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Sample records for activation clinical pregnancy

  1. Lupus Activity in Pregnancy

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    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. CLINICAL STUDY OF ECTOPIC PREGNANCY

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    Swami

    2015-10-01

    Full Text Available An ectopic pregnancy is one in which fertilized ovum is implanted at the site other than normal uterine cavity.[1] Incidence of ectopic pregnancy is 1:160 deliveries.[2] Clinical presentation is variable from acute to chronic type. Due to its varied clinical presentation ectopic pregnancy poses great diagnostic difficulty both to obstetrician, physician and surgeons.[3] OBJECTIVE: To find out incidence in our study population and to evaluate symptomatically and clinical presentation in these patients. MATERIALS AND METHODS: Retrospective study of 34 ectopic pregnancies admitted and treated in Medical College hospital, Ujjain from 2010 to 2015 are included in the study. RESULTS: The incidence of ectopic pregnancy is more between the age group of 21-30years (73.52% and in Multigravida 64.71%. Infertility and previous tubal surgery are the high risk factors for tubal pregnancy. Pain in abdomen was present in all 34 cases, amenorrhea in 97.05% and bleeding per vagina in 76.47% cases. Syncopal attacks, vomiting were detected in 14.70% cases. Acute ectopic pregnancy was detected in 14.71% and chronic in 85.29% cases. 82.35% cases presented with adnexal mass, 79.41% with cervical motion tenderness, 50% with pallor, 32.35% with abdominal lump and tenderness and 11.76% with fullness in POD. CONCLUSION: Ectopic pregnancy is leading cause of maternal mortality in first trimester. In spite of advanced diagnostic techniques. It poses great diagnostic difficulties due to varied signs and symptoms. Previous tubal surgery pelvic inflammatory disease and infertility are the risk factors of tubal pregnancy.

  3. Clinical study of ectopic pregnancy.

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    Chhabra, S; Aher, K; Jaiswal, M

    1992-01-01

    Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.

  4. INVESTIGATION OF THROMBOMODULIN AND PLASMINOGEN ACTIVATOR INHIBITOR TYPE-I IN PREGNANCY INDUCED HYPERTENSION AND ITS CLINICAL SIGNIFICANCE

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    马水清; 白春梅; 边旭明

    2001-01-01

    Objective. To measure the circulating levels of thrombomodulin (TM) and plasminogen activator inhibitor type-I (PAI-I) inwomen with pregnancy induced hypertension (PIH). Methods. Blood samples were drawn from 97 pregnant women in their third trimester, grouped as 25 mild PIH, 26 moderate PIH, 22 severe PIH and 24 normotensive healthy pregnant women for determining levels of TM by ELISA, PAI-I by colorimetric assay methods, and creatinine (Cr) in serum by biochemical method. Results. Circulating levels of TM, PAI-I and TM/Cr ratio increased with increasing severity of PIH. There were no significant differences between mild and normotensive pregnant women. The parameters were significantly changed in the moderate and severe PIH groups. Conclusion. TM and PAI-I may serve as meaningful clinical markers for the assessment of the endothelial damage in PIH,which is very important in evaluating and following the development of PIH.

  5. INVESTIGATION OF THROMBOMODULIN AND PLASMINOGEN ACTIVATOR INHIBITOR TYPE-I IN PREGNANCY INDUCED HYPERTENSION AND ITS CLINICAL SIGNIFICANCE

    Institute of Scientific and Technical Information of China (English)

    马水清; 白春梅; 边旭明

    2001-01-01

    Objective. To measure tbe circulating levels of thrombomodulin (TM) and plasminogen activator inhibitor type-Ⅰ(PAI-I) in women with pregnancy induced hypertension (PIH).``Methods. Blood samples were drawn from 97 pregnant women in their third trimester, grouped as 25 mild PIH, 26 moderate PIH, 22 severe PIH and 24 normotensive healthy pregnant women for determining levels of TM by ELISA, PAI-I by colorimetric assay methods, and creatinine (Cr) in serum by biochemical method.``Results. Circulating levels of TM, PAId and TM/Cr ratio increased with increasing severity of PIH. There were no significant differences between mild and normotensive pregnant women. The parameters were significantly changed in the moderate and severe PIH groups.``Conclv, sion. TM and PAI-Ⅰ may serve as meaningful clinical markers for the assessment of the endothelial damage in PIH,which is very important in evaluating and following the development of PIH.

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

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    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

  7. Clinical management of pregnancy in cats.

    Science.gov (United States)

    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

  8. Benign encephalopathy of pregnancy. Preliminary clinical observations.

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    Poser, C M; Kassirer, M R; Peyser, J M

    1986-01-01

    A survey of 67 pregnancies in 51 professional women (physicians, psychologists, nurses, administrators, etc.) revealed the occurrence of symptoms of cognitive dysfunction such as forgetfulness, disorientation, confusion and reading difficulties in 28 pregnancies occurring in 21 women. These were unrelated to such factors as age of delivery, percentage weight gain, the baby's sex or birth weight, alcohol consumption, smoking, a history of migraine or allergy or other symptoms occurring during pregnancy such as sleepiness and lack of concentration, irritability, loss of interest in job or nightmares. Nor was there any correlation with hypertension, proteinuria, glycosuria, ketonuria, anemia, or morning sickness. Furthermore, these cognitive disturbances were not related to depression or sleep deprivation. Despite these symptoms, none of the women suffering from them were forced to interrupt their professional activities during pregnancy. The syndrome of benign encephalopathy of pregnancy should be recognized so that simple precautions can be taken to prevent any interference with professional or other activities. The etiology of the syndrome is unknown.

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

    OpenAIRE

    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...

  10. THE SOCIAL AND CLINICAL CHARACTERISTIC OF PATIENTS WITH THE ISOLATED GENITAL TUBERCULOSIS ASSOCIATED WITH INFERTILITY, THE ACTIVE AND CLINICALLY CURED TUBERCULOSIS OF RESPIRATORY ORGANS IN COMBINATION WITH PREGNANCY

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    A. V. Mordyk

    2015-01-01

    Full Text Available Due to the high incidence of tuberculosis of women of reproductive age research at 270 patients was conducted. The group of research included women with infertility and genital tuberculosis, pregnant women with active tuberculosis of lungs, pregnant women with clinically cured tuberculosis of respiratory organs. Pregnant women with tuberculosis of lungs were more often from sociopathic families, had venereal diseases, HIV infection, hepatitises.

  11. [Toxoplasmosis in pregnancy - questions in clinical practice].

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    Geleneky, Markéta

    2013-06-01

    Toxoplasmosis acquired during pregnancy is a serious disease that may significantly affect fetal development and cause irreversible or therapeutically hardly influenced damage to the newborn. Early and correct diagnosis of the disease in the mother is essential for determining prognosis and further diagnostic and therapeutic procedures. The case study combines a number of factors to be encountered in clinical practice which may complicate diagnostic considerations. One of them is the existence of a rare phenomenon of reinfection - its possible effects on prenatal screening and other interpretations of such findings. Another problem is the evaluation of the origin of sonographically confirmed fetopathy in relation to Toxoplasma etiology and the choice of next steps that should follow in this situation. Finally, the text discusses the selection of postnatal examinations so that they sufficiently contribute to decision-making about the newborn's treatment initiation.

  12. Clinical study of cardiac diseases during pregnancy

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    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

  13. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    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....

  14. Summary of International Guidelines for Physical Activity Following Pregnancy

    OpenAIRE

    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...

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

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    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

  16. CLINICAL AND EPIDEMIOLOGICAL STUDY OF CUTANEOUS MANIFESTATIONS OF PREGNANCY

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    Sharath Kumar

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: Pregnancy is a period of profound immunologic, endocr ine, metabolic and vascular changes which are tolerated by the body for a relatively short time. Almost all pregnant women (90% may develop both physiologic and pathologic changes in the skin, nails, and hair which should be recognized and appropriately m anaged 1 . Moreover, pregnancy modifies the course of a number of pre - existing dermatological conditions. AIMS: To find out the frequency and pattern of skin changes in pregnant women i.e. physiological skin changes, dermatoses modified by pregnancy and spec ific dermatoses of pregnancy . DESIGN: Prospective descriptive study . METHODS AND MATERIAL: A total of 300 pregnant women attending antenatal OPD and those admitted in wards having symptoms related to skin and mucosa, at tertiary care centre between June 20 11 and November 2012 were studied. Patients not willing to give informed consent were only excluded. . Detailed history, clinical examination and relevant investigations were done. RESULTS: In our study age distribution of pregnancy, was in range of 16 - 30 years. Most of the cases belonged to 2 nd and 3 rd trimester (93%. Pigmentary changes were the most common non specific pregnancy dermatosis, seen in almost all cases. Of these linea nigra (87% being the commonest. Overall 54 cases showed specific dermatos es of pregnancy. Of these the most common was prurigo of pregnancy (12% followed by pruritus of pregnancy (4%, PUPPP (2%. Among the other dermatological conditions, scabies (16% was the commonest. Fungal infections were seen in 14%, viral infections in 8% and bacterial infections in 5%. CONCLUSION: Majority of the dermatoses associated with pregnancy were observed in third trimester and among multigravidas. Pigmentary changes was the commonest physiological change observed. Prurigo of pregnancy was the commonest specific dermatosis of pregnancy. There were no cases of dermatoses modified during pregnancy

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

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    O. V. Gaisenok

    2014-01-01

    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.

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

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    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...

  19. Telomerase activity in pregnancy complications (Review)

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    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

  20. Telomerase activity in pregnancy complications (Review).

    Science.gov (United States)

    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. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

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    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.

  2. Acute Fatty Liver of Pregnancy: A Clinical-Paraclinical Survey

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    Mohammad Jafari

    2015-02-01

    Full Text Available Background Acute Fatty Liver of Pregnancy (AFLP is one of the serious complications of the pregnancy period. Surveying the laboratory and clinical signs is effective in timely prognosis and fast treatment of this illness. Objectives The current study aimed to evaluate AFLP among the hospitalized subjects. Patients and Methods This retrospective study was conducted on clinical and preclinical records of 25 females with AFLP for maternal and perinatal prognosis from 2000 to 2009. The data was analyzed using SPSS ver. 19. Results The patients aged 16 - 45 years old with one to four pregnancies (pregnancy; they were 24 to 39 weeks pregnant with the mean of 33.56 weeks, and 56% were multifarious. The most prevalent clinical symptoms were nausea, vomiting, abdominal pain, headache, pruritus, and icterus. The laboratory signs included disorders of liver, coagulation, kidney, and hypoglycemia. Nausea and vomiting in the first and second age groups (Group 1, patients were 35 years. were the most prevalent symptoms. No patient had fever, ascites, and polydipsia. There was one case of mother and fetal death. Conclusions In the current study, the clinical and paraclinical signs of AFLP were mostly - liver, coagulation, kidney, and hypoglycemia disorders. Considering that patients mostly refer in three phases of clinical, laboratory, and complications, it is essential to evaluate the suspected ones who present clinical symptoms especially nausea, vomiting and abdominal pain.

  3. Pregnancy loss: French clinical practice guidelines.

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    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 miscarriage in women who want a new pregnancy is not recommended (Grade A). A work-up for women with recurrent pregnancy loss should include the following: diabetes (Grade A), antiphospholipid syndrome (Grade A), hypothyroidism with anti-thyroid peroxidase (anti-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 (miscarriage or preterm delivery (Grade A). Among women with a threatened late miscarriage, an isolated undilated shortened cervix (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 women with obstetric antiphospholipid syndrome (Grade A). Glycaemic levels

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

    OpenAIRE

    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...

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

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    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.

  6. A clinical study of skin changes in pregnancy

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    Kumari Rashmi

    2007-01-01

    Full Text Available Background: During pregnancy profound immunologic, metabolic, endocrine and vascular changes occur, that are responsible for the changes of the skin and its appendages, both physiologic and pathologic. Aims: We undertook a clinical study to find out the frequency and pattern of skin changes in pregnant women. Methods: All consecutive pregnant women were included in the study. Results: A total of 607 pregnant women were included in this study. Of these, 303(49.9% pregnant women were primigravida and 304(51.1% were multigravida. Skin changes grouped into: physiological changes (all cases, specific dermatoses (22 cases and other dermatoses affected by pregnancy (125 cases. Most common physiological changes were pigmentary alterations seen in 555 (91.4% followed by striae seen in 484(79.7% cases. Of the various specific dermatoses of pregnancy, pruritic urticarial papules and plaques of pregnancy (PUPPP was the most common disorder (14 cases followed by pruritus gravidarum (5 cases. The most common dermatoses affected by pregnancy were candidal vaginitis (17 cases, acne vulgaris (15 cases, skin tags (15 cases, eczemas (14 cases. Conclusion: This study brings into focus various skin changes during pregnancy in south India.

  7. Clinical Analysis of 45 Cases of Caesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    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.

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

    OpenAIRE

    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...

  9. Thyroid Autoantibodies in Pregnancy: Their Role, Regulation and Clinical Relevance

    Science.gov (United States)

    Balucan, Francis S.; Morshed, Syed A.; Davies, Terry F.

    2013-01-01

    Autoantibodies to thyroglobulin and thyroid peroxidase are common in the euthyroid population and are considered secondary responses and indicative of thyroid inflammation. By contrast, autoantibodies to the TSH receptor are unique to patients with Graves' disease and to some patients with Hashimoto's thyroiditis. Both types of thyroid antibodies are useful clinical markers of autoimmune thyroid disease and are profoundly influenced by the immune suppression of pregnancy and the resulting loss of such suppression in the postpartum period. Here, we review these three types of thyroid antibodies and their antigens and how they relate to pregnancy itself, obstetric and neonatal outcomes, and the postpartum. PMID:23691429

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

    DEFF Research Database (Denmark)

    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...... than MMP cases (P cases, the possible karyotypes had similar frequencies, whereas, in PPM cases, 43% had the karyotype 69, XXX, 51% had the karyotype 69, XXY, and 6% had the karyotype 69, XYY. Molar phenotype was seen only in PPM cases. However, PPM cases with a nonmolar phenotype were...... also seen. For both parental genotypes, various fetal phenotypes were seen at autopsy. Levels of human chorionic gonadotropin in maternal serum were low in MMP cases and varying in PPM cases, some being as low as in the MMP cases. CONCLUSION: In a triploid pregnancy, suspicion of hydatidiform mole...

  11. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    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...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... 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. Recommendations of activity restriction in high-risk pregnancy scenarios

    DEFF Research Database (Denmark)

    Bendix, Jane; Hegaard, Hanne Kristine; Bergholt, Thomas;

    2015-01-01

    and the Danish Association of Midwives were asked to complete a tested, structured questionnaire. Results: We sent 1815 invitations; the overall response rate was 54%. A majority of clinicians recommended some form of activity restriction in the nine scenarios. The midwives recommended strict or moderate...... to the obstetricians, the midwives also reported that they expected the recommendation to be more effective. Most midwives and obstetricians reported that they thought strict activity restriction was associated with severe or moderate adverse effect, and recommended antithrombotic prophylaxis. Conclusions: Danish...... obstetricians and midwives prescribe activity restriction in most high-risk pregnancies. The degree of activity restriction and the presumed effect vary between clinicians. This may reflect different attitudes and lack of guidelines based on clinical studies of a possible benefit of activity restriction....

  13. A clinical study of skin changes in pregnancy

    OpenAIRE

    Kumari Rashmi; Jaisankar T; Thappa Devinder

    2007-01-01

    Background: During pregnancy profound immunologic, metabolic, endocrine and vascular changes occur, that are responsible for the changes of the skin and its appendages, both physiologic and pathologic. Aims: We undertook a clinical study to find out the frequency and pattern of skin changes in pregnant women. Methods: All consecutive pregnant women were included in the study. Results: A total of 607 pregnant women were included in this study. Of these, 303(49.9%) pregnant women ...

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

    OpenAIRE

    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...

  15. Waist hip ratio in early pregnancy as a clinical indicator of serum lipid levels and predictor of pregnancy complications

    Directory of Open Access Journals (Sweden)

    Divya Khare

    2016-06-01

    Conclusions: The waist hip ratio in early pregnancy has the potential to serve as a clinical indicator of lipid levels. It can also be explored as a predictor of pregnancy complications such as gestational hypertension in larger cohort studies. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1709-1713

  16. Jaundice in pregnancy: a clinical study at JSS hospital, Mysore

    OpenAIRE

    Triveni Kondareddy; Krithika KA

    2016-01-01

    Background: Jaundice in pregnancy is an important medical disorder seen more often in developing countries than in developed ones. It could be peculiar to the pregnancy viz., acute fatty liver of pregnancy, recurrent cholestatic jaundice in pregnancy and jaundice complicating toxemia of pregnancy. It can be concurrent with pregnancy such as due to infective pathology like viral hepatitis or due to gallstones or other causes. Jaundice in pregnancy carries a grave prognosis for both the fetus a...

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

  19. Mild Clinical Presentation of Acute Fatty Liver in the Second Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Alaeddine Yassin

    2011-01-01

    Full Text Available We report a case of 29 years old woman who was diagnosed with acute fatty liver of pregnancy at 23 weeks of gestation with unusual evolution (pregnancy prolonged until 36 weeks of gestation to draw attention on the possibility of occurrence of this pathology in the second trimester of pregnancy even with a milder clinical presentation and course.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 多胎妊娠妊娠期并发症及临床处理分析%Analysis of pregnancy complications and clinical management of multiple pregnancy

    Institute of Scientific and Technical Information of China (English)

    赵梅

    2011-01-01

    目的 探讨多胎妊娠妊娠期并发症及临床处理.方法 对2005年1月至2010年I0月住院分娩的60例多胎妊娠病例的早产、妊娠期高血压疾病、贫血及羊水过多等妊娠期并发症及其处理进行回顾性分析.结果 早产、妊娠期高血压疾病、贫血及羊水过多孕妇在积极防治措施下绝大多数妊娠结局良好.结论 加强多胎妊娠的产前监护和护理,积极预防和治疗并发症,对改善多胎妊娠预后和降低围产儿死亡率具有重要的意义.%Objective To investigate the multiple pregnancy pregnancy complications and clinical management. Methods From January 2005 to October 2010 in our hospital 60 cases of premature multiple pregnancy, gestational hypertension, anemia and pregnancy complications such as polyhydr-amnios and its treatment were analyzed retrospectively. Results Premature birth, pregnancy - induced hypertension, anemia and amniotic fluid of pregnant women after the active control measures have the most favorable pregnancy outcomes. Conclusions Strengthening the monitoring of multiple pregnancies and prenatal care, prevention and treatment of complications of multiple pregnancy to improve prognosis and reduce perinatal mortality have great significance.

  2. Clinical study of venous thromboembolism during pregnancy and puerperium.

    Science.gov (United States)

    Adachi, T; Hashiguchi, K; Arai, Y; Ohta, H

    2001-01-01

    We encountered 16 cases of venous thromboembolism (VTE) in women during pregnancy and/or puerperium over the past 15 years at our perinatal center, representing 0.14% of all patients who delivered babies. The present study was undertaken to analyze the risk factors, clinical course and outcomes in these 16 cases. The ages of the patients varied from 29 to 39 years. Four women had pulmonary embolism (PE), 3 of which after caesarean section (C/S) at 35 to 40 weeks, and one case after ovarian cystectomy at 13 weeks of gestation. Twelve cases had deep venous thrombosis (DVT), 4 of which during pregnancy, and the remaining 8 cases after C/S. Four patients who had DVT during a normal course of pregnancy had severe thrombophilia: antiphospholipid antibody syndrome, a history of thrombosis and antithrombin (AT) deficiency. They were treated with heparin with or without AT and had healthy babies via successful vaginal deliveries. The common risk factors in 3 cases of PE with C/S was prolonged bed rest due to threatened premature delivery with total placenta previa, uterine myoma and Ehlers-Danlos syndrome. Other risk factors were massive bleeding, and positive lupus anticoagulant. However, the case of the ovarian cystectomy had only one risk factor, which was obesity. This patient died but the remaining patients recovered with treatment. Because of the low incidence of thrombosis in the Japanese population, prophylactic anticoagulant therapy has not routinely been given to patients undergoing obstetrical operations. However, proper management including prophylactic anticoagulant therapy might be considered for risk patients, depending on the risk factors.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

  5. Maternal Active and Passive Smoking and Hypertensive Disorders of Pregnancy

    Science.gov (United States)

    Engel, Stephanie M.; Scher, Erica; Wallenstein, Sylvan; Savitz, David A.; Alsaker, Elin R.; Trogstad, Lill; Magnus, Per

    2014-01-01

    Background The inverse association between prenatal smoking and preeclampsia is puzzling, given the increased risks of prematurity and low birthweight associated with both smoking and preeclampsia. We analyzed the Norwegian Mother and Child Birth Cohort (MoBa) to determine whether the associations varied by timing of prenatal smoking. Methods We conducted an analysis of 74,439 singleton pregnancies with completed second- and third- trimester questionnaires. Active and passive smoke exposure by trimester were determined by maternal self-report, and covered the period of preconception through approximately 30 weeks’ gestation. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results Rates of active smoking declined dramatically during pregnancy: for trimester 1, 23%; trimester 2, 9%; and trimester 3, 8%. Active smoking in the third trimester was associated with reduced odds of preeclampsia and gestational hypertension, with the strongest association among continuous smokers (for preeclampsia, OR = 0.57 [95% CI = 0.46–0.70]). Women who quit smoking before the third trimester had approximately the same risk of preeclampsia and gestational hypertension as nonsmokers. There was some evidence of dose-response, with the heaviest smokers (more than eight cigarettes per day) having the lowest risks of preeclampsia (0.48 [0.32–0.73]) and gestational hypertension (0.51 [0.28–0.95]). There was little evidence of an association with passive smoking exposure. Conclusion The association between smoking and preeclampsia varies substantially according to the timing and intensity of exposure. A better understanding of the biologic pathways that underlie these associations may provide important clues to the etiology of preeclampsia and the development of effective clinical interventions. PMID:23429405

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

    OpenAIRE

    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...

  7. ASSESSMENT OF RHEUMATOID ARTHRITIS ACTIVITY DURING PREGNANCY AND POSTPARTUM

    Directory of Open Access Journals (Sweden)

    E. V. Matyanova

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic disease that may affect women of childbearing age. The occurrence  of their pregnancy is frequently accompanied by the lower activity of RA and its exacerbation may occur postpartum.  Regular disease activity monitoring  during pregnancy and postpartum  is a necessary condition  for adequate therapy correction in this category of patients.Objective: to determine an optimal method to assess RA activity during pregnancy and postpartumSubjects and methods. Thirty-two  pregnancies were prospectively followed up during each trimester and within 12 months postpartum  in 29 women with RA (according  to the 1987 ACR criteria who had been examined at the V.A. Nasonova Research Institute  of Rheumatology  from February 2011 to August 2014.Results. Comparison  of different methods to assess RA activity demonstrated that DAS28-ESR  shows overrated estimates due to a physiological ESR elevation during pregnancy. CDAI and SDAI are greatly affected by a patient's subjective assessment of his/her  health, which may be overestimated during pregnancy and in the first month after giving birth. DAS28-CRP(3 recommended in the world literature to assess RA activity in pregnant women showed the same changes as DAS28-CRP(4. The latter  is widespread in international studies and has been validated in a large number of patients. Thus, DAS28-CRP(4 may be considered optimal to monitor RA activity during pregnancy and postpartum.

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

    OpenAIRE

    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...

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

    Science.gov (United States)

    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

  10. Clinical Aspects of Pregnancy-induced Amelioration of Rheumatoid Arthritis: PARA-study

    NARCIS (Netherlands)

    Y.A. de Man (Yael)

    2009-01-01

    textabstractIn this PhD thesis, embedded in the PARA (Pregnancy-induced Amelioration of Rheumatoid Arthritis) study, several clinical aspects of the spontaneously occurring pregnancy-induced improvement of rheumatoid arthritis (RA) are addressed. An overview is given of inflammatory rheumatic disea

  11. Breast cancer in pregnancy: A brief clinical review.

    Science.gov (United States)

    Becker, Sven

    2016-05-01

    As global wealth increases and demographic changes similar to Europe and North America start affecting other societies, the global breast cancer epidemic will coincide with a delayed maternal age during first and subsequent pregnancies. Breast cancer in pregnancy will continue to increase, and standardized treatment strategies are required to be developed. This study will review current diagnostic and treatment approaches.

  12. Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

    OpenAIRE

    Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn

    2013-01-01

    Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnan...

  13. Asthma in pregnancy - from immunology to clinical management

    Directory of Open Access Journals (Sweden)

    Tamási Lilla

    2010-08-01

    Full Text Available Abstract Asthma is one of the most common chronic medical conditions that may complicate pregnancy. Asthma influences the outcome of pregnancy and, vice versa, pregnancy affects asthma severity, but the underlying immunological mechanisms of this interaction are not fully understood. As a sign of pregnancy-induced immunotolerance, attenuation of allergic responses can be detected in controlled asthmatic pregnant patients; however non controlled asthmatic pregnant women show significant asthma-associated immune reactions that may, beside other factors, influence fetal growth. Generally, although uncontrolled asthma may increase the risk of adverse perinatal outcomes, women with well-controlled and adequately treated disease during pregnancy do not develop maternal or fetal complications.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

  17. Clinical observation of interventional treatment for tubal pregnancy

    International Nuclear Information System (INIS)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  1. Attitudes toward consequences of pregnancy in young women attending a family planning clinic.

    Science.gov (United States)

    Paikoff, R L

    1990-10-01

    This study examines the relationship between young women's knowledge and attitude concerning pregnancy and their sexual behavior. The study involved 78 young women (14-20 years of age) who had attended a midwestern family planning clinic. Primarily from a larger socioeconomic status, 70% of the participants said that they had never been pregnant. Adapting the testing methods of previous investigations, the study presented the participants with various exams intended to measure the following: 1) knowledge concerning "how babies are made"; 2) knowledge regarding intercourse and pregnancy; 3) anticipation of future consequences of adolescent childbirth; 4) anticipation of immediate consequences or fears of adolescent pregnancy. The study also examined the participants' contraceptive behavior and pregnancy history. The findings indicate that knowledge concerning understanding "how babies are made" does not influence sexual behavior, with no significant difference found between contraceptive users and non-contraceptive users. Also, the participants generally had accurate knowledge concerning intercourse and pregnancy. But the study did reveal significant differences in the evaluation of the consequences of pregnancy and childbirth. Those women who had previously been pregnant -- including those who had terminated their pregnancies -- showed a less negative attitude towards the consequences of pregnancy and childbirth than those who had never been pregnant. Furthermore, as the age of the women increased, the attitude became more positive. However, the study found that the attitude towards the consequences of pregnancy and childbirth had no impact on contraceptive behavior. PMID:12283995

  2. Clinical guidelines for management of thyroid nodule and cancer during pregnancy.

    Science.gov (United States)

    Galofré, Juan Carlos; Riesco-Eizaguirre, Garcilaso; Alvarez-Escolá, Cristina

    2014-03-01

    Special considerations are warranted in management of thyroid nodule and thyroid cancer during pregnancy. The diagnostic and therapeutic approach of thyroid nodules follows the standard practice in non-pregnant women. On the other hand, differentiated thyroid cancer management during pregnancy poses a number of challenges for the mother and fetus. The available data show that pregnancy is not a risk factor for thyroid cancer development or recurrence, although flare-ups cannot be completely ruled out in women with active disease. If surgery is needed, it should be performed during the second term or, preferably, after delivery. A majority of pregnant patients with low-risk disease only need adjustment in levothyroxine therapy. However, women with increased serum thyroglobulin levels before pregnancy or structural disease require regular thyroglobulin measurements and neck ultrasound throughout pregnancy. Pregnancy is an absolute contraindication for radioactive iodine administration.

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

    International Nuclear Information System (INIS)

    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)

  4. Physical activity and health-related quality of life during pregnancy: a secondary analysis of a cluster-randomised trial.

    Science.gov (United States)

    Kolu, Päivi; Raitanen, Jani; Luoto, Riitta

    2014-11-01

    The aim of the study was to evaluate the role of physical activity before and during pregnancy on health-related quality of life (HRQoL). Data from the cluster-randomised gestational diabetes mellitus primary prevention trial conducted in maternity clinics were utilised in a secondary analysis. The cases considered were pregnant women who reported engaging in at least 150 min of moderate-intensity leisure-time physical activity per week (active women) (N = 80), and the controls were women below these recommendations (less active) (N = 258). All participants had at least one risk factor for gestational diabetes mellitus. Their HRQoL was evaluated via the validated generic instrument 15D, with HRQoL at the end of pregnancy examined in relation to changes in physical activity during pregnancy. Logistic regression models addressed age, parity, education, and pre-pregnancy body mass index. At the end of pregnancy, the expected HRQoL was higher (tobit regression coefficient 0.022, 95 % CI 0.003-0.042) among active women than less active women. Active women also had greater mobility (OR 1.98, 95 % CI 1.04-3.78), ability to handle their usual activities (OR 2.22, 95 % CI 1.29-3.81), and vitality (OR 2.08, 95 % CI 1.22-3.54) than did less active women. Active women reported higher-quality sleep (OR 2.11, 95 % CI 1.03-4.30) throughout pregnancy as compared to less active women. Meeting of the physical activity guidelines before pregnancy was associated with better overall HRQoL and components thereof related to physical activity.

  5. Vasopressin in preeclampsia: a novel very early human pregnancy biomarker and clinically relevant mouse model.

    Science.gov (United States)

    Santillan, Mark K; Santillan, Donna A; Scroggins, Sabrina M; Min, James Y; Sandgren, Jeremy A; Pearson, Nicole A; Leslie, Kimberly K; Hunter, Stephen K; Zamba, Gideon K D; Gibson-Corley, Katherine N; Grobe, Justin L

    2014-10-01

    Preeclampsia, a cardiovascular disorder of late pregnancy, is characterized as a low-renin hypertensive state relative to normotensive pregnancy. Because other nonpregnant low-renin hypertensive disorders often exhibit and are occasionally dependent on elevated arginine vasopressin (AVP) secretion, we hypothesized a possible use for plasma AVP measurements in the prediction of preeclampsia. Copeptin is an inert prosegment of AVP that is secreted in a 1:1 molar ratio and exhibits a substantially longer biological half-life compared with AVP, rendering it a clinically useful biomarker of AVP secretion. Copeptin was measured throughout pregnancy in maternal plasma from preeclamptic and control women. Maternal plasma copeptin was significantly higher throughout preeclamptic pregnancies versus control pregnancies. While controlling for clinically significant confounders (age, body mass index, chronic essential hypertension, twin gestation, diabetes mellitus, and history of preeclampsia) using multivariate regression, the association of higher copeptin concentration and the development of preeclampsia remained significant. Receiver operating characteristic analyses reveal that as early as the sixth week of gestation, elevated maternal plasma copeptin concentration is a highly significant predictor of preeclampsia throughout pregnancy. Finally, chronic infusion of AVP during pregnancy (24 ng per hour) is sufficient to phenocopy preeclampsia in C57BL/6J mice, causing pregnancy-specific hypertension, renal glomerular endotheliosis, proteinuria, and intrauterine growth restriction. These data implicate AVP release as a novel predictive biomarker for preeclampsia very early in pregnancy, identify chronic AVP infusion as a novel and clinically relevant model of preeclampsia in mice, and are consistent with a potential causative role for AVP in preeclampsia in humans.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Pregnancy outcomes in Ghana : Relavance of clinical decision making support tools for frontline providers of care

    NARCIS (Netherlands)

    Amoakoh-Coleman, M.

    2016-01-01

    Ghana’s slow progress towards attaining millennium development goal 5 has been associated with gaps in quality of care, particularly quality of clinical decision making for clients. This thesis reviews the relevance and effect of clinical decision making support tools on pregnancy outcomes. Relevanc

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2011-02-01

    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 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.

  14. Relationship between Clinical and Immunological Features of Thyroid Autoimmunity and Ophthalmopathy during Pregnancy

    Directory of Open Access Journals (Sweden)

    Jack R. Wall

    2015-01-01

    Full Text Available Problem. Clinical features of Graves’ hyperthyroidism (GH generally improve during pregnancy and rebound in the postpartum period. It is unclear whether the ophthalmopathy that is associated with GH and, less often, Hashimoto’s thyroiditis (HT changes in parallel with the thyroid associated antibody reactions and clinical features or runs a different course. Method of Study. We retrospectively studied 19 patients with autoimmune thyroid disease over 22 pregnancies: 9 pregnancies with GH and 13 with HT. Ophthalmopathy was defined by NOSPECS class. Results. Thyroid peroxidase (TPO and thyroglobulin (Tg antibody titres decreased during pregnancy and rose in the postpartum period. During pregnancy, 5 patients with GH and 4 patients with HT developed mild ophthalmopathy and two patients with GH and HT developed new upper eyelid retraction (UER. In the postpartum period, eye scores improved in 3 patients with GH and 3 with HT, remained stable in two and 5 patients, respectively, and worsened in 2 patients with GH and one with HT. Conclusions. In patients with mild to moderate eye signs associated with GH and HT, the orbital and thyroid reactions ran different courses during pregnancy. Since no patient had severe ophthalmopathy, we cannot draw definitive conclusions from this preliminary study.

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

    Science.gov (United States)

    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

  16. Ills from the womb? A critical examination of clinical guidelines for obesity in pregnancy.

    Science.gov (United States)

    Jette, Shannon; Rail, Geneviève

    2013-07-01

    In this article, we critically examine the clinical guidelines for obesity in pregnancy put forth by the Society of Obstetricians and Gynaecologists of Canada (SOGC) that are underpinned by the rules of Evidence-Based Medicine (EBM), a system of ranking knowledge that promises to provide unbiased evidence about the effectiveness of treatments. While the SOGC guidelines are intended to direct health practitioners on 'best practice' as they address pregnancy weight gain with clients in the clinical context, we question their usefulness, arguing that despite their commitment to objectivity, they remain mired in cultural biases that stigmatize large female bodies and associates them to 'unfit' mothers.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    To describe patterns of leisure time physical activity during pregnancy in relation to pre-pregnancy leisure time physical activity, socio-demographic characteristics, fertility history, and lifestyle factors. 4,718 nulliparous with singleton pregnancy and intended spontaneous vaginal delivery were...... 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...

  18. Thyroid screening in pregnancy - a compulsory preventive activity

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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

  3. Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications.

    Science.gov (United States)

    Karras, Spyridon N; Fakhoury, Hana; Muscogiuri, Giovanna; Grant, William B; van den Ouweland, Johannes M; Colao, Anna Maria; Kotsa, Kalliopi

    2016-08-01

    Low maternal vitamin D levels during pregnancy have been associated with a plethora of adverse neonatal outcomes, including small for gestational age and preterm births, detrimental effect on offspring bone and teeth development, and risk of infectious diseases. Although most observational studies indicate a significant linear relationship between maternal 25-hydroxyvitamin D and the above outcomes, some randomized controlled trials to date are inconclusive, mostly due to differences in study design and supplementation regimen. The currently available results indicate that vitamin D supplementation during pregnancy reduces the risk of preterm birth, low birth weight, dental caries of infancy, and neonatal infectious diseases such as respiratory infections and sepsis. This narrative review aims to summarize available trial results regarding the effect of low maternal vitamin D levels during pregnancy, in conjunction with neonatal outcomes on the field, with a discourse on the appropriate clinical approach of this important issue. PMID:27493691

  4. [Effects of active and passive smoking during pregnancy on the blood flow in uterine artery in third trimester of pregnancy].

    Science.gov (United States)

    Krzyścin, Mariola; Napierała, Marta; Chuchracki, Marek; Breborowicz, Grzegorz H; Florek, Ewa

    2015-01-01

    The aim of the study was to evaluate the influence of active and passive maternal tobacco smoking on the parameters of blood flow in the uterine arteries in the third trimester. of pregnancy. The study was performed among 96 pregnant women in a single full-term pregnancy in the third trimester of pregnancy. A questionnaire assessing the status of the concentration of nicotine and nicotine metaboliteotinine in the serum of pregnant. The plasma was extracted technique of liquid-liquid, and then performed laboratory assays using high performance liquid chromatography with spectrophotometric detection using norepinephrine as an internal standard. Based on the concentration of cotinine and interview patients were assigned to three groups: Group 1--patients smoking cigarettes during the entire pregnancy (23), group 2--patients exposed to environmental tobacco smoking (30) and a control group 3--nonsmokers and patients unexposed to passive smoking (43). In the third trimester of pregnancy blood flow in the uterine arteries was performed using "B-mode" technique with function of spectral Doppler. We analized the pulsatility index and resistance index in both uterine arteries, the presence of the indent diastolic "notch" and the scale of the uterine arteries. There were no statistically significant differences with regards to pulsatility index and index of resistance in blood flow in the uterine arteries in different groups of patients. The presence of the indent diastolic "notch" was significantly more frequent among active smokers, compared to women passively exposed to tobacco smoke and non-smoking women (39.1% vs. 20% vs. 4.6%; p = 0.012). The values in the scale of uterine arteries showed no significant difference between groups. Both active and passive smoking had no significant effect on the blood flow in uterine artery in pregnant women in the third trimester of pregnancy. PMID:26946568

  5. Clinical impact of mild carbohydrate intolerance in pregnancy

    DEFF Research Database (Denmark)

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

    2001-01-01

    OBJECTIVE: The objective was to study the clinical impact of mild carbohydrate intolerance in pregnant women with risk factors for gestational diabetes mellitus. STUDY DESIGN: This was a historical cohort study of 2904 pregnant women examined for gestational diabetes on the basis of risk factors....... 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...... diabetes, there was a graded increase in the frequency of shoulder dystocia and other maternal-fetal complications with increasing glucose levels during an oral glucose tolerance test....

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

    DEFF Research Database (Denmark)

    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...

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

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Stretch Marks of Pregnancy (Striae of Pregnancy)

    Science.gov (United States)

    ... 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. ...

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

    DEFF Research Database (Denmark)

    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......) for 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...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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 ...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    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

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

    DEFF Research Database (Denmark)

    Olsen, S F; Secher, N J; Tabor, A;

    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....

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

    DEFF Research Database (Denmark)

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Vascular neuroeffector activity in the rat during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Hart, J.L.; Freas, W.; Muldoon, S.M.

    1986-03-01

    The activity of the vascular neuroeffector junction was examined in pregnant (PG) and non-pregnant (NPG) rats to determine if changes could account for the reported alterations in sympathetic control of the maternal circulation. Caudal and mesenteric arteries were removed from NPG and 19-21PG rats and prepared for isometric tension recording in Krebs-filled, 37/sup 0/C tissue baths. At optimal passive tension frequency-response measurements were obtained with and without cocaine (10-/sup 5/M), followed by norepinephrine (NE) and tyramine conc-response measurements. The densely innervated caudal artery developed more tension in response to NE, tyramine and transmural electrical stimulation than did the moderately innervated mesenteric artery. There were no significant differences in responses between vessels from NPG and PG rats, NE content, /sup 3/H-NE accumulation, and effects of plasma on /sup 3/H-NE accumulation of NPG and PG caudal arteries were also compared. The NE content of the NPG artery (8.61 +/- .61) was not different from that of the PG artery (9.97 +/- .71 ..mu..g/g). Also, NE accumulation was similar, and plasma inhibited /sup 3/H-NE accumulation to the same extent. These results indicate that vascular neuroeffector functions of NE release, receptor sensitivity and uptake are not modified in the rat during pregnancy. Changes in sympathetic control of the circulation previously reported, therefore, are likely to be dependent on alterations at sites other than the neuroeffector junction.

  3. [Research activity in clinical biochemistry

    DEFF Research Database (Denmark)

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    International Nuclear Information System (INIS)

    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)

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

    DEFF Research Database (Denmark)

    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 randomisation. SETTING: Nineteen university delivery wards in seven European countries. SUBJECTS: Pregnant women with preterm delivery, intrauterine growth retardation (IUGR), or pregnancy-induced hypertension (PIH) in a previous pregnancy (group 1, n=495); with twin pregnancies (group 2, n=367......); or with 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...

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

    Directory of Open Access Journals (Sweden)

    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. Severe hypoglycaemia during pregnancy in women with type 1 diabetes: possible role of renin-angiotensin system activity?

    DEFF Research Database (Denmark)

    Nielsen, L Ringholm; Pedersen-Bjergaard, U; Thorsteinsson, B;

    2009-01-01

    AIMS: To investigate whether increased risk of severe hypoglycaemia in early pregnancy is related to pregnancy-induced changes in renin-angiotensin system (RAS) activity in women with type 1 diabetes (T1DM). METHODS: Severe hypoglycaemic events the year preceding pregnancy were recorded...... preceding pregnancy and postpartum ACE activity (relative rate of severe hypoglycaemia above versus below median ACE activity: 4.4 (CI: 1.7-11.9), p=0.003). No association was found between severe hypoglycaemia during pregnancy and renin angiotensin system activity at 8 weeks. CONCLUSIONS: In early...

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

    OpenAIRE

    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...

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

    DEFF Research Database (Denmark)

    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....

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

    OpenAIRE

    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....

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  14. Rheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use

    Science.gov (United States)

    Hazes, Johanna M.W.; Coulie, Pierre G.; Geenen, Vincent; Vermeire, Séverine; Carbonnel, Franck; Louis, Edouard; Masson, Pierre

    2011-01-01

    It has long been known that pregnancy and childbirth have a profound effect on the disease activity of rheumatic diseases. For clinicians, the management of patients with RA wishing to become pregnant involves the challenge of keeping disease activity under control and adequately adapting drug therapy during pregnancy and post-partum. This article aims to summarize the current evidence on the evolution of RA disease activity during and after pregnancy and the use of anti-rheumatic drugs around this period. Of recent interest is the potential use of anti-TNF compounds in the preconception period and during pregnancy. Accumulating experience with anti-TNF therapy in other immune-mediated inflammatory diseases, such as Crohn’s disease, provides useful insights for the use of TNF blockade in pregnant women with RA, or RA patients wishing to become pregnant. PMID:21890617

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2015-12-01

    [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 validity was examined by comparing the Pregnancy Physical Activity Questionnaire with the long form of the International Physical Activity Questionnaire and step counts with pedometer. [Results] The mean age of the participants was 28.23±4.94 years, and the mean for BMI was 26.09±4.40. For test-retest reliability, r values were respectively 0.961, 0.934, 0.957 and 0.981 for self-reported sedentary, light, moderate, and vigorous activity, respectively. Intraclass correlation coefficient scores ranged from 0.924 to 0.993. For validity, the Pearson's correlation coefficients between the Pregnancy Physical Activity Questionnaire and long form of the International Physical Activity Questionnaire ranged from moderate (r = 0.329) to high (r = 0.672). The correlation value between the total score of the Pregnancy Physical Activity Questionnaire and the step counts was 0.70. [Conclusion] The Turkish version of the Pregnancy Physical Activity Questionnaire is a valid and reliable tool for measurement of the physical activity level of pregnant women.

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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…

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

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    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.

    Science.gov (United States)

    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

    Directory of Open Access Journals (Sweden)

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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  9. Parabolic trend in endometrial thickness at embryo transfer in in vitro fertilization/intracytoplasmic sperm injection cases with clinical pregnancy evidence.

    Science.gov (United States)

    Lamanna, Giuseppina; Scioscia, Marco; Lorusso, Filomenamila; Serrati, Giuseppe; Selvaggi, Luigi E; Depalo, Raffaella

    2008-10-01

    Sonographic measurement of endometrial thickness at embryo transfer is thought to be a good predictor of the success of in vitro fertilization/intracytoplasmic sperm injection cycles because the clinical pregnancy rate increases as the endometrium thickens. Nevertheless, a retrospective analysis of a study population of 606 patients showed a decrease of clinical pregnancy rates in the setting of extreme endometrial thicknesses.

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

    OpenAIRE

    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 from menarche to first pregnancy and risk of breast cancer.

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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. Clinical Pharmacodynamies of Mffepristone (RU486) for Terminationof Early-Pregnancy

    Institute of Scientific and Technical Information of China (English)

    贺昌海; 王忠兴; 汪嵘卿; 范倩; 桂幼伦; 陈俊康

    1994-01-01

    Twenty-four healthy female volunteers with amenorrhea for seven weeks or less,asking .for legal termination of pregnancy were recruited and divided into 4 groups (6each), The subjects were orally administered with RU486 of 50mg (Group I), 50mgQ12h×6 (Group Ⅱ ), 200mg (GroupⅢ) or 600mg (Group Ⅳ ). Vacuum aspiration( Group Ⅰ) or Methyl Carprost Suppository ( PG05 1.0mg) (Group Ⅱ-Ⅳ) was given 72h after the first dose followed by a 6-hour medical surveillance. Blood samples were collected on day 1-6, 8, 15, 43 to measure the serum levels of β-hCG, E2, P, PRL,ACTH, Cortisol. T3, T4 and TSH in eaeh subject. The results showed that no significant dose-effect relationship was observed in terms of clinical efficacy, vaginal bleeding or side effects, All four groups shared the same tendency of changes in serum levels of β-hCG, E2 and P, β-hCG levels increased by 50-100% (P 0.05). This study indicated that RU486 has no dose-effect relationship when used for interruption of early pregnancy and its main action site seems neither in ovary nor in villi. It has some effects on pituitary-adrenat axis, especially in large dosage, however, it has no obvious impact on pituitary-thyroid axis. It seems that the changes in PRL serum levels were directly due to the drug itself, its clinical significance should be further studied,

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

    Directory of Open Access Journals (Sweden)

    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.

  15. The complement system and adverse pregnancy outcomes.

    Science.gov (United States)

    Regal, Jean F; Gilbert, Jeffrey S; Burwick, Richard M

    2015-09-01

    Adverse pregnancy outcomes significantly contribute to morbidity and mortality for mother and child, with lifelong health consequences for both. The innate and adaptive immune system must be regulated to insure survival of the fetal allograft, and the complement system is no exception. An intact complement system optimizes placental development and function and is essential to maintain host defense and fetal survival. Complement regulation is apparent at the placental interface from early pregnancy with some degree of complement activation occurring normally throughout gestation. However, a number of pregnancy complications including early pregnancy loss, fetal growth restriction, hypertensive disorders of pregnancy and preterm birth are associated with excessive or misdirected complement activation, and are more frequent in women with inherited or acquired complement system disorders or complement gene mutations. Clinical studies employing complement biomarkers in plasma and urine implicate dysregulated complement activation in components of each of the adverse pregnancy outcomes. In addition, mechanistic studies in rat and mouse models of adverse pregnancy outcomes address the complement pathways or activation products of importance and allow critical analysis of the pathophysiology. Targeted complement therapeutics are already in use to control adverse pregnancy outcomes in select situations. A clearer understanding of the role of the complement system in both normal pregnancy and complicated or failed pregnancy will allow a rational approach to future therapeutic strategies for manipulating complement with the goal of mitigating adverse pregnancy outcomes, preserving host defense, and improving long term outcomes for both mother and child.

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

    Science.gov (United States)

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

    DEFF Research Database (Denmark)

    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...

  18. Study protocol: Differential effects of diet and physical activity based interventions in pregnancy on maternal and fetal outcomes - individual patient data (IPD) meta-analysis and health economic evaluation

    DEFF Research Database (Denmark)

    Ruifrok, Anneloes E; Rogozinska, Ewelina; van Poppel, Mireille N M;

    2014-01-01

    BACKGROUND: Pregnant women who gain excess weight are at risk of complications during pregnancy and in the long term. Interventions based on diet and physical activity minimise gestational weight gain with varied effect on clinical outcomes. The effect of interventions on varied groups of women...... and pregnancy outcomes in clinically relevant subgroups of women. METHODS/DESIGN: Randomised trials on diet and physical activity in pregnancy will be identified by searching the following databases: MEDLINE, EMBASE, BIOSIS, LILACS, Pascal, Science Citation Index, Cochrane Database of Systematic Reviews......, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database. Primary researchers of the identified trials are invited to join the International Weight Management in Pregnancy Collaborative Network and share their individual patient...

  19. 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.

    Directory of Open Access Journals (Sweden)

    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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    , light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were......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...

  1. Effect of Vitamin D3 Supplementation During Pregnancy on Risk of Persistent Wheeze in the Offspring A Randomized Clinical Trial

    DEFF Research Database (Denmark)

    Chawes, Bo L.; Bonnelykke, Klaus; Stokholm, Jakob;

    2016-01-01

    during the third trimester of pregnancy reduces the risk of persistent wheeze in the offspring. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, single-center, randomized clinical trial conducted within the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort. Enrollment began March 2009......IMPORTANCE: Observational studies have suggested that increased dietary vitamin D intake during pregnancy may protect against wheezing in the offspring, but the preventive effect of vitamin D supplementation to pregnant women is unknown. OBJECTIVE: To determine whether supplementation of vitamin D3...... with a goal of 708 participants, but due to delayed ethical approval, only 623 women were recruited at 24 weeks of pregnancy. Follow-up of the children (N = 581) was completed when the youngest child reached age 3 years in March 2014. INTERVENTIONS Vitamin D3 (2400 IU/d; n = 315) or matching placebo tablets...

  2. Teen Sexual Activity, Pregnancy and Childbearing among Latinos in the United States. Fact Sheet.

    Science.gov (United States)

    National Campaign To Prevent Teen Pregnancy, Washington, DC.

    The Latino population is the fastest-growing major racial/ethnic group in the United States. By 2020, approximately 16 percent of the population will be Latino. This increase will be even more pronounced among teens. This fact sheet summarizes data from the National Vital Statistics Reports on reported sexual activity, pregnancy rates, and…

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

    Directory of Open Access Journals (Sweden)

    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

    Directory of Open Access Journals (Sweden)

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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. Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Pereira, Priscila Krauss; Lovisi, Giovanni Marcos; Pilowsky, Daniel L; Lima, Lúcia Abelha; Legay, Leticia Fortes

    2009-12-01

    Depression is the most prevalent psychiatric disorder during pregnancy and is associated with psychosocial and clinical obstetric factors. Despite being an important public health issue, there are few studies about this issue in Brazil. A cross-sectional study was carried out, involving 331 pregnant women attending a public primary health service over a one-year period in Rio de Janeiro city, Brazil. Participants were interviewed about their socio-demographic status, obstetric/medical conditions, life events and violence during pregnancy. Depression was assessed using the Composite International Development Interview. The prevalence of depression during pregnancy was 14.2% (95%CI: 10.7-18.5) and associated factors included: previous history of depression and any psychiatric treatment, unplanned pregnancy, serious physical illness and casual jobs. These data emphasize the need for screening for depression and its risk factors during pregnancy in settings where care is available. Psychosocial interventions and social policies need to be devised for this population. PMID:20191163

  8. Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers: the Screening for Pregnancy Endpoints (SCOPE) international cohort study.

    Science.gov (United States)

    Kenny, Louise C; Black, Michael A; Poston, Lucilla; Taylor, Rennae; Myers, Jenny E; Baker, Philip N; McCowan, Lesley M; Simpson, Nigel A B; Dekker, Gus A; Roberts, Claire T; Rodems, Kelline; Noland, Brian; Raymundo, Michael; Walker, James J; North, Robyn A

    2014-09-01

    More than half of all cases of preeclampsia occur in healthy first-time pregnant women. Our aim was to develop a method to predict those at risk by combining clinical factors and measurements of biomarkers in women recruited to the Screening for Pregnancy Endpoints (SCOPE) study of low-risk nulliparous women. Forty-seven biomarkers identified on the basis of (1) association with preeclampsia, (2) a biological role in placentation, or (3) a role in cellular mechanisms involved in the pathogenesis of preeclampsia were measured in plasma sampled at 14 to 16 weeks' gestation from 5623 women. The cohort was randomly divided into training (n=3747) and validation (n=1876) cohorts. Preeclampsia developed in 278 (4.9%) women, of whom 28 (0.5%) developed early-onset preeclampsia. The final model for the prediction of preeclampsia included placental growth factor, mean arterial pressure, and body mass index at 14 to 16 weeks' gestation, the consumption of ≥3 pieces of fruit per day, and mean uterine artery resistance index. The area under the receiver operator curve (95% confidence interval) for this model in training and validation cohorts was 0.73 (0.70-0.77) and 0.68 (0.63-0.74), respectively. A predictive model of early-onset preeclampsia included angiogenin/placental growth factor as a ratio, mean arterial pressure, any pregnancy loss preeclampsia in populations of mixed parity and risk. In nulliparous women, combining multiple biomarkers and clinical data provided modest prediction of preeclampsia.

  9. Updates on Lupus and Pregnancy

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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.

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

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    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.

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

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    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

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

    OpenAIRE

    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.

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

    DEFF Research Database (Denmark)

    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......-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...... 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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    -related worries with the Cambridge Worry Scale (CWS). In addition, socio-demographic characteristics, lifestyle factors, and perceptions and attitude regarding weight management and physical activity were measured. Linear regression analyses were performed to assess the association of mental health status......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...... and lifestyle intervention for the prevention of gestational diabetes mellitus (DALI) study were used. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behaviour was measured with accelerometers. Depressed mood was measured with the WHO well-being index (WHO-5) and pregnancy...

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

    DEFF Research Database (Denmark)

    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...

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

    OpenAIRE

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  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

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    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.

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

    Science.gov (United States)

    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

  4. RADIOACTIVE IRON ABSORPTION IN CLINICAL CONDITIONS: NORMAL, PREGNANCY, ANEMIA, AND HEMOCHROMATOSIS.

    Science.gov (United States)

    Balfour, W M; Hahn, P F; Bale, W F; Pommerenke, W T; Whipple, G H

    1942-07-01

    Radio iron is a tool which makes iron absorption studies quite accurate in dogs and reasonably satisfactory in human beings. This method is vastly superior to others previously used. Normal human pregnancy without significant anemia may show active radio iron absorption-16 to 27 per cent of iron intake. The pregnant woman as a rule shows 2 to 10 times the normal absorption of radio iron. Diseased states in which iron stores are known to be very abundant-pernicious anemia, hemochromatosis, familial icterus, and Mediterranean anemia -show very little absorption, probably less than normal. This is in spite of a severe anemia in all conditions except hemochromatosis. Chronic infections in spite of anemia show no utilization of radio iron, whether it may be absorbed or not. Leukemia shows little utilization of radio iron in red cells in spite of absorption (autopsy), probably because of white cells choking the red marrow. Polycythemia shows very low values for iron absorption as do normal persons. Two pregnant women showed only normal iron absorption. We believe that reserve stores of iron in the body, rather than anemia, control iron absorption. This control is exerted upon the gastro-intestinal mucosa which can refuse or accept iron under various conditions.

  5. Diabetes and obesity in pregnancy.

    Science.gov (United States)

    Simmons, David

    2011-02-01

    An epidemic of obesity is affecting growing numbers of women in their childbearing years increasing their risk of obstetric complications including diabetes, hypertension, pre-eclampsia, some malformations, macrosomia and the need for obstetric intervention. There is growing evidence that maternal obesity may increase the risk of obesity and diabetes in the offspring. Obesity and diabetes in pregnancy have independent and additive effects on obstetric complications, and both require management during pregnancy. Management of obesity including weight loss and physical activity prior to pregnancy is likely to be beneficial for mother and baby, although the benefits of bariatric surgery remain unclear at this time. Limiting gestational weight gain to 5-9 kg among pregnant obese women is likely to improve obstetric outcomes, but how to achieve this remains an active area of research. If gestational diabetes develops, there is good evidence that clinical management reduces the risk of adverse pregnancy outcomes.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    LENUS (Irish Health Repository)

    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.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    )) 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......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......); or with 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  13. Biomarkers for Ectopic Pregnancy and Pregnancy of Unknown Location

    OpenAIRE

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Acute fatty liver of pregnancy: An update on pathogenesis and clinical implications

    Institute of Scientific and Technical Information of China (English)

    Jamal A Ibdah

    2006-01-01

    Acute fatty liver of pregnancy (AFLP) is a serious maternal illness occurring in the third trimester of pregnancy with significant perinatal and maternal mortality. Till recently, it has been considered a mysterious illness. In this editorial, we review the recent advances in understanding the pathogenesis of AFLP and discuss the studies documenting a fetal-maternal interaction with a causative association between carrying a fetus with a defect in mitochondrial fatty acid oxidation and development of AFLP.Further, we discuss the impact of these recent advances on the offspring born to women who develop AFLP, such that screening for a genetic defect can be life saving to the newborn and would allow genetic counseling in subsequent pregnancies.The molecular basis and underlying mechanism for this unique fetal-maternal interaction causing maternal liver disease is discussed.

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

    International Nuclear Information System (INIS)

    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

  18. Ectopic ovarian pregnancy

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Oocytes with a dark zona pellucida demonstrate lower fertilization, implantation and clinical pregnancy rates in IVF/ICSI cycles.

    Directory of Open Access Journals (Sweden)

    Wei Shi

    Full Text Available The morphological assessment of oocytes is important for embryologists to identify and select MII oocytes in IVF/ICSI cycles. Dysmorphism of oocytes decreases viability and the developmental potential of oocytes as well as the clinical pregnancy rate. Several reports have suggested that oocytes with a dark zona pellucida (DZP correlate with the outcome of IVF treatment. However, the effect of DZP on oocyte quality, fertilization, implantation, and pregnancy outcome were not investigated in detail. In this study, a retrospective analysis was performed in 268 infertile patients with fallopian tube obstruction and/or male factor infertility. In 204 of these patients, all oocytes were surrounded by a normal zona pellucida (NZP, control group, whereas 46 patients were found to have part of their retrieved oocytes enclosed by NZP and the other by DZP (Group A. In addition, all oocytes enclosed by DZP were retrieved from 18 patients (Group B. No differences were detected between the control and group A. Compared to the control group, the rates of fertilization, good quality embryos, implantation and clinical pregnancy were significantly decreased in group B. Furthermore, mitochondria in oocytes with a DZP in both of the two study groups (A and B were severely damaged with several ultrastructural alterations, which were associated with an increased density of the zona pellucida and vacuolization. Briefly, oocytes with a DZP affected the clinical outcome in IVF/ICSI cycles and appeared to contain more ultrastructural alterations. Thus, DZP could be used as a potential selective marker for embryologists during daily laboratory work.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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.

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 妊娠期肺炎的临床分析%Clinical analysis to pneumonia in pregnancy

    Institute of Scientific and Technical Information of China (English)

    高惠丽; 王红阳

    2013-01-01

    Objective Understand to patients pneumonia in pregnancy the characteristics of clinical and prognosis.Methods A retrospective study was performed on 51 cases disease of pneumonia in pregnancy from Feb.2005 to Feb.2011.Among of all cases influenza A(H1N1) pneumonia in pregnancy is 16 cases and community-Acquired pneumonia in pregnancy is 35 cases.Results White blood count always lower influenza A (H1N1) pneumonia in pregnancy (6.49 ± 2.54) × 109/L compared to community Acquired pneumonia in pregnancy (12.14 ± 4.93) × 109/L (P < 0.000 1< 0.05).CRP is (85.07±61.02) mg/L in the influenza A(H1N1) pneumonia,is high compared CRP is (46.13±35.46)mg/L community-Acquired pneumonia in pregnancy (P =0.030 2 < 0.05).Influenza A (H1N1)pneumonia in pregnancy 12 case (75%) were compared with the community-Acquired pneumonia in pregnancy 17 case (40%) the following CT findings were obvious (P =0.020 3).Changes CT image were more appeared in the two side of lung.Death rate of fetus is higher in the influenza A(H1N1)pneumonia-in pregnancy,it is 4 case.But community-Acquired pneumonia in pregnancy is no case.Conclusions In the influenza A(H1N1) pneumonia in pregnancy,white cell is lower compared with community-Acquired pneumonia in pregnancy.The former CRP is significant high in the latter.Changes CT image were more appeared in the two side of lung.Death rate of fetus is higher in the influenza A (H1N1) pneumonia in pregnancy.%目的 了解妊娠期肺炎患者的临床特点和预后.方法 回顾性分析2005年2月至2011年2月住院的妊娠期肺炎51例,其中妊娠期甲型H1N1流感肺炎组16例,妊娠期社区获得性肺炎组35例.结果 妊娠期甲型H1N1流感肺炎组白细胞(6.49±2.54)×109/L低于妊娠期社区获得性肺炎组白细胞(12.14±4.93)×109/L,(P<0.000 1<0.05);妊娠期甲型H1N1流感肺炎组C反应蛋白(85.07±61.02) mg/L高于妊娠期社区获得性肺炎组C反应蛋白(46.13±35.46) mg/L(P=0.030 2<0.05).

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

    Directory of Open Access Journals (Sweden)

    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

  9. Eating Right during Pregnancy

    Science.gov (United States)

    ... 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 ...

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

    Science.gov (United States)

    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

  11. Pregnancy Outcomes in Chinese Patients with Systemic Lupus Erythematosus (SLE: A Retrospective Study of 109 Pregnancies.

    Directory of Open Access Journals (Sweden)

    Ming Ku

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem autoimmune disease that primarily affects women during their reproductive years. The interaction between SLE and pregnancy remains debated. The objective of this study was to analyze the fetal and maternal outcomes of Chinese women with SLE. A total of 109 pregnancies in 83 SLE patients from June 2004 to June 2014 at a tertiary university hospital were reviewed retrospectively. Patients' characteristics, clinical and laboratory data during pregnancy were obtained from electronic medical records. After exclusion of elective abortions, the live birth rate was 61.5%. Significantly, APS (antiphospholipid syndrome, disease activity, hypertension, hypocomplementemia, thrombocytopenia, and anemia during pregnancy were more commonly observed in fetal loss pregnancies than in live birth pregnancies. Compared to the 64 women with a history of SLE, 19 women with new-onset lupus during pregnancy had worse pregnancy outcome. Furthermore, the 64 patients with a history of SLE were divided into lupus nephritis group and SLE group (non-renal involvement. We found that the lupus nephritis group had worse maternal outcome than the SLE group. We conclude that new-onset lupus during pregnancy predicts both adverse maternal and fetal outcomes, while a history of lupus nephritis predicts adverse maternal outcomes. It is essential to provide SLE women with progestational counseling and regular multispecialty care during pregnancy.

  12. Hormonal activity in clinically silent adrenal incidentalomas

    OpenAIRE

    Babińska, Anna; Siekierska-Hellmann, Małgorzata; Błaut, Krzysztof; Lewczuk, Anna; Wiśniewski, Piotr; Gnacińska, Maria; Obołończyk, Łukasz; Świątkowska-Stodulska, Renata; Sworczak, Krzysztof

    2012-01-01

    Introduction The rapid development of modern imaging techniques, has led to an increase in accidentally discovered adrenal masses without clinically apparent hormonal abnormalities. Such tumours have been termed “incidentalomas”. The diagnostic work-up in patients with adrenal incidentalomas is aimed at the determination of hormonal activity of the tumour and identification of patients with potentially malignant tumours. The aim of our study was a retrospective analysis of selected clinical c...

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

    International Nuclear Information System (INIS)

    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.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Masselli, Gabriele; Gualdi, Gianfranco [Sapienza University, Radiology Dea Department, Umberto I Hospital, Rome (Italy); Brunelli, Roberto; Perrone, Giuseppina [Sapienza University, Department of Gynecology and Obstetrics, Umberto I Hospital, Rome (Italy); Parasassi, Tiziana [Institute of Neurobiology and Molecular Medicine, National Research Council, Rome (Italy)

    2011-09-15

    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.)

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

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    Ping Peng; Xin-Yan Liu; Lei Li; Li Jin; Wei-Lin Chen

    2015-01-01

    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 ofmifepristone 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 termination of mid

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

    OpenAIRE

    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...

  18. 异位妊娠发病的原因临床分析%The pathogenesis of ectopic pregnancy clinical analysis of the reasons

    Institute of Scientific and Technical Information of China (English)

    汪涟

    2013-01-01

    objective: to study and analysis of the relevant causes of ectopic pregnancy and positive way of prevention and treatment. Methods: In our hospital in December 1, 2011 -2013 year in April 1st 118 cases of ectopic pregnancy patients in clinical study.Results: The main reasons lead to ectopic pregnancy patients is inflammation of Department of gynaecology, multiple pregnancy. Conclusion: To lead to early intervention related factors of ectopic pregnancy, conducive to the prevention and treatment of ectopic pregnancy, it has important clinical value.%目的:研究并分析异位妊娠的相关发病原因以及积极的预防和治疗方式。方法:选取我院2011年12月1日-2013年4月1日收治异位妊娠患者118例进行临床研究。结果:导致患者出现异位妊娠的主要原因是妇科炎症、多次孕产等。结论:对导致异位妊娠相关因素进行早期干预,有利于防治异位妊娠,具有重要的临床价值。

  19. Heterotrophic Pregnancy- Rare Presentation

    OpenAIRE

    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 ...

  20. Concurrent bilateral ectopic pregnancy: a rarity

    Directory of Open Access Journals (Sweden)

    Prabhleen Kaur

    2015-08-01

    Full Text Available Bilateral ectopic pregnancy is a rare twin gestation with only a few cases reported in the literature. We report a 30 year old woman without any high risk factor for ectopic pregnancy, who had concurrent bilateral ectopic pregnancy. A 30 year old female presented to the Gynecology emergency department complaining of vaginal bleeding and abdominal pain. The presumptive diagnosis of ruptured left sided ectopic pregnancy was made on basis of clinical findings and ultrasound finings. An emergency laparotomy was done revealed a hemoperitoneum of 1.5 liters, a ruptured left tubal pregnancy with active bleeding and right tubal un-ruptured ectopic was found. A bilateral salpingectomy was performed. Histopathology confirmed presence of chorionic villi in both tubes. In theory, laparoscopic salpingostomy is the best surgical approach in bilateral tubal pregnancy. However, bilateral salpingectomy may be necessary when both tubes are extensively damaged or are actively bleeding. Successful pregnancies have been reported after conservative surgical treatment of bilateral ectopic, but the risk of recurrence is high. Our decision for an emergency laparotomy followed by bilateral salpingectomy was based on the fact that the patient presented with acute abdomen and was haemodynamically unstable and there was extensive bilateral tubal damage. As the incidence of ectopic pregnancies is increasing concurrently with the incidences of pelvic inflammatory disease and use of assisted fertility techniques; it may be that these and ldquo;rare ectopics and rdquo; will become less uncommon. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1197-1199

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

    Directory of Open Access Journals (Sweden)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. Juvenile Dermatomyositis in Pregnancy

    Directory of Open Access Journals (Sweden)

    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.

  4. Juvenile dermatomyositis in pregnancy.

    Science.gov (United States)

    Madu, Anthony Emeka; Omih, Edwin; Baguley, Elaine; Lindow, Stephen W

    2013-01-01

    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.

  5. Mental health, pregnancy and self-rated health in antenatal women attending primary health clinics.

    Science.gov (United States)

    Sonkusare, S; Adinegara; Hebbar, S

    2007-12-01

    The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health. PMID:18705476

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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. The Effects of Active and Passive Smoking upon Pregnancy and Fetus

    Directory of Open Access Journals (Sweden)

    Ruhusen Kutlu

    2008-10-01

    Full Text Available Cigarette smoking is the most important avoidable cause of morbidity and premature death in the world. Maternal smoking during pregnancy is related not only to perinatal adverse events but also to important postnatal problems. Gestational maternal smoking is also associated with many developmental problems, including impaired fetal growth, which is largely assumed to be due to poor placental development, childhood respiratory ill-health, and abnormalities of the nervous system and cognition, as well as possible increased mortality risk for fetuses. Cigarette contains a complex mix of chemicals which can affect fetal development, including metals, nicotine and polycyclic aromatic hydrocarbons (PAH. Pregnant women who continue their smoking often give birth prematurely, the infants are often small for their gestational age, and they have more perinatal incidents. In addition to active smoking, to exposure the environmental tobacco smoke (ETS is a major risk factor for respiratory disease in children. ETS exposure during pregnancy and the first years of life has been consistently found to have an impact on the respiratory system including symptoms such as wheezing, cough, bronchitis, RSV bronchiolitis, otitis media and asthma, but also on intrauterine growth, sudden infant death, behaviour and cognitive functioning. [TAF Prev Med Bull 2008; 7(5.000: 445-448

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    G. T. Kairov

    2012-01-01

    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.

  11. Weight management in pregnancy

    OpenAIRE

    Olander, E. K.

    2015-01-01

    Key learning points: - Women who start pregnancy in an overweight or obese weight category have increased health risks - Irrespective of pre-pregnancy weight category, there are health risks associated with gaining too much weight in pregnancy for both mother and baby - There are currently no official weight gain guidelines for pregnancy in the UK, thus focus needs to be on supporting pregnant women to eat healthily and keep active

  12. Clinical significance of an isolated choroid plexus cysts in the second trimester of pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye; Lee, You Me; Son, Jung Ryun; Shin, Yong Won; Kim, Ji Hye; Lee, Sook Hwan [Pochon CHA University College of Medicine, Pochon (Korea, Republic of)

    2001-03-15

    To evaluate the significance of fetal choroid plexus cysts (CPCs) in the second trimester of pregnancy. Eighty-nine cases of isolated CPCs were prospectively followed up and 5 consecutive pregnancies of trisomy 18 were analyzed. Isolated CPCs were defined as follows: 1)there were no other abnormalities except CPCs on the detailed ultrasound. 2) the mother did not have any risk factors requiring amniocentesis. We compared maternal age, gestational age at time of detection, and the characteristics of CPCs in the groups of isolated CPCs and trisomy 18. We evaluated the autopsy findings or sonographic abnormalities in the group of trisomy 18. Material and gestational age were not different in both groups (29 +- 2.1 vs 31 +- 3.9 years old; 19 +- 1.8 vs 19 +- 1.3 week; p>0.05). The size of isolated CPCs was smaller than that of trisomy 18 (6.5 +- 2.5 vs 12.6 +- 4.6 mm; p<0.01). All of isolated CPCs had disappeared and there was no trisomy 18. In the group of trisomy 18, all of them had CPCs and at least one other associated abnormalities. The risk of trisomy 18 in cases of isolated CPCs was very low. In this setting, the detailed ultrasound examination rather than the routine karyotyping is mandatory.

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

    OpenAIRE

    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.

  14. Ultrasound pregnancy

    Science.gov (United States)

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; ...

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

    International Nuclear Information System (INIS)

    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)

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

    Science.gov (United States)

    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

  17. Heterotrophic Pregnancy- Rare Presentation

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  2. Ectopic molar pregnancy: a case report.

    Science.gov (United States)

    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

  3. Renal histology and pregnancy performance in systemic lupus erythematosus.

    Science.gov (United States)

    Devoe, L D; Loy, G L; Spargo, B H

    1983-01-01

    Previous reports indicate that maternal and fetal outcome in pregnancies complicated by systemic lupus erythematosus (SLE) may be strongly influenced by the presence of renal disease. As the relationship between renal histology and clinical function in SLE is not consistent, prospective data on the outcomes of such pregnancies would aid patient counselling. Fifteen women with SLE had 18 pregnancies subsequent to renal biopsies, performed from 3 months to 8 years prior to conception. Their renal function was evaluated before, during and after pregnancy. Fourteen of 15 patients had evidence of renal involvement, based on by light and electron microscopic sections: 7 had mesangial involvement (WHO Class II); 5 had active focal or diffuse glomerulonephritis (Classes III and IV); two had membranous involvement (Class V); 1, no evident disease. Perinatal outcome was similar whether lesions were milder (8 continuing pregnancies, 4 term deliveries) or more severe (6 continuing pregnancies, 3 term deliveries). Clinical renal function was normal in all but 3 cases at the beginning of pregnancy; 2 additional patients experienced moderate deteriorations in renal function during pregnancy but recovered normal function in the puerperium. Fetal outcome was abnormal (3 premature deliveries, 1 neonatal death, 1 spontaneous abortion) in all cases where renal function was decreased, while 10 of 13 pregnancies in patients with normal renal function ended in term deliveries. The data suggest that currently preconceptual renal histology provides a less accurate basis for perinatal counselling than does the assessment of clinical renal function.

  4. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation.

    Science.gov (United States)

    Picchietti, Daniel L; Hensley, Jennifer G; Bainbridge, Jacquelyn L; Lee, Kathryn A; Manconi, Mauro; McGregor, James A; Silver, Robert M; Trenkwalder, Claudia; Walters, Arthur S

    2015-08-01

    Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is common during pregnancy, affecting approximately one in five pregnant women in Western countries. Many report moderate or severe symptoms and negative impact on sleep. There is very little information in the medical literature for practitioners on the management of this condition during pregnancy. Accordingly, a task force was chosen by the International RLS Study Group (IRLSSG) to develop guidelines for the diagnosis and treatment of RLS/WED during pregnancy and lactation. A committee of nine experts in RLS/WED and/or obstetrics developed a set of 12 consensus questions, conducted a literature search, and extensively discussed potential guidelines. Recommendations were approved by the IRLSSG executive committee, reviewed by IRLSSG membership, and approved by the WED Foundation Medical Advisory Board. These guidelines address diagnosis, differential diagnosis, clinical course, and severity assessment of RLS/WED during pregnancy and lactation. Nonpharmacologic approaches, including reassurance, exercise and avoidance of exacerbating factors, are outlined. A rationale for iron supplementation is presented. Medications for RLS/WED are risk/benefit rated for use during pregnancy and lactation. A few are rated "may be considered" when RLS/WED is refractory to more conservative approaches. An algorithm summarizes the recommendations. These guidelines are intended to improve clinical practice and promote further research.

  5. Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study

    DEFF Research Database (Denmark)

    Hegaard, H K; Petersson, K; Hedegaard, M;

    2010-01-01

    , light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were......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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  7. Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women

    DEFF Research Database (Denmark)

    Østerdal, M L; Strøm, M; Klemmensen, A K;

    2008-01-01

    OBJECTIVE: To examine the association between physical activity in early pregnancy and risk of pre-eclampsia. DESIGN: Prospective cohort. SETTING: Denmark. POPULATION: A total of 85,139 pregnant Danish women, recruited between 1996 and 2002. METHODS: The authors assessed leisure time physical act...

  8. The clinical study of twin pregnancy complicated by preeclampsia%双胎妊娠并发子痫前期的临床研究

    Institute of Scientific and Technical Information of China (English)

    朱秀君

    2015-01-01

    Objective To investigate the effects of twin pregnancies complicated by pre eclampsia of pregnancy complications and neonatal outcomes,further guide clinical.Methods retrospective analysis of the clinical data of 48 patients with twin pregnancies com-plicated by pre eclampsia patients and the same period in our hospital from 201 1 January to 2014 January were 48 cases of normal sin-gleton pregnancies,the twin pregnancies complicated by pre eclampsia patients as the observation group,while the normal single preg-nancy patients as a control group,the two groups were observed and compared analysis of the influence of comorbidity and maternal and neonatal outcomes of pregnancy.Results the group of premature rupture of membranes,the rate of postpartum hemorrhage,premature delivery,cesarean section and neonatal asphyxia was significantly higher than that in the control group,the difference was significant, with statistical significance (P<0.05 ).Conclusion The twin pregnancies complicated by pre eclampsia were more prone to pregnancy induced hypertension syndrome,affects the prognosis of mother and child,clinical worth attention.%目的:探讨双胎妊娠并发子痫前期对妊娠合并症及母婴结局的影响,进一步指导临床。方法:回顾性的分析48例双胎妊娠并发子痫前期患者和同期收治的48例双胎妊娠无并发子痫前期患者的临床资料,将双胎妊娠并发子痫前期患者作为观察组,而双胎妊娠无并发子痫前期患者作为对照组,观察两组患者对妊娠合并症及母婴结局的影响进行对比分析。结果:观察组胎膜早破、产后出血率、早产、剖宫产率及新生儿窒息情况明显高于对照组,差异具有统计学意义(P<0.05)。结论:双胎妊娠并发子痫前期较易发生妊娠期合并症,影响母婴的预后,临床值得加以重视。

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Mammalian target of rapamycin is activated in association with myometrial proliferation during pregnancy.

    Science.gov (United States)

    Jaffer, Shabana; Shynlova, Oksana; Lye, Stephen

    2009-10-01

    The adaptive growth of the uterus during gestation involves gradual changes in cellular phenotypes from the early proliferative to the intermediate synthetic phase of cellular hypertrophy, ending in the final contractile/labour phenotype. The mammalian target of rapamycin (mTOR) signaling pathway regulates cell growth and proliferation in many tissues. We hypothesized that mTOR was a mediator of hormone-initiated myometrial hyperplasia during gestation. The protein expression and phosphorylation levels of mTOR, its upstream regulators [insulin receptor substrate-1, phosphoinositide-3-kinase (PI3K), Akt], and downstream effectors [S6-kinase-1 (S6K1) and eI4FE-binding protein 1 (4EBP1)] were analyzed throughout normal pregnancy in rats. In addition, we used an ovariectomized (OVX) rat model to analyze the modulation of the mTOR pathway and proliferative activity of the uterine myocytes by estradiol alone and in combination with the mTOR-specific inhibitor rapamycin. Our results demonstrate that insulin receptor substrate-1 protein levels and the phosphorylated (activated) forms of PI3K, mTOR, and S6K1 were significantly up-regulated in the rat myometrium during the proliferative phase of pregnancy. Treatment of the OVX rats with estradiol caused a transient increase in IGF-I followed by an up-regulation of the PI3K/mTOR pathway, which became apparent by a cascade of phosphorylation reactions (P-P85, P-Akt, P-mTOR, P-S6K1, and P-4EBP1). Rapamycin blocked activation of P-mTOR, P-S6K1, and P-4EBP1 proteins and significantly reduced the number of proliferating cells in the myometrium of OVX rats. Our in vivo data demonstrate that estradiol was able to activate the PI3K/mTOR signaling pathway in uterine myocytes and suggest that this activation is responsible for the induction of myometrial hyperplasia during early gestation.

  11. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    International Nuclear Information System (INIS)

    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)

  14. Exercise in Pregnancy: Guidelines.

    Science.gov (United States)

    Artal, Raul

    2016-09-01

    In recent years it has been recognized that in all phases of life, including pregnancy, physical activity promotes health benefits and precludes comorbidities, the scientific evidence is indisputable. Several organizations around the world have updated in recent years the guidelines and recommendations for exercise in pregnancy. The December 2015, updated guidelines of the American College of Obstetricians and Gynecologists emphasize that physical activity in pregnancy has minimal risk. Although recommending exercise in pregnancy, the anatomic/physiological changes, absolute and relative contraindications should be considered. Women who exercised regularly before pregnancy, in the absence of contraindications, can continue and engage in moderate to strenuous activities, although information on strenuous activities in pregnancy is still limited. This review summarizes the most recent published and recommended guidelines. PMID:27398880

  15. Physical activity as an aid to smoking cessation during pregnancy (LEAP trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ussher Michael

    2012-10-01

    Full Text Available Abstract Background Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And Pregnant smokers (LEAP trial is investigating whether a PA intervention is effective and cost-effective when used for smoking cessation by pregnant women, and will be the largest study of its kind to date. Methods/design The LEAP study is a pragmatic, multi-center, two-arm, randomized, controlled trial that will target pregnant women who smoke at least one cigarette a day (and at least five cigarettes a day before pregnancy, and are between 10 and 24 weeks pregnant. Eligible patients are individually randomized to either usual care (that is, behavioral support for smoking cessation or usual care plus a intervention (entailing supervised exercise on a treadmill plus PA consultations. The primary outcome of the trial is self-reported and biochemically validated continuous abstinence from smoking between a specified quit date and the end of pregnancy. The secondary outcomes, measured at 1 and 4 weeks after the quit date, and at the end of pregnancy and 6 months after childbirth, are PA levels, depression, self-confidence, and cigarette withdrawal symptoms. Smoking status will also be self-reported at 6 months after childbirth. In addition, perinatal measures will be collected, including antenatal complications, duration of labor, mode of delivery, and birth and placental weight. Outcomes will be analyzed on an intention-to-treat basis, and logistic regression models used to compare treatment effects on the primary outcome. Discussion This trial will assess whether a PA intervention is effective when used for

  16. Assessment of Fetal Autonomic Nervous System Activity by Fetal Magnetocardiography: Comparison of Normal Pregnancy and Intrauterine Growth Restriction

    Directory of Open Access Journals (Sweden)

    Akimune Fukushima

    2011-01-01

    Full Text Available Objective. To clarify the developmental activity of the autonomic nervous system (ANS of the normal fetus and intrauterine growth restriction (IUGR cases using fetal magnetocardiography (FMCG. Subjects and Methods. Normal pregnancy (n=35 and IUGR (n=12 cases at 28–39 and 32–37 weeks of gestation, respectively, were included in this study. The R-R interval variability was used to calculate the coefficient of variance (CVRR and low frequency/high frequency (LF/HF ratio. Results. The value of CVRR in the normal pregnancy group displayed a slight increasing trend with gestational age. However, no such trend was observed in the IUGR group. In contrast, the LF/HF ratio in both the normal pregnancy group and the IUGR group clearly increased over the gestational period; the normal group showing statistical significance. Conclusion. The development of fetal ANS activity in IUGR cases might differ from that observed in the normal pregnancy group, and this may facilitate early detection of IUGR.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  19. Immune re-activation by cell-free fetal DNA in healthy pregnancies re-purposed to target tumors: novel check-point inhibition in cancer therapeutics

    Directory of Open Access Journals (Sweden)

    Elizabeth Ann Lieser Enninga

    2015-08-01

    Full Text Available The role of the immune system in cancer progression has become increasingly evident over the past decade. Chronic inflammation in the promotion of tumorigenesis is well established, and cancer-associated tolerance/immune evasion has long been appreciated. Recent developments of immunotherapies targeting cancer-associated inflammation and immune tolerance such as cancer vaccines, cell therapies, neutralizing antibodies, and immune checkpoint inhibitors, have shown promising clinical results. However, despite significant therapeutic advances, most patients diagnosed with metastatic cancer still succumb to their malignancy. Treatments are often toxic, and the financial burden of novel therapies is significant. Thus, new methods for utilizing similar biological systems to compare complex biological processes can give us new hypotheses for combating cancer. One such approach is comparing trophoblastic growth and regulation to tumor invasion and immune escape. Novel concepts regarding immune activation in pregnancy, especially reactivation of the immune system at labor through toll like receptor engagement by fetal derived DNA, may be applicable to cancer immunotherapy. This review summarizes mechanisms of inflammation in cancer, current immunotherapies used in the clinic, and suggestions for looking beyond oncology for novel methods to reverse cancer-associated tolerance and immunologic exhaustion utilizing mechanisms encountered in normal human pregnancy.

  20. Clinical analysis of 83 cases of hypertensive disorders in pregnancy%妊娠期高血压疾病83例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘靖

    2013-01-01

    回顾性分析我院收治83例患者临床资料,根据国际妇产科联盟(ACOG )2002年诊断标准,分为妊娠期高血压及轻度先兆子痫、重度先兆子痫及子痫二组,比较二组间孕产妇住院情况、并发症及围产儿结局等方面差异。结果妊娠期高血压及轻度先兆子痫组并发症少,母儿预后好;重度先兆子痫及子痫组并发症较多,母儿预后较差。结论1.妊娠高血压疾病是多基因决定并受多因素影响的疾病,早期发现和适当处理能改善孕产妇和新生儿预后。2.孕周≥37周时发生妊娠高血压疾病,宜尽早终止妊娠,依据产科情况选择分娩方式。3.妊娠<37周发生妊娠高血压疾病宜积极治疗,充分评估孕妇及胎儿情况,选择终止妊娠时机,避免严重并发症产生。%Objective To investigate the hypertensive disorders in pregnancy prenatal risk assessment and clinical treatment.Method Retrospective analysis of hospital admitted 83 patients with clinical data, according to the International Federation of Gynecology and Obstetrics (ACOG) 2002 diagnostic criteria, divided into gestational hypertension and mild Pre-eclampsia, severe pre-eclampsia and eclampsia two groups, compare maternal hospitalizations, complications and perinatal outcome differences between the two groups. Result Fewer complications, gestational hypertension and mild pre-eclampsia group, the prognosis of mother and child; severe pre-eclampsia and eclampsia group, more complications, the mother of children with poor prognosis. Conclusion 1. Gestational hypertension is polygenic decisions and disease influenced by multiple factors, early detection and appropriate treatment can improve maternal and neonatal outcomes.2. Gestational age≥ 37 balls are dropped gestational hypertension should early termination of pregnancy, mode of delivery is selected based on obstetric conditions.3. Gestational age <37 balls are dropped produce should be

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    Rutwa J. Chavda

    2014-02-01

    Conclusions: A good clinical examination can pick up most subjects of abnormal liquor volume. Abnormal liquor volumes are associated with increased maternal morbidity and adverse perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 181-184

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

    Science.gov (United States)

    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

  5. [Cardiovascular disease in pregnancy].

    Science.gov (United States)

    Hilfiker-Kleiner, Denise; Bauersachs, Johann

    2016-01-01

    Cardiovascular diseases are among the most frequent complications in pregnancies. Among them preexisting heart diseases including congenital heart disease, genetic cardiomyopathies, myocardial infarction and chemotherapy-induced cardiomyopathies display a special challenge for the mother and her physicians. Moreover, the incidence of cardiovascular disease induced by or associated with pregnancy, i.e. hypertensive disorders and peripartum cardiomyopathies, has increased over the past decades. In the present overview we explain why pregnancy is a stress model for the maternal heart and summarize the current knowledge on the influence of pregnancy on preexisting cardiomyopathies. We highlight recent advances in research with regard to hypertensive complications in pregnancy and peripartum cardiomyopathy (PPCM). Moreover, we summarize etiologies, risk factors, pathomechanisms, diagnosis, treatment, management and prognosis. Finally, interdisciplinarity between different clinical fields and basic science is a key requirement to avoid longterm damage to the cardiovascular system induced by pregnancy associated impacts and with this improve women's health in general. PMID:26800071

  6. Acute pancreatitis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Capecomorin S Pitchumoni; Balaji Yegneswaran

    2009-01-01

    Acute pancreatitis (AP) is a rare event in pregnancy,occurring in approximately 3 in 10 000 pregnancies.The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated with greater concerns as it deals with two lives rather than just one as in the nonpregnant population. The recent advances in clinical gastroenterology have improved the early diagnosis and effective management of biliary pancreatitis. Diagnostic studies such as endoscopic ultrasound,magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography and therapeutic modalities that include endoscopic sphincterotomy, biliary stenting, common bile duct stone extraction and laparoscopic cholecystectomy are major milestones in gastroenterology. When properly managed AP in pregnancy does not carry a dismal prognosis as in the past.

  7. Successful expectant management of tubal heterotopic pregnancy

    Directory of Open Access Journals (Sweden)

    Asha Baxi

    2010-01-01

    Full Text Available Expectant management for tubal heterotopic pregnancy could be considered as a successful option in a symptom-free patient where the ectopic embryo has a limited craniocaudal length with no cardiac activity. We report the obstetric outcome after expectant management for a right tubal heterotopic pregnancy. Heterotopic pregnancy was first recognized at 6 weeks gestation in a 32-year-old salpingectomized woman with an 8-year history of subfertility who conceived after in utero transfer of three embryos obtained by in vitro fertilization. Expectant management and close ultrasonographic and clinical monitoring were done. The intrauterine pregnancy proceeded unremarkably. A cesarean section was performed for breech presentation, and it allowed the delivery of a healthy 2260-g male infant. The examination of the adnexa showed a pre-rupture of the right fallopian tube.

  8. Pregnancy Complications

    Science.gov (United States)

    ... 639-2888 Contact Media Pregnancy Complications Recommend on Facebook Tweet Share Compartir On this Page Before Pregnancy ... if necessary. Mental Health Conditions Some women experience depression during or after pregnancy. Symptoms of depression are: ...

  9. The Effect of School-Based Health Clinics on Teenage Pregnancy and Parenting Outcomes: An Integrated Literature Review

    Science.gov (United States)

    Strunk, Julie A.

    2008-01-01

    Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy…

  10. Maternal Serum Resistin Is Reduced in First Trimester Preeclampsia Pregnancies and Is a Marker of Clinical Severity

    DEFF Research Database (Denmark)

    Christiansen, Michael; Hedley, Paula L; Placing, Sophie;

    2015-01-01

    OBJECTIVE: To examine whether resistin levels in first trimester maternal serum are associated with insulin resistance or preeclampsia (PE). METHODS: A case-control study of maternal serum resistin concentration conducted using 285 normal pregnancies and 123 PE pregnancies matched for gestational...

  11. Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti

    Directory of Open Access Journals (Sweden)

    Aduloju Olusola Peter

    2013-01-01

    Full Text Available Background: Malaria is a public health problem globally especially in the Sub-Saharan Africa and among the under five children and pregnant women and is associated with a lot of maternal and foetal complications. Objective: The study was on the effect of intermittent preventive treatment of malaria in pregnancy on the prevalence of malaria in pregnancy and the outcome of pregnancy. Materials and Methods: In a descriptive cross-sectional study, a semi-structured questionnaire was administered to women admitted in Ekiti State University Teaching Hospital labour ward, Ado-Ekiti. About 4,200 women participated in the study and the inclusion criteria were women who were booked in the hospital, attended at least four antenatal clinic visits, and consented to the study while the exclusion criteria were those who didn′t book in the hospital and failed to give their consent. Results: The study revealed that about 75% of the pregnant women studied had access to intermittent preventive treatment of malaria. Among the women attending the antenatal clinic that received sulphadoxine-pyrimethamine (SP, about 78% of them took two doses of SP. The prevalence of clinical malaria was statistically higher in women who did not receive intermittent preventive treatment with SP during pregnancy (44.7% vs. 31.3%, P = 0.0001 and among women who had one dose of the drug instead of two doses (40.0% vs. 28.7%, P = 0.0001. There was no statistical significant difference in the mean age in years (31.53 ± 5.238 vs. 31.07 ± 4.751, P = 0.09 and the gestational age at delivery (38.76 ± 1.784 vs. 38.85 ± 1.459, P = 0.122 between the women who did not receive SP and those who had it. There was a statistical significant difference in the outcome of pregnancy among women who had Intermittent Preventive Treatment in pregnancy (IPTp and those who did not viz.-a-viz. in the duration of labor (8.6 ± 1.491 vs. 8.7 ± 1.634, P = 0.011 and the birth weight of the babies (3.138 ± 0

  12. Ovarian pregnancy: an unusual presentation

    Directory of Open Access Journals (Sweden)

    Ayesha Arif Hussain

    2016-08-01

    Full Text Available Ovarian pregnancy is a rare type of ectopic pregnancy and usually, it ends with rupture before the end of the first trimester. The clinical picture generally mimics that of ruptured tubal ectopic pregnancy and hemorrhagic ovarian cyst. Transvaginal sonography may be helpful. We report a rare primary ruptured ovarian pregnancy in a 23 years lady. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2888-2890

  13. Personal care product use and urinary phthalate metabolite and paraben concentrations during pregnancy among women from a fertility clinic.

    Science.gov (United States)

    Braun, Joe M; Just, Allan C; Williams, Paige L; Smith, Kristen W; Calafat, Antonia M; Hauser, Russ

    2014-01-01

    Parabens and phthalates are potential endocrine disruptors frequently used in personal care/beauty products, and the developing fetus may be sensitive to these chemicals. We measured urinary butyl-paraben (BP), methyl-paraben, propyl-paraben, mono-n-butyl phthalate (MBP), and monoethyl phthalate (MEP) concentrations up to three times in 177 pregnant women from a fertility clinic in Boston, MA. Using linear mixed models, we examined the relationship between self-reported personal care product use in the previous 24 h and urinary paraben and phthalate metabolite concentrations. Lotion, cosmetic, and cologne/perfume use were associated with the greatest increases in the molar sum of phthalate metabolite and paraben concentrations, although the magnitude of individual biomarker increases varied by product used. For example, women who used lotion had BP concentrations 111% higher (95% confidence interval (CI): 41%, 216%) than non-users, whereas their MBP concentrations were only 28% higher (CI: 2%, 62%). Women using cologne/perfume had MEP concentrations 167% (CI: 98%, 261%) higher than non-users, but BP concentrations were similar. We observed a monotonic dose-response relationship between the total number of products used and urinary paraben and phthalate metabolite concentrations. These results suggest that questionnaire data may be useful for assessing exposure to a mixture of chemicals from personal care products during pregnancy. PMID:24149971

  14. The role of social media in recruiting for clinical trials in pregnancy.

    Directory of Open Access Journals (Sweden)

    Mahvash Shere

    Full Text Available Recruitment of women in the periconceptional period to clinical studies using traditional advertising through medical establishments is difficult and slow. Given the widespread use of the internet as a source for medical information and research, we analyze the impact of social media in the second phase of an ongoing randomized, open-label clinical trial among pregnant women. This study aims to assess the effectiveness of social media as a recruitment tool through the comparison of diverse recruitment techniques in two different phases of the trial.Recruitment in Phase 1 of the study consisted solely of traditional healthcare-based sources. This was compared to Phase 2 of the study where traditional recruitment was continued and expanded, while social media was used as a supplementary source. Yearly recruitment and recruitment rates in the two phases were compared using the Mann Whitney U test. The contributions of each recruitment source to overall recruitment were analyzed, and the impact of potential confounders on recruitment rate was evaluated using a multiple regression and Interrupted Time Series Analysis.In the first phase of the study, with over 56 months of recruitment using traditional sources, 35 women were enrolled in the study, resulting in a mean rate of ±0.62 recruits/month. In the 6 months implementing recruitment through social media, 45 women were recruited, for a 12-fold higher rate of ±7.5 recruits/month. Attrition rates remained constant, suggesting that social media had a positive impact on recruitment. The Interrupted Time Series Analysis detected a significant difference in recruitment after the intervention of social media (p<0.0001 with an evident increase in the number of recruits observed after the use of social media.Clinicians and scientists recruiting for clinical studies should learn how to use online social media platforms to improve recruitment rates, thus increasing recruitment efficiency and cost-effectiveness.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    %), 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...... associated with an increased rate of childhood clinical malaria (adjusted hazard ratio [aHR], 1.24 [95% confidence interval (CI), 1.10-1.41] and 1.20 [95% CI, 1.05-1.38], respectively). S. mansoni infection had no consistent association with childhood malaria.Conclusion. This is the first report...

  16. Gestational diabetes during pregnancy intervention in relation with the pregnancy outcome of 158 cases of clinical study%对妊娠期糖尿病患者进行健康指导的效果探析

    Institute of Scientific and Technical Information of China (English)

    吴莹莹

    2015-01-01

    [ abstract ] objective: to study the relationship between gestational diabetes intervention during pregnancy and pregnancy outcome. Methods: randomly selected - in May 2014, in January 2013 in our hospital for treatment of 158 cases of gestational diabetes women, it can be divided into two groups (group, control group), each group had 79 cases of maternal, treatment with an intervention team mothers during pregnancy and the control group did not take any maternal interventions, compared two groups of maternal pregnancy outcome. Results: gestational diabetes mothers, after the nursing intervention group, maternal in premature rupture of membranes, the incidence of fetal distress, neonatal hypoglycemia, etc, to compared with the control group, was better than control group, two groups compared significant difference (P < 0.05), there is statistical significance. Conclusion: the gestational diabetes during pregnancy intervention can effectively reduce the incidence of adverse pregnancy outcomes, is worth popularizing in clinical use.%目的:探讨对妊娠期糖尿病患者进行健康指导的临床效果。方法:对2013年1月~2014年5月期间我院收治的158例妊娠期糖尿病患者的临床资料进行回顾性研究。将这158例患者随机分为对照组和观察组,每组各有79例患者。对观察组患者进行健康指导,对对照组产妇未进行健康指导。然后,比较两组患者的妊娠结局。结果:观察组患者不良妊娠结局的发生率明显低于对照组患者,二者相比差异具有显著性(P<0.05)。结论:对妊娠期糖尿病患者进行健康指导的效果显著,可有效地降低其不良妊娠结局的发生率。此方法值得在临床上推广使用。

  17. Clinical analysis of 15 cases with pulmonary embolism during pregnancy%妊娠合并肺栓塞15例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘益芬; 何玉甜; 陈敦金; 王燕; 胡雪娴; 谢健

    2014-01-01

    目的:分析妊娠合并肺栓塞临床特点及妊娠结局。方法收集广州医科大学附属第三医院妇产科2010年3月至2014年1月收治的15例妊娠合并肺栓塞患者的临床资料,对其一般情况、临床症状、辅助检查、治疗措施及妊娠结局进行回顾性分析。结果(1)发病时间:妊娠早期1例,妊娠中期6例,妊娠晚期2例,剖宫产术后产褥期6例。(2)终止妊娠方式:剖宫产8例,剖宫取胎术5例,利凡诺引产1例,自然流产1例。(3)结局:孕妇死亡4例,存活11例;健康足月儿6例,早产儿3例,死胎6例。结论提高对妊娠合并肺栓塞疾病的认识,尽早确诊和治疗,改善其妊娠结局。%Objective To analyze the clinical characteristics and pregnancy outcomes of pregnancy complicating pulmonary embolism.Methods This study collected the clinical data of 15 pregnancies complicating pulmonary embolism, which were admitted into The Third Affiliated Hospital of Guangzhou Medical University from March 2010 to January 2014.The clinical data, including general condition, clinical symptoms, examinations, treatment and pregnancy outcomes were retrospectively analyzed.Results (1) Onset of disease:1 case occurred in the first trimester of pregnancy, 6 cases in the second trimester of pregnancy, and 2 cases in the third trimester of pregnancy, and the other 6 cases in the puerperal period after caesarean section.( 2 ) Methods of pregnancy termination: 8 cases chose cesarean section to insure newborn′s safe, 5 cases chose caesarean section due to the severity of mother′s condition, 1 case chose abortion by injecting rivanol, and the other one occurred spontaneous abortion. (3) Outcomes: 4 mothers died, 11 mothers were survival; 6 newborns were healthy term infants, 3 newborns were premature, and there were 6 stillbirths.Conclusion With increasing recognition of pregnancy complicating pulmonary embolism, we should early diagnose and treat

  18. Sexual activity during menstrual period and pregnancy%月经期、妊娠期性生活

    Institute of Scientific and Technical Information of China (English)

    刘凤文

    1997-01-01

    In order to investigate the sexual desire,coital frequency and sexual psychology during menstrual period and pregnancy,200 women of child-bearing age and 142 mothers were interviewed.The data for the women of child-bearing age revealed that 6.2% had no change in sexual desire during menstrual period,13% had increase in libido premenstruation,7% had marked increment in libido midmenstruation and 18% had hypereroticism postmenstruation;no one experienced hypoeroticism.97.5% abstained from sexual intercourse during menstrual period,while 2.5% had casual or occasional intercourse.The data for mothers revealed that coital frequencies before pregnancy were 6-7 times/week in 3.5% of subjects,4-5times/week in 7.7%,2-3 times/week in 53.5%,once/week in 26.8%.once/two weeks in 7.7%,and once/1-3months in 0.8%,while 88.7% had a tendency of decrease in coital frquency during each of the three trimesters of gregnancy,and 11.3% had no sexual intercourse at all during all the course of pregnancy.The decline in sexual activity was due to the following reasons:a)the woman's fears of abortion,premature labor,"inflammation" and physical disomfort associated with intercourse in 97.9% of cases;b)reduced libido during pregnancy in 1.4%;and c) the husband's sexual dysfunction in 0.7%.The mother's incidence reta postpartum and the child's perinatal fatality rate and incidence rate were zero percent in toth the women who had sexuality during pregnancy and those who had not,there being no difference between the two groups.

  19. Thyroid diseases and pregnancy

    Directory of Open Access Journals (Sweden)

    Marco Grandi

    2013-05-01

    Full Text Available BACKGROUND Thyroid diseases and diabetes mellitus are the most common endocrine diseases during pregnancy. Internal Medicine doctors could be involved in the management of pregnant women affected by thyroid diseases, in particular if an Endocrine Unit lacks in the hospital; it is mandatory that they have the skills to cope with these diseases. METHODS In this work authors describe the most common thyroid abnormalities that can occur during pregnancy: hypothyroidism (clinical and subclinical, hyperthyroidism (clinical and sub-clinical, autoimmune thyroiditis (in particular the so called post-partum thyroiditis, nodular diseases and cancer. They discuss moreover the peculiar pathophysiologic mechanisms by which these diseases appear, the diagnostic tools and the therapies, according to their own experience and the more recent international guidelines. RESULTS AND CONCLUSIONS It is important to evaluate thyroid function tests before and during pregnancy, at 16th and 28th gestational week; it is mandatory to cure also the “sub-clinical” hypothyroidism during pregnancy, when TSH level are higher than 5 μIU/mL; the optimal dose of levo-thyroxine during pregnancy is, average, 30-50% higher than that used before pregnancy; it is not correct to treat mild or sub-clinical hyperthyroidism; propylthyouracil is the best drug to treat hyperthyroidism during pregnancy; the post-partum thyroiditis is generally transient, so that a careful monitoring of thyroid function is advisable, in particular after 9-12 months of therapy; thyroid cancer, if discovered during pregnancy, generally has no negative effects on the outcome of the pregnancy; it would be better to treat surgically thyroid cancer during the last trimester of the pregnancy.

  20. 17-Hydroxyprogesterone caproate to prolong pregnancy after preterm rupture of the membranes: early termination of a double-blind, randomized clinical trial

    OpenAIRE

    Combs, C Andrew; Thomas J. GARITE; Maurel, Kimberly; Mallory, Kimberly; Edwards, Rodney K.; Lu, George; Porreco, Richard; Das, Anita; ,

    2011-01-01

    Abstract Background Progestational agents may reduce the risk of preterm birth in women with various risk factors. We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P) given to women with preterm rupture of the membranes (PROM) will prolong pregnancy and thereby reduce neonatal morbidity. Methods Double-blind, placebo-controlled randomized clinical trial. Women with PROM at 23.0 to 31.9 weeks of gestation were randomly assigned to receive a...

  1. 17-Hydroxyprogesterone caproate to prolong pregnancy after preterm rupture of the membranes: early termination of a double-blind, randomized clinical trial

    OpenAIRE

    Combs C Andrew; Garite Thomas J; Maurel Kimberly; Mallory Kimberly; Edwards Rodney K; Lu George; Porreco Richard; Das Anita

    2011-01-01

    Abstract Background Progestational agents may reduce the risk of preterm birth in women with various risk factors. We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P) given to women with preterm rupture of the membranes (PROM) will prolong pregnancy and thereby reduce neonatal morbidity. Methods Double-blind, placebo-controlled randomized clinical trial. Women with PROM at 23.0 to 31.9 weeks of gestation were randomly assigned to receive a weekly intra...

  2. [Teenage pregnancy].

    Science.gov (United States)

    Mora-Cancino, María; Hernández-Valencia, Varcelino

    2015-05-01

    In Mexico, 20% of the annual births are presented in women younger than 20 years old. Pregnancy in adolescents puts at risk mother and child health. This risk is major while the woman is younger, especially when the social and economic conditions are not favorable, which is decisive in later psychosocial development. It has been pointed out that the youths with low education, with minor academic and laboral expectations, with low self-esteem and assertiveness, tend to begin early their active sexual life, to use less frequently contraceptives, and in the case of younger women, to be pregnant, with the risk of abortion because they cannot to make the best decision. It is important to take into account the social context and the special characteristics of the family to understand situation of adolescent at risk of pregnancy. PMID:26233975

  3. Pregnancy and pituitary adenomas.

    Science.gov (United States)

    Glezer, Andrea; Jallad, Raquel S; Machado, Marcio C; Fragoso, Maria C; Bronstein, Marcello D

    2016-09-01

    Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper- and hyposecretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas. We review literature about specific follow-up and management in pregnant women harboring prolactinomas, acromegaly, or Cushings disease and the impact of clinical and surgical treatment on each condition. PMID:26977888

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

    OpenAIRE

    Sudha; Juhi; Mahendra

    2013-01-01

    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 Ind...

  5. [Pregnancy, children, clinical trials and HIV infection. Ethical limitations and therapeutical implications].

    Science.gov (United States)

    Gouveia-Andrade, Luís

    2003-01-01

    In what concerns women and children infected with HIV, clinical investigation related ethical issues are both unavoidable and controversial. Different arguments are presented by different partners, and policies and laws are made in order to protect women and children, who, in spite of all that, keep suffering the effects of all this controversy, protection and legislation. Evidence based Medicine is responsible for new and demanding challenges and the same ethics that requires that new drugs are used only after unquestionable safety and efficacy are presented, tends to protect children, pregnant women and other vulnerable groups from being exposed to investigational drugs. This is why there are so few therapeutical options for HIV-infected children and pregnant women. So, ironically, in times of evidence based medicine, these two special populations are treated in an empirical way, because the same Medicine that wants to protect them, offers wide-open doors to the most terrible infections that mankind has ever faced. In this article, ethical dilemmas, philosophical principles, epidemiological context and different perspectives concerning this painful, yet extremely important, subject will be presented. The purposes will be to broaden horizons, to stimulate discussion and to provide some light into a subject still so restrict, still so unspoken, still so left in the shadows of something that we like to describe as modern medicine.

  6. Clinical analysis of pregnancy outcomes in advanced age pregnant woman and pregnancy complications%高龄孕妇妊娠结局与妊娠并发症的临床分析

    Institute of Scientific and Technical Information of China (English)

    凌莉

    2015-01-01

    目的:探讨高龄孕妇妊娠结局与妊娠并发症的临床特点。方法选取2013年5月~2014年9月我院产科收治适龄产妇145例,根据孕妇年龄是否>35岁分为高龄组(63例)和适龄组(82例),对两组产妇进行随访,比较妊娠结局及妊娠并发症发生率。结果高龄组初产妇产后出血、胎儿窘迫及胎膜早破不良妊娠结局发生率高于适龄组(36.00% vs 4.92%,44.00% vs 14.75%,36.00% vs 13.11%,P0.05)。高龄组初产妇前置胎盘、妊娠高血压、早产并发症发生率均高于适龄组(24.00%v s 1.64%,32.00%vs 3.28%,40.00%vs 4.92%,P<0.05);高龄组经产妇妊娠高血压并发症发生率高于适龄组(42.11%vs 4.76%,P<0.05)。结论高龄初产妇妊娠并发症和不良妊娠结局发生率较高,临床中应针对性进行预防,保障母婴安全。%Objective To explore the clinical features of pregnancy outcomes in advanced age pregnant woman and pregnancy complications. Methods From May 2013 to September 2014,145 pregnant women in advanced age admitted into our hospital were selected.According to whether the age was over 35 years old or not,they were divided into ad-vanced age group (n=63) and appropriate age group (n=82).The puerperae between two groups were followed up,and their pregnancy outcomes and incidence of pregnancy complications were compared. Results In the advanced age group,the incidences of postpartum hemorrhage,fetal distress,and premature rupture of fetal membranes in primiparae were higher compared with that in appropriate group at proportions of 36.00%v s 4.92%,44.00%v s 14.75%,and 36.00%v s 13.11% respectively (P<0.05).There was no statistical difference in incidences of adverse pregnancy outcomes in pluriparae.In the advanced age group,the incidence of complications like placenta previa,gestational hypertension,and premature delivery was higher in comparison with that in appropriate age group at proportions of 24.00% vs 1.64%, 32.00% v s 3

  7. 妊娠合并心脏病812例临床分析%Pregnancy Complicated with Heart Disease: Clinical Analysis of 812 Cases

    Institute of Scientific and Technical Information of China (English)

    张凌燕; 马艳娟; 林恩宇; 刘陶; 蔺洁

    2013-01-01

    significantly improve the prognosis of mothers and infants,clinical emphasis should be paid on patients with heart disease in maternal pre-pregnancy counselling,prenatal examination and pregnancy care,emphasis on pregnancy,childbirth,postpartum multidisciplinary,specification management,cesarean section is relatively safe delivery.

  8. Mitochondrial Toxicity in Human Pregnancy: An Update on Clinical and Experimental Approaches in the Last 10 Years

    Directory of Open Access Journals (Sweden)

    Constanza Morén

    2014-09-01

    Full Text Available Mitochondrial toxicity can be one of the most dreadful consequences of exposure to a wide range of external agents including pathogens, therapeutic agents, abuse drugs, toxic gases and other harmful chemical substances. However, little is known about the effects of mitochondrial toxicity on pregnant women exposed to these agents that may exert transplacental activity and condition fetal remodeling. It has been hypothesized that mitochondrial toxicity may be involved in some adverse obstetric outcomes. In the present study, we investigated the association between exposure to mitochondrial toxic agents and pathologic conditions ranging from fertility defects, detrimental fetal development and impaired newborn health due to intra-uterine exposure. We have reviewed data from studies in human subjects to propose mechanisms of mitochondrial toxicity that could be associated with the symptoms present in both exposed pregnant and fetal patients. Since some therapeutic interventions or accidental exposure cannot be avoided, further research is needed to gain insight into the molecular pathways leading to mitochondrial toxicity during pregnancy. The ultimate objective of these studies should be to reduce the mitochondrial toxicity of these agents and establish biomarkers for gestational monitoring of harmful effects.

  9. 孕早期规范性系统化营养体重管理对妊娠结局临床意义%The clinical significance of trimester normative systematic nutrition weight management on pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    吴秋英

    2015-01-01

    Objective Analysis the clinical and social value of nutrition and weight management in early pregnancy.Methods 486 cases of first and single tire pregnant woman whose gestational age <13 weeks were collected, randomly divided into intervention and control groups, intervention group take individualized integrated management through three dietary, lifestyle, regular activities; the control group did not implement nutrition weight management; observed and recorded the dynamic changes of BMI during pregnancy, the incidence of complications and pregnancy outcomes. Results Weight control were better than control group in intervention group (P<0.05), and cesarean section rate and complication rates were lower than the control group (P<0.05). Conclusion Normative systematic nutrition weight management can reduce pregnancy complications and cesarean section rate,improve the occurrence of adverse outcomes of pregnancy, worthy of clinical application.%目的 探讨孕早期进行营养体重管理的临床价值及社会效益.方法 收集自2012年1月~2014年6月孕周<13周开始到我院产检的初产单胎妇女486例,随机平均分为干预组和对照组,干预组通过膳食营养、生活方式、适量活动等三个方面进行个体化的综合管理;对照组不实施营养体重管理;观察记录两组孕妇孕期BMI动态变化、并发症发生情况和妊娠结局.结果 干预组体重控制较对照组好(P<0.05),剖宫产率和并发症发生率都较对照组低(P<0.05).结论 孕早期规范性系统化营养体重管理可以减少妊娠并发症降低剖宫产率,改善妊娠不良结局的发生,值得在临床推广应用.

  10. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation.

    Science.gov (United States)

    Götestam Skorpen, Carina; Hoeltzenbein, Maria; Tincani, Angela; Fischer-Betz, Rebecca; Elefant, Elisabeth; Chambers, Christina; da Silva, Josè; Nelson-Piercy, Catherine; Cetin, Irene; Costedoat-Chalumeau, Nathalie; Dolhain, Radboud; Förger, Frauke; Khamashta, Munther; Ruiz-Irastorza, Guillermo; Zink, Angela; Vencovsky, Jiri; Cutolo, Maurizio; Caeyers, Nele; Zumbühl, Claudia; Østensen, Monika

    2016-05-01

    A European League Against Rheumatism (EULAR) task force was established to define points to consider on use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Based on a systematic literature review and pregnancy exposure data from several registries, statements on the compatibility of antirheumatic drugs during pregnancy and lactation were developed. The level of agreement among experts in regard to statements and propositions of use in clinical practice was established by Delphi voting. The task force defined 4 overarching principles and 11 points to consider for use of antirheumatic drugs during pregnancy and lactation. Compatibility with pregnancy and lactation was found for antimalarials, sulfasalazine, azathioprine, ciclosporin, tacrolimus, colchicine, intravenous immunoglobulin and glucocorticoids. Methotrexate, mycophenolate mofetil and cyclophosphamide require discontinuation before conception due to proven teratogenicity. Insufficient documentation in regard to fetal safety implies the discontinuation of leflunomide, tofacitinib as well as abatacept, rituximab, belimumab, tocilizumab, ustekinumab and anakinra before a planned pregnancy. Among biologics tumour necrosis factor inhibitors are best studied and appear reasonably safe with first and second trimester use. Restrictions in use apply for the few proven teratogenic drugs and the large proportion of medications for which insufficient safety data for the fetus/child are available. Effective drug treatment of active inflammatory rheumatic disease is possible with reasonable safety for the fetus/child during pregnancy and lactation. The dissemination of the data to health professionals and patients as well as their implementation into clinical practice may help to improve the management of pregnant and lactating patients with rheumatic disease.

  11. 妊娠合并系统性红斑狼疮的临床分析%Clinic Analysis of Pregnancy Complicated with Systemic Lupus Erythematosus

    Institute of Scientific and Technical Information of China (English)

    张建瑜; 黄凯清; 李婷

    2012-01-01

    Objective To investigate the risk factors of systemic lupus erythematosus(SLE) during pregnancy,and its relationship with pregnancy outcomes and obstetric complications. Methods Clinical data of 51 pregnant women with SLE from 2006 to 2011 was analyzed retrospectively. Results ①SLE fare was found in patients with unstable SLE status progestational, pregnancy before SLE initially onset,SLE patients using prednisone irregularly. Active SLE was found in 11 cases(Group A) and active in 40 cases (Group B). ②SLE damage in the Croup A included 1 case of proteinuria and 2 cases of anemia. In group B, SLE flare was mainly found in the second trimester,which resulted in lupus nephritis and blood system injuries. One case of maternal death and 7 cases of preeclampsia was reported. ③The rate of fetal loss, premature labor and low neonates weight was 9.1% ,20% and 27.3% in group A were better than those corresponding rate in group B(42.5% ,60.9% and 65.2%) significantIy(P<0.05). The neonates weight in group A (2661 ± 699 g) was better significantly than that in group B ( 2268 ±849 g), P < 0. 05. Conclusion Adverse maternal and fetal outcomes should increase after SLE onset. Unstable progestational SLE status and irregular use of prednisone are the important risk factors of SLE flare.%目的 探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情活动情况,及其与妊娠结局、产科并发症的关系.方法 对2006~2011年收治的51例次妊娠合并SLE的49名患者临床资料进行回顾性分析.结果 ①根据SLE活动与否分为A组和B组:临床无SLE活动,妊娠前1年不用糖皮质激素或泼尼松剂量≤10 mg/d为A组;妊娠前1年内有SLE活动,或妊娠过程SLE首次发病及SLE病情加重为B组.A组患者仅发生微量蛋白尿l例和中度贫血2例;B组以妊娠中期SLE首发及病情加重为主,主要损害肾脏和血液系统;并发生产妇死亡一例及重度先兆子痫7例.②A组胎儿丢失率(9.1

  12. 66例系统性红斑狼疮患者67次妊娠特点及妊娠结局分析%Clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus:a study of 66 cases with 67 pregnancies

    Institute of Scientific and Technical Information of China (English)

    王立葵; 桑洪爱; 马玉燕; 徐银涛; 王琳琳

    2014-01-01

    目的:探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情活动的临床特点及对妊娠结局的影响。方法收集并回顾性分析2005年8月至2014年8月就诊于山东大学齐鲁医院的66例妊娠合并SLE患者67次妊娠(计为67例,非活动组31例,活动组36例)的临床资料。结果妊娠合并SLE患者活动组的早产率、小于胎龄儿发生率、治疗性流产率、总妊娠丢失率及重度子痫前期发生率较非活动组明显增高(P<0.05)。且SLE病情活动多发生于妊娠中晚期,以蛋白尿、皮疹的发生率最高,多表现为多器官、多系统受损,肾脏尤甚。而妊娠早期,SLE活动的临床表现以血液系统损害多见,或(和)出现皮疹等。结论 SLE孕期活动主要累及患者的血液系统及肾脏,可导致不良母儿结局风险增加,但大多数SLE患者能获得良好的妊娠结局。建议SLE患者行计划妊娠,孕前疾病稳定至少6个月以上,孕期密切监测,及早发现疾病活动并及时治疗。%Objective To investigate the clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus (SLE).Methods Clinical datas of 66 pregnant women with 67 pregnancies (36 cases in flare group and 31 cases in non-flare group)with SLE treated in our hospital during Aug.2005 and Aug.2014 were collected and retrospectively analyzed.Results The incidence rates of preterm birth,small for gestational age infant,therapeutic a-bortion,pregnancy loss and severe preeclampsia increased significantly in the flare group compared with the non-flare group (all P<0.05).SLE was mostly active in the middle and late pregnancy,with the highest rate of proteinuria and skin rash,which were involved with multi-organ and multi-system damage,especially kidney damage.SLE flare in ear-ly pregnancy harmed the blood system,with or without skin rash.Conclusion SLE flare can lead to damage of the blood system,kidney and

  13. Clinical analysis of 31 cases of special-site ectopic pregnancies%少见部位异位妊娠31例临床分析

    Institute of Scientific and Technical Information of China (English)

    李素华

    2011-01-01

    目的:探讨少见部位异位妊娠的临床特征及误诊原因.方法:对2001年2月~2011年2月我院收治的31例少见部位异位妊娠进行回顾性分析.结果:少见部位异位妊娠占同期异位妊娠的6.39%,误诊率为74.2%.除宫颈妊娠及宫角妊娠保守治疗成功者外,均需手术探查.结论:少见部位异位妊娠早期诊断较困难,对疑诊病例应及早清除病灶或手术探查,治疗效果好.%Objective: To explore the clinical characteristics and misdiagnosis of specia-site ectopic pregnancy. Methods:The retrospective analysis was performed on 31 cases of special-site ectopic pregnancies in our hospital from February 2001 to February 2011. Results: The incidence in that of synchronization ectopic pregnancy was 6.39%. and the misdiagnosis rate was 74.2%. Excluding the cervix pregnancy and a-nook-uteri pregnancy received the conservative treatment success, all the other patients received the emergency exploratory laparotomy. Conclusion: It'S difficult for preoperative diagnosis of special-site ectopic. If there is a suspicion of the disease, Clearing the lesions or surgical exploration should be preformed earlier to get better therapeutic effects.

  14. Single-embryo transfer reduces clinical pregnancy rates and live births in fresh IVF and Intracytoplasmic Sperm Injection (ICSI cycles: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Oliveira João

    2009-04-01

    Full Text Available Abstract Background It has become an accepted procedure to transfer more than one embryo to the patient to achieve acceptable ongoing pregnancy rates. However, transfers of more than a single embryo increase the probability of establishing a multiple gestation. Single-embryo transfer can minimize twin pregnancies but may also lower live birth rates. This meta-analysis aimed to compare current data on single-embryo versus double-embryo transfer in fresh IVF/ICSI cycles with respect to implantation, ongoing pregnancy and live birth rates. Methods Search strategies included on-line surveys of databases from 1995 to 2008. Data management and analysis were conducted using the Stats Direct statistical software. The fixed-effect model was used for odds ratio (OR. Fixed-effect effectiveness was evaluated by the Mantel Haenszel method. Seven trials fulfilled the inclusion criteria. Results When pooling results under the fixed-effect model, the implantation rate was not significantly different between double-embryo transfer (34.5% and single-embryo transfer group (34.7% (P = 0.96; OR = 0.99, 95% CI 0.78, 1.25. On the other hand, double-embryo transfer produced a statistically significantly higher ongoing clinical pregnancy rate (44.5% than single-embryo transfer (28.3% (P Conclusion Meta-analysis with 95% confidence showed that, despite similar implantation rates, fresh double-embryo transfer had a 1.64 to 2.60 times greater ongoing pregnancy rate and 1.44 to 2.42 times greater live birth rate than single-embryo transfer in a population suitable for ART treatment.

  15. Clinical analysis of the effect of pregnancy induced hypertension on pregnancy outcome%妊娠期高血压对妊娠结局影响的临床分析

    Institute of Scientific and Technical Information of China (English)

    宋俊霞

    2016-01-01

    Objective:To investigate the effect and countermeasures of pregnancy induced hypertension on pregnancy outcome. Methods:152 pregnant women with hypertension were selected.152 pregnant women with normal blood pressure were taken as the control group at the same time.Results:In the PIH group,the maternal blood coagulation dysfunction,prolonged pregnancy, postpartum hemorrhage,HELLP syndrome,fetal distress,neonatal asphyxia,low birth weight,fetal malformations were significantly higher than the control group(P<0.05).Conclusion:Pregnancy induced hypertension has a great influence on maternal and fetal outcomes,and we need to actively respond to it.%目的:探讨妊娠期高血压对妊娠结局的影响及应对措施。方法:收治妊娠期高血压产妇152例,并随机抽取同时期血压正常产妇152例作为对照组。结果:妊高征组产妇的凝血功能障碍、过期妊娠、产后出血、HELLP综合征、胎儿窘迫、新生儿窒息、低体重儿、胎儿畸形的发生率均明显高于对照组(P<0.05)。结论:妊高征对产妇结局及胎儿结局均有较大影响,需要积极应对。

  16. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction.

    NARCIS (Netherlands)

    Pool-Goudzwaard, A.; Slieker ten Hove, M.C.; Vierhout, M.E.; Mulder, P.H.M. de; Pool, J.; Snijders, C.J.; Stoeckart, R.

    2005-01-01

    To assess the occurrence of pelvic floor dysfunction (PFD) in pregnancy- related low back and pelvic pain (PLBP) patients, a cross-sectional study was performed, comprising 77 subjects. Each subject underwent physical assessment, and filled in the Urogenital Distress Inventory completed with gynaeco

  17. Clinical significance of determination of changes of serum TGF-β1, IL-8 and VEGF levels in patients with pregnancy induced hypertension complicated with nephropathy

    International Nuclear Information System (INIS)

    Objective: To explore the significance of changes of serum TGF-β1, IL-8 and VEGF levels in patients with hypertensive disorder complicating pregnancy. Methods: Serum IL-8 (with RIA), serum TGF-β1, VEGF(with ELISA) levels were measured in 33 patients with pregnancy induced hypertension complicated with nephropathy, as well as in 35 healthy controls. Results: The serum TGF-β1, IL-8 and VEGF levels in patients were significantly higher than those in controls (P1 levels were positively correlated to IL-8 (r=0.6132, 0.5834, P<0.01). Conclusion: VEGF levels were closely related with the diseases process of PIH. Determination of their changes might be useful for clinical diagnosis and predicting therapeutic effects in patients with PIH. (authors)

  18. 剖宫产瘢痕妊娠的临床研究进展%Clinical research of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    梁婵玉(综述); 谭毅(审校)

    2016-01-01

    剖宫产瘢痕妊娠( cesarean scar pregnancy,CSP)是一种比较少见的异位妊娠,随着剖宫产率的增加,其发生率呈现了增长的趋势,并引起了产科医师的关注。该文对其临床研究的进展情况作一简要的介绍。%Cesarean scar pregnancy ( CSP) is a relatively rare ectopic pregnancy.With the increase of cesar-ean section rate, the incidence of CSP shows a growing trend, which causes the attention of the obstetricians.In this paper, the progress of its clinical research is reviewed.

  19. Clinical Analysis of Pregnancy Complicated with Systemic Lupus Erythematosus%妊娠合并系统性红斑狼疮妊娠结局的临床分析

    Institute of Scientific and Technical Information of China (English)

    唐国珍; 冉凤萍; 叶俊儒

    2016-01-01

    Objective To investigate the clinical characteristics and pregnancy outcomes in pregnant women with systemic lupus erythematosus (SLE) .Methods The clinical data of 18 pregnant women with SLE treated in The First Affiliated Hospital of Chengdu Medical College between September of 2004 and August of 2015 were collected and analyzed retrospectively .The 18 cases were divided into the flare group with 11 cases and the non‐flare group with 7 cases according to the disease activity of SLE .Results The incidence of pregnancy loss ,premature birth and pregnancy complications was significantly higher in the flare group than in the non‐flare group (P<0.05) . The most common symptoms of SLE in the pregnancy in the flare group were skin rash ,lupus nephritis ,and antiphospholipid syndrome .Conclusion The pregnancy complicated with SLE can result in more risks of poor maternal and neonatal outcomes .Therefore ,it is suggested that the patients with SLE should make a detailed plan of pregnancy and make the SLE conditions stable for at least half a year before conception under the guidance of obstetricians .Meanwhile ,the clinical indexes should be monitored closely during pregnancy .%目的:探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情及其对妊娠结局的影响。方法收集并回顾性分析2004年9月至2015年8月就诊于成都医学院第一附属医院的18例妊娠合并SLE患者的临床资料,根据SLE活动性的不同,将患者分为活动组(n=11)和非活动组(n=7)。结果活动组的妊娠丢失率、早产率、妊娠期合并症及并发症发生率较非活动组明显增高,差异有统计学意义(P<0.05)。妊娠期SLE病情活动以皮肤黏膜损害、狼疮性肾炎和抗磷脂综合症为主。结论妊娠合并SLE可增加不良母儿结局风险,建议SLE患者在医师指导下制定妊娠计划,孕前SLE稳定至少半年以上;同时,加强孕期随访,及早发现疾病活动并及时治疗。

  20. Perspectives on tuberculosis in pregnancy

    Directory of Open Access Journals (Sweden)

    Matthew Bates

    2015-03-01

    Full Text Available Tuberculosis (TB has been recognized as an important cause of morbidity and mortality in pregnancy for nearly a century, but research and efforts to roll out comprehensive TB screening and treatment in high-risk populations such as those with a high prevalence of HIV or other diseases of poverty, have lagged behind similar efforts to address HIV infection in pregnancy and the prevention of mother-to-child-transmission. Immunological changes during pregnancy make the activation of latent TB infection or de novo infection more likely than among non-pregnant women. TB treatment in pregnancy poses several problems that have been under-researched, such as contraindications to anti-TB and anti-HIV drugs and potential risks to the neonate, which are particularly important with respect to second-line TB treatment. Whilst congenital TB is thought to be rare, data from high HIV burden settings suggest this is not the case. There is a need for more studies screening for TB in neonates and observing outcomes, and testing preventative or curative actions. National tuberculosis control programmes (NTPs should work with antenatal and national HIV programmes in high-burden populations to provide screening at antenatal clinics, or to establish functioning systems whereby pregnant women at high risk can drop in to routine NTP screening stations.

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

    Institute of Scientific and Technical Information of China (English)

    SHANG, Zhi-Cai(商志才); HU, Gui-Xiang(胡桂香); WU, Tian-Xing(吴天星); FANG, Yui-Ying(方瑞英); YU, Qing-Sen(俞庆森)

    2004-01-01

    In order to clarify the structural requirement of pregnancy-terminating drugs, the quantitative structure-activity relationship (QSAR) of 2-aryl imidazo[2,1-a]isoquinolines was studied on the basis of quantum mechanical calculation and multiple regression analysis. A Good correlation equation was obtained (r2=0.925, q2=0.871). Some new compounds were designed according to the equation. Two of them, compounds 21 and 22, were synthesized and evaluated in NIH mice. The results showed that the difference of activity between 21 (median effective dose ED50=0.943 mg/kg/day) and 22 (ED50=1.099 mg/kg/day) was small and both of them were potent. It is also agreed with the computational results. Compared with L14105 which is the most potent pregnancy-terminating agent, these two compounds possess high activity. The evaluation of the anti-implanting activity showed that they were 100% effective at tested dosage 50.0, 25.0, 12.5 mg/kg/day×3 days in oral administration, which proved the both of them had anti-implanting activity and low first-pass effects.

  2. 妊娠合并卵巢肿瘤的临床研究%Clinical study of ovarian tumor during pregnancy

    Institute of Scientific and Technical Information of China (English)

    高清霞

    2015-01-01

    目的:探讨妊娠合并卵巢肿瘤的治疗方法和疗效。方法回顾本院收治的120例妊娠合并卵巢肿瘤患者的临床资料,统计其诊断方法、治疗方式、病理类型、妊娠结局。结果120例妊娠合并卵巢肿瘤患者中,妊娠合并卵巢良性肿瘤者64例,占比53.33%,其中成熟性畸胎瘤20例,占比31.25%;瘤样病变53例,占比44.4%;恶性肿瘤3例,占比2.5%。108例患者采用肿瘤切除术或附件切除术进行治疗,3例妊娠合并卵巢恶性肿瘤患者有2例进行术后化疗。有94例患者通过产前检查、B超检查确诊,占比78.33%;12例患者因出现并发症进行急诊手术时确诊,其中卵巢囊肿破裂4例,卵巢囊肿蒂扭转8例。足月分娩98例,早产13例,流产9例。结论产前检查、B超检查在确诊妊娠合并卵巢肿瘤方面发挥重要作用,临床上,妊娠合并卵巢肿瘤多以良性良性肿瘤为主,治疗该疾病的主要手段为肿瘤切除术或附件切除术;经过有效治疗,足月妊娠率较高。%Objective To explore the treatment method and treatment of pregnancy with ovarian tumor effect. Methods Retrospective in our hospital treated 120 cases of pregnancy with ovarian tumor patients'clinical data,statistical its diagnosis methods,treatment,pathological type,the pregnancy outcome. Results 120 cases of pregnancy with ovarian tumor patients,64 cases of pregnancy with ovarian benign tumor,accounted for 53.33%,including 20 cases maturity teratoma and accounted for 31.25%;Pathological changes of 53 cases of tumor samples,accounted for 44.4%;3 cases of malignancy,accounted for 2.5%.108 patients treated with tumor resection or adnexectomy,3 cases of pregnancy with ovarian malignant tumor patients with postoperative chemotherapy in 2 cases.94 patients by antenatal examination,ultrasound diagnosis,accounted for 78.33%; 12 patients with complications after undergoing emergency surgery diagnosed,including 4

  3. Clinical Analysis of Related Factors With Postterm Pregnancy%过期妊娠相关因素临床分析

    Institute of Scientific and Technical Information of China (English)

    刘霜梅

    2015-01-01

    目的:研究探讨过期妊娠的相关因素及对孕妇和围生儿的影响,为临床过期妊娠人群筛查提供有效依据。方法随机抽取我院2012年7月~2014年7月收治的过期妊娠分娩孕妇60例(观察组)和同期我院正常足月分娩的孕妇60例(对照组)为研究对象。研究分析临床过期妊娠的相关因素。结果分析结果发现,造成孕妇过期妊娠的因素主要有经产妇、孕前体重指数高(超重和肥胖)、孕期体重增加过多、胎盘成熟度III级和男性胎儿,两组数据具有统计学意义(P<0.05);在分析中还发现剖宫产、巨大儿、胎儿窘迫和新生儿窒息的发生概率,观察组产妇发生概率高于对照组产妇,两组数据具有统计学意义(P<0.05)。结论在孕产妇分娩的过程中,妊娠前体重指数高、妊娠期体重增加过多、男性胎儿和胎盘成熟度III级以及经产妇是过期妊娠的相关因素。其中剖宫产和软产道损伤以及产后出血对产妇造成的影响最为明显。针对过期妊娠的相关因素,及时采取有效的措施,能够有效避免过期妊娠的发生。%Objective To study the related factors of postterm pregnancy and efect in pregnant women and perinatal infant,provide efective basis for the clinical screening of postterm pregnancy.Methods Randomly selected 60 cases of postterm pregnancy women (observation group) and 60 cases of normal term delivery in our hospital during the same period of the pregnant women (control group) as the research object.Results Theanalysis results show that the factors, resulting in prolonged pregnancy pregnant women are mainly by maternal pre pregnancy body mass index,high(overweight and obesity),excessive weight gain during pregnancy,placental maturity and III level of male fetuses,two groups of data with statistical significance(P<0.05); in the analysis also found that cesarean section,great infant,fetal distress and neonatal

  4. 过期妊娠相关因素临床分析%Clinical Analysis of Related Factors With Postterm Pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘霜梅

    2015-01-01

    Objective To study the related factors of postterm pregnancy and efect in pregnant women and perinatal infant,provide efective basis for the clinical screening of postterm pregnancy.Methods Randomly selected 60 cases of postterm pregnancy women (observation group) and 60 cases of normal term delivery in our hospital during the same period of the pregnant women (control group) as the research object.Results Theanalysis results show that the factors, resulting in prolonged pregnancy pregnant women are mainly by maternal pre pregnancy body mass index,high(overweight and obesity),excessive weight gain during pregnancy,placental maturity and III level of male fetuses,two groups of data with statistical significance(P<0.05); in the analysis also found that cesarean section,great infant,fetal distress and neonatal asphyxia and the occurrence probability of occurrence probability,the observe group were significantlyhigher than those in the control group mothers,with statistical significance of the data of the two groups(P<0.05).Conclusion In the process of childbirth,pregnancy before the high BMI,gestational weight gain too much,a male fetus and placenta maturity level III and multiparas were related factors of postterm pregnancy. According to the related factors of postterm pregnancy,to take timely and efective measures,can efectively avoid the occurrence of prolonged pregnancy.%目的:研究探讨过期妊娠的相关因素及对孕妇和围生儿的影响,为临床过期妊娠人群筛查提供有效依据。方法随机抽取我院2012年7月~2014年7月收治的过期妊娠分娩孕妇60例(观察组)和同期我院正常足月分娩的孕妇60例(对照组)为研究对象。研究分析临床过期妊娠的相关因素。结果分析结果发现,造成孕妇过期妊娠的因素主要有经产妇、孕前体重指数高(超重和肥胖)、孕期体重增加过多、胎盘成熟度III级和男性胎儿,两组数据具有统计学意义(P<0.05

  5. Wnt-activation down-regulates Olfactomedin-1 (Olfm-1) in Fallopian tubal Epithelial cells: A Microenvironment Predisposed to Tubal Ectopic Pregnancy

    OpenAIRE

    Kodithuwakku, Suranga P; Pang, Ronald T. K.; Ernest H Y Ng; Cheung, Annie N. Y.; Horne, Andrew W.; Ho, Pak-Chung; Yeung, William S. B.; Lee, Kai-Fai

    2011-01-01

    Ectopic pregnancy occurs when the embryo failed to transits to the uterus and attached to the luminal epithelium of Fallopian tube. Tubal ectopic pregnancy (EP) is a common gynecological emergency and more than 95% of EP occurs in the ampullary region of the Fallopian tube (FT). In humans, Wnt-activation and down-regulation of Olfactomedin-1 (Olfm-1) occur in the receptive endometrium and coincided with embryo implantation in vivo. Whether similar molecular changes happen in the Fallopian tub...

  6. Abdominal pregnancy as a cause of hemoperitoneum

    OpenAIRE

    Shafi Sheikh; Malla Misbha; Salaam Parvaiz; Kirmani Omer

    2009-01-01

    The coexistence of intrauterine and extrauterine pregnancy, the heterotopic pregnancy, is a rare obstetric phenomenon. The preoperative diagnosis of this condition is very difficult; leading to a higher maternal morbidity and fetal loss. We experienced a case of intrauterine pregnancy and ruptured abdominal pregnancy implanted on the illeocaecal region in a 26-year-old primiparous woman. She was clinically misdiagnosed as a case of ruptured ectopic pregnancy, but ultrasonography showed it to ...

  7. Anorexia nervosa during pregnancy.

    OpenAIRE

    Goldman, Ran D.; Koren, Gideon

    2003-01-01

    QUESTION: A 22-year-old patient in my clinic was diagnosed with anorexia nervosa (AN) 7 years ago. She is now married and planning her first pregnancy. She is still underweight. What should she expect during pregnancy, and are there any implications for her unborn baby? ANSWER: Women with AN are at higher risk of complications during pregnancy, mainly because of low body weight. Apgar scores and birth weights of infants born to mothers with AN have been found to be significantly lower than th...

  8. Clinical application of uterine arterial embolization for treatment of placenta praevia with hemorrhage in advanced stage of pregnancy

    International Nuclear Information System (INIS)

    Objective: To investigate the value of the uterine arterial embolization for the placenta praevia and hemorrhage in late stage of pregnancy. Methods: 16 patients of placenta praevia with hemorrhage in late stage of pregnancy were treated with uterine arterial embolization (UAE)and simultaneously with Lee Rivanol intra-amniotic membrane injection for artificial laboring. Results: During late stage of pregnancy, uterine arteries appeared to be elongated and enlarged with numerous dilated tortuous branches with positive proportion to gestalional age, and rich in blood supply of the placenta. 15 cases passed successfully through the induced abortion. The procedure completed with an average of 4.5 h afterwards, without postpartum hemorrhage. The other ease failed due to complicated reasons and cured by caesarean section. Conclusion: UAE is a safe and effective method for late stage placenta praevia with hemaorrhage and also provides the reservation of fertility and together with promotion of induced abortion. (authors)

  9. Pregnancy and periodontal disease

    OpenAIRE

    Sağlam, Ebru; SARUHAN, Nesrin; Çanakçı, Cenk Fatih

    2015-01-01

    Some maternal immunological changes due to pregnancy increases susceptibility to infections. Periodontal disease, the main cause is plaque, is a common disease which is seen multifactorial and varying severity. There are many clinical criteria for diagnosis of periodontal disease. Correlation between pregnancy and periodontal inflammation is known for many years. Periodontal disease affects pregnant’s systemic condition and also has negative effects on fetus. Periodontal disease increases the...

  10. Influence of stress during pregnancy on maternal HPA activity and neonatal behavior

    OpenAIRE

    Rieger, M.; Pirke, K. -M.; Buske-Kirschbaum, A.; Wurmser, H.; Papoušek, M.; Hellhammer, D

    2004-01-01

    Prenatal maternal stress has been shown to impair birth outcome and behavioral functioning in nonhuman primate offspring. Little is known about the effects of prenatal stress on behavioral development in humans. We assessed the effect of self-reported prenatal stress on behavioral characteristics of 81 newborns using the Neonatal Behavioral Assessment Scale (NBAS). We suspected that high levels of perceived chronic stress during pregnancy may negatively affect the brain development of the fet...

  11. Ectopic Pregnancy

    Science.gov (United States)

    ... woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, ... tubes. The result is usually a miscarriage. Ectopic pregnancy can be a medical emergency if it ruptures. ...

  12. Teenage Pregnancy

    Science.gov (United States)

    ... plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother ... later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks ...

  13. [Diagnosis of toxoplasmosis in pregnancy].

    Science.gov (United States)

    Prömpeler, H J; Vogt, A; Petersen, E E

    1989-07-01

    Even today, toxoplasmosis infection during pregnancy is an unsolved problem. In studies of 2206 pregnant women, toxoplasmosis specific IgM-antibodies have been detected in 69 cases (3.1%). Using more sophisticated serological techniques only 12 active toxoplasmosis cases needing therapy remained. Decisive discrimination criteria of the various tests were exact time of the examination as well as the level of the antibody titer. Although only 12 toxoplasmosis infections were treated, no connatal infections have been observed. On the other hand, in some outpatients, referred to our clinic, cases of severe connatal toxoplasmosis infections were found although they had undergone therapy. To solve the problem of toxoplasmosis, we recommend a general screening before pregnancy if possible. For optimal results of this screening, serologic reference laboratories and efficient sonography units must be established to obtain, when required, umbilical venous blood.

  14. Clinical analysis of 56 cases of pregnancy-induced hypertension disease%56例妊娠高血压患者临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    黄新; 蒋蓉

    2012-01-01

    Objective To summarize the experiences of clinical diagnosis and treatment for pregnancy-induced hypertension disease. Methods 56 patients with pregnancy-induced hypertension were included. Their production modes, neonatal status, maternal prognosis and complications were observed. Results 38 patients chosed cesarean section (67. 87%) among the 56 cases of pregnancy-induced hypertension. There occurred in the mothers 15 cases of postpartum hemorrhage (26. 78%), 2 cases of placental abruption (3. 57%), 1 case of heart failure (1. 78%), and 1 case of renal failure (1.78%); Apgar scores for the neonate showed 6 cases of premature birth (10.71%), 4 cases of suffocation (7. 14%) , 1 case of death (1. 78%), and 1 case of fetal death (1. 78%). Conclusion It is necessary to terminate the pregnancy except for the treatment of the primary disease when pregnancy-induced hypertension occurs, and the best approach to terminate the pregnancy is cesarean section for the safety of mothers and children.%目的 总结妊娠高血压患者的临床诊治经验.方法 对收治的56例临床诊断为妊娠高血压患者,观察其生产方式、新生儿状况、孕产妇预后及并发症发生情况.结果 56例妊娠高血压患者中,剖宫产38例(67.87%),发生产后出血15例(26.78%),胎盘早剥2例(3.57%),发生心衰1例(1.78%),发生肾衰1例(1.78%);新生儿Apgar评分,早产6例(10.71%),窒息4例(7.14%),死亡1例(1.78%),死胎1例(1.78%).结论 对妊娠高血压患者,在治疗原发病的同时应适时终止妊娠;为了母婴安全,终止妊娠最好应首选剖宫产方式.

  15. 氨甲喋呤治疗异位妊娠的临床分析%Clinical Analysis of Ectopic Pregnancy With Methotrexate Therapy

    Institute of Scientific and Technical Information of China (English)

    丁涛; 刘树妍

    2015-01-01

    目的:分析研究异位妊娠采取氨甲喋呤治疗的临床应用价值。方法选取2013年3月~2014年3月我院接收的异位妊娠患者76例,采取氨甲喋呤治疗,对治疗效果分析研究。结果76例患者中,治愈70例,占92.11%。结论异位妊娠采取氨甲喋呤治疗,可以使治愈率明显提高,且不良反应较小。%ObjectiveAnalysis the clinical value of ectopic pregnancy using methotrexate therapy. Methods76 cases of ectopic pregnancy in March 2013~March 2014 in our hospital were taking methotrexate therapy,analysis of its therapeutic effect.Results70 in 76 cases were cured, accounting for 92.11%.ConclusionEctopic pregnancy using methotrexate therapy can make the cure rate signiifcantly improved.

  16. Will Stress during Pregnancy Affect My Baby?

    Science.gov (United States)

    ... Research Information Clinical Trials Resources and Publications Will stress during pregnancy affect my baby? Skip sharing on ... health care provider during your prenatal visits. Posttraumatic Stress Disorder (PTSD) and Pregnancy PTSD is a more ...

  17. 妊娠晚期发热对妊娠结局影响的临床分析%Clinical Analysis of Late Pregnancy Fever Impact on Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    杨如容; 陈重泽; 何彩平

    2015-01-01

    Objective:The aim of the study was to summarize the cause of the late pregnancy fever and its influence on pregnancy outcome.Methods:68 cases of patients with late pregnancy merge fever were collected during July 2012 to May 2014 in our hospital,and the clinical data were retrospectively analyzed.According to the degree of fever,the pa-tients were divided into group A (37.5 ~ 38.9℃ temperature)and group B (39.0 ~ 41.0℃ temperature),and 20 ca-ses among pregnant women without feverwere randomly selected as the control group at the same time,and what the relation between the causes of fever in late pregnancy,treatment and the outcome of pregnancy was analyzed.Results:In late pregnancy fever the main reasons were respiratory tract infection,urinary tract infection,the uplink genital tract infection,premature rupture of membranes,enteritis,appendicitis,and so on.The incidence of fetal distress and cesarean section both in A group and B group were higher than in the control group,The incidence of the neonatal neumonia, sepsis,fetal neonatal mortality rate,postpartum hemorrhage in B group were higher than the control group,and the in-cidence of B group with fetal neonatal mortality,fetal distress were rather than A group.Conclusion:The late pregnan-cy fever cause with upper respiratory tract infection saw more,and the pathogen was virus-based;late pregnancy fever exist have impact on delivery mode selection and adverse pregnancy outcomes associated with the level of fever,and ef-fective control with the level of fever and duration of fever,which was expected to improve pregnancy outcome.%目的::总结晚期妊娠发热的主要原因及对妊娠结局的影响。方法:收集2012年7月—2014年5月于我院住院的妊娠晚期合并发热患者68例,对其临床资料进行回顾性分析;按患者发热程度分为 A 组(体温37.5~38.9℃)、B组(体温39.0~41.0℃),并从同期孕期无发热的孕妇中随机抽取20例作为对照组,分析晚期妊

  18. Laparoscopic treatment of 68 cases of ectopic pregnancy clinical experience%腹腔镜治疗宫外孕68例临床体会

    Institute of Scientific and Technical Information of China (English)

    邱洁

    2012-01-01

      目的:研究68例腹腔镜手术治疗宫外孕的临床特点。方法:整合性研究2011年1月到2012年3月在我院接受腹腔镜治疗的68例宫外孕患者的临床疗效。结果:68例患者在腹腔镜下确诊为患有宫外孕疾病,并即刻实行手术治疗。手术中检查发现为输卵管妊娠的有37例,卵巢妊娠有7例,而这其中输卵管妊娠的流产型为9例,破裂型为17例。手术进行最短的用时为30分钟,最长时间为70分钟,平均的时间为40分钟。手术中腹腔内出现出血过多的为1200毫升,出血较少的为20毫升,平均出血量为260毫升。小于500毫升的有49例,500毫升至1000毫升之间的有11例,大于1000毫升的有8例。术后无并发症现象,5—10天内血HCG已恢复如常。结论:腹腔镜手术治疗宫外孕疾病,具有伤口小、创伤轻微、住院时间短等优点。对于治疗宫外孕疾病是最有效的方法。%  objective:to study the treatment of 68 cases of laparoscopic surgery clinical characteristics of the ectopic pregnancy. Methods:integration research between January 2011 and March 2012 in our hospital laparoscopic treatment of 68 cases of ectopic pregnancy patients clinical curative effect. Results:in 68 patients with laparoscopic diagnosed as ectopic pregnancy disease, and immediate surgery treatment. In the operation findings for tubal pregnancy with 37 cases, ovarian pregnancy have 7 cases, of which the abortion type tubal pregnancy for 9 cases, fracture type for 17 cases. The operation when the shortest for 30 minutes, the longest time for 70 minutes, the average time for 40 minutes. Surgery intraperitoneal appear haemorrhage too much for 1200 ml, less bleeding for 20 ml, average amount of bleeding for 260 ml. Less than 500 ml of 49 cases, 500 ml to 1000 ml of between 11 cases, more than 1000 ml of 8 cases. No postoperative complications phenomenon, 5--10 days HCG blood has returned to normal. Conclusion:laparoscopic surgery

  19. 妊高症合并胎盘早剥的临床效果观察%Pregnancy-induced hypertension clinical effect of the merger of placental abruption

    Institute of Scientific and Technical Information of China (English)

    范连竹

    2014-01-01

    Objective to analyze the clinical observation of pregnancy-induced hypertension merger placental abruption, improve early diagnosis and reduce perinatal mortality. Methods from april 2013 to January 2014, 96 cases in our hospital's pregnancy-induced hypertension patients were analyzed retrospectively. divided into observation group and control group. observation group 56 cases of pregnancy-induced hypertension in patients with placental abruption merger control group, 40 cases of normal pregnant women. Results the clinical condition of the patients blood pressure, 24-hour urine protein, vaginal bleeding, fetal monitor fetal distress, headache, vertigo, nausea and other symptoms. Which blood pressure ≧ 160 / 110mmHg, 24-hour urine protein ≧ 5g and fetal monitors the incidence of fetal distress was 100%. and consciously headache, vertigo, nausea, abdominal tenderness and vaginal bleeding incidence was 83.93%, 75% and 21.43% respectively. Pregnancy-induced hypertension, placental abruption merged group and normal group compared to the situation newborns, pregnancy-induced hypertension preterm children merger abruption, low birth weight children, stillbirth, neonatal death and birth defects in children and other aspects should be higher than the normal group. Conclusion Placental abruption is one of the most dangerous pregnancy hypertension onset of symptoms, and multiple pregnancy-induced hypertension are also severe stage of disease. abruption of early prevention, early detection, early treatment is the treatment of pregnancy-induced hypertension key while reducing harm to the mother and baby.%目的:研究分析妊高症合并胎盘早剥的临床观察,提高早期诊断率和降低围产儿死亡率。方法从2013年4月到2014年1月,选取我院的96例妊高症患者进行回顾性分析。分成观察组和对照组。观察组56例妊高症合并胎盘早剥患者,对照组40例正常孕妇。结果观察组患者临床病症的血压、24小时

  20. Clinical analysis of 70 cases of cesarean scar pregnancy%剖宫产瘢痕妊娠70例临床分析

    Institute of Scientific and Technical Information of China (English)

    汤雅玲; 汪燕; 邱娜璇

    2016-01-01

    Objective To investigate the clinical diagnosis , treatment and outcomes of cesarean scar pregnancy .Methods The clinical data of 70 cases of cesarean scar pregnancy women treated in the first affiliated hospital of Xiamen University from January 2012 to December 2014 were analyzed retrospectively .Results 70 cases of cesarean scar pregnancy patients were diagnosed between 5~16 gestational weeks .65 patients whose gestational weeks less than or equal to 12 weeks chose pregnancy termination , in which 24 cases were treated by uterine artery embolization (UAE) and curettage,6 cases received transvaginal lesion resection , 3 cases received hysteroscopic surgery ,4 cases received laparoscopic surgery ,20 cases were treated by drug and curettage ,8 cases were treated by drug only.All these patients were cured,none received hysterectomy.The other 5 patients diagnosed between 14 ~16 gestational weeks continued the pregnancies .One case had hysterectomy due to placenta accrete bleeding and stillbirth in 23 gestational weeks .Four cases were treated by cesarean delivery between 27 to 32 weeks, in which three newborns survived .Conclusion Cesarean scar pregnancy is one kind of serious complications of cesarean delivery .Every case should receive individualized treatment .Though continuing the cesarean scar pregnancy is possible to have a live newborn ,but the risk of hysterectomy due to placenta accrete bleeding increases.%目的:探讨剖宫产瘢痕妊娠( cesarean scar pregnancy ,CSP)临床诊治方法及结局。方法收集2012年1月至2014年12月厦门大学附属第一医院70例CSP患者的临床资料并作回顾性分析。结果70例诊断为CSP的患者孕周为5~16周,孕周≤12周的65例患者选择终止妊娠,其中24例行子宫动脉栓塞+刮宫术,6例行经阴道病灶切除术,3例行宫腔镜手术,4例行腹腔镜手术,20例药物治疗配合刮宫术,8例单纯药物治疗,均达到治愈目的,无1

  1. Pregnancy-related issues in women with systemic lupus erythematosus.

    Science.gov (United States)

    Singh, Abha G; Chowdhary, Vaidehi R

    2015-02-01

    While fertility is preserved in females with systemic lupus erythematosus (SLE), it is well established that pregnancy in these patients is associated with adverse maternal and fetal outcomes, including pregnancy loss, pre-eclampsia, preterm delivery and intrauterine growth retardation, as well as neonatal mortality. Mechanisms underlying these adverse outcomes are poorly understood, and better understanding of these would allow development of targeted and personalized treatment strategies. Established risk factors for adverse pregnancy outcomes include active disease within 6 months prior to conception and during pregnancy, active nephritis, maternal hypertension, antiphospholipid antibodies and hypocomplementemia. While intensive monitoring is recommended, the comparative effectiveness of appropriate management strategies is unclear. While current strategies are able to achieve live births in 85-90% of pregnancies, certain aspects such as prevention of preterm birth, treatment of congenital heart block due to neonatal lupus and recurrent pregnancy loss despite best management, remains challenging. Pregnancy is also associated with an increased risk of flare of lupus, particularly in patients with active disease at time of conception or within 6 months prior to conception. Pregnant patients with SLE should be followed in a high-risk obstetric clinic, and care should be closely coordinated between the obstetrician and rheumatologist. PMID:25545844

  2. A clinical study on ultrasonographic measurement of cervical length at 18-24 weeks of gestation and pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Jayati Nath

    2016-04-01

    Conclusions: Shorter cervices lead to shorter gestations and early labour. Thus ultrasonographic measurement of cervical length at 18-24 weeks of gestation is very important, more so in asymptomatic women and can be utilized as a tool for predicting adverse pregnancy outcome especially preterm labour and delivery. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1088-1092

  3. Adverse pregnancy outcome in women with mild glucose intolerance: is there a clinically meaningful threshold value for glucose?

    DEFF Research Database (Denmark)

    Jensen, Dorte; Lauridsen, Lars Korsholm; Ovesen, Per Glud;

    2008-01-01

    The diagnostic criteria of gestational diabetes mellitus (GDM) have been based on the risk of future maternal diabetes rather than the short-term risk of mother and infant. Our aim was to illustrate the relation between various adverse pregnancy outcomes and maternal glucose levels in women...

  4. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... pregnancy: Be aware of risk factors. Know your family history. Make sure your doctor knows about any ... blood clots or blood clotting disorders in your family. Remain active, with your doctor's approval. Be aware ...

  5. Allergic rhinitis during pregnancy.

    Science.gov (United States)

    2016-04-01

    During pregnancy, the first-choice drugs for allergic rhinitis are nasal or oral "non-sedating" antihistamines without antimuscarinic activity, in particular cetirizine, or loratadine after the first trimester. PMID:27186624

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

    DEFF Research Database (Denmark)

    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......, and type of physical activity were assessed by a telephone interview at approximately week 12 of gestation. Admission to hospital due to depression (PPD-admission) and prescription of an antidepressant (PPD-prescription) were treated as separate outcomes. RESULTS: Through linkage to national registers, we...... identified 157 cases of PPD-admission and 1,305 cases of PPD-prescription. Women engaging in vigorous physical activity during pregnancy had a lower risk of PPD-prescription compared to women who were not physically active (adjusted odds ratio, 0.81; 95% CI, 0.66-0.99). No association was observed between...

  7. Clinical analysis of outcome of 64 pregnancies in patients with systemic lupus erythematosus%64例次系统性红斑狼疮患者妊娠结局及临床分析

    Institute of Scientific and Technical Information of China (English)

    王芬; 徐建华; 徐胜前; 刘爽; 连莉; 陈珊宇

    2011-01-01

    目的 了解系统性红斑狼疮(systemic lupus erythematosus,SLE)患者妊娠结局,分析妊娠期间SLE病情恶化、不良妊娠结局的相关因素.方法 回顾性分析64例次SLE患者妊娠的孕产史、临床及实验室资料.结果 60例SLE患者妊娠64例次,妊娠时年龄21~39岁,平均(28.4±4.1)岁,SLE病程2~12年,平均(5.5±3.1)年.共有26例次(40.6%)妊娠期间SLE病情恶化,恶化主要在妊娠中、晚期.妊娠足月产15例次(23.4%),早产23例次(35.9%).治疗性流产21例次(32.8%),自然流产3例次(4.7%),死产2例次(3.1%).总活产率59.4%.引起妊娠期间SLE病情恶化的危险因素有24 h尿蛋白定量(OR=15.76,95% CI:2.07~120.31)、妊娠前泼尼松剂量(OR=1.18,95% CI:1.01~1.38).引起胎儿丢失的危险因素有补体C3水平(OR=0.002,95% CI:0.000~0.410)、妊娠前疾病活动(OR=8.297,95% CI:1.464~47.029).结论 应制定合理有效的治疗方案积极控制妊娠前病情,并在妊娠期间严密随访,以减少可引发不良妊娠结局的危险因素,从而改善妊娠结局.%Objective To summarize the pregnancy outcome in patients with systemic lupus erythematosus (SLE) and to analyse the related factor of SLE exacerbations and poor outcome. Methods Retrospective analysis of maternal history, clinical and laboratory data of 64 pregnancies in patients with SLE was conducted. Results Sixty cases of SLE patients had 64 pregnancies in total, their gestational age range was from 21 to 39(28.4 ± 4.1) years old and the duration of SLE was (5.5 ± 3.1) years (2 to 12 years). SLE exacerbation occurred in 26 pregnancies (40. 6%), mostly in the second and third trimester of pregnancy. There were 15 cases of mature delivery (23. 4%), 23 cases were premature (35.9% ), 21 cases of therapeutic abortion (32.8% ), 3 cases of spontaneous abortion (4. 7%) and 2 cases of stillbirth (3.1%). The total live birth rate was 59.4%. The predictor of SLE exacerbation during pregnancy were 24 h urinary

  8. Planning your pregnancy

    Science.gov (United States)

    ... Pregnancy > Before or between pregnancies > Planning your pregnancy Planning your pregnancy E-mail to a friend Please ... partner as you start your family. Why is planning your pregnancy important? Planning your pregnancy can help ...

  9. Expression of stretch-activated two-pore potassium channels in human myometrium in pregnancy and labor.

    Directory of Open Access Journals (Sweden)

    Iain L O Buxton

    Full Text Available BACKGROUND: We tested the hypothesis that the stretch-activated, four-transmembrane domain, two pore potassium channels (K2P, TREK-1 and TRAAK are gestationally-regulated in human myometrium and contribute to uterine relaxation during pregnancy until labor. METHODOLOGY: We determined the gene and protein expression of K2P channels in non-pregnant, pregnant term and preterm laboring myometrium. We employed both molecular biological and functional studies of K2P channels in myometrial samples taken from women undergoing cesarean delivery of a fetus. PRINCIPAL FINDINGS: TREK-1, but not TREK-2, channels are expressed in human myometrium and significantly up-regulated during pregnancy. Down-regulation of TREK-1 message was seen by Q-PCR in laboring tissues consistent with a role for TREK-1 in maintaining uterine quiescence prior to labor. The TRAAK channel was unregulated in the same women. Blockade of stretch-activated channels with a channel non-specific tarantula toxin (GsMTx-4 or the more specific TREK-1 antagonist L-methionine ethyl ester altered contractile frequency in a dose-dependent manner in pregnant myometrium. Arachidonic acid treatment lowered contractile tension an effect blocked by fluphenazine. Functional studies are consistent with a role for TREK-1 in uterine quiescence. CONCLUSIONS: We provide evidence supporting a role for TREK-1 in contributing to uterine quiescence during gestation and hypothesize that dysregulation of this mechanism may underlie certain cases of spontaneous pre-term birth.

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

    OpenAIRE

    Warren Lucie; Rance Jaynie; Hunter Billie

    2012-01-01

    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 d...

  11. The Contribution of Normal Pregnancy to Eclampsia.

    Directory of Open Access Journals (Sweden)

    Abbie Chapman Johnson

    Full Text Available Eclampsia, clinically defined as unexplained seizure in a woman with preeclampsia, is a life threatening complication unique to the pregnant state. However, a subpopulation of women with seemingly uncomplicated pregnancies experience de novo seizure without preeclamptic signs or symptoms, suggesting pregnancy alone may predispose the brain to seizure. Here, we hypothesized that normal pregnancy lowers seizure threshold and investigated mechanisms by which pregnancy may affect seizure susceptibility, including neuroinflammation and plasticity of gamma-aminobutyric acid type A receptor (GABAAR subunit expression. Seizure threshold was determined by quantifying the amount of pentylenetetrazole (PTZ required to elicit electrical seizure in Sprague Dawley rats that were either nonpregnant (Nonpreg, n = 7 or pregnant (Preg; d20, n = 6. Seizure-induced vasogenic edema was also measured. Further, activation of microglia, a measure of neuroinflammation (n = 6-8/group, and GABAAR δ- and γ2-subunit protein expression in the cerebral cortex and hippocampus (n = 6/group was determined. Seizure threshold was lower in Preg compared to Nonpreg rats (36.7±9.6 vs. 65.0±14.5 mg/kg PTZ; p<0.01 that was associated with greater vasogenic edema formation (78.55±0.11 vs. 78.04±0.19% water; p<0.05. The % of active microglia was similar between groups; however, pregnancy was associated with downregulation of cortical GABAAR-δ and hippocampal GABAAR-γ2 expression. Overall, pregnancy appears to be a state of increased seizure susceptibility that is not due to neuroinflammation, but rather is associated with reduced expression of GABAAR subunits and greater edema. Understanding neurophysiological changes occurring in normal pregnancy could allow for better prevention and management of de novo seizure, including pathologic states such as eclampsia.

  12. Elevated Levels of Uterine Anti-Apoptotic Signaling May Activate NFKB and Potentially Confer Resistance to Caspase 3-Mediated Apoptotic Cell Death During Pregnancy in Mice1

    Science.gov (United States)

    Jeyasuria, Pancharatnam; Subedi, Kalpana; Suresh, Arvind; Condon, Jennifer C.

    2011-01-01

    Preserving the uterus in a state of relative quiescence is vital to the maintenance of a successful pregnancy. Elevated cytoplasmic levels of uterine caspase 3 during pregnancy have been proposed as a potential regulator of uterine quiescence through direct targeting and disabling of the uterine contractile architecture. However, despite highly elevated levels of uterine caspase 3 during pregnancy, there is minimal evidence of apoptosis. This current study defines the mechanism whereby the pregnant uterine myocyte may harness the tocolytic activity of active caspases while avoiding apoptotic cell death. Using the pregnant mouse model, we have analyzed the uterus for changes in pro- and antiapoptotic signaling patterns associated with the advancing stages of pregnancy. Briefly, we have found that members of the IAP family, such as SURVIVIN and XIAP, and the Bcl2 family members, such as MCL1, are elevated in the uterine myocyte during late gestation. The IAP family members are the only endogenous inhibitors of active caspase 3, and MCL1 limits activation of caspase 3 by suppressing proapoptotic signaling. Elevated XIAP levels partner with SURVIVIN, resulting in increased levels of the antiapoptotic MCL1 via NFKB activation; these together have the potential to limit both the activity and level of active caspase 3 in the pregnant uterus as term approaches. We propose that modification of these antiapoptotic signaling partners allows the pregnant uterus to escape the apoptotic action of elevated active caspase 3 levels but also functions to limit the levels of active uterine caspase 3 near term. PMID:21566000

  13. Association of plasminogen activator inhibitor-1 and angiotensin converting enzyme polymorphisms with recurrent pregnancy loss in Iranian women

    Directory of Open Access Journals (Sweden)

    Fatemeh Shakarami

    2015-10-01

    Full Text Available Background: Recurrent pregnancy loss (RPL defined by two or more failed pregnancies before 20 weeks of gestation. Several factors play a role in RPL including thrombophilic conditions which can be influenced by gene polymorphisms. Plasminogen activator inhibitor-1 (PAI-1 and angiotensin converting enzyme (ACE genes are closely related to fibrinolytic process, embryonic development and pregnancy success. Objective: The aim of this study was to investigate the relationship between RPL and common polymorphisms in ACE and PAI-1 genes. Materials and Methods: In this case control study, 100 women with recurrent abortions (at least two were selected as cases and 100 healthy women with two or more normal term deliveries without a history of abortion as controls. Total genomic DNA was isolated from blood leukocytes. The status of the PAI-1 4G/5G and ACE (D/I polymorphism was determined by PCR-RFLP. Results: Homozygosity for PAI-1 4G polymorphism was seen in 17 cases (17%, and 5 controls (5% (p=0.006 so patients with homozygote 4G mutation were significantly more prone to RPL in contrast to control group (OR: 4.63, % 95 CI: 1.55-13.84. In addition, 7 patients (7 %, and no one from the control group, were homozygote (I/I for ACE polymorphism (p=0.034, suggesting no significant associations between ACE D allele or DD genotype and RPL. Conclusion: Considering these results, because 4G/4G polymorphism for PAI-1 gene could be a thrombophilic variant leading to abortion, analysis of this mutation and other susceptibility factors are recommended in patients with RPL.

  14. Adnexal mass in tubal pregnancy

    International Nuclear Information System (INIS)

    Off the evaluation of clinical significance and pathologic correlation of echogenic adnexal mass in tubal pregnancy, which is separated from ipsilateral ovary, we performed a retrospective analysis of 15 proved tubal pregnancies. All showed hematosalpinx containing blood coagulum and chorionic villi with intact fallopian tube.The echogenicity of the adnexal mass was considered to represent the nonclotted or clotted blood within the fallopian tube. We conclude that the discrete, echogenic adnexal mass is the suggestive finding of unrupturedtubal pregnancy

  15. Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: Short-term results of a randomized clinical trial [ISRCTN08477490

    Directory of Open Access Journals (Sweden)

    Bastiaanssen Janneke M

    2006-02-01

    Full Text Available Abstract Background For the moment, scientific evaluation of programs on treatment of pregnancy-related pelvic girdle and/or low back pain after delivery is hardly available with only one study with a positive result, suggesting uncertainty about the optimal approach. Investigators draw particular attention to biomedical factors but there is growing evidence that biopsychosocial factors appear to be even more important as a basis of an intervention program. Methods We studied the effectiveness of a tailor-made program with respect to biopsychosocial factors (intervention group in women with pregnancy-related pelvic girdle and/ or low back pain versus usual care based on a pain contingent basis (control group shortly after delivery in a randomized controlled trial. Women with severe complaints shortly after delivery were selected from a longitudinal prospective cohort study (n = 7526, aimed at pregnancy-related pelvic girdle and/or low back pain in the Netherlands. A concealed block randomization was performed after collecting baseline data. Researchers were blinded to treatment assignment. Outcomes were evaluated within the domains of the biopsychosocial approach. Primary outcome concerned limitations in activities (RDQ. Follow-up measurements were performed 12 weeks after delivery. Results Since May 2001 until July 2003, 869 women out of the cohort made a request for treatment by a physiotherapist, 10 days after delivery. Because of a quick recovery in two weeks time, we included only 126 women three weeks after delivery. There was a statistically significant and clinically relevant difference in improvement on the primary outcome (RDQ between the two groups in favor of the experimental intervention. Conclusion The results favored the hypotheses. Women's worries about their condition were major targets in the experimental intervention. The prognosis after delivery, especially in de first weeks, turned out to be favorable.

  16. 妊娠期子宫颈癌的临床治疗效果观察%Clinical treatment of cervical cancer during pregnancy Efficacy

    Institute of Scientific and Technical Information of China (English)

    罗利

    2015-01-01

    Objective:To investigate the clinical diagnosis and treatment of cervical cancer, the effects of pregnancy;Methods:A retrospective analysis of our hospital in January 2013~December 2013 admitted to the clinical data in pregnancy five cases of cervical cancer, compared to its as well as the results of surgical treatment.outcome of pregnancy in patients with cervical cancer treatment results son areas in 5 cases, 4 of 5 patients underwent radical surgery, radiotherapy and chemotherapy before surgery in 3 cases, no recurrence after surgery, with the clinical effect of surgical approach contrast was no significant difference in terms of (P <0.05);Conclusion:trimester pelvic examination and cervical cytology examination can detect cervical cancer, and treatment of cervical cancer in pregnancy needs of patients according to tumor stage and willingness and other factors considered choice of treatment.%目的:探讨妊娠期子宫颈癌的临床诊断治疗方法及其效果。方法回顾分析我院2013年1月—2013年12月收治的妊娠期子宫颈癌5例临床资料,对比其手术方式及临床疗效。结果:5例妊娠期子宫颈癌患者中4例行根治性手术,3例行术前放化疗,术后均未复发,在手术方式同临床效果方面的对比差异无统计学意义(P<0.05);结论:妊娠早期妇科检查以及宫颈细胞学方面的检查可以及时发现子宫颈癌,并且妊娠期子宫颈癌的治疗过程中需要根据肿瘤分期及患者的意愿等因素综合考虑选择治疗方式。

  17. 子宫角部妊娠34例临床分析%Clinical Analysis of 34 Cases of Cornual Pregnancy

    Institute of Scientific and Technical Information of China (English)

    李莉; 刘雪琴; 陈丽萍

    2011-01-01

    Objective To investigate the therapeutic experience of cornual pregnancy.Methods The clinical data of 34 consecutive cases of cornual pregnancy during September 2009 and September 2010 in our hospital were respectively analyzed.Results There were many clinical symptoms and signs, such as menopausal history(27 case) or no menopausal history (7 cases), irregular vaginal bleeding (30 cases), lower abdominal pain in varying degrees (32 cases), abdominal tenderness and rebound tenderness (25 cases), syncope and shock (6 cases), abdominal positive shifting dullness (14 cases) and cervical helde pain with a uterine floating sense of swing (12 cases).Urine HCG test turned out to be positive in 34 cases, and blood HCG in all patients were higher than normal.Ultrasound diagnosis of 29 cases showed uterine pregnancy corner in 9 cases, among whom 20 cases were misdiagnosed.12 cases were misdiagnosed as interstitial tubal pregnancy and 8 cases of intrauterine pregnancy ( 1 case was misdiagnosed as placental abruption, 5 cases of suspected cases).Vaginal fornix puncture extracted uncoagulated blood in 12 cases, 11 cases was diagnosed by hysteroscopy, and 8 cases by laparoscopy.34 patients received uterine wedge resection or curettage under B ultrasound-guided or laparoscopy combined surgery, and was diagnosed as cornual pregnancy confirmed by pathological examination.Conclusion Physicians should pay more attention to corner pregnancy, because it is easily misdiognosed for its early atypical signs and symptoms.%目的 探讨子宫角部妊娠的诊治经验.方法 对我院2001年9月~2008年9月收治的34例子宫角部妊娠临床资料进行回顾性分析.结果 本组27例有明确停经史,7例无停经史.30例有不规则阴道出血,32例有不同程度下腹痛,25例有下腹压痛、反跳痛,25例有腹部肿块,6例出现晕厥和休克,14例腹部移动性浊音阳性,12例宫颈举痛、摇摆痛及子宫漂浮感明显.34例尿绒毛膜促性腺激素(HCG)均

  18. Physical activity and excess weight in pregnancy have independent and unique effects on delivery and perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Kelly L Morgan

    Full Text Available This study examines the effect of low daily physical activity levels and overweight/obesity in pregnancy on delivery and perinatal outcomes.A prospective cohort study combining manually collected postnatal notes with anonymised data linkage. A total of 466 women sampled from the Growing Up in Wales: Environments for Healthy Living study. Women completed a questionnaire and were included in the study if they had an available Body mass index (BMI (collected at 12 weeks gestation from antenatal records and/or a physical activity score during pregnancy (7-day Actigraph reading. The full statistical model included the following potential confounding factors: maternal age, parity and smoking status. Main outcome measures included induction rates, duration of labour, mode of delivery, infant health and duration of hospital stay.Mothers with lower physical activity levels were more likely to have an instrumental delivery (including forceps, ventouse and elective and emergency caesarean in comparison to mothers with higher activity levels (adjusted OR:1.72(95%CI: 1.05 to 2.9. Overweight/obese mothers were more likely to require an induction (adjusted OR:1.93 (95%CI 1.14 to 3.26, have a macrosomic baby (adjusted OR:1.96 (95%CI 1.08 to 3.56 and a longer hospital stay after delivery (adjusted OR:2.69 (95%CI 1.11 to 6.47.The type of delivery was associated with maternal physical activity level and not BMI. Perinatal outcomes (large for gestational age only were determined by maternal BMI.

  19. Should I Exercise During My Pregnancy?

    Science.gov (United States)

    ... of the week. 7 benefits of regular, moderate physical activity during pregnancy: Helps you and your baby gain ... to a healthy weight. 5 steps for safe exercise during pregnancy: Choose moderate activities unlikely to injure, ...

  20. Clinical analysis of 30 cases in the treatment of gestational diabetes mellitus for influence on pregnancy outcome%妊娠期糖尿病治疗对妊娠结局影响30例临床分析

    Institute of Scientific and Technical Information of China (English)

    王亚

    2014-01-01

    目的:探讨、分析中短效胰岛素合用、预混胰岛素两类胰岛素治疗方法对妊娠期糖尿病患者的妊娠结局的影响,以指导临床上对妊娠糖尿病的进行有效的治疗.方法:选取2013年在我院诊治的妊娠期糖尿病(GDM)患者30例,随机分为两组,各15例.两组均施以积极地干预措施:糖尿病健康教育、严格规划营养饮食、运动治疗、病情监测和高血糖的药物治疗,以控制高血糖.第一组以中短效胰岛素合用进行药物治疗,每日皮下注射四次;第二组以预混胰岛素进行药物治疗,每日两次.产后定期随访,观察两组孕妇妊娠结局.运用统计学方法,比较两组妊娠不良事件的发生有无统计学差异.结果:两组相比,孕期和产期并发症、婴儿情况有统计学差异(P<0.05),第二组治疗对妊娠糖尿病的妊娠结局的改善情况更为明显.结论:预混胰岛素治疗方法对妊娠期糖尿病患者的妊娠结局的影响较中短效胰岛素合用更佳,能更好地改善妊娠期糖尿病患者的妊娠结局.%AIM:To investigate and analyze the influence on pregnancy outcome of patients with gestational diabetes mellitus by two ways of insulin treatment including intermediate-acting and short-acting insulin share and premixed insulin,in order to guide the clinical treatment of gestational diabetes mellitus effectively. METHODS:Chosen 30 cases with gestational diabetes mellitus (GDM)in our hospital 201 3,who were randomly divided into two groups,each group with 1 5 cases.They all received active inter-ventions including diabetes health education,strict planning nutri-tion diet,exercise therapy,drug treatment,condition monitoring and medication for hyperglycemia to control blood sugar.The first group received intermediate-acting and short-acting insulin thera-py,hypodermic injection four times a day,while the second group received premixed insulin

  1. Tularemia during pregnancy.

    Science.gov (United States)

    Ata, N; Kılıç, S; Övet, G; Alataş, N; Çelebi, B

    2013-08-01

    Tularemia is a zoonotic infection caused by Francisella tularensis with a worldwide distribution and diverse clinical manifestations. Although F. tularensis has been recognized as a human pathogen for a century, there are few reports regarding the occurrence of tularemia in pregnant women and its effect on the fetus; only seven cases have been reported in the literature. In view of the sparse literature, it is not clear whether tularemia increases the risk of adverse pregnancy outcomes. In this paper we review tularemia infection during pregnancy, its complications and management. In addition, we present a case of tularemia that occurred in the first trimester of pregnancy and resulted in third-trimester intrauterine fetal death, highlighting the consequences of tularemia in pregnancy and the importance of early detection and treatment.

  2. [Neuroinfections and pregnancy].

    Science.gov (United States)

    Gusev, V A; Koniaeva, V V

    1985-01-01

    The course of neuroinfections (both acute and chronic) associated with pregnancy was studied in a series of 156 women. The patients were divided into two groups. Out of the 36 women comprising the first group who fell ill during gestation, 12 had a fulminant course of the disease with five lethal cases, 24 women had a subacute course and pregnancy progressed to a normal delivery. The second group included 120 patients who conceived in the presence of the residual manifestations of the previous cerebral arachnoiditis, arachnoencephalitis, encephalitis and diencephalitis. The authors describe the clinical course of the residual forms of neuroinfections in relation to pregnancy, parturition and puerperium and offer recommendations on the obstetrical management of pregnancy complicated by neuroinfections.

  3. Hypertension in pregnancy.

    Science.gov (United States)

    Lindheimer, Marshall D; Taler, Sandra J; Cunningham, F Gary

    2010-01-01

    Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO(4) is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

  4. Turner's syndrome and pregnancy: has the 45,X/47,XXX mosaicism a different prognosis? Own clinical experience and literature review.

    Science.gov (United States)

    Bouchlariotou, Sofia; Tsikouras, Panagiotis; Dimitraki, Marina; Athanasiadis, Apostolos; Papoulidis, Ioannis; Maroulis, George; Liberis, Anastasios; Liberis, Vasileios

    2011-05-01

    Turner's syndrome is characterized by an ovarian failure which occurs in most cases before puberty and leads to infertility. In less than 10% of women with Turner syndrome, puberty may occur and spontaneous pregnancies is possible but with a high risk of fetal loss, chromosomal and congenital abnormalities. We present the case of a 33-year-old woman with a mosaic Turner's syndrome karyotype 45,X/47,XXX who conceived spontaneously and had two successful pregnancies. Short stature was the only manifestation of Turner's syndrome. In the present report, we reviewed the available literature on the fertility of women with Turner's syndrome and the phenotypic effects of mosaicism for a 47,XXX cell line in Turner's syndrome.

  5. Adaptive increases in expression and vasodilator activity of estrogen receptor subtypes in a blood vessel-specific pattern during pregnancy.

    Science.gov (United States)

    Mata, Karina M; Li, Wei; Reslan, Ossama M; Siddiqui, Waleed T; Opsasnick, Lauren A; Khalil, Raouf A

    2015-11-15

    Normal pregnancy is associated with adaptive hemodynamic, hormonal, and vascular changes, and estrogen (E2) may promote vasodilation during pregnancy; however, the specific E2 receptor (ER) subtype, post-ER signaling mechanism, and vascular bed involved are unclear. We tested whether pregnancy-associated vascular adaptations involve changes in the expression/distribution/activity of distinct ER subtypes in a blood vessel-specific manner. Blood pressure (BP) and plasma E2 were measured in virgin and pregnant (day 19) rats, and the thoracic aorta, carotid artery, mesenteric artery, and renal artery were isolated for measurements of ERα, ERβ, and G protein-coupled receptor 30 [G protein-coupled ER (GPER)] expression and tissue distribution in parallel with relaxation responses to E2 (all ERs) and the specific ER agonist 4,4',4″-(4-propyl-[1H]-pyrazole-1,3,5-triyl)-tris-phenol (PPT; ERα), diarylpropionitrile (DPN; ERβ), and G1 (GPER). BP was slightly lower and plasma E2 was higher in pregnant versus virgin rats. Western blots revealed increased ERα and ERβ in the aorta and mesenteric artery and GPER in the aorta of pregnant versus virgin rats. Immunohistochemistry revealed that the increases in ERs were mainly in the intima and media. In phenylephrine-precontracted vessels, E2 and PPT caused relaxation that was greater in the aorta and mesenteric artery but similar in the carotid and renal artery of pregnant versus virgin rats. DPN- and G1-induced relaxation was greater in the mesenteric and renal artery than in the aorta and carotid artery, and aortic relaxation to G1 was greater in pregnant versus virgin rats. The nitric oxide synthase inhibitor N(ω)-nitro-l-arginine methyl ester with or without the cyclooxygenase inhibitor indomethacin with or without the EDHF blocker tetraethylammonium or endothelium removal reduced E2, PPT, and G1-induced relaxation in the aorta of pregnant rats, suggesting an endothelium-dependent mechanism, but did not affect E2-, PPT

  6. Clinical observation and nursing of pregnancy complicated with Gitleman syndrome%妊娠合并Gitleman综合征的临床观察和护理

    Institute of Scientific and Technical Information of China (English)

    陈晓芬

    2012-01-01

    目的 探讨妊娠合并Gitleman综合征的临床特点及其护理.方法 回顾性分析3例妊娠合并Gitleman综合征的临床资料和护理体会.结果 3例患者均表现为怀孕后引起疾病,主要表现为低血钾碱中毒,血浆肾素活性增高而血压正常.并根据尿钙明显减少及低血镁,诊断为妊娠合并Gitleman综合征.结论 通过护士全面细致的观察病情,做出预见性的评估,实施全面整体的护理措施,促进了患者的康复.%Objective To explore the clinical features and nursing of pregnancy complicated with Giteman syndrome. Methods The clinical data and nursing of 3 cases of pregnancy complicated with Giteman syndrome were retrospectively analyzed. Results The symptoms of three pregnant women mainly included hypokalemic alkalosis,hyperreninemia with normal blood pressure,decreasing urine calcium and hypomagnesemia. Those women were diagnosed as Giteman syndrome. Conclusion Nurses can make a foreseeing evaluation carefully observing the progression of disease and implement overall nursing measure to promote the recovery of patients.

  7. 超声诊断早期妊娠流产的临床意义%The ultrasound diagnosis early pregnancy miscarries clinical significance

    Institute of Scientific and Technical Information of China (English)

    刘正兰; 李颖

    2009-01-01

    Objective: To discuss ultrasonic characteristic of early pregnancy abortion. Methods: Retrospective analysis was performed in 83 patients who were diagnosed as early pregnancy abortion. Results:The threatened abortion were 55 examples, account for 66%; the inevitable abortion were 8 examples, account for 10%; the missed abortion were 9 exam-ples, accounts for 11%; the incomplete abortion were 11 examples, accounts for 13%. Conclusion:According on the dif-ferent representation of the gestational bag, yolk sac,embryo and fetal heart beat,the ultrasonographic measurements can provide, procise diagnosis for early clinical proc abortion .Uhrasonography is a valuable guidance for clinical treatment.%目的:探讨早期妊娠流产的声像特征.方法:对83例超声诊断为妊娠流产的声像图进行回顾性分析.结果:先兆流产55例,占66%;难免流产8例,占10%;过期流产9例,占11%;不全流产11例,占13%.结论:依据妊娠囊、卵黄囊、胚芽和心管搏动的特异性表现,超声对早期流产有较准确的诊断,为临床处理提供了重要依据.

  8. THE JOY OF UNFOUND PREGNANCY - HETEROTROPIC SPONTANEOUS PREGNANCY : A CASE REPORT

    OpenAIRE

    Neelam; Anju; Amit; Rajinder; Renu

    2015-01-01

    Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extra uterine pregnancies coexist. It can be a life threatening condition and can be easily missed with the diagnosis being overloo ked. Heterotopic pregnancy occurs in 1 in 30 , 000 of spontaneous pregnancies though it is becoming commoner with assisted reproductive techniques. A 24 year s old female was referred as a case of ? Ruptured Ectopic pregnancy at POG four we...

  9. Pregnancy Desire, Partner Serodiscordance, and Partner HIV Disclosure among Reproductive Age HIV-Infected Women in an Urban Clinic

    OpenAIRE

    Rhodes, Corinne M.; Susan Cu-Uvin; Rana, Aadia I.

    2016-01-01

    Women comprise 25% of the US HIV epidemic, with many women of reproductive age. There is a need for providers to address the reproductive needs and desires of women with HIV given that effective antiretroviral therapy has transformed HIV into a chronic disease. This cross-sectional study shows high rates of partner serodiscordance (61%) and moderate HIV disclosure to partners (61%). Patients surveyed reported practitioners discuss condoms (94%) and contraception (71%) more often than pregnanc...

  10. Smoking cessation early in pregnancy and birth weight, length, head circumference, and endothelial nitric oxide synthase activity in umbilical and chorionic vessels: an observational study of healthy singleton pregnancies

    DEFF Research Database (Denmark)

    Andersen, Malene R; Simonsen, Ulf; Uldbjerg, Niels;

    2009-01-01

    BACKGROUND: Reduced production of the vasodilator nitric oxide (NO) in fetal vessels in pregnant smokers may lower the blood flow to the fetus and result in lower birth weight, length, and head circumference. The present study measured endothelial NO synthase (eNOS) activity in fetal umbilical...... and chorionic vessels from nonsmokers, smokers, and ex-smokers and related the findings to the fetal outcome. METHODS AND RESULTS: Of 266 healthy, singleton pregnancies, 182 women were nonsmokers, 43 were smokers, and 41 stopped smoking early in pregnancy. eNOS activity and concentration were quantified...... in endothelial cells of the fetal vessels. Cotinine, lipid profiles, estradiol, l-arginine, and dimethylarginines that may affect NO production were determined in maternal and fetal blood. Serum cotinine verified self-reported smoking. Newborns of smokers had a lower weight (P

  11. Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF).

    Science.gov (United States)

    Vayssière, Christophe; Haumonte, Jean-Baptiste; Chantry, Anne; Coatleven, Frédéric; Debord, Marie Pascal; Gomez, Conchita; Le Ray, Camille; Lopez, Emmanuel; Salomon, Laurent J; Senat, Marie Victoire; Sentilhes, Loïc; Serry, Aurelie; Winer, Norbert; Grandjean, Hélène; Verspyck, Eric; Subtil, Damien

    2013-07-01

    The duration of pregnancy varies between 40(+0) and 41(+3) weeks. Conventionally, and essentially arbitrarily, a pregnancy is considered to be "prolonged" after 41(+0) weeks, but the infant is not considered "post-term" until 42(+0) weeks (Professional consensus). A term birth thus occurs during the period from 37(+0) to 41(+6) weeks. In France, prolonged pregnancies (≥41(+0)weeks) involve 15-20% of pregnant women, and post-term pregnancies (≥42(+0) weeks) approximately 1%. The frequency of post-term pregnancies is very heterogeneous: in Europe and the United States, it ranges from 0.5% to 10% according to country. In prolonged pregnancies, the cesarean section rate-especially the emergency cesarean rate-is multiplied by approximately 1.5 (grade B). From 37(0-6) to 43(0-6) weeks, the risk of perinatal mortality increases regularly, from 0.7‰ to 5.8‰. Meconium aspiration syndrome is responsible for substantial morbidity and mortality, and its incidence increases regularly between 38(+0) and 42(+6) weeks, from 0.24‰ to 1.42‰ (grade B). Similarly, the risks of neonatal acidosis (grade B), 5-min Apgar scores less than 7 (grade B) and admissions to neonatal intensive care (grade B) increase progressively between 38(+0) and 42(+6) weeks. These risks appear to double for post-term growth-restricted newborns (grade C). Ultrasound dating of the pregnancy makes it possible to reduce the risk that it will be incorrectly considered prolonged and that labor will therefore be induced unnecessarily. To harmonize practices, if the crown-rump length (CRL) is correctly measured (this measurement should be taken between 11(+0) and 13(+6) weeks, when CRL should measure from 45 to 84mm), ultrasound dating based on it should be used to determine the official date pregnancy began, regardless of its difference from the date assumed by the patient or estimated based on the date of the last menstrual period. This rule does not apply to pregnancies by IVF, for which the date

  12. Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF).

    Science.gov (United States)

    Vayssière, Christophe; Haumonte, Jean-Baptiste; Chantry, Anne; Coatleven, Frédéric; Debord, Marie Pascal; Gomez, Conchita; Le Ray, Camille; Lopez, Emmanuel; Salomon, Laurent J; Senat, Marie Victoire; Sentilhes, Loïc; Serry, Aurelie; Winer, Norbert; Grandjean, Hélène; Verspyck, Eric; Subtil, Damien

    2013-07-01

    The duration of pregnancy varies between 40(+0) and 41(+3) weeks. Conventionally, and essentially arbitrarily, a pregnancy is considered to be "prolonged" after 41(+0) weeks, but the infant is not considered "post-term" until 42(+0) weeks (Professional consensus). A term birth thus occurs during the period from 37(+0) to 41(+6) weeks. In France, prolonged pregnancies (≥41(+0)weeks) involve 15-20% of pregnant women, and post-term pregnancies (≥42(+0) weeks) approximately 1%. The frequency of post-term pregnancies is very heterogeneous: in Europe and the United States, it ranges from 0.5% to 10% according to country. In prolonged pregnancies, the cesarean section rate-especially the emergency cesarean rate-is multiplied by approximately 1.5 (grade B). From 37(0-6) to 43(0-6) weeks, the risk of perinatal mortality increases regularly, from 0.7‰ to 5.8‰. Meconium aspiration syndrome is responsible for substantial morbidity and mortality, and its incidence increases regularly between 38(+0) and 42(+6) weeks, from 0.24‰ to 1.42‰ (grade B). Similarly, the risks of neonatal acidosis (grade B), 5-min Apgar scores less than 7 (grade B) and admissions to neonatal intensive care (grade B) increase progressively between 38(+0) and 42(+6) weeks. These risks appear to double for post-term growth-restricted newborns (grade C). Ultrasound dating of the pregnancy makes it possible to reduce the risk that it will be incorrectly considered prolonged and that labor will therefore be induced unnecessarily. To harmonize practices, if the crown-rump length (CRL) is correctly measured (this measurement should be taken between 11(+0) and 13(+6) weeks, when CRL should measure from 45 to 84mm), ultrasound dating based on it should be used to determine the official date pregnancy began, regardless of its difference from the date assumed by the patient or estimated based on the date of the last menstrual period. This rule does not apply to pregnancies by IVF, for which the date

  13. Effects of Calcium Carbonate on Pain Symptoms in Third Trimester of Pregnancy and Nursing Period: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Soosan Alimohammadzadeh Taher

    2008-06-01

    Full Text Available Objective: The study evaluated the efficacy of oral calcium carbonate supplement on leg pain in pregnancy and nursing period.Materials and methods: A total number of 176 women at third trimester of pregnancy or nursing period till to one year after delivery with complaint of leg pain, low back pain (LBP, and posterior pelvic pain (PPP were evaluated for distinct primary causes and were excluded, then 58 patients randomized into calcium group (n=27 treated with 500 mg calcium carbonate orally per day just for one week, and control group (n=31 received no drug. Incidence of days with leg, low back, and posterior pelvic pain per week were evaluated and compared between the two groups at 3 different weeks before, during, and after discontinuation of drug. Statistical significance was defined as P<0.05.  Results: Mean number of days with leg pain per week during calcium carbonate intake was significantly different between the study and control groups (P<0.05. Mean number of days with LBP and PPP was not significantly different between two groups.Conclusion: The use of oral calcium supplement was associated with lower episodes of leg pain but failed to reduce the incidence of LBP and PPP in pregnancy and nursery period.

  14. Treating Psoriasis During Pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Rørbye, Christina; Skov, Lone

    2015-01-01

    Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable......, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well...

  15. Hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2015-01-01

    INTRODUCTION: Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism in pregnancy are Graves' disease and chorionic gonadotrophin (hCG)-mediated hyperthyroidism. METHODS AND OUTCOMES......: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of antithyroid drug treatments for hyperthyroidism in pregnancy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews...

  16. Active surveillance for clinically localized prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Brasso, Klaus; Klotz, Laurence H;

    2014-01-01

    Active surveillance (AS) has been introduced as an observational strategy to delay or avoid curative treatment without compromising long-term cancer-specific survival. The 10 studies included in this review, published between 2008 and 2013, generally agreed upon patients selection...

  17. Modulation of the Culture Supernatant of Decidual Cells with Exogenous Cytokines on Killing Activity of Natural Killer Cells in Early Pregnancy

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To investigate the important function of cytokines in early pregnancy and to provide basic and experimental evidence for understanding the mechanism of their action. Methods Add interferon-γ (IFN-γ) , interleukin- 2(IL- 2) , interleukin- 6(IL-6) and epidermal growth factor (EGF) to the confluent culturing decidual cells with three different concentrations and harvest the culture supernatant after 12, 24 and 48 h separately. Observe the effect of the supernatant on killing activity of NK cells with radioimmunological assay of 51Cr immersion. Results The culture supernatant of decidual cells can promote the killing activity of NK cells in various degrees, and the effect is independent of the type, concentration and acting time of cytokines. Conclusion In normal pregnancy, decidual cytokine network is in a dynamic equilibri um. Exogenous cytokines would be harm to normal pregnancy by interfering the equi librium state, but the exact mechanism needs further study.

  18. Modulation of the Culture Supernatant of Decidual Cells with Exogenous Cytokines on Killing Activity of Natural Killer Cells in Early Pregnancy

    Institute of Scientific and Technical Information of China (English)

    胡冬梅; 王丽莉; 何援利

    2000-01-01

    Objective To investigate the important function of cytohines in early pregnancy and to provide basic and experimental evidence for understanding the mechanism of their action.Methods Add interferon-γ (IFN-γ) ,interleuhin-2(IL-2) , interleuhin-6(IL-6) andepidermal growth factor(EGF) to the confluent culturing decidual cells with three different concentrations and harvest the culture supernatant after 12, 24 and 48 h separately. Observe the effect of the supernatant on killing activity of NK cells with radioimmunological assay of 51Cr immersion.Results The culture supernatant of decidual cells can promote the killing activity of NK cells in various degrees, and the effect is independent of the type, concentration and acting time of cytokines.Conclusion In normal pregnancy, decidual cytokine network is in a dynamic equilibri-um. Exogenous cytokines would be harm to normal pregnancy by interfering the equi-librium state, but the exact mechanism needs further study.

  19. Liver diseases in pregnancy: diseases not unique to pregnancy.

    Science.gov (United States)

    Almashhrawi, Ashraf A; Ahmed, Khulood T; Rahman, Rubayat N; Hammoud, Ghassan M; Ibdah, Jamal A

    2013-11-21

    Pregnancy is a special clinical state with several normal physiological changes that influence body organs including the liver. Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Few challenges arise in reaching an accurate diagnosis in light of such physiological changes. Laboratory test results should be carefully interpreted and the knowledge of what normal changes to expect is prudent to avoid clinical misjudgment. Other challenges entail the methods of treatment and their safety for both the mother and the baby. This review summarizes liver diseases that are not unique to pregnancy. We focus on viral hepatitis and its mode of transmission, diagnosis, effect on the pregnancy, the mother, the infant, treatment, and breast-feeding. Autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson's disease, Budd Chiari and portal vein thrombosis in pregnancy are also discussed. Pregnancy is rare in patients with cirrhosis because of the metabolic and hormonal changes associated with cirrhosis. Variceal bleeding can happen in up to 38% of cirrhotic pregnant women. Management of portal hypertension during pregnancy is discussed. Pregnancy increases the pathogenicity leading to an increase in the rate of gallstones. We discuss some of the interventions for gallstones in pregnancy if symptoms arise. Finally, we provide an overview of some of the options in managing hepatic adenomas and hepatocellular carcinoma during pregnancy.

  20. Outcome of Subsequent Pregnancies in Familial Molar Pregnancy

    Directory of Open Access Journals (Sweden)

    Masoumeh Fallahian

    2013-01-01

    Full Text Available Familial recurrent molar pregnancy is an exceedingly rare condition, in which completehydatidiform moles are mostly diploid but biparental in origin and the outcome of subsequentpregnancies is likely to be a hydatidiform mole or other type of reproductiveloss. We previously reported a case of familial molar pregnancy (family K comprisingfive affected members (four sisters and one of their cousins each with at least one hydatidiformmole (HM. In addition to the molar pregnancies, these patients have a total ofthree miscarriages and 8 normal pregnancies leading to healthy children; but the youngestmember of this family has given birth to a boy with Down syndrome.Our second family (case S includes two sisters with diploid biparental complete moles.They have a total of six molar pregnancies with no living child. Recently the younger sisterhad a partial molar pregnancy with apparently normal XX fetus accompanying diffusemolar changes of the placenta that led to preeclampsia and preterm delivery.Overall, these families have had 26 pregnancies including 12 molar pregnancies (completeor partial and three abortions.We concluded that these families are predisposed to various genetic mutations, chromosomalabnormalities and clinical manifestations, which affect their offspring. Furtherstudies of patients are needed to determine any relationship between a history of familialmolar pregnancy and trisomy or other chromosomal abnormalities in offspring and geneticmutations in the products of conception to complete the puzzle and manage familialmolar pregnancy.

  1. Clinical Analysis of 87 Examples Repeated Ectopic Pregnancy LI Yuanqin. Chengdu Tianda Sterlity Hospital.%重复性异位妊娠87例分析

    Institute of Scientific and Technical Information of China (English)

    刘媛琴

    2013-01-01

    Objective: Analyze the risk factors of Repeated Ectopic Pregnancy (REP), raise the consciousness of REP and take precautions against REP. Methods: A retrospective analysis about relations between treatment of first-time ectopic pregnancy and the position of REP was performed on the clinical data in the Peking University People’s Hospital and folow-up of 87 cases (Observation Group) of REP patients since 2007Compare contemporaneous 570 first-time REP patients (control group) who have surgical therapies with those cases showing above and find the relationship between morbidity of repeated ectopic pregnancy and, the anamnesis, the condition of pelvic cavities and so forth. Results: Among the 87 cases, 52 cases (59.8﹪ of total cases) occurred after first-time ectopic pregnancy expectant treatment, including 32 cases of ipsilateral REP and 20 cases of contralateral REP; 35 (40.2﹪) cases occurred after tubal resection, including 2 cases of ipsilateral REP and 33 cases of contralateral REP. The difference between these two groups is obvious (p<0.01). In comparison with the control group, observation group results in a significantly higher morbidity of repeated ectopic and has more risk to develop pelvic adhesion, endometriosis and contralateral tubal pathology (p<0.05). Conclusion: Treatment of first-time ectopic pregnancy is relevant to REP and the position of ectopic pregnancy. And, pelvic operation history, pelvic adhesion, endometriosis and contralateral tubal pathology are al risk factors of morbidity of repeated ectopic pregnancy.%  目的分析重复性异位妊娠(REP)的高危因素,提高对REP的认识及预防REP的发生.方法采用回顾分析方法,对北大人民医院5年来手术治疗的87例REP患者(观察组)的首次异位妊娠的治疗方法与REP部位进行了回顾性分析,并与同期收治的570例手术治疗的初次异位妊娠患者(对照组)的临床数据为对照,观察两组患者盆腔情况、既往病

  2. Study of clinical features of acute pancreatitis during pregnancy%妊娠期急性胰腺炎的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    薛倩; 王晶桐

    2013-01-01

    目的 总结妊娠期急性胰腺炎的病因、临床表现、治疗方案及预后等临床特点,为妊娠期急性胰腺炎的诊断治疗及预防提供临床经验.方法 回顾性分析1990年1月至2012年12月在我院确诊为妊娠期急性胰腺炎并住院接受治疗11例患者的临床资料.结果 患者年龄25 ~ 34岁;其中轻型胰腺炎5例(45.5%),重型胰腺炎6例(54.5%);2例(18.2%)为胆源性胰腺炎,7例(63.6%)存在高脂血症,1例(9.1%)为胆源性胰腺炎合并高脂血症,1例(9.1%)未找到明确病因.急性胰腺炎5例(45.5%)发生在中期妊娠,6例(54.5%)发生在晚期妊娠.无孕妇死亡发生.胎儿足月分娩4例(36.4%),早产5例(45.4%),死亡2例(18.2%),所有出生婴儿均健康存活.结论 妊娠期急性胰腺炎的病因主要为胆源性和高血脂症,以妊娠中晚期发病最为多见;妊娠期急性胰腺炎易导致早产、死胎;早期的诊断及治疗对于妊娠期急性胰腺炎的预后至为重要.%Objective To investigate the clinical features of acute pancreatitis during pregnancy,including etiology,clinical manifestation,treatment and prognosis,in order to provided the clinical experience to prevent and treat the acute pancreatitis.Methods Retrospective analyse the clinical information of 11 patients with acute pancreatitis during pregnancy in the People's Hospital Affiliated to Peking University from January 1990 to December 2012.Results The age rage of patients was 25-34 years old.Of them,mild acute pancreatitis(MAP) was 5 cases (45.5%),while severe acute pancreatitis (SAP) were 6 cases (54.5%).Pathogenic data showed that 2 cases (18.2%) were biliary pancreatitis,7 cases (63.6%) were with hyperlipidemia,1 case(9.1%) was gallstone pancreatitis with hyperlipidemia,and 1 case (9.1%) did not find a clear cause.Five cases occurred during second trimester(45.5%),and 6 cases occurred during third trimester (54.5%) as well as no maternal death was

  3. Clinical observation on termination methods of uterus didelphys early pregnancy%终止双子宫早期妊娠方法的临床观察

    Institute of Scientific and Technical Information of China (English)

    邓红梅

    2014-01-01

    目的 通过对不同终止双子宫早期妊娠的临床方法观察和总结,分析其利弊,以进一步提高临床医疗质量.方法 研究2009年1月至2013年1月,采用回顾性分析我院收治的11例双子宫终止早期妊娠病例,对不同的临床方法产生的结局和并发症进行观察总结和分析.结果 5例选择米非司酮联合米索前列醇后配合清宫术的,5例均成功,无明显并发症;4例选择单纯人流术的,1例成功,2例漏吸,1例子宫穿孔;2例选择米非司酮联合米索前列醇药流术的,2例均成功,但2例均出现阴道多量出血并发症.结论 选择米非司酮联合米索前列醇后配合清宫术终止双子宫早期妊娠能提高成功率,减少并发症,值得基层医院临床推广.%Objective To observe and summary the different clinical termination methods for uterus didelphys early pregnancy,analyze its advantages and disadvantages,and to further improve the quality of quality of clinical medical care.Methods From January 2009 to January 2013,11 cases undergoing different uterus didelphys early pregnancy termination methods were retrospectively analyzed in our hospital,to observe and analyze the clinical outcomes and complications.Results 5 cases received curettage following oral mifepristone combined with misoprostol medicine flow,5 cases were successful,no significant complications found; 4 cases chose abortion alone,1 case success,2 cases of suction drain,and 1 case of uterus perforation; 2 cases which chose mifepristone combined with misoprostol medicine flow operation,were all successful,but all had vaginal heavy bleeding complications.Conclusion Choosing curettage following oral mifepristone combined misoprostol medicine flow for early pregnancy of uterus didelphys can improve the success rate,reduce the complications,which is worthy of clinical promotion in basic-level hospitals.

  4. 妊娠合并急性胰腺炎的临床分析%Clinical analysis of acute pancreatitis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    张艳梅; 田野

    2014-01-01

    目的:研究妊娠合并急性胰腺炎( acute pancreatitis,AP)的发病相关因素、临床特征及预后。方法选取妊娠合并AP的患者30例为观察组,并选取同期同年龄段非妊娠AP的女性患者30例为对照组,回顾性分析患者发病的相关因素、临床特征、治疗方法及妊娠结局。结果1.两组的发病因素前三位分别是胆源性疾病、高脂血症及饮食因素;观察组的重症胰腺炎( severe acute pancreatitis ,SAP)发病率、并发症发生率及误诊率均高于对照组(P<0.05);2.观察组的白细胞计数、血清C-反应蛋白、血糖、血甘油三酯高于对照组,血红蛋白低于对照组(P<0.05);3.观察组围生儿总丢失率为20%,孕早、中、晚期丢失率分别为33.3%、12.5%、21.1%。结论妊娠合并AP的主要发病因素为胆道疾病、高脂血症及饮食因素,合并SAP及并发症较多且误诊率高,应尽早预防及早期诊断,给予个体化综合治疗是关键。%Objective To eXplore related factors and clinical characteristics of acute pancreatitis( AP)in pregnancy and its treatment and prognosis. Methods 30 patients With AP in pregnancy Were selected as observation group,and 30 cases of non pregnancy Women With AP during the same period Were selected as control group. The related factors,clinical characteristics treatment methods and pregnancy outcomes Were retrospectively analyzed. Results 1. The top three pathogenic factors Were biliary systemic diseases,hyperlipidaemia and dietary problems respectively. The incidence of severe acute pancreatitis( SAP)and complications,the misdiagnosis rate in observation group Were higher than control group(P<0. 05). 2. White blood cell count,serum C - reactive protein,blood sugar and blood triglycerides in observation group Were higher than control group Whereas hemoglobin in observation group Was loWer than control group(P<0. 05). 3. the total rate of lost fetus in observation

  5. Artificial oocyte activation: evidence for clinical readiness.

    Science.gov (United States)

    Ebner, T; Montag, M

    2016-03-01

    Artificial oocyte activation using Ca(2+)ionophores or similar compounds is a widely applied technique in IVF laboratories. This is all the more interesting as most of the agents aiming for intracellular Ca(2+) increase do not result in physiological Ca(2+) oscillations but much rather cause a single Ca(2+) transient. Two observations from mammals may explain why a rather non-physiological single Ca(2+) peak caused by ionophores is sufficient to rescue cycles showing severe male factor infertility, deficient oocyte maturation, developmental problems in humans, or both. On the one hand, it has been shown that it is mainly the initial Ca(2+) rise that drives further downstream events, in particular calcium/calmodulin-dependent protein kinase II (CaMKII) action, and on the other, it is possible that this enzyme remains active even in the absence of Ca(2+). It therefore seems that mammalian oocytes can respond to a wide range of intracellular Ca(2+) signals and have a surprisingly high degree of tolerance for changes in cytosolic Ca(2+). As epigenetic consequences or differences in gene expression have not been studied to date, artificial oocyte activation has to be considered as experimental and should only be applied with a proper indication. PMID:26776820

  6. Oral health in pregnancy

    Directory of Open Access Journals (Sweden)

    Blagojević Duška

    2002-01-01

    Full Text Available Introduction Good oral health care during pregnancy is essential but often overlooked factor of dental growth as well as of other structures of oral cavity. Pregnancy is the time when conscious approach to preventive oral care should increase. Preventive measures during pregnancy Preventive measures during pregnancy mean usage of fluorides, special dietary measures and increased oral hygiene habits. Preventive measures in pregnant women have one goal: providing conditions for development of fetal teeth as well as preventing tooth decay in pregnant women. The optimal period for introducing preventive measures is the first trimester of pregnancy. Alterations of oral health during pregnancy Because of hormonal alterations there is an increased incidence of dental diseases: gingivitis and low salivary pH (inflammation and bleeding gums. Impact of nutrition during pregnancy on oral health Eating habits of pregnant women may lead to frequent snacking on candy or other decay-promoting foods, thereby increasing the risk of caries. However, very poor oral health, possible dental complications and their consequences to the health as well as emotional status represent very strong reasons for activation of dental health care in this period.

  7. Isolated congenital heart block in undifferentiated connective tissue disease and in primary Sjögren’s syndrome: a clinical study of 81 pregnancies in 41 patients

    Directory of Open Access Journals (Sweden)

    S. Todesco

    2011-09-01

    Full Text Available Objective: To study the incidence and the features of congenital heart block (CHB in patients with undifferentiated connective tissue disease (UCTD and primary Sjögren’s syndrome (pSS. Methods: We studied 81 pregnancies of 41 women attending the Outpatients’ Clinic of the Rheumatology Unit of University Hospital of Padova from July 1989 to March 2004. Twenty five of these (61% were affected with UCTD and 16 (39% with pSS. Serologic inclusion criteria was anti-Ro/La positivity, assessed by counterimmunoelectrophoresis and ELISA. Results: CHB was found in 2 out of the 46 (4,3% pregnancies followed by our Staff and in 2 out of the 35 (5,7% included in the retrospective part of the study. In 3 cases CHB was a 3rd degree block, causing pregnancy termination in 2. The only 2nd degree block was identified in one patient at the 22nd week of gestation and treated with dexamethasone and plasma-exchange. All of the women were positive to 52 kd and 60 kd Ro autoantibodies. CHB mothers had higher titer antibodies to 52 kd Ro protein than did the mothers with healthy infants (P = 0,026. Electrocardiographic abnormalities at birth were found in 3 out of 29 asymptomatic infants. One presented sinus bradycardia, the second abnormalities of ventricular repolarization, both regressed spontaneously, while the third ventricular extrasystoles which continue even now at 5 months. Conclusion: These results showed that in UCTD and pSS there is a higher incidence of CHB than that reported in Systemic Lupus Erythematosus. Electrocardiographic screening in all infants born to mothers with anti-Ro/La antibodies would seem an important measure to identify those with irreversible heart conduction abnormalities.

  8. 妊娠合并血小板减少105例临床分析%Clinical analysis of 105 patients with thrombocytopenia in pregnancy

    Institute of Scientific and Technical Information of China (English)

    黄鑫; 朱艳; 黄达; 余宏男

    2012-01-01

    Objective To investigate the pregnancy with the pathogenesis of thrombocytopenia and perinatal treatment. Methods We take the clinical data of 105 pregnant women with thrombocytopenia for retrospective study. Results There were 55 cases of PAT, 19 cases of ITP, 37 cases of PIH, 3 cases of liver disease and 1 case of systemic lupus erythematosus. And there were 65 ca ses of cesarean section, accounting for 61. 9% and 40 cases of vaginal delivery, accounting for 38. 1%. Conclusion The pregnancy with thrombocytopenia generally occurs in late pregnancy, and PAT is the most common. An appropriate prenatal platelet level in crease could reduce the incidence of complications.%目的 探讨妊娠合并血小板减少症的发病机制及围生期处理方法.方法 对105例妊娠合并血小板减少患者的临床资料作回顾性研究.结果 出现妊娠相关性血小板减少症(PAT)55例,特发性血小板减少性紫癜(ITP)19例,妊娠期高血压疾病先兆子痫(PIH)37例,肝病3例,系统性红斑狼疮1例.其中剖宫产65例,占61.9%;阴道分娩40例,占38.1%.结论 PAT一般发生在妊娠晚期,以PAT最常见,产前适当提高血小板水平,可以减少并发症发生.

  9. Clinical management and analysis of renal colic in pregnancy%妊娠期肾绞痛的临床治疗及分析

    Institute of Scientific and Technical Information of China (English)

    叶朝阳; 刘文刚; 李杰; 黎明

    2015-01-01

    目的:探讨妊娠期肾绞痛患者的临床治疗特点,总结临床经验。方法分析2010年6月~2012年6月因肾绞痛就诊于我院泌尿外科的49例妊娠期患者的临床资料。结果其中15例保守治疗后肾绞痛缓解。29例置入输尿管D-J管,3例行输尿管镜下钬激光碎石,2例行经皮肾造瘘术,所有妊娠期患者均顺利分娩。结论妊娠期肾绞痛的患者首选保守治疗,对于顽固性肾绞痛患者,外科治疗首选逆行插管引流尿液,必要时可选择输尿管镜检查或经皮肾穿刺。%Objective To analyze the clinical features of renal colic during pregnancy of renal colic during pregnancy. Methods A total of 49 pregnant women admitted into our hospital for renal colic from June 2010 to June 2012 were retrospectively analyzed. Results 15 patients underwent medicine therapy successfully. 29 cases underwent double J stents, 3 cases underwent holmium laser lithotripsy through ureteropyeloscopy, and 2 cases underwent percutaneous nephrostomy. 49 cases experienced full term pregnancy were likely to end in a lie birth. Conclusion For the pregnant women complicating with upper urinary tract calculi, medicine therapy is the preliminary consideration. The double J stents inserting, the percutaneous nephrostomy, and urteroscopy are safety choices.

  10. Clinical study on 67 cases of intrahepatic cholestasis during pregnancy%妊娠期肝内胆汁淤积症67例临床分析

    Institute of Scientific and Technical Information of China (English)

    赵菁; 陈瑶

    2012-01-01

    目的 探讨妊娠期肝内胆汁淤积症(ICP)的危害、监护与诊治方法.方法 以67例ICP患者为研究对象,并选择同期分娩的70例非ICP患者作为对照组,进行回顾性分析.结果 研究组胎儿窘迫率、羊水污染率、早产率、剖宫产率及产后出血率均显著高于对照组,差异有显著性(P<0.05).结论 ICP对胎儿危害严重,及时诊断、积极治疗、密切胎儿监护并适时终止妊娠能有效改善妊娠结局.%Objective To explore the hazard of intrahepatic cholestasis during pregnancy ( ICP ) and the method for its monitoring, diagnosis and treatment. Methods The clinical data of 67 cases of ICP were retrospectively analyzed, and 70 normal pregnant women were selected as control group. Results In comparison with control group, there were significant differences in rates of contaminated amniotic fluid, fetal distress, preterm labor, cesarean section and postpartum hemorrhage( P <0.05 ). Conclusion ICP will cause serious hazard to embryo, hence prompt diagnosis , proper treatment, carefully monitoring and timely termination of pregnancy are effective ways to improve the outcome of pregnancy.

  11. 垂体催乳素瘤合并妊娠的临床观察%Clinical observation on pituitary prolactinoma complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    冯娟娟; 吕敏茹; 白桂芹

    2012-01-01

    目的 观察垂体催乳素瘤合并妊娠患者的临床经过,为垂体催乳素瘤患者在孕期的监护及治疗提供依据.方法 选择陕西省妇幼保健院2000年1月至2010年1月确诊为垂体催乳素瘤并且怀孕的患者40例,观察其在孕期药物使用情况、垂体催乳素瘤大小的变化、视力及视野的改变、妊娠结局及胎儿发育情况等.结果 垂体催乳素微腺瘤患者33例,2例发生早产,2例发生自然流产,,其余29例患者均妊娠至足月,其中22例行剖宫产,7例阴道自然分娩,新生儿均存活,且无畸形.7例妊娠晚期MRI检查提示肿瘤增大,3例较前缩小,21例肿瘤大小无明显变化,均无头痛、视力改变及视野缺损等症状发生.垂体催乳素大腺瘤7例,妊娠经过及结局不良,仅有1例妊娠经过顺利,足月妊娠后行剖宫产,新生儿存活,无畸形;2例在妊娠中期出现头痛、视力缺损等症状,给予溴隐亭治疗后症状缓解,继续妊娠至足月,行剖宫产,新生儿存活,无畸形;1例妊娠中期出现上述症状,经溴隐亭治疗后未见明显缓解,引产后行手术+放射治疗;2例发生早期流产;1例于孕18周流产.结论 垂体催乳素微腺瘤患者孕期停药妊娠结局良好,而大腺瘤患者妊娠经过及结局不良,需引起临床工作者的重视.%To observe the clinical progress of pituitary prolactinoma complicating pregnancy in order to provide some evidence for monitoring and treatment for cases with pituitary prolactinoma in pregnancy. Methods From January 2000 to January 2010 40 pregnant cases diagnosed with pituitary prolactinoma in Shaanxi Maternal and Child Care Service Centre were selected in the study. The drug use during pregnancy, change of tumor size, change of eyesight and visual field, pregnancy outcomes and fetal growth were observed. Results There were 33 cases of microadenoma. Except 2 cases of premature birth and another 2 cases of spontaneous abortion, the other 29 had full

  12. N-carbamylglutamate enhances pregnancy outcome in rats through activation of the PI3K/PKB/mTOR signaling pathway.

    Directory of Open Access Journals (Sweden)

    Xiangfang Zeng

    Full Text Available Administration of N-carbamylglutamate (NCG, an analogue of endogenous N-acetyl-glutamate (an activator of arginine synthesis has been shown to enhance neonatal growth by increasing circulating arginine levels. However, the effect of NCG on pregnancy remains unknown. This study examined the effects of NCG on pregnancy outcome and evaluated potential mechanisms involved. Reproductive performance, embryo implantation, and concentration of amino acids in serum and uterine flushing, were determined in rats fed control or NCG supplemented diets. Ishikawa cells and JAR cells were used to examine the mechanism by which NCG affects embryo implantation. Dietary NCG supplementation increased serum levels of arginine, onithine, and proline, as well as uterine levels of arginine, glutamine, glutamate, and proline. Additionally, it stimulated LIF expression, and enhanced the activation of signal transduction and activator of transcription 3 (Stat3, protein kinase B (PKB, and 70-kDa ribosomal protein S6 kinase (S6K1 during the periimplantation period, resulting in an increase in litter size but not birth weight. In uterine Ishikawa cells, LIF expression was also enhanced by treatment with arginine and its metabolites. In trophoblast JAR cells, treatment with arginine and its metabolites enhanced Stat3, PKB, and S6K1 activation and facilitated cellular adhesion activity. These effects were abolished by pretreatment with inhibitors of phosphatidylinositol 3-kinase (wortmannin and mammalian target of rapamycin (rapamycin. The results demonstrate that NCG supplementation enhances pregnancy outcome and have important implications for the pregnancy outcome of mammalian species.

  13. [Diabetic retinopathy during pregnancy.

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Rasmussen, K.L.; Laugesen, C.S.;

    2008-01-01

    INTRODUCTION: The aim was to evaluate the prevalence and progression of diabetic retinopathy during pregnancy in women with type 1 or type 2 diabetes. MATERIAL AND METHODS: Dilated fundal photography was performed at approximately 10 and 28 gestational weeks in 58 and 18 women with type 1 and type...... 2 diabetes, respectively. Retinopathy was classified as five stages +/- macular oedema. Progression was defined as deterioration corresponding to at least one stage between the two examinations. Clinical parameters were obtained from the medical records. RESULTS: Diabetic retinopathy was found in 36...... among women with high HbA1c values in early pregnancy. A few women developed proliferations, macular oedema and reduction of visual acuity. Development of sight-threatening alterations during pregnancy remains a clinical problem Udgivelsesdato: 2008/12/8...

  14. Diabetes in pregnancy

    DEFF Research Database (Denmark)

    Feig, Denice S; Corcoy, Rosa; Jensen, Dorte Møller;

    2015-01-01

    BACKGROUND: Rising rates of diabetes in pregnancy have led to an escalation in research in this area. As in any area of clinical research, outcome definitions vary from study to study, making it difficult to compare research findings and draw conclusions. Our aim was to compile and create...... a repository of definitions, which could then be used universally. METHODS: A systematic review of the literature was performed of published and ongoing randomized controlled trials (RCTs) in the area of diabetes in pregnancy between Jan 1, 2000 and June 1, 2012. Other sources included the World Health...... Organization and Academic Society Statements. The advice of experts was sought when appropriate definitions were lacking. RESULTS: Among the published RCTs on diabetes and pregnancy, 171 abstracts were retrieved, 64 full texts were reviewed, and 53 were included. Among the ongoing RCTs published in Clinical...

  15. Zeta Sperm Selection Improves Pregnancy Rate and Alters Sex Ratio in Male Factor Infertility Patients: A Double-Blind, Randomized Clinical Trial

    Science.gov (United States)

    Nasr Esfahani, Mohammad Hossein; Deemeh, Mohammad Reza; Tavalaee, Marziyeh; Sekhavati, Mohammad Hadi; Gourabi, Hamid

    2016-01-01

    Background Selection of sperm for intra-cytoplasmic sperm injection (ICSI) is usually considered as the ultimate technique to alleviate male-factor infertility. In routine ICSI, selection is based on morphology and viability which does not necessarily preclude the chance injection of DNA-damaged or apoptotic sperm into the oocyte. Sperm with high negative surface electrical charge, named “Zeta potential”, are mature and more likely to have intact chromatin. In addition, X-bearing spermatozoa carry more negative charge. Therefore, we aimed to compare the clinical outcomes of Zeta procedure with routine sperm selection in infertile men candidate for ICSI. Materials and Methods From a total of 203 ICSI cycles studied, 101 cycles were allocated to density gradient centrifugation (DGC)/Zeta group and the remaining 102 were included in the DGC group in this prospective study. Clinical outcomes were com- pared between the two groups. The ratios of Xand Y bearing sperm were assessed by fluorescence in situ hybridization (FISH) and quantitative polymerase chain reaction (qPCR) methods in 17 independent semen samples. Results In the present double-blind randomized clinical trial, a significant increase in top quality embryos and pregnancy rate were observed in DGC/Zeta group compared to DGC group. Moreover, sex ratio (XY/XX) at birth significantly was lower in the DGC/Zeta group compared to DGC group despite similar ratio of X/Y bearings sper- matozoa following Zeta selection. Conclusion Zeta method not only improves the percentage of top embryo quality and pregnancy outcome but also alters the sex ratio compared to the conventional DGC method, despite no significant change in the ratio of Xand Ybearing sperm population (Registration number: IRCT201108047223N1).

  16. [Effects of active and passive smoking during pregnancy on the development of gestational hypertension and fetal hypotrophy].

    Science.gov (United States)

    Krzyścin, Mariola; Dera-Szymanowska, Anna; Napierała, Marta; Chuchracki, Marek; Markwitz, Wiesław; Breborowicz, Grzegorz H; Florek, Ewa

    2015-01-01

    In prenatal life the fetus can be exposed to more incentires which affect the mother. In case of both active and passive smoking by pregnant women many pernicious substances contained in tobacco smoke can influence the foetus. The components of tobacco smoke can contribute to various antenatal complications. The aim of present work was to assess if the data given by the patient in anonymous questionnaire go along with the real exposure to components of smoke assessed on the basis of concentration of nicotine metabolite- cotinine in mother's serum and next to assess the risk of development of gestational hypertension and hypotrophy. The biological material was extracted with means of liquid-liquid technique and next we performed laboratory determinations with means of liquid chro- matography with sectrophotometric detection, in which norephedrine is used as inner sample. The study was carried out on 106 women in perinatal period who give birth from single, full term pregnancy. On the basis of questionnaire data considering the concentration of cotinine, the patients were divided into three groups: I group--active smokers (n = 27), II group--passive smokers (n = 32), III group--not exposed to tobacco smoke (n = 41). The average concentration of cotinine in blood serum in the first group was 129.6 ng/ml, second group--5.1 ng/ ml, but in all patients from the control group the concentration of cotinine was below the detection level. Gestational hypertension was diagnosed in 17 women (16%) and hypotrophy of the foetus was diagnosed in 15 patients (14%). Tobacco smoking didn't influence the development of gestational hypertension and hypotrophy showered it is more often observed in women exposed to components of tobacco smoke during pregnancy. PMID:26731869

  17. HLA-G in human early pregnancy: control of uterine immune cell activation and likely vascular remodeling.

    Science.gov (United States)

    Le Bouteiller, Philippe

    2015-01-01

    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. PMID:25163504

  18. Clinical analysis of 38 cesarean scar pregnancy cases%剖宫产瘢痕妊娠38例临床分析

    Institute of Scientific and Technical Information of China (English)

    张磊; 关华; 胡金菊

    2015-01-01

    Objective To investigate choice of treatment strategies for uterine lower segmental cesarean scar pregnancy, and to provide method and reference for rationally clinical diagnosis and treatment. Methods Clinical data of 38 patients with cesarean scar pregnancy were retrospectively analyzed, along with their diagnosis and treatment process. Results Menolipsis occurred in all the 38 cases. There were 32 cases with vaginal bleeding (84.2%), 6 cases with vaginal bleeding and complicated mild lower abdominal pain (15.8%), and all of the cases with increased human chorionic gonadotropin (HCG). Pelvic color Doppler ultrasound was used in detection and diagnosis for all the 38 cases. There were 32 cases receiving drug therapy + uterine curettage, while 1 case among them received hysterectomy. The other 6 cases received laparoscopic removal of cesarean scar pregnancy with successful process. Conclusion Among multiple treatment methods for uterine lower segmental cesarean scar pregnancy, uterine curettage after decreased HCG to 1000 U/L by gestational sac injection of methotrexate (MTX) and laparoscopic lesion resection can provide few bleeding and precise effect. Improvement of clinical diagnosis for cesarean scar pregnancy, early diagnosis and treatment are necessary for avoiding occurrence of severe adverse reactions, and guaranteeing fertility function and health in patients.%目的:探讨子宫下段剖宫产瘢痕妊娠治疗策略的选择,为临床合理诊治提供方法及依据。方法回顾性分析38例剖宫产瘢痕妊娠患者的临床资料,分析其诊断及其治疗过程。结果38例患者均有停经,阴道流血者有32例(84.2%),6例表现为阴道流血伴下腹部轻微疼痛(15.8%),全部伴有血人绒毛膜促性腺激素(HCG)升高。38例均由盆腔彩超检测诊断,32例行药物治疗+清宫术,其中1例行子宫切除术;6例行腹腔镜下子宫切口瘢痕妊娠清除术,过程顺利。结论子宫下段剖宫产瘢痕妊娠的治

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

    Directory of Open Access Journals (Sweden)

    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.Este estudo examina os padrões de atividade física antes da concepção até o segundo trimestre de gravidez e a relação entre o nível de atividade física, com base nas recomendações de atividade física, a qualidade de vida relacionada à saúde (QVRS e depressão ao longo da gravidez. Cinquenta e seis grávidas saudáveis reportaram nível de atividade física, QVRS e depressão às 10-15 e 19-24 semanas de gravidez, além de atividade física antes da concepção. Enquanto a atividade física vigorosa no lazer diminuiu depois da concepção, as atividades físicas moderadas no lazer e no trabalho mantiveram-se estáveis. A prevalência de atividade física recomendada foi de 39,3%, 12,5% e 14,3% antes, no primeiro e no segundo trimestres de gravidez, respectivamente

  20. Analysis of tubal pregnancy

    International Nuclear Information System (INIS)

    Objective: This study was carried out to determine the frequency, etiological factors, modes of presentation, accuracy of diagnostic modalities, operative findings and surgical treatment of tubal pregnancies. Design: Observational study. Place and duration of study: This study was conducted in gynae unit iii, Sir Ganga Ram Hospital, Lahore from January 1995 to December 1996. Subject and Methods: All the patients diagnosed as a case of tubal pregnancy in two years period were included in the study. Detailed history regarding the symptoms and risk factors of tubal pregnancy was taken followed by clinical examination. The diagnostic and treatment modality used and operative findings were also recorded. All the data was recorded on a proforma and finally the results were analysed. Results: Incidence of tubal pregnancy was found out to be 1:305 deliveries. Out of these, 70% of the cases occurred in the age group of 21-30 years and in patients with low parity (in para 0-2) 65% of the patients had high risk factor e.g previous abdominopelvic surgery PID or history of infertility. Pain was the commonest symptom (90% of cases) followed by vaginal bleeding (80%) adnexal masses (70%) and amenorrhea (65%). Acute tubal pregnancy was found in 85% of the cases while 15% of cases had chronic tubal pregnancy. Tubal pregnancy in the ampullary region was detected in 65% patients. Conclusion: Previous abdominopelvic surgery, PID or history of infertility and use of intra-uterine contraceptive device are the main etiologic factors. Most of the patients present at a very late stage with ruptured tubal pregnancy followed by salpingostomy in 95% of cases. Only 5% of cases had conservative surgical treatment i.e salpingostomy. Culdocentesis ultrasonography and laparoscopy were good diagnostic modalities. (author)

  1. Diagnosis of Toxoplasmosis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Umit Savasci

    2012-12-01

    Full Text Available Toxoplasmosis is a common worldwide parasitic infection that caused by Toxoplasma gondii. The clinical progress is generally asymptomatic in patient with normal immune system, on the other hand severe clinical presentations seen in patients with immune deficiency or pregnancy. Congenital toxoplasmosis can emerge due to contamination during pregnancy but 6-8 weeks prior to pregnancy are also at risk. Infants with toxoplasmosis have some clinical semptoms such as chorioretinitis, epilepsia, hypotonia, psychomotor disorders, mental retardation, encephalitis, microcephaly, hydrocephalus, intracranial calcifications, hepatosplenomegaly. Early diagnosis during pregnancy and subsequent treatment. may prevent malformations. Toxoplasmosis diagnosis during pregnancy is mostly based on IgM and IgG antibody screening tests. While IgM indicates the acute infection, it disappears in early period and can be detected in low consantrations through long ages. Therefore IgG avidity test takes more place in the diagnosis of toxoplasmosis during pregnancy. High avidity levels indicate acquired infection prior than 16 weeks, so that it is recommended to perform the test in the first trimester. Low IgG avidity level may indicate a newly onset infection. Amniotic fluid T.gondii PCR, anomaly screening with ultrasonography, Toxoplasma gondii cyst dying with Wright-Giemsa dye in plasental and fetal tissue are the other diagnostic tools can be performed during pregnancy. Avidity test methods during the 16 weeks of pregnancy reduce repeating serum analysis, amniotic fluid PCR reguirement, unnecessary antibiotic treatments and noncompulsory abortus. [TAF Prev Med Bull 2012; 11(6.000: 767-772

  2. CLINICAL RESEARCH OF PULMONARY HYPERTENSION IN PREGNANCY%妊娠合并肺动脉高压临床研究

    Institute of Scientific and Technical Information of China (English)

    易媛媛; 其木格; 周晓霞

    2016-01-01

    Objective:To analyze the clinical characteristics of pregnant patients with pulmonary hypertension,and explore manner and timing of their delivery. Methods:To retrospective analyze 32 cases of pulmonary hypertension of pregnancy 2010 to 2014 in the department of obstetrics of our hospital. Result:According to pulmonary artery systolic pressure 32 patients were divided into mild group(30~40 mmHg)18 cases,moderate group(41~69 mmHg)9 cases,severe group(≥70 mmHg)5 cases. Perinatal child mortality 3 cases, maternal mortality 3 cases, early pregnancy embryo stop education 2 cases, second trimester stillbirth 2 cases, the rest discharge after childbirth and heart function improved. Conclusion:The higher pulmonary artery pressure,the worse maternal heart function and maternal outcomes. according to the patient the timing of termination of pregnancy should be integrated to determine,caesarean section to terminate the pregnancy is a safer way.%目的::分析妊娠合并肺动脉高压( pulmonary hypertension,PH)病人的临床特点,探讨其妊娠分娩方式与时机。方法:回顾分析2010~2014年在我院产科诊治32例妊娠合并肺动脉高压。结果:32例病人根据肺动脉收缩压情况分为轻度组(30~40 mmHg)18例,中度组(41~69 mmHg)9例,重度组(≥70 mmHg)5例。围生儿死亡3例,孕产妇死亡3例,孕早期胚胎停育2例,孕中期死胎2例,其余均在分娩后,心功能经改善后出院。结论:肺动脉压力越高,孕产妇心功能情况及母婴结局越差。应根据病人情况综合判断终止妊娠的时机,剖宫产手术终止妊娠是较安全方式。

  3. Pregnancy-associated plasma protein-A (PAPP-A) modulates early developmental rate in zebrafish independent of its proteolytic activity

    DEFF Research Database (Denmark)

    Kjær-Sørensen, Kasper; Engholm, Ditte Høyer; Kamei, Hiroyasu;

    2013-01-01

    Pregnancy-associated plasma protein-A (PAPP-A) is a large metalloproteinase specifically cleaving IGF binding proteins, causing increased IGF bioavailability and hence local regulation of IGF receptor activation. We have identified two highly conserved zebrafish homologs of the human PAPP-A gene...

  4. Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort.

    Directory of Open Access Journals (Sweden)

    Lesley M E McCowan

    Full Text Available OBJECTIVE: Small for gestational age (SGA infants comprise up to 50% of all stillbirths and a minority are detected before birth. We aimed to develop and validate early pregnancy predictive models for SGA infants. METHODS: 5628 participants from SCOPE, a prospective study of nulliparous pregnant women, were interviewed at 15 ± 1 weeks' gestation. Fetal anthropometry, uterine and umbilical Doppler studies were performed at 20 ± 1 weeks'. The cohort was divided into training (n = 3735 and validation datasets (n = 1871. All-SGA (birthweight 12 months to conceive, university student, cigarette smoking, proteinuria, daily vigorous exercise and diastolic blood pressure ≥ 80. Recreational walking ≥ 4 times weekly, rhesus negative blood group and increasing random glucose were protective. AUC for clinical risk factors was 0.63. Fetal abdominal or head circumference z scores <10(th centile and increasing uterine artery Doppler resistance at 20 ± 1 weeks' were associated with increased risk. Addition of these parameters increased the AUC to 0.69. Clinical predictors of Normotensive and Hypertensive-SGA were sub-groups of All-SGA predictors and were quite different. The combined clinical and ultrasound AUC for Normotensive and Hypertensive-SGA were 0.69 and 0.82 respectively. CONCLUSION: Predictors for SGA of relevance to clinical practice were identified. The identity and predictive potential differed in normotensive women and those who developed hypertension.

  5. Twin pregnancy

    DEFF Research Database (Denmark)

    Sperling, Lene; Tabor, A

    2001-01-01

    Determination of chorionicity is one of the most important issues in the management of twin pregnancy. Modern ultrasound equipment has made it possible to accurately assess placentation already in the first trimester with the lambda sign. With regard to prenatal diagnosis, it is important to know...... for clinicians caring for twin pregnancies....

  6. Sex during Pregnancy

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy ... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ...

  7. Academic physiatry. Balancing clinical practice and academic activities.

    Science.gov (United States)

    Grabois, M

    1992-04-01

    The need for continued and diversified growth of both scholarly and clinical activities within academic physical medicine and rehabilitation (PM&R) departments is discussed with reference to the demands placed on academic departments by the various components of their mission, such as administration, clinical service, education and research. The expansion and improvement of clinical services should include the following components: program development, resources needed, finances required and marketing. Clinical subspecialization of faculty and solid affiliation with nonacademic hospitals and rehabilitation facilities is essential for academic PM&R. The faculty should include three categories: clinical faculty, clinical-research faculty and research faculty. Adequate financial resources must comprise an appropriate balance of academic funds, clinical income and grant sources. Clinical funds will play a greater role as other sources of funds diminish. Any practice plan must recognize the equality of the differing faculty members' practices, whether their interests are clinical, educational or research-oriented. The expansion and intensification of clinical programs by academy PM&R departments could increase competition in the medical community. Sensitivity to the perceptions of other practitioners and institutions, careful planning and cooperation will help the field grow and improve levels of care for the patients we serve in light of the changing medical care environment.

  8. Decreased antitoxic activities among children with clinical episodes of malaria

    DEFF Research Database (Denmark)

    Jakobsen, P H; McKay, V; N'Jie, R;

    1998-01-01

    with clinical symptoms. Concentrations of soluble tumor necrosis factor receptor I and C-reactive protein were associated with levels of parasitemia. We detected antitoxic activities in sera as measured by their capacity to block toxin-induced Limulus amoebocyte lysate (LAL) activation. Symptomatic children had...

  9. Perspectives on tuberculosis in pregnancy

    OpenAIRE

    Matthew Bates; Yusuf Ahmed; Nathan Kapata; Markus Maeurer; Peter Mwaba; Alimuddin Zumla

    2015-01-01

    Tuberculosis (TB) has been recognized as an important cause of morbidity and mortality in pregnancy for nearly a century, but research and efforts to roll out comprehensive TB screening and treatment in high-risk populations such as those with a high prevalence of HIV or other diseases of poverty, have lagged behind similar efforts to address HIV infection in pregnancy and the prevention of mother-to-child-transmission. Immunological changes during pregnancy make the activation of latent TB i...

  10. Clinical Analysis of 38 Pregnancies with Thrombocytopenia%妊娠合并血小板减少症38例临床分析

    Institute of Scientific and Technical Information of China (English)

    刘桂玲; 邹青

    2011-01-01

    目的 探讨妊娠合并血小板减少症的病因、临床特征和诊治.方法 选取蚌埠第三人民医院2004年1月-2011年6月间就诊的38例妊娠合并血小板减少症患者进行回顾性分析.结果 妊娠合并血小板减少症的病因为妊娠相关性血小板减少(PAT)24例,免疫性血小板减少症(ITP)7例,再生障碍性贫血2例,营养性巨幼细胞性贫血2例,急性白血病1例,系统性红斑狼疮2例.治疗方法是给予糖皮质激素或丙种球蛋白或输注血小板等,其中23例行剖宫产,有1例出现产后出血,所有患者均未出现新生儿颅内出血及新生儿死亡.结论 妊娠期血小板减少原因较多并且多发生于妊娠中晚期,应积极治疗合并症和并发症,预防出血倾向及加强胎儿监护.对于血小板<50×109/L或有严重出血倾向的患者可予以糖皮质激素和(或)人血丙种球蛋白治疗,产前适当提高血小板水平,可以减少并发症的出现.%Objective To study the pathogeny,clinical characteristic,diagnosis and treatment of thrombocytopenia in pregnancy. Methods The clinical data of 38 pregnancies with thrombocytopenia from Jan. 2004 to Jun. 2011 in our hospital was analyzed retrospectively. Results In all 38 cases,24 were with pregnancy-associated thrombocytopenia (PAT) ,7 with immune thrombocytopenia,2 with aplastic anemia( AA) ,2 with nutritional megaloblastic anemia, 1 with acute leukemia(AL) ,2 with systemic lupus erythematosus( SLE). Glucocorticoid, immunoglobulin or platelet transfusion was selectively administered. The cesarean section was performed in 23 cases, and 1 case was with posrpartum hemorrhage. There was no intracranial hemorrhage of the newborn and perinatal mortality. Conclusion A number of causes may result in thrombocytopenia in pregnancy that mostly occurred in the middle-late pregnancy. More attentions should be paid on the treatment of complication to prevent the haemorrhage and carefully neonatal intensive care. For the

  11. Redefining women's work during pregnancy: toward a more comprehensive approach.

    Science.gov (United States)

    DeJoseph, J F

    1993-06-01

    The potential effects of work and activity on the processes and outcomes of pregnancy should be assessed when a woman's care plan is developed. Perinatal caregivers are limited by a narrow definition of work that encompasses only employment. This commentary expands the description of women's work during pregnancy, and proposes the addition of some activities not currently considered in most prenatal assessments, including home care responsibilities, the maintenance and development of intimate relationships, and the tasks identified with becoming a mother. All this has implications for research, clinical practice, and public and health policy. PMID:8240612

  12. Plasma progesterone concentrations during pregnancy and pseudopregnancy and onset of ovarian activity post partum in indigenous goats in Zimbabwe.

    Science.gov (United States)

    Llewelyn, C A; Ogaa, J S; Obwolo, M J

    1992-11-01

    Eight pregnant does were housed individually and fed a hay and concentrate diet throughout pregnancy and lactation. The mean gestation period was 146.7 +/- 3.0 days, with a twinning rate of 75 per cent. Mean body condition scores improved from 2.4 +/- 0.2 to 2.8 +/- 0.2 over the first 80 days of gestation and were maintained at 2.8 until 45 days before kidding. From then until kidding, mean scores fell to 2.2 +/- 0.2. Plasma progesterone concentrations during pregnancy rose significantly from 3.91 +/- 0.51 ng/ml on day 40 to 5.96 +/- 0.51 ng/ml on day 60 (P < 0.05) and remained high until 5 days before kidding. Three pseudopregnant does had similar progesterone profiles to pregnant does over the first 80 days, but the rise around day 35 to 40 was not significant and progesterone concentrations returned gradually to basal levels after day 100. The same 8 does, together with an additional 4 does which had been brought inside 60 to 70 days before kidding, were used to study onset of ovarian activity post partum. The twinning percentage was 83 per cent. Mean body condition score at parturition was 2.2 +/- 0.1. By day 35 post partum, mean condition scores had fallen to 1.9 +/- 0.1, and mean weights from 36.9 +/- 1.9 kg at kidding to 32.1 +/- 2.0 kg. Ovarian cyclicity was resumed just before mean scores and weights started to improve. The mean interval from kidding to onset of oestrous cycles was 97.3 +/- 9.5 days. This coincided with mean time to weaning which was 99.5 +/- 5.5 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1305347

  13. Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth

    Directory of Open Access Journals (Sweden)

    Kowalska, Joanna

    2014-10-01

    Full Text Available Aim. The aim of this study was to answer the question of whether physical activity during pregnancy and participation in childbirth classes prepare women for childbirth; further, does it influence the levels of perceived stress and the occurrence of depressed mood. Methods. 100 women participated in the study. Half of the women had taken part in the childbirth classes before giving birth. A questionnaires of own authorship, Edinburgh Postnatal Depression Scale (EPDS and Perceived Stress Scale (PSS-10 were used. Results. There was no significant relationship observed between participation in childbirth classes and the results of EPDS and PSS-10. The mood of women after childbirth correlated significantly with the level of stress in the whole study group (p<0.0001. Best mean wellbeing and lowest mean perceived stress were observed in women who stayed in a relationship (p = 0.0029, p = 0.0008. Women physically active during pregnancy were also characterized by better mood and lower levels of perceived stress (6.7 and 14.4 vs. 8.4 and 16.0. Among women exercising during pregnancy the participants in childbirth classes was far more numerous (p<0.0001. Conclusions. Declared physical activity during pregnancy was linked to lower levels of stress experienced by women and less severe depressive symptoms after childbirth, especially in the group of childbirth classes participants.

  14. 17-Hydroxyprogesterone caproate to prolong pregnancy after preterm rupture of the membranes: early termination of a double-blind, randomized clinical trial

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    Combs C Andrew

    2011-12-01

    Full Text Available Abstract Background Progestational agents may reduce the risk of preterm birth in women with various risk factors. We sought to test the hypothesis that a weekly dose of 17-hydroxyprogesterone caproate (17P given to women with preterm rupture of the membranes (PROM will prolong pregnancy and thereby reduce neonatal morbidity. Methods Double-blind, placebo-controlled randomized clinical trial. Women with PROM at 23.0 to 31.9 weeks of gestation were randomly assigned to receive a weekly intramuscular injection of 17P (250 mg in 1 mL castor oil or placebo (1 mL castor oil. The primary outcome was the rate of continuing the pregnancy until 34.0 weeks of gestation or until documentation of fetal lung maturity at 32.0 to 33.9 weeks of gestation. Planned secondary outcomes were duration of latency period and rate of composite neonatal morbidity. Enrollment of 111 participants per group, 222 total, was planned to yield 80% power to detect an increase in the primary outcome from 30% with placebo to 50% with 17P. Results Twelve women were enrolled of whom 4 were randomly assigned to receive 17P and 8 to receive placebo. The trial was terminated prematurely because of two separate issues related to the supply of 17P. No adverse events attributable to 17P were identified. Conclusion Because of premature termination, the trial does not have adequate statistical power to evaluate efficacy or safety of 17P in women with PROM. Nonetheless, ethical principles dictate that we report the results, which may contribute to possible future metaanalyses and systematic reviews. Trial Registration ClinicalTrials.gov: NCT01119963 Supported by a research grant from the Center for Research, Education, and Quality, Pediatrix Medical Group, Sunrise, FL

  15. Clinical characteristics and outcomes of cerebral venous sinus thrombosis during pregnancy and puerperium%妊娠期及产褥期合并颅内静脉窦血栓患者的临床特点及结局

    Institute of Scientific and Technical Information of China (English)

    周齐; 王凤英; 张鹏; 龙晓宇; 孙晓燕; 刘彤

    2010-01-01

    Objective To explore the clinical features and outcomes of patients with cerebral venous sinus thrombosis (CVT) during pregnancy and puerperium.Methods A retrospective study was performed in 24 cases of pregnant women with CVT among 15 625 deliveries in Xuanwu Hospital fromJanuary 2002 to October 2009,including 7 cases happened during pregnancy and 17 during puerperium.The etiology,clinical presentations,imaging examination results,other relevant examinations,and pregnant outcomes of these patients were analyzed.Results (1) Incidence and etiology:the incidence of CVT during pregnancy and puerperium was 0.15% (24/15 652) and 29% (7/24) of the patients fell ill during pregnancy and 71% (17/24) during puerperium.Five were complicated with severe preeclampsia,while another 5 complicated with hyperemesis.One woman was complicated with anemia.CVT was identified after spontaneous delivery in 9 cases and 8 after cesarean section.(2) Clinical presentations:Among the 24 CVT cases,22(92% ) suffered from headache,16(67% ) reported nausea and vomiting,15(63% )experienced hyperspasmia and 6 (25%) complained of blurred vision.On admission,8 (33%) patients were unconscious,3 (13%) with hemiplegia,and 8 (33%) were febrile.(3) Imaging and laboratory examinations:twelve patients underwent digital subtraction arteriography ( DSA) and were diagnosed.Fifteen women showed superior sagittal sinus thrombosis in MRI and magnetic resonance intravenous angiograph(MRV).Examination of the fundus found papilledema in 4 cases.Normal cerebral sinus fluid and laboratory routine tests were reported in 13 cases,but 6 cases of hyperlipidemia,7 cases of abnormal activated partial thromboplastin time ( APTT),5 cases of abnormal international normalized ratio (INR),3 cases elevated platelet count,4 cases of positive D-dipolymer,1 cases of low hemoglobulin level ( 4 g/L) were identified.(4) Management and pregnancy outcomes; among the 7 cases happened during pregnancy,2 were complicated with severe

  16. The clinical efficacy of methotrexate and 5-fluorouracil in the interventional treatment of uterine incisional pregnancy after cesarean section: a comparative study

    International Nuclear Information System (INIS)

    Objective: To compare the interventional therapeutic efficacy of methotrexate (MTX) with that of 5-fluorouracil (5-FU) in treating uterine incisional pregnancy after cesarean section. Methods: A total of 92 patients with uterine incisional pregnancy after cesarean section, who were admitted to the hospital during the period from 2007 to 2010, were randomly divided into two groups: group MTX and group 5-FU. Patients in group MTX (n=46) received intra-arterial infusion of MTX (60-200) mg, which was followed by arterial embolization. Patients in group 5-FU (n=46) received intra-arterial infusion of 5-FU (1000-1250) mg, which was followed by arterial embolization. After the treatment the serum β-HCG and progesterone levels were determined daily for three succeeding days. The patients were followed up for three months. The clinical results were compared between the two groups. Results: The cure rates in group MTX and group 5-FU were 97.2% and 100%, respectively. No significant difference in cure rate existed between the two groups (P>0.05). A rapid fall in the serum β-HCG and progesterone levels within 1-3 days after the treatment were detected in 40 cases of group MTX and 38 cases of group 5-FU, and the decreasing extent was over 50%-80%, but the difference between the two groups was not significant (P>0.05). At the operation day, all patients of both groups had abdominal pain, and three patients in group MTX and 2 patients in 5-FU group had nausea and vomiting, but the difference between the two groups was not significant (P>0.05). During the follow-up period, no significant difference in the recovery time of the mental cycle and the hormone levels were found between the two groups (P>0.05). Conclusion: For the interventional treatment of uterine incisional pregnancy after cesarean section, the use of MTX has the same clinical efficacy as the use of 5-FU does. (authors)

  17. Pregnancy-induced hypertension in a rat heterogeneity model.

    NARCIS (Netherlands)

    J.W.M. Hutten

    1988-01-01

    textabstractThis thesis presents an approach to develop pregnancy-induced hypertension (PIH) in animals by means of an immunologic model. Hypertensive pregnancy disorders in man may be considered a clinical expression of maladaptation in pregnancy. Maladaptation disease develops early in pregnancy,

  18. A cervical ectopic masquerading as a molar pregnancy.

    Science.gov (United States)

    Masir, N; Tamby, M R; Jamil, M A

    2000-03-01

    We report a case of cervical pregnancy complicated by life threatening hemorrhage. An initial diagnosis of molar pregnancy was made preoperatively. During uterine evacuation she developed profuse hemorrhage which required an emergency hysterectomy for uncontrolled bleeding. Histopathological examination confirmed a cervical pregnancy. The clinical and pathological criteria for the diagnosis and the etiology of cervical pregnancy are discussed. PMID:11072500

  19. Intrahepatic cholestasis of pregnancy

    Institute of Scientific and Technical Information of China (English)

    Victoria Geenes; Catherine Williamson

    2009-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus in the third trimester, raised serum bile acids and increased rates of adverse fetal outcomes. The etiology of ICP is complex and not fully understood, but it is likely to result from the cholestatic effects of reproductive hormones and their metabolites in genetically susceptible women. Equally unclear are the mechanisms by which the fetal complications occur. This article reviews the epidemiology, clinical features, diagnosis, etiology and management of ICP.

  20. 112 eases of clinical analysis on the pregnancy associated with cardiac disease%妊娠合并心脏病112例临床分析

    Institute of Scientific and Technical Information of China (English)

    苏碧霞; 唐助; 黎洁贞

    2008-01-01

    目的 探讨妊娠合并心脏病的种类、围生期处理及妊娠结局.方法 (1)总结1998年至2007年间某院112例妊娠合并心脏病患者的临床资料.(2)按病因对患者进行心脏病种类分析.(3)按病情轻重程度分为两组,心功能Ⅰ~Ⅱ级患者80例(A组),心功能Ⅲ~Ⅳ级患者32例(B组),并对比两组患者的妊娠结局.结果 (1)妊娠合并心脏病的种类主要为先天性心脏病和心脏瓣膜关闭不全.(2)B组患者的剖宫产率为93.8%,A组患者的剖宫产率为70.0%,两组比较差异有统计学意义(P<0.01).(3)A组患者无孕产妇死亡,B组患者孕产妇死亡2例,均为妊娠期高血压性心脏病、子痫患者.(4)B组患者的早产、新生儿窒息、围生儿死亡发生率分别为43.8%、25.0%、12.5%,明显高于A组的12.5%、2.5%、0,两组比较差异有统计学意义(P<0.01).结论 妊娠合并心脏病是引起孕产妇死亡及围生儿死亡的主要原因,规范的产前检查,适时终止妊娠及相关学科的密切合作能改善妊娠结局.%Objective This article intends to study the varieties of the prenancy associated with cardiac dis-ease, how to treat with the perinataI period and the pregnancy outcome. Methods (1)Sum up 112 sufferers' clinical data of the pregnancy associated with cardiac disease in this hospital from 1998 to 2007. (2)Analysc the varieties of the pregnancy associated with cardiac disease according to the sufferers' pathogeny. (3)Divided into two groups ac-cording to the state of an illness,80 cases are the heart function Ⅰ~Ⅱ (group A) ,32 cases are heart function Ⅲ~Ⅳ (group B) ,and contrast the two group sufferers' pregnancy outcome. Results (1)The varieties of the pregnancy associated with cardiac disease are mainly the congenital heart disease and the incompetency heart valve. (2)The rate of the uterine-incision delivered sufferers in group B is 93.8 % ,while the other one of the uterine-incision deliveredsufferers in group A is 70

  1. A comparative study between cleavage stage embryo transfer at day 3 and blastocyst stage transfer at day 5 in in-vitro fertilization/intra-cytoplasmic sperm injection on clinical pregnancy rates

    Directory of Open Access Journals (Sweden)

    Prabhleen Kaur

    2014-01-01

    Full Text Available Objective: To evaluate the efficacy of blastocyst transfer in comparison with cleavage stage transfer. Study Design: A randomized, prospective study was conducted in Infertility clinic, Department of Obstetrics and Gynecology, Mahatma Gandhi Hospital, Jaipur on 300 patients aged 25-40 years undergoing in-vitro fertilization (IVF/intra-cytoplasmic sperm injection (ICSI cycle from May 2010-April 2011. When three or more Grade-I embryos were observed on day 2 of culture, patients were divided randomly into two study groups, cleavage stage transfer and blastocyst transfer group having 150 patients each. Primary outcomes evaluated were, Clinical pregnancy rate and Implantation rate. The results were analyzed using proportions, standard deviation and Chi-square test. Results: Both the groups were similar for age, indication and number of embryos transferred. Clinical pregnancies after blastocyst transfer were significantly higher 66 (44.0% compared to cleavage stage embryo transfer 44 (29.33% (P < 0.01.Implantation rate for blastocyst transfer group was also significantly higher (P < 0.001. Conclusion: Blastocyst transfer having higher implantation rate and clinical pregnancy rate lead to reduction in multiple pregnancies.

  2. Pregnancy induces transcriptional activation of the peripheral innate immune system and increases oxidative DNA damage among healthy third trimester pregnant women.

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    Xinyin Jiang

    Full Text Available BACKGROUND: Pregnancy induces physiological adaptations that may involve, or contribute to, alterations in the genomic landscape. Pregnancy also increases the nutritional demand for choline, an essential nutrient that can modulate epigenomic and transcriptomic readouts secondary to its role as a methyl donor. Nevertheless, the interplay between human pregnancy, choline and the human genome is largely unexplored. METHODOLOGY/PRINCIPAL FINDINGS: As part of a controlled feeding study, we assessed the influence of pregnancy and choline intake on maternal genomic markers. Healthy third trimester pregnant (n = 26, wk 26-29 gestation and nonpregnant (n = 21 women were randomized to choline intakes of 480 mg/day, approximating the Adequate Intake level, or 930 mg/day for 12-weeks. Blood leukocytes were acquired at study week 0 and study week 12 for microarray, DNA damage and global DNA/histone methylation measurements. A main effect of pregnancy that was independent of choline intake was detected on several of the maternal leukocyte genomic markers. Compared to nonpregnant women, third trimester pregnant women exhibited higher (P<0.05 transcript abundance of defense response genes associated with the innate immune system including pattern recognition molecules, neutrophil granule proteins and oxidases, complement proteins, cytokines and chemokines. Pregnant women also exhibited higher (P<0.001 levels of DNA damage in blood leukocytes, a genomic marker of oxidative stress. No effect of choline intake was detected on the maternal leukocyte genomic markers with the exception of histone 3 lysine 4 di-methylation which was lower among pregnant women in the 930 versus 480 mg/d choline intake group. CONCLUSIONS: Pregnancy induces transcriptional activation of the peripheral innate immune system and increases oxidative DNA damage among healthy third trimester pregnant women.

  3. Pregnancy Outcomes and Appropriate Timing of Pregnancy in 183 pregnancies in Korean Patients with SLE

    Directory of Open Access Journals (Sweden)

    Hyun Sun Ko, Hyun Young Ahn, Dong Gyu Jang, Sae-Kyung Choi, Yong-Gyu Park, In Yang Park, Guisera Lee, Sung-Hwan Park, Jong Chul Shin

    2011-01-01

    Full Text Available This study was undertaken to investigate the pregnancy outcomes in patients with systemic lupus erythematosus (SLE and the appropriate timing of pregnancy. We performed a retrospective evaluation of 183 pregnancies with SLE at Catholic University Medical Center during the 13-year period from 1998 to 2010. Pregnancy outcomes were compared according to SLE characteristics. The predictive value of the different cut-off points of the stable period before conception on adverse pregnancy outcomes was calculated by ROC (Receiver operating characteristics curve analysis. In multivariate analysis, the presence of antiphospholipid antibodies (aPLs increased the risk of pregnancy loss (p<0.0001 and premature birth (p=0.0040. Active disease at conception increased the risk of premature birth (p< 0.0001 and complications (IUGR, PIH, or both (p= 0.0078. The other predictor of complications was found to be lupus flare (p=0.0252. At a cut-off level of stable period of 4 months before conception, sensitivity and specificity were 70.8% and 53.2%, 71.4% and 61.5%, and 63.6 % and 59.8 %, respectively on reducing pregnancy loss, premature birth, and complications. Pregnancies with aPLs, active disease at conception and SLE flares are at a higher risk of adverse outcomes. It is essential that disease activity remains stable at least 4 months before conception, for favorable pregnancy outcomes.

  4. Clinical value of detection of HPL-expressing intermediate trophoblasts in abortion or curettage-obtained specimens for diagnosis of intrauterine or ectopic pregnancies

    International Nuclear Information System (INIS)

    Objective: To investigate the value of detection of HPL-expressing intermediate trophoblasts in endometrial specimens for diagnosis of intrauterine and ectopic pregnancies. Methods: The examined specimens included: (1) Group I, 35 specimens with suspected intermediate trophoblast in decidua (2) Group II, 30 specimens with decidua-like plump endometrial stroma cells and/ or A-S phenomena in glandular epithelium (3) 30 specimens from proven intrauterine pregnancies serving as controls. Histochemistry (SP method) was used for HPL detection in all these specimens. Results: In the 30 proven intrauterine pregnancies, decidua and villa were present in all the specimens. Only 24 of the 30 were found to be HPL(+) with 6 HPL negatives (20%). In Group I , 28 of the 35 specimens were found to be HPL(+) and all of 28 were from intrauterine pregnancies: Of the 7 HPL negative cases, 5 were later confirmed as with ectopic pregnancy, the remaining 2 were with intrauterine pregnancy. In Group II, 22 of 30 specimens were HPL(+) and all were from intrauterine pregnancy. Of the 8 HPL negative cases, 6 were later confirmed as with ectopic pregnancy and 2 were with intrauterine pregnancy. Combining the data from Group I and II, we could see that in the total 15 HPL negative cases, 11 were with ectopic pregnancy (11/15=73.3%) and 4 were with intrauterine pregnancy (4/15=26.7%). Conclusion: In specimens of intrauterine contents, demonstration of HPL (+) cells could be regarded as confirmative evidence of intrauterine pregnancy. However, the reverse did not hold true. Many of the HPL negative specimens were from intrauterine pregnancies (in this study 4/15 or 26.7%). Therefore, in HPL negative cases, there was a high possibility of ectopic pregnancy but further examinations were required to ascertain the diagnosis. (authors)

  5. Abdominal pregnancy as a cause of hemoperitoneum

    Directory of Open Access Journals (Sweden)

    Shafi Sheikh

    2009-01-01

    Full Text Available The coexistence of intrauterine and extrauterine pregnancy, the heterotopic pregnancy, is a rare obstetric phenomenon. The preoperative diagnosis of this condition is very difficult; leading to a higher maternal morbidity and fetal loss. We experienced a case of intrauterine pregnancy and ruptured abdominal pregnancy implanted on the illeocaecal region in a 26-year-old primiparous woman. She was clinically misdiagnosed as a case of ruptured ectopic pregnancy, but ultrasonography showed it to be a case of heterotopic pregnancy. Subsequently, the patient was subjected to laparotomy and the ruptured abdominal pregnancy was evacuated. She continued with the intrauterine pregnancy till term and delivered a healthy female baby. Although this condition is unusual, any general surgeon in the emergency department must be aware of this complication and its management, which is often initially misdiagnosed.

  6. 妊娠期高血压疾病合并脑血管疾病的临床观察%Clinical observation on hypertensive disorder complicating pregnancy combined with cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    阚淑娟; 陈永立; 李云霞

    2011-01-01

    Objective: To explore the causes, preventive measures and therapeutic schedule of hypertensive disorder complicating pregnancy (HDCP) combined with cerebrovascular disease. Methods: The clinical data of 487 cases with HDCP combined with cerebrovas-cular disease who were treated in the hospital from 2003 to 2008 were analyzed retrospectively. Results: 2 416 patients with HDCP were treated in the hospital from 2003 to 2008, and 487 patients were combined with cerebrovascular disease (20. 16% ) , including 23 patients with subarachnoid hemorrhage, 58 patients with cerebral hemorrhage and 406 patients with cerebral infarction. The clinical symptoms included headache, dizziness, somnolence, blurred vision, disturbance of consciousness, vomiting, hyperspasmia, limb sensory disturbance or mild dyskinesia; the diagnosis was confirmed by CT or MRI; after termination of pregnancy timely, spasmolysis and depressurization, one pregnant woman and three fetuses died. Conclusion: HDCP should be prevented actively during pregnancy, and cerebrovascular blood flow should be monitored regularly. For patients with HDCP combined with cerebrovascular disease, timely cerebral CT and MRI should be carried out for definite diagnosis, terminating pregnancy timely and active treatment are important to ensure the safety of mothers and their infants.%目的:探讨妊娠期高血压合并脑血管疾病的发病原因、预防措施以及治疗方案.方法:回顾性分析该院2003~2008年收治的487例妊娠期高血压疾病合并脑血管疾病的临床资料.结果:2003~2008年共收治妊娠期高血压疾病患者2 416例,其中合并脑血管疾病487例(20.16%),包括蛛网膜下腔出血23例,脑出血58例和脑梗死406例.临床症状包括头痛、眩晕、嗜睡、视物模糊、意识障碍、呕吐、抽搐以及肢体感觉或轻度运动障碍;头颅CT或MRI检查后可确诊;及时终止妊娠,解痉降压治疗后,1例产妇死亡,3例胎儿死亡.结论:妊娠

  7. Pregnancy Loss

    Science.gov (United States)

    ... Pregnancy that ends before 20 weeks is called miscarriage. Miscarriage usually happens because of genetic problems in the ... uterus or cervix might play a role in miscarriage. Health problems, such as polycystic ovary syndrome , might ...

  8. Multiple Pregnancy

    Science.gov (United States)

    ... Can multiple pregnancy affect my risk of postpartum depression? Having multiples might increase your risk of postpartum ... Membership For Journalists For Junior Fellows For Medical Students For Patients Contact Us Copyright Information Privacy Statement ...

  9. Dydrogesterone use in early pregnancy.

    Science.gov (United States)

    Mirza, Fadi Ghazi; Patki, Ameet; Pexman-Fieth, Claire

    2016-01-01

    Successful oocyte implantation and a favorable pregnancy outcome rely on optimal progesterone levels. Therefore, progesterone deficiencies associated with infertility and miscarriage have commonly been treated with progestogens that mimic the activity of progesterone. Among those is dydrogesterone, an oral retrosteroid with a structure closely related to that of progesterone yet with a greater bioavailability and higher selectivity for the progesterone receptor. This review describes the efficacy of dydrogesterone for the treatment of threatened and recurrent miscarriage, and infertility due to luteal phase insufficiency. Data from clinical trials evaluating dydrogesterone in assisted reproductive technology are also discussed. Prospective clinical trials, systematic reviews and meta-analyses have demonstrated that dydrogesterone significantly improves pregnancy outcomes in women with threatened miscarriage or with a history of miscarriage. Although this is not yet a registered indication, dydrogesterone was as effective as vaginal micronized progesterone for luteal phase support in the setting of assisted reproductive technology. The safety and tolerability of dydrogesterone treatment in pregnant women are also briefly addressed and the data support a well-established and favorable benefit-risk profile. PMID:26800266

  10. Denied pregnancy.

    Science.gov (United States)

    Habek, Dubravko

    2010-06-01

    Two cases of non-psychotic denied pregnancy are presented and discussed. Following obstetric expertise, the forensic-criminal evaluation should investigate the reported crimes of denied pregnancy associated infanticide or criminal abortion as well as the potential involvement of other persons in these crimes. All this would require close collaboration between obstetricians, psychiatrists and crime investigation experts in the forensic expertise of these criminal offences.

  11. Correlation Questions Clinical Discussion of Uterine Artery Embolization in Induced Abortion Patients with Management of Cesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    Ai-hua FAHG; Qin-fang CHEN; Zao-xia QIAN; Qun-ying LI; Yu MENG

    2009-01-01

    Objective To analyze retrospectively the utility of uterine arterial embolization(UAE)for cesarean scar pregnancy(CSP).Methods Fifty-one women with CSP were pretreated with UAE before dilatation & curettage(D&C).Indexes such as blood loss volume,operation-associated complications,serum hCG level,ultrasound imaging and hospitalization cost were analyzed.Results Thirty-eight women accepted D&C following UAE(group A),10 patients had medicine(3 took trichosanthin injection,7 took MTX injection)before UAE and D&C(group B).Uterine packing following emergency UAE were performed in another 3 women due to severe hemorrhage during direct curettage without pretreatment (group C).There were no statistically significant differences between group A and group B about the serum β-hCG level resolution time and the blood loss in the opertation.Patients had shorter duration of hospital stay(P<0.01)and cheaper cost of hospitalization(P<0.05)of group A than group B.Conclusion Pretreatment with UAE before curettage is safe and effective in terminating CSP,reducing hospitalization cost.UAE followed by curettage is recommended to medical facilities where UAE is available.

  12. Clinical Observation on Termination of Early Pregnancy of 213 Cases after Caesarian Section with Repeated Use of Mifepristone and Misoprostol

    Institute of Scientific and Technical Information of China (English)

    高佩佩; 汪平

    1999-01-01

    Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.

  13. Diagnosis early period uterine scar pregnancy of clinical analysis%早期诊治子宫瘢痕妊娠的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘素云; 李高文; 陈芳

    2011-01-01

    Objective Discussion early period diagnosis uterine scar pregnancy effective method.Methods According to clinical medical history,HCG test,Type-B ultrasonic ( MR if Necessary) diagnosis.Under type-B ultrasonic monitoring clear uterine after interventional embolization of uterine artery drug infusion.Results 41 cases (89.13% ) according to clinical mdical history,HCG test,Type-B ultrasonic diagnosis.5 cases( 10.87% ) diagnosed with nuclear magnetic resonance(MR),diagnosis rate 100%.46 cases disposable thorough clear uterine after interventional? embolization of uterine artery drug infusion,cure rate 100%.Conclusion According of clinical medical history,HCG test,Type-B ultrasonic was the best method of diagnosis uterine scar pregnancy in early period.Using interventional embolization of uterine artery drug infusion and then clear it,it was Safe reliable method.%目的 探讨早期诊治子宫瘢痕妊娠的有效方法.方法 根据临床病史,HCG值检验,超声检查(必要时MR)诊断.先行介入子宫动脉药物灌注栓塞术后,在超声监视下清宫.结果 41例(89.13%)根据临床病史、HCG值检验、超声检查确诊,5例(10.87%)借助核磁硔振(MR)确诊,诊断符合率100%.46例经子宫动脉药物灌注栓塞术后清宫,一次性彻底清宫完,治愈率100%.结论 根据临床病史,HCG值检验,超声检查是子宫瘢痕妊娠早期诊断有效方法.先行介入子宫动脉药物灌注栓塞术再清宫,是治疗子宫瘢痕妊娠安全可靠方法.

  14. Active Interventions in Clinical Practice: Contributions of Gestalt Therapy.

    Science.gov (United States)

    Lammert, Marilyn; Dolan, Mary M.

    1983-01-01

    Describes two dimensions of Gestalt therapy that can enhance clinical practice--orientation to the present and active-experimental style--and examines them in relation to some traditional principles of practice. Gestalt theory offers a method of discovery that is a combination of phenomenology and behaviorism. (JAC)

  15. Is ACOG guideline helpful for encouraging pregnant women to do exercise during pregnancy?

    Directory of Open Access Journals (Sweden)

    Fatemeh Davari Tanha

    2014-06-01

    Full Text Available To evaluate physical activity of pregnant women before and after ACOG guideline study. Four hundred and eighty-five pregnant women enrolled in this before-after study. They were asked to study ACOG guideline. A structured questionnaire filled by women at first visit and the last visit in the prenatal clinic.Type, frequency, duration and anxiety about doing exercises during pregnancy period. Before education, 411 did exercises before pregnancy onset, among them, 346 were walking out and 65 did light exercises such as aerobics. After studying the protocol, 434 (89.4% did walking during pregnancy period in comparison to 71% who did walking before pregnancy (P<0.001. Forty two (56.7% out of 74 who had not done sport before, went for walking after the protocol reading, and nine continued not doing exercise. Among 74 participants who had not done exercise before the protocol reading, 16 (21% were doing exercise three times a week and 11 (14% changed their habit to daily exercise practice (P<0.001. Forty percent (195 women were anxious about doing exercise during pregnancy before guideline study, while 116 reported that after the protocol reading, they had no anxiety about doing exercises during pregnancy (P<0.001. Guidelines providing information about physical activity during pregnancy will help pregnant women to do exercise during pregnancy with convenience and less anxiety.

  16. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes

    OpenAIRE

    Murphy, V E; Clifton, V.L.; Gibson, P G

    2006-01-01

    Exacerbations of asthma during pregnancy represent a significant clinical problem and may be related to poor pregnancy outcomes. A systematic review of the literature was conducted for publications related to exacerbations during pregnancy. Four studies with a control group (no asthma) and two groups of women with asthma (exacerbation, no exacerbation) were included in meta‐analyses using fixed effects models. During pregnancy, exacerbations of asthma which require medical intervention occur ...

  17. Immunosuppressive activity of human amniotic fluid of normal and abnormal pregnancies.

    Science.gov (United States)

    Shohat, B; Faktor, J M

    1988-01-01

    Twenty specimens of amniotic fluid (AF) obtained between week 16 and 18 of gestation from normal pregnant women and six specimens from pregnant women in which trisomia of chromosome 21 was found were tested for immunosuppressive activity. Incubation of normal human donor lymphocytes with 0.2-1 mL of AF from normal pregnant women for one hour at 37 degrees C was sufficient for induction of significant inhibition of the ability of these cells to induce a local xenogeneic graft-versus-host reaction (GVHR) as well as inhibition of E and E-active rosette formation, the GVHR being the most sensitive test. On the other hand, amniotic fluid obtained from the six pregnant women in which trisomia of chromosome 21 was found showed no inhibitory activity in either the E or E-active rosette formation, nor in the local xenogeneic graft-versus-host reaction. AF from all the women tested was found to have no effect on phenotype expression of the lymphocytes, as tested by the monoclonal antibodies OKT4+ and OKT8+, nor on B-lymphocytes, as tested by surface immunoglobulins. No correlation was found between the alpha-fetoprotein levels in the sera of those women and the immunosuppressive activity. These findings indicate that genetic defects of the conceptus are not limited to the embryo but may affect the composition of immunosuppressive components present in normal amniotic fluid.

  18. [Pregnancy and vaccinoprevention].

    Science.gov (United States)

    Galev, A; Nacheva, A

    2014-01-01

    Vaccinations protect woman and her fetus against different infectious diseases, but their application on pregnant should be extremely responsible. In this review I present information about some infectious diseases and vaccines during pregnancy. Women, planning to get pregnant should be advised to do serological tests in order to find out their immune status against some infections, leading to fetal congenital malformations (rubella, chicken pox, hepatitis B) and if necessary to get vaccinated at least a month before pregnancy. Despite the lack of vaccines against Cytomegalovirus (CMV), parvovirus 19 and Toxoplasma gondii it is good to know woman's immune status against these infections in order to clarify the clinical approach in case of future contact with sick or carriers. Parvovirus 19 could cause fetal death, while CMV could be transmitted to the child. Immune women wouldn't get sick and wouldn't transmit Toxoplasmagondii to the fetus during pregnancy. Recommended vaccines before pregnancy include vaccines against flu, human papilloma virus, MMR (morbilli, measles, rubella), Tdap (tetanus, diphtheria, whooping cough), chicken pox. CDC-Atlanta recommends during pregnancy two vaccines--against flu, in case it wasn't done before pregnancy, and Tdap during every pregnancy between 27-th and 36-th gestation week. Whooping cough is very dangerous for the baby during the first two months after birth, while it is not yet vaccinated. From this point of view it is of best interest of the mother to have strong immunity in order to transfer antibodies during breastfeeding, as well as for the father and the rest who will take care for the newborn child to be vaccinated against whooping cough. During pregnancy vaccinations against tuberculosis, morbilli, measles, rubella, meningococcal disease, typhoid fever and chicken pox are contraindicated. In case of contact vaccinations against rabies, anthrax, small pox, poliomyelitis and yellow fever should be taken into

  19. Has increased clinical experience with methotrexate reduced the direct costs of medical management of ectopic pregnancy compared to surgery?

    Directory of Open Access Journals (Sweden)

    Westaby Daniel T

    2012-09-01

    Full Text Available Abstract Background There is a debate about the cost-efficiency of methotrexate for the management of ectopic pregnancy (EP, especially for patients presenting with serum human chorionic gonadotrophin levels of >1500 IU/L. We hypothesised that further experience with methotrexate, and increased use of guideline-based protocols, has reduced the direct costs of management with methotrexate. Methods We conducted a retrospective cost analysis on women treated for EP in a large UK teaching hospital to (1 investigate whether the cost of medical management is less expensive than surgical management for those patients eligible for both treatments and (2 to compare the cost of medical management for women with hCG concentrations 1500–3000 IU/L against those with similar hCG concentrations that elected for surgery. Three distinct treatment groups were identified: (1 those who had initial medical management with methotrexate, (2 those who were eligible for initial medical management but chose surgery (‘elected’ surgery and (3 those who initially ‘required’ surgery and did not meet the eligibility criteria for methotrexate. We calculated the costs from the point of view of the National Health Service (NHS in the UK. We summarised the cost per study group using the mean, standard deviation, median and range and, to account for the skewed nature of the data, we calculated 95% confidence intervals for differential costs using the nonparametric bootstrap method. Results Methotrexate was £1179 (CI 819–1550 per patient cheaper than surgery but there were no significant savings with methotrexate in women with hCG >1500 IU/L due to treatment failures. Conclusions Our data support an ongoing unmet economic need for better medical treatments for EP with hCG >1500 IU/L.

  20. Influence of Echinacea purpurea intake during pregnancy on fetal growth and tissue angiogenic activity.

    Directory of Open Access Journals (Sweden)

    Ewa Sommer

    2008-04-01

    Full Text Available The process of angiogenesis and control of blood vessels sprouting are fundamental to human health, as they play key roles in many physiological and pathological conditions. Intake of different pharmaceuticals with antiangiogenic activity by pregnant women may lead to severe developmental disturbances as it was described in case of thalidomide. It may also cause immunomodulatory effects as it was shown for antibiotics, theobromine, caffeic acid or catechins on the pregnant mice model. At present, Echinacea purpurea-based phytoceuticals are among the most popular herbals in the marketplace. Many compounds of Echinacea extracts (polysaccharides, alkamides, polyphenols, glycoproteins exert immunomodulatory, anti-oxidative and anti-inflammatory activity. Echinacea is one of the most powerful and effective remedies against many kinds of bacterial and viral infections. In previous studies we shown significant inhibitory effect of the Echinacea purpurea based remedy on tumour angiogenic activity using cutaneous angiogenesis test, and an inhibitory effect on L-1 sarcoma growth was observed . The aim of the present study was to establish whether pharmaceuticals containing alcoholic extracts of Echinacea purpurea given to pregnant mice influence angiogenic activity and tissue VEGF and bFGF production of their fetuses. We showed that angiogenic activity of tissue homogenates was increased in Esberitox group and diminished in case of Immunal forte as compared to standard diet group. In case of Echinapur group we did not find significant differences in angiogenic activity. VEGF and bFGF concentration were lower in all groups compared to the control. In the case of Echinapur and Esberitox number of fetuses in one litter were slightly lower as compared to control group, but the difference is on the border of statistical significance. In conclusion, there is some possibility that pharmaceuticals containing Echinacea purpurea might influence fetal development in

  1. The Clinical Study of Telomerase Activity in Gastric Tumor

    Institute of Scientific and Technical Information of China (English)

    XI Weihong; NI Xiaoqian; SHEN Yuqin; HUANG Qinmei

    2002-01-01

    Telomerase activity was detected with both telomeric repeat amplification protocol (TRAP) - silver stain and polymerase chain reaction (PCR) - enzyme linked immuno - sorbent assay (ELISA). We have studied the telomerase activity in the 68 gastric tumors and their neighboring tissues,25 gastric ulcer, and 3 tumor cell colonies. The positive rate of telomerase activity in gastric tumors was 86.8% (59/68) and which was obviously higher than 7.3% (5/68) in the normal tissues adjacent to the tumors and 4% (1/25) in gastric ulcer. The telomerase activity was 100% (3/3) in the tumor colonies. It allowed to be seen that higher telomerase activity was associated with the origin and development of the gastric tumor. We believe that telomerase activity may be a useful clinical diagnostic marker for the gastric tumor.

  2. The effect of iodine supplementation in pregnancy on early childhood neurodevelopment and clinical outcomes: results of an aborted randomised placebo-controlled trial

    OpenAIRE

    Zhou, Shao J.; Sheila A. Skeaff; Ryan, Philip; Doyle, Lex W; Anderson, Peter J.; Kornman, Louise; McPhee, Andrew J; Yelland, Lisa N; Makrides, Maria

    2015-01-01

    Background Concern that mild iodine deficiency in pregnancy may adversely affect neurodevelopment of offspring has led to recommendations for iodine supplementation in the absence of evidence from randomised controlled trials. The primary objective of the study was to investigate the effect of iodine supplementation during pregnancy on childhood neurodevelopment. Secondary outcomes included pregnancy outcomes, maternal thyroid function and general health. Methods Women with a singleton pregna...

  3. Spontaneous Heterotopic Pregnancy, Simultaneous Ovarian, and Intrauterine: A Case Report

    OpenAIRE

    Francesca Basile; Cristina Di Cesare; Lorena Quagliozzi; Laura Donati; Marina Bracaglia; Alessandro Caruso; Giancarlo Paradisi

    2012-01-01

    Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. The occurrence of an ovarian heterotopic pregnancy is a singular event as it comprises only 2.3% of all heterotopic pregnancies, extremely rare among women who conceive naturally. A case of a 28-year old patient was treated for spontaneously conceived heterotopic pregnancy. The patient was admitted to our center with lower abdominal pain and amenorrhoea. A ...

  4. Spontaneous Heterotopic Pregnancy with Term Delivery of a Live Infant

    OpenAIRE

    Yeral, İlkin; Şimşek, Yavuz; Seçkin, Doğa; Danişman, Nuri

    2011-01-01

    Objective: The aim of this report is to present a case of heterotopic pregnancy occurring in spontaneous cycle and ended up in term delivery. Case: A 21 year-old primigravida admitted to the emergency clinic with the complaints of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound scan showed an 8 weeks old live intrauterine pregnancy and a left tubal ectopic pregnancy. Laparoscopic salpingostomy was performed for ectopic pregnancy and intrauterine pregnancy was cont...

  5. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  6. Hemostatic changes in pregnancy

    Directory of Open Access Journals (Sweden)

    Paolo Simioni

    2013-08-01

    Full Text Available Normal pregnancy is associated with changes in all aspects of haemostasis, including increase in concentrations of most clotting factors, decreasing concentrations of some of the natural anticoagulants and diminishing fibrinolytic activity. These changes help in maintaining placental function during pregnancy but result in a state of hypercoagulability that may predispose to thrombosis and placental vascular complications. During pregnancy, the concentrations of coagulation factors V, VII, VIII, IX, X, XII and von Willebrand factor rise significantly, accompanied by a pronounced increase in fibrinogen levels which increases up to two-fold from non-pregnant levels. Furthermore, there is a decrease in physiological anticoagulants manifested by a significant reduction in protein S activity and by acquired activated protein C resistance. The overall fibrinolytic activity is impaired during pregnancy, but returns rapidly to normal following delivery. This is largely due to placental derived plasminogen activator inhibitor type 2 (PAI-2, which is present in substantial quantities during pregnancy. D-Dimer levels increase in pregnancy but are not thought to indicate intravascular coagulation as fibrinolysis is depressed. These D-Dimers may originate from the uterus. Finally, the platelet count decreases in normal pregnancy possibly due to increased destruction and haemodilution with a maximal decrease in the third trimester. Immediately after delivery there is an increase in platelet count, especially in patients undergoing cesarean section. During treatment of severe post-partum hemorrhage, it is absolutely essential to have the knowledge that the starting values of the platelets are very different as compared to a non-pregnant patient. Moreover, after delivery, also the levels of fibrinogen increase. Since the value of fibrinogen represents a crucial parameter for the management of acute bleeding, it is essential to administer the proper amount of

  7. HIV and Pregnancy

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG HIV and Pregnancy Home For Patients Search FAQs HIV ... HIV and Pregnancy FAQ113, December 2012 PDF Format HIV and Pregnancy Pregnancy What is human immunodeficiency virus ( ...

  8. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  9. Street Drugs and Pregnancy

    Science.gov (United States)

    ... and premature birth Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how ... Is it safe? > Street drugs and pregnancy Street drugs and pregnancy E-mail to a friend Please ...

  10. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  11. Leg Cramps during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  12. Alcohol and Pregnancy

    Medline Plus

    Full Text Available ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  13. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  14. Weight Gain during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  15. Alcohol and Pregnancy

    Medline Plus

    Full Text Available ... Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? Labor & ... Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? Labor & ...

  16. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? Labor & ... Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? Labor & ...

  17. Alcohol during Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Is it safe? > Alcohol during pregnancy Alcohol during pregnancy E-mail to a friend Please ... and fetal alcohol spectrum disorders. How does drinking alcohol during pregnancy affect your baby's health? Drinking alcohol ...

  18. Travel during Pregnancy

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Travel During Pregnancy Home For Patients Search FAQs Travel ... Travel During Pregnancy FAQ055, February 2016 PDF Format Travel During Pregnancy Pregnancy When is the best time ...

  19. Alcohol and Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  20. Exercise during Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  1. Pregnancy Complications: Cervical Insufficiency

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is it safe? ...

  2. Back Pain During Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Back Pain During Pregnancy Home For Patients Search FAQs Back ... During Pregnancy FAQ115, January 2016 PDF Format Back Pain During Pregnancy Pregnancy What causes back pain during ...

  3. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  4. Alcohol and Pregnancy

    Medline Plus

    Full Text Available ... card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Body & lifestyle changes Is ...

  5. Alcohol and pregnancy

    Science.gov (United States)

    Drinking alcohol during pregnancy; Fetal alcohol syndrome - pregnancy; FAS - fetal alcohol syndrome ... lead to lifelong damage. DANGERS OF ALCOHOL DURING PREGNANCY Drinking a lot of alcohol during pregnancy can ...

  6. Clinical and arthroscopic findings in recreationally active patients

    Directory of Open Access Journals (Sweden)

    Fowler Elizabeth M

    2010-01-01

    Full Text Available Abstract Objective To examine the diagnostic accuracy of standard clinical tests for the shoulder in recreational athletes with activity related pain. Design Cohort study with index test of clinical examination and reference standard of arthroscopy. Setting Sports Medicine clinic in Sheffield, U.K. Participants 101 recreational athletes (82 male, 19 female; mean age 40.8 ± 14.6 years over a six year period. Interventions Bilateral evaluation of movements of the shoulder followed by standardized shoulder tests, formulation of clinical diagnosis and shoulder arthroscopy conducted by the same surgeon. Main Outcome Measurements Sensitivity, specificity, likelihood ratio for a positive test and over-all accuracy of clinical examination was examined retrospectively and compared with arthroscopy. Results Isolated pathology was rare, most patients (72% having more than one injury recorded. O'Brien's clinical test had a mediocre sensitivity (64% and over-all accuracy (54% for diagnosing SLAP lesions. Hawkins test and Jobe's test had the highest but still not impressive over-all accuracy (67% and sensitivity (67% for rotator cuff pathology respectively. External and internal impingement tests showed similar levels of accuracy. When a positive test was observed in one of a combination of shoulder tests used for diagnosing SLAP lesions or rotator cuff disease, sensitivity increased substantially whilst specificity decreased. Conclusions The diagnostic accuracy of isolated standard shoulder tests in recreational athletes was over-all very poor, potentially due to the majority of athletes (71% having concomitant shoulder injuries. Most likely, this means that many of these injuries are missed in general practice and treatment is therefore delayed. Clinical examination of the shoulder should involve a combination of clinical tests in order to identify likely intra articular pathology which may warrant referral to specialist for surgery.

  7. The meaning of the Occupational Therapy activities in the hospitalization context of high risk pregnancy

    Directory of Open Access Journals (Sweden)

    Laís Abdala Martins

    2014-09-01

    Full Text Available Objective: The present study aimed to describe and interpret the meaning and realization of activities directed to motherhood during occupational therapy treatment with hospitalized high-risk pregnant women. Methods: An interpretative qualitative study carried out with forty-five high-risk pregnant women under treatment at the University Hospital of the Federal University of Parana - UFPR. Data from a total of 90 interviews, conducted with all hospitalized pregnant women who agreed to participate in the study, were collected and submitted to content analysis. Results: In the study of the two sets of categories obtained, many analysis units emerged. In the category related to hospitalization, 14 units were found: anxiety, loneliness, boredom, and worry for the baby were among the main ones. In the category related to therapeutic process, 9 units were highlighted: satisfaction, relaxation, and family proximity were among the most often mentioned. Conclusions: Hospitalization is a stressful life event and influences the emotional state of pregnant women. The process of realization of therapeutic occupational activities directed to motherhood allowed the rescue of being active, being able to live and revive positive and natural experiences of the gestational process, allowing the reframing of hospitalization.

  8. Pregnancy scares and subsequent unintended pregnancy

    OpenAIRE

    Heather Gatny; Yasamin Kusunoki; Jennifer Barber

    2014-01-01

    Background: A substantial number of young women experience pregnancy scares - thinking they might be pregnant, and later discovering that they are not. Although pregnancy scares are distressing events, little is known about who experiences them and whether they are important to our understanding of unintended pregnancy. Objective: We describe the young women who experience pregnancy scares, and examine the link between pregnancy scares and subsequent unintended pregnancy. Methods: We us...

  9. Surgical management of tubal pregnancy

    OpenAIRE

    Mol, F

    2013-01-01

    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and meta-analysis was performed to evaluate the effectiveness of surgery, medical treatment and expectant management in terms of treatment success (i.e. complete elimination of trophoblastic tissue), financ...

  10. Clinical Analysis of Pregnancy Accompany With Malignant Tumor%妊娠期合并恶性肿瘤的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘玉昆; 刘颖琳; 张蜀宁; 刘梅兰; 张建平

    2013-01-01

    目的 探讨妊娠期合并恶性肿瘤的治疗及对母婴结局的影响.方法 选择2006年1月至2011年12月,于本院产科分娩的妊娠期合并恶性肿瘤20例为研究对象.其中乳腺癌为6例(30.00%),宫颈癌为5例(25.00%),肝癌为3例(15.00%),卵巢癌为2例(10.00%),甲状腺癌为2例(10.00%),鼻咽癌为1例(5.00%),颅内恶性肿瘤为1例(5.00%).妊娠期合并恶性肿瘤发生率为0.24%(20/8261).回顾性分析患者的临床表现、诊断结果、孕期和产后治疗情况,分娩孕周,分娩方式,新生儿出生体重,生后1 min Apgar评分及有无畸形等,并电话随访患者的生存情况截至2012年4月(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象签署临床研究知情同意书).结果 20例患者中,放弃妊娠行引产术为6例(30.00%),继续妊娠的14例(60.00%)患者中,孕期接受化疗者为4例,孕期行肿瘤手术治疗者为4例;剖宫产为11例,阴道分娩为3例.新生儿分娩时胎龄为30+5~39孕周,新生儿出生体重为(1380~3200)g,无一例新生儿窒息和畸形发生.结论 妊娠期合并恶性肿瘤以乳腺癌和宫颈癌最为常见.治疗应根据肿瘤分期、妊娠时间、孕妇意愿(是否继续妊娠)等因素综合考虑后,进行个体化治疗.中、晚孕期可相对安全地对部分患者实施手术治疗,并使用相对安全的化疗药物.%Objective To investigate the clinical effects of pregnancy accompany with malignant tumor and its impact on mother and fetus. Methods The clinical data of 20 pregnant women accompany with malignant tumor in SUN Yat-sen Memorial Hospital from 2006 to 2011 were analyzed retrospectively. Among them, the tumors associated with pregnancy were breast cancer (6/20, 30. 00%), cervical cancer (5/20, 25.00%), liver cancer(3/20, 15. 00%) , ovarian cancer (2/20, 10.00%), thyroid cancer (2/20, 10.00%), nasopharyngeal carcinoma (1/20, 5. 00%), and malignant brain

  11. Clinical activity of alvocidib (flavopiridol) in acute myeloid leukemia.

    Science.gov (United States)

    Zeidner, Joshua F; Karp, Judith E

    2015-12-01

    There have been minimal therapeutic advancements in acute myeloid leukemia (AML) over the past 4 decades and outcomes remain unsatisfactory. Alvocidib (formerly flavopiridol) is a multi-serine threonine cyclin-dependent kinase inhibitor with demonstrable in vitro and clinical activity in AML when combined in a timed sequential chemotherapy regimen, FLAM (alvocidib followed by cytarabine continuous infusion and mitoxantrone). FLAM has been evaluated in sequential phase 1 and phase 2 studies in 149 and 256 relapsed/refractory and newly diagnosed non-favorable risk AML patients, respectively, with encouraging findings in both patient populations warranting further investigation. This review highlights the mechanism of action of alvocidib, pre-clinical studies of alvocidib in AML, and the clinical trials evaluating alvocidib alone and in combination with cytotoxic agents (FLAM) in AML.

  12. Teenage pregnancy.

    Science.gov (United States)

    Molina Cartes, Ramiro; González Araya, Electra

    2012-01-01

    Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested. PMID:22846537

  13. Clinical experience from Thailand noninvasive prenatal testing as screening tests for trisomies 21, 18 and 13 in 4736 pregnancies

    DEFF Research Database (Denmark)

    Manotaya, S.; Uerpairojkit, B.; Chen, F.;

    2016-01-01

    PurposeThe purpose of this article is to report the clinical experience and performance of massively parallel sequencing-based noninvasive prenatal testing (NIPT) as a screening method in detecting trisomy 21, 18, and 13 (T21/T18/T13) in a mixed-risk population in Thailand. MethodsIn a 30-month...... as the screening test in a large-scale mixed-risk population in Thailand for the first time. It provides the experience of implementing NIPT in a developing country with patient-funded prenatal screening system and continuous quests for applicable nationwide uptake of prenatal screening and diagnosis....... period, 121 medical centers in Thailand offered NIPT as clinical screening tests for fetal T21, T18, and T13 in the mixed-risk population. All NIPT-positive cases were recommended to undergo invasive prenatal diagnosis. ResultsA total of 4736 participants received the NIPT test, including 2840 high...

  14. Stages of Pregnancy

    Science.gov (United States)

    ... Know your pregnancy rights Getting ready for baby Childbirth and beyond Mom-to-be tools Government in action on pregnancy Pregnancy in Spanish ( en español ) Subscribe to Stages of pregnancy email updates. Enter email address Submit Home > Pregnancy > You're pregnant: Now what? Pregnancy This ...

  15. Efficacy of 17α- hydroxy progestrone on decreasing preterm labor in ART pregnancies: A randomized clinical trial

    OpenAIRE

    Abbas Aflatoonian; Hoora Amouzegar; Razieh Dehghani Firouzabadi

    2013-01-01

    Background: Preterm labor (PTL) is one of the most important causes in neonatal mortality and morbidity. Late preterm labor (34-36w) includes 75% of such birth. Assisted reproductive technology (ART) pregnant women are at increased risk of PTL. Objective: The study has been undertaken to determine whether beginning and continuing 17-α hydroxy progesterone caproate can reduce risk of PTL or change neonatal mortality. Materials and Methods: In a double-blind clinical randomized control trial, 1...

  16. 系统性红斑狼疮合并妊娠145例次母婴结局及临床预测因素%Clinical preditors of maternal and fetal outcome of 145 pregnancies in patients with systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    刘冬舟; 赵岩; 宋亦军; 谭艳红; 洪小平; 孙保东

    2009-01-01

    目的 总结系统性红斑狼疮(SEE)合并妊娠的母婴结局,分析妊娠期问SLE病情恶化、胎儿丢失、不良胎儿结局的预测因素.方法 回顾性分析1990年1月至2007年12月在北京协和医院和深圳市人民医院住院的SEE合并妊娠临床资料.结果 120例SEE合并妊娠145例次,妊娠时年龄18~4I岁,平均(28±4)岁,SEE病程0.5~18年,平均(5±4)年.共有46例次(31.7%)妊娠期间SLE病情恶化,主要在妊娠中、晚期,常累及皮肤黏膜及关节肌肉系统.妊娠期间SEE病情恶化与妊娠前病情活动及低补体血症有关(P<0.05).妊娠前病情活动组子痫前期及子痫的发生率明显高于病情稳定组(P<0.01).共成功分娩104例次(71.7%,其中双胞胎2例),18例次自然流产(12.4%),10例次死产(6.9%),13例次治疗性流产(9.0%).早产36例次(34.6%),新生儿出现宫内生长迟缓(IUGR)37例次(35.6%).胎儿丢失(包括自然流产及死产)的危险因素有合并抗磷脂综合征(APS)、妊娠前病情活动(P<0.05);引起不良胎儿结局(包括早产或IUGR)的危险因素有妊娠前抗dsDNA抗体阳性、泼尼松剂量≥10 mg/d及妊娠期间SLE病情恶化(P<0.05).21例患者行胎盘病理学检查,其中13例发现胎盘组织血管壁纤维素样坏死、梗死表现,该组患者抗磷脂抗体阳性率明显高于胎盘病理基本健康组(P<0.05).结论 妊娠前SEE病情活动、低补体血症与SEE妊娠期间SEE病情恶化相关.合并APS、妊娠前病情活动使胎儿丢失的危险性增加,而妊娠前抗dsDNA抗体阳性、泼尼松剂量≥10 mg/d及妊娠期间SLE病情恶化使不良胎儿结局的危险性增加.%Objective To summarize the maternal and fetal outcomes of pregnancies of patients with systemic lupus erythematosus (SLE) and to evaluate the clinical predictors of SLE exacerbations,fetal loss and poor fetal outcome.MethodsOne hundred and forty five pregnancies in 120 SLE patients treated between January 1990 and December

  17. Outcome of pregnancy in patients with inactive systemic lupus erythromatosus and minimal proteinuria

    Directory of Open Access Journals (Sweden)

    Alshohaib Saad

    2009-01-01

    Full Text Available Systemic lupus erythematosus (SLE is a multisystem disease. This study was under-taken to assess the outcome of pregnancies in patients with inactive SLE. We prospectively studied 20 female patients with diagnosis of stable class IV Lupus nephritis followed up at King Abdul Aziz University Hospital, in Jeddah, Saudi Arabia between 1998 and 2008. Before each pregnancy all the patients had their blood pressure, serum creatinine, creatinine clearance, serology for SLE and 24-hour urine protein excretion measured and then repeated at monthly intervals during the pregnancy. Statistical analysis was performed using the Wilcoxon signed-rank test. Despite having negative antinuclear antibody (ANA significant complications were observed during pregnancy. The daily proteinuria during 34-36 weeks′ gestation was significantly higher (P< 0.05 than during 32 weeks. Two patients had abortions one stillbirth and 2 required termination of the pregnancy; one due to severe hypertension, and other due to renal impairment. One patient developed HELLP (hemolysis, elevated liver enzymes, low platelets syndrome. 14 patients had a successful preg-nancy, including 4 requiring a cesarian section. In conclusion, although no clinical evidence of lupus disease activity was demonstrated pre-conception proteinuria significantly increased during pregnancy along with maternal and fetal complications. Pregnant females with diagnosis of SLE need a multidisciplinary care during the pregnancy and post-partum period.

  18. Analysis the influencing factors on the clinical pregnancy rate of intrauterine insemination with husband sperm%夫精宫腔内人工授精影响因素与临床妊娠率关系分析

    Institute of Scientific and Technical Information of China (English)

    周军英; 朱立华; 孙秀芬; 周瑾; 许玉刚; 欧建平

    2011-01-01

    目的 探讨宫腔内人工授精(IUI)影响因素与临床妊娠率的关系,以提高IUI治疗的临床效果.方法 对252个IUI治疗周期的159例患者的年龄、不孕年限、促排卵方案、人工授精时机、IUI治疗周期数、不孕原因与临床妊娠率的关系进行分析.结果 促排卵周期显著提高临床妊娠率(P<0.05);小于等于30岁组临床妊娠率显著高于30以上组(P<0.05);随不孕年限延长临床妊娠率降低、单次排卵前、单次排卵后和双次授精妊娠率无统计学差异;IUI治疗周期数以3个周期为宜、不孕原因与临床妊娠率有关但无统计学差异.结论 促排卵方案和年龄是影响临床妊娠率的主要因素.%Objective: To investigate the influencing factors of intrauterine insemination (IUI) in order to improve the clinical outcome of IUI treatment. Methods: 159 couples in 252 cycles who underwent IUI treatment were collected. The correlation between pregnancy rate and the following factors were analyzed, such as the stimulation protocols, age of women, the duration of infertility,timing of intrauterine insemination, treatment cycles of IUI, causes of infertility. Results: IUI treatment with ovarian stimulation significantly increased clinical pregnancy rate ( P < 0. 05). The pregnancy rate was significantly higher in younger women group (less than 30 years old) than those women whose were more than 30 years old ( P < 0. 05). With the increase in duration of infertility,the pregnancy rate was decreased. There was no significant difference in the pregnancy rate between single insemination and twice inseminations before and/after ovulation. 3 cycles was suitable for IUI treatment. There was no significant difference in the pregnancy rate between primary and secondary infertility, the same to reasons of infertility. Conclusion: The protocols of ovarian stimulation and age of women were two major influencing factors for clinical pregnancy rate in IUI treatment.

  19. Pharmacokinetics of clomipramine during pregnancy

    NARCIS (Netherlands)

    ter Horst, P. G. J.; Proost, J. H.; Smit, J. P.; Vries, M. T.; Jong-van den Berg, de L. T. W.; Wilffert, B.

    2015-01-01

    Clomipramine is one of the drugs for depression during pregnancy; however, pharmacokinetic data of clomipramine and its active metabolite desmethylclomipramine in this vulnerable period are lacking. In this study, we describe clomipramine and desmethylclomipramine concentrations including their rati

  20. Pharmacokinetics of clomipramine during pregnancy

    NARCIS (Netherlands)

    Ter Horst, P G J; Proost, J H; Smit, J P; Vries, M T; de Jong-van den Berg, Lolkje; Wilffert, B

    2015-01-01

    PURPOSE: Clomipramine is one of the drugs for depression during pregnancy; however, pharmacokinetic data of clomipramine and its active metabolite desmethylclomipramine in this vulnerable period are lacking. In this study, we describe clomipramine and desmethylclomipramine concentrations including t

  1. Primary hyperparathyroidism in pregnancy.

    Science.gov (United States)

    Diaz-Soto, Gonzalo; Linglart, Agnès; Sénat, Marie-Victoire; Kamenicky, Peter; Chanson, Philippe

    2013-12-01

    Primary hyperparathyroidism (PHPT) is rarely diagnosed during pregnancy but is associated with significant maternal and fetal morbidity and mortality. Information on appropriate management is limited. We reviewed the medical literature through December 2012 for key articles on PHPT during pregnancy, focusing on large series. Clinical knowledge in this area is restricted to isolated case reports and a few retrospective studies. Diagnosis can be difficult, owing to the non-specific nature of signs and symptoms of hypercalcemia during pregnancy. Pregnant women with a calcium level over 2.85 mmol/L (11.4 mg/dL) and prior pregnancy loss are at a particularly high risk of maternal complications (hypercalcemic crisis, nephrolithiasis, pancreatitis, etc.) and fetal loss. Around one-half of neonates born to mothers with untreated PHPT have hypocalcemia and tetany. Algorithms proposed for the management of the pregnant woman with PHPT are not evidence based, reflecting the paucity of data. Treatment should thus be individually tailored. Gestational age and the severity of hypercalcemia should be taken into account when assessing the risk-benefit balance of a conservative approach (hyperhydration and vitamin D supplementation) versus parathyroid surgery. Current evidence supports parathyroidectomy as the main treatment, performed preferably during the second trimester, when the serum calcium is above 2.75 mmol/L (11 mg/dL). In the patients with mild forms of PHPT, which are nowadays the most frequent, a conservative management is generally preferred. PMID:23670708

  2. Neurosurgical procedures in pregnancy

    Directory of Open Access Journals (Sweden)

    Cirak Bayram

    2003-01-01

    Full Text Available PURPOSE: Over the past few decades maternal mortality has progressively declined because of improved management of the major obstetric problems of hemorrhage, infection, and toxemia. As a result, the relative incidence of deaths resulting from non obstetric causes has increased. Chief among nonobstetric causes are neurologic disorders. Those most common during pregnancy are low back pain, intracranial tumors, subarachnoid hemorrhage, and neurotrauma. The management of the neurosurgical pathologies during pregnancy needs some specifications for both the mother and the fetus. METHODS: We performed a retrospective study evaluating the clinical, radiological, and surgical characteristics of 9 patients who have cranial neuropathologies and have undergone neurosurgical intervention. RESULTS: Most of the patients in this study had vaginal delivery. Prominent neurosurgical disease related to cerebral damage. Every patient underwent a laboratory and radiological evaluation. All except one survived the neurosurgical pathology. Neither baby nor mother had significant problem during delivery and neurosurgical intervention. CONCLUSION: Pregnant women may face to every kind of neurosurgical pathology that nonpregnant women have faced. In addition, pregnancy itself, gives rise some metabolic changes in the women and those changes may cause some neurologic pathologies to be symptomatic or to aggravate the present symptomatology. Because of those reasons, close neurologic follow up of a pregnant woman is of vital importance. At the end of a pregnancy having experienced some neurologic interventions including diagnostic evaluation or surgical intervention does not necessitates the cesarean section for a neurologically intact infant and mother.

  3. Pregnancy Complications

    Science.gov (United States)

    ... Eating disorders Body image changes during pregnancy can cause eating disorders to worsen. Eating disorders are linked to many ... including birth defects and premature birth . Women with eating disorders also have higher ... to control seizures might cause birth defects. For most pregnant women with epilepsy, ...

  4. Teen Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2014-04-16

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the issue of teen pregnancy and some strategies to address it.  Created: 4/16/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/16/2014.

  5. Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample

    Directory of Open Access Journals (Sweden)

    van den Bree Marianne BM

    2007-06-01

    Full Text Available Abstract Background Attention Deficit Hyperactivity Disorder (ADHD is a genetically influenced condition although indicators of environmental risk including maternal smoking during pregnancy, low birth weight and low social class have also been found to be associated with the disorder. ADHD is a phenotypically heterogeneous disorder in terms of the predominant symptom types (inattention, hyperactive-impulsivity, their severity and comorbidity, notably Conduct Disorder. It is possible that these different clinical manifestations of the disorder may arise because of the differing effects of the environmental indicators of environmental risk. We set out to test this hypothesis. Methods In a sample of 356 children diagnosed with ADHD, we sought to investigate possible effects of three indicators of environmental risk – maternal smoking during pregnancy, birth weight and social class – on comorbid Conduct Disorder, conduct disorder symptoms and inattentive and hyperactive-impulsive symptom severity. Results Multiple regression analysis revealed that, after controlling for significant covariates, greater hyperactive-impulsive symptom severity was significantly associated with maternal smoking during pregnancy (r2 = 0.02, Beta = 0.11, t = 1.96, p = 0.05 and social class (r2 = 0.02, Beta = 0.12, t = 2.19, p = 0.03 whilst none of the environmental risk indicators significantly predicted number of inattentive symptoms. Conduct Disorder symptoms were positively predicted by maternal smoking in pregnancy (r2 = 0.04, Beta = 0.18, t = 3.34, p = 0.001 whilst both maternal smoking during pregnancy and social class significantly predicted a diagnosis of Conduct Disorder (OR = 3.14, 95% CI: 1.54, 6.41, Wald = 9.95, p = 0.002 and (OR = 1.95 95% CI: 1.18, 3.23 Wald = 6.78, p = 0.009 respectively. Conclusion These findings suggest that indicators of environmental risk, in this instance maternal smoking in pregnancy and environmental adversity indexed by lower

  6. Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample

    Science.gov (United States)

    Langley, Kate; Holmans, Peter A; van den Bree, Marianne BM; Thapar, Anita

    2007-01-01

    Background Attention Deficit Hyperactivity Disorder (ADHD) is a genetically influenced condition although indicators of environmental risk including maternal smoking during pregnancy, low birth weight and low social class have also been found to be associated with the disorder. ADHD is a phenotypically heterogeneous disorder in terms of the predominant symptom types (inattention, hyperactive-impulsivity), their severity and comorbidity, notably Conduct Disorder. It is possible that these different clinical manifestations of the disorder may arise because of the differing effects of the environmental indicators of environmental risk. We set out to test this hypothesis. Methods In a sample of 356 children diagnosed with ADHD, we sought to investigate possible effects of three indicators of environmental risk – maternal smoking during pregnancy, birth weight and social class – on comorbid Conduct Disorder, conduct disorder symptoms and inattentive and hyperactive-impulsive symptom severity. Results Multiple regression analysis revealed that, after controlling for significant covariates, greater hyperactive-impulsive symptom severity was significantly associated with maternal smoking during pregnancy (r2 = 0.02, Beta = 0.11, t = 1.96, p = 0.05) and social class (r2 = 0.02, Beta = 0.12, t = 2.19, p = 0.03) whilst none of the environmental risk indicators significantly predicted number of inattentive symptoms. Conduct Disorder symptoms were positively predicted by maternal smoking in pregnancy (r2 = 0.04, Beta = 0.18, t = 3.34, p = 0.001) whilst both maternal smoking during pregnancy and social class significantly predicted a diagnosis of Conduct Disorder (OR = 3.14, 95% CI: 1.54, 6.41, Wald = 9.95, p = 0.002) and (OR = 1.95 95% CI: 1.18, 3.23 Wald = 6.78, p = 0.009) respectively. Conclusion These findings suggest that indicators of environmental risk, in this instance maternal smoking in pregnancy and environmental adversity indexed by lower social class

  7. Teen pregnancy prevention: a rural model using school and community collaboration.

    Science.gov (United States)

    Barnes, N D; Harrod, S E

    1993-11-01

    From 1980 to 1989 there were 2069 babies born to teenage mothers in northeastern Connecticut, accounting for more than 10% of all births in this region. A Connecticut model program that combats teen pregnancy and emphasizes a collaborative venture between a state-funded community-based pregnancy prevention program and a regional vocational-technical high school located in a rural setting is described. Beginning in the fall of 1987, a group of local providers and concerned citizens formed a steering committee which was given funding to initiate services in early 1988. The objectives of the Northeast Connecticut Teen Pregnancy Prevention Program were (a) to enhance the capacity of parents to prevent teen pregnancy, (b) to increase public education concerning the prevention of teenage pregnancy, (c) to increase the coordinated planning of teen pregnancy prevention resources, and (d) to mobilize additional teen pregnancy prevention resources. At the regional vocational-technical high school in rural north eastern Connecticut a pregnancy prevention program for students in grades 9 through 12 was designed called Contemporary Life Issues Clinic (CLIC). This voluntary experiential program lasted 8 weeks for male and female students. Each week, one session operated during regular school hours. Students preregistered for each week's activity or clinic in the guidance office. CLIC's consisted of eight topics with accompanying activities aimed at improving sexual responsibility; increasing the decision-making skills of students; encouraging the development of coping skills; fostering emotional growth; cultivating success-oriented attitudes; providing information in pregnancy prevention, sexually transmitted disease including AIDS; and providing information regarding the financial and legal implications of parenthood. During the fall of 1990, CLIC had 98 participants. The majority of the students were young women. The most heavily attended session dealt with contraception; the

  8. Clinical Analysis of 32 Patients with Intrahepatic Cholestasis of Pregnancy%32例妊娠期肝内胆汁淤积症临床分析

    Institute of Scientific and Technical Information of China (English)

    白月婷

    2012-01-01

    Objective To investigate the harm of intrahepatic cholestasis of pregnancy( ICP) and the time and manner of delivery in patients with ICP. Methods The clinical data of 32 patients with ICP from 2007 to 2011 in Haidian maternal and child health hospital were analyzed retrospectively. Results There were 13 patients had complications,3 cases were with hypertension in pregnancy,2 with severe pre-eclampsia, 1 with gestational diabetes mellitus,2 with pregnancy impaired glucose tolerance, 1 with thrombocytopenia, 1 with fetal growth restriction, 1 with still birth ,4 with amniotic fluid pollution and 1 with postpartum hemorrhage. 13 patients with the mild ICP had no amniotic fluid pollution,fetal distress or still birth. A premature delivery was seen in 2 patients with mild ICP. 6 patients with the severe ICP had premature cesarean section delivery because of serious condition or complications. Conclusion For the patients with mild ICP a full term trial of vaginal labour can be performed under the close monitoring and a relaxed cesarean section indications. The patients with severe ICP should immediately be cared in hospital with closely monitoring and positive treatment. The cesarean section should be timely carried out to terminate the gestation on the 36th weeks.%目的 探讨妊娠期肝内胆汁淤积症(ICP)的危害、分娩时机及方式.方法 回顾性分析海淀区妇幼保健院2007 ~ 2011年收治的32例ICP患者的临床资料.结果 13例患者出现并发症,其中妊娠期高血压3例,重度子痫前期2例,妊娠期糖尿病1例,妊娠期糖耐量受损2例,血小板减少1例,胎儿生长受限1例,胎死宫内1例,羊水污染4例,产后出血1例.轻度ICP患者13例,无羊水污染、胎儿窘迫、胎死宫内发生,早产2例;重度ICP患者19例,早产6例,均因病情严重、合并症/并发症剖宫产分娩.结论 轻度ICP可观察至妊足月,在密切监护下行阴道试产,并放宽剖宫产指征.一旦诊断重度ICP,需立即

  9. Cesarean uterine scar pregnancy clinical study of early diagnosis%剖宫产子宫瘢痕妊娠早期诊断的临床研究

    Institute of Scientific and Technical Information of China (English)

    梁春燕; 范开蓉; 黄艳萍; 刘志玲; 冯芳; 艾国华; 姚小丽; 陈晓营

    2012-01-01

    Objective To explore uterine incision of cesarean section scar pregnancy in the early diagnosis method. Methods 20 cases with CPS of our hospital and MCH hospital in recent 2 years were collected as observation group, 25 cases which were normal position of pregnancy after cesarean section were as control group, the abdominal combined transvaginal color ultrasound, beta-HCG rise rate and progesterone were compared between the observation group and the control group, to determine the CSP early diagnosis method. Results The observation group compared with the control group, the color ultrasound of observation group was that the cervical canal without gestational sac, cesarean section incision was significantly expanded, the uterus wall under the internal orifice of uterus muscle layer above the discontinuity of wedge-shaped depressions or thinning, here to see the gestational sac or clutter echo area; the serum beta-HCG 48 h titre rise of control group was (65.6±3.2)%, the progesterone was (25.6±2.7) nmol/L, the serum beta-HCG 48 h titre rise of observation group was (42.2±1.2)%, the progesterone was (14.3±2.7) nmol/L, there were significiant differences between the observation group and the control group of the two indexes (P < 0.05). Conclusion Abdominal and vaginal color Doppler ultrasound, serum beta-HCG and progesterone detection in early diagnosis of CSP reliable clinical methods of examination, early diagnosis, prompt treatment to prevent the CSP serious complications, have important social and economic value.%目的 探讨剖宫产子宫切口瘢痕部位妊娠(cesarean scars pregnancy,CSP)的早期诊断方法.方法 收集我院及市妇幼保健院两家医院近2年来CPS 20例作为观察组,剖宫产后正常位置妊娠25例作为对照组,比较观察组与对照组腹部联合阴道彩色超声、β-HCG升高率和孕酮来确定CSP早期诊断的方法.结果 观察组与对照组相比,观察组B超示宫颈管无孕囊,剖宫产切口处明显

  10. 腹腔镜治疗剖宫产瘢痕妊娠%Clinical research of laparoscopy in the treatment of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    胡碧洪; 黄浩; 李莉芳; 王帅

    2014-01-01

    Objective To investigate the application value of laparoscopy on cesarean scar pregnancy(CSP). Methods Four-teen patients with CSP in this hospital from June 2009 to June 2011 were selected. Six of them had β-HCG average 24 271. 5 U/ L in blood. Their transvaginal sonography showed large uterus and gestational Sac or hypoechonic masses which were 3. 3 ~ 4. 8 cm (4. 1 cm average)with rich blood. The clinical data and treatment outcome of 6 patients with laparoscopic wedge resection of the lesion + uterine scar repair to treatments cesarean scar pregnancy were retrospectively analyzed. Results Six patients were suc-cessfully operated with less bleeding and hysterectomy,minimally invasive,effective,quick recovery treatment. Conclusion Ce-sarean scar pregnancy underwent laparoscopic resection of local lesions of uterine repair can not only effectively terminate the preg-nancy,and can also repair scar defect and repair the uterus to retain reproductive function,so it is a very valuable method.%目的:探讨腹腔镜技术治疗剖宫产瘢痕妊娠(CSP)的价值。方法回顾性分析2009年6月至2011年6月在南方医科大学附属南海人民医院住院治疗的14例剖宫产瘢痕妊娠患者,其中6例患者因血β-人绒毛膜促性腺激素较高,平均24271.5 U/ L,阴道彩超提示:子宫增大,剖宫产切口部位见孕囊或不均质中低回声包块,长径3.3~4.8 cm,平均4.1 cm,包块周围有丰富血流信号,均突向浆膜层。6例患者均采用腹腔镜下子宫瘢痕部位病灶切除术+子宫修补术治疗。结果6例均顺利完成手术,出血少,避免子宫切除术,达到微创、有效、恢复快的治疗效果。结论 CSP 行腹腔镜下局部病灶切除+子宫修补术不仅可以有效终止妊娠,同时可以修补瘢痕缺陷、修复子宫,保留生育功能,是一种有价值的方法。

  11. Renal tubular acidosis type 4 in pregnancy.

    Science.gov (United States)

    Jakes, Adam Daniel; Baynes, Kevin; Nelson-Piercy, Catherine

    2016-03-17

    We describe the clinical course of renal tubular acidosis (RTA) type 4 in pregnancy, which has not been previously published. Renal tubular acidosis type 4 is a condition associated with increased urinary ammonia secondary to hypoaldosteronism or pseudohypoaldosteronism. Pregnancy may worsen the hyperkalaemia and acidosis of renal tubular acidosis type 4, possibly through an antialdosterone effect. We advise regular monitoring of potassium and pH throughout pregnancy to ensure safe levels are maintained.

  12. Laparoscopic Appendicectomy in all Trimesters of Pregnancy

    OpenAIRE

    Machado, Norman Oneil; Grant, Christopher S.

    2009-01-01

    Background: The laparoscopic approach for appendicectomy in pregnancy was not considered the preferred procedure until recently. The aim of this study was to examine our experience with laparoscopic appendicectomy in pregnancy and review the scientific evidence available in the medical literature. Method: The clinical data of all patients who underwent laparoscopic appendicectomy during pregnancy at our hospital between 1999 and 2007 were collected and retrospectively analyzed. A Medline lite...

  13. The proteolytic activity of pregnancy-associated plasma protein-A is potentially regulated by stanniocalcin-1 and -2 during human ovarian follicle development

    DEFF Research Database (Denmark)

    Jepsen, Malene R.; Kløverpris, Søren; Bøtkjær, Jane A.;

    2016-01-01

    of PAPP-A proteolytic activity is suggested by the identification of inhibited protein complexes between PAPP-A and STC1 or STC2 in human follicular fluid (FF). WHAT IS KNOWN ALREADY: The insulin-like growth factor (IGF)-regulating proteinase PAPP-A is secreted by the granulosa cells of estrogen......STUDY QUESTION: Is the proteolytic activity of pregnancy-associated plasma protein-A (PAPP-A) regulated by the stanniocalcins (STC1 and STC2) during human follicle maturation? SUMMARY ANSWER: The STCs and PAPP-A show similar expression by immunohistochemistry in developing follicles, and regulation...

  14. 60例妊娠合并甲状腺功能减退症患者临床分析%Clinical analysis of 60 cases of pregnancy complicated hypothyroidism in patients

    Institute of Scientific and Technical Information of China (English)

    陈艳

    2014-01-01

    目的:分析妊娠合并甲减的危害及临床诊治办法。方法:调取安徽省立医院2009~2013年60例妊娠合并甲减孕妇为研究对象,并随机选取该院同期住院无甲减合并症的60例孕妇作为对照组,调取患者的临床资料开展回顾性分析。结果:在选取安徽省立医院近5年间60例妊娠合并甲减病例中,妊娠合并甲减的发生率逐年升高,而子痫前期、贫血、糖代谢异常等并发症的发生率一直较高,影响妊娠结局。结论:妊娠合并甲减的发生率逐年上升,早期积极接受足量治疗,多可获得正常妊娠结局。%Objective: Hazard analysis and clinical diagnosis and treatment of pregnancy complicated with hypothyroidism way. Methods:Access to 2009-2013 in Anhui provincial hospital between 60 cases of pregnancy complicated with hypothyroidism pregnant women as the object of study, and randomly selected 60 cases of pregnant women with no complications as control group. Clinical data, they carried out retrospectively. Results:in the selection of Anhui provincial hospital in recent 5 years in 60 cases of pregnancy complicated with hypothyroidism cases of pregnancy complicated with hypothyroidism, the incidence increased year by year, and preeclampsia, anemia, abnormal glucose metabolism and the complication rate has been high, pregnancy outcome. Conclusion:Pregnancy complicated with hypothyroidism prevalence increased year by year, early aggressive received adequate treatment, which can have normal pregnancy outcome.

  15. 妊娠合并系统性红斑狼疮孕妇的妊娠时机及对妊娠结局的影响(附25例临床资料分析)%Pregnancy Time and Affect of Pregnancy Outcome in Pregnancy Women with Systemic Lupus Erythematosus:A Clinical Analysis on 25 Cases

    Institute of Scientific and Technical Information of China (English)

    荣琴英; 马锦琪; 高涛

    2014-01-01

    目的:探讨影响妊娠合并系统性红斑狼疮(SLE)妊娠结局的相关因素,提出SLE患者最佳受孕时机和孕期的治疗监护,预防妊娠合并SLE的恶化及SLE对妊娠的不良影响,以提高围产质量。方法回顾性分析25例妊娠合并SLE的临床资料。结果25例妊娠合并SLE患者,14例病情处于缓解期或控制期的患者,仅1例双胎妊娠发生早产,新生儿窒息0例,1例孕妇狼疮性肾炎加重,子痫前期0例;11例病情未控制或有SLE活动者,发生早产4例,新生儿窒息2例,孕期发生狼疮性肾炎3例,血小板减少3例,子痫前期2例。结论SLE患者应首先控制疾病的活动,在产科医师及风湿免疫科医师的指导下受孕,妊娠期加强胎儿监护及SLE疾病的监测、治疗。泼尼松是目前安全可靠的妊娠期治疗及预防SLE恶化、控制SLE活动的首选药物。SLE孕妇应加强孕期的监护,争取良好的妊娠结局。%Objective To investigate the correlative factors that affect the outcome of pregnancy complicated with SLE and try to provide the best chance for conception and pregnant monitoring, to prevent the deterioration of SLE and improve the perinatal quality. Methods Retrospective analysis of 25 cases of pregnancy complicated with SLE. Results In 25 cases pregnancy complicated with SLE, 14 cases were in remission and well-controlled stage, 1 case premature labor, neonatal asphyxia 0 case, lupus nephritis 1 case, preeclampsia 0 case, 11 cases unstable, premature labor 4 cases, neonatal asphyxia 2 cases, lupus nephritis 3 cases, low serum platelet 3 cases, preeclampsia 2 cases. Conclusion The results show that first of all, the activity of SLE should be controlled and patients should get conception under the guidance of the obstetricians and physicians, Prednisone is one of the safe drugs for prevent women to control the activation of SLE and to prevent deterioration. Intensive monitors should be offered

  16. Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China

    Directory of Open Access Journals (Sweden)

    Ravari Shahrzad

    2009-04-01

    Full Text Available Abstract Background To explore any association between the timing of the initiation of sexual activity and sexual behaviors and risks among university students in China. Methods Data were derived from a cross-sectional study on sexual behavior among university students conducted in Ningbo municipality, China, at the end of 2003. Students completed a self-administered, structured questionnaire. Of 1981 sexually active male students, 1908 (96.3% completed the item for timing of the initiation of sexual activity and were included in bivariate trend analyses and multiple logistic regression analyses to compare the association between this timing and sexual behavior and risks. Results Male early sexual initiators had a significantly higher risk profile, including a significantly higher proportion reporting non-regular partners (i.e., casual or commercial partners, multiple partners, diagnosis with a sexually transmitted disease (STD, partner history of pregnancy, partner history of induced abortion, and less condom and oral contraceptive use, compared with late initiators. Multivariate analyses confirmed the increased likelihood of these risks in early initiators versus late initiators, other than partner type during the last year. Conclusion Our results showed that, compared to late initiators, people who initiated sexual activity early engaged in more risky behaviors that could lead to elevated risks of unwanted pregnancies and STDs or human immunodeficiency virus infection. Sex-education strategies should be focused on an earlier age, should include advice on delaying the age of first sexual activity, and should target young people who continue to take sexual risks.

  17. Aggressive angiomyxoma in pregnancy

    Directory of Open Access Journals (Sweden)

    Prashant Goyal

    2014-06-01

    Full Text Available Aggressive angiomyxoma (AA is a rare, slow-growing mesenchymal neoplasm of vulvo-perineal region. Although AA is common in females of reproductive age, only a few cases during pregnancy have been documented in the English literature. It carries a high risk of local recurrence but rarely metastasizes. The high recurrence rate can partially be due to inadequate excision, which may be due to an incorrect preoperative diagnosis. We present a case of 25-year-old pregnant female presenting with a painless and soft mass attached to left labia majora by a stalk. This mass was clinically thought to be a lipoma. It was completely excised and was diagnosed as AA on histopathology. Gynecologists should consider the diagnosis of AA when a young female especially during her pregnancy presents with a vulvo-perineal mass. Incorrect diagnosis may lead to incomplete excision and recurrence.

  18. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    OpenAIRE

    Kaija-Leena Kolho; Dan Turner

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000  μ g/g). The best cut-off value for calprotectin for predicting poor outcome was 800  μ g/g (sensitivity...

  19. Teenage Pregnancy

    OpenAIRE

    Lee, Basil

    1984-01-01

    More liberal teenage behavior has made pregnancy in this age group an important issue. Live births to adolescent mothers have decreased, while therapeutic abortions for this age group have increased by 27.9% in Canada. The obstetrical and psychosocial risks of the pregnant teenager are related more to inadequate care than to her age. There is a higher perinatal mortality rate among infants born of teenaged mothers. Risk of abuse, neglect, or developmental delay is mitigated by family and soci...

  20. Phase I pilot clinical trial of antenatal maternally administered melatonin to decrease the level of oxidative stress in human pregnancies affected by pre-eclampsia (PAMPR): study protocol

    OpenAIRE

    Hobson, Sebastian R; Lim, Rebecca; Gardiner, Elizabeth E; Alers, Nicole O; Wallace, Euan M

    2013-01-01

    Introduction Pre-eclampsia is a common pregnancy condition affecting between 3% and 7% of women. Unfortunately, the exact pathophysiology of the disease is unknown and as such there are no effective treatments that exist notwithstanding prompt delivery of the fetus and culprit placenta. As many cases of pre-eclampsia occur in preterm pregnancies, it remains a significant cause of maternal and perinatal morbidity and mortality. Recently, in vitro and animal studies have highlighted the potenti...

  1. Activity-based costing for clinical paths. An example to improve clinical cost & efficiency.

    Science.gov (United States)

    Asadi, M J; Baltz, W A

    1996-01-01

    How much does this medical service or surgical procedure cost the hospital to provide? What is the most efficient clinical pathway that maximizes the quality of patient care while minimizing costs? More and more hospitals are discovering that they don't have solid answers to these critically important questions. In an age of managed care and capitation, however, it is imperative for management to know if the patient care services they provide are making or losing money-and by how much. This article discusses how a powerful new tool called activity-based costing (ABC) can be used to help hospitals accurately determine patient care costs. We show how to build a model that combines both clinical and financial data to measure how efficiently the operation allocates human, material and capital resources to provide its services. The modeling approach described in this article can be used to better analyze a wide range of important operational and financial issues, including: How to efficiently allocate resources, and what resources will be needed as patient demand changes-ideal for operational management and planning; How efficiently activities and processes are performed to meet patient needs-effective for measuring performance and improving quality; Determining clinical pathway profitability-essential for understanding where you're making or losing money; Cycle time, throughput and the impact of resource capacity constraints-critical for meeting patient demand; Costs of idle capacity-important for using resources more efficiently. We will illustrate with an example how this modeling technique can be used to develop and implement efficient clinical pathways. PMID:8982988

  2. Activity-based costing for clinical paths. An example to improve clinical cost & efficiency.

    Science.gov (United States)

    Asadi, M J; Baltz, W A

    1996-01-01

    How much does this medical service or surgical procedure cost the hospital to provide? What is the most efficient clinical pathway that maximizes the quality of patient care while minimizing costs? More and more hospitals are discovering that they don't have solid answers to these critically important questions. In an age of managed care and capitation, however, it is imperative for management to know if the patient care services they provide are making or losing money-and by how much. This article discusses how a powerful new tool called activity-based costing (ABC) can be used to help hospitals accurately determine patient care costs. We show how to build a model that combines both clinical and financial data to measure how efficiently the operation allocates human, material and capital resources to provide its services. The modeling approach described in this article can be used to better analyze a wide range of important operational and financial issues, including: How to efficiently allocate resources, and what resources will be needed as patient demand changes-ideal for operational management and planning; How efficiently activities and processes are performed to meet patient needs-effective for measuring performance and improving quality; Determining clinical pathway profitability-essential for understanding where you're making or losing money; Cycle time, throughput and the impact of resource capacity constraints-critical for meeting patient demand; Costs of idle capacity-important for using resources more efficiently. We will illustrate with an example how this modeling technique can be used to develop and implement efficient clinical pathways.

  3. 晚期妊娠宫内感染253例临床分析%The clinical analysis of 253 cases of intrauterine infection in late pregnancy

    Institute of Scientific and Technical Information of China (English)

    林穗青; 程蔚蔚

    2012-01-01

    Objective Investigate the cause of intrauterine infection in late pregnancy, the main pathogens, its impact on maternal and child outcomes and prevention measures. Methods International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine,253 cases was diagnosed of intrauterine infection in late pregnancy between January 1, 2006 and December 31 ,2011 were analyzed retrospectively. Results The hospital in the past of six years the number of cases to intrauterine infection accounted for 0. 41 % of the same period the total number of deliveries, including preterm intrauterine infection accounted for 2. 36% of the total number of premature delivery. Intrauterine infection is associated with premature rupture of membranes, to the time of treatment, the production process duration and the number of vaginal examinations and others. The main pathogens of intrauterine infection followed by GBS (20. 6% ) , escherichia coli (19. 4% ) , enterococcus faecalis (18. 9% ). Of the intrauterine infection patients, rate of eesarean section 76.1% , puerperal infection 14. 2% , neonatal infection 20. 9% , perinatal mortality 3. 2%. Conclusions To strengthen the health care during pregnancy and the management of treatment, the production process. Active prevention and timely diagnosis and treatment of intrauterine infection can improve the prognosis of female and children.%目的 探讨晚期妊娠宫内感染的病因、主要致病菌、对母儿的影响及防治措施.方法 对上海交通大学医学院附属国际和平妇幼保健院2006年1月1日至2011年12月31日诊断为晚期妊娠宫内感染的253例患者资料进行回顾性分析.根据分娩孕周分成早产组(82例)及足月组(171例),比较两组病例的临床结果及母儿预后等.结果 6年来宫内感染的病例数占同期分娩总数的0.41%,其中早产宫内感染占早产总数的2.36%.早产组胎膜早破率、产褥感染率、新生儿感染率及围产

  4. Clinical Analysis of 23 Cases of Hypertensive Disease and Heart Disease During Pregnancy%妊娠期高血压性心脏病23例临床分析

    Institute of Scientific and Technical Information of China (English)

    纪艳洁; 刘爱红

    2009-01-01

    Objective: Discussing effective ways to combat hypertensive disease and heart disease during pregnancy, reducing the complications and mortality rate of pregnant women, lying-in women and fetus. Methads:Analyzing of 23 cases of hypertensive disease and heart disease during pregnancy. Result: The incidence of pregnancy-induced hypertension and heart disease is 0.15 %, accounted for 1.65 % in the same period of pregnancy-induced hypertension. Maternal mortality rate is 0.01% and prenatal mortality rate is 34.78 %. Conclusion: Strengthening the organization of maternal and child health and doing universal prenatal care. Early detection and aggressive treatment of diseases of pregnancy-induced hypertension can reduco the incidence of hypertensive disease and heart disease during pregnancy; Hypertensive disorders in pregnancy with anemia, hypoproteinemia, severee edema and inappropriate expansion of the dissolved pregnancy-induced hypertension treatment is risk factor for hypertensive disease and heart disease during pregnancy;Treatment should be based on strengthening heart; diuresis, vasodilator. Treating the original Plot-level disease and determining the pregnancy timely. When the general treatment can not improve the clinical symptoms, the doctor should be decisive termination of pregnancy to save the mothers life.%目的:防治妊娠期高血压性心脏病的有效方法,减少并发症,降低孕产妇和围生儿的死亡率.方法:采用回顾性分析的方法对23例妊娠期高血压疾病心脏病进行分析.结果:妊娠期高血压疾病心脏病的发生率为0.15%,占同期妊娠期高血压疾病的1.65%,孕产妇病死率为0.01%.围生儿病死率为34.78%.结论:加强基层妇幼保健工作,普遍进行产前检查,早期发现并积极治疗妊娠高血压疾病可降低妊娠期高血压性心脏病的发生率;妊娠期高血压疾病合并贫血、低蛋白血症、严重水肿及不恰当的扩溶治疗是妊娠期高血压疾病中心脏

  5. RHEUMATOID ARTHRITIS AND PREGNANCY

    Directory of Open Access Journals (Sweden)

    N. M. Kosheleva

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA generally starts at the age when many women have already become mothers; however, it may occur in childhood or adolescence. Furthermore, there has been recently a women’s tendency to plan pregnacy for a more mature age, which necessitates a discussion about gestation in this disease. Investigation of mechanisms pregnancy can influence the development of RA both in the gestation and long-term periods is of important theoretical and practical value. The results of these investigations may be used to develop new treatments for RA and management tactics for patients during pregnancy and lactation. The  aper gives the data available in the literature on fertility in RA, impact of pregnancy on its activity and that of RA on the course and outcomes of gestation, as well as current ideas on lactation and use of oral contraceptives in RA. Particular attention is given to drug therapy in pregnant and breastfeeding women with RA: groups of anti-rheumatic drugs are considered in detail in relation to the safety of or a potential risk from their use. A therapeutic algorithm and recommendations for pregnancy planning and a follow-up of patients with RA during gestation are proposed.

  6. The growth hormone receptor: mechanism of activation and clinical implications.

    Science.gov (United States)

    Brooks, Andrew J; Waters, Michael J

    2010-09-01

    Growth hormone is widely used clinically to promote growth and anabolism and for other purposes. Its actions are mediated via the growth hormone receptor, both directly by tyrosine kinase activation and indirectly by induction of insulin-like growth factor 1 (IGF-1). Insensitivity to growth hormone (Laron syndrome) can result from mutations in the growth hormone receptor and can be treated with IGF-1. This treatment is, however, not fully effective owing to the loss of the direct actions of growth hormone and altered availability of exogenous IGF-1. Excessive activation of the growth hormone receptor by circulating growth hormone results in gigantism and acromegaly, whereas cell transformation and cancer can occur in response to autocrine activation of the receptor. Advances in understanding the mechanism of receptor activation have led to a model in which the growth hormone receptor exists as a constitutive dimer. Binding of the hormone realigns the subunits by rotation and closer apposition, resulting in juxtaposition of the catalytic domains of the associated tyrosine-protein kinase JAK2 below the cell membrane. This change results in activation of JAK2 by transphosphorylation, then phosphorylation of receptor tyrosines in the cytoplasmic domain, which enables binding of adaptor proteins, as well as direct phosphorylation of target proteins. This model is discussed in the light of salient information from closely related class 1 cytokine receptors, such as the erythropoietin, prolactin and thrombopoietin receptors. PMID:20664532

  7. Advances in interspecific pregnancy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Interspecific pregnancy in which the conceptus and female carrying the pregnancy are of different species is a key step to interspecific cloning. Cloning endangered animals by interspecific pregnancy is such a highlight catching people's eyes nowadays. In this article, the history of interspecific pregnancy, the methods for establishment of interspecific pregnancy, the corresponding theories, barriers and applied prospects are reviewed.``

  8. Black Teenage Pregnancy: A Challenge for Educators.

    Science.gov (United States)

    Ladner, Joyce A.

    1987-01-01

    Analyzes the impact of teen pregnancy on the education of Black adolescents. Examines the scope of the problem, its social context, and its consequences. Discusses several effective approaches to teenage pregnancy prevention, including sex/family life education, school-based health clinics, life skills instruction, school retention, and…

  9. Fecal Calprotectin and Clinical Disease Activity in Pediatric Ulcerative Colitis

    Science.gov (United States)

    Kolho, Kaija-Leena; Turner, Dan

    2013-01-01

    Objective. To explore fecal calprotectin levels in pediatric ulcerative colitis (UC) in relation with the validated clinical activity index PUCAI. Methods. This study included all 37 children (median age 14 years) with UC who had calprotectin measured (PhiCal ELISA Test) by the time of PUCAI assessment at the Children's Hospital of Helsinki in a total of 62 visits. Calprotectin values 1000 μg/g). The best cut-off value for calprotectin for predicting poor outcome was 800 μg/g (sensitivity 73%, specificity 72%; area under the ROC curve being 0.71 (95%CI 0.57–0.85)) and for the PUCAI best cut-off values >10 (sensitivity 62%, specificity 64%; area under the ROC curve 0.714 (95%CI 0.58–0.85)). Conclusion. The clinical relevance of somewhat elevated calprotectin during clinical remission in pediatric UC is not known and, until further evidence accumulates, does not indicate therapy escalation. PMID:23533791

  10. Ball with the music delivery method in clinical pregnancy of childbirth%分娩球配合音乐疗法在妊娠分娩中的临床应用探讨

    Institute of Scientific and Technical Information of China (English)

    覃媛; 张庚秀; 黄丽玲

    2011-01-01

    Objective: To observe the ball joint music delivery method in the pregnancy and delivery of results. Methods: in our hospital from 1 December 2009, 264 cases were treated pregnant women giving birth were randomly divided into two groups (birth ball joint's method group) and control group (normal delivery group) of the 132 patients, compared two groups of maternal birth process time and the production process pain. Results :The observation group and control group from the incubation period, active period, the first stage of labor are significant differences in the timing comparison ( P < 0.01 ). The study group classification of pain ≤1 grade 82 cases in observation group, 43 eases grade 2; control pain ratings ≤ 1 grade in 61 cases, grade 2 in 29 cases. Significant difference between the two groups (P < 0.01 ), with statistical significance. Conclusion:The ball joint music delivery method assisted pregnancy and delivery, can serve to shorten the first stage, the effect of reducing labor pain,it is worthy to use in clinical.%目的:观察分娩球联合音乐疗法在妊娠分娩中的应用效果.方法:选取我院264例妊娠分娩孕妇并随机分为观察组(分娩球联合音乐法组)和对照组(常规分娩组)各132例,比较两组产妇的分娩进程时间及生产过程中疼痛情况.结果:观察组与对照组从潜伏期、活跃期、第一产程时间方面比较均有明显差异(P<0.05).观察组疼痛分级≤1级者82例,2级者43例;对照组疼痛分级≤1级者61例,2级者29例.两组比较差异显著(P<0.01),具有统计学意义.结论:分娩球联合音乐法辅助妊娠分娩,可以起到缩短第一产程、减轻分娩疼痛的效果,值得在临床推广使用.

  11. Analysis Negative Influence on the Clinical Pregnancy Rate of Intrauterine Insemination in Infertility Women with Advancing Age%高龄不孕妇女IUI临床妊娠的不利影响因素分析

    Institute of Scientific and Technical Information of China (English)

    陈孟循; 马文敏; 朱莉; 吴雅琴; 司徒艳球; 谭晓慧

    2014-01-01

    目的:分析影响高龄不孕妇女IUI获临床妊娠的不利因素,并找出高龄妇女转变助孕方式的时机。方法回顾佛山市妇幼保健院生殖中心自2008年1月~2012年1月行IUI助孕325对夫妇550个IUI周期的资料,统计分析女方不同年龄段、不孕类型、不孕年限、接受IUI的周期数、3种促排卵周期和自然周期对高龄妇女IUI临床妊娠率的影响。结果≧40岁组临床妊娠率明显低于35~36岁组(=0.028);≧5年组临床妊娠率明显低于1~2年组(=0.037);HMG/丽申宝促排卵周期临床妊娠率明显高于自然周期和CC/CC+HMG周期(P值分别为0.012、0.020),40岁及以上患者使用CC/CC+HMG促排卵共21周期,未见有临床妊娠,而HMG/丽申宝促排卵周期临床妊娠率为9.0%(6/67);≧40岁且不孕年限≧5年妇女行IUI助孕共有33周期,仅有1例获临床妊娠,妊娠率为3.0%(1/33);≧40岁妇女接受第3次及以上助孕周期共15周期,未有获临床妊娠者。结论不孕年限及促排卵方案是影响高龄妇女IUI获临床妊娠的重要因素,40岁以上患者通过IUI的获临床妊娠率机会低下。高龄妇女行IUI建议使用Gn促排卵,避免使用CC,进行2个周期的IUI助孕治疗后可考虑转其他助孕方式,特别是对不孕年限≧5年或40岁及以上妇女;不孕年限达5年或者以上,并且患者≧40岁,则建议直接行IVF/ICSI助孕。%Objective To investigate and analyze factors that influence pregnancy rate of intrauterine insemination (IUI)with husband sperm in women of advancing age,to find the best timing to change assisted reproductive technology.Methods The clinical data of 325 infertile couples undergoing 550 IUI were analyzed in Center,Foshan Maternal &Children Health Hospital.Relationships between pregnancy rate and maternal age,infertile types,infertile time,natural cycle and 3 types of ovulation induction cycle were investigated.Results The clinical pregnancy rate was significantly lower in

  12. Activities and interactions of baccalaureate nursing students in clinical practica.

    Science.gov (United States)

    Polifroni, E C; Packard, S A; Shah, H S; MacAvoy, S

    1995-01-01

    Basic nursing education is governed by individual state rules and regulations lacking in uniformity across the United States and based on unstated and perhaps mistaken assumptions. At the same time, there is increasing evidence of problems and difficulties with the current traditional model of nursing education. Before proposing changes in said model, the authors chose to examine what it is that a nursing student does in a clinical area. The perspective of activities and interactions was chosen to illustrate, through a nonparticipant observation study, the patterns and utilization of time during a scheduled clinical experience for baccalaureate nursing students. The goal of the study was to determine who, other than the client/patient, influences the student learning at the clinical site and how learning time is spent. Two schools (one private and one public) and nine clinical sites with 37 observations were used to collect the data for this study. Findings are best summarized in four (overlapping) categories of school time, registered nurse (RN) staff time, hospital staff time, and supervised time. School time, or time spent interacting with the instructor, another student, and/or the student on his/her own in the practice setting (time exclusive of staff input) constituted 84 per cent of all time. RN staff time that was time spent with either the primary nurse or other RNs on the unit used 10 per cent of the student time, Fourteen per cent of student time was spent in hospital staff time, which includes interactions with any nursing staff or other hospital personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Terminology for pregnancy loss prior to viability

    DEFF Research Database (Denmark)

    Kolte, A M; Bernardi, L A; Christiansen, O B;

    2015-01-01

    Pregnancy loss prior to viability is common and research in the field is extensive. Unfortunately, terminology in the literature is inconsistent. The lack of consensus regarding nomenclature and classification of pregnancy loss prior to viability makes it difficult to compare study results from...... different centres. In our opinion, terminology and definitions should be based on clinical findings, and when possible, transvaginal ultrasound. With this Early Pregnancy Consensus Statement, it is our goal to provide clear and consistent terminology for pregnancy loss prior to viability....

  14. Managing antiepileptic drugs during pregnancy and lactation

    DEFF Research Database (Denmark)

    Sabers, Anne; Tomson, Torbjörn

    2009-01-01

    PURPOSE OF REVIEW: This review discusses data on the pharmacokinetics of antiepileptic drugs (AEDs) in pregnancy and lactation, and the clinical consequences thereof, thus providing a basis for a rational management of AEDs during pregnancy and lactation. RECENT FINDINGS: Studies have confirmed...... of AEDs in pregnancy and during lactation is important to enable optimal treatment. Gestation induced alterations in pharmacokinetics vary with the AED but also between patients and are difficult to predict. Therapeutic drug monitoring is, therefore, advisable during pregnancy and the use...... of the individual patient's optimal prepregnancy drug level is recommended as reference. Breastfeeding is in general safe but needs appropriate observation of the nursing infant....

  15. Managing lupus patients during pregnancy

    OpenAIRE

    Lateef, Aisha; Petri, Michelle

    2013-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease, primarily affecting young females. Pregnancy in a woman with SLE remains a high risk situation with higher maternal and fetal mortality and morbidity. Although live births are achieved in majority of the pregnancies, active disease and major organ involvement can negatively affect the outcomes. Higher risk of fetal loss, pre-term birth, intra-uterine growth restriction and neonatal lupus syndromes are major fetal issues. Mothers are...

  16. Adhesion molecules levels in blood correlate with MRI activity and clinical activity in multiple sclerosis

    International Nuclear Information System (INIS)

    Research into pathogenesis of multiple sclerosis (MS) has prompted efforts to identify immunological markers associated with disease activity. Adhesion molecules ICAM-1 and VCAM-1 are associated with inflammatory mediated blood-brain barrier (BBB) dysfunction. In this study investigates the correlation between blood level of circulating ICAM-1 and VCAM-1 and magnetic resonance imaging (MRI) activity in different clinical phases of patients with MS. We show that RRMS and SPMS patients in clinically active phase with Gd-enhancing lesions in CNS had higher blood levels of cICAM-1 and cVCAM-1 compared these parameters levers of RRMS patients in remission stage. These results suggest that cICAM-1 and cVCAM-1 is a sensitive indicator of disease activity associated with BBB inflammatory dysfunction. Elevated blood level of cICAM-1 more strongly correlated with clinical activity and BBB damage, than cVCAM-1 and that could be used as biological marker of disease activity. Circulating VCAM-1 as an early indicator of BBB disturbance, may also serve as marker of beneficial activity in relapses phase of MS course. (authors)

  17. Placental exosomes in normal and complicated pregnancy.

    Science.gov (United States)

    Mitchell, Murray D; Peiris, Hassendrini N; Kobayashi, Miharu; Koh, Yong Q; Duncombe, Gregory; Illanes, Sebastian E; Rice, Gregory E; Salomon, Carlos

    2015-10-01

    While there is considerable contemporary interest in elucidating the role of placenta-derived extracellular vesicles in normal and complicated pregnancies and their utility as biomarkers and therapeutic interventions, progress in the field is hindered by a lack of standardized extracellular vesicle taxonomy and isolation protocols. The term "extracellular vesicle" is nonspecific and refers to all membrane-bound vesicles from nanometer to micrometer diameters and of different biogenic origins. To meaningfully ascribe biological function and/or diagnostic and therapeutic utility to extracellular vesicles, and in particular exosomes, greater specificity and vesicle characterization is required. The current literature relating to exosome biology must be interpreted in this context. Exosomes are a subtype of extracellular vesicle that are specifically defined by an endosomal biogenesis and particle size (40-120 nm) and density (1.13-1.19 g/mL(-1)). Exosomes are specifically package with signaling molecules (including protein, messenger RNA, microRNA, and noncoding RNA) and are released by exocytosis into biofluid compartments. Exosomes regulate the activity of both proximal and distal target cells, including translational activity, angiogenesis, proliferation, metabolism, and apoptosis. As such, exosomal signaling represents an integral pathway mediating intercellular communication. During pregnancy, the placenta releases exosomes into the maternal circulation from as early as 6 weeks of gestation. Release is regulated by factors that include both oxygen tension and glucose concentration and correlates with placental mass and perfusion. The concentration of placenta-derived exosomes in maternal plasma increases progressively during gestation. Exosomes isolated from maternal plasma are bioactive in vitro and are incorporated into target cells by endocytosis. While the functional significance of placental exosomes in pregnancy remains to be fully elucidated, available

  18. 妊娠合并糖尿病早期干预与妊娠结局的临床探讨%Clinical Pregnancy with Diabetes Early Intervention and Pregnancy outcome

    Institute of Scientific and Technical Information of China (English)

    阿孜古丽·吐尔逊; 夏木西丁.马合木提

    2015-01-01

    目的:研究分析妊娠合并糖尿病早期干预对妊娠结局的影响. 方法:回顾分析我院2012年5月~2014年5月收治的妊娠期糖尿病患者58例,对其中有31例妊娠期糖尿病患者采取了早期干预治疗作为观察组,另有27例同期入院前未做相关检查产时确诊为GDM患者作为对照组,对比2组患者妊娠结局的差异. 结果:2组患者围产期情况对比,明显低于对照组(P<0. 05),差异有统计学意义. 2组孕妇产新生儿围产期情况对比,明显低于对照组(P<0. 05),差异有统计学意义. 结论:早期监测发现妊娠合并糖尿病时,及时采取干预治疗,可显著降低妊娠期糖尿病患者以及新生儿的围产期并发症的发生率,改善妊娠结局.%To study the analysis of the pregnancy with diabetes early intervention effects on pregnancy outcome. Methods:retrospective analysis of our hospital from May 2012 to May 2014 were 58 patients with gestational diabetes, including 31 cases of gesta-tional diabetes patients to take early intervention treatment as observation group, the same period and another 27 cases do not make rele-vant inspection before admission intrapartum diagnosed with GDM patients as control group, compared the difference of two groups of pa-tients with pregnancy outcome. Results:two groups of patients with perinatal situation contrast, significantly lower than the control group ( P < 0. 05) difference was statistically significant. Obvious contrast, two groups of pregnant women from perinatal newborn is lower than the control group (P < 0. 05) difference was statistically significant. Conclusion:early pregnancy with diabetes found, take timely inter-vention treatment, can significantly reduce the gestational diabetes patients and incidence of neonatal perinatal complications, improve the pregnancy outcome.

  19. Zinc supplementation during pregnancy: effects on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent.

    Science.gov (United States)

    Hunt, I F; Murphy, N J; Cleaver, A E; Faraji, B; Swendseid, M E; Coulson, A H; Clark, V A; Browdy, B L; Cabalum, T; Smith, J C

    1984-09-01

    The effects of zinc supplementation on levels of various blood constituents and the outcome of pregnancy in 213 Hispanic women attending a prenatal clinic in Los Angeles was assessed in this double-blind study. The women were randomized into either a control (C) or a zinc-supplemented (Z) group and received similar vitamin and mineral supplements except that 20 mg zinc was added to the Z group's capsules. At the final interview, women (C + Z) with low serum Zn levels (less than or equal to 53 micrograms/dl) had higher (p less than 0.01) mean ribonuclease activity and lower (p less than 0.01) mean delta-aminolevulinic acid dehydratase activity than women with acceptable serum zinc levels. The incidence of pregnancy-induced hypertension was higher (p less than 0.003) in the C than in the Z group, but pregnancy-induced hypertension was not associated with low serum zinc levels at either the initial or final interview. The expected increase in serum copper levels was greater (less than 0.001) in women with pregnancy-induced hypertension (C + Z) than in normotensives. Except for pregnancy-induced hypertension, there was a higher incidence of abnormal outcomes of pregnancy in the noncompliers than in the compliers (C + Z). PMID:6475822

  20. [In vitro fertilization at the Erasme Hospital: 10 years and 1000 pregnancies later...].

    Science.gov (United States)

    Englert, Y; Van den Bergh, M; Delbaere, A; Devreker, F; Koenig, I; Hannes, M; Emiliani, S; Biramane, J; Vannin, A S; Govaerts, I; Holoye, A; Revelard, P

    1999-10-01

    This contribution summarize ten years of in vitro fertilization of clinical work. Activity growth, improvements of results (mean fertilization rate increased from 45% to 58%, fertilization failure dropped from 18% to 7%, pregnancy chances gains 9% to reach 44% per trial) and new treatments possibilities (severe male infertility) thanks to the ICSI technic were the major characteristics of this last ten years. The original anonymous oocyte donation program with donors permutation initiated as soon as 1990 has imposed itself due to it's exceptional efficiency with a pregnancy rate of 95% per oocyte pick up on a population of 46 donors and 145 recipient cycles. Thanks to the large population studied (4028 cycles, 1071 pregnancies), the tendencies in human fecundity (impact of age) and the risks linked to multiples pregnancies could be highlighted, stressing the importance of future developments presented in the other contributions following this general presentation of results.

  1. Spontaneous Heterotopic Pregnancy, Simultaneous Ovarian, and Intrauterine: A Case Report

    Directory of Open Access Journals (Sweden)

    Francesca Basile

    2012-01-01

    Full Text Available Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. The occurrence of an ovarian heterotopic pregnancy is a singular event as it comprises only 2.3% of all heterotopic pregnancies, extremely rare among women who conceive naturally. A case of a 28-year old patient was treated for spontaneously conceived heterotopic pregnancy. The patient was admitted to our center with lower abdominal pain and amenorrhoea. A transvaginal ultrasound scan showed an ovarian and an intrauterine heterotopic pregnancy. This was managed laparoscopically. Considering spontaneous pregnancies, every physician treating women of reproductive age should be aware of the possibility of heterotopic pregnancy. It can occur in the absence of any predisposing risk factors; only with an early diagnosis and treatment the intrauterine pregnancies will reach viability with a great chance of a favorable obstetric outcome.

  2. Mercury and Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Is it safe? > Mercury and pregnancy Mercury and pregnancy E-mail to a friend Please ... vision problems. How can you be exposed to mercury? Mercury has several forms: It can be a ...

  3. Pregnancy and Fifth Disease

    Science.gov (United States)

    ... during the first half of pregnancy. Testing for Parvovirus B19 during Pregnancy A blood test for parvovirus B19 ... infected, or have had a recent infection. Monitoring Parvovirus B19 Infection during Pregnancy If you are pregnant, you ...

  4. Pregnancy and Thyroid Disease

    Science.gov (United States)

    ... Disease Organizations (PDF, 269 KB). Alternate Language URL Pregnancy and Thyroid Disease Page Content On this page: ... responds by decreasing TSH production. [ Top ] How does pregnancy normally affect thyroid function? Two pregnancy-related hormones— ...

  5. Tests Related to Pregnancy

    Science.gov (United States)

    ... to learn. Search form Search Tests related to pregnancy You are here Home Testing & Services Testing for ... to Genetic Counseling . What Are Tests Related to Pregnancy? Pregnancy related testing is done before or during ...

  6. Pregnancy and IBD

    Science.gov (United States)

    ... Center Home > Resources > Pregnancy and IBD Go Back Pregnancy and IBD Email Print + Share If you have ... on the developing fetus or newborn. EFFECT OF PREGNANCY ON WOMEN WITH IBD Women should be well ...

  7. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... premature birth Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to ... your baby Common illnesses New parents Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

  8. Alcohol and Pregnancy

    Medline Plus

    Full Text Available ... premature birth Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Birth defects prevention Learn how to ... your baby Common illnesses New parents Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

  9. Pregnancy test via milk

    NARCIS (Netherlands)

    Siemes, H.; Woelders, H.

    2011-01-01

    Determining a pregnancy through the milk. Wageningen University is researching the possibilities. The first steps have been taken. Researchers have identified five milk proteins that release a signal of a pregnancy. A pregnancy test via the milk comes within sight.

  10. Exercise during Pregnancy

    Science.gov (United States)

    ... high blood pressure Severe anemia What are the benefits of exercise during pregnancy? Regular exercise during pregnancy benefits you ... weeks after childbirth. In addition to these health benefits, exercise after pregnancy can help you lose the extra ...

  11. Cystic Fibrosis and Pregnancy

    Science.gov (United States)

    ... Complications & Loss > Pregnancy complications > Cystic fibrosis and pregnancy Cystic fibrosis and pregnancy E-mail to a friend Please ... this page It's been added to your dashboard . Cystic fibrosis (CF) is a condition that affects breathing and ...

  12. Rheumatic diseases during pregnancy

    OpenAIRE

    Yavuz, Rahman

    2013-01-01

    Pregnancy induces immunologic changes that may differentially impact rheumatic disorders. The effects of pregnancy on rheumatic diseases vary by condition. The systemic rheumatic illnesses commonly complicating pregnancy are systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), rheumatoid arthritis (RA), scleroderma.

  13. 双(多)胎脑瘫患儿的病因学及临床特征分析%Etiology and Clinical Features of Cerebral Palsy in Twin or Multiple Pregnancies

    Institute of Scientific and Technical Information of China (English)

    孙殿荣; 候梅; 高翔

    2011-01-01

    目的 探讨双(多)胎儿童发生脑瘫的相关因素及临床特征.方法 对52例双胎或多胎脑瘫患儿进行围产期高危因素调查、临床分型、影像学检查及粗大运动功能测评(GMFCS).结果 和结论双(多)胎之一脑瘫的发生和妊娠并发症无明显相关.同性别双胎、出生体重偏重一胎发生脑瘫的机会大.双(多)胎脑瘫以痉挛型双瘫最多见,影像学改变以侧脑室周围白质软化为主.痉挛型双瘫和偏瘫患儿GMFCS多在Ⅰ~Ⅲ级,而不随意运动型、四肢瘫和混合型患儿多在Ⅳ~Ⅴ级.%Objective To analyze the related factors and clinical features of cerebral palsy in twin or multiple pregnancies. Methods 52 cerebral palsy children in twin or multiple pregnancies were reviewed with the risk factors in perinatal period, the clinical type, findings of radiology and the gross motor function (GMFCS). Results and Conclusion No significant link was found between these pregnancy complications and cerebral palsy in twins or multiple pregnancies. The prevalence of cerebral palsy was higher for the one with more birthweight in twins of the same gender. Spastic diplegia was the most type, and most of them were found with periventricular leucomalacia. The GMFCS levels was Ⅰ ~ Ⅲ in spastic hemiplegic or spastic diplegic children, while was Ⅳ ~ Ⅴ in children with spastic quadriplegia, dyskinesia or mixed CP.

  14. Value of intramuscular methotrexate and bilateral uterine artery embolization for treating cervical ectopic pregnancy

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of bilateral uterine artery chemotherapy embolization (UACE) for cervical ectopic pregnancy analyzed. Methods: Clinical records of 40 patients with cervical ectopic pregnancy treated using UACE were retrospectively analyzed. Results: 8 patients with severe active vaginal bleeding after curettage were treated urgently with UACE. The remaining 32 patients were treated with UACE combined with sequential ultrasound-guided curettage. Active vaginal bleeding was stopped after UACE. There was no recurrent hemorrhage with the sequential ultrasound-guided curettage procedure. The β-HCG levels of all patients were normalized after 1 month. Conclusion: Bilateral uterine artery chemotherapy embolization is valuable as emergency treatment for patients with severe vaginal bleeding from cervical ectopic pregnancy. UACE combined with sequential ultrasound-guided curettage may be more effective. (authors)

  15. Mudanças na apresentação clínica da gravidez molar The changing clinical presentation of molar pregnancy

    Directory of Open Access Journals (Sweden)

    Paulo Belfort

    2004-07-01

    Full Text Available OBJETIVO: determinar se a apresentação clínica da mola hidatiforme tem mudado nos últimos anos (1992-1998 quando comparada a registros históricos de controle (1960-1981. MÉTODOS: foram revisadas 80 fichas de pacientes com mola hidatiforme acompanhadas entre 1960-1981 no Centro de Neoplasia Trofoblástica Gestacional da Santa Casa da Misericórdia (Rio de Janeiro Brasil e as de 801 pacientes atendidas entre 1992-1998 no mesmo centro. Foram analisados os seguintes parâmetros: idade, número de gestações, sangramento vaginal, hiperêmese, edema dos membros inferiores, hipertensão arterial, útero grande para a idade gestacional e cistos teca-luteínicos dos ovários. Para análise estatística foram utilizados os testes do qui-quadrado e o cálculo do odds ratio (OR com intervalo de confiança (IC de 95%. RESULTADOS: com relação à idade, a ocorrência de mola em pacientes com menos de 15 anos ou mais de 40 foi significativamente mais freqüente no grupo II do que no grupo I; quanto ao número de gestações, a diferença entre os dois grupos só não foi significativa entre aquelas pacientes que gestavam pela terceira e quarta vez. A hipertensão arterial, foi detectada em porcentagem semelhante nos dois grupos e útero grande para a idade gestacional foi mais freqüente no grupo II (41,4 vs 31,2% - p OBJECTIVE: to determine whether the clinical presentation of hydatidiform mole has changed in the recent years (1992-1998 when compared with historic controls (1960-1981. METHODS: medical records of 80 patients with hydatidiform mole attended in the 1960-1981 period (Group I were reviewed and compared to data from 801 patients followed in the 1992-1998 period (Group II. The clinical signals and symptoms analyzed were: age distribution, number of pregnancies, vaginal bleeding, hyperemesis, edema, hypertension, large uterus for gestation date and theca lutein cysts of the ovaries. Statistical analyses employed chi-square tests and odds

  16. MR features of ectopic pregnancy

    International Nuclear Information System (INIS)

    Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When TVS findings are indeterminate, magnetic resonance imaging (MRI) may provide better delineation of the focus of EP owing to its excellent tissue contrast. The key MRI features of EP include gestational sac (GS)-like structures that typically appear as a cystic sac-like structure, frequently associated with surrounding acute hematoma of distinct low intensity on T2-weighted images. In tubal pregnancy, an enhanced tubal wall on postcontrast images may be another diagnostic finding. Ruptured EP is inevitably associated with acute hematoma outside these structures. In intrauterine EP, recognition of the relationship between GS-like structure and the myometrium can aid in differentiating from normal pregnancy. Diagnostic pitfalls include heterotopic pregnancy, decidual changes in endometrial cyst and theca lutein cysts mimicking GS-like structures. Knowledge of a spectrum of clinical and MRI features of EP is essential for establishing an accurate diagnosis and determining appropriate management. (orig.)

  17. MR features of ectopic pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Tamai, Ken; Togashi, Kaori [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Koyama, Takashi [Kyoto University Hospital, Department of Radiology, Kyoto (Japan)

    2007-12-15

    Ectopic pregnancy (EP), in which a fertilized ovum implants outside the uterine cavity, is the leading cause of pregnancy-related death in the first trimester. EP is usually suspected by a positive pregnancy test and an empty uterus on transvaginal sonography (TVS). Although TVS is the initial modality of choice, it may occasionally fail to demonstrate the implantation site. When TVS findings are indeterminate, magnetic resonance imaging (MRI) may provide better delineation of the focus of EP owing to its excellent tissue contrast. The key MRI features of EP include gestational sac (GS)-like structures that typically appear as a cystic sac-like structure, frequently associated with surrounding acute hematoma of distinct low intensity on T2-weighted images. In tubal pregnancy, an enhanced tubal wall on postcontrast images may be another diagnostic finding. Ruptured EP is inevitably associated with acute hematoma outside these structures. In intrauterine EP, recognition of the relationship between GS-like structure and the myometrium can aid in differentiating from normal pregnancy. Diagnostic pitfalls include heterotopic pregnancy, decidual changes in endometrial cyst and theca lutein cysts mimicking GS-like structures. Knowledge of a spectrum of clinical and MRI features of EP is essential for establishing an accurate diagnosis and determining appropriate management. (orig.)

  18. Narcolepsy and pregnancy

    DEFF Research Database (Denmark)

    Maurovich-Horvat, Eszter; Kemlink, David; Högl, Birgit;

    2013-01-01

    In a retrospective cohort study undertaken in 12 European countries, 249 female narcoleptic patients with cataplexy (n = 216) and without cataplexy (n = 33) completed a self-administrated questionnaire regarding pregnancy and childbirth. The cohort was divided further into patients whose symptoms...... of narcolepsy started before or during pregnancy (308 pregnancies) and those in whom the first symptoms of narcolepsy appeared after delivery (106 pregnancies). Patients with narcolepsy during pregnancy were older during their first pregnancy (P ...

  19. Analysis of Clinical Data of 177 Patients with Preterm Twin Pregnancies%双胎妊娠早产177例临床分析

    Institute of Scientific and Technical Information of China (English)

    吴芹; 杨茵; 邱娜璇

    2011-01-01

    Objective To investigate the cause and delivery time and mode of preterm twin preg nancies. Methods Clinical data of twin pregnancies delivered in this hospital from 2000 to 2009 were col lected and analyzed, including 177 preterm twins and 208 term twins. Results Spontaneous preterm birth accounted for the most proportion of all preterm twins, Iatrogenic preterm birth was the second a mong the late preterm twins(P<0. 05) ;There was significant difference in both caesarean and vaginal de livery rates of twin pregnancy at different gestational age(P<0.05); The incidence of single intrauterine demise, discordant fetal growth and small for gestational age showed statistical difference among three groups; The lower Apgar score rates and mortality rates in twins decreased with the increase of gestational age. Conclusion Spontaneous preterm birth is the main cause of preterm delivery in twins. The deliv ery mode of twins should be considered comprehensively. Selection of appropriate delivery gestations is thne important measures to improve the neonatal outcomes.%目的 探讨双胎妊娠早产的病因、终止妊娠的方式和时机.方法 对2000年1月-2009年12月双胎妊娠病例资料进行回顾性分析.双胎早产共177例,其中早期早产组(A组)72例,晚期早产组(B组)105例;选择双胎足月产208例为对照组(C组).结果 双胎早产发生原因以自发性早产为首位,晚期早产中医源性早产比率高于早期早产组,差别有统计学意义(P<0.05);双胎妊娠剖宫产率及阴道分娩率在不同孕周组间差异有统计学意义(P<0.05);3组一胎宫内死胎率、生长不一致率和小于孕龄儿率均不同,差别有统计学意义(P<0.05);随着分娩孕周的增加,双胎儿低Apgar评分率及死亡率下降.结论 双胎早产的主要原因为自发性早产;其分娩方式应综合决定.为改善围产儿结局,应选择适宜的分娩孕周.

  20. 妊娠合并血小板减少89例临床分析%Clinical analysis of 89 thrombocytopenia in pregnancy

    Institute of Scientific and Technical Information of China (English)

    王洪英; 齐小雪; 王跃莲

    2009-01-01

    目的 探讨妊娠合并血小板减少的病因、治疗及分娩方式.方法 回顾性分析我院2006年1月~2009年3月收治的89例妊娠合并血小板减少患者的临床资料.结果 妊娠期血小板减少的主要病因有妊娠相关性血小板减少症(PAT)65例(73.03%),妊娠期高血压疾病(HDCP)11例(12.36%),特发性血小板减少性紫癜(ITP)6例(6.74%),妊娠合并肝脏疾病5例(5.61%),系统性红宽狼疮合并妊娠2例(2.24%).PAT孕期不需特殊处理,妊娠结局良好,对血小板<50×109/L的12例患者分娩前给予地塞米松10~20mg/d,5例无效者分娩时输注血小板.结论 妊娠期血小板减少以PAT多见,孕期不需特殊处理.其次为妊娠期高血压疾病(HDCP).当血小板≤50×109/L分娩前给予地塞米松治疗,静脉点滴3~5d,无效者分娩时输注血小板,分娩方式以剖宫产为宜,产后出血发生率12.35%.%Objective To explore the causes,therapy and the way of delive of pregnant women with thromboeytopenia. Methods The data of 89 cases with thrombocytopenia during pregnancy were reviewed from Jan. 2006 to Mar. 2009. Results The main cause of thrombocytopenia during pregnancy were pregnancy associated thrombocytopenia (PAT) has 65 cases (73.03%), Hypertensive disorder complicating pregnancy(HDCP) has 11 cases(12.36%). Idiopathic thromboeytopenia(ITP) has 6 cases(6.74%). Hepatic disease in pregnancy has 5 cases (5.61% ,Systemic lupus erythematosus in pregnancy has 2cases (2.24%). Pregnancy associated thrombocytopenia need not to be specially treated during pregnancy, To the 12 patients whose platelet <50×109/L given dexamethasone 10~20mg/d treatment before delivery ,But five patients who has no effect intravenous platelet treatment during delivery. Conclusion Pregnancy associated thrombocytopenia is the common reason in thrombocytope-nia during pregnancy, Pregnancy associated thrombocytopenia need not to be specially treated during pregnancy. The second rea-son is hypertensive