WorldWideScience

Sample records for activation clinical pregnancy

  1. CLINICAL STUDY OF ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    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.

  2. Clinical characteristics of fulminant hepatitis in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Xiao-Mao Li; Lin Ma; Yue-Bo Yang; Zhong-Jie Shi; Shui-Sheng Zhou

    2005-01-01

    AIM: To investigate the clinical characteristics of fulminant hepatitis in pregnancy.METHODS: We compared and analyzed the etiology,clinical characteristics, and laboratory examinations of 25 cases of fulminant hepatitis in pregnancy and 30 cases of fulminant hepatitis not in pregnancy.RESULTS: HBV infection and chronic fulminant hepatitis were most common both in the pregnant and in the non-pregnant groups. Jaundice, digestive tract symptoms,increase of bilirubin and thrombinogen activity were the main manifestations. The incidence of hepatic encephalopathy (HE) and hepato-renal syndrome (HRS) was significantly different between the two groups. The incidence of preterm labor, dead fetus and neonatal asphyxia was high.CONCLUSION: Fulminant hepatitis is likely to occur in late pregnancy with more severe complications, which significantly influences maternity, perinatal fetus, and newborn.

  3. Measuring physical activity during pregnancy

    Directory of Open Access Journals (Sweden)

    Teede Helena J

    2011-03-01

    Full Text Available Abstract Background Currently, little is known about physical activity patterns in pregnancy with prior estimates predominantly based on subjective assessment measures that are prone to error. Given the increasing obesity rates and the importance of physical activity in pregnancy, we evaluated the relationship and agreement between subjective and objective physical activity assessment tools to inform researchers and clinicians on optimal assessment of physical activity in pregnancy. Methods 48 pregnant women between 26-28 weeks gestation were recruited. The Yamax pedometer and Actigraph accelerometer were worn for 5-7 days under free living conditions and thereafter the International Physical Activity Questionnaire (IPAQ was completed. IPAQ and pedometer estimates of activity were compared to the more robust and accurate accelerometer data. Results Of 48 women recruited, 30 women completed the study (mean age: 33.6 ± 4.7 years; mean BMI: 31.2 ± 5.1 kg/m2 and 18 were excluded (failure to wear [n = 8] and incomplete data [n = 10]. The accelerometer and pedometer correlated significantly on estimation of daily steps (ρ = 0.69, p -1 day-1 were not significantly correlated and there was poor absolute agreement. Relative to the accelerometer, the IPAQ under predicted daily total METs (105.76 ± 259.13 min-1 day-1 and light METs (255.55 ± 128.41 min-1 day-1 and over predicted moderate METs (-112.25 ± 166.41 min-1 day-1. Conclusion Compared with the accelerometer, the pedometer appears to provide a reliable estimate of physical activity in pregnancy, whereas the subjective IPAQ measure performed less accurately in this setting. Future research measuring activity in pregnancy should optimally encompass objective measures of physical activity. Trial Registration Australian New Zealand Clinical Trial Registry Number: ACTRN12608000233325. Registered 7/5/2008.

  4. Clinical study of ectopic pregnancy.

    Science.gov (United States)

    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.

  5. Ovarian Heterotopic Pregnancy Clinically Mimicking Endometrioma

    Directory of Open Access Journals (Sweden)

    Nilüfer ONAK KANDEMİR

    2010-01-01

    Full Text Available Heterotopic pregnancy is a very uncommon entity with a difficult preoperative diagnosis. In the present study, we presented an ovarian heterotopic pregnancy case, clinically mimicking endometrioma developed in a 33-year-old female following an in vitro fertilization procedure. The importance of clinical, histopathological, and immunohistochemical examinations in the diagnosis of heterotopic pregnancy are emphasized.

  6. 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.

  7. 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 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. Clinical pregnancies and livebirths achieved by intracytoplasmic injection of round headed acrosomeless spermatozoa with and without oocyte activation in familial globozoospermia:case report

    Institute of Scientific and Technical Information of China (English)

    Enver K.Dirican; Ahmet Isik; Kubilay Vicdan; Eran Sozen; Zekiye Suludere

    2008-01-01

    We report the successful outcome of intracytoplasmic sperm injection (ICSI) treatment in two siblings with familial globozoospermia. After controlled ovarian hyperstimulation and oocyte pick-up, retrieved oocytes were mechanically activated before ICSI and a fertilization rate of 33.3% was achieved in the first case. The second couple underwent ICSI without oocyte activation and a 9.1% fertilization rate was obtained. The transfer of two grade Ⅰ embryos in the first couple and one grade Ⅰ embryo in the second couple resulted in clinical pregnancies with healthy livebirths. It was concluded that the main problem of cases with globozoospermia is a low fertilization rate, and even though ICSI and oocyte activation can increase this rate it is not necessarily needed to achieve a pregnancy.

  10. 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.

  11. Clinical aspects of multiple pregnancy

    NARCIS (Netherlands)

    J.G. Santema

    1996-01-01

    textabstractThe natural wonder of multiple pregnancy and birth has fascinated mankind since ancient times and twins figure prominently in legends, folktales and myths. One of the best known traditional stories is that of Romulus and Remus, the twins who were abandoned on the banks of the Tiber and s

  12. Urolithiasis in pregnancy: survey in clinical epidemiology.

    Science.gov (United States)

    Liu, Guoqing; Wang, Jianfeng; Li, Jierong; Zheng, Jintao; Huang, Zhenqiang; Ye, Zhangqun

    2011-04-01

    This study examined the association of pregnancy with urolithiasis and provided new insights into urolithiasis in pregnancy. A total of 462 subjects were studied from January 2004 to December 2009 in Foshan Maternal and Child Health Hospital, China. Among the 462 subjects, 162 cases of urolithiasis during pregnancy (UPG) were selected as the observation group, 150 cases of no urolithiasis during pregnancy (NUPG) served as pregnancy control group, and 150 cases of no pregnancy (NPG) at reproductive age who took part in physical examination were randomly assigned into non-pregnant control group. At the same time, the patients in observation group were divided into the following sub-groups: no symptomatic urinary calculus (NSUC) and symptomatic urinary calculus (SUC) groups; SUC group was further divided into surgical intervention (SI) and conservative management (CM) groups. The general information and the data of blood and urine were collected and compared among the groups. The results showed that the incidence of urinary calculi in pregnant women was lower than that in non-pregnant women, the formation of urinary stone was associated with the change of metabolism of protein and sugar in pregnant women, and the surgical intervention was a practicable alternative to treat the clinical intractable symptomatic urinary calculi in pregnancy.

  13. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Richa

    2014-07-01

    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease

  14. [Clinical and ultrasonographic data in ectopic pregnancy].

    Science.gov (United States)

    Romero Gutierrez, G; Patiño Segura, A; Pulido Ochoa, J J; Valadéz Ortega, A

    1994-06-01

    In order to evaluate the clinical and sonographic findings in 60 patients with ectopic pregnancy confirmed at laparotomy, we carried out a prospective study at the Hospital de Gineco-Obstetricia del Centro Médico León, Instituto Mexicano del Seguro Social. The patients were 28.17 years old, average. The ectopic pregnancy was more common in multiparous women (80%) than in nuliparous ones. The obstetric risk factors more frequent were abortion (26.6%) and use of intrauterine device (23.3%). The clinical sign reported most common was pelvic pain, referred in 48 patients (80%). Hemodynamic changes were detected in 21.6% of the cases. The ultrasound findings were seen in most of the patients and heterogeneous adnexal mass was observed in 91.6% of them, moreover intraperitoneal fluid was reported in 61.6% of the patients with ectopic pregnancy. The heterogeneous adnexal mass had a direct relationship with the diagnosis of ectopic pregnancy and had a correlation coefficient value R = 0.99 (P < 0.01). The ultrasonographic findings seen with transvaginal technique were similar than those obtained through transabdominal procedure. We conclude that ultrasonography has a definite role in improving the diagnosis of ectopic pregnancy.

  15. Nail alterations during pregnancy: a clinical study.

    Science.gov (United States)

    Erpolat, Seval; Eser, Ayla; Kaygusuz, Ikbal; Balci, Hatice; Kosus, Aydin; Kosus, Nermin

    2016-10-01

    During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

  16. Benign encephalopathy of pregnancy. Preliminary clinical observations.

    Science.gov (United States)

    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.

  17. Clinical use of placental hormones in pregnancy management.

    Science.gov (United States)

    De Bonis, M; Vellucci, F L; Di Tommaso, M; Voltolini, C; Torricelli, M; Petraglia, F

    2012-09-01

    Across human pregnancy, placenta represents a transit of oxygen and nutrients from the mother to the fetus and actively produces a large number of hormones that serve to regulate and balance maternal and fetal physiology. An abnormal secretion of placental hormones may be part of the pathogenesis of the main obstetric syndrome, from early to late pregnancy, in particular chromosomopathies, miscarriage, gestational trophoblastic diseases, preeclampsia, gestational diabetes, and pre-term delivery. The possibility to measure placental hormones represents an important tool not only for the diagnosis and management of gestational disorders, but it is also fundamental in the early identification of women at risk for these pregnancy complications. In the last decades, the use of ultrasound examination has provided additional biophysical markers, improving the early diagnosis of gestational diseases. In conclusion, while few placental hormones have sufficient sensitivity for clinical application, there are promising new biochemical and biophysical markers that, if used in combination, may provide a valid screening tool.

  18. First clinical manifestation of Brugada syndrome during pregnancy.

    Science.gov (United States)

    Prochnau, Dirk; Figulla, Hans R; Surber, Ralf

    2013-09-01

    The role of hormonal changes during pregnancy in Brugada syndrome is unknown. Only rare case reports of Brugada syndrome during pregnancy have been published. In this article, we describe a patient with first clinical manifestation of Brugada syndrome during pregnancy. The definitive diagnosis could only be achieved by drug challenge with ajmaline after childbirth because the spontaneous typical Brugada-like pattern was absent. Elevated hormone levels during pregnancy may increase the risk for arrhythmias in particular cases.

  19. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  1. CLINICAL AND EPIDEMIOLOGICAL STUDY OF CUTANEOUS MANIFESTATIONS OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    O. V. Gaisenok; O. A. Zamyatina; N. Yu. Denisova; A. S. Leonov

    2015-01-01

    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.

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

    OpenAIRE

    O. V. Gaisenok; O. A. Zamyatina; N. Yu. Denisova; A. S. Leonov

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    O. V. Gaisenok

    2015-09-01

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

  6. A clinical study of ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Shanti Sri Asuri

    2016-11-01

    Conclusions: The early diagnosis of an ectopic pregnancy is one of the greatest challenges for a physician. It requires a high index of suspicion to diagnose an ectopic pregnancy. The importance of an early diagnosis lies in the fact that the lady can be offered a conservative line of management which can definitely have a beneficial effect on her reproductive career. [Int J Reprod Contracept Obstet Gynecol 2016; 5(11.000: 3750-3753

  7. Clinical investigation of risk factors in ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Ling-yun HU

    2013-05-01

    Full Text Available Objective  To discuss the relative and independent risk factors in ectopic pregnancy. Methods  The clinical data of 870 patients with ectopic pregnancy, admitted from 2005 to 2012, were retrospectively analyzed, with 800 cases of normal pregnancy serving as control. Monofactorial correlation analysis was used to analyze the related risk factor, and logistic regression analysis was used to analyze the independent risk factor. Results  Pelvic adhesion, previous operation, cesarean section delivery, number of pregnancy, artificial abortion, medical abortion, in vitrofertilization and embryo replacement (IVF-ER, and placement of intrauterine device (IUD are the risk factors of ectopic pregnancy, pelvic adhesion, artificial abortion, operation, number of pregnancies and IUD are the independent risk factors, and pelvic adhesion is the major risk factor. Conclusion  Avoidance of unexpected pregnancy as possible, reduction of the number of artificial abortion, prevention and treatment of genital duct inflammation, and standardization of pelvic operation may reduce the incidence of ectopic pregnancy.

  8. Urolithiasis in pregnancy--a clinical challenge.

    Science.gov (United States)

    Buchholz, N P; Biyabani, R; Sulaiman, M N; Talati, J

    1998-09-01

    Symptomatic urolithiasis in pregnancy is a rare event. We present a series of 13 cases. Although controversial, we think that X-rays should be avoided if possible. Ultrasound may not be the perfect diagnostic tool in every case of stone disease, however in pregnancy it is the imaging of choice and led to an accurate diagnosis in all our cases. Thirty-eight percent of the patients were managed conservatively throughout their pregnancy, and another thirty-eight percent of our patients needed more extended treatment but could be managed by simple insertion of a double J ureteric stent (DJ). Therefore, in our series invasive treatment was not necessary in the majority of patients. Each one patient required a percutaneous nephrostomy (PCN) and a nephrectomy for a non-functional pyonephrotic kidney. Urolithiasis in pregnant women constitutes a challenge for the treating urologists since they are deprived of some of their essential tools, such as X-rays and extracorporeal shock wave lithotripsy (ESWL), and since normally tolerable complications of less invasive treatments can have disastrous consequences in pregnant patients. Therefore, decisions on any kind of treatment have to be made very prudently and critically. We present an algorithm for the management of stones in pregnancy which may be helpful in decision making.

  9. Aspirin in pregnancy : clinical and biochemical studies

    NARCIS (Netherlands)

    H.A. Bremer (Henk)

    1994-01-01

    textabstractAspirin, acetylsalicylic acid, is the most frequently consumed drug in pregnancy,47 mostly taken without a prescription because of headache or a minor ailment. 226,277 Numerous preparations containing acetylsalicylic acid are freely available over the counter under a variety of proprieta

  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 XYY. Molar phenotype was seen only in PPM cases. However, PPM cases with a nonmolar phenotype were...

  11. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    2013-01-01

    CNS-active drugs are used relatively often during pregnancy. Use during early pregnancy may increase the risk of a congenital malformation; use during the later part of pregnancy may be associated with preterm birth, intrauterine growth disturbances and neonatal morbidity. There is also a possibility that drug exposure can affect brain development with long-term neuropsychological harm as a result. This paper summarizes the literature on such drugs used during pregnancy: opioids, anticonvulsa...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  16. 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.

  17. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana

    2011-04-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17 or IG- "intervention" (n=16. IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP, professional prophylaxis (PROPH and oral hygiene instruction (OHI. NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD, clinical attachment level (CAL, plaque index (PI and sulcular bleeding index (SBI at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (0.05 at IG and worsening of all periodontal parameters at NIG (p<0.0001, except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001. The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

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

    Directory of Open Access Journals (Sweden)

    Francis S. Balucan

    2013-01-01

    Full Text Available 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.

  19. Activating the Consumer about Pregnancy and Childbirth.

    Science.gov (United States)

    James, Gordon B.

    1980-01-01

    A variety of consumer issues involved in education about pregnancy and childbirth are outlined for inclusion in health education programs. They include consumer concern prior to and during pregnancy, and surrounding childbirth. (JMF)

  20. Clinical features and pregnancy outcome in antiphospholipid syndrome patients with history of severe pregnancy complications.

    Science.gov (United States)

    Matsuki, Yuko; Atsumi, Tatsuya; Yamaguchi, Koushi; Hisano, Michi; Arata, Naoko; Oku, Kenji; Watanabe, Noriyoshi; Sago, Haruhiko; Takasaki, Yoshinari; Murashima, Atsuko

    2015-03-01

    Abstract Objective. To clarify the clinical significance of antiphospholipid antibody (aPL) profile in patients with obstetric antiphospholipid syndrome (APS). Methods. Clinical records of 13 pregnant patients (15 pregnancies) with obstetrical APS were reviewed over 10 years. Patients who met the Sapporo Criteria fully were studied, whereas those with only early pregnancy loss were excluded. In addition to classical aPL: lupus anticoagulant (LA), anticardiolipin antibody (aCL), and anti-β2-glycoprotein I (aβ2GPI); phosphatidylserine-dependent anti-prothrombin antibody (aPS/PT) and kininogen-dependent anti-phosphatidylethanolamine antibody (aPE) were also examined in each case. Results. Cases were divided into two groups according to patient response to standard treatment: good and poor outcome groups. All cases with poor outcome presented LA, with IgG aβ2GPI and IgG aPS/PT were also frequently observed. IgG aPE did not correlate with pregnancy outcome. Conclusion. aPL profile may predict pregnancy outcome in patients with this subset of obstetric APS.

  1. 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....

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

    Directory of Open Access Journals (Sweden)

    Cheng Qihui

    2012-01-01

    Full Text Available Aim. This paper investigated the pathogenesis and treatment strategies of acute pancreatitis (AP in pregnancy. Methods. We analyzed retrospectively the characteristics, auxiliary diagnosis, treatment strategies, and clinical outcomes of 26 cases of patients with AP in pregnancy. Results. All patients were cured finally. (1 Nine cases of 22 mild acute pancreatitis (MAP patients selected automatic termination of pregnancy because of the unsatisfied therapeutic efficacy or those patients’ requirements. (2 Four cases of all patients were complicated with severe acute pancreatitis (SAP; 2 cases underwent uterine incision delivery while one of them also received cholecystectomy, debridement and drainage of pancreatic necrosis, and percutaneous jejunostomy. One case had a fetal death when complicated with SAP; she had to receive extraction of bile duct stones and drainage of abdominal cavity after induced abortion. The other one case with hyperlipidemic pancreatitis was given induced abortion and hemofiltration. Conclusions. The first choice of MAP in pregnancy is the conventional therapy. Apart from the conventional therapy, we need to terminate pregnancy as early as possible for patients with SAP. Removing biliary calculi and drainage is supposed to be considered for acute biliary pancreatitis. Lowering blood lipids treatment should be applied to hyperlipidemic pancreatitis or given to hemofiltration when necessary.

  3. Clinical, ultrasonographic, and endocrinological studies on donkey pregnancy.

    Science.gov (United States)

    Crisci, Angelica; Rota, Alessandra; Panzani, Duccio; Sgorbini, Micaela; Ousey, Jennifer C; Camillo, Francesco

    2014-01-15

    Although donkey breeding has gained new interest in the past two decades, knowledge about donkey reproduction is still scarce, particularly on jenny pregnancy. The aim of this study was to describe the ultrasonographic and endocrine profiles of the physiological pregnancy in the jenny. The study was performed on 12 pregnancies of 7 Amiata donkeys from Day 10 after ovulation to delivery. Because three pregnancies, respectively at weeks 42, 44, and 45, were considered pathologic and treated pharmacologically, data collected from 2 weeks before diagnosis to the end of pregnancy were removed from the analysis. Average length of the normal pregnancies was 353.4 ± 13.0 days (range, 339-370 days). Timing, dimensions, and development during the first phases of embryonic growth, evaluated using transrectal ultrasound, were similar to that previously described in jennies and mares: first detection of embryonic vesicle was at 11.8 ± 1.3 days of gestation and diameter was 6.5 ± 1.9 mm, loss of spherical shape occurred at 18.5 ± 1.4 days, and embryo and heart beat were first seen at 22.0 ± 1.1 and 25 ± 1.1 days, respectively. The intrauterine growth in the second half of pregnancy, evaluated using the transrectal and transabdominal approach, also showed strong positive correlations, similar to that reported for the mare. The trends of the combined thickness of the utero-placental unit and the echogenicity of the amniotic and allantoic fluids are examples. The diameters (mm) of fetal chest, eye orbit, and aorta increased throughout pregnancy and were 40.6 ± 2.9, 8.7 ± 1.5, and 3.5 ± 0.7, respectively, at week 13, and 190.9 ± 12.0, 21.4 ± 1.5, and 30.6 ± 1.8 at the last evaluation before parturition. In contrast, heart rate decreased as pregnancy progressed. Regression analyses between these parameters and day of gestation were statistically significant (P < 0.001). All fetuses consistently showed some intrauterine activity. Maternal plasma progestagens and estrone

  4. MRI for clinically suspected appendicitis during pregnancy.

    NARCIS (Netherlands)

    Cobben, L.P.; Groot, I.; Haans, L.; Blickman, J.G.; Puylaert, J.

    2004-01-01

    OBJECTIVE: The purpose of this study was to evaluate whether MRI can be used to accurately diagnose or exclude appendicitis in pregnant patients with clinically suspected appendicitis. CONCLUSION: Our results suggest that MRI is helpful in the examination and diagnosis of acute appendicitis in pregn

  5. Antiretroviral therapy initiation before, during, or after pregnancy in HIV-1-infected women: maternal virologic, immunologic, and clinical response.

    Directory of Open Access Journals (Sweden)

    Vlada V Melekhin

    Full Text Available 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 initiating HAART before pregnancy had lower CD4+ nadir and higher baseline HIV-1 RNA. Women initiating HAART after pregnancy were more likely to receive triple-nucleoside reverse transcriptase inhibitors. Multivariable analyses adjusted for baseline CD4+ lymphocytes, baseline HIV-1 RNA, age, race, CD4+ lymphocyte count nadir, history of ADE, prior use of non-HAART ART, type of HAART regimen, prior pregnancies, and date of HAART start. In these models, women initiating HAART during pregnancy had better 6-month HIV-1 RNA and CD4+ changes than those initiating HAART after pregnancy (-0.35 vs. 0.10 log(10 copies/mL, P = 0.03 and 183.8 vs. -70.8 cells/mm(3, P = 0.03, respectively but similar to those initiating HAART before pregnancy (-0.32 log(10 copies/mL, P = 0.96 and 155.8 cells/mm(3, P = 0.81, respectively. There were 3 (25% AIDS-defining events or deaths in women initiating HAART before pregnancy, 3 (4% in those initiating HAART during pregnancy, and 5 (17% in those initiating after pregnancy (P = 0.01. There were no statistical differences in rates of HIV disease progression between groups. CONCLUSIONS: HAART initiation during pregnancy was associated with better immunologic and virologic responses than initiation after pregnancy.

  6. Video laparoscopic intervention for an interstitial pregnancy after failure of clinical treatment

    Directory of Open Access Journals (Sweden)

    Nilson Abrão Szylit

    Full Text Available CONTEXT: Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determining the most appropriate course of action in these situations. CASE REPORT: In a patient with an ultrasound diagnosis of interstitial pregnancy, clinical treatment using methotrexate was chosen. However, after one week, there was a marked decline in the serum level of the β subunit of chorionic gonadotropin hormone, although an ultrasound examination revealed embryonic cardiac activity. A second dose of the chemotherapy was administered. Embryonic cardiac activity persisted 48 hours later. Video laparoscopy was performed to achieve right-side cornual resection, which resulted in satisfactory resolution of the case.

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

    DEFF Research Database (Denmark)

    Hegaard, Hanne Kristine; Kjaergaard, Hanne; Damm, Peter P;

    2010-01-01

    National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study...

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

    DEFF Research Database (Denmark)

    Hegaard, Hanne; Kjaergaard, Hanne; Damm, Peter P;

    2010-01-01

    National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study w...

  9. 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

  10. 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...

  11. Clinical presentation and management of diabetes mellitus in pregnancy

    Directory of Open Access Journals (Sweden)

    Al-Azemi N

    2013-12-01

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

  12. [Clinical guideline for detection and diagnosis of hypertensive pregnancy disease].

    Science.gov (United States)

    Lagunes-Espinosa, Alma Luisa; Ríos-Castillo, Brenda; Peralta-Pedrero, María Luisa; del Rocío Cruz-Cruz, Polita; Sánchez-Ambríz, Slivia; Sánchez-Santana, Joaquín Renato; Ramírez-Mota, Carolina; Zavaleta-Vargas, Norma Octavia; López-Cisneros, Gabriela

    2011-01-01

    Hypertensive disorders in pregnancy (HDP) are the main complication and cause of maternal and perinatal death. Pre-eclampsia represents a 34%, according to the Secretaría de Salud de México. To offer the family physicians tools for the opportune detection and diagnosis of HDP a clinical guideline was developmented. Clinical questions were formulated and structured. A standardized sequence to search for Practice Guidelines, based on the key words: hypertensive disorders in pregnancy, pre-eclampsia. Tripdatabase, MDConsult, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence were used. In addition, Cochrane Library Plus, Science Direct and OVID were used. Most of the recommendations were taken from guidelines selected and supplemented with the remaining material. The information is expressed in levels of evidence and grade of recommendation according to the characteristics of the study design and type of publications. To reduce morbidity and mortality from HDP health professionals should identify risk factors; conduct a close monitoring and early diagnosis. It is essential to provide information to the pregnant patient on alarm data and behavior to follow. This clinical practice guide offers current evidence for screening and diagnosis of HDP in primary care.

  13. 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.

  14. Effect of folic acid supplementation in pregnancy on preeclampsia: the folic acid clinical trial study.

    Science.gov (United States)

    Wen, Shi Wu; Champagne, Josee; Rennicks White, Ruth; Coyle, Doug; Fraser, William; Smith, Graeme; Fergusson, Dean; Walker, Mark C

    2013-01-01

    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 8(0/7) and 16(6/7) 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.

  15. 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.

  16. 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.

  17. A clinical approach to intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Diken, Zaid; Usta, Ihab M; Nassar, Anwar H

    2014-01-01

    Intrahepatic cholestasis of pregnancy (ICP) has a varying prevalence worldwide. The etiology behind this disease remains not fully understood with multiple factors influencing its development including genetic variations, dietary factors, hormonal changes, and environmental influences. Presenting mainly during the third trimester with generalized itching and resolving spontaneously postpartum, this condition is still associated with fetal morbidity and mortality. The diagnosis is based on clinical presentation in association with biochemical abnormalities. Elevation in total bile acid levels is the most frequent laboratory abnormality and seems to be the most important for gauging further management of the disease. The most appropriate gestational age for the delivery of women with ICP is yet to be determined. In this review we discuss the epidemiology, clinical features, diagnosis, etiology, and management of ICP, trying to shed light on some controversial aspects of the disease.

  18. 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.

  19. 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.

  20. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus.

    Science.gov (United States)

    Lazzaroni, Maria Grazia; Dall'Ara, Francesca; Fredi, Micaela; Nalli, Cecilia; Reggia, Rossella; Lojacono, Andrea; Ramazzotto, Francesca; Zatti, Sonia; Andreoli, Laura; Tincani, Angela

    2016-11-01

    Nowadays, most of the young women affected by Systemic Lupus Erythematosus (SLE) can carry out one or more pregnancies thanks to the improvement in treatment and the consequent reduction in morbidity and mortality. Pregnancy outcome in these women has also greatly improved in the last decades. A correct timing for pregnancy (tailored on disease activity and established during a preconception counselling), together with a tight monitoring during the three trimesters and the post-partum period (to timely identify and treat possible obstetric complications or maternal disease flares), as well as the concept of multidisciplinary management, are currently milestones of the management of pregnancy in SLE patients. Nevertheless, the increasing knowledge on the compatibility of drugs with pregnancy has allowed a better treatment of these patients, by choosing medications that control maternal disease activity without harming the foetus. However, particular attention and strict monitoring should be dedicated to SLE pregnant women in particular clinical settings: patients with lupus nephritis and patients with aPL positivity or Antiphospholipid syndrome, who are at higher risk for maternal and foetal complications, but also patients with anti-Ro/SSA and/or anti-La/SSB antibodies, because of the risk of neonatal lupus. A discussion on family planning, as well as counselling on contraception, should be part of the everyday-practice for physicians caring for SLE women during their reproductive age. Another issue is the possible reduction of fertility in these women, that can be due to different reasons. Consequently, the request for assisted reproduction techniques has been increasing in the last years, so that rheumatologists and gynaecologists should be prepared to counsel SLE patients also in this particular setting.

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

    OpenAIRE

    Shi Wu Wen; Josee Champagne; Ruth Rennicks White; Doug Coyle; William Fraser; Graeme Smith; Dean Fergusson; Walker, Mark C.

    2013-01-01

    Copyright © 2013 Shi Wu Wen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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 recrui...

  2. 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

  3. 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...

  4. 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.

  5. 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.

  6. Tailoring clinical services to address the unique needs of adolescents from the pregnancy test to parenthood.

    Science.gov (United States)

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

    2013-04-01

    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-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the healthcare system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Bengt Källén

    2013-10-01

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

  9. Systemic lupus erythematosus and pregnancy: clinical evolution, maternal and perinatal outcomes and placental findings

    Directory of Open Access Journals (Sweden)

    Fernanda Garanhani de Castro Surita

    2007-03-01

    Full Text Available CONTEXT AND OBJECTIVE: Systemic lupus erythematosus is a chronic disease that is more frequent in women of reproductive age. The relationship between lupus and pregnancy is problematic: maternal and fetal outcomes are worse than in the general population, and the management of flare-ups is difficult during this period. The aim here was to compare the outcomes of 76 pregnancies in 67 women with lupus, according to the occurrence or absence of flare-ups. DESIGN AND SETTING: An observational cohort clinical study evaluating the evolution of pregnant women with lupus who were receiving care at the prenatal outpatient clinic, Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas (CAISM/Unicamp, between 1995 and 2002. METHODS: Data were collected on a precoded form. The women were divided into two groups according to the occurrence or absence of flare-ups, as defined by the systemic lupus erythematosus disease activity index (SLEDAI. The presence or absence of flare-ups and renal involvement was considered to be the independent variable and the other results were dependent variables. RESULTS: Flare-ups occurred in 85.3% of cases, and were most significant when there was renal involvement. This was related to greater numbers of women with preeclampsia and poor perinatal outcome. Intrauterine growth restriction was more common in the women with active disease. Placental weight was significantly lower in the women with renal involvement. CONCLUSIONS: Flare-ups and renal involvement in lupus patients during pregnancy are associated with increased maternal and perinatal complications.

  10. Acute kidney injury in pregnancy: a clinical challenge

    OpenAIRE

    Machado, S.; Figueiredo, N.; Borges, A.; Pais, MS; Freitas, L; Moura, P.; Campos, M.

    2012-01-01

    The incidence of acute kidney injury in pregnancy declined significantly over the second half of the 20th century; however, it is still associated with major maternal and perinatal morbidity and mortality. A set of systemic and renal physiological adaptive mechanisms occur during a normal gestation that will constrain several changes in laboratory parameters of renal function, electrolytes, fluid and acid-base balances. The diagnosis of acute kidney injury in pregnancy is based on the serum c...

  11. 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.

  12. 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.

  13. 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.

  14. The Effect of Topical Rosa damascena (Rose) Oil on Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Shirazi, Mahbobeh; Mohebitabar, Safieh; Bioos, Sodabeh; Yekaninejad, Mir Saeed; Rahimi, Roja; Shahpiri, Zahra; Malekshahi, Farhad; Nejatbakhsh, Fatemeh

    2017-01-01

    The study aimed to assess the efficacy of topical rose oil in women with pregnancy-related low back pain. A randomized controlled clinical trial was conducted on 120 women with pregnancy-related low back pain. Patients were allocated to 3 parallel groups to receive topical rose oil (in the carrier of almond oil), placebo (carrier oil), or no intervention. All groups were followed for 4 weeks. All participants were evaluated by Visual Analog Scale and the Roland-Morris Disability Questionnaires to assess the pain intensity and its impact on daily activities before and after the intervention. Significant decrease in pain intensity compared to carrier oil or no intervention was observed. The rose oil also improves the functional ability of these patients in contrast with no intervention, while its effect on function is not significant compared to carrier oil. Rose oil reduced pregnancy-related low back pain intensity without any significant adverse effect.

  15. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  16. 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 we...

  17. A national audit to monitor and promote the uptake of clinical guidelines on the management of diabetes in pregnancy.

    Science.gov (United States)

    Penney, G C; Pearson, D

    2000-01-01

    Seeks to assess maternity care for women with Type 1 diabetes in relation to recommendations in a national clinical guideline using a criterion-based clinical audit. The audit covered all 22 consultant-led maternity units in Scotland, focusing on 268 completed pregnancies in women with Type 1 diabetes. Results are presented and discussed. Concludes that a national audit to monitor the impact of clinical guidelines proved feasible. Antenatal care is organised in line with guideline recommendations but there is lower provision of formal prepregnancy care. Pregnancy planning and periconceptual care fall short of recommendations but care during pregnancy is meticulous. Adverse pregnancy outcomes remain commoner than in non-diabetic pregnancies.

  18. Clinical Investigations and Management of Refractive Changes in Pregnancy: A Case Report.

    Science.gov (United States)

    Ekpenyong, Bernadine N; Aruotu, Nwakuso A; Uzodike, Ebele B; Njoku, Chimela G

    2015-12-01

    Pregnancy also presents with ocular changes, just as it affects other non-reproductive systems of the female. It has been reported to be associated with development of new health conditions or can exacerbate pre- existing health conditions. This paper reviews the management of Mrs AA, a 41 year old pregnant woman (primigravida) with refractive changes from myopia in the first trimester, to hyperopia in the second and third trimesters of her pregnancy. A comprehensive ocular examination was performed including fundus photograph and Optical Coherent Tomography. The results revealed signs of Central Serous Chorioretinopathy in both eyes which may have been due to various hormonal changes in pregnancy with resultant changes in refractive error. These ocular changes associated with pregnancy are, most often transient in nature, though occasionally permanent. This condition therefore requires clinical observation and monitoring until the resolution of the serous detachment is complete, and vision returned back to normal. Other ocular changes that are pregnancy related were reviewed.

  19. Dose of selective serotonin uptake inhibitors across pregnancy: clinical implications.

    Science.gov (United States)

    Hostetter, A; Stowe, Z N; Strader, J R; McLaughlin, E; Llewellyn, A

    2000-01-01

    The use of antidepressants during pregnancy has undergone considerable scrutiny with respect to safety issues, though limited data with respect to dose management and symptom resolution is available. Previous reports on tricyclic antidepressants (TCAs) have demonstrated the need to adjust maternal dose later in pregnancy to maintain therapeutic serum concentrations. However, there is no data on the dosage of selective serotonin uptake inhibitors (SSRIs) required to maintain symptom resolution in women treated for major depression during pregnancy. The purpose of this study, then, was to assess the medication dosage requirements of SSRIs during this time. In this naturalistic study, pregnant women with a primary diagnosis of major depression were followed prospectively through pregnancy at monthly intervals with symptom assessment. Subjects were included in data analysis if they presented prior to 28 weeks gestation, were treated with SSRI monotherapy, received all psychiatric treatment during the pregnancy at the Emory Pregnancy and Postpartum Mood Disorders Program, and achieved euthymia after initial treatment intervention (CGI = 1 and Beck Depression Inventory (BDI) < 9) during pregnancy or failed to respond after eight weeks of treatment. Medication selection was based on personal treatment history or family treatment history (if any), and the published data on SSRIs in pregnancy. All medication dose adjustments were based on depressive symptoms as measured by the BDI and a psychiatric interview (ZNS). Thirty-four pregnant women were included in final analysis. Two thirds of the subjects (n = 22) required an increase in their daily dose of medication to maintain euthymia. The dose increases occurred at 27.1 +/- 7.1 weeks gestation, with mean BDI scores of 16.4 +/- 9.6, compared to a mean treatment response BDI of 6.9 +/- 5.4. Subject's age, education, past personal and familial psychiatric history were not significantly associated with dose adjustment. These

  20. Activation of Blood CD3+CD56+CD8+ T Cells during Pregnancy and Multiple Sclerosis

    Science.gov (United States)

    de Andrés, Clara; Fernández-Paredes, Lidia; Tejera-Alhambra, Marta; Alonso, Bárbara; Ramos-Medina, Rocío; Sánchez-Ramón, Silvia

    2017-01-01

    A striking common feature of most autoimmune diseases is their female predominance, with at least twice as common among women than men in relapsing–remitting multiple sclerosis (MS), the prevailing MS clinical form with onset at childbearing age. This fact, together with the protective effect on disease activity during pregnancy, when there are many biological changes including high levels of estrogens and progesterone, puts sex hormones under the spotlight. The role of natural killer (NK) and NKT cells in MS disease beginning and course is still to be elucidated. The uterine NK (uNK) cells are the most predominant immune population in early pregnancy, and the number and function of uNK cells infiltrating the endometrium are sex-hormones’ dependent. However, there is controversy on the role of estrogen or progesterone on circulating NK (CD56dim and CD56bright) and NKT cells’ subsets. Here, we show a significantly increased activation of CD3+CD56+CD8+ cells in pregnant MS women (MSP) compared with non-pregnant MS women (NPMS) (p pregnancy. Further studies on specific CD8+ NKT cells function and their role in pregnancy beneficial effects on MS are warranted to move forward more effective MS treatments. PMID:28280497

  1. Frequency and Perception of Sexual Activity during Pregnancy in Iranian Couples

    Directory of Open Access Journals (Sweden)

    Farahnaz Torkestani

    2012-01-01

    Full Text Available Background: Pregnancy stimulates partners to search for ways to preserve their mutual emotionalrelations and satisfy their sexual needs, with some limitations. This study evaluates thefrequency and perception of sexual intercourse during pregnancy in a group of Iranian couples.Materials and Methods: In this cross-sectional study, 155 pregnant women were recruitedfrom two academic clinics in Tehran. The exclusion criteria were: any underlying disease,history of pelvic surgery or gynecologic and obstetric complications, abortion or sterility, andprevious preterm labor. A checklist was administrated in the labor room, that included: demographicdata, partus and their viewpoints about sexuality. Frequency of sexual activity in eachtrimester, vaginal intercourse, coitus position, orgasm, breast stimulation, condom usage, andpregnancy outcome were recorded. Data were analyzed with t- and chi-square tests.Results: Women and their husbands with sexual behaviors during pregnancy had a lowermean age; the majority were nulipara (p<0.05. The biggest reason for decreased intercoursein the first trimester was fear of abortion (39.45%. No significant relationshipbetween sexual activity in pregnancy and preterm labor, gestational age, membrane rupture,and fetal outcome was shown. There was a significant negative relationship betweenintercourse in the 2nd and 3rd trimesters and need to induction.Conclusion: Although our results showed that sexual intercourse had no adverse effecton the fetus and was a proper stimulus for the induction of delivery, its frequency wasreduced during the gestational stage due to parents’ fear of adverse effects.

  2. Acute kidney injury in pregnancy: a clinical challenge.

    Science.gov (United States)

    Machado, Susana; Figueiredo, Nuno; Borges, Andreia; São José Pais, Maria; Freitas, Luís; Moura, Paulo; Campos, Mário

    2012-01-01

    The incidence of acute kidney injury in pregnancy declined significantly over the second half of the 20th century; however, it is still associated with major maternal and perinatal morbidity and mortality. A set of systemic and renal physiological adaptive mechanisms occur during a normal gestation that will constrain several changes in laboratory parameters of renal function, electrolytes, fluid and acid-base balances. The diagnosis of acute kidney injury in pregnancy is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate are not validated in this population. During the first trimester of gestation, acute kidney injury develops most often due to hyperemesis gravidarum or septic abortion. In the third trimester, the differential diagnosis is more challenging for the obstetrician and the nephrologist and comprises some pathologies that are reviewed in this article: preeclampsia/HELLP syndrome, acute fatty liver of pregnancy and thrombotic microangiopathies.

  3. 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.

  4. Immunogenicity and Clinical Efficacy of Influenza Vaccination In Pregnancy

    Directory of Open Access Journals (Sweden)

    Alexander W Kay

    2015-06-01

    Full Text Available Pregnant women are at high risk from influenza due to disproportionate morbidity, mortality, and adverse pregnancy outcomes following infection. As such, they are classified as a high priority group for vaccination. However, changes in the maternal immune system required to accommodate the allogeneic fetus may alter the immunogenicity of influenza vaccines. A large number of studies have evaluated the safety of the influenza vaccine. Here, we will review available studies on the immunogenicity and efficacy of the influenza vaccine during pregnancy, focusing on both humoral and cellular immunity.

  5. Clinical assessment of retinopathy post management of pregnancy induced hypertension

    Directory of Open Access Journals (Sweden)

    Rahul Navinchandra Bakhda

    2015-07-01

    Full Text Available Pregnancy induced hypertension (PIH is a multi-system disorder and common complication occurring during pregnancy responsible for maternal and fetal mortality and morbidity. PIH also exerts its influence on the eye and visual pathways. Common ocular symptoms being blurring of vision, photopsias, scotomas, diplopia and in severe cases blindness. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent PIH and its complications. The review discusses the after effects of medical management of PIH on the retina.

  6. 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.

  7. [Breast cancer developing during pregnancy--clinical cases and review of the literature].

    Science.gov (United States)

    Alexandrova, E; Sergieva, S; Kostova, P; Michailova, I; Timcheva, K; Taushanova, M; Milev, A

    2015-01-01

    The goal of the present paper is to discuss diagnosis, treatment approaches and histopathologic characteristics of breast cancer developing during pregnancy, based on our results and published literature data. We retrospectively evaluated clinical and pathologic features of tumors, treatment methods, decisions related to pregnancy and final outcome by eight pregnant patients with breast cancer. The patients' age varied from 26 to 36 years. At the last medical examination in October 2013, three among all eight patients were alive, two of them were without local and distant recurrence, and one patient has distant metastases and is carrying out a treatment. The aim of this paper was to discuss the characteristics of breast cancer developing during pregnancy. Retrospectively have been analyzed clinical-pathological characteristics of the tumors in eight pregnant women with breast cancer, the treatment, the management of the pregnancy, and the final outcome. The results are analyzed by comparing with data published in the literature.

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Triveni Kondareddy

    2016-07-01

    Conclusions: Jaundice and pregnancy is a deadly combination resulting in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2257-2260

  11. Brucellosis in pregnancy: clinical aspects and obstetric outcomes

    Directory of Open Access Journals (Sweden)

    Gustavo Vilchez

    2015-09-01

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

  12. Regulatory considerations in the clinical development of vaccines indicated for use during pregnancy.

    Science.gov (United States)

    Roberts, Jeffrey N; Gruber, Marion F

    2015-02-18

    Despite supportive public health policies (e.g., ACIP recommendations), the potential for providing clinical benefit through maternal immunization has yet to be fully realized. For vaccines already licensed and approved for use in adults, specific FDA approval for use during pregnancy to prevent disease in the mother and/or infant may have a significant impact on uptake and usage in pregnant women. In addition, for either a licensed vaccine or a novel vaccine, FDA approval for use during pregnancy would result in labeling that would serve as a resource for practitioners and would facilitate the safe and effective use of the vaccine during pregnancy. In the U.S., while many vaccines are approved for use in adults and most are not contraindicated for use in pregnant women, no vaccine is licensed for use specifically during pregnancy. Among the perceived obstacles hindering the clinical development of vaccines for use in pregnancy, regulatory issues are frequently cited. One aim of this article is to address the perceived regulatory obstacles. General concepts and regulatory considerations for clinical safety and effectiveness evaluations for vaccines indicated for use during pregnancy will be discussed. This discussion is not intended to establish data requirements or to articulate agency policy or guidance regarding specific vaccine products.

  13. 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

  14. Relationship between the length of the uterine cavity and clinical pregnancy rates after in vitro fertilization or intracytoplasmic sperm injection.

    Science.gov (United States)

    Chun, Sang Sik; Chung, Min Ji; Chong, Gun Oh; Park, Kee Sang; Lee, Taek Hoo

    2010-02-01

    In this prospective clinical study involving 354 IVF-intracytoplasmic sperm injection cycles, we determined the influence of the length of the uterine cavity on clinical pregnancy rates. Our data showed that clinical pregnancy and implantation rates are associated positively with an increased length of the uterine cavity.

  15. 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

  16. PREVALENCE OF SUB CLINICAL HYPOTHYROIDISM IN FIRST TRIMESTER OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Nataraj

    2015-04-01

    Full Text Available Thyroid disorder is s econd most common endocrine disorder in pregnancy . Hypothyroidism is more common in women in their reproductive age. Subclinical hypothyroidism is one of the type of thyroid disorders with incidence of 2 - 5% . The present study is to know the prevalence of subclinical hypothyroidism in pregnancy . METHODS : A prospective study conducted in Department of Obstetrics and Gynecology , ESIMC PGI MSR Bangalore , Karnataka . Data collected from One Hundred Fifty pregnant women attending antenatal checkup in our hospital in first trimester . According to Endocrinology society thyroid function test is done , if TSH is high then FT3 , FT4 values are estimated . Normal value for TSH is 0.1 - 2.5IU/ml in 1 st trimester . RESULT: In our study out of 150 women , Primi are 85 in number and Multie are 65 in number , Women with subclinical hypothyroidism is 20 . Prevalence of hypothyroidism in our study is 13% . CONCLUSION: Universal screening of thyroid disorder is necessary during pregnancy to prevent fetal and maternal morbidity associated with subclinical hypothyroidism

  17. Management of Psoriasis Herpeticum in Pregnancy: A Clinical Conundrum

    Directory of Open Access Journals (Sweden)

    Leanne Almario

    2016-01-01

    Full Text Available Introduction. Kaposi varicelliform eruption (KVE is a widespread cutaneous viral infection, most commonly herpes simplex virus, which affects patients with underlying dermatosis. When KVE occurs in a patient with a history of psoriasis, it is referred to as psoriasis herpeticum, a rare subtype of KVE with only a handful of cases reported in the literature. To the authors’ knowledge, we report for the first time a case of psoriasis herpeticum in pregnancy. Case Presentation. A 23-year-old woman in her third pregnancy presented at 26-week gestation with a 10-year history of psoriasis. Cutaneous examination revealed diffuse psoriatic plaques with scattered ~1 cm erosions. Punch biopsy of the skin revealed herpes simplex virus (HSV infection within a psoriatic plaque, necessitating dermatological treatment. The patient experienced premature rupture of membranes at 37-week gestation. Pelvic exam showed no evidence of herpetic lesions. After labor augmentation, the patient delivered a healthy female infant with no evidence of HSV infection. Discussion. Psoriasis herpeticum is a rare and potentially devastating complication of an underlying dermatosis. With a paucity of data available to guide pregnancy-specific issues, the general management of this condition is controversial and requires a multidisciplinary care approach. Concerns for systemic infection in the mother and vertical transmission to the neonate are of critical importance.

  18. 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.

  19. 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

  20. 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.

  1. Unplanned pregnancy among active duty servicewomen, U.S. Air Force, 2001.

    Science.gov (United States)

    Robbins, Anthony S; Chao, Susan Y; Frost, Lucinda Z; Fonseca, Vincent P

    2005-01-01

    Unplanned pregnancy is a major public health problem in the United States. Although the U.S. Air Force has the highest proportion of active duty women of any of the U.S. military services, there are no published data on the occurrence of unplanned pregnancy among active duty Air Force (ADAF) women. Civilian female interviewers conducted telephone interviews with a random sample of 2,348 ADAF women during early 2002, using questions that were closely based on the 1995 National Survey of Family Growth. During 2001, approximately 12% of ADAF women had one or more pregnancies. By National Survey of Family Growth criteria, approximately 54% of these pregnancies were unplanned. Thus, approximately 7% of ADAF women had one or more unplanned pregnancies during 2001. Roughly one-half of unplanned pregnancies represented contraceptive nonuse and the other half represented contraceptive failure or misuse. Unplanned pregnancy is a serious and frequently occurring problem among ADAF women, with many opportunities for prevention.

  2. 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 women...... are very physically active during leisure time, while others have a sedentary lifestyle....

  3. Serum α-klotho concentrations during preimplantation can predict aging or quality of human oocytes and clinical pregnancy rates

    OpenAIRE

    Takemura, Takashi; Okabe, Midori

    2016-01-01

    Background To discover simple biomarkers to evaluate the aging or quality of human oocytes and clinical pregnancy rates is needed. However, the association among serum α-klotho concentrations during preimplantation, the aging or quality of human oocytes and clinical pregnancy rates has not been investigated. Findings The serum α-klotho concentrations during preimplantation decreased due to aging (p 

  4. 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.

  5. Women's age and embryo developmental speed accurately predict clinical pregnancy after single vitrified-warmed blastocyst transfer.

    Science.gov (United States)

    Kato, Keiichi; Ueno, Satoshi; Yabuuchi, Akiko; Uchiyama, Kazuo; Okuno, Takashi; Kobayashi, Tamotsu; Segawa, Tomoya; Teramoto, Shokichi

    2014-10-01

    The aim of this study was to establish a simple, objective blastocyst grading system using women's age and embryo developmental speed to predict clinical pregnancy after single vitrified-warmed blastocyst transfer. A 6-year retrospective cohort study was conducted in a private infertility centre. A total of 7341 single vitrified-armed blastocyst transfer cycles were included, divided into those carried out between 2006 and 2011 (6046 cycles) and 2012 (1295 cycles). Clinical pregnancy rate, ongoing pregnancy rate and delivery rates were stratified by women's age (149 h) as embryo developmental speed. In all the age groups, clinical pregnancy rate, ongoing pregnancy rate and delivery rates decreased as the embryo developmental speed decreased (P pregnancy rates observed in the 2006-2011 cohort. Subsequently, the novel grading score was validated in the 2012 cohort (1295 cycles), finding an excellent association. In conclusion, we established a novel blastocyst grading system using women's age and embryo developmental speed as objective parameters.

  6. Pregnancy in HIV clinical trials in Sub Saharan Africa: failure of consent or contraception?

    Directory of Open Access Journals (Sweden)

    Agnes Ssali

    Full Text Available OBJECTIVE: Higher than expected pregnancy rates have been observed in HIV related clinical trials in Sub-Saharan Africa. We designed a qualitative study to explore the factors contributing to high pregnancy rates among participants in two HIV clinical trials in Sub-Saharan Africa. METHODS: Female and male participants enrolled in one of two clinical HIV trials in south-west Uganda were approached. The trials were a phase III microbicide efficacy trial among HIV negative women using vaginal gel (MDP; and a trial of primary prevention prophylaxis for invasive cryptococcal disease using fluconazole among HIV infected men and women in Uganda (CRYPTOPRO. 14 focus group discussions and 8 in-depth interviews were conducted with HIV positive and negative women and their male partners over a six month period. Areas explored were their experiences about why and when one should get pregnant, factors affecting use of contraceptives, HIV status disclosure and trial product use. RESULTS: All respondents acknowledged being advised of the importance of avoiding pregnancy during the trial. Factors reported to contribute to pregnancy included; trust that the investigational product (oral capsules/vaginal gel would not harm the baby, need for children, side effects that led to inconsistent contraceptive use, low acceptance of condom use among male partners. Attitudes towards getting pregnant are fluid within couples over time and the trials often last for more than a year. Researchers need to account for high pregnancy rates in their sample size calculations, and consider lesser used female initiated contraceptive options e.g. diaphragm or female condoms. In long clinical trials where there is a high fetal or maternal risk due to investigational product, researchers and ethics committees should consider a review of participants contraceptive needs/pregnancy desire review after a fixed period, as need for children, partners and health status of participants may

  7. Clinical characteristics and prognosis of cerebral venous thrombosis in Chinese women during pregnancy and puerperium

    Science.gov (United States)

    Liang, Zhu-Wei; Gao, Wan-Li; Feng, Li-Min

    2017-01-01

    Due to the specific physiology associated with pregnancy and puerperium, cerebral venous sinus thrombosis (CVT) may manifest different characteristics. This study aimed to identify the clinical manifestations and prognosis of pregnancy-associated CVT. A total of 43 pregnancy-associated CVT patients were enrolled. We analysed the clinical presentations of the disease and performed a multivariate logistic regression analysis to determine which variables were associated with prognosis. Our descriptive results showed the following: 1) the incidence was 202 per 100,000 deliveries, and the mortality rate was 11.63%; 2) the most frequent symptom was headache; 3) the most frequent abnormal laboratory findings were increased levels of fibrinogen and several serum lipoproteins (including triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein A1, and apolipoprotein B); and 4) the superior sagittal sinus and transverse sinus were the most frequently affected locations. Moreover, an increased modified Rankin Scale score was positively associated with infection, seizure, intracerebral haemorrhage (ICH) and hypertensive disorders of pregnancy (HDP). Comparably, the occurrence of death was positively and significantly associated with infection, seizure and ICH. Consequently, timely diagnosis and treatment of pregnancy-associated CVT patients with infection, seizure, ICH or HDP are needed. Patients with infection, seizure or ICH have a greater risk of death. PMID:28262755

  8. Building Competency in Infant Mental Health Practice: The Edith Cowan University Pregnancy to Parenthood Clinic

    Science.gov (United States)

    Matacz, Rochelle; Priddis, Lynn

    2016-01-01

    This article describes a unique Australian infant mental health (IMH) service for families from pregnancy through to early parenthood (0-3 years) and training center for postgraduate clinical psychology students. The Australian Association for Infant Mental Health Incorporated, West Australia Branch (AAIMHI WA) "Competency Guidelines"®…

  9. A clinical study of fetomaternal outcome in pregnancy with polyhydramnios

    Directory of Open Access Journals (Sweden)

    Aditi Anil Rajgire

    2016-12-01

    Full Text Available Background: Amniotic fluid not only provides protection to the fetus from traumatic forces, cord compression, and microbial pathogens, but also plays an integral role in the normal development of the fetal musculoskeletal, pulmonary, and gastrointestinal systems. Polyhydramnios, defined as an excessive amount of amniotic fluid, complicates approximately 0.4-3.3% of all pregnancies. Fetal conditions that are associated with polyhydramnios include major congenital anomalies and both the immunologic and non-immunologic forms of hydrops foetalis. Maternal medical conditions are also known to be associated with polyhydramnios and subsequently alter perinatal outcome. So by diagnosing these cases as early as possible, these maternal complications can be prevented and advise proper prenatal counseling in relevant cases. Methods: This study was conducted in obstetrics and gynaecology department at a tertiary care hospital, over the period of from September 2015 to September 2016. Prospective observational study. Results: Polyhydramnios is commoner in primigravida. Causative factor are mainly idiopathic after which the most important is fetal defects. Diabetes is also associated finding with polyhydramnios in 8.3% cases. The occurrence of fetal congenital abnormality was directly proportional to the gestational age of pregnancy. Incidence of congenital abnormality was found to be 1.25 %. Congenital heart disease and cleft lip and cleft palate (3% were the commonest congenital abnormality associated with polyhydramnios followed by anencephaly and spina bifida (3.3%. Conclusions: In our study Idiopathic polyhydramnios was found to be the most common cause of polyhydramnios. A careful study must be done for detection of etiological factors in all cases of polyhydramnios, careful screening, prenatal and antenatal counseling will help to improve the foetal outcome as well as to prevent the maternal complication.

  10. A correlation of pregnancy term, disease activity, serum female hormones, and cytokines in uveitis

    OpenAIRE

    Chan, C-C; Reed, G F; Kim, Y.; Agrón, E; Buggage, R R

    2004-01-01

    Background/aims: Pregnancy and the postpartum period are associated with the activity of autoimmune diseases including uveitis. Although the exact mechanism is unknown, hormones are reported to alter inflammatory cytokines and influence disease activity. The authors studied ocular inflammation, female hormones, and serum cytokine levels during and after pregnancy.

  11. Cumulative clinical pregnancy rates after COH and IUI in subfertile couples.

    Science.gov (United States)

    Farhi, Jacob; Orvieto, Raoul

    2010-07-01

    To evaluate the influence of female age and cause of infertility on the outcome of controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI), we studied 2717 COH cycles in 1035 subfertile couples. The cumulative clinical pregnancy rates were 39% and 58% after three and six COH cycles, respectively. The cumulative pregnancy rate significantly decreased with maternal age and differed by cause of infertility. The cumulative pregnancy rate continued to increase with an increase in COH cycle number up to the third, or forth cycle, in patients with mechanical and combined infertility, respectively, and in up to the second cycle in patients aged 40 years or more. These findings provide treatment guidelines for clinicians in determining the likelihood of treatment success and the point at which to proceed to the next treatment strategy.

  12. Fetal cardiac activity analysis during twin pregnancy using a multi-channel SQUID system

    Science.gov (United States)

    Costa Monteiro, E.; Schleussner, E.; Kausch, S.; Grimm, B.; Schneider, A.; Hall Barbosa, C.; Haueisen, J.

    2001-05-01

    The use of SQUID magnetometers for non-invasive in utero assessment of cardiac electrical disturbances has already been shown to be a valuable clinical tool. In this way, its applicability also for the complicated case of twin pregnancy, in which the proximity of the cardiac magnetic source of each fetus can hamper the individual analysis of cardiac electrical activity, is of clinical interest. In this paper, we present fetal magnetocardiography performed on a mother pregnant of twins with 26 weeks gestational age, measured inside a magnetically shielded room, by using two identical 31-channel low- Tc SQUID magnetometer systems. Each sensor array has been positioned over one of the fetuses, according to its heart position previously assessed with the aid of ultrasound measurements. The raw data is initially averaged in time and, afterwards, analyzed by means of time plots and isofield maps. The time recordings allow the study of the morphology of each fetus’ cardiac signal and the cardiac time intervals. The resultant equivalent dipole obtained from the isofield maps indicates the position and orientation of each fetus heart. The results agree with the ultrasound analysis performed immediately before the measurements and used to obtain the approximate location of the fetuses’ hearts. Since a distinct analysis of the cardiac electrical activity of each fetus could be achieved, the results indicate the potential of the fetal magnetocardiography in the individual antenatal diagnosis of each one of the fetuses of a twin pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Rama Bharathi

    2015-01-01

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

  14. Pregnancies in women with hyperprolactinaemia: clinical course and obstetric complications of 41 pregnancies in 27 women. [Yttrium 90

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, W.F.; Doyle, F.H.; Mashiter, K.; Banks, L.M.; Gordon, H.; Joplin, G.F.

    1979-09-01

    Observations are reported on 41 pregnancies in 27 patients who initially had infertility and raised serum prolactin concentrations. Associated symptoms were secondary amenorrhoea and galactorrhoea. All patients were at risk of pituitary expansion during pregnancy, especially these 19 (70 per cent) with radiological evidence of pituitary tumors. Fifteen patients had 21 pregnancies after pituitary implantation with 90 yttrium; 14 patients had 20 pegnancies without prior pituitary implantation or any other attempt to prevent tumor expansion. The induction and Cesarean section rates were about 30 per cent in 32 term pregnancies in 25 patients. Details of how pregnancy was achieved and the associated obstetric problems are given.

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Fernanda Campos MACHADO

    Full Text Available Abstract 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.

  17. 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...

  18. 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.

  19. Clinical impact of mild carbohydrate intolerance in pregnancy

    DEFF Research Database (Denmark)

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

    2001-01-01

    . Information on oral glucose tolerance test results and clinical outcomes was collected from laboratory charts and medical records. RESULTS: The following outcomes increased significantly with increasing glucose values during the oral glucose tolerance test: shoulder dystocia, macrosomia, emergency cesarean...... 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....

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

    Science.gov (United States)

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

    2003-01-01

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

  1. 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...

  2. 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...

  3. 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.

  4. Activity pattern and energy expenditure due to physical activity before and during pregnancy in healthy Swedish women.

    Science.gov (United States)

    Lof, Marie; Forsum, Elisabet

    2006-02-01

    Human pregnancy is associated with increased requirements for dietary energy and this increase may be partly offset by reductions in physical activity during gestation. Studies in well-nourished women have shown that the physical activity level (PAL), obtained as the total energy expenditure (TEE) divided by the BMR, decreases in late pregnancy. However, it is not known if this decrease is really caused by reductions in physical activity or if it is the result of decreases in energy expenditure/BMR (the so-called metabolic equivalent, MET) for many activities in late pregnancy. In the present study activity pattern, TEE and BMR were assessed in twenty-three healthy Swedish women before pregnancy as well as in gestational weeks 14 and 32. Activity pattern was assessed using a questionnaire and heart rate recording. TEE was assessed using the doubly labelled water method and BMR was measured by means of indirect calorimetry. When compared to the pre-pregnant value, there was little change in the PAL in gestational week 14 but it was significantly reduced in gestational week 32. Results obtained by means of the questionnaire and by heart rate recording showed that the activity pattern was largely unaffected by pregnancy. The findings support the following conclusion: in a population of well-nourished women where the activity pattern is maintained during pregnancy, the increase in BMR represents approximately the main part of the pregnancy-induced increase in TEE, at least until gestational week 32.

  5. 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....

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

    Science.gov (United States)

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

    2016-04-01

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

  7. [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...

  8. 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

  9. 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...

  10. 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.

  11. 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....

  12. Clinical Experience of Treating Hypertension of Pregnancy%妊娠高血压临床治疗体会

    Institute of Scientific and Technical Information of China (English)

    杜晓丹

    2014-01-01

    Objective To explore the clinical treatment of patients with gestational hypertension and experience. Methods A retrospective analysis between January 2012 and December 2012, the diagnosis and treatment of obstetrics and gynecology hospital clinical data of 92 patients with pregnancy-induced hypertension disease. Results 92 cases of pregnancy-induced hypertension patients after taking sedative, spasmolysis, step-down, active treatment of postpartum hemorrhage, the ef ective control condition, al safe delivery, no maternal death and other serious complications. Conclusion Gestational hypertension early found its incentive and carries on the positive and ef ective prevention, spasmolysis, calm, reasonable treatment, such as hypertension, when necessary, timely termination of pregnancy. Can ef ectively reduce the high stretch marks to pregnant women.%目的探讨妊娠期高血压患者的临床治疗方法及体会。方法回顾性分析2012年1月~2013年12月我院妇产科诊治的92例妊娠高血压疾病患者的临床资料。结果92例妊娠高血压患者经过采取镇静、解痉、降压,积极治疗产后出血等措施,病情得到有效控制,全部安全分娩,无孕产妇死亡等严重并发症。结论妊娠高血压早期发现其诱因并进行积极有效预防,解痉,镇静,降压等合理治疗,必要时适时终止妊娠。可有效降低妊高征给孕妇带来的损害。

  13. 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.

  14. 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

    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...

  15. 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

    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......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...

  16. Association between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection.

    Science.gov (United States)

    Luz, Caroline Mantovani da; Giorgi, Vanessa Silvestre Innocenti; Coelho Neto, Marcela Alencar; Martins, Wellington de Paula; Ferriani, Rui Alberto; Navarro, Paula Andrea

    2016-09-01

    Introduction Infertility has a high prevalence in the general population, affecting ∼ 5 to 15% of couples in reproductive age. The assisted reproduction techniques (ART) include in vitro manipulation of gametes and embryos and are an important treatment indicated to these couples. It is well accepted that the implantation rate is positively influenced by the morphology of transferred embryos. However, we question if, apart from the assessment of embryo morphology, the number of produced embryos per cycle is also related to pregnancy rates in the first fresh transfer cycle. Purpose To evaluate the clinical pregnancy rate according to the number of formed embryos and the transfer of top quality embryos (TQEs). Methods In a retrospective cohort study, between January 2011 and December 2012, we evaluated women who underwent intracytoplasmic sperm injection (ICSI), aged < 40 years, and with at least 1 formed embryo fresh transferred in cleavage stage. These women were stratified into 3 groups according to the number of formed embryos (1 embryo, 2-3 and ≥ 4 embryos). Each group was divided into 2 subgroups according to the presence or not of at least 1 transferred TQE (1 with TQE; 1 without TQE; 2-3 with TQE, 2-3 without TQE; ≥ 4 with TQE; ≥ 4 without TQE). The clinical pregnancy rates were compared in each subgroup based on the presence or absence of at least one transferred TQE. Results During the study period, 636 women had at least one embryo to be transferred in the first fresh cycle (17.8% had 1 formed embryo [32.7% with TQE versus 67.3% without TQE], 42.1% of women had 2-3 formed embryos [55.6% with TQE versus 44.4% without TQE], and 40.1% of patients had ≥ 4 formed embryos [73.7% with TQE versus 26.3% without TQE]). The clinical pregnancy rate was significantly higher in the subgroup with ≥ 4 formed embryos with at least 1 transfered TQE (45.2%) compared with the subgroup without TQE (28.4%). Conclusions Having at

  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.

  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.

  19. Clinical analysis of recurrent ectopic pregnancy in 50 cases%50例重复性异位妊娠临床分析

    Institute of Scientific and Technical Information of China (English)

    侯淑萍; 刘溪; 邱娅

    2013-01-01

    Objective To summarize the clinical characteristics of recurrent ectopic pregnancy and to discuss the prevetion of recurrent ectopic pregnancy.Methods 50 cases of recurrent ectopic pregnancy collected between January 2011 and July 2012 were retrospectively evaluated for demographic features,risk factors and treatment modalities.Results The risk of recurrent ectopic pregnancy was increased with history of surgery,previous ectopic pregnancy and pevic infection.Conclusion The important measures for prevention and reduction of recurrent ectopic pregnancy include management of pelvic inflammatory disease actively,improvement of local medical and sanitary conditions,and selection of preferred treatment options for ectopic pregnancy.%目的 总结重复异位妊娠的临床特点,探讨重复异位妊娠的预防方法.方法 回顾性分析2011年1月-2012年7月的50例重复异位妊娠患者的社会人口学特征、危险因素和诊疗结果并进行随访.结果 盆腔炎症、前一次腹部手术史及其手术方式是重复异位妊娠的危险因素.结论 积极治疗盆腔炎症,改善当地的医疗卫生条件,选择最佳的异位妊娠治疗方式是预防并降低本地重复性异位妊娠发生的重要措施.

  20. Clinical and scientific results in perinatal care of pregnancy complicated by insulin dependent diabetes mellitus in Croatia.

    Science.gov (United States)

    Djelmis, J

    1998-01-01

    At the Department of Obstetrics and Gynecology, Perinatal Unit for Diabetes and Fetal Growth, School of Medicine, Zagreb, perinatal care of pregnancies complicated with insulin dependent diabetes melitus (IDDM), has been performed for more than 36 years. The intention of this review is to show our own results in the management of IDDM pregnancies and the latest clinical advances in perinatal care of such pregnancies. Pregnancy complicated with IDDM is at risk because of numerous maternal, fetal and neonatal complications. Recent advances in medicine, especially in diabetology and perinatology, helps clinician avoid or lessen antenatal or perinatal complications in IDDM pregnancies. The main result of improved perinatal care is that today fetal and neonatal mortality in IDDM pregnancy is almost equal to that of healthy pregnant population. Intensive preconceptual care and optimal regulation of IDDM have resulted not only in decreased perinatal mortality but also in a decreased rate of congenital malformation. Tight glycemia control during pregnancy has a beneficial effect on fetal growth. Intensive control of fetal growth, verification of lung maturation at term by amniocenthesis, and control of fetal oxygenation will result in delivery of a mature eutrophic newborn with the lowest rate of neonatal complications possible. Perinatal mortality of less than 2% in IDDM pregnancy can be obtained by planned delivery between 38 and 39 weeks of gestation by either vaginal route or cesarean section, depending on indications. After delivery, intensive care of the newborn is necessary.

  1. 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.

  2. Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy.

    Science.gov (United States)

    Gherman; Goodwin; Leung; Byrne; Montoro

    1998-07-01

    Objective: To determine the incidence, timing, and associated clinical characteristics of objectively diagnosed pregnancy-associated venous thromboembolism (VTE).Methods: A retrospective review of VTE cases occurring between 1978 and 1996 was performed. Cases of deep venous thrombosis (DVT) and pulmonary embolism (PE) were identified by ICD-9 discharge diagnosis code and review of antepartum and coagulation laboratory databases. Study inclusion criteria required the objective diagnosis of VTE with either Doppler ultrasound, impedance plethysmography, pulmonary angiography, ventilation-perfusion scanning, or CT/MRI.Results: Among 268,525 deliveries there were 165 (0.06%) episodes of VTE (1/1627 births). There were 127 cases of DVT and 38 cases of PE. Only 14% (23/165) had a prior history of DVT or PE. Most DVTs occurred in the left leg (104/127, 81.9%). Nearly three quarters of the DVTs (95/127, 74.8%) occurred in the antepartum period. Among the antepartum DVT cases, half were detected prior to 15 weeks of gestation (47/95, 49.5%), with only 28 cases occurring after 20 weeks (P cesarean section. Only 1 patient developed PE while on heparin therapy for DVT while 11 others had complications attributable to heparin use.Conclusion: Most pregnancy-related VTE occurs in the antepartum period. The risk of deep venous thrombosis appears to begin early in pregnancy, even before the second trimester. The highest risk period for pulmonary embolism is after cesarean delivery. Maternal complications of heparin anticoagulation during pregnancy are rare.

  3. 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

    OpenAIRE

    2015-01-01

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

  4. 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

  5. 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

    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...... with less physical activity. The combined risk of poor mental health and low physical activity levels makes women vulnerable for pregnancy complications. Whether a depressed mood may be a barrier for improving physical activity warrants further study....... 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...

  6. 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

  7. 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…

  8. 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

  9. 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 women...... are very physically active during leisure time, while others have a sedentary lifestyle....

  10. 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.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

  14. 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.

    2017-01-01

    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

  15. 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.

  16. 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.

  17. Clinical correlation with pathology of placenta in medical disorders of pregnancy and its comparison in normal pregnancy

    Directory of Open Access Journals (Sweden)

    Ratnamala Siddheshware

    2016-12-01

    Full Text Available Background: Healthy placenta is responsible for maintaining pregnancy and promoting normal foetal development. It reflects the intrauterine status of the foetus. Methods: In the present prospective study, total 50 Placentae from Medical Disorders of Pregnancies were studied and compared with equal number of Placentae from normal Pregnancies. Results: The significant macroscopic changes were calcification and infarction seen in Hypertensive Disorder. Extensive placental infarction was associated with high incidence of low APGAR (82% and perinatal deaths (66.67%. No significant gross macroscopic changes were seen in Anaemia, Diabetes Mellitus and Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity were significant microscopic changes in Hypertensive Disorder. In Anaemia stromal fibrosis, increased syncytial knots were seen, whereas in Diabetes Mellitus villous edema was the most significant microscopic finding. No significant microscopic change was found in Heart Disease. Increased syncytial knots, fibrinoid degeneration, vasculo-syncytial membrane paucity, stromal fibrosis were associated with increased perinatal mortality. Conclusions: Gross and microscopic examination of placenta is strongly recommended in cases where maternal co-morbid conditions is likely to have an adverse perinatal outcome.

  18. 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.

  19. Large D-Dimer Fluctuation in Normal Pregnancy

    DEFF Research Database (Denmark)

    Hedengran, Katrine K; Andersen, Malene R; Stender, Steen

    2016-01-01

    pregnancies were recruited. D-dimer was repeatedly measured during pregnancy, at active labor, and on the first and second postpartum days. Percentiles for each gestational week were calculated. Each individual D-dimer was normalized by transformation into percentiles for the relevant gestational age......Introduction. D-dimer levels increase throughout pregnancy, hampering the usefulness of the conventional threshold for dismissing thromboembolism. This study investigates the biological fluctuation of D-dimer in normal pregnancy. Methods. A total of 801 healthy women with expected normal...... normal pregnancy, repeated D-dimer measurements are of no clinical use in the evaluation of thromboembolic events during pregnancy....

  20. Development, Implementation, and Evaluation of a Pilot Parenting Educational Intervention in a Pregnancy Buprenorphine Clinic.

    Science.gov (United States)

    Giles, Averie C; Ren, Dianxu; Founds, Sandra

    2016-01-01

    We developed a pilot evidence-based prenatal educational intervention to increase knowledge of neonatal abstinence syndrome (NAS) and early parenting skills for women with opiate dependency who enrolled in a pregnancy buprenorphine clinic. We developed, implemented, and tested modules regarding expectations during newborn hospitalization for observation or treatment of NAS and regarding evidence-based parenting skills in response to NAS behaviors. Testing evaluated baseline knowledge of early parenting skills with newborns at risk for NAS and change from baseline after the educational intervention. No statistically significant difference in composite knowledge scores was observed. A brief survey completed by the participants postpartum affirmed the perception of women that the educational intervention effectively prepared them for the early postpartum period while their newborns were hospitalized.

  1. 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,

  2. Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

    Science.gov (United States)

    Yuan, Ting; Wang, Wei; Li, Xue-Lan; Li, Chun-Fang; Li, Chao; Gou, Wen-Li; Han, Zhen

    2016-01-01

    Abstract The aim of our study was to compare the clinical characteristics of fetal and neonatal outcomes in twin pregnancies between women with preeclampsia (PE) and those with normotension in a Chinese population. There were 143 preeclamptic women and 367 normotensive women with twin pregnancies included in this retrospective case–control study. The baseline characteristics and perinatal outcomes were collected and compared between the groups. Multiple logistic regression and linear regression were used to assess the correlations between PE and the outcomes. Significant increases were observed in the frequencies of preterm delivery (OR = 2.75, P < 0.001), iatrogenic preterm birth (OR = 3.52, P < 0.001), and IUGR (OR = 2.94, P = 0.001) in the PE group, and the PE group had more than a 2-fold risk of adverse neonatal outcomes. Preeclamptic twin neonates had lower birth weights (β = −147.34, P = 0.005; β = −169.47, P = 0.001). The comparison on the discordance of intertwin weight was not significantly different. Twin pregnancies with PE are associated with worse perinatal outcomes. The adverse outcomes of preeclamptic twin pregnancies may be associated with lower birth weights rather than the discordance of the intertwin weight, which requires further confirmation. The results may provide helpful references for better clinical assessments, evaluations of prognosis, and a deeper understanding of preeclamptic twin pregnancies. PMID:27787375

  3. Clinical analysis of 184 cases of ectopic pregnancy%184例异位妊娠临床分析

    Institute of Scientific and Technical Information of China (English)

    王新霞

    2015-01-01

    Objective To explore the diagnosis and treatment of 184 cases of ectopic pregnancy.Methods Retrospective analysis of 2011 January-2014 year in June in our hospital 184 cases of ectopic pregnancy clinical data.Results 184 cases of ectopic pregnancy,9 cases were misdiagnosed,the misdiagnosis rate of 4.9%.All patients underwent abdominal operation and laparotomy were diagnosed by pathology. Conclusion The clinical features of ectopic pregnancy,reduce misdiagnosis,early diagnosis,timely treatment is the key to the diagnosis and treatment of ectopic pregnancy.%目的:探讨184例异位妊娠诊断与治疗方法。方法回顾分析2011年1月—2014年6月我科收治的184例异位妊娠的临床资料。结果184例异位妊娠,误诊9例,误诊率4.9%。所有患者均行腹腔手术或开腹手术经病理确诊。结论掌握异位妊娠的临床特点,减少误诊,早期诊断,及时处理是诊治异位妊娠的关键。

  4. 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.

  5. 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 ...

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

    DEFF Research Database (Denmark)

    Hegaard, Hanne; Ottesen, Bent; Hedegaard, M;

    2010-01-01

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

  7. 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

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

  8. 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…

  9. Does adenosine deaminase activity play a role in the early diagnosis of ectopic pregnancy?

    Science.gov (United States)

    Turkmen, G G; Karçaaltıncaba, D; Isık, H; Fidancı, V; Kaayalp, D; Tımur, H; Batıoglu, S

    2016-01-01

    Early diagnosis of ectopic pregnancy (EP) is important due to life-threatening consequences in the first trimester of pregnancy. In this study we aimed to investigate the role of adenosine deaminase (ADA) activity in the prediction of EP. Forty-one patients with unruptured ectopic pregnancy comprised the case group and forty-two first trimester pregnant women with shown foetal heart beating in ultrasound comprised the control group. The mean ADA level in EP (10.9 ± 3.0 IU/L) was higher than that in control group (9.2 ± 3.6 IU/L) (p = 0.018). Receiver operating characteristics or ROC curve identified ADA value of 10.95 IU/L as optimal threshold for the prediction of EP with 56% sensitivity and 67% specificity. High ADA levels are valuable in the early diagnosis of EP. However more comprehensive studies are required.

  10. Physical activity during pregnancy and language development in the offspring

    DEFF Research Database (Denmark)

    Jukic, Anne Marie Z; Lawlor, Debbie A; Juhl, Mette

    2013-01-01

    language development. METHODS: At 18 weeks of gestation, women reported the hours per week they participated in 11 leisure-time physical activities and the hours per week spent in general physical activity (leisure, household and occupational). Caregivers completed a modified MacArthur Infant Communication...... with leisure-time physical activity compared with general physical activity need further exploration....

  11. Semaphorin 3F expression is reduced in pregnancy complicated by preeclampsia. An observational clinical study

    Science.gov (United States)

    Stallone, Giovanni; Matteo, Maria; Netti, Giuseppe Stefano; Infante, Barbara; Di Lorenzo, Adelaide; Prattichizzo, Clelia; Carlucci, Stefania; Trezza, Federica; Gesualdo, Loreto; Greco, Pantaleo

    2017-01-01

    Background and objective Preeclampsia is a systemic disorder, affecting 2–10% of pregnancies, characterized by a deregulated pro- and anti-angiogenic balance. Semaphorin 3F is an angiogenesis inhibitor. We aimed to investigate whether semaphorin 3F expression is modulated in preeclampsia. Design, setting, participants, and measurements We performed two observational single center cohort studies between March 2013 and August 2014. In the first we enrolled 110 consecutive women, undergoing an elective cesarean section; in the second we included 150 consecutive women undergoing amniocentesis for routine clinical indications at 16–18 week of gestation. Semaphorin 3F concentration was evaluated in maternal peripheral blood, venous umbilical blood and amniotic fluid, along with its placenta protein expression at the time of delivery in the first study group and in the amniotic fluid at 16–18 weeks of gestation in the second study group. Results In the first study 19 patients presented at delivery with preeclampsia. Semaphorin 3F placenta tissue expression was significantly reduced in preeclampsia. In addition, semaphorin 3F level at delivery was significantly lower in serum, amniotic fluid and venous umbilical blood of preeclamptic patients compared with normal pregnant women. In the prospective cohort study 14 women developed preeclampsia. In this setting, semaphorin 3F amniotic level at 16–18 weeks of gestation was reduced in women who subsequently developed preeclampsia compared to women with a normal pregnancy. ROC curve analysis showed that semaphorin 3F amniotic levels could identify women at higher risk of preeclampsia. Conclusions Semaphorin 3F might represent a predictive biomarker of preeclampsia. PMID:28350837

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Gözde R. Özalp

    2013-05-01

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

  14. 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.)

  15. To Explore the Clinical Features of Twin Pregnancy%双胎妊娠的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    马智慧

    2015-01-01

    ObjectiveTo investigate the clinical characteristics and treatment of twin pregnancy.MethodsThe twin pregnancy in the maternity department of our hospital were selected in this study. The clinical features, complications and treatment were analyzed in gestation period and the stage of labor.Results In the 30 patients of twin pregnancies, 10 cases received vaginal delivery, 20 cases received cesarean section, without the death of perinatal infants.Conclusion The incidence of complication for the twin pregnancy is high in gestation period and the stage of labor, with high incidence of premature delivery, low birth weight and children with birth defect which increase the perinatal mortality. So twin pregnancy is high-risk pregnancy.%目的:探讨双胎妊娠的临床特点与处理。方法选取我院的30例双胎妊娠产妇,对妊娠期与分娩期的临床特点、并发症及处理方法进行分析。结果双胎妊娠患者30例,阴道分娩10例,剖宫产20例,无围生儿死亡。结论双胎妊娠孕期及分娩期并发症多,早产率、低体重儿、畸形儿发生率高,使围产儿死亡率增加,为高危妊娠范畴。

  16. 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.

  17. Analysis of Clinical Nursing Care of 26 Cases of Ectopic Pregnancy%26例宫外孕的临床护理分析

    Institute of Scientific and Technical Information of China (English)

    李慧

    2015-01-01

    目的:分析宫外孕患者的抢救治疗及护理。方法选取26例宫外孕的临床抢救及护理资料进行分析。结果26例宫外孕患者经积极抢救和精心的护理所有患者均治愈出院,住院时间7~30天,平均13天。结论出血得到控制,生命体征恢复正常,缓解疼痛,患者情绪平稳,能积极配合治疗和护理。%Objective To salvage therapy in patients with ectopic pregnancy and nursing.Methods26 cases of clinical data rescue and care of ectopic pregnancy were analyzed.Results 26 cases of ectopic pregnancy patients with active rescue and careful care of all patients were cured, hospitalization time of 7 to 30 days, an average of 13 days.Conclusion Bleeding under control, vital signs returned to normal, pain relief, the patient emotional stability, to actively cooperate with the treatment and care.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. A free terminal ileal perforation from active crohn disease in pregnancy: a diagnostic challenge.

    Science.gov (United States)

    Philip, Sunu; Kamyab, Armin; Orfanou, Paraskevi

    2015-03-01

    The surgical management of the complications of Crohn disease is often challenging. These difficulties are compounded in pregnancy by competing interests of the mother and the baby. In this report, we describe the presentation and surgical management of a patient in her second trimester with active Crohn disease who required emergent surgical intervention. She had presented with the uncommon complication of a free perforation in the presence of active untreated disease.

  1. 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.

  2. 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

  3. Influence of position and length of uterus on implantation and clinical pregnancy rates in IVF and embryo transfer treatment cycles.

    Science.gov (United States)

    Egbase, P E; Al-Sharhan, M; Grudzinskas, J G

    2000-09-01

    In a prospective study of 807 consecutive women shown to have an apparently normal uterus after hysterosalpingography, hysteroscopy or pelvic ultrasonography prior to IVF or intracytoplasmic sperm injection (ICSI) and embryo transfer, the position and length of the uterine cavity was measured routinely at a pre-treatment mock transfer procedure. The apparent length of the uterine cavity was 9 cm in 85 women (group 3). The uterus was noted to be retroverted in 38. 2% (308) women. The embryo transfer catheter was advanced to 5 mm from the uterine fundus based on the previously determined cavity length in all the embryo transfer procedures at 48 h after oocyte collection. Implantation and clinical pregnancy rates were not significantly different with respect to position of the uterus, difficulties encountered in passage of the catheter, mean age of the women, aetiology or duration of infertility or embryology events. An apparently greater cavity length was seen in older and/or parous women, but the difference was not statistically significant. Although the highest implantation and clinical pregnancy rates were seen in women with a cavity length of 7-9 cm (group 2) the differences were not statistically significant: group 1, 18.9 and 36. 7%; group 2, 21.0 and 46.5%; and group 3, 17.3 and 32.9% respectively. The incidence of ectopic pregnancy per reported clinical pregnancy was highest in group 1 women, being 14.9% (7/47) in comparison with group 2 (1.8%, 5/276) and group 3 (0%, 0/27) (P: size of the uterus is a critical factor in the aetiology of ectopic pregnancy in IVF/ICSI-embryo transfer.

  4. 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...

  5. Physical activity changes during pregnancy in a comparative impact trail

    Science.gov (United States)

    Delta Healthy Sprouts was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, physical activity, and other health behaviors of rural, Southern African American women and their infants. Results pertaining to physical activity outcomes in the gestat...

  6. 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.

  7. 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.

  8. Problems sleeping during pregnancy

    Science.gov (United States)

    ... sleeping References Balserak BI, Lee KA. Sleep and sleep disorders associated with pregnancy. In: Kryger M, Roth T, ... Elsevier; 2017:chap 156. Ibrahim S, Foldvary-Shaefer N. Sleep disorders in pregnancy: implications, evaluation, and treatment. Neurologic Clinics . ...

  9. High-Risk Pregnancy

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications High-Risk Pregnancy: Condition Information Skip sharing on social media links Share this: Page Content A high-risk pregnancy refers to anything that puts the ...

  10. Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ayman A Al-Talib

    2016-01-01

    Full Text Available Objectives: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Materials and Methods: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient′s age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Results: Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7% were older than 35 years, and were nulliparous (45.5%. The commonest symptom was vaginal bleeding (86.4% followed by hyperemesis gravidarum (41.0%; Hyperthyroidism was seen in 1 patient (4.5%. Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%. The majority of patients (63.6% had normal BhCG within 9 weeks (63 days after suction curettage. The majority of the cases followed a benign course. Conclusion: Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.

  11. Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia

    Science.gov (United States)

    Al-Talib, Ayman A.

    2016-01-01

    Objectives: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Materials and Methods: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient's age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Results: Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7%) were older than 35 years, and were nulliparous (45.5%). The commonest symptom was vaginal bleeding (86.4%) followed by hyperemesis gravidarum (41.0%); Hyperthyroidism was seen in 1 patient (4.5%). Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%). The majority of patients (63.6%) had normal BhCG within 9 weeks (63 days) after suction curettage. The majority of the cases followed a benign course. Conclusion: Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear. PMID:27625583

  12. Multiple Pregnancy

    Science.gov (United States)

    ... active during multiple pregnancy is important for your health, but you may need to avoid strenuous exercise. Try low-impact exercise, such as swimming, prenatal yoga, and walking. You should aim for 30 minutes ...

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Shi, Wei; Xu, Bo; Wu, Li-Min; Jin, Ren-Tao; Luan, Hong-Bing; Luo, Li-Hua; Zhu, Qing; Johansson, Lars; Liu, Yu-Sheng; Tong, Xian-Hong

    2014-01-01

    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.

  15. 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

  16. 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

  17. 异位妊娠的临床护理体会%Clinical nursing experience of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    明淑芹

    2015-01-01

    目的:探讨异位妊娠的相关因素,制定相应的预防和护理对策。方法:收治异位妊娠患者90例,回顾性分析其临床资料。结果:在基础护理的基础上,结合患者特点给予相应护理干预措施,有助于异位妊娠患者的治疗与康复。结论:通过术前、术中和术后系统护理,对异位妊娠患者的治疗和康复有着十分重要的意义。%Objective:To explore the related factors of ectopic pregnancy,and to make corresponding prevention and nursing countermeasures.Methods:90 patients with ectopic pregnancy were selected,and the clinical data were retrospectively analyzed. Results:On the basis of basic nursing,combined with the features of the patients,giving the corresponding nursing intervention measures was helpful in healing and recovery of patients with ectopic pregnancy.Conclusion:Preoperative,intraoperative and postoperative systemic nursing care played a very important role in the treatment and rehabilitation of patients with ectopic pregnancy.

  18. Effects of relaxation on depression levels in women with high-risk pregnancies: a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Wanda Scherrer de Araújo

    Full Text Available ABSTRACT Objective: to analyse the effects of relaxation as a nursing intervention on the depression levels of hospitalised women with high-risk pregnancies. Methods: a randomised clinical trial realised in a reference centre for high-risk pregnancies. The sample consisted of 50 women with high-risk pregnancies (25 in the control group and 25 in the intervention group. The Benson relaxation technique was applied to the intervention group for five days. Control variables were collected using a predesigned form, and the signs and symptoms of depression were evaluated using the Edinburgh Postnatal Depression Scale (EPDS. The Statistical Package for Social Sciences (SPSS, version 20.0, was used with a significance level of 5%. The Wilcoxon and paired t-tests were used to evaluate depression levels between two timepoints. Using categorical data, the McNemar test was used to analyse differences in depression severity before and after the intervention. Results: depression levels decreased in the intervention group five days after the relaxation technique was applied (4.5 ± 3, p<0.05 compared with the levels at the first timepoint (10.3±5.9. Conclusion: as a nursing intervention, relaxation was effective in decreasing the symptoms of depression in hospitalised women with high-risk pregnancies.

  19. The dermatoses of pregnancy

    Directory of Open Access Journals (Sweden)

    Sachdeva Silonie

    2008-01-01

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

  20. 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

  1. 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.

  2. Pregnancy Complications

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

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

    Directory of Open Access Journals (Sweden)

    Alexandre Faisal-Cury

    2008-09-01

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

  4. 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.

  5. 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.

  6. Physical activity and maternal obesity: cardiovascular adaptations, exercise recommendations, and pregnancy outcomes.

    Science.gov (United States)

    Mottola, Michelle F

    2013-10-01

    Although a healthy lifestyle approach is intuitive for obese pregnant women, no guidelines currently exist to manage these women throughout pregnancy. Women who are medically prescreened for contraindications can engage in a walking program three to four times per week, starting at 25 min per session and adding 2 min per week until reaching 40 min, with sessions continuing until delivery. A target heart rate of 102-124 beats per minute should be promoted for women 20-29 years of age and a rate of 101-120 beats per minute for women 30-39 years of age. A pedometer step count of 10,000 steps per day is suggested as a goal, as this level of activity provides important health benefits. Combining healthy eating with a walking plan prevents excessive weight gain during pregnancy and promotes a healthy fetal environment.

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

    OpenAIRE

    Bastani P; Hamdi K; Abasalizadeh F; Navali N

    2011-01-01

    Parvin Bastani, Kobra Hamdi, Fatemeh Abasalizadeh, Nazli NavaliWomen's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranObjective: Available evidence about the role of supplementary vitamin E in normal pregnancy is inadequate. This study assessed the potential benefit of vitamin E supplementation on some pregnancy health indices.Methods: A 1:2 weighted simple randomization technique was used to allocate 104 eligible pregnant women to receive vita...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Bastani P

    2011-06-01

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

  10. 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.

  11. Low-dose growth hormone supplementation increases clinical pregnancy rate in poor responders undergoing in vitro fertilisation.

    Science.gov (United States)

    Lattes, Karinna; Brassesco, Mario; Gomez, Manuel; Checa, Miguel A

    2015-07-01

    Poor ovarian response (POR) often means low success rates after in vitro fertilisation (IVF). We aim to study the impact of a low-dose growth hormone (GH) supplementation in pregnancy rates in poor responders in a prospective, self-controlled study of 64 poor responders to previous IVF cycles, who failed to achieve pregnancy and were supplemented with low-doses of GH in a subsequent cycle using the same gonadotropin dose and protocol. Our primary endpoint was the clinical pregnancy rate (CPR), considering secondary endpoints, the number of retrieved oocytes, embryos, embryo quality and the proportion of cycles with embryo transfer. CPR in the GH group was 34.4%. Significant differences were observed for the GH group both in the number of top quality embryos (0.64 ± 0.88 versus 1.03 ± 1.17, p < 0.05) and cryopreserved embryos (0.3 ± 0.81 versus 0.85 ± 1.49, p < 0.05). This is, to our knowledge, the first clinical trial to use a low dose of GH as a supplement for IVF in POR patients. Despite this low dose, we achieved excellent success rates in patients with a very poor prognosis, at a reasonable cost and without side effects, which makes this a safe and cost-effective alternative.

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

    Science.gov (United States)

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

    2016-01-01

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

  13. 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

    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...... 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...... supplementation was not associated with the risk of persistent wheeze, but the number of episodes of troublesome lung symptoms was reduced, and the airway immune profile was up-regulated (principal component analysis, P=.04). There was no effect on additional end points. Intrauterine death was observed in 1 fetus...

  14. 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.

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

    Science.gov (United States)

    Patel, Roshni R; Hollins, Kathryn

    2015-01-01

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

  16. 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.

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

    OpenAIRE

    Ussher, M; Aveyard, P; Manyonda, I; Lewis, S.; West, R.; Lewis, B.; Marcus, B.; Taylor, AH; Barton, P.; Coleman, T

    2012-01-01

    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 ...

  18. Hair cortisol levels as a retrospective marker of hypothalamic-pituitary axis activity throughout pregnancy: Comparison to salivary cortisol

    OpenAIRE

    D’Anna-Hernandez, Kimberly L.; ROSS, RANDAL G .; Natvig, Crystal L.; Laudenslager, Mark L.

    2011-01-01

    Maternal stress during pregnancy is associated with negative maternal/child outcomes. One potential biomarker of the maternal stress response is cortisol, a product of activity of the hypothalamic-pituitary-adrenal axis. This study evaluated cortisol levels in hair throughout pregnancy as a marker of total cortisol release. Cortisol levels in hair have been shown to be easily quantifiable and may be representative of total cortisol release more than single saliva or serum measures. Hair corti...

  19. 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.

  20. Pregnancy Outcomes in Women With Diabetes-Lessons Learned From Clinical Research

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R

    2016-01-01

    with diabetes and observational studies that support antihypertension treatment for pregnant women with microalbuminuria or diabetic nephropathy preventing preeclampsia and early preterm delivery are presented here. Obtaining and maintaining strict glycemic control before and during pregnancy is paramount......Among women with diabetes, the worst pregnancy outcome is seen in the subgroup of women with diabetic nephropathy. Development of severe preeclampsia that leads to early preterm delivery is frequent. Predictors and pathophysiological mechanisms for the development of preeclampsia among women...... to prevent preterm delivery. The cornerstones of diabetes management are appropriate diet and insulin, although the risk of severe hypoglycemia always needs to be taken into account when tailoring a diabetes treatment plan. Pathophysiological mechanisms of the increased risk of hypoglycemia during pregnancy...

  1. 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.

  2. Clinical Analysis of 46 Cases of Measles Infection in Pregnancy%妊娠合并麻疹46例临床分析

    Institute of Scientific and Technical Information of China (English)

    龙滨; 李晶; 郭晓峰; 樊银欢

    2016-01-01

    Objective Further understanding the epidemiologic features of pregnancy combined measles, the clinical manifestation, the maternal-fetal adverse effects, and the prognosis.Methods A retrospective study was performed on 46 cases of pregnancy combined measles during January 2012 to December 2014, the analysis was emphasized on both maternal- fetal effects and its prognosis.Results 22 of 46 cases were in first and second trimester, the other 24 cases were third trimester pregnancy. 9 of the 22 (19.5%) ended in miscarriage or still birth. 1 premature delivery, 8 c-section and 2 neonatal measles were observed among the 24 late pregnancy patients.Conclusion Viral effects on nervous system may increase the possibility of miscarriage in ifrst and second trimester when maternal infection happens in early pregnancy. Contracting in second and third trimester may lead to still birth and premature delivery. Active intervention is suggested to be given from second trimester to diminish the complication, still birth and premature birth.%目的:探讨妊娠合并麻疹的流行病学特点、临床特征、对母儿的不良影响及妊娠转归。方法回顾性分析我院2012年1月-2014年12月收治的46例妊娠合并麻疹患者的流行病学史、临床资料,重点分析妊娠合并麻疹对母儿的影响和妊娠转归。结果22例早、中期妊娠者发生流产及死胎9例,占19.5%,24例晚期妊娠患者中1例早产;8例剖宫术;2例新生儿出现麻疹。结论孕早期感染麻疹,病毒影响神经系统可以使早期及晚期流产率上升,孕中、晚期感染麻疹易导致死胎和早产,中、晚期应积极治疗,减少并发症、死胎和早产的发生。

  3. 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.

  4. Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

    Directory of Open Access Journals (Sweden)

    Donny L. F. Chang

    2013-01-01

    Full Text Available Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.

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

    Science.gov (United States)

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

    2016-02-01

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

  6. 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

  7. 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.

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

    Science.gov (United States)

    Westgarth, Carri; Liu, Jihong; Heron, Jon; Ness, Andrew R; Bundred, Peter; Gaskell, Rosalind M; German, Alexander J; McCune, Sandra; Dawson, Susan

    2012-01-01

    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, PDog 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, PDog 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, Pdog 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.

  9. 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.

  10. Effect of Foot Massage on Physiological Edema During Pregnancy

    OpenAIRE

    Fatemeh Rahimikian; Azadeh Shadmehr; Abbas Mehran; Mahdieh Kiani

    2015-01-01

    Introduction: One of the most common and annoying problems during pregnancy is physiological foot edema that may cause activity restrictions during pregnancy for pregnant women. Present study aimed to determine the effect of foot massage on physiological edema during pregnancy. Methods: This study was non-randomized clinical trial and performed in 2012. 120 pregnant women aged 20 to 35 years were non randomly assigned to treatment and control groups. Treatment group, received 20 minutes d...

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

    Directory of Open Access Journals (Sweden)

    Andrea Olmos-Ortiz

    2015-01-01

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

  12. 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.

  13. 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).

  14. Approaches to adolescent pregnancy prevention.

    Science.gov (United States)

    Haffner, D; Casey, S

    1986-09-01

    The US has one of the highest teenage pregnancy rates in the industrialized world, over 1,000,000 a year. This can add to social problems including poverty, unemployment, family breakup, juvenile crime, school dropouts, and child abuse. In several studies various approaches have been developed and it is concluded that teens must not only be given the knowledge to avoid teen pregnancies, but the motivation to do so. Sex education is an important part of pregnancy prevention, but few programs go beyond the facts of reproduction and less than 14% of them are 40 hours long. Studies have shown mixed results as to the effect of education on teen pregnancy. There are many programs that have been developed by different communities, including computer programs and youth service agencies. Religious groups also play an important part in sex education and they have some distinct advantages in affecting teens' sexual values and activities. Education programs for teen's parents appear to be very important since studies show when sexuality is discussed at home, the teens begin activity later and use birth control more. Clinics have had difficulty recruiting and retaining teen patients and devote special attention to establishing a rapport with them. The school-based clinic is becoming increasingly popular and can provide birth control counseling, contraceptives, family planning clinic referral, examinations, pregnancy testing, and prenatal care. There success is due to confidentiality, convenience, and comprehensive service. However, since nearly all efforts on teen pregnancy prevention are directed at girls, 1/2 of those involved in teen pregnancies--males--are not participating in programs. This must change for longterm success of these programs and also the involvement of the community and media.

  15. 妊娠期亚临床甲减对妊娠结局的影响分析%The Analysis of Sub-clinical Hypothyroidism during Pregnancy Impact on Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    沈冬梅

    2015-01-01

    ObjectiveTo investigate the effects of subclinical hypothyroidism on pregnancy outcome during pregnancy, further guide clinical application. Methods 60 patients with subclinical hypothyroidism during pregnancy were admitted to hospital delivery in our hospital from January 2013 to January 2015, as an observation group. During the same period, 60 patients with maternal health were admitted to hospital delivery, as a control group. Then retrospectively analyzed the clinical data, and observed the effect on pregnancy outcome in both groups.Results The incidence rates of hypertensive disorders in pregnancy, anemia, premature delivery, placental abruption, fetal distress, low birth weight children in the observation group were significantly higher than that of the control group, the difference had statistical significant (P<0.05).Conclusion The subclinical hypothyroidism during pregnancy can lead to complications during pregnancy. To improve pregnancy outcome, the screening during first trimester of pregnancy should be strengthened, and closely monitor the situation of maternal subclinical hypothyroidism during pregnancy.%目的:探讨妊娠期亚临床甲减对妊娠结局的影响,进一步指导临床。方法选取我院2013年1月至2015年1月收治住院分娩的妊娠期亚临床甲减患者60例,将其作为观察组,与同期随机收治住院分娩的正常健康产妇患者60例,将其作为对照组,对其两组临床资料进行回顾性分析,观察两组患者对妊娠结局的影响。结果观察组患者妊娠期高血压疾病、贫血、早产、胎盘早剥以及胎儿窘迫、低体质量儿发生率明显高于对照组,差异显著,具有统计学意义(P<0.05)。结论妊娠期亚临床甲减能够引发妊娠期并发症,应加强孕早期的筛查,严密监测妊娠期亚临床甲减产妇的情况,对改善妊娠结局具有重要的意义。

  16. Effects of pregnancy and protein-energy malnutrition on monooxygenase O-dealkylation activity in rat liver microsomes

    Directory of Open Access Journals (Sweden)

    S.N. Kuriyama

    2000-01-01

    Full Text Available Xenobiotic metabolism is influenced by a variety of physiological and environmental factors including pregnancy and nutritional status of the individual. Pregnancy has generally been reported to cause a depression of hepatic monooxygenase activities. Low-protein diets and protein-energy malnutrition have also been associated with a reduced activity of monooxygenases in nonpregnant animals. We investigated the combined effects of pregnancy and protein-energy malnutrition on liver monooxygenase O-dealkylation activity. On pregnancy day 0 rats were assigned at random to a group fed ad libitum (well-nourished, WN or to a malnourished group (MN which received half of the WN food intake (12 g/day. WN and MN rats were killed on days 0 (nonpregnant, 11 or 20 of pregnancy and ethoxy- (EROD, methoxy- (MROD and penthoxy- (PROD resorufin O-dealkylation activities were measured in liver microsomes. Only minor changes in enzyme activities were observed on pregnancy day 11, but a clear-cut reduction of monooxygenase activities (pmol resorufin min-1 mg protein-1 was noted near term (day 0 vs 20, means ± SD, Student t-test, P<0.05 in WN (EROD: 78.9 ± 15.1 vs 54.6 ± 10.2; MROD: 67.8 ± 10.0 vs 40.9 ± 7.2; PROD: 6.6 ± 0.9 vs 4.3 ± 0.8 and in MN (EROD: 89.2 ± 23.9 vs 46.9 ± 15.0; MROD: 66.8 ± 13.8 vs 27.9 ± 4.4; PROD: 6.3 ± 1.0 vs 4.1 ± 0.6 dams. On pregnancy day 20 MROD was lower in MN than in WN dams. Malnutrition did not increase the pregnancy-induced reduction of EROD and PROD activities. Thus, the present results suggest that the activities of liver monooxygenases are reduced in near-term pregnancy and that protein-energy malnutrition does not alter EROD or PROD in pregnant rats.

  17. Improved fertility following conservative surgical treatment of ectopic pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Lund, Claus Otto; Ottesen, Bent;

    2003-01-01

    OBJECTIVE: To evaluate fertility after salpingectomy or tubotomy for ectopic pregnancy. DESIGN: Retrospective cohort study. SETTING: Clinical University Center, Hvidovre Hospital, Copenhagen. POPULATION: Two hundred and seventy-six women undergoing salpingectomy or tubotomy for their first ectopic...... pregnancy between January 1992 and January 1999 and who actively attempted to conceive were followed for a minimum of 18 months. METHODS: Retrospective cohort study combined with questionnaire to compare reproductive outcome following salpingectomy or tubotomy for ectopic pregnancy. Cumulative probabilities...... of pregnancy for each group were calculated by the Kaplan-Meier estimator and compared by Cox regression analysis to control for potential confounders. MAIN OUTCOME MEASURES: Intrauterine pregnancy rates and recurrence rates of ectopic pregnancy after surgery for ectopic pregnancy. RESULTS: The cumulative...

  18. 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.

  19. Perinatal outcome of illicit substance use in pregnancy--comparative and contemporary socio-clinical profile in the UK.

    Science.gov (United States)

    Goel, Nitin; Beasley, Dana; Rajkumar, Veena; Banerjee, Sujoy

    2011-02-01

    The aim of the study was to determine the contemporary socio-clinical profile and perinatal outcome of illicit substance use in pregnancy in a large UK city and compare with published literature. Cases were identified retrospectively from the 'cause for concern' referrals over 5 years (2003-2007). Data was collected on mother-infant pair from medical notes and laboratory records. Chi-square and Mann-Whitney U tests were used where appropriate for statistical analysis. One hundred sixty-eight women were identified as using illicit substance in pregnancy. Smoking (97.4%), unemployment (85.4%) and single status (42.3%) were frequent. Besides controlled use of methadone, heroin, cannabis and benzodiazepines were the most commonly used drugs. Hepatitis C prevalence was high (29.9%) despite low antenatal screening rates (57.7%). Neonatal morbidity was related to prematurity (22.9%), small for dates (28.6%) and neonatal abstinence syndrome (NAS; 58.9%). By day 5 of life, 95.1% of the babies developing NAS and 96.1% of those requiring pharmacological treatment were symptomatic. Of the infants developing NAS, 31.7% required pharmacological treatment. A total of 82.5% babies went home with their mother, and 21.2% were placed on the Child Protection Register. Only 14.3% were breast feeding at discharge. Illicit substance use in pregnancy continues to be associated with significant maternal and neonatal morbidity, and the socio-clinical profile in this decade appears unchanged in the UK. Hepatitis C prevalence is high, and detection should be improved through targeted antenatal screening. Where facility in the community is unavailable, 5 days of hospital stay is sufficient to safely identify babies at risk of developing NAS. Most babies were discharged home with their mother.

  20. Adolescent pregnancy and contraception.

    Science.gov (United States)

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena

    2014-09-01

    7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods.

  1. Pregnancy after breast cancer: Are young patients willing to participate in clinical studies?

    Science.gov (United States)

    Pagani, Olivia; Ruggeri, Monica; Manunta, Silvia; Saunders, Christobel; Peccatori, Fedro; Cardoso, Fatima; Kaufman, Bella; Paluch-Shimon, Shani; Gewefel, Hanan; Gallerani, Elisa; Abulkhair, O Malkahi; Pistilli, Barbara; Warner, Ellen; Saloustros, Emmanouil; Perey, Lucien; Zaman, Khalil; Rabaglio, Manuela; Gelber, Shari; Gelber, Richard D; Goldhirsch, Aron; Korde, Larissa; Azim, Hatem A; Partridge, Ann H

    2015-06-01

    Young patients with breast cancer (BC) are often concerned about treatment-induced infertility and express maternity desire. Conception after BC does not seem to affect outcome, but information in estrogen-receptor positive (ER+) disease is not definitive. From September 2012-March 2013, 212 evaluable patients with ER+ early BC, pregnancy. Overall, 37% of respondents were interested in the study; younger patients (≤30 years) reported higher interest (57%). Motivation in younger patients treated >30 months was higher (83%) than in older women (14%), interest was independent of age in patients treated for ≤30 months. A prospective study in this patient population seems relevant and feasible. The International-Breast-Cancer-Study-Group (IBCSG), within the Breast-International-Group (BIG) - North-American-Breast-Cancer-Groups (NABCG) collaboration, is launching a study (POSITIVE) addressing ET interruption to allow pregnancy.

  2. Clinical and epidemiological aspects of obesity during pregnancy and the puerperium

    OpenAIRE

    Storck Lindholm, Elisabeth

    2013-01-01

    Objective: To study different aspects of obesity during pregnancy, birth and the puerperium. Paper I is an intervention study of obese pregnant women. Paper II compares fatty acid (FA) patterns in breast milk and neonates ́ plasma phospholipids in normal-weight mothers and an intervention group of obese mothers. Paper III reports the risk of obstetric anal sphincter la - cerations in relation to maternal obesity among primiparas. Paper IV compares health care consumption...

  3. 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.

  4. Clinical, biological and hormonal study of mid-pregnancy termination in cats with aglepristone.

    Science.gov (United States)

    Fieni, Francis; Martal, Jacques; Marnet, Pierre Guy; Siliart, Brigitte; Guittot, Franck

    2006-10-01

    In order to evaluate the efficacy, the safety and the variation in plasma concentrations of estrogens, progesterone, PGFM, oxytocin, cortisol and prolactin after mid-pregnancy termination induced by aglepristone, 61 pregnant queens (33.3 + 4.2 days), were injected subcutaneously with 15 [corrected] mg/kg aglepristone, (Alizine) [corrected] repeated once 24 h later. Five queens served as control and received a placebo. The efficacy of aglepristone was 88.5% and termination of pregnancy was achieved in 50% of the queens within 3 days. Brief periods of depression and anorexia were noted in 9.3% of the queens before fetal expulsion (these symptoms were attributed to the phenomenon of fetal expulsions). Not one of the queens that aborted developed uterine disease. There were no changes in plasma concentrations of estrogen, prostaglandin, prolactin or oxytocin following aglepristone administration. However, there were significant increases in plasma concentrations of progesterone and cortisol 60 and 30 h, respectively, after aglepristone administration. Termination of pregnancy occurred with high plasma progesterone concentrations. Fetal expulsion was characterised by an increase in estrogen, PGFM and oxytocin concentrations, whereas prolactin and cortisol levels remained at a basal level.

  5. 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.)

  6. A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy Among Women Attending Urban STD Clinics

    Science.gov (United States)

    Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly

    2014-01-01

    Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level. PMID:24385650

  7. 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.

  8. 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。

  9. 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

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

    Directory of Open Access Journals (Sweden)

    Ping Peng

    2015-01-01

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

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Successful completion of pregnancy in a patient with chronic myeloid leukemia without active intervention: a case report and review of the literature.

    Science.gov (United States)

    Cole, Suzanne; Kantarjian, Hagop; Ault, Patricia; Cortés, Jorge E

    2009-08-01

    The management of patients with chronic myeloid leukemia (CML) during pregnancy is a matter of continued debate. We present a 21-year-old woman in whom CML was diagnosed during early pregnancy. Because the patient was asymptomatic and desired to carry the pregnancy to term while minimizing fetal exposure to medication, she was observed with no therapy for the duration of her pregnancy. The white blood cell count showed a slow downward trend throughout her pregnancy. She delivered a healthy baby and breast fed for a time before initiating therapy for CML. We reviewed the published case reports of women who had a pregnancy occur in the setting of treatment with imatinib. Given the adverse effects of fetal exposure to imatinib as treatment for the mother with CML, close observation might be an option for selected patients who are diagnosed with CML while pregnant and who have minimal clinical manifestations of CML.

  17. Hypertensive disorders in twin pregnancy

    OpenAIRE

    Santema, Job; Koppelaar, Elin; Wallenburg, Henk

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending the antenatal clinic and booked before a gestational age of 24 weeks was matched for maternal age, parity, and gestational age at delivery with a singleton pregnancy delivered in the same year. Prima...

  18. An examination of the proteolytic activity for bovine pregnancy-associated glycoproteins 2 and 12.

    Science.gov (United States)

    Telugu, Bhanu Prakash V L; Palmier, Mark O; Van Doren, Steven R; Green, Jonathan A

    2010-01-01

    The pregnancy-associated glycoproteins (PAGs) represent a complex group of putative aspartic peptidases expressed exclusively in the placentas of species in the Artiodactyla order. The ruminant PAGs segregate into two classes: the 'ancient' and 'modern' PAGs. Some of the modern PAGs possess alterations in the catalytic center that are predicted to preclude their ability to act as peptidases. The ancient ruminant PAGs in contrast are thought to be peptidases, although no proteolytic activity has been described for these members. The aim of the present study was to investigate (1) if the ancient bovine PAGs (PAG-2 and PAG-12) have proteolytic activity, and (2) if there are any differences in activity between these two closely related members. Recombinant bovine PAG-2 and PAG-12 were expressed in a baculovirus expression system and the purified proteins were analyzed for proteolytic activity against a synthetic fluorescent cathepsin D/E substrate. Both proteins exhibited proteolytic activity with acidic pH optima. The k(cat)/K(m) for bovine PAG-2 was 2.7x10(5) m(-1) s(-1) and for boPAG-12 it was 6.8x10(4) m(-1) s(-1). The enzymes were inhibited by pepstatin A with a K(i) of 0.56 and 7.5 nm for boPAG-2 and boPAG-12, respectively. This is the first report describing proteolytic activity in PAGs from ruminant ungulates.

  19. Level of Pregnancy-associated Plasma Protein-A,Cystatin C and Homocysteine in Pregnancy Induced Hypertension Patients and the Clinical Value%Medical Recapitulate

    Institute of Scientific and Technical Information of China (English)

    杨慧丽; 张秀欣

    2016-01-01

    目的:研究妊娠相关蛋白A( PAPP-A)、胱抑素C( CysC)、血同型半胱氨酸( Hcy)在妊娠期高血压疾病患者体内水平和其临床价值。方法选择2013年9月至2014年10月青岛市胶州中心医院收治的80例妊娠期高血压疾病患者作为研究组,另选30例正常妊娠妇女作为对照组。对两组收缩压、舒张压、心率等常规指标进行对比分析。依照观察组疾病类型分为妊娠期高血压、子痫、轻度先兆子痫、重度先兆子痫4个亚组,比较各组PAPP-A、CysC、Hcy水平差异。结果研究组患者收缩压、舒张压、心率、血尿酸均显著高于对照组[(166±20) mmHg(1 mmHg =0.133 kPa)比(131±15) mmHg、(108±20) mmHg 比(85±10) mmHg、(101±8)次/min 比(85±6)次/min、(383±63)μmol/L 比(310±52)μmol/L],白蛋白水平显著低于对照组[(30±7) g/L比(42±4) g/L],差异有统计学意义(P<0.05)。研究组PAPP-A、CysC、Hcy水平显著高于对照组[(37.0±7.7)μmol/L比(28.7±5.5)μmol/L、(1.5±0.4) mg/L 比(0.8±0.3) mg/L、(24.7±1.7)μmol/L 比(9.9±0.8)μmol/L],差异有统计学意义(P<0.05)。妊娠期高血压组、轻度先兆子痫组、重度先兆子痫组、子痫组患者PAPP-A、CysC、Hcy水平均依次升高,4组比较差异有统计学意义( P<0.05)。结论妊娠期高血压疾病患者血清中PAPP-A、CysC、Hcy水平均显著高于正常健康妊娠孕妇,病情越严重,其水平越高,对于妊娠期高血压疾病的临床诊治具有重要指导意义。%Objective To study the level of pregnancy associated protein A ( PAPP-A) ,serum cystatin C (Cys C),plasma homocysteine (Hcy) in patients with pregnancy induced hypertension and the clinical value. Methods Chosen from Sep.2013 to Oct.2014 in Qingdao Jiaozhou Central Hospital 80 cases of pregnancy

  20. Coagulation and Fibrinolytic System Protein Profiles in Women with Normal Pregnancies and Pregnancies Complicated by Hypertension.

    Science.gov (United States)

    Hale, Sarah A; Sobel, Burton; Benvenuto, Anna; Schonberg, Adrienne; Badger, Gary J; Bernstein, Ira M

    2012-04-01

    OBJECTIVE: The current study longitudinally evaluated concentrations of fibrinogen (Fib), D-Dimer, plasminogen activator type-1 (PAI-1) and tissue type plasminogen activator (T-Pa) before pregnancy and in the first and third trimesters of pregnancy with a focus on the pregnancy transition. STUDY DESIGN: Twenty healthy, nonsmoking, nulliparous women, aged 29.8 ± 3.0 years, BMI 23.3 ± 3.2 kg/m(2) were studied during menstrual cycle day 8 ± 4 and again in early (11 - 15 wks) and late (31 - 34 wks) pregnancy. Seventeen women had singleton conceptions and delivered at term with uncomplicated pregnancies (CTL) and three women developed complicated hypertension (CH) during pregnancy after the third trimester (late pregnancy) evaluation. Data are means ± SEM, Significance was based on p < 0.05. RESULTS: Fib was the only protein evaluated that increased in early pregnancy relative to the prepregnancy assessment. D-dimer, PAI-1 and T-Pa increased in the third trimester compared with prepregnant and early pregnant values (p < .001). T-PA was significantly higher during late pregnancy in CH subjects compared with CTL (8.1 ± 0.7 ng/ml vs. 5.0 ± 0.2 ng/ml, p = .02). There were no other differences between groups. CONCLUSIONS: Increases in fibrinogen are evident in early pregnancy whereas fibrinolysis, perhaps in response to the procoagulant environment of pregnancy, is increased during late pregnancy. Before development of clinically overt hypertension, T-Pa is increased without concomitant changes in other proteins assessed. This is consistent with altered endothelial function with preeclampsia that may contribute to, or reflect, the vasculopathy accompanying this disorder.

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

    Directory of Open Access Journals (Sweden)

    M Dutto

    2012-01-01

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

  2. 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.

  3. Obstetric and perinatal effects of active and/or passive smoking during pregnancy

    Directory of Open Access Journals (Sweden)

    Mary Uchiyama Nakamura

    Full Text Available CONTEXT: Cigarette smoke, whether inhaled voluntarily or not, causes damage to the mother-infant pair. The antenatal period may present the best opportunity for performing effective anti-smoking campaigns. OBJECTIVE: To study the obstetric and perinatal effects of smoking on pregnancy and the infant. TYPE OF STUDY: Prospective study, interviewing pregnant women who were randomly selected at the maternity hospital as they were being discharged after giving birth. SETTING: Hospital Municipal Vereador José Storópolli, São Paulo, Brazil. METHODS: 758 patients were interviewed regarding smoke inhalation before being discharged from the maternity hospital. The groups were formed by 42 active smokers, 272 passive smokers, 108 who inhaled smoke both actively and passively, and 336 non-smokers. The groups were compared regarding age, parity, school education, incidence of spontaneous abortion, rate of caesarian births, average gestational age at birth, rate of low birth weight and adequacy of weight in relation to the gestational age of newborn infants. For all variables we considered p < 0.05 as statistically significant. RESULTS: There was a high rate (55.7% of pregnant smokers, including 5.5% active, 35.9% passive and 14.3% active-passive smokers. Active and active-passive smokers were older and had higher parity. Active smokers had lower education levels and higher rates of previous spontaneous abortion. The weights of newborn babies were lower for smoking mothers. DISCUSSION: The study was performed among patients that were mostly of low economic, social and cultural levels, thus possibly explaining the high incidence of smokers. Worse still was that 35.9% of the non-smokers were actually passive smokers. These rates we report were similar to those from the literature. The typical receptiveness of teenage girls to unrestricted advertising in the media contributes towards an early start to acquiring the habit of smoking, including during pregnancy

  4. Pregnancy Tests

    Science.gov (United States)

    ... Us Home A-Z Health Topics Pregnancy tests Pregnancy tests > A-Z Health Topics Pregnancy test fact ... To receive Publications email updates Enter email Submit Pregnancy tests If you think you may be pregnant , ...

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

    Science.gov (United States)

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

    2015-02-01

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

  6. 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.

  7. 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.

  8. Impacts of Abstinence Education on Teen Sexual Activity, Risk of Pregnancy, and Risk of Sexually Transmitted Diseases

    Science.gov (United States)

    Trenholm, Christopher; Devaney, Barbara; Fortson, Kenneth; Clark, Melissa; Bridgespan, Lisa Quay; Wheeler, Justin

    2008-01-01

    This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexually transmitted diseases (STDs). Based on an experimental design, the impact analysis uses survey data collected in 2005 and early 2006 from more than 2,000 teens who had been randomly assigned to either a…

  9. Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

    Science.gov (United States)

    Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

    2017-01-01

    Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

  10. 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.

  11. Characterization of the peptidase activity of recombinant porcine pregnancy-associated glycoprotein-2.

    Science.gov (United States)

    Telugu, Bhanu Prakash V L; Green, Jonathan A

    2008-12-01

    The pregnancy-associated glycoproteins (PAGs) belong to the aspartic peptidase family. They are expressed exclusively in trophoblasts of even-toed ungulates such as swine, cattle, sheep, etc. In pigs, two distinct PAG transcripts (and some variants) have been described. One of the transcripts, porcine PAG-1 (poPAG-1) may not be capable of acting as a peptidase. The second transcript, poPAG-2, possesses a conserved catalytic centre and has been predicted, but not shown, to have proteolytic activity. The thrust of this work was to test such a possibility. PoPAG-2 was expressed as a recombinant protein with an amino-terminal 'FLAG-tag' in a Baculoviral expression system. The expressed proteins were affinity purified by using an anti-FLAG antibody. The purified preparations were then analysed for proteolytic activity against a fluorescent substrate. Porcine PAG-2 had optimal proteolytic activity around pH 3.5. Against this substrate, it had a k(cat)/K(m) of 1.2 microM(-1) s(-1) and was inhibited by the aspartic peptidase inhibitor, pepstatin A, with a K(i) of 12.5 nM. Since the proteolytic activity of PAGs in the pig has now been established, the search for putative substrates to gain insight into the physiological role of PAGs will likely be the focus of future investigations.

  12. Daily cholecalciferol supplementation during pregnancy alters markers of regulatory immunity, inflammation, and clinical outcomes in a randomized controlled trial

    Science.gov (United States)

    Vitamin D deficiency is widespread in pregnancy and has been associated with adverse health conditions for mothers and infants. Vitamin D supplementation in pregnancy may support maintenance of pregnancy by its effects on adaptive and innate immunity. We assessed the effects of vitamin D supplement...

  13. Pruritic folliculitis of pregnancy*

    Science.gov (United States)

    Delorenze, Lilian Mathias; Branco, Letícia Guedes; Cerqueira, Luiza Fiszon; Vasques, Wellington Batista; Salles, Simone de Abreu Neves; Vilar, Enoi Guedes

    2016-01-01

    Pruritic folliculitis of pregnancy is a rare disease of unknown etiology. It occcurs primarily during pregnancy, usually with spontaneous resolution postpartum. It is characterized by a benign dermatosis, with papular and pustular follicular lesions that first appear on the torso and occasionally spread throughout the body. We report the case of a patient in the 27th week of pregnancy, with a two-month evolution of pruritic and papular erythematous lesions on her lower back. Differential diagnosis includes other pregnancy-specific dermatoses: gestational pemphigoid, pruritic urticarial papules and plaques of pregnancy (PUPPP), prurigo of pregnancy, and (PUPPP) and prurigo of pregancy. Histopathological tests showed changes consistent with pruritic folliculitis of pregnancy. This case is relevant due to its rare nature and its clinical and histopathological characteristics.

  14. Probiotics and pregnancy.

    Science.gov (United States)

    Gomez Arango, Luisa F; Barrett, Helen L; Callaway, Leonie K; Nitert, Marloes Dekker

    2015-01-01

    Complications of pregnancy are associated with adverse outcomes for mother and baby in the short and long term. The gut microbiome has been identified as a key factor for maintaining health outside of pregnancy and could contribute to pregnancy complications. In addition, the vaginal and the recently revealed placental microbiome are altered in pregnancy and may play a role in pregnancy complications. Probiotic supplementation could help to regulate the unbalanced microflora composition observed in obesity and diabetes. Here, the impact of probiotic supplementation during pregnancy and infancy is reviewed. There are indications for a protective role in preeclampsia, gestational diabetes mellitus, vaginal infections, maternal and infant weight gain and allergic diseases. Large, well-designed randomised controlled clinical trials along with metagenomic analysis are needed to establish the role of probiotics in adverse pregnancy and infancy outcomes.

  15. Urinary incontinence and pelvic girdle pain during pregnancy: a clinical trial

    Directory of Open Access Journals (Sweden)

    Reihaneh Pirjani

    2016-07-01

    Full Text Available Background: To examine the association among pelvic girdle pain (PGP, urinary incontinence (UI and pelvic floor muscle (PFM function in pregnant women in second and third trimester. Methods: 300 pregnant women who admitted for standard pregnancy care were enrolled in the study. Urinary incontinency was measured via the international consultation on incontinence questionnaire short form. Pelvic girdle pain was diagnosed according to existing guidelines. Vaginal examination assessed pelvic muscles contract- relax patterns and muscle strength. The software stata version 13 (Stata Corp., TX, USA was used for data analysis. Results: Overall 300 women (150 with PGP and 150 without PGP were included in final analyses. There was not significant differences between the demographic data including, body mass index before pregnancy, maternal age, mode of delivery. Prevalence of urinary incontinence in women with pelvic girdle pain was 41.5 percent (CI 95%: 32.01- 51.48 while the prevalence of urinary incontinence in women without pain was 21.9 percent (CI 95%: 14.99-30.03. Using logistic regression, the relationship between urinary incontinence and pelvic girdle pain was significant. (CI 95%: 1.07-3.31, P=0.02. Multivariate logistic regression analysis was used to evaluate the relationship between PGP and pelvic floor muscle function and results showed that pelvic floor muscle strength in women with PGP was significantly lower than women without PGP. (CI 95%: 0.24-0.68, OR= 0.4, P<0.001. The duration of the contraction of the pelvic floor muscles in patients with PGP was significantly shorter than women without PGP. (CI 95%: 0.21-0.60, OR =0.35, P<0.001. Conclusion: There was a significant association between pelvic girdle pain and urinary incontinence during the second and third trimesters of pregnancy and also the pelvic floor muscle strength and duration of the contraction of the pelvic floor muscles in women with pelvic girdle pain was significantly

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

    Directory of Open Access Journals (Sweden)

    Marcus Bess

    2008-09-01

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

  17. 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.

  18. 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.

  19. Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome.

    Science.gov (United States)

    Palagini, Laura; Gemignani, Angelo; Banti, Susanna; Manconi, Mauro; Mauri, Mauro; Riemann, Dieter

    2014-08-01

    Short sleep duration, poor sleep quality, and insomnia frequently characterize sleep in pregnancy during all three trimesters. We aimed: (i) to review the clinical evidence of the association between conditions of sleep loss during pregnancy and adverse pregnancy outcomes; and (ii) to discuss the potential pathophysiological mechanisms that may be involved. A systematic search of cross-sectional, longitudinal studies using Medline, Embase, and PsychINFO, and MeSH headings and key words for conditions of sleep loss such as 'insomnia', 'poor sleep quality', 'short sleep duration', and 'pregnancy outcome' was made for papers published between January 1, 1960 and July 2013. Twenty studies met inclusion criteria for sleep loss and pregnancy outcome: seven studies on prenatal depression, three on gestational diabetes, three on hypertension, pre-eclampsia/eclampsia, six on length of labor/type of delivery, eight on preterm birth, and three on birth grow/birth weight. Two main results emerged: (i) conditions of chronic sleep loss are related to adverse pregnancy outcomes; and (ii) chronic sleep loss yields a stress-related hypothalamic-pituitary-adrenal axis and abnormal immune/inflammatory, reaction, which, in turn, influences pregnancy outcome negatively. Chronic sleep loss frequently characterizes sleep throughout the course of pregnancy and may contribute to adverse pregnancy outcomes. Common pathophysiological mechanisms emerged as being related to stress system activation. We propose that in accordance to the allostatic load hypothesis, chronic sleep loss during pregnancy may also be regarded as both a result of stress and a physiological stressor per se, leading to stress 'overload'. It may account for adverse pregnancy outcomes and somatic and mental disorders in pregnancy.

  20. 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.

  1. 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

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

  2. Melanoma during pregnancy

    DEFF Research Database (Denmark)

    de Haan, Jorine; Lok, Christianne A; de Groot, Christianne J M

    2017-01-01

    The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome......, recommendations for clinical practice are provided. From the 'International Network on Cancer, Infertility and Pregnancy' database, pregnant patients with melanoma were identified and analysed. Sixty pregnancies were eligible for analysis. Fifty percent of the patients presented with advanced melanoma during...... pregnancy (14 stage III and 16 stage IV), and 27% were diagnosed with recurrent melanoma. Surgery was the main therapeutic strategy during pregnancy. Only four patients with advanced melanoma were treated during pregnancy with systemic therapy (n=1) or radiotherapy (n=3). Premature delivery was observed...

  3. 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。

  4. 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.

  5. 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.)

  6. Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

    NARCIS (Netherlands)

    D. Berks (Durk)

    2017-01-01

    markdownabstractWomen with a history of cardiometabolic complicated pregnancy are at increased risk for future disease. The experience of having had a complicated pregnancy might open up a window of opportunity to guide these women to a healthier future. The general aim of the thesis is to develop a

  7. Fetal and maternal cardiac responses to physical activity and exercise during pregnancy.

    Science.gov (United States)

    May, Linda E; Allen, John J B; Gustafson, Kathleen M

    2016-03-01

    Since the 1970s, researchers have studied the influence of exercise during pregnancy on offspring heart development. With the knowledge and current evidence of fetal programming effects, research has demonstrated that exercise is safe and beneficial for mother, fetus, and neonate. Predominantly, research has focused on maternal and fetal cardiac adaptations related to aerobic exercise during pregnancy; less is known regarding the effects of resistance or combination (aerobic and resistance) training during pregnancy. Ongoing research is focusing on fetal responses to different intensity, duration and modes of maternal exercise throughout pregnancy. This article will summarize our current state of knowledge regarding the influence of exercise intensity, duration, and modes during pregnancy on maternal and fetal cardiac responses.

  8. [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.

  9. 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

  10. 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.

  11. Obstetric nephrology: lupus and lupus nephritis in pregnancy.

    Science.gov (United States)

    Stanhope, Todd J; White, Wendy M; Moder, Kevin G; Smyth, Andrew; Garovic, Vesna D

    2012-12-01

    SLE is a multi-organ autoimmune disease that affects women of childbearing age. Renal involvement in the form of either active lupus nephritis (LN) at the time of conception, or a LN new onset or flare during pregnancy increases the risks of preterm delivery, pre-eclampsia, maternal mortality, fetal/neonatal demise, and intrauterine growth restriction. Consequently, current recommendations advise that the affected woman achieve a stable remission of her renal disease for at least 6 months before conception. Hormonal and immune system changes in pregnancy may affect disease activity and progression, and published evidence suggests that there is an increased risk for a LN flare during pregnancy. The major goal of immunosuppressive therapy in pregnancy is control of disease activity with medications that are relatively safe for a growing fetus. Therefore, the use of mycophenolate mofetil, due to increasing evidence supporting its teratogenicity, is contraindicated during pregnancy. Worsening proteinuria, which commonly occurs in proteinuric renal diseases toward the end of pregnancy, should be differentiated from a LN flare and/or pre-eclampsia, a pregnancy-specific condition clinically characterized by hypertension and proteinuria. These considerations present challenges that underscore the importance of a multidisciplinary team approach when caring for these patients, including a nephrologist, rheumatologist, and obstetrician who have experience with these pregnancy-related complications. This review discusses the pathogenesis, maternal and fetal risks, and management pertinent to SLE patients with new onset or a history of LN predating pregnancy.

  12. The Role of Social Media in Recruiting for Clinical Trials in Pregnancy

    OpenAIRE

    Mahvash Shere; Xiu Yan Zhao; Gideon Koren

    2014-01-01

    Background 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...

  13. Diabetes insipidus during pregnancy.

    Science.gov (United States)

    Ananthakrishnan, Sonia

    2016-03-01

    Diabetes insipidus (DI) in pregnancy is a heterogeneous syndrome, most classically presenting with polyuria and polydipsia that can complicate approximately 1 in 30,000 pregnancies. The presentation can involve exacerbation of central or nephrogenic DI during pregnancy, which may have been either overt or subclinical prior to pregnancy. Women without preexisting DI can also be affected by the actions of placental vasopressinase which increases in activity between the 4th and 38th weeks of gestation, leading to accelerated metabolism of AVP and causing a transient form of DI of pregnancy. This type of DI may be associated with certain complications during pregnancy and delivery, such as preeclampsia. Management of DI of pregnancy depends on the pathophysiology of the disease; forms of DI that lack AVP can be treated with desmopressin (DDAVP), while forms of DI that involve resistance to AVP require evaluation of the underlying causes.

  14. Clinical Analysis of 56 Patients of Pregnancy with Epilepsy%妊娠合并癫痫56例临床分析

    Institute of Scientific and Technical Information of China (English)

    阚淑娟; 郑丽娜; 李云霞

    2011-01-01

    [Objective]To explore the pathogenesis, clinical features and treatment method of pregnancy with epilepsy. [Methods] The clinical data of 56 patients of pregnancy with epilepsy were retrospectively analyzed. The clinical manifestations, treatment method and prognosis were investigated. [Results] Among 56 patients of pregnancy with epilepsy,49 patients were primary epilepsy and 7 patients were secondary epilepsy. Twenty three patients took systematically antiepilepsy drug(AED). Seizure frequency of epilepsy during pregnancy in 29 patients increased, and that in 17 patients did not change, and that in 10 patients decreased. Eight cases were complicated with pregnancy-induced hypertension. Premature rupture of membrane occurred in 6 patients, premature delivery in 5 patients and fetal growth restriction in 3 patients. Twenty three cases underwent vaginal delivery and 41 patients underwent caesarean operation. Seven infants were mild suffocation, and 5 infants were low birth-weight, and 2 infants were malformation. [Conclusion] Pregnancy can increase the seizure frequency of epilepsy and induce epilepsy which can lead to the increasing of complications during pregnancy and delivery term. It is necessary to monitor the plasma concentration and supply with folic acid during pregnancy.%[目的]探讨妊娠合并癫痫的发病机制、临床特点及处理办法.[方法]回顾性分析56例妊娠合并癫痫患者的临床资料,探讨患者的临床表现、处理办法和预后情况.[结果]56例妊娠合并癫痫患者中原发性癫痫49例,继发性癫痫7例;系统服用抗癫痫药物患者23例;孕期发作频率增加29例,发作不变17例,发作减少10例;合并妊高征8例,胎膜早破6例,早产5例,胎儿宫内生长受限3例;阴道分娩23例,剖宫产33例;新生儿轻度窒息7例,低体重儿5例,新生儿畸形2例.[结论]妊娠使癫痫发作频率增加可诱发癫痫,癫痫可使孕期及分娩期并发症增多,孕期需积极监测血药浓度并补充叶酸.

  15. 35例特殊部位异位妊娠临床分析%Clinical analysis of 35 cases specific ectopic pregnancies

    Institute of Scientific and Technical Information of China (English)

    冯惠娟

    2001-01-01

    Objective: Investigate the clinical characteristics and misdiagnosis cause of specific ectopic pregnancies to decrease misdiagnosis rate. Methods: 35 cases of the specific ectopic pregnancies were analysed retrospectively. Results: This group accounted for 9.04% of all ectopic pregnancies occurring during this period.the rate of misdiagnosis is 80%. Tubal interstital pregnancies often had fatal intraperitoneal hemorrhage . Cornual pregancy presented unsyminetrical uterus enlargement.Abdominal pregnancy had the lower abdominal pain momently. It is difficult to diagnose ovarian pregnancy prior to surgical exploration . Painless vaginaI recurrent bleeding is main clinical manifestatio in cervical pregnancy. Conclusion:To advantageous recognition specific ectopic pregnancy . detail history, attention to clinical manipestation, Analyse comprehensively β-HCG、B-ultrasound and laparoscope ect and avoide the misdiagnosis.%目的:探讨特殊部位异位妊娠的临床特征及误诊原因,降低误诊率。方法:对35例特殊部位异位妊娠进行回顾性分析。结果:其发生率占同期异位妊娠的9.04%,误诊率80%。输卵管间质部妊娠易引起致命性腹腔出血、宫角妊娠子宫不对称性增大,腹腔妊娠孕早期一过性下腹痛,卵巢妊娠术前不易确诊,宫颈妊娠以无痛性阴道反复流血为主要临床表现。结论:提高对特殊部位异位妊娠的认识、详询病史,重视临床表现,结合β-HCG、B超及腹腔镜等综合分析、避免误诊。

  16. 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.

  17. 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

  18. 孕期运动的研究进展%Research Progress of Physical Activity During Pregnancy

    Institute of Scientific and Technical Information of China (English)

    吴伟珍; 梁丽霞; 何青; 谢玉珍; 邓燕红(综述); 李映桃(审校)

    2014-01-01

    The body mass and motor ability of pregnant woman could be influenced by the changes of nutrition metabolism and physiological functions during pregnancy.Proper physical activity during pregnancy is good for both mother and her fetus,but need to consult the physician advice to exclude exercise contraindication for all pregnant women before doing exercise and take the recommended physical activity form,duration and intensity.This article is the review of the necessity and features of physical activity,to aim at offer a proper and safe plan for physical activity during pregnancy.%孕妇孕期的营养代谢和生理改变,可影响孕妇体质量及运动能力。孕期适度运动对母、胎健康有利,但所有孕妇运动前需征询医师意见以排除运动禁忌证,并按照医师推荐的孕期运动形式、时间和强度实施。本文对孕期运动的必要性及特点进行综述,旨在为临床制定合理、安全的孕期运动方案提供指导。

  19. Clinical study on the influence of phloroglucinol on plasma angiotensin II and D-Dimer index in patients with severe pregnancy-induced hypertension.

    Science.gov (United States)

    Ai, Liang; Lan, Xinzhi; Wang, Limin; Xu, Yanjie; Zhang, Bin

    2016-07-01

    To observe the effect of phloroglucinol on plasma angiotensin II and D-dimer index when it was applied to patients with severe pregnancy-induced hypertension. 212 cases of severe pregnancy-induced hypertension patients diagnosed clinically were selected to be randomly divided into the research group and the control group. The research groups were given phloroglucinol, while the control groups were given magnesium sulfate. The plasma angiotensin II and D-dimer index in patients were detected before treatment and after 7 days respectively with statistical analysis of results. The diffidence after treatment was statistically significant (P0.05). It showed that the research group could reduce the plasma D-dimer and angiotensin II index in severe pregnancy-induced hypertension patients, and its effect was significantly better than the control group according to the plasma D-dimer and angiotensin II index changes in patients, it indicated that it was effective of phloroglucinol treatment for patients with pregnancy-induced hypertension disease and superior to the western medicine conventional treatment, worth clinical promotion.

  20. Clinical Application of Transvaginal Ultrasound in Diagnosis of Ectopic Pregnancy%经阴道超声诊断宫外孕的临床应用体会

    Institute of Scientific and Technical Information of China (English)

    温美艳

    2011-01-01

    目的:探讨经阴道超声诊断宫外孕的临床价值。方法:采用PHILIPS实时超声诊断仪,对我院经腹部壁声(TAS)和阴道超声(TVS)检查的108例术前宫外孕患者进行回顾性分析。结果:TVS诊断异位妊娠76例,其中完整胎囊型18例,混合包块型51例,实性包块7例;32例异位妊娠经TAS诊断仅12例为异位妊娠。108例术后病理证实,输卵管妊娠103例(占95%),卵巢妊娠1例(占0.92%),宫角妊娠2例(占1.85%),TVS误诊2例(占2.6%)。TVS诊断符合率为96.3%,TAS诊断符合率为25%。结论:TVS诊断异位妊娠操作方便,诊断符合率高,对早期未破裂的输卵管妊娠具有重要诊断意义。%Objective: To explore the clinical effective of Transvaginal ultrasound in diagnosis of ectopic pregnancy.Methods: One hundred and eight cases of ectopic pregnancy received ultrasound examination before surgery in our hospital were conducted a retrospectively analysis.Results: There were 76 cases of ectopic pregnancy diagnosed according to transvaginal ultrasound(TVS) diagnosis,in which 18 cases were complete gestational sac type,51 cases were mixed type mass,7 cases were solid mass.Whereas,there were 12 cases in 32 cases diagnosed as ectopic pregnancy with abdominal ultrasound(TAS).Pathological diagnosis confirmed that there were 103 cases(95%) of tubal pregnancy,1 case of(0.92%) ovarian pregnancy,2 cases(1.85%) of cornual pregnancy.The diagnose accordance rate of TVS was 96.3% and 25% of TAS.Conclusion: With the easy operation and the high rate of diagnosis,TVS is valuable in diagnosis of ectopic pregnancy,especially the early unruptured tubal pregnancy.

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

    OpenAIRE

    2011-01-01

    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 ...

  2. 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.

  3. 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

  4. 妊娠合并白血病27例临床分析%Clinical Analysis of 27 Cases of Leukemia with Pregnancy

    Institute of Scientific and Technical Information of China (English)

    潘剑榕; 戴秋兰; 张延珍

    2015-01-01

    Objective To discuss the treatment and prognosis of leukemia complicating pregnan‐cy . Methods The clinical data of 27 cases of leukemia complicating pregnancy were retrospectively ana‐lyzed . Data analyzed included pregnancy features ,clinical treatment ,and pregnancy outcomes . Results (1)The clinical treatment during pregnancy and pregnancy outcome:Of the nine cases diagnosed before pregnancy ,eight were delivered in full‐term and one continued chemotherapy after abortion in the early pregnancy term . Of the three cases diagnosed in the early pregnancy term ,two received chemotherapy after abortion and one was delivered in full‐term . Of the eleven cases diagnosed in the mid term ,six were delivered in full‐term ,four received chemotherapy after induction of labor and one died . Four cases were diagnosed in the late pregnancy term ,all of whom were delivered in full‐term . (2) maternal and infant follow‐up:five cases were lost to follow‐up ,the rest were followed up for 6~144 months ,twelve cases were alive and ten cases were dead . There were nineteen live births in twenty seven cases . The Apgar scores for the 19 cases were greater than seven points after delivery ,they are all still alive . Among them we did not find any history of fetal malformation ,dysphasia ,leukemia . Conclusion Should leukemia pa‐tients in remission be careful about pregnancy ,there may be a good pregnancy outcome . There is risk as result of leukemia and the treatment for the leukemia to the fetus and pregnant women ,needing to be in a general hospital capable of the comprehensive treatment and supervision .%目的:探讨妊娠合并白血病患者的临床处理及妊娠结局。方法收集27例妊娠合并白血病患者的临床资料,回顾性分析其孕期特点、临床处理及妊娠结局进行分析。结果(1)孕期临床处理及妊娠结局:孕前诊断9例,8例均足月分娩,1例在孕早期流产后继续化疗。孕早期诊断3例:2

  5. 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…

  6. 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...

  7. A retrospective study of 100 cases of ectopic pregnancy: clinical presentation, site of ectopic and diagnosis evaluation

    Directory of Open Access Journals (Sweden)

    Manthan Patel

    2016-12-01

    Conclusions: Ampullary part of the fallopian tube is the most common site of ectopic pregnancy observed during our study. Complex adnexal mass was the most common finding on ultrasound. Surgical management by laparotomy and salpingectomy continues to be the preferred mode of management of ectopic pregnancy in our institution. [Int J Reprod Contracept Obstet Gynecol 2016; 5(12.000: 4313-4316

  8. Significance of (sub) clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy : a systematic review

    NARCIS (Netherlands)

    van den Boogaard, Emmy; Vissenberg, Rosa; Land, Jolande A.; van Wely, Madelon; van der Post, Joris A. M.; Goddijn, Mariette; Bisschop, Peter H.

    2011-01-01

    BACKGROUND: Thyroid dysfunction and thyroid autoimmunity are prevalent among women of reproductive age and are associated with adverse pregnancy outcomes. Preconception or early pregnancy screening for thyroid dysfunction has been proposed but is not widely accepted. We conducted a systematic review

  9. 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

  10. Study on Clinical Treatment of Patients With Pregnancy Complicated With Hyperthyroidism%妊娠合并甲亢患者的临床治疗探析

    Institute of Scientific and Technical Information of China (English)

    蔡志伟

    2015-01-01

    Objective Clinical treatment effect to patients with pregnancy complicated and hyperthyroidism is to be investigated. Methods Choose 31 patients with pregnancy complicated and hyperthyroidism who are treated in hospital from December 2012 to December 2013 and separate them into two groups,patients in control group are diagnosed but not given proper medication treatment,while patients in study group are given propylthiouracil oral medication treatment,and then compare patients’ hormone changes and their pregnancy outcomes between two groups. Results Patients’ hormone changes and their pregnancy outcomes in study group are quite favorable,and in addition,there is no improvement in patients’ hormone level in control group and their pregnancy outcomes are unfavorable; there is a treatment differential between two groups,and such a differential has statistic value(P<0.05).Conclusion propylthiouracil oral medication is of efficacy in treatment of patients with pregnancy complicated with hyperthyroidism,it is conducive to al eviating clinical symptoms and improving unfavorable pregnancy outcomes with satisfactory treatment efficiency, such a treatment approach is quite worthwhile to be promoted clinical y.%目的:探析妊娠合并甲亢患者的临床治疗效果。方法选取2012年12月~2013年12月间我院收治的妊娠合并甲亢患者31例,对照组确诊后并未应用相应药物治疗,治疗组应用丙基硫氧嘧啶口服治疗,比较两组激素水平变化与妊娠结局。结果治疗组激素水平改善显著,妊娠结局良好;对照组激素水平未见改善,结局不良,两组治疗效果差异有统计学意义(P<0.05)。结论妊娠合并甲亢应用丙基硫氧嘧啶口服能够控制临床症状,改善不良结局,疗效满意。

  11. Exercise in Pregnancy

    OpenAIRE

    2015-01-01

    Context: Health professionals who care for pregnant women should discuss potential health benefits and harms of exercise. Although most pregnant women do not meet minimal exercise recommendations, there are a growing number of physically active women who wish to continue training throughout pregnancy. Evidence Acquisition: A search of the Web of Science database of articles and reviews available in English through 2014. The search terms exercise pregnancy, strenuous exercise pregnancy, and vi...

  12. 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。

  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.

  14. 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.

  15. [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.

  16. Variant surface antigen-specific IgG and protection against clinical consequences of pregnancy-associated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Staalsoe, Trine; Shulman, Caroline E; Bulmer, Judith N;

    2004-01-01

    cytometry to measure VSA-specific IgG concentrations in plasma samples taken during child birth from 477 Kenyan women selected from a cohort of 910 women on the basis of HIV-1 status, gravidity, and placental histology. We measured VSA expressed by one placental P falciparum isolate and two isolates......G. No such relation was shown for concentrations of IgG with specificity for non-pregnancy-associated malaria VSA. INTERPRETATION: VSA-PAM-specific IgG protects against low birthweight and maternal anaemia. Our data indicate an important mechanism of clinical protection against malaria and raise hope for the clinical...... effectiveness of a potential VSA-based vaccine against pregnancy-associated malaria....

  17. TGF-beta expression during rat pregnancy and activity on decidual cell survival

    Directory of Open Access Journals (Sweden)

    Déry Marie-Claude

    2005-05-01

    Full Text Available Abstract Background During early rat pregnancy, trophoblast of the tiny embryo joins with the endometrium and epithelial cells undergo apoptosis. Near the end of pregnancy, regression of the decidua basalis (DB is also observed (from day 14 to 20. However, little is known about the intra-cellular and molecular mechanisms involved in apoptosis regulation in the uterus during pregnancy. The objective of the present study was to investigate the presence and the developmental expression of transforming growth factor-beta isoforms (TGF-beta well known differentiation factor in the rat endometrium throughout pregnancy and its action in vitro using cultured endometrial stromal cells. Methods In vivo: Rats were killed at different days of pregnancy (days 2–20 and uteri removed to collect endometrial protein extracts or the uteri were fixed, embedded and sectioned for immunohistochemistry (IHC and in situ cell death analyses using TdT-mediated dUTP nick end labeling (TUNEL. In vitro: Rats were ovariectomized and decidualization was induced using sex steroids. Endometrial stromal decidual cells were then collected and cultured. Results An increase of apoptosis in the DB on days 14, 16 and 18 was observed. Cleaved caspase-3 was clearly detected during regression of the DB by Western analysis and immunofluorescence. Western analyses using endometrial protein extracts demonstrated that TGF-beta1, TGF-beta2 and TGF-beta3 were highly expressed at the time of DB regression (day 14. During early pregnancy, TGF-beta1 and -beta2 expressions raised at days 5.5 to 6.5. TGF-beta3 protein was not detected during early pregnancy. IHC analyses revealed that TGF-beta1 and -2 were found surrounding both epithelium (luminal and glandular in the stroma compartment at the implantation site, and TGF-beta3 was mainly located surrounding endometrial epithelium in the stroma compartment. Smad2 phosphorylation was increased at the time of DB regression. In vitro studies using

  18. 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.

  19. HLA-G promotes myeloid-derived suppressor cell accumulation and suppressive activity during human pregnancy through engagement of the receptor ILT4.

    Science.gov (United States)

    Köstlin, Natascha; Ostermeir, Anna-Lena; Spring, Bärbel; Schwarz, Julian; Marmé, Alexander; Walter, Christina B; Poets, Christian F; Gille, Christian

    2017-02-01

    Establishing and maintaining maternal-fetal tolerance is essential for a successful pregnancy; failure of immunological adaptation to pregnancy leads to severe complications such as abortion or preterm delivery. Myeloid-derived suppressor cells (MDSCs) are innate immune cells that suppress T-cell responses, expand during pregnancy and thus may play a role in tolerance induction. Human leucocyte antigen G (HLA-G) is a major histocompatibility complex (MHC) I molecule with immune-modulatory properties, which is expressed during pregnancy. Here, we investigated the impact of HLA-G on MDSCs accumulation and activation in pregnant women. We demonstrate that granulocytic MDSCs (GR-MDSCs) express receptors for HLA-G, namely immunoglobulin-like transcript (ILT) 2 and 4, and that ILT4-expression by GR-MDSCs is regulated during pregnancy. Stimulation with soluble HLA-G (sHLA-G) increased suppressive activity of GR-MDSCs, induced MDSCs from peripheral blood mononuclear cells (PBMCs) and led to phosphorylation of the signal transducer and activator of transcription 3 (STAT3) and induction of indoleamine-2,3-dioxygenase (IDO) in myeloid cells. Effects of sHLA-G on MDSC accumulation were mediated through ILT4. These results suggest an interaction between MDSCs and HLA-G in humans as a potential mechanism for maintaining maternal-fetal tolerance. Modulating MDSC function during pregnancy via HLA-G might provide new opportunities for a therapeutic manipulation of immunological pregnancy complications.

  20. RelB activation in anti-inflammatory decidual endothelial cells: a master plan to avoid pregnancy failure?

    Science.gov (United States)

    Masat, Elisa; Gasparini, Chiara; Agostinis, Chiara; Bossi, Fleur; Radillo, Oriano; De Seta, Francesco; Tamassia, Nicola; Cassatella, Marco A; Bulla, Roberta

    2015-10-14

    It is known that excessive inflammation at fetal-maternal interface is a key contributor in a compromised pregnancy. Female genital tract is constantly in contact with microorganisms and several strategies must be adopted to avoid pregnancy failure. Decidual endothelial cells (DECs) lining decidual microvascular vessels are the first cells that interact with pro-inflammatory stimuli released into the environment by microorganisms derived from gestational tissues or systemic circulation. Here, we show that DECs are hypo-responsive to LPS stimulation in terms of IL-6, CXCL8 and CCL2 production. Our results demonstrate that DECs express low levels of TLR4 and are characterized by a strong constitutive activation of the non-canonical NF-κB pathway and a low responsiveness of the canonical pathway to LPS. In conclusion, DECs show a unique hypo-responsive phenotype to the pro-inflammatory stimulus LPS in order to control the inflammatory response at feto-maternal interface.

  1. Molar tubal ectopic pregnancy: Report of two cases.

    Science.gov (United States)

    Mbarki, Chaouki; Jerbi, Emna; Hsayaoui, Najeh; Zouari, Fatma; Ben Brahim, Ehsen; Oueslati, Hedhili

    2015-06-01

    Ectopic molar pregnancy is a rare occurrence and consequently not often considered as a diagnostic possibility. We report two cases of molar hydatidiform tubal pregnancy. Diagnosis of ectopic pregnancy was confirmed on clinical biological and sonographic investigations. Diagnosis of molar pregnancy was done on histopathology. The clinical course was favorable for both patients. Although rare, molar changes can occur at any site of an ectopic pregnancy. Clinical diagnosis of a molar pregnancy is difficult but histopathology is the gold standard for diagnosis.

  2. 重复异位妊娠32例临床分析%Recurrent ectooic pregnancy 32 cases clinical analysis.

    Institute of Scientific and Technical Information of China (English)

    谢珊莉; 杨晋蓉

    2011-01-01

    Objective To investigate the clinical features, diagnosis, treatment and prevention of recurrent ectopic pregnancy.Methods Clinical data of 32 cases of recurrent ectopic pregnancy were reviewed from October 2005 to October 2010 in our hospital.Results Of 32 ectopic pregnancy cases, ectopic pregnancy accounted for 7.17% over the same period, the mean age of(34 ±O.8) years old, the average interval between ectopic pregnancy 38.72 months, clinical symptoms including menopause, abdominal pain, vaginal bleeding, positive gynecological examining, higher HCG and B ultrasound showing adnexal mass and so on.Of 32 cases, 4 patients with drug-conservative treatment, 28 cases of surgical treatment, conservative surgery in 11 cases, 17 cases of ipsilateral salpingectomy, plus 5 cases of contralateral tubal ligation, surgery confirmed they were all tubal pregnancy, pelvic adhesions in 21 cases (75%).Conclusion Recurrent ectopic pregnancy usually occurs in young women, The risk factors are pelvic inflammatory disease, the first ectopic pregnancy and conservative treatment.Reduce the incidence of pelvic inflammatory disease, a reasonable and timely treatment of the first ectopic pregnancy and postoperative effective monitoring and treatment is an effective prevention method of recurrent ectopic pregnancy.%目的 探讨重复异位妊娠的临床特征、诊断、治疗及预防.方法 回顾性分析2005年10月~2010年10月在我院住院治疗的32例重复异位妊娠的临床资料.结果 异位妊娠32例,占同期异位妊娠7.17%.平均发病年龄(34±0.8)岁,两次异位妊娠平均间隔时间38.72个月,多有停经、腹痛、阴道流血、妇检阳性、hCG增高及B超示附件包块等表现,4例药物保守治疗成功,28例手术治疗,其中保守手术11例,患侧输卵管切除17例,加对侧输卵管结扎5例,术中证实均系输卵管妊娠,有盆腔粘连21例(75%).结论 重复异位妊娠好发于年轻女性,盆腔炎症、首次异位妊娠保

  3. Pregnancy and Lupus Nephritis.

    Science.gov (United States)

    Kattah, Andrea G; Garovic, Vesna D

    2015-09-01

    The management of lupus nephritis in pregnancy presents a diagnostic and therapeutic challenge for providers. Pregnancy creates a series of physiologic changes in the immune system and kidney that may result in an increased risk of disease flare and adverse maternal and fetal outcomes, such as preeclampsia, fetal loss, and preterm delivery. Conception should be delayed until disease is in remission to ensure the best pregnancy outcomes. Maternal disease activity and fetal well-being should be monitored closely by an interdisciplinary team, including obstetricians, rheumatologists, and nephrologists throughout pregnancy. Careful attention must be paid to the dosing and potential teratogenicity of medications.

  4. 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.

  5. Clinic and pathological characteristics observation of early pregnancy cesarean scar pregnancy%早孕期剖宫产瘢痕妊娠的临床及病理特点观察

    Institute of Scientific and Technical Information of China (English)

    蒯莉莉

    2015-01-01

    目的:探讨早孕期剖宫产瘢痕妊娠不同分型的临床与病理学特点。方法:收治剖宫产瘢痕妊娠患者60例,回顾性分析其临床资料及病理学特点。结果:50例患者经超声检查确诊,诊断率83.33%,另10例患者通过MRI检查确诊;40例患者的病理标本发生病理变化,病理变化概率66.67%;40例患者中外生型28例,内生型12例,外生型的病理改变率明显高于内生型(P<0.05)。结论:内生型与外生型剖宫产瘢痕妊娠的临床症状及病理特点存在较大不同,而平滑肌肌层缝隙是导致剖宫产瘢痕妊娠产生的首要因素。MRI检查可明确诊断剖宫产瘢痕妊娠的临床分型,同时还可借助病理组织检查结果为疾病确诊提供支持。%Objective:To explore the clinic and pathological characteristics of early pregnancy cesarean scar pregnancy in different type.Methods:60 patients with cesarean scar pregnancy were selected.The clinical data and pathological characteristics were retrospectived analyzed.Results:50 patients were diagnosed by ultrasound examination,and the diagnosis rate was 83.33%. Other 10 patients were diagnosed by MRI examination.The pathological specimens of 40 patients had pathological changes,and the probability of pathological changes was 66.67%.In 40 patients,28 cases were exogenous type,and 12 cases were endogenous type.The pathological change rate of exogenous type was significantly higher than that of endogenous type(P<0.05).Conclusion:The clinical symptoms and pathological characteristics of endogenous type and exogenous type cesarean scar pregnancy are quite different,and the smooth muscle layer crack is the main cause of cesarean scar pregnancy.MRI examination can confirm the diagnosis of cesarean scar pregnancy clinical typing,but also with the histopathologic examination results provide support for the disease diagnosis.

  6. 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.

  7. Acquired Activated Protein C Resistance, Thrombophilia and Adverse Pregnancy Outcomes: A Study Performed in an Irish Cohort of Pregnant Women

    Directory of Open Access Journals (Sweden)

    Sara Sedano-Balbás

    2011-01-01

    Full Text Available The combination of thrombophilia and pregnancy increases the risk of thrombosis and the potential for adverse outcomes during pregnancy. The most significant common inherited risk factor for thrombophilia is activated protein C resistance (APCR, a poor anticoagulant response of APC in haemostasis, which is mainly caused by an inherited single-nucleotide polymorphism (SNP, factor V G1691A (FV Leiden (FVL, referred as inherited APCR. Changes in the levels of coagulation factors: FV, FVIII, and FIX, and anticoagulant factors: protein S (PS and protein C (PC can alter APC function causing acquired APCR. Prothrombin G20210A and methylenetetrahydrofolate reductase (MTHFR C677T are prothrombotic SNPs which in association with APCR can also increase the risk of thrombosis amongst Caucasians. In this study, a correlation between an acquired APCR phenotype and increased levels of factors V, VIII, and IX was demonstrated. Thrombophilic mutations amongst our acquired APCR pregnant women cohort are relatively common but do not appear to exert a severe undue adverse effect on pregnancy.

  8. 彩色多普勒超声诊断异位妊娠的临床意义%Clinical assessment of ectopic pregnancy by color Doppler sonography

    Institute of Scientific and Technical Information of China (English)

    张敏

    2011-01-01

    Objective: To evaluate clinical sigiificance of color Doppler ultrasound in diagnosis of ectopic pregnancy.Methods: 176 patients with suspected ectopic pregnancy were checked by transvaginal two-dimensional ultrasound, color Doppler flow imaging (CDFI), the results of the ultrasound and clinical pathology and follow-up datas were compared.Results: 148 cases of ultrasound diagnosis of ectopic preWancy and surgical and conservative treatment of clinically diagnosed 143 cases, false positive rate was 0.2% and false negative rate 0.14%, diagnostic accuracy was 96.6%.Conclusion:Color Doppler ultrasound diagnosis of ectopic pregnancy with high accuracy, diagnosis of ectopic pregnancy is intuitive,safe, convenient and reproducible is good, it can proviod reliable clinical basis for the diagnoaia.It has important clinical value and is preferred examination method in the ditWiosis of ectopic pregnancy.%目的:探讨彩色多普勒超声诊断异位妊娠的临床意义.方法:对176例临床可疑异位妊娠的患者,采用经阴道二维超声、彩色多普勒(CDFI)进行检查,将超声结果与临床病理以及随访资料进行对比.结果:超声诊断异位妊娠148例,经临床手术及保守治疗后确诊143例,假阳性率0.2%,假阴性率0.14%,诊断准确率为96.6%.结论:彩色多普勒超声检查对异位妊娠诊断准确性高,对异位妊娠诊断直观、安全、方便、重复性好,能为临床提供可靠诊断依据,具有重要的临床应用价值,是诊断异位妊娠的首选检查方法.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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。

  14. Clinical features of maternal and neonatal outcomes of twin preeclampsia pregnancies%双胎妊娠并发子痫前期临床比较分析

    Institute of Scientific and Technical Information of China (English)

    梅吉; 乔东艳; 徐玉娟; 于红

    2014-01-01

    目的:探讨双胎妊娠并发子痫前期的临床特点及围产结局。方法:回顾分析江阴市人民医院妇产科及东南大学附属中大医院妇产科2009年1月至2012年12月收治的双胎妊娠并发子痫前期30例孕妇及同期双胎正常妊娠30例孕妇的临床资料。对所有纳入对象进行临床流行病学调查,分析比较两组临床资料,包括孕妇一般情况、个人史、既往史及家族史、月经及婚育史、孕期情况和分娩结局等。结果:双胎妊娠并发子痫前期组与双胎正常妊娠组孕前及分娩前BMI、孕期体重增长比较,差异有统计学意义(均P<0.05);双胎妊娠并发子痫前期组中低蛋白血症、早产、产后出血发生率显著高于双胎正常妊娠组(均P<0.05);双胎正常妊娠组胎膜早破发生率高于双胎妊娠并发子痫前期组(P<0.05);双胎妊娠并发子痫前期组中血白蛋白、血小板计数显著低于双胎正常妊娠组,而血肌酐显著高于双胎正常妊娠组(均P<0.05);双胎妊娠并发子痫前期组剖宫产率高于双胎正常妊娠组(P<0.05)。结论:临床资料分析显示,孕前BMI过高、孕期体重增长过多为双胎妊娠并发子痫前期的常见表现;早产、低蛋白血症、产后出血为双胎妊娠并发子痫前期较常见的并发症;双胎妊娠并发子痫前期可出现血小板减少、血肌酐升高、白蛋白降低等表现。%Objective: To explore clinical features of maternal and neonatal outcomes of twin preeclampsia pregnancies .Methods:Thirty twin pregnant women with preeclampsia were selected as observation group .Thirty cases of normal twin pregnant women , clinical data over the same period , were selected as a control group .All of them came from Jiangyin People's Hospital and Zhongda Hospital Affiliated to the Southeast University from January 2009 to December 2012.All of them were Chinese Han people and all

  15. 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.

  16. Hypertension in pregnancy.

    Science.gov (United States)

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

    Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders.

  17. 宫外孕的彩超诊断价值及临床意义%Diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2014-01-01

    目的:探讨彩超对宫外孕的诊断价值以及临床意义。方法回顾性分析88例宫外孕患者的临床及影像学资料。结果超声检查的88例宫外孕患者,诊断符合82例,误诊6例,确诊率为93.18%。结论彩超对宫外孕的诊断分辨力高、简便、快捷、诊断符合率较高,能为临床提供及时和切实可靠的诊断依据。%Objective To explore the diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy. Methods A retrospective analysis was made on the clinical and imaging data of 88 ectopic pregnancy patients. Results Among the 88 cases, who underwent color Doppler ultrasound examination, there were 82 cases with qualified diagnosis and 6 misdiagnosed cases. The accurate diagnosis rate was 93.18%. Conclusion Color Doppler ultrasound for ectopic pregnancy has the advantages of high diagnostic definition, convenience, high speed, and high diagnose accordance rate, thus it can provide timely and reliable information for clinicosis.

  18. Clinical analysis of 3 patients with acute fatty liver of pregnancy%妊娠期急性脂肪肝3例临床分析

    Institute of Scientific and Technical Information of China (English)

    虞晴

    2011-01-01

    Objective: To study the clinical diagnosis, treatment and prognosis of acute fatty liver of pregnancy (AFLP), and to decrease the fatality rate of pregnant and lying-in women and perinatal fetus. Methods: The clinical data of 3 cases of AFLP patients were retrospectively analyzed. Results: 3 cases of AFLP patients were single birth and the late pregnancy. All cases had gastrointestinal symptoms. Cesarean sections were done immediately and all patients and babies were survived. Conclusion: Early diagnosis is key to reduce motality of AFLP patients. Timely termination of pregnant and infusion of high dose of fresh plasma can increase survival rate of AFLP patients.%目的:探讨妊娠期急性脂肪肝(acute fatty liver of pregnancy,AFLP)的临床诊断、治疗及预后,降低孕产妇及围生儿病死率.方法:回顾性分析3例AFLP患者的临床资料.结果:3例患者均为单胎妊娠,发生于妊娠晚期,有明显的消化道症状,入院后立即行剖宫产术,母儿均存活.结论:早期诊断是降低AFLP患者死亡率的关键,立即终止妊娠和术后输注大剂量新鲜血浆可提高患者的生存率.

  19. N-Carbamylglutamate Enhances Pregnancy Outcome in Rats through Activation of the PI3K/PKB/mTOR Signaling Pathway

    OpenAIRE

    Xiangfang Zeng; Zhimin Huang; Xiangbing Mao; Junjun Wang; Guoyao Wu; Shiyan Qiao

    2012-01-01

    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 determi...

  20. Pregnancy outcome after intracytoplasmic sperm injection with strontium oocyte activation in a globozoospermic patient

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yu Yang; Jing Wang; Jia-Yin Liu; Yan Gao; Zuo-Min Zhou; Jia-Hao Sha; Wei Zhang; Yu-Gui Cui; Xiao-Qiao Qian

    2012-01-01

    Dear Editor,I am Dr Xiao-Yu Yang,from the Center of Clinical Reproductive Medicine in the First Affiliated Hospital at the NanJing Medical University,Nanjing,China.We present here a case report of a globozoospermic patient whose partner became pregnant after intracytoplasmic sperm injection (ICSI) with assisted oocyte activation (AOA).Globozoospermia is characterized by the presence of 100% round- headed spermatozoa lacking an acrosome.The lack of the acrosome,which renders spermatozoa unable to bind to the zona pellucida or fuse with the oocyte oolemma,is considered to be the cause of infertility in these patients.

  1. 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。

  2. 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.

  3. The Clinical Analysis of Examination by Abdominal Ultrasound in Diagnosis of Ectopic Pregnancy%腹部超声诊断宫外孕的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘治荣

    2015-01-01

    Objective Clinical value of examination by abdominal ultrasound in diagnosis of ectopic pregnancy is to be investigated. Methods Chose 43 patients with ectopic pregnancy received and treated in our hospital from May 2013 to May 2014 and examined by abdominal ultrasound,then compare patients’examination results to their pathology result in order to analyze the application value of abdominal ultrasound examination in diagnosis of ectopic pregnancy. Results there were 43 cases diagnosed as ectopic pregnancy by pathology examination and 38 cases were diagnosed by abdominal ultrasound examination; the diagnosis accuracy rate was up to 88.37%; there was no statistic differential between pathology examination and abdominal ultrasound examination(P>0.05). Conclusion Adominal ultrasound examination is the primary approach to diagnose ectopic pregnancy; it is of guidance significance and practical in clinical treatment of ectopic pregnancy.%目的:分析宫外孕应用腹部超声诊断的临床价值。方法选取2013年5月~2014年5月间我院收治的宫外孕患者43例,均给予腹部超声诊断,并与病理结果作为对照,分析腹部超声诊断在宫外孕中的应用价值。结果病理证实宫外孕43例,腹部超声检出38例,准确率为88.37%,腹部超声诊断结果与病理结果比较差异无统计学意义(P>0.05)。结论腹部超声是宫外孕的首选诊断方法,对临床治疗具有指导意义,切实可行。

  4. 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

  5. Hypertension in pregnancy.

    Science.gov (United States)

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

    Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease.

  6. 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...

  7. Acute appendicitis in pregnancy

    OpenAIRE

    Ortiz-Gualdrón César Augusto

    2012-01-01

    Acute appendicitis is the most common non-obstetric surgery pathology in pregnancy, itsincidence can be varied and occurs at a higher rate during the first and second trimesterof gestation. Its diagnosis is difficult and can be confused by the anatomical andphysiological changes during pregnancy, which alter their clinical presentation. Commonsymptoms are abdominal located pain, vomiting and nausea. The diagnosis is mainlyclinical, but laboratory tests and additional imaging help confirm or r...

  8. 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...

  9. Ultrasound diagnosis of ectopic pregnancy in 56 cases and its clinical application value%超声诊断异位妊娠56例及其临床应用价值

    Institute of Scientific and Technical Information of China (English)

    朱渊

    2016-01-01

    Objective:To explore the accuracy of transabdominal ultrasound in the diagnosis of ectopic pregnancy.Methods:Compared with the results of operation and pathological examination,the results of ultrasonic examination in 56 cases of ectopic pregnancy were analyzed.Results:In 56 cases of ectopic pregnancy,there were 31 cases of tubal pregnancy,2 cases of cervical pregnancy,1 case of abdominal pregnancy,1 case of ovarian pregnancy,1 case of right uterine horn pregnancy and 10 cases of old ectopic pregnancy.Conclusion:Ultrasound diagnosis of ectopic pregnancy has a high accuracy.It has a extremely important clinical application value,and it has a very important reference value on the choice of treatment schedule for patients with ectopic pregnancy.%目的:探讨经腹超声(TAS)诊断异位妊娠的准确性。方法:与手术和病理检查结果对照,分析56例异位妊娠超声检查结果。结果:56例异位妊娠中有输卵管妊娠31例,宫颈妊娠2例,腹腔妊娠1例,卵巢妊娠1例,右侧宫角妊娠1例,陈旧性宫外孕10例。结论:超声诊断异位妊娠具有很高的准确率,有极其重要的临床应用价值,并对异位妊娠患者选择治疗方案有很重要的参考价值。

  10. [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.

  11. Pregnancy ultrasound

    Science.gov (United States)

    ... the baby's age Look for problems, such as ectopic pregnancies or the chances for a miscarriage Determine the ... to some of the following conditions: Birth defects Ectopic pregnancy Poor growth of a baby while in the ...

  12. Ectopic Pregnancy

    Science.gov (United States)

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

  13. Ectopic Pregnancy

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... low blood pressure (also caused by blood loss) lower back pain continue What Causes an Ectopic Pregnancy? An ectopic ...

  14. Molar Pregnancy

    Science.gov (United States)

    ... may check for other medical problems, including: Preeclampsia Hyperthyroidism Anemia A molar pregnancy can't continue as a normal viable pregnancy. To prevent complications, the molar tissue must be removed. Treatment usually consists of one or more of the ...

  15. What Health Problems Can Develop during Pregnancy?

    Science.gov (United States)

    ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications What health problems can develop during pregnancy? Skip sharing on ...

  16. CDC Vital Signs: Preventing Teen Pregnancy

    Science.gov (United States)

    ... Press Kit Read the MMWR Science Clips Preventing Teen Pregnancy A Key Role for Health Care Providers Language: ... The Federal government is Supporting efforts to prevent teen pregnancy by providing affordable family planning services. Developing clinical ...

  17. 妊娠高血压疾病终止妊娠时机及母婴结局临床分析%Hypertensive disorders of pregnancy and maternal and fetal outcomes of pregnancy termination timing of clinical analysis

    Institute of Scientific and Technical Information of China (English)

    李新琳

    2012-01-01

    目的:探讨妊娠期高血压疾病与母婴结局的关系.方法:回顾性分析2003年6月至2012年3月我院就诊的459例妊娠期高血压疾病患者的临床资料,分为重度子痫前期组、轻度子痫前期组、妊娠高血压组,对比研究母婴并发症及分娩方式.结果:妊娠高血压组胎儿窘迫、早产的发生率显著低于轻度组;轻度组孕产妇FGR、并发症显著低于重度组(P<0.0.01);妊娠期高血压组产后大出血的发生率显著低于轻度组,轻度组产后出血、早产、新生儿窒息、胎儿窘迫显著低于重度组(P<0.05).结论:围产儿预后与妊娠期高血压疾病的严重程度成正比,适时选择剖宫产终止妊娠是重要的治疗措施,对提高母婴的生存率有重要意义.%Objective: To investigate hypertensive diseases of pregnancy and maternal and fetal outcomes of relationship.Methods A retrospective analysis of 2003 June to 2012 March in our hospital, 459 cases of hypertensive disorders in pregnancy in patients with clinical data, according to the new diagnostic standard: classification of severe preeclampsia group, mild preeclampsia, gestational hypertensive group, comparative study of maternal complications and delivery mode.ResultS: The gestational hypertensive group fetal distress, the incidence of preterm birth was significantly lower than that of the mild group; group FGR, mild maternal complications were significantly lower than those of severe group (P<0.01); the gestational hypertensive group of postpartum hemorrhage incidence was significantly lower than that of the mild group, mild group of postpartum hemorrhage, neonatal asphyxia, premature delivery, fetal distress was significantly lower than that of the severe group (P <0.05).Conchision: The perinatal prognosis in patients with hypertensive disorder complicating pregnancy proportional to its severity, timely choice of cesarean section pregnancy termination are important therapeutic measures, to

  18. 异位妊娠的临床超声诊断分析%Analysis of clinical ultrasound diagnosis of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈梦宇

    2014-01-01

    Objective To analyze the application value of ultrasound examination in the diagnosis of ectopic pregnancy. Methods 84 patients suspected with ectopic pregnancy were selected and given ultrasonic examination.The ultrasonic examination results were compared with the surgical and pathological examination results. Results All the 84 patients suspected with ectopic pregnancy were diagnosed with ectopic pregnancy by surgical and pathological examination. Seventy-seven cases were detected by ultrasound,of which 27 cases were ruptured type,20 cases were non-ruptured type,7 cases were old type and 23 cases were abortive type,and all were confirmed by surgical and pathological exami-nation.The ultrasound detection rate of ectopic pregnancy was 91.7%. Conclusion Ultrasound examination can increase the diagnosis rate of ectopic pregnancy largely,it is worthy of popularization and application in clinic.%目的:分析超声检查在宫外孕诊断中的应用价值。方法选取疑似异位妊娠患者84例,均行超声检查,并将超声检查结果与手术及病理检查结果进行对比。结果84例疑似异位妊娠的患者手术及病理检查均确诊为异位妊娠,超声检出77例,其中破裂型27例,未破裂型20例,陈旧型7例,流产型23例,均经手术及病理检查证实,异位妊娠超声检出率为91.7%。结论超声检查可大幅提高异位妊娠的诊断率,值得临床推广应用。

  19. 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.

  20. Clinical analysis of 34 cases of measles infection in pregnancy%妊娠麻疹34例临床分析

    Institute of Scientific and Technical Information of China (English)

    韩旭; 杨积明

    2012-01-01

    目的探讨妊娠妇女感染麻疹的症状、体征及妊娠结局,为妊娠麻疹的防治提供依据.方法回顾性分析2005年1月-2010年5月天津市传染病医院34例妊娠合并麻疹患者的麻疹疫苗接种史、临床表现、检查结果、并发症以及治疗和转归.结果在34例中,23例早、中期妊娠合并麻疹发生流产及死胎5例,占21.7%,高于正常妊娠自然流产发病率(10%~15%);11例晚期妊娠中2例早产,2例因宫内窘迫行剖宫术,3例新生儿麻疹.结论建议未患过麻疹或未接种过麻疹疫苗的育龄期妇女,在准备怀孕前注射麻疹疫苗,注射疫苗与准备怀孕的时间至少间隔1个月.%Objective To investigate the signs and symptoms and outcome of measles infection in pregnancy, so as to pro vide evidence for the prevention and treatment of measles infection in pregnancy. Methods A retrospective study was carried out on measles vaccination history, clinical manifestations, laborotary results, complications, treatment and outcome in 34 cases of measles infection in pregnancy treated in Tianjin Infectious Diseases Hospital from Jan. 2005 to May 2010. Results Abortion and stillbirth occurred in 5 (21.7%) patients among 23 patients in the early and middle stages of pregancy, and the percentage was high er than that of normal incidence of spontaneous abortion, which was 10% to 15%. Of 11 patients in the late stage of pregnancy, preterm birth occurred in 2 patients, caesarean section was performed on 2 patients due to fetal distress, and 3 patients had neonates with measles. Conclusions It is suggested that the women in childbearing age who have not been infected with measles or vacci nated with a measles vaccine should be given measle vaccination before the preparation for pregnancy, and the interval between vaccination and preparation for pregnancy should be at least 1 month.

  1. 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...... activity in first trimester by a telephone interview and categorised women a priori into seven groups: 0 (reference), 1-44, 45-74, 75-149, 150-269, 270-419 and 420+ minutes/week. Pre-eclampsia diagnoses were extracted from the Danish National Patient Registry. A number of potential confounders were...... adjusted for by logistic regression. MAIN OUTCOME MEASURES: Pre-eclampsia and severe pre-eclampsia. RESULTS: The two highest physical activity levels were associated with increased risk of severe pre-eclampsia compared with the nonexercising group, with adjusted odds ratios of 1.65 (95% CI: 1...

  2. 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

    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...... moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (/=4500 g) was also unchanged. In conclusion, in this large population-based study, we found...... no association between sports and leisure-time physical activity and low-birth weight, high-birth weight, or average-birth weight....

  3. 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 ...

  4. Bed rest during pregnancy

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000581.htm Bed rest during pregnancy To use the sharing features on ... your daily activities. Why Do I Need Bed Rest? Bed rest used to be recommended routinely for ...

  5. 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.

  6. To Investigate the Clinical Value of Early Diagnosis of Ectopic Pregnancy B Ultrasound%探讨B超对异位妊娠早期诊断的价值

    Institute of Scientific and Technical Information of China (English)

    玛依拉·达吾列提

    2015-01-01

    目的探讨B超对异位妊娠的诊断价值。方法对在我服务站检查的15例异位妊娠患者资料进行回顾性分析。结果输卵管妊娠9例,卵巢妊娠4例,右宫角妊娠1例,1例黄体破裂误诊为异位妊娠,准确率高达93.3%。结论腹部超声检查是一种无创性检查方法,能及时、准确诊断异位妊娠,对临床治疗具有指导意义。%Objective To investigate the B ultrasound diagnostic value of ectopic pregnancy.Methods A retrospective analysis of clinical data of 15 patients with ectopic pregnancy.Results 9 cases of tubal pregnancy,4 cases of ovarian pregnancy,1 cases of right cornual pregnancy,1 cases of rupture of corpus luteum misdiagnosed as ectopic pregnancy,The accuracy rat is as high as 93.3%. Conclusion Abdominal ultrasonography is a noninvasive method,can diagnose ectopic pregnancy in time and accurately,and has significance in guiding clinical treatment.

  7. 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

  8. 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

  9. 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

  10. 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

  11. Clinical analysis of caesarean section scar pregnancy 42 cases%42例剖宫产子宫切口疤痕妊娠的临床分析

    Institute of Scientific and Technical Information of China (English)

    张娜

    2014-01-01

    OBJECTIVE: The clinical features of caesarean section scar pregnancy and treatment were analyzed and discussed. Methods: 42 patients in our hospital caesarean section scar pregnancy patients, for example, clinical characteristics of al patients were analyzed, the implementation of targeted therapy. Results: The patients had a history of menopause, more performance for vaginal bleeding. Under section B surreal anterior muscular presence blob, ultrasonography showed the presence of clumps of color flow signals around. Al patients were discharged after treatment. Conclusion: For patients with previous caesarean section scar pregnancy, need to be implemented in the clinical condition of the patient for targeted therapy, diagnostics and strengthen efforts to reduce the rate of misdiagnosis.%目的:对剖宫产子宫切口疤痕妊娠的临床特点以及治疗进行分析和探讨。方法:选取我院收治的42例剖宫产子宫切口疤痕妊娠患者为例,对所有患者的临床特点进行分析,实施针对性治疗。结果:患者均存在停经史,多表现为阴道出血。B超现实前壁下段肌层存在团状物,彩超显示团块周围存在彩色血流信号。患者经治疗均全部出院。结论:对于剖宫产子宫切口疤痕妊娠患者,在临床上需要针对患者的病情实施针对性治疗,并加强诊断力度,减少误诊率。

  12. The Effect of High Dose Folic Acid throughout Pregnancy on Homocysteine (Hcy Concentration and Pre-Eclampsia: A Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Manizheh Sayyah-Melli

    Full Text Available Pre-eclampsia is a pregnancy-related multi-systemic hypertensive disorder and affects at least 5% of pregnancies. This randomized clinical trial aimed at assessing the effect of low doses and high doses of folic acid on homocysteine (Hcy levels, blood pressure, urea, creatinine and neonatal outcome. A randomized clinical trial was done at Alzahra Teaching Hospital, Tabriz University of Medical Sciences from April 2008 to March 2013. Four-hundred and sixty nulliparous pregnant women were randomly assigned into two groups. Group 1 (n = 230 received 0.5 mg of folic acid and group 2 (n = 230 received 5 mg of folic acid per daily. They were followed until delivery. Blood pressure and laboratory changes, including plasma Hcy levels, were measured and compared between the groups. Homocysteine concentrations were significantly higher at the time of delivery in group 1 (13.17±3.89 μmol/l than in group 2 (10.31±3.54, μmol/l (p<0.001. No statistically significant differences were observed in systolic and diastolic blood pressure (p = 0.84 and 0.15, respectively. Birth weight was significantly higher in group 2 (p = 0.031 and early abortion was significantly higher in group 1 than group 2 (p = 0.001. This study has provided evidence that a high dosage of folic acid supplements throughout pregnancy reduces Hcy concentrations at the time of delivery.Iranian Registry of Clinical Trials IRCT201402175283N9.

  13. 妊娠期急性脂肪肝17例临床分析%Clinical analysis of 17 cases with acute fatty liver of pregnancy

    Institute of Scientific and Technical Information of China (English)

    龙丽; 王玉珏; 杨业洲

    2013-01-01

    Objective To investigate the clinical characteristics, diagnosis, treatment and maternal-fetal prognosis of acute fatty liver of pregnancy ( AFLP) . Methods A retrospective analysis was performed in 17 cases with AFLP from January 2003 to December 2012 at the department of gynecology and obstetrics in our hospital. Results In 17 cases with AFLP,there were two cases of maternal deaths (11. 2% ) and two cases of fetal death (11. 2% ). The clinical manifestations of the most patients were gastrointestinal symptoms. Laboratory examinations showed abnormal liver function and disturbances of blood coagulation. Treatments included timely termination of pregnancy, comprehensive treatment and intensive care. Conclusions AFLP is a dangerous disease with high rate of mother-fetal death. The understanding of the diseases, timely diagnosis and comprehensive treatment may improve the clinical outcome.%目的 探讨妊娠期急性脂肪肝(acute fatty liver of pregnancy,AFLP)的临床特征、诊治及母儿预后.方法 回顾性分析17例AFLP患者的临床资料,总结患者症状、体征、实验室检查及治疗情况.结果 17例AFLP中,孕产妇死亡2例(11.2%),胎儿死亡2例(11.2%).就诊时患者主要表现为消化道症状,实验室检查提示肝功能异常及凝血机制障碍.治疗措施包括及时终止妊娠、综合治疗、加强监护.结论 AFLP发病凶险,母-胎死亡率高;加强认识、及时诊断及综合治疗可改善其治疗结局.

  14. Miniaturization and globalization of clinical laboratory activities.

    Science.gov (United States)

    Melo, Murilo R; Clark, Samantha; Barrio, Daniel

    2011-04-01

    Clinical laboratories provide an invaluable service to millions of people around the world in the form of quality diagnostic care. Within the clinical laboratory industry the impetus for change has come from technological development (miniaturization, nanotechnology, and their collective effect on point-of-care testing; POCT) and the increasingly global nature of laboratory services. Potential technological gains in POCT include: the development of bio-sensors, microarrays, genetics and proteomics testing, and enhanced web connectivity. In globalization, prospective opportunities lie in: medical tourism, the migration of healthcare workers, cross-border delivery of testing, and the establishment of accredited laboratories in previously unexplored markets. Accompanying these impressive opportunities are equally imposing challenges. Difficulty transitioning from research to clinical use, poor infrastructure in developing countries, cultural differences and national barriers to global trade are only a few examples. Dealing with the issues presented by globalization and the impact of developing technology on POCT, and on the clinical laboratory services industry in general, will be a daunting task. Despite such concerns, with appropriate countermeasures it will be possible to address the challenges posed. Future laboratory success will be largely dependent on one's ability to adapt in this perpetually shifting landscape.

  15. 钙尔奇D用于妊娠期补钙的临床观察%Caltrate D for Clinical Observation of Calcium Supplementation During Pregnancy

    Institute of Scientific and Technical Information of China (English)

    曲秀萍

    2014-01-01

    Objective Pregnancy calcium necessary research. Methods 20~32 weeks pregnant women with Caltrate D600 tablets, 1 days at a time. To observe the incidence of symptoms of calcium deficiency, calcium levels in the blood, fetal development, pregnancy induced hypertension syndrome, intrauterine growth retardation. Results The clinical symptoms of calcium deficiency calcium group, fetal growth decreased significantly, pregnancy induced hypertension syndrome, intrauterine growth retardation, postpartum hemorrhage decreased, serum calcium level was significantly higher in pregnancy. Conclusion Thus, pregnant to add enough calcium, help reduce calcium deficiency symptoms, reduced in PIH, IUGR incidence rate, reduce the amount of postpartum hemorrhage. The mother and child are very good, and no adverse reaction.%目的:研究孕期补钙必要必要性。方法孕20~32w的妇女服用钙尔奇D600片剂,1次/d。观察缺钙症状、胎儿发育、血钙水平、妊高征、胎儿宫内发育迟缓的发生率。结果补钙组临床缺钙症状、胎儿发育明显降低、妊高征,胎儿宫内发育迟缓、产后出血降低,妊娠期血钙水平明显升高。结论由此可见,孕中晚期补充足够的钙,有益于降低缺钙症状的发生,降低妊高征,胎儿宫内发育迟缓发生率,减少产后出血量。对母婴均非常有益,且无不良反应。

  16. Clinical value of transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy%阴道彩超诊断异位妊娠的临床价值

    Institute of Scientific and Technical Information of China (English)

    刘华; 张卉

    2012-01-01

    目的 探讨经阴道彩超检查对早期异位妊娠的诊断价值.方法 对226例经阴道超声检查诊断为早期异位妊娠的超声声像图和临床资料进行回顾性分析.结果 226例经阴道超声检查诊断为异位妊娠的病例,218例与临床及病理诊断符合,诊断符合率为96.4%,漏诊率为1.77% (4/226),误诊率为1.77%(4/226).结论 经阴道彩超诊断异位妊娠技术操作简单,图像显示清晰,对异位妊娠的检出率非常高.同时对异位妊娠发生的部位定位较准确,对病变的进展程度也可作出相应的评价.%[Objective]To explore the diagnostic value of transvaginal color Doppler ultrasound examination for early ectopic pregnancy. [Methods] The ultrasound images and clinical data of 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound were analyzed retrospectively. [ Results ] Among 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound, 218 cases accorded with the clinical and pathological diagnosis, the diagnostic accordance rate was 96.4% , the rate of missed diagnosis was 1.77% (4/226), and the rate of misdiagnosis was 1.77% (4/226). [Conclusion] The transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy has the advantages of simple operation, clear image display and high detection rate. Meanwhile, it can accurately determine the position of ectopic pregnancy, and make an appropriate evaluation on degree of disease.

  17. 妊娠期乳腺癌临床特点及超声诊断%Clinical characteristics and ultrasonic diagnosis of breast cancer during pregnancy

    Institute of Scientific and Technical Information of China (English)

    玄英华; 朱庆莉; 姜玉新

    2012-01-01

    目的 探讨妊娠期乳腺癌的临床、超声和病理学特征.方法 回顾性分析7例妊娠期诊断为乳腺癌的患者的临床、超声和病理学特征.结果 1例患者在早孕期获得诊断,6例在中晚孕期诊断;对5例行术前超声检查,均表现为形态不规则、边界不清的低回声,其中4例血流丰富,术前均正确诊断为恶性病变;7例患者均接受患侧乳癌改良根治术,孕期未接受化疗及放疗;病理示病灶大小1.7~5.5 cm;术后病理5例为浸润性导管癌,1例导管内癌,1例浸润性多形性癌;3例有患侧腋窝淋巴结转移.结论 妊娠期乳腺癌恶性度高,预后差,超声有助于早期、正确诊断妊娠期乳腺癌.%Objective To investigate clinical findings, ultrasonic and pathological features of breast cancer diagnosed during pregnancy. Methods Clinical data, ultrasonic findings and postoperative pathology of 7 pregnancy patients with breast cancer were analyzed retrospectively. Results One patient was diagnosed in the first trimester while 6 cases were diagnosed in the second and the third trimester. Five of the 7 patients underwent preoperative ultrasonic examinations which showed irregular, ill-defined hypoechoic masses in the breasts with 4 demonstrated rich blood supply indicating malignancy. All cases received modified radical mastectomy, no one underwent chemotherapy and radiation during pregnancy. All the lesions were sized from 1. 7 to 5. 5 cm. Postoperative pathology showed 5 cases of invasive ductal carcinoma, 1 of ductal carcinoma in situ and 1 case of pleomorphic carcinoma. Lymph node involvements were detected in 3 cases. Conclusion Breast cancer during pregnancy is highly malignant and of poor prognosis. Ultrasound assists the early accurate diagnosis of breast cancer during pregnancy.

  18. A Randomized Trial to Evaluate the Effect of Local Endometrial Injury on the Clinical Pregnancy Rate of Frozen Embryo Transfer Cycles in Patients With Repeated Implantation Failure

    Directory of Open Access Journals (Sweden)

    Ensieh Shahrokh-Tehraninejad

    2016-12-01

    Full Text Available Objective: Repeated implantation failure (RIF is a condition in which the embryos implantation decreases in the endometrium. So, our aim was to evaluate the effect of local endometrial injury on embryo transfer results.Materials and methods: In this simple randomized clinical trial (RCT, a total of 120 patients were selected. The participants were less than 40 years old, and they are in their minimum two cycles of vitro fertilization (IVF. Patients were divided randomly into two groups of LEI (Local endometrial injury and a control group (n = 60 in each group. The first group had four small endometrial injuries from anterior, posterior, and lateral uterus walls which were obtained from people who were in 21th day of their previous IVF cycle. The second group was the patients who have not received any intervention.Results: The experimental and control patients were matched in the following factors. Regarding the clinical pregnancy rate, there was no significant difference noted between the experimental and the control group.Conclusion: Local endometrial injury in a preceding cycle does not increase the clinical pregnancy rate in the subsequent FET cycle of patients with repeated implantation failure.

  19. 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.

  20. 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.

  1. 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 with ...

  2. Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery - a clinical recommendation

    DEFF Research Database (Denmark)

    Haahr, Thor; Ersbøll, Anne S; Karlsen, Mona A

    2016-01-01

    INTRODUCTION: Bacterial vaginosis (BV) is characterized by a dysbiosis of the vaginal microbiota with a depletion of Lactobacillus spp. In pregnancy, prevalence's between 7 and 30% have been reported depending on the study population and the definition. BV may be associated with an increased risk...

  3. 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

  4. 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 ...

  5. 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

  6. 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.

  7. 早孕期终止瘢痕子宫患者意外妊娠的临床分析%Clinical analysis of unplanned pregnancy termination in patients with scarred uterus during early pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘小艳; 杨合荣; 王江; 常青

    2012-01-01

    Objective To analyze the characeristics and ending of induced abortion conducted in unplannedly pregnant women with scarred uterus. Methods Clinical data of 599 patients admitted to hospital with unplanned pregnancy after cesarean section who had been subjected to induced abortion from January 2010 to March 2011 were retrospectively analyzed. Among them, 588 pregnant women with scarred uterus were divided into 2 groups according to the abortion methods which were induced abortion group (n-274) and curettage after medical abortion group(n -314). The clinical data of 600 unplannedly pregnant women without scarred uterus(300 cases of painless induced abortion and 300 cases of curettage after medical abortion) in the same period served as control. Results Among 599 patients,11 patients hospitalized due to uterine incision pregnancy and treated with laparoscopic surgery. In 588 pregnant women with scarred uterus,the success rates of surgery of patients in induced abortion group and curettage after medical abortion group showed no significantly difference(P>0. 05) , however, they were both markedly lower than those of patients without scarred uterus(P0.05). The success rate of induced abortion accepted at the time within a year from previous cesarean section was obviously lower than that of induced abortion accepted after a year(P0.05);妊娠距前次剖宫产术时间在1年内的人工流产的成功率显著低于1年后(P<0.05).结论 剖宫产术后意外妊娠行人工流产手术难度大,风险高,非切口妊娠患者应选择合理的流产方式以降低手术风险.

  8. 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

  9. 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.

  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. 妊娠期肝内胆汁淤积症118例的诊治研究及妊娠结局%Clinical research and pregnancy outcome of 118 cases of intrahepatic cholestasis of pregnancy

    Institute of Scientific and Technical Information of China (English)

    梁美燕; 罗一平; 欧阳晓红

    2014-01-01

    Objective:To observe the clinical symptoms of intrahepatic cholestasis of pregnancy(ICP).To analyze its harm of maternal and child and the effective treatments of reducing the fetal death,neonatal asphyxia,premature delivery.Methods:118 cases with intrahepatic cholestasis of pregnancy were selected from January 2008 to June 2013.The clinical data were retrospectively analyzed.The clinical characteristics,delivery mode,postpartum hemorrhage and pregnancy outcome were summarized.Results:In the 118 ICP cases,81 cases were cesarean section,and 37 cases were vaginal delivery.25 cases(21.2%) were premature delivery,19cases (16.1%) were fetal distress,and 12 cases(10.2%) were neonatal asphyxia.ICP onset time was more early.The liver damage was more serious,and the harm was more greater.Neonatal appearance had no abnormalities.1 case high risk infant was died because of multiple organ failure after new pediatric treatment.Through the comparison with another 50 cases of the treatment group,it found that the treatment had significant improvement on the maternal and child health.Conclusion:ICP can cause intrauterine fetal anoxia,premature delivery,fetal distress and neonatal asphyxia,which has a great harm to the maternal and child.The early diagnosis,early treatment,and strengthening of fetal heart rate monitoring and timely termination of pregnancy can effectively reduce the neonatal hazards and improve the maternal and child health.%目的:观察妊娠期肝内胆汁淤积症(ICP)的临床症状,分析其对母婴的危害及降低胎儿宫内死亡、新生儿窒息、早产的有效治疗方法。方法:2008年1月-2013年6月收治ICP患者118例,对其临床资料进行回顾性分析,总结其临床特点、分娩方式、产后出血量及妊娠结局。结果:118例ICP患者中,剖宫产81例,阴道分娩37例。其中早产25例(21.2%),胎儿窘迫19例(16.1%),新生儿窒息12例(10.2%)。ICP发病时间越早,其肝损伤越严重,危害

  12. 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。

  13. 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.

  14. [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.

  15. 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.

  16. 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

  17. Clinical analysis of bacterial vaginosis at late pregnancy and pregnancy outcomes%妊娠晚期细菌性阴道病与妊娠结局的临床分析

    Institute of Scientific and Technical Information of China (English)

    南延荣; 李红梅; 苏叶青

    2014-01-01

    目的:观察妊娠期细菌性阴道病( BV)对妊娠结局的不良影响。方法选择2011至2012年在延安大学附属医院产科门诊就诊,孕龄>35周的妊娠晚期妇女,将BV检测阳性的孕妇138例为BV组,将200例正常孕妇为对照组,跟踪观察其妊娠结局。结果 BV组的早产、胎膜早破、产褥感染、宫内感染明显高于对照组(χ2值为10.730~35.628,均P<0.05);BV组围生儿的胎儿窘迫、新生儿感染、新生儿黄疸、低出生体重儿明显高于对照组(χ2值为21.607~33.511,均P<0.05)。结论妊娠期BV可明显增加早产、胎膜早破、产褥感染、新生儿感染等不良妊娠结局的发生率,故对妊娠期进行常规BV筛查和治疗是十分必要的。%Objective To observe the adverse effects of bacterial vaginosis ( BV) during late pregnancy on pregnancy outcomes .Methods Pregnant women with gestational age >35 weeks who visiting the outpatient clinic of obstetrics of Yan ’ an University Affiliated Hospital in 2011 and 2012 were observed .Totally 138 pregnant women with positive results of BV were recruited in BV group , and 200 normal pregnant women were selected in control group .The pregnancy outcomes of them were observed .Results The incidences of preterm birth , premature rupture of membrane , puerperal infection and intrauterine infection in BV group were significantly higher than those of the control group (χ2 value ranged 10.730-35.628, all P<0.05).The incidences of fetal distress of perinatal infants , neonatal infection, jaundice of newborn and low birth weight in BV group were higher than those of the control group (χ2 value ranged 21.607 -33.511, all P<0.05).Conclusion Pregnancy with BV can obviously increase the incidence of preterm birth , premature rupture of membrane, puerperal infection and neonatal infection and other adverse outcomes , so screening of BV and treatment during pregnancy are quite necessary .

  18. 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...

  19. Clinical Activity in General Practice and Cancer

    DEFF Research Database (Denmark)

    Hjertholm, Peter

    2015-01-01

    BACKGROUND AND AIMS Cancer is a common, serious disease and early diagnosis is a cornerstone in the effort to improve the outcome from cancer disease. The general practitioner (GP) plays a crucial role in achieving this goal. Little is known about GPs’ suspicion of cancer and the activities the GPs...... institute in relation to such suspicion. Knowledge is also sparse on any effects of different diagnostic activities in general practice. The overall aims of this thesis were therefore: -to describe how often Danish GPs suspected cancer or other serious diseases and how they acted on the suspicion......, and to analyse how a suspicion influenced the demand for health care services and predicted a future diagnosis of serious disease - to investigate whether variation in GPs’ diagnostic activity influences cancer patients’ prognosis in relation to prostate-specific antigen (PSA) testing and prostate cancer...

  20. 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.

  1. 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.

  2. Uptake of family planning methods and unplanned pregnancies among HIV-infected individuals: a cross-sectional survey among clients at HIV clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Wanyenze Rhoda K

    2011-06-01

    Full Text Available Abstract Background Prevention of unplanned pregnancies among HIV-infected individuals is critical to the prevention of mother to child HIV transmission (PMTCT, but its potential has not been fully utilized by PMTCT programmes. The uptake of family planning methods among women in Uganda is low, with current use of family planning methods estimated at 24%, but available data has not been disaggregated by HIV status. The aim of this study was to assess the utilization of family planning and unintended pregnancies among HIV-infected people in Uganda. Methods We conducted exit interviews with 1100 HIV-infected individuals, including 441 men and 659 women, from 12 HIV clinics in three districts in Uganda to assess the uptake of family planning services, and unplanned pregnancies, among HIV-infected people. We conducted multivariate analysis for predictors of current use of family planning among women who were married or in consensual union and were not pregnant at the time of the interview. Results One-third (33%, 216 of the women reported being pregnant since their HIV diagnoses and 28% (123 of the men reported their partner being pregnant since their HIV diagnoses. Of these, 43% (105 said these pregnancies were not planned: 53% (80 among women compared with 26% (25 among men. Most respondents (58%; 640 reported that they were currently using family planning methods. Among women who were married or in consensual union and not pregnant, 80% (242 were currently using any family planning method and 68% were currently using modern family planning methods (excluding withdrawal, lactational amenorrhoea and rhythm. At multivariate analysis, women who did not discuss the number of children they wanted with their partners and those who did not disclose their HIV status to sexual partners were less likely to use modern family planning methods (adjusted OR 0.40, range 0.20-0.81, and 0.30, range 0.10-0.85, respectively. Conclusions The uptake of family planning

  3. 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.

  4. 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 for the AS stra...

  5. 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...

  6. Pemphigus vulgaris in pregnancy.

    Science.gov (United States)

    Salzberg, Kelsey W; Gero, Melanie J; Ragsdale, Bruce D

    2014-10-01

    We report the case of a 34-year-old woman who was diagnosed with pemphigus vulgaris (PV) during pregnancy. The patient presented with widespread blistering dermatitis and associated burning and pruritus. At 6 weeks' gestation the patient was admitted to the hospital to expedite her diagnosis and initiate treatment. A skin biopsy revealed suprabasal acantholysis, and direct immunofluorescence demonstrated diffuse intercellular IgG in the epidermis and basal intercellular C3, which confirmed the diagnosis of PV. Treatment with corticosteroids was instituted after discussions with the patient about possible adverse effects to the fetus. Pemphigus vulgaris is rare in pregnancy and active PV presents potential threats of fetal spread and transient lesion production, which is associated with increased mortality and morbidity in the fetus. Our patient had active PV and required treatment throughout her pregnancy. The pregnancy progressed to premature delivery of the neonate without skin lesions or apparent complications.

  7. 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

  8. 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.

  9. Energy metabolism during human pregnancy.

    Science.gov (United States)

    Forsum, Elisabet; Löf, Marie

    2007-01-01

    This review summarizes information regarding how human energy metabolism is affected by pregnancy, and current estimates of energy requirements during pregnancy are presented. Such estimates can be calculated using either increases in basal metabolic rate (BMR) or increases in total energy expenditure (TEE). The two modes of calculation give similar results for a complete pregnancy but different distributions of energy requirements in the three trimesters. Recent information is presented regarding the effect of pregnancy on BMR, TEE, diet-induced thermogenesis, and physical activity. The validity of energy intake (EI) data recently assessed in well-nourished pregnant women was evaluated using information regarding energy metabolism during pregnancy. The results show that underreporting of EI is common during pregnancy and indicate that additional longitudinal studies, taking the total energy budget during pregnancy into account, are needed to satisfactorily define energy requirements during the three trimesters of gestation.

  10. Sigmoid volvulus in pregnancy

    OpenAIRE

    Atamanalp, Sabri Selçuk; Öztürk, Gürkan

    2012-01-01

    To review the clinical outcomes of 9 patients with sigmoid volvulus (SV), a rare complication during pregnancy. Materials and methods: The clinical records of the patients were reviewed retrospectively. Results: The age range of the patients was 24-39 years (mean: 30.6 years). All patients were multiparous, and 6 patients (66.7%) were in the third trimester when diagnosed with SV. The main clinical features were abdominal pain/tenderness, obstipation, and distention in all patients (100.0%...

  11. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    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-

  12. 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.

  13. 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.

  14. 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.

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

    Science.gov (United States)

    Zeng, Xiangfang; Huang, Zhimin; Mao, Xiangbing; Wang, Junjun; Wu, Guoyao; Qiao, Shiyan

    2012-01-01

    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.

  16. 妊娠晚期羊水过少临床分析%Clinical Analysis of Late Pregnancy Oligohydramnios

    Institute of Scientific and Technical Information of China (English)

    王薇; 赵艳梅; 马晓宏; 夏彩凤; 关美芹; 马艳辉

    2015-01-01

    目的:分析妊娠晚期羊水过少的相关因素以及妊娠结局。方法回顾性分析2011年2月~2015年1月我院收治的40例妊娠晚期羊水过少患者的临床资料,以此为实验组,并选择同期收治的40例正常产妇为对照组。分析引起羊水过少的相关因素和妊娠结局。结果实验组剖宫产率、发生新生儿窒息、低体重儿、胎儿窘迫以及新生儿死亡率均高于对照组。结论羊水过少与妊高症、胎盘功能不全、胎儿畸形等密切相关。羊水过少会对围产儿造成严重危害,要加强对产妇的产前监护,并且及时进行正确的处理,以改善母婴结局。%Objective To analyze the relevant factors and pregnancy outcome of late pregnancy oligohydramnios. Methods The experiment group included 40 patients with late pregnancy oligohydramnios in our hospital from February 2011 to January 2015. The control group included 40 cases of normal parturient women treated within the same period. Analyzing the factors that cause oligohydramnios and the pregnancy outcome. Results The rates of cesarean section, neonatal asphyxia, low birth weight children, fetal distress and neonatal mortality were al higher than control group. Conclusion Oligohydramnios is closely related to pregnancy-induced hypertension, placental insufficiency and fetal malformations. Oligohydramnios is harmful to prenatal infants. So it is proper to strengthen prenatal care for pregnant women, and offer prompt and correct treatment, so as to improve maternal and child outcomes.

  17. 94例妊娠期高血压疾病临床分析%Clinical analysis of 94 cases of hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    王东霞

    2016-01-01

    目的:探讨患者的发病因素、患者及围产儿的预后情况。方法:选取某医院收治的妊娠期高血压患者94例作为临床研究对象,对患者的临床资料进行回顾性分析。结果:致病因素:妊娠期高血压疾病的发病因素主要有为社会因素和产科因素。社会因素中,居住地、系统产前检查与妊娠期高血压疾病有着紧密的联系;产科因素中,产次与妊娠期高血压疾病有着紧密的关联。结论:妊娠期高血压并发低蛋白血症对产妇及围生儿预后的影响:并发低蛋白血症的产妇其终止妊娠孕周明显短于没有并发低蛋白血症的产妇,且围生儿体重更轻,胎儿生长受限发生率明显更高,结果对比差异显著(P<0.05)。%Objective:To investigate the incidence, the patient and the prognosis of perinatal infants. Methods: 94 cases of hypertensive patients in hospital were selected as clinical research object, the clinical data of patients were retrospectively analyzed. Results: pathogenic factors: in this study, the incidence of hypertensive disorder complicating pregnancy is mainly social and obstetric factors. In social factors, the place of residence, the system prenatal examination and pregnancy induced hypertension disease has a close link between the obstetric factors, and pregnancy induced hypertension disease has a close relationship. Conclusion: the effect of gestational hypertension complicated with hypoalbuminemia on maternal and perinatal prognosis: complicated hypoproteinemia were the pregnancy was significantly shorter than that without complicated hypoproteinemia maternal and perinatal lighter weight, fetal growth restriction was significantly higher, the results had significant differences (P<0.05).

  18. 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

  19. Primary psoas muscle abscess in pregnancy.

    Science.gov (United States)

    Swanson, Amy; Lau, Kenneth K; Korman, Tony M; Kornman, Tony; Wallace, Euan M; Polyakov, Alex

    2008-12-01

    Primary iliacus-psoas muscle abscess formation is very uncommon during pregnancy. We present a case of a primary iliacus-psoas muscle abscess in pregnancy causing back pain with delayed diagnosis and treatment. Understanding the clinical presentation of iliacus-psoas muscle abscess helps with considering it in the differential diagnosis of back pain during pregnancy.

  20. Radiation and pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Harding, L. K.; Thomson, W. H. [City Hospital NHS Trust, Physics and Nuclear Medicine Department, Birmingham (United Kingdom)

    2000-12-01

    Irradiation of pregnant women either in the workplace or as a consequence of clinical diagnosis is often unavoidable. This paper reviews the issues relating to this topic. For clinical exposures the missed period rule is applied prior to most clinical studies. However normal physiological variations in the menstrual cycle may need to be understood. The possible effects of irradiation, both deterministic and stochastic, on the fetus are also described. The decision process in relation to irradiation of a pregnant or potentially pregnant patient is discussed in terms of the regulatory guidance. A different approach is needed for studies which clearly involve a low dose to the uterus compared with studies involving a high dose, including therapy. The issue of a pregnant or potentially pregnant worker in nuclear medicine is also considered. Restrictions on certain work activities may be necessary once pregnancy is declared. Other areas considered are biomedical research and also the potential for exposure of pregnant woman in the home or in the workplace as a consequence of others having a nuclear medicine study.

  1. 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

  2. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies

    Science.gov (United States)

    Bartsch, Emily; Medcalf, Karyn E; Park, Alison L

    2016-01-01

    Objective To develop a practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤16 weeks’ gestation to estimate a woman’s risk of pre-eclampsia. Design Systematic review and meta-analysis of cohort studies. Data sources PubMed and Embase databases, 2000-15. Eligibility criteria for selecting studies Cohort studies with ≥1000 participants that evaluated the risk of pre-eclampsia in relation to a common and generally accepted clinical risk factor assessed at ≤16 weeks’ gestation. Data extraction Two independent reviewers extracted data from included studies. A pooled event rate and pooled relative risk for pre-eclampsia were calculated for each of 14 risk factors. Results There were 25 356 688 pregnancies among 92 studies. The pooled relative risk for each risk factor significantly exceeded 1.0, except for prior intrauterine growth restriction. Women with antiphospholipid antibody syndrome had the highest pooled rate of pre-eclampsia (17.3%, 95% confidence interval 6.8% to 31.4%). Those with prior pre-eclampsia had the greatest pooled relative risk (8.4, 7.1 to 9.9). Chronic hypertension ranked second, both in terms of its pooled rate (16.0%, 12.6% to 19.7%) and pooled relative risk (5.1, 4.0 to 6.5) of pre-eclampsia. Pregestational diabetes (pooled rate 11.0%, 8.4% to 13.8%; pooled relative risk 3.7, 3.1 to 4.3), prepregnancy body mass index (BMI) >30 (7.1%, 6.1% to 8.2%; 2.8, 2.6 to 3.1), and use of assisted reproductive technology (6.2%, 4.7% to 7.9%; 1.8, 1.6 to 2.1) were other prominent risk factors. Conclusions There are several practical clinical risk factors that, either alone or in combination, might identify women in early pregnancy who are at “high risk” of pre-eclampsia. These data can inform the generation of a clinical prediction model for pre-eclampsia and the use of aspirin prophylaxis in pregnancy. PMID:27094586

  3. 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...

  4. Anorectal abscess during pregnancy.

    Science.gov (United States)

    Koyama, Shinsuke; Hirota, Masaki; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko

    2014-02-01

    Anorectal symptoms and complaints caused by hemorrhoids or anal fissures are common during pregnancy. It is known that one-third of pregnant women complain of anal pain in the third trimester. Anal pain may be caused by a wide spectrum of conditions, but if it begins gradually and becomes excruciating within a few days it may indicate anorectal abscess. We experienced a case of anorectal abscess during pregnancy which was diagnosed by magnetic resonance imaging and treated by incision and seton drainage at 36 weeks of gestation, followed by a normal spontaneous delivery at 38 weeks of gestation. To our knowledge, this is the first case report of anorectal abscess during pregnancy in the English-language published work. The clinical course of our case and clinical considerations of anorectal abscesses are discussed.

  5. 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

  6. 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.

  7. 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.

  8. Pregnancy with autoimmune hepatitis

    Science.gov (United States)

    Braga, António Costa; Vasconcelos, Carlos; Braga, Jorge

    2016-01-01

    Aim: The aim of this study was to review our experience with gestations in autoimmune hepatitis patients. Background: There are only limited data describing pregnancy in patients with autoimmune hepatitis. Patients and methods: Retrospective analysis of pregnancies with autoimmune hepatitis followed in Centro Hospitalar do Porto, Portugal in the last ten years. Results: We reported nine pregnancies in seven patients with autoimmune hepatitis. Two patients had documented liver cirrhosis prior to the pregnancy. In this study, 66.7% of patients were treated with azathioprine and 88.9% with prednisolone. Clinical improvements were observed in 11.1% of pregnancies and 22.2% exacerbations were diagnosed. There were six live births and two preterm deliveries (preterm delivery rate of 33%). We also report three first trimester miscarriages (early gestation miscarriage rate of 33%). There were no neonatal or maternal deaths. Conclusion: The favorable obstetric outcome is a realistic expectation in patients with autoimmune hepatitis. Tight monitoring and control of asymptomatic and unpredictable exacerbations, which are unrelated to the severity of the underlying disease, are essential to the prognosis of the current pregnancy. PMID:27458515

  9. 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

  10. Quantification of urinary chorionic gonadotropin in spontaneous abortion of pre-clinically recognized pregnancy: method development and analytical validation.

    Science.gov (United States)

    Reis, M Fátima; Aniceto, Pedro; Aguiar, Pedro; Simão, Filipa; Segurado, Susana

    2007-05-01

    Determination of environmental impacts on reproductive health and specifically on the incidence of early spontaneous abortion requires accurate estimates of the latter. This negative reproductive outcome can be detected by the pattern of elevation and decline of human chorionic gonadotropin (hCG) levels near and shortly beyond the expected time of implantation, requiring daily biomonitoring of hCG levels during the relevant period of the menstrual cycle. Prospective pregnancy studies to assess effects of potentially toxic exposures on human reproductive outcomes can involve up to three menstrual cycles and a huge number of samples in each, for the quantification of the inherently very low hCG levels usually can be determined only in serum. The invasive nature of blood collection, the number of samples needed for the development of prospective studies, and the lack of quantitative methods for the determination of low hCG levels in urine point to the need for collecting urine rather than blood and make it imperative to develop suitable quantitative methods for biomonitoring of very low levels of hCG in urine. This paper describes the development and validation procedures of an automated solid-phase two-site chemiluminescent immunometric assay for the quantification of urinary hCG in early pregnancy and early pregnancy loss. For the validation, both undiluted and diluted urine and control samples have been prepared. From the results, it can be concluded that the assay has a calibration range that extends to 5000 mIU/ml, with a detection limit of approximately 1.2 mIU/ml, practically identical to that found by the IMMULITE 2000 manufacturer's validation study. The intra- and inter-assay precision ranges up to a maximum of around 7%, meaning that the practical limit for functional sensitivity can be established as low as 10%. This means that the immunoassay from DPC can identify, with relatively high confidence, non-pregnant women and the typical "rise and fall" pattern

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

    Directory of Open Access Journals (Sweden)

    Nasr Esfahani Mohammad Hossein

    2016-07-01

    Full Text Available 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.

  12. Pharmacological management of hypertension in pregnancy.

    Science.gov (United States)

    Easterling, Thomas R

    2014-12-01

    Hypertension in pregnancy remains a significant public health problem. Pharmacological management of blood pressure in pregnancy is impacted by changes in maternal drug disposition and by the pharmacodynamic effects of specific agents. This article will review the impact of pregnancy on pathways of drug elimination and the associated clinical implications, the pharmacodynamic effects of specific drugs and classes of drugs in pregnancy, and the data to date on the impact of antihypertensive therapy on mothers and their fetuses.

  13. 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

  14. 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.

  15. Cravings during Pregnancy

    Science.gov (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... more. Stony Point, NY 10980 Close X Home > Pregnancy > Nutrition, weight & fitness > Cravings during pregnancy Cravings during pregnancy ...

  16. Travel during Pregnancy

    Science.gov (United States)

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

  17. Metformin versus Insulin in the Management of Pre-Gestational Diabetes Mellitus in Pregnancy and Gestational Diabetes Mellitus at the Korle Bu Teaching Hospital: A Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Titus Beyuo

    Full Text Available To determine if metformin monotherapy or metformin in combination with insulin is equally effective as insulin monotherapy at glycemic control in diabetes mellitus in pregnancy among Ghanaians.This was a study involving 104 pregnant women with type 2 diabetes mellitus (T2DM or gestational diabetes mellitus (GDM at 20-30 weeks gestation. Participants were randomized into metformin and insulin treatment groups. Starting dose of metformin was 500 mg once a day and increased gradually over two (2 weeks, to meet glycemic targets. Insulin was added if targets could not be reached on metformin alone at maximum doses. Total daily dose of premixed insulin at initiation was calculated as 0.3 IU/kg body weight and titrated upwards to achieve glycemic control. Glycemic profile monitoring was done every two weeks.The two hour post prandial blood glucose (2HPG levels were significantly lower in the metformin group than the insulin group (p= 0.004.The findings of this study suggest that metformin monotherapy is effective in achieving glycemic targets in the management of diabetes in pregnancy. It is more effective than insulin in lowering the 2HPG level.Australian New Zealand Clinical Trials Registry (ANZCTR ACTRN12614000942651.

  18. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  19. Pregnancy test

    Science.gov (United States)

    ... called human chorionic gonadotropin (HCG). HCG is a hormone produced during pregnancy. It appears in the blood and urine of ... A pregnancy test is done using blood or urine. There are 2 types of ... how much HCG is present The blood test is done by drawing ...

  20. Kidney stones during pregnancy.

    Science.gov (United States)

    Semins, Michelle J; Matlaga, Brian R

    2014-03-01

    Kidney stones affect 10% of people at some point in their lives and, for some unfortunate women, this happens during pregnancy. Pregnancy is a complex state and both physiological and mechanical changes alter risk factors for kidney stone formation. When a pregnant woman develops acute nephrolithiasis, the situation is more complicated than in nonpregnant women. Imaging limitations and treatment restrictions mean that special diagnostic and management algorithms are needed upon presentation. Ultrasonography remains the gold-standard first-line diagnostic imaging modality for kidney stones during pregnancy but several second-line alternatives exist. Acute renal colic during pregnancy is associated with risks to both mother and fetus. As such, these patients need to be handled with special attention. First-line management is generally conservative (trial of passage and pain management) and is associated with a high rate of stone passage. Presentation of obstructive nephrolithiasis with associated infection represents a unique and serious clinical situation requiring immediate drainage. If infection is not present and conservative management fails, ureteroscopy can be offered if clinically appropriate, but, in some circumstances, temporary drainage with ureteral stent or nephrostomy tube might be indicated. Shockwave lithotripsy and percutaneous nephrolithotomy are contraindicated during pregnancy.

  1. 畸形子宫早孕药物流产的临床观察%Clinical Observation on Drug Induced Abortion in Abnormal Uterine Pregnancy

    Institute of Scientific and Technical Information of China (English)

    赵童; 张立红

    2016-01-01

    Objective:To investigate the clinical effect of drug induced abortion in abnormal uterine preg-nancy (the uterine septum,uterus bicornis,bicorbate uterus and uterus unicornis).Methods:37 patients with abnormal uterine pregnancy received drug induced abortion (mifepristone combined with misoprostol) termination of pregnancy.Results:Among the 37 patients,28 patients were complete abortion,8 patients were incomplete abortion,1 case was abortion failure.Incomplete abortion and abortion failure patients un-derwent curettage,the postoperative course was uneventful,no accidents such as uterine perforation or suc-tion leaks occurred.The complete abortion rate was 75.7%,the curettage rate was 24.3%.Conclusion:The success rate of drug induced abortion in abnormal uterine pregnancy is high,and for incomplete abortion and medical abortion failure patients,because early drug effects enable embryo stripping,uterine contraction ex-trusion blastocyst and uterine luminal contents of depression or partial discharge,it can effectively reduce the risk of abortion.%目的::针对药物流产终止畸形子宫(子宫纵隔、双角子宫及鞍状子宫、单角子宫)早孕的临床效果展开探讨。方法:37名畸形子宫早孕患者用药物流产(米非司酮联合米索前列醇口服)终止妊娠。结果:37名患者中完全流产28名,未完全流产8名,流产失败1名。而后为不全流产及流产失败患者均行清宫术,手术过程顺利,未产生子宫穿孔、漏吸等情况。完全流产率为75.7%,清宫率为24.3%。结论:畸形子宫早孕应用药物流产成功概率较高,对不全流产及药流失败者因前期药物作用使胚胎剥离,子宫收缩挤压胚囊及宫腔内容物下移或部分排出,可有效降低清宫术的风险。

  2. The Clinical Treatment Analysis of Vaginal Bleeding in Early Pregnancy%妊娠早期阴道出血的临床治疗探析

    Institute of Scientific and Technical Information of China (English)

    刁然

    2014-01-01

    Objective The clinical treatment and its ef ect on vaginal bleeding in early pregnancy to be investigated. Methods Choose 41 patients with vaginal bleeding in early pregnancy who are treated in hospital from May 2013 to May 2014;patients in study group are given laboratory tests and ultrasound examination to find out the reason for bleeding. And then treat patients with proper treatment and observe the ef ect. Results There are 29 patients of incipient abortion, 5 cases of cervical polyps, 6 cases of cervical erosion, and one case of coleitis. And 37 patients successful y prevent from miscarriage (90.24%), 2 patients have spontaneous abortion(4.88%), another 2 patients have therapeutic abortion(4.88%), the result has statistical significance(P<0.05).Conclusion The way to treat patients with vaginal bleeding in early pregnancy is to find out the cause of the disease and to treat patients with symptomatic treatment, the treatment of patients with vaginal bleeding in early pregnancy is of importance.%目的:探析妊娠早期阴道出血的临床治疗方法及效果。方法搜集2013年5月~2014年5月我院接收的妊娠早期阴道流血41例患者,对全部患者进行实验室检查及超声检查,明确研究组出血病因,并根据病因给予相应的治疗,观察疗效。结果29例先兆流产,5例宫颈息肉,6例宫颈糜烂,1例阴道炎。37例保胎成功(90.24%),2例自然流产(4.88%),2例人工流产(4.88%),结果有统计学意义(P<0.05)。结论对于妊娠早期阴道出血患者,应积极找出病因,并根据病因予以相应治疗,需引起重视。

  3. 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。

  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. Key Challenges to Maintenance Activities in Clinical Engineering

    Institute of Scientific and Technical Information of China (English)

    Azman Hamid

    2016-01-01

    Objective Maintenance of biomedical equipment has undergone tremendous improvements over the last several decades since the publication of Ralph Nader’s fateful article in 1971. The uproar caused by Nader’s article had called for stringent electrical safety testing. Clinical engineering fraternities worldwide hurried to provide solutions and addressed the damage. In the process, we saw improvements in many areas of clinical engineering. Yet, despite these improvements, clinical engineering is still grappling with challenges in its maintenance activities that seem to persist. This paper seeks to identify these challenges which have caused difficulties, and to some extent, impede the performance of effective maintenance. The paper also seeks to propose solutions and recommendations for improvements. Methods Over the course of his work, the author has noticed areas that have posed major challenges in clinical engineering. One such challenge is in the area of clinical engineering competency. Non-standardization in maintenance activities is another area where some tough decisions may be needed. Other challenges will be identified, explained and where possible, solutions will be offered. Results In this paper, the author identifies ten major challenges that have affected the provision of clinical engineering services. Most of these challenges, if properly addressed may significantly improve healthcare delivery and/or provide clinical engineering with clear guidelines on the breadth and limits of the discipline. Some have severely affected maintenance performances while several have been left unattended and unresolved. Regardless, the ten challenges are common and normally experienced at clinical engineering department across the globe. Conclusion By pointing out these key challenges, clinical engineering practitioners would be able to identify shortfalls and trends in clinical engineering maintenance and systematically focus their attention towards assisting in

  6. ACE2 activation by xanthenone prevents leptin-induced increases in blood pressure and proteinuria during pregnancy in Sprague-Dawley rats.

    Science.gov (United States)

    Ibrahim, Hisham Saleh; Froemming, Gabrielle Ruth Anisah; Omar, Effat; Singh, Harbindar Jeet

    2014-11-01

    This study investigates the effect of ACE2 activation on leptin-induced changes in systolic blood pressure (SBP), proteinuria, endothelial activation and ACE2 expression during pregnancy in Sprague-Dawley rats. Pregnant rats were given subcutaneous injection of either saline, or leptin, or leptin plus xanthenone (ACE2 activator), or xanthenone (XTN) alone. SBP, serum ACE, ACE2, endothelin-1, E-selectin and ICAM-1 levels were estimated; also their gene expressions were determined in the kidney and aorta respectively. Compared to control, SBP was higher in the leptin-only treated group (Pleptin-only treated rats (Pleptin-only treated rats when compared to controls (Pleptin administration during pregnancy significantly increases SBP, proteinuria, endothelial activation, but decreases ACE2 level and expression. These effects are prevented by concurrent administration of xanthenone.

  7. 试管婴儿双胎与自然受孕双胎产妇和新生儿的临床结局分析%Analysis of clinical outcomes of twin pregnancy women and neonates with twin pregnancy and natural pregnancy

    Institute of Scientific and Technical Information of China (English)

    夏燕; 潘晖; 魏兆莲

    2016-01-01

    目的:探讨试管婴儿双胎与自然受孕双胎产妇和新生儿的临床结局。方法收集2014年8月至2015年6月收治的60例试管婴儿双胎妊娠(试管组)与78例自然受孕双胎妊娠(对照组)产妇的妊娠周期、妊娠期合并症、分娩方式、年龄、新生儿体重、新生儿出生缺陷等资料,对比两组产妇之间的差异性。结果与对照组对比,试管组产妇年龄显著升高,差异有统计学意义( P 0.05);与对照组对比,试管组产妇妊娠期高血压发生率显著升高,差异有统计学意义( P 0.05);与对照组对比,试管组新生儿在28~31孕周早产的发生率显著升高,极低体质量儿及转新生儿科新生儿比率显著升高,差异有统计学意义( P 0.05)。结论试管婴儿双胎较自然受孕双胎发生不良妊娠结局的危险性相对较高,应加强对试管婴儿双胎妊娠的产前及产时监护,防治并发症的发生。%Objective To explore the clinical outcome of twin pregnancy and newborn twins with twin pregnancy in vitro. Methods From August 2014 to June 2015 in our hospital 60 cases of obstetrics and gynecology IVF twin pregnancy(tube group)and 78 cases of naturally conceived twin pregnancies( control group)were collected. Maternal pregnancy cycle,pregnancy complications,mode of delivery,age,birth weight,birth defects of the two groups were collected,and compared. Results Compared with the control group,test tube group of maternal age was significantly increased,the difference was statistically significant( P 0. 05). Compared with the control group,test tube group of maternal gestational hypertension incidence increased significantly,the difference was statistically significant( P 0. 05). Compared with the control group,the premature gestational incidence in 28 ~ 31 in tube group increased significantly,basal body weight infant and newborn proportion increased significantly,the difference was statisti

  8. 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

  9. Pustular psoriasis of pregnancy (impetigo herpetiformis)--case report.

    Science.gov (United States)

    Kondo, Rogerio Nabor; Araújo, Fernanda Mendes; Pereira, Allamanda Moura; Lopes, Vivian Cristina Holanda; Martins, Ligia Márcia Mario

    2013-01-01

    Impetigo herpetiformis is a rare dermatosis of pregnancy with typical onset during the last trimester of pregnancy and rapid resolution in the postpartum period. Clinically and histologically, it is consistent with pustular psoriasis. This similarity has led some authors to name the disease "the pustular psoriasis of pregnancy". We report the case of a patient who developed impetigo herpetiformis in two successive pregnancies.

  10. Polymorphic eruption of pregnancy developing postpartum: 2 case reports

    Directory of Open Access Journals (Sweden)

    Ellen Cathrine Pritzier

    2012-06-01

    Full Text Available Polymorphic eruption of pregnancy (PEP, also known as pruritic urticarial papules and plaques of pregnancy, is a common benign dermatosis of pregnancy mainly affecting primigravidae and multiple pregnancies. We report here two cases of PEP with typical clinical and histological features presenting in the postpartum period.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Clinical analysis of pregnancy and delivery in 636 older pregnant women%高龄孕妇妊娠与分娩636例分析

    Institute of Scientific and Technical Information of China (English)

    彭惠媛; 张颖

    2011-01-01

    Objective To explore the clinical characteristics of pregnancy and delivery in older pregnant women. Methods Retrospectively analyzed the clinical deta of old group ( age > = 35, n = 636) and non-old group ( age < 35, n = 4 202) in same time, compared the incidence of pregnant complications and delivery complications, situation of perinatal infants between the two groups. Results The incidence rates of gestational diabetes,hypertension disease, placenta previa, cesarean section, postpartum hemorrhage, fetal macrosomia were higher in old group and neonatal deformity,neonatal asphyxia were not different in two groups. Condusion The complications during pregnancy and delivery increased in older pregnant women,which had no benifits for mother son.%目的 探讨高龄孕妇妊娠与分娩的临床特点。方法 回顾分析高龄孕妇(≥35岁)636例(高龄组)和同期非高龄孕妇(< 35岁)4 202例(非高龄组)分娩的临床资料,比较两组妊娠合并症、分娩期并发症及新生儿娩出情况。结果高龄组妊娠期糖尿病、高血压疾病、前置胎盘、剖宫产、产后出血、巨大儿的发生率均高于对照组。结论高龄孕妇妊娠期及分娩期并发症多,对母儿有不利影响。

  13. Comparative Study of Calcium efficacy and placebo on leg muscle cramps during pregnancy in patients referred to clinics supervised by Bushehr University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Rozita Khoramroudi

    2011-09-01

    Full Text Available Background: Muscle cramps are common complains during pregnancy muscle cramps occur mostly during nights causing sleep disorder. The causes of muscle cramps are unknown. One probable cause could be the imbalance between intake and excretion of serum electrolyte such as calcium. Methods: The method used for the present study was double blind clinical trial. The study was conducted on 60 pregnant women suffering from leg muscle cramps who sought medical treatment in three selected clinics in Bushehr from April 2006 to November 2007. All subjects being third trimester of pregnancy, single pregnant, only used iron and multivitamins. Irregular use of medication, PLP (Preterm Labor Pain, disability completion forms excluded of study. Simple and accessible sampling was used in this study. Selection of study group and placebo were random. Visual analog forms were used to record the number and intensity of muscle cramps. These forms had provisions for 7 days of pretreatment and 28 days of treatments. At the end of the first week, the subjects were prescribed to take medications every night for four weeks. The subjects were asked to record the intensity of their muscle cramps on the visual analog forms during these four weeks. Results: The number and intensity of muscle cramps were considered in this study. The results of the study showed no significant change in intensity in the two groups. However, there was a significant reduction in the number of cramps in the study group after taking calcium (p=< 0.02<0.05. Conclusion: Taking calcium resulted in a significant reduction in the number of cramps in this study compared to placebo group. Therefore, prescribing calcium is effective in reducing the number of cramps, when the numbers of occurrences are excessive. In cases of highly intensive and painful cramps, however, taking calcium is as effective as placebo.

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

    Directory of Open Access Journals (Sweden)

    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. 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.

  16. Pregnancy and Antiphospholipid Syndrome

    DEFF Research Database (Denmark)

    Schreiber, Karen; Hunt, Beverley J

    2016-01-01

    and increases the risk of conditions associated with ischemic placental dysfunction, such as stillbirth, intrauterine death, preeclampsia, premature birth, and fetal growth restriction. The use of low-dose aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant...... women with APS will deliver a viable live infant. However, current management does not prevent all maternal, fetal, and neonatal complications of APS and the current treatment fails in 20 to 30% of APS pregnancies, raising the need to explore other treatments to improve obstetrical outcome. Two clinical...

  17. Low clinical burden of 2009 pandemic influenza A (H1N1 infection during pregnancy on the island of La Reunion.

    Directory of Open Access Journals (Sweden)

    Patrick Gérardin

    Full Text Available BACKGROUND: Pregnant women have been identified as a group at risk, both for respiratory complications than for the admissions to the Intensive Care Unit (ICU during the 2009 H1N1 influenza pandemic (pdm. The purpose of this prospective register-based cohort-study was to characterize the clinical virulence of the pdm (H1N1/09v during pregnancy in La Réunion. METHODS/PRINCIPAL FINDINGS: Over a twelve-week pdm wave (13 July to 3 October 2009, 294 pregnant women presented with an influenza-like illness (ILI to one of the three maternity departments of the South Reunion area, Indian Ocean. Out of these, 278 were checked by RT-PCR for influenza viruses (157 positive and 121 negative, of whom, 141 with pdm flu and 132 with ILIs of non pdm origin, 5 untyped. The median body temperature was higher in women experiencing pdm flu than in those with non pdm ILI (38.9 degrees C versus 38.3 degrees C, P<0.0001, without evidence linked to circulating viremia. Oseltamivir was given for 86% of pdm flu cases in a median time inferior than 48 hrs (range 0-7 days. The hospitalization rate for pdm flu was of 60% and not associated with underlying conditions. Six viral pneumonia and fourteen asthma attacks were observed among 84 hospitalized pdm flu cases, of whom, only one led to the ICU for an acute lung injury. No maternal death occurred during the pdm wave. None adverse pregnancy outcome was associated with pdm flu. No congenital birth defect, nor early-onset neonatal influenza infection was attributable to pdm flu exposure. CONCLUSIONS/SIGNIFICANCE: This report mitigates substantially the presumed severity of pandemic H1N1/09 influenza infection during pregnancy. The reasons for which the clinical burden of H1N1/09 influenza virus may differ worldwide raise questions about a differential local viral-strain effect and public health preparedness, notably in timely access to special care and antiviral treatments.

  18. Phytoestrogens in Human Pregnancy

    Directory of Open Access Journals (Sweden)

    John Jarrell

    2012-01-01

    Full Text Available Background. The hormonal milieu associated with pregnancy has become a focus of interest owing to potential links with the developmental origins of health and disease. Phytoestrogens are hormonally active plant-derived chemicals that may have an impact on human reproductive processes. However, developmental exposure to phytoestrogens has not been well characterized and thus our objective was to quantify phytoestrogen exposure during pregnancy and lactation. Methods. Women in the second trimester of pregnancy entered the study during counseling for prenatal genetic information. Women who had an indication for a genetic amniocentesis on the basis of late maternal age were approached for inclusion. They completed an environmental questionnaire; a sample of amniotic fluid was collected for karyotype, blood was collected from women during pregnancy and at birth, from the umbilical cord and breast milk. Samples were tested for the presence of daidzein and genistein by GC Mass Spectroscopy. Findings. Phytoestrogens are commonly found in pregnant women’s serum and amniotic fluid during pregnancy. There is a sex difference in the concentrations with higher levels in amniotic fluid containing female fetuses. This difference was not present in maternal serum. Soy ingestion increases amniotic fluid phytoestrogen concentrations in female and male fetuses. The presence and concentrations of phytoestrogens did not differ in relation to common pregnancy complications or preexisting infertility.

  19. 超声对剖宫产瘢痕妊娠的临床应用价值%Value of ultrasonography in the Clinical application of caesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘宇清; 卢琼洁; 贾保霞

    2010-01-01

    Objective To explore the value of sonography in the clinical application of caesarean scar pregnancy. Methods The ultrasound imaging of twenty-four patients with caesarean scar pregnancy and their clinical treatments were retrospectively analyzed. Results Twenty-four patients were classified into three types according to the location of pregnancy matter relation with the caesarean scar: the first type included 5 patients with pregnancy matter implanted in the caesarean scar,the second type included 13 patients in which the pregnancy matter located in uterine cavity close to the caesarean scar, and the third type included 6 patients with pregnancy matter located partly in the caesarean scar and partly in the uterine cavity. Select treatment options depending on the types and distribution of nourish blood besides the pregnancy matter. Conclusion Sonography is valuable for the diagnosis and treatment of caesarean scar pregnancy by observing the location of pregnancy natter relation with the caesarean scar and distribution of nourish blood besides the pregnancy matter.%目的 探讨超声对剖宫产术后子宫瘢痕妊娠的诊断治疗方面的临床应用.方法 回顾性分析24例诊断为子宫瘢痕妊娠患者的声像图表现及临床资料.结果 24例瘢痕妊娠病例根据妊娠物与瘢痕的位置关系分为三型:癜痕处肌层内型(5例)、瘢痕处宫腔内型(13例)及混合型(6例),根据分型及瘢痕处滋养血流分布状况选择治疗方案并超声随访.结论 超声通过观测妊娠物与瘢痕的位置关系及瘢痕处滋养血流分布状况对于瘢痕妊娠的诊断、指导治疗等方面具有重要作用.

  20. Human pregnancy-specific glycoprotein 1a (PSG1a) induces alternative activation in human and mouse monocytes and suppresses the accessory cell-dependent T cell proliferation.

    Science.gov (United States)

    Motrán, Claudia Cristina; Díaz, Fernando López; Gruppi, Adriana; Slavin, Daniela; Chatton, Bruno; Bocco, José Luis

    2002-09-01

    It has been proposed that pregnancy-specific factors induce the suppression of a specific arm of the maternal response accompanied by activation of the nonspecific, innate immune system. The aim of this study was to determine whether pregnancy-specific glycoprotein 1a (PSG1a), the major variant of PSG polypeptides, is able to modulate the monocyte/macrophage (Mo) metabolism to regulate T cell activation and proliferation. Using the recombinant form of this glycoprotein (rec-PSG1a), expressed in mammalian cells with a vaccinia-based expression vector, we have demonstrated that human PSG1a induces arginase activity in peripheral blood human Mo and human and murine Mo cell lines. In addition, rec-PSG1a is able to induce alternative activation because it up-regulates the arginase activity and inhibits the nitric oxide production in Mo activated by lipopolysaccharides. We also observed that rec-PSG1a is an important accessory cells-dependent T cell suppressor factor that causes partial growth arrest at the S/G2/M phase of the cell cycle. Additionally, an impaired T cell proliferative response induced by mitogens and specific antigen was observed in BALB/c mice upon in vivo expression of PSG1a. Our results suggest that PSG1a function contributes to the immunomodulation during pregnancy, having opposite effects on maternal innate and adaptative systems.

  1. 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.

  2. 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.

  3. Clinical analysis of single or twin pregnancy complicated with preeclampsia%单、双胎妊娠并发子痫前期临床分析

    Institute of Scientific and Technical Information of China (English)

    匡丽云; 汤雯婷; 周燕媚; 孙雯; 龚景进; 李晓梅; 李秀英; 陈敦金

    2016-01-01

    Objective To explore the clinical features and pregnancy outcomes of single or twin pregnancy complicated with preeclampsia.Methods From January 2009 to April 2013, 405 pregnancies complicated with preeclampsia, who were admitted to the Obstetrics department of the Third Affiliated Hospital of Guangzhou Medical University were enrolled in this retrospective study.This study included 43 twin pregnancies in research group and 362 singleton pregnancies in the control group.The clinical features and pregnancy outcomes of the two groups were retrospectively analyzed.Results The length of hospital stay in research group and control group were ( 13.28 ±11.23 ) day and ( 9.48 ±4.97 ) day, respectively.There was significant difference in the two groups (t=2.20, P<0.05).In research group, the incidence of cesarean section, premature rupture of membranes, postpartum hemorrhage, heart failure were 97.67%, 13.95%, 11.63% and 11.63%, respectively, which were higher than that in control group ( 79.83%, 5.25%, 5.25% and 4.14%) with significant difference ( P <0.05 ) .In research group, the incidence of newborn infection and jaundice were 25.58%and 48.84%,which were higher than that in control group ( 15.19% and 32.60%) with significant difference ( P <0.05 ) .Conclusion Compared to singleton pregnancy complicated with preeclampsia, twin pregnancy complicated with preeclampsia increased the incidence of cesarean section, premature rupture of membranes, postpartum hemorrhage and heart failure, and extended maternal hospital stay.%目的探讨单、双胎妊娠并发子痫前期的临床特点及妊娠结局。方法选取2009年1月至2013年4月在广州医科大学附属第三医院产科住院分娩的43例双胎并发子痫前期的孕妇为研究组,362例单胎并发子痫前期产妇作为对照组,回顾性分析两组患者的临床特点及母婴结局的情况。结果研究组住院时间(13.28±11.23)d,较对照组(9.48±4.97)d延长,t=2.20,P<0

  4. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  5. Different Sonographic Faces of Ectopic Pregnancy.

    Science.gov (United States)

    Chanana, Charu; Gupta, Nishant; Bansal, Itisha; Hooda, Kusum; Sharma, Pranav; Gupta, Mohit; Gandhi, Darshan; Kumar, Yogesh

    2017-01-01

    Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

  6. 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.

  7. Different Sonographic Faces of Ectopic Pregnancy

    Science.gov (United States)

    Chanana, Charu; Gupta, Nishant; Bansal, Itisha; Hooda, Kusum; Sharma, Pranav; Gupta, Mohit; Gandhi, Darshan; Kumar, Yogesh

    2017-01-01

    Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

  8. Twin tubal pregnancy: A large unruptured ectopic pregnancy.

    Science.gov (United States)

    Goswami, Deepti; Agrawal, Nidhi; Arora, Vrinda

    2015-11-01

    Twin ectopic pregnancy is a rare occurrence, with an estimated incidence of 1 in 20 000 spontaneous pregnancies. We describe a case of unilateral twin ectopic pregnancy in which the gravid fallopian tube showed no signs of tubal rupture despite marked tubal distension. A 25-year-old woman presented with clinical features suggestive of large right-sided tubal ectopic pregnancy. Serum β-human chorionic gonadotropin was 10 800 IU/mL. Laparotomy revealed markedly distended right fallopian tube. There was no hemoperitoneum. The tube contained twin gestational sacs. The crown-rump length of the embryos was 2 cm. The ectopic gestation was thus unique, in that despite marked tubal distension, the trophoblastic invasion was not significant to cause tubal rupture. There may be a role for medical management based on individual gestational sac size in selected cases of twin tubal pregnancy in which there is no evidence of hemoperitoneum.

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

    Science.gov (United States)

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

    2013-01-01

    Transforming growth factor beta (TGF-βs) are secreted from cells as latent complexes and the activity of TGF-βs is controlled predominantly through activation of these complexes. Tolerance to the fetal allograft is essential for pregnancy success; TGF-β1 and -β2 play important roles in regulating these processes. Pregnancy-specific β-glycoproteins (PSGs) are present in the maternal circulation at high concentration throughout pregnancy and have been proposed to have anti-inflammatory functions. We found that recombinant and native PSG1 activate TGF-β1 and TGF-β2 in vitro. Consistent with these findings, administration of PSG1 protected mice from DSS-induced colitis, reduced the secretion of pro-inflammatory cytokines and increased the number of T regulatory cells. The PSG1-mediated protection was greatly inhibited by the co-administration of neutralizing anti-TGF-β Ab. Our results indicate that proteins secreted by the placenta directly contribute to the generation of active TGF-β and identify PSG1 as one of the few known biological activators of TGF-β2. PMID:23945545

  10. 妊娠高血压综合症患者的临床护理%Clinical Nursing of Patients with Pregnancy - induced Hypertension Syndrome

    Institute of Scientific and Technical Information of China (English)

    李合平

    2011-01-01

    Objective To explore the nursing methods and key points of care in the clinical treatment course of pregnancy- induced hypertension syndrome. Methods We retrospectively analyzed the nursing experience of 68 patients with pregnancy- induced hypertension syndrome who were hospitalized in the First Hospital Affiliated to Changsha Medical College from January to December 2010. All the patients were received general nursing, psychological nursing, and dietary nursing. According to the severity of disease, different patients were given different nursing care. Results 76.9% of patients with mild pregnancy- induced hypertension were cured, with the control rate of 15.4%. 59.4% of patients with moderate pregnancy - induced hypertension were changed to mild, with the control rate of 15.6%. 20.0% of patients with severe pregnancy - induced hypertension were changed to mild, with the control rate of 40.0%. All the patients were successfully delivered, no life - threatening medical condition was found in mothers and neonates. The control rate of treatment group was superior to that of control group (P<0.05). Conclusions A variety of effective nursing cares combined with medical treatments can improve the efficacy of drug therapies, reduce complications and mortality, and ensure the safety of mothers and neonates.%目的 探讨妊娠高血压综合症患者在临床治疗过程中的护理方法和要点.方法 对长沙医学院2010年1-12月68例妊娠高血压综合症患者进行临床护理监测,对患者采取一般护理、心理护理和饮食护理相结合,轻度、中度和重度患者分别采取不同的护理方式,并总结临床护理经验.结果 76.9%轻度妊高症患者治愈,控制率为15.4%;59.4%中度妊高症患者转至轻度,控制率为15.6%;20.0%重度妊高症患者转至轻度,控制率为40.0%.患者全部顺利生产,产妇和新生儿均无生命危险.实验组显著优于对照组(P<0.05).结论 各种有效护理与医疗

  11. 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

  12. Pregnancy Complications

    Science.gov (United States)

    ... pregnancy, generally referred to as severe maternal morbidity (SMM) , affect more than 50,000 women in the ... this burden has been steadily increasing. Rises in SMM are likely driven by a combination of factors, ...

  13. Teenage Pregnancy

    Science.gov (United States)

    ... Pediatrician Ages & Stages Prenatal Baby Toddler Preschool Gradeschool Teen Dating & Sex Fitness Nutrition Driving Safety School Substance Abuse Young Adult Healthy Children > Ages & Stages > Teen > Dating & Sex > Teenage Pregnancy Ages & Stages Listen Español Text Size ...

  14. Pre-pregnancy and pregnancy predictors of obesity.

    Science.gov (United States)

    Melzer, K; Schutz, Y

    2010-12-01

    Obesity has progressively become a global epidemic that constitutes one of the biggest current health problems worldwide. Pregnancy is a risk factor for excessive weight gain. Factors that may predict development of obesity in later life mainly include gestational weight gain, pre-pregnancy nutritional status, age, parity and race. Change in lifestyle factors, such as eating habits, enrollment in physical activity, smoking and duration of lactation, in addition to the above factors, may also contribute to the development of obesity but are still not fully understood. Women who retain more body weight after pregnancy have, in general, larger pregnancy body weight gain, higher pre-pregnancy body mass index, marked weight changes in previous pregnancies, lactate slightly less and stop smoking during pregnancy to a larger extent. In addition, irregular eating habits and decreased leisure time activity after delivery influence postpartum weight retention. Taking into consideration the epidemic of obesity, with all its adverse long-term consequences, there is an increasing need to promote counseling before, during and after pregnancy on the role of diet and physical activity in reproductive health.

  15. Maternal Physical Activity and Insulin Action in Pregnancy and Their Relationships With Infant Body Composition

    OpenAIRE

    Pomeroy, Jeremy; Renström, Frida; Gradmark, Anna M.; Mogren, Ingrid; Persson, Margareta; Bluck, Les; Wright, Antony; Kahn, Steven E; Domellöf, Magnus; Franks, Paul W.

    2013-01-01

    OBJECTIVE We sought to assess the association between maternal gestational physical activity and insulin action and body composition in early infancy. RESEARCH DESIGN AND METHODS At 28–32 weeks' gestation, pregnant women participating in an observational study in Sweden underwent assessments of height, weight, and body composition, an oral glucose tolerance test, and 10 days of objective physical activity assessment. Thirty mothers and infants returned at 11–19 weeks postpartum. Infants under...

  16. 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.

  17. Diabetes e gravidez: aspectos clínicos e perinatais Diabetes and pregnancy: clinical and perinatal features

    Directory of Open Access Journals (Sweden)

    Francisco Mauad Filho

    1998-05-01

    Full Text Available Durante a gestação, as pacientes que não se ajustam às alterações metabólicas próprias da gravidez e aquelas com alterações prévias no metabolismo dos carboidratos apresentam um aumento significativo da morbimortalidade perinatal. Visando contribuir para o aperfeiçoamento da conduta pré-natal na gestante diabética, os autores estudaram retrospectivamente 60 casos de gravidez associada ao diabetes, atendidos no Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. A amostra estudada foi dividida em dois grupos: com controle pré-natal segundo o protocolo para a gestante diabética e encaminhadas ao Serviço para resolução da gravidez. No grupo com pré-natal adequado não ocorreram óbitos fetais ou neonatais e as complicações neonatais observadas estiveram associadas principalmente com a prematuridade. No grupo encaminhado para resolução e sem seguimento pré-natal adequado foram diagnosticados 3 casos de malformação fetal múltipla, 1 caso de hipoglicemia neonatal grave, 3 casos de prematuridade, 1 caso de retardo de crescimento intra-uterino, 1 caso de macrossomia fetal e ainda um caso de óbito neonatal. A comparação entre os grupos estudados demonstra claramente os benefícios do controle pré-natal adequado para a gestante diabética e expõe também a necessidade de uma maior integração entre a rede periférica regional e os centros de atenção terciária, permitindo o diagnóstico e o encaminhamento precoce de todos os casos de gestação complicada pelo diabetes.The patients who do not adjust to the metabolic changes of pregnancy and those with previous alterations in carbohydrate metabolism show a significant increase in perinatal morbidity and mortality. In order to contribute to a better prenatal management of diabetic patients, the authors reviewed 60 cases of diabetes during pregnancy, assisted at the Department of Obstetrics and Gynecology

  18. 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.

  19. Exploring Patient Activation in the Clinic: Measurement from Three Perspectives

    Science.gov (United States)

    Ledford, Christy J. W.; Ledford, Christopher C.; Childress, Marc A.

    2013-01-01

    Objective. To further conceptualize and operationalize patient activation (PA), using measures from patient, physician, and researcher perspectives. Data Source/Study Setting. Multimethod observation in 2010 within a family medicine clinic. Study Design. Part of an intervention with 130 patients with type 2 diabetes, this observational study…

  20. 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)

  1. TYROSINE KINASE INHIBITORS AND PREGNANCY

    Directory of Open Access Journals (Sweden)

    Elisabetta Abruzzese

    2014-04-01

    Full Text Available The management of patients with chronic myeloid leukemia (CML during pregnancy has became recently a matter of continuous debate.  The introduction of the Tyrosine Kinase Inhibitors (TKIs in clinical practice has dramatically changed the prognosis of CML patients.  Patients diagnosed in chronic phase can reasonably expect many years of excellent disease control and good quality of life, as well as a normal life expectancy.  This fact has come the necessity to address issues relating to fertility and pregnancy. Physicians are not infrequently being asked for advice regarding the need for, and or the appropriateness of, stopping treatment in order to conceive. In this report we will review the data published in terms of fertility, conception, pregnancy, pregnancy outcome and illness control for all the approved TKIs, as well as suggest how to manage a planned and/or unplanned pregnancy.

  2. Clinical analysis of 73 pregnancy cases with severe hepatitis%妊娠合并重型肝炎73例临床分析

    Institute of Scientific and Technical Information of China (English)

    李炜; 王平; 刘保华; 李晓良; 李卓家; 杨桂林; 杨燕

    2014-01-01

    妊娠晚期患者外周血 GLB(28.74±4.82)g/L、Alb (49.42±10.32)g/L与妊娠早中期患者外周血GLB(28.32±5.68)g/L、Alb(40.23±5.96)g/L比较均出现不同程度的增高。结论妊娠合并重型肝炎病情危重,及时纠正患者低蛋白血症及肝功能障碍,适时终止妊娠可阻止肝脏功能进一步损害,能预防弥散性血管内凝血的发生,对降低母婴围产期病死率有重要的意义。%Objective To investigate the clinical features and treatment of pregnancy with severe hepatitis and reduce perinatal mortality with maternal disease. Methods The clinical data of 73 pregnancy patients with severe hepatitis from 2007 January to 2012 December in our hospital were retrospectively analyzed. Results The mortality rate of these 73 patients was 8.22% (6/73). Ten cases were terminated pregnancy of termination by cesarean section,of which 4 cases underwent hysterectomy,and 3 cases died. Other 63 cases delivered,of which 2 cases died from vaginal delivery,and 1 case died from cesarean section;perinatal survival rate of the rest of 61 cases (1 cases of twins)was 81.97% (50/61). Compared with single pathogen infection,the patients which infected by two different pathogen had higher fatality rate and worse pregnancy outcomes. Cesarean section rate (55. 56% ,10/18 ),the mortality rate (16.67% ,3/18)and fetal mortality (16.67% ,3/18)in patients with hepatitis B infection alone were significantly higher than those of patients with other hepatitis virus infection;Cesarean section rate (1 00% ,1 5/1 5 ),mortality rate (20% , 3/1 5 )and fetal mortality (26 .67% ,4/1 5 )were significantly higher in patients combined with hepatitis A and B infection than those of other patients with other hepatitis virus infection,and the differences were statistically significant (P<0.05),respectively. Late pregnancy patients had a significantly lower rate of efficacy therapy with 62.5% (30/48)than that of early pregnancy patients with 88% (22/25)(P<0

  3. 辅助生殖技术后特殊部位异位妊娠8例临床分析%Clinical analysis of assisted reproductive technology in 8 cases with ectopic pregnancy of specific position

    Institute of Scientific and Technical Information of China (English)

    胡芬; 王仙萍; 王咏莲; 武学清

    2015-01-01

    Objective To investigate the diagnosis and treatment plan of assisted reproductive technology (ART) in specific ectopic pregnancy.Methods 8 cases with specific ectopic pregnancy in our center from January 2014 to June 2014 were analyzed retrospectively. After the diagnosis of ectopic pregnancy were promptly underwent laparoscopic surgery.Results Eight cases were pathologically confirmed ectopic pregnancy, intrauterine pregnancy with tubal pregnancy were four cases, and interstitial tubal pregnancy were two cases, one case with bilateral tubal pregnancies, one case with abdominal pregnancy. 4 cases with ectopic pregnancy after intrauterine pregnancy did not occur abortion, one case had been childbirth, the neonatal currently had no obvious abnormalities, and the other three cases were continuing pregnancy. The remaining four cases were in the postoperative serum hCG to normal within 30 days.Conclusion In patients with clinical work for ART should be carefully followed up after, and should be given individualized treatment combined with patient needs based on the patient's condition. Incidence of ectopic pregnancy after ART treatment by a variety of factors, clinical work should be strengthened to specific ectopic pregnancy awareness and attention in order to avoid misdiagnosis.%目的:探讨在辅助生殖技术(ART)后特殊部位异位妊娠的诊治方案。方法对我中心2014年1~6月ART后特殊部位异位妊娠8例进行回顾性分析,其诊断为异位妊娠后均及时进行了腹腔镜手术。结果8例术后病理均证实为异位妊娠,其中宫内妊娠合并输卵管妊娠4例,输卵管间质部妊娠2例,双侧输卵管同时妊娠1例,腹腔妊娠1例。术后宫内妊娠合并异位妊娠患者4例术后均未发生流产,其中1例已分娩,新生儿目前无明显异常,另3例目前仍在继续妊娠中。其余4例患者血HCG均在术后30d之内降至正常。结论在临床工作中对于进行ART后的患者应

  4. 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.

  5. [Intensity of lipid peroxidation processes and activity of antioxidant enzymes in erythrocytes during anemia in pregnancy].

    Science.gov (United States)

    Riazantsev, V V; Grishchenko, O V; Pereĭra, A A; Belous, A M

    1996-01-01

    The given report deals with investigation of the level of spontaneous lipid peroxidation (LPO) (as judged by the accumulation of MDA) and activity of antioxidative enzymes (GSH-peroxidase, GSH-reductase) in red blood cells of pregnant women (24-26 weeks) suffering from minor (blood Hb is 95 g/l) and medium (blood Hb is 85-90 g/l) anemias. We have found that as the anemia becomes deeper, the red blood cells of pregnant women demonstrate a linear increase in the level of spontaneous LPO, which rises by 54% during anemia of moderate severity (p < 0.02) as compared with control. At the same time, simultaneously with LPO, the activity of the above glutathione-containing enzymes increases as the anemia progresses, which, apparently, is of the compensatory nature, aimed at the maintenance of the reduced glutathione pool, the latter being an important component of the cell antioxidative system during LPO activation. The authors think the increased activity of the physiological antioxidative system and intensification of the LPO processes to be a natural adaptive process, since lipid hydroperoxides are the activators of synthesis of prostaglandins, which are required in delivery.

  6. Analysis of the clinical diagnosis and treatment of acute fatty liver of pregnancy%妊娠急性脂肪肝的临床诊治分析

    Institute of Scientific and Technical Information of China (English)

    张彦

    2012-01-01

    Objective: To explore the early diagnosis and therapeutic principle of acute fatty liver of pregnancy (AFLP). Methods: Clinical data of 7 cases with AFLP who were treated in the Chinese PL A General Hospital from January 2007 to October 2011 were analyzed retrospectively. Results: AFLP often presented symptoms including anorexia (6 cases, 85. 7%) ,nausea and vomiting (5 cases, 71. 4%), jaundice (7 cases, 100. 0%) and edema (6 cases, 85. 7%),and it was usually complicated with postpartum hemorrhage (5 cases, 71. 4%), renal failure (3 cases, 42. 9%), disseminated intravascular coagulation (3 cases, 42. 9%) and so on. Six AFLP patients recovered after early delivery,and comprehensive treatments. One pregnant woman died of multiple organ dysfunction syndrome. There was one perinatal fetus death. Conclusion: AFLP is a serious complication which occurs in late trimester of pregnancy. Early diagnosis, termination of pregnancy by cesarean section as soon as possible, and comprehensive therapy are crucial for improving the prognosis of both mother and newborn.%目的:探讨妊娠急性脂肪肝( AFLP)的早期诊断方法和治疗原则.方法:对2007年1月-2011年10月在解放军总医院收治的7例AFLP患者的临床资料进行回顾性分析.结果:7例AFLP患者中食欲下降6例(85.7%),恶心、呕吐5例(71.4%),黄疸7例(100.0%),水肿6例(85.7%);并发产后大出血5例(71.4%),肾功能衰竭3例(42.9%),弥散性血管内凝血(DIC)3例(42.9%).6例患者经过及时终止妊娠和综合治疗,预后良好.1例孕产妇死于多脏器功能障碍综合症,1例围产儿死亡.结论:早期诊断,及时终止妊娠,加强多学科综合治疗是改善AFLP母婴预后的关键.

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

    Directory of Open Access Journals (Sweden)

    Joanna Chorostowska-Wynimko

    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

  8. Effect of Tramadol on Rabbit Uterine Contractile Activity Induced in Late Pregnancy.

    Science.gov (United States)

    Yakovleva, A A; Nazarova, L A; Prokopenko, V M; Pavlova, N G

    2017-01-01

    Effect of Tramadol infusion (5 mg/ml) on oxytocin-induced uterine contractile activity was studied in chronic experiment on female rabbits with different degrees of biological readiness for parturition. In case of sufficient biological readiness for parturition, Tramadol did not change the number of uterine contractions, but increased the amplitude and duration of each contraction against the background of increased creatine phosphate consumption by the myometrium. At the same time, Tramadol infusion to females without biological readiness for partirition suppressed induced uterine contractile activity by reducing the amplitude of each uterine contraction.

  9. 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