Clinical pattern of gynaecological / early pregnancy complaints and ...

African Journals Online (AJOL)

complaints of vaginal bleeding with or without pains, history of amenorrhea or infertility ; clinical and ultrasound impressions of early pregnancy complaints including ectopic pregnancies and pelvic inflammatory diseases (PID) with exclusion of uro-genital and gastrointestinal complaints/ cases. Pregnancies greater than 12 ...

Menstrual cycle pattern and fertility

DEFF Research Database (Denmark)

Kolstad, Henrik A.; Bonde, Jens Peter; Hjøllund, Niels Henrik

1999-01-01

OBJECTIVE: To characterize how the menstrual cycle pattern relates to fertility regardless of potential biases caused by inappropriate coital timing during the menstrual cycle or early embryonal loss. DESIGN: Prospective follow-up study. SETTING: Healthy couples recruited throughout Denmark....... PATIENT(S): Two hundred ninety-five couples who were planning their first pregnancy were followed up from the discontinuation of birth control until a pregnancy was recognized within six menstrual cycles. Early embryonal losses were detected by changes in urinary hCG levels. INTERVENTION(S): None. MAIN...... OUTCOME MEASURE(S): The probability of pregnancy occurring within one menstrual cycle (fecundity). RESULT(S): In women who had a cycle length that differed by >10 days from the usual cycle length, fecundity was approximately 25% that of women who had no variation (odds ratio 0.25, 95% confidence interval...

[Diagnosis and monitoring of endangered early pregnancies with determination of oestrone, oestradiol 17beta, oestriol, progesterone and HPL in plasma and the pregnancy test in graduated dilutions of urine (author's transl)].

Science.gov (United States)

Strecker, J R; Negulescu, R; Dahlén, H; Musch, K

1977-06-01

Unconjugated oestrone (Oe1), oestradiol-17beta (Oe2), oestriol (Oe3), progesterone (P) and HPL in plasma were determined by radioimmunoassay and the immunological pregnancy-test in urine was carried out in 70 patients with normal pregnancy or imminent abortion from 4th-20th week of gestation. Oe2 and HPL showed the most pronounced rises, Oe3 increased especially after the first trimester. In cases with abortion symptoms and poor prognosis Oe2 and HPL gave the most reliable results concerning the endocrin function of early normal pregnancy. Oe1- and P-values in normal pregnancy did not differ so clearly from concentrations observed during normal menstrual cycles and were thus of less value. The pregnancy-test was positive (greater than 1000 IU/1) even in most cases of dead pregnancy and therefore not reliable. With increasing production of oestrogen precursors in the fetal adrenal cortex after the first trimester determination of Oe3 becomes more important. In cases with abortion symptoms in early pregnancy and subsequent normal development, plasma Oe2- and Oe3- values represented best criteria for a prognosis. -- For the diagnosis and control of the endangered early pregnancy we recommend, as a consequence of this study, determination of Oe2 up to the 13th week of pregnancy and thereafter Oe3 in maternal plasma.

Adolescent pregnancy: intervention into the poverty cycle.

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Johnson, C L

1974-01-01

Adolescent pregnancy, irrespective of the marital status of the mother, seems to be a determining factor in the incidence of female headed households, divorce, excessive fertility, and poverty. In addition, the pregnant teenager is, obstetrically, a high risk patient, and her offspring, due to poor prenatal care and inadequate nutrition on the part of the mother, is likely to suffer in terms of physical and mental development. This in turn will lead to further poverty, which will continue the cycle. One way to interrupt the cycle may be by delaying the first birth to young adolescent girls. There are 3 stages at which prevention can take place: preventing intercourse, preventing conception, and terminating pregnancy. For the teenager, preventing conception seems the most feasible. Effforts to design family planning programs especially for teenager should be expanded. By this, 2 generation can benefit: the teenager herself and her potential offspring.

Hormonal monitoring of early pregnancy by a direct radioimmunoassay of steroid glucuronides in first morning urine

International Nuclear Information System (INIS)

Mendizabal, A.F.; Quiroga, S.; Farinati, Z.; Lahoz, M.; Nagle, C.

1984-01-01

The usefulness of the direct 4-hour radioimmunoassay of estriol-16-glucuronide (E 3 G) and pregnanediol-3-glucuronide (P 2 G) in first morning urine (FMU) for establishing a prognosis of the early pregnancy outcome was evaluated in 106 patients that became pregnant. Microaliquots of FMU were serially assayed from day 3 of the conception cycle until day 80 of pregnancy. The E 3 G and P 2 G profiles of 19 pregnancies which terminated in spontaneous abortion with either a diagnosis of the blighted ovum syndrome (n = 11) or presumption of a corpus luteum/trophoblast failure (n = 8) have been compared with those of clinically normal pregnancies (n = 87). Normal pregnancies displayed typical patterns of E 3 G and P 2 G development, while variations were observed in abortive events that reflected changes of the fetoplacental unit

Pregnancy and neonatal outcomes following letrozole use in frozen-thawed single embryo transfer cycles.

Science.gov (United States)

Tatsumi, T; Jwa, S C; Kuwahara, A; Irahara, M; Kubota, T; Saito, H

2017-06-01

Are pregnancy and neonatal outcomes following letrozole use comparable with natural and HRT cycles in patients undergoing single frozen-thawed embryo transfer (FET)? Letrozole use was significantly associated with higher rates of clinical pregnancy, clinical pregnancy with fetal heart beat and live birth, and with a lower rate of miscarriage, compared with natural and HRT cycles. Letrozole is the most commonly used aromatase inhibitor for mild ovarian stimulation in ART. However, the effect of letrozole on pregnancy and neonatal outcomes in FET are not well known. A retrospective cohort study was conducted using data from the Japanese national ART registry between 2012 and 2013. A total of 110 722 single FET cycles with letrozole (n = 2409), natural (n = 41 470) or HRT cycles (n = 66 843) were included. The main outcomes were the rates of clinical pregnancy, clinical pregnancy with fetal heart beat, miscarriage and live birth. Adjusted odds ratios and relative risks (RRs) were calculated using a generalized estimating equation adjusting for correlations within clinics. The rates of clinical pregnancy, clinical pregnancy with fetal heart beat, and live birth were significantly higher, while the rate of miscarriage was significantly lower in the letrozole group compared with the natural and HRT groups. In blastocyst stage transfers, the adjusted RRs for clinical pregnancy with fetal heart beat of letrozole compared with natural and HRT cycles were 1.48 (95% CI: 1.41-1.55) and 1.62 (95% CI: 1.54-1.70), respectively. Similarly, the adjusted RRs of letrozole for miscarriage compared with natural and HRT cycles were 0.91 (95% CI: 0.88-0.93) and 0.84 (95% CI: 0.82-0.87), respectively. Neonatal outcomes were mostly similar in letrozole, natural and HRT cycles. Important limitations of this study included the lack of information concerning the reasons for selecting the specific FET method, parity, the number of previous ART failures, embryo quality and the dose and duration

Selected non-somatic risk factors for pregnancy loss in patients with abnormal early pregnancy

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Maciej Paszkowski

2015-12-01

The results of this study confirm the complexity of the early pregnancy loss etiopatogenesis. Further research need to be conducted in order to identify the non-somatic causative agents of various clinical forms of miscarriage. It may help do select women in reproductive age at high risk of early pregnancy loss and show the ways in which effective preventive measures can be introduced in such population.

Effects of piroxicam administration on pregnancy outcome in intrauterine insemination (IUI) cycles: a randomized clinical trial.

Science.gov (United States)

Zarei, A; Mahboubi, M; Parsanezhad, M E; Alborzi, S; Younesi, M; Madadi, G

2016-01-01

Uterus contractibility is considered a powerful prognostic factor in predicting the embryo transfer outcome. Moreover, uterine contractions are known to be stimulated by prostaglandins which are produced by cyclooxygenase from arachidonic acid. As such, suppressing the inflammatory response and contractions using anti-inflammatory and relaxant agents is expected to result in increased success rate of embryo transfer and artificial insemination. To investigate the effect of piroxicam administration on the success rate in intrauterine insemination (IU) cycles in patients presenting with unexplained infertility. This randomized, placebo-controlled clinical trial included 260 women with unexplained infertility undergoing IUI cycles. Patients were randomly assigned to receive either piroxicam ten mg/day on days 4-6 after IUI or placebo (control group). The main outcome measures were number of IUI cycles, pregnancy, abortion, and multiple pregnancy rates. The pregnancy rate was found to be 25 (19.2%) and 16 (12.3%) in piroxicam and control groups, respectively (p = 0.039). Five patients (3.8%) in piroxicam group experienced twin pregnancy whereas only three patients (2.3%) in control group had twin pregnancy (p = 0.361). The pregnancy rate per cycle was also significantly higher in those who received piroxicam as compared to controls (11.16 vs. 6.66; p = 0.021). Administration of piroxicam after IUI is associated with decreased number of cycles, as well as increased pregnancy rate and pregnancy rate per cycle in IUI cycles. However, piroxicam did not have any effect on abortion, multiple pregnancy, and ongoing pregnancy rates.

Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

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Ashok K. Balhara

2013-01-01

Full Text Available An early and accurate diagnosis of reproductive dysfunctions or aberrations is crucial to better reproductive management in livestock. High reproductive efficiency is a prerequisite for high life-time production in dairy animals. Early pregnancy diagnosis is key to shorten the calving interval through early identification of open animals and their timely treatment and rebreeding so as to maintain a postpartum barren interval close to 60 days. A buffalo, the most important dairy animal in the Indian subcontinent, is known for problems related to high calving interval, late puberty, and high incidence of anestrus. Lack of reliable cow-side early pregnancy diagnosis methods further aggravates the situation. Several methods of pregnancy diagnosis are being practiced in bovine species, yet none qualifies as the ideal pregnancy diagnosis method due to the inherent limitations of sensitivity, accuracy, specificity, speed, and ease of performing the test. The advancement of molecular techniques like proteomics and their applications in animal research has given a new hope to look for pregnancy biomarker molecules in these animals. This review attempts to examine common pregnancy diagnosis methods available for dairy animals, while assessing the usefulness of the modern technologies in detecting novel pregnancy markers and designing future strategies for research in this area.

Changes in fruit and vegetable consumption habits from pre-pregnancy to early pregnancy among Norwegian women.

Science.gov (United States)

Skreden, Marianne; Bere, Elling; Sagedal, Linda R; Vistad, Ingvild; Øverby, Nina C

2017-04-04

A healthy diet is important for pregnancy outcome and the current and future health of woman and child. The aims of the study were to explore the changes from pre-pregnancy to early pregnancy in consumption of fruits and vegetables (FV), and to describe associations with maternal educational level, body mass index (BMI) and age. Healthy nulliparous women were included in the Norwegian Fit for Delivery (NFFD) trial from September 2009 to February 2013, recruited from eight antenatal clinics in southern Norway. At inclusion, in median gestational week 15 (range 9-20), 575 participants answered a food frequency questionnaire (FFQ) where they reported consumption of FV, both current intake and recollection of pre-pregnancy intake. Data were analysed using a linear mixed model. The percentage of women consuming FV daily or more frequently in the following categories increased from pre-pregnancy to early pregnancy: vegetables on sandwiches (13 vs. 17%, p <0.01), other vegetables (11 vs. 14%, p = 0.01), fruits (apples, pears, oranges or bananas) (24 vs. 41%, p < 0.01), other fruits and berries (8 vs. 15%, p < 0.01) and fruits and vegetables as snacks (14 vs. 28%, p < 0.01). The percentage of women who reported at least daily consumption of vegetables with dinner (22% at both time points) was stable. A higher proportion of older women increased their consumption of vegetables and fruits as snacks from pre-pregnancy to early pregnancy compared to younger women (p=0.04). We found an increase in the proportion of women consuming FV daily or more frequently from pre-pregnancy to early pregnancy. ClinicalTrials.gov database, NCT01001689 . https://clinicaltrials.gov/ct2/show/NCT01001689?term=NCT01001689&rank=1 .

Hormonal monitoring of early pregnancy by a direct radioimmunoassay of steroid glucuronides in first morning urine

Energy Technology Data Exchange (ETDEWEB)

Mendizabal, A.F.; Quiroga, S.; Farinati, Z.; Lahoz, M.; Nagle, C.

1984-11-01

The usefulness of the direct 4-hour radioimmunoassay of estriol-16-glucuronide (E/sub 3/G) and pregnanediol-3-glucuronide (P/sub 2/G) in first morning urine (FMU) for establishing a prognosis of the early pregnancy outcome was evaluated in 106 patients that became pregnant. Microaliquots of FMU were serially assayed from day 3 of the conception cycle until day 80 of pregnancy. The E/sub 3/G and P/sub 2/G profiles of 19 pregnancies which terminated in spontaneous abortion with either a diagnosis of the blighted ovum syndrome (n = 11) or presumption of a corpus luteum/trophoblast failure (n = 8) have been compared with those of clinically normal pregnancies (n = 87). Normal pregnancies displayed typical patterns of E/sub 3/G and P/sub 2/G development, while variations were observed in abortive events that reflected changes of the fetoplacental unit.

Clinical pattern of gynecological/early pregnancy complaints and the ...

African Journals Online (AJOL)

... complaints of vaginal bleeding, with or without pain, history of amenorrhea or infertility, clinical and ultrasound impression of early pregnancy complaints, including ectopic pregnancies and pelvic inflammatory diseases (PID), with exclusion of urogenital and gastrointestinal complaints/cases. Pregnancies greater than 12 ...

Correlation between pregnancy outcomes and hormone levels in early pregnancy of women with threatened abortion and subchorionic hematoma

Directory of Open Access Journals (Sweden)

Xiao-Hua Liu

2016-02-01

Full Text Available Objective: To investigate the correlation between pregnancy outcomes and hormone levels in early pregnancy of women with threatened abortion and subchorionic hematoma. Methods: Three groups of subjects (48 cases each were selected including the group of healthy pregnant women (Group C, and the two groups of subchorionic hematoma diagnosed via B-ultrasound examination with and without (Groups A and B positive symptoms of threatened abortion such as abdominal pain, colporrhagia etc. Chemiluminescence analysis was applied to determine serum progesterone and HCG levels of all three groups, and investigate the correlation between variations of such levels and pregnancy outcomes. Results: Statistical significance existed in the differences between serum progesterone and HCG levels of the three groups at 12, 28 and 37 weeks of gestation. In early pregnancy, serum progesterone and β-HCG levels were lower in Group A than Groups B and C, and lower in Group B than Group C. In the second trimester, the serum β-HCG level was higher, while the progesterone level lower in Group A than Groups B and C; the serum β-HCG level higher, while the progesterone level lower in Group B than Group C. And the comparative results in late pregnancy were the same as those of the second trimester. The premature birth rate, abortion rate, fetal death rate were the highest, and the full time delivery rate was the lowest in Group A among all the three groups. Adverse pregnancy outcomes of women with threatened abortion and subchorionic hematoma were closely related to serum progesterone and HCG levels in early gestation. Conclusion: Serum progesterone and HCG levels in early pregnancy of women with threatened abortion and subchorionic hematoma are positively correlated with pregnancy outcomes; the lower such levels of the two early indicators, the higher the incidence of adverse pregnancy outcomes. Therefore, tests of early pregnancy serum progesterone and HCG levels can be

Management of early pregnancy loss

NARCIS (Netherlands)

Graziosi, G. C. M.; Mol, B. W.; Ankum, W. M.; Bruinse, H. W.

2004-01-01

Objectives: In order to assess the available evidence on the management of early pregnancy loss, we performed a meta-analysis on the subject. Methods: MEDLINE and EMBASE were searched for randomized studies reporting on the effectiveness of expectant management, misoprostol treatment or curettage.

Mental health in early pregnancy is associated with pregnancy outcome in women with pregestational diabetes

DEFF Research Database (Denmark)

Callesen, N F; Secher, A L; Cramon, P

2015-01-01

-related quality of life, anxiety, depression and locus of control were seen in women delivering large or appropriate for gestational age infants. CONCLUSIONS: Poor mental quality of life and the presence of depressive symptoms in early pregnancy were associated with preterm delivery in women with pregestational......AIM: To explore the role of early pregnancy health-related quality of life, anxiety, depression and locus of control for pregnancy outcome in women with pregestational diabetes. METHODS: This was a cohort study of 148 pregnant women with pregestational diabetes (118 with Type 1 diabetes and 30...... with Type 2 diabetes), who completed three internationally validated questionnaires: the 36-item Short-Form Health Survey, the Hospital Anxiety and Depression Scale and the Multidimensional Health Locus of Control survey at 8 weeks. Selected pregnancy outcomes were preterm delivery (

Effect of local endometrial injury on pregnancy outcomes in ovum donation cycles.

Science.gov (United States)

Dain, Lena; Ojha, Kamal; Bider, David; Levron, Jacob; Zinchenko, Viktor; Walster, Sharon; Dirnfeld, Martha

2014-10-01

To evaluate the effect of local endometrial injury (LEI) on clinical outcomes in ovum donation recipients. Retrospective cohort analysis of ovum donation cycles conducted from 2005 to 2012. Two private IVF centers. Total 737 ovum donation cycles. LEI by endometrial "scratch" with the use of a Pipelle catheter. Clinical pregnancy and live birth rates. No statistically significant differences were found in clinical pregnancy rates and live birth rates in cycles subjected to LEI compared with those without. Combination of LEI with fibroid uterus resulted with significantly higher clinical pregnancy rates compared with LEI in normal uterine anatomy. This is the first study done in ovum recipients who underwent LEI by a "scratch" procedure after failed implantation. Unlike most previous reports, which found improved pregnancy rates with the use of "scratch effect" or "minor endometrial injury" after repeated implantation failures in standard IVF with own eggs, we did not find any changes in implantation rates in a population of egg recipients following this procedure. In view of a possible positive effect of LEI in cycles with a previous four or more failures, prospective randomized controlled studies are warranted to better define the target population who may benefit from this intervention. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan [Aju University SChool of Medicine, Suwon (Korea, Republic of)

1999-06-15

To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

Transvaginal color Doppler imaging of uterine contractions in early pregnancies: Significance of uterine contractions in early pregnancy failure

International Nuclear Information System (INIS)

Lee, Eun Ju; Han, Chang Jin; Suh, Jung Ho; Kwon, Hyuck Chan

1999-01-01

To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography (TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy failure. 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examines with TVCDS. The presence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude (grade 1-3), and interval of uterine contractions were also evaluated. Uterine contractions were identified in 42 (55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2 (5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disappeared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients (57.7%),showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients (76.6%) showed uterine contraction of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4 (20%) of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The presence of uterine contractions was significantly different in abnormal pregnancies compared with that of normal and also among the tree different groups of abnormal pregnancies, but the amplitude did not differ.

Improvement of Dairy Cattle Productivity Through Early Non-Pregnancy Diagnosis

International Nuclear Information System (INIS)

Indetie, D.

2002-01-01

Reproductive wastage bears a great deal on the productivity of dairy cattle by prolonging the calving intervals thereby reducing the milk produced and the number of calves born over the lifetime of a cow. early identification of a non-cyclic or non-pregnant cows can result in early intervention and rebreeding of the affected cattle ths improving productivity. Determination of progesterone levels in milk can be used as a good indicator of the reproductive status of dairy cows. five hundred and thirty two cows were sampled by collecting milk sample on day of AI, day 12 and 13 and day 22 to 24 after AI. The milk samples were assayed to determine progesterone levels at these stages of the estrus cycle, which were then used to deduce the reproductive status of the cow. Out of the cows sampled 16% were not cycling and had progesterone levels of 1 nm/L or less during the mid luteal phase. Insemination of cows whose Progesterone levels were less than 3 nm/L resulted in conception rates of 80% and indication of the timeliness of insemination. Inseminating cows 19 hours after onset of standing heat resulted in conception rates of 79% compared with insemination early whose conception rates were 15%.It can be concluded that the timeliness of AI will determine the success of conception rates if heat is detected properly and the cow is in the right reproductive state. Early non-pregnancy diagnosis using progesterone can reduce the anoestrus period as well as detecting cows with reproductive anomalies which can be rectified early and the cows presented for rebreeding thus reducing the calving interval and improving the productivity of the dairy enterprise

Correlates of early pregnancy serum brain-derived neurotrophic factor in a Peruvian population.

Science.gov (United States)

Yang, Na; Levey, Elizabeth; Gelaye, Bizu; Zhong, Qiu-Yue; Rondon, Marta B; Sanchez, Sixto E; Williams, Michelle A

2017-12-01

Knowledge about factors that influence serum brain-derived neurotrophic factor (BDNF) concentrations during early pregnancy is lacking. The aim of the study is to examine the correlates of early pregnancy serum BDNF concentrations. A total of 982 women attending prenatal care clinics in Lima, Peru, were recruited in early pregnancy. Pearson's correlation coefficient was calculated to evaluate the relation between BDNF concentrations and continuous covariates. Analysis of variance and generalized linear models were used to compare the unadjusted and adjusted BDNF concentrations according to categorical variables. Multivariable linear regression models were applied to determine the factors that influence early pregnancy serum BDNF concentrations. In bivariate analysis, early pregnancy serum BDNF concentrations were positively associated with maternal age (r = 0.16, P BDNF concentrations. Participants with moderate antepartum depressive symptoms (Patient Health Questionnaire-9 (PHQ-9) score ≥ 10) had lower serum BDNF concentrations compared with participants with no/mild antepartum depressive symptoms (PHQ-9 score BDNF concentrations in low-income Peruvian women. Biological changes of CRP during pregnancy may affect serum BDNF concentrations.

Risk estimation of radiation exposure in early pregnancy

International Nuclear Information System (INIS)

Neumeister, K.; Waesser, S.

1977-01-01

The biomedical effects of radiation exposure (occupational, by X-ray diagnosis or examinations in nuclear medicine) to low doses on early pregnancy have been subject of a research work dealing with the dose level which, in case of exceeding, may lead to somatic damage (1.5 to 10 rem), and with the type of radiation injuries (malformations, functional disorder, cancer induction, increase in morbidity rate, genetic damage). A pilot study was the basis for the programme which will record such cases from all over the GDR. Within the scope of the health centre at the National Board of Nuclear Safety and Radiation Protection of the GDR, medical opinion on the interruption or preservation of pregnancy at its early stage, after exposure, was delivered in more than 50 cases. Exposure of the foetus was exactly determined. These children were re-investigated at the age of 1 to 3 years by applying pediatric and genetic examinations. The latter were based on clinical and biochemical methods as well as chromosome analyses. From these results, the risk of exposure in early pregnancy is estimated and adequate dose limits are suggested. In case these limits are exceeded, an interruption should be advised

Early pregnancy angiogenic markers and spontaneous abortion

DEFF Research Database (Denmark)

Andersen, Louise B; Dechend, Ralf; Karumanchi, S Ananth

2016-01-01

BACKGROUND: Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy and may be associated to spontaneous abortion. OBJECTIVE: We investigated the association between...... maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. STUDY DESIGN: In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week ..., interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum

Maternal nutrient intakes and levels of energy underreporting during early pregnancy.

LENUS (Irish Health Repository)

McGowan, C A

2012-08-01

Pregnancy is a critical period in a woman\\'s life where nutrition is of key importance for optimal pregnancy outcome. The aim of this study was to assess maternal nutrient intakes during early pregnancy and to examine potential levels of energy underreporting.

Accuracy rate of pregnancy detection in dairy cow by measuring the early pregnancy factor

Directory of Open Access Journals (Sweden)

S Mosaferi

2007-08-01

Full Text Available Early pregnancy factor (EPF a protein with immunosuppressive properties can be detected in the serum of most domestic animals at early pregnancy. In this study, pregnancy detection in 41 dairy cows following artificial insemination was evaluated by detecting EPF in blood serum using the rosette inhibition test (RIT. The amount of EPF activity 1-3 and 4-7 days after artificial insemination of cows was measured by RIT. Pregnancies were confirmed 45-60 days after insemination by rectal palpation. The results indicated that sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this technique in detecting pregnancy 1-3 days following insemination was 88.88,  66.66,  72.72,  85.71  and  77.77 percent  respectively and RIT titers of above 8 and below 4 were seen in pregnant and non-pregnant animals at this period. The value of the above parameters were 91,  83.83,  83.33,  91  and  87 percent  respectively  4-7  days  after insemination and also RIT titers of above 8 and below 4 were achieved in pregnant and non pregnant cows during this period. The results of this study indicated that there are significant differences in RIT titers between pregnant and non-pregnant cows 1-3 and 4-7 days following artificial insemination (P

Performance IQ in children is associated with blood cadmium concentration in early pregnancy.

Science.gov (United States)

Jeong, Kyoung Sook; Park, Hyewon; Ha, Eunhee; Hong, Yun-Chul; Ha, Mina; Park, Hyesook; Kim, Bung-Nyun; Lee, Bo-Eun; Lee, Soo-Jeong; Lee, Kyung Yeon; Kim, Ja Hyeong; Kim, Yangho

2015-04-01

To investigate whether performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy. The present study is a component of the Mothers' and Children's Environmental Health (MOCEH) study, a multi-center birth cohort project in Korea that began in 2006. The study cohort consisted of 119 children whose mothers underwent testing of blood cadmium during early pregnancy. All children were evaluated using the Korean version of the Wechsler Preschool and Primary Scale of Intelligence, revised edition (WPPSI-R), at 60 months of age. Multivariate linear regression analysis was performed to analyze the correlation between IQ in children and maternal blood cadmium concentration in early pregnancy, after adjustment for covariates. Maternal blood cadmium concentration during early pregnancy was inversely associated with performance IQ, after adjustment for covariates such as sex, educational levels of both parents, family income, and maternal BMI. Maternal blood cadmium concentration, however, was not associated with cognitive IQ. Performance IQ in children is associated with maternal blood cadmium concentration in early pregnancy. Copyright © 2014 Elsevier GmbH. All rights reserved.

Rapid radioimmunological test for HCG in normal and disturbed early pregnancy

International Nuclear Information System (INIS)

Dericks-Tan, J.S.E.; Taubert, H.D.

1979-01-01

The clinical evaluation of a rapid radioimmunological test for HCG in serum showed that this method is as suitable as conventional radioimmunoassay or receptor methods in the diagnosis of normal and disturbed early pregnancy. Using a direct immunosorbent method total time requirements for the estimation could be reduced to half a working day. Sera of 314 women with normal pregnancies showed an exponential increase of HCG concentrations in serum during the first 8 weeks and thereafter steady levels for several weeks. As the anti-HCG serum used has only a slight cross reactivity with LH, false-positive results need hardly be expected in states if high LH levels in serum (menopause, polycystic ovaries, preovulatory LH peak). HCG concentrations in serum were clearly diminished in all pregnancies ending in abortion and in nearly all extrauterine pregnancies. Repeated estimations in early pregnancy enable a diagnosis of ectopic or disturbed intrauterine pregnancy to be made before symptoms of rupture, haemorrhage and similar complications occur. (orig.) [de

[Woman's participation in the decision process of the pregnancy and puerperal cycle: nursing care integrative review].

Science.gov (United States)

Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa; Lunardi, Valéria Lerch; dos Santos, Silvana Sidnei

2011-12-01

This is an integrative review that aims to identify the contribution of nursing care for woman's participation in the decision process of the pregnancy and puerperal cycle, as described in Brazilian scientific publications. The scientific productions were retrieved in May, 2010, from the Virtual Library of Health (Biblioteca Virtual em Saúde) database. From the eight articles reviewed, two themes stood out: Contributions of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle; and Limitations of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle. The following review supports the production of knowledge in nursing, by identifying a gap in what nurses know and do about this issue, as shown by the lack of nursing researches that concern, specifically, the participation of the woman in the decision process during the pregnancy and puerperal cycle and the possible contributions of nursing care to ensure women of this right.

Effect of endometrial cavity fluid on pregnancy rate of fresh versus frozen In Vitro fertilization cycle

Directory of Open Access Journals (Sweden)

Nitika Gupta

2017-01-01

Full Text Available Objective: This study aims to study the difference in etiology and outcome in terms of implantation rate and abortion rate in fresh (self-stimulated versus frozen (oocyte donation cycle in vitro fertilization (IVF and in transient versus persistent fluid. Material and Methods: This retrospective study was conducted in the Department of Reproductive Medicine of tertiary care center from January 2012 to November 2015. Data were collected retrospectively from the departmental files. Twenty-four patients from fresh IVF-stimulated cycles and 24 from frozen oocyte donation cycle with their endometrium prepared by hormone replacement treatment were included in the study. All patients selected in the study had grade-A embryo transfer of day 3–4 with maximum three embryo transferred. Pregnancy was defined by rising serum beta-human chorionic gonadotrophin levels performed after 14 days of embryo transfer and further confirmed by ultrasonographic visualization of gestational sac at 6 weeks. All biochemical pregnancies were included in implantation failure. All pregnant patients were followed till the termination of pregnancy and further noted as live birth or abortion. Results: Clinical pregnancy rate was seen more in self-stimulated cycle (62.5% with live birth rate of 50% than hormone replacement treatment cycle, in which clinical pregnancy rate was 45.83% with live birth rate of 33.33%. Clinical pregnancy rate was highest in group with very less fluid in cavity (1–2 mm 63% and with live birth of 52.63%. Clinical pregnancy was seen only in two patients of group B with anterior and posterior (AP diameter of fluid in cavity of 2–3 mm with live birth of only one, whereas in group C, with AP diameter of 3–5 mm, none of the patient conceived. This difference was statistically significant. Clinical pregnancy rate was 65.62% in transient fluid accumulation with live birth rate of 53.25%, which was significantly higher than persistent fluid accumulation

Early Pregnancy Losses: Review of Nomenclature, Histopathology, and Possible Etiologies.

Science.gov (United States)

Pinar, M Halit; Gibbins, Karen; He, Mai; Kostadinov, Stefan; Silver, Robert

2018-05-08

Miscarriage is a frequent complication of human pregnancy: ∼50% to 70% of spontaneous conceptions are lost prior to the second trimester. Etiology of miscarriage includes genetic abnormalities, infections, immunological and implantation disorders, uterine and endocrine abnormalities, and lifestyle factors. Given such variability, knowledge regarding causes, pathophysiological mechanisms, and morphologies of primary early pregnancy loss has significant gaps; often, pregnancy losses remain unexplained. Pathologic evaluation of miscarriage tissue is an untapped source of knowledge. Although miscarriage specimens comprise a significant part of pathologists' workload, information reported from these specimens is typically of minimal clinical utility for delineating etiology or predicting recurrence risk. Standardized terminology is available, though not universally used. We reintroduce the terminology and review new information about early pregnancy losses and their morphologies. Current clinical terminology is inconsistent, hampering research progress. This review is a resource for diagnostic pathologists studying this complex problem.

Correlates of poor mental health in early pregnancy in obese European women

DEFF Research Database (Denmark)

Sattler, Matteo C; Jelsma, Judith G M; Bogaerts, Annick

2017-01-01

health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS: In this cross-sectional observational study, baseline data from early pregnancy (... in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. TRIAL REGISTRATION: ISRCTN70595832...

Oxytocin is not involved in luteolysis and early maternal recognition of pregnancy (MRP) in alpacas.

Science.gov (United States)

Ciccarelli, Michela; Waqas, Muhammad Salman; Pru, James K; Tibary, Ahmed

2017-12-01

Pregnancy maintenance depends on the maternal recognition of pregnancy (MRP), a physiological process by which the lifespan of the corpus luteum is prolonged. This mechanism is not well characterized in camelids. The objectives of the present research were to determine if exogenous oxytocin prolongs the corpus luteum activity in alpacas and to evaluate expression and localization of oxytocin receptors within the endometrium at 9 and 14days post-mating. In the oxytocin studies, plasma progesterone profiles were determined after ovulation in the same alpacas on 2 cycles: one cycle without oxytocin treatment and one cycle with oxytocin treatment. Oxytocin was administered daily by intramuscular injections (IM) at a dose of 20IU (experiment 1, n=6) or 60IU (experiment 2, n=7 from day 3 through day 10 after induction of ovulation with GnRH IM. There was no significant difference in the length of the luteal phase (i.e. corpus luteum lifespan) between the treated and control cycles using either 20 or 60IU of oxytocin. In the final experiment, uteri from open and pregnant alpacas (n=4 per group) at 9 and 14days post-mating were evaluated for expressions of oxytocin receptors by immunohistochemistry. No significant difference (P≤0.05) in the expression of oxytocin receptors was observed between open and pregnant animals in either staining intensity or tissue localization. We conclude that oxytocin is not involved in luteolysis and early MRP in alpacas. Published by Elsevier B.V.

Early pregnancy vitamin D status and risk of preeclampsia.

Science.gov (United States)

Mirzakhani, Hooman; Litonjua, Augusto A; McElrath, Thomas F; O'Connor, George; Lee-Parritz, Aviva; Iverson, Ronald; Macones, George; Strunk, Robert C; Bacharier, Leonard B; Zeiger, Robert; Hollis, Bruce W; Handy, Diane E; Sharma, Amitabh; Laranjo, Nancy; Carey, Vincent; Qiu, Weilliang; Santolini, Marc; Liu, Shikang; Chhabra, Divya; Enquobahrie, Daniel A; Williams, Michelle A; Loscalzo, Joseph; Weiss, Scott T

2016-12-01

Low vitamin D status in pregnancy was proposed as a risk factor of preeclampsia. We assessed the effect of vitamin D supplementation (4,400 vs. 400 IU/day), initiated early in pregnancy (10-18 weeks), on the development of preeclampsia. The effects of serum vitamin D (25-hydroxyvitamin D [25OHD]) levels on preeclampsia incidence at trial entry and in the third trimester (32-38 weeks) were studied. We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia. Of 881 women randomized, outcome data were available for 816, with 67 (8.2%) developing preeclampsia. There was no significant difference between treatment (N = 408) or control (N = 408) groups in the incidence of preeclampsia (8.08% vs. 8.33%, respectively; relative risk: 0.97; 95% CI, 0.61-1.53). However, in a cohort analysis and after adjustment for confounders, a significant effect of sufficient vitamin D status (25OHD ≥30 ng/ml) was observed in both early and late pregnancy compared with insufficient levels (25OHD preeclampsia (FDR preeclampsia incidence in the intention-to-treat paradigm. However, vitamin D levels of 30 ng/ml or higher at trial entry and in late pregnancy were associated with a lower risk of preeclampsia. Differentially expressed vitamin D-associated transcriptomes implicated the emergence of an early pregnancy, distinctive immune response in women who went on to develop preeclampsia. ClinicalTrials.gov NCT00920621. Quebec Breast Cancer Foundation and Genome Canada Innovation Network. This trial was funded by the National Heart, Lung, and Blood Institute. For details see Acknowledgments.

Maternal nutritional status in early pregnancy is associated with body water and plasma volume changes in a pregnancy cohort in rural Bangladesh.

Science.gov (United States)

Gernand, Alison D; Christian, Parul; Schulze, Kerry J; Shaikh, Saijuddin; Labrique, Alain B; Shamim, Abu Ahmed; West, Keith P

2012-06-01

Plasma volume expansion has been associated with fetal growth. Our objective was to examine the associations between maternal nutritional status in early pregnancy and extracellular water (ECW), total body water (TBW), and percentage plasma volume change across pregnancy. In a subsample of 377 pregnant women participating in a cluster-randomized trial of micronutrient supplementation, hemoglobin, hematocrit, and multi-frequency bioelectrical impedance were measured at ~10, 20, and 32 wk of gestation. In early pregnancy, women were short (mean ± SD, 148.9 ± 5.3 cm) and thin (19.5 ± 2.5 kg/m(2)). In mixed-effects multiple regression models, a 1-unit higher BMI at ~10 wk was associated with higher ECW and TBW (0.27 and 0.66 kg per kg/m(2), respectively; P pregnancy BMI was negatively associated with gains in ECW and TBW (-0.06 and -0.14 kg per kg/m(2), respectively; P pregnancy have lower ECW and TBW in early, mid, and late pregnancy and lower late pregnancy plasma volume expansion, potentially increasing risk of fetal growth restriction.

Determination of serum progesterone by radioimmunoassay (RIA) on fertility control and early pregnancy diagnosis in angora goats

International Nuclear Information System (INIS)

Ozsar, S.; Guven, B.; Ozekin, N.; Noyan, A.

1984-01-01

This study was undertaken to provide information on diagnosis of cyclicity, confirmation of estrus so that mating timing and confirmation of return on non-return (pregnancy diagnosis) in Angora goats by using progesterone radioimmunoassay (RIA) in serum as well as observing the sexual behaviours of the goats. The cyclic reproductive activity of 20 mature Angora goat does with normal previous reproductive function, 5 does which had never become pregnant in the previous breeding seasons, and 10 does which were old for breeding was investigated. Circulating progesterone was relatively low (0.45 ng/ml) at estrus (day 0) and increased progressively to 3.45 ng/ml during the subsequent luteal phase. This high level was maintained until day-3 of the succeding estrus cycle, when it decreased abruptly. Pregnancy diagnosis based on the levels of progesterone in serum was confirmed by kidding. 1.5 ng/ml or more progesterone was used as an indication of pregnancy (within 21 days after mating). The accuracy of pregnancy by progesterone assay was 100%. It was concluded that the use of progesterone RIA in serum is a reliable and convenient means of monitoring ovarian activity and early pregnancy. (author)

Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum.

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Heberlein, Emily C; Frongillo, Edward A; Picklesimer, Amy H; Covington-Kolb, Sarah

2016-05-01

This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women's food security and (2) psychosocial outcomes among food-insecure women. We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancy™ group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p care average predicted probability, p care average predicted probability, p = 0.052) in intention-to-treat models. Group participants were more likely to change perceptions on affording healthy foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032). Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy.

Early Embryonic Heart Rate in Normal Pregnancies In Memory of ...

African Journals Online (AJOL)

To determine the appearance and development of embryonic heart rate a total of n = 317 Nigerian pregnant women were studied in the very early pregnancy from 23 – 56 days from the onset of last menstrual period (LMP). All pregnancies had a subsequent successful outcome. Transvaginal ultrasonography was ...

Radiation induction of developmental effects during the very early stages of pregnancy

International Nuclear Information System (INIS)

Jacquet, P.

2009-01-01

Various studies have shown that early embryos of several mouse strains are sensitive to radiation-induction of congenital anomalies. The presence of mutations in particular genes seems to increase the sensitivity of embryos to such effects, but studies in that field are extremely limited. The aim of these studies is to determine (1) whether the sensitivity to radiation-induction of congenital anomalies during very early stages of gestation is transmitted to the following generation; (2) how mutations in genes involved in important cellular processes, like DNA repair, cell cycle regulation and apoptosis (cell suicide of a damaged cell), can influence the radiation sensitivity of the mammalian embryo during sensitive stages of early pregnancy. Emphasis is put on heterozygous mutations (in which only one of the two copies of the gene is mutated), which are relatively numerous in the human population and do not affect the viability and the fertility of individuals carrying them. The studies under way in that field are supported by contracts with the European Union and the Federal Agency for Nuclear Control (FANC-AFCN)

Early Pregnancy Loss

Science.gov (United States)

... go on to have successful pregnancies. Repeated pregnancy losses are rare. Testing and evaluation can be done ... find a cause if you have several pregnancy losses. Even if no cause is found, most couples ...

Screening and treatment for heritable thrombophilia in pregnancy failure: inconsistencies among UK early pregnancy units.

Science.gov (United States)

Norrie, Gillian; Farquharson, Roy G; Greaves, Mike

2009-01-01

The significance of heritable thrombophilia in pregnancy failure is controversial. We surveyed all UK Early Pregnancy Units and 70% responded. The majority test routinely for heritable thrombophilias; 80%, 76% and 88% undertook at least one screening test in late miscarriage, recurrent miscarriage and placental abruption, respectively. The range of thrombophilias sought is inconsistent: testing for proteins C and S deficiency and F5 R506Q (factor V Leiden) is most prevalent. Detection of heritable thrombophilia frequently leads to administration of antithrombotics in subsequent pregnancies. Thus, thrombophilia testing and use of antithrombotics are widespread in the UK despite controversies regarding the role of heritable thrombophilia in the pathogenesis of pregnancy complications, and the lack of robust evidence for the efficacy of antithrombotic therapy.

Grieving after early pregnancy loss--a common reality.

LENUS (Irish Health Repository)

Purandare, N

2013-05-24

A miscarriage can be very traumatic for a couple and their immediate family. The aim of this study was to assess, using the Perinatal Grief Scale (PGS), whether the type of early pregnancy loss influences the severity of grief and whether the presence of living children influences the severity of grief. Over a period of 6 months in 2008, seventy five patients were recruited for the study, of which 7 (9.3%) had molar pregnancies, 20 (26.7%) had ectopic pregnancies, 43 (573%) had a miscarriage and 5 (6.7%) had recurrent miscarriages. In this study there was no significant difference in severity of grief, between women that had a miscarriage and ectopic pregnancy (p = 0.14) or, between women that had a miscarriage and a molar pregnancy (p = 0.85). Women who had experienced a ectopic pregnancy did not have a higher grief intensity than the women that had a molar pregnancy (p = 0.75). However, for women with a child, the grief intensity significantly increases with the number of miscarriages (p = 0.015). Women with no children with an ectopic pregnancy grieve significantly more than those with a child (p = 0.019). An appointment for the \\'Miscarriage Clinic\\' should be offered to all of these women but special attention should be paid to those in the categories most at risk

Early pregnancy ultrasound and management – effect of a multifaceted training on physician knowledge

LENUS (Irish Health Repository)

O’Leary, B

2016-02-01

Vaginal bleeding is a common event in early pregnancy, with 20-40% of pregnancies affected. Prompt diagnosis and management of bleeding is important, both to reduce morbidity and to avoid excessive emotional distress. This was a prospective study of an educational programme aimed at Obstetrics and Gynaecology BST trainees in the National Maternity Hospital, Dublin. The educational programme consisted of didactic lectures, and simulation and practical sessions. A questionnaire reviewing early pregnancy complications was used to assess participant knowledge. Six trainees participated in the programme, with five (83%) answering the questionnaire. The pre-education questionnaire showed a generally poor level of knowledge of early pregnancy complications with 8\\/50 (16%) questions answered correctly. Following the educational intervention there was a statistically significant increase in participant knowledge with 45\\/50 (90%) questions answered correctly. A significant increase in participant knowledge of early pregnancy complications followed our multifaceted educational programme. Study limitations exist, however we have shown the potential value of our educational programme.

Management of drug-induced hyperbilirubinaemia in early pregnancy

African Journals Online (AJOL)

perinatal outcomes because of the increased risks of preterm delivery and ... induced hepatotoxicity in early pregnancy. ... for threatened abortion since the 6th week. Her past and ... gene mutations, a disease complicated by unconjugated.

Diclofenac/misoprostol during early pregnancy and the risk of miscarriage

DEFF Research Database (Denmark)

Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L

2016-01-01

INTRODUCTION: Misoprostol can be used in the prevention of gastric ulcer in treatment with diclofenac and is used in rheumatic diseases. Since misoprostol causes contractions of the uterus, it can also be used to induce abortions when administrated vaginally. The aim of the study was to investigate...... if early pregnancy exposure to oral diclofenac/misoprostol was associated with miscarriage. METHOD: We conducted a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2011. All births were identified using the Medical Birth Registry, and all records of induced abortion...... and miscarriage were from the National Hospital Register. Data on drug use were from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed to diclofenac/misoprostol in early pregnancy. RESULT: We identified 1...

The impact of nausea and vomiting on women: a burden of early pregnancy.

Science.gov (United States)

Smith, C; Crowther, C; Beilby, J; Dandeaux, J

2000-11-01

Nausea and vomiting are troublesome symptoms occurring in the first trimester of pregnancy. The aim of this study was to describe the impact these symptoms have on women in early pregnancy by interviewing, using a structured questionnaire, 593 pregnant women presenting with nausea and vomiting in the first trimester of pregnancy. The women were asked to complete the Rhodes index of nausea and vomiting and the MOS 36 Short Form Health Survey (SF-36). Symptoms of nausea and vomiting started early in pregnancy. Nausea was the most troublesome symptom experienced by women, both in its duration and intensity. Low scores for the SF-36 were found for all items, particularly physical functioning, energy and social functioning. The women described substantial effects on working, household duties and parenting activities. Findings from this study suggest nausea and vomiting in early pregnancy has a profound impact on women's general sense of well-being and day to day life activities.

Alcohol consumption and binge drinking in early pregnancy. A cross-sectional study with data from the Copenhagen Pregnancy Cohort

DEFF Research Database (Denmark)

Iversen, Mette Langeland; Sørensen, Nina Olsén; Broberg, Lotte

2015-01-01

BACKGROUND: Since 2007 the Danish Health and Medicines Authority has advised total alcohol abstinence from the time of trying to conceive and throughout pregnancy. The prevalence of binge drinking among pregnant Danish women has nevertheless been reported to be up to 48 % during early pregnancy....... Since the introduction of the recommendation of total abstinence, no studies have examined pre-pregnancy lifestyle and reproductive risk factors associated with this behaviour in a Danish context. The aims of this study were therefore to describe the prevalence of weekly alcohol consumption and binge...... and multivariate logistic regression analysis was used to assess the potential associated risk factors (adjusted odds ratio (aOR)). RESULTS: Questionnaires from 3,238 women were included. A majority of 70 %, reported weekly alcohol consumption before pregnancy. The prevalence decreased to 3 % during early...

Two consecutive pregnancies in early and late stage of amyotrophic lateral sclerosis.

Science.gov (United States)

Sarafov, Stayko; Doitchinova, Maryana; Karagiozova, Zhvka; Slancheva, Boriana; Dengler, Reinhard; Petri, Susanne; Kollewe, Katja

2009-01-01

There are few reports on pregnancies in sporadic and familial amyotrophic lateral sclerosis (ALS). We report on a young woman with sporadic ALS who gave birth twice during the course of her disease. The first pregnancy occurred 13 months after the onset of symptoms, and one month after diagnosis. The pregnancy was uncomplicated and resulted in vaginal delivery of a healthy boy. Fifteen months later, when she was already bed-ridden, she became pregnant again. She received a percutaneous endoscopic gastrostomy in the 21st gestational week and underwent early Caesarean section in the 34th week of gestation. The child was ventilated for 72 h in a neonatological unit. The patient was tracheotomized and ventilated two months later, i.e. 47 months after symptom onset, and died nine months later from gastrointestinal haemorrhage. Her two children have developed without abnormalities to date. This case confirms that pregnancies in early-stage ALS can develop normally and may result in uncomplicated vaginal delivery. Pregnancies in late stages may be critical for mother and child, and early delivery by Caesarean section may become necessary although neonatal outcome can be good.

Effect of metformin on early pregnancy loss in women with polycystic ovary syndrome.

Science.gov (United States)

Al-Biate, Mawahib A S

2015-06-01

To evaluate the effectiveness of metformin therapy in reducing early pregnancy loss in pregnant women with polycystic ovary syndrome (PCOS). This is a prospective cohort study conducted in the Obstetric Department of the Gulf Medical College Hospital in Ajman, UAE, for a period of 3 years. This study involved 106 nondiabetic pregnant women with PCOS who became pregnant while using metformin. They were divided into two groups, namely, the group that received metformin throughout pregnancy (metformin group) and the group that discontinued using the drug once pregnancy started (control group). A comparison was made between the two groups of patients with respect to certain basal characteristics (age, body mass index, previous obstetric outcome, serum glucose with free testosterone). Statistical analysis was performed using Chi-square test to compare the differences between the two groups. There were 56 patients who received metformin during pregnancy (metformin group) compared with 50 patients who did not receive the treatment (control group). The rate of early pregnancy loss in the metformin group was 8.9% (5/56) compared with 36% (18/50) in the control group (p metformin group with a history of previous miscarriage, the rate of pregnancy loss was 45% (35 cases/50 pregnancies). Metformin therapy in pregnant women with PCOS was associated with a significant reduction in the rate of early pregnancy loss. Copyright © 2015. Published by Elsevier B.V.

Urinary cortisol and depression in early pregnancy: role of adiposity and race.

Science.gov (United States)

Luiza, John W; Gallaher, Marcia J; Powers, Robert W

2015-02-13

Depression before and during pregnancy is associated with adverse birth outcomes including low birth weight and preterm birth. Abnormal maternal cortisol has been hypothesized as one mediator between depression and adverse birth outcomes. The relationship between cortisol and depression in pregnancy is exhibited most strongly in the African American population, and most studies have focused either on circulating or placental levels of cortisol. The utility of urinary cortisol in early pregnancy related to depression and adiposity has not been investigated. Twenty-five pregnant African American women identified by the Edinburgh Depression Scale as having depression were investigated and matched by body mass index (BMI), age, race, and infant birth weight centile to non-depressed subjects. Maternal urine and plasma cortisol in early pregnancy were quantified and investigated in relation to depression and adiposity. Morning urine cortisol levels tracked positively with plasma cortisol (r(2) = 0.25, p cortisol between depressed and non-depressed pregnant women. Plasma cortisol was significantly negatively associated with several measures of maternal adiposity including percent body fat (r(2) = -0.10, p obese women were found to have significantly higher cortisol levels compared to women with depression, obesity or both (p obese pregnant women evidence atypical cortisol levels compared to non-depressed non-obese pregnant women. Plasma cortisol in early pregnancy is negatively associated with measures of maternal adiposity. Atypical low circulating maternal cortisol among depressed (lean and obese) and non-depressed obese pregnant African American women may indicate hypothalamic-pituitary axis dysfunction in early pregnancy.

Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

International Nuclear Information System (INIS)

Hassan, J.A.; Anbareen, T.

2011-01-01

Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

Metformin therapy prevents early pregnancy loss in polycystic ovarian syndrome

Energy Technology Data Exchange (ETDEWEB)

Hassan, J A; Anbareen, T [Dow University of Health Sciences, Karachi (Pakistan). Dept. of Gynae; Anbareen, T [Hamdard University Hospital, Karachi (Pakistan)

2011-01-15

Background: The study was done to compare the early pregnancy loss rate in women with polycystic ovarian syndrome who received or did not receive metformin in pregnancy. Study type, settings and duration: A case control interventional study carried out at Civil Hospital Karachi, Hamdard University Hospital and Private Gynaecology clinics from January 2005 to July 2008. Subjects and Methods Eighty two non diabetic patients with polycystic ovarian syndrome who became pregnant were included in the study. A questionnaire was filled for all patients that included information on basic demography and mean age, parity, weight. Fasting blood sugar and serum insulin levels were done for all these women. Only patients with raised insulin levels (more than 10 mu/l) were included in the study and all were offered to use oral metformin throughout pregnancy as 500 mg three times a day with folic acid supplements 5 mg once daily. Those who agreed to take the drug throughout pregnancy and to comply with the therapy were taken as cases, while those who did not agree to take the medicine acted as controls. Patients with other causes of recurrent pregnancy loss were excluded from the study. All pregnancies were followed using serial ultrasound examination to see any pregnancy loss in the two groups. Eighty two cases of polycystic ovaries with pregnancy were seen during the study period. All cases had raised serum insulin levels. Fifty patients agreed to take metformin through out pregnancy while, 32 cases did not agree to take metformin during pregnancy and thus acted as controls. The two groups did not differ in mean age, parity, weight and mean fasting blood sugar levels. Fasting insulin levels were high in metformin group (18.40 mu/l ) than in controls (12.53 mu/l). Missed abortion rate was significantly lower (12%) in metformin group than in controls (28%) (p<0.028). No congenital anomalies were found in both the groups on ultrasound at 16-19 weeks. Metformin treatment during

Anxiety associated with diagnostic uncertainty in early pregnancy.

Science.gov (United States)

Richardson, A; Raine-Fenning, N; Deb, S; Campbell, B; Vedhara, K

2017-08-01

To determine anxiety levels of women presenting to an early pregnancy assessment unit (EPAU) with abdominal pain and/or vaginal bleeding and to assess how these levels change over time and according to ultrasonographic diagnosis. We undertook a prospective cohort study in an EPAU in a large UK teaching hospital. Women with abdominal pain and/or vaginal bleeding in early pregnancy (anxiety levels were assessed using the standardized short form of Spielberger's state-trait anxiety inventory (STAI) on three occasions (before, immediately after and 48-72 hours after an ultrasound scan). Scores were correlated with ultrasonographic diagnosis. The diagnosis was either certain or uncertain. Certain diagnoses were either positive, i.e. a viable intrauterine pregnancy (IUP), or negative, i.e. a non-viable IUP or ectopic pregnancy. Uncertain diagnoses included pregnancy of unknown location and pregnancy of uncertain viability. Statistical analysis involved mixed ANOVAs and the post-hoc Tukey-Kramer test. A total of 160 women were included in the study. Anxiety levels decreased over time for women with a certain diagnosis (n = 128), even when negative (n = 64), and increased over time for women with an uncertain diagnosis (n = 32). Before the ultrasound examination, anxiety levels were high (STAI value, 21.96 ± 1.11) and there was no significant difference between the five groups. Immediately after the ultrasound examination, anxiety levels were lower in the viable IUP group (n = 64; 7.75 ± 1.13) than in any other group. The difference between the five groups was significant (P anxiety levels than had those with an uncertain diagnosis (10.77 ± 4.30 vs 22.94 ± 1.65; P anxiety levels more than does the positive or negative connotations associated with the diagnosis per se. Healthcare providers should be aware of this when communicating uncertain diagnoses. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons

Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Directory of Open Access Journals (Sweden)

Fernanda Rebelo

2015-04-01

Full Text Available Background: The maternal cardiovascular system undergoes progressive adaptations throughout pregnancy, causing blood pressure fluctuations. However, no consensus has been established on its normal variation in uncomplicated pregnancies. Objective: To describe the variation in systolic blood pressure (SBP and diastolic blood pressure (DBP levels during pregnancy according to early pregnancy body mass index (BMI. Methods: SBP and DBP were measured during the first, second and third trimesters and at 30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI (kg/m2 was measured up to the 13th gestational week and classified as normal-weight (<25.0 or excessive weight (≥25.0. Longitudinal linear mixed-effects models were used for statistical analysis. Results: A decrease in SBP and DBP was observed from the first to the second trimester (βSBP=-0.394; 95%CI: -0.600- -0.188 and βDBP=-0.617; 95%CI: -0.780- -0.454, as was an increase in SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI: 0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018. Women with excessive weight at early pregnancy showed higher mean SBP in all gestational trimesters, and higher mean DBP in the first and third trimesters. Excessive early pregnancy BMI was positively associated with prospective changes in SBP (βSBP=7.055; 95%CI: 4.499-9.610 and in DBP (βDBP=3.201; 95%CI: 1.136-5.266. Conclusion: SBP and DBP decreased from the first to the second trimester and then increased up to the postpartum period. Women with excessive early pregnancy BMI had higher SBP and DBP than their normal-weight counterparts throughout pregnancy, but not in the postpartum period.

Early detection of diabetes after pregnancy complicated by gestational diabetes

DEFF Research Database (Denmark)

Nielsen, Jane Hyldgård; Overgaard, Charlotte; Olesen, Christinna Rebecca

Title: Early detection of diabetes after pregnancy complicated by gestational diabetes Background: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. 40% of women with a history gestational diabetes mellitus (GDM...... of health consequences for women. Aims: Examine the extent of participation in follow-up screening in the Danish Region of North Jutland, and the possible consequences of nonattendance. Methods: A register based study. In Danish national registers 2171 birthing women whose pregnancy was complicated by GDM...

Comparison of early gestational development between natural and stimulated pregnancies

International Nuclear Information System (INIS)

Jun, Soon Ae; Ahn, M. O.; Yoon, T. K.; Cha, G. Y.

1990-01-01

In order to assess the difference in growth and development between the stimulated and natural pregnancies, we compared the sonographic measurement of early embryos from the fifth to seventh gestational week, in terms of mean size of gestational sac, crown rump length, fetal heart rate and yolk sac size between 26 ovulation stimulated pregnancies and 38 natural pre gnancies. The two groups were compared by multiple regression analysis, The data suggest that there is attend that embryos smaller in stimulated pregnancies though significant statistical differences was not proved

Preconception and early pregnancy maternal haemodynamic changes in healthy women in relation to pregnancy viability.

Science.gov (United States)

Foo, F L; Collins, A; McEniery, C M; Bennett, P R; Wilkinson, I B; Lees, C C

2017-05-01

. Similarly, between the groups, there were no differences in pregnancy adaptation with similar trends in cardiovascular function changes from pre-pregnancy to 6 weeks gestation. Whilst this is the first study to investigate preconception and early pregnancy haemodynamic and arterial function in relation to viability, the relatively modest number of miscarriages may not be sufficient to show subtle differences in haemodynamic changes if these were present. This study suggests that pre-pregnancy haemodynamic and arterial function is unlikely to be the causal link between miscarriages and future cardiovascular disease. Our findings suggests that factors other than the presence of a viable embryo drive cardiovascular changes in early pregnancy. This study raises new questions about miscarriages as an independent risk event which predisposes women to increased cardiovascular risk later in life. The investigators are funded by NIHR Imperial BRC, NIHR Cambridge BRC, Action Medical Research, Imperial College Healthcare Charity and Tommy's Charity. We acknowledge the loan of ultrasound equipment from Samsung Medison (South Korea)/MIS Ltd and provision of fertility monitors from SPD Development Company Ltd (Bedford, UK). There are no competing interests. C.C.L. is supported by the UK National Institute for Health Research Biomedical Research Centre based at Imperial College Healthcare National Health Service Trust and Imperial College London. N/A. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis.

Science.gov (United States)

Pribenszky, Csaba; Nilselid, Anna-Maria; Montag, Markus

2017-11-01

Embryo evaluation and selection is fundamental in clinical IVF. Time-lapse follow-up of embryo development comprises undisturbed culture and the application of the visual information to support embryo evaluation. A meta-analysis of randomized controlled trials was carried out to study whether time-lapse monitoring with the prospective use of a morphokinetic algorithm for selection of embryos improves overall clinical outcome (pregnancy, early pregnancy loss, stillbirth and live birth rate) compared with embryo selection based on single time-point morphology in IVF cycles. The meta-analysis of five randomized controlled trials (n = 1637) showed that the application of time-lapse monitoring was associated with a significantly higher ongoing clinical pregnancy rate (51.0% versus 39.9%), with a pooled odds ratio of 1.542 (P loss (15.3% versus 21.3%; OR: 0.662; P = 0.019) and a significantly increased live birth rate (44.2% versus 31.3%; OR 1.668; P = 0.009). Difference in stillbirth was not significant between groups (4.7% versus 2.4%). Quality of the evidence was moderate to low owing to inconsistencies across the studies. Selective application and variability were also limitations. Although time-lapse is shown to significantly improve overall clinical outcome, further high-quality evidence is needed before universal conclusions can be drawn. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Impact of demographic factors, early family relationships and depressive symptomatology in teenage pregnancy.

Science.gov (United States)

Quinlivan, Julie A; Tan, Louisa H; Steele, Angela; Black, Kirsten

2004-04-01

Teenage pregnancy has been well studied from a demographic risk perspective, but less data examining the early interpersonal family experiences of teenage mothers are available. We aimed to explore the relative impact of demographic, early interpersonal family relationships and depressive symptomatology as associations for teenage, as compared to non-teenage, childbearing. A prospective cross-sectional cohort study was undertaken. Institutional ethics committee approval and informed consent were obtained. Data from consecutive teenage (teenage) and non-teenage (control) subgroups of antenatal women were compared. Subjects were interviewed and completed the following questionnaires: demographic, drug use and lifestyle; early life experiences; Hospital Anxiety and Depression Scale (HADS); and General Health Questionnaire-28. In multivariate analysis, the following factors had a significant independent association with younger age of motherhood in order of magnitude: a history of parental separation/divorce in early childhood; exposure to family violence in early childhood; illicit drug use (ever or in pregnancy); idealization of the pregnancy; low family income; a positive HADS-A or HADS-D subscale score; and a low level of education. Interventions to reduce the rate of teenage births need to be multifocal and should include strategies to address early childhood exposure to parental separation and violence, reduce idealization of pregnancy, diagnose psychological symptomatology and offer alternative career choices to children defaulting in the education system.

Evaluation of von Willebrand factor during pregnancy, lactation and oestrous cycle in bitches affected and unaffected by von Willebrand disease.

Science.gov (United States)

Mattoso, C R S; Takahira, R K; Beier, S L; Araujo, J P; Corrente, J E

2013-06-01

Plasmatic concentrations of von Willebrand Factor (vWF) increase during pregnancy in humans and dogs; however the mechanism of such increase is still not well defined. The aims of this study were: (i) to evaluate changes in vWF concentration during pregnancy and during the subsequent oestrous cycle in bitches affected and unaffected by von Willebrand Disease (vWD); (ii) to correlate the vWF levels and cortisol levels in both groups. Seven vWD affected (GI) and nine unaffected (GII) bitches were used. The animals were assessed during pregnancy, parturition, lactation and non-gestational oestrous cycle in 11 moments (Pregnancy 1, Pregnancy 2, Parturition, Lactation 1, Lactation 2, Lactation 3, Anestrus, Proestrus, Oestrus, Diestrus 1, and Diestrus 2). The following tests were performed; measurement of von Willebrand factor antigen (vWF:Ag), albumin and cortisol. In both groups, vWF concentration remained stable during the non-gestational oestrous cycle, but increased during pregnancy, with the highest value observed at parturition. Increases of 70% and 124% in vWF were seen in GI and GII, respectively, compared to anestrus. No correlation was found between vWF and cortisol. Values of vWF:Ag changed during pregnancy, with a peak at parturition, both in vWD affected and unaffected animals. Values of vWF were not altered in the different phases of the oestrous cycle following pregnancy in both groups. Evaluation of vWF during pregnancy can cause false negative results for vWD, but assessment can be performed at any point in the oestrous cycle of non-pregnant bitches. © 2012 Blackwell Verlag GmbH.

Anxiety and depression in women and men from early pregnancy to 3-months postpartum.

Science.gov (United States)

Figueiredo, Bárbara; Conde, Ana

2011-06-01

To investigate high-anxiety and depression in women and men from early pregnancy to 3-months postpartum, 260 Portuguese couples (N = 520) filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the first, second, and third pregnancy trimesters, childbirth, and 3-months postpartum. Rates for high-anxiety (STAI-S ≥ 45) in women (13.1%; 12.2%; 18.2%; 18.6%; 4.7%) and men (10.1%; 8.0%, 7.8%; 8.5%; 4.4%) and for depression (EPDS ≥ 10) in women (20.0%, 19.6%, 17.4%, 17.6%; 11.1%) and men (11.3%; 6.6%; 5.5%; 7.5%; 7.2%) were high. Rates for depression were higher than rates for high-anxiety only in women during early pregnancy and the postpartum, but not at the third pregnancy trimester and childbirth. Rates for high-anxiety and depression were higher in women than in men during pregnancy/childbirth, but not at 3-months postpartum. Rates for high-anxiety but not rates for depression were higher during pregnancy/childbirth compared to 3-months postpartum and only in women. Considering that 15.9% of the parents-to-be were highly anxious and/or depressed during pregnancy-comparing to 9.3% at 3-months postpartum-particular attention should be drawn to both women's and men's mental health early in pregnancy.

Exposure to Selective Serotonin Reuptake Inhibitors in Early Pregnancy and the Risk of Miscarriage

DEFF Research Database (Denmark)

Andersen, Jon Thor Trærup; Andersen, Nadia Lyhne; Horwitz, Henrik

2014-01-01

OBJECTIVE: To investigate whether exposure to selective serotonin reuptake inhibitors (SSRIs) in early pregnancy is associated with miscarriage. METHODS: This was a nationwide cohort study identifying all registered pregnancies in Denmark from 1997 to 2010. All births were identified using...... the Medical Birth Registry, and all records of induced abortion or miscarriage were gathered from the National Hospital Register. Data on SSRI use were gathered from the National Prescription Register. Cox proportional hazard regression models were used to calculate the hazard of miscarriage in women exposed...... to an SSRI in early pregnancy and the hazard of miscarriage in women discontinuing treatment before pregnancy. RESULTS: We identified 1,279,840 pregnancies (911,569 births, 142,093 miscarriages, 226,178 induced abortions). Of the 22,884 exposed to an SSRI during the first 35 days of pregnancy, 12.6% (2...

Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

Science.gov (United States)

Masukume, Gwinyai; Khashan, Ali S; Kenny, Louise C; Baker, Philip N; Nelson, Gill

2015-01-01

Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality. The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609), to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation. The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin prevalence of anaemia (2.2%), that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78), and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score pregnancy outcomes were however more common in those with anaemia than in those without. In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

Computer-Assisted Sperm Analysis (CASA) parameters and their evolution during preparation as predictors of pregnancy in intrauterine insemination with frozen-thawed donor semen cycles.

Science.gov (United States)

Fréour, Thomas; Jean, Miguel; Mirallié, Sophie; Dubourdieu, Sophie; Barrière, Paul

2010-04-01

To study the potential of CASA parameters in frozen-thawed donor semen before and after preparation on silica gradient as predictors of pregnancy in IUI with donor semen cycles. CASA parameters were measured in thawed donor semen before and after preparation on a silica gradient in 132 couples undergoing 168 IUI cycles with donor semen. The evolution of these parameters throughout this process was calculated. The relationship with cycle outcome was then studied. Clinical pregnancy rate was 18.4% per cycle. CASA parameters on donor semen before or after preparation were not significantly different between pregnancy and failure groups. However, amplitude of lateral head displacement (ALH) of spermatozoa improved in all cycles where pregnancy occurred, thus predicting pregnancy with a sensitivity of 100% and a specificity of 20%. Even if CASA parameters do not seem to predict pregnancy in IUI with donor semen cycles, their evolution during the preparation process should be evaluated, especially for ALH. However, the link between ALH improvement during preparation process and pregnancy remains to be explored. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Healthy Lifestyle During Early Pregnancy and Risk of Gestational Diabetes Mellitus.

Science.gov (United States)

Badon, Sylvia E; Enquobahrie, Daniel A; Wartko, Paige D; Miller, Raymond S; Qiu, Chunfang; Gelaye, Bizu; Sorensen, Tanya K; Williams, Michelle A

2017-08-01

Previous studies have found associations between individual healthy behaviors and reduced risk of gestational diabetes mellitus (GDM); however, the association of composite healthy lifestyle during pregnancy with GDM has not been examined. Participants in the Omega Study (n = 3,005), a pregnancy cohort study conducted in Washington State (1996-2008), reported information on diet, physical activity, smoking, and stress during early pregnancy. Lifestyle components were dichotomized into healthy/unhealthy and then combined into a total lifestyle score (range, 0-4). Regression models were used to determine relative risk of GDM (n = 140 cases) in relation to healthy lifestyle. Twenty percent of participants had a healthy diet, 66% were physically active, 95% were nonsmokers, and 55% had low stress. Each 1-point increase in lifestyle score was associated with a 21% lower risk of GDM (95% confidence interval: 0.65, 0.96) after adjustment for age, race, and nulliparity. Adjustment for prepregnancy body mass index, prepregnancy physical activity, and prepregnancy smoking attenuated the associations slightly. Associations were similar in normal-weight and overweight/obese women. In this study, a composite measure of healthy lifestyle during early pregnancy was associated with substantially lower GDM risk. Public health messaging and interventions promoting multiple aspects of a healthy lifestyle during early pregnancy should be considered for GDM prevention. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Risk Psychosocial Factors to School Dropout and Early Teenage Pregnancy

Directory of Open Access Journals (Sweden)

Fabián Antonio Dávila Ramírez

2016-01-01

Full Text Available To explore the frequency and weight that psychosocial risk factors predispose to outcomes of early pregnancy and scholar dropout, a descriptive review was conducted. Materials and Meth­ods: A search and review of the results reported by observational studies in the PubMed data­base indexed from July 27, 2010 until July 25, 2013 was performed, restricting the search to studies in humans, Spanish or English written, not made in countries in Africa or Asia. Search was widened to LILACS database for the years 2006 to 2013 for Latinamerican countries. For inclusion, all case-control studies comparing different types of interventions and psychosocial risk factors in adolescents were eligible. Results: The review suggests violence experienced dur­ing adolescence, sexual abuse, belonging to a low socioeconomic status, low self-esteem, eating behavior disorders, smoking, alcoholism and drug addiction, mental disorders, early initiation of sex, poor family ties, lack of access to information, and resources for family planning as main psychosocial factors related to early pregnancy and scholar dropout in adolescents. Conclusions: Both risk factors associated with pregnancy and scholar dropout were described, and interven­tions targeting the described risk factors could potentially contribute to the reduction of these outcomes were described.

Ultrasonographic findings of early abortion: suggested predictors

International Nuclear Information System (INIS)

Jun, Soon Ae; Ahn, Myoung Ock; Cha, Kwang Yul; Lee, Young Doo

1992-01-01

To investigate predictable ultrasonographic findings of early abortion. To investigate objective rules for the screening of abortion. Ultrasonographic examination of 111 early pregnancies between the sixth and ninth week in women who had regular 28 day menstrual cycles was performed. Ultrasonographic measurements of the gestational sac, crown rump length and fetal heart rate were performed using a linear array real time transducer with doppler ultrasonogram. All measurements of 17 early abortions were compared to those of 94 normal pregnancies. Most of early aborted pregnancies were classified correctly by discriminant analysis with G-SAC and CRL (G-SAC=0.5 CRL + 15, sensitivity 76.5%, specificity 96.8%). With the addition of FHR, 94.1% of early abortions could be predicted. In conclusion, ultrasonographic findings of early intrauterine growth retardation, small gestational sac and bradycardia can be predictable signs suggestive of poor prognosis of early pregnancies

Study of early pregnancy factor (EPF) in equine (Equus caballus).

Science.gov (United States)

Ohnuma, K; Yokoo, M; Ito, K; Nambo, Y; Miyake, Y I; Komatsu, M; Takahashi, J

2000-03-01

Early pregnancy factor (EPF) is an immunosuppressive protein detected in the early pregnancy serum. We have already reported that we developed the rosette inhibition test for mare EPF and detected EPF in thoroughbreds. The aim of this study was to determine whether or not our method could be used clinically. The rosette inhibition test for equine EPF was carried out on serum from six nonpregnant and six pregnant Shetland ponies, a female and a male Chinese pony, and four nonpregnant and 13 pregnant thoroughbred mares. In the thoroughbreds sera were collected during the pregnancy period. Furthermore, we measured progesterone and detected pregnant mare serum gonadotrophin (PMSG) in order to confirm pregnancy of the Chinese pony 3 and 6 months after mating. In the nonpregnant Shetland ponies, the rosette inhibition titre (RIT) was 6.0+/-1.0 and EPF was negative. In contrast, in the pregnant ponies, the RIT was 9.2+/-0.4 and EPF was positive. Based on these results, we diagnosed pregnancy of the Chinese pony. The RIT of the female Chinese pony (3 months after mating) was above 10 and EPF was positive. Furthermore, we detected PMSG and progesterone in the serum of this pony. EPF appeared in the maternal blood circulation at 24-72 hr after mating, it was detected until the second trimester, and after that it disappeared from the maternal serum. The pony's EPF was detected by using the same rosette inhibition test as in the thoroughbred and was present from 24 to 72 hr after mating until the second trimester. The results indicated that our method was useful for pregnancy diagnosis of Equine.

Head circumference at birth and exposure to tobacco, alcohol and illegal drugs during early pregnancy.

Science.gov (United States)

Ortega-García, Juan A; Gutierrez-Churango, Jorge E; Sánchez-Sauco, Miguel F; Martínez-Aroca, Miguel; Delgado-Marín, Juan L; Sánchez-Solis, M; Parrilla-Paricio, J J; Claudio, Luz; Martínez-Lage, Juan F

2012-03-01

We aimed to assess the effects of exposure to tobacco smoke, alcohol and illegal drugs during early pregnancy on the head circumference (HC) at birth of otherwise healthy neonates. A follow-up study from the first trimester of pregnancy to birth was carried out in 419 neonates. An environmental reproductive health form was used to record data of substance exposure obtained during the first obstetric visit at the end of the first trimester. A multiple linear regression model was created for this purpose. Alcohol intake during pregnancy and medical ionizing radiation exposure were the most significant predictors of HC. The mothers' alcohol consumption increased with the mothers' and fathers' education level, net family income and fathers' alcohol consumption. In contrast, maternal smoking decreased with increasing mothers' and fathers' education level and net family income. About 13% of the surveyed embryos were exposed to illegal drugs. Mild to moderate alcohol consumption diminishes the at-birth HC of theoretically healthy newborns in a linear form. There was no threshold dose. We perceived a need for increasing the awareness, and for training, of health care professionals and parents, in regard to risks of alcohol consumption and for recommending abstinence of these substances in both parents during pregnancy. It should also be remembered that medical ionizing radiation should be performed only during the first half of the cycle in fertile women. We think that our study has an important social impact as it affords data for implementing policies for promoting "healthy pregnancies".

Reliability of three-dimensional sonographic measurements in early pregnancy using virtual reality

NARCIS (Netherlands)

C.M. Verwoerd-Dikkeboom (Christine); A.H.J. Koning (Anton); W.C.J. Hop (Wim); M. Rousian (Melek); P.J. van der Spek (Peter); N. Exalto (Niek); R.P.M. Steegers-Theunissen (Régine)

2008-01-01

textabstractObjective: To establish the reliability of three-dimensional (3D) ultrasound measurements in early pregnancy using a virtual reality system (the Barco I-Space). Methods: The study included 28 pregnancies with gestational ages ranging from 6 to 14 (median, 10) weeks. 3D volumes were

Changes in mode of transportation to work or school from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study

Directory of Open Access Journals (Sweden)

Marianne Skreden

2015-01-01

Conclusions: In this sample of Norwegian women there was a significant change towards less active transportation to work or school and lower levels of physical activity from pre-pregnancy to early pregnancy.

Hair progesterone contents during oestrus cycle and pregnancy in goats

International Nuclear Information System (INIS)

Zeng Xianyin; Guo Dazhi; Liu Xianyi

1991-01-01

Hair progesterone contents during gestasion and milk progesterone levels during oestrus cycle in Saanen(S), crosses F 1 (SXChengdu Mah) and F 2 (SX(SXChengdu Mah)) goats were determined using the RIA kit. The results showed that progesterone in goats hair could be detected using the RIA kit. In pregnant goats, hair progesterone contents was correlated with the milk progesterone profile during 1-28 days after oestrus (r=0.5458, p<0.01). In non-pregnant goats, similar correlation was observed (r=7832, p<0.01). After milk samples were collected 22 days, 3.9ng/ml of progesterone was taken as the discriminatory level, and precision of pregnancy and non-pregnancy diagnosis were 82.4% and 100% respectively. After hair samples were collected 22 days, 3.7ng/50mg of progesterone was taken as discriminatory level, and precision of pregnancy and non-pregnancy diagnosis were 77.8% and 100% respectively. During gestation, hair progesterone content increased gradually from day 30(5.67±0.98ng/50mg hair)to day 120 (9.85±1.20ng/50mg) and decreased rapidly from -8(before parturition, 7.73±1.91ng/50mg) to day 0(parturition, 4.93±0.25ng/50mg)

Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort.

Directory of Open Access Journals (Sweden)

Gwinyai Masukume

Full Text Available Anaemia in pregnancy is a major public health and economic problem worldwide, that contributes to both maternal and fetal morbidity and mortality.The aim of the study was to calculate the prevalence of anaemia in early pregnancy in a cohort of 'low risk' women participating in a large international multicentre prospective study (n = 5 609, to identify the modifiable risk factors for anaemia in pregnancy in this cohort, and to compare the birth outcomes between pregnancies with and without anaemia in early gestation.The study is an analysis of data that were collected prospectively during the Screening for Pregnancy Endpoints study. Anaemia was defined according to the World Health Organization's definition of anaemia in pregnancy (haemoglobin < 11g/dL. Binary logistic regression with adjustment for potential confounders (country, maternal age, having a marital partner, ethnic origin, years of schooling, and having paid work was the main method of analysis.The hallmark findings were the low prevalence of anaemia (2.2%, that having no marital partner was an independent risk factor for having anaemia (OR 1.34, 95% CI 1.01-1.78, and that there was no statistically significant effect of anaemia on adverse pregnancy outcomes (small for gestational age, pre-tem birth, mode of delivery, low birth weight, APGAR score < 7 at one and five minutes. Adverse pregnancy outcomes were however more common in those with anaemia than in those without.In this low risk healthy pregnant population we found a low anaemia rate. The absence of a marital partner was a non-modifiable factor, albeit one which may reflect a variety of confounding factors, that should be considered for addition to anaemia's conceptual framework of determinants. Although not statistically significant, clinically, a trend towards a higher risk of adverse pregnancy outcomes was observed in women that were anaemic in early pregnancy.

Soluble Flt-1 and PlGF: new markers of early pregnancy loss?

LENUS (Irish Health Repository)

Muttukrishna, Shanthi

2012-01-31

Recent data have indicated a relationship between placental oxygen and angiogenic protein levels in the first trimester of normal pregnancies. Our objective was to investigate if maternal serum levels of angiogenic factors Soluble vascular endothelial growth factor (VEGF) receptor 1 (sFlt-1), soluble Endoglin and placental growth factor (PlGF) are altered in women with symptoms of threatened miscarriage (TM) and if they are predictive of a subsequent miscarriage. Blood samples were collected at 6-10 weeks from women presenting with TM (n = 40), from asymptomatic controls (n = 32) and from non- pregnant women in their luteal phase (n = 14). All samples were assayed for serum level of sFLT-1, PlGF, sEndoglin and HSP70 using commercial ELISAs. Samples were analysed retrospectively on the basis of pregnancy outcome. TM group included 21 women with a normal pregnancy outcome and 19 with subsequent complete miscarriage. The latter subgroup had significantly lower mean maternal serum (MS) sFlt-1 (83%, P<0.001) and PlGF (44%, P<0.001) compared to those with a normal pregnancy outcome. Asymptomatic control pregnant women had similar MS levels of sFlt-1 and PlGF compared to the TM patients with a normal outcome. The mean MS sFlt-1 (>10 fold) and MS PlGF ( approximately 2 fold) levels were significantly (P<0.001) higher in control pregnant women compared to the non-pregnant group in the luteal phase of the menstrual cycle. Soluble Endoglin was not altered in the normal pregnant women compared to non pregnant women, although lower in the TM subgroup with a subsequent miscarriage ( approximately 25%, P<0.001) compared to TM with a live birth. There was no significant difference in the mean MS HSP 70 levels between the different groups. This study shows that sFlt1 and PlGF MS levels are increased by several folds in early pregnancy and that MS sFlt-1 and MS PlGF are markedly decreased in threatened miscarriage patients who subsequently have a miscarriage suggesting these

Soluble Flt-1 and PlGF: new markers of early pregnancy loss?

LENUS (Irish Health Repository)

Muttukrishna, Shanthi

2011-01-01

Recent data have indicated a relationship between placental oxygen and angiogenic protein levels in the first trimester of normal pregnancies. Our objective was to investigate if maternal serum levels of angiogenic factors Soluble vascular endothelial growth factor (VEGF) receptor 1 (sFlt-1), soluble Endoglin and placental growth factor (PlGF) are altered in women with symptoms of threatened miscarriage (TM) and if they are predictive of a subsequent miscarriage. Blood samples were collected at 6-10 weeks from women presenting with TM (n = 40), from asymptomatic controls (n = 32) and from non- pregnant women in their luteal phase (n = 14). All samples were assayed for serum level of sFLT-1, PlGF, sEndoglin and HSP70 using commercial ELISAs. Samples were analysed retrospectively on the basis of pregnancy outcome. TM group included 21 women with a normal pregnancy outcome and 19 with subsequent complete miscarriage. The latter subgroup had significantly lower mean maternal serum (MS) sFlt-1 (83%, P<0.001) and PlGF (44%, P<0.001) compared to those with a normal pregnancy outcome. Asymptomatic control pregnant women had similar MS levels of sFlt-1 and PlGF compared to the TM patients with a normal outcome. The mean MS sFlt-1 (>10 fold) and MS PlGF (∼2 fold) levels were significantly (P<0.001) higher in control pregnant women compared to the non-pregnant group in the luteal phase of the menstrual cycle. Soluble Endoglin was not altered in the normal pregnant women compared to non pregnant women, although lower in the TM subgroup with a subsequent miscarriage (∼25%, P<0.001) compared to TM with a live birth. There was no significant difference in the mean MS HSP 70 levels between the different groups. This study shows that sFlt1 and PlGF MS levels are increased by several folds in early pregnancy and that MS sFlt-1 and MS PlGF are markedly decreased in threatened miscarriage patients who subsequently have a miscarriage suggesting these proteins are

Ultrasonographically documented early pregnancy loss in an Asian elephant (Elephas maximus).

Science.gov (United States)

Lueders, Imke; Drews, Barbara; Niemuller, Cheryl; Gray, Charlie; Rich, Peter; Fickel, Jörns; Wibbelt, Gudrun; Göritz, Frank; Hildebrandt, Thomas B

2010-01-01

Early embryonic resorption or fetal loss is known to occur occasionally in captive elephants; however, this has mostly been reported anecdotally. The present study documents the case of a 24-year-old, multiparous Asian elephant cow that suffered embryonic death and resorption at around 18 weeks of gestation. From ovulation onwards, this female was sonographically examined 58 times. Blood was collected twice weekly for progestagen determination via enzyme immunoassay. On Day 42 after ovulation, a small quantity of fluid was detected in the uterine horn, which typically indicates the presence of a developing conceptus. Repeated inspections followed what appeared to be a normal pregnancy until Day 116. However, on Day 124, signs of embryonic life were absent. Progestagen concentrations started declining two weeks later, reaching baseline levels one month after embryonic death. Retrospectively, ultrasound examination revealed several abnormalities in the uterine horn. Besides an existing leiomyoma, multiple small cystic structures had formed in the endometrium at the implantation site and later in the placenta. These pathological findings were considered as possible contributors to the early pregnancy failure. PCR for endotheliotropic elephant herpes virus (EEHV) (which had occurred previously in the herd) as well as serology for other infectious organisms known to cause abortion in domestic animals did not yield any positive results. Although no definitive reason was found for this pregnancy to abort, this ultrasonographically and endocrinologically documented study of an early pregnancy loss provides important insights into the resorption process in Asian elephants.

Fecal estrogen, progestagen and glucocorticoid metabolites during the estrous cycle and pregnancy in the giant anteater (Myrmecophaga tridactyla): evidence for delayed implantation.

Science.gov (United States)

Knott, Katrina K; Roberts, Beth M; Maly, Morgan A; Vance, Carrie K; Debeachaump, Jennifer; Majors, Jackie; Riger, Peter; Decaluwe, Heather; Kouba, Andrew J

2013-08-27

Declining numbers of wild giant anteaters highlight the importance of sustainable captive populations. Unfortunately, captive reproductive management is limited by the lack of external physical indicators of female reproductive status and the aggressive behavior of males. We examined the endocrinology of the estrous cycle and pregnancy, and whether delayed implantation is a gestational strategy for giant anteaters as described for other xenarthrans. Feces were collected from seven captive females 3-5 times weekly and mating was recorded. Concentrations of estrogen (estrone-glucuronide, E1, and estradiol-17β, E2), progestagen (20-oxo-progestagens, P4), and glucocorticoid (GC) metabolites were examined in fecal extracts by enzyme immunoassay. Estrous cycles for nulliparous females (6 cycles, n = 2) compared to the multiparous female (6 cycles, n = 1) were shorter (47.3 +/- 4.3 days versus 62.5 +/- 2.6 days) with relatively lower luteal phase concentrations of P4 (49.4 +/- 2.9 ng/g versus 136.8 +/- 1.8 ng/g). The four remaining females had unclear ovarian activity: two females exhibited apparent luteal activity but unclear fluctuations in estrogens, while the other two females had parallel fecal P4 and estrogens concentrations. Pregnancy ranged 171-183 days with females returning to estrus post-partum as early as 60 days (n = 3, 1.8-4 years of age at mating). Delayed implantation was indicated by a biphasic elevation in fecal P4 metabolites: the initial 4-fold increase occurred for 81-105 days and was followed by a 26-fold secondary rise in P4 metabolites lasting 66-94 days prior to parturition. Fecal GC was correlated with fecal estrogens and greatest during estrus, late pregnancy, and six days prior to parturition (estrous cycle GC, 14.4-62.8 ng/g; pregnancy GC, 13.6-232.7 ng/g). Estrous cycles of giant anteaters occurred year-round, but were shorter and more intermittent in younger nulliparous animals compared to a multiparous female. A pronounced

The use of iloprost in early pregnancy in patients with pulmonary arterial hypertension.

Science.gov (United States)

Elliot, C A; Stewart, P; Webster, V J; Mills, G H; Hutchinson, S P; Howarth, E S; Bu'lock, F A; Lawson, R A; Armstrong, I J; Kiely, D G

2005-07-01

In patients with pulmonary hypertension, pregnancy is associated with a high risk of maternal death. Such patients are counselled to avoid pregnancy, or if it occurs, are offered early interruption. Some patients, however, decide to continue with their pregnancy and others may present with symptoms for the first time whilst pregnant. Pulmonary vasodilator therapy provides a treatment option for these high-risk patients. The present study describes three patients with pulmonary arterial hypertension of various aetiologies who were treated with the prostacyclin analogue iloprost during pregnancy, and the post-partum period. Nebulised iloprost commenced as early as 8 weeks of gestation and patients were admitted to hospital between 24-36 weeks of gestation. All pregnancies were completed with a duration of between 25-36 weeks and all deliveries were by caesarean section under local anaesthetic. All patients delivered children free from congenital abnormalities, and there was no post-partum maternal or infant mortality. In conclusion, although pregnancy is strongly advised against in those with pulmonary hypertension, the current authors have achieved a successful outcome for mother and foetus with a multidisciplinary approach and targeted pulmonary vascular therapy.

Corpus luteum blood flow in normal and abnormal early pregnancy: evaluation and analysis with transvaginal color and pulsed doppler sonography

International Nuclear Information System (INIS)

Tang Xiaoyi; Lin Meifang; Zheng Meirong; Liang Xiaoxian; Liu Jianfeng

2005-01-01

Objective: Detecting and assessment the corpus luteum blood flow in normal and abnormal early pregnancy. Methods: Using transvaginal color and pulse Doppler sonography, we detected 215 pregnant women including 150 normal intrauterine pregnancies, 25 abortion, 29 ectopic pregnancies, and then recorded corpus luteum blood flow feature and the blood flow indexes (Vmax, RI and PI). Results: 1) Corpus luteum was successfully identified in 148 cases out of 150 of normal early pregnancies, 25 cases out of 26 of threatened abortion; 22 cases out of 29 of ectopic pregnancy. 2) Three groups shared the same feature of Color Doppler imaging: a circumferential rim around the entire corpus luteum. 3) The flow index revealed mean PVS, RI and PI had no statistical difference in normal and abnormal early pregnancy; The mean PVS was lower in ectopic pregnancy than in normal pregnancy (P<0.05), while PI and PR had no characteristic in ectopic pregnancy group compared with the indexes obtained in normal pregnancy group. Conclusion: The corpus luteum can be precisely identified in most pregnancy using transvaginal color Doppler and manifests a characterized rim Doppler imaging. PVS may help in differentiating the ectopic pregnancy from normal early pregnancy. (authors)

Effect of Estradiol Prescribed during Luteal Phase of Art Cycles and Pregnancy Outcome

Directory of Open Access Journals (Sweden)

M Karimzadeh

2007-01-01

Full Text Available Introduction: Implantation is one of the most important steps in ART cycles and it depends upon embryo and endometrial reception. Different protocols have been suggested for getting better endometrium. It seems estrogen increases the endometrial reception and pregnancy rate by inducing changes in the hormonal status. The aim of this study was to evaluate the effect of estradiol(E2 on luteal phase support and pregnancy rate in ART cycles Methods: This prospective randomized study was done in Yazd at the IVF center from March until December, 2002. 68 patients who had undergone IVF or ICSI were enrolled in the study. Exclusion criteria was age>40, endometriosis and ovarian hyper stimulation syndrome. Induction ovulation protocol was long suppression with GnRH analogues.After embryo transfer, patients were divided in two groups randomly. Both groups received 100mg progesterone IM daily from the transfer day. Estradiol valerate 2 mg/day was added from the 7th transfer day to progesterone in Group I and continued if the BhCG became positive. Abortion and malformations were measured in all patients. Data analyzed with SPSS 11.0 and P value <0.05 considered statistically significant. Results: Pregnancy rate in the 34 patients of estradiol group (group I was 26.5%which was significantly higher than 11.8 %( 4 cases in the other group (Pvalue=0.034. Abortion rate was higher in estradiol group (3 cases, but there was no abortion in the progesterone group(P=0.119. 2 cases of major fetal malformations were observed in E2 supplementation group (P=0.246 . Conclusions: E2 suplementation to progesterone in the luteal phase of ART cycles, especially in the long GnRH analogues causes higher endometrial receptivity and pregnancy rate.

Problems arising from effects of low radiation doses in early pregnancy

International Nuclear Information System (INIS)

Neumeister, K.

1976-01-01

From 1970 to 1974, 37 expert opinions concerning interruption of pregnancy because of radiation stress of the foetus had to be given at the Centre for Clinical Radiobiology of the Karl-Marx University, Leipzig. In the cases investigated, radiation stress occurred between the first and tenth week of pregnancy at a maximum amount of approximately 20 R. X-ray diagnostic measures had been taken in the abdominal range or a tumour radiotherapy had been made, all in cases of unknown pregnancy. The individual determination of the foetal dose showed that different doses result, depending on the setting technique of photographs, physico-technical conditions and body size. In no case did anamnesis show special features. At the given doses an interruption seemed necessary only in one case (radiotherapy). According to this survey, diagnostic radiation stresses in early pregnancy almost always show radiation doses which, at the present stage of knowledge, do not make an interruption seem necessary. Individual differences of dose values for the same exposures, however, make it necessary to calculate exactly the radiation stress of the foetus in each case and to make the corresponding decision. As recent literature agrees in negating a so-called threshold dose for early damage, it is, apart from genetic considerations, necessary to avoid radiation stresses in early pregnancy for this reason also. In the author's opinion, an indication for an interruption is given at doses above 10 R (see also Hammer-Jacobsen, 1959). At lower radiation stresses, an interruption should be recommended in case of simultaneous additional noxae. This paper communicates the results of the check-ups of children who had been subject to a radiation stress of below 7 R in utero in the above cases. (author)

Evaluation of gestational diabetes mellitus risk factors using abdominal subcutaneous fat thickness for early pregnancy in the US imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Chang Soo; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Yang, Sung Hee [Dept. of Radiology, Ilsin Christian Hospital, Busan (Korea, Republic of)

2017-03-15

The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and early pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM.

Evaluation of gestational diabetes mellitus risk factors using abdominal subcutaneous fat thickness for early pregnancy in the US imaging

International Nuclear Information System (INIS)

Kim, Chang Soo; Kim, Jung Hoon; Yang, Sung Hee

2017-01-01

The purpose of this study was to investigate the relationship between abdominal subcutaneous fat thickness(ASFT) and maternal gestational diabetes mellitus(GDM) measured by ultrasound at period of pregnancy. We compared maternal age, pre-pregnancy body mass index, and weight gain during pregnancy in 286 pregnant women who were diagnosed with early pregnancy ASFT and high GDM screening test(50 g OGTT) of more than 140 mg/dL. ROC curve analysis was used to determine the cut-off value of ASFT for GDM prediction. Maternal age and weight gain during pregnancy were not related to GDM in the mid-trimester and pre-pregnancy body mass index and early pregnancy ASFT were significantly different between normal and GDM high risk groups. The cut-off value of ASFT for GDM prediction was 2.23 cm(AUC 0.913. Sensitivity 76.19%, Specificity 93.72%). ASFT measured by ultrasound in early pregnancy was useful as an important index for predicting mid-trimester GDM prediction. Therefore, ASFT can be used as an auxiliary diagnostic index for early recognition of GDM

Serum prolactin profiles of normal human conception cycles

Energy Technology Data Exchange (ETDEWEB)

Adejuwon, C A [Ibadan Univ. (Nigeria). Coll. of Medicine; Faundes, Anibal [Universidade Estadual de Campinas (Brazil). Faculdade de Medicina; Segal, S J [Rockefeller Foundation, New York (USA); Alvarez-Sanchez, Francisco [Hospital Moscoso Puello, Santo Domingo (Dominican Republic). Dept. of Obstet. and Gynaecol.

1984-06-01

Commencing on day 10 of the menstrual cycle through onset of subsequent menses, or confirmation of pregnancy, daily sera collected from 15 women planning pregnancy were analyzed by radioimmunoassays (RIA) for prolactin (hPRL), estradiol-17..beta.. and luteinizing hormone (hLH). Two of the observed subjects became pregnant in the single cycles studied. The profiles of these hormones during the early gestation following spontaneous ovulation were established. No distinct midcycle peaks of hPEL were observed in either subject. Enormous spikes were observed in daily prolactin values, with wide variations between subjects.

Improving early cycle economic evaluation of diagnostic technologies.

Science.gov (United States)

Steuten, Lotte M G; Ramsey, Scott D

2014-08-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

Maternal smoking during pregnancy and rapid weight gain from birth to early infancy

Directory of Open Access Journals (Sweden)

Tomosa Mine

2017-04-01

Full Text Available Background: Although several studies have focused on the association between maternal smoking during pregnancy and rapid weight gain (RWG during infancy, the dose-response relationship has not yet been confirmed, and very few studies have included Asian populations. Using a record-linkage method, we examined the association between maternal smoking during pregnancy and RWG in infants at around 4 months of age to clarify the dose-response relationship. Methods: Two databases were used: maternal check-ups during pregnancy and early infancy check-ups (between April 1, 2013 and March 31, 2014 in Okinawa, Japan were linked via IDs and provided to us after unlinkable anonymizing. For 10,433 subjects (5229 boys and 5204 girls, we calculated the change in infants' weight z-score by subtracting the z-score of their birth weight from their weight at early infancy check-ups. Smoking exposure was categorized into five groups. We used Poisson regression to examine the association of maternal smoking during pregnancy with RWG in early infancy. Results: Overall, 1524 (14.6% were ex-smoker and 511 (4.9% were current smoker. Compared with the reference category of non-smokers, the adjusted risk ratio of RWG was 1.18 (95% confidence interval [CI], 1.06–1.32 for ex-smokers, 1.18 (95% CI, 0.93–1.50 for those who smoked 1–5 cigarettes per day, 1.57 (95% CI, 1.24–2.00 for those who smoked 6–10 cigarettes per day, and 2.13 (95% CI, 1.51–3.01 for those who smoked ≥11 cigarettes per day. There was a clear dose-response relationship. Conclusion: Our study suggests that maternal smoking during pregnancy is associated in a dosedependent manner with increased risk of RWG in early infancy.

Compliance with national recommendations for exercise during early pregnancy in a Danish cohort

DEFF Research Database (Denmark)

Broberg, Lotte; Ersbøll, Anne S; Backhausen, Mette G

2015-01-01

BACKGROUND: Exercise during pregnancy is associated with health benefits for both the mother and the fetus, and is therefore recommended in several national guidelines. Only few studies investigate whether these guideline recommendations are met. The aims of this study were 1. To assess...... the prevalence of pregnant women meeting the Danish recommendations for exercise during early pregnancy, 2. To identify pre-pregnancy factors associated with a lower probability for meeting the recommendations, and 3. To describe which types of exercise pregnant women prefer before and during pregnancy. METHODS...... the recommendation for exercise from the Danish Health and Medicines Authority (≥3.5 hours a week). Multiparity, previous miscarriage use of assisted reproductive technology, no engagement in exercise before pregnancy, smoking, pregnancy following assisted reproductive technology, overweight, not understanding...

Preventing Pregnancy in Kenya Through Distribution and Use of the CycleBeads Mobile Application.

Science.gov (United States)

Shelus, Victoria; Ashcroft, Nicki; Burgess, Sarah; Giuffrida, Monica; Jennings, Victoria

2017-09-01

Given the proportion of Kenyan women not using hormonal contraceptives, the country appears to have a substantial need for a modern, natural family planning option. The CycleBeads® mobile phone application (app), a digital platform for the Standard Days Method® of family planning, could help address this issue. After the CycleBeads app was promoted in Kenya in May-June 2015, a three-month pilot study was conducted to collect quantitative and qualitative data from 185 female app users. Chi-square testing, binary logistic regression and thematic content analysis were used to assess whether the app brought new users to family planning, to understand users' experiences and to assess how user experiences vary by distribution channel. Participants learned about the app through nongovernmental organizations (17%), via digital media (33%) or from family or friends (50%). Most used the app to track their periods (54%) or prevent pregnancy (37%); a few used it to plan a pregnancy (7%) or for other reasons (2%). The main reason for choosing the Standard Days Method was fear of side effects from hormonal methods (64%). The majority of women found the app and method easy to use (53%). Among those preventing pregnancy, 42% had never before used a method. By midline, all participants knew when fertile days occurred, and most (97%) knew the method's cycle-length requirements. Women reported high rates of condom use (88%), abstinence (68%) and withdrawal (46%) on fertile days. Offering the CycleBeads app to support women in use of the Standard Days Method may expand family planning options, reduce unmet need and make family planning more widely available.

Clinical indicators for success of misoprostol treatment after early pregnancy failure.

Science.gov (United States)

Robledo, C; Zhang, J; Troendle, J; Barnhart, K; Creinin, M D; Westhoff, C; Huang, X; Frederick, M

2007-10-01

To identify clinical indicators for success of misoprostol treatment after early pregnancy failure. A total of 473 women with early pregnancy failure received 800 microg of vaginal misoprostol on treatment day 1. At the follow-up visit on day 3, a second dose was given if expulsion was incomplete. On day 8, vacuum aspiration was offered if expulsion had not occurred. Ultrasonography was used as gold standard for success. A Classification and Regression Tree analysis was undertaken to derive two decision trees for the success of misoprostol treatment on study days 3 and 8. Heavy bleeding after the first dose and an open cervical os were identified as clinical indicators of treatment success on day 3. Treatment success occurred in 84% of women with either or both indicators. Reporting passage of tissue after a second misoprostol dose and old blood in the vagina were potential indicators of treatment success or failure on day 8. A woman with either of these indicators has a 65% chance of treatment success after the second dose. Conversely, a woman with neither indicator on day 8 has a 94% chance of treatment failure. Standard clinical findings may be useful as indicators for success or failure of medical management of early pregnancy failure in settings with limited or no access to ultrasonography. More research to identify even better indicators is warranted.

Randomized controlled trial of the effect of endometrial injury on implantation and clinical pregnancy rates during the first ICSI cycle.

Science.gov (United States)

Maged, Ahmed M; Rashwan, Hamsa; AbdelAziz, Suzy; Ramadan, Wafaa; Mostafa, Walaa A I; Metwally, Ahmed A; Katta, Maha

2018-02-01

To assess whether endometrial injury in the cycle preceding controlled ovarian hyperstimulation during intracytoplasmic sperm injection (ICSI) improves the implantation and pregnancy rates. Between January 1, 2016, and March 31, 2017, a randomized controlled trial was conducted at a center in Egypt among 300 women who met inclusion criteria (first ICSI cycle, aged endometrial scratch in the cycle preceding controlled ovarian hyperstimulation (n=150) or to a control group (n=150). Only data analysts were masked to group assignment. The primary outcomes were the implantation and clinical pregnancy rates at 14 days and 4 weeks after embryo transfer, respectively. Analyses were by intention to treat. The implantation rate was significantly higher in the endometrial scratch group (41.3% [90/218]) than in the control group (30.0% [63/210]; Pendometrial scratch group (44.2% [61/138]) than in the control group (30.4% [41/135]; PEndometrial injury in the cycle preceding the stimulation cycle improved implantation and pregnancy rates during ICSI. CLINICALTRIALS.GOV: NCT02660125. © 2017 International Federation of Gynecology and Obstetrics.

Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women

OpenAIRE

Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

2013-01-01

Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of...

Robust early pregnancy prediction of later preeclampsia using metabolomic biomarkers.

LENUS (Irish Health Repository)

Kenny, Louise C

2012-01-31

Preeclampsia is a pregnancy-specific syndrome that causes substantial maternal and fetal morbidity and mortality. The etiology is incompletely understood, and there is no clinically useful screening test. Current metabolomic technologies have allowed the establishment of metabolic signatures of preeclampsia in early pregnancy. Here, a 2-phase discovery\\/validation metabolic profiling study was performed. In the discovery phase, a nested case-control study was designed, using samples obtained at 15+\\/-1 weeks\\' gestation from 60 women who subsequently developed preeclampsia and 60 controls taking part in the prospective Screening for Pregnancy Endpoints cohort study. Controls were proportionally population matched for age, ethnicity, and body mass index at booking. Plasma samples were analyzed using ultra performance liquid chromatography-mass spectrometry. A multivariate predictive model combining 14 metabolites gave an odds ratio for developing preeclampsia of 36 (95% CI: 12 to 108), with an area under the receiver operator characteristic curve of 0.94. These findings were then validated using an independent case-control study on plasma obtained at 15+\\/-1 weeks from 39 women who subsequently developed preeclampsia and 40 similarly matched controls from a participating center in a different country. The same 14 metabolites produced an odds ratio of 23 (95% CI: 7 to 73) with an area under receiver operator characteristic curve of 0.92. The finding of a consistent discriminatory metabolite signature in early pregnancy plasma preceding the onset of preeclampsia offers insight into disease pathogenesis and offers the tantalizing promise of a robust presymptomatic screening test.

Robust Early Pregnancy Prediction of Later Preeclampsia Using Metabolomic Biomarkers.

LENUS (Irish Health Repository)

Kenny, Louise C

2010-09-13

Preeclampsia is a pregnancy-specific syndrome that causes substantial maternal and fetal morbidity and mortality. The etiology is incompletely understood, and there is no clinically useful screening test. Current metabolomic technologies have allowed the establishment of metabolic signatures of preeclampsia in early pregnancy. Here, a 2-phase discovery\\/validation metabolic profiling study was performed. In the discovery phase, a nested case-control study was designed, using samples obtained at 15±1 weeks\\' gestation from 60 women who subsequently developed preeclampsia and 60 controls taking part in the prospective Screening for Pregnancy Endpoints cohort study. Controls were proportionally population matched for age, ethnicity, and body mass index at booking. Plasma samples were analyzed using ultra performance liquid chromatography-mass spectrometry. A multivariate predictive model combining 14 metabolites gave an odds ratio for developing preeclampsia of 36 (95% CI: 12 to 108), with an area under the receiver operator characteristic curve of 0.94. These findings were then validated using an independent case-control study on plasma obtained at 15±1 weeks from 39 women who subsequently developed preeclampsia and 40 similarly matched controls from a participating center in a different country. The same 14 metabolites produced an odds ratio of 23 (95% CI: 7 to 73) with an area under receiver operator characteristic curve of 0.92. The finding of a consistent discriminatory metabolite signature in early pregnancy plasma preceding the onset of preeclampsia offers insight into disease pathogenesis and offers the tantalizing promise of a robust presymptomatic screening test.

Preconception Blood Pressure Levels and Reproductive Outcomes in a Prospective Cohort of Women Attempting Pregnancy.

Science.gov (United States)

Nobles, Carrie J; Mendola, Pauline; Mumford, Sunni L; Naimi, Ashley I; Yeung, Edwina H; Kim, Keewan; Park, Hyojun; Wilcox, Brian; Silver, Robert M; Perkins, Neil J; Sjaarda, Lindsey; Schisterman, Enrique F

2018-05-01

Elevated blood pressure in young adulthood is an early risk marker for cardiovascular disease. Despite a strong biological rationale, little research has evaluated whether incremental increases in preconception blood pressure have early consequences for reproductive health. We evaluated preconception blood pressure and fecundability, pregnancy loss, and live birth in the EAGeR trial (Effects of Aspirin on Gestational and Reproduction; 2007-2011), a randomized clinical trial of aspirin and reproductive outcomes among 1228 women attempting pregnancy with a history of pregnancy loss. Systolic and diastolic blood pressure were measured during preconception in the first observed menstrual cycle and in early pregnancy and used to derive mean arterial pressure. Fecundability was assessed as number of menstrual cycles until pregnancy, determined through human chorionic gonadotropin testing. Pregnancy loss included both human chorionic gonadotropin-detected and clinical losses. Analyses adjusted for treatment assignment, age, body mass index, race, marital status, smoking, parity, and time since last loss. Mean preconception systolic and diastolic blood pressure were 111.6 mm Hg (SD, 12.1) and 72.5 (SD, 9.4) mm Hg. Risk of pregnancy loss increased 18% per 10 mm Hg increase in diastolic blood pressure (95% confidence interval, 1.03-1.36) and 17% per 10 mm Hg increase in mean arterial pressure (95% confidence interval, 1.02-1.35) in adjusted analyses. Findings were similar for early pregnancy blood pressure. Preconception blood pressure was not related to fecundability or live birth in adjusted analyses. Findings suggest that preconception blood pressure among healthy women is associated with pregnancy loss, and lifestyle interventions targeting blood pressure among young women may favorably impact reproductive health. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00467363. © 2018 American Heart Association, Inc.

High serum IGF-1 levels are associated with pregnancy loss following frozen-thawed euploid embryo transfer cycles.

Science.gov (United States)

Irani, Mohamad; Nasioudis, Dimitrios; Witkin, Steven S; Gunnala, Vinay; Spandorfer, Steven D

2018-06-01

An elevated level of insulin growth factor (IGF-1) in rat uterine fluid has been shown to exert detrimental effects of embryo development possibly leading to an increase in pregnancy loss. Interestingly, the administration of somatostatin to rats undergoing superovulation reduced IGF-1 levels in uterine luminal fluid and thus reversed its deleterious effects on embryo development and increased the number of normal embryos. Therefore, we investigated whether serum levels of IGF-1 correlate with the incidence of pregnancy loss following IVF. To account for aneuploidy and the effect of hormonal supplementation on serum IGF levels, we only included natural frozen-thawed euploid embryo transfer (N-FET) cycles. Sera collected in the follicular phase (cycle day 10) were tested for levels of IGF-1, IGF-2, and IGF-binding protein 1 (IGFBP-1) using quantitative ELISA. A total of 156 N-FET cycles were included: 120 resulted in a live birth whereas 36 led to a first trimester pregnancy loss. Women with a pregnancy loss had significantly higher serum IGF-1 levels compared to those who achieved a live birth (18.0 ± 1.1 vs. 14.6 ± 0.7 ng/mL, respectively). The two groups had comparable serum IGF-2 and IGFBP-1 levels. There was no significant difference in maternal age, body mass index, gravidity, parity, number of prior miscarriages, peak endometrial thickness, or infertility diagnosis between the two groups. In conclusion, women undergoing euploid blastocyst transfer with elevated serum IGF-1 concentrations may be at increased risk of pregnancy loss. This may constitute a novel molecular explanation of pregnancy loss of euploid conceptus. Copyright © 2018. Published by Elsevier B.V.

The history of Belgian assisted reproduction technology cycle registration and control: a case study in reducing the incidence of multiple pregnancy.

Science.gov (United States)

De Neubourg, D; Bogaerts, K; Wyns, C; Albert, A; Camus, M; Candeur, M; Degueldre, M; Delbaere, A; Delvigne, A; De Sutter, P; Dhont, M; Dubois, M; Englert, Y; Gillain, N; Gordts, S; Hautecoeur, W; Lesaffre, E; Lejeune, B; Leroy, F; Ombelet, W; Perrier D'Hauterive, S; Vandekerckhove, F; Van der Elst, J; D'Hooghe, T

2013-10-01

What is the effect of a legal limitation of the number of embryos that can be transferred in an assisted reproductive technology (ART) cycle on the multiple delivery rate? The Belgian national register shows that the introduction of reimbursement of ART laboratory costs in July 2003, and the imposition of a legal limitation of the number of embryos transferred in the same year, were associated with a >50% reduction of the multiple pregnancy rate from 27 to 11% between 2003 and the last assessment in 2010, without any reduction of the pregnancy rate per cycle. Individual Belgian IVF centres have published their results since the implementation of the law, and these show a decrease in the multiple pregnancy rate on a centre by centre basis. However, the overall national picture remains unpublished. Cohort study from 1990 to 2010 of all ART cycles in Belgium (2685 cycles in 1990 evolving to 19 110 cycles in 2010), with a retrospective analysis from 1990 to 2000 and prospective online data collection since 2001. Registration evolved from paper written reports per centre to a compulsory online registration of all ART cycles. From 2001 up to mid-2009, data were collected from Excel spread sheets or MS Access files into an MS Access database. Since mid-2009, data collection is done via a remote and secured web-based system (www.belrap.be) where centres can upload their data and get immediate feedback about missing data, errors and inconsistencies. National Belgian registration data show that reimbursement of IVF laboratory costs in July 2003, coupled to a legal limitation in the number of embryos transferred in utero, were associated with a 50% reduction of the multiple pregnancy rate from 27 to 11% without reduction of the pregnancy rate per cycle, and with an increase in the number of fresh and frozen ART cycles due to improved access to treatment. There is potential underreporting of complications of ART treatment, pregnancy outcome and neonatal health. Over the 20

Pregnancy, maternal tobacco smoking and early age leukemia in Brazil

Directory of Open Access Journals (Sweden)

Sergio eKoifman

2012-11-01

Full Text Available Background: Cigarette smoking has been associated with acute myeloid leukemia but hypothesis on the association between maternal smoking during pregnancy and childhood leukemia is unclear. Objectives: To investigate the association between maternal exposure to tobacco smoking during pregnancy and early age (< 2 yr. leukemia (EAL. Methods: A hospital-based multicenter case-control study aiming to explore EAL risk factors was carried out in Brazil during 1999-2007. Data were collected by direct interview with the biological mothers using a standardized questionnaire. The present study included 675 children, being 193 acute lymphoblastic leukemia (ALL, 59 acute myeloid leukemia (AML, and 423 controls, being the latter age frequency matched and paired by area of residence with the cases. Unconditional logistic regression was performed, and odds ratios (OR on the association between tobacco smoking (3 months before pregnancy, during pregnancy, and 3 months after delivery and EAL were ascertained after adjustment for selected variables (maternal age at birth and education, birth weight, infant skin color, and oral contraceptives use during pregnancy.Results: Smoking was reported by 17.5% of case mothers and 20.6% of controls´. Among women who reported to have smoked 20 or more cigarettes during the index pregnancy, an adjusted OR = 5.28 (95% C.I. 1.40-19.95 for ALL was observed. Heavy smoking during breastfeeding yielded an adjusted risk estimate for ALL, OR = 7.78 (95% C.I. 1.33-45.5. No dose-response effect was observed according to smoking exposure during pregnancy and EAL. An association between secondhand smoking during pregnancy or breastfeeding was not observed. Conclusion: An association between maternal smoking and AAL in the offspring was restricted to women who have reported an intense exposure to tobacco smoke during pregnancy and breastfeeding.

The value of combined detection of serum β-HCG and progesterone in diagnosis of early ectopic pregnancy

International Nuclear Information System (INIS)

Lu Yanting; Wang Taisong

2011-01-01

To explore the value of combined detection of serum β-HCG and P in diagnosis of early ectopic pregnancy and expectant therapeutic efficacy. Serum levels of β-HCG and P of 324 patients with early ectopic pregnancy and 146 normal early pregnant women were determined and compared by RIA, Serum β-HCG and P were compared between before and after treatment. The required time when serum β-HCG and P decreased to the normal rang of the patients treated successfully were observed respectively. The results showed that the serum β-HCG and P value in ectopic pregnancy group were significantly lower than those in intrauterine gestation group (P<0.05). The variation of P was significant between success and failure groups of drug conservative treatment, but β-HCG had no significant difference. The required time when serum P decreased to the normal was significantly less than the serum β-HCG dropped to normal. Combined detection of serum levels of β-HCG and P is an adjunctive method to diagnose early ectopic pregnancy, so it giants opportunity for treatment of early ectopic pregnancy and is of positive clinical application value for observation therapeutic effect and prognosis of the disease. P values may be one of the more important reference index to predict whether conservative treatment is successful or not than β-HCG. (authors)

Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases.

Science.gov (United States)

Tan, Shu-Yin; Hang, Fu; Purvarshi, Gowreesunkur; Li, Min-Qing; Meng, Da-Hua; Huang, Ling-Ling

2015-10-01

To evaluate the predictive value of three-dimensional (3D)-power Doppler sonography on recurrent miscarriage. The study patients were divided into a recurrent miscarriage group (30 cases) and a normal pregnancy group (21 cases). Measurement of endometrial thickness was performed using two-dimensional transvaginal ultrasound in the midluteal phase. The endometrial volume, vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) in midluteal and placenta volume, as well as the VI, FI, and VFI of early pregnancy were measured using Virtual Organ Computer-aided Analysis of 3D-power Doppler ultrasound. Endometrial thickness, endometrial volume, endometrial vascular data, VI, FI, and VFI of the midluteal phase were lower in the recurrent miscarriage group compared with the normal pregnancy group (p FI between the recurrent miscarriage and control groups during early pregnancy (p > 0.05). The predictive accuracy of endometrial thickness, endometrial volume, VI, FI, and VFI in the midluteal phase, and placenta volume, VI, FI, and VFI in early pregnancy as measured by the receiver operating characteristic curve to predict miscarriage before 12 gestational weeks in participants was 0.681, 0.876, 0.770, 0.720, 0.879, 0.771, 0.907, 0.592, respectively. The 3D-power Doppler ultrasound is a more comprehensive and sensitive method for evaluating endometrial receptivity. Endometrial volume, VI, FI, and VFI in the midluteal phase, as well as VI in early pregnancy, can be considered as predictive factors for recurrent miscarriage. Copyright © 2015. Published by Elsevier B.V.

The decidua of preeclamptic-like BPH/5 mice exhibits an exaggerated inflammatory response during early pregnancy.

Science.gov (United States)

Heyward, C Y; Sones, J L; Lob, H E; Yuen, L C; Abbott, K E; Huang, W; Begun, Z R; Butler, S D; August, A; Leifer, C A; Davisson, R L

2017-04-01

Preeclampsia is a devastating complication of pregnancy characterized by late-gestation hypertension and proteinuria. Because the only definitive treatment is delivery of the fetus and placenta, preeclampsia contributes to increased morbidity and mortality of both mother and fetus. The BPH/5 mouse model, which spontaneously develops a syndrome strikingly similar to preeclampsia, displays excessive inflammation and suppression of inflammation improves pregnancy outcomes. During early pregnancy, decidual macrophages play an important role in promoting maternal tolerance to fetal antigens and regulating tissue remodeling, two functions that are critical for normal placental development. BPH/5 pregnancies are characterized by abnormal placentation; therefore, we hypothesized that macrophage localization and/or function is altered during early pregnancy at the site of placental formation (the decidua) compared to C57BL/6 controls. At early gestation time points, before the onset of maternal hypertension or proteinuria, there was a reduction in the number of macrophages in BPH/5 decidua and a concomitant increase in activated T cells compared with C57BL/6. BPH/5 decidua also exhibited decreased expression of the immunosuppressive cytokine, IL-10, and increased expression of pro-inflammatory, inducible nitric oxide synthase. Together, these data suggest that a reduction in decidual macrophages during pregnancy is associated with immune activation in BPH/5 mice, inadequate placental development and may contribute to adverse pregnancy outcomes in this model. Copyright © 2017 Elsevier B.V. All rights reserved.

Early Pregnancy Biomarkers in Pre-Eclampsia: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Pensée Wu

2015-09-01

Full Text Available Pre-eclampsia (PE complicates 2%–8% of all pregnancies and is an important cause of perinatal morbidity and mortality worldwide. In order to reduce these complications and to develop possible treatment modalities, it is important to identify women at risk of developing PE. The use of biomarkers in early pregnancy would allow appropriate stratification into high and low risk pregnancies for the purpose of defining surveillance in pregnancy and to administer interventions. We used formal methods for a systematic review and meta-analyses to assess the accuracy of all biomarkers that have been evaluated so far during the first and early second trimester of pregnancy to predict PE. We found low predictive values using individual biomarkers which included a disintegrin and metalloprotease 12 (ADAM-12, inhibin-A, pregnancy associated plasma protein A (PAPP-A, placental growth factor (PlGF and placental protein 13 (PP-13. The pooled sensitivity of all single biomarkers was 0.40 (95% CI 0.39–0.41 at a false positive rate of 10%. The area under the Summary of Receiver Operating Characteristics Curve (SROC was 0.786 (SE 0.02. When a combination model was used, the predictive value improved to an area under the SROC of 0.893 (SE 0.03. In conclusion, although there are multiple potential biomarkers for PE their efficacy has been inconsistent and comparisons are difficult because of heterogeneity between different studies. Therefore, there is an urgent need for high quality, large-scale multicentre research in biomarkers for PE so that the best predictive marker(s can be identified in order to improve the management of women destined to develop PE.

Features of psychoemotional state of pregnant women with missed abortion in the early stages of pregnancy

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O.O. Bala

2016-06-01

Full Text Available Purpose. To determine peculiarities of psychoemotional state of pregnant women with missed abortion in the early stages of pregnancy. Patients and methods. The study included 60 women with missed abortion in the early stages of pregnancy (I group and 30 women with an advanced pregnancy to 8 weeks of gestation (II control group. To determine peculiarities of psychoemotional status of women conducted a survey according to standard methods: determination of the level of neuropsychic tension on questionnaire Nemchina, the level of anxiety according to the scale Spielberg—Hanin, the level of anxiety on a scale of Taylor—Norakidze. Results. Analysis of psychoemotional state groups have demonstrated that pregnant women with physiological course of pregnancy at an early stage (group II is characterized by a moderate level of mental stress (40.8±1.3 on a scale of Nemchina, the average level of personal and reactive anxiety (38.6±1.1 and 37.2±1.2, respectively according to the scale Spielberg—Hanin, the average anxiety level on a scale of Taylor— Norakidze. In women with the missed abortion at the early stages of pregnancy there is a high level of psychoemotional load, reactive anxiety (57.3±1.6, mental stress (of 62.6±1.4 and anxiety (31.8±2.3 years. Conclusions. The obtained results indicate the need for strong psychological support and if necessary medical assistance to women with missed abortion in the early stages of pregnancy, since the accession of psychopathological symptoms does not contribute to the psycho-emotional adaptation and can provoke the development of psychosomatic pathological syndromes in postabortion period and on the phase of rehabilitation and subsequent pregravid preparation.

Early pregnancy vaginal microbiome trends and preterm birth.

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Stout, Molly J; Zhou, Yanjiao; Wylie, Kristine M; Tarr, Phillip I; Macones, George A; Tuuli, Methodius G

2017-09-01

, diversity, and evenness during pregnancy (P vaginal microbiome instability compared to term birth. No distinct taxa were associated with preterm birth. In a predominantly African-American population, a significant decrease of vaginal microbial community richness and diversity is associated with preterm birth. The timing of this suppression appears early in pregnancy, between the first and second trimesters, suggesting that early gestation may be an ecologically important time for events that ordain subsequent term and preterm birth outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Early human pregnancy serum cytokine levels predict autoimmunity in offspring.

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Lindehammer, Sabina Resic; Björck, Sara; Lynch, Kristian; Brundin, Charlotte; Marsal, Karel; Agardh, Daniel; Fex, Malin

2011-09-01

It is generally believed that pregnancy is mediated by a Th2 response, which includes cytokines that promote placental growth and are involved in inducing tolerance to the foetus. If the balance between Th1/and Th2-mediated cytokines is disrupted, systemic and local changes could predispose the foetus to future disease. Therefore, a shift in the Th1/Th2 balance during pregnancy, possibly caused by underlying environmental factors, could be associated with post-partum autoimmune disease in the offspring. Based on this presumption, we used celiac disease as a model to investigate whether autoimmunity is triggered in the foetus during early pregnancy, observed as changes in the mother's cytokine profile. Ten cytokines were measured by electro-chemi-luminescent multiplex ELISA in serum samples obtained from mothers during early pregnancy. Cases included women with children who had developed verified celiac disease before the age of 5, who were compared with other women as matched controls. We observed that 7 out of 10 cytokine levels were significantly increased in our case mothers when compared to controls. Five of these belonged to what is generally known as a Th1-mediated response (TNFα, IFNγ, IL-2, IL-1β and IL-12) and two were Th2 cytokines (IL-13 and IL-10). However, the IL-10 cytokine is known to have features from both arms of the immune system. These results were confirmed in a logistic regression model where five out of the initial seven cytokines remained. This study suggests that increase in Th1 serum cytokines may be associated with celiac disease in offspring.

Medication use in early pregnancy-prevalence and determinants of use in a prospective cohort of women.

LENUS (Irish Health Repository)

Cleary, Brian J

2012-02-01

PURPOSE: To examine the extent, nature and determinants of medication use in early pregnancy. METHODS: We reviewed early pregnancy medication use, as reported to a midwife at the booking interview, in women delivering between 2000 and 2007 in a large maternity hospital in Dublin, Ireland (n = 61 252). RESULTS: Excluding folic acid, at least one medication was reported in 23 989 (39.2%) pregnancies. Over the counter (OTC) medications were reported in 11 970 (19.5%) pregnancies, illicit drugs or methadone in 545 (0.9%) and herbal medicines\\/supplements in 352 (0.58%). FDA category D and X medications were reported by 1532 (2.5%) and 1987 (3.2%) women. Asthma, depression and hypertension were among the most commonly reported chronic medical disorders. Medications with potential for foetal harm were reported by 86 (15.7%) women treated for depression and 68 (20%) women treated for hypertension. Factors associated with reporting the use of medications with potential for foetal harm included unplanned pregnancy (adjusted odds ratio [aOR] 1.31, 95% confidence interval [CI] 1.12-1.52), booking at less than 12 weeks gestation (aOR 1.83, 95%CI 1.58-2.13), being above 25 years of age, unemployed (aOR 2.58, 95%CI 2.03-3.29), nulliparous (aOR 1.41; 95%CI 1.22-1.63), single (aOR 1.28; 95%CI 1.06-1.54) or smoking during pregnancy (aOR 1.96, 95%CI 1.67-2.28). CONCLUSIONS: Women frequently report medication use in early pregnancy. Women and prescribers need to be aware of the lack of pregnancy safety data for many medications, and the need for pre-pregnancy planning. Prescribers should ensure that optimal medications are used when treating women of childbearing potential with chronic medical disorders.

Does tea consumption during early pregnancy have an adverse effect on birth outcomes?

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Lu, Jin-Hua; He, Jian-Rong; Shen, Song-Ying; Wei, Xue-Ling; Chen, Nian-Nian; Yuan, Ming-Yang; Qiu, Lan; Li, Wei-Dong; Chen, Qiao-Zhu; Hu, Cui-Yue; Xia, Hui-Min; Bartington, Suzanne; Cheng, Kar Keung; Lam, Kin Bong Hubert; Qiu, Xiu

2017-09-01

Tea, a common beverage, has been suggested to exhibit a number of health benefits. However, one of its active ingredients, caffeine, has been associated with preterm birth and low birthweight. We investigated whether tea consumption during early pregnancy is associated with an increased risk of preterm birth and abnormal fetal growth. A total of 8775 pregnant women were included from the Born in Guangzhou Cohort Study. Tea consumption (type, frequency, and strength) during their first trimester and social and demographic factors were obtained by way of questionnaires administered during pregnancy. Information on birth outcomes and complications during pregnancy was obtained from hospital medical records. Overall habitual tea drinking (≥1 serving/week) prevalence among pregnant women was low, at 16%. After adjustment for potential confounding factors (eg, maternal age, educational level, monthly income) tea drinking during early pregnancy was not associated with an increased risk of preterm birth or abnormal fetal growth (small or large for gestational age) (P>.05). We did not identify a consistent association between frequency of tea consumption or tea strength and adverse birth outcomes among Chinese pregnant women with low tea consumption. Our findings suggest that occasional tea drinking during pregnancy is not associated with increased risk of preterm birth or abnormal fetal growth. Given the high overall number of annual births in China, our findings have important public health significance. © 2017 Wiley Periodicals, Inc.

Acute abdomen in early pregnancy due to ovarian torsion following successful in vitro fertilization treatment

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Hsing-Chun Tsai

2015-08-01

Conclusion: Ovarian hyperstimulation during IVF–embryo transfer treatment is a risk factor for developing adnexal torsion. Early diagnosis and prompt surgical intervention is the only way to protect the ovary and preserve the pregnancy. Laparoscopic surgery in early pregnancy causes no harm to the fetus and should be encouraged once the diagnosis is confirmed. Delaying surgery may induce serious infection and jeopardize the lives of both the fetus and mother.

[Clinical study of induced abortion of early-early pregnancy: an analysis of 10, 404 cases].

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Kang, Jian; Wang, Xue-fen; Zhang, Li; Liu, Jian-hua

2012-01-03

To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA). A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA). The amount of hemorrhage and operative duration, degree of pain, rate of induced-abortion syndrome, rate of incomplete abortion, menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups. The average age, ratio of parous cases, ratio of the cases of first-pregnancy induced abortion were not different between 2 groups (P > 0.05). The amount of hemorrhage bleeding ((4.9 ± 3.2) ml), operative duration ((90.3 ± 12.4) s), degree of pain, rate of induced-abortion syndrome, menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P abortion (0.44%) in the EPIA group was significantly higher than that (0.21%) in the CIA group (P abortion stays high.

Soluble human leukocyte antigen-G isoforms in maternal plasma in early and late pregnancy

DEFF Research Database (Denmark)

Rizzo, Roberta; Andersen, Anita Sylvest; Lassen, Michael Rud

2009-01-01

-G generated by specific HLA-G transcripts, have been investigated early [median of 16.4 weeks of gestation (GW)] and late (median: 38.9 GW) in pregnancy in an original cohort of 580 pregnant Caucasian women. RESULTS: Lower concentrations of sHLA-G1 were found late in pregnancy (>32 GW) in a group of women...

Recurrent pregnancy loss

DEFF Research Database (Denmark)

Egerup, P; Kolte, A M; Larsen, E C

2016-01-01

STUDY QUESTION: Is there a different prognostic impact for consecutive and non-consecutive early pregnancy losses in women with secondary recurrent pregnancy loss (RPL)? SUMMARY ANSWER: Only consecutive early pregnancy losses after the last birth have a statistically significant negative prognostic...... impact in women with secondary RPL. WHAT IS KNOWN ALREADY: The risk of a new pregnancy loss increases with the number of previous pregnancy losses in patients with RPL. Second trimester losses seem to exhibit a stronger negative impact than early losses. It is unknown whether the sequence of pregnancy...... losses plays a role for the prognosis in patients with a prior birth. STUDY DESIGN, SIZE, DURATION: This retrospective cohort study of pregnancy outcome in patients with unexplained secondary RPL included in three previously published, Danish double-blinded placebo-controlled trials of intravenous...

Duration of blastulation may be associated with ongoing pregnancy rate in single euploid blastocyst transfer cycles.

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Mumusoglu, Sezcan; Ozbek, Irem Y; Sokmensuer, Lale K; Polat, Mehtap; Bozdag, Gurkan; Papanikolaou, Evangelos; Yarali, Hakan

2017-12-01

Not all euploid embryos implant, necessitating additional tools to select viable blastocysts in preimplantation genetic screening cycles. In this retrospective cohort study, 129 consecutive patients who underwent 129 single euploid blastocyst transfers in cryopreserved embryo transfer cycles were included. All embryos were individually cultured in a time-lapse incubator from intracytoplasmic sperm injection up to trophoectoderm biopsy. Twenty-three time-lapse morphokinetic variables were tested among patients with (n = 68) or without (n = 61) ongoing pregnancy. All 23 time-lapse morphokinetic variables, apart from duration of blastulation (tB-tSB), were comparable between patients with or without ongoing pregnancy. Duration of blastulation was significantly shorter in patients with ongoing pregnancy (8.1 ± 3.2 versus 9.5 ± 3.4 h; P = 0.014); shorter duration of blastulation remained an independent predictor for ongoing pregnancy, when tested by logistic regression analysis (OR 0.81; 95% CI 0.70 to 0.93). One important limitation of this study, and a reason for caution, is the use of multiple comparisons, which can lead to differences at the 0.05 level simply by chance or random variation. Nonetheless, the study suggests that when more than one euploid blastocyst is available, priority might be given to those with a shorter duration of blastulation. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Correlates of poor mental health in early pregnancy in obese European women.

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Sattler, Matteo C; Jelsma, Judith G M; Bogaerts, Annick; Simmons, David; Desoye, Gernot; Corcoy, Rosa; Adelantado, Juan M; Kautzky-Willer, Alexandra; Harreiter, Jürgen; van Assche, Frans A; Devlieger, Roland; Jans, Goele; Galjaard, Sander; Hill, David; Damm, Peter; Mathiesen, Elisabeth R; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Blumska, Kinga; Lapolla, Annunziata; Dalfrà, Maria G; Bertolotto, Alessandra; Dunne, Fidelma; Jensen, Dorte M; Andersen, Lise Lotte T; Snoek, Frank J; van Poppel, Mireille N M

2017-12-04

Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. In this cross-sectional observational study, baseline data from early pregnancy (mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. ISRCTN70595832 , 02.12.2011.

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

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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…

Factors associated with monozygosity in assisted reproductive technology pregnancies and the risk of recurrence using linked cycles.

Science.gov (United States)

Luke, Barbara; Brown, Morton B; Wantman, Ethan; Stern, Judy E

2014-03-01

To evaluate factors associated with monozygosity (MZ) (number of fetal heartbeats on early ultrasound greater than the number of embryos transferred) and the risk of recurrence in subsequent pregnancies using a national assisted reproduction database. Historical cohort study. Clinic-based data. 197,327 pregnancies (including 2,824 with evidence of MZ) from cycles reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) between 2004 and 2010. None. Evidence of MZ, adjusted odds ratios and their 95% confidence intervals computed from logistic regression models. In the univariate analysis, the risk of MZ was increased with ovulation disorders, donor oocytes, gonadotropin-releasing hormone agonist (GnRH-a) suppression, assisted hatching (AZH), and day 5-6 transfer, and was decreased with higher follicle-stimulating hormone (FSH) doses (≥3,000 IU). In the multivariate analysis, the risk of MZ was increased with GnRH-a suppression, AZH, and decreased with intracytoplasmic sperm injection (ICSI) and higher FSH dose. The interaction showed that although MZ was more likely with day 5-6 embryos, AZH had a minimal nonsignificant effect, whereas in day 2-3 embryos, AZH had a substantial statistically significant effect. Only one woman had a recurrence of MZ in a subsequent assisted reproduction pregnancy, which is consistent with randomness. The risk of MZ was higher with fresh day 5-6 embryos, donor oocytes, GnRH-a suppression, lower FSH doses, and AZH (particularly with day 2-3 embryos). Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Effect of Intercourse around Embryo Transfer on Pregnancy Rate in Assisted Reproductive Technology Cycles

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Nasim Tabibnejad

2009-01-01

Full Text Available Background: Implantation failure is the most important cause of recurrent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI failure. Several reports suggest that intercourse during theperitransfer period might improve pregnancy rates. This study is designed to determine whetherintercourse during the peritransfer period will improve pregnancy and implantation rates in patientsundergoing IVF or ICSI.Materials and Methods: In a randomized control trial study, 390 women with at least five yearsinfertility were evaluated. In the study group, 195 patients had intercourse at least once 12 hours afterembryo transfer. Implantation and clinical pregnancy rates were compared with 195 patients in thecontrol group who had no intercourse for the entire assisted reproductive technology (ART cycle.Results: Implantation rate in the study group was 6.5% in comparison with 5.5% for the controlgroup. Clinical pregnancy rates were not significantly higher in study patients when compared tothe control group (14.2% and 11.7% respectively.Conclusion: The results showed that intercourse during the peritransfer period can not increasepregnancy outcome.

Effects of single dose GnRH agonist as luteal support on pregnancy outcome in frozen-thawed embryo transfer cycles: an RCT

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Robab Davar

2015-08-01

Full Text Available Background: There is no doubt that luteal phase support is essential to enhance the reproductive outcome in IVF cycles. In addition to progesterone and human chorionic gonadotropin, several studies have described GnRH agonists as luteal phase support to improve implantation rate, pregnancy rate and live birth rate, whereas other studies showed dissimilar conclusions. All of these studies have been done in fresh IVF cycles. Objective: To determine whether an additional GnRH agonist administered at the time of implantation for luteal phase support in frozen-thawed embryo transfer (FET improves the embryo developmental potential. Materials and Methods: This is a prospective controlled trial study in 200 FET cycles, patients were randomized on the day of embryo transfer into group 1 (n=100 to whom a single dose of GnRH agonist (0.1 mg triptorelin was administered three days after transfer and group 2 (n=100, who did not receive agonist. Both groups received daily vaginal progesterone suppositories plus estradiol valerate 6 mg daily. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were implantation rate, chemical, ongoing pregnancy rate and abortion rate. Results: A total of 200 FET cycles were analyzed. Demographic data and embryo quality were comparable between two groups. No statistically significant difference in clinical and ongoing pregnancy rates was observed between the two groups (26% versus 21%, p=0.40 and 21% versus 17%, p=0.37, respectively. Conclusion: Administration of a subcutaneous GnRH agonist at the time of implantation does not increase clinical or ongoing pregnancy.

Adnexal Torsion during Pregnancy after Oocyte In Vitro Maturation and Intracytoplasmic Sperm Injection Cycle

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Simone Giulini

2010-01-01

Full Text Available We report a case of right adnexal torsion during pregnancy after an oocyte in vitro maturation and intracitoplasmic sperm injection cycle in patient with polycystic ovary syndrome. A 31-year-old woman with a typical clinical disorder of polycystic ovarian syndrome was included in an oocyte in vitro maturation program. Right adnexal torsion occurred two days after embryo transfer, and laparoscopy detorsion was successfully performed with preservation of adnexa. The patient had a full-term pregnancy and delivered a healthy infant at 40 weeks of gestation. To our knowledge this is the first report of adnexal torsion after an oocyte in vitro maturation and intracitoplasmic sperm injection program.

[Assessment of thyroid function in women treated for vomiting in early pregnancy].

Science.gov (United States)

Makowska, Beata; Preis, Krzysztof; Swiatkowska-Freund, Małgorzata; Leszczyńska, Katarzyna

2005-08-01

Hyperthyroidism does not influence procreation ability significantly, but very often causes complications of the course of pregnancy and increases neonatal morbidity and mortality in newborns. Nausea and vomiting in the first trimester of pregnancy are very common complaints in these patients. The aim of the study was to prove, that assessment of the thyroid hormones in every vomiting woman in the first trimester allows to start the proper treatment of hyperthyreosis as early as possible and improves the prognosis. Authors analyzed 22 pregnant women treated for vomiting during the first trimester in the Department of Obstetrics and 5 women treated in the Outpatient Clinic. In none of them hormonal dysfunction was diagnosed before pregnancy. In 21 patients free thyroxine (fT4) in serum was assessed. In 8 cases (38%) hyperthyreosis was diagnosed. Except the routine anti vomiting treatment, they received a beta-blocker 30 mg per day. It allowed to avoid hospitalization in three pregnant women treated in the outpatient clinic. Two patients, who had earlier two spontaneous abortions, delivered healthy babies. 1. The beta-blocker in treatment gives very good results and allows to avoid hospitalization in patients with hyperthyroidism and hyper emesis gravidarum. 2. In some patients vomiting may be the only symptom of sub clinical hyperthyroidism in early pregnancy. Assessment of the thyroid hormones levels and adequate treatment may give these women a chance for a healthy child.

Does binge drinking during early pregnancy increase the risk of psychomotor deficits?

Science.gov (United States)

Kesmodel, Ulrik Schiøler; Bay, Bjørn; Wimberley, Theresa; Eriksen, Hanne-Lise F; Mortensen, Erik Lykke

2013-07-01

The potential effects of binge drinking during pregnancy on child motor function have only been assessed in a few, small studies. We aimed to examine the effects of binge alcohol consumption during early pregnancy, including number of binge episodes and timing of binge drinking, on child motor function at age 5. We performed a prospective follow-up study of 678 women and their children sampled from the Danish National Birth Cohort based on maternal alcohol consumption during pregnancy. At 5 years of age, the children were tested with the Movement Assessment Battery for Children. Parental education, maternal IQ, prenatal maternal smoking, the child's age at testing, sex of child, and tester were considered core confounders, while the full model also controlled for prenatal maternal average alcohol intake, maternal age and prepregnancy body mass index, parity, home environment, postnatal parental smoking, health status, participation in organized sport, and indicators for hearing and vision impairment. There were no systematic or significant differences in motor function between children of mothers reporting isolated episodes of binge drinking and children of mothers with no binge episodes. No association was observed with respect to the number of binge episodes (maximum of 12) and timing of binge drinking. In this study, we found no systematic association between isolated episodes of binge drinking during early pregnancy and child motor function at age 5. Copyright © 2013 by the Research Society on Alcoholism.

Parental Family Stress during Pregnancy and Cognitive Functioning in Early Childhood: The Generation R Study

Science.gov (United States)

Henrichs, Jens; Schenk, Jacqueline J.; Kok, Rianne; Ftitache, Bouchra; Schmidt, Henk G.; Hofman, Albert; Jaddoe, Vincent W. V.; Verhulst, Frank C.; Tiemeier, Henning

2011-01-01

We investigated whether parental family stress during pregnancy is associated with cognitive functioning in early childhood in a population-based cohort (n = 3139). Family stress was assessed using the Family Assessment Device at the 20th week of pregnancy and was reported by mothers and fathers. Mothers completed the MacArthur Communicative…

Incidence of Subclinical Hypothyroidism and Hypothyroidism in Early Pregnancy.

Science.gov (United States)

Akram, Frida Hosseini; Johansson, Bengt; Möllerström, Gunnar; Landgren, Britt-Marie; Stavreus-Evers, Anneli; Skjöldebrand-Sparre, Lottie

2017-11-01

Untreated and subclinical hypothyroidism (SCH) has been associated with adverse pregnancy complications such as increased risk of miscarriage, hypertension, preeclampsia, and preterm delivery. However, in Sweden, screening for thyroid dysfunction during pregnancy is only recommended for women with a high risk of thyroid disease. Therefore, the aim of this study was to determine the incidence of clinical and SCH in women in the first trimester of pregnancy. In this prospective study, 1298 pregnant women were divided into three groups: one unselected general screening group (n = 611), one low-risk group comprising women without risk factors for thyroid disorder (n = 511), and one high-risk group comprising women with an inheritance or suspicion of thyroid disease or undergoing treatment for thyroid disease (n = 88). Serum was obtained up to gestational week 13, and thyrotropin (TSH) was analyzed. The incidences of thyroid dysfunction in the three screening groups were 9.8% in the general screening group, 9.6% in the low-risk group, and 10.2%, p = 0.948, in the high-risk group. In the women with known hypothyroidism on levothyroxine treatment, 50.6% had serum TSH levels above 2.0 mIU/L. High-risk screening is not useful in predicting which women are at risk of thyroid disease in early pregnancy since ∼10% of women with SCH or hypothyroidism could not be diagnosed in this way.

Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles.

Science.gov (United States)

Bu, Zhiqin; Wang, Keyan; Dai, Wei; Sun, Yingpu

2016-07-01

In order to explore the relationship between endometrial thickness on the day of embryo transfer and pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles, we retrospectively analyzed data from 2997 patients undergoing their first FET cycles from January 2010 to December 2012. All patients were divided into three groups (Group A, ≤8 mm; Group B, 9-13 mm; Group C, ≥14 mm) according to the endometrial thickness on embryo transfer day. Compared with patients in the other two groups, patients with thin endometrial thickness in Group A had significantly lower clinical pregnancy rate (33.4%, 41.3% and 45.4%, p birth rate (23.8%, 32.2% and 34.0%, p confidence interval (CI): 1.10-1.77, p birth rate (aOR: 1.50; 95% CI: 1.16-1.95, p < 0.01) were significant. We conclude that for patients undergoing FET, endometrial thickness on the embryo transfer day significantly affects IVF outcomes in cleavage embryo transfer cycles independent of other factors.

Factors associated with nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy.

Science.gov (United States)

Mridha, Malay K; Matias, Susana L; Arnold, Charles D; Dewey, Kathryn G

2018-02-18

Bangladesh has a high prevalence of adolescent pregnancy, but little is known about the nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy or associated factors. We used the baseline data of 1552 pregnant adolescents from a longitudinal, cluster-randomized effectiveness trial conducted in northwest Bangladesh. Forty-four percent of the adolescents were short for their age, 36% had low body mass index, 28% were anemic, 10% had iron deficiency, and 32% had vitamin A deficiency. The mean consumption of animal-source foods was 10.3 times/week. In multivariate analysis, socioeconomic status, education, and food security were generally positively associated with anthropometric indicators and dietary practices but not with iron or vitamin A status. Our findings confirm that there is a high burden of undernutrition among these Bangladeshi adolescents in early pregnancy. Understanding factors related to undernutrition can help to identify adolescent pregnant women at higher risk and provide appropriate counseling and care. © 2018 New York Academy of Sciences.

Reduced prevalence of early preterm delivery in women with Type 1 diabetes and microalbuminuria--possible effect of early antihypertensive treatment during pregnancy

DEFF Research Database (Denmark)

Nielsen, L R; Kragh-Müller, Claus; Damm, P

2006-01-01

In normotensive women with Type 1 diabetes and microalbuminuria we previously found preterm delivery (pregnancies. Antihypertensive treatment was initiated in late pregnancy when preeclampsia was diagnosed and diastolic blood pressure > 90 mmHg. From April 2000 our routine...... was changed and early antihypertensive treatment with methyldopa was initiated if antihypertensive treatment was given prior to pregnancy, if urinary albumin excretion (UAE) was > 2 g/24 h, or blood pressure > 140/90 mmHg. The present study describes the impact of this more aggressive antiypertensive...

ESHRE PGD Consortium data collection XIV-XV: cycles from January 2011 to December 2012 with pregnancy follow-up to October 2013.

Science.gov (United States)

De Rycke, M; Goossens, V; Kokkali, G; Meijer-Hoogeveen, M; Coonen, E; Moutou, C

2017-10-01

How does the data collection XIV-XV of the European Society of Human Reproduction and Embryology (ESHRE) PGD Consortium compare with the cumulative data for data collections I-XIII? The 14th and 15th retrospective collection represents valuable data on PGD/PGS cycles, pregnancies and children: the main trend observed is the increased application of array technology at the cost of FISH testing in PGS cycles and in PGD cycles for chromosomal abnormalities. Since 1999, the PGD Consortium has collected, analysed and published 13 previous data sets and an overview of the first 10 years of data collections. Data were collected from each participating centre using a FileMaker Pro database (versions 5-12). Separate predesigned FileMaker Pro files were used for the cycles, pregnancies and baby records. The study documented cycles performed during the calendar years 2011 and 2012 and follow-up of the pregnancies and babies born which resulted from these cycles (until October 2013). Data were submitted by 71 centres (full PGD Consortium members). Records with incomplete or inconsistent data were excluded from the calculations. Corrections, calculations and tables were made by expert co-authors. For data collection XIV-XV, 71 centres reported data for 11 637 cycles with oocyte retrieval (OR), along with details of the follow-up on 2147 pregnancies and 1755 babies born. A total of 1953 cycles to OR were reported for chromosomal abnormalities, 144 cycles to OR for sexing for X-linked diseases, 3445 cycles to OR for monogenic diseases, 6095 cycles to OR for PGS and 38 cycles to OR for social sexing. From 2010 until 2012, the use of arrays for genetic testing increased from 4% to 20% in PGS and from 6% to 13% in PGD cycles for chromosomal abnormalities; the uptake of biopsy at the blastocyst stage (from cycles for structural chromosomal abnormalities, alongside the application of array comparative genomic hybridization. The findings apply to the 71 participating centres and may

Validity of a food frequency questionnaire to estimate long-chain polyunsaturated fatty acid intake among Japanese women in early and late pregnancy.

Science.gov (United States)

Kobayashi, Minatsu; Jwa, Seung Chik; Ogawa, Kohei; Morisaki, Naho; Fujiwara, Takeo

2017-01-01

The relative validity of food frequency questionnaires for estimating long-chain polyunsaturated fatty acid (LC-PUFA) intake among pregnant Japanese women is currently unclear. The aim of this study was to verify the external validity of a food frequency questionnaire, originally developed for non-pregnant adults, to assess the dietary intake of LC-PUFA using dietary records and serum phospholipid levels among Japanese women in early and late pregnancy. A validation study involving 188 participants in early pregnancy and 169 participants in late pregnancy was conducted. Intake LC-PUFA was estimated using a food frequency questionnaire and evaluated using a 3-day dietary record and serum phospholipid concentrations in both early and late pregnancy. The food frequency questionnaire provided estimates of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake with higher precision than dietary records in both early and late pregnancy. Significant correlations were observed for LC-PUFA intake estimated using dietary records in both early and late pregnancy, particularly for EPA and DHA (correlation coefficients ranged from 0.34 to 0.40, p food frequency questionnaire, which was originally designed for non-pregnant adults and was evaluated in this study against dietary records and biological markers, has good validity for assessing LC-PUFA intake, especially EPA and DHA intake, among Japanese women in early and late pregnancy. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Transcriptional factor PU.1 regulates decidual C1q expression in early pregnancy in human

Directory of Open Access Journals (Sweden)

Priyaa Madhukaran Raj

2015-02-01

Full Text Available C1q is the first recognition subcomponent of the complement classical pathway, which in addition to being synthesized in the liver, is also expressed by macrophages and dendritic cells. Trophoblast invasion during early placentation results in accumulation of debris that triggers the complement system. Hence, both early and late components of the classical pathway are widely distributed in the placenta and decidua. In addition, C1q has recently been shown to significantly contribute to feto-maternal tolerance, trophoblast migration, and spiral artery remodeling, although the exact mechanism remains unknown. Pregnancy in mice, genetically deficient in C1q, mirrors symptoms similar to that of human preeclampsia. Thus, regulated complement activation has been proposed as an essential requirement for normal successful pregnancy. Little is known about the molecular pathways that regulate C1q expression in pregnancy. PU.1, an Ets-family transcription factor, is required for the development of hematopoietic myeloid lineage immune cells, and its expression is tissue- specific. Recently, PU.1 has been shown to regulate C1q gene expression in dendritic cells and macrophages. Here, we have examined if PU.1 transcription factor regulates decidual C1q expression. We used immune-histochemical analysis, PCR and immunostaining to localize and study the gene expression of PU.1 transcription factor in early human decidua. PU.1 was highly expressed at gene and protein level in early human decidual cells including trophoblast and stromal cells. Surprisingly, nuclear as well as cytoplasmic PU.1 expression was observed. Decidual cells with predominantly nuclear PU.1 expression had higher C1q expression. It is likely that nuclear and cytoplasmic PU.1 localization has a role to play in early pregnancy via regulating C1q expression in the decidua during implantation.

Physical violence during pregnancy and pregnancy outcomes in Ghana

NARCIS (Netherlands)

Pool, M.S.; Otupiri, E.; Owusu-Dabo, E.; de Jonge, J.; Agyemang, C.

2014-01-01

Background: In pregnancy, violence can have serious health consequences that could affect both mother and child. In Ghana there are limited data on this subject. We sought to assess the relationship between physical violence during pregnancy and pregnancy outcomes (early pregnancy loss, perinatal

High gonadotropin dosage does not affect euploidy and pregnancy rates in IVF PGS cycles with single embryo transfer.

Science.gov (United States)

Barash, Oleksii O; Hinckley, Mary D; Rosenbluth, Evan M; Ivani, Kristen A; Weckstein, Louis N

2017-11-01

Does high gonadotropin dosage affect euploidy and pregnancy rates in PGS cycles with single embryo transfer? High gonadotropin dosage does NOT affect euploidy and pregnancy rates in PGS cycles with single embryo transfer. PGS has been proven to be the most effective and reliable method for embryo selection in IVF cycles. Euploidy and blastulation rates decrease significantly with advancing maternal age. In order to recruit an adequate number of follicles, the average dosage of gonadotropins administered during controlled ovarian stimulation in IVF cycles often increases significantly with advancing maternal age. A retrospective study of SNP (Single Nucleotide Polymorphism) PGS outcome data from blastocysts biopsied on day 5 or day 6 was conducted to identify differences in euploidy and clinical pregnancy rates. Seven hundred and ninety four cycles of IVF treatment with PGS between January 2013 and January 2017 followed by 651 frozen embryo transfers were included in the study (506 patients, maternal age (y.o.) - 37.2 ± 4.31). A total of 4034 embryos were analyzed (5.1 ± 3.76 per case) for euploidy status. All embryos were vitrified after biopsy, and selected embryos were subsequently thawed for a hormone replacement frozen embryo transfer cycle. All cycles were analyzed by total gonadotropin dosage (5000 IU), by number of eggs retrieved (1-5, 5-10, 10-15 and >15 eggs) and patient's age (cycles) euploidy rates ranged from 62.3% (cycle) to 67.5% (>5000 IU were used in the IVF cycle) (OR = 0.862, 95% CI 0.687-1.082, P = 0.2) and from 69.5% (1-5 eggs retrieved) to 60.0% (>15 eggs retrieved) (OR = 0.658, 95% CI 0.405-1.071, P = 0.09). Similar data were obtained in the oldest group of patients (≥41 y.o. - 189 IVF cycles): euploidy rates ranged from 30.7 to 26.4% (OR = 0.811, 95% CI 0.452-1.454, P = 0.481) when analyzed by total dosage of gonadotropins used in the IVF cycle and from 40.0 to 30.7% (OR = 0.531, 95% CI 0.204-1.384, P = 0.19), when assessed by the total

First trimester pregnancy-associated plasma protein A and human chorionic gonadotropin-beta in early and late pre-eclampsia

DEFF Research Database (Denmark)

Karahasanovic, Azra; Sørensen, Steen; Nilas, Lisbeth

2014-01-01

Abstract Background: The aim of this study was to compare pregnancy-associated plasma protein A (PAPP-A) and the β-subunit of human chorionic gonadotropin (hCGβ) measured in maternal plasma at the first trimester screening, in women who later developed early or late pre-eclampsia (PE) to women...... with normal pregnancies. Methods: In the study were included 161 cases with PE and 88 controls with uncomplicated pregnancies. Plasma PAPP-A and hCGβ were measured between gestational age (GA) 8+2 and 14+0, and cases with early and late onset PE were compared with controls. Results: Median of hCGβ (Mo...

[IDENTIFICATION OF CAUSES OF EARLY PREGNANCY LOSSES ACCORDING TO HYSTOMORPHOLOGIC FEATURES].

Science.gov (United States)

Gotsiridze, K; Kintraia, N; Pailodze, M; Gogia, T; Tsaava, F

2017-01-01

Retrospective analysis of the early spontaneous abortions has been conducted (486 cases). Histomorphologic analysis of the curettage material contents erveledinvolutive-regressive developmental chsnges in 108 (22,28%) cases, in 370 cases (77.78%) pathologic changes, like inflammatory changes of deciduas and chorionic villis in 302 cases (80.2%), pathologic prematurity of chorionic vili in 48 cases (12.6%), hydatidiform mole in 28 cases (7.4%). As most cases of pregnancy loss has been reported at 7-9 weeks /172 cases/, we compared histomorphologic data revealed at 7-8 (71 cases) weeks to 5-6 (135 cases) and 10-12 weeks of gestation. Morphologic research data confimed, that at 7-8 weeks compared to 5-6 weeks leading reason ofpregnancy loss was inflammatory changes (OR-1,584), what can be cause of 110 pregnancy losses at 1000 pregnant women (AR-0.11). Data comparing7-9 weeks to 10-12 weeks pregnancy losses, confirm the priority of pathologic immaturity (OR-1,279) and hydatidiform mole (OR-1,557) and could be the risk of 100 cases of pregnancy termination at 1000 pregnant women (AR-0.10).Existing results are of great importance for the preconceptional preparation of women.

Studies on luteinizing hormone receptors of human corpora lutea during menstrual cycle and pregnancy

International Nuclear Information System (INIS)

Izumi, Yasushi

1982-01-01

With the purpose of explicating the lifespan of human corpora lutea, using human corpora lutea of the menstrual cycle and pregnancy, binding of 125 I-LH to the 20,000g cell membrane fraction was examined. 1) Specific bindings of 125 I-LH, 125 I-HCG were demonstrated in the 20,000g cell membrane fraction. Although LH and HCG were parallel in inhibiting 125 I-LH binding, HCG was found to be more effective. FSH did not inhibit binding. 2) Binding of 125 I-LH was dependent on time, temperature, 125 I-LH concentration, amount of the cell membrane fraction protein and pH. The highest binding was seen at pH 6.0 while incubating for 60 min at 37 0 C. 3) The number of LH receptors in human corpora lutea of the menstrual cycle increased towards midluteal phase, especiallt on 5th day from ovulation, and decreased towards late luteal phase. LH receptor was not found in corpus albicans. The apparent dissociation constant of each corpus luteum did not change throughout the menstrual cycle. 4) Corpora lutea of pregnancy contained a few or no receptors which bound 125 I-LH specifically. These data suggest that LH receptor is an important factor regulating the lifespan of corpus luteum and exogenous HCG has effect on luteal insufficiency, but the effect of HCG on threatened abortion is uncertain. (author)

Physical violence during pregnancy and pregnancy outcomes in Ghana

NARCIS (Netherlands)

Pool, Michelle Sharon; Otupiri, Easmon; Owusu-Dabo, Ellis; de Jonge, Ank; Agyemang, Charles

2014-01-01

In pregnancy, violence can have serious health consequences that could affect both mother and child. In Ghana there are limited data on this subject. We sought to assess the relationship between physical violence during pregnancy and pregnancy outcomes (early pregnancy loss, perinatal mortality and

Maternal TSH level and TPOAb status in early pregnancy and their relationship to the risk of gestational diabetes mellitus.

Science.gov (United States)

Ying, Hao; Tang, Yu-Ping; Bao, Yi-Rong; Su, Xiu-Juan; Cai, XueYa; Li, Yu-Hong; Wang, De-Fen

2016-12-01

Subclinical hypothyroidism is common in pregnant women and often related to adverse pregnancy outcomes, but its relationship with gestational diabetes remains controversial. In particular, the impact of thyroperoxidase antibodies status on the relationship between subclinical hypothyroidism and gestational diabetes is not clear. We investigated the association between combined thyroid stimulating hormone (TSH) level and thyroperoxidase antibodies status in early pregnancy (gestation) and gestational diabetes mellitus. A total of 7084 pregnant women met the inclusion criteria, which included thyroperoxidase antibodies-positive subclinical hypothyroidism [TSH(H)TPOAb(+)] (n = 78), thyroperoxidase antibodies-negative subclinical hypothyroidism [TSH(H)TPOAb(-)] (n = 281), thyroperoxidase antibodies-positive euthyroidism [TSH(N)TPOAb(+)] (n = 648), and thyroperoxidase antibodies-negative euthyroidism [TSH(N)TPOAb(-)] (n = 6077). Of the 7084 cases included in our study, 1141 cases were diagnosed with gestational diabetes mellitus at 24-28 weeks of pregnancy. The prevalence of gestational diabetes mellitus in TSH(N)TPOAb(-), TSH(H)TPOAb(-), TSH(N)TPOAb(+), and TSH(H)TPOAb(+) was 14.65, 19.57, 24.85, and 46.15 %, respectively. Compared with TSH(N)TPOAb(-) women, the risk of gestational diabetes mellitus was increased in all other groups of women in early pregnancy. After dividing early pregnancy into first and second trimesters, we found that TSH(H)TPOAb(-) women in the first trimester do not show this increase. Our study suggests that subclinical hypothyroidism and thyroperoxidase antibodies-positive euthyroidism in early pregnancy are associated with an increased risk of gestational diabetes mellitus.

Metabolic profiling uncovers a phenotypic signature of small for gestational age in early pregnancy.

LENUS (Irish Health Repository)

Horgan, Richard P

2012-01-31

Being born small for gestational age (SGA) confers increased risks of perinatal morbidity and mortality and increases the risk of cardiovascular complications and diabetes in later life. Accumulating evidence suggests that the etiology of SGA is usually associated with poor placental vascular development in early pregnancy. We examined metabolomic profiles using ultra performance liquid chromatography-mass spectrometry (UPLC-MS) in three independent studies: (a) venous cord plasma from normal and SGA babies, (b) plasma from a rat model of placental insufficiency and controls, and (c) early pregnancy peripheral plasma samples from women who subsequently delivered a SGA baby and controls. Multivariate analysis by cross-validated Partial Least Squares Discriminant Analysis (PLS-DA) of all 3 studies showed a comprehensive and similar disruption of plasma metabolism. A multivariate predictive model combining 19 metabolites produced by a Genetic Algorithm-based search program gave an Odds Ratio for developing SGA of 44, with an area under the Receiver Operator Characteristic curve of 0.9. Sphingolipids, phospholipids, carnitines, and fatty acids were among this panel of metabolites. The finding of a consistent discriminatory metabolite signature in early pregnancy plasma preceding the onset of SGA offers insight into disease pathogenesis and offers the promise of a robust presymptomatic screening test.

Early neonatal mortality in twin pregnancy: Findings from 60 low- and middle-income countries.

Science.gov (United States)

Bellizzi, Saverio; Sobel, Howard; Betran, Ana Pilar; Temmerman, Marleen

2018-06-01

Around the world, the incidence of multiple pregnancies reaches its peak in the Central African countries and often represents an increased risk of death for women and children because of higher rates of obstetrical complications and poor management skills in those countries. We sought to assess the association between twins and early neonatal mortality compared with singleton pregnancies. We also assessed the role of skilled birth attendant and mode of delivery on early neonatal mortality in twin pregnancies. We conducted a secondary analysis of individual level data from 60 nationally-representative Demographic and Health Surveys including 521 867 singleton and 14 312 twin births. We investigated the occurrence of deaths within the first week of life in twins compared to singletons and the effect of place and attendance at birth; also, the role of caesarean sections against vaginal births was examined, globally and after countries stratification per caesarean sections rates. A multi-level logistic regression was used accounting for homogeneity within country, and homogeneity within twin pairs. Early neonatal mortality among twins was significantly higher when compared to singleton neonates (adjusted odds ratio (aOR) 7.6; 95% confidence interval (CI) = 7.0-8.3) in these 60 countries. Early neonatal mortality was also higher among twins than singletons when adjusting for birth weight in a subgroup analysis of those countries with data on birth weight (n = 20; less than 20% of missing values) (aOR = 2.8; 95% CI = 2.2-3.5). For countries with high rates (>15%) of caesarean sections (CS), twins delivered vaginally in health facility had a statistically significant (aOR = 4.8; 95% CI = 2.4-9.4) increased risk of early neonatal mortality compared to twins delivered through caesarean sections. Home twin births without SBA was associated with increased mortality compared with delivering at home with SBA (aOR = 1.3; 95% CI = 1.0-1.8) and

Outcome in clients with positive pregnancy test following IVF/ICSI ...

African Journals Online (AJOL)

Background: A retrospective analysis of the outcome of all patients who have recorded a positive pregnancy test following IVF/ICSI treatment from June 1999 to December 2002 was done. Materials and Methods: A total of 1256 treatment cycles were carried out using the long day 1 (early follicular phase) or day 21 ...

Effect of women's nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review.

Science.gov (United States)

Ramakrishnan, Usha; Grant, Frederick; Goldenberg, Tamar; Zongrone, Amanda; Martorell, Reynaldo

2012-07-01

Current understanding of biologic processes indicates that women's nutritional status before and during early pregnancy may play an important role in determining early developmental processes and ensuring successful pregnancy outcomes. We conducted a systematic review of the evidence for the impact of maternal nutrition before and during early pregnancy (health outcomes and included 45 articles (nine intervention trials and 32 observational studies) that were identified through PubMed and EMBASE database searches and examining review articles. Intervention trials and observational studies show that periconceptional (importance of women's nutrition prior to and during the first trimester of pregnancy, but there is a need for well-designed prospective studies and controlled trials in developing country settings that examine relationships with low birthweight, SGA, PTD, stillbirth and maternal and neonatal mortality. The knowledge gaps that need to be addressed include the evaluation of periconceptional interventions such as food supplements, multivitamin-mineral supplements and/or specific micronutrients (iron, zinc, iodine, vitamin B-6 and B-12) as well as the relationship between measures of prepregnancy body size and composition and maternal, neonatal and child health outcomes. © 2012 Blackwell Publishing Ltd.

Prevalence of menstrual cycles and outcome of 50 pregnancies after high-dose chemotherapy and auto-SCT in non-Hodgkin and Hodgkin lymphoma patients younger than 40 years.

Science.gov (United States)

Akhtar, S; Youssef, I; Soudy, H; Elhassan, T A M; Rauf, S M; Maghfoor, I

2015-12-01

Data are limited regarding the prevalence of menstrual cycles and pregnancies after high-dose chemotherapy (HDC) and auto-stem cell transplantation (SCT). Female patients who underwent HDC auto-SCT for non-Hodgkin and Hodgkin lymphoma (1997-2012) were reviewed. The selection criteria were as follows: (1) alive without disease 12 and 24 months after auto-SCT for menstrual cycles and pregnancy, respectively, (2) age SCT, and (3) no primary infertility. One-hundred and seventy-six females underwent single auto-SCT. Eighty-nine were eligible for menstrual cycles and pregnancy analysis. Median age at auto-SCT was 25 years (14-40 years), at pregnancy 27 years (20-37 years), median follow-up 65 months (range 24-190). Regular menstrual-cycles resumed in 56/89 patients (63%). Increasing age (P=0.02) and number of prior chemotherapy cycles (P=0.02) are associated with higher risk of amenorrhea. Forty patients tried to get pregnant, 26 (65%) became pregnant 50 times: 43 (86%) live birth, 7 (14%) miscarriage and 2/50 had birth defects. Twenty-four patients practiced breastfeeding (median duration 4 months (1-24 months)). Enough breast milk production was reported 62.5% vs 100% in those patients who did or did not receive above the diaphragm radiation therapy, respectively, (P=0.066). Our data highlights significantly higher than perceived incidence of menstrual cycle resumption, successful pregnancies and breastfeeding after HDC auto-SCT.

Does Binge Drinking During Early Pregnancy Increase the Risk of Psychomotor Deficits?

DEFF Research Database (Denmark)

Kesmodel, Ulrik Schiøler; Bay, Bjørn; Wimberley, Theresa

2013-01-01

BACKGROUND: The potential effects of binge drinking during pregnancy on child motor function have only been assessed in a few, small studies. We aimed to examine the effects of binge alcohol consumption during early pregnancy, including number of binge episodes and timing of binge drinking......, on child motor function at age 5. METHODS: We performed a prospective follow-up study of 678 women and their children sampled from the Danish National Birth Cohort based on maternal alcohol consumption during pregnancy. At 5 years of age, the children were tested with the Movement Assessment Battery...... for Children. Parental education, maternal IQ, prenatal maternal smoking, the child's age at testing, sex of child, and tester were considered core confounders, while the full model also controlled for prenatal maternal average alcohol intake, maternal age and prepregnancy body mass index, parity, home...

The effect of different alcohol drinking patterns in early to mid pregnancy on the child's intelligence, attention, and executive function

DEFF Research Database (Denmark)

Kesmodel, Ulrik Schiøler; Bertrand, J.; Denny, Ch.

2012-01-01

Please cite this paper as: Kesmodel U, Bertrand J, Støvring H, Skarpness B, Denny C, Mortensen E, the Lifestyle During Pregnancy Study Group. The effect of different alcohol drinking patterns in early to mid pregnancy on the child's intelligence, attention, and executive function. BJOG 2012......;119:1180-1190. Objective To conduct a combined analysis of the estimated effects of maternal average weekly alcohol consumption, and any binge drinking, in early to mid pregnancy on general intelligence, attention, and executive function in 5-year-old children. Design Follow-up study. Setting Neuropsychological testing...... in four Danish cities 2003-2008. Population A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Methods Participants were sampled based on maternal alcohol consumption during early pregnancy. At age 5 years, the children were tested for general intelligence, attention...

Symptoms of Allergic Rhinitis in Women during Early Pregnancy Are Associated with Higher Prevalence of Allergic Rhinitis in Their Offspring

Directory of Open Access Journals (Sweden)

Miwa Shinohara

2007-01-01

Results: Offspring whose mothers had any AR symptoms during early pregnancy showed a significantly higher adjusted odds ratio for the onset of AR in offspring than those whose mothers had no symptoms during pregnancy (adjusted Odds Ratio: 6.26, p=0.036. However, the symptoms of AR during late pregnancy showed no effects on the odds ratio. In contrast, the presence or absence of AR symptoms during early or late pregnancy showed no association with the prevalence of food allergy, atopic dermatitis or asthma in offspring. Conclusions: Our results suggest the presence of possible epigenetic mechanisms regulating the onset of AR in humans presumably through increased organ-specific hypersensitivity.

Interferon-τ increases BoLA-I for implantation during early pregnancy in dairy cows.

Science.gov (United States)

Zhu, Zhe; Li, Binbin; Wu, Yue; Wang, Xiao; Deng, GanZhen

2017-11-10

Interferon-τ (IFN-τ) signals pregnancy recognition in ruminants. We investigated the effects of IFN-τ produced by embryo trophoblastic cells (ETCs) on expression of bovine leukocyte antigen-I (BoLA-I), a bovine analogue of human MHC-I, in endometrial luminal epithelial cells (EECs) during early pregnancy in dairy cows. Expression of IFN-τ and BoLA-I was increased in endometrial tissues during early pregnancy. Expression of the anti-inflammatory cytokine IL-10 was increased in endometrial tissues, while expression of the pro-inflammatory cytokine IL-6 was decreased, indicating immunosuppression. Progesterone increased IFN-τ expression in EECs. IFN-τ increased p-STAT1 and p-STAT3 levels in EECs, but reduced TRAF3 levels. In addition, IFN-τ increased expression of BoLA-I and IL-10, but decreased expression of IL-6 in EECs. These results indicate that IFN-τ enables stable implantation in dairy cows by increasing expression of BoLA-I, and by immunosuppression mediated by increased IL-10 and decreased IL-6 expression.

Pregnancy and HIV Disease Progression in an Early Infection Cohort from Five African Countries.

Science.gov (United States)

Wall, Kristin M; Rida, Wasima; Haddad, Lisa B; Kamali, Anatoli; Karita, Etienne; Lakhi, Shabir; Kilembe, William; Allen, Susan; Inambao, Mubiana; Yang, Annie H; Latka, Mary H; Anzala, Omu; Sanders, Eduard J; Bekker, Linda-Gail; Edward, Vinodh A; Price, Matt A

2017-03-01

Understanding associations between pregnancy and HIV disease progression is critical to provide appropriate counseling and care to HIV-positive women. From 2006 to 2011, women less than age 40 with incident HIV infection were enrolled in an early HIV infection cohort in Kenya, Rwanda, South Africa, Uganda, and Zambia. Time-dependent Cox models evaluated associations between pregnancy and HIV disease progression. Clinical progression was defined as a single CD4 measurement pregnancy. Among 222 women, 63 experienced clinical progression during 783.5 person-years at risk (8.0/100). Among 205 women, 87 experienced immunologic progression during 680.1 person-years at risk (12.8/100). The association between pregnancy and clinical progression was adjusted hazard ratio [aHR] = 0.7; 95% confidence interval (CI): 0.2, 1.8. The association between pregnancy and immunologic progression was aHR = 1.7; 95% CI: 0.9, 3.3. Models controlled for age; human leukocyte antigen alleles A*03:01, B*45, B*57; CD4 set point; and HIV-1 subtype. CD4 measurements before versus after pregnancies were not different. In this cohort, pregnancy was not associated with increased clinical or immunologic HIV progression. Similarly, we did not observe meaningful deleterious associations of pregnancy with CD4s. Our findings suggest that HIV-positive women may become pregnant without harmful health effects occurring during the pregnancy. Evaluation of longer-term impact of pregnancy on progression is warranted.

Successful management of heterotopic pregnancy after fetal reduction using potassium chloride and methotrexate

Directory of Open Access Journals (Sweden)

Deepika Deka

2012-01-01

Full Text Available Heterotopic pregnancy, the presence of two gestational sacs simultaneously, is a rare event but with the advent of Assisted Reproductive Technology, it is now an increasingly common complication. The reported incidence of a heterotopic pregnancy in a spontaneous cycle is quoted as 1 in 30,000. We report the case of a 38-year-old primigravida who was referred to our center at 11 + 2 weeks gestation with a diagnosis of heterotopic pregnancy for further management. A non-surgical intervention comprising of transvaginal ultrasound-guided potassium chloride and methotrexate into the cervical pregnancy resulted in a successful outcome. As an obstetrician, a high index of clinical suspicion and an early scan is mandatory to make a diagnosis of a heterotopic pregnancy and manage accordingly.

[Sodium restriction during pregnancy: an outdated advice].

Science.gov (United States)

de Leeuw, P W; Peeters, L L

1999-10-23

Even in an early phase of pregnancy marked haemodynamic changes occur, including a fall in vascular resistance and blood pressure and a rise in cardiac output. To compensate for the increased intravascular capacity the kidney retains more sodium and water. Apparently, the set point of sodium homeostasis shifts to a higher level at the expense of an expansion of extracellular volume. Studies during the normal menstrual cycle have shown that these changes, albeit smaller, also occur during the luteal phase. These fluctuations with the menstrual cycle are less apparent if salt intake is low, suggesting that a high salt intake is needed to facilitate the process of sodium retention. In pregnancies complicated by hypertension and/or pre-eclampsia body fluid volumes are low with an enhanced tendency to retain sodium after a volume challenge. These data, together with the lack of an apparent benefit of sodium restriction, suggest that the practice of prescribing a low-salt diet to hypertensive pregnant women should be abandoned.

Is the fertility treatment itself a risk factor for early pregnancy loss?

NARCIS (Netherlands)

Brandes, M.; Verzijden, J.C.; Hamilton, C.J.C.M.; Weys, N.P. de; Bruin, J.P. de; Bots, R.S.; Nelen, W.L.D.M.; Kremer, J.A.M.

2011-01-01

This longitudinal multicentre cohort study aimed to identify the role of the conception mode in infertile couples with an early pregnancy loss (EPL). All couples referred to the fertility clinic for the first time in the period 2002-2006 because of infertility were followed up to their first

Prediction of Maternal Cytomegalovirus Serostatus in Early Pregnancy: A Retrospective Analysis in Western Europe.

Directory of Open Access Journals (Sweden)

Lorenz Kuessel

Full Text Available Cytomegalovirus (CMV is the most prevalent congenital viral infection and thus places an enormous disease burden on newborn infants. Seroprevalence of maternal antibodies to CMV due to CMV exposure prior to pregnancy is currently the most important protective factor against congenital CMV disease. The aim of this study was to identify potential predictors, and to develop and evaluate a risk-predicting model for the maternal CMV serostatus in early pregnancy.Maternal and paternal background information, as well as maternal CMV serostatus in early pregnancy from 882 pregnant women were analyzed. Women were divided into two groups based on their CMV serostatus, and were compared using univariate analysis. To predict serostatus based on epidemiological baseline characteristics, a multiple logistic regression model was calculated using stepwise model selection. Sensitivity and specificity were analyzed using ROC curves. A nomogram based on the model was developed.646 women were CMV seropositive (73.2%, and 236 were seronegative (26.8%. The groups differed significantly with respect to maternal age (p = 0.006, gravidity (p<0.001, parity (p<0.001, use of assisted reproduction techniques (p = 0.018, maternal and paternal migration background (p<0.001, and maternal and paternal education level (p<0.001. ROC evaluation of the selected prediction model revealed an area under the curve of 0.83 (95%CI: 0.8-0.86, yielding sensitivity and specificity values of 0.69 and 0.86, respectively.We identified predictors of maternal CMV serostatus in early pregnancy and developed a risk-predicting model based on baseline epidemiological characteristics. Our findings provide easy accessible information that can influence the counseling of pregnant woman in terms of their CMV-associated risk.

Early breeding and pregnancy diagnosis in Syrian awassi sheep yearlings

International Nuclear Information System (INIS)

Al-Merestani, M. R.; Zarkawi, M.; Wardeh, M.

2000-01-01

Fifty-nine female yearlings of local Awassi sheep were randomly divided into 2 groups. Animals in group T (treated) were fitted with intravaginal sponges containing 60 mg of medroxyprogesterone acetate for 14 days followed by 400 IU of pregnant mare's serum gonadotrophin (PMSG) at sponge withdrawal, whereas group C (control) received no treatment. Oestrus rate was 92.7% and 11.2% for groups T and C, respectively. Lambing rate was 78% and 5.6% for groups T and C, respectively. Twinning rate was 31.3% in group T compared to zero in group C. Average birth weight for single born lams (4.7 ± 0.6 kg) was significantly (P > 0.05) higher than twin born lams (3.0 ± 0.5 kg) in group T. The average concentration of blood progesterone collected between days 17-19 after mating was 19.30 nmol/1 and the accuracy of early pregnancy diagnosis was 100%. It was concluded that, it is possible to induce synchronized oestrus, and to increase the twinning rate in Syrian Awassi sheep yearlings outside the breeding season, using intravaginal sponges and PMSG. In addition, early pregnancy diagnosis could be successfully determined in female Awassi sheep yearlings between days 17-19 after-mating. (author)

T helper cell 2 immune skewing in pregnancy/early life

DEFF Research Database (Denmark)

McFadden, J P; Thyssen, J P; Basketter, D A

2015-01-01

During the last 50 years there has been a significant increase in Western societies of atopic disease and associated allergy. The balance between functional subpopulations of T helper cells (Th) determines the quality of the immune response provoked by antigen. One such subpopulation - Th2 cells...... that in Westernized societies reduced exposure during early childhood to pathogenic microorganisms favours the development of atopic allergy. Pregnancy is normally associated with Th2 skewing, which persists for some months in the neonate before Th1/Th2 realignment occurs. In this review, we consider...... the immunophysiology of Th2 immune skewing during pregnancy. In particular, we explore the possibility that altered and increased patterns of exposure to certain chemicals have served to accentuate this normal Th2 skewing and therefore further promote the persistence of a Th2 bias in neonates. Furthermore, we propose...

Trimethoprim use in early pregnancy and the risk of miscarriage

DEFF Research Database (Denmark)

Andersen, Jon Trærup; Petersen, M; Jimenez-Solem, E

2012-01-01

SUMMARY The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study...... including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox...

Social inequalities in pregnancy outcomes and early childhood behaviour: the Generation R study

NARCIS (Netherlands)

P.W. Jansen (Pauline)

2009-01-01

textabstractaim of this thesis was to extend the existing knowledge on the relation of social disadvantage with pregnancy outcomes and early childhood behaviour. More specifically, we aimed to identify the mechanisms underlying this association. In this thesis, several indicators of social

Inability to have children caused by recurrent HELLP syndrome in early pregnancies - implications for a review of literature.

Science.gov (United States)

Pawelec, Małgorzata; Karmowski, Andrzej; Karmowski, Mikołaj; Krzemieniewska, Joanna; Kulczycka, Aleksandra; Gabryś, Marian Stanisław; Koryś, Jerzy; Gworys, Bohdan

2013-01-01

This review is inspired by a case of two pregnancies of the same patient complicated by HELLP syndrome, which suggests that there is a predisposition for the occurrence of preeclampsia and HELLP syndrome in early pregnancy. HELLP syndrome, uncommon below the 20th week and rarer still in two consecutive pregnancies, appeared in two pregnancies of the same woman. The aim of our work is to try to understand the cause of heterogeneity of HELLP syndrome and help find a way of prolonging such pregnancies. Recurrent HELLP syndrome in early pregnancy is a form of severe, fulminant preeclampsia. The preceding symptom is a surge in blood pressure. The hypertension becomes resistant to antihypertensive drugs, which indicates that preexisting hypertension is later accompanied by other factors contributing to the rise in blood pressure. Different effects of high dosage of corticosteroids on liver and platelets show that there are different factors responsible for liver damage and for thrombocytopenia. It seems that the symptoms have various origins, so the therapy with one drug only is not sufficiently effective. Nicotine analogues or a plant extract (from rootstock of Eriosema kraussianum) used by South African traditional healers for erectile dysfunction seem to give a chance of prolonging pregnancy and, consequently, having children.

Early pregnancy peripheral blood gene expression and risk of preterm delivery: a nested case control study

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Muhie Seid Y

2009-12-01

Full Text Available Abstract Background Preterm delivery (PTD is a significant public health problem associated with greater risk of mortality and morbidity in infants and mothers. Pathophysiologic processes that may lead to PTD start early in pregnancy. We investigated early pregnancy peripheral blood global gene expression and PTD risk. Methods As part of a prospective study, ribonucleic acid was extracted from blood samples (collected at 16 weeks gestational age from 14 women who had PTD (cases and 16 women who delivered at term (controls. Gene expressions were measured using the GeneChip® Human Genome U133 Plus 2.0 Array. Student's T-test and fold change analysis were used to identify differentially expressed genes. We used hierarchical clustering and principle components analysis to characterize signature gene expression patterns among cases and controls. Pathway and promoter sequence analyses were used to investigate functions and functional relationships as well as regulatory regions of differentially expressed genes. Results A total of 209 genes, including potential candidate genes (e.g. PTGDS, prostaglandin D2 synthase 21 kDa, were differentially expressed. A set of these genes achieved accurate pre-diagnostic separation of cases and controls. These genes participate in functions related to immune system and inflammation, organ development, metabolism (lipid, carbohydrate and amino acid and cell signaling. Binding sites of putative transcription factors such as EGR1 (early growth response 1, TFAP2A (transcription factor AP2A, Sp1 (specificity protein 1 and Sp3 (specificity protein 3 were over represented in promoter regions of differentially expressed genes. Real-time PCR confirmed microarray expression measurements of selected genes. Conclusions PTD is associated with maternal early pregnancy peripheral blood gene expression changes. Maternal early pregnancy peripheral blood gene expression patterns may be useful for better understanding of PTD

Measurement of the uterus and gestation sac by ultrasound in early normal and abnormal pregnancy.

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Chandra, M; Evans, L J; Duff, G B

1981-01-14

Uterine volumes measured by two different ultrasonic methods, and gestation sac volumes in early normal pregnancy are reported. The results obtained for uterine volume measurements are compared. Methods using measurements obtained from only a longitudinal scan were simpler but slightly less accurate. Uterine volumes were also calculated in a series of patients with pregnancy complicated by threatened abortion. The accuracy of the prediction of the outcome of the pregnancy, based solely on uterine volume was 71 percent. Uterine volume measurement is most useful in identifying cases of missed abortion where the period of gestation is known.

Studies on luteinizing hormone receptors of human corpora lutea during menstrual cycle and pregnancy

Energy Technology Data Exchange (ETDEWEB)

Izumi, Yasushi (Keio Univ., Tokyo (Japan). School of Medicine)

1982-10-01

With the purpose of explicating the lifespan of human corpora lutea, using human corpora lutea of the menstrual cycle and pregnancy, binding of /sup 125/I-LH to the 20,000g cell membrane fraction was examined. 1) Specific bindings of /sup 125/I-LH, /sup 125/I-HCG were demonstrated in the 20,000g cell membrane fraction. Although LH and HCG were parallel in inhibiting /sup 125/I-LH binding, HCG was found to be more effective. FSH did not inhibit binding. 2) Binding of /sup 125/I-LH was dependent on time, temperature, /sup 125/I-LH concentration, amount of the cell membrane fraction protein and pH. The highest binding was seen at pH 6.0 while incubating for 60 min at 37/sup 0/C. 3) The number of LH receptors in human corpora lutea of the menstrual cycle increased towards midluteal phase, especially on 5th day from ovulation, and decreased towards late luteal phase. LH receptor was not found in corpus albicans. The apparent dissociation constant of each corpus luteum did not change throughout the menstrual cycle. 4) Corpora lutea of pregnancy contained a few or no receptors which bound /sup 125/I-LH specifically. These data suggest that LH receptor is an important factor regulating the lifespan of corpus luteum and exogenous HCG has effect on luteal insufficiency, but the effect of HCG on threatened abortion is uncertain.

Developmental predictors of inattention-hyperactivity from pregnancy to early childhood.

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Stéphanie Foulon

Full Text Available The objective of the study was to characterize the developmental sequence of pre- and postnatal risk factors for inattention-hyperactivity symptoms in preschoolers.Longitudinal data came from a French population based birth cohort study (EDEN; N = 1311 mother-child pairs followed from the pregnancy onwards. Inattention-hyperactivity symptoms were assessed with the Strengths and Difficulties Questionnaire when participating children were 3 years of age. Potential risk factors were classified in four domains (fetal exposures and child somatic characteristics, child temperament, child neurodevelopmental status, psychosocial environment and four periods (before pregnancy, prenatal/birth, infancy, toddlerhood. Their role as potential moderator or mediator was tested with path analysis to determine the developmental sequence.A low family socioeconomic status before pregnancy was the main environmental risk factor for inattention-hyperactivity symptoms at 3 years, and its effect occurred via two pathways. The first was a risk pathway, where lower SES was associated with higher maternal depression and anxiety during pregnancy; then to higher maternal and child distress and dysregulation in infancy; and in turn to higher levels of inattention-hyperactivity at 3 years. The second was a protective pathway, where higher SES was associated with longer duration of breastfeeding during infancy; then to better child neurodevelopmental status in toddlerhood; and in turn to lower levels of inattention-hyperactivity at 3 years.This study identified psychosocial factors at several developmental periods that represent potential targets for preventing the emergence of inattention-hyperactivity symptoms in early childhood.

Biology of primate relaxin: A paracrine signal in early pregnancy?

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Hayes Eric S

2004-06-01

Full Text Available Abstract Relaxin is a peptide hormone that exerts numerous effects in a variety of tissues across a broad range of species. Although first identified more than 75 years ago interest in relaxin biology has waxed and waned over the years consistent with peaks and troughs of new experimental data on its wide-ranging biological effects and advances in relaxin enabling technologies. Recent insights into species-dependent differences in relaxin biology during pregnancy have once again stimulated a relative surge of interest in the study of relaxin's reproductive biology. Identification and pharmacological characterization of orphaned relaxin receptors and exploration of its paracrine effects on pregnancy using genomic and proteomic technologies have succeeded in fueling current interest in relaxin research. Primates and non-primate vertebrates exhibit very disparate profiles of relaxin genomics, proteomics and functional biology. Non-human primates appear to exhibit a very close similarity to humans with respect to relaxin reproductive biology but the similarities and subtle differences are only just beginning to be understood. We, and others, have shown that relaxin produces significant changes to the non-human primate endometrium during the peri-implantation period that are consistent with relaxin's long perceived role as a paracrine modulator of pregnancy. The purpose of this review is to summarize the reproductive biology of relaxin in non-human primates with a specific emphasis on the paracrine role of ovarian and endometrial relaxin during embryo implantation and early pregnancy.

Fetal bilateral renal agenesis, phocomelia, and single umbilical artery associated with cocaine abuse in early pregnancy.

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Kashiwagi, Maki; Chaoui, Rabih; Stallmach, Thomas; Hürlimann, Sandra; Lauper, Urs; Hebisch, Gundula

2003-11-01

Maternal cocaine abuse in pregnancy is associated with complications such as intrauterine growth retardation, abruptio placentae, and preterm delivery. We report what is, to our knowledge, the first published observation of fetal bilateral renal agenesis associated with a vascular disruption syndrome comprising upper limb reduction defect and a single umbilical artery following maternal cocaine abuse in early pregnancy. This constellation in a fetus aborted at 18 weeks extends the spectrum of complications possibly associated with cocaine abuse in pregnancy. Copyright 2003 Wiley-Liss, Inc.

The antiprogesterone steroid RU 486: a short pharmacological and clinical review, with emphasis on the interruption of pregnancy.

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Garfield, R E; Baulieu, E E

1987-02-01

In this review we have briefly outlined the clinical applications and mechanism of action of the progesterone antagonist RU 486. RU 486 has been successfully used in a variety of conditions to regulate the reproductive cycle and to control fertility in women. We suggest that the mechanism by which RU 486 acts during the cycle and early pregnancy is probably by affecting mainly the endometrium. During late pregnancy, the compound has significant effects on the myometrium including the induction of gap junctions between myometrium cells, which is required for muscle contractility during labour. The use of RU 486 has helped to demonstrate that progesterone is required for maintenance of the late stages of pregnancy in women.

Is alcohol binge drinking in early and late pregnancy associated with behavioural and emotional development at age 7 years?

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Niclasen, Janni; Andersen, Anne-Marie Nybo; Strandberg-Larsen, Katrine

2014-01-01

The purpose of this study was to investigate associations of maternal binge drinking in early and late pregnancy with child behavioural and emotional development at age seven. It was hypothesised that late exposure is associated with more negative outcomes than early exposure. Differences were...... expected on the continuous outcome measures, but not on above cutoff scale scores. Data were derived from the Danish National Birth Cohort. Three exposure groups were defined according to binge drinking from three interviews regarding binge episodes in early, middle and late pregnancy. A 'no binge' group...... included women with no binge episodes reported in any of the interviews, the 'early bingers' reported episodes in the first interview only, and the 'late bingers' in the last part of pregnancy only. The outcome measure was the Strengths and Difficulties Questionnaire (SDQ) used as continuous externalising...

Biomarkers for Ectopic Pregnancy and Pregnancy of Unknown Location

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Senapati, Suneeta; Barnhart, Kurt T.

2013-01-01

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

How education changes clinical documentation in early pregnancy.

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Ali, Fida; Higgins, Mary F

2016-05-01

The aim of this audit was to record medical history taking in the records of women attending with early pregnancy issues in order to assess the effect of training in this area. The medical education intervention comprised of a 30-min interactive tutorial. Retrospective chart review at three time points: pre education (July 2013, n = 45), immediately post-education (August 2013, n = 45) and longer term post-intervention (October 2013, n = 20). Pre-education, medical history was missing in 77.8% of charts compared to 13.4% immediately post-intervention and 10% long-term post-intervention (p Education in requirements for medical history taking can improve documentation.

Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy

NARCIS (Netherlands)

Pop, V. J.; Kuijpens, J. L.; van Baar, A. L.; Verkerk, G.; van Son, M. M.; de Vijlder, J. J.; Vulsma, T.; Wiersinga, W. M.; Drexhage, H. A.; Vader, H. L.

1999-01-01

Maternal thyroid function during early pregnancy is an important determinant of early fetal brain development because the fetal thyroid is unable to produce any T4 before 12-14 weeks' gestation. Overt maternal hypothyroidism as seen in severe iodine-deficient areas is associated with severely

Hospitalization for early bonding of the genetic mother after a surrogate pregnancy: report of two cases.

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Sharan, H; Yahav, J; Peleg, D; Ben-Rafael, Z; Merlob, P

2001-12-01

In surrogate pregnancies the genetic parents have little opportunity for early bonding to their infant, either prenatally (in utero) or in the immediate postnatal period. The purpose of this article is to describe a new method for encouraging early parent-infant bonding after surrogate pregnancy by hospitalizing the genetic mother in the maternity ward immediately after the delivery. Two genetic mothers were hospitalized in the maternity ward (rooming-in system) at the Rabin Medical Center in Israel immediately after delivery of their infants by surrogate arrangement. The first birth was a singleton pregnancy with vaginal delivery and the second, a twin pregnancy with delivery by cesarean section. The genetic parents were counseled by a social worker from the adoption agency, starting 3 months before the estimated date of delivery. The parents were referred to the hospital social worker before the delivery. To assess attachment, we observed the parents' behavior toward their children during two daily 15-minute periods of free, unstructured interaction. The parents showed good primary caregiving functions and established affective verbal and physical contact with the infants. They began to recognize the infants' needs and temperament, and exhibited an aura of self-confidence during their interactions. All expressed satisfaction with the method at discharge and reported on reduction of their fears about returning home with the infants. We believe that early hospitalization of the genetic mother in a surrogate delivery may be desirable to establish good and safe early mother-infant bonding, and that it should be considered for adoption as regular hospital policy. Further randomized studies with larger samples over the long term are warranted.

Quantitative Proteomics Analysis of Altered Protein Expression in the Placental Villous Tissue of Early Pregnancy Loss Using Isobaric Tandem Mass Tags

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Xiaobei Ni

2014-01-01

Full Text Available Many pregnant women suffer miscarriages during early gestation, but the description of these early pregnancy losses (EPL can be somewhat confusing because of the complexities of early development. Thus, the identification of proteins with different expression profiles related to early pregnancy loss is essential for understanding the comprehensive pathophysiological mechanism. In this study, we report a gel-free tandem mass tags- (TMT- labeling based proteomic analysis of five placental villous tissues from patients with early pregnancy loss and five from normal pregnant women. The application of this method resulted in the identification of 3423 proteins and 19647 peptides among the patient group and the matched normal control group. Qualitative and quantitative proteomic analysis revealed 51 proteins to be differentially abundant between the two groups (≥1.2-fold, Student's t-test, P<0.05. To obtain an overview of the biological functions of the proteins whose expression levels altered significantly in EPL group, gene ontology analysis was performed. We also investigated the twelve proteins with a difference over 1.5-fold using pathways analysis. Our results demonstrate that the gel-free TMT-based proteomic approach allows the quantification of differences in protein expression levels, which is useful for obtaining molecular insights into early pregnancy loss.

[Histochemical detection of glycoproteins and glycosaminoglycans in the respiratory mucosa of albino rats during estrous cycle, pregnancy and puerperium].

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Pontes, P A; Simões, M J; Merzel, J

1989-11-01

In this work we attempted to detect, with histochemical methods, the possible modifications in the mucus of the respiratory mucosa of albino female rats during estral cycle, pregnancy and puerperium. Based on its results, it was possible to conclude that: a--There were no modifications in the nature of the epithelial and supraepithelial mucus during the studied periods: b--The Alcian Blue staining from lamina propria is absent during pregnancy and present during puerperium.

Differential expression and localization of lipid transporters in the bovine mammary gland during the pregnancy-lactation cycle

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Mani, O; Sørensen, M T; Sejrsen, K

2009-01-01

biopsies and blood samples were taken from 10 animals at 7 stages of the pregnancy-lactation cycle. Expression levels of the specific mRNAs were determined by quantitative reverse transcription-PCR, whereas ABCA1 was localized by immunohistochemistry. Blood serum metabolites were determined by common...

Maternal pre-pregnancy body mass index and circulating microRNAs in pregnancy.

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Enquobahrie, Daniel A; Wander, Pandora L; Tadesse, Mahlet G; Qiu, Chunfang; Holzman, Claudia; Williams, Michelle A

Maternal pre-pregnancy overweight and obese status has been associated with a number of pregnancy complications and adverse offspring outcomes. Mechanisms for observed associations, however, are largely unknown. We investigated associations of pre-pregnancy body mass index with early-mid pregnancy epigenetic biomarkers, circulating microRNAs. Peripheral blood was collected from participants (16-27 weeks gestation) of two multi-racial pregnancy cohorts, the Omega Study and the Pregnancy Outcomes and Community Health Study. Plasma miRNA expression was characterised using epigenome-wide (319 miRNAs) profiling among 20 pregnant women in each cohort. Cohort-specific linear regression models that included the predictor (pre-pregnancy body mass index), the outcome (microRNA expression), and adjustment factors (maternal age, gestational age at blood collection, and race) were fit. Expression of 27 miRNAs was positively associated with pre-pregnancy body mass index in both cohorts (p-values pregnancy body mass index is associated with circulating miRNAs in early-mid pregnancy. Published by Elsevier Ltd.

Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

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Annika Chadee

2016-01-01

Full Text Available Introduction. Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID, tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. Case. This paper represents two cases of heterotopic pregnancies as well as a literature review. Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.

The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5-year-old children

DEFF Research Database (Denmark)

Eriksen, H-L Falgreen; Mortensen, Erik Lykke; Kilburn, Tina R.

2012-01-01

Please cite this paper as: Falgreen Eriksen H, Mortensen E, Kilburn T, Underbjerg M, Bertrand J, Støvring H, Wimberley T, Grove J, Kesmodel U. The effects of low to moderate prenatal alcohol exposure in early pregnancy on IQ in 5-year-old children. BJOG 2012;119:1191-1200. Objective To examine...... the effects of low to moderate maternal alcohol consumption during early pregnancy on children's intelligence (IQ) at age 5 years. Design Prospective follow-up study. Setting Neuropsychological testing in four Danish cities 2003-2008. Population A cohort of 1628 women and their children sampled from...... the Danish National Birth Cohort. Methods Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, children were tested with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R). Parental education, maternal IQ, maternal smoking in pregnancy...

Sex determination using free fetal DNA in early pregnancy: With the approach to sex linked recessive disorders

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Amir Monfaredan

2017-03-01

Full Text Available Introduction: Prenatal diagnosis is testing for detection of diseases or conditions in a fetus or embryo before it is born. Most of prenatal diagnostic (PD techniques are invasive and done in late stages of pregnancy. Using fetal DNA in maternal blood for fetal sex determination in early pregnancy might help in management of X-linked genetic diseases. This study aimed to investigate the accuracy of sex determination using fetal DNA in maternal blood at 8-12 weeks of gestation. Methods: In this cross-sectional study, 30 pregnant women at 8-12 weeks of gestation were enrolled. The sex-determining region Y (SRY gene expression with the internal control (IC glyceraldehyde 3-phosphate dehydrogenase (GAPDH was investigated with quantitative real-time polymerase chain reaction (PCR using specific primers and probes. Results: Accuracy of sex determination with SRY gene expression in 8-12 weeks of pregnancy were 85%, 85%, 90% and 100% respectively. Conclusion: It seems that fetal sex determining using fetal DNA in maternal blood is a reliable method for early stage of pregnancy.

Prediction of preeclampsia in type 1 diabetes in early pregnancy by clinical predictors

DEFF Research Database (Denmark)

Vestgaard, Marianne; Sommer, Miriam Colstrup; Ringholm, Lene

2018-01-01

PURPOSE: The purpose of this study is to evaluate the prevalence and possible clinical predictors of preeclampsia present in early pregnancy among women with type 1 diabetes. METHODS: A systematic search of PubMed was conducted in April 2017. Inclusion criteria were largely unselected cohort, inc...

Elevated serum estradiol levels in artificial autologous frozen embryo transfer cycles negatively impact ongoing pregnancy and live birth rates.

Science.gov (United States)

Fritz, Rani; Jindal, Sangita; Feil, Heather; Buyuk, Erkan

2017-12-01

The aim of this study is to evaluate the correlation between serum estradiol (E 2 ) levels during artificial autologous frozen embryo transfer (FET) cycles and ongoing pregnancy/live birth rates (OP/LB). A historical cohort study was conducted in an academic setting in order to correlate peak and average estradiol levels with ongoing pregnancy/live birth rates for all autologous artificial frozen embryo transfer cycles performed from 1/2011 to 12/2014. Average and peak E 2 levels from 110 autologous artificial FET cycles from 95 patients were analyzed. Average E 2 levels were significantly lower in cycles resulting in OP/LB compared to those that did not (234.1 ± 16.6 pg/ml vs. 315 ± 24.8 pg/ml, respectively, p = 0.04). Although peak E 2 levels were not significantly different between cycles resulting in OP/LB compared with those that did not (366.9 ± 27.7 pg/ml vs. 459.1 ± 32.3 pg/ml, respectively, p = 0.19), correlation analysis revealed a statistically significant (p = 0.02) downward trend in OP/LB rates with increasing peak E 2 levels. This study suggests that elevated E 2 levels in artificial autologous FET cycles are associated with lower OP/LB rates. Estradiol levels should be monitored during artificial FET cycles.

Patient satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy in women with diabetes

DEFF Research Database (Denmark)

Secher, A L; Madsen, A B; Nielsen, Lene Ringholm

2012-01-01

of initial monitoring). Ten women (15%) did not wish to use continuous glucose monitoring again in pregnancy. Main causes behind early removal of continuous glucose monitoring were self-reported skin irritation, technical problems and continuous glucose monitoring inaccuracy. No differences were found......Aim: To evaluate self-reported satisfaction and barriers to initiating real-time continuous glucose monitoring in early pregnancy among women with pregestational diabetes. Methods: Fifty-four women with Type 1 diabetes and 14 women with Type 2 diabetes were offered continuous glucose monitoring...

Does screening for vaginal infection have an impact on pregnancy rates in intracytoplasmic sperm injection cycles?

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Özlem Eldivan

2016-03-01

Full Text Available Objective: Assisted reproduction techniques have become widespread worldwide. Considering their costs, physicians endeavor to improve pregnancy rates. Infections are one of the disrupting problems in this arena. We aimed to investigate the effects of screening for vaginal infection on pregnancy rates in intracytoplasmic sperm injection cycles. Materials and Methods: One hundred twenty patients randomized into two groups for this study. Patients were screened for vaginal infections in group 1, and no screening was performed in group 2. The assisted reproduction outcomes were investigated and compared between the two groups. Results: There was no significant difference between ages, or durations and causes of infertility of patients who conceived and of those who did conceive. Forty-five patients in group 1, and 40 patients in group 2 reached the embryo transfer stage. The rates of conception were 23.5% (n=4 in culture-positive patients (n=17, and 42.9% (n=12 in culture-negative patients (n=28 in group 1. There was no significant difference among patients who were not screened, screen-positive, and screen-negative, in terms of pregnancy rates. None of the patients had Neisseria gonorrhoeae or Trichomonas vaginalis. Bacterial vaginosis was detected in 13 patients, and both bacterial vaginosis and Chlamydia trachomatis were detected in 4 patients. Three of 4 patients who conceived screen-positive and 8 of 12 patients who conceived screen-negative delivered healthily at term. Conclusion: No significant difference was found between patients who were sampled for culture and patients who were not sampled in terms of pregnancy rates. Also, no difference was found between the patients who were culture-negative and patients who were treated with antimicrobials after a culture positive result. Further larger studies are warranted to clarify this issue. PRECIS: No significant difference was found between patients who were sampled for culture and those who

The effect of post-wash total progressive motile sperm count and semen volume on pregnancy outcomes in intrauterine insemination cycles: a retrospective study.

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Ok, Elvan Koyun; Doğan, Omer Erbil; Okyay, Recep Emre; Gülekli, Bülent

2013-01-01

The purpose of this study was to determine the impact of post-wash total progressive motile sperm count (TPMSC) and semen volume on pregnancy outcomes in intrauterine insemination (IUI) cycles. The retrospective study included a total of 156 cycles (141 couples) and was performed in our center over a 24-month period. The semen parameters were recorded for each man and each insemination. The semen samples were re-evaluated after the preparation process. Post-wash TPMSC values were divided into four groups; Group 1: 10×10(6). Post-wash inseminated semen volume was divided into three groups; Group 1: 0.3 mL; Group 2: 0.4 mL; Group 3: 0.5 mL. The effect of post-wash total progressive motile sperm and semen volume on pregnancy outcomes was evaluated. The pregnancy rates per cycle and per couple were 27.56% and 30.49%, respectively. There was not a significant relationship between the inseminated semen volume and pregnancy rate (p>0.05). However, a significant linear-by-linear association was documented between the TPMSC and pregnancy rate (p=0.042). Our findings suggest that the post-wash inseminated semen volume should be between 0.3-0.5 mL. An average post-wash total motile sperm count of 10×10(6) may be a useful threshold value for IUI success, but more studies are needed to determine a cut-off value for TPMSC.

Effect of the time in administration of clomiphene on follicular growth, endometrium and pregnancy rates in PCOS patients

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Mahtab Zeinalzadeh

2017-03-01

Full Text Available Background: Clomiphene citrate is very successful in inducing ovulation; there is usually a discrepancy between ovulation and pregnancy rate. If treatment is started early in the cycle this negative effect is reduced. The aim of this study was to investigate the effect of the time of administration of clomiphene citrate on follicular growth, endometrial thickness and ovulation and pregnancy rates in PCOS (Polycystic ovary syndrome patients. Methods: This randomized controlled trial study was performed on 115 PCOS (Polycystic ovary syndrome women in Fateme Zahra Fertility and Infertility Research Health Center in April 2012. Patients randomly divided into two groups. Patients in the early group (No. 55 received 100 milligrams of clomiphene citrate tablet daily starting the next day after finishing medroxyprogesterone acetate tablet for 5 day, whereas the patient in the late group (No. 60 received 100 milligrams of clomiphene citrate tablet daily for 5 day starting on day 3 of the menstrual cycle. Then on follicular growth, endometrial thickness and ovulation and pregnancy rates by SPSS software, version 16 (Armonk, NY, USA were compared in two groups. Results: 36.4% of patients of early administration of clomiphene and 60% of patients in the later administration of Clomiphene were able to build dominant follicle. This difference was statistically significant (P<0.011. There was no statistically significant difference between the two groups on age, body mass index, duration of infertility. Findings showed that in the early group 14 (63.6% and in the late groups 8 (36.4% women who made dominant follicle, were pregnant. There was significant difference between these two groups (P<0.001. But, in the number of follicles, endometrial thickness and pregnancy rate, there were no significant difference. In the early administration of clomiphene, the pregnancy rate was 25.5%. However in the later administration of clomiphene it was 13.3% (P=0

Early diastolic time intervals during hypertensive pregnancy.

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Spinelli, L; Ferro, G; Nappi, C; Farace, M J; Talarico, G; Cinquegrana, G; Condorelli, M

1987-10-01

Early diastolic time intervals have been assessed by means of the echopolycardiographic method in 17 pregnant women who developed hypertension during pregnancy (HP) and in 14 normal pregnant women (N). Systolic time intervals (STI), stroke volume (SV), ejection fraction (EF), and mean velocity of myocardial fiber shortening (VCF) were also evaluated. Recordings were performed in the left lateral decubitus (LLD) and then in the supine decubitus (SD). In LLD, isovolumic relaxation period (IRP) was prolonged in the hypertensive pregnant women compared with normal pregnant women (HP 51 +/- 12.5 ms, N 32.4 +/- 15 ms p less than 0.05), whereas time of the mitral valve maximum opening (DE) was not different in the groups. There was no difference in SV, EF, and mean VCF, whereas STI showed only a significant (p less than 0.05) lengthening of pre-ejection period (PEP) in HP. When the subjects shifted from the left lateral to the supine decubitus position, left ventricular ejection time index (LVETi) and SV decreased significantly (p less than 0.05) in both normotensive hypertensive pregnant women. IRP and PEP lengthened significantly (p less than 0.05) only in normals, whereas they were unchanged in HP. DE time did not vary in either group. In conclusion, hypertension superimposed on pregnancy induces lengthening of IRP, as well as of PEP, and minimizes the effects of the postural changes in preload on the above-mentioned time intervals.

Sociodemographic and Perinatal Predictors of Early Pregnancy Per- and Polyfluoroalkyl Substance (PFAS) Concentrations.

Science.gov (United States)

Sagiv, Sharon K; Rifas-Shiman, Sheryl L; Webster, Thomas F; Mora, Ana Maria; Harris, Maria H; Calafat, Antonia M; Ye, Xiaoyun; Gillman, Matthew W; Oken, Emily

2015-10-06

Per- and polyfluoroalkyl substances (PFASs), used in food packaging and stain-resistant coatings, are suspected developmental toxicants that are ubiquitous and persistent in the environment. We measured plasma PFAS concentrations during early pregnancy (median = 9.7 weeks gestation) among 1645 women in the Boston-area Project Viva cohort, recruited during 1999-2002. We used multivariable linear regression to estimate associations of sociodemographic and perinatal predictors, including measures of pregnancy physiology (albumin, glomerular filtration rate (GFR)), with log-transformed plasma PFAS concentrations. Geometric mean concentrations for the four main PFASs, perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), perfluorohexanesulfonate (PFHxS) and perfluorononanoate (PFNA) were 25.4, 5.7, 2.5, and 0.6 ng/mL, respectively, comparable with general U.S. population concentrations during those years. Higher early pregnancy PFAS concentrations were associated with younger age (except PFNA), less educational attainment, nulliparity, no history of breastfeeding and higher prepregnancy body mass index in adjusted models. In addition, lower GFR was associated with 3-4% higher PFAS concentrations and higher albumin was associated with 4-6% higher PFAS concentrations. Our results show associations consistent (parity and breastfeeding) and less consistent (age and education) with previous studies. We also report associations with GFR and albumin, which were strongly related to PFAS concentrations and thus could confound estimates of PFAS-outcome associations in epidemiologic studies.

Unexpected Pregnancy and Ovarian Hyperstimulation Syndrome Following Ivf Cycle with all Embryos Frozen: A Case Report

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Chi-Feng Fu

2005-03-01

Conclusion: Prompt recognition of pregnancy and proper medical intervention should be given to patients with late-onset OHSS, even if no embryo was transferred in the fresh cycle. We suggest that more preventive procedures for OHSS may be necessary for patients undergoing COH and receiving no embryo transfer, such as oocyte donors and patients with polycystic ovary syndrome.

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

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... were similar for nonsmokers, smokers, and ex-smokers. CONCLUSIONS: The findings suggest that maternal smoking reduces eNOS activity in the fetal vascular bed, contributing to retarded fetal growth caused by the reduction of vasodilatory capacity, and suggest that smoking cessation early in pregnancy...

A Case of Uterine Prolapse Complicating Pregnancy in Early Second Trimester

Directory of Open Access Journals (Sweden)

Necmiye Döver

2011-12-01

estimate disease prevalence.But uterine prolapse is a rare condition during pregnancy which can be complicated with severe maternal and neonatal outcomes.We report a case of uterine prolapse and cervical alongation which is first diagnosed at the 17th week of gestation.After the recognation, the patent is administered by both conservative and then non-surgical(pessary managements. Unique part about our case is early gestastional age at the time of diagnosis and the fact that our patient had only one previous vaginal delivery and no more risk factors for a pelvic organ prolapse with new-onset uterine prolapse in her current(secondpregnancy.In majority of cases pregnancy is superimposed on a preexisting prolapse.Prolapse occurs as a result of relaxation and tearing down of the supportive structures.

Vitamin D deficiency in early pregnancy.

Directory of Open Access Journals (Sweden)

Shannon K Flood-Nichols

Full Text Available Vitamin D deficiency is a common problem in reproductive-aged women in the United States. The effect of vitamin D deficiency in pregnancy is unknown, but has been associated with adverse pregnancy outcomes. The objective of this study was to analyze the relationship between vitamin D deficiency in the first trimester and subsequent clinical outcomes.This is a retrospective cohort study. Plasma was collected in the first trimester from 310 nulliparous women with singleton gestations without significant medical problems. Competitive enzymatic vitamin D assays were performed on banked plasma specimens and pregnancy outcomes were collected after delivery. Logistic regression was performed on patients stratified by plasma vitamin D concentration and the following combined clinical outcomes: preeclampsia, preterm delivery, intrauterine growth restriction, gestational diabetes, and spontaneous abortion.Vitamin D concentrations were obtained from 235 patients (mean age 24.3 years, range 18-40 years. Seventy percent of our study population was vitamin D insufficient with a serum concentration less than 30 ng/mL (mean serum concentration 27.6 ng/mL, range 13-71.6 ng/mL. Logistic regression was performed adjusting for age, race, body mass index, tobacco use, and time of year. Adverse pregnancy outcomes included preeclampsia, growth restriction, preterm delivery, gestational diabetes, and spontaneous abortion. There was no association between vitamin D deficiency and composite adverse pregnancy outcomes with an adjusted odds ratio of 1.01 (p value 0.738, 95% confidence intervals 0.961-1.057.Vitamin D deficiency did not associate with adverse pregnancy outcomes in this study population. However, the high percentage of affected individuals highlights the prevalence of vitamin D deficiency in young, reproductive-aged women.

Quality of life, anxiety and depression symptoms in early and late pregnancy in women with pregestational diabetes

DEFF Research Database (Denmark)

Do, Nicoline C; Secher, Anna L; Cramon, Per

2017-01-01

INTRODUCTION: The aim of this study was to explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes. MATERIAL AND METHODS: An observational cohort study including 137 pregnant women with pregestational diabetes (110...... with type 1 and 27 with type 2). To evaluate changes from early to late pregnancy, the internationally validated questionnaires 36-Item Short-Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were completed at 8 and 33 gestational weeks. RESULTS: From early to late pregnancy....... The HADS anxiety score improved slightly from 5.0 (3.3) to 4.5 (3.4) (p = 0.04) whereas the HADS depression score remained unchanged. The prevalence of women with HADS anxiety or depression score ≥8 did not change. CONCLUSIONS: Physical quality of life deteriorated whereas mental quality of life improved...

Induction of synchronized oestrous and early pregnancy diagnosis in Syrian awassi ewes, outside the breeding season

International Nuclear Information System (INIS)

Zarkawi, M.; Al-Merstani, M.R.; Wardeh, M.

2000-01-01

An experiment was conducted on indigenous awassi ewes to evaluate the effect of intravaginal progestogen sponges containing 60 mg of medroxyprogesterone acetate (MAP) followed by treatment with pregnant mare serum gonadotrophin (PMSG) on inducing synchronized oestrous outside the normal breeding season, improving fecundity and on early diagnosis of pregnancy using progesterone profiles. 96 awassi ewes were divided into 2 groups. ewes in the Group T, were fitted with MAP for 14 days and injected with 600 IU PMSG at the sponge withdrawal, whereas ewes in the control Group C, received no treatment. The results indicated that oestrous was induced within 36-48 h post sponge withdrawal in 82% of the treated ewes. There were significant (p<0.05) differences between groups T and C in total oestrous response, lambing rate, and fecundity. The means being 96% and 32.6%; 80% and 32.6% and 137.5% and 106.7%, respectively. The accuracy of early diagnosis of pregnancy at 17-19 days post-mating was 100%. The mean birth weight of lambs was similar in both groups (4.3 and 4,4 Kg for groups T and C, respectively).However, single born lambs were significantly (p<0.05) heavier at birth than individual twins (5.0 versus 3.9 Kg). It was concluded that it is possible to induce synchronized and fertile oestrous, successful pregnancy and lambing, and that serum progesterone measurement determinations are useful tool for early pregnancy diagnosis in awassi ewes induced oestrous and bred out of season. (author)

Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus

International Nuclear Information System (INIS)

Robledo, Candace A.; Mendola, Pauline; Yeung, Edwina; Männistö, Tuija; Sundaram, Rajeshwari; Liu, Danping; Ying, Qi; Sherman, Seth; Grantz, Katherine L.

2015-01-01

Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk. Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5 μm (PM 2.5 ) and PM 2.5 constituents, PM ≤ 10 μm (PM 10 ), nitrogen oxides (NO x ), carbon monoxide, sulfur dioxide (SO 2 ) and ozone (O 3 ) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1–24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity. Results: Preconception maternal exposure to NO X (RR=1.09, 95% CI: 1.04, 1.13) and SO 2 (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O 3 was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy. Conclusion: Maternal exposures to NO x and SO 2 preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O 3 appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation. - Highlights: • Air pollution may be related to gestational diabetes (GDM). • No prior studies have examined preconception exposure. • Maternal exposure to NO x and SO 2 before conception increased subsequent GDM risk. • NO x and SO 2 exposure in the first seven weeks of pregnancy also increased GDM risk. • Early exposure to O 3 reduced GDM risk but risk increased

Isolation and Purification of an Early Pregnancy Factor–Like Molecule from Culture Supernatants Obtained from Lymphocytes of Pregnant Women

OpenAIRE

Aranha, Clara; Natraj, Usha; Iyer, K. S.; Shahani, Savitri

1998-01-01

Purpose:Our purpose was to determine whether lymphocytes synthesize proteins during pregnancy, to observe whether one of the proteins synthesized has early pregnancy factor (EPF)–like activity and to isolate and purify this molecule from culture supernatants obtained from stimulated lymphocytes of pregnant women.

Impact of new society of radiologists in ultrasound early first-trimester diagnostic criteria for nonviable pregnancy.

Science.gov (United States)

Hu, Maowen; Poder, Liina; Filly, Roy A

2014-09-01

New early first-trimester diagnostic criteria for nonviable pregnancy recommended by the Society of Radiologists in Ultrasound via a multispecialty consensus panel extended the diagnostic size criteria of crown-rump length from 5 to 7 mm for embryos without a heartbeat and mean sac diameter from 16 to 25 mm for "empty" sacs. Our study assessed the potential impact of the new criteria on the number of additional follow-up sonograms these changes would engender. A retrospective study of all first-trimester sonograms in women with first trimester bleeding from 1999 to 2008 was conducted. Everyone included in the study had a visible gestational sac in the uterus. There were no pregnancies of unknown location or ectopic pregnancies included in this study cohort. Pregnancy of unknown location was used to describe cases in which there were no signs of pregnancy inside or outside the uterus on transvaginal sonography despite a positive pregnancy test result. A total of 1013 patients met the inclusion criteria. Seven hundred fifty-two patients (74%) had identifiable embryos, and 261 (26%) did not. Of those with an identifiable embryo, 286 (38%) had no detectable embryonic cardiac activity. The breakdown of crown-rump lengths in this group was as follows: 100 measuring less than 5 mm, 36 measuring 5 to 7 mm, and 150 measuring 7 mm or greater. The breakdown of mean sac diameters in those without a visible embryo was as follows: 120 measuring less than 16 mm, 90 measuring 16 to 25 mm, and 51 measuring 25 mm or greater. When diagnosing a failed pregnancy, there can be no room for error. Only 126 of 1013 early pregnancies threatening to abort (12%) fell into the more conservative zones defined by the new compared to the former size criteria (crown-rump length, 5-7 mm; mean sac diameter, 16-25 mm). Therefore, the potential impact of the new guidelines on follow-up sonograms does not appear inordinate. © 2014 by the American Institute of Ultrasound in Medicine.

[CHALLENGING THE OPTIMAL NUMBER OF RETRIEVED OOCYTES AND ITS IMPACT ON PREGNANCY AND LIVE BIRTH RATES IN IVF/ICSI CYCLES].

Science.gov (United States)

Blais, Idit; Lahav-Baratz, Shirly; Koifman, Mara; Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

2015-06-01

Large numbers of retrieved oocytes are associated with higher chances of having cryopreservation of embryos. However, the process entailed exposes women to increased risk for ovarian hyperstimulation syndrome. Furthermore, mild ovary stimulation protocols are more patient-friendly and with less adverse effects. Only limited reports exist on the significance of the number of retrieved oocytes achieved in a single stimulation cycle. To investigate the optimal number of retrieved oocytes to achieve pregnancy and live birth. This retrospective analysis included 1590 IVF cycles. Oocytes maturation, fertilization, cleavage, as well as pregnancy and live birth rates were analyzed according to the number of retrieved oocytes. Oocyte maturation, fertilization and cleavage rates were lower in cycles with more than 10 retrieved oocytes compared with other groups. Live birth rates were highest when the number of retrieved oocytes was 11-15. Retrieval of more than 15 oocytes was not associated with a significant increase in chances of conception and birth. The better oocyte quality with 10 or less oocytes retrieved could be the result of a possible interference with the natural selection, or the minimized exposure of growing follicles to the potentially negative effects of ovarian stimulation. Although the average number of available embryos was higher when more than 10 oocytes were retrieved, achievement of more than 15 oocytes did not improve IVF outcome in terms of pregnancy and delivery rates. Analysis of 1590 IVF cycles including the frozen-thawed transfers shows that the best outcomes were achieved with an optimal number of 11-15 oocytes.

Maternal hypothyroxinaemia in early pregnancy and problem behavior in 5-year-old offspring.

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Oostenbroek, Maurits H W; Kersten, Remco H J; Tros, Benjamin; Kunst, Anton E; Vrijkotte, Tanja G M; Finken, Martijn J J

2017-07-01

There is evidence, though not consistent, that offspring born to mothers with subtle decreases in thyroid function early in their pregnancies may be at risk of cognitive impairments and attention problems. However, other types of problem behavior have not been addressed thus far. We tested whether maternal thyroid function in early pregnancy is associated with several types of problem behavior in offspring at age 5-6 years. This was a longitudinal study that included the data of 2000 mother-child pairs from the Amsterdam Born Children and their Development study. At a median gestational age of 12.9 (interquartile range: 11.9-14.1) weeks, maternal blood was sampled for assessment of free T4 and TSH. Overall problem behavior, hyperactivity/inattention, conduct problems, emotional problems, peer relationship problems and prosocial behavior were measured at age 5-6 years using the Strengths and Difficulties Questionnaire, which was filled out by both parents and teachers. Maternal hypothyroxinaemia behavior. Our results partially confirm previous observations, showing that early disruptions in the maternal thyroid hormone supply may be associated with ADHD symptoms in offspring. Our study adds that there is no evidence for an effect on other types of problem behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis in a Setting With No Systematic Screening in Pregnancy

Science.gov (United States)

Stajner, Tijana; Bobic, Branko; Klun, Ivana; Nikolic, Aleksandra; Srbljanovic, Jelena; Uzelac, Aleksandra; Rajnpreht, Irena; Djurkovic-Djakovic, Olgica

2016-01-01

Abstract To determine the risk of congenital toxoplasmosis (CT) and provide early (pre- or postnatal) identification of cases of CT in the absence of systematic screening in pregnancy. In the presented cross-sectional study, serological criteria were used to date Toxoplasma gondii infection versus conception in 80 pregnant women with fetal abnormalities or referred to as suspected of acute infection, and in 16 women after delivery of symptomatic neonates. A combination of serological, molecular (qPCR), and biological (bioassay) methods was used for prenatal and/or postnatal diagnosis of CT. Most (77.5%) pregnant women were examined in advanced pregnancy. Of all the examined seropositive women (n = 90), infection could not be ruled out to have occurred during pregnancy in 93.3%, of which the majority (69%) was dated to the periconceptual period. CT was diagnosed in 25 cases, of which 17 prenatally and 8 postnatally. Molecular diagnosis proved superior, but the diagnosis of CT based on bioassay in 7 instances and by Western blot in 2 neonates shows that other methods remain indispensable. In the absence of systematic screening in pregnancy, maternal infection is often diagnosed late, or even only when fetal/neonatal infection is suspected. In such situations, use of a complex algorithm involving a combination of serological, biological, and molecular methods allows for prenatal and/or early postnatal diagnosis of CT, but lacks the preventive capacity provided by early maternal treatment. PMID:26945416

Pregnancy loss after frozen-embryo transfer--a comparison of three protocols

DEFF Research Database (Denmark)

Tomás, Candido; Alsbjerg, Birgit; Martikainen, Hannu

2012-01-01

was similar in all groups (27.7%, 29.1%, and 24.3%, respectively). Moreover, no differences were seen between groups regarding the live-birth rate (20.1%, 23.5%, and 20.7%, respectively). A logistic regression analysis showed that the type of protocol was the only predictor of pregnancy loss, while age...... of embryos and ET. MAIN OUTCOME MEASURE(S): Pregnancy test rate, clinical pregnancy rate, and pregnancy loss rate. RESULT(S): The natural cycle followed by P (NC + P) was used in 26% of cycles, the natural cycle with hCG (NC + hCG) in 10%, and the substituted cycle with estrogen and P (E + P) in 64......% of cycles. The rate of transfers after thawing was similar in all groups (87.2%, 73.9%, and 87.2%, respectively). There was a significantly higher positive pregnancy test rate in the E + P (34.3%) and NC + hCG (35.5%) cycles as compared with the NC + P cycles (26.7%). However, the clinical pregnancy rate...

The emotional-behavioural functioning of children exposed to maternal depressive symptoms across pregnancy and early childhood: a prospective Australian pregnancy cohort study.

Science.gov (United States)

Giallo, Rebecca; Woolhouse, Hannah; Gartland, Deirdre; Hiscock, Harriet; Brown, Stephanie

2015-10-01

Children exposed to maternal depression during pregnancy and in the postnatal period are at increased risk of a range of health, wellbeing and development problems. However, few studies have examined the course of maternal depressive symptoms in the perinatal period and beyond on children's wellbeing. The present study aimed to explore the relationship between both the severity and chronicity of maternal depressive symptoms across the early childhood period and children's emotional-behavioural difficulties at 4 years of age. Data from over 1,085 mothers and children participating in a large Australian prospective pregnancy cohort were used. Latent class analysis identified three distinct trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum: (1) no or few symptoms (61%), (2) persistent subclinical symptoms (30%), and (3) increasing and persistently high symptoms (9%). Regression analyses revealed that children of mothers experiencing subclinical and increasing and persistently high symptoms were at least two times more likely to have emotional-behavioural difficulties than children of mothers reporting minimal symptoms, even after accounting for known risk factors for poor outcomes for children. These findings challenge policy makers and health professionals to consider how they can tailor care and support to mothers experiencing a broader spectrum of depressive symptoms across the early childhood period, to maximize opportunities to improve both short-and long-term maternal and child health outcomes.

Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women

DEFF Research Database (Denmark)

Backhausen, Mette G.; Ekstrand, Maria; Tydén, Tanja

2014-01-01

Objective To investigate the extent to which Danish women attending antenatal care plan their pregnancies and to determine the association between pregnancy planning and the intake of folic acid, alcohol consumption and smoking habits prior to conception and before the 16th week of gestation....... Methods A cross-sectional survey of 258 women. Main outcome measures: intake of folic acid, alcohol consumption and smoking. Pregnancy planning was assessed by the London Measure of Unplanned Pregnancy (LMUP) and the five graded Swedish Pregnancy Planning Scale. Results Most (77%) of the participants...... reported that their pregnancies were very or fairly well planned. Higher median LMUP scores were observed in women taking folic acid (p...

Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

Science.gov (United States)

Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

2016-01-01

The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

Predicting the intrauterine fetal death of fetuses with cystic hygroma in early pregnancy.

Science.gov (United States)

Shimura, Mai; Ishikawa, Hiroshi; Nagase, Hiromi; Mochizuki, Akihiko; Sekiguchi, Futoshi; Koshimizu, Naho; Itai, Toshiyuki; Odagami, Mizuha

2018-01-11

We investigated whether it was possible to predict the prognosis of fetuses with cystic hygroma in early pregnancy based on the degree of neck thickening. We retrospectively analyzed 57 singleton pregnancies with fetuses with cystic hygroma who were examined before the 22nd week of pregnancy. The fetuses were categorized according to the outcome, structural abnormalities at birth, and chromosomal abnormalities. Here, we proposed a new sonographic predictor with which we assessed neck thickening by dividing the width of the neck thickening by the biparietal diameter, which is expressed as the cystic hygroma width/biparietal diameter ratio. The median cystic hygroma width/biparietal diameter ratio in the intrauterine fetal death group (0.51) was significantly higher than that in the live birth group (0.27). No significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the structural abnormalities group at birth and the no structural abnormalities group, and no significant difference in the median cystic hygroma width/biparietal diameter ratio was found between the chromosomal abnormality group and the no chromosomal abnormality group. We used receiver operating characteristic analysis to evaluate the cystic hygroma width/biparietal diameter ratio to predict intrauterine fetal death. When the cystic hygroma width/biparietal diameter ratio cut-off value was 0.5, intrauterine fetal death could be predicted with a sensitivity of 52.9% and a specificity of 100%. It is possible to predict intrauterine fetal death in fetuses with cystic hygroma in early pregnancy if cystic hygroma width/biparietal diameter ratio is measured. However, even if cystic hygroma width/biparietal diameter ratio is measured, predicting the presence or absence of a structural abnormality at birth or a chromosomal abnormality is difficult. © 2018 Japanese Teratology Society.

Improving early cycle economic evaluation of diagnostic technologies

NARCIS (Netherlands)

Steuten, Lotte Maria Gertruda; Ramsey, Scott D.

2014-01-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to

Reduced prevalence of early preterm delivery in women with Type 1 diabetes and microalbuminuria--possible effect of early antihypertensive treatment during pregnancy

DEFF Research Database (Denmark)

Nielsen, L R; Kragh-Müller, Claus; Damm, P

2006-01-01

In normotensive women with Type 1 diabetes and microalbuminuria we previously found preterm delivery (treatment was initiated in late pregnancy when preeclampsia was diagnosed and diastolic blood pressure > 90 mmHg. From April 2000 our routine...... treatment in the prevalence of preterm delivery....... was changed and early antihypertensive treatment with methyldopa was initiated if antihypertensive treatment was given prior to pregnancy, if urinary albumin excretion (UAE) was > 2 g/24 h, or blood pressure > 140/90 mmHg. The present study describes the impact of this more aggressive antiypertensive...

The effect of alcohol binge drinking in early pregnancy on general intelligence in children

DEFF Research Database (Denmark)

Kesmodel, Ulrik S.; Eriksen, H-L Falgreen; Underbjerg, Mette

2012-01-01

Please cite this paper as: Kesmodel U, Falgreen Eriksen H, Underbjerg M, Kilburn T, Støvring H, Wimberley T, Mortensen E. The effect of alcohol binge drinking in early pregnancy on general intelligence in children. BJOG 2012;119:1222-1231. Objective  To examine the effects of binge alcohol...... sampled from the Danish National Birth Cohort. Methods  Participants were sampled on the basis of maternal alcohol consumption during pregnancy. At 5 years of age the children were tested with six subtests from the Wechsler Preschool and Primary Scale of Intelligence - Revised (WPPSI-R). Parental...... education, maternal IQ, prenatal maternal smoking, the child's age at testing, the gender of the child, and tester were considered core confounding factors, whereas the full model also controlled for prenatal maternal average alcohol intake, maternal age, maternal pre-pregnancy body mass index (BMI), parity...

Vitamin D Deficiency Prevalence and Predictors in Early Pregnancy among Arab Women

Directory of Open Access Journals (Sweden)

Sara Al-Musharaf

2018-04-01

Full Text Available Data regarding the prevalence and predictors of vitamin D deficiency during early pregnancy are limited. This study aims to fill this gap. A total of 578 Saudi women in their 1st trimester of pregnancy were recruited between January 2014 and December 2015 from three tertiary care antenatal clinics in Riyadh, Saudi Arabia. Information collected includes socio-economic, anthropometric, and biochemical data, including serum vitamin D (25(OHD levels, intake of calcium and vitamin D, physical activity, and sun exposure indices. Pregnant women with 25(OHD levels <50 nmol/L were considered vitamin D deficient. The majority of participants (n = 468 (81% were vitamin D deficient. High levels of indoor activity, whole body clothing, multiparity, total cholesterol/HDL ratio(>3.5, low HDL-cholesterol, and living in West Riyadh were significant independent predictors for vitamin D deficiency, with odds ratios (ORs (95% confidence interval of 25.4 (5.5–117.3, 17.8 (2.3–138.5, 4.0 (1.7–9.5, 3.3 (1.4–7.9, 2.8 (1.2–6.4, and 2.0 (1.1–3.5, respectively. Factors like increased physical activity, sun exposure at noon, sunrise or sunset, high educational status, and residence in North Riyadh were protective against vitamin D deficiency with ORs 0.2 (0.1–0.5; 0.2 (0.1–0.6; 0.3 (0.1–0.9; and 0.4 (0.2–0.8, respectively. All ORs were adjusted for age, BMI, sun exposure, parity, summer season, vitamin D intake, multivitamin intake, physical activity, education, employment, living in the north, and coverage with clothing. In conclusion, the prevalence of vitamin D deficiency among Saudi women during early pregnancy was high (81%. Timely detection and appropriate supplementation with adequate amounts of vitamin D should reduce the risks of vitamin D deficiency and its complications during pregnancy.

Client preferences and acceptability for medical abortion and MVA as early pregnancy termination method in Northwest Ethiopia

Directory of Open Access Journals (Sweden)

White Mary T

2011-06-01

Full Text Available Abstract Background Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services. Methods A prospective study was conducted in two hospitals and two clinics from March 2009 to November 2009. The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days' estimated gestation. Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit. Results The study groups were similar with respect to age, marital status, educational status, religion and ethnicity. Their mean age was about 23, majority in both group completed secondary education and about half were married. Place of residence and duration of pregnancy were associated with method choice. Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (91.2% vs 82.4%; P Conclusions Women receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination.

Interventions for hyperthyroidism pre-pregnancy and during pregnancy.

Science.gov (United States)

Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

2013-11-19

Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. To identify interventions used in the management of hyperthyroidism pre-pregnancy or during pregnancy and to ascertain the impact of these interventions on important maternal, fetal, neonatal and childhood outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013). We planned to include randomised controlled trials, quasi-randomised controlled trials, and cluster-randomised trials comparing antithyroid interventions for hyperthyroidism pre-pregnancy or during pregnancy with another intervention or no intervention (placebo or no treatment). Two review authors assessed trial eligibility and planned to assess trial quality and extract the data independently. No trials were included in the review. As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid interventions for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil.

The radioimmunoassay of a pregnancy specific-β1-glycoprotein in plasma as a pregnancy test for subfertile women

International Nuclear Information System (INIS)

Anthony, F.; Masson, G.M.; Wood, P.J.

1980-01-01

A pregnancy specific-β 1 -glycoprotein (SP 1 ) radioimmunoassay was used to monitor 72 menstrual cycles of 38 apparently subfertile women who were trying to become pregnant. Blood samples were taken up to day 42 from the start of the previous menstrual cycle. Using serum SP 1 levels greater than 6 μg/l as indicative of pregnancy, 16 positive results were obtained of which 11 were later confirmed by a human chorionic gonadotrophin haemagglutination pregnancy test. Three of the five women whose pregnancies were not confirmed had a subsequent history of spontaneous abortion. (author)

Correlates of poor mental health in early pregnancy in obese European women

DEFF Research Database (Denmark)

Sattler, Matteo C; Jelsma, Judith G M; Bogaerts, Annick

2017-01-01

BACKGROUND: Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental...... health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS: In this cross-sectional observational study, baseline data from early pregnancy (... and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. RESULTS: A total of 735 pregnant women were...

Mast cell dynamics in the house rat (Rattus rattus) ovary during estrus cycle, pregnancy and lactation.

Science.gov (United States)

Batth, B K; Parshad, R K

2000-02-01

The distribution of mast cells in various ovarian compartments was studied during different stages of the reproductive cycles in Rattus rattus. Two types of mast cell populations were recognized with light microscopy i.e., light purple and deep purple, the latter also includes deeply stained cells with extruded granules. Mast cells identified by electron microscopy showed the ultrastructural features during granule formation and release of their content. Significantly higher numbers of mast cells per unit area of ovary were seen at estrus and diestrus. Numbers of mast cells also remained high during pregnancy with possible involvement of mast cell products in vascularization of corpora lutea. A positive correlation existed between mast cell counts and embryo number during pregnancy. However, numbers of mast cells declined significantly after parturition.

Diet-induced obesity reduces core body temperature across the estrous cycle and pregnancy in the rat.

Science.gov (United States)

Crew, Rachael C; Waddell, Brendan J; Maloney, Shane K; Mark, Peter J

2018-04-16

Obesity during pregnancy causes adverse maternal and fetal health outcomes and programs offspring for adult-onset diseases, including cardiovascular disease. Obesity also disrupts core body temperature (T c ) regulation in nonpregnant rodents; however, it is unknown whether obesity alters normal maternal T c adaptations to pregnancy. Since T c is influenced by the circadian system, and both obesity and pregnancy alter circadian biology, it was hypothesized that obesity disrupts the normal rhythmic patterns of T c before and during gestation. Obesity was induced by cafeteria (CAF) feeding in female Wistar rats for 8 weeks prior to and during gestation, whereas control (CON) animals had free access to chow. Intraperitoneal temperature loggers measured daily T c profiles throughout the study, while maternal body composition and leptin levels were assessed near term. Daily temperature profiles were examined for rhythmic features (mesor, amplitude and acrophase) by cosine regression analysis. CAF animals exhibited increased fat mass (93%) and associated hyperleptinemia (3.2-fold increase) compared to CON animals. CAF consumption reduced the average T c (by up to 0.29°C) across the estrous cycle and most of pregnancy; however, T c for CAF and CON animals converged toward the end of gestation. Obesity reduced the amplitude of T c rhythms at estrus and proestrus and on day 8 of pregnancy, but increased the amplitude at day 20 of pregnancy. Photoperiod analysis revealed that obesity reduced T c exclusively in the light period during pre-pregnancy but only during the dark period in late gestation. In conclusion, obesity alters rhythmic T c profiles and reduces the magnitude of the T c decline late in rat gestation, which may have implications for maternal health and fetal development.

Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

DEFF Research Database (Denmark)

Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

2011-01-01

The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting...... that preeclampsia is associated with cardiovascular changes in early pregnancy....

Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates.

Science.gov (United States)

Grimstad, F W; Nangia, Ajay K; Luke, B; Stern, J E; Mak, W

2016-12-01

Does ICSI improve outcomes in ART cycles without male factor, specifically in couples with a history of tubal ligation as their infertility diagnosis? The use of ICSI showed no significant improvement in fertilization rate and resulted in lower pregnancy and live birth (LB) rates for women with the diagnosis of tubal ligation and no male factor. Prior studies have suggested that ICSI use does not improve fertilization, pregnancy or LB rates in couples with non-male factor infertility. However, it is unknown whether couples with tubal ligation only diagnosis and therefore iatrogenic infertility could benefit from the use of ICSI during their ART cycles. Longitudinal cohort of nationally reported cycles in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) of ART cycles performed in the USA between 2004 and 2012. There was a total of 8102 first autologous fresh ART cycles from women with the diagnosis of tubal ligation only and no reported male factor in the SART database. Of these, 957 were canceled cycles and were excluded from the final analysis. The remaining cycles were categorized by the use of conventional IVF (IVF, n = 3956 cycles) or ICSI (n = 3189 cycles). The odds of fertilization, clinical intrauterine gestation (CIG) and LB were calculated by logistic regression modeling, and the adjusted odds ratios (AORs) with 95% confidence intervals were calculated by adjusting for the confounders of year of treatment, maternal age, race and ethnicity, gravidity, number of oocytes retrieved, day of embryo transfer and number of embryos transferred. The main outcome measures of the study were odds of fertilization (2PN/total oocytes), clinical intrauterine gestation (CIG/cycle) and live birth (LB/cycle). The fertilization rate was higher in the ICSI versus IVF group (57.5% vs 49.1%); however, after adjustment this trend was no longer significant (AOR 1.14, 0.97-1.35). Interestingly, both odds of CIG (AOR 0.78, 0

The total pregnancy potential per oocyte aspiration after assisted reproduction-in how many cycles are biologically competent oocytes available?

DEFF Research Database (Denmark)

Lemmen, J G; Rodríguez, N M; Andreasen, L D

2016-01-01

PURPOSE: While stimulation of women prior to assisted reproduction is associated with increased success rates, the total biological pregnancy potential per stimulation cycle is rarely assessed. METHODS: Retrospective sequential cohort study of the cumulative live birth rate in 1148 first IVF/ICSI...

Maternal Thyroid Function in Early Pregnancy and Neuropsychological Performance of the Child at 5 Years of Age.

Science.gov (United States)

Andersen, Stine Linding; Andersen, Stig; Liew, Zeyan; Vestergaard, Peter; Olsen, Jørn

2018-02-01

Abnormal maternal thyroid function in pregnancy may impair fetal brain development, but more evidence is needed to refine and corroborate the hypothesis. To estimate the association between maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age. Follow-up study. A cohort of 1153 women and their children sampled from the Danish National Birth Cohort. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured in stored biobank sera from early pregnancy. Child neuropsychological test results (Wechsler Intelligence Scale/Test of Everyday Attention), test of motor function (Movement Assessment Battery), and results of parent and teacher reports (Behavior Rating Inventory of Executive Function/Strengths and Difficulties Questionnaire). Altogether 145 children (12.6%) were born to mothers with abnormal thyroid function in the early pregnancy. High maternal TSH and low fT4 were associated with lower child verbal intelligence quotient (adjusted mean difference TSH ≥ 10 mIU/L vs 0.1 to 2.49 mIU/L, -8.9 [95% confidence interval (CI), -15 to -2.4]; fT4 function was also associated with adverse motor function and teacher-reported problems of executive function and behavior, and these associations were dominated by exposure to maternal hypothyroxinemia. Maternal thyroid hormone abnormalities were associated with adverse neuropsychological function of the child at 5 years of age. For intelligence, marked hypothyroidism was important, whereas for motor function and executive and behavior problems, maternal hypothyroxinemia was predominant. Copyright © 2017 Endocrine Society

Isolation, purification and partial characterization of early pregnancy factor (EPF) from sera of pregnant women.

Science.gov (United States)

Haq, A; Mothi, B A; Al-Hussein, K; Al-Tufail, M; Hollanders, J; Jaroudi, K; Al-Waili, N; Shabani, M

2001-05-29

Early pregnancy factor (EPF) is a pregnancy protein, which is secreted into the maternal serum 12-16 hours after fertilization. It is thought to be an immunosuppressive molecule. EPF is detected in pregnant woman's serum by the rosette inhibition assay (RIA). In this study, EPF was purified from the pregnant woman's sera by using ion exchange chromatography and analyzed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). The proteins which showed a positive result with the RIA, were found to be 35 kDa and 17 kDa molecular weights. The biological activities of these proteins were stable upon heat treatment at 56 degrees C for 30 min. Proteins isolated and purified in this study might be of great significance to the field of human reproduction with particular reference to pregnancy and recurrent abortion.

Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women.

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Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

2013-04-01

Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. A prospective cohort study was conducted at a tertiary care teaching hospital of north India. Pregnant women till 20 wk (n=371) and between 32 to 34 wk gestation (n=274) having no urinary complaints were included. Their mid stream urine sample was sent for culture and sensitivity. Women having > 10 [5] colony forming units/ml of single organism were diagnosed positive for ASB and treated. They were followed till delivery for obstetric outcome. Relative risk with 95% confidence interval was used to describe association between ASB and outcome of interest. ASB was found in 17 per cent pregnant women till 20 wk and in 16 per cent between 32 to 34 wk gestation. Increased incidence of preeclamptic toxaemia (PET) [RR 3.79, 95% CI 1.80-7.97], preterm premature rupture of membrane (PPROM)[RR 3.63, 45% CI 1.63-8.07], preterm labour (PTL) [RR 3.27, 95% CI 1.38-7.72], intrauterine growth restriction (IUGR)[RR 3.79, 95% CI 1.80-79], low birth weight (LBW) [RR1.37, 95% CI 0.71-2.61] was seen in late detected women (32-34 wk) as compared to ASB negative women, whereas no significant difference was seen in early detected women (till 20 wk) as compared to ASB negative women. Early detection and treatment of ASB during pregnancy prevents complications like PET, IUGR, PTL, PPROM and LBW. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn.

Asymptomatic bacteriuria & obstetric outcome following treatment in early versus late pregnancy in north Indian women

Science.gov (United States)

Jain, Vaishali; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

2013-01-01

Background & objectives: Asymptomatic bacteriuria during pregnancy if left untreated, may lead to acute pyelonephritis, preterm labour, low birth weight foetus, etc. Adequate and early treatment reduces the incidence of these obstetric complications. The present study was done to determine presence of asymptomatic bacteriuria (ASB) and obstetric outcome following treatment in early versus late pregnancy. Methods: A prospective cohort study was conducted at a tertiary care teaching hospital of north India. Pregnant women till 20 wk (n=371) and between 32 to 34 wk gestation (n=274) having no urinary complaints were included. Their mid stream urine sample was sent for culture and sensitivity. Women having > 105 colony forming units/ml of single organism were diagnosed positive for ASB and treated. They were followed till delivery for obstetric outcome. Relative risk with 95% confidence interval was used to describe association between ASB and outcome of interest. Results: ASB was found in 17 per cent pregnant women till 20 wk and in 16 per cent between 32 to 34 wk gestation. Increased incidence of preeclamptic toxaemia (PET) [RR 3.79, 95% CI 1.80-7.97], preterm premature rupture of membrane (PPROM)[RR 3.63, 45% CI 1.63-8.07], preterm labour (PTL) [RR 3.27, 95% CI 1.38-7.72], intrauterine growth restriction (IUGR)[RR 3.79, 95% CI 1.80-79], low birth weight (LBW) [RR1.37, 95% CI 0.71-2.61] was seen in late detected women (32-34 wk) as compared to ASB negative women, whereas no significant difference was seen in early detected women (till 20 wk) as compared to ASB negative women. Interpretation & conclusions: Early detection and treatment of ASB during pregnancy prevents complications like PET, IUGR, PTL, PPROM and LBW. Therefore, screening and treatment of ASB may be incorporated as routine antenatal care for safe motherhood and healthy newborn. PMID:23703344

Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus

Energy Technology Data Exchange (ETDEWEB)

Robledo, Candace A. [Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892 (United States); Mendola, Pauline, E-mail: pauline.mendola@mail.nih.gov [Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892 (United States); Yeung, Edwina; Männistö, Tuija [Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892 (United States); Sundaram, Rajeshwari; Liu, Danping [Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Biostatistics and Bioinformatics Branch, Rockville, MD 20892 (United States); Ying, Qi [Texas A& M University, Zachary Department of Civil Engineering, College Station, TX 77845 (United States); Sherman, Seth [The EMMES Corporation, Rockville, MD 20852 (United States); Grantz, Katherine L. [Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892 (United States)

2015-02-15

Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk. Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5 μm (PM{sub 2.5}) and PM{sub 2.5} constituents, PM ≤ 10 μm (PM{sub 10}), nitrogen oxides (NO{sub x}), carbon monoxide, sulfur dioxide (SO{sub 2}) and ozone (O{sub 3}) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1–24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity. Results: Preconception maternal exposure to NO{sub X} (RR=1.09, 95% CI: 1.04, 1.13) and SO{sub 2} (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O{sub 3} was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy. Conclusion: Maternal exposures to NO{sub x} and SO{sub 2} preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O{sub 3} appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation. - Highlights: • Air pollution may be related to gestational diabetes (GDM). • No prior studies have examined preconception exposure. • Maternal exposure to NO{sub x} and SO{sub 2} before conception increased subsequent GDM risk. • NO{sub x} and SO{sub 2} exposure in the first seven weeks of pregnancy also increased

[Genital bacterial carriage during the last trimester of pregnancy and early-onset neonatal sepsis].

Science.gov (United States)

Balaka, B; Agbèrè, A; Dagnra, A; Baeta, S; Kessie, K; Assimadi, K

2005-05-01

Bacterial infections remain a major cause of morbidity and mortality in newborn infants. To determine the bacterial ecology and pathological status of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of materno-foetal infections and to find out a drug prophylaxis. Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. An exploration was carried out in every newborn suspected of infection. Genital samples were collected from 306 pregnant women. Among them, 118 were at 29-32 weeks of gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. albicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. These pregnancies led to 334 live births with 27 cases of early-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19,7%) were most often linked. Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of

Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: parity differences and effects.

Science.gov (United States)

Figueiredo, Bárbara; Conde, Ana

2011-07-01

This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second-time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum. Copyright © 2011 Elsevier B.V. All rights reserved.

Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies

NARCIS (Netherlands)

Verhaegen, Jorine; Gallos, Ioannis D.; van Mello, Norah M.; Abdel-Aziz, Mohamed; Takwoingi, Yemisi; Harb, Hoda; Deeks, Jonathan J.; Mol, Ben W. J.; Coomarasamy, Arri

2012-01-01

Objective To determine the accuracy with which a single progesterone measurement in early pregnancy discriminates between viable and non-viable pregnancy. Design Systematic review and meta-analysis of diagnostic accuracy studies. Data sources Medline, Embase, CINAHL, Web of Science, ProQuest,

Possible Roles of CC- and CXC-Chemokines in Regulating Bovine Endometrial Function during Early Pregnancy

Directory of Open Access Journals (Sweden)

Ryosuke Sakumoto

2017-03-01

Full Text Available The aim of the present study was to determine the possible roles of chemokines in regulating bovine endometrial function during early pregnancy. The expression of six chemokines, including CCL2, CCL8, CCL11, CCL14, CCL16, and CXCL10, was higher in the endometrium at 15 and 18 days of pregnancy than at the same days in non-pregnant animals. Immunohistochemical staining showed that chemokine receptors (CCR1, CCR2, CCR3, and CXCR3 were expressed in the epithelial cells and glandular epithelial cells of the bovine endometrium as well as in the fetal trophoblast obtained from a cow on day 18 of pregnancy. The addition of interferon-τ (IFNT to an endometrial tissue culture system increased CCL8 and CXCL10 expression in the tissues, but did not affect CCL2, CCL11, and CCL16 expression. CCL14 expression by these tissues was inhibited by IFNT. CCL16, but not other chemokines, clearly stimulated interferon-stimulated gene 15 (ISG15 and myxovirus-resistance gene 1 (MX1 expression in these tissues. Cyclooxygenase 2 (COX2 expression decreased after stimulation with CCL8 and CCL14, and oxytocin receptor (OTR expression was decreased by CCL2, CCL8, CCL14, and CXCL10. Collectively, the expression of chemokine genes is increased in the endometrium during early pregnancy. These genes may contribute to the regulation of endometrial function by inhibiting COX2 and OTR expression, subsequently decreasing prostaglandin production and preventing luteolysis in cows.

Prevalence & consequences of anaemia in pregnancy.

Science.gov (United States)

Kalaivani, K

2009-11-01

Prevalence of anaemia in India is among the highest in the world. Prevalence of anaemia is higher among pregnant women and preschool children. Even among higher income educated segments of population about 50 per cent of children, adolescent girls and pregnant women are anaemic. Inadequate dietary iron, folate intake due to low vegetable consumption, perhaps low B12 intake and poor bioavailability of dietary iron from the fibre, phytate rich Indian diets are the major factors responsible for high prevalence of anaemia. Increased requirement of iron during growth and pregnancy and chronic blood loss contribute to higher prevalence in specific groups. In India, anaemia is directly or indirectly responsible for 40 per cent of maternal deaths. There is 8 to 10-fold increase in MMR when the Hb falls below 5 g/dl. Early detection and effective management of anaemia in pregnancy can contribute substantially to reduction in maternal mortality. Maternal anaemia is associated with poor intrauterine growth and increased risk of preterm births and low birth weight rates. This in turn results in higher perinatal morbidity and mortality, and higher infant mortality rate. A doubling of low birth weight rate and 2 to 3 fold increase in the perinatal mortality rates is seen when the Hb is anaemia contributes to intergenerational cycle of poor growth in the offspring. Early detection and effective management of anaemia in pregnancy can lead to substantial reduction in undernutrition in childhood, adolescence and improvement in adult height.

Menstrual cycle, pregnancy and oral contraceptive use alter attraction to apparent health in faces.

Science.gov (United States)

Jones, B C; Perrett, D I; Little, A C; Boothroyd, L; Cornwell, R E; Feinberg, D R; Tiddeman, B P; Whiten, S; Pitman, R M; Hillier, S G; Burt, D M; Stirrat, M R; Law Smith, M J; Moore, F R

2005-02-22

Previous studies demonstrating changes in women's face preferences have emphasized increased attraction to cues to possible indirect benefits (e.g. heritable immunity to infection) that coincides with periods of high fertility (e.g. the late follicular phase of the menstrual cycle). By contrast, here we show that when choosing between composite faces with raised or lowered apparent health, women's preferences for faces that are perceived as healthy are (i) stronger during the luteal phase of the menstrual cycle than during the late follicular, fertile phase, (ii) stronger in pregnant women than in non-pregnant women and (iii) stronger in women using oral contraceptives than in women with natural menstrual cycles. Change in preference for male faces was greater for short- than long-term relationships. These findings indicate raised progesterone level is associated with increased attraction to facial cues associated with possible direct benefits (e.g. low risk of infection) and suggest that women's face preferences are influenced by adaptations that compensate for weakened immune system responses during pregnancy and reduce the risk of infection disrupting foetal development.

Early expression of pregnancy-specific glycoprotein 22 (PSG22) by trophoblast cells modulates angiogenesis in mice.

Science.gov (United States)

Blois, Sandra M; Tirado-González, Irene; Wu, Julie; Barrientos, Gabriela; Johnson, Briana; Warren, James; Freitag, Nancy; Klapp, Burghard F; Irmak, Ster; Ergun, Suleyman; Dveskler, Gabriela S

2012-06-01

Mouse and human pregnancy-specific glycoproteins (PSG) are known to exert immunomodulatory functions during pregnancy by inducing maternal leukocytes to secrete anti-inflammatory cytokines that promote a tolerogenic decidual microenvironment. Many such anti-inflammatory mediators also function as proangiogenic factors, which, along with the reported association of murine PSG with the uterine vasculature, suggest that PSG may contribute to the vascular adaptations necessary for successful implantation and placental development. We observed that PSG22 is strongly expressed around the embryonic crypt on Gestation Day 5.5, indicating that trophoblast giant cells are the main source of PSG22 during the early stages of pregnancy. PSG22 treatment up-regulated the secretion of transforming growth factor beta 1 and vascular endothelial growth factor A (VEGFA) in murine macrophages, uterine dendritic cells, and natural killer cells. A possible role of PSGs in uteroplacental angiogenesis is further supported by the finding that incubation of endothelial cells with PSG22 resulted in the formation of tubes in the presence and absence of VEGFA. We determined that PSG22, like human PSG1 and murine PSG17 and PSG23, binds to the heparan sulfate chains in syndecans. Therefore, our findings indicate that despite the independent evolution and expansion of human and rodent PSG, members in both families have conserved functions that include their ability to induce anti-inflammatory cytokines and proangiogenic factors as well as to induce the formation of capillary structures by endothelial cells. In summary, our results indicate that PSG22, the most abundant PSG expressed during mouse early pregnancy, is likely a major contributor to the establishment of a successful pregnancy.

Travel during Pregnancy

Science.gov (United States)

... 36 weeks of pregnancy. Some domestic airlines restrict travel completely or require a medical certificate during the last month of pregnancy. For international flights, the cutoff point often is earlier, sometimes as early as 28 ...

Association of testosterone and antimüllerian hormone with time to pregnancy and pregnancy loss in fecund women attempting pregnancy.

Science.gov (United States)

Sjaarda, Lindsey A; Mumford, Sunni L; Kuhr, Daniel L; Holland, Tiffany L; Silver, Robert M; Plowden, Torie C; Perkins, Neil J; Schisterman, Enrique F

2018-03-01

To examine whether higher T and/or antimüllerian hormone (AMH) was associated with anovulation, time to pregnancy (TTP), or pregnancy loss risk among healthy, fecund women without diagnosed polycystic ovary syndrome. Prospective cohort study conducted as a secondary analysis from the Effects of Aspirin in Gestation and Reproduction randomized trial. University medical centers. A total of 1,198 healthy, eumenorrheic women aged 18-40 years attempting spontaneous pregnancy with one to two prior pregnancy losses were included. Women were categorized by baseline antimüllerian hormone (AMH), as a surrogate marker of antral follicle count, and T concentrations; the highest quartile for each was "high," and below the top quartile (i.e., lower 75% of values) was "norm," forming four groups: norm T/norm AMH (n = 742), norm T/high AMH (n = 156), high T/norm AMH (n = 157), and high T/high AMH (n = 143). Not applicable. Anovulation, pregnancy incidence, TTP, and pregnancy loss incidence. Women with high T/high AMH had a greater anovulation risk (risk ratio 1.58, 95% confidence interval 1.13-2.22) compared with women with norm T/norm AMH, but with imprecise differences in incidence of pregnancy, TTP, or pregnancy loss. Women with higher T and AMH had more frequent anovulatory cycles but with marginal impacts on TTP or pregnancy loss. A continuum of mild inefficiency in reproductive function may be related to higher T and AMH, including in fecund women with normal menstrual cycles and no clinical diagnosis of polycystic ovary syndrome, but with unclear effects on fecundability and pregnancy loss. NCT00467363. Published by Elsevier Inc.

Radioimmunological determination of HPL and HCG and semiquantitative HCG determination in normal early pregnancies and in case of imminent abortion

International Nuclear Information System (INIS)

Domanowsky-Rolssenn, U.

1977-01-01

In the prognosis of endangered early pregnancies for purely clinical purposes, HPL determination in addition to immunochemical HCG determination appears sufficient and most economical. For special indications, the extension of the method to the HCG-RIA up to the 15th week of pregnance appears useful and justifiable. (orig./AJ) [de

Pregnancy outcomes decline in recipients over age 44: an analysis of 27,959 fresh donor oocyte in vitro fertilization cycles from the Society for Assisted Reproductive Technology.

Science.gov (United States)

Yeh, Jason S; Steward, Ryan G; Dude, Annie M; Shah, Anish A; Goldfarb, James M; Muasher, Suheil J

2014-05-01

To use a large and recent national registry to provide an updated report on the effect of recipient age on the outcome of donor oocyte in vitro fertilization (IVF) cycles. Retrospective cohort study. United States national registry for assisted reproductive technology. Recipients of donor oocyte treatment cycles between 2008 and 2010, with cycles segregated into five age cohorts: ≤34, 35 to 39, 40 to 44, 45 to 49, and ≥50 years. None. Implantation, clinical pregnancy, live-birth, and miscarriage rates. In donor oocyte IVF cycles, all age cohorts ≤39 years had similar rates of implantation, clinical pregnancy, and live birth when compared with the 40- to 44-year-old reference group. Patients in the two oldest age groups (45 to 49, ≥50 years) experienced statistically significantly lower rates of implantation, clinical pregnancy, and live birth compared with the reference group. Additionally, all outcomes in the ≥50-year-old group were statistically significantly worse than the 45- to 49-year-old group, demonstrating progressive decline with advancing age. Recent national registry data suggest that donor oocyte recipients have stable rates of pregnancy outcomes before age 45, after which there is a small but steady and significant decline. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Teenage pregnancy.

Science.gov (United States)

Molina Cartes, Ramiro; González Araya, Electra

2012-01-01

Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested. Copyright © 2012 S. Karger AG, Basel.

Dynamics and Predictors of Serum TSH and fT4 Reference Limits in Early Pregnancy

DEFF Research Database (Denmark)

Laurberg, Peter; Andersen, Stine Linding; Hindersson, Peter

2016-01-01

CONTEXT: Thyroid hormones are important developmental factors and levels should be adequate both in the pregnant woman and in the fetus. However, there is no consensus on maternal thyroid test reference limits in early pregnancy. OBJECTIVE: Estimation of week-to-week changes in and predictors of ...

PP064. Total vascular resistances in early pregnancy: A key to understand abnormal cardiovascular adaptation associated with spontaneous abortion.

Science.gov (United States)

Lo Presti, Damiano; Scala, Roberta Licia; Tiralongo, Grazia Maria; Pisani, Ilaria; Gagliardi, Giulia; Novelli, Gian Paolo; Vasapollo, Barbara; Valensise, Herbert

2013-04-01

From early pregnancy, maternal hemodynamic profile begins to change. The absence of these changes leads to increased risk of complication during the gestation. Aim of this study is to understand in early pregnancy the behaviour of total vascular resistances (TVR) as a sign of maternal cardiovascular adaptation to pregnancy. A cross section study was conducted. We followed 160 healthy women with singleton pregnancy during the first trimester of gestation. We evaluated cardiac output (CO) and TVR at 7, 9 and 11 weeks of gestation. We obtained the following haemodynamic measurements with the USCOM system, a non invasive method: heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), CO and TVR. 160 healthy pregnant women were selected, 8 patients, were excluded for a bad signal. Absolute values of the haemodynamic measures are shown in Fig. 1. 41 patients underwent spontaneous embryonic demise. This last group of patients showed in 54% (group A) TVR values within the normal limits (TVR1200) and CO values below the normal adaptation to pregnancy. Table 1 shows hemodynamic measures for the group A and group B; we found differences in term of CO, TVR and PAS between the two groups. Elevated TVR might indicate an abnormal vascular adaptation already in first weeks of pregnancy. Moreover, in women who undergo to abortion, elevated TVR could be use to distinguish genetic or environmental causes of miscarriage. Copyright © 2013. Published by Elsevier B.V.

Hormone profiles and haematological characteristics during oestrous cycle, pregnancy and lactation in Egyptian breeds of sheep

International Nuclear Information System (INIS)

Salem, M.H.; Badawy, A.M.; El-Nouty, F.D.; Hassan, G.A.; Latif, M.G.

1988-01-01

Cyclic animals showed an increase around oestrus in rectal temperature (RT), serum protein, blood total leucocyte counts and neutrophils, and plasma cortisol and thyroxine (T 4 ). This was accompanied by a decline in blood haemoglobin (Hb) and lymphocytes and in plasma progesterone levels. The lower incidence of oestrous activity during the spring season was associated with higher average plasma progesterone levels. The seasonal changes in plasma cortisol and T 4 were noted only in Rahmani ewes. In the pregnant animals there was a gradual decline in blood glucose, Hb and serum proteins, with minimum values at parturition. This was associated with a decline in plasma osmolality and an increase in plasma aldosterone during the second half of gestation. There was a rise in plasma cortisol, accompanied by a rise in blood total leucocyte counts and neutrophils and a decline in lymphocytes two weeks before parturition, showing a peak on day of lambing. Plasma T 4 and triiodothyronine (T 3 ) declined particularly during late pregnancy. Progesterone concentration increased with the advance of pregnancy, showing a sharp rise after the third month and a sharp decline during the week before parturition. Plasma progesterone level can be used successfully for the early diagnosis of pregnancy. Summer pregnancy was associated with a decrease in the overall mean plasma T 4 , and an increase in plasma osmolality, aldosterone, progesterone and cortisol; these seasonal changes were noted only in the Rahmani ewes. Plasma cortisol and T 3 were low during early lactation, tended to rise around mid-lactation to late lactation, and were negatively related to levels of milk production. Present results suggest that the temperate evolved Rahmani is more sensitive to unfavourable environmental conditions than the desert adapted Barki breed. 39 refs, 5 figs

Predictive value of early serum beta-human chorionic gonadotrophin for the successful outcome in women undergoing in vitro fertilization

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Neeta Singh

2013-01-01

Full Text Available Aims: Pregnancies achieved by in vitro fertilization (IVF are at increased risk of adverse outcome. The main objective of this study was to evaluate the predictive value of β-human chorionic gonadotrophin (β-HCG and age of the patient for the successful outcome in IVF. Materials and Methods: A retrospective study was done in 139 pregnancies after IVF at single IVF center from June 2007 to July 2012. The age of the patient and initial serum values of β-HCG on day 14 of embryo transfer were correlated with ongoing pregnancy (>12 weeks gestation. Results: The β-HCG level on day 14 of more than 347 mIU/ml has a sensitivity of 72.2% and specificity of 73.6% in prediction of pregnancy beyond 12 weeks period of gestation. Positive likelihood ratio (LR is 2.74 and negative LR is 0.37, (receiver operating characteristic area = 0.79. Discussion: In IVF cycles, there is a lot of stress on the couples while the cycle is going on. There was a positive correlation between the higher values of early serum β-HCG levels and ongoing pregnancy. Hence, it can be used as an independent predictor of a successful outcome of IVF cycle. Conclusion: We concluded from our study that early serum β-HCG can be used as a predictor of a successful outcome in IVF.

A Rare Cause of Low Back Pain in Pregnancy: Pregnancy Associated Osteoporosis

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Alparslan Yetişgin

2016-12-01

Full Text Available Pregnancy associated osteoporosis is a rare entity seen at the third trimester of first pregnancy or early postpartum period. It does not recur frequently in the subsequent pregnancies; however, it might lead to various complications unless it is treated. In this paper, we presented a woman diagnosed with pregnancy-associated osteoporosis with back pain at the 6th month of the pregnancy in order to discuss the points to be taken into consideration in the diagnosis/differential diagnosis and treatment options of pregnancy associated osteoporosis.

Severe hydronephrosis secondary to uterine artery pseudoaneurysm in the early second trimester of pregnancy: A case report.

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Amano, Tsukuru; Tokoro, Shinsuke; Tsuji, Shunichiro; Inoue, Takashi; Kimura, Fuminori; Murakami, Takashi

2017-09-25

Uterine artery pseudoaneurysm (UAP) normally presents genital bleeding in the puerperal period, and severe hydronephrosis rarely presents during pregnancy. We report a rare case of severe ureteral obstruction accompanied by uterine artery pseudoaneurysm in the early second trimester of pregnancy, which was successfully treated by surgical intervention. A 42-year-old nulligravid woman who had undergone myomectomy 3 years earlier was referred to our hospital for acute left abdominal pain at the 17th week of gestation. Ultrasonography showed severe left hydronephrosis and a 6-cm mass in the parauterine space. Color Doppler ultrasonography revealed a spinning turbulent flow pattern inside the mass lesion. Contrast-enhanced computed tomography revealed the left uterine artery feeding blood flow to the mass and left ureteral obstruction by the mass. These results indicated left hydronephrosis secondary to left uterine artery pseudoaneurysm. To resolve the problem, laparotomy was performed. As uterine artery isolation was impossible, ligation of the left internal iliac artery and releasing of the ureteral obstruction were carried out. The hydronephrosis and abdominal pain promptly resolved after the surgery. Thereafter, fetal development proceeded normally in the remaining months of the pregnancy. A healthy baby was delivered through cesarean section at 36 weeks gestational age. At the cesarean section, the left lower uterine segment where the UAP had been present was not visible because of the firm adhesion in around it. Uterine artery pseudoaneurysm can cause hydronephrosis in the early second trimester of pregnancy. Ligation of the unilateral internal iliac artery is a safe and effective intervention to block the blood flow to the uterine artery pseudoaneurysm during pregnancy, when uterine artery ligation seems not possible. In the pregnancy after previous surgical procedures to the uterus, uterine artery pseudoaneurysm should be considered in the differential

Hexokinase 2 drives glycogen accumulation in equine endometrium at day 12 of diestrus and pregnancy.

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Bramer, Sarah A; Macedo, Alysson; Klein, Claudia

2017-01-05

Secretion of histotroph during the prolonged pre-implantation phase in mares is crucial to pregnancy maintenance, manifested as increased embryonic loss in mares with age-related endometrial degeneration. Glycogen content of uterine histotroph is higher during the progesterone-dominated phase of the estrous cycle in mares, but regulatory mechanisms are not well understood. mRNA expression of glycogen-metabolizing enzymes (HK1, HK2, GSK3B, GYS1, PEPCK, PKM, PYGM) in endometrial samples were compared among mares in anestrus, estrus, and at Day 12 of diestrus and pregnancy. In addition, hexokinase 2 (HK2) activity was assessed using a colorimetric assay. HK2 was the key regulator of glycogen accumulation during diestrus and pregnancy; hexokinase transcript abundance and enzyme activity were significantly higher during diestrus and pregnancy than estrus and anestrus. In addition, despite similar relative transcript abundance, hexokinase activity was significantly greater in the pregnant versus diestrous endometrium. Therefore, we inferred there was regulation of hexokinase activity through phosphorylation, in addition to its regulation at the transcriptional level during early pregnancy. Based on immunohistochemistry, HK2 was localized primarily in luminal and glandular epithelial cells, with weaker staining in stromal cells. Among glycogen metabolizing enzymes identified, expression of HK2 was significantly greater during the progesterone-dominated phase of the cycle.

Thrombophilia and Pregnancy Complications

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Louise E. Simcox

2015-11-01

Full Text Available There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction. Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

Pregnancy and HIV

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... 17, 2014 Select a Language: Fact Sheet 611 Pregnancy and HIV HOW DO BABIES GET AIDS? HOW CAN WE ... doses due to nausea and vomiting during early pregnancy, giving HIV a chance to develop resistance The risk of ...

Monitoring ovarian cycle and pregnancy in the giant anteater (Myrmecophaga tridactyla) by faecal progestagen and oestrogen analysis.

Science.gov (United States)

Patzl, M; Schwarzenberger, F; Osmann, C; Bamberg, E; Bartmann, W

1998-10-01

Oestrogen and progestagen metabolites were measured in the faeces of five female giant anteaters (Myrmecophaga tridactyla), to characterise the oestrous cycle and pregnancy. Faecal samples were collected twice weekly for a minimum of 6 months, and immunoreactive progestagens and oestrogens were analysed using enzyme immunoassays (EIA). For progestagens, two antibodies that cross-reacted with 20alpha-hydroxy- or 20-oxo-progestagens were used. Both assays effectively monitored ovarian cyclicity; however, the concentrations obtained using the antibody for 20alpha-hydroxy-progestagens were higher, and the hormonal changes were more pronounced. Regular ovarian cycles were identified in three of the five females. Average (+/-SEM) length of the oestrous cycle (n=10) was 51.4+/-5.6 days. Peak concentrations of 20alpha-hydroxy-progestagens ranged from 80-660 ng/g of faeces and those of oestrogens from 20-100 ng/g. Hormone concentrations were measured during parts of two pregnancies and during four post-partum periods. The length of one gestation (from oestrous oestrogen peak until parturition) was 184 days. In the second half of gestation, progestagen concentration started to increase above luteal phase values; in the week before parturition it was approximately 20 times higher than those during the luteal phase. Concentrations of excreted oestrogens began to increase after two thirds of gestation and exceeded that of the follicular phase by approximately 2.5-fold in the week before parturition. Onset of ovarian cyclicity after parturition varied from 4-11 weeks. In conclusion, the measurement of faecal immunoreactive progestagens and oestrogens in the giant anteater indicated an ovarian cycle of approximately 7 weeks in length and provided potentially useful data for successful breeding management.

Brain-derived neurotrophic factor improves proliferation of endometrial epithelial cells by inhibition of endoplasmic reticulum stress during early pregnancy.

Science.gov (United States)

Lim, Whasun; Bae, Hyocheol; Bazer, Fuller W; Song, Gwonhwa

2017-12-01

Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family binds to two transmembrane receptors; neurotrophic receptor tyrosine kinase 2 (NTRK2) with high affinity and p75 with low affinity. Although BDNF-NTRK2 signaling in the central nervous system is known, signaling in the female reproductive system is unknown. Therefore, we determined effects of BDNF on porcine endometrial luminal epithelial (pLE) cells isolated from Day 12 of pregnancy, as well as expression of BDNF and NTRK2 in endometria of cyclic and pregnant pigs. BDNF-NTRK2 genes were expressed in uterine glandular (GE) and luminal (LE) epithelia during early pregnancy. In addition, their expression in uterine GE and LE decreased with increasing parity of sows. Recombinant BDNF increased proliferation in pLE cells in a dose-dependent, as well as expression of PCNA and Cyclin D1 in nuclei of pLE cells. BDNF also activated phosphorylation of AKT, P70S6K, S6, ERK1/2, JNK, P38 proteins in pLE cells. In addition, cell death resulting from tunicamycin-induced ER stress was prevented when pLE cells were treated with the combination of tunicamycin and BDNF which also decreased cells in the Sub-G 1 phase of the cell cycle. Furthermore, tunicamycin-induced unfolded protein response genes were mostly down-regulated to the basal levels as compared to non-treated pLE cells. Our finding suggests that BDNF acts via NTRK2 to induce development of pLE cells for maintenance of implantation and pregnancy by activating cell signaling via the PI3K and MAPK pathways and by inhibiting ER stress. © 2017 Wiley Periodicals, Inc.

Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics

DEFF Research Database (Denmark)

Adeltoft, Teresa Ajslev; Andersen, C S; Gamborg, M

2011-01-01

Objective: To investigate whether delivery mode (vaginal versus by caesarean section), maternal pre-pregnancy body mass index (BMI) and early exposure to antibiotics (..., with information on maternal pre-pregnancy BMI, delivery mode and antibiotic administration in infancy, were assessed. Logistic regression analyses were performed with childhood height and weight at the 7-year follow-up as outcome measures. Results: Delivery mode was not significantly associated with childhood.......54, 95% CI: 0.30–0.98). The same tendency was observed among children of obese mothers (OR: 0.85, 95% CI: 0.41–1.76). Conclusion: The present cohort study revealed that a combination of early exposures, including delivery mode, maternal pre-pregnancy BMI and antibiotics in infancy, influences the risk...

Hysteroscopic Differences in the Gestational Sac in Asymptomatic Blighted Ovum and Viable Pregnancy at Early Gestation

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Fu-Tsai Kung

2005-12-01

Conclusions: The anatomic alterations of the gestational sac reflect impending sac necrosis and abortion in early-stage pregnancy loss. There were no morphologic differences between the two groups in the pattern of capillary distribution on the endometrium or the implantation base.

A Rare Cause of Low Back Pain in Pregnancy: Pregnancy Associated Osteoporosis

OpenAIRE

Alparslan Yetişgin; Dilek Şen Dokumacı; Mehmet Ali Eren; Hamza Karabağ

2016-01-01

Pregnancy associated osteoporosis is a rare entity seen at the third trimester of first pregnancy or early postpartum period. It does not recur frequently in the subsequent pregnancies; however, it might lead to various complications unless it is treated. In this paper, we presented a woman diagnosed with pregnancy-associated osteoporosis with back pain at the 6th month of the pregnancy in order to discuss the points to be taken into consideration in the diagnosis/differential diagnosis and t...

Effects of the estrous cycle, pregnancy and interferon tau on expression of cyclooxygenase two (COX-2 in ovine endometrium

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Bazer Fuller W

2003-08-01

Full Text Available Abstract In sheep, the uterus produces luteolytic pulses of prostaglandin F2α (PGF on Days 15 to 16 of estrous cycle to regress the corpus luteum (CL. These PGF pulses are produced by the endometrial lumenal epithelium (LE and superficial ductal glandular epithelium (sGE in response to binding of pituitary and/or luteal oxytocin to oxytocin receptors (OTR and liberation of arachidonic acid, the precursor of PGF. Cyclooxygenase-one (COX-1 and COX-2 are rate-limiting enzymes in PGF synthesis, and COX-2 is the major form expressed in ovine endometrium. During pregnancy recognition, interferon tau (IFNτ, produced by the conceptus trophectoderm, acts in a paracrine manner to suppress development of the endometrial epithelial luteolytic mechanism by inhibiting transcription of estrogen receptor α (ERα (directly and OTR (indirectly genes. Conflicting studies indicate that IFNτ increases, decreases or has no effect on COX-2 expression in bovine and ovine endometrial cells. In Study One, COX-2 mRNA and protein were detected solely in endometrial LE and sGE of both cyclic and pregnant ewes. During the estrous cycle, COX-2 expression increased from Days 10 to 12 and then decreased to Day 16. During early pregnancy, COX-2 expression increased from Days 10 to 12 and remained higher than in cyclic ewes. In Study Two, intrauterine infusion of recombinant ovine IFNτ in cyclic ewes from Days 11 to 16 post-estrus did not affect COX-2 expression in the endometrial epithelium. These results clearly indicate that IFNτ has no effect on expression of the COX-2 gene in the ovine endometrium. Therefore, antiluteolytic effects of IFNτ are to inhibit ERα and OTR gene transcription, thereby preventing endometrial production of luteolytic pulses of PGF. Indeed, expression of COX-2 in the endometrial epithelia as well as conceptus is likely to have a beneficial regulatory role in implantation and development of the conceptus.

The impact of pregnancy on physical activity level.

Science.gov (United States)

Fell, Deshayne B; Joseph, K S; Armson, B Anthony; Dodds, Linda

2009-09-01

The purpose of this study was to compare women's levels of physical activity during early pregnancy and during the year before pregnancy, and to identify characteristics associated with discontinuing sports and exercise among women previously active during the year before pregnancy. Data collected from 1,737 women enrolled in a prospective cohort study and who had no contraindications for exercise were included in this analysis. Measures of physical activity (including household and care-giving activities, active living and sports and exercise activities) during early pregnancy were compared to the year before pregnancy. Log binomial regression was used to identify factors associated with discontinuing sports and exercise during pregnancy. There was a statistically significant decrease in all summary measures of physical activity during early pregnancy. The largest decreases were observed in sports and exercise activity. Among women active before pregnancy, age pregnancy body mass index (BMI) > or = 30 kg/m(2) and lower levels of pre-pregnancy exercise were associated with discontinuing sports and exercise activities during pregnancy. Most women reduced their physical activity level during the first 20 weeks of pregnancy compared with their level of activity during the year prior to pregnancy, particularly for sports and exercise, although a small proportion of women in this study actually increased their activity in this area during early pregnancy. Participation in sports and exercise activity during pregnancy is potentially modifiable and could favorably impact perinatal health and maternal post-partum weight. The results of this study suggests that pregnancy is an event that leads to a decrease in physical activity.

Continuation of metformin reduces early pregnancy loss in obese Pakistani women with polycystic ovarian syndrome.

Science.gov (United States)

Nawaz, Fauzia Haq; Rizvi, Javed

2010-01-01

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory infertility worldwide. In addition to a poor conception rate, pregnancy loss rates are significantly higher (30-50%) during the first trimester in women with PCOS. Insulin resistance (IR) in this syndrome is not only implicated toward early pregnancy loss (EPL) but also pathognomic for various obstetrical complications during pregnancy. We evaluated the role of Metformin in the reduction of EPL in women with PCOS who conceived spontaneously or after induction ovulation with or without Metformin. The primary objective was to evaluate the effectiveness of Metformin in the reduction of EPL in women with PCOS. Secondary outcomes like gestational diabetes, pregnancy-induced hypertension and intrauterine growth restriction were also analyzed at the end of the study. This case-control study was conducted from March 2005 to March 2008 in the infertility and antenatal clinics of the Department of Obstetrics and Gynecology of Aga Khan University Hospital, Karachi, Pakistan. A total of 197 infertile women with PCOS were included. 'Cases' were women with PCOS who conceived while taking Metformin and it whom it was continued throughout pregnancy. 'Controls' were women in whom Metformin was either stopped in first trimester after confirmation of pregnancy (by serum betaHCG or by ultrasound) or they conceived spontaneously without the use of Metformin. All 197 women in this study had a confirmed diagnosis of PCOS (Rotterdam criteria). These women were followed till the final outcome of pregnancy was achieved. Both groups were compared for risk of EPL. It was found that continuation of Metformin during pregnancy reduces EPL, i.e. 8.8 vs. 29.4% in cases and controls, respectively (p pregnancy loss rate was 12.5% in the Metformin versus 49.4% in control group (p = 0.002). Metformin continuation during pregnancy significantly reduces EPL in women with PCOS. IR may play a significant role in EPL. Copyright 2009

Periodontal disease early in pregnancy is associated with maternal systemic inflammation among African American women.

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Horton, Amanda L; Boggess, Kim A; Moss, Kevin L; Jared, Heather L; Beck, James; Offenbacher, Steven

2008-07-01

Maternal periodontal disease is a chronic oral infection with local and systemic inflammatory responses and may be associated with adverse pregnancy outcomes. This study determined whether maternal periodontal disease in early pregnancy is associated with elevated serum C-reactive protein (CRP) levels and whether maternal race influences the relationship between maternal periodontal disease and systemic inflammatory responses. A secondary analysis of prospectively collected data from the Oral Conditions and Pregnancy study was conducted. Healthy women at Periodontal disease was categorized by clinical criteria, and maternal serum was analyzed for CRP levels using highly sensitive enzyme-linked immunosorbent assay kits. An elevated CRP level was defined as >75th percentile. Demographic and medical data were obtained from the women's charts. Chi-square and multivariable logistic regression models were used to determine maternal factors associated with an elevated CRP. An adjusted odds ratio (OR) for elevated CRP levels was calculated and stratified by race and periodontal disease category. The median (interquartile) CRP level was 4.8 (0.6 to 15.7) microg/ml, and an elevated CRP level (>75th percentile) was 15.7 microg/ml. African American race and moderate/severe periodontal disease were significantly associated with elevated CRP levels. When stratified by race, moderate/severe periodontal disease remained associated with an elevated CRP level among African American women (adjusted OR: 4.0; 95% confidence interval [CI]: 1.2 to 8.5) but not among white women (adjusted OR: 0.9; 95% CI: 0.2 to 3.6) after adjusting for age, smoking, parity, marital status, insurance status, and weight. Among African American women, moderate/severe periodontal disease is associated with elevated CRP levels early in pregnancy.

Smoking and Pregnancy

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Smoking and Pregnancy Smoking can cause problems for a woman trying to become pregnant or who is already pregnant, and for her baby ... too early • Pregnancy occurs outside of the womb Smoking causes these health effects. Smoking could cause these ...

Depression in pregnancy and postpartum period.

Science.gov (United States)

Sood, Mamta; Sood, A K

2003-01-01

This prospective study was carried out in a service hospital, with the aim to study the prevalence and incidence of depression in pregnancy and postpartum period. Eighty Four consecutive patients attending the antenatal outpatient in the Obstetrics & Gynaecology department in their last trimester of pregnancy were recruited for the study. They were assessed on Beck Depression Inventory thrice viz. during third trimester of pregnancy, within 3 days of delivery (early postpartum period) & within 4-8 weeks of delivery (late postpartum period).The prevalence of depression was 8.3%, 20% and 12.8% respectively at three ratings. The incidence was 16% and 10% in the early & late postpartum period respectively. Further analysis revealed that depression in pregnancy correlated significantly with depression in early postpartum period, but not with late postpartum period. Depression in early postpartum period correlated with depression in late postpartum period.These findings have implications for early detection and care of women at risk for developing depression.

The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5-year-old children

DEFF Research Database (Denmark)

Skogerbø, A; Kesmodel, Ulrik S.; Wimberley, Theresa

2012-01-01

Please cite this paper as: SkogerbøÅ, Kesmodel U, Wimberley T, Støvring H, Bertrand J, Landrø N, Mortensen E. The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5-year-old children. BJOG 2012;119:1201-1210. Objective  To examine...... the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on children's executive functions at the age of 5 years. Design  Follow-up study. Setting  Neuropsychological testing in four Danish cities 2003-2008. Population  A cohort of 1628 women and their children sampled...... from the Danish National Birth Cohort. Methods  Participants were sampled based on maternal alcohol drinking patterns during early pregnancy. When the children were 5 years old, the parent and teacher forms of the Behaviour Rating Inventory of Executive Function (BRIEF) were completed by the mothers...

The effect of air bubble position after blastocyst transfer on pregnancy rates in IVF cycles.

Science.gov (United States)

Friedman, Brooke E; Lathi, Ruth B; Henne, Melinda B; Fisher, Stephanie L; Milki, Amin A

2011-03-01

To investigate the relationship between air bubble position after blastocyst transfer (BT) and pregnancy rates (PRs). Retrospective cohort study. University-based infertility center. Three hundred fifteen consecutive nondonor BTs by a single provider. Catheters were loaded with 25 μL of culture media, 20 μL of air, 25 μL of media containing the blastocysts, 20 μL of air, and a small amount of additional media. The distance from the air bubble to the fundus, as seen on abdominal ultrasound examination, was measured at the time of transfer. Air bubble location was categorized as 20 mm from the fundus. Clinical pregnancy rate. After controlling for age, parity, FSH and frozen transfers, and accounting for repeated cycles per patient, the PRs for both the >20-mm (38.3%) and the 10-20-mm (42.0%) from the fundus group were significantly reduced compared with the group in which the bubble was Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament.

Science.gov (United States)

Agrati, Daniella; Browne, Dillon; Jonas, Wibke; Meaney, Michael; Atkinson, Leslie; Steiner, Meir; Fleming, Alison S

2015-10-01

The aims of this study were to examine the anxiety trajectories of women from pregnancy to 2 years postpartum and to assess the influence of their early life experiences and the temperament of the child on these trajectories. We evaluated state anxiety (State-Trait Anxiety Inventory) at pregnancy and 3, 6, 12, 18, and 24 months postpartum and determined its course as a function of self-reported early adverse experiences (Childhood Trauma Questionnaire) and the temperament of the child at 18 months (Early Child Behavior Questionnaire). Based on growth curve modeling, we found that anxiety followed a general U-shape pattern from gestation to 2 years postpartum, which was modified by early life experience of women. Greater early adversity was associated with higher gestational anxiety, followed by a marked decrease once the baby was born, and subsequent increase during the later postpartum period. The temperament of the child also modulated anxiety trajectories. Thus, mothers of children high in negative affectivity and who also experienced greater early adversity had elevated and flat anxiety trajectories, while child extraversion was associated with increasing anxiety courses approaching 2 years postpartum. These results show that maternal anxiety dynamically changes through the postpartum period with a course that is affected by previous and current experiences.

A prospective cohort study of alcohol exposure in early and late pregnancy within an urban population in Ireland.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2014-02-01

Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We performed a prospective cohort study, conducted from November 2010 to December 2011 at a teaching hospital in the Republic of Ireland. Of the 907 women with a singleton pregnancy who booked for antenatal care and delivered at the hospital, 185 (20%) abstained from alcohol in the first trimester but drank in the third trimester, 105 (12%) consumed alcohol in the first and third trimesters, and the remaining 617 (68%) consumed no alcohol in pregnancy. Factors associated with continuing to drink in pregnancy included older maternal age (30-39 years), Irish nationality, private healthcare, smoking, and a history of illicit drug use. Compared to pre-pregnancy, alcohol consumption in pregnancy was markedly reduced, with the majority of drinkers consuming ≤ 5 units per week (92% in first trimester, 72-75% in third trimester). Perhaps because of this, perinatal outcomes were similar for non-drinkers, women who abstained from alcohol in the first trimester, and women who drank in the first and third trimester of pregnancy. Most women moderate their alcohol consumption in pregnancy, especially in the first trimester, and have perinatal outcomes similar to those who abstain.

Preimplantation genetic diagnosis for Down syndrome pregnancy

Institute of Scientific and Technical Information of China (English)

ZHANG Yu; XU Chen-ming; ZHU Yi-min; DONG Min-yue; QIAN Yu-li; JIN Fan; HUANG He-feng

2007-01-01

Objective: To evaluate the effect of preimplantation genetic diagnosis (PGD) conducted for women who had Down syndrome pregnancy previously. Methods: Trisomy 21 was diagnosed by using fluorescence in site hybridization (FISH) before embryo transfer in two women who had Down syndrome pregnancies. Each received one or two PGD cycles respectively. Results:Case 1: one PGD cycle was conducted, two oocytes were fertilized and biopsied. One embryo is of trisomy 21 and the other of monosomy 21. No embryo was transferred. Case 2: two PGD cycles were conducted, in total, sixteen oocytes were fertilized and biopsied. Four embryos were tested to be normal, six of trisomy 21, and one of monosomy 21. Five had no signal. Four normal embryos were transferred but no pregnancy resulted. Conclusion: For couples who had pregnancies with Down syndrome previously, PGD can be considered, and has been shown to be an effective strategy.

Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases

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Shu-Yin Tan

2015-10-01

Conclusion: The 3D-power Doppler ultrasound is a more comprehensive and sensitive method for evaluating endometrial receptivity. Endometrial volume, VI, FI, and VFI in the midluteal phase, as well as VI in early pregnancy, can be considered as predictive factors for recurrent miscarriage.

Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry.

Science.gov (United States)

Provost, Meredith P; Acharya, Kelly S; Acharya, Chaitanya R; Yeh, Jason S; Steward, Ryan G; Eaton, Jennifer L; Goldfarb, James M; Muasher, Suheil J

2016-03-01

To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles. Retrospective cohort study. Not applicable. A total of 239,127 fresh IVF cycles from the 2008-2010 Society for Assisted Reproductive Technology registry were stratified into cohorts based on World Health Organization BMI guidelines. Cycles reporting normal BMI (18.5-24.9 kg/m(2)) were used as the reference group (REF). Subanalyses were performed on cycles reporting purely polycystic ovary syndrome (PCOS)-related infertility and those with purely male-factor infertility (34,137 and 89,354 cycles, respectively). None. Implantation rate, clinical pregnancy rate, pregnancy loss rate, and live birth rate. Success rates and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for all pregnancy outcomes were most favorable in cohorts with low and normal BMIs and progressively worsened as BMI increased. Obesity also had a negative impact on IVF outcomes in cycles performed for PCOS and male-factor infertility, although it did not always reach statistical significance. Success rates in fresh autologous cycles, including those done for specifically PCOS or male-factor infertility, are highest in those with low and normal BMIs. Furthermore, there is a progressive and statistically significant worsening of outcomes in groups with higher BMIs. More research is needed to determine the causes and extent of the influence of BMI on IVF success rates in other patient populations. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Increased maternal plasma leptin in early pregnancy and risk of gestational diabetes mellitus.

Science.gov (United States)

Qiu, Chunfang; Williams, Michelle A; Vadachkoria, Surab; Frederick, Ihunnaya O; Luthy, David A

2004-03-01

Emerging evidence suggests that leptin, an adipocyte-derived hormone, may have independent direct effects on both insulin secretion and action, in addition to its well documented effects on appetite and energy expenditure. Some, but not all, previously published studies suggest that maternal leptin concentrations may be increased in pregnancies complicated by gestational diabetes mellitus (GDM). We examined the association between plasma leptin concentration and GDM risk. Women were recruited before 16 weeks of gestation and were followed up until delivery. Maternal plasma leptin concentrations (collected at 13 weeks of gestation) were measured by using immunoassay. We used generalized linear models to estimate relative risks and 95% confidence intervals. GDM developed in 5.7% of the cohort (47 of 823). Elevated leptin concentrations were positively associated with GDM risk (P for trend risk of GDM (95% confidence interval 1.2, 18.0) as compared with women who had concentrations of 14.3 ng/mL or lower. We noted a strong linear component of trend in risk of GDM with increasing maternal plasma leptin concentration. Each 10-ng/mL increase in the leptin concentration was associated with a 20% increase in GDM risk (relative risk 1.2; 95% confidence interval 1.0, 1.3). Hyperleptinemia, independent of maternal adiposity, in early pregnancy appears to be predictive of an increased risk of GDM later in pregnancy. Additional larger prospective cohort studies are needed to confirm and more precisely assess the etiologic importance of hyperleptinemia in pregnancy. II-2

Juvenile Dermatomyositis in Pregnancy

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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.

Patient-centered early pregnancy care: a systematic review of quantitative and qualitative studies on the perspectives of women and their partners.

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van den Berg, M M J; Dancet, E A F; Erlikh, T; van der Veen, F; Goddijn, M; Hajenius, P J

2018-01-01

Early pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of therapeutic management. An overview of aspects of care valued by women and/or their partners is missing. This systematic review aims to provide an overview of aspects of care valued by women and/or their partners faced with early pregnancy complications and to identify potential targets for improvement in early pregnancy healthcare. We searched five electronic databases for empirical quantitative or qualitative studies on patients' perspectives of early pregnancy care in July 2017. We first identified aspects of early pregnancy care valued by women and/or their partners based on qualitative and quantitative data and organized these aspects of care according to the eight dimensions of patient-centered care. Second, we extracted the assessment of service quality from women and/or their partners on each of these aspects of care based on quantitative data. Third, we combined the findings on patients' values with the findings of service quality assessment to identify potential targets for improvement in five groups according to how likely these targets are to require improvement. The search yielded 6240 publications, of which 27 studies were eligible for inclusion in this review. All included studies focused on miscarriage or recurrent miscarriage care. We identified 24 valued aspects of care, which all covered the eight dimensions of patient-centered care. The most frequently reported valued aspect was 'being treated as an individual person experiencing a significant life event rather than a common condition'. Assessment of service quality from women and/or their partners was available for 13 of the 24 identified aspects of care. Quantitative studies all documented service quality

Non-invasive identification of protein biomarkers for early pregnancy diagnosis in the cheetah (Acinonyx jubatus.

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Diana C Koester

Full Text Available Approximately 80% of cheetahs living in typical zoological collections never reproduce. In more than 60% of breedings, the female is confirmed to ovulate, but parturition fails to occur. It is unknown if these non-pregnant intervals of elevated progesterone (deemed luteal phases are conception failures or a pregnancy terminating in embryonic/fetal loss. There have been recent advances in metabolic profiling and proteome analyses in many species with mass spectrometry used to identify 'biomarkers' and mechanisms indicative of specific physiological states (including pregnancy. Here, we hypothesized that protein expression in voided cheetah feces varied depending on pregnancy status. We: 1 identified the expansive protein profile present in fecal material of females; and 2 isolated proteins that may be candidates playing a role in early pregnancy establishment and diagnosis. Five hundred and seventy unique proteins were discovered among samples from pregnant (n = 8, non-pregnant, luteal phase (n = 5, and non-ovulatory control (n = 5 cheetahs. Four protein candidates were isolated that were significantly up-regulated and two were down-regulated in samples from pregnant compared to non-pregnant or control counterparts. One up-regulated candidate, immunoglobulin J chain (IGJ; an important component of the secretory immune system was detected using a commercially available antibody via immunoblotting. Findings revealed that increased IGJ abundance could be used to detect pregnancy successfully in >80% of 23 assessed females within 4 weeks after mating. The discovery of a novel fecal pregnancy marker improves the ability to determine reproductive, especially gestational, status in cheetahs managed in an ex situ insurance and source population.

Non-invasive identification of protein biomarkers for early pregnancy diagnosis in the cheetah (Acinonyx jubatus).

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Koester, Diana C; Wildt, David E; Maly, Morgan; Comizzoli, Pierre; Crosier, Adrienne E

2017-01-01

Approximately 80% of cheetahs living in typical zoological collections never reproduce. In more than 60% of breedings, the female is confirmed to ovulate, but parturition fails to occur. It is unknown if these non-pregnant intervals of elevated progesterone (deemed luteal phases) are conception failures or a pregnancy terminating in embryonic/fetal loss. There have been recent advances in metabolic profiling and proteome analyses in many species with mass spectrometry used to identify 'biomarkers' and mechanisms indicative of specific physiological states (including pregnancy). Here, we hypothesized that protein expression in voided cheetah feces varied depending on pregnancy status. We: 1) identified the expansive protein profile present in fecal material of females; and 2) isolated proteins that may be candidates playing a role in early pregnancy establishment and diagnosis. Five hundred and seventy unique proteins were discovered among samples from pregnant (n = 8), non-pregnant, luteal phase (n = 5), and non-ovulatory control (n = 5) cheetahs. Four protein candidates were isolated that were significantly up-regulated and two were down-regulated in samples from pregnant compared to non-pregnant or control counterparts. One up-regulated candidate, immunoglobulin J chain (IGJ; an important component of the secretory immune system) was detected using a commercially available antibody via immunoblotting. Findings revealed that increased IGJ abundance could be used to detect pregnancy successfully in >80% of 23 assessed females within 4 weeks after mating. The discovery of a novel fecal pregnancy marker improves the ability to determine reproductive, especially gestational, status in cheetahs managed in an ex situ insurance and source population.

[Mexican adolescentes' goals as determinants in the prevention of early pregnancies].

Science.gov (United States)

Atienzo, Erika E; Campero, Lourdes; Lozada, Ana Lilia; Herrera, Cristina

2014-01-01

This study aims to explore adolescents' intentions related to the early formation of a family. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974). Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents' expectations for their child's education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13). In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

EFFECT OF POST-MATING GNRH TREATMET ON SERUM PROGESTERONE, LUTEINIZING HORMONE LEVELS, DURATION OF ESTROUS CYCLE AND PREGNANCY RATES IN COWS

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H. YILDIZ, E. KAYGUSUZOĞLU, M. KAYA1 AND M. ÇENESIZ1

2009-07-01

Full Text Available Pregnancy rate, estrous cycle lenght, serum progesterone and luteinizing hormone (LH concentrations were determined in gonadotropin releasing hormone (GnRH; 10.5 μg synthetic gonadotrophin releasing hormone agonist, receptal administered cows on day 12 post-mating (n=9 compared to control cows (n=8. Their oestrous cycles were synchronised by intramuscular administration of prostaglandin F2 alpha (its analog, cloprostenol twice at 11 days interval. Estrous exhibited cows were mated naturally. Blood samples were collected every two days from all animals. Serum progesterone and LH concentrations were measured by ELISA method. GnRH administration significantly increased serum LH concentration which reached peak levels 2-3 h after treatment. However, serum progesterone concentration was not affected. There were no differences in mean progesterone concentrations on days 12 to 24 post-mating between GnRH administrated and control pregnant cows. However, in non pregnant animals, progesterone concentrations on days 16 in the treated group were lower than control group (P<0.01. Pregnancy diagnosis in animals made by B-mode ultrasonography between the 30th and 35th day showed that 77.7% of treated cows were pregnant compared to 50% in control group. Duration of the estrous cycle in the non-pregnant animals was not affected by the treatment (control, 21.3 ± 0.8 days; treated, 22.5 ± 0.5 days. In conclusion, this study supports the use of GnRH on day 12 post-mating as a method for enhancing pregnancy rates in lactating dairy cattle.

Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy

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Kohei Ogawa

2017-05-01

Full Text Available Background: No previous study has shown the validity of a food frequency questionnaire (FFQ in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP. The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women. Method: We included 188 women before 15 weeks of gestation and compared estimated nutrient intake and food group intake based on a modified FFQ with that based on 3-day dietary records (DRs. Spearman's rank correlation coefficients, adjusting energy intake and attenuating within-person error, were calculated. Subgroup analysis for those with and without NVP was conducted. We also examined the degree of appropriate classification across categories between FFQ and DRs through division of consumption of nutrients and food groups into quintiles. Results: Crude Spearman's correlation coefficients of nutrients ranged from 0.098 (sodium to 0.401 (vitamin C, and all of the 36 nutrients were statistically significant. In 27 food groups, correlation coefficients ranged from −0.015 (alcohol to 0.572 (yogurt, and 81% were statistically significant. In subgroup analysis, correlation coefficients in 89% of nutrients and 70% of food groups in women with NVP and 97% of nutrients and 74% of food groups in women without NVP were statistically significant. On average, 63.7% of nutrients and 60.4% of food groups were classified into same or adjacent quintiles according to the FFQ and DRs. Conclusions: The FFQ is a useful instrument, regardless of NVP, for assessing the diet of women in early pregnancy in Japan.

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

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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.

The duration of gonadotropin stimulation does not alter the clinical pregnancy rate in IVF or ICSI cycles.

Science.gov (United States)

Purandare, N; Emerson, G; Kirkham, C; Harrity, C; Walsh, D; Mocanu, E

2017-08-01

Ovarian stimulation is an essential part of assisted reproduction treatments. Research on whether the duration of stimulation alters the success in assisted reproduction has not been conclusive. The purpose of the study was to establish whether the duration of ovarian stimulation alters the success in assisted reproduction treatments. All fresh (non-donor) stimulation cycles performed in an academic tertiary referral ART centre over a period of 18 years, between 1st January 1997 and 31st December 2014, were identified. Data were prospectively and electronically collected. IVF and ICSI cycles were analysed independently. Each category was then subdivided into assisted reproduction cycles where the antagonist, long (down regulation) and flare protocol were used. Clinical pregnancy was the main outcome measured. A total of 10,478 stimulation cycles (6011 fresh IVF and 4467 fresh ICSI) reaching egg collection were included. We showed no significant difference in CP rates in IVF cycles for the long (p = 0.082), antagonist (p = 0.217) or flare (p = 0.741) protocol cycles or in ICSI cycles with the long (p = 0.223), antagonist (p = 0.766) or the flare (p = 0.690) protocol with regards the duration of stimulation. The duration of stimulation does not alter the CP rate in ICSI or IVF cycles using the long, antagonist or flare stimulation protocol.

Preferences of subfertile women regarding elective single embryo transfer : additional in vitro fertilization cycles are acceptable, lower pregnancy rates are not

NARCIS (Netherlands)

Twisk, Moniek; van der Veen, Fulco; Repping, Sjoerd; Heineman, Maas-Jan; Korevaar, Johanna C.; Bossuyt, Patrick M. M.

2007-01-01

With identical pregnancy rates after elective single embryo transfer (ET) and double ET strategies consisting of three cycles of IVF or intracytoplasmic sperm injection (ICSI) plus transfers of thawed/frozen embryos if available, 46% of the women undergoing IVF/ICSI favor elective single ET. If

Preferences of subfertile women regarding elective single embryo transfer: additional in vitro fertilization cycles are acceptable, lower pregnancy rates are not

NARCIS (Netherlands)

Twisk, Moniek; van der Veen, Fulco; Repping, Sjoerd; Heineman, Maas-Jan; Korevaar, Johanna C.; Bossuyt, Patrick M. M.

2007-01-01

With identical pregnancy rates after elective single embryo transfer (ET) and double ET strategies consisting of three cycles of IVF or intracytoplasmic sperm injection (ICSI) plus transfers of thawed/frozen embryos if available, 46% of the women undergoing IVF/ICSI favor elective single ET. If

Goserelin with chemotherapy to preserve ovarian function in pre-menopausal women with early breast cancer: menstruation and pregnancy outcomes.

Science.gov (United States)

Wong, M; O'Neill, S; Walsh, G; Smith, I E

2013-01-01

Premature ovarian failure and infertility following chemotherapy in early breast cancer (EBC) are major concerns for young women. The role of gonadotrophin-releasing hormone (GnRH) agonists with chemotherapy in EBC in reducing the incidence of chemotherapy-induced early menopause remains uncertain, and long-term data on the recovery of fertility are sparse. We report an audit of our experience with the GnRH agonist, goserelin (Zoladex®), used with chemotherapy to preserve ovarian function and maintain fertility. Pre-menopausal women were given goserelin subcutaneously every 28 days during chemotherapy, starting 0-14 days before treatment. The main clinical end point was recovery of menstruation after chemotherapy. The other end points were rate of successful conception and median time to recovery of menses. About 84% of 125 women recovered menstruation with the median time to recovery of 6 months (1-43 months), including 76% of 71 patients aged over 35. Of the 42 patients who attempted pregnancy, 71% (n=30) managed to achieve pregnancies. At the time of analysis, there were 42 pregnancies and 30 healthy deliveries. The GnRH agonist, goserelin, given with chemotherapy for EBC is associated with a low risk of long-term chemotherapy-induced amenorrhoea and a high chance of pregnancy. Further randomised trials are needed.

Timing of intermittent preventive treatment for malaria during pregnancy and the implications of current policy on early uptake in north-east Tanzania

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Chambo Pili

2008-05-01

Full Text Available Abstract Background Intermittent preventive treatment (IPTp is efficacious in reducing the adverse outcomes associated with pregnancy-associated malaria, however uptake of the recommended two doses is low in Tanzania, and little is known of the timepoint during pregnancy at which it is delivered. This study investigated the timing of delivery of IPTp to pregnant women attending antenatal clinics (ANC, and the potential determinants of timely uptake. Methods Structured interviews were conducted with staff and pregnant women at antenatal clinics in northeast Tanzania, and antenatal consultations were observed. Facility-based and individual factors were analysed for any correlation with timing of IPTp uptake. Results Almost half the women interviewed first attended ANC during or before the fourth month of gestation, however 86% of these early attendees did not receive IPTp on their first visit. The timing of IPTp delivery complied closely with the national guidelines which stipulate giving the first dose at 20–24 weeks gestation. Uptake of at least one dose of IPTp among women who had reached this gestation age was 67%, although this varied considerably between clinics. At one facility, IPTp was not delivered because SP was out of stock. Conclusion Early uptake of IPTp was found to be hampered by factors external to health worker performance or women's individual preferences. These include insufficient drug stocks and an apparent lack of information to health workers on the reasoning for continued use of SP for IPTp when it has been replaced as a first-line treatment. In addition, an unexpectedly high proportion of women attend antenatal clinics before 20 weeks of pregnancy. While current policy denies the use of IPTp at this time, there is emerging, but incomplete, evidence that malaria in early pregnancy may contribute considerably to the burden of pregnancy-related malaria. Current policy may thus result in a missed opportunity for maximising

Improving Outcomes for Teenage Pregnancy and Early Parenthood for Young People in Out-of-Home Care: A Review of the Literature

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Mendes, Philip

2009-01-01

Young people leaving out-of-home care are overrepresented among teenage parents. This paper examines the research literature and identifies key factors that contribute to early pregnancy and parenthood for care leavers, the challenges of early parenting and the positive effects of early parenting. The implications for out-of-home care policy and…

A logistic model to predict early pregnancy loss following in vitro fertilization based on 2601 infertility patients.

Science.gov (United States)

Yi, Yan; Lu, Guangxiu; Ouyang, Yan; lin, Ge; Gong, Fei; Li, Xihong

2016-03-31

According to previous studies, even after embryonic cardiac activity is detected, the pregnancy loss rate remains 3-4 %. The objectives of this study were to investigate the differences in ultrasound parameters between a miscarriage group and an ongoing pregnancy group during the 1(st) trimester and to build a logistic model to predict early pregnancy loss (EPL) after the appearance of embryonic cardiac activity in patients who have undergone in vitro fertilization embryo transfer (IVF-ET) treatment. A total of 2601 patients with early singleton pregnancies with embryonic cardiac activity were retrospectively analyzed after IVF from January 2010 to June 2011. Transvaginal sonography (TVS) was performed at 6 to 10 weeks of gestational age (GA). The mean gestational sac diameter (MSD), crown-rump length (CRL), fetal heart rate (FHR), and yolk sac diameter (YSD) were measured by TVS. A total of 2400 patients had an ongoing pregnancy and an additional 201 (7.7 %) patients miscarried during the first trimester after fetal cardiac activity had been established. The maternal age (MA) and infertility duration were much greater, and the MSD, CRL, and FHR were much lower in the miscarriage group than in the ongoing pregnancy group after IVF (P model utilized the following equation: the possibility of EPL = exp(z)/(1 + exp(z)), where z = -21.456 + (0.114 × MA) + (4.305 × × GA) - (0.043 × MSD) - (0.359 × CRL) - (0.091 × FHR) + 2.243 (fluid collection present around the gestational sac (GS)) + 2.519 (when YSD  5.5). The MA, MSD, CRL, YSD, FHR, infertility duration, and fluid collection around the GS were each correlated with EPL after IVF in infertile patients. A logistic model is a useful tool for predicting EPL after the appearance of embryonic cardiac activity (area under the curve [AUC] = 0.909).

Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

DEFF Research Database (Denmark)

Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

2011-01-01

The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting that preecla......The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting...... that preeclampsia is associated with cardiovascular changes in early pregnancy....

Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy.

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Sixto E Sanchez

Full Text Available To examine the associations of Intimate partner violence (IPV with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST] and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI] during early pregnancy.This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR and 95% confidence intervals (95%CIs were calculated using logistic regression procedures.Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08-2.17 and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33-2.81. Compared with women experiencing no IPV during lifetime, the aOR (95% CI for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84-1.83, sexual abuse only 3.44 (95%CI: 1.07-11.05, and physical and sexual abuse 2.51 (95% CI: 1.27-4.96. The corresponding aORs (95% CI for poor sleep quality were: 1.72 (95% CI: 1.13-2.61, 2.82 (95% CI: 0.99-8.03, and 2.50 (95% CI: 1.30-4.81, respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17-3.67 and poor sleep quality (aOR = 2.27; 95% CI: 1.30-3.97 during pregnancy.Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health.

Association between ambient air pollution and pregnancy rate in women who underwent IVF.

Science.gov (United States)

Choe, S A; Jun, Y B; Lee, W S; Yoon, T K; Kim, S Y

2018-04-05

Are the concentrations of five criteria air pollutants associated with probabilities of biochemical pregnancy loss and intrauterine pregnancy in women? Increased concentrations of ambient particulate matter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO) during controlled ovarian stimulation (COS) and after embryo transfer were associated with a decreased probability of intrauterine pregnancy. Exposure to high ambient air pollution was suggested to be associated with low fertility and high early pregnancy loss in women. Using a retrospective cohort study design, we analysed 6621 cycles of 4581 patients who underwent one or more fresh IVF cycles at a fertility centre from January 2006 to December 2014, and lived in Seoul at the time of IVF treatment. To estimate patients' individual exposure to air pollution, we computed averages of hourly concentrations of five air pollutants including PM10, NO2, CO, sulphur dioxide (SO2) and ozone (O3) measured at 40 regulatory monitoring sites in Seoul for each of the four exposure periods: period 1 (start of COS to oocyte retrieval), period 2 (oocyte retrieval to embryo transfer), period 3 (embryo transfer to hCG test), and period 4 (start of COS to hCG test). Hazard ratios (HRs) from the time-varying Cox-proportional hazards model were used to estimate probabilities of biochemical pregnancy loss and intrauterine pregnancy for an interquartile range (IQR) increase in each air pollutant concentration during each period, after adjusting for individual characteristics. We tested the robustness of the result using generalised linear mixed model, accounting for within-woman correlation. Mean age of the women was 35 years. Average BMI was 20.9 kg/m2 and the study population underwent 1.4 IVF cycles on average. Cumulative pregnancy rate in multiple IVF cycles was 51.3% per person. Survival analysis showed that air pollution during periods 1 and 3 was generally associated with IVF outcomes. Increased NO2 (adjusted HR = 0.93, 95% CI

The value of creatine kinase, estradiol and progesterone levels in early diagnosis of ectopic pregnancies: a prospective controlled study

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Feride Mimaroğlu

2010-06-01

Full Text Available INTRODUCTION: To evaluate the role of serum creatine kinase, progesterone and estradiol as a biochemical marker in the early diagnosis of tubal pregnancy. MATERIAL-METHODS: A prospective controlled study was carried out on 44 women with first trimester pregnancy. First group (n=22 with tubal pregnancy formed the study group and second group (n=22 with normal intrauterine pregnancy was taken as controls. Serum beta hCG, creatine kinase, progesterone and estradiol levels in the two groups were compared. Surgical treatment had choosen as a treatment modality of ectopic pregnancy. RESULTS: The optimal cutoff value of creatine kinase to be used for the prediction of ectopic pregnancy was 45 IU/l, which resulted in a sensitivity of 86%, specificity of 31%, positive predictive value 55 % and negative predictive value 70 %. The same values for estradiol and progesterone were detected >225 pg/ml, 100 %, 68 %, 75%, 100 % and >13 ng/mL, 95 %, 81 %, % 84, % 97 in discriminating ectopic pregnancies. According to AUC levels there was a significant difference between estradiol-creatine kinase levels, progesterone-estradiol levels and progesterone–creatin kinase levels (p values 0.024, 0.0082, and 0.0001, respectively. CONCLUSION: Serum creatine kinase values appear to be a useful marker in the diagnosis of ectopic pregnancy.

A follow-up study of environmental and biologic determinants of fertility among 430 Danish first-pregnancy planners

DEFF Research Database (Denmark)

Bonde, J P; Hjollund, N H; Jensen, T K

1998-01-01

This paper presents design and methods of a follow-up study of fecundability (defined as the probability of conception during one menstrual cycle) in first-pregnancy planners. We recruited 430 couples by postal letter among 52,255 members of four trade unions. Couples without earlier reproductive......-18%). Among all conceptions the proportion of early embryonal loss was 17% (95% CI 12-22%). This study demonstrates the feasibility of a prospective study of fertility and that the established study base can provide useful information on environmental risk to subfertility.......This paper presents design and methods of a follow-up study of fecundability (defined as the probability of conception during one menstrual cycle) in first-pregnancy planners. We recruited 430 couples by postal letter among 52,255 members of four trade unions. Couples without earlier reproductive...

Establishment and maintenance of donkey-in-mule pregnancy after embryo transfer in a non-cycling mule treated with oestradiol benzoate and long-acting progesterone

Energy Technology Data Exchange (ETDEWEB)

Bottrel, M.; Fortes, T.; Ortiz, I.; Hidalgo, M.; Dorado, J.

2017-07-01

Female mules are considered as infertile; however, they could be used as recipients in interspecific embryo transfer. This study reports for the first time how it is possible to obtain the birth of a live Andalusian donkey foal after transfer a donkey embryo to a non-cycling mule. Two non-cycling mules were used as recipients, oestradiol benzoate was administered when donors showed oestrus and long-acting progesterone after ovulation. The mules also received long-acting progesterone every 7 days until 120 days of gestation. One embryo was collected from the two donor jennies and transferred to one of the mules after 5 days of progesterone treatment. Pregnancy was established and maintained after embryo transfer. The pregnant mule carried to term and delivered a live donkey foal after 375 days of pregnancy. In conclusion, non-cycling mules treated with oestradiol benzoate and long-acting progesterone can be successfully used as recipients of donkey embryos, which open new ways for the conservation of endangered donkey species.

Establishment and maintenance of donkey-in-mule pregnancy after embryo transfer in a non-cycling mule treated with oestradiol benzoate and long-acting progesterone

International Nuclear Information System (INIS)

Bottrel, M.; Fortes, T.; Ortiz, I.; Hidalgo, M.; Dorado, J.

2017-01-01

Female mules are considered as infertile; however, they could be used as recipients in interspecific embryo transfer. This study reports for the first time how it is possible to obtain the birth of a live Andalusian donkey foal after transfer a donkey embryo to a non-cycling mule. Two non-cycling mules were used as recipients, oestradiol benzoate was administered when donors showed oestrus and long-acting progesterone after ovulation. The mules also received long-acting progesterone every 7 days until 120 days of gestation. One embryo was collected from the two donor jennies and transferred to one of the mules after 5 days of progesterone treatment. Pregnancy was established and maintained after embryo transfer. The pregnant mule carried to term and delivered a live donkey foal after 375 days of pregnancy. In conclusion, non-cycling mules treated with oestradiol benzoate and long-acting progesterone can be successfully used as recipients of donkey embryos, which open new ways for the conservation of endangered donkey species.

Effect of metformin on early pregnancy loss in women with polycystic ovary syndrome

OpenAIRE

Al-Biate, Mawahib A.S.

2015-01-01

Objective: To evaluate the effectiveness of metformin therapy in reducing early pregnancy loss in pregnant women with polycystic ovary syndrome (PCOS). Materials and methods: This is a prospective cohort study conducted in the Obstetric Department of the Gulf Medical College Hospital in Ajman, UAE, for a period of 3 years. This study involved 106 nondiabetic pregnant women with PCOS who became pregnant while using metformin. They were divided into two groups, namely, the group that receive...

Maternal plasma concentrations of beta-lipotrophin, beta-endorphin and gamma-lipotrophin throughout pregnancy.

Science.gov (United States)

Browning, A J; Butt, W R; Lynch, S S; Shakespear, R A

1983-12-01

Plasma beta-LPH, beta-EP and gamma-LPH concentrations were measured by radioimmunoassay in 10 pregnant women from 12 weeks gestation until term and in nine women in the early follicular phase of the cycle. There was a progressive and significant rise in the concentration of all three peptides throughout pregnancy and by 32 weeks the concentrations of beta-LPH and beta-EP were greater than the corresponding concentrations in the follicular phase: gamma-LPH was greater than in the follicular phase by the end of pregnancy in those women who were delivered after 40 weeks. The ratio of beta-LPH to gamma-LPH did not change significantly throughout pregnancy, but there was a progressive fall in the beta-LPH/beta-EP ratio. The possible presence of a 'big LPH' to explain this finding is discussed.

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...

TryCYCLE: A Prospective Study of the Safety and Feasibility of Early In-Bed Cycling in Mechanically Ventilated Patients.

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Michelle E Kho

Full Text Available The objective of this study was to assess the safety and feasibility of in-bed cycling started within the first 4 days of mechanical ventilation (MV to inform a future randomized clinical trial.We conducted a 33-patient prospective cohort study in a 21-bed adult academic medical-surgical intensive care unit (ICU in Hamilton, ON, Canada. We included adult patients (≥ 18 years receiving MV who walked independently pre-ICU. Our intervention was 30 minutes of in-bed supine cycling 6 days/week in the ICU. Our primary outcome was Safety (termination, measured as events prompting cycling termination; secondary Safety (disconnection or dislodgement outcomes included catheter/tube dislodgements. Feasibility was measured as consent rate and fidelity to intervention. For our primary outcome, we calculated the binary proportion and 95% confidence interval (CI.From 10/2013-8/2014, we obtained consent from 34 of 37 patients approached (91.9%, 33 of whom received in-bed cycling. Of those who cycled, 16(48.4% were female, the mean (SD age was 65.8(12.2 years, and APACHE II score was 24.3(6.7; 29(87.9% had medical admitting diagnoses. Cycling termination was infrequent (2.0%, 95% CI: 0.8%-4.9% and no device dislodgements occurred. Cycling began a median [IQR] of 3 [2, 4] days after ICU admission; patients received 5 [3, 8] cycling sessions with a median duration of 30.7 [21.6, 30.8] minutes per session. During 205 total cycling sessions, patients were receiving invasive MV (150 [73.1%], vasopressors (6 [2.9%], sedative or analgesic infusions (77 [37.6%] and dialysis (4 [2.0%].Early cycling within the first 4 days of MV among hemodynamically stable patients is safe and feasible. Research to evaluate the effect of early cycling on patient function is warranted.Clinicaltrials.gov: NCT01885442.

Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation r study

NARCIS (Netherlands)

G. Bai (Guannan); I.J. Korfage (Ida); E.H.D. Hafkamp-De Groen (Esther); V.W.V. Jaddoe (Vincent); Mautner, E. (Eva); H. Raat (Hein)

2016-01-01

textabstractThe objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early

Effect of endometrial biopsy on intrauterine insemination outcome in controlled ovarian stimulation cycle.

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Wadhwa, Leena; Pritam, Amrita; Gupta, Taru; Gupta, Sangeeta; Arora, Sarika; Chandoke, Rajkumar

2015-01-01

The objective was to evaluate the effect of endometrial biopsy (EB) on intrauterine insemination (IUI) outcome in controlled ovarian stimulation (COS) cycle. Prospective randomized control study. Tertiary care center. A total of 251 subjects were enrolled in the study. Subjects undergoing COS with IUI were randomly allocated into three groups. Group A: EB was taken between D19 and 24 of the spontaneous menstrual cycles that precedes the fertility treatment and IUI, which was done in next cycle (n = 86). Group B: EB was taken before D6 of the menstrual cycle, and fertility treatment and IUI was done in the same cycle (n = 90). Group C: (control group) no EB in previous 3 cycle (n = 75). Clinical pregnancy rate (CPR). Clinical pregnancy rate was 19.77%, 31.11%, and 9.3% for Group A, Group B, and Group C, respectively. The results show a highly significant value for the paired t-test of intervention Group B and control Group C of the cases (P = 0.000957). CPR was maximum after first cycle of ovulation induction and IUI following EB scratch in both Groups A and in Group B (P Endometrial biopsy done in early follicular phase in the same cycle of stimulation with IUI gives better CPR as compared with EB done in the luteal phase of the previous cycle.

Effects of transfer of embryos independently cultured in essential and sequential culture media on pregnancy rates in assisted reproduction cycles.

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Geber, Selmo; Bossi, Renata; Guimarães, Fernando; Valle, Marcello; Sampaio, Marcos

2012-10-01

Several culture media are available to be used in ART. However it is uncertain whether embryos would preferably benefit from one type of medium or the association of different media. We performed this study to evaluate the impact of simultaneous transfer of embryos independently cultured in two distinct culture media, on pregnancy outcome. A total of 722 couples who underwent infertility treatment were sequentially allocated into three groups: those who had half of the embryos individually cultured in MEM and the other half cultured in sequential media (MEM + Seq Group) (n = 243); those who had all embryos cultured only in sequential medium (Seq Group) (n = 239); and those who had all embryos cultured only in MEM (MEM Group) (n = 240). The pregnancy rate was higher in the MEM + Seq group (51.8 %) than the Seq group (36.7 %) (p < 0.001). However the pregnancy rate observed in the MEM group was similar to the others (44.2 %). When a logistic regression test was applied it demonstrated that the number of transferred embryos did not interfere in the pregnancy rates. Our results suggests that offering different culture conditions for sibling embryos with subsequent transfer of embryos that were kept in distinct culture media, might increase pregnancy rates in assisted reproduction cycles.

Prediabetes in pregnancy, can early intervention improve outcomes? A feasibility study for a parallel randomised clinical trial.

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Hughes, Ruth C E; Rowan, Janet; Williman, Jonathan

2018-03-03

Measurement of glycated haemoglobin (HbA1c) in early pregnancy is routine in New Zealand to identify women with diabetes and prediabetes. However, the benefit of early intervention in women with prediabetes is inconclusive. Our aim was to test the feasibility of a two-arm parallel randomised controlled trial of standard care versus early intervention in pregnancies complicated by prediabetes. Two tertiary referral centres in New Zealand. Women measured at booking, without pre-existing diabetes. Randomisation was done by remote web-based allocation into one of two groups. Women in the early intervention group attended an antenatal diabetes clinic, commenced daily home blood glucose monitoring, and medication was prescribed if lifestyle measures failed to maintain target blood glucose levels. Controls received lifestyle education, continued standard care with their midwife and/or obstetrician, and were asked to perform a 75 g oral glucose tolerance test at 24 weeks' gestation with a referral to clinic if this test was positive. Both groups received lifestyle questionnaires at recruitment and in late pregnancy. Recruitment rate, adherence to protocol and validation of potential primary outcomes. Recruitment rates were lower than expected, especially in Māori and Pacific women. Non-adherence to allocated treatment protocol was significant, 42% (95% CI 24% to 61%) in the early intervention group and 30% (95% CI 16% to 51%) in controls. Caesarean section and pre-eclampsia were signalled as potential primary outcomes, due to both the high observed incidence in the control group and ease of measurement. For a future definitive trial, extending the gestation of eligibility and stepped-wedge cluster randomisation may overcome the identified feasibility issues. Consistent with published observational data, pre-eclampsia and emergency caesarean section could be included as primary outcome measures, both of which have a significant impact on maternal and neonatal morbidity and

Risk of Vaginal Infections at Early Gestation in Patients with Diabetic Conditions during Pregnancy: A Retrospective Cohort Study.

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Julian Marschalek

Full Text Available Pregnant women with gestational diabetes mellitus (GDM are reported to be at increased risk for infections of the genital tract. This study aimed to compare the prevalence of asymptomatic bacterial vaginosis (BV and Candida colonization at early gestation between pregnant women with and without diabetic conditions during pregnancy. We included data from 8, 486 singleton pregnancies that underwent an antenatal infection screen-and-treat programme at our department. All women with GDM or pre-existing diabetes were retrospectively assigned to the diabetic group (DIAB, whereas non-diabetic women served as controls (CON. Prevalence for BV and Candida colonization was 9% and 14% in the DIAB group, and 9% and 13% in the CON group, respectively (n.s.. No significant difference regarding stillbirth and preterm delivery (PTD, defined as a delivery earlier than 37 + 0 (37 weeks plus 0 days weeks of gestation was found. We could not find an increased risk of colonization with vaginal pathogens at early gestation in pregnant women with diabetes, compared to non-diabetic women. Large prospective studies are needed to evaluate the long-term risk of colonization with vaginal pathogens during the course of pregnancy in these women.

Pregnancy Loss and Miscarriage

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... Bulletins-Gynecology/Early-Pregnancy-Loss What are common symptoms? Causes and Risks How is it diagnosed? Is there a way to prevent? Related A-Z Topics High-Risk Pregnancy Polycystic Ovary Syndrome (PCOS) Stillbirth NICHD News Spotlights Release: Anti-HIV ...

Repertoire of noncoding RNAs in corpus luteum of early pregnancy in buffalo (Bubalus bubalis

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A. Jerome

2017-09-01

Full Text Available Aim: The present study was designed to identify other noncoding RNAs (ncRNAs in the corpus luteum (CL during early pregnancy in buffalo. Materials and Methods: For this study, CL (n=2 from two buffalo gravid uteri, obtained from the slaughter house, was transported to laboratory after snap freezing in liquid nitrogen (-196°C. The stage of pregnancy was determined by measuring the crown-rump region of the fetus. This was followed by isolation of RNA and deep sequencing. Post-deep sequencing, the obtained reads were checked and aligned against various ncRNA databases (GtRNA, RFAM, and deep guide. Various parameters, namely, frequency of specific ncRNAs, length, mismatch, and genomic location target in several model species were deciphered. Results: Frequency of piwi-interacting RNAs (piwi-RNAs, having target location in rodents and human genomes, were significantly higher compared to other piwi-RNAs and ncRNAs. Ribosomal RNAs (rRNAs deduced had nucleotides (nts ranging from 17 to 50 nts, but the occurrence of small length rRNAs was more than lengthier fragments. The target on 16S rRNA species confirms the conservation of 16S rRNA across species. With respect to transfer RNA (tRNA, the abundantly occurring tRNAs were unique with no duplication. Small nucleolar RNAs (snoRNAs, identified in this study, showed a strong tendency for coding box C/D snoRNAs in comparison to H/ACA snoRNAs. Regulatory and evolutionary implications of these identified ncRNAs are yet to be delineated in many species, including buffaloes. Conclusion: This is the first report of identification of other ncRNAs in CL of early pregnancy in buffalo.

Effects of triploidy incidence on clinical outcomes for IVF-ET cycles in different ovarian stimulation protocols.

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Li, Mingzhao; Xue, Xia; Zhang, Silin; Li, Wei; Zhao, Xiaoli; Ren, Wenjuan; Shi, Juanzi

2015-10-01

To discuss the relationship between triploidy incidence and clinical outcomes of embryos derived from normally fertilized oocytes from the same cohort for in vitro fertilization-embryo transfer (IVF-ET) cycles in different ovarian stimulation protocol. This study included 2070 in vitro fertilization (IVF) cycles with long-term protocol, 802 IVF cycles with ultra short-term protocol and 508 IVF-D (in vitro fertilization by donor semen) cycles with long-term protocol from January 2013 to September 2014. According to the different 3PN rate, patients were divided into three groups as follows: Group 1 included patients with 0% 3PN zygotes, Group 2 included patients with 1-25% 3PN zygotes and Group 3 included patients with >25% 3PN zygotes. female age, no. of retrieved oocytes, normal fertilization rate, day-3 grade I + II embryos rate, day-3 grade I + II + III embryos rate, implantation rate, pregnancy rate and early abortion rate. Triploidy cycle incidence rate in IVF and IVF-D cycles with long-term protocol were significantly higher than in IVF cycles with ultra short-term protocol (p  0.05). In three protocols, normal fertilization rate in 3PN = 0% and 3PN = 1-25% groups were significantly higher compared to 3PN > 25% group (p cycles with long-term protocol, the day-3 grade I + II embryos, implantation and pregnancy rate in 3PN > 25% group were significantly lower than other two groups (p  0.05). In IVF cycles with ultra short-term protocol, there were no significant differences found in day-3 grade I + II embryos, day-3 grade I + II + III embryos, implantation, pregnancy and early abortion rate (p > 0.05). In IVF-D cycles with long-term protocol, the day-3 grade I + II embryos, day-3 grade I + II + III embryos and implantation rate in 3PN > 25% group were significantly lower than other two groups (p  0.05). We observed that high proportion of triploid zygotes made a negative effect on

Mexican adolescents’ goals as determinants in the prevention of early pregnancies

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Erika E Atienzo

2014-05-01

Full Text Available Objective. This study aims to explore adolescents’ intentions related to the early formation of a family. Materials and methods. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974. Results. Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents’ expectations for their child’s education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13. Conclusions. In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

Cancer in pregnancy

DEFF Research Database (Denmark)

Han, Sileny N; Kesic, Vesna I; Van Calsteren, Kristel

2013-01-01

OBJECTIVE: To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy. STUDY DESIGN: A 30-item questionnaire was mailed electronically to physicians across Europe, who were potentially involved in care of pregnant patients and....../or cancer, using the membership directories of different professional societies. RESULTS: 142 surveys were eligible for analysis. A median of 2 (range 0-100) patients with cancer in pregnancy were treated per center in 2010. The vast majority of respondents (94%) agreed that management of pregnant patients...... with cancer should be decided by a multidisciplinary team. When cancer is diagnosed in the first or early second trimester of pregnancy, 44% of respondents prefer termination of pregnancy: if the patient wishes to preserve the pregnancy, 77% consider deliberate delay and treatment later in pregnancy. When...

Validation of a food frequency questionnaire for Japanese pregnant women with and without nausea and vomiting in early pregnancy.

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Ogawa, Kohei; Jwa, Seung-Chik; Kobayashi, Minatsu; Morisaki, Naho; Sago, Haruhiko; Fujiwara, Takeo

2017-05-01

No previous study has shown the validity of a food frequency questionnaire (FFQ) in early pregnancy with consideration of nausea and vomiting during pregnancy (NVP). The aim of this study was to evaluate the validity of a FFQ in early pregnancy for Japanese pregnant women. We included 188 women before 15 weeks of gestation and compared estimated nutrient intake and food group intake based on a modified FFQ with that based on 3-day dietary records (DRs). Spearman's rank correlation coefficients, adjusting energy intake and attenuating within-person error, were calculated. Subgroup analysis for those with and without NVP was conducted. We also examined the degree of appropriate classification across categories between FFQ and DRs through division of consumption of nutrients and food groups into quintiles. Crude Spearman's correlation coefficients of nutrients ranged from 0.098 (sodium) to 0.401 (vitamin C), and all of the 36 nutrients were statistically significant. In 27 food groups, correlation coefficients ranged from -0.015 (alcohol) to 0.572 (yogurt), and 81% were statistically significant. In subgroup analysis, correlation coefficients in 89% of nutrients and 70% of food groups in women with NVP and 97% of nutrients and 74% of food groups in women without NVP were statistically significant. On average, 63.7% of nutrients and 60.4% of food groups were classified into same or adjacent quintiles according to the FFQ and DRs. The FFQ is a useful instrument, regardless of NVP, for assessing the diet of women in early pregnancy in Japan. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Pregnancy outcome in women with endometriosis achieving pregnancy with IVF.

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Benaglia, Laura; Candotti, Giorgio; Papaleo, Enrico; Pagliardini, Luca; Leonardi, Marta; Reschini, Marco; Quaranta, Lavinia; Munaretto, Maria; Viganò, Paola; Candiani, Massimo; Vercellini, Paolo; Somigliana, Edgardo

2016-12-01

Are women with endometriosis who conceive with IVF at increased risk of preterm birth? Women with endometriosis who conceive with IVF do not face an increased risk of preterm birth. The eutopic endometrium of women with endometriosis has been repeatedly shown to present molecular and cellular alterations. On this basis, it has been hypothesized that pregnancy outcome may be altered in affected women. However, to date, available evidence from epidemiological studies is scanty and conflicting. Data tended to be partly consistent only for an increased risk of preterm birth and placenta previa. Retrospective matched case-control study of women achieving an IVF singleton pregnancy progressing beyond 12 weeks' gestation. Women achieving IVF singleton pregnancies that progressed beyond 12 weeks' gestation at two infertility units were reviewed. Cases were women with a history of surgery for endometriosis and/or with a sonographic diagnosis of the disease at the time of the IVF cycle. Controls were women without current or past evidence of endometriosis who were matched to cases by age (± 6 months), type of cycle (fresh or frozen cycle) and study period. Male factor and unexplained infertility were the most common diagnoses in the control group. Two hundred and thirty-nine women with endometriosis and 239 controls were selected. The main outcome of the study was the rate of preterm birth (birth IVF pregnancies only, and specific data from properly designed studies are required to support any inference for natural pregnancies. The results of our study suggest that women with endometriosis conceiving with IVF can be reassured regarding the risk of preterm birth. The observed association with placenta previa requires further investigation and may open a new avenue of research. No external funding was used for this study. None of the authors have any conflict of interest to declare. © The Author 2016. Published by Oxford University Press on behalf of the European Society

Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia.

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Kattah, Andrea; Milic, Natasa; White, Wendy; Garovic, Vesna

2017-10-01

We performed a prospective, longitudinal study of pregnant women presenting to their first obstetrics visits to characterize the changes in spot urine protein-to-creatinine (UPCR) and albumin-to-creatinine ratios (UACR) in normotensive pregnancies, as well as identify clinical characteristics associated with isolated proteinuria and preeclampsia. We measured spot urinary albumin, protein, and creatinine at the first prenatal visit, end of the second trimester, and at delivery. In the normotensive pregnancies ( n = 142), we found that from the beginning of pregnancy to delivery, UACR increased by a median [interquartile range (IQR)] of 14.7 mg/g Cr (3.74-51.8) and UPCR by 60 mg/g Cr (30-130) ( P 300 mg/g Cr in the absence of hypertension) was identified in 19/142 (13.4%) normotensive pregnancies. Increases in systolic and diastolic blood pressure from early pregnancy to delivery and increases in UACR from early to midpregnancy were associated with isolated proteinuria at delivery. Twelve women developed preeclampsia. Nulliparity, early, and midpregnancy diastolic blood pressures were strongly associated with the development of preeclampsia, but early changes in UACR were not. In conclusion, women who develop isolated proteinuria at delivery have a larger increase in blood pressure than women without proteinuria and have a "microalbuminuric" phase earlier in gestation, unlike women who develop preeclampsia. These findings suggest a different mechanism of urine protein excretion in women with isolated proteinuria as compared with women with preeclampsia, where proteinuria has a more abrupt onset. Copyright © 2017 the American Physiological Society.

Report of a Case of Primary Abdominal Pregnancy

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Sh Beigi

2006-01-01

Full Text Available Ectopic pregnancy (EP is a potentially life-threatening condition in which the embryo implants outside the uterine endometrial cavity. Abdominal pregnancy is an atypical site wherein the product of conception lies totally outside the reproductive tract. Primary abdominal pregnancy is a very rare condition with a high mortality rate. Diagnosis is often late or misdiagnosed. The aim of introducing this case report is to present a new case of early primary abdominal pregnancy. Despite regular menstrual bleeding and contraception with IUD (intrauterine device, this pregnancy occurred in a 24-year old woman. Emergency laparotomy was performed because of abdominal pain, unstable condition and positive urine pregnancy test. It revealed more than 1500 ml of blood in the abdominal cavity. The uterus, both fallopian tubes and ovaries were completely intact. A 3X4 cm mass lateral to the left utersacral ligament was observed and resected. Since IUD strings could not be identified, endometrial currettage was performed and then the IUD was removed. Histological report of the mass and tissue of uterine cavity was placental villi and secretory endometrium, respectively, which according to Studdifords criteria is a new case of early primary abdominal pregnancy. To reduce maternal mortality and morbidity, early recognition of ectopic pregnancy is critical. According to review of the literature and the case report, a high index of suspicion is vital for the early diagnosis of ectopic pregnancy because the signs and symptoms of EP overlap with many surgical and gynecologic conditions. With early diagnosis of EP, we can suggest many therapeutic options and also retain fertility (if desired by patient, while minimizing disease and treatment-related morbidity.

Ruptured Ectopic Pregnancy

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Valentina Park

2016-09-01

Full Text Available History of present illness: A 21-year-old female presented with sudden onset suprapubic abdominal pain associated with dysuria. The patient also experienced near syncope during bowel movements three times three days ago without falling or losing consciousness. She denied fever, nausea, and vomiting. She stated that she was five weeks pregnant by last menstrual period. She had an ultrasound a few weeks before that showed no intrauterine pregnancy, but she had not followed up for additional testing. Significant findings: The patient’s serum beta-hCG was 5,637 mIU/mL. The transvaginal ultrasound showed an empty uterus with free fluid posteriorly in the pelvis and Pouch of Douglas (00:00. A 4.5 cm heterogeneous mass was visible in the left adnexa concerning for an ectopic pregnancy (00:10. Discussion: Ectopic pregnancies are a leading cause of maternal morbidity and mortality, as well as decreased fertility.1,2 Differentiating between an ectopic pregnancy and a normal early pregnancy may be difficult, since ultrasound and quantitative beta-hCG may show inconclusive results.3,4 Patients who have used fertility treatment may further complicate the picture because they are at risk for heterotypic pregnancies.5 Ectopic pregnancies most commonly implant in the fallopian tube, but may alternatively implant in the ovary, cervix, abdomen, or uterine cornua.4 Ultrasonography may show an empty uterus, adnexal mass, pelvic free fluid, or an extra-uterine gestational sac, yolk sac, and/or embryo.6 Treatment options for ectopic pregnancy include surgery or methotrexate.2,4 Some patients may be candidates for close outpatient surveillance if the diagnosis is unclear or in very limited cases for early, non-ruptured ectopic pregnancies.2,4

Like father, like son: the intergenerational cycle of adolescent fatherhood.

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Sipsma, Heather; Biello, Katie Brooks; Cole-Lewis, Heather; Kershaw, Trace

2010-03-01

Strong evidence exists to support an intergenerational cycle of adolescent fatherhood, yet such a cycle has not been studied. We examined whether paternal adolescent fatherhood (i.e., father of study participant was age 19 years or younger when his first child was born) and other factors derived from the ecological systems theory predicted participant adolescent fatherhood. Data included 1496 young males who were interviewed annually from the National Longitudinal Survey of Youth 1997. Cox regression survival analysis was used to determine the effect of paternal adolescent fatherhood on participant adolescent fatherhood. Sons of adolescent fathers were 1.8 times more likely to become adolescent fathers than were sons of older fathers, after other risk factors were accounted for. Additionally, factors from each ecological domain-individual (delinquency), family (maternal education), peer (early adolescent dating), and environment (race/ethnicity, physical risk environment)-were independent predictors of adolescent fatherhood. These findings support the need for pregnancy prevention interventions specifically designed for young males who may be at high risk for continuing this cycle. Interventions that address multiple levels of risk will likely be most successful at reducing pregnancies among partners of young men.

Early postnatal treatment with clomipramine induces female sexual behavior and estrous cycle impairment.

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Molina-Jiménez, Tania; Limón-Morales, Ofelia; Bonilla-Jaime, Herlinda

2018-03-01

Administration of clomipramine (CMI), a tricyclic antidepressant, in early stages of development in rats, is considered an animal model for the study of depression. This pharmacological manipulation has induced behavioral and physiological alterations, i.e., less pleasure-seeking behaviors, despair, hyperactivity, cognitive dysfunction, alterations in neurotransmitter systems and in HPA axis. These abnormalities in adult male rats are similar to the symptoms observed in major depressive disorders. One of the main pleasure-seeking behaviors affected in male rats treated with CMI is sexual behavior. However, to date, no effects of early postnatal CMI treatment have been reported on female reproductive cyclicity and sexual behavior. Therefore, we explored CMI administration in early life (8-21 PN) on the estrous cycle and sexual behavior of adult female rats. Compared to the rats in the early postnatal saline treatment (CTRL group), the CMI rats had fewer estrous cycles, fewer days in the estrous stage, and longer cycles during a 20-day period of vaginal cytology analysis. On the behavioral test, the CMI rats displayed fewer proceptive behaviors (hopping, darting) and had lower lordosis quotients. Also, they usually failed to display lordosis and only rarely manifested marginal or normal lordosis. In contrast, the CTRL rats tended to display normal lordosis. These results suggest that early postnatal CMI treatment caused long-term disruptions of the estrous cycle and female sexual behavior, perhaps by alteration in the hypothalamic-pituitary-gonadal (HPG) axes and in neuronal circuits involved in the regulation of the performance and motivational of sexual behavior as the noradrenergic and serotonergic systems. Copyright © 2018 Elsevier Inc. All rights reserved.

Poor response cycles: when should we cancel? Comparison of outcome between egg collection, intrauterine insemination conversion, and follow-up cycles after abandonment.

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Nicopoullos, James D M; Abdalla, Hossam

2011-01-01

To determine optimal management with one or two mature follicles after stimulation. Retrospective analysis. Lister fertility clinic. A total of 1,350 IVF/intracytoplasmic sperm injection cycles (7.3% of total) during 1998-2009 were found to have one or two mature follicles. Group 1 (n = 807) comprised those who proceeded to vaginal egg collection (VEC) (59.8%; outcome per egg collection), group 2 (n=248) those who converted to IUI (18.4%; outcome per insemination) and group 3 (n=259) those who abandoned the current cycle (21.9%; outcome per abandoned cycle in first subsequent cycle). Live birth rate, clinical pregnancy rate, and biochemical pregnancy rate. Biochemical pregnancy rates of 13.1%, 4.9%, and 9.7%, clinical pregnancy rates of 8.1%, 3.6%, and 7.2%, and ongoing pregnancy rates of 6.8%, 2.0%, and 5.5% were achieved in groups 1, 2, and 3, respectively. All pregnancy outcomes were significantly higher after VEC (group 1) than for those converted to IUI (group 2), and all pregnancy outcomes were higher with borderline significance in group 3 vs. group 2. There was no significant difference in outcome between groups 1 and 3. Our data suggest that for such poor responders, proceeding to VEC may represent their best chance of successful outcome. Conversion to IUI offers the poorest outcome, and despite the potential for improvements in cycle protocol, abandoning and a further attempt does not improve outcome (using abandoned cycle as the denominator). Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

How Should Clinicians Counsel a Woman with a Strong Family History of Early-Onset Alzheimer's Disease about Her Pregnancy?

Science.gov (United States)

Mapes, Marianna V; O'Brien, Barbara M; King, Louise P

2017-07-01

Counseling patients regarding the benefits, harms, and dilemmas of genetic testing is one of the greatest ethical challenges facing reproductive medicine today. With or without test results, clinicians grapple with how to communicate potential genetic risks as patients weigh their reproductive options. Here, we consider a case of a woman with a strong family history of early-onset Alzheimer's disease (EOAD). She is early in her pregnancy and unsure about learning her own genetic status. We address the ethical ramifications of each of her options, which include genetic testing, genetic counseling, and termination versus continuation of the pregnancy. Our analysis foregrounds clinicians' role in helping to ensure autonomous decision making as the patient reflects on these clinical options in light of her goals and values. © 2017 American Medical Association. All Rights Reserved.

Sleep disordered breathing in pregnancy

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Bilgay Izci Balserak

2015-12-01

Sleep disordered breathing (SDB is very common during pregnancy, and is most likely explained by hormonal, physiological and physical changes. Maternal obesity, one of the major risk factors for SDB, together with physiological changes in pregnancy may predispose women to develop SDB. SDB has been associated with poor maternal and fetal outcomes. Thus, early identification, diagnosis and treatment of SDB are important in pregnancy. This article reviews the pregnancy-related changes affecting the severity of SDB, the epidemiology and the risk factors of SDB in pregnancy, the association of SDB with adverse pregnancy outcomes, and screening and management options specific for this population.

The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on behaviour in 5-year-old children: a prospective cohort study on 1628 children

DEFF Research Database (Denmark)

Skogerbø, Åshild; Kesmodel, Ulrik Schiøler; Denny, Clark

2013-01-01

To examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on behaviour in children at the age of 5 years.......To examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on behaviour in children at the age of 5 years....

Retrospective cohort study of the effects of obesity in early pregnancy on maternal weight gain and obstetric outcomes in an obstetric population in Africa

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Iyoke CA

2013-08-01

Full Text Available Chukwuemeka A Iyoke,1 George O Ugwu,1 Frank O Ezugwu,2 Osaheni L Lawani,3 Azubuike K Onyebuchi31Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, 2Departments of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Enugu, 3Departments of Obstetrics and Gynaecology, Federal Medical Centre, Abakaliki, Ebonyi State, NigeriaObjective: The purpose of this study was to compare maternal weight gain in pregnancy and obstetric outcomes between women with obesity in early pregnancy and those with a normal body mass index (BMI in early pregnancy.Methods: This was a retrospective cohort study of women with obesity in early pregnancy and those with a normal BMI who were seen at three teaching hospitals in South-East Nigeria. Statistical analysis was performed using Statistical Package for the Social Sciences version 17.0 software, with descriptive and inferential statistics at the 95% level of confidence.Results: The study sample consisted of 648 women (324 obese and 324 healthy-weight. The mean age of the obese women was 26.7 ± 5.1 years and that of the healthy-weight women was 26.6 ± 4.9 years. Although both excessive weight gain (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.23–0.54 and inadequate weight gain (OR 0.08, 95% CI 0.04–0.15 were less common in women with early pregnancy obesity than in healthy-weight women, a significantly higher proportion of obese women with excessive weight gain had adverse fetomaternal outcomes. Also, a significantly higher proportion of obese women had specific complications, such as premature rupture of membranes (OR 2.36, 95% CI 1.12–5.04, gestational hypertension/pre-eclampsia (OR 2.31, 95% CI 1.12–5.04, antepartum hemorrhage (OR 2.78, 95% CI 1.02–7.93, gestational diabetes (OR 4.24, 95% CI 1.62–11.74, cesarean delivery (OR 2.3, 95% CI 1.2–5.44, macrosomia (OR 4.08, 95% CI 1.06–8.41, severe birth asphyxia (OR 2.8, 95% CI 1.2–6

Early Evolution of Earth's Geochemical Cycle and Biosphere: Implications for Mars Exobiology

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DesMarais, David J.; Chang, Sherwood (Technical Monitor)

1997-01-01

Carbon (C) has played multiple key roles for life and its environment. C has formed organics, greenhouse gases, aquatic pH buffers, redox buffers, and magmatic constituents affecting plutonism and volcanism. These roles interacted across a network of reservoirs and processes known as the biogeochemical C cycle. Changes in the cycle over geologic time were driven by increasing solar luminosity, declining planetary heat flow, and continental and biological evolution. The early Archean C cycle was dominated by hydrothermal alteration of crustal rocks and by thermal emanations of CO2 and reduced species (eg., H2, Fe(2+) and sulfides). Bioorganic synthesis was achieved by nonphotosynthetic CO2-fixing bacteria (chemoautotrophs) and, possibly, bacteria (organotrophs) utilizing any available nonbiological organic C. Responding both to abundant solar energy and to a longterm decline in thermal sources of chemical energy and reducing power, the blaspheme first developed anoxygenic photosynthesis, then, ultimately, oxygenic photosynthesis. O2-photosynthesis played a central role in transforming the ancient environment and blaspheme to the modem world. The geochemical C cycles of early Earth and Mars were quite similar. The principal differences between the modem C cycles of these planets arose during the later evolution of their heat flows, crusts, atmospheres and, perhaps, their blasphemes.

The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles

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Zhao Jing

2012-11-01

Full Text Available Abstract Background To study the effect of endometrial thickness and pattern measured using ultrasound upon pregnancy outcomes in patients undergoing IVF-ET. Method One thousand nine hundred thirty-three women undergoing IVF treatment participated in the study. We assessed and recorded endometrial patterns and thickness on the day of human chorionic gonadotropin (hCG administration. Receiver operator curves (ROC were used to determine the predictive accuracy of endometrial thickness. Cycles were divided into 3 groups depending on the thickness (group 1: ≤ 7 mm; group 2: > 7 mm to ≤ 14 mm; group 3: > 14 mm. Each group was subdivided into three groups according to the endometrial pattern as follows: pattern A (a triple-line pattern consisting of a central hyperechoic line surround by two hypoechoic layers; pattern B (an intermediate isoechogenic pattern with the same reflectivity as the surrounding myometrium and a poorly defined central echogenic line; and pattern C (homogenous, hyperechogenic endometrium. Clinical outcomes such as implantation and clinical pregnancy rates were analyzed. Results The endometrial thickness predicts pregnancy outcome with high sensitivity and specificity. The cutoff value was 9 mm. The implantation rate and clinical pregnancy rate in group 3 were 39.1% and 63.5%, respectively, which were significantly higher than those in group 2 (33.8% and 52.1%, respectively and group 1 (13% and 25.5%, respectively. Among those with Pattern A, the implantation rate and clinical pregnancy rate were 35.3% and 55.2%, respectively, which were significantly higher than among women with Pattern B (32.1% and 50.9%, respectively and Pattern C (23.4% and 37.4%, respectively. In groups 1 and 3, clinical pregnancy and implantation rates did not show any significant differences between different endometrial patterns (P > 0.05, whereas in group 2, the clinical pregnancy rate and implantation rate in women with pattern A were

Giving offspring a healthy start: parents' experiences of health promotion and lifestyle change during pregnancy and early parenthood

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Edvardsson Kristina

2011-12-01

Full Text Available Abstract Background There are good opportunities in Sweden for health promotion targeting expectant parents and parents of young children, as almost all are reached by antenatal and child health care. In 2005, a multisectoral child health promotion programme (the Salut Programme was launched to further strengthen such efforts. Methods Between June and December 2010 twenty-four in-depth interviews were conducted separately with first-time mothers and fathers when their child had reached 18 months of age. The aim was to explore their experiences of health promotion and lifestyle change during pregnancy and early parenthood. Qualitative manifest and latent content analysis was applied. Results Parents reported undertaking lifestyle changes to secure the health of the fetus during pregnancy, and in early parenthood to create a health-promoting environment for the child. Both women and men portrayed themselves as highly receptive to health messages regarding the effect of their lifestyle on fetal health, and they frequently mentioned risks related to tobacco and alcohol, as well as toxins and infectious agents in specific foods. However, health promotion strategies in pregnancy and early parenthood did not seem to influence parents to make lifestyle change primarily to promote their own health; a healthy lifestyle was simply perceived as 'common knowledge'. Although trust in health care was generally high, both women and men described some resistance to what they saw as preaching, or very directive counselling about healthy living and the lack of a holistic approach from health care providers. They also reported insufficient engagement with fathers in antenatal care and child health care. Conclusion Perceptions about risks to the offspring's health appear to be the primary driving force for lifestyle change during pregnancy and early parenthood. However, as parents' motivation to prioritise their own health per se seems to be low during this period

The transabdominal chorionic villus sampling puncture guided by color Doppler ultrasound during early pregnancy

International Nuclear Information System (INIS)

Liang Weixiang; Chen Zhiyi; Yuan Wenlin; Cai Kuan; Zhu Junlin; Wang Weiqun; Chen Xia

2008-01-01

Objective: To study the operation of chorionic villus sampling (CVS) guided by color Doppler ultrasound (CDU) via abdomen puncture during early pregnancy and investigate the advertences during the operation. Methods: CVS guided by CDU probe via abdomen puncture were operated on 28 pregnant women who had the indications of antenatal diagnosis. CDU was used to observe the implantation position of the fo1iaceous villis and help setting mark of the puncture point and puncture range on body surface before operation. The needle was punctured under real-time ultrasound guidance and villis were aspirated during the operation: The choice of the right time of puncture and the operation skills were emphasized in the study. Results: The CVS puncture approach should be set through CDU ob servation, which attend to avoid the surrounding blood vessels, intestinal canal and surrounding important organs. The puncture point should be chosen in a point where lobif0rmed villis distributed wider and with a larger scope. The operations were performed from 10 to13 weeks of pregnancy, with an average of 11 weeks. Among these 28 cases, 9.6 were successfully drawn materials in one time, 1 in twice and l failure, with the total ratio of achievement was 96.4%. For all the cases, fetal heart pulsating could be seen by real-time CDU observation fight after the operation, and no larger hematoma echo in the placental site occurred. Ultrasound reexamined one week after the operation, fetal heart pulsation could be found in all cases, and no abortion cases occurred after regular follow-up in 25 continued pregnant patients. Conclusion: Abdominal CVS puncture guided by CDU probe is conveniently operated, safe and available in clinic. It is an important method for antenatal diagnosis during early pregnancy. The puncture localization, skills and the time are the key points for the success in obtaining the materials. (authors)

Perceived Financial Satisfaction, Health Related Quality of Life and depressive Symptoms in Early Pregnancy.

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Sahrakorpi, Niina; Koivusalo, Saila B; Eriksson, Johan G; Kautiainen, Hannu; Stach-Lempinen, Beata; Roine, Risto P

2017-07-01

Objectives To assess the associations of perceived financial satisfaction and health-related quality of life (HRQoL) and depressive symptoms in an unselected pregnant population in early pregnancy. Methods 750 consecutive pregnant women attending the first communal ultrasound examination before gestational week 14 were invited to participate. Questionnaires assessing HRQoL (15D), depressive symptoms (Edinburgh Depression Scale, EPDS), medical, obstetric, and socioeconomic status were handed out. The participants were divided into three groups according to their satisfaction with their financial status, (unsatisfied, somewhat satisfied, and satisfied). Main outcome measures were 15D and EPDS-scores and dimensions of HRQoL. Results 325 (43,3%) questionnaires were returned. The mean 15D-score for HRQoL was 0,926 (SD 0,056). The financially unsatisfied women had lower HRQoL than women in more satisfied groups (0.906, 0.923 and 0.931, p = 0.012). The result remained significant, even after adjusting for age and education(p = 0.032). The unsatisfied women had a higher mean body mass index (BMI) (25.4, 24.4 and 23.2 kg/m 2 , p for linearity = 0.002), were more often smokers, (13 vs. 4 and 3%, p = 0.029), and had experienced at least one abortion (18, 14 and 7%, p = 0.017). Dimensions of depression, distress and sleep explained the differences between the groups. 27% of unsatisfied women scored EPDS ≥10 points suggesting increased risk of depression. Conclusions Financial satisfaction in early pregnancy associates with HRQoL and risk of perinatal depressive symptoms. Unsatisfied women more often have risk factors for unfavourable pregnancy outcomes which may influence the later health and wellbeing of the mother and child.

The added value of mifepristone to non-surgical treatment regimens for uterine evacuation in case of early pregnancy failure: a systematic review of the literature

NARCIS (Netherlands)

Berg, J. van den; Gordon, B.B.; Snijders, M.P.M.L.; Vandenbussche, F.P.H.A.; Coppus, S.F.P.J.

2015-01-01

OBJECTIVE(S): Early pregnancy failure (EPF) is a common complication of pregnancy. Surgical intervention carries a risk of complications and, therefore, medical treatment appears to be a safe alternative. Unfortunately, the current medical treatment with misoprostol alone has complete evacuation

Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study.

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Simpson, William; Steiner, Meir; Coote, Marg; Frey, Benicio N

2016-01-01

Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1) to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2) to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3) to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Thirty-three healthy pregnant women were recruited from the Women's Health Concerns Clinic at St. Joseph's Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL)-6, IL-10, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001), IL-6 (p = 0.025), and IL-10 (p = 0.006) were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS) score. Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

"These are not good things for other people to know": how rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality.

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Haws, Rachel A; Mashasi, Irene; Mrisho, Mwifadhi; Schellenberg, Joanna Armstrong; Darmstadt, Gary L; Winch, Peter J

2010-11-01

Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events. Copyright © 2010 Elsevier Ltd. All rights reserved.

Polyphenols and IUGR pregnancies: Maternal hydroxytyrosol supplementation improves prenatal and early-postnatal growth and metabolism of the offspring.

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Marta Vazquez-Gomez

Full Text Available Hydroxytyrosol is a polyphenol with antioxidant, metabolism-regulatory, anti-inflammatory and immuno-modulatory properties. The present study aimed to determine whether supplementing the maternal diet with hydroxytyrosol during pregnancy can improve pre- and early post-natal developmental patterns and metabolic traits of the offspring. Experiment was performed in Iberian sows fed a restricted diet in order to increase the risk of IUGR. Ten sows were treated daily with 1.5 mg of hydroxytyrosol per kg of feed between Day 35 of pregnancy (30% of total gestational period until delivery whilst 10 animals were left untreated as controls. Number and weight of offspring were assessed at birth, on post-natal Day 15 and at weaning (25 days-old. At weaning, body composition and plasma indexes of glucose and lipids were measured. Treatment with hydroxytyrosol was associated with higher mean birth weight, lower incidence of piglets with low birth weight. Afterwards, during the lactation period, piglets in the treated group showed a higher body-weight than control piglets; such effects were even stronger in the most prolific litters. These results suggest that maternal supplementation with hydroxytyrosol may improve pre- and early post-natal development of offspring in pregnancies at risk of IUGR.

Effect of endometrial biopsy on intrauterine insemination outcome in controlled ovarian stimulation cycle

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Leena Wadhwa

2015-01-01

Full Text Available OBJECTIVE: The objective was to evaluate the effect of endometrial biopsy (EB on intrauterine insemination (IUI outcome in controlled ovarian stimulation (COS cycle. DESIGN: Prospective randomized control study. SETTING: Tertiary care center. MATERIALS AND METHODS: A total of 251 subjects were enrolled in the study. Subjects undergoing COS with IUI were randomly allocated into three groups. Group A: EB was taken between D19 and 24 of the spontaneous menstrual cycles that precedes the fertility treatment and IUI, which was done in next cycle (n = 86. Group B: EB was taken before D6 of the menstrual cycle, and fertility treatment and IUI was done in the same cycle (n = 90. Group C: (control group no EB in previous 3 cycle (n = 75. MAIN OUTCOME MEASURE: Clinical pregnancy rate (CPR. RESULTS: Clinical pregnancy rate was 19.77%, 31.11%, and 9.3% for Group A, Group B, and Group C, respectively. The results show a highly significant value for the paired t-test of intervention Group B and control Group C of the cases (P = 0.000957. CPR was maximum afterfirst cycle of ovulation induction and IUI following EB scratch in both Groups A and in Group B (P < 0.001. CONCLUSIONS: Endometrial biopsy done in early follicular phase in the same cycle of stimulation with IUI gives better CPR as compared with EB done in the luteal phase of the previous cycle.

[Sodium intake during pregnancy].

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Delemarre, F M; Franx, A; Knuist, M; Steegers, E A

1999-10-23

International studies have yielded contradictory results on efficacy of a sodium-restricted diet during pregnancy in preventing and curing hypertension of pregnancy. In the Netherlands three studies have been performed to investigate the value of dietary sodium restriction in pregnancy; they concerned epidemiology, prevention and treatment. Midwives often prescribed this dietary intervention. Urinary sodium excretion was not related to blood pressure changes in pregnancy. Dietary sodium restriction from the third month of pregnancy onwards did not reduce the incidence of pregnancy-induced hypertension. Maternal side effects were a decreased intake of nutrients, decreased maternal weight gain, lowered plasma volume and stimulation of the renin-angiotensin-aldosterone system. A dietary sodium restriction in women with early symptoms of pregnancy-induced hypertension showed no therapeutic effect on blood pressure. There is no place for dietary sodium restriction in the prevention or treatment of hypertension in pregnancy.

The acute phase protein ceruloplasmin as a non-invasive marker of pseudopregnancy, pregnancy, and pregnancy loss in the giant panda.

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Erin L Willis

Full Text Available After ovulation, non-pregnant female giant pandas experience pseudopregnancy. During pseudopregnancy, non-pregnant females exhibit physiological and behavioral changes similar to pregnancy. Monitoring hormonal patterns that are usually different in pregnant mammals are not effective at determining pregnancy status in many animals that undergo pseudopregnancy, including the giant panda. Therefore, a physiological test to distinguish between pregnancy and pseudopregnancy in pandas has eluded scientists for decades. We examined other potential markers of pregnancy and found that activity of the acute phase protein ceruloplasmin increases in urine of giant pandas in response to pregnancy. Results indicate that in term pregnancies, levels of active urinary ceruloplasmin were elevated the first week of pregnancy and remain elevated until 20-24 days prior to parturition, while no increase was observed during the luteal phase in known pseudopregnancies. Active ceruloplasmin also increased during ultrasound-confirmed lost pregnancies; however, the pattern was different compared to term pregnancies, particularly during the late luteal phase. In four out of the five additional reproductive cycles included in the current study where females were bred but no birth occurred, active ceruloplasmin in urine increased during the luteal phase. Similar to the known lost pregnancies, the temporal pattern of change in urinary ceruloplasmin during the luteal phase deviated from the term pregnancies suggesting that these cycles may have also been lost pregnancies. Among giant pandas in captivity, it has been presumed that there is a high rate of pregnancy loss and our results are the first to provide evidence supporting this notion.

HIV-related stigma in pregnancy and early postpartum of mothers living with HIV in Ontario, Canada.

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Ion, Allyson; Wagner, Anne C; Greene, Saara; Loutfy, Mona R

2017-02-01

HIV-related stigma is associated with many psychological challenges; however, minimal research has explored how perceived HIV-related stigma intersects with psychosocial issues that mothers living with HIV may experience including depression, perceived stress and social isolation. The present study aims to describe the correlates and predictors of HIV-related stigma in a cohort of women living with HIV (WLWH) from across Ontario, Canada during pregnancy and early postpartum. From March 2011 to December 2012, WLWH ≥ 18 years (n = 77) completed a study instrument measuring independent variables including sociodemographic characteristics, perceived stress, depression symptoms, social isolation, social support and perceived racism in the third trimester and 3, 6 and 12 months postpartum. Multivariable linear regression was employed to explore the relationship between HIV-related stigma and multiple independent variables. HIV-related stigma generally increased from pregnancy to postpartum; however, there were no significant differences in HIV-related stigma across all study time points. In multivariable regression, depression symptoms and perceived racism were significant predictors of overall HIV-related stigma from pregnancy to postpartum. The present analysis contributes to our understanding of HIV-related stigma throughout the pregnancy-motherhood trajectory for WLWH including the interactional relationship between HIV-related stigma and other psychosocial variables, most notably, depression and racism.

Changes in oscillatory dynamics in the cell cycle of early Xenopus laevis embryos.

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Tony Y-C Tsai

2014-02-01

Full Text Available During the early development of Xenopus laevis embryos, the first mitotic cell cycle is long (∼85 min and the subsequent 11 cycles are short (∼30 min and clock-like. Here we address the question of how the Cdk1 cell cycle oscillator changes between these two modes of operation. We found that the change can be attributed to an alteration in the balance between Wee1/Myt1 and Cdc25. The change in balance converts a circuit that acts like a positive-plus-negative feedback oscillator, with spikes of Cdk1 activation, to one that acts like a negative-feedback-only oscillator, with a shorter period and smoothly varying Cdk1 activity. Shortening the first cycle, by treating embryos with the Wee1A/Myt1 inhibitor PD0166285, resulted in a dramatic reduction in embryo viability, and restoring the length of the first cycle in inhibitor-treated embryos with low doses of cycloheximide partially rescued viability. Computations with an experimentally parameterized mathematical model show that modest changes in the Wee1/Cdc25 ratio can account for the observed qualitative changes in the cell cycle. The high ratio in the first cycle allows the period to be long and tunable, and decreasing the ratio in the subsequent cycles allows the oscillator to run at a maximal speed. Thus, the embryo rewires its feedback regulation to meet two different developmental requirements during early development.

Disturbances in Maternal Steroidogenesis and Appearance of Intrauterine Growth Retardation at High-Altitude Environments Are Established from Early Pregnancy. Effects of Treatment with Antioxidant Vitamins.

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Victor H Parraguez

Full Text Available Pregnancies at high-altitudes are influenced by hypoxia and oxidative stress and frequently affected by IUGR. However, a common thought is that early pregnant women visiting altitude have no major complications for gestation development, since IUGR is developed during the second half of pregnancy. Thus, using a well-characterized sheep-model, we aimed to determine whether long- and/or short-term exposure to high-altitude may affect maternal steroidogenesis and therefore embryo-fetal growth from conception. The second aim was to differentiate the relative role of hypoxia and oxidative stress by assessing the effects of supplementation with antioxidant agents during this early-pregnancy stage, which were previously found to be useful to prevent IUGR. The results indicate that both long- and short-term exposure to high-altitude causes disturbances in maternal ovarian steroidogenesis and negatively affects embryo-fetal growth already during the very early stages of gestation, with the consequences being even worsened in newcomers to high-altitude. The supply of antioxidant during this period only showed discrete effects for preventing IUGR. In conclusion, the present study gives a warning for clinicians about the risks for early-pregnant women when visiting high-altitude regions and suggests the need for further studies on the effects of the length of exposure and on the interaction of the exposure with the pregnancy stage.

Maternal cardiac metabolism in pregnancy

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Liu, Laura X.; Arany, Zolt

2014-01-01

Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

Acute Kidney Injury in Pregnancy.

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Jim, Belinda; Garovic, Vesna D

2017-07-01

Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas. Differentiating among these conditions may be difficult or impossible based on clinical criteria only. In difficult and rare cases, a renal biopsy may need to be considered for the exact diagnosis and to facilitate appropriate treatment, but the risks and benefits need to be carefully weighed. The use of eculizumab for the treatment of atypical HUS has demonstrated efficacy in early case reports. Non-pregnancy related causes such as volume depletion and pyelonephritis require early and aggressive resuscitative as well as antibiotic measures respectively. We will discuss in this review the various etiologies of AKI in pregnancy, current diagnostic approaches, and the latest treatment strategies. Given the recent trends of increasing maternal age at the time of pregnancy, and the availability of modern reproductive methods increase the risks of AKI in pregnancy in the coming years. Copyright © 2017 Elsevier Inc. All rights reserved.

The applied observation of ultrasonography on before and after anti-early pregnancy with mifepristone (reports of 660 cases)

International Nuclear Information System (INIS)

Liu Qinglan; Li Yan; Li Julian; He Lihong

2004-01-01

Objective: To estimate the clinical significance of ultrasonography on before and after anti-early pregnancy with mifepristone. Methods: 660 cases of premedical abortion were ultrasonic diagnosed to know the status of inner-uterus pregnancy and exclude the taboo of medical abortion; after-medical abortion ultrasonic were performed to find rudimental embryo in uterus, recuperation of uterus, etc. Results: 88.18% of cases are full abortion; 10.15% of cases are semi-abortion; 1.7% of cases are unsuccessful abortion. Conclusions: It is a quick and safe method to use ultrasonography before and after medical abortion. (authors)

Exposure to Zearalenone During Early Pregnancy Causes Estrogenic Multitoxic Effects in Mice.

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Kunishige, Kohji; Kawate, Noritoshi; Inaba, Toshio; Tamada, Hiromichi

2017-03-01

Although zearalenone (ZEN; Sigma Chemicals, St Louis, Missouri) is a well-known mycotoxin with estrogenic activity, the toxic effects of ZEN during pregnancy are unknown. This study compared the effects of daily subcutaneous injections of ZEN (2, 4, or 8 mg/kg) with those of 17β-estradiol (E2; [Sigma Chemicals] 0.8, 1.6, or 3.2 μg/kg) in mice. Injections were administered on gestational days (GDs) 1 to 5, the period including implantation which is sensitive to hormonal balance. The effects of ZEN or E2 were evaluated by comparing the number of live fetuses, their weight, and absorbed conceptuses on GD 18, with those in vehicle-treated controls. In addition, implantation, embryos in the oviducts and those in uteri without implantation sites were investigated on GD 5. In mice treated with the highest dose of ZEN or E2, decidual responses and plasma progesterone concentrations were measured on GDs 5 and 6, respectively, and delayed implantation was investigated on GDs 9 and 14. The results showed that treatment with ZEN, in a manner similar to that seen for E2, led to obstruction of essential processes for establishing and maintaining pregnancy, such as embryo migration from oviducts to uteri, the decidual response, and activation of luteal function. Zearalenone also induced delayed implantation and loss of conceptuses and at low doses caused a retarded growth of the fetuses after normal implantation. It was therefore concluded that ZEN causes multiple estrogenic toxic actions when administered during early pregnancy in mice.

The total pregnancy potential per oocyte aspiration after assisted reproduction-in how many cycles are biologically competent oocytes available?

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Lemmen, J G; Rodríguez, N M; Andreasen, L D; Loft, A; Ziebe, S

2016-07-01

While stimulation of women prior to assisted reproduction is associated with increased success rates, the total biological pregnancy potential per stimulation cycle is rarely assessed. Retrospective sequential cohort study of the cumulative live birth rate in 1148 first IVF/ICSI-cycles and 5-year follow up of frozen embryo replacement (FER) cycles were used. Oocyte number, number of embryos transferred, and cryopreserved/thawed and transferred embryos in a FER cycle were registered for all patients. Children per oocyte and per transferred embryo and percentage of cycles with births were calculated. We obtained 9529 oocytes. Embryos (2507) were transferred in either fresh or FER cycles, resulting in 422 births and 474 live born children. Median age of the women was 32.5 years (range 20-41.5 years). In total, 34.3 % of all cycles ended with a live birth while in 65.7 % of the cycles, no oocytes were capable of developing into a child. The average number of oocytes needed per live born child after transfer of fresh and thawed embryos was 20 as only 5.0 % of oocytes aspirated in the first IVF/ICSI cycle had the competence to develop into a child. In our setting, overall 5.0 % of the oocytes in a first cycle were biologically competent and in around 2/3 of all cycles, none of the oocytes had the potential to result in the birth of a child.

Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study.

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Ruiz-Gracia, Teresa; Duran, Alejandra; Fuentes, Manuel; Rubio, Miguel A; Runkle, Isabelle; Carrera, Evelyn F; Torrejón, María J; Bordiú, Elena; Valle, Laura Del; García de la Torre, Nuria; Bedia, Ana R; Montañez, Carmen; Familiar, Cristina; Calle-Pascual, Alfonso L

2016-06-01

Early-pregnancy lifestyle (EPL) could influence the development of gestational diabetes mellitus(GDM), depending on the diagnostic criteria used. We studied EPL in 1750 pregnant women using Carpenter-Coustan criteria(CCc), and in 1526 with the International Association of Diabetes and Pregnancy Study Groups criteria(IADPSGc). GDM risk factors were assessed in women between 24 and 28 weeks of gestational age during two consecutive years. A semiquantitative frequent-food-consumption questionnaire was used to evaluate lifestyle during pregnancy. Multiple logistic regression analysis was conducted to assess GDM risk with different lifestyle patterns. Using IADPSGc, the GDM ORs (95%CI) for intake/week were: nuts >3 times: 0.59 (0.39-0.91; p < 0.015), refined cereals ≤1 serving: 0.72(0.58-0.89; p < 0.003), juices <4 servings: 0.77 (0.62-0.95; p < 0.017), cookies and pastries <4 servings: 0.71(0.57-0.89; p < 0.003) as compared to opposite habits. No significant nutritional patterns were found to be significant using CCc. The OR (95%CI) for GDM with none of the four risk patterns as compared to having three-four risk factors was 0.21(0.07-0.62; p < 0.005), remaining significant after stratification by BMI, age, obstetric events, parity and family history. The multiple logistic regression model including nutritional categories and pregestational BMI, age, obstetric history, parity, personal/family history, had an area under the curve(AUC) of the receiver operating curve(ROC) for the probability to predict GDM of 0.66 (CI 95%: 0.63-0.69; p < 0.001). Our study is the first to identify four early-pregnancy nutritional patterns associated with the GDM when using IADPSGc. Adherence to a low-risk nutritional pattern from early pregnancy on could be an effective strategy for GDM prevention. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Adaptive changes in spatiotemporal gait characteristics in women during pregnancy.

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Błaszczyk, Janusz W; Opala-Berdzik, Agnieszka; Plewa, Michał

2016-01-01

Spatiotemporal gait cycle characteristics were assessed at early (P1), and late (P2) pregnancy, as well as at 2 months (PP1) and 6 months (PP2) postpartum. A substantial decrease in walking speed was observed throughout the pregnancy, with the slowest speed (1±0.2m/s) being during the third trimester. Walking at slower velocity resulted in complex adaptive adjustments to their spatiotemporal gait pattern, including a shorter step length and an increased duration of both their stance and double-support phases. Duration of the swing phase remained the least susceptible to changes. Habitual walking velocity (1.13±0.2m/s) and the optimal gait pattern were fully recovered 6 months after childbirth. Documented here adaptive changes in the preferred gait pattern seem to result mainly from the altered body anthropometry leading to temporary balance impairments. All the observed changes within stride cycle aimed to improve gait safety by focusing on its dynamic stability. The pregnant women preferred to walk at a slower velocity which allowed them to spend more time in double-support compared with their habitual pattern. Such changes provided pregnant women with a safer and more tentative ambulation that reduced the single-support period and, hence, the possibility of instability. As pregnancy progressed a significant increase in stance width and a decrease in step length was observed. Both factors allow also for gait stability improvement. Copyright © 2015 Elsevier B.V. All rights reserved.

Serum Leptin Concentrations during the Menstrual Cycle in Iranian Healthy Women

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Nahid Einollahi

2010-10-01

Full Text Available Leptin, a circulating 16-kd polypeptide consisting of 167 amino acids, appears to be involved in the body weight homeostasis. Moreover leptin plays an important role for the reproductive system, early embryogenesis, and fat metabolism during pregnancy and puberty. Significant correlations have been found between leptin and sexual hormones, which is a cytokine and has hormonal properties. The aim of this study was to determine serum leptin levels during the menstrual cycle, and the association between serum leptin and reproductive hormones in young, healthy Iranian women. 42 healthy women volunteered for the study. They all had regular menstrual cycles, with cycle length varying between 26 and 32 days. None of them used oral contraceptives. All were of normal weight, with body mass index ( BMI

[Experience with Pregnosticon-planotest, a 2-minute immunologic pregnancy test].

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Hancsók, M; Huber, G; Páhoki, I; Czeizel, E

1969-08-23

Pregnosticon-Planotest (PPT), produced by N.V. Organon, is an immunological latex-suspension pregnancy test that can be read in 2 minutes (or up to 60 minutes) and requires no special equipment such as centrifuges. Parallel pregnancy tests, using PPT and the biological Galli-Mainin Reaction (GMR) were carried out on 381 women for a total of 407 tests. The cases included 334 possible early pregnancies, 38 supected extrauterine pregnancies, and 35 suspected fetal deaths. The 2 tests agreed in 93.9% of the cases, and of 23 cases on which results differed, the PPT reading proved correct for 21 cases. Both tests gave false-negative readings for 36 early pregnancies and 1 extrauterine pregnancy. However, PPT results were correct for 80% of the extrauterine pregnancies (where production of human chorionic gonadotropin, the substance tested for, is low); the GMR was correct in 68.8% of these cases. The sensitivity of PPT was also shown in its early detection of pregnancies - 3.3-4 days earlier than with GMR. PPT is thus judged to be a sensitive, reliable, simple, and quick pregnancy test.

Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort

NARCIS (Netherlands)

Leffelaar, Evelien R.; Vrijkotte, Tanja G. M.; van Eijsden, Manon

2010-01-01

Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and

Heterotopic Pregnancy: A Diagnosis Which Should Be Consider More Often

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Eray Çaliskan

2012-03-01

Full Text Available The aim of this case report is to present two cases of heterotopic pregnancy in the light of the literature, to present the incidence of heterotopic pregnancy which has increased due to ovulation induction and assisted reproductive techniques and that might cause serious problems for the pregnant women and intrauterine pregnancy. A 33 year old woman who conceived via ovulation induction with gonadotropins and intrauterine insemination was evaluated due to abdominal pain at 6th weeks of gestation. Despite an unknown diagnosis with multidiciplinary approach, she was sent to our center due to acute abdomen with unstable hemodynamic status. The 9 weeks old intrauterine fetus was diagnosed to be dead. She was performed emergency laparotomy salpingectomy for the ruptured tubal pregnancy and she received whole blood transfusions. The postoperative period was uneventhful and she was recovered without any complications. Our second case is a 31 years old woman who conceived via spontaneous cycle. She was evaluated due to abdominal pain at 8th weeks of gestation. Heterotopic pregnancy could have been diagnosed with ultrasonography. She had laparascopic salpingectomy with stable vital signs and stable hemoglobin values. Blood transfusion was not necessary and intrauterine pregnancy was continued with healthy. In women admitting with pelvic pain after conceiving with assisted reproductive techniques, for early diagnosis of heterotropic pregnancy, a carefull ultrasonographic examination of the adnexal regions should be performed and heterotopic pregnancy should be kept in mind for the differential diagnosis of any cystic mass. This approach might help plan the optimum treatment and also minimize the harm to the pregnant women and the intrauterine fetus.

A randomised controlled trial of expectant management versus surgical evacuation of early pregnancy loss.

Science.gov (United States)

Nadarajah, Ravichandran; Quek, Yek Song; Kuppannan, Kaliammah; Woon, Shu Yuan; Jeganathan, Ravichandran

2014-07-01

To show whether a clinically significant difference in success rates exists between expectant and surgical management of early pregnancy loss. Randomised controlled trial comparing expectant versus surgical management of early pregnancy loss over a 1-year period from 1st January to 31st December 2009 at Sultanah Aminah Hospital, Johor Bahru. Pregnant women with missed or incomplete miscarriages at gestations up to 14 weeks were recruited in this study. The success rate in the surgical group was measured as curettage performed without any complications during or after the procedure, while the success rate in the expectant group was defined as complete spontaneous expulsion of products of conception within 6 weeks without any complication. A total of 360 women were recruited and randomised to expectant or surgical management, with 180 women in each group. There was no statistically significant difference in the success rate between the groups and between the different types of miscarriage. With expectant management, 131 (74%) patients had a complete spontaneous expulsion of products of conception, of whom 106 (83%) women miscarried within 7 days. However, the rates of unplanned admissions (18.1%) and unplanned surgical evacuations (17.5%) in the expectant group were significantly higher than the rates (7.4% and 8% respectively) in the surgical group. The complications in both groups were similar. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Mental health of women who suffer intimate partner violence during pregnancy

Directory of Open Access Journals (Sweden)

Mariana de Oliveira Fonseca-Machado

2014-07-01

Full Text Available Objective. To identify the relationship between intimate partner violence (IPV during pregnancy and mental disorders in women in the pregnancy-puerperal cycle. Methodology. A review was conducted of papers published in Portuguese, English and Spanish regarding the study theme. The databases explored were PubMed, CINAHL, LILACS and PsycINFO. Results. The 17 included papers studied the relationship between IPV and: pre- and postpartum depression (41%; pregnancy anxiety (23% and pregnancy posttraumatic stress disorder (12%. None of the studies investigated the association between IPV and suicidal ideation. Conclusion. IPV against women during the pregnancy-puerperal cycle causes negative impacts on mental health. Concrete actions shall be proposed regarding the prevention, identification and treatment of women exposed to IPV during their pregnancy period.

Maternal complications in pregnancy and wheezing in early childhood

DEFF Research Database (Denmark)

Zugna, Daniela; Galassi, Claudia; Annesi-Maesano, Isabella

2015-01-01

BACKGROUND: Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient. METHODS: A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy comp...

Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

Directory of Open Access Journals (Sweden)

William Simpson

Full Text Available Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1 to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2 to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3 to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL-6, IL-10, tumor necrosis factor alpha (TNF-α, and C-reactive protein (CRP at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001, IL-6 (p = 0.025, and IL-10 (p = 0.006 were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

Folic acid supplements in pregnancy and early childhood respiratory health.

Science.gov (United States)

Håberg, S E; London, S J; Stigum, H; Nafstad, P; Nystad, W

2009-03-01

Folate supplementation is recommended for pregnant women to reduce the risk of congenital malformations. Maternal intake of folate supplements during pregnancy might also influence childhood immune phenotypes via epigenetic mechanisms. To investigate the relationship between folate supplements in pregnancy and risk of lower respiratory tract infections and wheeze in children up to 18 months of age. In the Norwegian Mother and Child Cohort Study, questionnaire data collected at several time points during pregnancy and after birth on 32,077 children born between 2000 and 2005 were used to assess the effects of folate supplements during pregnancy on respiratory outcomes up to 18 months of age, while accounting for other supplements in pregnancy and supplementation in infancy. Folate supplements in the first trimester were associated with increased risk of wheeze and respiratory tract infections up to 18 months of age. Adjusting for exposure later in pregnancy and in infancy, the relative risk for wheeze for children exposed to folic acid supplements in the first trimester was 1.06 (95% CI 1.03 to 1.10), the relative risk for lower respiratory tract infections was 1.09 (95% CI 1.02 to 1.15) and the relative risk for hospitalisations for lower respiratory tract infections was 1.24 (95% CI 1.09 to 1.41). Folic acid supplements in pregnancy were associated with a slightly increased risk of wheeze and lower respiratory tract infections up to 18 months of age. The results suggest that methyl donors in the maternal diet during pregnancy may influence respiratory health in children consistent with epigenetic mechanisms.

Gene expression in the mouse brain following early pregnancy exposure to ethanol

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Christine R. Zhang

2016-12-01

Full Text Available Exposure to alcohol during early embryonic or fetal development has been linked with a variety of adverse outcomes, the most common of which are structural and functional abnormalities of the central nervous system [1]. Behavioural and cognitive deficits reported in individuals exposed to alcohol in utero include intellectual impairment, learning and memory difficulties, diminished executive functioning, attention problems, poor motor function and hyperactivity [2]. The economic and social costs of these outcomes are substantial and profound [3,4]. Improvement of neurobehavioural outcomes following prenatal alcohol exposure requires greater understanding of the mechanisms of alcohol-induced damage to the brain. Here we use a mouse model of relatively moderate ethanol exposure early in pregnancy and profile gene expression in the hippocampus and caudate putamen of adult male offspring. The effects of offspring sex and age on ethanol-sensitive hippocampal gene expression were also examined. All array data are available at the Gene Expression Omnibus (GEO repository under accession number GSE87736.

Hyperglycaemia in early pregnancy: the Treatment of Booking Gestational diabetes Mellitus (TOBOGM) study. A randomised controlled trial.

Science.gov (United States)

Simmons, David; Hague, William M; Teede, Helena J; Cheung, N Wah; Hibbert, Emily J; Nolan, Christopher J; Peek, Michael J; Girosi, Federico; Cowell, Christopher T; Wong, Vincent W-M; Flack, Jeff R; McLean, Mark; Dalal, Raiyomand; Robertson, Annette; Rajagopal, Rohit

2018-05-28

Gestational diabetes mellitus (GDM) causes adverse pregnancy outcomes that can be averted by treatment from 24-28 weeks' gestation. Assessing and treating women for overt diabetes in pregnancy (ODIP) at the first antenatal clinic booking is now recommended in international guidelines. As a consequence, women with milder hyperglycaemia are being diagnosed and treated for early GDM, but randomised controlled trial (RCTs) assessing the benefits and harms of such treatment have not been undertaken. The Treatment Of Booking Gestational diabetes Mellitus (TOBOGM) study is a multi-centre RCT examining whether diagnosing and treating GDM diagnosed at booking improves pregnancy outcomes. Methods and analysis: 4000 adult pregnant women (lean body mass. The primary maternal outcome is pre-eclampsia. Ethics approval: South Western Sydney Local Health District Research and Ethics Office (reference, 15/LPOOL/551). Dissemination of results: Peer-reviewed publications, scientific meetings, collaboration with research groups undertaking comparable studies, discussions with guideline groups and policy makers. Australian New Zealand Clinical Trials Registry, ACTRN12616000924459.

Prevalence of pregnancy anxiety and associated factors

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Girija Kalayil Madhavanprabhakaran

2015-01-01

Conclusion: During the transition to motherhood, the risk factors and timing of heightened pregnancy-specific anxiety differ. Higher prevalence of pregnancy anxiety among nulliparous and younger pregnant women necessitates an integrated routine screening of PSA during prenatal care. Early detection, prevention and management of pregnancy anxiety will enable women to cope with the challenges of pregnancy.

Expression and regulation of prostaglandin transporters, ATP-binding cassette, subfamily C, member 1 and 9, and solute carrier organic anion transporter family, member 2A1 and 5A1 in the uterine endometrium during the estrous cycle and pregnancy in pigs

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Hwanhee Jang

2017-05-01

Full Text Available Objective Prostaglandins (PGs function in various reproductive processes, including luteolysis, maternal pregnancy recognition, conceptus development, and parturition. Our earlier study has shown that PG transporters ATP-binding cassette, subfamily C, member 4 (ABCC4 and solute carrier organic anion transporter family, member 2A1 (SLCO2A1 are expressed in the uterine endometrium in pigs. Since several other PG transporters such as ABCC1, ABCC9, SLCO4C1, and SLCO5A1 are known to be present in the uterine endometrium, this study investigated the expression of these PG transporters in the porcine uterine endometrium and placenta. Methods Uterine endometrial tissues were obtained from gilts on day (D 12 and D15 of the estrous cycle and days 12, 15, 30, 60, 90, and 114 of pregnancy. Results ABCC1, ABCC9, SLCO4C1, and SLCO5A1 mRNAs were expressed in the uterine endometrium, and levels of expression changed during the estrous cycle and pregnancy. Expression of ABCC1 and ABCC9 mRNAs was localized mainly to luminal and glandular epithelial cells in the uterine endometrium, and chorionic epithelial cells during pregnancy. Conceptuses during early pregnancy and chorioallantoic tissues from mid to late pregnancy also expressed these PG transporters. Estradiol-17β increased the expression of ABCC1 and SLCO5A1, but not ABCC9 and SLCO4C1 mRNAs and increasing doses of interleukin-1β induced the expression of ABCC9, SLCO4C1, and SLCO5A1 mRNAs in endometrial explant tissues. Conclusion These data showed that several PG transporters such as ABCC1, ABCC9, SLCO4C1, and SLCO5A1 were expressed at the maternal-conceptus interface, suggesting that these PG transporters may play an important role in the establishment and maintenance of pregnancy by regulating PG transport in the uterine endometrium and placenta in pigs.

Distinct Transcriptional and Alternative Splicing Signatures of Decidual CD4+ T Cells in Early Human Pregnancy

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Weihong Zeng

2017-06-01

Full Text Available Decidual CD4+ T (dCD4 T cells are crucial for the maternal-fetal immune tolerance required for a healthy pregnancy outcome. However, their molecular and functional characteristics are not well elucidated. In this study, we performed the first analysis of transcriptional and alternative splicing (AS landscapes for paired decidual and peripheral blood CD4+ T (pCD4 T cells in human early pregnancy using high throughput mRNA sequencing. Our data showed that dCD4 T cells are endowed with a unique transcriptional signature when compared to pCD4 T cells: dCD4 T cells upregulate 1,695 genes enriched in immune system process whereas downregulate 1,011 genes mainly related to mRNA catabolic process and the ribosome. Moreover, dCD4 T cells were observed to be at M phase, and show increased activation, proliferation, and cytokine production, as well as display an effector-memory phenotype and a heterogenous nature containing Th1, Th17, and Treg cell subsets. However, dCD4 T cells undergo a comparable number of upregulated and downregulated AS events, both of which are enriched in the genes related to cellular metabolic process. And the changes at the AS event level do not reflect measurable differences at the gene expression level in dCD4 T cells. Collectively, our findings provide a comprehensive portrait of the unique transcriptional signature and AS profile of CD4+ T cells in human decidua and help us gain more understanding of the functional characteristic of these cells during early pregnancy.

Diagnosis of Toxoplasmosis in Pregnancy

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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

Persistent organic pollutants in early pregnancy and risk of gestational diabetes mellitus.

Science.gov (United States)

Vafeiadi, Marina; Roumeliotaki, Theano; Chalkiadaki, Georgia; Rantakokko, Panu; Kiviranta, Hannu; Fthenou, Eleni; Kyrtopoulos, Soterios A; Kogevinas, Manolis; Chatzi, Leda

2017-01-01

.68) respectively. Prenatal DDE and HCB exposure were not significantly associated GDM risk. These findings suggest that women with high PCBs levels in early pregnancy had higher risk for GDM. Further studies are needed to replicate these results and to evaluate potential biological mechanisms underlying the observed associations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tight interplay in early pregnancy between follistatin and anti-mullerian hormone in women with polycystic ovarian syndrome (PCOS).

Science.gov (United States)

Köninger, Angela; Kampmeier, Antje; Mach, Pawel; Schmidt, Boerge; Strowitzki, Thomas; Kimmig, Rainer; Gellhaus, Alexandra

2018-05-01

Follistatin levels increase during the course of pregnancy and may play a role in ovarian arrest, reflected by the simultaneous decrease of anti-mullerian-hormone (AMH) levels. The aim of the study was to investigate AMH and follistatin levels during the hormonal window at the beginning of pregnancy. Since both parameters are described as deregulated in polycystic ovarian syndrome (PCOS), subgroup analysis of PCOS patients may additionally elucidate their interplay and effects on ovarian activity. Serum samples were retrospectively analyzed using the AMH Gen II ELISA and the Human Follistatin Quantikine ELISA Kit. Samples were collected longitudinally from 57 patients (32 with PCOS and 25 controls) before conception and during the first trimester. In 18 patients, measurements from the early and the late first trimester were available. Potential associations of AMH and follistatin levels with PCOS-related parameters were compared between the subgroups as well as longitudinally before and in the first trimester of pregnancy. For statistical analysis, the Spearman's correlation, Wilcoxon test, t test, Friedman test and multiple linear regression analysis was performed. In contrast to AMH, follistatin levels differed not between controls and PCOS patients before and in pregnancy. In both subgroups, AMH levels significantly decreased and follistatin levels significantly increased in longitudinally performed measurements before conceiving and in the first trimester of pregnancy. Follistatin levels are not suited as a biomarker for PCOS, but could be involved in suppressing ovarian activity, as reflected by AMH levels at the beginning of pregnancy.

A prospective examination of depression, anxiety and stress throughout pregnancy.

Science.gov (United States)

Rallis, Sofia; Skouteris, Helen; McCabe, Marita; Milgrom, Jeannette

2014-12-01

Perinatal distress has largely been conceptualised as the experience of depression and/or anxiety. Recent research has shown that the affective state of stress is also present during the perinatal period and thus may add to a broader understanding of perinatal distress. The aims of the present study were to investigate the changes in depression, anxiety and stress symptoms across pregnancy, and to explore the prospective relationships between these symptoms. Two-hundred and fourteen pregnant women were recruited when they were less than 16 weeks gestation. Women completed depression, anxiety and stress measures on a monthly basis, from 16 weeks gestation through to 36 weeks gestation. The covariate measures of sleep quality and social support were assessed bi-monthly at 16, 24 and 32 weeks gestation. Levels of depression, anxiety and stress symptoms were all shown to change over time, with women experiencing fewer symptoms during the middle of their pregnancy. Higher symptoms early in pregnancy predicted higher symptom levels throughout the rest of pregnancy. Higher depression scores early in pregnancy were also shown to predict higher anxiety and higher stress scores in late pregnancy. Increased stress scores during mid pregnancy also predicted higher anxiety scores in late pregnancy. Current findings indicate that symptom levels of depression, anxiety and stress vary over the course of pregnancy. Increased depression in early pregnancy seemed to be particularly pertinent as it not only predicted later depression symptoms, but also increased anxiety and stress in late pregnancy. Collectively, these results further highlight the importance of emotional health screening early in pregnancy. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Socio-economic, environmental and nutritional characteristics of urban and rural South Indian women in early pregnancy: findings from the South Asian Birth Cohort (START).

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Dwarkanath, Pratibha; Vasudevan, Anil; Thomas, Tinku; Anand, Sonia S; Desai, Dipika; Gupta, Milan; Menezes, Gladys; Kurpad, Anura V; Srinivasan, Krishnamachari

2018-06-01

High frequency of low birth weight (LBW) is observed in rural compared with urban Indian women. Since maternal BMI is known to be associated with pregnancy outcomes, the present study aimed to investigate factors associated with BMI in early pregnancy of urban and rural South Indian women. Prospective observational cohort. A hospital-based study conducted at an urban and a rural health centre in Karnataka State. Pregnant women (n 843) aged 18-40 years recruited in early pregnancy from whom detailed sociodemographic, environmental, anthropometric and dietary intake information was collected. A high proportion of low BMI (32 v. 26 %, Pwomen were younger, had lower body weight, tended to be shorter and less educated. They lived in poor housing conditions, had less access to piped water and good sanitation, used unrefined fuel for cooking and had lower standard of living score. The age (β=0·21, 95 % CI 0·14, 0·29), education level of their spouse (β=1·36, 95 % CI 0·71, 2·71) and fat intake (β=1·24, 95 % CI 0·20, 2·28) were positively associated with BMI in urban women. Our findings indicate that risk factors associated with BMI in early pregnancy are different in rural and urban settings. It is important to study population-specific risk factors in relation to perinatal health.

Heterotopic Pregnancy in a Natural Conception Following Failed ...

African Journals Online (AJOL)

2011-02-23

Feb 23, 2011 ... patient underwent emergency laparotomy and evacuation of products of intrauterine pregnancy. A high index of suspicion is necessary to ensure early diagnosis and management. KEY WORDS: Contraceptive, emergency, heterotrophic, laparotomy, pregnancy. INTRODUCTION. Heterotopic pregnancy ...

The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP).

Science.gov (United States)

Tranquilli, Andrea L; Brown, Mark A; Zeeman, Gerda G; Dekker, Gustaaf; Sibai, Baha M

2013-01-01

There is discrepancy in the literature on the definitions of severe and early-onset pre-eclampsia. We aimed to determine those definitions for clinical purposes and to introduce them in the classification of the hypertensive disorders of pregnancy for publication purposes. We circulated a questionnaire to the International Committee of the International Society for the Study of Hypertension in Pregnancy focusing on the thresholds for defining severe preeclampsia and the gestation at which to define early-onset preeclampsia, and on the definition and inclusion of the HELLP syndrome or other clinical features in severe preeclampsia. The questions were closed, but all answers had space for more open detailed comments. There was a general agreement to define preeclampsia as severe if blood pressure was >160mmHg systolic or 110mmHg diastolic. There was scarce agreement on the amount of proteinuria to define severity. The HELLP syndrome was considered a feature to include in the severe classification. Most investigators considered early-onset preeclampsia as that occurring before 34weeks. A definition of pre-eclampsia is paramount for driving good clinical practice. Classifications on the other hand are useful to enable international comparisons of clinical data and outcomes. We used the results of this survey to update our previous classification for the purposes of providing clinical research definitions of severe and early onset pre-eclampsia that will hopefully be accepted in the international literature. Copyright © 2012 International Society for the Study of Hypertension in Pregnancy. All rights reserved.

Immunohistochemical distribution of early pregnancy factor in ovary, oviduct and placenta of pregnant gilts.

Science.gov (United States)

Grosso, M C; Bellingeri, R V; Motta, C E; Alustiza, F E; Picco, N Y; Vivas, A B

2015-01-01

Early pregnancy factor (EPF) is an immunosuppressant that promotes maternal immune system tolerance of the allogenic fetus. Little is known about localization of this factor in different tissues and nothing has been reported about localization in swine reproductive and placental tissues. We determined the concentration of EPF in serum of gilts and porcine placenta conditioned medium (PPCM). We also analyzed the expression of EPF in different reproductive tissues of pregnant gilts at 10, 30, 60 and 90 days of pregnancy. EPF concentration in serum and PPCM was determined by western blot and densitometry. EPF expression in reproductive tissue was assessed by immunohistochemistry. The highest concentration of EPF was observed at 30 days in serum and PPCM; the concentration was higher in PPCM than in serum at the stages we evaluated. All reproductive tissues from the gestational stages analyzed showed specific labeling of EPF, but this labeling did not appear in non-pregnant gilts. At 30 days pregnancy, the EPF expression in the ovary was predominantly in follicular lutein cells, probably owing to its function as a luteotrophic factor. In the oviduct, EPF was expressed in unciliated secretory epithelial cells and in the cilia of ciliated cells. In the placenta, EPF was expressed in the fetal portion (mesoderm chorioallantois and epithelium of endoderm). EPF acts as an autocrine and paracrine growth factor for the trophoblast during the peri-implantation period.

In Vitro Fertilization and Multiple Pregnancies

Science.gov (United States)

2006-01-01

the cost of IVF for women with bilaterally blocked Fallopian tubes only, in which case it is funded for 3 cycles, excluding the cost of drugs. The cost of IUI is covered except for preparation of the sperm and drugs used for COS. Diffusion of Technology According to Canadian Assisted Reproductive Technology Registry data, in 2004 there were 25 infertility clinics across Canada offering IVF and 7,619 IVF cycles performed. In Ontario, there are 13 infertility clinics with about 4,300 IVF cycles performed annually. Literature Review Royal Commission Report on Reproductive Technologies The 1993 release of the Royal Commission report on reproductive technologies, Proceed With Care, resulted in the withdrawal of most IVF funding in Ontario, where prior to 1994 IVF was fully funded. Recommendations of the Commission to withdraw IVF funding were largely based on findings of the systematic review of randomized controlled trials (RCTs) published before 1990. The review showed IVF effectiveness only in cases of bilateral tubal obstruction. As for nontubal causes of infertility, there was not enough evidence to establish whether IVF was effective or not. Since the field of reproductive technology is constantly evolving, there have been several changes since the publication of the Royal Commission report. These changes include: increased success rates of IVF; introduction of ICSI in the early 1990’s as a treatment for male factor infertility; and improved embryo implantation rates allowing for the transfer of a single embryo to avoid multiple pregnancies after IVF. Studies After the Royal Commission Report: Review Strategy Three separate literature reviews were conducted in the following areas: clinical effectiveness of IVF, cost-effectiveness of IVF, and outcomes of single embryo transfer (SET) in IVF cycles. Clinical effectiveness of IVF: RCTs or meta-analyses of RCTs that compared live birth rates after IVF versus alternative treatments, where the cause of infertility was

Laboratory reference intervals during pregnancy, delivery and the early postpartum period

DEFF Research Database (Denmark)

Klajnbard, Anna; Szecsi, Pal Bela; Colov, Nina P

2010-01-01

Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological ...

Laboratory reference intervals during pregnancy, delivery and the early postpartum period

DEFF Research Database (Denmark)

Klajnbard, Anna; Szecsi, Pal Bela; Colov, Nina P

2010-01-01

Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological...

Nutrition in pregnancy and early childhood and associations with obesity in developing countries.

Science.gov (United States)

Yang, Zhenyu; Huffman, Sandra L

2013-01-01

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review. Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy. By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500-3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat-free mass and lower fat mass compared with low birthweights (obesity in adults. Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High-protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood. In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat-free mass, and was only weakly associated with fat mass. The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many

The effect of preconception counselling on lifestyle and other behaviour before and during pregnancy

NARCIS (Netherlands)

Elsinga, Joyce; de Jong-Potjer, Lieke C.; van der Pal-de Bruin, Karin M.; le Cessie, Saskia; Assendelft, Willem J. J.; Buitendijk, Simone E.

2008-01-01

BACKGROUND: Recent studies suggest that the basis for adverse pregnancy outcomes is often established early in pregnancy, during organogenesis. It is therefore important to take preventive action as early as possible, preferably before pregnancy. Because most adverse pregnancy outcomes occur in

The Effect of Preconception Counselling on Lifestyle and Other Behaviour Before and During Pregnancy

NARCIS (Netherlands)

Elsinga, J.; Jong-Potjer, L.C. de; Pal-de Bruin, K.M. van der; Cessie, S. le; Assendelft, W.J.J.; Buitendijk, S.E.

2008-01-01

Background: Recent studies suggest that the basis for adverse pregnancy outcomes is often established early in pregnancy, during organogenesis. It is therefore important to take preventive action as early as possible, preferably before pregnancy. Because most adverse pregnancy outcomes occur in

Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes.

Science.gov (United States)

Phillips, Katie M; Heiser, Alyssa; Gaudin, Robert; Hadlock, Tessa A; Jowett, Nate

2017-12-01

The incidence of Bell's palsy (BP) is elevated in the late phases of pregnancy. Controversy exists as to whether pregnancy is a risk factor for worse outcomes in BP, and whether such outcomes are the result of factors intrinsic to pregnancy or the tendency to withhold medical therapy in this cohort. Long-term facial function outcomes in cases of pregnancy-associated BP (PABP) were compared against outcomes in cases affecting nonpregnant adult women of child-bearing age by a blinded expert using the electronic clinician-graded facial function scale (eFACE) facial grading system. Fifty-one pregnancy-associated cases and 58 nonpregnancy-associated cases were included. Among patients who received early corticosteroid therapy, significantly worse static, synkinesis, and composite facial function eFACE scores were demonstrated among cases of PABP compared to nonpregnancy-associated cases (static median = 86 vs. 92.5, P = 0.005; synkinesis median = 79 vs. 86, P = 0.007; composite median = 78 vs. 84, P = 0.023). Among those not treated with corticosteroids, significantly worse dynamic and composite facial function eFACE scores were demonstrated in cases of PABP compared to those for nonpregnancy-associated cases (dynamic median = 74 vs. 92.5, P = 0.038; composite median = 73 vs. 86.5, P = 0.038). A trend toward improved outcomes was demonstrated within both groups for those treated with corticosteroids compared to those who were not. In comparison to cases unrelated to pregnancy, late-term PABP is associated with worse long-term outcomes to a degree that cannot solely be explained by differences in medical therapy. 4. Laryngoscope, 127:2854-2859, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Early primary cytomegalovirus infection in pregnancy: maternal hyperimmunoglobulin therapy improves outcomes among infants at 1 year of age.

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Visentin, Silvia; Manara, Renzo; Milanese, Laura; Da Roit, Anna; Forner, Gabriella; Salviato, Eleonora; Citton, Valentina; Magno, Fioretta Marciani; Orzan, Eva; Morando, Carla; Cusinato, Riccardo; Mengoli, Carlo; Palu, Giorgio; Ermani, Mario; Rinaldi, Roberto; Cosmi, Erich; Gussetti, Nadia

2012-08-01

Primary cytomegalovirus (CMV) infection during pregnancy is the leading infectious cause of congenital neurological disabilities. Early CMV infection carries a higher risk of adverse neonatal outcome (sensorineural hearing loss or neurological deficits). Intravenous hyperimmunoglobulin (HIG) therapy seems to be promising, but its efficacy needs further investigation. Since 2002, we have enrolled consecutively all pregnant women with early (ie, before gestational week 17) CMV infection. Beginning in 2007, all women were offered treatment with HIG (200 UI per kilogram of maternal weight, in a single intravenous administration). Outcome of infants was evaluated at the age of 1 year. Of the 592 women with early primary CMV infection, amniocentesis for CMV DNA detection was performed for 446. Of the 92 CMV-positive fetuses, pregnancy was terminated for 24, HIG was administered to mothers of 31, and no treatment was received by mothers of 37. Fetuses of treated mothers did not differ from fetuses of nontreated mothers according to mother's age, gestational week of infection, CMV load, or detection of abnormal ultrasonography findings. At the 1-year evaluation, 4 of 31 infants with treated mothers (13%; 95% confidence interval [CI], 1%-25%) and 16 of 37 infants with nontreated mothers (43%; 95% CI, 27%-59%) presented with poor outcomes (P primary CMV infection before gestational week 17.

US findings of tubal pregnancy

International Nuclear Information System (INIS)

Lee, Hwa Sung; Kim, Hyun Hee; Jee, Mi Hyun; Kweon, Young Hwa; Oh, Yoon Jin; Hong, Ju Hee; Kim, Soon Yong; Kim, Sang Young

1994-01-01

Early diagnosis of ruptured and unruptured tubal pregnancy became more accurate with the introduction of transvaginal sonographic equipment. The management principle of tubal pregnancy might be changed according to the sonographic findings. The purposes of this study were to define the sonographic findings of tubal pregnancy and to determine whether it is possible to differentiate the unruptured tubal pregnancies from the ruptured ones depending on the sonographic findings. The authors investigated the sonographic findings of the surgically confirmed 25 tubal pregnancy patients. There were 22(88%) unruptured and 3(12%) ruptured tubal pregnancies. Unruptured pregnancies showed tubal ring in 8, well defined hematosalpinx in 11, and poorly defined hematosalpinxin 2 patients. Ruptured pregnancies showed tubal sac with irregular margin in 2, and ill-defined hematosalpinx in one patient. In summary, well marginated tubal ring and hematosalpinx suggested unruptured tubal pregnancy, while tubal sac with irregular margin suggested ruptured pregnancy. However, it was difficult to differentiate the unruptured tubal pregnancy from the ruptured one when hematosalpinx was ill-defined

Glycosaminoglycan and transforming growth factor beta1 changes in human plasma and urine during the menstrual cycle, in vitro fertilization treatment, and pregnancy.

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De Muro, Pierina; Capobianco, Giampiero; Formato, Marilena; Lepedda, Antonio Junior; Cherchi, Gian Mario; Gordini, Laila; Dessole, Salvatore

2009-07-01

To evaluate transforming growth factor beta1 (TGF-beta1) and glycosaminoglycans (GAG) changes in human plasma and urine during the menstrual cycle, IVF-ET, and pregnancy. Prospective clinical study. University hospital. Thirteen women with apparently normal menstrual cycle (group 1); 18 women undergoing IVF-ET (group 2); and 14 low-risk pregnant women (group 3). We assayed plasma and urine concentrations of TGF-beta1, urine content, and distribution of GAG. Blood and urine samples were collected during days 2 to 3, 12 to 13, and 23 to 24 in group 1; in group 2, samples were obtained at menstrual phase, oocyte pick-up day, and 15 days after ET; in group 3, samples were obtained during gestational weeks 10-12, 22-24, and 30-32 and 1 month after delivery. Changes in TGF-beta1 and GAG content. The mean value of total urinary trypsin inhibitor/chondroitin sulfate (UTI/CS) showed a distinct peak at day 12 of the menstrual cycle in the fertile women in whom we monitored the ovulatory period. In the IVF-ET group, GAG distribution and TGF-beta1 levels showed significant differences during the cycle. We observed increased levels of plasma TGF-beta1 15 days after ET. A significant increase of total UTI/CS value with increasing gestation was detected. Transforming growth factor beta1 and GAG levels could represent an additional tool to monitor reproductive events and could be useful, noninvasive markers of ovulation and ongoing pregnancy.

Thrombocytopenia in Pregnancy

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Mehmet Ozsurmeli

2016-09-01

Full Text Available Thrombocytopenia, which is encountered in 7-10% of pregnancies is characterized with decreased number of thrombocytes. The most frequent cause of thrombocytopenia during pregnancy is gestational thrombocytopenia. These patients usually do not have symptoms due to mild thrombocytopenia. The diagnosis is usually established by excluding connective tissue disorders, drug effects and obstetric causes. The etiology of thrombocytopenia during early pregnancy is most frequently due to autoimmune causes. Thrombocytopenia secondary to obstetric causes like preeclampsia, HELLP syndrome should always be kept in mind. Under these circumstances the thrombocytopenia will not resolve unless pregnancy is terminated. The clinician should be able to distinguish between thrombocytopenia that does not require treatment and the causes that require emergent and serious medical interventions. [Archives Medical Review Journal 2016; 25(3.000: 420-432

Environmental perturbation of the circadian clock disrupts pregnancy in the mouse.

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Keith C Summa

Full Text Available The circadian clock has been linked to reproduction at many levels in mammals. Epidemiological studies of female shift workers have reported increased rates of reproductive abnormalities and adverse pregnancy outcomes, although whether the cause is circadian disruption or another factor associated with shift work is unknown. Here we test whether environmental disruption of circadian rhythms, using repeated shifts of the light:dark (LD cycle, adversely affects reproductive success in mice.Young adult female C57BL/6J (B6 mice were paired with B6 males until copulation was verified by visual identification of vaginal plug formation. Females were then randomly assigned to one of three groups: control, phase-delay or phase-advance. Controls remained on a constant 12-hr light:12-hr dark cycle, whereas phase-delayed and phase-advanced mice were subjected to 6-hr delays or advances in the LD cycle every 5-6 days, respectively. The number of copulations resulting in term pregnancies was determined. Control females had a full-term pregnancy success rate of 90% (11/12, which fell to 50% (9/18; p<0.1 in the phase-delay group and 22% (4/18; p<0.01 in the phase-advance group.Repeated shifting of the LD cycle, which disrupts endogenous circadian timekeeping, dramatically reduces pregnancy success in mice. Advances of the LD cycle have a greater negative impact on pregnancy outcomes and, in non-pregnant female mice, require longer for circadian re-entrainment, suggesting that the magnitude or duration of circadian misalignment may be related to the severity of the adverse impact on pregnancy. These results explicitly link disruptions of circadian entrainment to adverse pregnancy outcomes in mammals, which may have important implications for the reproductive health of female shift workers, women with circadian rhythm sleep disorders and/or women with disturbed circadian rhythms for other reasons.

Studies on radioimmunoassay diagnosis of cow pregnancy at an early period by milk sample communication

International Nuclear Information System (INIS)

Wu Meiwen

1986-01-01

Cow pregancy was diagnosed at an early period by milk sample communication and radioimmunoassay (RIA). Liquid milk samples were converted into solid forms on filter paper and mailed to the laboratory from appointed locations, and concentrations of progesterone in milk samples were then determined by RIA method. Milks were sampled 19 and 23 days after mating. Criterion used for the judgement of cow pregnancy was as follows: When the progesterone content in milk was 5 ng/ml or less, the cow was not pregnant; when progesterone content was between 5-11 ng/ml, it was doubtful; when progesterone content was 11 ng/ml or more, it was pregnant. According to this criterion, among 215 cows, 131 were pregnant, 73 were not pregnant, and 11 were doubtful. The results were further checked by palpation 3 months after inseminations. The unpregnancy and pregnancy accuracies were 97.6% and 89.2%, respectively. Forther milk samples were collected on 44 days for above cows that had been diagnosed on 19 and 23 days showing pregnancy to diagnose embryo forming. Among 91 cows, 74 had embryo. 7 had none, and the other 10 were doubtful. The embryo and unembryo accuracies were 94.6% and 100% respectively checking by palpation 3 months after inseminations

Cancer and pregnancy: the clinician's perspective.

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Dotters-Katz, Sarah; McNeil, Michael; Limmer, Jane; Kuller, Jeffrey

2014-05-01

Although uncommon, the incidence of cancer complicating pregnancy is increasing. Managing these pregnancies creates many diagnostic, therapeutic, and ethical dilemmas for the patient, her family, and the medical care team. Despite concerns for fetal well-being, maternal survival should be the first priority. Although surgery and chemotherapy may be used during pregnancy, radiation is generally contraindicated. For most nongynecologic cancers, termination of pregnancy does not improve maternal outcome. Iatrogenic prematurity is the most common pregnancy complication associated with malignancy in pregnancy because many of these infants are delivered early to facilitate maternal treatment. Overall, maternal cancer survival is generally good and does not differ from that of nonpregnant patients.

PREGNANCY LOSS IN MARES

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Tibary A

2015-12-01

Full Text Available Pregnancy loss is an important aspect of equine practice due to the economic and emotional loss that it engenders. Pregnancy loss is often divided in two categories: early pregnancy loss (EPL or embryonic death (ED (first 42 days and fetal losses (after 42 days. Diagnosis of the causes of pregnancy loss is often very challenging. Many of the causes of EPL remain poorly documented but studies on embryo development and embryo-uterine interaction have been able to shed some light on predisposing factors. Fetal losses or abortions are dominated by infectious causes and particularly bacterial placentitis. Detailed reviews of pregnancy loss were recently published by the authors (Tibary et al., 2012; Tibary and Pearson, 2012; Tibary et al., 2014. The objective of this paper is to provide an overview of the epidemiology, etiology, diagnosis and prevention of pregnancy loss in the mare.

Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae root extract

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Ratnasooriya W.D.

2003-01-01

Full Text Available The root extract of Salacia reticulata Wight (family: Celastraceae is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-260 g when administered orally (10 g/kg during early (days 1-7 and mid- (days 7-14 pregnancy. The root extract significantly (P<0.05 enhanced post-implantation losses (control vs treatment: early pregnancy, 4.7 ± 2.4 vs 49.3 ± 13%; mid-pregnancy, 4.7 ± 2.4 vs 41.7 ± 16.1%. Gestational length was unaltered but the pups born had a low birth weight (P<0.05 (early pregnancy, 6.8 ± 0.1 vs 5.3 ± 0.1 g; mid-pregnancy, 6.8 ± 0.1 vs 5.0 ± 0.1 g and low birth index (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9%; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1%, fetal survival ratio (P<0.05 (early pregnancy, 95.2 ± 2.4 vs 50.7 ± 12.9; mid-pregnancy, 95.2 ± 2.4 vs 58.3 ± 16.1, and viability index (P<0.05 (early pregnancy, 94.9 ± 2.6 vs 49.5 ± 12.5%; mid-pregnancy, 94.9 ± 2.6 vs 57.1 ± 16.1%. However, the root extract was non-teratogenic. We conclude that the S. reticulata root extract can be hazardous to successful pregnancy in women and should not be used in pregnancy complicated by diabetes.

Adverse pregnancy outcome in rats following exposure to a Salacia reticulata (Celastraceae) root extract.

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Ratnasooriya, W D; Jayakody, J R A C; Premakumara, G A S

2003-07-01

The root extract of Salacia reticulata Wight (family: Celastraceae) is used in Sri Lanka by traditional practitioners as a herbal therapy for glycemic control even during pregnancy. It is recognized that some clinically used antidiabetic drugs have harmful effects on pregnancy but the effects of the S. reticulata root extract on reproductive outcome is unknown and deserves examination. We determined the effects of the S. reticulata root extract on the reproductive outcome of Wistar rats (250-260 g) when administered orally (10 g/kg) during early (days 1-7) and mid- (days 7-14) pregnancy. The root extract significantly (P<0.05) enhanced post-implantation losses (control vs treatment: early pregnancy, 4.7 2.4 vs 49.3 13%; mid-pregnancy, 4.7 2.4 vs 41.7 16.1%). Gestational length was unaltered but the pups born had a low birth weight (P<0.05) (early pregnancy, 6.8 0.1 vs 5.3 0.1 g; mid-pregnancy, 6.8 0.1 vs 5.0 0.1 g) and low birth index (P<0.05) (early pregnancy, 95.2 2.4 vs 50.7 12.9%; mid-pregnancy, 95.2 2.4 vs 58.3 16.1%), fetal survival ratio (P<0.05) (early pregnancy, 95.2 2.4 vs 50.7 12.9; mid-pregnancy, 95.2 2.4 vs 58.3 16.1), and viability index (P<0.05) (early pregnancy, 94.9 2.6 vs 49.5 12.5%; mid-pregnancy, 94.9 2.6 vs 57.1 16.1%). However, the root extract was non-teratogenic. We conclude that the S. reticulata root extract can be hazardous to successful pregnancy in women and should not be used in pregnancy complicated by diabetes.

Pregnancy after hydrosalpinx treatment with Essure

Science.gov (United States)

Inocêncio, Gonçalo; Coutinho, Lúcia; Maciel, Raquel; Barreiro, Márcia

2013-01-01

We present a case of a 29-year-old woman, with a history of ectopic pregnancy, which required left salpingectomy, and with a tortuous and impermeable right fallopian tube, compatible with hydrosalpinx. As hydrosalpinx itself can compromise a future pregnancy, treatment with Essure was proposed before passing to medically assisted procreation techniques. Five months after placement of Essure in the right fallopian tube, an in vitro fertilisation cycle was successfully completed and the woman had a singleton pregnancy and vaginal delivery without intercurrences. PMID:23536627

Non-invasive diagnosis and management of ectopic pregnancy

NARCIS (Netherlands)

van Mello, N.M.

2013-01-01

The work presented in this thesis begins with a focus on non-invasive diagnostic methods for ectopic pregnancy. The heterogeneity found in studies on diagnostic tests for ectopic pregnancy has led to an international recommendation on uniform definitions of early pregnancy complications. Hereafter,

Elevated basal progesterone levels are associated with increased preovulatory progesterone rise but not with higher pregnancy rates in ICSI cycles with GnRH antagonists.

Science.gov (United States)

Mutlu, Mehmet Firat; Erdem, Mehmet; Mutlu, Ilknur; Bulut, Berk; Erdem, Ahmet

2017-09-01

To ascertain the association between basal progesterone (P) levels and the occurrence of preovulatory progesterone rise (PPR) and clinical pregnancy rates (CPRs) in ICSI cycles with GnRH antagonists. Serum P levels of 464 patients were measured on day 2 and day of hCG of cycles. Cycles with basal P levels>1.6ng/mL were cancelled. All embryos were cryopreserved in cycles with P levels≥2ng/mL on the day of hCG. The primary outcome measures were the incidence of PPR (P>1.5ng/mL) and CPR with regard to basal P. Basal P levels were significantly higher in cycles with PPR than in those without PPR (0.63±0.31 vs. 0.48±0.28ng/mL). Area under the curve for basal P according to ROC analysis to discriminate between elevated and normal P levels on the day of hCG was 0.65 (0.58-0.71 95% CI, pcycles with and without PPR was 0.65ng/mL. Cycles with basal P levels above 0.65ng/mL had a significantly higher incidence of PPR (30.9% vs. 13.5%) but similar clinical and cumulative pregnancy rates (38.8% vs. 31.1% and 41.7% vs. 32.6%, respectively) in comparison to cycles with basal P levels below 0.65ng/mL. In multivariate regression analysis, basal P levels, LH level on the first day of antagonist administration, and estradiol levels on the day of hCG trigger were the variables that predicted PPR. Basal P levels were associated with increased incidence of PPR but not with CPR. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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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.

Marriage season, promptness of successful pregnancy and first-born sex ratio in a historical natural fertility population - evidence for sex-dependent early pregnancy loss?

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Nonaka, K.; Desjardins, Bertrand; Charbonneau, Hubert; Légaré, Jacques; Miura, Teiji

We investigated population-based vital records of the seventeenth and eighteenth century French Canadian population to assess the effects of marriage season on the outcome of the first births under natural fertility conditions (n=21,698 marriages). Promptness of the first successful conception after marriage differed according to marriage season; the proportion of marriages with a marriage-first birth interval of 8.0-10.0 months was lowest (34%) for marriages in August-October (P=0.001). Although the male/female sex ratio of the babies born with an interval of 8.0-10.0 months was generally higher (1.10) than those with an interval of 10.0-24.0 months (1.05), the marriages in August-October resulted in a significantly reduced sex ratio (0.96) among only the prompt conceptions (P=0.026). We discuss whether this seasonal reduction of the sex ratio could be partly explained by a clustered pregnancy loss of male zygotes in early pregnancy.

The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on selective and sustained attention in 5-year-old children

DEFF Research Database (Denmark)

Underbjerg, Mette; Kesmodel, Ulrik S.; Landrø, Nils Inge

2012-01-01

Please cite this paper as: Underbjerg M, Kesmodel U, Landrø N, Bakketeig L, Grove J, Wimberley T, Kilburn T, Svaerke C, Thorsen P, Mortensen E. The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on selective and sustained attention in 5-year-old children. BJOG...... 2012;119:1211-1221. Objective  The aim was to examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on children's attention at 5 years of age. Design  Prospective follow-up study. Setting  Neuropsychological testing in four Danish cities 2003......-2008. Population  A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Methods  Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, the children were tested with the recently developed Test of Everyday Attention for Children...

Clinical analyses of successful and previously failed intracytoplasmic sperm injection cycle parameters in patients with poor ovarian reserve

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Tayfun Kutlu

2017-03-01

Full Text Available Objective: To determine some major characteristic differences between two consecutive successful and unsuccessful intracytoplasmic sperm injection (ICSI cycles in poor responders. Materials and Methods: Sixty women with poor ovarian response as determined using the Bologna criteria underwent ICSI cycles following an unsuccessful trial. Some parameters of both cycles including age, body mass index (BMI, serum follicle-stimulating hormone (FSH and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, embryo transfer day, number of embryo cells, and fertilization rate were compared in the same patients to identify predictors of cycles with clinical pregnancy. Results: The mean age, BMI, serum FSH, estradiol concentrations, and antral follicle count were 35.9 years (range, 30-42 years, 25.9 kg/m2 (range, 18.4-33.5 kg/m2, 10.9 IU/mL (range, 7-13 IU/mL, 52.9 pg/mL (range, 11.6-75 pg/mL, and 4.7 (range, 2-10, respectively. A comparison of cycle characteristics showed a significantly higher total number of mature and fertilized oocytes in successful cycles. The fertilization rate was also significantly higher in cycles with clinical pregnancy. Early initiation of antagonist was shown to result in favorable outcomes. A comparison of embryo characteristics showed that transfer of higher-stage embryos and embryos with higher numbers of cells had a significant impact on cycle outcomes. Conclusion: Our comparison of parameters of failed and successful ICSI cycles in poor responders revealed significantly earlier antagonist initiation, higher total number of mature and fertilized oocytes, fertilization rate, and significantly higher stage of embryo development and cell numbers at transfer in cycles that resulted in clinical pregnancy.

Weathering the storm; a review of pre-pregnancy stress and risk of spontaneous abortion.

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Frazier, Tyralynn; Hogue, Carol J Rowland; Bonney, Elizabeth A; Yount, Kathryn M; Pearce, Brad D

2018-06-01

The Weathering Effect is a theory that links stress exposure, over the life-course, with racial disparities in reproductive outcomes, through the effects of social adversity on a woman's body. The concept of maternal "weathering" captures cumulative somatic and psychological adversities that can exacerbate the effects of aging. Much of the evidence for weathering comes from observational studies linking self-report measures with reproductive outcomes. The purpose of this review is to explore biological mechanisms that underlie these observations. We focus on spontaneous abortion because this event is understudied despite evidence of racial disparities in this outcome. Spontaneous abortion is the most common pregnancy failure, and it happens early in pregnancy. Early pregnancy is a time most susceptible to the harmful effects of immune dysregulation that may, in part, result from adversities experienced before pregnancy begins. In exploring these mechanisms, we draw on well-defined signaling processes observed in the stressor-depression relationship. Pro-inflammatory dysregulation, for example, has particular relevance to immunological control occurring early in pregnancy. Early pregnancy immunologic changes affect the trajectories of pregnancy via control of trophoblastic invasion. Within the first few weeks of pregnancy, uterine derived cytokines operate within cytokine networks and play a critical role in this invasion. Programming for pro-inflammatory dysregulation can occur before conception. This dysregulation, brought into early pregnancy, has implications for viability and success of the index pregnancy. These patterns suggest early pregnancy health is susceptible to stress processing pathways that influence this immunologic control in the first six to eight weeks of pregnancy. In this review, we discuss the known mediating role of immune factors in the stressor-depression relationship. We also discuss how adversity experienced before the index pregnancy, or

Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women.

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Lukose, Ammu; Ramthal, Asha; Thomas, Tinku; Bosch, Ronald; Kurpad, Anura V; Duggan, Christopher; Srinivasan, Krishnamachari

2014-01-01

Many women of reproductive age from developing countries have poor nutritional status, and the prevalence of depression during pregnancy is high. The objective of the present study was to assess the prevalence of antenatal depressive symptoms in early pregnancy, and to identify the demographic and nutritional factors associated with these symptoms in a sample of urban South Indian pregnant women. This cross-sectional study was the baseline assessment of a prospective randomized controlled trial of vitamin B12 supplementation in urban pregnant south Indian women between the ages of 18 and 40 years ( www.clinicaltrials.gov : NCT00641862). 365 women in their first trimester of pregnancy were screened for depressive symptoms at an urban clinic in Karnataka, South India, using the Kessler Psychological Distress Scale (K-10). Nutritional, clinical and biochemical factors were also assessed. Mean (SD) age of the cohort was 22.6 (3.7) years and mean (SD) BMI was 20.4 (3.3) kg/m(2). 121 (33 %) of the women in the 1st trimester had symptoms consistent with depression (K-10 score >6). In multivariate log binomial regression analysis, presence of antenatal depressive symptoms in the first trimester were positively associated with vomiting, prevalence ratio (PR) = 1.54 (95 % CI 1.10, 2.16) and negatively with anemia, PR = 0.67 (95 % CI 0.47, 0.96). Nutrient intakes, serum vitamin B12, methylmalonic acid, homocysteine and red cell folate levels were not associated with measures of depression. Antenatal depressive symptoms in early pregnancy are highly prevalent in urban Indian women and are more common in women with vomiting and without anemia. In this cross-sectional data, blood concentrations of vitamin B12 and folate were not associated with depressive symptoms. The relationship between nutritional status and depressive symptoms may require larger and longitudinal studies.

Managing hyperthyroidism in pregnancy: current perspectives

Science.gov (United States)

Andersen, Stine Linding; Laurberg, Peter

2016-01-01

Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves’ disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6–10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the consequences of untreated or inadequately treated disease, and finally how to treat overt hyperthyroidism in pregnancy. PMID:27698567

Managing hyperthyroidism in pregnancy: current perspectives.

Science.gov (United States)

Andersen, Stine Linding; Laurberg, Peter

2016-01-01

Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6-10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the consequences of untreated or inadequately treated disease, and finally how to treat overt hyperthyroidism in pregnancy.

Variability and predictors of serum perfluoroalkyl substance concentrations during pregnancy and early childhood.

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Kingsley, Samantha L; Eliot, Melissa N; Kelsey, Karl T; Calafat, Antonia M; Ehrlich, Shelley; Lanphear, Bruce P; Chen, Aimin; Braun, Joseph M

2018-08-01

Exposure to poly- and perfluoroalkyl substances (PFAS), ubiquitous and persistent environmental contaminants, could be associated with adverse health outcomes, but there are limited longitudinal data assessing patterns and predictors of exposure during childhood. We quantified concentrations of eight different PFAS in sera collected from women during pregnancy and children at delivery and ages 3 and 8 years in 367 mother-child pairs enrolled in a prospective cohort from 2003 to 2006. In general, median childhood PFAS concentrations increased from birth to age 3 and then decreased by age 8. Maternal serum PFAS concentrations during pregnancy were strongly correlated with cord serum concentrations (0.76 PFAS concentrations, including income, race, and parity. In children, serum PFAS concentrations were associated with maternal age at delivery, race, parity, and child age. Breastfeeding duration was positively associated with childhood PFAS concentrations at ages 3 and 8 years. In addition, stain repellant use was associated with higher perfluorooctanoic acid and perfluorohexane sulfonic acid concentrations at age 8 years. Serum PFAS concentrations are higher during early childhood, a potentially sensitive period of development, and were highest among breastfed children. Copyright © 2018 Elsevier Inc. All rights reserved.

Maternal Exposure to Occupational Asthmagens During Pregnancy and Autism Spectrum Disorder in the Study to Explore Early Development.

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Singer, Alison B; Windham, Gayle C; Croen, Lisa A; Daniels, Julie L; Lee, Brian K; Qian, Yinge; Schendel, Diana E; Fallin, M Daniele; Burstyn, Igor

2016-11-01

Maternal immune activity has been linked to children with autism spectrum disorder (ASD). We examined maternal occupational exposure to asthma-causing agents during pregnancy in relation to ASD risk. Our sample included 463 ASD cases and 710 general population controls from the Study to Explore Early Development whose mothers reported at least one job during pregnancy. Asthmagen exposure was estimated from a published job-exposure matrix. The adjusted odds ratio for ASD comparing asthmagen-exposed to unexposed was 1.39 (95 % CI 0.96-2.02). Maternal workplace asthmagen exposure was not associated with ASD risk in this study, but this result does not exclude some involvement of maternal exposure to asthma-causing agents in ASD.

BRS 331 – Early cycle double-haploid wheat cultivar

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Pedro Luiz Scheeren

2016-12-01

Full Text Available The wheat cultivar ‘BRS 331’ was developed by Embrapa. It results from an interspecific cross between wheat and maize by double-hapolid method. ‘BRS 331’ shows solid stem in the base of the plant, short leaves and super-early cycle to maturity. It is classified as bread wheat in all of the regions that is recommended in the States of Rio Grande do Sul, Paraná and Santa Catarina, Brazil.

Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study

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Anne-Lise Bjørke-Monsen

2016-11-01

Full Text Available Maternal nutrition and inflammation have been suggested as mediators in the development of various adverse pregnancy outcomes associated with maternal obesity. We have investigated the relation between pre-pregnancy BMI, B vitamin status, and inflammatory markers in a group of healthy pregnant women. Cobalamin, folate, pyridoxal 5′-phosphate, and riboflavin; and the metabolic markers homocysteine, methylmalonic acid, and 3-hydroxykynurenine/xanthurenic acid ratio (HK/XA; and markers of cellular inflammation, neopterin and kynurenine/tryptophan ratio (KTR were determined in pregnancy week 18 and related to pre-pregnancy body mass index (BMI, in 2797 women from the Norwegian Mother and Child Cohort Study (MoBa. Pre-pregnancy BMI was inversely related to folate, cobalamin, pyridoxal 5′-phosphate (PLP, and riboflavin (p < 0.001, and associated with increased neopterin and KTR levels (p < 0.001. Inflammation seemed to be an independent predictor of low vitamin B6 status, as verified by low PLP and high HK/XA ratio. A high pre-pregnancy BMI is a risk factor for low B vitamin status and increased cellular inflammation. As an optimal micronutrient status is vital for normal fetal development, the observed lower B vitamin levels may contribute to adverse pregnancy outcomes associated with maternal obesity and B vitamin status should be assessed in women with high BMI before they get pregnant.

A Successful Pregnancy by Utilization of Gradually Increasing Low Dose Gonadotrophin Stimulation in a Modified Natural Cycle in Vitro Fertilization Procedure: Case Report

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Serkan Kahyaoğlu

2016-05-01

Full Text Available The modified natural cycle in vitro fertilization (MNC-IVF treatment can be a promising method for poor responder patients especially in young patients with poor ovarian reserve. A 34-year-old primary infertile woman presented with a history of poor ovarian response and cycle cancellation following controlled ovarian hyperstimulation during an IVF-ET procedure two months ago. During MNC-IVF treatment with intracytoplasmic sperm injection (ICSI, gradually increasing doses of hMG for three days (totally 675 IU have been administered accompanied by daily 0,25 mg cetrorelix. Following ovulation triggering, one oocyte was picked up and a good quality (grade 1 embryo was transferred on day 2. A clinical pregnancy was established with ultrasonography on sixth weeks of gestation. Acceptable pregnancy rates per embryo transfer, low medication cost, relatively low risk of complications and higher patient acceptability are the main advantages of MNC-IVF treatment as a feasible treatment option especially for poor responder patients.

Persistent ectopic pregnancy after milking procedure: Case report

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