1994-01-01

    Kentucky has the fourth highest percentage of infants born to teenage mothers in the US. Risk factors for adolescent pregnancy are poor academic performance, family history of adolescent pregnancy, absence of one or both biological parents in the home, troubled family relationships, family violence, history of substance abuse, and poor self-concept. Pregnancy adds new developmental requirements to the continual developmental crisis of adolescence. Some of these developmental requirements are dealing with pregnancy and birth of a child and peer and family reactions and relationships. Pregnant teens are at high risk for anemia, preeclampsia, preterm delivery, and low birth weight infants. The health care team must assess the abilities, needs, practices, and priorities of teens. Nurses should promote health and positive health practices in teens. They should focus on prevention of adolescent pregnancy and on meeting the needs of pregnant teens. Adolescent pregnancy interventions include education and adolescent-centered special programs. Peer groups, role playing, videos, and computer games are individualized and effective education techniques for teens. Formal adolescent pregnancy prevention programs are abstinence education, knowledge-based programs, and clinic-focused or school-based programs. A combination of approaches is more effective than using just one approach. Adolescent pregnancy prevention interventions should promote the value of education, discourage substance abuse, and provide counseling for victims of child abuse. Pregnant teens should receive prenatal care as soon as possible. One health care agency should combine physical care, psychosocial support, and education for teens. Kentucky schools help pregnant teens continue their education and help them obtain information and support for care for themselves and their babies. Nurses can be effective at reducing the number of unwanted teen pregnancies. PMID:7934083

  9. Biomarkers for Ectopic Pregnancy and Pregnancy of Unknown Location

    Senapati, Suneeta; Barnhart, Kurt T.

    2013-01-01

    Early pregnancy failure is the most common complication of pregnancy, and 1–2% of all pregnancies will be ectopic. As one of the leading causes of maternal morbidity and mortality, diagnosing ectopic pregnancy and determining the fate of a pregnancy of unknown location are of great clinical concern. Several serum and plasma biomarkers for ectopic pregnancy have been investigated independently and in combination. The following is a review of the state of biomarker discovery and development for...

  10. Activity in Pregnancy for Patients with a History of Preterm Birth.

    Satterfield, Nichelle; Newton, Edward R; May, Linda E

    2016-01-01

    Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area. PMID:27226741

  11. Activity in Pregnancy for Patients with a History of Preterm Birth

    Satterfield, Nichelle; Newton, Edward R.; May, Linda E.

    2016-01-01

    Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area. PMID:27226741

  12. The investigation for the relationship among serum leptin, erythrocyte membrane Ca2+-ATPase activity and hypertensive disorder complicating pregnancy

    Chunfang Li; Wenli Gou; Xuelian Chen; Shuping Zhang

    2007-01-01

    Objective: To study the significance of Leptin and the activity of erythrocyte membrane Ca2+-ATPase (EMCA) in the development of hypertensive disorder complicating pregnancy. Methods: Radioimmunoassay was used to test the level of serum Leptin,and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results: The level of serum Leptin in hypertensive disorder complicating pregnancy(gestational hypertension: 13.76 ± 3.46 ng/ml; preeclampsia:15.76 ± 5.47 ng/ml; eclampsia: 18.32 ± 6.38 ng/ml)was significantly higher than that in normotensive pregnant women (11.33 ± 2.93 ng/ml), respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy (gestational hypertension: 1.65 ± 0.24 μmol· pi/mg·h; preeclampsia: 1.37 ± 0.19 μmol·pi/mg·h; eclampsia:1.12 ± 0.14 μ mol·pi/mg·h) was significantly lower than that of normotensive pregnant women(1.83 ±0.38 μ mol·pi/mg·h),respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy (r = -0.63). Conclusion: Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.

  13. Laparoscopic Excision of Coexisting Left Tubal and Right Pseudotubal Pregnancy after Conservative Management of Previous Ectopic Pregnancy with Methotrexate: An Unusual Clinical Entity

    Panayotis Xiromeritis

    2015-01-01

    Full Text Available Tubal pregnancy concerns 97% of all ectopic pregnancies. Treatment can be either surgical (salpingostomy or salpingectomy or medical (methotrexate administration. We present a case of a pseudotubal pregnancy after methotrexate treatment of a previous ectopic pregnancy. A37-year-old woman was diagnosed with ectopic pregnancy in the left Fallopian tube. A year ago, she had an ectopic pregnancy in the right tube, which was successfully treated with intramuscular methotrexate. During laparoscopy, two tubal masses were revealed, one in each Fallopian tube, and bilateral salpingectomy was performed. Histological analysis confirmed tubal pregnancy in the left Fallopian tube and presence of endosalpingitis in the right tube with no signs of chorionic villi. The optimal management of such cases has not yet been clarified. However, evaluation of tubal patency after a medically treated ectopic pregnancy would permit proper counsel of the patient on her fertility options, in order to choose the appropriate method of conception to achieve and accomplish a future pregnancy.

  14. Clinical significance of measurement of changes of plasma ET-1, NO, INH and EGF levels in patients with pregnancy induced hypertension

    Objective: To explore the clinical significance of changes of plasma ET-1, NO, INH and EGF levels in patients with pregnancy induced hypertension (PIH). Methods: Serum NO levels (with biochemistry), INH, EGF levels (with ELISA) and ET-1 levels (with RIA) were determined in 41 patients with pregnancy induced hypertension and 35 controls. Results: The plasma ET-1, INH levels were significantly higher in patients with PIH than those in the controls (P<0.01), while the plasma NO, EGF levels were significantly lower (P<0.01). Conclusion: Changes of plasma ET-1, NO, INH and EGF levels might be of prognostic importance in patients with pregnancy induced hypertension. (authors)

  15. Ectopic ovarian pregnancy

    A case of ectopic ovarian pregnancy is presented occurring in a 24 years old woman after natural conception. The clinical diagnosis was ruptured tubal pregnancy. Gross findings were suggestive of ruptured corpus luteum cyst on exploration. The histopathological examination of specimen brought forward the diagnosis of ovarian pregnancy. (author)

  16. Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding.

    Susan Morrison

    Full Text Available During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART, despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.

  17. Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding

    Susan Morrison; Grace John-Stewart; John J Egessa; Sezi Mubezi; Sylvia Kusemererwa; Dennis K Bii; Nulu Bulya; Francis Mugume; Campbell, James D.; Jonathan Wangisi; Bukusi, Elizabeth A.; Connie Celum; Baeten, Jared M.

    2015-01-01

    During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART), despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.

  18. Clinical Application of Endovascular Interventional Therapy in Treatment of Uterine Ectopic Pregnancy%血管内介入治疗在子宫异位妊娠治疗中的临床应用

    熊斌; 王奇; 潘峰; 梁惠民; 冯敢生; 叶天和; 易长虹; 李浩

    2012-01-01

    Objective To evaluate the clinical value of the endovascular interventional therapy in the treatment of uterine ectopic pregnancy. Methods We retrospectively analyzed the clinical data of 122 patients with uterine ectopic pregnancy in our Interventional Radiology Department from January 2006 to April 2012. All the 122 patients including 49 cases of cervical pregnancy ,9 cases of isthmus pregnancy ,60 cases of scar pregnancy and 4 cases of cornual pregnancy ,were subjected to the treatment of bilateral uterine artery methotrexate (MTX)infusion combined with uterine artery embolization with gelatin sponge particles. Results In the 122 patients ,24 patients including 10 cases of cervical pregnancy ,1 case of isthmus pregnancy ,12 cases of scar pregnancy and 1 case of cornual pregnancy underwent emergency bilateral uterine artery methotrexate infusion and uterine arterial embolization with massive vaginal bleeding after the curettage for ectopic pregnancy;the remaining 98 patients with ectopic pregnancy underwent the sequential ultrasound-guided uterine curettage after bilateral uterine artery chemoembolization (UACE). The active vaginal bleeding was prevented after UACE ,and there was no severe vaginal bleeding complication in the sequential ultrasound-guided curettage process. The fi-HCG levels in all patients were became normal after one month. Conclusion UACE could be considered as the first choice for the emergency treatment of postoperative hemorrhage af -ter uterine ectopic pregnancy curettage. The sequential ultrasound-guided uterine curettage after UACE can be used as a new strategy for the treatment of uterine ectopic pregnancy.%目的 评估血管内介入治疗在子宫异位妊娠治疗中的临床应用价值.方法 回顾性分析122例子宫异位妊娠患者血管内介入治疗前后的临床资料,其中宫颈妊娠49例、峡部妊娠9例、瘢痕妊娠60例、宫角妊娠4例,所有患者均行经股动脉穿刺双侧子宫动脉甲

  19. Investigating the Effect of Maternal Elective Position during Active Phase on the First Pregnancy Outcome

    Seyed- Mahmoud Latefi

    2009-01-01

    Full Text Available Introduction: Final hours of human pregnancy are diagnosed with floored uterine contractions that induce the dilatation of cervix and pushing of the fetus throughout the delivery passage. Mothers position during labor can influence uterine contractions as well as the mothers psychological status. This study aimed at investigating the effect of maternal elective position in labor stage on the pregnancy outcome. Methods: In this randomized controlled trial (quasi-experimental study a total of 100 people were randomly selected from the population of first pregnancy women referring to Ya Zahra Maternity Hospital and they were randomized into a 50- person usual care or control group and a 50-person elective position or case group. At admission (4- cm dilatation women in the control group remained confined to the labor bed and received the usual medical care. But women in elective position were allowed to choose their preferred position such as walking sitting standing knee-chest etc. The Data were collected through information forms scale clock Burford pain scale and observation record forms and they were analyzed by t-test and Chi-square statistical tests. Results: The results indicated that relative length of the active phase in the case and control groups was 142.2 and 212.4 minutes respectively which shows a significant reduction. The mean labor scores in the case and control groups were respectively reported as 6.9±1.1 and 8.1±1.2 which indicate a significant difference. The need for oxytocin augmentation reduced (8% vs 64% and mothers satisfaction of child birth experience significantly increased. The incidence of fetal heart rate abnormalities was significantly smaller in the case group. When asked whether they would choose elective position during future labors 76% of women in the case group answered positively. Conclusion: Maternal elective position during active phase not only has no abnormal effects on the pregnancy outcome but also it

  20. French Pregnancy Physical Activity Questionnaire compared with an accelerometer cut point to classify physical activity among pregnant obese women.

    Nadia Chandonnet

    Full Text Available Given the high risk for inactivity during pregnancy in obese women, validated questionnaires for physical activity (PA assessment in this specific population is required before evaluating the effect of PA on perinatal outcomes. No questionnaire was validated in pregnant obese women. The Pregnancy Physical Activity Questionnaire (PPAQ has been designed based on activities reported during pregnancy and validated in pregnant women. We translated the PPAQ to French and assessed reliability and accuracy of this French version among pregnant obese women. In this cross-sectional study, pregnant obese women were evenly recruited at the end of each trimester of pregnancy. They completed the PPAQ twice, with an interval of 7 days in-between, to recall PA of the last three months. Between PPAQ assessments, participants wore an accelerometer (Actigraph GT1M during 7 consecutive days. Fourty-nine (49 pregnant obese women (29.8±4.2 yrs, 34.7±5.1 kg x m(-2 participated to the study. The intraclass correlation coefficients (ICCs between the two PPAQ assessments were 0.90 for total activity, 0.86 for light and for moderate intensity, and 0.81 for vigorous intensity activities. It ranged from 0.59 for "Transportation" to 0.89 for "Household and Caregiving" activities. Spearman correlation coefficients (SCCs between the PPAQ and the Matthews' cut point used to classify an activity of moderate and above intensity were 0.50 for total activity, 0.25 for vigorous intensity and 0.40 for moderate intensity. The correlations between the PPAQ and the accelerometer counts were 0.58 for total activity, 0.39 for vigorous intensity and 0.49 for moderate intensity. The highest SCCs were for "Occupation" and "Household and Caregiving" activities. Comparisons with other standard cutpoints were presented in files S1, S2, S3, S4, S5, S6, S7. The PPAQ is reliable and moderately accurate for the measure of PA of various intensities and types among pregnant obese women.

  1. Dog ownership during pregnancy, maternal activity, and obesity: a cross-sectional study.

    Carri Westgarth

    Full Text Available The Avon Longitudinal Study of Parents and Children (ALSPAC is an observational study of 14,273 UK pregnant singleton mothers in 1990/1991. We examined outcomes of self report of strenuous activity (hours per week at 18 and 32 weeks of gestation, hours spent in leisure-time physical activities and types, and pre-pregnancy body mass index (BMI; overweight status was defined as pre-pregnancy BMI≥25 and obesity BMI≥30. Pet ownership and activity data were reported for 11,466 mothers. Twenty-five percent of mothers owned at least one dog. There was a positive relationship between participation in activity at least once a week and dog ownership (at 18 weeks, Odds ratio 1.27, 95% confidence interval 1.11-1.44, P<0.001. Dog owners were 50% more likely to achieve the recommended 3 hours activity per week, equivalent to 30 minutes per day, most days of the week (1.53, 1.35-1.72, P<0.001. Dog owners were also more likely to participate in brisk walking activity than those who did not have a dog (compared to no brisk walking 2-6 hrs per week 1.43, 1.23 to 1.67, P<0.001; 7+ hrs per week 1.80, 1.43 to 2.27, P<0.001. However, no association was found with any other types of activities and there was no association between dog ownership and weight status. During the time period studied, pregnant women who had dogs were more active, through walking, than those who did not own dogs. As walking is a low-risk exercise, participation of pregnant women in dog walking activities may be a useful context to investigate as part of a broader strategy to improve activity levels in pregnant women.

  2. Sclerosing angiomatoid nodular transformation of the spleen during pregnancy: Diagnostic challenges and clinical management.

    Corrado, Giacomo; Tabanelli, Valentina; Biffi, Roberto; Petralia, Giuseppe; Tinelli, Andrea; Peccatori, Fedro A

    2016-08-01

    We report the first case of sclerosing angiomatoid nodular transformation (SANT) of the spleen diagnosed during pregnancy, discussing differential diagnosis, immunohistochemical profile and treatment. A G2P1 37-year-old woman presented during the 19th week of gestation because of pruritus at lower limbs. To exclude cholestasis, an abdominal ultrasound and whole body magnetic resonance were performed and a single solid lesion with intrinsic vascularization was identified. Therefore, at 22 weeks gestation, after normal fetal assessment, the patient was referred for a splenectomy. No further treatment was suggested and the patient gave birth at 42 weeks gestation with a spontaneous delivery. Distinguishing SANT from other vascular neoplasms of the spleen during pregnancy is a difficult task. Surgical excision should be performed to exclude malignancy and to resolve symptoms, if present. PMID:27080826

  3. ANTI IMPLANTATION AND PREGNANCY INTERRUPTION ACTIVITY OF JAPAKUSUMA (HIBISCUS ROSA SINENSIS IN ALBINO RATS

    Kashinath Hadimur

    2013-06-01

    Full Text Available Increase in population has affected many socio-economic conditions of people by increasing crimes, illiteracy, destructive activities, diseases, improper food and shelter. Thus to control this population and limit the family size at a personal level and at a national level, modern contraceptive methods and medicines were introduced long back. There are many new contraceptives available now, but they have various side effects. Some traditional practitioners used to dispense oral contraceptives mentioned in Ayurvedic classics. Such as 1 Pippali (Piper longum, Vidanga (Emblica ribes and Tankana (Sodii Biboras. 2 Talisapatra (Taxus baccata and Gairika (Hematite with cold water and 3 Kanji bhavita Japakusuma (Hibiscus rosa sinensis. An experimental study on above mentioned 1 and 2 formulations has proved its efficacy as temporary contraceptive medicine. To evaluate the permanent or long term temporary contraceptive effect of Japakusuma, an attempt was made in this study. Study was conducted by Choudary and Khanna method on 18 female, 36 male (for mating albino rats. Japakusuma, Propylene glycol, Ovral L formed the materials. Single dose was administered on proestrous stage of rat oestrous cycle and observed for anti-implantation and pregnancy interruption activity. Test drug showed significant anti implantation and pregnancy interruption activity. Thus showing the temporary contraceptive activity of Japakusuma (Hibiscus rosa sinensis.

  4. Fetal cardiac time intervals (fCTI) in early pregnancy: Possible clinical applications

    Minha Lim; Hubert Preissl

    2010-01-01

    On the basis of earlier studies, it is known that fetal atrioventricular conduction system can be investigated by fetal magnetocardiography (fMCG) measuring fetal cardiac time intervals (fCTI). It has been suggested, that fCTI can be used to quantify fetal arrhythmias [1]. In prenatal treatments, pregnancies with autoimmune diseases like Systemic lupus erythematosus (SLE) and Sjögren's syndrome with diagnosed presence of maternal autoantibodies demand more precise monitoring of fetal ca...

  5. Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound

    To compare the accuracy of magnetic resonance (MRI) and colour Doppler-ultrasound (US) in the diagnosis of late pregnancy bleeding and to assess the accuracy of the different MR sequences in visualizing the origin of haemorrhage. 42 patients in the third trimester of pregnancy underwent to US and MRI for the evaluation of painless vaginal bleeding. Multiplanar HASTE, True Fisp, 3D T1 GRE and sagittal DWI sequences were acquired. Two radiologists, blinded to the results of US, reviewed each case, resolving by consensus any discrepancy. Reference standards were surgical and pathological findings. The reference standards identified 22 placenta previa, 11 placental abruptions (1 coincident with a placental chorioangioma), 1 thrombohaematoma and 1 fibroma with haemorrhagic degeneration. MRI identified correctly all these condition with an interobserver agreement of 0.955. DWI and T1 weighted sequences were statistically superior to Haste and True Fisp sequences in detecting the cause of bleeding (p <.001). US had 6 false negatives and 2 false positive results, its diagnostic accuracy resulting lower than MRI (p =.001). MRI accurately evaluates pregnancy bleeding with an excellent interobserver agreement and can grant new and additional data when US is negative. (orig.)

  6. Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions.

    Sinead Currie

    Full Text Available PURPOSE: Physical activity (PA typically declines throughout pregnancy. Low levels of PA are associated with excessive weight gain and subsequently increase risk of pre-eclampsia, gestational diabetes mellitus, hypertension disorders, delivery by caesarean section and stillbirth. Systematic reviews on PA during pregnancy have not explored the efficacy of behaviour change techniques or related theory in altering PA behaviour. This systematic review evaluated the content of PA interventions to reduce the decline of PA in pregnant women with a specific emphasis on the behaviour change techniques employed to elicit this change. SEARCH AND REVIEW METHODOLOGY: Literature searches were conducted in eight databases. Strict inclusion and exclusion criteria were employed. Two reviewers independently evaluated each intervention using the behaviour change techniques (BCT taxonomy to identify the specific behaviour change techniques employed. Two reviewers independently assessed the risk of bias using the guidelines from the Cochrane Collaboration. Overall quality was determined using the GRADE approach. FINDINGS: A total of 1140 potentially eligible papers were identified from which 14 studies were selected for inclusion. Interventions included counselling (n = 6, structured exercise (n = 6 and education (n = 2. Common behaviour change techniques employed in these studies were goal setting and planning, feedback, repetition and substitution, shaping knowledge and comparison of behaviours. Regular face-to-face meetings were also commonly employed. PA change over time in intervention groups ranged from increases of 28% to decreases of 25%. In 8 out of 10 studies, which provided adequate data, participants in the intervention group were more physically active post intervention than controls. CONCLUSIONS AND IMPLICATIONS: Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy

  7. Eating Right during Pregnancy

    ... For Women For Seniors Top Tips for Eating Right During Pregnancy Reviewed by Jill Kohn, MS, RDN, ... pregnancy include eating a balanced diet; gaining the right amount of weight; enjoying regular physical activity; taking ...

  8. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus).

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R

    2015-07-01

    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions. PMID:26224434

  9. Clinical Analyses of 66 Cases of Mid-trimester Pregnancy Termination in Women with Prior Cesarean

    Ping Peng

    2015-01-01

    Full Text Available Background: The rate of cesarean delivery has significantly increased in China in the last decade. Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history. The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean. Methods: We conducted this retrospective study of women with prior cesarean section, who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital. The protocol was oral administration of mifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate (EL for those with at least 16 weeks of gestational ages. The thickness of the lower uterine segment (LUS was measured before the termination of pregnancy. Logistic regression was used to study the risk factors of uterine rupture. Results: The total rate of successful abortion was 93.9% (62/66. Four patients failed in induction, and one of them received curettage, whereas the other three experienced uterine rupture (4.5%. The successful rates of abortion were 85.7% (30/35 for women treated with mifepristone-misoprostol and 86.1% (31/36 for those treated with EL. There was a significant difference in the mean LUS thickness between the uterine rupture group (3.0 ± 2.0 mm and the nonrupture group (7.0 ± 3.0 mm (P < 0.05. The LUS thickness of <3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean (odds ratio, 94.0; 95% confidence interval 4.2-2106.1 after adjusted maternal age, gestational age, interdelivery interval and prior cesarean section. Severe bleeding that required transfusion occurred in one case (1.5%. Conclusions: Both the mifepristone-misoprostol and the EL regimens were effective and safe for the

  10. Regulation of Calcitriol Biosynthesis and Activity: Focus on Gestational Vitamin D Deficiency and Adverse Pregnancy Outcomes

    Andrea Olmos-Ortiz

    2015-01-01

    Full Text Available Vitamin D has garnered a great deal of attention in recent years due to a global prevalence of vitamin D deficiency associated with an increased risk of a variety of human diseases. Specifically, hypovitaminosis D in pregnant women is highly common and has important implications for the mother and lifelong health of the child, since it has been linked to maternal and child infections, small-for-gestational age, preterm delivery, preeclampsia, gestational diabetes, as well as imprinting on the infant for life chronic diseases. Therefore, factors that regulate vitamin D metabolism are of main importance, especially during pregnancy. The hormonal form and most active metabolite of vitamin D is calcitriol. This hormone mediates its biological effects through a specific nuclear receptor, which is found in many tissues including the placenta. Calcitriol synthesis and degradation depend on the expression and activity of CYP27B1 and CYP24A1 cytochromes, respectively, for which regulation is tissue specific. Among the factors that modify these cytochromes expression and/or activity are calcitriol itself, parathyroid hormone, fibroblast growth factor 23, cytokines, calcium and phosphate. This review provides a current overview on the regulation of vitamin D metabolism, focusing on vitamin D deficiency during gestation and its impact on pregnancy outcomes.

  11. Ruptured heterotopic pregnancy: an unusual presentation of an uncommon clinical problem

    Gibson, Kyle R; Horne, Andrew W

    2012-01-01

    A 30-year-old nulliparous lady presented to our Emergency Gynaecology Service with a 3-day history of epigastric pain and vomiting at 7 weeks of gestation. An intrauterine pregnancy had been confirmed 3 days earlier when she had attended with an episode of left-iliac fossa pain. Unfortunately, she became more unwell within 1 h of admission and as the cause of her symptoms was unclear, she was taken to the theatre for a joint gynaecology and general surgical diagnostic laparoscopy. This reveal...

  12. Stings from Euscorpius flavicaudis (De Geer, 1778 (Scorpiones, Euscorpiidae during pregnancy: a clinical case report

    M Dutto

    2012-01-01

    Full Text Available We report a case in which a 21-week pregnant woman was stung by a Euscorpius flavicaudis (De Geer, 1778 scorpion. Symptoms and signs experienced by the patient were the same as those documented in the literature and with no ill-effects for the pregnancy. Envenoming was local and of low degree of intensity. It is important to emphasize that the patient was stung in her home, which differs from stings in most other parts of the world, in which scorpionism is mostly a risk in outdoor areas.

  13. Heterotrophic Pregnancy- Rare Presentation

    AB Chattopadhyay; Somshekhar Sharma; Kushagra Garg

    2013-01-01

    Heterotopic pregnancy, a potentially dangerous and life-threatening clinical associated with intrauterine (IU) and extra uterine pregnancies at the same time. Incidence of such cases are rare but very often missed as the diagnosis being overlooked during examination of the pregnant women with risk factors for an ectopic pregnancy such as free fluid with or without an adnexal mass or acute abdominal pain and shock presentation. Hence a high degree of clinical evaluation is warranted examining ...

  14. Lupus anticoagulant, disease activity and low complement in the first trimester are predictive of pregnancy loss

    Mankee, Anil; Petri, Michelle; Magder, Laurence S.

    2015-01-01

    Introduction Multiple factors, including proteinuria, antiphospholipid syndrome, thrombocytopenia and hypertension, are predictive of pregnancy loss in systemic lupus erythematosus (SLE). In the PROMISSE study of predictors of pregnancy loss, only a battery of lupus anticoagulant tests was predictive of a composite of adverse pregnancy outcomes. We examined the predictive value of one baseline lupus anticoagulant test (dilute Russell viper venom time) with pregnancy loss in women with SLE. Me...

  15. Clinical analysis of 14 cases of systemic lupus erythematous complicated with pregnancy%系统性红斑狼疮合并妊娠14例临床分析

    张兰玲; 刘淑玉

    2013-01-01

    目的 探讨妊娠与系统性红斑狼疮(SLE)的临床特点、治疗及妊娠结局.方法 回顾性分析14例妊娠合并SLE患者临床资料.结果 14例妊娠合并SLE患者中非活动期4例,活动期10例.非活动期4例中并发子痫前期1例,足月顺产3例,早产1例,低体重儿1例,无妊娠丢失.活动期10例中并发子痫前期6例,产妇死亡1例,治疗性流产3例,死胎引产2例,早产3例,足月产2例,低体重儿4例,新生儿死亡1例,胎儿窘迫3例,妊娠丢失6例.结论 妊娠可诱发或加重SLE患者病情,非活动期选择性妊娠,并加强孕期母胎监护,合理应用糖皮质激素,可改善母儿结局.%[ Objective ] To investigate the clinical features, therapy and outcome of pregnancy complicated with SLE. [Methods] Retrospect analysis of 14 cases of pregnancy complicated with SLE was carried out. [Results] A-mong all the 14 cases of pregnant women with SLE patients: 4 cases were in inactive phase, 10 cases in active. A-mong the 4 cases in inactive phase: 1 case of complicated by preeclampsia, 3 cases of full-term delivery, 1 case was premature delivery and 1 case with loss birth weight, no pregnancy loss. Among the 10 cases in active phase:6 cases of complicated by preeclampsia, 1 cases of maternal deaths, 3 cases of therapeutic abortion, 2 cases were induced labor, 3 cases were premature delivery, 2 cases of full-term delivery, 4 cases with loss birth weight, 1 cases of neonatal deaths and 3 cases of fetal distress, 6 cases of pregnancy loss. [ Conclusion ] Pregnancy can induce or aggravate the condition of patients with SLE, pregnancy was selected while in inactive phase, strengthening the guardianship for mother and infants during the pregnancy, and proper use of glucocorticoids, maternal-fetal pregnancy outcome can be improved.

  16. Subchorionic hematomas in early pregnancy: clinical outcome and blood flow patterns.

    Kurjak, A; Schulman, H; Zudenigo, D; Kupesic, S; Kos, M; Goldenberg, M

    1996-01-01

    A case control study of 59 women with subchorionic hematomas compared to 135 normally pregnant. Transvaginal ultrasound was used to image the pregnancy, and identify the site and size of the hematomas. Color flow Doppler was used to calculate velocity indices of the spiral arteries. More spontaneous abortions occurred in women with subchorionic hematomas (SCH). There was general correlation between gestational age, velocity indices, and hematoma size. There were 10 spontaneous abortions in the study group (17%) versus 9 (6.5%) in the controls (P = 0.02). Hematoma size did not affect outcome, but site did. Most hematomas associated with abortion were found in the corpus or fundus of the uterus, not in the supracervical area (P = 0.03). The presence of a hematoma did not affect the frequency of preterm delivery. In conclusion, subchorionic hematomas in early pregnancy are associated with an increased risk of spontaneous abortion. Flow disturbances are seen in the spiral arteries, but these are probably secondary effects. The critical factor is site of hematoma, not volume. PMID:8796766

  17. Juvenile Dermatomyositis in Pregnancy

    Anthony Emeka Madu

    2013-01-01

    Full Text Available Juvenile dermatomyositis has variable clinical presentations both in and outside of pregnancy. A literature review indicated that optimal maternal and fetal outcomes can be anticipated when the pregnancy is undertaken while the disease is in remission. Poorer outcomes are associated with flare-up of the disease in early pregnancy compared with exacerbation in the second or third trimester, when fetal prognosis is usually good. We present a case of JDM in pregnancy with disease exacerbation late in pregnancy and review of the relevant literature.

  18. Pregnancy-Related Group A Streptococcal Infections: Temporal Relationships Between Bacterial Acquisition, Infection Onset, Clinical Findings, and Outcome

    Stephanie M Hamilton; Stevens, Dennis L.; Bryant, Amy E.

    2013-01-01

    The development and outcome of pregnancy-related group A streptococcal infections are dependent upon the stage of pregnancy or puerperium, epidemiologic factors of the patient's home and hospital environments, and virulence of the prevalent pathogens.

  19. Pregnancy specific glycoprotein 1 (PSG1) activates TGF-β and prevents dextran sodium sulfate (DSS)-induced colitis in mice

    Blois, Sandra M.; Sulkowski, Gisela; Tirado-González, Irene; Warren, James; Freitag, Nancy; Klapp, Burghard F.; Rifkin, Daniel; Fuss, Ivan; Strober, Warren; Dveksler, Gabriela S.

    2013-01-01

    Transforming growth factor beta (TGF-βs) are secreted from cells as latent complexes and the activity of TGF-βs is controlled predominantly through activation of these complexes. Tolerance to the fetal allograft is essential for pregnancy success; TGF-β1 and -β2 play important roles in regulating these processes. Pregnancy-specific β-glycoproteins (PSGs) are present in the maternal circulation at high concentration throughout pregnancy and have been proposed to have anti-inflammatory function...

  20. Effect of Mifepristone on the Telomerase Activity in Chorion and Decidua during Early Pregnancy

    Ge-qing XIA; Ya-li XIONG; Yong-hong SUN

    2004-01-01

    Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group).Results Positive expression, of chorion telomerase was significantly different between the experimental group (28%, 11/40) and the control group (73%, 29/40) (P<0. 05).While in decidua, the positive rate was 28% (11/40) in the experimental group and 20% (9/40) in the control group, there was no significant difference (P>0. 05).Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.

  1. SELECTED PROFESSIONAL ACTIVATION INSTRUMENTS OF WOMEN DURING PREGNANCY AND CHILDBIRTH IN POLAND

    Anna Galik

    2015-03-01

    Full Text Available This article describes selected professional activation instruments of women during their pregnancy and after birth in Poland. An author indicates the main macroeconomic aggregates in the context of women's fertility and analysed available data in order to show the scale of the problem and identify a statistic picture of a woman who enters into motherhood. The article presents the situation of women, employed on the basis of the Labour Code, before and after childbirth in the context of current rights and privileges. The last part of the paper shows different forms of childcare services, their availability and limitations. The purpose of this article is to present the individual behaviour of economically active female as pregnant women, and after birth who make choices based on the available tools, selecting the most beneficial for their households. In conclusion the author identify new solutions that are beneficial for the individual, household, and the whole economy.

  2. Clinical significance of determination of the changes of plasma vasoactive substances ET, NO, CGRP levels in patients with pregnancy induced hypertension

    Objective: To investigate the clinical significance of changes of plasma ET, CGRP and NO levels in patients with pregnancy induced hypertension. Methods: Plasma levels of ET, CGRP (with RIA) and NO (with colorimetry) were measured in 36 patients with pregnancy induced hypertension 30 women with normal pregnancy and 32 controls. Results: Plasma levels of ET, CGRP and NO in normal pregnant women were not significantly different from those in controls (P>0.05) and plasma levels of ET, CGRP and NO in patients with mild pregnancy induced hypertension (n=12) were not significantly different flora those in normal pregnant women (P>0.05), However, plasma levels of ET in patients with moderate (n=14) and severe (n=10) pregnancy induced hypertension were significantly higher than those in normal pregant women, while levels of CGRP and NO were significantly lower (all P< 0.01). Conclusion: Detection of changes of plasma ET, CGRP and NO contents in patients with pregnancy induced hypertension provides a valuable laboratory basis for study of relationship between endothelial cell function and pathogenesis of hypertension. (authors)

  3. Clinical usefulness of dynamic determination of serum progesterone and HCG levels in patients with threatened abortion, inevitable abortion and ectopic pregnancy

    Objective: To study the clinical differential diagnostic usefulness of dynamic determinations of serum progesterone and HCG levels in patients with abortion and ectopic pregnancy. Methods: Serum progesterone (with CLIA) and HCG (with RIA) levels were determined twice (48h apart) in 98 patients with threatened abortion, 75 patients with inevitable abortion, 52 patients with ectopic pregnancy, and 83 controls. Results: Among the three groups of patients, the serum progesterone levels were highest in the patients with threatened abortion, being significantly higher than those in the other two groups (P<0.05, P<0.01). The progesterone levels were lowest in the patients with ectopic pregnancy, being significantly less than those in other two groups (P<0.05, P<0.01). The serum HCG levels were also significantly higher in the patients with threatened abortion than those in the other two groups (P < 0.05 ), but there were no significant differences between the levels in patients with inevitable abortion and patients with ectopic pregnancy. The differences between the first and second determination HCG levels, either increased or decreased, in patients with ectopic pregnancy were significantly less than those in patients with inevitable abortion (P<0.05). Conclusion: Dynamic determination of serum progesterone and HCG levels might be of differential diagnostic help in patients with threatened abortion, inevitable abortion and ectopic pregnancy. (authors)

  4. Hypnotizability and opinions about hypnosis in a clinical trial for the hypnotic control of pain and anxiety during pregnancy termination.

    Dufresne, Alexandra; Rainville, Pierre; Dodin, Sylvie; Barré, Patrick; Masse, Benoît; Verreault, René; Marc, Isabelle

    2010-01-01

    This descriptive study evaluates the hypnoanalgesic experience's effect on participants' hypnotizability and opinions about hypnosis and identifies factors associated with hypnotizability. Hypnotizability was assessed using the Stanford Hypnotic Susceptibility Scale: Form A in 290 women 1 month after their participation in a randomized clinical trial evaluating hypnotic intervention for pain/anxiety versus standard care during pregnancy termination. Opinions were collected before and after the intervention. The regression model describing hypnotizability (F = 13.55; p < .0001; R(2) = 0.20) retained 5 variables but not the intervention group. The variable explaining most of total variance (62.9%) was the level of perceived automaticity/involuntariness. Opinions about hypnosis were modified by the hypnotic experience compared to standard care but were not associated with hypnotizability. Exposure to hypnoanalgesia did not influence hypnotizability but modifies significantly the opinions about hypnosis. Consistent with previous findings, perceived automaticity appears to best predict hypnotizability. PMID:20183740

  5. Activity of kallikrein-kinin system of blood and state of placental circulation at full-term pregnancy

    G. T. Kairov

    2016-03-01

    Full Text Available The activity of kallikrein-kinin system of blood and the state of placental circulation at full-term physiological pregnancy have been studied.In 30 pregnant women aged 18—27 at 38th—40th weeks of pregnancy, the activity of  kallikrein-kinin system (KKS of blood before and after the action double local hypoxia of arm and the state of placental hemodynamics were analyzed. Three types of reaction of kininogenase and inhibitory chains of KSS were revealed: adaptive, kininogenase, and inhibitory. Disturbed placental hemodynamics  was observed in pregnant women with kininogenase and inhibitory types of KSS reaction.

  6. Depression in pregnancy is associated with decreased glutathione peroxidase activity in fetal cord blood.

    Camkurt, Mehmet Akif; Fındıklı, Ebru; Bakacak, Murat; Karaaslan, Mehmet Fatih; Tolun, Fatma İnanç; Tuman, Taha Can

    2016-08-01

    The investigation of fetal cord blood (FCB) during child delivery has created a novel topic in the field of psychiatric research. The umbilical vein receives nutrients and oxygen from the mother's circulation and transports them to the fetal circulation. Investigating fetal cord blood during delivery is beneficial for understanding the fetal environment. Depression in pregnancy is associated with medical and emotional burdens. In this study, we aimed to investigate glutathione peroxidase (Gpx) and myeloperoxidase (MPO) activity in the FCB of depressed mothers and healthy controls. Our study included 45 depressed mothers and 59 healthy controls. The FCB samples were collected from the umbilical vein during delivery. We found that Gpx levels were significantly decreased in the FCB of depressed mothers than healthy controls, medians were 0.14 U/ml and 0.16 U/ml respectively, Z: -3.567 and p < 0.001. MPO levels were similar in both groups, medians were 1.0 U/L and 1.2 U/L respectively, Z: -1.837 and p:0.066. Depression in pregnancy may be associated with decreased antioxidant levels, and this condition may cause an oxidative load, which may lead to improper brain development. Future studies should be performed in larger samples to clarify our preliminary results. PMID:27174401

  7. Coagulation inhibitors and activated protein C resistance in recurrent pregnancy losses in Indian women

    P Lalita Jyotsna

    2011-01-01

    Full Text Available Background: Thrombophilias, both acquired and inherited, have been investigated in the etiopathogenesis of unexplained recurrent pregnancy loss. Aim: To study coagulation inhibitors and activated protein C resistance (APCR in recurrent pregnancy losses (RPL occurring in second and third trimesters. Materials and Methods: A total of 30 pregnant women (group A with two or more recurrent unexplained fetal loses were evaluated for APCR, protein C deficiency, protein S deficiency, antithrombin deficiency, and antiphospholipid antibodies (APLA. Thirty age-matched controls were taken (group B comprising of pregnant women with at least one live issue. Statistical Analysis: Comparisons between two group frequencies and group means were made using Chi square test and Student′s t test, respectively. Results: Protein C and protein S levels were reduced in group A compared with group B and the difference was statistically significant (P=0.005 and P=0.032, respectively. The mean value of antithrombin was slightly reduced in group A compared with group B. APCR was observed in 16.6% cases and 3.3% controls. However, the difference was not statistically significant. APLA was observed in 20% cases and none of the controls. Of these, lupus anticoagulant was positive in 16.6% cases and anticardiolipin antibodies in 10% cases. Combined defects were seen in seven patients. Conclusion: There is a significant risk of RPL in pregnant women with thrombophilias. Therefore, screening for thrombophilias may be justified in pregnant women with unexplained recurrent fetal wastage, especially in second and third trimester.

  8. Síndrome de ovario poliquístico (SOP y embarazo: Experiencia clínica Polycystic ovary syndrome and pregnancy: Clinical experience

    Ana Claudia Villarroel

    2007-12-01

    Full Text Available Background: Polycystic ovary syndrome (PCOS is an endocrine metabolic dysfunction closely associated with insulin resistance and obesity, which predisposes to pregnancy complications. Aim: To report a prospective clinical experience in PCOS patients who became pregnant after diet, exercise and metformin treatment intervention, and were followed up during the whole pregnancy. Patients and Methods: Seventy pregnant PCOS (PPCOS women and forty normal pregnant (NP women of similar age and with singleton pregnancies were included in the study. During gestational ages 10-16 and 22-28 weeks, a 2h, 75 g oral glucose tolerance test (OGTT was performed with measurement of glucose and insulin in each sample. Results: No differences were found in duration of gestation, weight gain during pregnancy, or systolic and diastolic blood pressure between PPCOS and NP women. There were significant differences in body mass index (BMI at the initiation and in the third trimester of pregnancy between both groups. The incidence of gestational diabetes was significantly higher (p <0.01 in the PCOS group (35.2% compared to the control group (5.0%. The prevalence of small for gestational age (SGA infants tended to be higher (p =0.09 in the PCOS group. During pregnancy, 2h glucose and insulin were significantly higher in PPCOS than in NP women. Conclusions: PCOS mothers showed a higher prevalence of gestational diabetes and SGA newborns, which cannot be attributed to the weight gain during pregnancy, and seems to be more related to the BMI at the initiation of pregnancy, and to the PCOS condition of the mothe

  9. Placental abruption and subchorionic hemorrhage in the first half of pregnancy: US appearance and clinical outcome.

    Sauerbrei, E E; Pham, D H

    1986-07-01

    In 30 pregnant patients who experienced vaginal bleeding between 10 and 20 weeks gestation, subchorionic hematomas were demonstrated on ultrasound examination. In 18 patients (60%), the margin of the placenta was separated from the uterine wall. In 15 patients the outcome was favorable (full-term delivery of normal infant) and in 15 patients the outcome was unfavorable (seven preterm births, four stillbirths, three spontaneous abortions, one therapeutic abortion). The major prognostic factor related to pregnancy outcome was the volume of the hematoma and, to a lesser extent, the relative volume of the hematoma (volume of hematoma divided by volume of gestational sac). For a volume less than 60 ml, the outcome tended to be favorable, and for a relative volume less than 0.4, the outcome tended to be favorable. PMID:3520643

  10. Associations between maternal helminth and malaria infections in pregnancy, and clinical malaria in the offspring

    Ndibazza, Juliet; Webb, Emily L; Lule, Swaib;

    2013-01-01

    Background. Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis that prenatal exposure to these parasites might influence susceptibility to infections such as malaria in childhood.Methods. In a birth cohort of 2,345 mother-child pairs in Uganda, maternal...... helminth and malaria infection status was determined during pregnancy, and childhood malaria episodes recorded from birth to age five years. We examined associations between maternal infections and malaria in the offspring.Results. Common maternal infections were hookworm (45%), Mansonella perstans (21......%), Schistosoma mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up. The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at annual visits was 5.4%. Maternal hookworm and M. perstans infections were...

  11. Pregnancy outcome after oocyte donation in patients with Turner's syndrome: Clinical experience and management.

    Deligeoroglou, Efthimios; Stergioti, Evgenia; Dimopoulos, Konstantinos D; Karountzos, Vassileios; Prapas, Yannis

    2016-05-01

    Turner's syndrome (TS) is a chromosomal defect with partial or total absence of the X chromosome. Our objective is to report our experience in Greece with patients suffering from TS and trying to conceive; therefore, we present four patients with TS, who underwent In vitro fertilization (ICSI) with donor oocytes in order to get pregnant. Three out of four patients managed to conceive and bring pregnancy to completion. It was shown that patients diagnosed in childhood or adolescence with TS have the possibility to undergo hormone replacement therapy (HRT) and thus, secondary sexual characteristics as well as uterus of almost normal size can develop. Assisted reproduction techniques (ART), predominantly with donated oocytes, could give these patients the possibility to have children. PMID:26757887

  12. Clinical application of Medical Resonance Therapy Music in high-risk pregnancies.

    Sidorenko, V N

    2000-01-01

    Music is an ancient method for healing. In the year 550 B.C., Pythagoras from Greece developed a concept for the use of music in medicine, esteeming music higher than many other medical treatments. The Medical Resonance Therapy Music (MRT-Music) of the German classical composer and musicologist Peter Huebner is built on this concept of Pythagorean music medicine. Its therapeutic effect may be best explained by the natural phenomenon of resonance between the harmony laws of the microcosm of music and the biological laws of the body. Results received after application of MRT-Music indicate multiple positive effects on the organism of pregnant women both with a healthy pregnancy as with a pathologic one, reducing the rate of premature births very effectively. Furthermore, MRT-Music came out to be an effective method in the complex therapy of late gestoses and a nearly irreplaceable method for preoperative preparation of pregnant woman for caesarean section. It demonstrated a powerful anti-stress effect and allowed to reduce the amount of administered pain-killers to pregnant women by the factor 1.5 to 2.0, thus reducing the negative pharmacological load to the foetus. It furthermore reduced labour time and shortened hospital stay. It helped to create optimal conditions for the course of pregnancy and heightened pain sensitivity threshold by means of improving the functional, hormonal, and psycho-emotional conditions of pregnant and lying-in women. Thus, the labour process became more natural, the delivery non-traumatic, and motherhood more happy and safe. PMID:11286372

  13. Comparative evaluation of pregnancy outcome in gonadotrophin-clomiphene combination vs clomiphene alone in polycystic ovarian syndrome and unexplained infertility-A prospective clinical trial

    Shiuli Mukherjee

    2010-01-01

    Full Text Available Objectives: A large prospective clinical trial was conducted to compare the efficacy of single dose uFSH and clomiphene citrate combination with clomiphene citrate alone for ovulation induction to improve the pregnancy rate. Materials and Methods: The study was a randomized, prospective clinical trial. Totally, 1527 infertile women (4381 cycles with polycystic ovarian syndrome (PCOS (n=911/2573 cycles and unexplained infertility (n=616/1808 cycles were randomized into two groups. Group A received single dose of uFSH on D 3 of menstrual cycle along with clomiphene. Group B received clomiphene only for ovulation induction. We compared the pregnancy rate and miscarriage rate between two groups. Results: Group A had a pregnancy rate of 17% compared to 8.3% of Group B which was significantly higher (P=0.0001. The miscarriage rate was 11% in Group A and 10% in Group B which was not significant (P=0.99. Pregnancy rates in PCOS women were 22% in Group A and 9.3% in Group B which shows significantly higher pregnancy rate (P=0.0001 in anovulatory infertility. But in unexplained infertility, there was no significant difference in pregnancy rate between Group A (11% and Group B(6.3%. Miscarriage rates were 8.8% and 9.5% in Group A and Group B, respectively, in PCOS women and 14% and 13% in women with unexplained infertility. Conclusion: Addition of single dose of uFSH improves pregnancy outcome particularly in anovulatory infertility (WHO II. Correction of unexplained infertility may need more than simple correction of possible subtle ovulatory effect.

  14. Ectopic Pregnancy in Uncommon Implantation Sites: Intramural Pregnancy and Rudimentary Horn Pregnancy.

    Wang, Yi; Yu, Fan; Zeng, Li-Qin

    2015-01-01

    Ectopic pregnancy is commonly located in the fallopian tube. Nevertheless, two unusual types of ectopic pregnancy, intramural pregnancy and rudimentary horn pregnancy, seriously threaten maternal life. The diagnosis and treatment of these unusual implantation sites present a clinical challenge. In this study, we illustrated the two unusual types of ectopic pregnancy and summarized the current data regarding diagnosis and optimal treatment from our experience. PMID:26819788

  15. Maternal inflammation during late pregnancy is lower in physically active compared with inactive obese women.

    Tinius, Rachel A; Cahill, Alison G; Strand, Eric A; Cade, W Todd

    2016-02-01

    The primary purpose of this study was to compare maternal plasma inflammation between physically active and inactive obese women during late pregnancy. The secondary purpose was to examine the relationships between maternal plasma inflammation and lipid metabolism and maternal and neonatal metabolic health in these women. A cross-sectional, observational study design was performed in 16 obese-inactive (OBI; means ± SD; age, 25.0 ± 4.8 years; prepregnancy body mass index (BMI), 36.3 ± 4.3 kg/m(2); body fat percentage in late gestation, 37.7% ± 3.5%) and 16 obese-active (OBA; age, 28.9 ± 4.8 years; prepregnancy BMI, 34.0 ± 3.7 kg/m(2); body fat in late gestation, 36.6% ± 3.8%) women during the third trimester of pregnancy. Maternal plasma inflammation (C -reactive protein (CRP)) and insulin resistance (Homeostatic Model Assessment-Insulin Resistance) were measured at rest. Plasma lipid concentration and metabolism (lipid oxidation and lipolysis) were measured at rest, during a 30-min bout of low-intensity (40% peak oxygen uptake) exercise, and during a resting recovery period using indirect calorimetry. Umbilical cord blood was collected for measurement of neonatal plasma insulin resistance, inflammation, and lipid concentration. Neonatal body composition was measured via air displacement plethysmography. Maternal plasma CRP concentration was significantly higher in OBI compared with OBA women (9.1 ± 4.0 mg/L vs. 6.3 ± 2.5 mg/L, p = 0.02). Maternal plasma CRP concentration was significantly associated with maternal lipolysis (r = 0.43, p = 0.02), baseline lipid oxidation rate (r = 0.39, p = 0.03), and baseline plasma free fatty acid concentration (r = 0.36, p = 0.04). In conclusion, maternal physical activity may reduce inflammation during pregnancy in obese women. Maternal lipid metabolism is related to systemic inflammation. PMID:26799789

  16. Hydroxychloroquine and pregnancy on lupus flares in Korean patients with systemic lupus erythematosus.

    Koh, J H; Ko, H S; Kwok, S-K; Ju, J H; Park, S-H

    2015-02-01

    We investigated the clinical and laboratory characteristics of pregnancies with systemic lupus erythematosus (SLE) and identified lupus flare predictors during pregnancy. Additionally, we examined lupus activity and pregnancy outcomes in SLE patients who continued, discontinued or underwent no hydroxychloroquine (HCQ) treatment during pregnancy. We retrospectively analyzed 179 pregnancies in 128 SLE patients at Seoul St. Mary's Hospital, Korea, between 1998 and 2012 and then assessed the clinical profiles and maternal and fetal outcomes. Overall, 90.5% of pregnancies resulted in a successful delivery and were divided into two groups: those who experienced lupus flares (80 pregnancies, 44.7%) and those who did not (99 pregnancies, 55.3%). Increased preeclampsia, preterm births, low birth weight, intrauterine growth restriction (IUGR), and low 1-minute Apgar scores occurred in pregnancies with lupus flares compared to pregnancies in quiescent disease. Lupus flares were predicted by HCQ discontinuation, a history of lupus nephritis, high pre-pregnancy serum uric acid and low C4 levels. Our study indicates that achieving pre-pregnancy remission and continuing HCQ treatment during pregnancy are important for preventing lupus flares. PMID:25305214

  17. Clinical indications and radiation doses to the conceptus associated with CT imaging in pregnancy: a retrospective study

    Woussen, S.; Vanbeckevoort, D.; Bosmans, H.; Oyen, R. [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Lopez-Rendon, X.; Zanca, F. [University Hospitals Leuven, Department of Imaging and Pathology, Leuven (Belgium)

    2016-04-15

    To perform an internal audit at a university hospital with the aim of evaluating the number, clinical indication and operating procedure of computed tomography (CT) performed on pregnant patients and of estimating the radiation doses to the conceptus. A retrospective review was conducted of all CT examinations performed in a single centre on pregnant patients between January 2008 and July 2013. The radiation doses to the conceptus were estimated. The results were compared with published data. The number of CT examinations during pregnancy increased from 3-4 per year in 2008-2011 to 11 per year in 2012. The mean estimated conceptus radiation dose was considered negligible for CT of the head and cervical spine, being less than 0.01 mGy, and for CT of the chest, less than 0.1 mGy. The estimated conceptus radiation dose from abdominopelvic CT was on average 28.7 mGy (range 6.7-60.5 mGy). The number of CT scans of pregnant patients increased threefold during the last few years. Most clinical indications and doses were in line with good clinical practice and literature; only in two cases the dose to the conceptus was higher than 50 mGy. (orig.)

  18. Heterotrophic Pregnancy- Rare Presentation

    AB Chattopadhyay

    2013-06-01

    Full Text Available Heterotopic pregnancy, a potentially dangerous and life-threatening clinical associated with intrauterine (IU and extra uterine pregnancies at the same time. Incidence of such cases are rare but very often missed as the diagnosis being overlooked during examination of the pregnant women with risk factors for an ectopic pregnancy such as free fluid with or without an adnexal mass or acute abdominal pain and shock presentation. Hence a high degree of clinical evaluation is warranted examining the pregnant women. In Present paper we report a case with rare presentation as heterotopic pregnancy from emergency hospital of teaching hospital.

  19. 妊娠期龈炎在不同孕期的临床及细菌学分析%Clinical and bacteria analysis of pregnancy gingivitis in different pregnancy stages

    方婕; 王露霏; 肖晓蓉; 周昕; 李一飞; 贾晓钦; 曹静; 刘兴会

    2012-01-01

    Objective To compare the severity of pregnancy gingivitis and microbiological differences among various pregnancy stages, and provide evidence (or prevention of pregnancy gingivitis. Methods According to the World Health Organization oral health survey basic method. 13 pregnancy gingivitis women who took a pregnancy test between October 2010 and March 2011 were selected for oral clinical examination and subgingival plaque bacterium detection. Results SBI difference among various stages was significant (P<0. 05), and the highest value (0. 93±0. 45) occurred in medium term. Bacteriological analysis showed that the prevalence of Staphylococcus was the highest in medium term, while the prevalence of Streptococcus was the highest in late term. Conclusion Many studies indicated that the prevalence of pregnancy gingivitis was positively associated with pregnancy period, but the relation between the severity and prevalence may not be positive. In different pregnancy stage, subgingival microenvironment played diverse roles in bacterium growth.%目的 比较中国人群不同孕期的妊娠期龈炎严重程度,以及细菌检出率的差异,为妊娠期龈炎的病因及防治研究提供相关依据.方法 按照世界卫生组织1987年制定的口腔健康基本调查方法,对2010年10月~2011年3月在四川大学华西第二医院门诊孕检的13名妊娠期龈炎妇女行口腔临床检查及龈下菌斑细菌检测.结果 不同孕期的SBI差异有统计学意义(P<0.05),其中以中孕组最高(0.93±0.45);细菌学分析结果发现,葡萄球菌属检出率在中孕组最高(P<0.05),链球菌属检出率在晚孕组最高(P<0.05).结论 由多项研究可知,孕期越长,龈炎患病率越高,但龈炎严重程度并不一定与患病率呈正相关;不同孕期的龈下微环境也会对葡萄球菌属与链球菌属的生长产生影响.

  20. Ectopic molar pregnancy: a case report.

    Bousfiha, Najoua; Erarhay, Sanaa; Louba, Adnane; Saadi, Hanan; Bouchikhi, Chahrazad; Banani, Abdelaziz; El Fatemi, Hind; Sekkal, Med; Laamarti, Afaf

    2012-01-01

    The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology exam of an ectopic pregnancy. We report the case of 32 years old nulliparus women who presented a vaginal bleeding, lower abdominal pain and 6 weeks amenorrhea corresponding to the last menstrual period. At the clinical examination, the arterial pressure was 100/60 mmHG. The gynecological examination was difficult because of lower abdominal pain. Serum gonadotropin activity was 3454 ui/l. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. Diagnostic laparoscopy revealed a left-sided unruptured ampullary ectopic pregnancy. A left laparoscopic salpingectomy was performed. The systematic histologic test identified an ectopic partial molar pregnancy, which was confirmed by DNA ploidy image analysis. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is pertinent that clinicians take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnose cases of ectopic molar gestations early and mount appropriate post treatment surveillance. PMID:22655097

  1. HLA-G in human early pregnancy: Control of uterine immune cell activation and likely

    Philippe Le Bouteiller

    2015-02-01

    Full Text Available Despite a number of controversies, the functional importance of human leukocyte antigen G (HLA-G in early human pregnancy is now sustained by a large amount of sound data. Membrane-bound and soluble HLA-G isoforms, either as β2-microglobulin-free or -associated as monomers or dimers, are expressed by different trophoblast subpopulations, the only fetal-derived cells that are directly in contact with maternal cells (maternal-fetal interfaces. Trophoblast HLA-G is the specific ligand of multiple cellular receptors present in maternal immune and non-immune cells, including CD8, leukocyte immunoglobulin-like receptor (LILR B1, LILRB2, killer cell immunoglobulin-like receptor (KIR 2DL4, and possibly CD160. Trophoblast HLA-G specific engagement of these cellular receptors triggers either inhibitory or activating signals in decidual CD8 + T cells, CD4 + T cells, natural killer (NK cells, macrophages, dendritic cells, or endothelial cells. Such HLA-G-receptor specific interactions first contribute to limit potentially harmful maternal anti-paternal immune response by impairment of decidual NK cell cytotoxicity, inhibition of CD4 + and CD8 + T-cell and B-cell proliferation, and induction of apoptosis of activated CD8 + T cells. Second, these HLA-G specific interactions contribute to stimulate placental development through secretion of angiogenic factors by decidual NK cells and macrophages, and to provide a protective effect for the outcome of pregnancy by the secretion of interleukin (IL-4 by decidual trophoblast antigen-specific CD4 + T cells.

  2. Clinical significance of measurement of changes of plasma ET-1, leptin and NPY levels in patients with pregnancy induced hypertension complicated with nephropathy

    Objective: To explore the clinical significance of changes of plasma ET-1, leptin, NPY levels in patients with pregnancy induced hypertension (PIH) complicated with nephropathy. Methods: Plasma ET-1 leptin and NPY (with RIA) levels were determined with RIA in 30 patients with pregnancy induced hypertension complicated with nephropathy and 35 controls. Results: The plasma ET-1 leptin and NPY levels were significantly higher in the patients than those in the controls(P<0.01). Plasma ET-1 levels were positively correlated with both leptin and NPY levels (r=0.5812, 0.6015, P<0.01). Conclusion: Detection of plasma ET-1 leptin and NPY levels might be of prognostic importance in patients with pregnancy induced hypertension complicated with nephropathy. (authors)

  3. Clinical significance of measurement of changes of serum TNF-α, IL-6 and IL-8 centent after treatment in patients with pregnancy induced hypertension (PIH)

    Objective: To explore the clinical significance of changes of serum TNF-α, IL-6 and IL-8 levels in patients with pregnancy induced hypertension. Methods: Serum TNF-α, IL-6 and IL-8 levels were measured with RIA in 36 patients with pregnancy induced hypertension both before and after 2 weeks of treatment as well as in 35 controls. Results: Before treatment, the serum TNF-α, IL-6 and IL-8 levels were significantly higher in patients with PIH than those in the controls (P0.05). Conclusion: The inflammatory cytokines such as TNF-α, IL-6 and IL-8 may play important roles in the pathogenesis of pregnancy induced hypertension. (authors)

  4. Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies

    Marcus Bess

    2008-09-01

    Full Text Available Abstract Background Pharmacotherapies for smoking cessation have not been adequately tested in pregnancy and women are reluctant to use them. Behavioural support alone has a modest effect on cessation rates; therefore, more effective interventions are needed. Even moderate intensity physical activity (e.g. brisk walk reduces urges to smoke and there is some evidence it increases cessation rates in non-pregnant smokers. Two pilot studies assessed i the feasibility of recruiting pregnant women to a trial of physical activity for smoking cessation, ii adherence to physical activity and iii womens' perceptions of the intervention. Methods Pregnant smokers volunteered for an intervention combining smoking cessation support, physical activity counselling and supervised exercise (e.g. treadmill walking. The first study provided six weekly treatment sessions. The second study provided 15 sessions over eight weeks. Physical activity levels and continuous smoking abstinence (verified by expired carbon monoxide were monitored up to eight months gestation. Results Overall, 11.6% (32/277 of women recorded as smokers at their first antenatal booking visit were recruited. At eight months gestation 25% (8/32 of the women achieved continuous smoking abstinence. Abstinent women attended at least 85% of treatment sessions and 75% (6/8 achieved the target level of 110 minutes/week of physical activity at end-of-treatment. Increased physical activity was maintained at eight months gestation only in the second study. Women reported that the intervention helped weight management, reduced cigarette cravings and increased confidence for quitting. Conclusion It is feasible to recruit pregnant smokers to a trial of physical activity for smoking cessation and this is likely to be popular. A large randomised controlled trial is needed to examine the efficacy of this intervention.

  5. [Abdominal pregnancy, institutional experience].

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  6. The association between occurrence and severity of subclinical and clinical mastitis on pregnancies per artificial insemination at first service of Holstein cows.

    Fuenzalida, M J; Fricke, P M; Ruegg, P L

    2015-06-01

    The objective of this prospective study was to determine associations between occurrence and severity of clinical (CM) and subclinical mastitis (SM) during a defined breeding risk period (BRP, 3d before to 32d after artificial insemination) on pregnancies per artificial insemination at first service (P/AI1). Dairy cows (n=3,144) from 4 Wisconsin herds were categorized based on the occurrence of one or more CM or SM events during and before the BRP: (1) healthy, (2) mastitis before BRP, (3) SM during BRP, (4) chronic SM, (5) CM during BRP, or (6) chronic CM. Clinical mastitis cases were categorized based on etiology (gram-negative, gram-positive, and no growth) and severity (mild, moderate, or severe). Compared with healthy cows, the odds of pregnancy were 0.56, 0.67, and 0.75 for cows experiencing chronic CM, CM, or SM during the BRP, respectively. The occurrence of chronic SM was not associated with reduced probability of P/AI1. Compared with healthy cows, the odds of pregnancy were 0.71 and 0.54 for cows experiencing mild or moderate-severe cases of CM during the BRP, respectively. The odds of pregnancy for cows experiencing CM caused by gram-negative or gram-positive bacteria during the BRP were 0.47 and 0.59, respectively. The occurrence of CM that resulted in no growth of bacteria in cultured milk samples was not associated with reductions in P/AI1. Regardless of etiology, microbiologically positive cases of CM with moderate or severe symptoms were associated with substantial reductions in P/AI1. Etiology, severity, and timing of CM were associated with decreases in the probability of pregnancy at first artificial insemination. Severity of the case was more important than etiology; however, regardless of severity, microbiologically negative cases were not associated with reduced probability of pregnancy. PMID:25795486

  7. Diagnosing Pulmonary Embolism in Pregnancy: Are Biomarkers and Clinical Predictive Models Useful?

    Parilla, Barbara V.; Fournogerakis, Rachel; Archer, Amy; Sulo, Suela; Laurent, Lisa; Lee, Patricia; Chhotani, Benazir; Hesse, Kathleen; Kulstad, Erik

    2016-01-01

    Objective The objective of this study was to evaluate whether trimester-specific D-dimer levels or the modified Wells score (MWS) is a useful risk stratification tool to exclude pregnant women at low risk of pulmonary embolism (PE) from diagnostic imaging. Study Design This is a prospective and retrospective cohort study. Pregnant women who underwent diagnostic imaging for suspected PE were prospectively enrolled. D-dimer serum levels were drawn, and a MWS was assigned. Pregnant women diagnosed with a PE before study launch who underwent diagnostic imaging and had a D-dimer level drawn were also evaluated. Results In this study, 17 patients were diagnosed with a PE and 42 patients had no PE on diagnostic imaging. Sixteen out of 17 patients with a PE versus 11 out of 42 without PE had an abnormal D-dimer level (p = 0.001). Four patients with a PE versus zero without a PE had an abnormal MWS (p = 0.005). The combination of a trimester-specific D-dimer level along with the MWS was abnormal in all 17 patients with a documented PE versus 11/42 (26.2%) patients without a documented PE (p = 0.001). Conclusion A combination of trimester-specific D-dimer levels along with a MWS can be used in pregnancy to triage women into a low-risk category for PE and thereby avoid radiation exposure in a majority of pregnant patients. PMID:27119048

  8. [Clinical application of skin sympathetic nerve activity].

    Iwase, Satoshi

    2009-03-01

    Skin sympathetic nerve activity (SSNA) is microneurographically recorded from the skin nerve fascicle in the peripheral nerves. It is characterized by the following features: 1) irregular, pulse asynchronous, burst activity with respiratory variation, 2) burst activity followed by vasoconstriction and/or sweating, 3) elicited by mental stress and arousal stimuli, e.g., sound, pain, electric stimulation, 4) burst with longer duration as compared with sympathetic outflow to muscles, and 5) burst activity following sudden inspiratory action. It comprises vasoconstrictor (VC) and sudomotor(SM) activity, as well as vasodilator (VD) activity. VC and SM discharge independently, whereas VD is the same activity with different neurotransmission. The VC and SM are differentiated by effector response, e.g., laser Doppler flowmetry and skin potential changes. SSNA function in thermoregulation in the human body; however it is also elicited by mental stress. SSNA is the lowest at thermoneutral ambient temperature (approximately 27 degrees C), and is enhanced in the pressence of ambient warm and cool air. The burst amplitude is well-correlated to both skin blood flow reduction rate or sweat rate change. The clinical application of SSNA comprises the following: 1) clarification of sweating phenomenon, 2) clarification and diagnosis of anhidrosis, 3) clarification and diagnosis of hyperhidrosis, 4) clarification of thermoregulatory function and diagnosis of thermoregulatory disorder, 5) clarification of pathophysiology and diagnosis of vascular diseases, e.g., Raynaud and Buerger diseases. 6) clarification of the relation between cognitive function and SSNA and 7) determination of pharmacological effect attributable to change in neuroeffector responses. PMID:19301594

  9. The inhibition of the Human Immunodeficiency Virus type 1 activity by crude and purified human pregnancy plug mucus and mucins in an inhibition assay

    Schoeman Leann

    2008-05-01

    Full Text Available Abstract Background The female reproductive tract is amongst the main routes for Human Immunodeficiency Virus (HIV transmission. Cervical mucus however is known to protect the female reproductive tract from bacterial invasion and fluid loss and regulates and facilitates sperm transport to the upper reproductive tract. The purpose of this study was to purify and characterize pregnancy plug mucins and determine their anti-HIV-1 activity in an HIV inhibition assay. Methods Pregnancy plug mucins were purified by caesium chloride density-gradient ultra-centrifugation and characterized by Western blotting analysis. The anti-HIV-1 activities of the crude pregnancy plug mucus and purified pregnancy plug mucins was determined by incubating them with HIV-1 prior to infection of the human T lymphoblastoid cell line (CEM SS cells. Results The pregnancy plug mucus had MUC1, MUC2, MUC5AC and MUC5B. The HIV inhibition assay revealed that while the purified pregnancy plug mucins inhibit HIV-1 activity by approximately 97.5%, the crude pregnancy plug mucus failed to inhibit HIV-1 activity. Conclusion Although it is not clear why the crude sample did not inhibit HIV-1 activity, it may be that the amount of mucins in the crude pregnancy plug mucus (which contains water, mucins, lipids, nucleic acids, lactoferrin, lysozyme, immunoglobulins and ions, is insufficient to cause viral inhibition or aggregation.

  10. Assessment of Safety in Newborns of Mothers Participating in Clinical Trials of Vaccines Administered During Pregnancy

    Munoz, Flor M.; Weisman, Leonard E.; Read, Jennifer S.; Siberry, George; Kotloff, Karen; Friedman, Jennifer; Higgins, Rosemary D.; Hill, Heather; Seifert, Harry; Nesin, Mirjana

    2014-01-01

    A panel of experts convened by the Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, developed proposed guidelines for the evaluation of adverse events in newborns of women participating in clinical trials of maternal immunization in the United States.