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Sample records for early pregnancy failure

  1. [Recent recommendations in the management of early pregnancy failure].

    Science.gov (United States)

    Stupak, Aleksandra; Kwaśniewska, Anna

    2015-01-01

    Spontaneous abortion refers to pregnancy loss up to the end of 22 weeks' (21(+7)) gestation. Currently, the terminology suggests early pregnancy loss or early pregnancy failure. Miscarriage occurs in 10-20% of pregnancies, and most of them take place up to 13 weeks'gestation. Management in the case of vaginal bleeding in women with a confirmed pregnancy requires a physical examination (with a speculum), and a biochemical and ultrasound diagnosis. Conservative, pharmacological or surgical management can be offered to patients with an incomplete miscarriage. The pharmacological method of proceeding in miscarriages is recommended by many scientific societies (ACOG, RCOG), and WHO, as well as in manuals for students and for obstetrician-gynecologists developed by leading experts in Poland. The procedure for pharmacological treatment with mizoprostol is: 1. Pregnancy under 9 weeks gestation: 800 mg vaginally, and if there is no effect after 4 h another 400 mg vaginally or orally. 2. Pregnancy over 9 weeks gestation: up to 4 x 400 mg every 3 hours. 3. In the absence of any effect after 36 hours from the start of the treatment, a surgical procedure is recommended. 4. The prevention of chlamydia infection in each patient: 1 g of metronidazole rectally and one dose of 1 g azithromycin, or 2 x 100 mg of doxycycline for 7 days. The legal aspects regarding the administrative proceedings after early pregnancy failure relate to the correct reporting of feat death on proper forms.

  2. EFFICACY OF SUBLINGUAL MISOPROSTOL IN TERMINATION OF EARLY PREGNANCY FAILURE

    Directory of Open Access Journals (Sweden)

    Nupur

    2014-06-01

    Full Text Available INTRODUCTION: Nearly 20% of all confirmed pregnancies end in spontaneous abortion. Misoprostol’s use in early pregnancy failure is varied and dose and route are not well established. AIM: To study the efficacy of sublingual misoprostol in causing expulsion of products of conception in early pregnancy failure. METHODS: Women with an ultrasound diagnosis of early pregnancy failure, less than 12 weeks gestation were included in the study. Tablet Misoprostol 600 mcg was given six hourly sublingually for 3 doses. All observations were noted and analyzed. RESULTS: Mean gestational age was 7.946+1.2 weeks. Mean induction abortion interval was 18.241+1.2 hours. Women with gestational age six to eight weeks had least mean induction-abortion interval time of 17.38+2. Mean dose required was 1564mcg.Efficacy of protocol was 92.85% in achieving complete abortion. CONCLUSION: The regime had 92.85% efficacy, acceptability (90% and few side effects. Thus by using a lower dose and appropriate interval between two doses (six hours, the side effects were lessened with high efficacy

  3. Misoprostol versus curettage in women with early pregnancy failure after initial expectant management : a randomized trial

    NARCIS (Netherlands)

    Graziosi, GCM; Mol, BWJ; Reuwer, PJH; Drogtrop, A; Bruinse, HW

    2004-01-01

    BACKGROUND: Little is known about the effectiveness of misoprostol treatment in women with early pregnancy failure who have been managed expectantly. We therefore performed a randomized trial on this subject. METHODS: Women with early pregnancy failure, who had been managed expectantly for at least

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

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    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.

  5. Economic evaluation of misoprostol in the treatment of early pregnancy failure compared to curettage after an expectant management

    NARCIS (Netherlands)

    Graziosi, GCM; van der Steeg, JW; Reuwer, PHW; Drogtrop, AP; Bruinse, HW; Mol, BWJ

    2005-01-01

    BACKGROUND: The increased pressure on health care expenses implies that physicians should consider economic aspects as part of the clinical decision-making process. Direct and indirect costs of a strategy starting with misoprostol in treatment of early pregnancy failure as compared to curettage is t

  6. Management of early pregnancy failure and induced abortion by family medicine educators.

    Science.gov (United States)

    Herbitter, Cara; Bennett, Ariana; Schubert, Finn D; Bennett, Ian M; Gold, Marji

    2013-01-01

    Reproductive health care, including treatment of early pregnancy failure (EPF) and induced abortion, is an integral part of patient-centered care provided by family physicians, but data suggest that comprehensive training is not widely available to family medicine residents. The purpose of this study was to assess EPF and induced abortion management practices and attitudes of family medicine physician educators throughout the United States and Canada. These data were collected as part of a cross-sectional survey conducted by the Council of Academic Family Medicine Educational Research Alliance that was distributed via E-mail to 3152 practicing physician members of Council of Academic Family Medicine organizations. The vast majority of respondents (88.2%) had treated EPF, whereas few respondents (15.3%) had provided induced medication or aspiration abortions. Of those who had treated EPF, most had offered medication management (72.7%), whereas a minority had provided aspiration management (16.4%). Almost all respondents (95%) agreed that EPF management is within the scope of family medicine, and nearly three-quarters (73.2%) agreed that early induced abortion is within the scope of family medicine. Our findings suggest that family physician educators are more experienced with EPF management than elective abortion. Given the overlap of skills needed for provision of these services, there is the potential to increase the number of family physician faculty members providing induced abortions.

  7. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  8. 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 rat

  9. [Early diagnosis of ectopic pregnancy].

    Science.gov (United States)

    Belics, Zoran; Gérecz, Balázs; Csákány, M György

    2014-07-20

    Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

  10. Early pregnancy azathioprine use and pregnancy outcomes.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-02-01

    BACKGROUND: Azathioprine (AZA) is used during pregnancy by women with inflammatory bowel disease (IBD), other autoimmune disorders, malignancy, and organ transplantation. Previous studies have demonstrated potential risks. METHODS: The Swedish Medical Birth Register was used to identify 476 women who reported the use of AZA in early pregnancy. The effect of AZA exposure on pregnancy outcomes was studied after adjustment for maternal characteristics that could act as confounders. RESULTS: The most common indication for AZA use was IBD. The rate of congenital malformations was 6.2% in the AZA group and 4.7% among all infants born (adjusted OR: 1.41, 95% CI: 0.98-2.04). An association between early pregnancy AZA exposure and ventricular\\/atrial septal defects was found (adjusted OR: 3.18, 95% CI: 1.45-6.04). Exposed infants were also more likely to be preterm, to weigh <2500 gm, and to be small for gestational age compared to all infants born. This effect remained for preterm birth and low birth weight when infants of women with IBD but without AZA exposure were used as a comparison group. A trend toward an increased risk of congenital malformations was found among infants of women with IBD using AZA compared to women with IBD not using AZA (adjusted OR: 1.42, 95% CI: 0.93-2.18). CONCLUSIONS: Infants exposed to AZA in early pregnancy may be at a moderately increased risk of congenital malformations, specifically ventricular\\/atrial septal defects. There is also an increased risk of growth restriction and preterm delivery. These associations may be confounded by the severity of maternal illness.

  11. Shifts in Color Discrimination during Early Pregnancy

    OpenAIRE

    Levente L. Orbán; Farhad N. Dastur

    2012-01-01

    The present study explores two hypotheses: a) women during early pregnancy should experience increased color discrimination ability, and b) women during early pregnancy should experience shifts in subjective preference away from images of foods that appear either unripe or spoiled. Both of these hypotheses derive from an adaptive view of pregnancy sickness that proposes the function of pregnancy sickness is to decrease the likelihood of ingestion of foods with toxins or teratogens. Changes to...

  12. Acute renal failure in pregnancy: our experience.

    Science.gov (United States)

    Aggarwal, Rohina S; Mishra, Vineet V; Jasani, Anil F; Gumber, Manoj

    2014-03-01

    Acute renal failure (ARF) is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during pregnancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH), post-partum hemorrhage (PPH), septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8). The first trimester, second trimester and puerperal groups comprised of four (8%), 25 (50%) and 21 patients (42%), respectively. Hemorrhage was the etiology for ARF in 15 (30%), APH in ten (20%) and PPH in five (10%) patients. Eleven (22%) patients had lower segment cesarian section (LSCS) while 36 (78%) patients had normal vaginal delivery. In 20 (40%) patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36%) patients. Two (4%) patients had disseminated intravascular coagulation on presentation while one (2%) patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n = 6

  13. Acute renal failure in pregnancy: Our experience

    Directory of Open Access Journals (Sweden)

    Rohina S Aggarwal

    2014-01-01

    Full Text Available Acute renal failure (ARF is a serious medical complication during pregnancy, and, in the post-partum period, is associated with significant maternal morbidity and mortality as well as fetal loss. The objective of our study is to find the etiology and maternal outcome of ARF during preg-nancy. The study was conducted at the Obstetrics and Gynecology Department of the Institute of Kidney Disease and Research Center, Ahmedabad, India from January 2009 to January 2011. Fifty previously healthy patients who developed ARF, diagnosed on oliguria and serum creatinine >2 mg%, were included in the study. Patients with a known history of renal disease, diabetes and hypertension were excluded from the study. All patients were followed-up for a period of six months. Patient re-cords, demographic data, urine output on admission and preceding history of antepartum hemorrhage (APH, post-partum hemorrhage (PPH, septicemia, operative interventions and retained product of conception were noted and need for dialysis was considered. Patients were thoroughly examined and baseline biochemical investigations and renal and obstetrical ultrasound were performed on each patient and bacterial culture sensitivity on blood, urine or vaginal swabs were performed in selected patients. The age range was 19-38 years (mean 26 ± 3.8. The first trimester, second trimester and puerperal groups comprised of four (8%, 25 (50% and 21 patients (42%, respectively. Hemorrhage was the etiology for ARF in 15 (30%, APH in ten (20% and PPH in five (10% patients. Eleven (22% patients had lower segment cesarian section (LSCS while 36 (78% patients had normal vaginal delivery. In 20 (40% patients, puerperal sepsis was the etiological factor, while pre-eclampsia, eclampsia and HELLP syndrome accounted for 18 (36% patients. Two (4% patients had dissemi-nated intravascular coagulation on presentation while one (2% patient was diagnosed with hemolytic uremic syndrome. Maternal mortality was 12% (n

  14. [CHRONIC RENAL FAILURE AND PREGNANCY--A CASE REPORT].

    Science.gov (United States)

    Amaliev, G M; Uchikova, E; Malinova, M

    2015-01-01

    Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure. Determining the optimum time for authorization birth depends on the condition of the mother, the condition of the fetus and the rate of progression of renal failure, and the deadline the pregnancy should be terminated is 35 weeks. We present a case of a patient with chronic renal failure, with favorable perinatal outcome.

  15. Drug-induced fulminant hepatic failure in pregnancy.

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    Firoz, Tabassum; Webber, Douglas; Rowe, Hilary

    2015-12-01

    Liver disease in pregnancy can be classified as predating, co-incidental or unique to pregnancy. Medications are often overlooked as a significant cause of liver disease. We present the case of a 39-year-old patient who presented at 20 weeks with jaundice, elevated liver enzymes, and abnormal liver function progressing eventually to fulminant hepatic failure. The patient was on methyldopa and labetalol from 12 weeks' gestational age. Liver biopsy was consistent with drug-induced liver injury. Both methyldopa and labetalol have been associated with hepatotoxicity including liver failure. This case highlights the importance of including medications as a cause of liver failure in pregnant patients.

  16. Legal liability for failure to prevent pregnancy (wrongful pregnancy

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    Lodewicus Charl Coetzee

    2017-05-01

    Full Text Available Can the conception of a child ever constitute damage recoverable in law? This article considers the liability of healthcare practitioners for failing to prevent a pregnancy. Developments leading to the recognition of wrongful pregnancy as a cause of (legal action in South Africa (SA, are briefly outlined. The salient points of the relevant judgments by SA courts are set out to expose the rationale underlying the judgments and to highlight that recognition of liability for wrongful pregnancy resulted from an application of fair and equitable principles of general application. Conduct that could expose practitioners to liability is identified from reported cases and inferred from general principles laid down in case law.

  17. Percutaneous nephrolithotomy in early pregnancy.

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    Shah, A; Chandak, P; Tiptaft, R; Glass, J; Dasgupta, P

    2004-08-01

    Most cases of urolithiasis in pregnancy are managed conservatively either with ureteric stents or percutaneous nephrostomy tubes, which need to be changed at regular intervals. Definitive management of the stone is usually delayed till after delivery. We describe a patient who presented with pyonephrosis in the fifth week of gestation, due to a stone obstructing the right ureteropelvic junction. This was managed by insertion of a nephrostomy tube. She declined nephrostomy tube/stent changes during the rest of her pregnancy and requested termination as an alternative. She successfully underwent percutaneous nephrolithotomy in the 14th week of pregnancy, with radiation exposure strictly localised to the kidney for 6 s. A healthy male baby was delivered at term.

  18. Shifts in Color Discrimination during Early Pregnancy

    Directory of Open Access Journals (Sweden)

    Levente L. Orbán

    2012-04-01

    Full Text Available The present study explores two hypotheses: a women during early pregnancy should experience increased color discrimination ability, and b women during early pregnancy should experience shifts in subjective preference away from images of foods that appear either unripe or spoiled. Both of these hypotheses derive from an adaptive view of pregnancy sickness that proposes the function of pregnancy sickness is to decrease the likelihood of ingestion of foods with toxins or teratogens. Changes to color discrimination could be part of a network of perceptual and physiological defenses (e.g., changes to olfaction, nausea, vomiting that support such a function. Participants included 13 pregnant women and 18 non-pregnant women. Pregnant women scored significantly higher than non-pregnant controls on the Farnsworth-Munsell (FM 100 Hue Test, an objective test of color discrimination, although no difference was found between groups in preferences for food images at different stages of ripeness or spoilage. These results are the first indication that changes to color discrimination may occur during early pregnancy, and is consistent with the view that pregnancy sickness may function as an adaptive defense mechanism.

  19. Acute Liver Failure Secondary to Hemophagocytic Lymphohistiocytosis during Pregnancy

    OpenAIRE

    Giard, Jeanne-Marie; Decker, Kerry A.; Lai, Jennifer C.; Gill, Ryan M.; Logan, Aaron C.; Fix, Oren K.

    2016-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive immune activation that mimics and occurs with other systemic diseases. A 35-year-old female presented with signs of viral illness at 13 weeks of pregnancy and progressed to acute liver failure (ALF). We discuss the diagnosis of HLH and Kikuchi-Fujimoto (KF) lymphadenitis in the context of pregnancy and ALF. HLH may respond to comorbid disease-specific therapy, and more toxic treatment can be avoided.

  20. Anti-early pregnancy by PDT

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    Ding, Ai-Hua; Chen, Hui-Ling

    1993-03-01

    The effect of laser on anti-early pregnancy in rabbits showed that laser in combination with HPD could induce necrosis of blastocysts and complete absorption. The anti-fertility efficiency of the combined treatment was more effective than that of the He-Ne laser or the HPD treatment alone. The fluorescence spectrum of HPD determined by PNQ3 showed that its affinity to embryonic tissue was about 4 times greater than that to uterine tissue. This may underlie the mechanisms of anti-early pregnancy of the laser. The operation of artificial abortion is a routine method to terminate early pregnancy. Though it is simple and easy, its syndrome and complications can not be absolutely avoided. Many antifertility drugs have been reported, however, they often bring in general reaction. Our present work is to explore a new way of anti-early pregnancy in rabbits by means of the light inhibitory and light sensitive effects of laser. It is a quite safe and painless treatment without expanding and scraping of the uterus.

  1. 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

  2. Maternal obesity in early pregnancy and subsequent pregnancy outcome in a Nigerian population.

    Science.gov (United States)

    Ezeanochie, M C; Ande, A B; Olagbuji, B N

    2011-12-01

    Despite a rising prevalence worldwide, there is limited data on pregnancy outcome among African women with prepregnancy or early pregnancy obesity. This was a case-control study to determine the prevalence of maternal obesity in early pregnancy and compare the subsequent pregnancy outcome between 201 women with obesity and 201 non-obese controls in a University Teaching Hospital in Nigeria. The prevalence of obesity in early pregnancy was 9.63%. Obesity was significantly associated with advanced maternal age and parity > or =1. It was also a risk factor for pregnancy induced hypertension, admissions during pregnancy, caesarean delivery and associated with 5th minute apgar score Obesity in early pregnancy is a risk factor for adverse pregnancy outcome among pregnant Nigerian women. This information should be utilised by physicians to improve the outcome of pregnancy and promote safe motherhood.

  3. Placental chimerism in early human pregnancy

    Directory of Open Access Journals (Sweden)

    Ashutosh Halder

    2005-01-01

    Full Text Available Background0 : Human chimerism is rare and usually uncovered through investigations of ambiguous genitalia or blood grouping or prenatal diagnosis. Most of the publications on placental chimerism are mainly case reports. There is no systematic search with sensitive techniques for placental chimerism in human. Aim0 : This study was aimed to asses placental chimerism through two sensitive molecular techniques i.e., interphase fluorescent in situ hybridization and quantitative fluorescent PCR. Material and methods0 : Placental chimerism was analyzed using X & Y dual color fluorescent in-situ hybridization onto 154 placentae from natural conceptions, obtained at termination of pregnancy between 7 to 16 weeks of gestation. Results0 : Three cases of placental sex chromosome chimerism were observed (1.95%. Exclusion of maternal contamination and diagnosis was confirmed later by quantitative fluorescent PCR. Conclusion0 : This finding indicates that placental chimerism in early human pregnancy is not rare.

  4. Respiratory Failure in Premature Babies Born from Multiple Pregnancy

    Directory of Open Access Journals (Sweden)

    S. A. Perepelitsa

    2010-01-01

    Full Text Available Objective: to reveal the factors that are responsible for the development of respiratory distress syndrome (RDS and the specific features of its course in preterm twin neonates. Subjects and methods. Twenty-three patients who had had twin pregnancy, including 9 (39.1% and 14 (60% with monochorial and bichorial biamniotic twin pregnancies, respectively, were examined. Their mean age was 28.5±5.4 years. Obstetric and gynecologic histories, conditions at conception, the course of pregnancy, the type of pla-centation, and fetal presentation were considered. The placentas were morphologically examined. In all the patients, pregnancy ended in birth of 46 premature neonates, of them there were 19 (41.3% boys and 27 (58.7% girls. The gestational age of the neonates averaged 31.7±2.3 weeks. The evaluation of the efficiency of performed therapy used clinical assessment of the status of the premature neonates; measurement of partial oxygen tension (pO2 and calculation of alveolar-arterial oxygen gradient (A-a DO2, respiratory index (RI, and oxygenation index (OI; death rates were analyzed. Results. The main cause of respiratory failure (RF was RDS in premature twins. Neonatal blood aspiration-caused pneumonia occurred in one case. The course of RDS was variable. Most neonatal infants needed exogenous surfactant replacement therapy and mechanical ventilation (MV. No signs of RF were present in 7 (15.2% premature neonates. Conclusion. Premature twins are a high RDS risk group. The unfavorable factors that contribute to the development of the disease are multiple pregnancy, a past maternal obstetric history, in-vitro fertilization-induced pregnancy, severe gestosis in the second half of pregnancy, and preterm delivery. The type of placentation affects the fetal status after birth. Fatal outcome occurred in infants from the monochorial bioamniotic twins. In multiple pregnancies, there are pathological changes in the placenta, its membranes, and umbilical

  5. [Support for teenage pregnancies and early emotional deprivation].

    Science.gov (United States)

    Andro, Gwénäelle

    2016-01-01

    The perinatal psychology and psychiatry unit of Caen university hospital has put in place two systematic intervention protocols relating to pregnancy: teenage pregnancy and denial of pregnancy. Professionals are particularly concerned with teenagers with a history of early emotional deprivation and mistreatment, with the spectre of repetition. A partnership with a motherhood centre helps all concerned to work together to build resilience.

  6. Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

    OpenAIRE

    Feras Sendy; Eman AlShehri; Amani AlAjmi; Elham Bamanie; Surekha Appani; Taghreed Shams

    2015-01-01

    Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in th...

  7. Evaluation and management of early virological failure.

    Science.gov (United States)

    Sax, Paul E

    2006-09-01

    To describe the causes, evaluation, and management of early virological failure in patients treated with their first antiretroviral regimen. Combination antiretroviral therapy predictably induces a rapid virological response, with the majority of patients achieving an undetectable HIV-RNA load by week 24. In clinical trials and cohorts, rates of virological suppression have improved over time. Poor adherence to therapy remains the most common cause of virological failure, and genotype resistance testing is a critical step in evaluating the optimal subsequent approach. Most studies suggest that transient HIV-RNA elevations do not warrant changing treatment, and may be a consequence of laboratory variation. For those who experience virological failure, resistance to individual components of the antiretroviral regimen is dependent on the initial choice of treatment. Once virological failure is confirmed and adherence issues addressed, a prompt change in treatment is warranted to limit the selection of further drug resistance. Resistance that occurs with early virological failure follows typical patterns, with limited resistance to most antiretroviral agents in the nucleoside reverse transcriptase and protease inhibitor classes. The likelihood of achieving virological suppression with subsequent regimens should be high so long as adherence can be assured.

  8. Hepatitis e and acute liver failure in pregnancy.

    Science.gov (United States)

    Shalimar; Acharya, Subrat K

    2013-09-01

    Hepatitis E virus is a positive strand RNA virus with three open reading frames which is transmitted predominantly through the fecal contamination of water and food. It is the most common cause of acute liver failure in endemic areas. Pregnant women especially from the Indian subcontinent and Africa are at increased risk of contracting acute HEV infection as well as developing severe complications including ALF. Transmission of HEV occurs from mother to unborn child. Both maternal and fetal complications may occur, including abortion, fetal demise, preterm labor and maternal or neonatal death. The precise reasons for increased susceptibility to HEV infection during pregnancy and associated severe disease are still an enigma. Management is supportive and termination of pregnancy is not recommended as a general rule. Prevention of infection is of vital importance, as availability of clean drinking water can reduce the burden of this disease in the community. There is a need for future research to focus on prevention of ALF in pregnancy and to study the disease pathogenesis, which is not explicitly understood at present. The availability of a vaccine may alter the natural course of the disease in this select population which is at risk.

  9. ISOLATION AND CHARACTERIZATION OF EARLY PREGNANCY FACTOR

    Institute of Scientific and Technical Information of China (English)

    左祥生; 苏宝田; 魏道严

    1994-01-01

    Early pregnancy factor(EPF)was purified from the pooled sera of 210 pregnant women at 3-8weeks of gestation.Sera from healthy nonpegnant women used as control.The samples (G-Ⅱ,G-Ⅲ and G-Ⅳ) ob-tained from pregnant women had EPF activity but no HCG activity.Polyacrylamide gel electrophopesis showed that the amjor bands in pregnant G-Ⅲ and G-Ⅳ were at similar positions in tube gels.The results of SDS-PAGE showed 3 bands in pregnant G-Ⅳ:57.0 kD,38.0 kD and 19.0 kD.The basic active form of EPF may be a small peptide of 19.0 kD. The isoelectric points of pregnant G-Ⅳ were 6.45 and 8.20.

  10. Early Childhood Adversity and Pregnancy Outcomes

    Science.gov (United States)

    Smith, Megan V.; Gotman, Nathan; Yonkers, Kimberly A.

    2016-01-01

    Objectives To examine the association between adverse childhood experiences (ACEs) and pregnancy outcomes; to explore mediators of this association including psychiatric illness and health habits. Methods Exposure to ACEs was determined by the Early Trauma Inventory Self Report Short Form; psychiatric diagnoses were generated by the Composite International Diagnostic Interview administered in a cohort of 2303 pregnant women. Linear regression and structural equation modeling bootstrapping approaches tested for multiple mediators. Results Each additional ACE decreased birth weight by 16.33 g and decreased gestational age by 0.063. Smoking was the strongest mediator of the effect on gestational age. Conclusions ACEs have an enduring effect on maternal reproductive health, as manifested by mothers’ delivery of offspring that were of reduced birth weight and shorter gestational age. PMID:26762511

  11. Pre-pregnancy weight status, early pregnancy lipid profile and blood pressure course during pregnancy: The ABCD study.

    Science.gov (United States)

    Oostvogels, Adriëtte J J M; Busschers, Wim B; Spierings, Eline J M; Roseboom, Tessa J; Gademan, Maaike G J; Vrijkotte, Tanja G M

    2017-01-01

    Although pre-pregnancy weight status and early pregnancy lipid profile are known to influence blood pressure course during pregnancy, little is known about how these two factors interact. The association between pre-pregnancy weight status and blood pressure course during pregnancy was assessed in the prospective ABCD study and the role (independent/mediating/moderating) of early pregnancy lipid profile in this association was determined. We included 2500 normal weight (lipids [median (IQR): 13 (12-14) weeks of gestation] and blood pressure during pregnancy [mean (SD) = 10 (2.3)]. Lipids (triglycerides, total cholesterol, apolipoprotein A1, apolipoprotein B and free fatty acids) were divided into tertiles. Multilevel piecewise linear spline models were used to describe the course of systolic and diastolic blood pressure (SBP/DBP) in four time periods during gestation for overweight and normal weight women. Both SBP (5.3 mmHg) and DBP (3.9 mmHg) were higher in overweight compared to normal weight women and this difference remained the same over all four time periods. The difference in SBP and DBP was not mediated or moderated by the lipid profile. Lipid profile had an independent positive effect on both SBP (range 1.3-2.2 mmHg) and DBP (0.8-1.1 mmHg), but did not change blood pressure course. Both pre-pregnancy weight status and early pregnancy lipid profile independently increase blood pressure during pregnancy. Improving pre-pregnancy weight status and early pregnancy lipid profile might result in a healthier blood pressure course during pregnancy.

  12. Ectopic pregnancy as contraceptive failure in patient with epilepsy.

    Science.gov (United States)

    Radaković, Branko; Goldstajn, Marina Sprem

    2012-12-01

    Epilepsy is a common neurologic condition which includes many women's health issues. Menstrual disorders, reproductive endocrinological disturbances, ovulatory dysfunction and infertility appear to be relatively frequent in women with epilepsy. Clinical decision making which contraceptive regimen is optimal for an individual woman with epilepsy is one of the most challenging tasks when taking care of women with epilepsy. A higher incidence of breakthrough bleeding and contraceptive failure was determined among women using antiepileptic drugs. There is the increased risk for contraceptive failure with the use of P450 3A4 enzyme-inducing antiepileptic drugs (AEDs) such as phenobarbital, carbamazepine, phenytoin, felbamate, topiramate and oxcarbazepine. Therefore, it is recommended to use noninducing AEDs, or for those who use inducing AEDs, the use of oral hormonal contraceptive pills which contained equal or more than 50 microg of estrogen, or intrauterine devices. The aim of the article is to present woman with epilepsy who was used combined low dose oral contraceptive pills containing 20 microg of ethinyl estradiol which in interaction with carbamazepine resulted with ectopic tubar pregnancy.

  13. Uso do misoprostol em substituição à curetagem uterina em gestações interrompidas precocemente Misoprostol in substitution at uterine curettage in early pregnancy failure

    Directory of Open Access Journals (Sweden)

    Francisco Carlos Nogueira Arcanjo

    2011-06-01

    Full Text Available OBJETIVOS: Avaliar a eficácia do misoprostol administrado via vaginal para esvaziamento uterino em gestações interrompidas precocemente, bem como o tempo entre a administração e o esvaziamento, correlacionando-os com a idade gestacional. MÉTODOS: Ensaio clínico com 41 pacientes com gestações interrompidas entre a 7ª e a 12ª semanas gestacionais, com média de idade de 27,3 (±6,1 anos. A paridade média foi de 2,2 (±1,2 partos; o número médio de abortamentos prévios foi 0,2 (±0,5. Foram administrados 800 µg de misoprostol via vaginal, em dose única; após 24 horas, foi realizado ultrassom transvaginal. Considerou-se abortamento completo quando o diâmetro anteroposterior da cavidade endometrial media 8 semanas de idade gestacional em relação aos desfechos: frequência de abortamento completo e intervalo entre administração de misoprostol e o abortamento (em minutos. O nível de significância utilizado foi de 5%. RESULTADOS: A idade gestacional, no momento do diagnóstico, foi de 8,5 semanas em média (DP=1,5. Os intervalos entre a administração de misoprostol e as contrações uterinas, e entre a administração e o abortamento, foram de 322,5±97,0 min e 772,5±201,0 min, respectivamente. Houve abortamento completo em 80,3%. No primeiro grupo, a taxa de sucesso foi de 96,2% e no segundo, de 53,3% (pPURPOSE: To evaluate the effectiveness of misoprostol administered vaginally for uterine evacuation in interrupted early pregnancies and the time between the administration and emptying correlated with gestational age. METHODS: Clinical trial with 41 patients with pregnancies interrupted between the 7th and the 12th gestational weeks. The mean age was 27.3 (±6.1 years. Mean parity was 2.2 (±1.2 deliveries. The average number of previous abortions was 0.2 (± 0.5. Misoprostol was administered vaginally in a single 800 µg dose and transvaginal ultrasound was performed after 24 hours. Abortion was considered complete when the

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

    Science.gov (United States)

    Backhausen, Mette G; Ekstrand, Maria; Tydén, Tanja; Magnussen, Britta Kjeldberg; Shawe, Jill; Stern, Jenny; Hegaard, Hanne K

    2014-02-01

    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. 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 planning and 98% of those with a low degree of planning had not taken folic acid prior to pregnancy. Binge drinking during early pregnancy was reported by 20% of women with a high degree of planned pregnancy and 31% of those with a low degree (p = 0.1). CONCLUSION Pregnancy planning was associated with a healthier lifestyle but still many women could improve their lifestyle in connection to pregnancy. Their level of alcohol consumption is higher than that recommended for best pregnancy outcome.

  15. Non-invasive assessment of maternal hemodynamics in early pregnancy

    NARCIS (Netherlands)

    van der Graaf, Anne Marijn; Zeeman, Gerda G.; Groen, Henk; Roberts, Claire; Dekker, Gus A.

    2013-01-01

    Objectives: Non-invasive assessment of maternal hemodynamics in early pregnancy may be promising in evaluating maternal hemodynamic (mal)adaptation to pregnancy. We explored usage of applanation tonometry and Doppler ultrasound for assessment of cardiac output (CO), systemic vascular resistance (SVR

  16. 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

    pregnancy. The overall proportion of women reporting binge drinking during early pregnancy was 35 % (n = 1,134). The following independent risk factors for binge drinking in early pregnancy were identified: lower degree of planned pregnancy, smoking and alcohol habits before pregnancy ((1 unit/weekly aOR 4......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...... drinking in early pregnancy among women living in the capital of Denmark. Secondly to identify pre-pregnancy lifestyle and reproductive risk factors associated with binge drinking during early pregnancy. METHODS: Data were collected from September 2012 to August 2013 at the Department of Obstetrics...

  17. Obesity in Early Pregnancy May Raise Child's Risk of Epilepsy

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_164428.html Obesity in Early Pregnancy May Raise Child's Risk of ... researchers said. "This means more severe grades of obesity correspond to increasingly higher risk," said study co- ...

  18. The public health challenge of early growth failure in India.

    Science.gov (United States)

    Young, M F; Martorell, R

    2013-05-01

    Recent recognition of the early onset and high prevalence of wasting (30%) and stunting (20%) among infants 0-5 months in India draws attention to the need to understand the causes and develop prevention strategies. Such growth failure has dire consequences in the short (increased mortality) and long-term (loss of human capital and increased risk of chronic diseases). Food interventions before 6 months will increase morbidity/mortality through contamination in settings of poor sanitation and hygiene. Waiting to improve nutrition only after the initiation of complementary feeding at 6 months is a missed opportunity and may permanently alter life trajectory and potential. This underscores the importance of maternal nutrition. Iron and folic acid and protein energy supplementation during pregnancy are interventions that can improve maternal nutrition and birth outcomes. Maternal supplementation during lactation should be considered as a means to improve maternal and child outcomes, although the evidence needs strengthening. Support and counseling are also required to improve maternal diets and promote exclusive breastfeeding. Programs focused on improving maternal nutrition across the continuum of preconception, pregnancy and lactation are likely to have the greatest impact as mothers are central gatekeepers to the health and future of their children.

  19. Docosahexaenoic Acid Supplementation Early in Pregnancy May Prevent Deep Placentation Disorders

    Directory of Open Access Journals (Sweden)

    Jorge A. Carvajal

    2014-01-01

    Full Text Available Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction. Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction.

  20. Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

    Directory of Open Access Journals (Sweden)

    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.

  1. Acute liver failure in pregnancy: Causative and prognostic factors

    Directory of Open Access Journals (Sweden)

    Shweta Sahai

    2015-01-01

    Full Text Available Background/Aims: Acute liver failure (ALF in pregnancy is often associated with a poor prognosis. In this single-center observational study we aim to study the incidence, causes, and factors affecting mortality in pregnant women with ALF. Patients and Methods: Sixty-eight pregnant women reporting with clinical features of liver dysfunction were enrolled as "cases." Their clinical course was followed and laboratory studies were performed. The presence of ALF was defined as the appearance of encephalopathy. The results were compared with a "control" group of 16 nonpregnant women presenting with similar complaints. The cases were further subdivided into two groups of "survivors" and "nonsurvivors" and were compared to find out the factors that contribute to mortality. Results: ALF was seen in significantly more number of pregnant women than the controls (P = 0.0019. The mortality rate was also significantly higher (P = 0.0287. Hepatitis E virus (HEV caused jaundice in a higher number of pregnant women (P < 0.001. It also caused ALF in majority (70.3% of pregnant women, but HEV infection was comparable between the survivors and nonsurvivors (P = 0.0668, hence could not be correlated with mortality. Conclusions: Pregnant women appear to be more susceptible for HEV infection and development of ALF. The mortality of jaundiced pregnant women increased significantly with appearance of ALF, higher bilirubin, lower platelet count, higher international normalized ratio, and spontaneous delivery.

  2. Heart Failure Protein May Signal Early Brain Damage

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162447.html Heart Failure Protein May Signal Early Brain Damage Higher levels ... stress. Blood levels of NT-proBNP rise when heart failure worsens and fall when it gets better. Previous ...

  3. Pregnancy in fanconi anaemia with bone marrow failure: a case report and review of the literature.

    Science.gov (United States)

    Sorbi, Flavia; Mecacci, Federico; Di Filippo, Alessandro; Fambrini, Massimiliano

    2017-02-03

    Fanconi anaemia is a rare inherited disease characterized by congenital abnormalities, progressive bone marrow failure and predisposition to malignancy. Successful pregnancies in transplanted patients have been reported. In this paper we will describe the pregnancy of a patient with Fanconi anaemia without transplantation. A 34-year-old nulliparous woman with Fanconi anaemia was referred to our institution. Pregnancy was complicated by progressive pancytopenia and two severe infections. C-section was performed at 36 weeks. Both infant and mother are well. Successful pregnancy in a Fanconi anaemia patient with bone marrow failure is possible. The mode of delivery in patients with bone marrow failure should be determined by obstetric indications. The case highlights the safe outcome of the pregnancy with strict clinical and laboratory control by a multidisciplinary team.

  4. First time pregnant women's experiences in early pregnancy

    Directory of Open Access Journals (Sweden)

    Modh Carin

    2011-04-01

    Full Text Available Background: There are few studies focusing on women's experiences of early pregnancy. Medical and psychological approaches have dominated the research. Taking women's experiences seriously during early pregnancy may prevent future suffering during childbirth. Aim: To describe and understand women's first time experiences of early pregnancy. Method: Qualitative study using a phenomenological hermeneutic approach. Data were collected via tape-recorded interviews in two antenatal care units in Sweden. Twelve first time pregnant women in week 10–14, aged between 17 and 37 years participated. Results: To be in early pregnancy means for the women a life opening both in terms of life affirming and suffering. The central themes are: living in the present and thinking ahead, being in a change of new perspectives and values and being in change to becoming a mother. Conclusions: The results have implications for the midwife's encounter with the women during pregnancy. Questions of more existential nature, instead of only focusing the physical aspects of the pregnancy, may lead to an improvement in health condition and a positive experience for the pregnant woman.

  5. 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.

  6. Pregnancy and early-stage melanoma

    NARCIS (Netherlands)

    Daryanani, D; Plukker, JT; De Hullu, JA; Kuiper, H; Nap, RE; Hoekstra, HJ

    2003-01-01

    BACKGROUND. Cutaneous melanomas are aggressive tumors with an unpredictable biologic behavior. It has been suggested that women who present with melanoma during pregnancy have a worse prognosis due to more aggressive behavior of the melanoma. The objective of the current study was to evaluate the lo

  7. Comparison of early gestational development between natural and stimulated pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Soon Ae; Ahn, M. O.; Yoon, T. K.; Cha, G. Y. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1990-12-15

    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

  8. Pregnancy, Maternal Tobacco Smoking, and Early Age Leukemia in Brazil

    OpenAIRE

    2012-01-01

    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 ...

  9. 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

  10. Reducing unintended pregnancies: a microsimulation of contraceptive switching, discontinuation, and failure patterns in france.

    Science.gov (United States)

    Diamond-Smith, Nadia G; Moreau, Caroline; Bishai, David M

    2014-12-01

    Although the rate of contraceptive use in France is high, more than one-third of pregnancies are unintended. We built a dynamic microsimulation model that applies data from the French COCON study on method switching, discontinuation, and failure rates to a hypothetical population of 20,000 women, followed for five years. We use the model to estimate the adjustment factor needed to make the survey data fit the demographic profile of France by adjusting for underreporting of contraceptive nonuse and abortion. We then test three behavior-change scenarios that could reduce unintended pregnancies: decreasing method failure, increasing time using effective methods, and increasing switching from less effective to more effective methods. Our model suggests that decreasing method failure is the most effective means of reducing unintended pregnancies, but we found that all of the scenarios reduced unintended pregnancies by at least 25 percent. Dynamic microsimulations may have great potential in reproductive health research and prove useful for policymakers.

  11. Anxiety in early pregnancy: prevalence and contributing factors.

    Science.gov (United States)

    Rubertsson, C; Hellström, J; Cross, M; Sydsjö, G

    2014-06-01

    Antenatal anxiety symptoms are not only a health problem for the expectant mother. Research has found that maternal anxiety may also have an impact on the developing baby. Therefore, it is important to estimate the prevalence of maternal anxiety and associated factors. The current study aims to estimate the prevalence of anxiety symptoms during the first trimester of pregnancy and to identify associated risk factors. Secondly, to investigate other factors associated with anxiety during early pregnancy including fear of childbirth and a preference for cesarean section. In a population-based community sample of 1,175 pregnant women, 916 women (78%) were investigated in the first trimester (gestation week 8-12). The Hospital Anxiety Depression Scale (HADS-A) was used to measure anxiety symptoms. The prevalence of anxiety symptoms (HADS-A scores≥8 during pregnancy) was 15.6% in early pregnancy. Women under 25 years of age were at an increased risk of anxiety symptoms during early pregnancy (OR 2.6, CI 1.7-4.0). Women who reported a language other than Swedish as their native language (OR 4.2, CI 2.7-7.0), reported high school as their highest level of education (OR 1.6, CI 1.1-2.3), were unemployed (OR 3.5, CI 2.1-5.8), used nicotine before pregnancy (OR 1.7, CI 1.1-2.5), and had a self-reported psychiatric history of either depression (OR 3.8, CI 2.6-5.6) or anxiety (OR 5.2, CI 3.5-7.9) before their current pregnancy were all at an increased risk of anxiety symptoms during early pregnancy. Anxiety symptoms during pregnancy increased the rate of fear of birth (OR 3.0, CI 1.9-4.7) and a preference for cesarean section (OR 1.7, CI 1.0-2.8). Caregivers should pay careful attention to history of mental illness to be able to identify women with symptoms of anxiety during early pregnancy. When presenting with symptoms of anxiety, the women might need counseling and or treatment in order to decrease her anxiety.

  12. SEASONAL EFFECT ON ACCURACY OF IN - HOME URINARY PREGNANCY TEST FOR DETECTION OF EARLY PREGNANCY

    Directory of Open Access Journals (Sweden)

    Gupta

    2014-01-01

    Full Text Available OBJECTIVE : A study was planned to find out the cause of false positive urinary pregnancy test in early pregnancy as some times when ultrasonography is done on these women with positive pregnancy test , they are found to be non - pregnant . Such reports on false positive urinary pregnancy test , confirmed by ultrason ography are few and therefore the study was planned. METHOD: A total number of 218 women who came to the Deptt. o f Radiology Era’s Lucknow Medical College Lucknow , for routine first trimester ultrasonographies from April 2012 to Dec 2012 were analyzed . All th ese women had their urinary pregnancy test positive tested by commonly available test kits. Some of them were found to be non - pregnant on ultrasonography. The study was conducted for nine months . RESULT: Out of the 218 women who came with positive urinary pregnancy test were examined by ultrasonography. Out of these 18(8.2% cases were found to be non - pregnant and the test was false positive. These women had performed the urinary pregnancy test by themselves and out of these 4 cases were confirmed by hospit al/ lab. These women had performed the urinary pregnancy test in the months from April 2012 to September 2012 , when atmospheric temperature is high and weather is dry. CONCLUSION : Care should be taken to avoid drying of the test membrane in the pregnancy car d test kit by replacing it in its packet soon after adding the urine sample. The result should be noted within the time mentioned on the pack. Such instructions should be followed strictly while testing the urine for pregnancy.

  13. 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.

  14. A retrospective analysis of outcome of pregnancy with acute renal failure during a period of one year at Geetanjali medical college AND hospitals, Udaipur, Rajasthan, India

    Directory of Open Access Journals (Sweden)

    Anjana Verma

    2016-04-01

    Conclusions: Multidisciplinary services at tertiary level may reduce mortality due to Pregnancy related Acute Renal Failure. Most common etiological factor was pre eclampsia and eclampsia. Disappearance of illegal abortion, improvement in ANC with effective management of complicated pregnancy, the facility for safe early elective delivery whenever indicated, the improvement in resuscitation of obstetric hemorrhage and increased preparation of hospital birth had all contributed to the prevention of this devastating complication of pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1140-1144

  15. Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy.

    Science.gov (United States)

    Ylikotila, Pauli; Ketola, Raimo A; Timonen, Susanna; Malm, Heli; Ruuskanen, Jori O

    2015-11-01

    Cerebral venous thrombosis (CVT) is an uncommon cause of stroke, accounting to less than 1% of all strokes. We describe a pregnant woman with a massive CVT in early pregnancy, complicated by status epilepticus. The mother was treated with levetiracetam, lacosamide, and enoxaparin throughout pregnancy. A male infant was born on pregnancy week 36, weighing 2.2kg. Both levetiracetam and and lacosamide were present in cord blood in levels similar to those in maternal blood. The infant was partially breast-fed and experienced poor feeding and sleepiness, starting to resolve after two first weeks. Milk samples were drawn 5 days after the delivery and a blood sample from the infant 3 days later. Lacosamide level in milk was low, resulting in an estimated relative infant dose of 1.8% of the maternal weight-adjusted daily dose in a fully breast-fed infant. This is the first case describing lacosamide use during pregnancy and lactation.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Ntobeko B A Ntusi

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

  18. A sociobiological origin of pregnancy failure in domestic dogs

    Science.gov (United States)

    Bartoš, Luděk; Bartošová, Jitka; Chaloupková, Helena; Dušek, Adam; Hradecká, Lenka; Svobodová, Ivona

    2016-01-01

    Among domestic dog breeders it is common practice to transfer a domestic dog bitch out of her home environment for mating, bringing her back after the mating. If the home environment contains a male, who is not the father of the foetuses, there is a potential risk of future infanticide. We collected 621 records on mating of 249 healthy bitches of 11 breed-types. The highest proportion of successful pregnancies following mating occurred in bitches mated within their home pack and remaining there. Bitches mated elsewhere and then returned to a home containing at least one male had substantially lower incidence of maintained pregnancy in comparison with bitches mated by a home male. After returning home, housing affected strongly the frequency of pregnancy success. Bitches mated elsewhere but released into a home pack containing a home male were four times more likely to maintain pregnancy than bitches which were housed individually after returning home. Suppression of pregnancy in situations where a bitch is unable to confuse a home male about parentage may be seen as an adaptation to avoid any seemingly unavoidable future loss of her progeny to infanticide after birth and thus to save energy. PMID:26917034

  19. Pregnancy outcomes of women with failure to retain rubella immunity.

    Science.gov (United States)

    Schwartzenburg, Christopher J; Gilmandyar, Dzhamala; Thornburg, Loralei L; Hackney, David N

    2014-12-01

    We sought to explore the clinical variables associated with the loss of rubella immunity during pregnancy and to determine if these changes are linked to obstetrical complications. This is a case-control study in which women were identified whose rubella antibody titers were equivocal or non-immune and compared to those who had retained immunity. Two hundred and eighty-five cases were identified and compared to the same number of controls using Student's t test, Mann-Whitney U-test or Fisher's exact test. Univariate and multivariate logistic regressions were employed. Subjects with diminished immunity were more likely to have public insurance and higher gravidity with a trend toward increased tobacco use. Diminished rubella immunity was not associated with adverse obstetrical outcomes, including preterm birth and pre-eclampsia and is likely not a risk factor for these pregnancy outcomes. While no adverse pregnancy outcomes were associated with a loss of rubella immunity, women with greater number of pregnancies appear to lose their immunity to rubella. This relationship needs to be explored further and if proven, revaccination prior to pregnancy may need to be addressed.

  20. Impact of early pregnancy on prenatal development in the pig

    NARCIS (Netherlands)

    Lende, van der T.

    1989-01-01

    In the present study aspects of the impact of early pregnancy on the average prenatal development per litter and on the within-litter weight distribution at birth have been investigated. The aims of the present study are given in the introduction (chapter 1). A brief review of the literatur

  1. Expression of regulatory T cell (Treg) activation markers in endometrial tissues from early and late pregnancy in the feline immunodeficiency virus (FIV)-infected cat.

    Science.gov (United States)

    Lockett, N N; Scott, V L; Boudreaux, C E; Clay, B T; Pruett, S B; Ryan, P L; Coats, K S

    2010-09-01

    Regulatory T cells (Tregs) support pregnancy maintenance by suppressing placental inflammation, while diminished Treg function may accompany reproductive failure. Experimental FIV infection frequently results in vertical transmission and increased pregnancy failure in the cat. The mechanism of reproductive compromise is unknown. We hypothesized that FIV infection alters endometrial Treg population dynamics and function, potentiating vertical transmission and reproductive failure. RNA collected from early and late gestation reproductive tissue and fetuses from FIV infected and control cats was probed for expression of FIV gag and Treg markers CD25, FOXP3, and CTLA4, using real time reverse-transcriptase (RT)-PCR. Frequent placental and fetal infection and reproductive failure were detected at early and late pregnancy. Expression of FOXP3 and CTLA4 was higher in early gestation tissues from control cats. FIV infection significantly reduced expression of FOXP3 and CTLA4 at early, but not late pregnancy. At late pregnancy, CTLA4 was expressed to higher levels in infected tissues. The number of tissues with decreased co-expression of FOXP3 and CTLA4 was significant in infected cats at early pregnancy. No significant changes in CD25 expression occurred between FIV-infected and control animals at early or late pregnancy. Differences in Treg marker expression were not significant between viable and non-viable pregnancies in infected cats. The detection of Treg markers in these feline tissues provides the first evidence of feline endometrial Tregs and suggests that such cells diminish as pregnancy progresses. These cells may be depleted or rendered less functional by viral infection, but understanding their role in pregnancy requires further study.

  2. Incidence, causes and consequences of pregnancy failure in viviparous lizards: implications for research and conservation settings.

    Science.gov (United States)

    Hare, Kelly M; Cree, Alison

    2010-01-01

    Research on the causes of pregnancy failure in vertebrates has historically been mammal-focussed. However, live-birth (viviparity) has evolved multiple times, and is present in all other vertebrate taxa except Aves and Agnatha. Viviparous lizards (O. Squamata, excluding snakes and amphisbaenians) provide a valuable experimental group when studying major evolutionary events and some are also species of high conservation value. Consequently, both researchers and herpetoculturists often require high reproductive output from captive-held lizards. We reviewed the literature to determine potential or known causes of pregnancy failure for captive lizards. Pregnancy success across species averages approximately 86%, but varies extensively and does not appear to be related to embryonic stage when brought into captivity or level of placentation. Causes of pregnancy failure also vary among species, but correct thermal environments are vital to success, and providing adequate nutrition before vitellogenesis increases the number of viable offspring. A coordinated sequence of hormonal changes involving both pro-pregnancy and pro-labour factors is important for successful pregnancies, although uncertainty remains around the maternal concentrations of corticosterone that allow successful development. Several research areas commonly studied in mammals have yet to be explored or fully addressed in pregnant lizards, including impacts of toxins, parasites, UV light and nutritional quality. As viviparity has evolved over 100 times in lizards, and many different levels of placentation exist, pregnant lizards provide valuable models for studies in ecology and evolution and offer a useful comparison for studies on other viviparous vertebrates.

  3. Early pregnancy B vitamin status, one carbon metabolism, pregnancy outcome and child development.

    Science.gov (United States)

    Solé-Navais, Pol; Cavallé-Busquets, Pere; Fernandez-Ballart, Joan D; Murphy, Michelle M

    2016-07-01

    Periconception supplementation with folic acid is recommended until 12 gestational weeks to prevent neural tube defects. Doses of folic acid contained in supplements and timing and length of use during pregnancy vary. The effects of status in periconception and pregnancy folate, cobalamin, betaine and their interactions on one carbon metabolism (1C), as well as the global effect of 1C on foetal growth and pregnancy outcome, are reviewed. Results from prospective studies are reviewed. Cessation of folic acid supplement use after the first trimester is associated with a sharp drop in plasma folate status and enhanced conversion of betaine to dimethylglycine. Dimethylglycine production is also higher in mothers with low folate status than in those with normal-high folate status. The effects of high doses of folic acid on one carbon metabolism in mothers with low early pregnancy cobalamin status and on foetal growth are also reviewed. Several studies report that moderately elevated early pregnancy fasting plasma total homocysteine (tHcy) is inversely associated with birth weight and a predictor of intrauterine growth retardation. There is also evidence for increased risk of preterm birth when maternal folate status is low.

  4. Vitamin D status in early pregnancy and risk of preeclampsia

    Science.gov (United States)

    Achkar, Madonna; Dodds, Linda; Giguère, Yves; Forest, Jean-Claude; Armson, B. Anthony; Woolcott, Christy; Agellon, Sherry; Spencer, Anne; Weiler, Hope A.

    2016-01-01

    OBJECTIVE We sought to examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia (PE). STUDY DESIGN This was a nested case-control study from 2 prospective Canadian cohorts conducted in Quebec City, Quebec, and Halifax, Nova Scotia, from 2002 through 2010. Participants were pregnant women (n=169 cases with PE and 1975 controls). Maternal serum was drawn child-bearing age should be explored as a strategy for reducing PE and for promoting a healthier pregnancy. PMID:25446694

  5. Failure Rate of Single Dose Methotrexate in Managment of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Feras Sendy

    2015-01-01

    Full Text Available Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67% received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225 of the patients. 28% (63/225 were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63 of failure received a second dose of methotrexate, and 37% (23/63 underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

  6. Failure rate of single dose methotrexate in managment of ectopic pregnancy.

    Science.gov (United States)

    Sendy, Feras; AlShehri, Eman; AlAjmi, Amani; Bamanie, Elham; Appani, Surekha; Shams, Taghreed

    2015-01-01

    Background. One of the treatment modalities for ectopic pregnancy is methotrexate. The purpose of this study is to identify the failure rate of methotrexate in treating patients with ectopic pregnancy as well as the risk factors leading to treatment failure. Methods. A retrospective chart review of 225 patients who received methotrexate as a primary management option for ectopic pregnancy. Failure of single dose of methotrexate was defined as drop of BHCG level less than or equal to 14% in the seventh day after administration of methotrexate. Results. 225 patients had methotrexate. Most of the patients (151 (67%)) received methotrexate based on the following formula: f 50 mg X body surface area. Single dose of methotrexate was successful in 72% (162/225) of the patients. 28% (63/225) were labeled as failure of single dose of methotrexate because of suboptimal drop in BhCG. 63% (40/63) of failure received a second dose of methotrexate, and 37% (23/63) underwent surgical treatment. Among patient who received initial dose of methotrexate, 71% had moderate or severe pain, and 58% had ectopic mass size of more than 4 cm on ultrasound. Conclusion. Liberal use of medical treatment of ectopic pregnancy results in 71% success rate.

  7. 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

    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......-Emotional [58.3 (38.1) vs. 82.9 (31.3); P = 0.0005] and Mental Health [67.7 (20.4) vs. 75.2 (15.8), P = 0.04], and a lower score for the 36-item Short-Form Health Survey scale Mental Component Summary (42.8 (13.1) vs. 48.8 (9.7), P = 0.03) in early pregnancy, compared with women with term deliveries. Depression...... symptoms (Hospital Anxiety and Depression Scale depression score ≥ 8) were more frequent in women with preterm vs. term deliveries (seven (25%) vs. six women (5%); P = 0.003), while levels of anxiety and locus of control were similar in these two groups. No difference in early pregnancy scores for health...

  8. Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection.

    Science.gov (United States)

    Hajishafiha, Masomeh; Ghasemi-Rad, Mohammad; Memari, Aishe; Naji, Siamak; Mladkova, Nikol; Saeedi, Vida

    2011-01-01

    There is a need to elucidate what affects the implantation and early pregnancy course in pregnancies conceived with assisted reproductive technology (ART) so that pregnancy rates and outcomes can be improved. Our aim was to determine the role of maternal Helicobacter pylori infection. We did a prospective study of 187 infertile couples undergoing intracytoplasmic sperm injection (ICSI) and segregated those according to underlying infertility etiology. We assessed the status of H. pylori IgG antibodies and anti-CagA IgG antibodies by ELISA assay. All pregnancies were followed for early pregnancy loss (EPL, first 12 weeks). The likelihood of H. pylori infection increased with age (1.01, 95% confidence interval [CI]: 1.0-1.13; P = 0.040) but there was no association with EPL. Women infected with CagA-positive strains were more likely to have EPL (19.39, 95% CI: 1.8-208.4; P = 0.014). Women with tubal factor or ovulatory disorder infertility were more likely to abort early (12.95, 95% CI: 1.28-131.11; P = 0.030, 10.84, 95% CI: 1.47-80.03; P = 0.020, respectively). There was no association between EPL and age, number of embryos formed or transferred, or number of oocytes retrieved. Our findings suggest that infection with CagA-positive H. pylori strains is linked to an increase in women's potential to abort early (possibly through increased release of inflammatory cytokines). In addition, tubal factor and ovulatory disorder infertility are linked to EPL after ICSI due to unknown mechanisms. Proposals to eradicate H. pylori infection prior to ICSI could lead to a decrease in EPL after ART.

  9. Does sequential embryo transfer improve pregnancy rate in patients with repeated implantation failure? A randomized control study

    Directory of Open Access Journals (Sweden)

    Wael A. Ismail Madkour

    2015-12-01

    Full Text Available Background: Repeated failure of in vitro fertilization treatment is frustrating to the patients and their clinicians. Various treatment plans and a change of protocol have been suggested for “low responders”; however, patients who fail treatment repeatedly inspite of good quality embryos pose a special therapeutic challenge. Additional challenge would be imposed on that particular group when the local IVF regulating low does not permit surplus embryo freezing. Objective: To examine whether sequential transfer of embryos on day 3 and on day 5 after ovum pick-up improves IVF/ET success rates in patients with repeated consecutive IVF failures (⩾ 3 trials compared to day 3 alone, with the background that local regulation prohibits embryo freezing. Study design: Randomized controlled study. Women scheduled for IVF/ET with repeated consecutive IVF failures (⩾ 3 trials were randomized to either sequential transfer of embryos on day 3 and on day 5 after ovum pick-up (Group I = 74 or conventional day 3 transfer (Group II = 73 as a control. The primary outcome measures were clinical pregnancy rate and implantation rate. The secondary outcome measures were ongoing pregnancy rate and early pregnancy loss. Results: Baseline and cycle characteristics were comparable in both groups. Clinical pregnancy rate (per embryo transfer was significantly higher in sequential ET group (37. 8% compared to that in day 3 group (21.9% (P value <0.05. Also, implantation rate (per embryos transferred was significantly higher in sequential ET group (17.1% compared to that in control group (10.5% (P value <0.01. Similarly, ongoing pregnancy (per embryo transfer was significantly higher in sequential ET group (33. 8% compared to that in day 3 group (19.2% (P value <0.05. Conclusions: Patients with repeated implantation failures, treatment with the sequential embryo transfer approach had significantly improved pregnancy outcomes compared to regular day 3 transfers

  10. 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.

  11. Association of early maternal hypertriglyceridemia with pregnancy-induced hypertension.

    Science.gov (United States)

    Chandi, Anadeep; Sirohiwal, Daya; Malik, Roopa

    2015-11-01

    Hypertensive diseases are directly responsible for 24 % of maternal deaths in India. A screening method is yet to be discovered to reduce the morbidity and mortality related to it. Serum triglyceride (TG) levels are reported to increase in hypertensive pregnant women. To predict pregnancy-induced hypertension (PIH) by serum triglyceride values. This study is a prospective cohort study that was conducted over three hundred normotensive, primigravida women with singleton pregnancy at 14-20 weeks of gestation. These were divided into two groups on the basis of their TG concentration estimated at 14-20 weeks of gestation. The pregnancy was then followed till delivery and, signs and symptoms of PIH were noted in both the groups. Out of 300 women, 210 women completed the study. Fifty-nine women developed PIH and 151 women remained normotensive. Among 59 women, 45 women had raised TG values i.e., ≥160 mg/dL and 14 women were with normal TG levels i.e., hypertriglyceridemia were found to be at higher risk of developing early-onset PIH. Our study supports the evidence that early pregnancy hypertriglyceridemia is associated with an increased risk of PIH.

  12. Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection

    Directory of Open Access Journals (Sweden)

    Hajishafiha M

    2011-10-01

    Full Text Available Masomeh Hajishafiha1, Mohammad Ghasemi-rad1, Aishe Memari1, Siamak Naji1, Nikol Mladkova2, Vida Saeedi1 1Urmia University of Medical Sciences, Urmia, Iran; 2Institute of Cell and Molecular Science, London, UK Background: There is a need to elucidate what affects the implantation and early pregnancy course in pregnancies conceived with assisted reproductive technology (ART so that pregnancy rates and outcomes can be improved. Our aim was to determine the role of maternal Helicobacter pylori infection. Material and methods: We did a prospective study of 187 infertile couples undergoing intracytoplasmic sperm injection (ICSI and segregated those according to underlying infertility etiology. We assessed the status of H. pylori IgG antibodies and anti-CagA IgG antibodies by ELISA assay. All pregnancies were followed for early pregnancy loss (EPL, first 12 weeks. Results: The likelihood of H. pylori infection increased with age (1.01, 95% confidence interval [CI]: 1.0–1.13; P = 0.040 but there was no association with EPL. Women infected with CagA-positive strains were more likely to have EPL (19.39, 95% CI: 1.8–208.4; P = 0.014. Women with tubal factor or ovulatory disorder infertility were more likely to abort early (12.95, 95% CI: 1.28–131.11; P = 0.030, 10.84, 95% CI: 1.47–80.03; P = 0.020, respectively. There was no association between EPL and age, number of embryos formed or transferred, or number of oocytes retrieved. Conclusion: Our findings suggest that infection with CagA-positive H. pylori strains is linked to an increase in women's potential to abort early (possibly through increased release of inflammatory cytokines. In addition, tubal factor and ovulatory disorder infertility are linked to EPL after ICSI due to unknown mechanisms. Proposals to eradicate H. pylori infection prior to ICSI could lead to a decrease in EPL after ART.Keywords: Helicobacter pylori, early pregnancy loss, early abortion, infertility, intracytoplasmic sperm

  13. Pregnancy outcomes following the administration of high doses of dexamethasone in early pregnancy.

    Science.gov (United States)

    Namdar Ahmadabad, Hasan; Kayvan Jafari, Sabah; Nezafat Firizi, Maryam; Abbaspour, Ali Reza; Ghafoori Gharib, Fahime; Ghobadi, Yusef; Gholizadeh, Samira

    2016-03-01

    In the present study, we aimed to evaluate the effects of high doses of dexamethasone (DEX) in early pregnancy on pregnancy outcomes. Pregnant BALB/c mice were treated with high-dose DEX in the experimental group or saline in the control group on gestational days (GDs) 0.5 to 4.5. Pregnant mice were sacrificed on GDs 7.5, 13.5, or 18.5 and their peripheral blood, placentas, fetuses, and uterine tissue were collected. Decidual and placenta cell supernatants were examined to evaluate the effect of DEX on the proliferation of mononuclear cells, the quantity of uterine macrophages and uterine natural killer (uNK) cells, and levels of progesterone and 17β-estradiol, as determined by an 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide assay, immunohistochemistry, and enzyme-linked immunosorbent assay, respectively. We also were measured fetal and placental growth parameters on GD 18.5. We found that high doses of DEX were associated with an increased abortion rate, enhancement of the immunosuppressive effect of the decidua, alterations in placental growth parameters, decreased progesterone and 17β-estradiol levels, and a reduced frequency of macrophages and uNK cells. Our data suggest that the high-dose administration of DEX during early pregnancy negatively affected pregnancy outcomes.

  14. Use of tramadol in early pregnancy and congenital malformation risk.

    Science.gov (United States)

    Källén, Bengt; Reis, Margareta

    2015-12-01

    Only few studies exist regarding the risk of a teratogenic effect of tramadol when used in early pregnancy. Using the Swedish Medical Birth Register, women (deliveries in 1997-2013) who had reported the use of tramadol in early pregnancy were identified. Maternal characteristics and concomitant drug use were analyzed. Among 1,682,846 women (1,797,678 infants), 1751 (1776 infants) had used tramadol, 96 of the infants had a congenital malformation and 70 of them were relatively severe. The adjusted odds ratio for a relatively severe malformation was 1.33 (95% CI 1.05-1.70). The odds ratios for cardiovascular defects (1.56, 95% CI 1.04-2.29) and for pes equinovarus (3.63, 95% CI 1.61-6.89) were significantly increased. The study suggests a teratogenic effect of tramadol but the risk increase is moderate. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. How pregnancy at early age protects against breast cancer.

    Science.gov (United States)

    Meier-Abt, Fabienne; Bentires-Alj, Mohamed

    2014-03-01

    Pregnancy at an early age has a strong protective effect against breast cancer in humans and rodents. Postulated mechanisms underlying this phenomenon include alterations in the relative dynamics of hormone and growth factor-initiated cell fate-determining signaling pathways within the hierarchically organized mammary gland epithelium. Recent studies in epithelial cell subpopulations isolated from mouse and human mammary glands have shown that early pregnancy decreases the proportion of hormone receptor-positive cells and causes pronounced changes in gene expression as well as decreased proliferation in stem/progenitor cells. The changes include downregulation of Wnt and transforming growth factor β (TGFβ) signaling. These new findings highlight the importance of cell-cell interactions within the mammary gland epithelium in modulating cancer risk and provide potential targets for breast cancer prevention strategies.

  16. A molar masquerading as an ectopic pregnancy in the early first trimester: a salutary lesson.

    Science.gov (United States)

    Govind, Abha; Lakhi, Nisha

    2012-01-01

    The authors report a case in which a molar pregnancy was mistaken for an ectopic pregnancy in the early first trimester. This confusion delayed diagnosis and caused distress; follow-up led to the final diagnosis of complete hydatidiform mole. Correct preoperative diagnosis of molar pregnancy by ultrasound in early pregnancy may be tricky. It is important to obtain histological evidence to make the final diagnosis of gestational trophoblastic disease. While relatively rare, consideration of molar pregnancy in the differential diagnosis of early pregnancy loss may avoid unnecessary distress.

  17. 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.

  18. Maternal Hypothyroidism in Early Pregnancy and Infant Structural Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Bengt Källén

    2014-01-01

    Full Text Available Background. The question is debated on whether maternal hypothyroidism or use of thyroxin in early pregnancy affects the risk for infant congenital malformations. Objectives. To expand the previously published study on maternal thyroxin use in early pregnancy and the risk for congenital malformations. Methods. Data from the Swedish Medical Birth Register were used for the years 1996–2011 and infant malformations were identified from national health registers. Women with preexisting diabetes or reporting the use of thyreostatics, anticonvulsants, or antihypertensives were excluded from analysis. Risk estimates were made as odds ratios (ORs or risk ratios (RRs after adjustment for year of delivery, maternal age, parity, smoking, and body mass index. Results. Among 23 259 infants whose mothers in early pregnancy used thyroxin, 730 had a major malformation; among all 1 567 736 infants, 48012 had such malformations. The adjusted OR was 1.06 (95% CI 0.98–1.14. For anal atresia the RR was 1.85 (95% CI 1.00–1.85 and for choanal atresia 3.14 (95% CI 1.26–6.47. The risk of some other malformations was also increased but statistical significance was not reached. Conclusions. Treated maternal hypothyroidism may be a weak risk factor for infant congenital malformations but an association with a few rare conditions is possible.

  19. Complementary and alternative medicine use during early pregnancy.

    Science.gov (United States)

    Pallivalappila, Abdul Rouf; Stewart, Derek; Shetty, Ashalatha; Pande, Binita; Singh, Rajvir; Mclay, James S

    2014-10-01

    To determine the prevalence and explore predictors of Complementary and Alternative Medicine (CAM) use during early pregnancy. A questionnaire survey of pregnant women (500) attending for mid trimester scan at the maternity services in Grampian, North-East Scotland. Outcome measures included; CAM used; vitamins and minerals used; independent predictors of use; views and experiences. Descriptive and inferential statistical analysis. The response rate was 66%. Two thirds of respondents (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. Respondents reported using a total of 28 different CAM modalities, of which oral herbal products were the most common (37% of respondents, 25 different products). The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3-7.3, ppregnancy (OR 2.4, 95% CI 1.2-4.8, p=0.014). In comparison to prescribed medicines, most users were uncertain if CAM were safer (63%), more effective (66%), free from possible adverse effects (46%) or drug-CAM interactions (50%). Despite the majority of respondents being uncertain about their safety and effectiveness, CAM modalities and CAM products are widely used during the early stages of pregnancy in this study population. The role of family and friends rather than health professionals in the decision to use CAM may be of concern and requires further investigation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. The prevalence of pregnancy-related acute renal failure in Asia: A systematic review.

    Science.gov (United States)

    Karimi, Zynab; Malekmakan, Leila; Farshadi, Maryam

    2017-01-01

    Acute renal failure (ARF) is a major complication during pregnancy and is associated with high mortality rate in developing countries. The aim of this study was to report the prevalence of pregnancy-related ARF in Asia. This study is a systematic review Google Scholar, PubMed, and Medline databases were searched for all papers in English on pregnancy related ARF (PR-ARF) in Asian countries that were published between 2010 and 2015 were reviewed. Of all the articles published in that period, 19 were selected - 17 were original articles and two were cases reports. We gathered information on the prevalence of PR-ARF, parity, duration of pregnancy when PR-ARF developed, etiology of PR-ARF, common clinical symptoms, and laboratory findings in PR-ARF.

  1. Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes.In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  2. Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  3. Reasons for pregnancy termination: negligence or failure of contraception?

    Science.gov (United States)

    Savonius, H; Pakarinen, P; Sjöberg, L; Kajanoja, P

    1995-11-01

    Interviews with 200 abortion seekers at a Finnish hospital revealed a high incidence of contraceptive failure. Although 93% claimed to have adequate knowledge about contraception, only 23 women (11.5%) were using a reliable method (pill or IUD) at the time of conception. 126 (63%) were relying on a less safe method (e.g., condoms, spermicides, rhythm) and 51 (25.5%) were not using any form of fertility control. 9 of the 16 pill users admitted irregular use; another 3 experienced vomiting or diarrhea at the time of conception, which may have compromised the method's effectiveness. Of the 116 condom users, 89 reported that the condom had broken or slipped off during intercourse or that use had been irregular. Concern about side effects was the most frequently cited reason for not using the pill or IUD; in many other cases, women had been advised by their physician to take a break from use of these methods. Overall, contraceptive failure was considered to have occurred in 43 cases (21.5%); the methods involved were IUD (7 cases), pill (4 cases), condoms (27 cases), and spermicides (5 cases). Recommended to reduce the high rate of contraceptive failure are counseling on proper method use and the alleviation of concern about side effects associated with the most effective methods.

  4. Early-onset preeclampsia : Constitutional factors and consequences for future pregnancy outcome and cardiovascular health

    NARCIS (Netherlands)

    van Rijn, B.B.

    2008-01-01

    In this thesis, maternal constitutional factors related to long-term cardiovascular health and subsequent pregnancy outcome in women with early-onset preeclampsia is addressed. Aims of the thesis: To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by early-onset

  5. Early-onset preeclampsia : Constitutional factors and consequences for future pregnancy outcome and cardiovascular health

    NARCIS (Netherlands)

    van Rijn, B.B.

    2008-01-01

    In this thesis, maternal constitutional factors related to long-term cardiovascular health and subsequent pregnancy outcome in women with early-onset preeclampsia is addressed. Aims of the thesis: To evaluate subsequent pregnancy outcome in women with a first pregnancy complicated by early-onset pre

  6. [Early pregnancy risk: development and validation of a predictive instrument].

    Science.gov (United States)

    Burrows, R; Rosales, M E; Díaz, M; Muzzo, S

    1994-06-01

    An early pregnancy risk scale, with scores ranging from 11 to 66 points from lower to higher risk, was constructed using variables associated with teenager's pregnancy. This scale was applied to 3000 female teenagers, coming from Metropolitan Santiago public schools. The sample was divided in three risk groups: group A (high risk) with scores equal or over 35 points, group B (low risk) with scores equal or below 20 points and group B (intermediate risk) with scores between 20.1 and 34.9 points. These girls were followed during 2 years. During this period, 84 girls became pregnant, 24 of 184 (13%) in group A, 60 of 2332 (2.6%) in group C and none of 307 in group B. There were 104 school desertions in group A and 37 in group B. To study associations and analyze risk, the sample was divided in two risk groups: high, with scores over 27 and low, with scores below 27. There was a high association between pregnancy risk score and the occurrence of pregnancy (RR 5.25 p school desertion (RR 3.32 p School desertion was predicted with a 74% sensitivity and 56% specificity. The importance variable weighing using multiple regression models, to improve the predictor's sensitivity and specificity, is discussed.

  7. Endocrinology of pregnancy and early pregnancy detection by reproductive hormones in reindeer (Rangifer tarandus tarandus).

    Science.gov (United States)

    Ropstad, E; Veiberg, V; Säkkinen, H; Dahl, E; Kindahl, H; Holand, O; Beckers, J F; Eloranta, E

    2005-04-01

    The endocrinology was studied throughout pregnancy in reindeer (Rangifer tarandus tarandus) located in Oulu, Finland (65 degrees N, 25 degrees E) with 13 captive, semi domestic adult females. Blood samples were analyzed for plasma progesterone (P4), estradiol (E2) and estrone sulphate (E1SO4), 15-ketodihydro-PGF2alpha (PG-metabolite) and pregnancy associated glycoproteins (PAG). The mean plasma P4 concentration peaked twice during gestation: at around 24 and three weeks prior to calving. In pregnant females the plasma PAG concentration increased over basal concentrations 21-30 days after the estimated day of conception and peaked at the time of calving. The concentrations of E2 and E1SO4 remained low until 60 days before calving when a rapid increase was found for both hormones. The mean plasma concentration of PG-metabolite increased throughout pregnancy to a maximum at parturition. The estimated mean (range) gestation length was 216 (212-220) days. Judged from measures on reproductive organs collected from 86 free-ranging, semi-domestic female reindeer of unknown age presented for slaughter at Roros, Norway (63 degrees N, 11 degrees E) in the second week of December 1999, it was concluded that the breeding season lasted from early September until the end of November. The results also showed that plasma PAG concentration could provide a tool for detection of pregnancy in reindeer.

  8. Early dental implant failure in patient associated with oral bisphosphonates

    Directory of Open Access Journals (Sweden)

    Ridhimaa Gupta

    2012-01-01

    Full Text Available Oral bisphosphonates are routinely prescribed to post menopausal women. These have shown to increase the risk of osteonecrosis. However, this action may be augmented by local factors. A case report is presented showing an early implant failure in a patient taking oral bisphosphonates. Two implants were placed in left maxillary incisor area. Central incisor was associated with a previous endodontic failure and extraction. Lateral incisor was avulsed 3 years back. After 4 weeks of an implant placement, necrotic bone was evident along with the failing implant in central incisor area. This case report emphasizes on the incidence and an increased risk of implant failure in patients taking oral bisphosphonates.

  9. Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle

    OpenAIRE

    2010-01-01

    Previous studies of hormone patterns after clinical miscarriage suggest reduced pituitary function. Hormonal effects of very early pregnancy loss (before six weeks gestation) have not been described. We used within-woman differences between menstrual cycles in urinary hormone measurements from women in the North Carolina Early Pregnancy Study to describe hormonal changes after very early pregnancy loss (n=28 early losses; 80 non-conception comparison cycles). We found lower pre-ovulatory lute...

  10. 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.

  11. 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.

  12. Drug addiction in pregnancy: disease not moral failure.

    Science.gov (United States)

    Maguire, Denise

    2014-01-01

    Nurses have demonstrated concern for years about their interactions with pregnant women who abuse drugs. Reports of nurses' concern with substance abuse have been reported in the literature since the 1980s. As with any chronic disease, drug addiction causes physiologic changes, and the pathology that occurs in the brain drives characteristic behaviors. Research suggests that choices that addicts make are driven by pathology rather than by failure of a moral compass. This article reviews the theoretical explanations for addictive behaviors, describes the pathophysiology of drug addiction that is responsible for the predictable symptoms and behaviors exhibited by women who abuse prescription drugs and other opioids, and identifies nursing interventions to impact positive outcomes. Nurses who have a working knowledge of this disease will provide more effective nursing care to the women they encounter and are better prepared to make a difference in the lives of both women and their children.

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

    Directory of Open Access Journals (Sweden)

    Divya Khare

    2016-06-01

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

  14. Forensic DNA expertise of incest in early period of pregnancy.

    Science.gov (United States)

    Jakovski, Zlatko; Jankova, Renata; Nikolova, Ksenija; Spasevska, Liljana; Jovanovic, Rubens; Janeska, Biljana

    2011-01-01

    Proving incest from tissue obtained by abortion early in pregnancy can be a challenge. Problems include the small quantity of embryonic tissue in the products of conception, and the mixing of DNA from mother and embryo. In many cases, this amorphous material cannot be grossly segregated into maternal and fetal components. Thus, morphological discrimination requires microscopy to select relevant tissue particles from which DNA can be typed. This combination of methods is reliable and efficient. In this article, we present two cases of incest discovered by examination of products of conception.

  15. Does Early Reading Failure Decrease Children's Reading Motivation?

    Science.gov (United States)

    Morgan, Paul L.; Fuchs, Douglas; Compton, Donald L.; Cordray, David S.; Fuchs, Lynn S.

    2008-01-01

    The authors used a pretest-posttest control group design with random assignment to evaluate whether early reading failure decreases children's motivation to practice reading. First, they investigated whether 60 first-grade children would report substantially different levels of interest in reading as a function of their relative success or failure…

  16. Sonographical predictive markers of failure of induction of labour in term pregnancy.

    Science.gov (United States)

    Brik, Maia; Mateos, Silvia; Fernandez-Buhigas, Irene; Garbayo, Paloma; Costa, Gloria; Santacruz, Belen

    2017-02-01

    Predictive markers of failure of induction of labour in term pregnancy were evaluated. A prospective study including 245 women attending induction of labour was performed. The inclusion criteria were singleton pregnancies, gestational age 37-42 weeks and the main outcomes were failure of induction, induction to delivery interval and mode of delivery. Women with a longer cervical length prior to induction (CLpi) had a higher rate of failure of induction (30.9 ± 6.8 vs. 23.9 ± 9.3, p < .001). BMI was higher and maternal height was lower in the group of caesarean section compared to vaginal delivery (33.1 ± 8 vs. 29.3 ± 4.6, 160 ± 5 vs. 164 ± 5, p < .001, respectively). A shorter CLpi correlated with a shorter induction to delivery interval (R Pearson .237, p < .001). In the regression analysis, for failure of induction the only independent predictor was the CL prior to induction. Therefore, the CLpi is an independent factor for prediction of failure of induction of labour.

  17. Early pregnancy vaginal microbiome trends and preterm birth.

    Science.gov (United States)

    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 preterm birth is associated with increased 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.

  18. Successful maternal and perinatal outcome of hepatitis E in pregnancy with fulminant hepatic failure

    OpenAIRE

    Meena N. Satia; Manali P. Shilotri

    2016-01-01

    Hepatitis E infection is an important cause of fulminant hepatic failure (FHF) in pregnancy in developing countries like India, with a high mortality rate. It is postulated that immunological and hormonal changes in pregnant women predispose them to developing FHF secondary to hepatitis E infection as compared to the less severe form seen in the non-pregnant population. A variation in the natural course of the disease is also seen amongst different geographical areas. Hepatitis E infection is...

  19. Early embryonic failure: Expression and imprinted status of candidate genes on human chromosome 21

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, L.S.; Bennett, P.R.; Moore, G.E. [Queen Charlotte`s and Chelsea Hospital, London (United Kingdom)

    1994-09-01

    Two cases of maternal uniparental (hetero)disomy for human chromosome 21 (mUPD21) have been identified in a systematic search for UPD in 23 cases of early embryonic failure (EEF). Bi-parental origin of the other chromosome pairs was confirmed using specific VNTR probes or dinucleotide repeat analysis. Both maternally and paternally derived isochromosomes 21q have previously been identified in two individuals with normal phenotypes. Full UPD21 has a different mechanism of origin than uniparental isochromosome 21q and its effect on imprinted genes and phenotypic outcome will therefore not necessarily be the same. EEF associated with mUPD21 suggests that developmentally important genes on HSA 21 may be imprinted such that they are only expressed from either the maternally or paternally derived alleles. We have searched for monoallelic expression of candidate genes on HSA 21 in human pregnancy (CBS, IFNAR, COL6A1) using intragenic DNA polymorphisms. These genes were chosen either because their murine homologues lie in imprinted regions or because they are potentially important in embryogenesis. Once imprinted candidate genes have been identified, their methylation status and expression in normal, early embryonic failure and uniparental disomy 21 pregnancies will be studied. At the same time, a larger number of cases of EEF are being examined to further investigate the incidence of UPD21 in this group.

  20. Early detection of diabetes after pregnancy complicated by gestational diabetes

    DEFF Research Database (Denmark)

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

    2016-01-01

    ) develops type 2 diabetes within a ten-year period. Early detection can prevent or delay the onset of late complications, for which follow-up screening is important. The women are recommended follow-up screening every 1-2 years after birth do to the potentials in early detection of diabetes and prevention...... 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...... and their participating in follow-up screening were identified. Diagnosis of diabetes or treatment with glucose-lowering agents after giving birth were also identified. Results: Attendance in follow-up screening significantly decreased with time after giving birth. Women attending follow-up screening had a significantly...

  1. 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.

  2. Intact HCG, free HCG beta subunit and HCG beta core fragment: longitudinal patterns in urine during early pregnancy

    National Research Council Canada - National Science Library

    McChesney, Ruth; Wilcox, Allen J; O'Connor, John F; Weinberg, Clarice R; Baird, Donna D; Schlatterer, John P; McConnaughey, D Robert; Birken, Steven; Canfield, Robert E

    2005-01-01

    Detecting and monitoring early pregnancy depend on the measurement of HCG. Little is known about how production of various forms of HCG may evolve over the earliest weeks of pregnancy, particularly in naturally conceived pregnancies...

  3. Management of ureteral stenting for postrenal failure during pregnancy after ureteral reimplantation: a case report.

    Science.gov (United States)

    Yoneoka, Yutaka; Kaku, Shoji; Tsuji, Shunichiro; Yamashita, Hiroto; Inoue, Takashi; Kimura, Fuminori; Murakami, Takashi

    2016-04-01

    Vesicoureteral reflux is thought to predispose to urinary tract infection and renal scarring, and ureteral reimplantation in childhood remains the gold standard for its treatment. It has been reported that the risk of postrenal failure during pregnancy is increased among women with Politano-Leadbetter ureteral reimplantation. In previous case reports on patients with progressive hydronephrosis and renal failure during pregnancy after ureteral reimplantation, percutaneous nephrostomy was always required, so there has been no information about the clinical management of such patients by ureteral stenting. Here we report a patient with a history of bilateral ureteral reimplantation, in whom severe hydronephrosis during pregnancy was managed with ureteral stents. A primigravida with severe hydronephrosis was referred to us at 29 weeks of gestation. Bilateral Politano-Leadbetter ureteral reimplantation had been performed at the age of 3 years. She was hospitalized immediately, and bilateral ureteral stents were successfully inserted. Post-obstructive diuresis occurred after the stents were placed. Urinary tract infection developed after removal of the urethral catheter 1 week later, but responded to antibiotic therapy and catheter replacement. Labor was induced at 39 weeks of gestation, with vaginal delivery of a healthy male infant. Both stents were found to have spontaneously migrated into the urethra after delivery. Repeat stenting under spinal anesthesia was required to improve postpartum symptoms of back pain and fever. Right distal ureteral obstruction persisted at 6 months after delivery and repeat ureteral reimplantation is planned. General obstetricians will not necessarily pay attention to a history of Politano-Leadbetter ureteral reimplantation, but these patients should undergo careful monitoring of renal function and urinary tract morphology during perinatal care. In the present case, ureteral stenting was effective for postrenal failure during pregnancy

  4. Successful maternal and perinatal outcome of hepatitis E in pregnancy with fulminant hepatic failure

    Directory of Open Access Journals (Sweden)

    Meena N. Satia

    2016-07-01

    Full Text Available Hepatitis E infection is an important cause of fulminant hepatic failure (FHF in pregnancy in developing countries like India, with a high mortality rate. It is postulated that immunological and hormonal changes in pregnant women predispose them to developing FHF secondary to hepatitis E infection as compared to the less severe form seen in the non-pregnant population. A variation in the natural course of the disease is also seen amongst different geographical areas. Hepatitis E infection is seen to be less severe in parts of the world like Egypt, Europe and the USA as against the Indian subcontinent. The mainstay of management of acute viral hepatitis (AVH and fulminant hepatic failure secondary to hepatitis E virus is supportive treatment. Since an increased severity of the disease is associated with the pregnant state, termination of pregnancy to alter its course is an option worth considering. Our case study showed promising results of induction of labour in a case of FHF (hepatic encephalopathy with disseminated intravascular coagulation caused by hepatitis E, in the third trimester of pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2475-2477

  5. Early failure of bioabsorbable anterior cervical fusion plates: case report and failure analysis.

    Science.gov (United States)

    Brkaric, Mario; Baker, Kevin C; Israel, Raj; Harding, Trevor; Montgomery, David M; Herkowitz, Harry N

    2007-05-01

    Case report with forensic failure analysis. To determine the failure modes of 3 explanted 70:30 PLDLA Mystique (Medtronic Sofamor Danek, Memphis, TN) graft containment plates retrieved from revision surgery for early device failure. To reduce the problems of stress-shielding and radiopacity associated with metallic systems, bioabsorbable polymers have been used in anterior cervical discectomy and fusion procedures. Degradation of mechanical properties in vivo is a major concern when using bioabsorbable systems. Three of 6 patients who underwent anterior cervical discectomy with instrumented fusion, using Mystique graft containment systems experienced early failure requiring revision to alternate hardware. Devices were retrieved after failure and analyzed by light microscopy and environmental scanning electron microscopy. Simulations were performed with an unused plating system to induce damage for comparison with the retrieved devices. A detailed case review was performed to identify possible sources of extraordinary loading or damage. One plating system failed at 6 weeks postimplantation due to fatigue fracture of the screws. Crack initiation sites were identified at the interface of the thread root and mold line of the screw. Another plating system failed at 16 weeks postimplantation due to the coalescence of radial microcracking between holes in the plate, leading to catastrophic failure of the plate. The final plating system failed during the implantation surgery, when the screw fractured in torsion. Stress concentrations at the screw head-shaft interface and thread-shaft interface reduce the fatigue performance of bioabsorbable screws. Hydrolysis of the polymer may also play a role in the reduction of resistance to crack initiation and propagation.

  6. Early Gestational Weight Gain Rate and Adverse Pregnancy Outcomes in Korean Women.

    Directory of Open Access Journals (Sweden)

    Eun-Hee Cho

    Full Text Available During pregnancy, many women gain excessive weight, which is related to adverse maternal and neonatal outcomes. In this study, we evaluated whether rate of gestational weight gain (RGWG in early, mid, and late pregnancy is strongly associated with adverse pregnancy outcomes. A retrospective chart review of 2,789 pregnant Korean women was performed. Weights were recorded at the first clinic visit, during the screening test for fetal anomaly, and during the 50g oral glucose challenge test and delivery, to represent early, mid, and late pregnancy, respectively. A multivariate logistic regression analysis was performed to examine the relationship between RGWG and adverse pregnancy outcomes. At early pregnancy, the RGWG was significantly associated with high risk of developing gestational diabetes mellitus (GDM, pregnancy-induced hypertension (PIH, large for gestational age (LGA infants, macrosomia, and primary cesarean section (P-CS. The RGWG of mid pregnancy was not significantly associated with any adverse pregnancy outcomes. The RGWG at late pregnancy was significantly associated with a lower risk of developing GDM, preterm birth and P-CS, but with a higher risk of developing LGA infants and macrosomia. When the subjects were divided into three groups (Underweight, Normal, and Obese, based on pre-pregnancy body mass index (BMI, the relationship between early RGWG and adverse pregnancy outcomes was significantly different across the three BMI groups. At early pregnancy, RGWG was not significantly associated to adverse pregnancy outcomes for subjects in the Underweight group. In the Normal group, however, early RGWG was significantly associated with GDM, PIH, LGA infants, macrosomia, P-CS, and small for gestational weight (SGA infants, whereas early RGWG was significantly associated with only a high risk of PIH in the Obese group. The results of our study suggest that early RGWG is significantly associated with various adverse pregnancy outcomes

  7. Progestogens and early pregnancy:prevention and treatment

    Institute of Scientific and Technical Information of China (English)

    Adolf E.Schindler

    2013-01-01

    During human and mammalian pregnancy,endogenous progesterone is the dominant hormone since it is not only essential for conception and implantation,but also needed throughout pregnancy.Progesterone provided the effects of prevention and treatment in human pregnancy by certain mechanisms.If one considers prevention or treatment with progestogens in human pregnancy,that all progestogens are progestogenic,if one condsiders the progestogens for prevention and therapeutic approaches,nowadays,only two progenstogens can be considered fully suitable for prevention and treatment in human pregnancy:progesterone and dydrogesteone.This review introduced the mechanism of progesterone and dydrogesterone in pregnancy and treatment in human.

  8. Comparison of Pregnancy Stress Between In Vitro Fertilization/Embryo Transfer and Spontaneous Pregnancy in Women During Early Pregnancy.

    Science.gov (United States)

    Shih, Fen-Fen; Chen, Chung-Hey; Chiao, Chia-Yi; Li, Chi-Rong; Kuo, Pi-Chao; Lai, Te-Jen

    2015-12-01

    Women who undergo in vitro fertilization/embryo transfer (IVF/ET) face complicated psychological stress and negative emotions, which may affect health during pregnancy and the development of the fetus. The current literature does not address the question of whether women who become pregnant spontaneously and women who undergo IVF face similar levels of pregnancy stress. This study investigates the differences in pregnancy stress between women with spontaneous pregnancy and women with IVF/ET pregnancy living in central Taiwan during their first 20 weeks of pregnancy. A prospective, longitudinal design with repeated measures, generalized estimated equations model, Wilks' λ, and Bonferroni test was used. Purposive samples of 163 women who had undergone IVF/ET and of 94 women who had undergone spontaneous pregnancy were enrolled as participants. Pregnancy stress was measured using the Chinese version of the self-administered Pregnancy Stress Scale at the 9th, 12th, and 20th weeks of pregnancy. The psychological stress experienced by IVF participants significantly increased with gestational week during the first 20 weeks of pregnancy (p pregnancy participants. Gestational week was the main factor found to influence stress ratings for "identifying maternal role." "Altering body structure and body function" was the main factor found to influence pregnancy stress (p pregnancy stress during the first 20 weeks of pregnancy (p > .05). The results of this study provide clinical evidence that IVF/ET does not cause more stress for women than spontaneous pregnancy. However, the intensity and trend of stresses differed between these two groups. These findings suggest that nurses should consider method of pregnancy when assessing the risk of stress in expectant mothers for each gestational week and when providing appropriate care and support.

  9. 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

    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......: We conducted a cross-sectional study based on a questionnaire during the first trimester among 7,915 women participating in the prospective Copenhagen Pregnancy Cohort. Associations were estimated by multivariate regression analyses. RESULTS: In early pregnancy, 38 % of the study population met...... 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...

  10. 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.

  11. 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...

  12. Predictors of single-dose methotrexate treatment failure in ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Azam Azargoon

    2014-07-01

    Methods: In this quasi-experimental research, we studied 70 women with ectopic preg-nancies who were treated with MTX, according to a single dose protocol from 2010 to 2013. EP was diagnosed whenever an intrauterine gestational sac was not identified by transvaginal ultrasonography (TVUS, accompanied by an abnormal rise or plateau in human chorionic gonadotropin (beta-hCG concentration. Briefly, women with ectopic pregnancies were considered candidates for MTX treatment if they were hemodynami-cally stable; did not desire surgical therapy, agreed to weekly follow-up; and did not have hepatic, hematologic, or renal disease. A Patient was considered a treatment suc-cess (group 1 if her beta-hCG levels decreased ≤10 m IU/ml after the first dose of MTX. Treatment failure (group 2 was defined as the need for a second or a third dose of MTX or surgery. The following risk factors were compared between the two groups: serum beta-hCG on the days 1 and 4, a ≥ 15% decrease in serum beta-hCG between the days 1-4 of the treatment, age, parity, gravidity, the size of the ectopic mass and the endometrial thickness. Results: The success rate of MTX treatment was 77.1%. There were no significant dif-ferences between the two groups in regard to the age, parity, gravidity, the size of ec-topic mass and the endometrial thickness in vaginal sonography, but the mean serum beta-hCG concentration on days 1 and 4 was lower in the success group than the failure group. We also observed a ≥ 15% decrease in serum beta-hCG in 80.9% of the women from the success group and in 38.5% of the cases whose treatment had failed. The presence of fetal heart activity was seen in only one patient and this patient’s treatment failed. Two patients had previous history of ectopic pregnancy and the treatment of both ended in failure. Conclusion: Among women with ectopic pregnancies who were candidates for MTX treatment, a high serum beta-hCG concentration on the days 1-4 and also a ≤ 15% fall in

  13. Ultrasound imaging in the management of bleeding and pain in early pregnancy.

    Science.gov (United States)

    Knez, Jure; Day, Andrea; Jurkovic, Davor

    2014-07-01

    Bleeding and pain are experienced by 20% of women during the first trimester of pregnancy. Although most pregnancies complicated by pain and bleeding tend to progress normally, these symptoms are distressing for woman, and they are also associated with an increased risk of miscarriage and ectopic pregnancy. Ultrasound is the first and often the only diagnostic modality that is used to determine location of early pregnancy and to assess its health. Ultrasound is an accurate, safe, painless and relatively inexpensive diagnostic tool, which all contributed to its widespread use in early pregnancy. Pain and bleeding in early pregnancy are sometimes caused by concomitant gynaecological, gastrointestinal, and urological problems, which could also be detected on ultrasound scan. In women with suspected intra-abdominal bleeding, ultrasound scan can be used to detect the presence of blood and provide information about the extent of bleeding. In this chapter, we comprehensively review the use of ultrasound in the diagnosis and management of early pregnancy complications. We include information about the diagnosis of gynaecological and other pelvic abnormalities, which could cause pain or bleeding in pregnancy. We also provide a summary of the current views on the safety of ultrasound in early pregnancy.

  14. [Ultrasonic observation on early pregnancy in patients using IUD].

    Science.gov (United States)

    Han, Z M

    1987-05-01

    The paper is a report of ultrasonic examinations of IUD positions in women who became pregnant with IUD in situ. 61 pregnant women aged 23 to 41 wearing stainless steel single ring IUD were examined between 1983 and 1985. The duration between the IUD insertion and pregnancy of these women ranged from one month to 5 years with 67.2% under 1 year. This indicated that the first year after IUD insertion is a critical period for method failure. Extra care should be taken in the follow-up of insertion. Among the cases studied, the IUD position of 42 women was below the embryo in the uterine cavity, including some around the cervix. The position change of IUD apparently lost its contraceptive effect. The declined position of IUD in the uterus could be associated with the skill of inserter, and the compatibility of the shape and the size of IUD with the uterine cavity. It was suggested that both the length and width of uterine cavity should be measured before the insertion, and IUD's of all sizes should be made available in the clinics where the insertions are conducted. IUD different shapes should also be kept too fit those women with irregularly shaped uteri.

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

    Science.gov (United States)

    Broberg, Lotte; Ersbøll, Anne S; Backhausen, Mette G; Damm, Peter; Tabor, Ann; Hegaard, Hanne K

    2015-11-27

    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. We conducted a cross-sectional study based on a questionnaire during the first trimester among 7,915 women participating in the prospective Copenhagen Pregnancy Cohort. Associations were estimated by multivariate regression analyses. In early pregnancy, 38 % of the study population met 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 Danish language and a low educational level were all factors associated a lower probability for meeting the recommendations. The preferred types of exercise before and during pregnancy were bicycling, brisk walking, running and strength training. The proportion of women engaged in any type of exercise decreased in early pregnancy with the exception of swimming and aquatic exercise. In this cohort, more than one-third met the Danish recommendation for exercise during early pregnancy. Exercise in pregnancy is still an issue to address because the most vulnerable groups of pregnant women do not exercise. This is a cause of concern because it may reflect social inequalities in health and highlights the need for a structural and systematic approach to preconception care and early antenatal counselling.

  16. Early pregnancy diagnosis by serum progesterone and ultrasound in sheep carrying somatic cell nuclear transfer-derived pregnancies.

    Science.gov (United States)

    Alexander, B; Coppola, G; Mastromonaco, G F; St John, E; Reyes, E R; Betts, D H; King, W A

    2008-04-01

    Early pregnancy diagnosis and monitoring play an important role following embryo transfer in sheep. The aims of the current study were to investigate (i) the pattern of serum progesterone profiles in sheep carrying somatic cell nuclear transfer (SCNT)-derived (clone) pregnancies, and (ii) the frequency of pregnancy loss during development following SCNT embryo transfer. Sheep SCNT embryos were made using standard nuclear transfer techniques. Day 7 embryos were surgically transferred to oestrus-synchronized recipients (n = 27). As a control, normal fertile ewes (n = 12) were bred by natural breeding. Serum was collected from all the ewes on the day of estrus (day 0 sample), 7 days post-estrus (day 7 sample) and 19 days post-estrus (day 19 sample) and every 10 days thereafter until lambing or pregnancy loss occurred. Serum progesterone (P4) was assessed using enzyme immunoassay. Pregnancy was confirmed by ultrasound scanning on day 35 of pregnancy followed by subsequent scanning every 10 days. In control ewes, pregnancy rate on day 35 was 83.3% (10/12), whereas in the ewes that received SCNT embryos, it was 22.2% (6/27; p sheep. Further, the serum P4 levels directly reflect the degree of placental development in these two groups.

  17. Anti-GBM of Pregnancy: Acute Renal Failure Resolved after Spontaneous Abortion, Plasma Exchange, Hemodialysis, and Steroids

    OpenAIRE

    Mohammed Muqeet Adnan; Jordan Morton; Syed Hashmi; Sufyan Abdul Mujeeb; William Kern; Benjamin Jr. Cowley

    2014-01-01

    Antiglomerular basement membrane disease presenting during pregnancy is very uncommon. We present a case of a pregnant female who presented with acute renal failure needing dialysis from Goodpasture's disease. She responded very well to just plasma exchange, high dose steroids, and hemodialysis. Cyclophosphamide was never started on this patient. She had a spontaneous abortion in her 8th week of pregnancy and henceforth did very well to regain her renal function. Patient became hemodialysis i...

  18. Maternal iron status in early pregnancy and birth outcomes: insights from the Baby's Vascular health and Iron in Pregnancy study.

    Science.gov (United States)

    Alwan, Nisreen A; Cade, Janet E; McArdle, Harry J; Greenwood, Darren C; Hayes, Helen E; Simpson, Nigel A B

    2015-06-28

    Fe deficiency anaemia during early pregnancy has been linked with low birth weight and preterm birth. However, this evidence comes mostly from studies measuring Hb levels rather than specific measures of Fe deficiency. The present study aimed to examine the association between maternal Fe status during the first trimester of pregnancy, as assessed by serum ferritin, transferrin receptor and their ratio, with size at birth and preterm birth. In the Baby VIP (Baby's Vascular health and Iron in Pregnancy) study, we recruited 362 infants and their mothers after delivery in Leeds, UK. Biomarkers were measured in maternal serum samples previously obtained in the first trimester of pregnancy. The cohort included sixty-four (18 %) small for gestational age (SGA) babies. Thirty-three babies were born preterm (9 %; between 34 and 37 weeks). First trimester maternal Fe depletion was associated with a higher risk of SGA (adjusted OR 2·2, 95 % CI 1·1, 4·1). This relationship was attenuated when including early pregnancy Hb in the model, suggesting it as a mediator (adjusted OR 1·6, 95 % CI 0·8, 3·2). For every 10 g/l increase in maternal Hb level in the first half of pregnancy the risk of SGA was reduced by 30 % (adjusted 95 % CI 0, 40 %); levels below 110 g/l were associated with a 3-fold increase in the risk of SGA (95 % CI 1·0, 9·0). There was no evidence of association between maternal Fe depletion and preterm birth (adjusted OR 1·5, 95 % 0·6, 3·8). The present study shows that depleted Fe stores in early pregnancy are associated with higher risk of SGA.

  19. Successful pregnancy outcome in grade IV lupus nephritis and secondary antiphospholipid antibody syndrome with recurrent pregnancy failures - challenging achievement of motherhood

    Directory of Open Access Journals (Sweden)

    Kaliki Hymavathi Reddy

    2016-12-01

    Full Text Available Systemic lupus erythematosus (SLE is a chronic multisystem autoimmune disease that occurs predominantly in women of childbearing age. The risk of complications and adverse fetal outcomes in pregnant women with lupus is high viz., increased risks of preterm birth, hypertensive diseases of pregnancy and lupus flares both during pregnancy and in the postpartum period. An additional association with Antiphospholipid antibody (APLA syndrome is expected to multiply the pregnancy complications. Though improved understanding of the disease nature and greater number of therapeutic options in the treatment of SLE, made the medical community regard these patients with less trepidation, the risk of significant morbidity to both the mother and the fetus still exist. We report an interesting case of grade IV Lupus nephritis (LN with secondary APLA syndrome and h/o recurrent pregnancy failures for twenty times but had a successful pregnancy and delivery in the 21st attempt though pregnancy was absolutely contraindicated in view of her medical illness. Many complications were encountered during her pregnancy which could be successfully tackled and a live male baby was delivered by Caesarean section.

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

    Science.gov (United States)

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

    2003-01-01

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

  1. Transient early preeclampsia in twin pregnancy with a triploid fetus : a case report

    NARCIS (Netherlands)

    van der Houwen, C.; Schukken, T.; van Pampus, M.

    2009-01-01

    INTRODUCTION: Triploid pregnancies have an increased risk of early preeclampsia. Twin pregnancies consisting of one healthy fetus and one complete or partial molar, with or without a triploid fetus, are rare and management is complex. CASE PRESENTATION: A 33-year-old Caucasian woman presented with a

  2. 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…

  3. Transient early preeclampsia in twin pregnancy with a triploid fetus : a case report

    NARCIS (Netherlands)

    van der Houwen, C.; Schukken, T.; van Pampus, M.

    2009-01-01

    INTRODUCTION: Triploid pregnancies have an increased risk of early preeclampsia. Twin pregnancies consisting of one healthy fetus and one complete or partial molar, with or without a triploid fetus, are rare and management is complex. CASE PRESENTATION: A 33-year-old Caucasian woman presented with a

  4. Clarithromycin in early pregnancy and the risk of miscarriage and malformation

    DEFF Research Database (Denmark)

    Andersen, Jon Thor Trærup; Petersen, Morten; Jimenez-Solem, Espen

    2013-01-01

    The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated...... with an increased risk for miscarriages and major malformations....

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

    Science.gov (United States)

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

    2003-01-01

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

  6. 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

  7. Continued smoking and continued alcohol consumption during early pregnancy distinctively associated with personality

    NARCIS (Netherlands)

    Beijers, C.; Burger, H.; Verbeek, T.; Bockting, C. L. H.; Ormel, J.

    2014-01-01

    Pregnancy is a unique period to quit smoking and alcohol consumption and although motivated, not all women succeed at this. We investigated the associations of personality with continued smoking and continued alcohol consumption during early pregnancy. In addition, we studied whether antenatal anxie

  8. [Pregnancy in a woman with chronic renal failure--the case of two successfully completed pregnancies and the review of the literature].

    Science.gov (United States)

    Pifczyk, Grzegorz; Wikarek, Tomasz; Maruniak-Chudek, Iwona; Chudek, Jerzy

    2011-08-01

    Together with the prolongation and improving the quality of life of young women with chronic renal failure (CRF), procreation becomes an important issue. Pregnancies in women on renal replacement therapy are associated with an increased risk of health complications, both for mothers and for fetuses. Medical management of pregnant women with CRF is a great challenge and requires a close co-operation of nephrologists, transplantologists, gynecologists and neonatologists. The complexity of problems in these particular pregnancies has urged us to describe the case of a woman with CRF who successfully delivered two babies. We also review the current state of knowledge on the topic. The first pregnancy five years after renal transplantation, was completed with the delivery of term newborn with Tetralogy of Fallot. Also the second pregnancy on hemodialysis therapy was finished by the birth of a healthy neonate at term. The described case indicates that the gynecologists should be prepared for the challenge of the care for pregnancies in women suffering from chronic renal failure on renal replacement therapy.

  9. Early Pregnancy and Academic Achievement of African-American Youth.

    Science.gov (United States)

    Prater, Loretta Pinkard

    1992-01-01

    Case studies of 10 unmarried, African-American adolescent mothers at risk of dropping out of school are presented, revealing the stressful situations created by competing demands of school and home. Educational deficits that existed prior to pregnancy and their influence on contraceptive behavior and pregnancy resolution are noted. Intervention…

  10. Factors affecting retention of early pregnancy in dairy cattle.

    Science.gov (United States)

    Starbuck, Melanie J; Dailey, Robert A; Inskeep, E Keith

    2004-08-01

    Potential factors affecting retention of pregnancy during weeks 5-9 of gestation were studied in dairy cows and heifers (N = 211) on two farms. Cows were examined by ultrasonography for presence of a viable embryo, and sizes of the corpus luteum (CL) and of follicles > or = 5mm were recorded. Blood samples were taken at each examination and assayed for progesterone and estradiol. Overall pregnancy loss was 11.4%. Cows with two CL did not have greater concentrations of progesterone than cows with one CL and they retained fewer pregnancies (P Embryos that were lost apparently died before CL regression. Retention of pregnancy declined in cows with high body condition and as age of the cow increased. Pregnancy retention was lower in cows bred to one of four frequently-used service sires (P body condition and service sire.

  11. Evaluation of the effects of methanol during early pregnancy in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Cummings, A.M.

    1993-01-01

    Recent attention to methanol (MeOH) as a potential alternative fuel prompted an evaluation of the chemical's effects during very early pregnancy. Rats were dosed by gavage during Days 1-8 of pregnancy at 0, 1.6, 2.4 or 3.2 g MeOH/kg/day. Groups of animals were killed on Days 9, 11 or 20 of pregnancy, and maternal, embryonic, or fetal parameters were assessed, depending on the stage of pregnancy. The decidual cell response (DCR) technique was also applied to rats treated with MeOH during pseudopregnancy. (Copyright (c) 1993 Elsevier Scientific Publishers Ireland Ltd.).

  12. Depression in Early Pregnancy Linked to Gestational Diabetes, NIH Study Finds

    Science.gov (United States)

    ... News Releases News Release Monday, September 19, 2016 Depression in early pregnancy linked to gestational diabetes, NIH ... Women with gestational diabetes at risk for postpartum depression. Researchers at the National Institutes of Health have ...

  13. Early proximal junctional failure in patients with preoperative sagittal imbalance.

    Science.gov (United States)

    Smith, Micah W; Annis, Prokopis; Lawrence, Brandon D; Daubs, Michael D; Brodke, Darrel S

    2013-10-01

    Study Type Retrospective review. Introduction Sagittal imbalance has been associated with lower health-related quality of life outcomes, and restoration of imbalance is associated with improved outcomes.123 The long constructs used in adult spinal deformity have potential consequences such as proximal junctional kyphosis (PJK). Clinically, the development of PJK may not be as important as failure of the construct or vertebrae at the proximal end. As PJK does not lead to worse clinical outcomes,45 we define the term early proximal junctional failure (EPJF) as fracture, implant failure, or myelopathy due to stenosis at the upper instrumental vertebra (UIV) or UIV + 1 within 6 months of surgery. Objective The purpose of this study is to report the incidence of EPJF in patients who are sagittally imbalanced preoperatively and to identify risk factors postoperatively that correlate with EPJF using commonly reported sagittal balance parameters. Methods We reviewed 197 patients with preoperative sagittal imbalance by at least one of the following: sagittal vertical axis more than 5 cm, global sagittal alignment more than 45 degrees, pelvic incidence-lumbar lordosis more than 10 degrees, or spine-sacral angle less than 120 degrees. Radiographic measurements also included proximal junctional angle, thoracic kyphosis, lumbar lordosis, pelvic parameters, and sagittal balance parameters/formulas, as well as UIV angle, UIV spinosacral angle, and UIV plumb line to assess as potential risk factors. EPJF incidence was calculated postoperatively for each of the accepted sagittal balance parameters/formulas. Results EPJF was observed in 49 of 197 patients (25%) with preoperative sagittal imbalance and was more common in fusions with UIV in the lower thoracic spine (TS) (35%) than in those with UIV in the upper TS (10%) or lumbar (25%) (p = 0.007). Of the 49 EPJF patients, 16 patients (33%) required revision surgery within the first year, for an overall early revision

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

    Science.gov (United States)

    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.

  15. Successful pregnancy after rituximab in a women with recurrent in vitro fertilisation failures and anti-phospholipid antibody positive.

    LENUS (Irish Health Repository)

    Ng, C T

    2012-02-01

    We report a case of successful pregnancy after rituximab in a patient with a history of in vitro fertilisation (IVF) failures and positive anti-cardiolipin antibody (ACA). Following a course of rituximab, her ACA became negative and she successfully conceived with IVF treatment. This is the first case in literature describing the use of rituximab therapy in this clinical scenario.

  16. Pregnancy-associated glycoprotein (PAG) concentration in plasma and milk samples for early pregnancy diagnosis in Lacaune dairy sheep.

    Science.gov (United States)

    El Amiri, B; Sousa, N M; Alvarez Oxiley, A; Hadarbach, D; Beckers, J F

    2015-04-01

    In the present study, four RIA systems (RIA-1 to -4) based on two antisera raised against ovine pregnancy-associated glycoproteins (ovPAGs), combined with an ovine or a bovine PAG tracer were used to measure PAG concentrations in plasma and milk samples of dairy ewes. Blood and milk samples were collected on different days of gestation: 0, 18, 20, 22, 25, 28, 32, 42, and 49. From day 20 onward, the PAG in plasma could be detected in all pregnant ewes using the four RIA systems. By using milk, except for RIA-1, the other systems showed a sensitivity of 100% from day 28 of gestation onward. In plasma, PAG concentrations were higher in multiple than in single pregnancies, while no clear relationship was observed in milk. In conclusion, milk is a good alternative to plasma for early pregnancy diagnosis in sheep from day 28 to day 42.

  17. Maternal complications in pregnancy and wheezing in early childhood

    DEFF Research Database (Denmark)

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

    2015-01-01

    complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes...... wheezing (P=0.027). CONCLUSIONS: Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring.......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...

  18. Management of drug-induced hyperbilirubinaemia in early pregnancy

    African Journals Online (AJOL)

    Maternal hyperbilirubinaemia during pregnancy worsens perinatal ... delivery and intra-uterine death.2 However, the effects of maternal ... multiple spontaneous abortions. .... is only one case report describing high levels of unconjugated.

  19. Early Pregnancy Plasminogen Activator Inhibitor-1 Levels in ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... mother and fetus, include changes in the expression of the coagulation ... inhibitor-1 (PAI-1) in normal pregnancy and preeclampsia and determined its relationship .... The continuous variables (age, body mass index [BMI],.

  20. The trophoblast plug during early pregnancy: a deeper insight

    OpenAIRE

    Weiss, Gregor; Sundl, Monika; Glasner, Andreas; Huppertz, Berthold; Moser, Gerit

    2016-01-01

    During the first trimester of pregnancy, foetal endovascular trophoblasts invade into maternal spiral arteries, accumulate and form plugs in the lumen of the vessels. These plugs only allow blood plasma to seep through. Hence, during the first trimester of pregnancy, a first flow of fluids through the placental intervillous space is established, resulting in a physiological oxygen gradient between mother and foetus. The trophoblast plugs block spiral arteries until the beginning of the second...

  1. Sigmoid volvulus in pregnancy: early diagnosis and intervention are important.

    Science.gov (United States)

    Ahmad, Anis; Shing, Koh Kai; Tan, Khim Khee; Krasu, Mary; Bickle, Ian; Chong, Vui Heng

    2014-05-01

    Bowel obstruction is rare in pregnancy, and delay in recognition can lead to serious maternal and fetal complications. Most reported causes of bowel obstruction in pregnancy (adhesions, intussusception, hernia, and carcinoma) require surgical intervention. Sigmoid volvulus is an acute surgical cause that can now be managed successfully without surgery. We report the case of 33-year-old lady who presented with a sigmoid volvulus that was successfully managed with urgent endoscopic decompression.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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......, including at least 100 women with type 1 diabetes, dealing with either the prevalence of preeclampsia or possible clinical predictors of preeclampsia identified in early pregnancy. RESULTS: Based on 11,518 pregnancies in 11 articles, the prevalence of preeclampsia in women with type 1 diabetes was 17%, five...... to six times more than in the background population. In early pregnancy, the following clinical predictors were associated with increased prevalence of preeclampsia: diabetic nephropathy (OR 3.7-23.5), microalbuminuria (OR 3.8-11.7), diabetic retinopathy (OR 1.9-2.9) and pre-existing hypertension (OR 3...

  3. TGF beta 2 mRNA expression and pregnancy failure in mice.

    Science.gov (United States)

    Gorivodsky, M; Torchinsky, A; Zemliak, I; Savion, S; Fein, A; Toder, V

    1999-08-01

    may be associated with pregnancy failure. It seems that beneficial effect of maternal immunostimulation may at least partly be due to the strong increase in TGF beta 2 mRNA expression at the fetomaternal interface.

  4. Ultrasonographic reproductive tract measures and pelvis measures as predictors of pregnancy failure and anestrus in restricted bred beef heifers.

    Science.gov (United States)

    Holm, Dietmar E; Nielen, Mirjam; Jorritsma, Ruurd; Irons, Peter C; Thompson, Peter N

    2016-02-01

    Previous reports have shown that reproductive tract score (RTS) can predict reproduction outcomes in seasonally bred beef heifers, although the accuracy can vary. Some ultrasonographic measures of the female reproductive tract and pelvis area have also been associated with reproductive outcome in young heifers. The objectives of this study were to determine which transrectal ultrasound or pelvis measures taken at a single examination are independent predictors of reproductive failure and whether the RTS system can be optimized with this information. In this observational study, year-old beef heifers (n = 488) in 2 birth cohorts were followed from just before the first breeding until confirmation of pregnancy. A single pre-breeding examination included body condition score, RTS, ultrasound measures of the reproductive tract (length and diameter of the left and right ovaries, presence and diameter of a CL, largest follicle diameter and left uterus horn diameter) and transverse and vertical diameters of the pelvis. Additional farm records including dam parity, sire, birth weight and birth date, weaning weight, weaning date, prebreeding body weight, AI dates, and semen used were available. Breeding consisted of 50 days of AI, followed 5 to 7 days later by a 42-day bull breeding period. Pregnancy failure was defined as the failure to become pregnant after the AI and bull breeding periods, while anestrus was defined as the failure to be detected in estrus during the 50-day AI period. From the prebreeding data and farm records, independent predictors of pregnancy failure and anestrus were identified using stepwise reduction in multiple logistic regression models. Age at the onset of breeding was the only consistent independent predictor of pregnancy failure and anestrus in both cohorts of this study (P pelvis area (PA) were the prebreeding examination variables that remained in prognostic models (P < 0.1). Combining either the model based on the 3 remaining ultrasound

  5. Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.

    Science.gov (United States)

    Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T; Long, Lawrence; Fox, Matthew P

    2017-07-17

    We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. This is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy. The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.

  6. 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.

  7. Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from sub-Saharan Africa.

    Science.gov (United States)

    Palermo, Tia; Peterman, Amber

    2009-06-01

    Female orphans are widely cited as being at risk for early marriage, early childbearing, and risky sexual behavior; however, to date no studies have examined these linkages using population-level data across multiple countries. This study draws from recent Demographic and Health Surveys from ten sub-Saharan African countries to examine the relationship between orphanhood status and measures of early marriage, early sexual debut, and teen pregnancy among adolescent girls aged 15 to 17. Results indicate that, overall, little association is found between orphanhood and early marriage or teen pregnancy, whereas evidence from seven countries supports associations between orphanhood and early sexual debut. Findings are sensitive to the use of multivariate models, type of orphan, and country setting. Orphanhood status alone may not be a sufficient targeting mechanism for addressing these outcomes in many countries; a broader, multidimensional targeting scheme including orphan type, schooling, and poverty measures would be more robust in identifying and aiding young women at risk.

  8. Compensatory placental growth after restricted maternal nutrition in early pregnancy.

    Science.gov (United States)

    Lumey, L H

    1998-01-01

    This study examined the effects of undernutrition in pregnancy on fetal and placental growth among infants born in 1944-1946 in The Netherlands, including infants born during the war-induced Dutch famine of 1944-1945. There was an increase in placental weight, but not in birthweight, in infants whose mothers' nutrition was compromised around conception or in the first trimester of pregnancy. Therefore, the placental index was also increased. Compared to pre-famine controls, the relative increase after first trimester exposure to undernutrition was larger in the northern part of the country (5.2 per cent, 95 per cent confidence interval 1.4, 9.0) where nutritional deprivation was presumably moderate compared to the west (3.5 per cent, 95 per cent confidence interval 0.2, 7.2) where nutritional deprivation was severe. The increase in placental weight is interpreted as compensatory for the reduction in maternal caloric intake. Whereas this suggests that pregnancy undernutrition can stimulate compensatory placental growth, the latter was only seen after first trimester undernutrition, which does not affect infant size at birth. For these infants, therefore, birthweight is not an appropriate proxy measure of undernutrition in pregnancy. These factors need to be considered in future studies relating pregnancy nutrition to adult health outcomes.

  9. Diclofenac/misoprostol during early pregnancy and the risk of miscarriage: a Danish nationwide cohort study.

    Science.gov (United States)

    Andersen, Jon T; Mastrogiannis, Dimitrios; Andersen, Nadia L; Petersen, Morten; Broedbaek, Kasper; Cejvanovic, Vanja; Nielsen, Torben K; Poulsen, Henrik E; Jimenez-Solem, Espen

    2016-08-01

    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. 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. We identified 1,338,824 pregnancies (970,491 births, 142,147 miscarriages, 226,145 induced abortions). One hundred sixty-six were exposed to diclofenac/misoprostol in the early pregnancy of which 28.3 % (47) ended up in a miscarriage compared to 10.6 % among unexposed. The adjusted hazard ratio of having a miscarriage after exposure to diclofenac/misoprostol in the first trimester was 3.6 (CI 95 % 2.6-4.9). We found an increased risk of miscarriage after exposure to diclofenac/misoprostol during the early pregnancy. Women in the fertile age should not be treated with the combination of diclofenac/misoprostol if other options were available.

  10. Limited validity of parental recall on pregnancy, birth, and early childhood at child age 10 years

    NARCIS (Netherlands)

    Jaspers, Merlijne; de Meer, Gea; Verhulst, Frank C.; Ormel, Johan; Reijneveld, Sijmen A.

    Objective: Evidence on the validity of parental recall of early childhood behavior is lacking. Our aim was to examine the validity of parental recall at child age 10-12 years for maternal lifestyle during pregnancy, the birth characteristics, and early childhood behavior. Study Design and Setting:

  11. Duration of pregnancy in relation to seafood intake during early and mid pregnancy: prospective cohort

    DEFF Research Database (Denmark)

    Olsen, S. F; Osterdal, M. L; Salvig, J. D

    2006-01-01

    We examined the association between exposure to seafood intake during two periods of pregnancy on the one hand and risks of preterm delivery and postterm delivery on the other. In a prospective cohort of 8729 pregnant Danish women, we assessed frequency of fish meals during the first and second.......23-4.61) times in those who never consumed fish (n = 308) vs. those who consumed both fish as main meal and fish in sandwiches at least once per week (n = 785). These measures were similar when fish intake was based solely on intake reported for mid-pregnancy. In the subgroup of women reporting same intake.......12-0.95), respectively, in zero fish consumers. All analyses were adjusted for potential confounding by factors such as maternal smoking, height, and prepregnant weight. We conclude that never consuming fish in the first two trimesters of pregnancy was an extremely strong risk factor for preterm delivery but was also...

  12. Duration of pregnancy in relation to seafood intake during early and mid pregnancy: prospective cohort

    DEFF Research Database (Denmark)

    Olsen, S. F; Osterdal, M. L; Salvig, J. D

    2006-01-01

    We examined the association between exposure to seafood intake during two periods of pregnancy on the one hand and risks of preterm delivery and postterm delivery on the other. In a prospective cohort of 8729 pregnant Danish women, we assessed frequency of fish meals during the first and second.......23-4.61) times in those who never consumed fish (n = 308) vs. those who consumed both fish as main meal and fish in sandwiches at least once per week (n = 785). These measures were similar when fish intake was based solely on intake reported for mid-pregnancy. In the subgroup of women reporting same intake...

  13. The immunohistochemical features of chorion and endometrium in women with early pregnancy losses

    Directory of Open Access Journals (Sweden)

    Trohimovych O.V.

    2015-03-01

    Full Text Available Background. According to present views proliferation and apoptosis plays an important role in the mechanisms of placenta formation, particularly in process of vasculogenesis that begins on the third week of pregnancy. Objective: To investigate the immunohistochemical features of chorion and endometrium in women with early pregnancy losses. Methods. 98 samples of abortive and surgical material in pregnant women in terms of 4-10 weeks of pregnancy were analyzed. 48 samples were obtained from women with missed abortion (1st group, 20 samples from women with spontaneous abortion (2nd group; 20 samples from women with tubal pregnancy (3rd group; 10 samples from pregnant women with normal singleton pregnancy, after medical abortion on their own wish (control group. Histological, histochemical and immunohistochemical methods were used. Monoclonal antibodies (MAbs to Ki-67 and bcl-2 were applied. Results. Pathological picture of spontaneous abortion is characterized by the dominance of violation of blood circulation, presence of significant foci of hemorrhage occurring parallel with a pronounced disruption of apoptosis and proliferation in chorionic villi and decidual tissue, leading to the detachment of placenta. Conclusion. In 75% of cases of tubal pregnancy ectopic cytotrophoblast invasion is caused by prominent changes in the structure of the fallopian tube. First of all due to the inflammatory process and a sharp reduction of proliferation in the basal chorion and parietal deciduitis in 65% of cases. Citation: Trohimovych OV. [The immunohistochemical features of chorion and endometrium in women with early pregnancy losses]. Morphologia. 2015;9(1:58-64. Russian.

  14. Early pregnancy sex steroids and maternal breast cancer: a nested case-control study.

    Science.gov (United States)

    Fortner, Renée T; Schock, Helena; Kaaks, Rudolf; Lehtinen, Matti; Pukkala, Eero; Lakso, Hans-Åke; Tanner, Minna; Kallio, Raija; Joensuu, Heikki; Grankvist, Kjell; Zeleniuch-Jacquotte, Anne; Toniolo, Paolo; Lundin, Eva; Surcel, Helja-Marja

    2014-12-01

    Pregnancy, parity, and circulating steroid hormone levels are associated with risk of breast cancer, but little is known about hormone concentrations during pregnancy and subsequent breast cancer risk. We evaluated early pregnancy (pregnancies registered in Finland since 1983. Individuals with samples collected in the first pregnancy leading to a live birth were eligible. Breast cancer cases (n = 1,199) were identified through linkage with the Finnish Cancer Registry; 2,281 matched controls were selected using incidence density sampling. ORs were calculated using conditional logistic regression. Hormone concentrations were not associated with breast cancer overall. Estradiol was positively associated with risk of breast cancer diagnosed age hormones were associated with increased risk of estrogen receptor (ER)- and progesterone receptor (PR)-negative tumors in women age hormones and ER(+)/PR(+) disease. These data suggest a positive association between high concentrations of early pregnancy steroid hormones and risk of ER(-)/PR(-) breast cancer in women diagnosed age pregnancy hormones and risk of steroid receptor-negative cancers is needed to further characterize this association.

  15. Differential expression of prostaglandin E receptor subtype EP2 in rat uterus during early pregnancy

    OpenAIRE

    J. J. Shi; Ma, X. H.; Diao, H.L.; Ni, H.; Xu, L.B.; Zhu, H.(Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China); Yang, Z. M.

    2005-01-01

    PGE2 is essential for mammalian female reproduction. This study was to examine the expression of EP2 gene in the rat uterus during early pregnancy, delayed implantation and artificial decidualization by in situ hybridization and immunohistochemistry. There was no detectable EP2 mRNA expression in the uterus from days 1 to 4 of pregnancy (day 1 = day of vaginal sperm). A low level of EP2 immunostaining was observed in the luminal and glandular epithelium from da...

  16. 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.

  17. Self-reported Vitamin Supplementation in Early Pregnancy and Risk of Miscarriage

    Science.gov (United States)

    Olshan, Andrew F.; Herring, Amy H.; Savitz, David A.; Siega-Riz, Anna Maria; Hartmann, Katherine E.

    2009-01-01

    Miscarriage is a common and poorly understood adverse pregnancy outcome. In this study, the authors sought to evaluate the relation between self-reported use of prenatal vitamins in early pregnancy and the risk of miscarriage. Between 2000 and 2008, 4,752 US women were prospectively enrolled in Right From the Start. Information about vitamin use was obtained from a first-trimester interview. Discrete-time hazard models were used, candidate confounders were assessed, and the following variables were included in the model: study site, maternal age, gravidity, marital status, education, race/ethnicity, smoking, and use of progesterone in early pregnancy. Approximately 95% of participants reported use of vitamins during early pregnancy. A total of 524 women had a miscarriage. In the final adjusted model, any use of vitamins during pregnancy was associated with decreased odds of miscarriage (odds ratio = 0.43, 95% confidence interval: 0.30, 0.60) in comparison with no exposure. These results should be viewed in the context of a potentially preventive biologic mechanism mitigated by possible confounding by healthy behaviors and practices that are also associated with vitamin supplement use during pregnancy. PMID:19372214

  18. Human leucocyte antigen class Ib molecules in pregnancy success and early pregnancy loss

    DEFF Research Database (Denmark)

    Dahl, Mette; Hviid, Thomas Vauvert F

    2013-01-01

    AND CONCLUSIONS The HLA class Ib molecules seem to induce suppression of the maternal immune system, but are not necessarily fundamental factors for pregnancy success. However, evidence points towards low expression of these proteins, especially HLA-G, being associated with reduced fertility. To clarify...

  19. Are women in early pregnancy following the national pyramid recommendations?

    LENUS (Irish Health Repository)

    O'Neill, J L

    2011-10-01

    Appropriate nutrition in pregnancy is fundamental for maternal and fetal health, and the long-term physiological wellbeing of the offspring. We aimed to determine whether a sample of pregnant women met the national guidelines for healthy eating during pregnancy, and to examine if compliance differs when analysed by Body Mass Index (BMI) category. Subjects completed a 24-hr dietary recall, and had their BMI calculated. The mean age was 27.8 years. The mean BMI was 25.1 kg\\/m2, with 32 (31.7%) subjects overweight and 14 (13.9%) obese based on BMI category. Although the majority of subjects thought that they had a healthy diet, less than half met the recommended guidelines for each individual food group with achievement of the dairy group being particularly low. Achievement of food group recommendations was not influenced by BMI category. Public health messages on healthy eating guidelines need to be clearly communicated to pregnant women.

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

    Science.gov (United States)

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

    2014-10-01

    Preeclampsia, a cardiovascular disorder of late pregnancy, is characterized as a low-renin hypertensive state relative to normotensive pregnancy. Because other nonpregnant low-renin hypertensive disorders often exhibit and are occasionally dependent on elevated arginine vasopressin (AVP) secretion, we hypothesized a possible use for plasma AVP measurements in the prediction of preeclampsia. Copeptin is an inert prosegment of AVP that is secreted in a 1:1 molar ratio and exhibits a substantially longer biological half-life compared with AVP, rendering it a clinically useful biomarker of AVP secretion. Copeptin was measured throughout pregnancy in maternal plasma from preeclamptic and control women. Maternal plasma copeptin was significantly higher throughout preeclamptic pregnancies versus control pregnancies. While controlling for clinically significant confounders (age, body mass index, chronic essential hypertension, twin gestation, diabetes mellitus, and history of preeclampsia) using multivariate regression, the association of higher copeptin concentration and the development of preeclampsia remained significant. Receiver operating characteristic analyses reveal that as early as the sixth week of gestation, elevated maternal plasma copeptin concentration is a highly significant predictor of preeclampsia throughout pregnancy. Finally, chronic infusion of AVP during pregnancy (24 ng per hour) is sufficient to phenocopy preeclampsia in C57BL/6J mice, causing pregnancy-specific hypertension, renal glomerular endotheliosis, proteinuria, and intrauterine growth restriction. These data implicate AVP release as a novel predictive biomarker for preeclampsia very early in pregnancy, identify chronic AVP infusion as a novel and clinically relevant model of preeclampsia in mice, and are consistent with a potential causative role for AVP in preeclampsia in humans. © 2014 American Heart Association, Inc.

  1. Influence of Early Pregnancy Termination by Focused Ultrasound Beams on Menstrual Recovery of Macaques

    Institute of Scientific and Technical Information of China (English)

    Yong-hong DU; Zheng-ai XIONG; Jian-zhong ZOU; Yi TAN; Jin BAI; Zhi-biao WANG

    2004-01-01

    Objective To explore the effects on macaques' menstrual recovery after terminating early pregnancy by focused ultrasound beams (FUB)Methods FUB was used to terminate early pregnancy in 5 macaques with gestation duration ranging from 37-66 d. Two circles after the recovery of menstruation, color Doppler flow imaging (CDFI) and magnetic resonance imaging (MRI) were used to estimate the shape, size and blood flow of uterus, and pathological examinations were performed to check against any lesions to uterine endometrium and ovary.Results Forty days after FUB abortion, menstruation recovered and the volume and duration of each macaque's menstruation were not changed compared with those before gestation. CDFI and MRI suggested that the siz.e and shape of uterus were normal.The endometrial line was clear and no lesions were found in adjacent organs.Conclusion FUB termination of early pregnancy in macaques did not damage their ovarian tissue and had no influence on subsequent menstrual recovery.

  2. Prevalence and outcome of asymptomatic bacteriuria in early pregnancy

    OpenAIRE

    Sreekumary Radha; Bindu Nambisan; Nisha Kizhekkepurakkal Prabhakaran; Shahida Jamal

    2016-01-01

    Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of ...

  3. Fertility-preserving treatment and pregnancy outcomes in the early stage of endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    TONG Xiao-mei; LIN Xiao-na; JIANG Hong-fei; JIANG Ling-ying; ZHANG Song-ying; LIANG Feng-bing

    2013-01-01

    Objective This study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility.Data sources The PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR"fertility preserving" AND "endometrial neoplasms" (MeSH).All relevant articles in English and the relevant references were collected.Study selection Data from published articles about fertility-preserving treatment of endometrial cancer,including the response and recurrence rate of conservative treatment,strategies of infertility treatment,pregnancy,and obstetric outcomes,were selected.Data were mainly extracted from 41 studies,which are listed in the reference section of this review.Results Hormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility.Sixty percent of the patients became pregnant after remission of the carcinoma.The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs.43.2%,P<0.01).A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group.The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer.The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%.Conclusions Assisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment.In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

  4. Ischemia-modified albumin as an oxidative stress biomarker in early pregnancy loss.

    Science.gov (United States)

    Cengiz, Huseyin; Dagdeviren, Hediye; Kanawati, Ammar; Suzen Çaypinar, Sema; Yesil, Ali; Ekin, Murat; Yasar, Levent

    2016-01-01

    This study aimed to determine the association between early pregnancy loss and serum ischemia-modified albumin (IMA) concentrations. Serum samples of 180 women that included healthy pregnant women, women admitted for termination of pregnancy due to the absence of fetal cardiac activity or absence of fetal pole on ultrasonographic examination, and healthy non-pregnant women attending for gynecological examination. Each group included 60 patients. Serum concentrations of IMA were compared among the groups, and the correlations with patients' age, gravidity, BMI, gestational age and total serum albumin concentrations were calculated. When the groups were compared with respect to IMA concentrations, the group with early pregnancy loss was found to have significantly higher IMA concentrations (p 163 ng/mL had a sensitivity of 75%, specificity of 55% to discriminate between healthy pregnant patients and patients with early pregnancy loss in first trimester. Our findings support the theory that possible oxidative stress, a more hypoxic environment and defective placentation lead to increased serum IMA concentrations. These findings may help to shed light on the complicated pathogenesis of early pregnancy loss.

  5. 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.

  6. Successful Pregnancy Outcome in Women with Recurrent IVF Failure and Anti-hCG Autoimmunity: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Valeria Muller

    2016-01-01

    Full Text Available We report three cases of effective management of infertility in women with a history of repeated unsuccessful IVF attempts, who have developed antibodies to hCG. A novel approach to conservative treatment of immunologic reproductive failure, suggested for selected patients, included membrane plasmapheresis, combined prednisolone, and intravenous immunoglobulin therapy. No adverse side effects were observed; all cases resulted in pregnancy and subsequent life births. In order to be given an adequate efficient treatment, women with recurrent implantation failure should be suspected for autoimmune factor of infertility and its possible association with anti-hCG autoimmunity.

  7. Pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. The Lin28/Let-7 system in early human embryonic tissue and ectopic pregnancy.

    Directory of Open Access Journals (Sweden)

    Teresa Lozoya

    Full Text Available Our objective was to determine the expression of the elements of the Lin28/Let-7 system, and related microRNAs (miRNAs, in early stages of human placentation and ectopic pregnancy, as a means to assess the potential role of this molecular hub in the pathogenesis of ectopic gestation. Seventeen patients suffering from tubal ectopic pregnancy (cases and forty-three women with normal on-going gestation that desired voluntary termination of pregnancy (VTOP; controls were recruited for the study. Embryonic tissues were subjected to RNA extraction and quantitative PCR analyses for LIN28B, Let-7a, miR-132, miR-145 and mir-323-3p were performed. Our results demonstrate that the expression of LIN28B mRNA was barely detectable in embryonic tissue from early stages of gestation and sharply increased thereafter to plateau between gestational weeks 7-9. In contrast, expression levels of Let-7, mir-132 and mir-145 were high in embryonic tissue from early gestations (≤ 6-weeks and abruptly declined thereafter, especially for Let-7. Opposite trends were detected for mir-323-3p. Embryonic expression of LIN28B mRNA was higher in early stages (≤ 6-weeks of ectopic pregnancy than in normal gestation. In contrast, Let-7a expression was significantly lower in early ectopic pregnancies, while miR-132 and miR-145 levels were not altered. Expression of mir-323-3p was also suppressed in ectopic embryonic tissue. We are the first to document reciprocal changes in the expression profiles of the gene encoding the RNA-binding protein, LIN28B, and the related miRNAs, Let-7a, mir-132 and mir-145, in early stages of human placentation. This finding suggests the potential involvement of LIN28B/Let-7 (deregulated pathways in the pathophysiology of ectopic pregnancy in humans.

  9. The Lin28/Let-7 system in early human embryonic tissue and ectopic pregnancy.

    Science.gov (United States)

    Lozoya, Teresa; Domínguez, Francisco; Romero-Ruiz, Antonio; Steffani, Liliana; Martínez, Sebastián; Monterde, Mercedes; Ferri, Blanca; Núñez, Maria Jose; AinhoaRomero-Espinós; Zamora, Omar; Gurrea, Marta; Sangiao-Alvarellos, Susana; Vega, Olivia; Simón, Carlos; Pellicer, Antonio; Tena-Sempere, Manuel

    2014-01-01

    Our objective was to determine the expression of the elements of the Lin28/Let-7 system, and related microRNAs (miRNAs), in early stages of human placentation and ectopic pregnancy, as a means to assess the potential role of this molecular hub in the pathogenesis of ectopic gestation. Seventeen patients suffering from tubal ectopic pregnancy (cases) and forty-three women with normal on-going gestation that desired voluntary termination of pregnancy (VTOP; controls) were recruited for the study. Embryonic tissues were subjected to RNA extraction and quantitative PCR analyses for LIN28B, Let-7a, miR-132, miR-145 and mir-323-3p were performed. Our results demonstrate that the expression of LIN28B mRNA was barely detectable in embryonic tissue from early stages of gestation and sharply increased thereafter to plateau between gestational weeks 7-9. In contrast, expression levels of Let-7, mir-132 and mir-145 were high in embryonic tissue from early gestations (≤ 6-weeks) and abruptly declined thereafter, especially for Let-7. Opposite trends were detected for mir-323-3p. Embryonic expression of LIN28B mRNA was higher in early stages (≤ 6-weeks) of ectopic pregnancy than in normal gestation. In contrast, Let-7a expression was significantly lower in early ectopic pregnancies, while miR-132 and miR-145 levels were not altered. Expression of mir-323-3p was also suppressed in ectopic embryonic tissue. We are the first to document reciprocal changes in the expression profiles of the gene encoding the RNA-binding protein, LIN28B, and the related miRNAs, Let-7a, mir-132 and mir-145, in early stages of human placentation. This finding suggests the potential involvement of LIN28B/Let-7 (de)regulated pathways in the pathophysiology of ectopic pregnancy in humans.

  10. 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 <200 cells/μl, percent CD4 <14%, or category C event, with censoring at antiretroviral (ART) initiation for reasons other than prevention of mother-to-child transmission (PMTCT). Immunologic progression was defined as two consecutive CD4s ≤350 cells/μl or a single CD4 ≤350 cells/μl followed by non-PMTCT ART initiation. Generalized estimating equations assessed changes in CD4 before and after 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.

  11. Pregnant women on thyroxine substitution are often dysregulated in early pregnancy.

    Science.gov (United States)

    Hallengren, Bengt; Lantz, Mikael; Andreasson, Bengt; Grennert, Lars

    2009-04-01

    Thyroid hormones are important for normal fetal development. Maternal hypothyroidism during early pregnancy is associated with impaired neuropsychological development of children and other adverse outcomes. The primary aim of this prospective study was to determine whether thyroxine-treated pregnant women with hypothyroidism are adequately thyroxine substituted in early pregnancy. A secondary aim was to determine if fetal loss differed between females with thyrotropin (TSH) values within and outside the reference range at their first TSH test, scheduled for 1-2 weeks after verification of pregnancy. This was a prospective open-labeled study. During the years 1997-2002, 119 consecutive pregnancies in 101 females with thyroid diseases were followed at the Department of Endocrinology, Malmö University Hospital. At the first visit, 63 patients, median age 30 years (range 17-45 years), were on thyroxine substitution therapy for hypothyroidism. In these patients 83% were in their first trimester at the time of the initial test. Of the 63 patients on thyroxine substitution for hypothyroidism 32 (51%; Group A) patients had serum TSH values within the reference range at their initial test and 31 (49%; Group B) had serum TSH values outside the reference range. Twelve (19%) had TSH values of 4.0 mIU=l. The fetal loss was 2 of 32 (6%) in Group A compared to 9 of 31 (29%) in Group B ( p pregnant women on thyroxine substitution, serum TSH values were outside the reference range when first tested, generally in the first trimester. Fetal loss was significantly greater in pregnant women with abnormal TSH values compared to those with normal TSH values. Thyroid function in pregnant women on thyroxine substitution should be monitored early in pregnancy and carefully followed during pregnancy. The thyroxine dose should be increased as needed early in pregnancy to avoid hypothyroidism.

  12. 3D power Doppler ultrasound characteristics of the corpus luteum and early pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Reda A. Ahmad

    2015-12-01

    Full Text Available Objective: to assess the relationship of corpus luteum morphology and vascularity by 3 dimensional power Doppler ultrasound and the pregnancy outcome in early pregnancy. Design: prospective observational cohort study. Setting: Zagazig University Hospital. Materials and methods: this is a prospective observational cohort study of thirty six pregnant patients examined by two dimensional and three dimensional transvaginal sonography for corpus luteum volume, echostructure and corpus luteum vascularization index in the period after documentation of fetal heart activity and nine weeks. Results: there were 36 study women, ultrasound morphologic features of corpus luteum: volume ranged from 0.91 to 42.8 ml with median of 6.85, vascularization index ranged from 0.05 to 23.8 with a median of 6.85, echostructure was cystic in 12 women (33.3%, hemorrhagic in 18 (50% and solid in 6 women (16.7%. The relation between CL volume and pregnancy outcome was significant (p-value was 0.02, being smaller in group of missed abortion. The relation between CL VI and pregnancy outcome was non significant (p-value was 0.229. The relation between CL echostructure and pregnancy outcome was highly significant (p-value was 0.009. The prognosis was worst in group of solid echostructure. Conclusion: the corpus luteum volume and echostructure assessed by 3D power Doppler ultrasound have statistical relationship with the early pregnancy outcome.

  13. Continued smoking and continued alcohol consumption during early pregnancy distinctively associated with personality.

    Science.gov (United States)

    Beijers, Chantal; Burger, Huibert; Verbeek, Tjitte; Bockting, Claudi L H; Ormel, Johan

    2014-05-01

    Pregnancy is a unique period to quit smoking and alcohol consumption and although motivated, not all women succeed at this. We investigated the associations of personality with continued smoking and continued alcohol consumption during early pregnancy. In addition, we studied whether antenatal anxiety and depressive symptoms can explain these associations. Two antenatal measurements from the population-based Pregnancy Anxiety and Depression cohort study were used. Pregnant women in their first trimester were recruited via midwifery practices and hospitals. We analyzed a sample of women who continued (n=101) or quit smoking (n=254), and a sample of women who continued (n=110) or quit alcohol consumption (n=1230). Measures included questions about smoking, alcohol consumption, the NEO-Five Factor Inventory (personality), the State Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. We found associations between continued alcohol consumption and higher levels of openness to experience, and lower levels of conscientiousness (psmoking emerged. This study contributes to the limited literature on personality differences between women who continue and quit smoking and alcohol consumption during early pregnancy. General population studies have not confirmed the association between openness to experience and alcohol consumption which implies that pregnancy is indeed a unique period. Increased insight in how personality influences continued smoking and alcohol consumption during pregnancy can help health professionals to improve lifestyle interventions targeted at pregnant women.

  14. Maternal fish consumption during pregnancy and risk of early childhood asthma.

    Science.gov (United States)

    Salam, Muhammad T; Li, Yu-Fen; Langholz, Bryan; Gilliland, Frank D

    2005-01-01

    Maternal fish consumption during pregnancy may affect children's asthma risk by modulating early-life immune development. Type of fish intake may be important because of differences in fatty acid content. To test this hypothesis, we conducted a nested case-control study, selecting subjects from the Children's Health Study, a population-based study of school-aged children in southern California. Cases had physician-diagnosed asthma and controls were asthma-free by age 5 years. Mothers or guardians provided information on fish consumption during pregnancy in telephone interviews. We computed odds ratio (OR) and 95% confidence interval (CI) by using conditional logistic regression models that accounted for the sampling. In children born to mothers with a history of asthma, the OR of asthma was 0.20 (95% CI = 0.06-0.65) when mothers ate oily fish at least monthly during pregnancy compared with no consumption (p(trend) = 0.006). Maternal oily fish consumption during pregnancy did not benefit children of non-asthmatic mothers. In contrast, fish stick (a source of trans-fats) consumption during pregnancy increased asthma risk in children (OR = 2.04; 95% CI = 1.18-3.51). Our results suggest that maternal oily fish intake during pregnancy may protect offspring from asthma; however, eating fish sticks during pregnancy may increase asthma risk in children.

  15. The role of pregnancy awareness on female sexual function in early gestation.

    Science.gov (United States)

    Corbacioglu, Aytul; Bakir, Vuslat Lale; Akbayir, Ozgur; Cilesiz Goksedef, Behiye Pinar; Akca, Aysu

    2012-07-01

    Female sexual function is negatively influenced by pregnancy due to the physical and emotional changes. Although the most significant effect is seen in the third trimester of pregnancy, a considerable decrease in the frequency of intercourse and sexual desire in the first trimester has also been shown. To investigate the factors that affect sexuality in early pregnancy and the impact of awareness of pregnancy on female sexual function in the first trimester of pregnancy using two self-reported questionnaires. In this cross-sectional study, 130 healthy, married pregnant women who were admitted to the gynecology clinic between the 4th and 10th week of gestation were asked to complete a self-administered questionnaire and the female sexual function index (FSFI). The factors associated with FSFI score and monthly sexual activity frequency in the first trimester, as well as the differences in sexual activity frequency and FSFI scores between the women who were previously aware of their pregnancy and those who were yet unaware of their pregnancy. Women who were unaware of their pregnancy had significantly higher coitus frequency in comparison with the aware group (P = 0.002). Total FSFI score was 21.99 ± 8.13 in the aware group and 24.66 ± 3.76 in the unaware group (P = 0.02). None of the obstetric and sociodemographic variables had an influence on desire and pain scores. Arousal, lubrication, and satisfaction scores were adversely affected by awareness of pregnancy. Orgasm scores were influenced negatively by awareness and positively by love marriage; however, in multivariate linear regression analysis none of these were defined as independent factor for orgasm scores. Overall FSFI scores and monthly frequency of sexual activity were only affected by awareness. The results of this study suggest that in early gestation, awareness of pregnancy is associated with lower female sexual function. Furthermore, obstetric and sociodemographic factors seem to be

  16. 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 TSH and free T4 (fT4) reference limits in the first trimester of pregnancy. DESIGN: Measurement of TSH and fT4 in biobank sera collected in pregnancy weeks 5-19 from a random sample of the Danish National Birth Cohort that enrolled 101 032 pregnant in 1996-2002. SETTING: National cohort of pregnant...... women. PARTICIPANTS: Healthy participants (n = 6671) were identified and individual characteristics retrieved using interview data and data from Danish national health registers. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Reference limits for TSH and fT4 in each first trimester pregnancy week...

  17. Prevalence and outcome of asymptomatic bacteriuria in early pregnancy

    Directory of Open Access Journals (Sweden)

    Sreekumary Radha

    2016-12-01

    Full Text Available Background: Bacteriuria is a major risk factor for developing symptomatic urinary tract infection which is associated with significant maternal and fetal risks. Various studies have put a prevalence of asymptomatic bacteriuria between 2-10% in pregnancy. Maternal and fetal complications like gestational hypertension, anaemia, premature delivery, IUGR, and low birth weight are commonly associated with pyelonephritis which occurs as a result of undiagnosed or inadequately treated infections of the urinary tract. The primary objective was to find out the prevalence of asymptomatic bacteriuria in pregnancies less than 28 weeks gestation in our hospital and to study the various adverse pregnancy outcomes in the study group. Methods: This was a cross sectional study done over a period of 12 months at this tertiary care centre in Government sector in Trivandrum, Kerala. A sample size was calculated statistically and 400 women with gestational age less than 28 weeks attending the outpatient department were included in this study. A structured proforma, urine microscopy and urine culture and sensitivity were the study tools. Results: Prevalence of asymptomatic bacteriuria in our study population was 8.25%. Commonest pathogen isolated was E.coli in 57.14% cases. Maternal morbidity was higher in women with asymptomatic bacteriuria (24.2% than those without (12.5%. Fetal morbidity in women with asymptomatic bacteriuria was 24% whereas it was 12.5% in those without it. Preterm labour, preeclampsia and prematurity were the common morbidities noted. Conclusions: Since pregnant women with asymptomatic bacteriuria were at an increased risk of adverse maternal and fetal outcome, routine screening for asymptomatic bacteriuria preferably in the first trimester is highly recommended.

  18. Pregnancy failure in patients with obstetric antiphospholipid syndrome with conventional treatment: the influence of a triple positive antibody profile.

    Science.gov (United States)

    Latino, J O; Udry, S; Aranda, F M; Perés Wingeyer, S D A; Fernández Romero, D S; de Larrañaga, G F

    2017-01-01

    Conventional treatment of obstetric antiphospholipid syndrome fails in approximately 20-30% of pregnant women without any clearly identified risk factor. It is important to identify risk factors that are associated with these treatment failures. This study aimed to assess the impact of risk factors on pregnancy outcomes in women with obstetric antiphospholipid syndrome treated with conventional treatment. We carefully retrospectively selected 106 pregnancies in women with obstetric antiphospholipid syndrome treated with heparin + aspirin. Pregnancy outcomes were evaluated according to the following associated risk factors: triple positivity profile, double positivity profile, single positivity profile, history of thrombosis, autoimmune disease, more than four pregnancy losses, and high titers of anticardiolipin antibodies and/or anti-βeta-2-glycoprotein-I (aβ2GPI) antibodies. To establish the association between pregnancy outcomes and risk factors, a single binary logistic regressions analysis was performed. Risk factors associated with pregnancy loss with conventional treatment were: the presence of triple positivity (OR = 5.0, CI = 1.4-16.9, p = 0.01), high titers of aβ2GPI (OR = 4.4, CI = 1.2-16.1, p = 0.023) and a history of more than four pregnancy losses (OR = 3.5, CI = 1.2-10.0, p = 0.018). The presence of triple positivity was an independent risk factor associated with gestational complications (OR = 4.1, CI = 1.2-13.9, p = 0.02). Our findings reinforce the idea that triple positivity is a categorical risk factor for poor response to conventional treatment.

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

    Science.gov (United States)

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

    2016-01-01

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

  20. 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...

  1. The effect of alcohol binge drinking in early pregnancy on child’s general intelligence

    DEFF Research Database (Denmark)

    Kesmodel, Ulrik Schiøler; Eriksen, Hanne-Lise 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...... consumption during early pregnancy, including the number of binge episodes and the timing of binge drinking, on general intelligence in 5-year-old children. Design  Follow-up study. Setting  Neuropsychological testing in four Danish cities 2003-2008. Population  A cohort of 1617 women and their children...... 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...

  2. FETAL HEART-RATE IN EARLY-PREGNANCY AND CHROMOSOMAL DISORDERS

    NARCIS (Netherlands)

    VANLITH, JMM; VISSER, GHA; MANTINGH, A; BEEKHUIS, [No Value

    1992-01-01

    Objective To investigate normal fetal heart rate in early pregnancy and assess the hypothesis that abnormal fetal heart rate is associated with fetal chromosomal abnormalities. Design Prospective descriptive cross-sectional study. Setting Antenatal clinic associated to the University Clinic of Obste

  3. 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 disadvant

  4. Seeking Safety and Empathy: Adolescent Health Seeking Behavior during Pregnancy and Early Motherhood in Central Uganda

    Science.gov (United States)

    Atuyambe, Lynn; Mirembe, Florence; Annika, Johansson; Kirumira, Edward K.; Faxelid, Elisabeth

    2009-01-01

    Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study…

  5. Use of Antibiotics during pregnancy increases the risk of Asthma in early childhood

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Simonsen, Jacob; Jensen, Signe Marie;

    2013-01-01

    OBJECTIVES: To investigate the hypothesis that mother's use of antibiotics in pregnancy could influence asthma and eczema in early life. STUDY DESIGN: Subjects were included from the Copenhagen Prospective Study on Asthma in Childhood cohort of children born of mothers with asthma (N = 411). Seve...

  6. 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

  7. TOXICOLOGICAL STUDR OF DL-111-IT,A NEW NON-STEROID EARLY PREGNANCY TERMINATING AGENT

    Institute of Scientific and Technical Information of China (English)

    FANGRui-Ying; ZHOUHui-Jun; YANGBao-Zhu; LIUHe-Chu; XUJian-Hua; LOUYi-Jia; ZHANGYuan-Pei

    1989-01-01

    DL-111-IT (3-ethylpheny1-5- (3-methoxyphenyl) -1, 2, 4-triazole) is highly effective for terminating early pregnancy in several species of animals without delayoel embryotoxic and teratogenic effects on the secondary embryo in rats. The present paper is a toxicological study of DI-111-IT.

  8. Birth defects after use of antithyroid drugs in early pregnancy

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Lönn, Stefan; Vestergaard, Peter

    2017-01-01

    .0%). For subtypes of birth defects, MMI was associated with an increased incidence of septal heart defects (p=0.02). PTU was associated with ear (p=0.005) and obstructive urinary system malformations (p=0.006). A case of choanal atresia was observed after exposure to both MMI and PTU. The incidence of birth defects...... in children born to mothers who received ATD before or after, but not in pregnancy, was 8.8% and not significantly different from non-exposed (p=0.3), MMI exposed (p=0.4) or PTU exposed (p=0.2). CONCLUSIONS: MMI and PTU were associated with subtypes of birth defects previously reported, but the frequency...

  9. Maternal obesity in early pregnancy and risk of adverse outcomes.

    Directory of Open Access Journals (Sweden)

    Inmaculada Bautista-Castaño

    Full Text Available OBJECTIVES: To assess the role of the health consequences of maternal overweight and obesity at the start of pregnancy on gestational pathologies, delivery and newborn characteristics. METHODS: A cohort of pregnant women (n = 6.558 having delivered at the Maternal & Child University Hospital of Gran Canaria (HUMIGC in 2008 has been studied. Outcomes were compared using multivariate analyses controlling for confounding variables. RESULTS: Compared to normoweight, overweight and obese women have greater risks of gestational diabetes mellitus (RR = 2.13 (95% CI: 1.52-2.98 and (RR = 2.85 (95% CI: 2.01-4.04, gestational hypertension (RR = 2.01 (95% CI: 1.27-3.19 and (RR = 4.79 (95% CI: 3.13-7.32 and preeclampsia (RR = 3.16 (95% CI: 1.12-8.91 and (RR = 8.80 (95% CI: 3.46-22.40. Obese women have also more frequently oligodramnios (RR = 2.02 (95% CI: 1.25-3.27, polyhydramnios. (RR = 1.76 (95% CI: 1.03-2.99, tearing (RR = 1.24 (95% CI: 1.05-1.46 and a lower risk of induced deliveries (RR = 0.83 (95% CI: 0.72-0.95. Both groups have more frequently caesarean section (RR = 1.36 (95% CI: 1.14-1.63 and (RR = 1.84 (95% CI: 1.53-2.22 and manual placenta extraction (RR = 1.65 (95% CI: 1.28-2.11 and (RR = 1.77 (95% CI: 1.35-2.33. Newborns from overweight and obese women have higher weight (p<0.001 and a greater risk of being macrosomic (RR = 2.00 (95% CI: 1.56-2.56 and (RR = 2.74 (95% CI: 2.12-3.54. Finally, neonates from obese mother have a higher risk of being admitted to special care units (RR = 1.34 (95% CI: 1.01-1.77. Apgar 1 min was significantly higher in newborns from normoweight mothers: 8.65 (95% CI: 8.62-8.69 than from overweight: 8.56 (95% CI: 8.50-8.61 or obese mothers: 8.48 (95% CI: 8.41-8.54. CONCLUSION: Obesity and overweight status at the beginning of pregnancy increase the adverse outcomes of the pregnancy. It is important to promote the normalization of bodyweight in those

  10. The relation between antihistamine medication during early pregnancy & birth defects

    Directory of Open Access Journals (Sweden)

    Rabah M. Shawky

    2015-10-01

    Full Text Available Antihistamines are a group of medications which can inhibit various histaminic actions at one of two histamine receptors (H1 or H2. H1 receptor antagonists are used for the relief of allergic dermatological and nondermatological conditions. We will review classes of antihistamines (H1 antagonists and the relationship between specific antihistamines and specific birth defects. Although many findings provide reassurance about the relative safety of many antihistamine drugs and that any malformation reported is most probably caused by chance, studies are still required to assure fetal safety. As pruritus is sometimes troublesome for pregnant women topical medications like emollients should be tried first in the first trimester of pregnancy. Also pregnant women should be advised to consult their health care provider before taking any medication.

  11. [Female genital mutilations, forced marriages, and early pregnancies].

    Science.gov (United States)

    Henrion, Roger

    2003-01-01

    Female genital mutilations, as well as forcible childhood marriage and their correlate adolescent pregnancies are traditional practices which, not only violate the dignity, but also jeopardize the health, and even the life, of women and their children. The complications of genital mutilations are frequent for a number of reasons: the fact that the clitoris is highly vascularized, the nature of the mutilations, excision or infibulation, and the poor conditions of hygiene. The short term complications are pain, hemorrhage, shock, and urinary retention. Medium term complications include gangrene, septicemia, tetanus, pelvic inflammatory disease, HIV/AIDS, and hepatitis B or C infections. Serious sequelae may occur, including infertility and gynecologic disorders, and sexual life is invariably altered. The main obstetrical complications of genital mutilations are genital lacerations involving the labia minor and the perineum, which can lead to hemorrhage and sequelae such as urinary or anal incontinence, recto-vaginal and vesico-vaginal fistulas. The role of doctors, which is delicate because these customs are entrenched, is to detect genital mutilations, repair them and prevent them, by participating in health education programs. The consequences of forcible childhood marriage are serious, besides the fact that this is a disguised form of rape. The obstetrical risks favored by the underdevelopment of the uterus and the pelvis, include uterine rupture, preeclampsia and eclampsia, and obstetrical hemorrhage. The fetus/neonate are jeopardized by these complications, which can result in perinatal asphyxia and death, as well as the high rates of intrauterine growth retardation and preterm delivery. The impact of genital mutilations on delivery are compounded in childhood pregnancies for anatomical reasons, but also because these adolescents or children are extremely vulnerable and have poor access to perinatal care. In France, as well as in Africa, non-governmental and

  12. First-time pregnant women's experiences of their body in early pregnancy.

    Science.gov (United States)

    Bergbom, Ingegerd; Modh, Carin; Lundgren, Ingela; Lindwall, Lillemor

    2016-10-11

    The body of first-time pregnant women is affected in many ways, and the women may not know what to expect. Conversations between women and healthcare personnel about women's bodily experience in early pregnancy can contribute to increased body knowledge, which may have a positive impact in later stages of their pregnancy and in relation to delivery. The aim of the study was to describe first-time pregnant women's experiences of their body in early pregnancy (pregnancy weeks 10-14). Twelve women were asked to draw pictures and answer questions freely about their experiences of their first pregnant body. Hermeneutical text interpretation was used to obtain an overall view of the experiences. A main theme emerged: 'the body is connected to the cycle of life'. This theme comprised five subthemes: 'bodily longing and a sense of ambivalence', 'being doubtful', 'welcoming changes in body and mind', 'feeling inner strength and struggle to find strength' and 'accepting a different body and mind'. This main theme and the subthemes were further interpreted and were understood as an experience of 'me and my body'. The body reminded the women to take care of it and gave rise to positive thoughts. When the body exhibited uncomfortable reactions and sensations, these were taken as evidence of pregnancy, which was also seen positive but it also triggered a sense of dissatisfaction with the body and a feeling of it becoming alien. © 2016 Nordic College of Caring Science.

  13. Early pregnancy plasminogen activator inhibitor-1 levels in Nigerian women and its relationship with preeclampsia.

    Science.gov (United States)

    Udenze, I C; Arikawe, A P; Makwe, C C

    2017-05-01

    This study compared early plasma levels of plasminogen activator inhibitor-1 (PAI-1) in normal pregnancy and preeclampsia and determined its relationship with disease severity. This was a prospective cohort study of 195 normotensive, aproteinuric pregnant women without prior history of gestational hypertension. The women were attending the Antenatal Clinic at The Lagos University Teaching Hospital and were within 24 weeks gestation at recruitment. The outcome measures were PAI-1, systolic blood pressure (SBP), diastolic blood pressure (DBP), and significant proteinuria. The endpoint of the study was the development of preeclampsia. The diagnosis of preeclampsia was made by the attending Obstetrician. The data were analyzed using the IBM SPSS statistical software. Statistical significance was set at P women who later developed preeclampsia compared to those who had a normal pregnancy (P women who later developed preeclampsia, PAI-1 had an inverse relationship with gestational age (r = 0.878) whereas in normal pregnancy, PAI-1 and gestational age had a direct relationship (r = 0.017). Second trimester systolic and DBP values were also significantly higher in the women who later developed preeclampsia compared to normal pregnancy, P = 0.007 and 0.004, respectively. There was, however, no correlation between PAI-1 values and SBP, DBP and proteinuria in the women who developed preeclampsia. Plasma levels of PAI-1 are increased early in pregnancies complicated by preeclampsia, but the lack of correlation of this marker with disease severity may limit its clinical utility.

  14. Early pregnancy alters the metabolic responses to restricted nutrition in sheep.

    Science.gov (United States)

    Sosa, C; Abecia, J A; Carriquiry, M; Forcada, F; Martin, G B; Palacín, I; Meikle, A

    2009-01-01

    This study investigated whether a 27-day period of nutrition at half-maintenance during early pregnancy (up to Day 14) could alter maternal endocrine responses. Forty-six ewes were fed all or half of their maintenance requirements and slaughtered on Day 14 of the oestrous cycle or pregnancy. We used real time RT-PCR to study gene expression of growth hormone receptor (GHR) and leptin in adipose tissue and GHR, GHR1A and of the insulin-like growth factor I (IGF-I) in the liver. Blood profiles of metabolites and metabolic hormones were also determined. Throughout the experiment, underfed animals presented lower body weight and body condition, greater plasma concentrations of non-esterified fatty acids (NEFA), and lower plasma concentrations of leptin, compared to adequately fed animals. Undernutrition affected the patterns of gene expression in adipose and hepatic tissues, and the responses differed between pregnant and non-pregnant ewes. In adequately fed ewes, pregnancy up-regulated leptin mRNA expression in adipose tissue, a response that was impaired in underfed ewes. The hepatic expression of IGF-I mRNA was increased by pregnancy in underfed animals while no effect was observed in adequately fed ewes. It remains to be determined whether the changes in the endocrine milieu are paralleled by modifications in uterine gene expression that could alter the environment of the embryo during early pregnancy.

  15. 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

    published studies that a high, detectable soluble HLA-G concentration in maternal plasma or serum is not mandatory for a successful pregnancy. However, complications during pregnancy, such as (severe) pre-eclampsia, spontaneous abortion, IUGR, and premature birth, are associated with a low or undetectable...... was to investigate the levels of different soluble HLA-G isoforms in maternal plasma in early and late pregnancy. METHOD OF STUDY: Soluble HLA-G (sHLA-G) can be detected in maternal blood, and in this study, two different isoforms of sHLA-G, namely sHLA-G1 generated by shedding of membrane-bound HLA-G1 and HLA......-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...

  16. Core Competencies and the Prevention of School Failure and Early School Leaving

    Science.gov (United States)

    Bradshaw, Catherine P.; O'Brennan, Lindsey M.; McNeely, Clea A.

    2008-01-01

    There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase…

  17. Core Competencies and the Prevention of School Failure and Early School Leaving

    Science.gov (United States)

    Bradshaw, Catherine P.; O'Brennan, Lindsey M.; McNeely, Clea A.

    2008-01-01

    There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase…

  18. The sheep conceptus modulates proteome profiles in caruncular endometrium during early pregnancy.

    Science.gov (United States)

    Arianmanesh, Mitra; Fowler, Paul A; Al-Gubory, Kaïs H

    2016-12-01

    The stage-specific expression of functional proteins within the endometrium, and their regulation by conceptus-derived signals, are crucial for conceptus development and successful establishment of pregnancy. Accurate knowledge of endometrium-conceptus interactions is key for the development of effective strategies to improve conceptus implantation rates both following natural conception and/or assisted reproductive technologies. The unilateral pregnant ewe provides a powerful experimental model for the study of endometrial function in the presence or absence of conceptuses during the peri-implantation period. Two-dimensional gel electrophoresis and mass spectrometry-based proteomics were used to compare and identify differentially expressed proteins in caruncular endometrium collected from the gravid uterine horns and the non-gravid uterine horns at the time of conceptus attachment (day 16 of pregnancy) and early post-implantation period (day 20 of pregnancy). Fifty seven protein spots were up-regulated in the gravid horn at day 16 of pregnancy and twenty seven protein spots were up-regulated in the gravid horn at day 20 of pregnancy. Sixteen proteins with different functions such as protein metabolism, cholesterol and ion transport and cell adhesion were identified. In conclusion, the use of the unilaterally pregnant ewe model provides evidence that the early implantation and post-implanting conceptus-derived signals up-regulate caruncle endometrial proteins, including carbonic anhydrase 2 (CA-II) and apolipoprotein A-1 (APOA1) and down-regulate caruncle endometrial proteins, including adenosylhomocysteinase (AHCY) and heat shock 60kDa protein 1 (HSP60). These regulated proteins are likely involved in providing a suitable intra-uterine environment required for conceptus attachment, implantation, early post-implantation development and the successful establishment of pregnancy in sheep.

  19. Secretion of estradiol-17beta by porcine endometrium and myometrium during early pregnancy and luteolysis.

    Science.gov (United States)

    Franczak, A; Kotwica, G

    2008-02-01

    Past studies of the source of estrogens secreted during maternal recognition of pregnancy in pigs have focused on embryonic rather than uterine origin of these steroids. The present study documents: (1) the expression of the gene CYP 17, encoding cytochrome P450 17alpha-hydroxylase/C(17-20) lyase and (2) the synthesis and secretion of estradiol-17 beta (E(2)) in endometrial and myometrial tissues in gilts. The expression of CYP 17 gene was shown in porcine endometrium and myometrium. Basal endometrial secretion of E(2) was higher in pregnant gilts than in cyclic gilts (days 14-16). The myometrium secreted more E(2) during the expected time of luteolysis compared to early pregnancy. Basal secretion of E(2) during pregnancy was higher from the endometrium than from the myometrium. Conversely, during luteolysis E(2) secretion was higher from the myometrium and lower from the endometrium. In pregnant and cyclic gilts (days 14-16), progesterone (P(4), 10(-5)M) in vitro significantly increased E(2) secretion regardless of reproductive status. Oxytocin (OT, 10(-7)M) had no influence on E(2) secretion and did not change the stimulatory effect of P(4) in both tissues examined. In conclusions: (1) the CYP 17 gene transcript is present in porcine endometrium and myometrium; (2) porcine endometrium and myometrium release E(2) in vitro; (3) the endometrium releases more E(2) than the myometrium during early pregnancy; (4) the myometrium releases E(2) mainly during luteolysis; (5) the endometrium and myometrium can increase E(2) release in vitro if substrate (P(4)) is provided during early pregnancy and luteolysis. These data suggest active estrogen production by the myometrium and endometrium as an alternative source for this signal for recognition of pregnancy in the pig.

  20. PRENATAL DIAGNOSIS AND SCREENING OF GENETIC ABNORMALITIES IN EARLY PREGNANCY

    Directory of Open Access Journals (Sweden)

    Jyothi Kiran Kohli

    2016-11-01

    Full Text Available BACKGROUND Genetic diseases are one of the major causes of hospital admissions due to disability and mortality particularly among children (1:5 children of hospital admission either partially/completely as distribution of genetic diseases is not related to socioeconomic background, which implies that developing world has a large number of genetic diseases largely left uncared for, i.e. overall incidence of foetal/neonatal loss due to genetic/genetic environmental causes are as follows: 1:50 newborns have major congenital abnormality, 1:100 have a unifactorial disorder, 1:200 have a major chromosomal abnormality before birth. Diagnosis of chromosomal anomalies in foetus is one of the most important challenges in modern perinatology as invasive or noninvasive methods. The aim of the study is to review on cytogenetic evaluation of CVS obtained (transcervically during first trimester of pregnancy by direct karyotyping of tissue. MATERIALS AND METHODS This study was conducted in 2001 in Department of Anatomy along with Obstetrics and Gynaecology Department, LNJP Hospital. 37 healthy cases with 6-12 weeks of gestational age coming for medical termination of pregnancy were included in the study. After written informed consent for procedure, ultrasound-guided transcervical chorionic villus sampling was done (Brambati’s method. Tissue procured was then processed for direct karyotyping and studied. Metaphase spreads were photographed and karyotypes prepared and studied. RESULTS Out of 37 pregnant females, 30 samples were successfully prepared and processed by Direct method out of which 23 were normal female (46, XX and 7 were normal male (46, XY. No normal anomaly was detected. Best biopsies were obtained with 8-12 weeks gestation. G Banding could not be performed as chromosome obtained were found to be resistant to banding. CONCLUSIONS To summarise chromosome preparations obtained from CVS by Direct method has advantage of providing sufficient number

  1. Failure of the emergency contraceptive levonorgestrel and the risk of adverse effects in pregnancy and on fetal development: an observational cohort study.

    Science.gov (United States)

    De Santis, Marco; Cavaliere, Anna Franca; Straface, Gianluca; Carducci, Brigida; Caruso, Alessandro

    2005-08-01

    To determine pregnancy and neonatal outcome after the failure of levonorgestrel as an emergency contraceptive. A retrospective observational cohort study. Telephone consultations concerning reproductive risk factors conducted by Telefono Rosso-Teratology Information Service, Catholic University of Sacred Heart, Rome, Italy. Women exposed to levonorgestrel (36 cases) compared with a control group (80 cases). Teratological counseling. The rate of congenital anomalies, the prepartum or peripartum complications, and the pregnancy outcomes. Twenty-five exposed newborns with length and weight identical to that of the control group were shown to be without increased risk of congenital malformation. No statistical differences were observed in terms of spontaneous or legal abortion and pregnancy and neonatal complications, and there was no ectopic pregnancy in either group. Although the sample size was small, in our experience, the failure of levonorgestrel as an emergency contraceptive was not associated with an increased risk of major congenital malformations, prepartum or peripartum complications, or an adverse pregnancy outcome.

  2. Congenital malformation of fetus in a pregnancy following spontaneous ovulation in a case of premature ovarian failure

    Directory of Open Access Journals (Sweden)

    Priya Selvaraj

    2010-01-01

    Full Text Available Premature ovarian failure (POF, that is, amenorrhea before 40 years of age can be attributed to a variety of etiologies. Approximately 1% of women before 30 years are diagnosed with POF. Spontaneous ovulation leading to pregnancy in POF is even a rarer entity. We report a case where congenital malformations were diagnosed in a fetus following spontaneous ovulation in a case of POF. A 33-year-old woman presented to our center with primary infertility. On complete work up, she was diagnosed with POF and conceived with hormone replacement therapy and donor oocyte program. She delivered a healthy female baby through caesarean section. The patient reviewed later with amenorrhea of 40 days and pregnancy was confirmed. However, during antenatal follow-up congenital anomalies in fetus were diagnosed sonographically. The decision for termination of pregnancy was taken. To conclude, we recommend large-scale retrospective analysis that would define medical guidelines in cases of pregnancy following spontaneous ovulation in POF.

  3. 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.

  4. 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.

  5. A case of painless thyroiditis in a very early stage of pregnancy.

    Science.gov (United States)

    Sato, Shiori; Endo, Kei; Iizaka, Toru; Saiki, Ryo; Iwaku, Kenji; Sato, Shotaro; Takahashi, Yasuyoshi; Otsuka, Fumiko; Taniyama, Matsuo

    2012-01-01

    We report a case of painless thyroiditis detected during the first trimester of pregnancy. A 29-year-old Japanese woman was hospitalized because of thyrotoxicosis and she was confirmed to be pregnant. The gestational age was 4 weeks. Blood examinations revealed negative TSH receptor antibodies, however, we started potassium iodide because we were unable to rule out Graves' disease. Thyroid hormone levels were normalized in 3 weeks and remained low even after discontinuation of medication. She received replacement therapy with levothyroxine sodium hydrate till 3 months after delivery. Painless thyroiditis can be one of the differential diagnoses of thyrotoxicosis in a very early stage of pregnancy.

  6. Cervico-isthmic pregnancy: early diagnostic imaging and successful dual therapy for uterine-sparing treatment.

    Science.gov (United States)

    Takeda, Akihiro; Koike, Wataru; Hayashi, Shotaro; Imoto, Sanae; Nakamura, Hiromi

    2015-01-01

    Cervico-isthmic pregnancy is a rare and potentially life-threatening form of ectopic gestation in which the blastocyst implants in the uterine cervico-isthmus between the histological and anatomical internal os, followed by subsequent extension to the lower uterine segment. Early diagnosis may allow a conservative therapeutic approach that avoids catastrophic hemorrhage requiring hysterectomy. Here we report the case of a 43-year-old primigravida woman whose cervico-isthmic pregnancy complicated by massive hematometra was diagnosed at 6 weeks gestation by multimodal imaging and successfully treated by hysteroscopic resection, securing adequate hemostasis, after transcatheter arterial chemoembolization.

  7. UAV Swarm Behavior Modeling for Early Exposure of Failure Modes

    Science.gov (United States)

    2016-09-01

    is present. If that is not feasible, the UAV should immediately reduce altitude and land. The landing method is a mission driven behavior that does...new operation to allow the nearest UAV to relieve the bingo fueled UAV. Once the new UAV arrives, the UAV experiencing the bingo fuel failure mode

  8. [Diabetes mellitus and early failures in oral implantology].

    Science.gov (United States)

    Niang, P; Ba, A; Dia, Tine S; Tamba, B; Gassama, Barry B C; Diallo, B

    2011-09-01

    It has become increasingly common for diabetic patients to be considered as candidates for dental implants. However even though success rates of implant therapy in diabetic are high, this does not preclude failures. Failure to osseointegrate in the initial healing phase results in a fibrous tissue encapsulation of the implant and clinical mobility, leading ultimately to the failure of the implant. This review presents the current knowledge regarding the effect of diabetes mellitus on the osseointegration of implants including pathophysiologic aspects as well as their potential implications on bone metabolism and osseointegration, implant success rate at the second-phase surgery and guidelines for pre and post-operative management. In experimental models of diabetes mellitus, a reduced level of bone-implant contact has been shown, and this can be reversed by means of treatment with insulin. Compared with the general population, a higher failure rate is seen in diabetic patients. Most of these occur at the second-phase surgery, seemingly pointing to the microvascular complications of this condition as a possible causal factor. It is necessary to take certain special considerations into account for the placement of implants in diabetic patient. A good control of plasma glycemia, together with other measures, has been shown to improve the percentages of implant survival in these patients.

  9. Focused-ultrasound termination of an early pregnancy in rhesus macaques (Macaca mulatta): a pilot study.

    Science.gov (United States)

    Du, Yong-Hong; Zou, Jian-Zhong; Bai, Jin; Zhan, Yang; Wu, Feng; Wang, Zhi-Biao

    2012-12-01

    We explored the effectiveness, safety, and feasibility of focused ultrasound in terminating undesired pregnancy. A high-intensity focused ultrasound therapeutic unit was employed to terminate early pregnancies in rhesus macaques. B-mode ultrasound incorporated within the system was used to locate and study the gestational sacs of 6 rhesus macaques with gestation ages of 37 to 66 days, and varying modes of ultrasound exposure were adopted in the termination of the early pregnancies of the rhesus macaques. After focused ultrasound exposure, B-mode ultrasound of the gestational sacs showed significant lethal changes. Of the 6 rhesus macaques, 5 underwent complete abortions whereas 1 rhesus macaque underwent an incomplete abortion. The rhesus macaques resumed their menstrual cycles 50 days after focused-ultrasound treatment. The results suggested that focused ultrasound could be safe, feasible, and effective in terminating early pregnancies in rhesus macaques. As a novel physical method, it may be a promising ablation for a potentially clinical application. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  10. Choosing early pregnancy termination methods in Urban Mozambique

    NARCIS (Netherlands)

    E.M.H. Mitchell; A. Kwizera; M. Usta; H. Gebreselassie

    2010-01-01

    Little is known about who chooses medication abortion with misoprostol and why. Women seeking early abortion in 5 public hospitals in Maputo, Mozambique were recruited in 2005 and 2006 to explore decision-making strategies, method preferences and experiences with misoprostol and vacuum aspiration fo

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

    Science.gov (United States)

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

    2015-10-14

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

  12. The effect of exposure to hypergravity on pregnant rat dams, pregnancy outcome and early neonatal development

    Science.gov (United States)

    Ladd, B.; Nguon, K.; Sajdel-Sulkowska, E. M.

    2006-01-01

    We previously reported that hypergravity exposure affects food intake and mass gain during pregnancy. In the present study, we explored the hypothesis that changes in maternal body mass in hypergravity-exposed pregnant rat dams affect pregnancy outcome and early offspring development. Furthermore, we hypothesized that the changes observed at 1.5G will be magnified at higher gravity and by exposure during critical developmental periods. To test this hypothesis, we compared maternal body mass gain, food consumption, birth outcome and early offspring development between Sprague Dawley rat dams exposed to graded (1.5 1.75G) chronic hypergravity (HG) or rotation (rotational control, RC) on a 24-ft centrifuge for 22.5 h starting on gestational day (G) 10 with dams housed under identical conditions but not exposed to hypergravity (SC). We also compared maternal body mass, food consumption, birth outcome and early offspring development between rat dams exposed to 1.65G during different stages of pregnancy and nursing. Exposure to hypergravity resulted in transient loss in body mass and prolonged decrease in food consumption in HG dams, but the changes observed at 1.5G were not magnified at 1.65G or 1.75G. On the other hand RC dams gained more mass and consumed more food than SC dams. Exposure to hypergravity also affected pregnancy outcome as evidenced by decreased litter size, lowered neonatal mass at birth, and higher neonatal mortality; pregnancy outcome was not affected in RC dams. Neonatal changes evidenced by impaired righting response observed at 1.5G was magnified at higher gravity and was dependent on the period of hypergravity exposure. On the other hand, righting response was improved in RC neonates. Hypergravity exposure during early postpartum affected the food consumption of nursing mothers and affected early survival of their offspring. The changes observed in dams and neonates appear to be due to hypergravity exposure since animals exposed to the rotation

  13. Relationship between obesity and early failure of total knee prostheses

    Directory of Open Access Journals (Sweden)

    De Palma Rossana

    2009-03-01

    Full Text Available Abstract Background Obesity is a risk factor for knee arthritis. Total knee arthroplasty is the definitive surgical treatment of this disease. Therefore, a high percentage of subjects treated are overweight. Since 2000 in the Emilia-Romagna Region the Register of Orthopedic Prosthetic Implantology, RIPO, has recorded data of all the primary and revision operations performed on the knee; height and weight of patients at the time of surgery have also been recorded. Methods To understand how overweight and obesity affect the outcome of knee arthroplasty, a population of subjects treated with cemented total knee arthroplasty between 2000 and 2005 was studied. 9735 knee prostheses were implanted in 8892 patients; 18.9% of the patients were normal weight, 48.2% were overweight (25 40. Mean and range of follow-up were respectively 3.1 and 1.5–6 yrs. Implant failure was defined as the exchange of at least one component for whatever reason. Results In normal weight patients there were 36 failures out of 1840 implants (1.96%, in overweight patients there were 87 out of 4692 (1.85%, in obese 59 out of 3031 (1.94%, and in morbidly obese there were 4 out of 172 (2.3%. The mean time to failure for each class was 1.57, 1.48, 1.60, 1.77 yrs. Cox regression analyses showed that the risk of implant failure was not influenced by BMI, absolute body weight, or sex. Conversely, an increased failure risk was observed in mobile meniscus prostheses in comparison with those with a fixed meniscus (Rate Ratio 1.88; an increased failure risk was also related to age (Rate Ratio 1.05 per year. These results were also confirmed when considering septic loosening as the end-point. There were no differences in the rate of perioperative complications and death in the 4 classes of BMI. Conclusion In conclusion, cemented knee prostheses, implanted in patients with arthritis do not have significantly different rates of survival or perioperative complications in obese subjects

  14. Ambulatory blood pressure monitoring for the early identification of hypertension in pregnancy.

    Science.gov (United States)

    Ayala, Diana E; Hermida, Ramón C

    2013-03-01

    Gestational hypertension and preeclampsia are major contributors to perinatal morbidity and mortality. The diagnosis of gestational hypertension still relies on conventional clinic blood pressure (BP) measurements and thresholds of ≥140/90 mm Hg for systolic (SBP)/diastolic (DBP) BP. However, the correlation between BP level and target organ damage, cardiovascular disease risk, and long-term prognosis is greater for ambulatory BP monitoring (ABPM) than clinic BP measurement. Accordingly, ABPM has been suggested as the logical approach to overcoming the low sensitivity and specificity of clinic BP measurements in pregnancy. With the use of ABPM, differing predictable BP patterns throughout gestation have been identified for clinically healthy and hypertensive pregnant women. In normotensive pregnancies, BP steadily decreases up to the middle of gestation and then increases up to the day of delivery. In contrast, women who develop gestational hypertension or preeclampsia show stable BP during the first half of pregnancy and a continuous linear BP increase thereafter until delivery. Epidemiologic studies have also consistently reported sex differences in the 24-h patterns of ambulatory BP and heart rate. Typically, men exhibit a lower heart rate and higher BP than women, the differences being larger for SBP than DBP. Additionally, as early as in the first trimester of gestation, statistically significant increased 24-h SBP and DBP means characterize women complicated with gestational hypertension or preeclampsia compared with women with uncomplicated pregnancies. However, the normally lower BP in nongravid women as compared with men, additional decrease in BP during the second trimester of gestation in normotensive but not in hypertensive pregnant women, and significant differences in the 24-h BP pattern between healthy and complicated pregnancies at all gestational ages have not been taken into consideration when establishing reference BP thresholds for the

  15. 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......,883) ended in miscarriage compared with 11.1% among unexposed. The adjusted hazard ratio of having a miscarriage after exposure to an SSRI was 1.27 (95% confidence interval [CI] 1.22-1.33) compared with unexposed. Women discontinuing SSRI treatment 3-12 months before pregnancy also had an increased hazard...

  16. Pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  17. Antecedents of teenage pregnancy.

    Science.gov (United States)

    Klein, L

    1978-12-01

    Antecedent factors operative in the causation of adolescent pregnancy include: The sexuality of contemporary society, especially the media. Prolongation of educational any vocational preparation in industrialized western society. Normal physical maturation at an early age. Peer and social pressure. Low expectations of life among minority and economically poor individuals. The conspiracy of silence surrounding sexuality and the inability of society to admit and deal realistically with the sexual activity of adolescents. Failure to provide sex education, clarification of values, family-life education, preparation for parenthood, and knowledge of birth-control and family-planning services targeted to teenagers, including adolescent males. Psychological and emotional problems. Failure to provide available and accessible early pregnancy-detection services with adequate counseling and support services. Failure to provide abortion services. Failure to provide supportive services to adolescents who have a child in order to prevent repeated pregnancy. Pregnancy, childbearing, and motherhood represent ultimate feminine fulfillment to many in our society, and unless attainable expectations and desirable alternatives are available, adolescents will continue to see little reason to postpone pregnancy and childbearing.

  18. Early Proximal Junctional Failure in Patients with Preoperative Sagittal Imbalance

    OpenAIRE

    2013-01-01

    Study Type Retrospective review. Introduction Sagittal imbalance has been associated with lower health-related quality of life outcomes, and restoration of imbalance is associated with improved outcomes.1 2 3 The long constructs used in adult spinal deformity have potential consequences such as proximal junctional kyphosis (PJK). Clinically, the development of PJK may not be as important as failure of the construct or vertebrae at the proximal end. As PJK does not lead to worse clinical outco...

  19. 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.

  20. Early adult psychological consequences for males of adolescent pregnancy and its resolution.

    Science.gov (United States)

    Buchanan, M; Robbins, C

    1990-08-01

    Using data front 2522 young men who were first surveyed as 7th-grade students in Houston, Texas in 1971, we examined the psychological consequences in early adulthood of having a girlfriend become pregnant in adolescence. By age 21, 15% of the young men were involved in a nonmarital pregnancy. Rates were higher for blacks (24%) than for whites (12%) or Hispanics (16%). Among whites, most adolescent pregnancies were ended by abortion (58%). Adolescent pregnancies to blacks most often resulted in single parenthood (56%). Hispanics tended to have the child, and marry or live together (55%). Consistent with the life course perspective, young men involved in adolescent pregnancies were more psychologically distressed as young adults than those who did not have a girlfriend become pregnant in adolescence. The greater distress in adulthood is not simply a function of accelerated role transitions, because men whose girlfriends had abortions are also distressed, and those who let their girlfriends assume major parenting responsibility are no less distressed than those who became fathers and married or lived with their girlfriends. Subgroup comparisons revealed that psychological distress levels of young black men were not influenced by adolescent pregnancy.

  1. Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review.

    Science.gov (United States)

    Hammarberg, K; Fisher, J R W; Wynter, K H

    2008-01-01

    It is known that infertility affects emotional well-being, satisfaction with life and self-esteem and that failed assisted reproductive technology (ART) treatment is associated with diminished life satisfaction, reduced self-confidence and substantial psychological distress. Investigations of whether these persist when treatment results in a pregnancy and live birth have been undertaken. A systematic search for English-language research articles on psychological and social aspects of pregnancy, childbirth and the first post-partum year after ART conception. Of 466 retrieved papers, 46 met inclusion criteria. These reported data from 28 studies. There is consistent evidence that marital satisfaction, emotional well-being and self-regard in pregnancy, attachment to the fetus and parent-infant relationship in ART groups are similar to comparison groups. Anxiety about the survival of the fetus and early parenting difficulties appear to be higher and post-natal self-confidence lower. Evidence about adjustment to pregnancy and parenthood and the experience of childbirth is inconclusive and reports of parental perceptions of infant temperament and behaviour are contradictory. Between-study methodological differences may explain the lack of consistency in findings of the influence of infertility and ART on some aspects of the transition to parenthood. Overall, this body of evidence is best described as emergent. It is possible that in pregnancy after ART, parenthood might be idealized and this might then hinder adjustment and the development of a confident parental identity.

  2. Transcriptional Factor PU.1 Regulates Decidual C1q Expression in Early Pregnancy in Human.

    Science.gov (United States)

    Madhukaran, Shanmuga Priyaa; Kishore, Uday; Jamil, Kaiser; Teo, Boon Heng Dennis; Choolani, Mahesh; Lu, Jinhua

    2015-01-01

    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 (DCs). 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 DCs 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.

  3. Serum fructosamine concentrations in relation to metabolic changes during late pregnancy and early lactation in mares.

    Science.gov (United States)

    Filipović, Natalija; Stojević, Zvonko; Prvanović, Nikica

    2010-01-01

    The changes in blood serum fructosamine concentrations as indicators of glycaemia during a longer period of time were investigated in mares during late pregnancy and early lactation, as well as their relationship to the changes in the concentration of biochemical indicators of energetic status. The samples were taken from eleven mares on 60 +/- 10 and 20 +/- 10 days before foaling, and 20 +/- 10 and 60 +/- 10 days after foaling. Concentrations of serum fructosamine, non-esterified fatty acids and triglycerides were higher during late pregnancy (from P < 0.05 to P < 0.0005), while the concentrations of beta- hydroxybutyrate increased significantly (P < 0.00001) during early lactation. A significant correlation between the concentrations of fructosamine and metabolic parameters was observed. The results indicate a relationship between energetic status and serum fructosamine in mares. Higher concentrations of fructosamine are related to the adaptation to late pregnancy. Therefore, the measurement of the serum fructosamine concentrations could serve as an indicator of energetic status of mares during pregnancy and lactation.

  4. 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.

  5. Pregnancy

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    OpenAIRE

    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.

  8. 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.

  9. Early pregnancy loss in women stimulated with gonadotropin-releasing hormone antagonist protocols according to oral contraceptive pill pretreatment.

    Science.gov (United States)

    Bellver, José; Albert, Carmen; Labarta, Elena; Pellicer, Antonio

    2007-05-01

    To evaluate and compare the risk of early pregnancy loss in patients stimulated with GnRH antagonist protocols according to oral contraceptive pill (OCP) pretreatment. Retrospective case-control study. Instituto Valenciano de Infertilidad. University of Valencia. Spain. One thousand five hundred thirty-nine patients, aged <36, stimulated with GnRH antagonists for IVF between January 1, 2000 and November 1, 2005. Reproductive outcome was compared based on the application (or not) of OCP pretreatment: 944 women were included in the OCP group and 595 in the non-OCP group. The Student's t test was used for statistics. Pregnancy, biochemical pregnancy, ectopic pregnancy, early clinical pregnancy loss, early pregnancy loss, and ongoing pregnancy rates. No significant differences were observed in any of the outcome parameters. Early pregnancy loss rates were similar: 23% in the OCP pretreatment group versus 19.2% in the non-OCP pretreatment group. However, longer periods of ovarian stimulation and higher doses of gonadotropins needed to be employed in the OCP group. There is not sufficient evidence to confirm OCP pretreatment as a risk factor for miscarriage in patients stimulated with GnRH antagonist protocols.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  11. Drug use during early pregnancy: cross-sectional analysis from the Childbirth and Health Study in Primary Care in Iceland.

    Science.gov (United States)

    Axelsdottir, Thury O; Sigurdsson, Emil L; Gudmundsdottir, Anna M; Kristjansdottir, Hildur; Sigurdsson, Johann A

    2014-09-01

    To analyse drug use in early pregnancy with special focus on socio-demographic factors associated with psychotropic and analgesic drug use. Cross-sectional study. A total of 1765 women were invited via their local health care centres, and 1111 participated at 11-16 weeks of pregnancy by filling out a postal questionnaire concerning socio-demographic and obstetric background, stressful life events, and drug use. Drug use prior to and early on in pregnancy, socio-demographic factors, smoking, and adverse life events were investigated. Drug categories screened for were psychotropics (collective term for antidepressants, relaxants, and sleep medication), analgesics, hormones, nicotine, vitamins/minerals, and homeopathic medicine. Drug use from the aforementioned drug categories, excluding vitamins/minerals and homeopathic medicine, was reduced by 18% during early pregnancy, compared with six months prior to conception (49% vs. 60%). Psychotropic drug use during early pregnancy was associated with elementary maternal education (p pregnancy (p pregnancy (p pregnancy. Our results indicate that lack of a support network, stressful life events, and lower status in society may predispose women to more drug use. GPs and midwives responsible for maternity care could take this into account when evaluating risk and gain for women and foetuses in the primary care setting.

  12. Early-life conditions and age at first pregnancy in British women.

    Science.gov (United States)

    Nettle, Daniel; Coall, David A; Dickins, Thomas E

    2011-06-01

    There is growing evidence that the reproductive schedules of female mammals can be affected by conditions experienced during early development, with low parental investment leading to accelerated life-history strategies in the offspring. In humans, the relationships between early-life conditions and timing of puberty are well studied, but much less attention has been paid to reproductive behaviour. Here, we investigate associations between early-life conditions and age at first pregnancy (AFP) in a large, longitudinally studied cohort of British women (n = 4553). Low birthweight for gestational age, short duration of breastfeeding, separation from mother in childhood, frequent family residential moves and lack of paternal involvement are all independently associated with earlier first pregnancy. Apart from that of birthweight, the effects are robust to adjustment for family socioeconomic position (SEP) and the cohort member's mother's age at her birth. The association between childhood SEP and AFP is partially mediated by early-life conditions, and the association between early-life conditions and AFP is partially mediated by emotional and behavioural problems in childhood. The overall relationship between early-life adversities and AFP appears to be approximately additive.

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

    Science.gov (United States)

    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.

  14. Genetic counseling for men with recurrent pregnancy loss or recurrent implantation failure due to abnormal sperm chromosomal aneuploidy.

    Science.gov (United States)

    Kohn, Taylor P; Kohn, Jaden R; Darilek, Sandra; Ramasamy, Ranjith; Lipshultz, Larry

    2016-05-01

    The purpose of this study is to review recurrent pregnancy loss (RPL) due to sperm chromosomal abnormalities and discuss the genetic counseling that is required for men with sperm chromosomal abnormalities. The literature was reviewed, and a genetic counselor lends her expertise as to how couples with RPL and sperm chromosomal abnormalities ought to be counseled. The review of the literature was performed using MEDLINE. Sperm fluorescence in situ hybridization (FISH) can be used to determine if disomy or unbalanced chromosomal translocations are present. In men with aneuploidy in sperm or who carry a chromosomal translocation, pre-implantation genetic screening (PGS) combined with in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) can increase chances of live birth. In men with abnormal sperm FISH results, the degree of increased risk of abnormal pregnancy remains unclear. Genetic counselors can provide information to couples about the risk for potential trisomies and sex chromosome aneuploidies and discuss their reproductive and testing options such as PGS, use of donor sperm, and adoption. The provision of genetic counseling also allows a couple to be educated about recommended prenatal testing since pregnancies conceived with a partner who has had abnormal sperm FISH are considered to be at increased risk for aneuploidy. We review the literature and discuss genetic counseling for couples with RPL or recurrent implantation failure due to increased sperm aneuploidy.

  15. 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.

  16. Effect of Low Dose of Mifeprostone in Capsules combined with Misoprostol on Termination of Early Pregnancy

    Institute of Scientific and Technical Information of China (English)

    黄紫蓉; 王巧风; 杜明昆; 王卫芳; 顾林金

    2001-01-01

    Objective In this double-blind randomized trial, we compare the effect of 75 mg mifeprostone in capsules on termination of early pregnancy was compared with that of 150 mg in tablets combined with misoprostol. Methods A total of 160 patients were randomly divided into two groups with 80 for each group. The capsule group was administered with mifeprostone 75 mg in capsules,placebo tablets and misoprostol 0. 6 mg. The tablet group was administered with mifeprostone 150 mg in tablets, placebo capsules and misoprostol 0. 6 mg.Results The complete abortion rate in the capsule group and in the tablet group was 98. 8% and 97. 5% respectively, with no significant difference (P> 0. 05). There were no significant differences in bleeding time after abortion, side effects, recovery of menstruation or length of menstrual period between the two groups.Conclusion The clinical effect of mifeprostone capsule is the same with that of tablet in combination with misoprostol in terminating early pregnancy, while dose and cost is lower and the side effect is smaller. Mi feprostone capsule is recommended to be widely used for terminating early pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Nilson Abrão Szylit

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

  18. Placental development during early pregnancy in sheep: Effects of embryo origin on vascularization

    Science.gov (United States)

    Grazul-Bilska, Anna T.; Johnson, Mary Lynn; Borowicz, Pawel P.; Bilski, Jerzy J.; Cymbaluk, Taylor; Norberg, Spencer; Redmer, Dale A.; Reynolds, Lawrence P.

    2014-01-01

    Utero-placental growth and vascular development are critical for pregnancy establishment that may be altered by various factors including assisted reproductive technologies (ART), nutrition, or others, leading to compromised pregnancy. We hypothesized that placental vascularization and expression of angiogenic factors are altered early in pregnancies after transfer of embryos created using selected ART methods. Pregnancies were achieved through natural mating (NAT), or transfer of embryos from natural mating (NAT-ET), or in vitro fertilization (IVF) or activation (IVA). Placental tissues were collected on day 22 of pregnancy. In maternal caruncles (CAR), vascular cell proliferation was less (P<0.05) for IVA than other groups. Compared to NAT, density of blood vessels was less (P<0.05) for IVF and IVA in fetal membranes (FM), and for NAT-ET, IVF and IVA in CAR. In FM, mRNA expression was decreased (P<0.01–0.08) in NAT-ET, IVF and IVA compared to NAT for vascular endothelial growth factor (VEGF) and its receptor FLT-1, placental growth factor (PGF), neuropilin (NP) 1 and 2, angiopoietin (ANGPT) 1 and 2, endothelial nitric oxide synthase (NOS3), hypoxia inducible factor-1A (HIF1A), fibroblast growth factor (FGF) 2 and its receptor FGFR2. In CAR, mRNA expression was decreased (P<0.01–0.05) in NAT-ET, IVF and IVA compared to NAT for VEGF, FLT-1, PGF, ANGPT1 and TEK. Decreased mRNA expression for 12 of 14 angiogenic factors across FM and CAR in NAT-ET, IVF and IVA pregnancies was associated with reduced placental vascular development, which would lead to poor placental function and compromised fetal and placental growth and development. PMID:24472816

  19. Interferon-γ Expression in Natural Killer Cells and Natural Killer T Cells Is Suppressed in Early Pregnancy

    Institute of Scientific and Technical Information of China (English)

    Yongyun Shi; Bin Ling; Ying Zhou; Ting Gao; Dingqing Feng; Min Xiao; Lin Feng

    2007-01-01

    Recent study has suggested that innate immune system might play an important role in pregnancy progression. In this study, to investigate whether NK cells and NKT cells, instead of T cells, are the dominant populations of peripheral blood in early pregnancy, flow cytometry was used to detect the percentage and intracellular cytokine expressions of T cells, NK cells, NKT cells in peripheral blood of non-pregnant women and early pregnant women.In our result, the percentages of NK cells and NKT cells were significantly increased in pregnancy compared to non-pregnancy. However, the percentage of T cells was not changed. We did not detect the Th2-dominance of total lymphocytes or T cells in peripheral blood of early pregnant women and there were also no significant changes of type 1 and type 2 cytokines in T cells, but IFN-γ production in both NK and NKT cells was decreased in early pregnancy. These results suggest that the innate immune system including NK cells and NKT cells should play a pivotal role in pregnancy progression. Type 1/type 2 shift mechanisms in innate immune system during the human early pregnancy should be paid more attention.

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

    Directory of Open Access Journals (Sweden)

    Agnes Ssali

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

  1. The Effect of Early Excessive Weight Gain on the Development of Hypertension in Pregnancy.

    Science.gov (United States)

    Ruhstaller, Kelly E; Bastek, Jamie A; Thomas, Ann; Mcelrath, Thomas F; Parry, Samuel I; Durnwald, Celeste P

    2016-10-01

    Background Previous studies have shown an association between total excessive gestational weight gain and hypertension in pregnancy. However, this may be a reflection of excessive water retention associated with the pathophysiology of hypertensive disorders of pregnancy. Early excessive weight gain, prior to the third trimester, results in greater maternal fat deposition and inflammation, which has also been associated with the development of hypertension. By focusing on early excessive weight gain, the association between maternal weight gain and the future development of hypertension can be examined. Objective To evaluate the association between early excessive maternal weight gain and the development of hypertension during pregnancy. Study Design This was a secondary analysis of a longitudinal cohort study of 1,441 women without chronic hypertension who were enrolled in a prospective study evaluating maternal angiogenic factors and the prediction of preeclampsia. Initial body mass index (BMI) was calculated by weight and height at the first study visit. Early excessive maternal weight gain was defined as weight gain by 28 weeks that exceeded the Institute of Medicine (IOM) guidelines and was calculated utilizing the maximum amount of weight gain per week recommended by the IOM based on the patient's starting BMI (normal: 0.45 kg; overweight: 0.32 kg; obese: 0.27 kg). Hypertension was defined as a sustained systolic blood pressure of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg. Logistic regression was used to determine the association between early excessive weight gain, initial BMI, and the development of hypertension, including gestational hypertension and preeclampsia, during pregnancy. Results Of 1,441 women, 767 (53.2%) had weight gain that exceeded the IOM guidelines in the first 28 weeks and 154 (10.8%) developed hypertension during pregnancy. Women whose weight gain exceeded the IOM guidelines were more likely to develop

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Observations on early school failure in Zulu children.

    Science.gov (United States)

    Frets-Van Buuren, J J; Letuma, E; Daynes, G

    1990-02-03

    The outcome of the screening of 2,190 children who had to repeat the school entry grades (Substandard A) in 25 junior primary schools in two KwaZulu townships is reported and the implications are discussed. The high number of repeaters did not appear to be due to an excess of mentally retarded children, the percentage being similar to that which could be expected in such a community world-wide. Difficulty in intelligence testing was experienced, but we describe how this was overcome by testing speed of learning. Visual defects, hearing defects and having no food before school accounted for the failure of many repeaters. Lack of preschool teaching by parents and schools and very strict discipline necessitated by large classes and a wide range in ages, which both led to anxiety on the part of the pupils, and sending children to school at too young an age were regarded as additional factors. Simple interventions were suggested to the school teachers; more than 1,000 pupils were followed up, with encouraging results.

  4. Intense adrenal enhancement in patients with acute pancreatitis and early organ failure.

    Science.gov (United States)

    Bollen, T L; van Santvoort, H C; Besselink, M G H; van Ramshorst, B; van Es, H W; Gooszen, H G

    2007-10-01

    Intense adrenal enhancement has previously been reported in patients with hypovolemic and septic shock. The purpose of this study was to assess whether this computed tomography (CT) finding is also observed in patients presenting with severe acute pancreatitis and early organ failure. A retrospective analysis of a prospectively collected database was performed. Out of 38 consecutive patients with predicted severe acute pancreatitis, 3 patients showed intense bilateral adrenal enhancement on early CT. All patients had early multiple organ failure and subsequently died. In two cases, pathologic correlation was obtained. Intense adrenal enhancement may be a new prognostic indicator in patients with acute pancreatitis, particularly when organ failure is present at the time of CT examination. Further studies are necessary to confirm this observation.

  5. Effect of progesterone on adiponectin system in the porcine uterus during early pregnancy.

    Science.gov (United States)

    Dobrzyn, K; Smolinska, N; Szeszko, K; Kiezun, M; Maleszka, A; Rytelewska, E; Kaminski, T

    2017-01-01

    The aim of this study was to investigate the influence of progesterone (P4) on adiponectin system genes and protein expression in the endometrium and myometrium during early gestation. Twenty-five gilts were assigned to 1 of 5 groups ( = 5): d 10 to 11 (embryo migration), 12 to 13 (maternal recognition of pregnancy), 15 to 16 (implantation), and 27 to 28 (end of implantation) of pregnancy and d 10 to 11 of the cycle (fully active corpora lutea, corresponding to the corpora lutea activity during gestation). The endometrial and myometrial tissues were cut into 100 mg slices, treated with P4 (10, 100, 1000 nM) and incubated for 24 h. Gene expression was analyzed by the real-time PCR method. Adiponectin secretion was determined by ELISA. Receptor protein content was defined using Western Blot analysis. In the endometrium, on d 10 to 11 of pregnancy, P4 stimulated adiponectin protein secretion. On those days, P4 enhanced adiponectin receptor type 1 () and type 2 () gene expression but inhibited both receptors' protein content. On d 12 to 13 of pregnancy, P4 inhibited adiponectin gene expression. During those period, P4 enhanced gene expression but suppressed both receptors' protein content. On d 15 to 16 of gestation, P4 increased adiponectin gene expression but inhibited the protein secretion. During those days, P4 suppressed gene expression and enhanced AdipoR2 protein content. On d 27 to 28 of gestation, P4 enhanced gene and AdipoR1 protein expression ( adiponectin and genes and AdipoR1 protein expression but decreased AdipoR2 protein content. On d 15 to 16 of gestation, P4 inhibited adiponectin gene expression. On those days, P4 enhanced gene and protein expression. On d 27 to 28 of gestation, P4 decreased adiponectin gene expression. On those days, P4 increased the myometrial AdipoR2 protein concentration and decreased gene protein expression ( adiponectin system in the porcine uterus during early pregnancy, which may suggest the involvement of this adipokine in

  6. Expression of the orexin system in the porcine uterus, conceptus and trophoblast during early pregnancy.

    Science.gov (United States)

    Smolinska, N; Kiezun, M; Dobrzyn, K; Szeszko, K; Maleszka, A; Kaminski, T

    2015-11-01

    Orexin A and B are hypothalamic peptides derived from the prepro-orexin (PPO) precursor. Orexins stimulate food intake and arousal. Those peptides bind and activate two G protein-coupled receptors: orexin receptor 1 (OX1R) and orexin receptor 2 (OX2R). Numerous authors have suggested that orexins play an important role in the regulation of the reproductive functions. The objective of the present study was to analyse the presence of and changes in the gene and protein expression pattern of the orexin system in the porcine uterus, conceptus and trophoblast (chorioallantois) during early pregnancy. In the endometrium, the highest PPO and OX1R gene expression was detected on days 15 to 16 of gestation. The OX2R mRNA content in the endometrium was higher on days 10 to 11 and 15 to 16 than on days 12 to 13 and 27 to 28. In the trophoblasts, PPO gene expression was higher on days 30 to 32 than on days 27 to 28. The highest PPO protein content in the endometrium was noted on days 12 to 13. The highest OX1R protein content in the endometrium was detected on days 10 to 11, whereas OX2R protein on days 15 to 16. In the trophoblasts, PPO and OX1R protein levels were more pronounced on days 27 to 28 than on days 30 to 32, but OX2R expression was higher on days 30 to 32. The expression of PPO, OX1R and OX2R was different in the conceptuses and trophoblasts during early pregnancy. Local orexin production and the presence of the specific orexin receptors suggest that the orexin system may participate in the control of porcine reproductive functions by exerting endocrine and auto/paracrine effects on the uterus, conceptuses and trophoblasts during early pregnancy. This study provides the first evidence for the presence of orexins and their receptors in the uteri, conceptuses and trophoblasts in pigs during early pregnancy. The local orexin system is dependent on the stage of pregnancy.

  7. The role of magnesium and thyroid function in early pregnancy after in-vitro fertilization (IVF: New aspects in endocrine physiology

    Directory of Open Access Journals (Sweden)

    Sibilla Stuefer

    2015-06-01

    General significance: We propose that magnesium plays a role in early pregnancy as well as in pregnancy success independently from anti-Müllerian hormone. Neither thyroid hormones nor thyroid antibodies were related to outcome.

  8. Safety of lamivudine treatment for chronic hepatitis B in early pregnancy

    Institute of Scientific and Technical Information of China (English)

    Wei Yi; Min Liu; Hao-Dong Cai

    2012-01-01

    AIM:To evaluate the safety of lamivudine (LAM) treatment for chronic hepatitis B in early pregnancy.METHODS:A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enrolled in this study.All of the pregnant women volunteered to take lamivudine during pregnancy and were not co-infected with hepatitis C virus,human immunodeficiency virus,cytomegalovirus,or other viruses.All infants received passiveactive immunoprophylaxis with 200 IU hepatitis B immunoglobulin and three doses of 10 μg hepatitis B vaccines (0-1-6 mo) according to the guidelines for the prevention and treatment of chronic hepatitis B.Adverse events were observed throughout the entire pregnancy and perinatal period,and the effectiveness of lamivudine treatment for blocking mother-to-infant transmission of hepatitis B virus (HBV) was evaluated.All adverse events in mothers and infants during pregnancy and the perinatal period and the HBV motherto-infant transmission blocking rate were compared with the literature.RESULTS:Among the 92 pregnant women,spontaneous abortions occurred in 11 cases,while 3 mothers had a second pregnancy after the initial abortion; 72 mothers delivered 73 live infants,of whom 68 infants were followed up for no less than 6 mo,and 12 mothers were still pregnant.During pregnancy,the main maternal adverse events were vaginitis (12/72,16.7%),spontaneous abortion (11/95,11.6%),and gestational diabetes (6/72,8.3%); only one case had 1-2 degree elevation of the creatine kinase level (195 U/L).During the perinatal period,the main matemal adverse events were premature rupture of the membranes (8/72,11.1%),preterm delivery (5/72,6.9%),and meconium staining of the amniotic fluid (4/72,5.6%).In addition,2 infants were found to have congenital abnormalities; 1 had a scalp hemangioma that did not change in size until 7 mo,and the other had early cerebral palsy,but with rehabilitation training,the infant's motor functions became

  9. 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...

  10. 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

  11. 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

    2013-04-01

    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.

  12. Early adolescent pregnancy increases risk of incident HIV infection in the Eastern Cape, South Africa: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Nicola J Christofides

    2014-03-01

    Full Text Available Introduction: Adolescents having unprotected heterosexual intercourse are at risk of HIV infection and unwanted pregnancy. However, there is little evidence to indicate whether pregnancy in early adolescence increases the risk of subsequent HIV infection. In this paper, we tested the hypothesis that adolescent pregnancy (aged 15 or younger increases the risk of incident HIV infection in young South African women. Methods: We assessed 1099 HIV-negative women, aged 15–26 years, who were volunteer participants in a cluster-randomized, controlled HIV prevention trial in the predominantly rural Eastern Cape province of South Africa. All of these young women had at least one additional HIV test over two years of follow-up. Outcomes were HIV incidence rates per 100 person years and HIV incidence rate ratios (IRRs estimated by Poisson multivariate models. Three pregnancy categories were created for the Poisson model: early adolescent pregnancy (a first pregnancy at age 15 years or younger; later adolescent pregnancy (a first pregnancy at age 16 to 19 years; and women who did not report an adolescent pregnancy. Models were adjusted for study design, age, education, time since first sexual experience, socio-economic status, childhood trauma and herpes simplex virus type 2 infection. Results: HIV incidence rates were 6.0 per 100 person years over two years of follow-up. The adjusted IRR was 3.02 (95% CI 1.50–6.09 for a pregnancy occurring at age 15 or younger. Women with pregnancies occurring between 16 and 19 years of age did not have a higher incidence of HIV (IRR 1.08; 95% CI 0.64–1.84. Early adolescent pregnancies were associated with higher partner numbers and a greater age difference with partners. Conclusions: Early adolescent pregnancies increase the incidence of HIV among South African women. The higher risk is associated with sexual risk behaviours such as higher partner numbers and a greater age difference with partners rather than a

  13. Termination of pregnancy at very early gestation without visible yolk sac on ultrasound.

    Science.gov (United States)

    Heller, Rebecca; Cameron, Sharon

    2015-04-01

    Requests for termination of pregnancy (TOP) at very early gestation (≤6 weeks) can prove challenging for abortion services as the ultrasound feature usually accepted as definitive evidence of an intrauterine pregnancy (IUP), the presence of a yolk sac within a gestational sac, may not yet be evident. In 2011 the Edinburgh TOP service introduced a protocol permitting women to proceed to treatment without further investigations provided that ultrasound showed the features of an eccentrically placed gestational sac (≥3 mm) with a decidual reaction, and there were no signs, symptoms or risk factors for ectopic pregnancy. A retrospective audit was conducted of outcomes of women presenting for TOP at ≤6 weeks' gestation over a 2-year period using the hospital computerised database. A total of 1155 women presented for TOP with an ultrasound gestational age of ≤6 weeks. Of these, 1030 (89%) had ultrasound evidence of a yolk sac. Eighty-seven women (7.5%) had an eccentrically placed gestational sac with a decidual reaction. All 87 women fulfilled our criteria to proceed to medical TOP, and 66 did so. In the remaining 21 cases, further investigations were performed before they proceeded to medical TOP. Two (0.17%) medical TOPs failed, both in women whose initial ultrasound had shown a yolk sac. Women with ultrasound features consistent with a very early IUP (≥3 mm eccentrically placed gestational sac with a decidual reaction) and without signs, symptoms or risk factors for ectopic pregnancy can proceed directly to medical TOP without the need for delay for further ultrasonography. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Transcriptomic analysis of the porcine endometrium during early pregnancy and the estrous cycle.

    Science.gov (United States)

    Franczak, Anita; Wojciechowicz, Bartosz; Kotwica, Genowefa

    2013-09-01

    The goal of this study was to describe the alterations in the transcriptome of the endometrium in pigs during the beginning of implantation (days 15-16 of pregnancy) compared to cyclic pigs during the onset of luteolysis (days 15-16 of the estrous cycle). The global expression of genes in porcine gravid and non-gravid endometria was investigated using the Porcine (V2) Two-color gene expression microarray, 4 × 44 (Agilent, USA). Analysis of the microarray data showed that, of 589 accurately annotated genes, the expression of 266 genes was up-regulated and expression of 323 was down-regulated in the endometrium harvested during early pregnancy compared with the endometrium during the estrous cycle. In pregnant pigs, genes with the most significantly altered expression were involved in the following biological processes: the metabolic process, cellular process, cell communication, immune system process, developmental process, cell adhesion, antigen processing and presentation, antigen processing and presentation of peptide or polysaccharide antigen via major histocompatibility complex (MHC) class II, immune response, and the polysaccharide metabolic process. In the pregnant endometrium, cell adhesion molecules and steroid hormone biosynthesis pathways were the most significantly enriched biological pathways. Analysis of the interaction network among selected genes showed that androgen receptor (AR) encoding genes interact with genes involved in important processes occurring during early pregnancy. The bioinformatic analysis revealed information about the meaning of differentially expressed genes. The data provided new insight into the dynamic changes of the endometrial gene expression profile during days 15-16 of pregnancy.

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

    Science.gov (United States)

    Kesmodel, U S; Eriksen, H-L Falgreen; Underbjerg, M; Kilburn, T R; Støvring, H; Wimberley, T; Mortensen, E L

    2012-09-01

    To examine the effects of binge alcohol consumption during early pregnancy, including the number of binge episodes and the timing of binge drinking, on general intelligence in 5-year-old children. Follow-up study. Neuropsychological testing in four Danish cities 2003-2008. A cohort of 1617 women and their children sampled from the Danish National Birth Cohort. 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, home environment, postnatal parental smoking, health status, and indicators for hearing and vision impairment. WPPSI-R. There were no systematic or significant differences in general intelligence between children of mothers reporting binge drinking and children of mothers with no binge episodes, except that binge drinking in gestational weeks 1-2 significantly reduced the risk of low, full-scale IQ (OR 0.54; 95% CI 0.31-0.96) when adjusted for core confounding factors. The results were otherwise not statistically significantly related to the number of binge episodes (with a maximum of 12) and timing of binge drinking. We found no systematic association between binge drinking during early pregnancy and child intelligence. However, binge drinking reduced the risk of low, full-scale IQ in gestational weeks 1-2. This finding may be explained by residual confounding. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  16. Dinitrogen oxide detection for process failure early warning systems.

    Science.gov (United States)

    Burgess, J E; Stuetz, R M; Morton, S; Stephenson, T

    2002-01-01

    A number of experiments were conducted in order to establish whether the concentration of N2O in the off-gas from an activated sludge pilot plant could be used as a indicator for monitoring the nitrification process and as an early indication of ammonia appearing in the plant effluent. A strong correlation was found between ammonia shock loads and the concentration of N20 in the off-gas from the aeration tank for ammonia shock loads and dissolved oxygen depletion. When subjecting the experimental setup to doses of a nitrification inhibitor (allylthiourea) a similar pattern was seen with a correlation between nitrite build up in the aeration tank and concentration increase of N2O in the off-gas from the aeration tank. The results from this work suggest the concentration and the changes in the concentration of N2O in the exhaust gas from a nitrifying process may be a useful parameter for monitoring nitrifying activated sludge processes.

  17. Fetal outcomes following emergency department point-of-care ultrasound for vaginal bleeding in early pregnancy.

    Science.gov (United States)

    Varner, Catherine; Balaban, Dahlia; McLeod, Shelley; Carver, Sally; Borgundvaag, Bjug

    2016-07-01

    To determine 20- and 40-week fetal outcomes following documentation of fetal cardiac activity (FCA) and intrauterine pregnancy (IUP) in women at less than 20 weeks' gestation presenting to the emergency department (ED) with vaginal bleeding. Prospective observational cohort study. Single-centre tertiary care ED. Pregnant women at less than 20 weeks' gestation presenting to the ED with vaginal bleeding. All study participants underwent ED point-of-care ultrasound (POCUS) to document IUP and FCA. Prevalence of spontaneous abortion or pregnancy loss by 40 weeks' gestational age following ED POCUS documentation of FCA or IUP in women at less than 20 weeks' gestation. A total of 85 of 111 eligible patients were enrolled; FCA and IUP were detected in 43 (50.6%) and 54 (63.5%) participants, respectively. Participants with documented FCA on ED POCUS were less likely to experience pregnancy loss than participants without documented FCA were (5.0% vs 92.7%; Δ = 87.7%; 95% CI 71.0% to 93.7%), and participants with documented IUP were less likely to experience pregnancy loss than participants without documented IUP were (22.0% vs 93.5%; Δ = 71.5%; 95% CI 52.1% to 81.9%). Compared with radiologist-interpreted ultrasound, ED POCUS had sensitivity of 88.9% (95% CI 75.9% to 96.2%) and specificity of 100.0% (95% CI 89.6% to 100.0%) for documenting FCA, and sensitivity of 96.0% (95% CI 86.3% to 99.4%) and specificity of 93.1% (95% CI 77.2% to 99.0%) for documenting IUP. In this cohort of women presenting to the ED with bleeding in the first 20 weeks of pregnancy, detection of IUP and especially FCA using POCUS performed by providers certified by the Canadian Emergency Ultrasound Society was associated with ongoing viable pregnancy at 20 and 40 weeks' gestational age. These data might be useful for ED physicians counseling women with symptomatic early pregnancies about the chance of miscarriage after an episode of vaginal bleeding.

  18. Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion.

    Science.gov (United States)

    Liu, Yinglin; Liu, Yukun; Li, Xuejiao; Jiao, Xuedan; Zhang, Rui; Zhang, Jianping

    2016-10-01

    To examine peak serum levels of the β-subunit of human chorionic gonadotropin (β-hCG) for prediction of early pregnancy outcomes among women with recurrent spontaneous abortion (RSA). In a retrospective study, the medical records of pregnant women with a history of RSA treated at Sun Yat-sen Memorial Hospital, China, between January 2011 and July 2013 were reviewed. Serum β-hCG had been measured twice weekly from 5 to 13weeks of pregnancy, and pregnancy was monitored by transvaginal ultrasonography to 13(+6)weeks. Optimal cutoff for peak β-hCG level was determined by receiver operator characteristic curve analysis and Youden index. Women were divided into four groups on the basis of optimal peak β-hCG cutoff and pregnancy outcome (pregnancy at 13weeks or spontaneous abortion). Peak β-hCG levels and length of pregnancy at this peak were examined. Overall, 1240 patients were included. The optimal cutoff value of peak β-hCG was 88 468IU/L, with a sensitivity, specificity, positive predictive value, and negative predictive value for successful pregnancy of 95.6%, 88.0%, 95.6%, and 89.0%, respectively. A faster rise in β-hCG, higher peak β-hCG, and longer pregnancy length at peak β-hCG were associated with successful early pregnancy. A cutoff value of serum β-hCG of 88 000IU/L could be used to predict early pregnancy outcomes for women with a history of RSA. Copyright © 2016. Published by Elsevier Ireland Ltd.

  19. Early predictors of renal dysfunction in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Umida Kamilova

    2013-04-01

    Full Text Available Study was aimed at an early detection of subclinical disorders in renal function in patients with chronic heart failure (CHF. Fifty-two patients with ischemic heart disease (IHD with post-infarction cardiosclerosis were examined. All the patients were underwent complex clinical examination, a level of serum creatinine, residual nitrogen and urine enzymes. Determination of urine enzymes level in CHF patients may be considered as diagnostic approach for an early diagnosis of renal dysfunction.

  20. 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.

  1. Humoral and cellular autoimmunity in women with recurrent pregnancy losses and repeated implantation failures: A possible role of vitamin D.

    Science.gov (United States)

    Kwak-Kim, Joanne; Skariah, Annie; Wu, Li; Salazar, Dinorah; Sung, Nayoung; Ota, Kuniaki

    2016-10-01

    Women with recurrent pregnancy losses (RPL) and repeated implantation failures (RIF) have auto- and cellular immune abnormalities. Approximately, 20% of women with RPL have autoimmune abnormalities, particularly antiphospholipid antibodies (APA). In addition, these women have a higher prevalence of antinuclear antibody, anti-thyroperoxidase and anti-thyroglobulin antibodies, and other non-organ-specific autoantibodies. In women with RPL, the presence of autoimmunity is often associated with cellular immune abnormalities, such as increased NK cell levels and Th1/Th2 cell ratios. Vitamin D (VD) plays a major role in regulation of auto- and cellular immune abnormalities. VD deficiency is prevalent in women with RPL, and women with VD deficiency have increased auto- and cellular immune abnormalities as compared with women with normal VD levels. VD has immune regulatory effects on various immune effectors including T, B and NK cells. Potential therapeutic application of VD for RPL and RIF with auto- and cellular immune abnormalities should be explored.

  2. [Early detection, prevention and management of renal failure in liver transplantation].

    Science.gov (United States)

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function.

  3. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non...

  4. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non-tr...

  5. High maternal serum ferritin in early pregnancy and risk of spontaneous preterm birth.

    Science.gov (United States)

    Khambalia, Amina Z; Collins, Clare E; Roberts, Christine L; Morris, Jonathan M; Powell, Katie L; Tasevski, Vitomir; Nassar, Natasha

    2015-08-14

    Previous studies have reported inconsistent associations between maternal serum ferritin concentrations and the risk of spontaneous preterm birth (sPTB). The aim of the present study was to examine the association between Fe biomarkers, including serum ferritin concentrations, and the risk of total ( 75th percentile ( ≥ 43 μg/l) (OR 1.49, 95% CI 1.06, 2.10) and >90th percentile ( ≥ 68 μg/l) (OR 1.92, 95% CI 1.25, 2.96). Increased odds of early and moderate-to-late sPTB were associated with ferritin levels >90th percentile (OR 2.50, 95% CI 1.32, 4.73) and >75th percentile (OR 1.56, 95% CI 1.03, 2.37), respectively. No association was found between the risk of sPTB and elevated sTfR levels or Fe deficiency. In conclusion, elevated maternal serum ferritin levels in early pregnancy are associated with an increased risk of sPTB from 34 weeks of gestation. The usefulness of early pregnancy ferritin levels in identifying women at risk of sPTB warrants further investigation.

  6. Maintenance of the corpus luteum of early pregnancy in the ewe. IV. Changes in luteal sensitivity to prostaglandin F2 alpha throughout early pregnancy.

    Science.gov (United States)

    Silvia, W J; Niswender, G D

    1986-10-01

    Two experiments were conducted to examine the temporal aspects of luteal resistance to the luteolytic effect of prostaglandin (PG) F2 alpha during early pregnancy. In Exp. 1, 14 pregnant and 12 nonpregnant ewes were treated with PGF2 alpha either on d 10 or 13 post-estrus. Jugular venous blood samples were collected at -30 min, 0, 6, 12, 18, 24, 30 and 36 h post-injection for quantification of progesterone. The difference (delta P) between pre-treatment and post-treatment concentrations of progesterone was calculated for each ewe. There was a significant interaction between pregnancy status and day of treatment on delta P (P less than .05). Pregnant and nonpregnant ewes treated on d 10 showed a large delta P. A large delta P also was observed in nonpregnant ewes treated on d 13 post-estrus. However, delta P in pregnant ewes treated on d 13 was smaller than in the other three groups (P less than .05). The temporal patterns of concentrations of progesterone in serum were different among treatment groups (P less than .05). A suppression in the concentration of progesterone was observed by 24 h post-injection in all four treatment groups. Progesterone returned to pre-treatment levels only in pregnant ewes treated on d 13. In Exp. 2, 47 pregnant ewes were treated with PGF2 alpha on d 10, 13, 16, 19, 22, 26 or 30 postestrus. Blood samples were collected and data were analyzed as described for Exp. 1.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study

    Science.gov (United States)

    Bjørke-Monsen, Anne-Lise; Ulvik, Arve; Nilsen, Roy M.; Midttun, Øivind; Roth, Christine; Magnus, Per; Stoltenberg, Camilla; Vollset, Stein Emil; Reichborn-Kjennerud, Ted; Ueland, Per Magne

    2016-01-01

    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 pregnant. PMID:27916904

  8. Maternal Alcohol Consumption during Pregnancy and Early Age Leukemia Risk in Brazil

    Directory of Open Access Journals (Sweden)

    Jeniffer Dantas Ferreira

    2015-01-01

    Full Text Available Objectives. To investigate the association between the maternal alcohol consumption during pregnancy and early age leukemia (EAL in offspring. Methods. Datasets were analyzed from a case-control study carried out in Brazil during 1999–2007. Data were obtained by maternal interviews using a standardized questionnaire. The present study included 675 children (193 acute lymphoid leukemia (ALL, 59 acute myeloid leukemia (AML, and 423 controls. Unconditional logistic regression was performed, and adjusted odds ratios (adj. OR on the association between alcohol consumption and EAL were ascertained. Results. Alcohol consumption was reported by 43% of ALL and 39% of AML case mothers and 35.5% of controls’. Beer consumption before and during pregnancy was associated with ALL in crude analysis (OR = 1.54, 95% CI, 1.08–2.19, although in adjusted analysis no statistical significance was found. For weekly intake of ≤1 glass (adj. OR = 1.30, 95% CI, 0.71–2.36 and ≥1 glass/week (adj. OR = 1.47, 95% CI, 0.88–2.46 a potential dose-response was observed (P trend < 0.03. Conclusion. This study failed to support the hypothesis of an increased risk of EAL associated with maternal alcohol intake during pregnancy, neither with the interaction with tobacco nor with alcohol consumption.

  9. Maternal Alcohol Consumption during Pregnancy and Early Age Leukemia Risk in Brazil.

    Science.gov (United States)

    Ferreira, Jeniffer Dantas; Couto, Arnaldo Cézar; Emerenciano, Mariana; Pombo-de-Oliveira, Maria S; Koifman, Sergio

    2015-01-01

    Objectives. To investigate the association between the maternal alcohol consumption during pregnancy and early age leukemia (EAL) in offspring. Methods. Datasets were analyzed from a case-control study carried out in Brazil during 1999-2007. Data were obtained by maternal interviews using a standardized questionnaire. The present study included 675 children (193 acute lymphoid leukemia (ALL), 59 acute myeloid leukemia (AML), and 423 controls). Unconditional logistic regression was performed, and adjusted odds ratios (adj. OR) on the association between alcohol consumption and EAL were ascertained. Results. Alcohol consumption was reported by 43% of ALL and 39% of AML case mothers and 35.5% of controls'. Beer consumption before and during pregnancy was associated with ALL in crude analysis (OR = 1.54, 95% CI, 1.08-2.19), although in adjusted analysis no statistical significance was found. For weekly intake of ≤1 glass (adj. OR = 1.30, 95% CI, 0.71-2.36) and ≥1 glass/week (adj. OR = 1.47, 95% CI, 0.88-2.46) a potential dose-response was observed (P trend pregnancy, neither with the interaction with tobacco nor with alcohol consumption.

  10. Reduced Maternal Erythrocyte Long Chain Polyunsaturated Fatty Acids Exist in Early Pregnancy in Preeclampsia.

    Science.gov (United States)

    Wadhwani, Nisha S; Narang, Ankita S; Mehendale, Savita S; Wagh, Girija N; Gupte, Sanjay A; Joshi, Sadhana R

    2016-01-01

    The present prospective study examines proportions of maternal erythrocyte fatty acids across gestation and their association with cord erythrocyte fatty acids in normotensive control (NC) and preeclamptic pregnancies. We hypothesize that maternal fatty acid status in early pregnancy influences fetal fatty acid stores in preeclampsia. 137 NC women and 58 women with preeclampsia were included in this study. Maternal blood was collected at 3 time points during pregnancy (16-20th weeks, 26-30th weeks and at delivery). Cord blood was collected at delivery. Fatty acids were analyzed using gas chromatography. The proportions of maternal erythrocyte α-linolenic acid, docosahexaenoic acid, nervonic acid, and monounsaturated fatty acids (MUFA) (p preeclampsia as compared with NC. Cord 18:3n-3, 22:6n-3, 24:1n-9, MUFA, and total n-3 fatty acids (p preeclampsia as compared with NC. A positive association was observed between maternal erythrocyte 22:6n-3 and 24:1n-9 at 16-20th weeks with the same fatty acids in cord erythrocytes (p preeclampsia. Our study for the first time indicates alteration in maternal erythrocyte fatty acids at 16th weeks of gestation which is further reflected in cord erythrocytes at delivery in preeclampsia.

  11. EFFECTS OF MIFEPRISTONE ON THE MECHANICAL AND ELECTRICAL ACTIVITY OF RABBIT UTERUS IN VIVO DURING EARLY-PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    JIANGChang-Song; ZHOUYou-You; XIONGCheng-Liang; WUXi-Rui

    1989-01-01

    The aim of this study is to examine the effect of mifepristone on the mechanical and elec trical activitles of uterus and the sensitivity of myometrium to 15-methyl-PGF2a in early-pregnant rabbits. The effect of termination of early-pregnancy was also observed.

  12. 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....

  13. 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

  14. 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

  15. Thrombophilia and Pregnancy Complications.

    Science.gov (United States)

    Simcox, Louise E; Ormesher, Laura; Tower, Clare; Greer, Ian A

    2015-11-30

    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.

  16. Thrombophilia and Pregnancy Complications

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

  18. Failure of ovarian ablation with goserelin in a pre-menopausal breast cancer patient resulting in pregnancy: a case report and review of the literature.

    Science.gov (United States)

    Hill, N; Madarnas, Y

    2011-08-01

    To report an unanticipated pregnancy during ovarian ablation treatment with goserelin (10.8 mg SC every 12 weeks) in a 26-year old female with breast cancer. Review of the current literature and reports in MEDLINE, PubMED, and EMBASE using searches with keywords "goserelin, pregnancy, breast cancer, breast neoplasms, fertility, ovarian ablation, gonadotropin releasing hormone agonists/analogs, leuprolide, pregnancy complications, teratogens" (July-September 2010). Only 3 other reports of failures with goserelin administration at ablative doses in breast cancer patients were discovered. For physicians and breast cancer patients using a GnRH analog, it is important to be aware of the possibility of inadequate ovarian function suppression and the potential for pregnancy.

  19. 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.

  20. Prediction of pregnancy outcomes with combined ultrasound scanning of yolk sacs and serum CA125 determinations in early threatened abortion.

    Science.gov (United States)

    Xie, Y J; Chen, M; Chen, S J

    2014-01-01

    To assess the predictive value of the combination of ultrasound scanning, yolk sacs and CA125 levels for pregnancy outcomes in early threatened abortion. A total 196 pregnant women at less than 12 weeks gestation were enrolled. They were assigned into: (A) normal pregnancy (n = 61); (B) early threatened abortion but with favorable outcomes after active treatment (n = 56); (C) pregnancy with spontaneous miscarriage and threatened abortions (n = 79). The yolk sacs were examined and serum CA125 levels were measured. The visualization rate in groups A and B were significantly higher than that in group C. For the mean yolk sac diameter, there was a statistically significant difference between groups A and C (p 0.05). The mean serum CA125 levels were significantly different (p ultrasound scanning of yolk sacs and measurement of serum CA125 levels is of great value for predicting pregnancy outcomes.

  1. Effect of progesterone, mifepristone, and estrogen treatment during early pregnancy on conceptus development and uterine capacity in Swine.

    Science.gov (United States)

    Vallet, J L; Christenson, R K

    2004-01-01

    A series of experiments was performed to investigate the influence of progesterone at Days 2 and 3 of pregnancy on conceptus development and uterine capacity. In experiment 1, unilaterally hysterectomized-ovariectomized (UHO) white crossbred gilts were given no treatment, estradiol valerate (5 mg given on Days 11 and 12), or progesterone (200 mg/day on Days 2 and 3 after mating). On Day 105 of pregnancy, each fetus and its associated placenta were weighed, and the number of live and dead fetuses was recorded for each litter. Early progesterone treatment reduced (P gestation length was decreased (P swine influence the rate of conceptus development during early pregnancy and uterine capacity during later pregnancy.

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

    DEFF Research Database (Denmark)

    Eriksen, Hanne-Lise Falgreen; Mortensen, Erik Lykke; Kilburn, Tina R.

    2012-01-01

    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......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...

  3. Risk factors for and impact of respiratory failure on mortality in the early phase of acute pancreatitis

    DEFF Research Database (Denmark)

    Dombernowsky, Tilde; Kristensen, Marlene Østermark; Rysgaard, Sisse

    2016-01-01

    : Retrospective cohort study including 359 patients admitted with acute pancreatitis. Information was gathered from electronic patient records. We defined respiratory failure based on the modified Marshall scoring system in the revised Atlanta criteria. Predictors of respiratory failure were evaluated......, or pneumonia may develop respiratory failure, suggests that acute lung injury, possibly associated with systemic inflammation, may be important.......BACKGROUND: The incidence of respiratory failure and other respiratory complications in the early phase of acute pancreatitis (AP) is not well investigated. OBJECTIVE: To evaluate the incidence and risk factors of respiratory failure, and its impact on mortality in the early phase AP. METHODS...

  4. Allopregnanolone and social stress: regulation of the stress response in early pregnancy in pigs.

    Science.gov (United States)

    Rault, Jean-Loup; Plush, Kate; Yawno, Tamara; Langendijk, Pieter

    2015-01-01

    This experiment investigated whether allopregnanolone, a neurosteroid metabolite from progesterone, modulates the stress response during early pregnancy. Twenty-five nulliparous sows (Sus scrofa) were allocated to one of three treatments: pregnant, ovariectomized or ovariectomized administered daily intravenously with alfaxalone as a synthetic allopregnanolone analog. On days 5, 12 and 19 of pregnancy, all sows were subjected to social stress by submitting them individually to a resident-intruder test, acting as the intruder. Blood samples were collected to analyze plasma progesterone, allopregnanolone, cortisol and adrenocorticotropic hormone (ACTH) concentrations. On day 26, 10 sows across the three treatments were subjected to a dexamethasone suppression test followed by a corticotrophin-releasing hormone administration to test the functionality of their hypothalamo-pituitary-adrenal (HPA) axis through cortisol release. Pregnant sows returned more rapidly to baseline cortisol concentrations following the resident-intruder test (p = 0.006). However, there were no other differences in cortisol or ACTH concentrations according to treatment or day, or to the HPA responsivity test on day 26. Allopregnanolone concentration in pregnant sows was higher than in ovariectomized sows (p pregnancy. Allopregnanolone concentration was correlated with longer resident-intruder test duration (pregnant: r = 0.66, p = 0.0003; ovariectomized: r = 0.47, p = 0.03), reflecting lower aggressiveness, and with progesterone concentration (r = 0.25, p = 0.03). Alfaxalone administration raised plasma allopregnanolone concentration in alfaxalone-administered sows but resulted in little behavioral and physiological effects. These findings did not support the hypothesis that the stress response of the female pig changes in the first third of pregnancy. Allopregnanolone was associated with lower aggression in social encounters.

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

    Institute of Scientific and Technical Information of China (English)

    高佩佩; 汪平

    1999-01-01

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

  6. Extra and intracellular calcium signaling pathway(s) differentially regulate histamine-induced myometrial contractions during early and mid-pregnancy stages in buffaloes (Bubalus bubalis).

    Science.gov (United States)

    Sharma, Abhishek; Nakade, Udayraj P; Choudhury, Soumen; Yadav, Rajkumar Singh; Garg, Satish Kumar

    2017-04-01

    This study examines the differential role of calcium signaling pathway(s) in histamine-induced uterotonic action during early and mid-pregnancy stages in buffaloes. Compared to mid pregnancy, tonic contraction, amplitude and mean-integral tension were significantly increased by histamine to produce myometrial contraction during early pregnancy with small effects on phasic contraction and frequency. Although uterotonic action of histamine during both stages of pregnancy is sensitive to nifedipine (a L-type Ca(2+) channels blocker) and NNC55-0396 (T-type Ca(2+) channels blocker), the role of extracellular calcium seems to be more significant during mid-pregnancy as in this stage histamine produced only 9.38±0.96% contraction in Ca(2+) free-RLS compared to 21.60±1.45% in uteri of early pregnancy stage. Intracellular calcium plays major role in histamine-induced myometrial contraction during early pregnancy as compared to mid pregnancy, as in the presence of cyclopiazonic acid (CPA) Ca(2+)-free RLS, histamine produced significantly higher contraction in myometrial strips of early-pregancy in comparison to mid-pregnancy (10.59±1.58% and 3.13±0.46%, respectively). In the presence of U-73122, the DRC of histamine was significantly shifted towards right with decrease in maximal effect (Emax) only in early pregnancy suggesting the predominant role of phospholipase-C (PL-C) in this stage of pregnancy.

  7. Engaging pregnant and parenting teens: early challenges and lessons learned from the Evaluation of Adolescent Pregnancy Prevention Approaches.

    Science.gov (United States)

    Asheer, Subuhi; Berger, Amanda; Meckstroth, Alicia; Kisker, Ellen; Keating, Betsy

    2014-03-01

    This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.

  8. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study.

    Science.gov (United States)

    Bjørke-Monsen, Anne-Lise; Ulvik, Arve; Nilsen, Roy M; Midttun, Øivind; Roth, Christine; Magnus, Per; Stoltenberg, Camilla; Vollset, Stein Emil; Reichborn-Kjennerud, Ted; Ueland, Per Magne

    2016-11-30

    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 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.

  9. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    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.

  10. Urinary iodine in early pregnancy is associated with subclinical hypothyroidism in Tianjin, China: an observational study.

    Science.gov (United States)

    Wang, Kunling; Zhang, Jie; Li, Fengao; Zhang, Wanqi; Wang, Hao; Ding, Li; Liu, Yaxin; Lin, Laixiang; Zhang, Shuang; Zhu, Mei

    2017-02-17

    Subclinical hypothyroidism (SH) is associated with adverse obstetric outcomes and neurodevelopment disorders. Both iodine deficiency and excess are associated with SH; however, few data regarding iodine nutrition status of pregnant women with SH are available. This study aimed to clarify whether iodine deficiency or excess is associated with SH, especially, when test results for anti-thyroid autoantibodies are negative. A total of 115 women with SH and 104 women with euthyroidism (EH) in early pregnancy in Tianjin, China were investigated, and their serum thyroid-stimulating hormone, free thyroxine, free triiodothyronine, anti-thyroid peroxidase antibody (TPOAb), anti-thyroid globulin antibody (TGAb), urinary iodine (UIC), and urinary creatinine (UCr) concentrations were measured. Thyroid ultrasonography was performed to determine thyroid echogenicity and volume. The UIC, UIC/UCr ratio, prevalence of TPOAb and TGAb positivity, and thyroid gland volume were compared between the EH and SH groups. UIC and ultrasonographic features were analysed in subjects in the SH group who were negative for TPOAb and TGAb. Median UIC of SH (154.0 μg/L) and EH (150.1 μg/L) met the World Health Organization criterion for iodine sufficiency in pregnant women. Neither UIC nor the UIC/UCr ratio differed significantly between groups. The prevalence of TPOAb and TGAb positivity in the SH group was significantly higher than that in the EH group (P Women in early pregnancy with SH in Tianjin were iodine sufficient, but still at risk of iodine deficiency as pregnancy progressed. UIC ≥ 250 μg/L was associated with increased risk of SH. Serological negative autoimmune thyroiditis and UIC ≥ 250 μg/L may play a role in pathogenesis of SH cases with negative results for autoantibodies.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Core competencies and the prevention of school failure and early school leaving.

    Science.gov (United States)

    Bradshaw, Catherine P; O'Brennan, Lindsey M; McNeely, Clea A

    2008-01-01

    There is an increasing awareness that school failure and early school leaving are processes, rather than discrete events, that often co-occur and can have lasting negative effects on children's development. Most of the literature has focused on risk factors for failure and dropout rather than on the promotion of competencies that can increase youths' likelihood of successfully completing high school. This chapter applies the core competencies framework to the promotion of youths' success within the school environment. We conclude with a brief review of evidence-based prevention strategies that address the five competencies and identify avenues for future research.

  13. Social and emotional adjustment following early pregnancy in young Australian women: a comparison of those who terminate, miscarry, or complete pregnancy.

    Science.gov (United States)

    Olsson, Craig A; Horwill, Emily; Moore, Elya; Eisenberg, Marla E; Venn, Alison; O'Loughlin, Christina; Patton, George C

    2014-06-01

    To compare social and emotional adjustment including educational attainment and substance use in women who had a child, pregnancy termination, or miscarriage by young adulthood. Data were from a population-based longitudinal study of the health and well-being of 1,943 young Australians (Victorian Adolescent Health Cohort Study) followed from 15 to 24 years of age. The sample was restricted to female participants and based on pregnancies reported by age 24 years. Analyses were adjusted for early teenage depressive symptoms, cigarette smoking, alcohol use, cannabis use, and parent socioeconomic context. A total of 208 pregnancies (in 170 women) were reported from a sample of 824 young women by 24 years of age. Compared with those who had never been pregnant, those who had a child had lower tertiary education completion and a higher risk of nicotine dependence; those who terminated a pregnancy were more commonly single and had a higher risk of smoking and alcohol use as well as nicotine and alcohol dependence; and those who had a miscarriage had a higher risk of depressive symptomatology and binge drinking as well as nicotine and cannabis dependence. Young women who have been pregnant by their mid-twenties report a range of difficulties in social and emotional adjustment that vary across the different pregnancy outcomes. Broad-based psychosocial health care is essential not only for young women whose pregnancies proceed to live birth, but also for those whose pregnancies end with miscarriage or induced abortion. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study.

    Science.gov (United States)

    Park, Sunmin; Yoon, Hyun-Koo; Ryu, Hyun-Mee; Han, You Jung; Lee, Si Won; Park, Bo Kyung; Park, So-Young; Yim, Chang-Hoon; Kim, Sung-Hoon

    2014-01-01

    The association between vitamin D deficiency in the first trimester and GDM development remains controversial in various ethnicities. We prospectively assessed whether pregnant women with vitamin D deficiency during early pregnancy had an increased likelihood of GDM development or poor fetal growth or pregnancy outcomes compared to those with sufficient vitamin D levels. Serum 25-OH-D measurements and fetal ultrasonograms were carried out at 12-14, 20-22, and 32-34 wk in 523 pregnant women. Each woman was screened for GDM at 24-28 wk. There were no differences in serum 25-OH-D levels at 12-14 wk or 22-24 wk of pregnancy between GDM and non-GDM women after adjusting for maternal age, BMI at prepregnancy, BMI at first visit, BMI at GDM screening, gestational age at sampling, previous history of GDM, vitamin D intake, and seasonal variation in sampling. The risk of GDM, insulin resistance, and impaired β-cell function had no association with serum 25-OH-D levels in crude or adjusted logistic regression analysis. GDM was not associated with maternal serum 25-OH-D deficiency during the first trimester or fetal growth during the first and second trimesters. Pregnancy outcomes such as miscarriage, Apgar 1, Apgar 5 and birth weight were independent of maternal serum 25-OH-D levels during the first, second and third trimester of pregnancy. In conclusion, neither GDM prevalence nor fetal growth during pregnancy is associated with vitamin D deficiency at the first trimester in Korean women. Pregnancy outcomes are also independent of maternal vitamin D status.

  15. Changes in vascular extracellular matrix composition during decidual spiral arteriole remodeling in early human pregnancy.

    Science.gov (United States)

    Smith, Samantha D; Choudhury, Ruhul H; Matos, Patricia; Horn, James A; Lye, Stephen J; Dunk, Caroline E; Aplin, John D; Jones, Rebecca L; Harris, Lynda K

    2016-05-01

    Uterine spiral arteriole (SA) remodeling in early pregnancy involves a coordinated series of events including decidual immune cell recruitment, vascular cell disruption and loss, and colonization by placental-derived extravillous trophoblast (EVT). During this process, decidual SA are converted from narrow, muscular vessels into dilated channels lacking vasomotor control. We hypothesized that this extensive alteration in SA architecture must require significant reorganization and/or breakdown of the vascular extracellular matrix (ECM). First trimester decidua basalis (30 specimens) was immunostained to identify spiral arterioles undergoing trophoblast-independent and -dependent phases of remodeling. Serial sections were then immunostained for a panel of ECM markers, to examine changes in vascular ECM during the remodeling process. The initial stages of SA remodeling were characterized by loss of laminin, elastin, fibrillin, collagen types III, IV and VI from the basement membrane, vascular media and/or adventitia, and surrounding decidual stromal cells. Loss of ECM correlated with disruption and disorganization of vascular smooth muscle cells, and the majority of changes occurred prior to extensive colonization of the vessel wall by EVT. The final stages of SA remodeling, characterized by the arrival of EVT, were associated with the increased mural deposition of fibronectin and fibrinoid. This study provides the first detailed analysis of the spatial and temporal loss of ECM from the walls of remodeling decidual SA in early pregnancy.

  16. Effects of professional support on nausea, vomiting, and quality of life during early pregnancy.

    Science.gov (United States)

    Liu, Mei-Chun; Kuo, Shih-Hsien; Lin, Chao-Po; Yang, Yung-Mei; Chou, Fan-Hao; Yang, Yi-Hsin

    2014-10-01

    The purpose of this study was to examine the effectiveness of a professional support (PS) intervention (including individualized health education and supportive phone calls) in reducing the severity of nausea and vomiting (NV) and improving the quality of life (QOL) of women in early pregnancy. An experimental pretest/posttest design with a control group was used. Participants were recruited from a regional teaching hospital in southern Taiwan. The women in the experimental group (n = 40) received the PS intervention, while those in the control group (n = 39) only received routine nursing care. Analysis of covariance and mixed models were used to compare the experimental and control groups while adjusting for covariates. The severity of NV and the perceived level of symptom distress were significantly lower in the experimental group than in the control group during weeks 2 and 4, and the women in the experimental group showed a significant improvement in their QOL in week 4 (p < .05). However, there was no significant difference between the two groups in body weight at week 4 (p = .501). These findings provide empirical evidence in support of the effectiveness of PS in reducing the severity of NV and improving QOL for women during early pregnancy. This intervention could be routinely applied in prenatal nursing health education. Future studies could apply the concept of PS to different populations and health issues.

  17. Influence of mefloquine administration during early pregnancy on rat embryonic development.

    Science.gov (United States)

    El-Dakdoky, Mai Helmy

    2015-02-01

    Mefloquine (MQ) is a potent effective antimalarial drug against multiple drug-resistant Plasmodium falciparum. It has been proved that MQ can be given safely during the second and third trimesters. However, there is very limited information on the drug safety during the first trimester. The aim of the present work was to investigate the embryotoxicity and teratogenicity of MQ during critical periods of early development. Wistar rats were orally administered with a single dose of MQ (45 mg/kg bwt or 187 mg/kg bwt) on the 1st, 6th or 13th days of pregnancy. Cyclophosphamide (CPA) was chosen as a positive control. On the 21st day of gestation, standard parameters of reproductive performance and fetal examination were estimated. Malondialdehyde (MDA) level, glutathione reductase activity and glutathione (GSH) content were evaluated in placenta and liver homogenates of mothers and fetuses. The results indicated that MQ did not adversely affect the number of implantation, resorption, litter size and fetal body weight and length. Only groups treated with MQ on the 1st day of gestation exhibited significant decrease in fetal body weight. Examination of fetuses for external, visceral and skeletal changes showed minimal variations involving extension of lateral brain ventricles and renal pelvis and signs of delayed ossification. These variations were accompanied with significant elevation of MDA level and reduction of GSH content of fetal liver. Prenatal exposure to MQ at early pregnancy did not cause any embryolethal or teratogenic effect. It could slightly exacerbate minor variations.

  18. Adiponectin, orexin A and orexin B concentrations in the serum and uterine luminal fluid during early pregnancy of pigs.

    Science.gov (United States)

    Smolinska, Nina; Kiezun, Marta; Dobrzyn, Kamil; Szeszko, Karol; Maleszka, Anna; Kaminski, Tadeusz

    2017-03-01

    Adiponectin is the most abundant adipose-released protein that circulates in human plasma at high concentrations. The neuropeptides orexin A (OXA, hypocretin-1) and orexin B (OXB, hypocretin-2) are derived from a common precursor peptide, prepro-orexin and are produced mainly by neurons located in the lateral hypothalamus. It has been demonstrated that the peptides such as adiponectin and orexins have an important role in the regulation of energy metabolism and neuroendocrine functions. These hormones appear to be implicated in both normal and disturbed pregnancy. The objectives of this study were to determine adiponectin and orexin concentrations in the plasma and uterine luminal fluid (ULF) of pigs during early gestation and to explore the relationships between hormone concentrations and stages of pregnancy. The greatest plasma concentrations of adiponectin were observed on days 15-16 and 27-28 of pregnancy, and the least concentrations were on days 30-32 of gestation and on days 10-11 of the oestrous cycle. In ULF, adiponectin concentrations were greater on days 15-16 of pregnancy and on days 10-11 of the oestrous cycle than on days 10-11 and days 12-13 of pregnancy. The greatest OXA concentrations in the blood plasma were noted on days 10-16 of gestation, and the least OXA concentrations were on days 27-32 of pregnancy and on days 10-11 of the oestrous cycle. Orexin A concentrations in ULF were greater on days 10-11 of the cycle than throughout pregnancy. Serum OXB concentrations were greatest on days 10-11 and 30-32 of pregnancy, and least on days 12-28 of gestation. The greatest OXB concentrations in ULF were on days 10-13 of gestation, and the least OXB concentrations were on days 15-16 of pregnancy. This is first study to demonstrate the presence of adiponectin and orexins in the serum and ULF during early pregnancy of pigs as well as the relationships between adiponectin and orexin concentrations and the stage of pregnancy. The fluctuations in adiponectin

  19. Breast cancer prevention: lessons to be learned from mechanisms of early pregnancy-mediated breast cancer protection.

    Science.gov (United States)

    Meier-Abt, Fabienne; Bentires-Alj, Mohamed; Rochlitz, Christoph

    2015-03-01

    Pregnancy at early, but not late age, has a strong and life-long protective effect against breast cancer. The expected overall increase in breast cancer incidence demands the development of a pharmaceutical mimicry of early-age pregnancy-mediated protection. Recently, converging results from rodent models and women on molecular and cellular mechanisms underlying the protective effect of early-age pregnancy have opened the door for translational studies on pharmacologic prevention against breast cancer. In particular, alterations in Wnt and TGFβ signaling in mammary stem/progenitor cells reveal new potential targets for preventive interventions, and thus might help to significantly reduce the incidence of breast cancer in the future. ©2015 American Association for Cancer Research.

  20. Ultrasonographic assessment of cervical length in pregnancies scheduled for a cesarean delivery: prediction of early spontaneous onset of labor.

    Science.gov (United States)

    Rizzo, Giuseppe; Aiello, Elisa; Pietrolucci, Maria Elena; Arduini, Domenico

    2016-10-01

    To investigate whether the cervical length measured by transvaginal ultrasound at 35 to 36 weeks of gestation is predictive of spontaneous early onset of labor in pregnancies scheduled for elective cesarean section (CS). This was a prospective observational study on 167 women scheduled for elective CS at 39 weeks of gestation. The cervical length was measured ultrasonographycally at 35 to 36 weeks of gestation and the pregnancies characteristics were recorded. The presence or absence of spontaneous onset of labor before the time scheduled for elective CS was related to cervical length and pregnancies characteristics. Of the 167 pregnancies enrolled, 25 (14.97%) underwent early spontaneous onset of labor before the time scheduled for the elective CS. The cervical length was significantly shorter in these women when compared with those delivering with an elective CS (21 vs. 30 mm z=5.49 Ponset of labor in univariate analysis (P=0.01). Multivariate logistic regression analysis showed that cervical length (adjusted odds ratio 1.40; 95% confidence interval (CI) 1.22-1.61; P≤0.0001) was the only predictor for the early onset of labor. The area under the receiver-operating characteristics curve for the prediction of early onset of labor was 0.844 (95% CI 0.738-0.950) for cervical length as test variable. Kaplan-Meier analysis demonstrated that a cervical length onset of labor in pregnancies scheduled for CS and may be useful in individualizing the gestational age for elective CS.

  1. A mechanism for the early detection and management of physical asset management strategy execution failure

    Directory of Open Access Journals (Sweden)

    Stimie, Johann

    2016-11-01

    Full Text Available The purpose of this paper is to present a mechanism that can assist physical asset management (PAM practitioners and academics with the early detection and management of PAM strategy execution failure. In the pursuit of this objective, case studies were applied to develop the theory related to this topic the methodologies involved in the development of theory through case studies was were applied. The paper commences with a brief literature review of the contemporary literature on general business strategy, strategy execution, and, more specifically, PAM strategy execution failure (PAMSEF. The physical asset management strategy execution enforcement mechanism (PAMSEEM is presented next. Validation of each one of the components of the PAMSEEM takes place within the context of an organisation that is highly dependent on physical assets (PA dependent organization. The conclusion reached is that the PAMSEEM, can indeed assist organisations with the early detection and management of PAMSEF.

  2. Left ventricular hypertrophy in ascending aortic stenosis mice: anoikis and the progression to early failure

    Science.gov (United States)

    Ding, B.; Price, R. L.; Goldsmith, E. C.; Borg, T. K.; Yan, X.; Douglas, P. S.; Weinberg, E. O.; Bartunek, J.; Thielen, T.; Didenko, V. V.; Lorell, B. H.; Schneider, M. (Principal Investigator)

    2000-01-01

    BACKGROUND: To determine potential mechanisms of the transition from hypertrophy to very early failure, we examined apoptosis in a model of ascending aortic stenosis (AS) in male FVB/n mice. METHODS AND RESULTS: Compared with age-matched controls, 4-week and 7-week AS animals (n=12 to 16 per group) had increased ratios of left ventricular weight to body weight (4.7+/-0.7 versus 3.1+/-0.2 and 5. 7+/-0.4 versus 2.7+/-0.1 mg/g, respectively, Phypertrophy to early failure in mice with chronic biomechanical stress and support the hypothesis that the disruption of normal myocyte anchorage to adjacent extracellular matrix and cells, a process called anoikis, may signal apoptosis.

  3. Difficult to predict early failure after major lower-extremity amputations

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Holm, Gitte; Gebuhr, Peter

    2015-01-01

    INTRODUCTION: The successful outcome of a major amputation depends on several factors, including stump wound healing. The purpose of this study was to examine the criteria upon which the index amputation was based and to identify factors associated with early amputation failure after major non......-traumatic lower-extremity amputation. METHODS: We studied a consecutive one-year series of 36 men and 34 women with a median (25-75% quartiles) age of 72 (63-83) years who were treated in an acute orthopaedic ward; 44 below-knee and 26 above-knee amputees of whom 47 had an American Society of Anesthesiologists...... rating above two. Patient characteristics and other factors potentially influencing early amputation failure within 30 days were evaluated. RESULTS: Eleven patients died (16%) and 11 (16%) had a re-amputation at a higher level, whereas four (6%) had a major revision at the same level within 30 days...

  4. Does intrauterine saline infusion by intrauterine insemination (IUI) catheter as endometrial injury during IVF cycles improve pregnancy outcomes among patients with recurrent implantation failure?: An RCT

    Science.gov (United States)

    Salehpour, Saghar; Zamaniyan, Marzieh; Saharkhiz, Nasrin; Zadeh modares, Shahrzad; Hosieni, Sedighe; Seif, Samira; Malih, Narges; Rezapoor, Parinaz; Sohrabi, Mohammad-Reza

    2016-01-01

    Background: Recurrent implantation failure is one of the most issues in IVF cycles. Some researchers found that beneficial effects of endometrial Scratching in women with recurrent implantation failure, while some authors demonstrated contrary results Objective: The present study aimed to investigate the effect of intrauterine. Saline infusion as a form of endometrial injury, during fresh in vitro fertilization-embryo transfer cycle, among patients with recurrent implantation failure. Materials and Methods: In this clinical trial study 63 women undergoing assisted reproductive technology were divided into two groups either local endometrial injury by intrauterine saline infusion during day 3-5 of the ongoing controlled ovarian stimulation cycle, or IVF protocol performed without any other intervention in Taleghani Hospital, Tehran, Iran. The main outcome measure was clinical pregnancy rates. Results: Patients who received intra uterine saline infusion (n=20), had significantly lower clinical pregnancy numbers (1 vs. 9, p0.05) and multiple pregnancy numbers (1 vs. 3, p>0.05) between groups. Conclusion: When intrauterine saline infusion as a form of endometrial injury is performed during the ongoing IVF cycles it has negative effect on reproductive outcomes among patients with recurrent implantation failure. PMID:27738660

  5. Donor age and early graft failure after lung transplantation: a cohort study

    Science.gov (United States)

    Baldwin, Matthew R; Peterson, Eric R; Easthausen, Imaani; Quintanilla, Isaac; Colago, Eric; Sonett, Joshua R.; D’Ovidio, Frank; Costa, Joseph; Diamond, Joshua M; Christie, Jason D; Arcasoy, Selim M; Lederer, David J

    2014-01-01

    Lungs from older adult organ donors are often unused because of concerns for increased mortality. We examined associations between donor age and transplant outcomes among 8,860 adult lung transplant recipients using Organ Procurement and Transplantation Network and Lung Transplant Outcomes Group data. We used stratified Cox proportional hazard models and generalized linear mixed models to examine associations between donor age and both 1-year graft failure and primary graft dysfunction. The rate of 1-year graft failure was similar among recipients of lungs from donors age 18–64 years, but severely ill recipients (LAS > 47.7 or use of mechanical ventilation) of lungs from donors age 56–64 years had increased rates of 1-year graft failure (p-values for interaction = 0.04 and 0.02, respectively). Recipients of lungs from donors <18 and ≥65 years had increased rates of 1-year graft failure (adjusted hazard ratio 1.23, 95% CI 1.01–1.50 and adjusted hazard ratio 2.15, 95% CI 1.47–3.15, respectively). Donor age was not associated with the risk of primary graft dysfunction. In summary, the use of lungs from donors age 56–64 years may be safe for adult candidates without a high LAS, and the use of lungs from pediatric donors is associated with a small increase in early graft failure. PMID:24034167

  6. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum.

    Science.gov (United States)

    Lundqvist, Anette; Sandström, Herbert; Stenlund, Hans; Johansson, Ingegerd; Hultdin, Johan

    2016-01-01

    Low vitamin D levels during pregnancy may have negative consequences for the health of both the mother and child. Cross-sectional studies in childbearing women suggest that vitamin D levels are low during pregnancy, but few studies have followed the same women during pregnancy and postpartum. The aims of this study were to longitudinally assess vitamin D status during pregnancy and postpartum and identify the factors associated with vitamin D status in pregnant women in northern Sweden. Between September 2006 and March 2009, 184 women were consecutively recruited at five antenatal primary care clinics. Blood was sampled, and dietary intake was estimated using a food frequency questionnaire with 66 food items/food aggregates and questions on the intake of vitamin supplements at gestational weeks 12, 21, and 35, as well as at 12 and 29 weeks after birth. Plasma 25(OH) vitamin D levels were analyzed using liquid chromatography tandem-mass spectrometry. At least one-third of the women had 25(OH) vitamin D levels pregnancy. The levels reverted to the baseline levels after birth. Multivariate analysis showed that gestational and postpartum week, season, dietary intake of vitamin D, and vitamin supplementation were significantly related to plasma levels. There was also an influence of season on the longitudinal concentration patterns. In conclusion, more than one-third of the women studied had low 25(OH) vitamin D levels, and gestational and postpartum week was related to 25(OH) vitamin D levels after adjustment for season and vitamin D intake.

  7. 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

  8. Thyroid peroxidase antibodies in early pregnancy: utility for prediction of postpartum thyroid dysfunction and implications for screening.

    Science.gov (United States)

    Premawardhana, L D K E; Parkes, A B; John, R; Harris, B; Lazarus, J H

    2004-08-01

    Thyroid peroxidase antibodies (TPOAb) in pregnancy are a marker for postpartum (PPTD) and long-term thyroid dysfunction, with variable sensitivity and specificity in PPTD prediction. To test its utility in prediction, we recruited 308 TPOAb-positive (147 developed PPTD (PPTD group) and 161 remained euthyroid [PPTE group]) and 102 TPOAb-negative women (none developed PPTD), in early pregnancy (median, 18; range, 9-19 weeks' gestation). TPOAb levels were higher in the PPTD group (median) (125.2 kIU/L; p < 0.001), and in its hypothyroid (162.4 kIU.; p < 0.0001), hyperthyroid (114.2 kIU/L; p < 0.007), and biphasic (105.1 kIU/L; p < 0.02) variants, compared to the PPTE group (66.7 kIU/L) The incidence of PPTD was significantly higher with TPOAb levels above 58.2 kIU/L (early pregnancy versus postpartum; relative risk, 1.37 [95% confidence interval [CI] 1.17-1.61] versus 0.78 [95% CI 0.5-1.2]) compared to levels below. The integrated postpartum TPOAb response was higher in the PPTD group (median) (159 kIU/L per week) and its variants (hypothyroid; 199 kIU/L per week; biphasic, 180 kIU/L per week; hyperthyroid, 120 kIU/L per week), compared to the PPTE group (86 kIU/L per week p < 0.004). Median early pregnancy TPOAb levels in the PPTD and PPTE groups correlated well with the postpartum antibody response (r = 0.58, p < 0.001). The sensitivity of TPOAb in PPTD prediction was 100% (early pregnancy and postpartum), specificity 62% (early pregnancy) versus 41% (postpartum) and positive predictive value 48% (early pregnancy and postpartum). The timing of TPOAb testing, the sensitive assay used and the absence of PPTD in TPOAb-negative subjects contributed to this high sensitivity. We recommend TPOAb in early pregnancy as a useful predictor of PPTD, particularly in populations where PPTD does not occur in TPOAb-negative women.

  9. High Body Mass Index Is an Indicator of Maternal Hypothyroidism, Hypothyroxinemia, and Thyroid-Peroxidase Antibody Positivity during Early Pregnancy.

    Science.gov (United States)

    Han, Cheng; Li, Chenyan; Mao, Jinyuan; Wang, Weiwei; Xie, Xiaochen; Zhou, Weiwei; Li, Chenyang; Xu, Bin; Bi, Lihua; Meng, Tao; Du, Jianling; Zhang, Shaowei; Gao, Zhengnan; Zhang, Xiaomei; Yang, Liu; Fan, Chenling; Teng, Weiping; Shan, Zhongyan

    2015-01-01

    Maternal thyroid dysfunction in early pregnancy may increase the risk of adverse pregnancy complications and neurocognitive deficiencies in the developing fetus. Currently, some researchers demonstrated that body mass index (BMI) is associated with thyroid function in nonpregnant population. Hence, the American Thyroid Association recommended screening thyroid function in obese pregnant women; however, the evidence for this is weak. For this purpose, our study investigated the relationship between high BMI and thyroid functions during early pregnancy in Liaoning province, an iodine-sufficient region of China. Serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) concentration, urinary iodine concentration (UIC), and BMI were determined in 6303 pregnant women. BMI ≥ 25 kg/m(2) may act as an indicator of hypothyroxinemia and TPOAb positivity and BMI ≥ 30 kg/m(2) was associated with increases in the odds of hypothyroidism, hypothyroxinemia, and TPOAb positivity. The prevalence of isolated hypothyroxinemia increased among pregnant women with BMI > 24 kg/m(2). High BMI during early pregnancy may be an indicator of maternal thyroid dysfunction; for Asian women whose BMI > 24 kg/m(2) and who are within 8 weeks of pregnancy, thyroid functions should be assessed especially.

  10. Effects of Shiga Toxin Type 2 on Maternal and Fetal Status in Rats in the Early Stage of Pregnancy

    Science.gov (United States)

    Sacerdoti, Flavia; Amaral, María M.; Zotta, Elsa; Franchi, Ana M.; Ibarra, Cristina

    2014-01-01

    Shiga toxin type 2 (Stx2), a toxin secreted by Shiga toxin-producing Escherichia coli (STEC), could be one of the causes of maternal and fetal morbimortality not yet investigated. In this study, we examined the effects of Stx2 in rats in the early stage of pregnancy. Sprague-Dawley pregnant rats were intraperitoneally (i.p.) injected with sublethal doses of Stx2, 0.25 and 0.5 ng Stx2/g of body weight (bwt), at day 8 of gestation (early postimplantation period of gestation). Maternal weight loss and food and water intake were analyzed after Stx2 injection. Another group of rats were euthanized and uteri were collected at different times to evaluate fetal status. Immunolocalization of Stx2 in uterus and maternal kidneys was analyzed by immunohistochemistry. The presence of Stx2 receptor (globotriaosylceramide, Gb3) in the uteroplacental unit was observed by thin layer chromatography (TLC). Sublethal doses of Stx2 in rats caused maternal weight loss and pregnancy loss. Stx2 and Gb3 receptor were localized in decidual tissues. Stx2 was also immunolocalized in renal tissues. Our results demonstrate that Stx2 leads to pregnancy loss and maternal morbidity in rats in the early stage of pregnancy. This study highlights the possibility of human pregnancy loss and maternal morbidity mediated by Stx2. PMID:25157355

  11. Effects of Shiga Toxin Type 2 on Maternal and Fetal Status in Rats in the Early Stage of Pregnancy

    Directory of Open Access Journals (Sweden)

    Flavia Sacerdoti

    2014-01-01

    Full Text Available Shiga toxin type 2 (Stx2, a toxin secreted by Shiga toxin-producing Escherichia coli (STEC, could be one of the causes of maternal and fetal morbimortality not yet investigated. In this study, we examined the effects of Stx2 in rats in the early stage of pregnancy. Sprague-Dawley pregnant rats were intraperitoneally (i.p. injected with sublethal doses of Stx2, 0.25 and 0.5 ng Stx2/g of body weight (bwt, at day 8 of gestation (early postimplantation period of gestation. Maternal weight loss and food and water intake were analyzed after Stx2 injection. Another group of rats were euthanized and uteri were collected at different times to evaluate fetal status. Immunolocalization of Stx2 in uterus and maternal kidneys was analyzed by immunohistochemistry. The presence of Stx2 receptor (globotriaosylceramide, Gb3 in the uteroplacental unit was observed by thin layer chromatography (TLC. Sublethal doses of Stx2 in rats caused maternal weight loss and pregnancy loss. Stx2 and Gb3 receptor were localized in decidual tissues. Stx2 was also immunolocalized in renal tissues. Our results demonstrate that Stx2 leads to pregnancy loss and maternal morbidity in rats in the early stage of pregnancy. This study highlights the possibility of human pregnancy loss and maternal morbidity mediated by Stx2.

  12. Antenatal Weight Management: Women’s Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy

    Directory of Open Access Journals (Sweden)

    J. A. Swift

    2016-01-01

    Full Text Available The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy sought to examine women’s self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+ were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n=80 between 12 and 14 and 43.0% (n=83 between 20 and 22 weeks. At recruitment 50.3% of participants (n=97 could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2 did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

  13. Antenatal Weight Management: Women's Experiences, Behaviours, and Expectations of Weighing in Early Pregnancy.

    Science.gov (United States)

    Swift, J A; Pearce, J; Jethwa, P H; Taylor, M A; Avery, A; Ellis, S; Langley-Evans, S C; McMullen, S

    2016-01-01

    The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy) sought to examine women's self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+) were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10-27 weeks, with 41.5% (n = 80) between 12 and 14 and 43.0% (n = 83) between 20 and 22 weeks. At recruitment 50.3% of participants (n = 97) could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m(2)) did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m(2). The majority of women (regardless of BMI) did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.

  14. Increased oxidative stress from early pregnancy in women who develop preeclampsia.

    Science.gov (United States)

    D'Souza, Vandita; Rani, Alka; Patil, Vidya; Pisal, Hemlata; Randhir, Karuna; Mehendale, Savita; Wagh, Girija; Gupte, Sanjay; Joshi, Sadhana

    2016-01-01

    Preeclampsia (PE) is a pregnancy-specific disorder, defined as new onset of maternal hypertension and proteinuria after 20 weeks of gestation. Our earlier study has shown increased maternal oxidative stress at delivery to be associated with poor birth outcome in PE. However, these results were observed when the pathology had progressed and may have been secondary to the effects of the disorder. To understand the role of antioxidant defense mechanisms in PE right from early pregnancy, in this prospective study, we measured malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione (GSH) concentrations in maternal blood at 3 time-points of gestation [16-20 weeks (T1), 26-30 weeks (T2), at delivery (T3)] and in cord blood. Gene expression of SOD and GPx and protein levels of endothelial nitric oxide synthase (eNOS) enzyme were also analyzed in the placenta. MDA levels were higher at T1 (p stress right from 16 to 20 weeks of gestation. This may alter placental development and lead to fetal programming of adult non-communicable disease in the offspring.

  15. Risk of leukemia in relation to exposure to ambient air toxics in pregnancy and early childhood.

    Science.gov (United States)

    Heck, Julia E; Park, Andrew S; Qiu, Jiaheng; Cockburn, Myles; Ritz, Beate

    2014-07-01

    There are few established causes of leukemia, the most common type of cancer in children. Studies in adults suggest a role for specific environmental agents, but little is known about any effect from exposures in pregnancy to toxics in ambient air. In our case-control study, we ascertained 69 cases of acute lymphoblastic leukemia (ALL) and 46 cases of acute myeloid leukemia (AML) from California Cancer Registry records of children leukemia associated with one interquartile range increase in air toxic exposure. Risk of ALL was elevated with 3(rd) trimester exposure to polycyclic aromatic hydrocarbons (OR=1.16, 95% CI 1.04, 1.29), arsenic (OR=1.33, 95% CI 1.02, 1.73), benzene (OR=1.50, 95% CI 1.08, 2.09), and three other toxics related to fuel combustion. Risk of AML was increased with 3rd trimester exposure to chloroform (OR=1.30, 95% CI 1.00, 1.69), benzene (1.75, 95% CI 1.04, 2.93), and two other traffic-related toxics. During the child's first year, exposure to butadiene, ortho-xylene, and toluene increased risk for AML and exposure to selenium increased risk for ALL. Benzene is an established cause of leukemia in adults; this study supports that ambient exposures to this and other chemicals in pregnancy and early life may also increase leukemia risk in children.

  16. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus.

    Science.gov (United States)

    Arnold, Dodie L; Enquobahrie, Daniel A; Qiu, Chungfang; Huang, Jonathan; Grote, Nancy; VanderStoep, Ann; Williams, Michelle A

    2015-05-01

    While associations of vitamin D deficiency with type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM. In a nested case-cohort study (135 GDM cases and 517 non-GDM controls), we measured maternal serum vitamin D status (total 25[OH]D and 25[OH]D3 ) in early pregnancy (16 weeks on average) using liquid chromatography-tandem mass spectroscopy. GDM was diagnosed according to the American Diabetes Association guidelines. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression models. GDM cases had lower mean total 25[OH]D (27.3 vs. 29.3 ng/mL) and 25[OH]D3 (23.9 vs. 26.7 ng/mL) concentrations compared with women who did not develop GDM (both P-values pregnancy vitamin D status, particularly 25[OH]D3 , is inversely associated with GDM risk. © 2015 John Wiley & Sons Ltd.

  17. A random protein-creatinine ratio accurately predicts baseline proteinuria in early pregnancy.

    Science.gov (United States)

    Hirshberg, Adi; Draper, Jennifer; Curley, Cara; Sammel, Mary D; Schwartz, Nadav

    2014-12-01

    Data surrounding the use of a random urine protein:creatinine ratio (PCR) in the diagnosis of preeclampsia is conflicting. We sought to determine whether PCR in early pregnancy can replace the 24-hour urine collection as the primary screening test in patients at risk for baseline proteinuria. Women requiring a baseline evaluation for proteinuria supplied a urine sample the morning after their 24-hour collection. The PCR was analyzed as a predictor of significant proteinuria (≥150 mg). A regression equation to estimate the 24-hour protein value from the PCR was then developed. Sixty of 135 subjects enrolled completed the study. The median 24-hour urine protein and PCR were 90 mg (IQR: 50-145) and 0.063 (IQR: 0.039-0.083), respectively. Fifteen patients (25%) had significant proteinuria. PCR was strongly correlated with the 24-hour protein value (r = 0.99, p proteinuria (AUC = 0.86). A PCR cut-point of 0.079 yielded a sensitivity of 93.3% and a specificity of 57.8%. The resulting regression equation [total protein = 46.5 + 904.2*PCR] accurately estimates the actual 24-hour protein (95% CI: ±88 mg). A random urine PCR accurately estimates the 24-hour protein excretion in the first half of pregnancy and can be used as the primary screening test for baseline proteinuria in at-risk patients.

  18. Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension.

    Science.gov (United States)

    Veerbeek, Jan H W; Hermes, Wietske; Breimer, Anath Y; van Rijn, Bas B; Koenen, Steven V; Mol, Ben W; Franx, Arie; de Groot, Christianne J M; Koster, Maria P H

    2015-03-01

    Observational studies have shown an increased lifetime risk of cardiovascular disease (CVD) in women who experienced a hypertensive disorder in pregnancy. This risk is related to the severity of the pregnancy-related hypertensive disease and gestational age at onset. However, it has not been investigated whether these differences in CVD risk factors are already present at postpartum cardiovascular screening. We evaluated postpartum differences in CVD risk factors in 3 subgroups of patients with a history of hypertensive pregnancy. We compared the prevalence of common CVD risk factors postpartum among 448 women with previous early-onset preeclampsia, 76 women with previous late-onset preeclampsia, and 224 women with previous pregnancy-induced hypertension. Women with previous early-onset preeclampsia were compared with women with late-onset preeclampsia and pregnancy-induced hypertension and had significantly higher fasting blood glucose (5.29 versus 4.80 and 4.83 mmol/L), insulin (9.12 versus 6.31 and 6.7 uIU/L), triglycerides (1.32 versus 1.02 and 0.97 mmol/L), and total cholesterol (5.14 versus 4.73 and 4.73 mmol/L). Almost half of the early-onset preeclampsia women had developed hypertension, as opposed to 39% and 25% of women in the pregnancy-induced hypertension and late-onset preeclampsia groups, respectively. Our data show differences in the prevalence of common modifiable CVD risk factors postpartum and suggest that prevention strategies should be stratified according to severity and gestational age of onset for the hypertensive disorders of pregnancy.

  19. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring

    Science.gov (United States)

    Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

    2015-01-01

    Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0

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

    Science.gov (United States)

    Rebelo, Fernanda; Farias, Dayana Rodrigues; Mendes, Roberta Hack; Schlüssel, Michael Maia; Kac, Gilberto

    2015-02-13

    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 (parto imediato segundo o índice de massa corporal (IMC) no início da gravidez. Métodos: A PAS e a PAD foram medidas no 1º, 2º e 3º trimestres gestacionais e aos 30-45 dias pós-parto em uma coorte prospectiva de 189 mulheres com idade entre 20 e 40 anos. O IMC (kg/m2) foi aferido até a 13a semana e classificado como normal (parto (βPAS=0,010; IC95%:0,006-0,014 e βPAD=0,015; IC95%:0,012-0,018). As mulheres com IMC excessivo apresentaram média de PAS maior em todos os trimestres, e de PAD maior no primeiro e no terceiro trimestres. O IMC excessivo no início da gestação esteve positivamente associado com mudanças na PAS (βPAS=7,055; IC95%:4,499-9,610) e na PAD (βPAD=3,201; IC95%:1,136-5,266). Conclusão: A PAS e a PAD diminuíram do primeiro para o segundo trimestre e aumentaram do segundo trimestre até o pósparto. Mulheres com IMC excessivo no início da gestação apresentaram valores mais elevados de PAS e PAD ao longo da gravidez, mas não no pós-parto, quando comparadas às de IMC normal.

  1. Effect of beryllium nitrate on early and late pregnancy in rats

    Energy Technology Data Exchange (ETDEWEB)

    Mathur, R.; Sharma, S.; Mathur, S.; Prakash, A.O.

    1987-01-01

    Beryllium is widely used in fatigue-resistant alloys, nuclear reactors, space device, missiles parts, electronics and other specialized purposes. Workers both in industries and mines are constantly exposed through inhalation or direct skin contact. A number of investigations have been made in different laboratories in relation to its toxicological effects in laboratory animals and humans. The lethal dose (LD/sub 50/) of beryllium nitrate through intravenous route in rats has been reported from our laboratory to be 3.16 mg/kg body weight. But not much is known about its effects on reproductive physiology. The present communication deals with the effect of beryllium nitrate on early and late pregnancy in the albino rats.

  2. Distributions of PCNA and Cas-3 in rat uterus during early pregnancy.

    Directory of Open Access Journals (Sweden)

    Jale Oner

    2010-06-01

    Full Text Available The aim of present study was to determine the distributions of proliferating cell nuclear agent (PCNA and Cas-pase-3 (Cas-3 and their possible roles in implantation and decidualization during early pregnancy at immunohistochemical level. The tissue samples from pregnant animals between gestational days 1-5 were incubated by PCNA and Cas-3 antibodies and the obtained results were evaluated quantitatively. It was observed that PCNA immunoreactivity in uterine luminal epithelium and glandular epithelium reduced as from day 2 of gestation and disappeared as from day 4 of gestation. PCNA staining intensity in stromal cells and myometrium increased gradually with progressing gestation. While Cas-3 immunoreactivity was strongly detected in luminal and glandular epithelium throughout the whole gestational period, its reactivity markedly increased as from day 3 of gestation. In conclusion, it may suggest that the blastocyst implantation induces the uterine luminal epithelial cell death and stromal cell proliferation around the embryo in the uterus.

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  4. [Ultrasound echographic imaging and measurement of the amniotic cavity and yolk sac in early pregnancy: comparative study of intact and disordered pregnancies].

    Science.gov (United States)

    Funk, A; Fendel, H

    1988-01-01

    The chorionic cavity, vertex-breech length, yolk sac, and amnion were systematically demonstrated and measured in 50 early pregnancies, i.e., between the end of the sixth and the tenth week of gestation post menstruationem (p.m.). This was done in 23 cases with clinically and sonographically intact pregnancies without symptoms of abortion, in 12 cases with living embryos with symptoms of abortion, and in 15 cases of retained miscarriage. The thin amniotic membrane is sonographically demonstrated as a narrow, sharply defined reflected band in the chorionic cavity. In addition to direct demonstration of the amniotic membrane, the amniotic cavity can be demonstrated by a density difference in the echogenicity of the chorionic and amniotic fluids. While there are delicate, homogenously distributed inner echoes in the chorionic cavity, the amniotic cavity is empty save for the embryo structure. Sonographically, therefore, the amniotic cavity stands out as a spherical structure within the chorionic cavity. In all pregnancies with a living embryo it was possible to demonstrate the yolk sac sonographically as a sharply defined ring structure in the chorionic cavity. In 10 of the 15 cases of retained miscarriage only a rudimentary remnant of the yolk sac could be detected. The development of the amniotic and chorionic cavities and vertex-breech length was constant in the pregnancies with living embryos, the amnion developing synchronously with the vertex-breech length.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Cytochrome P450 26A1 modulates natural killer cells in mouse early pregnancy.

    Science.gov (United States)

    Meng, Chao-Yang; Li, Zhong-Yin; Fang, Wen-Ning; Song, Zhi-Hui; Yang, Dan-Dan; Li, Dan-Dan; Yang, Ying; Peng, Jing-Pian

    2017-04-01

    Cytochrome P450 26A1 (CYP26A1) has a spatiotemporal expression pattern in the uterus, with a significant increase in mRNA and protein levels during peri-implantation. Inhibiting the function or expression of CYP26A1 can cause pregnancy failure, suggesting an important regulatory role of CYP26A1 in the maintenance of pregnancy. However, little is known about the exact mechanism involved. In this study, using a pCR3.1-cyp26a1 plasmid immunization mouse model and a Cyp26a1-MO (Cyp26a1-specific antisense oligos) knockdown mouse model, we report that the number of Dolichos biflorus agglutinin (DBA) lectin-positive uterine natural killer (uNK) cells was reduced in pCR3.1-cyp26a1 plasmid immunized and Cyp26a1-MO-treated mice. In contrast, the percentage of CD3(-) CD49b(+) NK cells in the uteri from the treatment group was significantly higher than that of the control group in both models. Similarly, significantly up-regulated expression of CD49b (a pan-NK cell marker), interferon gamma, CCL2, CCR2 (CCL2 receptor) and CCL3 were detected in the uteri of pCR3.1-cyp26a1- and Cyp26a1-MO-treated mice. Transcriptome analysis suggested that CYP26A1 might regulate NK cells through chemokines. In conclusion, the present data suggest that silencing CYP26A1 expression/function can decrease the number of uNK cells and significantly increase the percentage of CD3(-) CD49b(+) NK cells in the uteri of pregnant mice. These findings provide a new line of evidence correlating the deleterious effects of blocking CYP26A1 in pregnancy with the aberrant regulation of NK cells in the uterus. © 2016 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  6. Psychometric Evaluation of the Ford Insomnia Response to Stress Test (FIRST) in Early Pregnancy.

    Science.gov (United States)

    Gelaye, Bizu; Zhong, Qiu-Yue; Barrios, Yasmin V; Redline, Susan; Drake, Christopher L; Williams, Michelle A

    2016-04-15

    To evaluate the construct validity and factor structure of the Spanish-language version of the Ford Insomnia Response to Stress Test questionnaire (FIRST-S) when used in early pregnancy. A cohort of 647 women were interviewed at ≤ 16 weeks of gestation to collect information regarding lifestyle, demographic, and sleep characteristics. The factorial structure of the FIRST-S was tested through exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency and construct validity were also assessed by evaluating the association between the FIRST-S with symptoms of depression, anxiety, and sleep quality. Item response theory (IRT) analyses were conducted to complement classical test theory (CTT) analytic approaches. The mean score of the FIRST-S was 13.8 (range: 9-33). The results of the EFA showed that the FIRST-S contained a one-factor solution that accounted for 69.8% of the variance. The FIRST-S items showed good internal consistency (Cronbach α = 0.81). CFA results corroborated the one-factor structure finding from the EFA; and yielded measures indicating goodness of fit (comparative fit index of 0.902) and accuracy (root mean square error of approximation of 0.057). The FIRST-S had good construct validity as demonstrated by statistically significant associations of FIRST-S scores with sleep quality, antepartum depression and anxiety symptoms. Finally, results from IRT analyses suggested excellent item infit and outfit measures. The FIRST-S was found to have good construct validity and internal consistency for assessing vulnerability to insomnia during early pregnancy. © 2016 American Academy of Sleep Medicine.

  7. Assesment of The Efficacy of Thyroid Function Screening in Early Pregnancy

    Directory of Open Access Journals (Sweden)

    Muzaffer Temur

    2013-10-01

    Full Text Available Aim: To asses the efficacy of screening thyroid function during early pregnancy. Material and Method: One hundred and eighty five pregnant women who attended a secondary center for their first antenatal visits (6-12 weeks of gestation between May 2012 and August 2012 were divided into two groups comprising 94 women regarded as high-risk and 91 low-risk. Maternal serum concentrations of TSH, fT4 and fT3 were measured. The thyroid function of the study group was evaluated for euthyroidism, hypothyroidism, hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism according to TSH, fT3 and fT4 results. Analysis of data were performed, using the SPSS software version 11.5. In all tests, p<0.05 was accepted as statistically significant. Results: We screened thyroid function in 185 pregnant women, of whom 151 (81.62% were euthyroid and 34 (18.38%  had thyroid dysfunction, with 24 (12.98% in the high-risk group and 10 (5.4% in the low-risk group. When the results of thyroid function tests were evaluated as normal and abnormal, the most statistically significant characteristics for abnormal results were found to be history of antithyroid therapy and thyroid surgery (p=0.005, p=0.015. We would fail to spot about one third of thyroid dysfunctions if only high-risk women were screened. Discussion: Risk-stratified screening for maternal thyroid dysfunction during early pregnancy may led to neglected diagnoses of thyroid disorders. Results here indicated universal screening, but the debate regarding the targeting of high-risk cases seems set to continue into the future.

  8. Folic acid supplementation during early pregnancy and the risk of gestational hypertension and preeclampsia.

    Science.gov (United States)

    Li, Zhiwen; Ye, Rongwei; Zhang, Le; Li, Hongtian; Liu, Jianmeng; Ren, Aiguo

    2013-04-01

    Emerging evidence has suggested that folic acid-containing multivitamins may markedly reduce the risk of gestational hypertension or preeclampsia. We examined whether maternal supplementation with folic acid alone during early pregnancy can prevent the occurrence of gestational hypertension and preeclampsia. The data are from a large population-based cohort study established to evaluate the effectiveness of the campaign to prevent neural tube defects with folic acid supplementation in China. We selected participants who were registered in 2 southern provinces, had exact information on folic acid use, and were not affected by chronic hypertension or diabetes mellitus before 20 weeks gestation. A logistic regression model was used to adjust for the effects of the main potential confounders, including age, body mass index, education, occupation, parity, and multiple births. The study size had 99.9% power (α=0.05) to detect a decrease of 10% over the unexposed rate of 9.4% for gestational hypertension. Among the 193 554 women (47.9% took folic acid, 52.1% did not), the overall incidence of gestational hypertension and preeclampsia was 9.5% and 2.5%, respectively. The incidence of gestational hypertension and preeclampsia was 9.7% and 2.5% for women who took folic acid, and 9.4% and 2.4% for women who did not use it. The adjusted risk ratio associated with folic acid use was 1.08 (95% confidence interval, 1.04-1.11) for gestational hypertension and 1.11 (95% confidence interval, 1.04-1.18) for preeclampsia. Our findings suggest that daily consumption of 400 μg folic acid alone during early pregnancy cannot prevent the occurrence of gestational hypertension and preeclampsia.

  9. 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 (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.

  10. Technical note: A new surgical technique for ovariohysterectomy during early pregnancy in beef heifers.

    Science.gov (United States)

    McLean, K J; Dahlen, C R; Borowicz, P P; Reynolds, L P; Crosswhite, M R; Neville, B W; Walden, S D; Caton, J S

    2016-12-01

    We hypothesized that a standing flank ovariohysterectomy procedure could be developed in beef heifers that would provide high quality tissues for addressing critical questions during early pregnancy, while concomitantly keeping livestock stewardship a high priority. To test the hypothesis, we: 1) developed a standing flank ovariohysterectomy procedure for use in beef heifers, and 2) implemented this procedure in a cohort of heifers up to d 50 of pregnancy for tissue collections, documentation of post-surgical recovery, and assessment of feedlot finishing performance. Ovariectomy and cesarean section protocols are well established in research and veterinary medicine and were used as starting points for procedural development. Crossbred Angus heifers ( = 46; ∼ 15 mo of age; BW = 362.3 ± 34.7 kg) were used to develop this new surgical tissue collection technique. Heifers were subjected to the 5-d CO-Synch + CIDR estrous synchronization protocol so ovariohysterectomy occurred at d 16, 22, 28, 34, 40, and 50 of gestation. Key aspects of the standing flank ovariohysterectomy technique included 1) use of local anesthetic for a standing flank incision, 2) locate the uterine and ovarian arteries via blind palpation and ligate them through the broad ligament via an improved clinch knot, 3) cut the ovaries and uterus free from the broad ligament, 4) ligate the cervix and uterine branch of the vaginal artery, and 5) cut through the cervix and remove the reproductive tract. Surgical times, from skin incision to placement of the last suture, were influenced ( = 0.04) by stage of gestation. In pregnant heifers, time decreased from d 22 (120.0 ± 12.0 min) of gestation to d 40 (79.5 ± 12.0 min) of gestation; then increased at d 50 (90.5 ± 14.7 min) of gestation. Using this procedure, we obtained uterine, placental, and embryo/fetal tissues that had experienced limited hypoxia, little or no trauma, and thus were excellent quality for scientific study. All heifers recovered

  11. Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda.

    Science.gov (United States)

    Atuyambe, Lynn; Mirembe, Florence; Annika, Johansson; Kirumira, Edward K; Faxelid, Elisabeth

    2009-08-01

    To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Two main themes emerged; 'feeling exposed and powerless', and 'seeking safety and empathy'. The categories identified in the first theme were "the dilemma of becoming an adolescent mother" and "lack of decision power". In the second theme the following categories were identified: "cultural practices and beliefs about birth", "expectations and experiences", "transport, a key determinant to health seeking", and "dealing with constraints". Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health

  12. Subclinical iron deficiency is a strong predictor of bacterial vaginosis in early pregnancy

    Directory of Open Access Journals (Sweden)

    Claeys Geert

    2005-07-01

    Full Text Available Abstract Background Bacterial vaginosis (BV is the single most common vaginal infection in women of childbearing age and associated with a sizeable infectious disease burden among both non-pregnant and pregnant women, including a significantly elevated risk of adverse pregnancy outcome. Overall, little progress has been made in identifying causal factors involved in BV acquisition and persistence. We sought to evaluate maternal iron status in early pregnancy as a putative risk factor for BV, considering that micronutrients, and iron deficiency in particular, affect the host response against bacterial colonization, even in the setting of mild micronutrient deficiencies. Methods In a nested case-control study, we compared maternal iron status at entry to prenatal care (mean gestational age 9.2 ± 2.6 weeks between eighty women with healthy vaginal microflora and eighteen women with vaginosis-like microflora. Vaginal microflora status was assessed by assigning a modified Nugent score to a Gram-stained vaginal smear. Maternal iron status was assayed by an array of conventional erythrocyte and serum indicators for iron status assessment, but also by more sensitive and more specific indicators of iron deficiency, including soluble transferrin receptors (sTfR as an accurate measure of cellular and tissue iron deficiency and the iron deficiency log10[sTfR/ferritin] index as the presently most accurate measure of body storage iron available. Results We found no statistically significant correlation between vaginal microflora status and routinely assessed iron parameters. In contrast, a highly significant difference between the healthy and vaginosis-like microflora groups of women was shown in mean values of sTfR concentrations (1.15 ± 0.30 mg/L versus 1.37 ± 0.38 mg/L, p = 0.008 and in mean iron deficiency log10[sTfR/ferritin] index values (1.57 ± 0.30 versus 1.08 ± 0.56, p = 0.003, indicating a strong association between iron deficiency and

  13. Early surgical outcomes of coronary artery bypass grafting in patients with dialysis-dependent renal failure: Effects of early hemodialysis

    Directory of Open Access Journals (Sweden)

    Chih-Yuan Lin

    2014-01-01

    Full Text Available Background: Coronary artery disease occurs frequently and is a major cause of morbidity and mortality in patients with chronic renal failure. Because the number of patients requiring dialysis for end-stage renal disease (ESRD has increased, the number of patients in this population who require coronary artery bypass grafting (CABG has increased. The aim of this study was to examine the effect of early hemodialysis (HD on the early surgical outcomes of ESRD patients undergoing CABG. Materials and Methods: Fifty-nine dialysis-dependent patients who underwent isolated CABG with cardiopulmonary bypass (CPB were enrolled in this study. These patients were divided into two groups based on the timing of the first postoperation HD session. In the early HD group, HD was performed within 6 h postoperation; in the scheduled HD group, HD was performed >6 h postoperation. The preoperative characteristics, operative variables, and postoperative outcomes were retrospectively analyzed. Results: The time to first HD after CABG was 2.43 ± 1.58 h in the early HD group and 20.68 ± 6.98 h in the scheduled HD group (P < 0.001. There were no significant differences in the operative variables, namely duration of operation, CPB time, and aortic cross-clamp time, between the two groups. The incidence of postoperative pneumonia was higher in the scheduled HD group (31.8% than in the early HD group (2.7%. There was a trend of decreased incidence of postoperative pneumonia in the early HD group with marginal significance from the univariate analysis. The intensive care unit and hospital stay duration of both groups were similar. Nine patients died in the hospital, yielding an overall 30-day mortality of 8.47%. Conclusion: In dialysis-dependent patients who underwent CABG, the short-term outcomes and surgical mortality were acceptable. Dialysis-dependent renal failure should not be considered a contraindication for CABG. Early HD in the postoperative period demonstrated

  14. Physiology: Capacity for Hormone Production of Cultured Trophoblast Cells Obtained from Placentae at Term and in Early Pregnancy

    OpenAIRE

    2001-01-01

    Problem: There is an increased doubt about the identity of isolated cytotrophoblast cells at term. Therefore, we compared pregnancy serum levels of three hormones [human placental lactogen (hPL), human chorionic gonadotropin (hCG), and leptin] with the capacity for hormone production of early placentae [EP; 8–13 weeks of gestation (WG)] and term placentae (TP; 38–42 WG).

  15. Deviant early pregnancy maternal triglyceride levels and increased risk of congenital anomalies : a prospective community-based cohort study

    NARCIS (Netherlands)

    Nederlof, M.; de Walle, H. E. K.; van Poppel, M. N. M.; Vrijkotte, T. G. M.; Gademan, M. G. J.

    ObjectiveThe maternal lipid profile could be of importance in congenital anomaly development. This study therefore investigates whether the maternal lipid profile during early pregnancy is associated with major nonsyndromic congenital anomalies (MNCA). DesignProspective community-based cohort study.

  16. Effect of Repeated Stress Treatments During the Follicular Phase and Early Pregnancy on Reproductive Performance of Gilts

    NARCIS (Netherlands)

    Soede, N.M.; Roelofs, J.B.; Verheijen, R.J.E.; Schouten, W.G.P.; Hazeleger, W.; Kemp, B.

    2007-01-01

    In pig husbandry, stress is being considered an important cause of impaired reproductive performance. Therefore, an experiment was performed to quantify effects of repeated stressors during the follicular phase and/or during early pregnancy on reproductive performance of gilts. Eighty-one cyclic

  17. Early pregnancy exposure to antihistamines and risk of congenital heart defects : results of two case-control studies

    NARCIS (Netherlands)

    Smedts, Huberdina P. M.; de Jonge, Linda; Bandola, Sarah J. G.; Baardman, Marlies E.; Bakker, Marian K.; Stricker, Bruno H. C.; Steegers-Theunissen, Regine P. M.

    2014-01-01

    UNLABELLED: We aimed to study the association between use of antihistamines in early pregnancy and congenital heart defects (CHD) in the offspring. DESIGN: Two case-control studies. SETTING: HAVEN study, Erasmus MC, University Medical Centre, Rotterdam, and Eurocat Northern Netherlands (NNL), Univer

  18. Thyroid hormone availability during pregnancy and early life: determinants, interpretation and consequences : Translating thyroid physiology into clinical epidemiology studies

    NARCIS (Netherlands)

    T.I.M. Korevaar (Tim)

    2017-01-01

    markdownabstractThis thesis contains studies that investigates determinants of thyroid function during pregnancy and early life. We identified novel determinants such as angiogenic factors, known factors such as hCG and also clinical factors that were incorporated into a prediction model. We also

  19. Expression of Smad2 and Smad4 in rhesus monkey endometrium during the menstrual cycle and early pregnancy

    Institute of Scientific and Technical Information of China (English)

    LIN Haiyan; WANG Hongmei; LI Qinglei; WANG Juan; ZHANG Xuan; LIU Donglin; LIU Huitu; ZHU Cheng

    2003-01-01

    Expression of Smad2 and Smad4 mRNAs in the endometrium of rhesus monkey on Days 8, 20 and 28 of the normal menstrual cycle and on Days 12, 18 and 26 of early pregnancy was detected using in situ hybridization. The results showed that Smad2 and Smad4 mRNAs were mainly localized in luminal epithelium and glandular epithelium. The expression of Smad2 mRNA in glandular epithelium was sustained at moderate level on Days 8, 20 and 28 of the menstrual cycle, while the expression of Smad4 gradually increased with the menstrual cycle. Both Smad2 and Smad4 mRNAs in functionalis glandular epithelium were expressed at the highest levels on Day 12 of early pregnancy, while in basalis glandular epithelium the most abundant expression of both Smads occurred on Days 12 and 18 of pregnancy. On Day 26, both Smads mRNAs were expressed at the lowest levels either in functionalis or in basalis. The data suggest that the epithelium is the major compartment where TGF-βs/activins exert their biological effects via Smads, and that Smad4 may play a role in the maintenance of endometrial gland function during secreting period of the menstrual cycle. During lacunar stage of early pregnancy, Smad2 and Smad4 are implicated in the tissue remodeling of endometrial functionalis and basalis, and during early villous stage both Smads are functional primarily in basalis.

  20. Maternal Exposure to Occupational Asthmagens during Pregnancy and Autism Spectrum Disorder in the Study to Explore Early Development

    Science.gov (United States)

    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

    2016-01-01

    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…

  1. Early warning indicators for monitoring the process failure of anaerobic digestion system of food waste.

    Science.gov (United States)

    Li, Lei; He, Qingming; Wei, Yunmei; He, Qin; Peng, Xuya

    2014-11-01

    To determine reliable state parameters which could be used as early warning indicators of process failure due to the acidification of anaerobic digestion of food waste, three mesophilic anaerobic digesters of food waste with different operation conditions were investigated. Such parameters as gas production, methane content, pH, concentrations of volatile fatty acid (VFA), alkalinity and their combined indicators were evaluated. Results revealed that operation conditions significantly affect the responses of parameters and thus the optimal early warning indicators of each reactor differ from each other. None of the single indicators was universally valid for all the systems. The universally valid indicators should combine several parameters to supply complementary information. A combination of total VFA, the ratio of VFA to total alkalinity (VFA/TA) and the ratio of bicarbonate alkalinity to total alkalinity (BA/TA) can reflect the metabolism of the digesting system and realize rapid and effective early warning.

  2. Early onset of puberty and early ovarian failure in CYP7B1 knockout mice

    OpenAIRE

    Omoto, Yoko; Lathe, Richard; Warner, Margaret; Gustafsson, Jan-Åke

    2005-01-01

    CYP7B1 is the enzyme responsible for hydroxylation and termination of the estrogenic actions of the androgen metabolite, 5α-androstane-3β, 17β-diol (3βAdiol). 3βAdiol is estrogenic in ERα or ERβ positive cells only if they do not express CYP7B1. In this study we show that female CYP7B1–/– mice experience early onset of growth of the uterus and mammary glands and commence estrus cycles 2 days earlier than their wild-type littermates. Adult mammary glands and uteri appear to be under continuous...

  3. Parity and tanned white skin as novel predictors of vitamin D status in early pregnancy

    DEFF Research Database (Denmark)

    Andersen, Lb; Abrahamsen, B; Dalgård, Christine

    2013-01-01

    CONTEXT: In pregnancy, vitamin D insufficiency and deficiency, defined as serum 25-hydroxyvitamin D (25(OH)D)......CONTEXT: In pregnancy, vitamin D insufficiency and deficiency, defined as serum 25-hydroxyvitamin D (25(OH)D)...

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

    Science.gov (United States)

    Do, Nicoline C; Secher, Anna L; Cramon, Per; Ringholm, Lene; Watt, Torquil; Damm, Peter; Mathiesen, Elisabeth R

    2017-02-01

    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. 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. From early to late pregnancy, the SF-36 scales Physical Function, Role Physical, Bodily Pain and Physical Component Summary worsened (p 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. Physical quality of life deteriorated whereas mental quality of life improved slightly during pregnancy in women with pregestational diabetes. A minor reduction in anxiety and stable depression symptoms was observed. The results on mental health are reassuring, considering the great demands that pregnancy places on women with pregestational diabetes. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  5. Prognostic significance of early lactate clearance rate for severe acute respiratory failure patients on extracorporeal membrane oxygenation

    Institute of Scientific and Technical Information of China (English)

    臧芝栋

    2014-01-01

    Objective To investigate the prognostic significanceof early lactate clearance rate for severe acute respiratory failure patients on extracorporeal membrane oxygenation(ECMO).Methods Forty-three patients with severe acute respiratory failure supported by venous-venous(v-v)ECMO were enrolled from January 2007 to January 2013.Arterial blood lactate at pre-ECMO support(0 h)and at

  6. 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...

  7. 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...

  8. 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.

  9. Insuficiência Hepática Aguda da Gravidez Experiência Clínica com Sete Casos Acute Liver Failure of Pregnancy ¾ Clinical Experience with Seven Cases

    Directory of Open Access Journals (Sweden)

    Marcelo Perosa

    2001-04-01

    complications and fetal outcome. Results: the mean age was 25.8 years (two were primigravidas, and the mean gestational age at onset was 30.1 weeks. The final diagnosis was acute fatty liver of pregnancy in four cases and intrahepatic cholestasis of pregnancy in three cases. Anorexia, nausea, abdominal pain, jaundice and encephalopathy were the main clinical findings. Two maternal deaths occurred: one due to hepatic failure, while waiting for transplantation, and another due to hepatic failure associated with coagulopathy and major intra-abdominal bleeding after liver biopsy. One patient with acute fatty liver of pregnancy underwent a successful liver transplantation one year ago (after chronification of her disease. The remaining four cases had complete resolution of the disorders after delivery and supportive measures. Maternal and fetal mortalities were 28.6% and 57.1%, respectively. Conclusion: from this initial experience, we conclude that acute liver failure of pregnancy is a serious disease, with high maternal-fetal mortality, and that early recognition of this illness, referral to tertiary liver centers, and prompt interruption of gestation are, together, very important for the success of the treatment.

  10. 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 (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...... treatment in the prevalence of preterm delivery....

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Effects of Mifepristone Compound on the Receptors of Estrogen and Progesterone in Early Pregnancy Deciduas

    Institute of Scientific and Technical Information of China (English)

    金力; 沈维雄; 孙志达; 范光升; 乌毓明; 王寒正

    2000-01-01

    Objectives To examine the effect of mifepristone compound (mifepristone + anordrin) on estrogen receptor (ER) and progesterone receptor (PR) in early pregnancy decidua.Materials & Methods A Controlled study was carried out among 60 normal early pregnant volunteers ( ≤ 49 d) in the department of obstetric and gynecology of Peking Union Medical Hospital. The concentrations of ER and PR were measured by radioligand and were compared with the control subjects after oral administration of mifepristone or mifepristone compound in different doses.Results The concentration of PR decreased while that of ER increased significantly in the decidua from all subjects administrated with mifepristone compound. We also found the concentration of EcR in Group 5 (mifepristone 30 mg + AF- 53 5 mg) was the highest among 6 groups. The compound may be in favor of estrogen's action on endometrium.Conclusion The results indicate that mi f epristone compound with AF-53 has a coordinated function and can change the proportion of PR and ER. Hence, it can facilitate abortion. The compound dose of mifepristone 30 mg q- AF- 53 5 mg is in favor of the endometrium recovering.

  13. A preliminary report on the toxicity of arecoline on early pregnancy in mice.

    Science.gov (United States)

    Liu, Shao-Tung; Young, Gau-Chyi; Lee, Yi-Chen; Chang, Yung-Fu

    2011-01-01

    Areca nut (Areca catechu) is chewed by roughly 10% of the world population, including India, Taiwan and parts of China. Lower mean birth-weight and higher neonatal jaundice were reported in the babies of betel chewing pregnant women in 1982. Although areca nut chewing during pregnancy has been associated with lower birth weight and premature delivery, the mechanism of such complications is not entirely understood. A possible contributor, arecoline, a major alkaloid in the areca nut, has been reported to be cytotoxic and genotoxic. To determine the influence of arecoline on reproduction, we study the effects of arecoline on embryos during peri-implantation stages in mice. Mice consuming varying dosages of arecoline were checked for their ability to successfully produce viable embryos. In addition, trophoblast outgrowth from mice blastocysts was evaluated the survival status of the embryos. Our investigation revealed that arecoline decreased the number of implanted embryos in early pregnant mice. In addition, trophoblast outgrowth expansion of blastocysts was also inhibited by arecoline. These observations suggest that arecoline is toxic to mouse embryos as early as peri-implantation. Improved understanding of the effects of arecoline during embryogenesis may help to establish public health policies and to develop potential treatments for such patients. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. 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

    2016-03-01

    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.I n 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.

  15. Excess pregnancy weight gain leads to early indications of metabolic syndrome in a swine model of fetal programming.

    Science.gov (United States)

    Arentson-Lantz, Emily J; Buhman, Kimberly K; Ajuwon, Kolapo; Donkin, Shawn S

    2014-03-01

    Few data exist on the impact of maternal weight gain on offspring despite evidence demonstrating that early-life environment precipitates risks for metabolic syndrome. We hypothesized that excessive weight gain during pregnancy results in programming that predisposes offspring to obesity and metabolic syndrome. We further hypothesized that early postweaning nutrition alters the effects of maternal weight gain on indications of metabolic syndrome in offspring. Pregnant sows and their offspring were used for these experiments due to similarities with human digestive physiology, metabolism, and neonatal development. First parity sows fed a high-energy (maternal nutrition high energy [MatHE]) diet gained 12.4 kg (42%) more weight during pregnancy than sows fed a normal energy (maternal nutrition normal energy) diet. Birth weight and litter characteristics did not differ, but offspring MatHE gilts weighed more (P pregnancy. These data indicate that excessive gestational weight gain during pregnancy in a pig model promotes early indications of metabolic syndrome in offspring that are further promoted by a high-energy postweaning diet.

  16. Diagnosis and urgent therapy for acute heart failure in pregnancy%产科急性心衰的诊断和抢救

    Institute of Scientific and Technical Information of China (English)

    林建华; 黄滔滔

    2011-01-01

    Characterized by rapid deterioration and high jeopardy, acute heart failure in pregnancy is one of the dominant reasons resulting in maternal, fetal and neonatal death. Main clinical manifestations of acute left heart failure are acute severe dyspnea, cyanosis, cough, and cough with pink frothy sputum.Main clinical manifestations of acute right heart failure are low-pressure status and cardiac shock. Primary urgent therapies of acute heart failure are removing etiologies and precipitating factors, medications (including digoxin, diuretic and vasodilator), and termination of pregnancy according to gestational weeks and maternal and fetal conditions.%妊娠合并急性心衰是导致孕产妇和围产儿死亡的重要原因之一.急性心衰病情发展快且凶险,以突发极度呼吸困难,口唇紫绀、咳嗽、咳粉红色泡沫痰为主要表现的急性左心衰多见,急性右心衰表现为低血压状态和心源性休克.去除病因和诱因以及强心、利尿、扩血管是主要的抢救手段,根据孕周及母儿情况适时终止妊娠.

  17. Early disruption of pregnancy as a manifestation of seasonal infertility in pigs.

    Science.gov (United States)

    Tast, A; Peltoniemi, O A T; Virolainen, J V; Love, R J

    2002-11-15

    All gilts and sows in production from which the detailed production information was available in a 160-sow unit were included to the study. In winter-spring, there were complete data available from 47 animals and in summer-autumn from 64 animals. The farm had a consistent history of the seasonally reduced farrowing rate in summer-autumn. Success of inseminations was monitored during a 4-month breeding period in winter-spring and in summer-autumn. Each animal was bled twice a week for 6 weeks starting a day before insemination and the blood samples were assayed to determine serum progesterone concentration. The blood samples were also assayed for cortisol to detect any acute infectious response. Starting on day 18, animals were pregnancy tested by transcutaneous real time ultrasound twice a week. In winter-spring, the farrowing rate was 72% (58 inseminations, 1.2 inseminations/sow) and in summer-autumn 63% (81 inseminations, 1.3 inseminations/sow). In winter-spring, there was only one detected case of early disruption of pregnancy (EDP), whereas nine such cases were recognised in summer-autumn. Five out of those nine animals returned to oestrus with a mean insemination to oestrus interval of 25.8+/-1.6 days. One sow returned to oestrus 35 days after insemination and three sows did not return to oestrus within 45 days. However, two of these sows had progesterone profiles that indicated an undetected oestrus around day 25. In those nine animals, no acute phase infectious response as indicated by a rise in serum cortisol was evident. Serum progesterone concentrations in the animals eventually loosing the pregnancy tended to be lower on day 13 (no significant difference) and were significantly lower on day 20 when compared with animals remaining pregnant. There was no difference in serum progesterone levels of pregnant animals between winter-spring and summer-autumn. Litter size was not affected by the season. The weaning to oestrus interval tended to be longer in

  18. Early Pregnancy Factor Enhances the Generation and Function of CD4(+)CD25(+) Regulatory T Cells.

    Science.gov (United States)

    Chen, Quangang; Zhu, Xiaorong; Chen, Renjin; Liu, Jing; Liu, Peng; Hu, Ankang; Wu, Lianlian; Hua, Hui; Yuan, Honghua

    2016-11-01

    The mechanisms of fetal semi-allograft acceptance by the mother's immune system have been the target of many immunological studies. Early pregnancy factor (EPF) is a molecule present in the serum of pregnant mammals soon after conception that has been reported to have immunomodulatory effects. In the present study, we aimed to determine whether immune cells such as CD4(+)CD25(+) regulatory T cells (Tregs) are involved in the suppressive mechanism of EPF. Accordingly, CD4(+)CD25(-) T cells were isolated from spleens of female C57BL/6 mice and stimulated with anti-CD3 antibody, anti-CD28 antibody and IL-2 in the presence or absence of EPF. Flow cytometry was used to analyze the differentiation of CD4(+)CD25(-) T cells to CD4(+)CD25(+) Tregs. We thus found a remarkable rise in the Treg ratio in the EPF-treated cells. Higher mRNA and protein levels of fork head box P3 (Foxp3), a marker of the Treg lineage, were also observed in cells treated with EPF. Furthermore, the effect of EPF on Treg immunosuppressive capacity was evaluated. EPF treatment induced the expression of interleukin-10 and transforming growth factor β1 in Tregs. The suppressive capacity of Tregs was further measured by their capability to inhibit T cell receptor-mediated proliferation of CD4(+)CD25(-) T cells. We thus found that EPF exposure can enhance the immunosuppressive functions of Tregs. Overall, our data suggest that EPF induces the differentiation of Tregs and increases their immunosuppressive activities, which might be an important mechanism to inhibit immune responses during pregnancy.

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

    Institute of Scientific and Technical Information of China (English)

    贺昌海; 王忠兴; 汪嵘卿; 范倩; 桂幼伦; 陈俊康

    1994-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Philippe Le Bouteiller

    2015-02-01

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

  1. Effect of Menstrual Age on Failure of Medical Management in Women With Early Pregnancy Loss.

    Science.gov (United States)

    Lavecchia, Melissa; Abenhaim, Haim A

    2015-07-01

    Objectif : Les femmes qui connaissent une fausse couche précoce et qui présentent un âge gestationnel logistique pour estimer l’effet de l’âge menstruel sur l’échec de la prise en charge médicale (lequel était défini par la nécessité de procéder à une dilatation-curetage [DC] ou d’effectuer un retour imprévu au service des urgences [RISU]). Résultats : Parmi 823 femmes enceintes s’étant présentées au service des urgences en raison de saignements au premier trimestre, 199 ont connu une fausse couche à < 8 semaines (âge gestationnel déterminé par échographie) et ont obtenu leur congé de l’hôpital à la suite de la mise en œuvre d’un traitement au misoprostol. Le risque de DC et de RISU était proportionnel à l’âge menstruel. Plus particulièrement, le risque de DC était de 11,8% à < 8 semaines, de 18,5 % à 8-9 semaines, de 25,3 % à 10-11 semaines et de 30,6 % à ≥ 12 semaines (P < 0,05). Le risque de RISU était de 14,7 % à < 8 semaines, de 27,8 % à 8-9 semaines, de 36,0 % à 10-11 semaines et de 41,7 % à ≥ 12 semaines (P < 0,05). Conclusion : La hausse de l’âge gestationnel (en fonction des dates menstruelles) est associée à une hausse du taux d’échec de la prise en charge médicale chez les femmes qui connaissent une fausse couche précoce, sans égard à l’âge gestationnel estimé par échographie. L’âge gestationnel déterminé en fonction des dates menstruelles devrait être pris en considération au moment de discuter des options de traitement avec les femmes qui connaissent une fausse couche précoce.

  2. Early tibial tray failure of a Duracon knee with retrieval analysis.

    Science.gov (United States)

    Ho, Ta-Feng; Tsai, Ruey-Yug; Lee, Pei-Yuan; Ku, Ming-Chou

    2004-09-01

    We report a case of early tibial tray fracture of a Duracon knee prosthesis. Aside from the clinical, radiographic, and gross analysis of the failed prosthesis, we also performed analysis on the retrieved polyethylene component and the fractured tibial baseplate. In the analyses, we noted significant femoral component malalignment, uneven tray cementation, and inherent metallurgical weakness. It appears that the high compressive load on the medial tray resulted in bending fatigue failure. To avoid this complication, it is important to restore the normal alignment of the knee joint and use a polyethylene insert of higher conformity, at least 6 mm thick.

  3. Can Biomarkers Help to Diagnose Early Heart Failure with Preserved Ejection Fraction?

    Directory of Open Access Journals (Sweden)

    Jaroslav Meluzín

    2015-01-01

    Full Text Available Early heart failure with preserved ejection fraction (HFpEF is a frequent disease, but its diagnosis is difficult and relies mostly on the evidence of left ventricular filling pressure (LVFP elevation during exercise. Several reports have suggested that natriuretic peptides plasma levels reflect exercise-induced increase in LVFP, but they still have significant limitations. In this context, any new laboratory biomarker that can accurately reflect LVFP elevation during exercise is desirable. Recently, cardiotrophin-1, soluble endoglin, ST2, growth differentiation factor 15, galectin-3, and other new laboratory markers associated with LVFP have emerged. However, the current data on the relationship of these biomarkers and diastolic dysfunction are limited to resting conditions. Therefore, their secretion deserves to be tested under the exercise to determine their potential role in making a diagnosis of early HFpEF.

  4. 胎盘早剥合并妊高症的诊疗分析%Analysis of diagnosis and treatment of pregnancy induced hypertension in placental early pregnancy

    Institute of Scientific and Technical Information of China (English)

    王新菊; 王晓丽

    2016-01-01

    目的:分析胎盘早剥合并妊高症的临床诊治措施和治疗效果。方法回顾分析2012年1月至2015年1月期间我院收治的30例胎盘早剥合并妊高症产妇的临床资料,总结产妇的临床诊治措施和治疗效果。结果在本次研究的30例胎盘早剥合并妊高症的患者中,通过常规的治疗和密切监护,30例患者中11例产妇为自然分娩,19例产妇进行剖宫产。其中2例因子宫胎盘卒中而行子宫切除术,2例产妇因胎儿宫内窘迫出现死胎,其余产妇经过治疗后病情得到控制,顺利手术或生产。结论妊高症中最危险的并发症是胎盘早剥,及时有效的治疗措施在胎盘早剥合并妊高症产妇的恢复过程中有着非常重要的作用,临床医师必须做到早发现、早诊断以及早治疗,以使产妇、胎儿转危为安。%Objective to analyze the clinical diagnosis and treatment of placental early pregnancy complicated with pregnancy induced hypertension.Methods the clinical data of 30 cases of early pregnancy associated with pregnancy induced hypertension in our hospital from January 2012 to January 2015 were analyzed retrospectively,and the clinical diagnosis and treatment measures were summarized.Results in this study,30 cases of patients with pregnancy induced hypertension were treated by routine treatment and close monitoring,30 cases of 1 1 cases of ma-ternal natural childbirth,19 cases of maternal cesarean section.Of which 2 cases of uteroplacental apoplexy underwent hysterectomy,2 cases of maternal fetal distress occurred after treatment of maternal fetal death,the disease under control,operation or production.Conclusion the risk of pregnancy induced hypertension in the complications of placental abruption,timely and ef ective measures in the treatment of placental abruption has a very important role in the recovery process with rengaozheng maternal,clinicians must be total =early discovery,early diagnosis and ear-ly

  5. Unmet need for family planning, contraceptive failure, and unintended pregnancy among HIV-infected and HIV-uninfected women in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Sandra I McCoy

    Full Text Available BACKGROUND: Prevention of unintended pregnancies among women living with HIV infection is a strategy recommended by the World Health Organization for prevention of mother-to-child transmission of HIV (PMTCT. We assessed pregnancy intentions and contraceptive use among HIV-positive and HIV-negative women with a recent pregnancy in Zimbabwe. METHODS: We analyzed baseline data from the evaluation of Zimbabwe's Accelerated National PMTCT Program. Eligible women were randomly sampled from the catchment areas of 157 health facilities offering PMTCT services in five provinces. Eligible women were ≥16 years old and mothers of infants (alive or deceased born 9 to 18 months prior to the interview. Participants were interviewed about their HIV status, intendedness of the birth, and contraceptive use. RESULTS: Of 8,797 women, the mean age was 26.7 years, 92.8% were married or had a regular sexual partner, and they had an average of 2.7 lifetime births. Overall, 3,090 (35.1% reported that their births were unintended; of these women, 1,477 (47.8% and 1,613 (52.2% were and were not using a contraceptive method prior to learning that they were pregnant, respectively. Twelve percent of women reported that they were HIV-positive at the time of the survey; women who reported that they were HIV-infected were significantly more likely to report that their pregnancy was unintended compared to women who reported that they were HIV-uninfected (44.9% vs. 33.8%, p<0.01. After adjustment for covariates, among women with unintended births, there was no association between self-reported HIV status and lack of contraception use prior to pregnancy. CONCLUSIONS: Unmet need for family planning and contraceptive failure contribute to unintended pregnancies among women in Zimbabwe. Both HIV-infected and HIV-uninfected women reported unintended pregnancies despite intending to avoid or delay pregnancy, highlighting the need for effective contraceptive methods that align with

  6. The dysfunction of CD4(+CD25(+ regulatory T cells contributes to the abortion of mice caused by Toxoplasma gondii excreted-secreted antigens in early pregnancy.

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    Jin-ling Chen

    Full Text Available Toxoplasma gondii is an opportunistic intracellular parasite that is highly prevalent in human and warm-blooded animals throughout the world, leading to potentially severe congenital infections. Although the abortion caused by T. gondii is believed to be dependent on the timing of maternal infection during pregnancy, the mechanism remains unclear. This study was focused on the effects of T. gondii excreted-secreted antigens on pregnant outcomes and CD4(+CD25(+ Foxp3(+ regulatory T cells at different stages of pregnancy. The results showed that in mice the frequency and suppressive function of CD4(+CD25(+ regulatory cells were diminished after injection of T. gondii excreted-secreted antigens at early and intermediate stages of pregnancy. The abortion caused by T. gondii excreted-secreted antigens at early pregnancy could be partly prevented by adoptively transferring of CD4(+CD25(+ cells from the mice injected with T. gondii excreted-secreted antigens at late pregnancy, but not from the mice with the same treatment at early pregnancy. Furthermore, T. gondii excreted-secreted antigens induced apoptosis of CD4(+CD25(+ regulatory cells of mice in early and intermediate stages of pregnancy by down-regulating their Bcl-2 expressions and Bcl-2/Bax ratio. This study provides new insights into the mechanism that T. gondii infection is the high risk factor for abortion in early pregnancy.

  7. [Early kidney transplant failure and return to peritoneal dialysis: preliminary study of permeability and dialysis efficacy].

    Science.gov (United States)

    Coronel, Francisco; Florit, Enrique; Cigarrán-Guldrís, Secundino; Herrero-Calvo, José A; Delgado-Córdova, Margarita; Rodríguez-Cubillo, Beatriz

    2014-01-01

    The return to dialysis after kidney transplant (TX) failure is increasingly common. On returning to dialysis after TX failure, there is usually a similar or worse clinical situation than in patients who are on haemodialysis or peritoneal dialysis (PD) for the first time. Although there are several studies on the clinical situation of patients who return to PD after long periods with a functioning TX, there is hardly any information on the progression of a patient subgroup returning to PD after TX failure a few days or weeks after transplantation. Assess whether a short period of time on suboptimal TX and aggressive treatment/measures may influence membrane permeability, the clinical situation and dialysis efficacy on returning to PD. In 9 patients (53.5 ± 15.4 years of age, 5 males and 4 females) who had previously been on PD before early TX failure and had returned to PD (25 ± 23 days, range 10-64) over the last five years, we studied laboratory data including inflammation, nutrition, kidney function, permeability and PD efficacy, at four points during progression: before TX, immediately after returning to PD and after one month and three months on PD. We did not detect significant differences in the progression of nutrition and inflammation parameters. Diuresis decreased significantly from pre-TX volume to diuresis on return to PD and after one month on PD (p=.032), remaining at low levels after three months on PD. UF decreased from 1407 to 951 ml/day (p=.022) and from 314 to 260 ml/4h (p=.018) in the peritoneal equilibration test after three months on PD, without changes being observed in the creatinine dialysate/plasma ratio. Kt/V and weekly creatinine clearance decreased slightly and remained at adequate efficacy levels. In this small sample of patients, who returned to PD after early TX failure, it does not appear that the measures involved in managing a graft at risk over a short period of time have a major effect on clinical parameters and permeability or

  8. First trimester maternal serum pregnancy-associated plasma protein-A is a predictive factor for early preterm delivery in normotensive pregnancies.

    Science.gov (United States)

    Dane, Banu; Dane, Cem; Batmaz, Gonca; Ates, Seda; Dansuk, Ramazan

    2013-06-01

    In this study, we investigated whether the concentrations of pregnancy-associated plasma protein-A (PAPP-A) or free β-hCG (fβhCG) in the first trimester can identify women at increased risk of subsequent preterm delivery in the absence of hypertensive disorders. Preterm and early preterm deliveries are defined as those deliveries before completing 37 and 34 weeks, respectively. A total of 868 women were enrolled into this study. According to the level of the markers, the patients were evaluated in three groups: 1 - maternal serum level ≤ 5 th percentile, 2 - between 5th and 95th percentiles, 3 - ≥ 95 th percentile. In the group of patients with a PAPP-A level ≤ 5 th percentile [≤ 0.35 multiples of the median (MoM)], mean gestational age (GA) at delivery, mean birth weight and the number of the cases with early preterm delivery were significantly lower than the others. Mean level of PAPP-A was significantly lower in cases with early preterm than term deliveries (0.58 ± 0.32 versus 1.09 ± 0.69; p = 0.01). Maternal serum level of fβhCG did not show significant difference between these groups (0.84 ± 0.45 versus 1.17 ± 0.77; p = 0.15). Low levels of maternal serum PAPP-A (≤ 0.35 MoM) (Odds ratio = 7; 95% confidence interval 1.8-27.7; p = 0.0048) significantly predicted early preterm delivery in normotensive pregnancies. Women with low levels of PAPP-A at first trimester have a higher risk of early preterm delivery even in the absence of hypertensive disorders.

  9. Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

    Science.gov (United States)

    Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.

    2015-12-01

    Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism

  10. Structural differentiation of human uterine luminal and glandular epithelium during early pregnancy: an ultrastructural and immunohistochemical study.

    Science.gov (United States)

    Demir, R; Kayisli, U A; Celik-Ozenci, C; Korgun, E T; Demir-Weusten, A Y; Arici, A

    2002-01-01

    The differentiation of human endometrial epithelium is a dynamic event that occurs throughout the menstrual cycle and early pregnancy. The structural transformation and differentiation of human uterine luminal and glandular epithelium of early human pregnancy (n=14) was investigated ultrastructurally and immunohistochemically using antibodies against cytokeratin (CT), endothelial marker CD31, Fas, and proliferating cell nuclear antigen (PCNA). Ultrastructurally, luminal epithelial cells showed distinctive euchromatic nuclei with prominent nucleoli and relatively loose cell membranes in all poles (apical to basal). Subcellular components were easily recognized in luminal epithelium except in degenerating cells. Mainly two cell types, dark and clear cells, formed the glandular epithelium. In the early gestation period, microvilli were abundant on the apical and apico-lateral poles of these cells. Only a few cytoplasmic projections were observed in dark cells. Numerous cilia were observed on the apical pole of some clear cells, located at the adluminal segment. In contrast, dark cells lacked cilia, nuclear channels, or giant mitochondrial profiles. Glycogen synthesis and apocrine secretion were recognizable for several days during early gestation. The apocrine secretory activity differed among dark cells of the glandular epithelium. The immunoreactivity of PCNA and Fas, and ultrastructural observations in the glandular epithelium suggest that, even in different segments of the same gland, epithelial cells do not regress during early gestation, but proliferate, perhaps representing a resistance against trophoblastic invasion. These morphological and molecular changes suggest that both luminal and glandular epithelium may play an important role in cellular defense and limitation for trophoblastic invasion during early pregnancy since plasma membrane alterations of the surface epithelium take place at the apical, basal and lateral poles compared to early secretory phase

  11. A Study of Changes in Uterine Leucocytes During Early Pregnancy in the Mouse-vole Interspesific Pregnancies

    Institute of Scientific and Technical Information of China (English)

    Diah Tri Widayati; Tatsuya Tada; Naoko Inoue

    2008-01-01

    Mouse and vole embryos were allogeneically and xenogeneically transferred into pseudopregnant CD.1 and immunodeficient (seid)female mice,and we investigated the distribution of uterine leucocytes cells in the implantation sites on days 5,6,and 7 of pregnancy. Maerophages were evenly distributed in the endometrium on days 5-7.Neutrophils were rarely seen on days 5-7,but lymphocytes were found throughout the endometrium,often in groups associated with glands or the luminal epithelium.The number of uNK cells increased markedly at the mesometrial uriangle and the outer decidual area in the CD-1 uteri containing vole embryos;by contrast,seid uteri having vole embryos showed almost the same number as those having mouse embryos.Mast cells were present in large numbers at the myometrium,but rarely in the decidua in all types of pregnant uteri.Cells at the myometrium were more numerous in xenogeneic than in allogeneic transfer.Maay mast cells appeared in the inner decidua where xenogeneically transferred vole embryos were dead and aborted.These results suggest the possibility that uterine leucocytes mediate various immunological events in the mouse-vole interspesific pregnancies.

  12. Detection of Taenia solium taeniasis coproantigen is an early indicator of treatment failure for taeniasis.

    Science.gov (United States)

    Bustos, Javier A; Rodriguez, Silvia; Jimenez, Juan A; Moyano, Luz M; Castillo, Yesenia; Ayvar, Viterbo; Allan, James C; Craig, Philip S; Gonzalez, Armando E; Gilman, Robert H; Tsang, Victor C W; Garcia, Hector H

    2012-04-01

    Taenia solium causes taeniasis and cysticercosis, a zoonotic complex associated with a significant burden of epilepsy in most countries. Reliable diagnosis and efficacious treatment of taeniasis are needed for disease control. Currently, cure can be confirmed only after a period of at least 1 month, by negative stool microscopy. This study assessed the performance of detection by a coproantigen enzyme-linked immunosorbent assay (CoAg-ELISA) for the early evaluation of the efficacy of antiparasitic treatment of human T. solium taeniasis. We followed 69 tapeworm carriers who received niclosamide as standard treatment. Stool samples were collected on days 1, 3, 7, 15, 30, and 90 after treatment and were processed by microscopy and CoAg-ELISA. The efficacy of niclosamide was 77.9% (53/68). Thirteen patients received a second course of treatment and completed the follow-up. CoAg-ELISA was therefore evaluated for a total of 81 cases (68 treatments, 13 retreatments). In successful treatments (n = 64), the proportion of patients who became negative by CoAg-ELISA was 62.5% after 3 days, 89.1% after 7 days, 96.9% after 15 days, and 100% after 30 days. In treatment failures (n = 17), the CoAg-ELISA result was positive for 70.6% of patients after 3 days, 94.1% after 7 days, and 100% after 15 and 30 days. Only 2 of 17 samples in cases of treatment failure became positive by microscopy by day 30. The presence of one scolex, but not multiple scolices, in posttreatment stools was strongly associated with cure (odds ratio [OR], 52.5; P taeniasis. Early assessment at day 15 would detect treatment failure before patients become infective.

  13. A mouse model of early-onset renal failure due to a xanthine dehydrogenase nonsense mutation.

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    Sian E Piret

    Full Text Available Chronic kidney disease (CKD is characterized by renal fibrosis that can lead to end-stage renal failure, and studies have supported a strong genetic influence on the risk of developing CKD. However, investigations of the underlying molecular mechanisms are hampered by the lack of suitable hereditary models in animals. We therefore sought to establish hereditary mouse models for CKD and renal fibrosis by investigating mice treated with the chemical mutagen N-ethyl-N-nitrosourea, and identified a mouse with autosomal recessive renal failure, designated RENF. Three-week old RENF mice were smaller than their littermates, whereas at birth they had been of similar size. RENF mice, at 4-weeks of age, had elevated concentrations of plasma urea and creatinine, indicating renal failure, which was associated with small and irregularly shaped kidneys. Genetic studies using DNA from 10 affected mice and 91 single nucleotide polymorphisms mapped the Renf locus to a 5.8 Mbp region on chromosome 17E1.3. DNA sequencing of the xanthine dehydrogenase (Xdh gene revealed a nonsense mutation at codon 26 that co-segregated with affected RENF mice. The Xdh mutation resulted in loss of hepatic XDH and renal Cyclooxygenase-2 (COX-2 expression. XDH mutations in man cause xanthinuria with undetectable plasma uric acid levels and three RENF mice had plasma uric acid levels below the limit of detection. Histological analysis of RENF kidney sections revealed abnormal arrangement of glomeruli, intratubular casts, cellular infiltration in the interstitial space, and interstitial fibrosis. TUNEL analysis of RENF kidney sections showed extensive apoptosis predominantly affecting the tubules. Thus, we have established a mouse model for autosomal recessive early-onset renal failure due to a nonsense mutation in Xdh that is a model for xanthinuria in man. This mouse model could help to increase our understanding of the molecular mechanisms associated with renal fibrosis and the

  14. Inversion Method for Early Detection of ARES-1 Case Breach Failure

    Science.gov (United States)

    Mackey, Ryan M.; Kulikov, Igor K.; Bajwa, Anupa; Berg, Peter; Smelyanskiy, Vadim

    2010-01-01

    A document describes research into the problem of detecting a case breach formation at an early stage of a rocket flight. An inversion algorithm for case breach allocation is proposed and analyzed. It is shown how the case breach can be allocated at an early stage of its development by using the rocket sensor data and the output data from the control block of the rocket navigation system. The results are simulated with MATLAB/Simulink software. The efficiency of an inversion algorithm for a case breach location is discussed. The research was devoted to the analysis of the ARES-l flight during the first 120 seconds after the launch and early prediction of case breach failure. During this time, the rocket is propelled by its first-stage Solid Rocket Booster (SRB). If a breach appears in SRB case, the gases escaping through it will produce the (side) thrust directed perpendicular to the rocket axis. The side thrust creates torque influencing the rocket attitude. The ARES-l control system will compensate for the side thrust until it reaches some critical value, after which the flight will be uncontrollable. The objective of this work was to obtain the start time of case breach development and its location using the rocket inertial navigation sensors and GNC data. The algorithm was effective for the detection and location of a breach in an SRB field joint at an early stage of its development.

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

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    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.

  16. 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.

  17. 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.

  18. The role of eating disorders for pregnancy, neonatal outcome and the child's early development

    OpenAIRE

    Koubaa, Saloua

    2013-01-01

    Little is known about the impact of eating disorders (ED) on pregnancy, infant growth and cognitive development. Preliminary reports indicate increased complications during pregnancy and lower birth weight in children of mothers with ED. There is need of prospective long-term follow-up of growth and cognitive development of the children of these mothers. Aims: To study the impact of ED on pregnancy and neonatal outcomes, maternal adjustment, and infant growth and cognitive development c...

  19. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

    2009-01-01

    score after detection of an intrauterine haematoma, the risk of VPTD and intrauterine growth restriction after a crown-rump length discrepancy, the risk of VPTD, LBW and VLBW after a vanishing twin phenomenon and the risk of PTD, LBW and low 5-min Apgar score in a pregnancy complicated by severe...... pregnancy with an OR > 2.0 after complications in the index pregnancy are the risk of LBW and very low birthweight (VLBW) after a threatened miscarriage, the risk of pregnancy-induced hypertension, pre-eclampsia, placental abruption, preterm delivery (PTD), small for gestational age and low 5-min Apgar...

  20. Impact of oxidative stress during pregnancy on fetal epigenetic patterns and early origin of vascular diseases.

    Science.gov (United States)

    Ávila, Jose Guillermo Ortega; Echeverri, Isabella; de Plata, Cecilia Aguilar; Castillo, Andrés

    2015-01-01

    Epidemiological studies have led scientists to postulate the developmental origins of health and disease hypothesis for noncommunicable diseases such as diabetes, cardiovascular diseases, hypertension, and obesity. However, the cellular and molecular mechanisms involved in the development of these diseases are not well understood. In various animal models, it has been observed that oxidative stress during pregnancy is associated with the early development of endothelial dysfunction in offspring. This phenomenon suggests that endothelial dysfunction may initiate in the uterus and could lead to increased risk of cardiovascular disease later in life. Currently, it is known that many of the fetal adaptive responses to environmental factors are mediated by epigenetic changes in the genome, especially by the degree of methylation in cytosines in the promoter regions of genes. These findings suggest that the establishment of a particular epigenetic pattern in the genome may be generated by oxidative stress. © The Author(s) 2014. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Obesity prevalence in a cohort of women in early pregnancy from a neighbourhood perspective

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    Alricsson Marie

    2009-08-01

    Full Text Available Abstract Background The evidence of an association between neighbourhood deprivation and overweight is established for different populations. However no previous studies on neighbourhood variations in obesity in pregnant women were found. In this study we aimed to determine whether obesity during early pregnancy varied by neighbourhood economic status. Methods A register based study on 94,323 primiparous pregnant women in 586 Swedish neighbourhoods during the years 1992–2001. Multilevel technique was used to regress obesity prevalence on socioeconomic individual-level variables and the neighbourhood economic status. Five hundred and eighty-six neighbourhoods in the three major cities of Sweden, Stockholm, Göteborg and Malmö, during 1992–2001, were included. The majority of neighbourhoods had a population of 4 000–10 000 inhabitants. Results Seven per cent of the variation in obesity prevalence was at the neighbourhood level and the odds of being obese were almost doubled in poor areas. Conclusion Our findings supports a community approach in the prevention of obesity in general and thus also in pregnant women.

  2. EFFECT OF EARLY PREGNANCY BODY MASS INDEX ON PREGNANCY OUTCOMES IN WOMEN DELIVERING SINGLETON BABIES- AN OBSERVATIONAL STUDY

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    Divya Vishnu

    2017-02-01

    Full Text Available BACKGROUND Maternal overweight/obesity causes many complications during pregnancy and delivery. It can also increase neonatal and infant morbidity and mortality. BMI is an important measure of under/overweight. This observational study examines the correlation between maternal Body Mass Index (BMI with maternal outcome in women. MATERIALS AND METHODS This study was conducted at Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, Kerala, for a period of one year. A sample of 300 pregnant women with intrauterine pregnancy of gestational age <12 weeks at first visit was taken for this study with an age between 18 and 35 years with singleton pregnancy. BMI of these women were calculated and they were classified into two categories (BMI <23 kg/m2 and BMI ≥23 kg/m2 . The Chi-square test was done to find the association of BMI and various maternal outcomes. RESULTS In the sample of 300 pregnant women, 39% were having BMI <23 kg/m2 and 61% were having BMI ≥23 kg/m2 . Pregnant women with BMI ≥23 kg/m2 were found to have significantly increased risk of developing gestational hypertension, gestational diabetes and macrosomia. We found that a significantly increased need of induction and increased risk of developing intrapartum and postpartum complications in those with BMI ≥23 kg/m2 . Our study also found out that an increased incidence of elective as well as emergency caesareans and increased risk of neonatal complications in women whose BMI ≥23 kg/m2 . CONCLUSION Adverse maternal and perinatal outcomes are significantly related to extremes of BMI categories and least complications were seen in normal BMI group. Therefore, it is ideal to reduce the body weight to an optimal level so that the complications, which are attributed to overweight and obesity can be reduced. We recommended future research on the association of BMI and maternal outcomes involving large samples comparable to those done in developed countries.

  3. A step-by-step diagnosis of exclusion in a twin pregnancy with acute respiratory failure due to non-fatal amniotic fluid embolism: a case report

    Directory of Open Access Journals (Sweden)

    Papaioannou Vasilios E

    2008-05-01

    Full Text Available Abstract Introduction Respiratory failure may develop during the later stages of pregnancy and is usually associated with tocolysis or other co-existing conditions such as pneumonia, sepsis, pre-eclampsia or amniotic fluid embolism syndrome. Case presentation We present the case of a 34-year-old healthy woman with a twin pregnancy at 31 weeks and 6 days who experienced acute respiratory failure, a few hours after administration of tocolysis (ritodrine, due to preterm premature rupture of the membranes. Her chest discomfort was significantly ameliorated after the ritodrine infusion was stopped and a Cesarean section was performed 48 hours later under spinal anesthesia; however, 2 hours after surgery she developed severe hypoxemia, hypotension, fever and mild coagulopathy. The patient was intubated and transferred to the intensive care unit where she made a quick and uneventful recovery within 3 days. As there was no evidence for drug- or infection-related thromboembolic or myocardial causes of respiratory failure, we conclude that our patient experienced a rare type of non-fatal amniotic fluid embolism. Conclusion In spite of the lack of solid scientific support for our diagnosis, we conclude that our patient suffered an uncommon type of amniotic fluid embolism syndrome and we believe that this report highlights the need for extreme vigilance and a high index of suspicion for such a diagnosis in any pregnant individual.

  4. 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.

  5. Synergistic effects of DL111-IT in combination with mifepristone and misoprostol on termination of early pregnancy in preclinical studies.

    Science.gov (United States)

    He, Qiao-jun; Yang, Bo; Wang, Wei-fang; Wu, Hong-Hai; Fang, Rui-ying

    2003-10-01

    This study evaluated the effectiveness and acute toxicity of DL111-IT combined with mifepristone (RU486) and misoprostol (MISO) on early pregnancy termination. In the pregnant rats experiments, the ED(50) values of RU486 in two-drug combinations were 0.16 (combined with DL111-IT) and 0.40 (combined with MISO) mg x kg(-1) x d(-1), while in three-drug combination treatment group (DL111-IT 9.0 mg x kg(-1) (toxicity, the LD(50) values and 95% confidence limit of DL111-IT (i.p.) alone and in combination with RU486 and MISO were 1379.4 (1278.2-1514.7) mg x kg(-1) and 1574.1 (1407.8-1762.7) mg x kg(-1), respectively. There was no significant difference. All data suggested that DL111-IT in combination with RU486 and MISO significantly increased the effect on early pregnancy termination without increasing acute toxicity compared to the treatment of DL111-IT alone, and this combination may be a promising regimen for early pregnancy termination.

  6. Heat shock protein 70 acts as a potential biomarker for early diagnosis of heart failure.

    Science.gov (United States)

    Li, Zongshi; Song, Yao; Xing, Rui; Yu, Haiyi; Zhang, Youyi; Li, Zijian; Gao, Wei

    2013-01-01

    Early identification for heart failure (HF) may be useful for disease modifying treatment in order to reduce heart disease progression or even to reverse it. In our previous studies, we have revealed a group of heat shock proteins (HSPs) which might be related to neonatal rat cardiomyocyte hypertrophy by proteomic approach. Here, we confirm that HSPs, including HSP27 and HSP70, altered in the early stage of cardiac remodeling in vivo animal model. Furthermore, plasma concentrations of those HSPs and their potential screening value were evaluated at different stages in 222 patient subjects. Plasma HSP27, HSP70 and HSP90 were measured using enzyme-linked immunosorbent assay. Results indicate that HSP70 was positively correlated to the severity (progression) of HF (r = 0.456, p<0.001). The area under the rate of change (ROC) curve was 0.601 (p = 0.017) in patients with stage B HF and 0.835 (p<0.001) in those with stage C HF. However, HSP27 and HSP90 did not display significant changes in any stage of HF in this study. Taken together, plasma concentrations of HSP70 elevated with the progression of HF and might act as a potential screening biomarker for early diagnosis of HF.

  7. Effects of clomiphene citrate on early pregnancy in guinea-pigs.

    Science.gov (United States)

    Motta, C M; Hutchinson, J S

    1991-05-01

    Clomiphene citrate (2 mg/kg body wt) given on the day of mating can block or interrupt pregnancy in guinea-pigs. Corpus luteum function, uterine histology, implantation and embryo development were studied in clomiphene-treated and control animals on Days 5, 9 and 20 of pregnancy. Following treatment, only 25% of the females were regularly pregnant, presenting large and healthy foetuses. The other females examined showed either pregnancy with embryos undergoing resorption or no sign of pregnancy. In these females, corpus luteum size was reduced, progesterone concentrations were very low and the endometrial glands and the epithelium were often altered. It is concluded that clomiphene causes a reduction in fertility by altering the uterus and, by directly or indirectly inducing luteolysis, causes later pregnancy loss.

  8.  The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Hala Abdul Qadir Al-Moayed

    2012-03-01

    Full Text Available  Objective: To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P,ß-HCG, and estradiol (E2 in the early diagnosis of ectopic pregnancy.Methods: Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011.Results: The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively. When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7�20specificity 100�20the positive predictive value was100�0and the negative predictive value 71.4�onclusion: The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

  9. Early Expression of Pregnancy-Specific Glycoprotein 22 (PSG22) by Trophoblast Cells Modulates Angiogenesis in Mice1

    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.

    2012-01-01

    ABSTRACT 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. PMID:22423048

  10. T-HELPER 1 CYTOKINES INCREASE DURING EARLY PREGNANCY IN WOMEN WITH A HISTORY OF RECURRENT SPONTANEOUS ABORTION

    Directory of Open Access Journals (Sweden)

    A. Rezaei A. Dabbagh

    2000-08-01

    Full Text Available The measurment of various cytokines may provide a different tool for evaluation of the immune system. Recent investigations have shown that the number and function of peripheral natural killer cells (NK- cells increase during early pregnancy in women with a history of unexplained recurrent spontaneous abortions (RSA. NK-cells activity may be responsible for some cases of RSA. The objective of this study was to assess the role of the Thl cytokines (IL-2, IFN-y, TNF-a ; TNF-/0 in this phenomenon, and detection of Thl cytokines in women with RSA. The control group consisted of 40 women with no history of pregnancy loss and complication. The abortion group comprised of 92 women having at least 3 pregnancy losses. Blood from the control group and women with RSA was taken at the end of first trimester of gestational age and at the time of abortion, respectively. Sera were separated and peripheral blood lymphocytes were challenged with PHA using RPMI medium. All samples were tested for concentration of Thl cytokines using ELISA methods. It was considered that sera from women with RSA produced higher concentration of TNF-«, TNF-/? , and IL-2 in comparison with sera from normal pregnant women (NPW (P<0.001. We were not able to detect IL-2 in (NPW whereas in 31% sera from RSA group, IL-2 was detectable (P<0.001. However, there was no significant difference between IFN-y, concentration in sera from patients and control group (P<0.182. Tissue culture supernatant from women with RSA also produced higher concentration of TNF-a. IFN-y, TNF-/* and IL2, than control group. These data may explain the increase NK-cells cytotoxicity during early pregnancy in women with a history of RSA. It may also provide a diagnostic tool to predict the outcome of pregnancy.

  11. Co-detection of acoustic emissions during failure of heterogeneous media: new perspectives for natural hazard early warning

    CERN Document Server

    Faillettaz, J; Reiweger, I

    2015-01-01

    A promising method for real time early warning of gravity driven rupture that considers both the heterogeneity of natural media and characteristics of acoustic emissions attenuation is proposed. The method capitalizes on co-detection of elastic waves emanating from micro-cracks by multiple and spatially separated sensors. Event co-detection is considered as surrogate for large event size with more frequent co-detected events marking imminence of catastrophic failure. Using a spatially explicit fiber bundle numerical model with spatially correlated mechanical strength and two load redistribution rules, we constructed a range of mechanical failure scenarios and associated failure events (mapped into AE) in space and time. Analysis considering hypothetical arrays of sensors and consideration of signal attenuation demonstrate the potential of the co-detection principles even for insensitive sensors to provide early warning for imminent global failure.

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

    National Research Council Canada - National Science Library

    Falgreen Eriksen, H‐L; Mortensen, EL; Kilburn, T; Underbjerg, M; Bertrand, J; Støvring, H; Wimberley, T; Grove, J; Kesmodel, US

    2012-01-01

    ..., 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...

  13. Aspirin and Statin Nonuse Associated With Early Biochemical Failure After Prostate Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zaorsky, Nicholas G. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Buyyounouski, Mark K., E-mail: mark.buyyounouski@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Li, Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Horwitz, Eric M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2012-09-01

    Purpose: To present the largest retrospective series investigating the effect of aspirin and statins, which are hypothesized to have antineoplastic properties, on biochemical failure (nadir plus 2 ng/mL) after prostate radiation therapy (RT). Methods and Materials: Between 1989 and 2006, 2051 men with clinically localized prostate cancer received definitive RT alone (median dose, 76 Gy). The rates of aspirin use and statin use (defined as any use at the time of RT or during follow-up) were 36% and 34%, respectively. The primary endpoint of the study was an interval to biochemical failure (IBF) of less than 18 months, which has been shown to be the single strongest predictor of distant metastasis, prostate cancer survival, and overall survival after RT. Patient demographic characteristics and tumor staging factors were assessed with regard to associations with the endpoint. Univariate analysis was performed with the {chi}{sup 2} test for categorical variables and the Wilcoxon test for continuous variables. Multivariable analysis was performed with a multiple logistic regression. Results: The median follow-up was 75 months. Univariate analysis showed that an IBF of less than 18 months was associated with aspirin nonuse (P<.0001), statin nonuse (P<.0001), anticoagulant nonuse (P=.0006), cardiovascular disease (P=.0008), and prostate-specific antigen (continuous) (P=.008) but not with Gleason score, age, RT dose, or T stage. On multivariate analysis, only aspirin nonuse (P=.0012; odds ratio, 2.052 [95% confidence interval, 1.328-3.172]) and statin nonuse (P=.0002; odds ratio, 2.465 [95% confidence interval, 1.529-3.974]) were associated with an IBF of less than 18 months. Conclusions: In patients who received RT for prostate cancer, aspirin or statin nonuse was associated with early biochemical failure, a harbinger of distant metastasis and death. Further study is needed to confirm these findings and to determine the optimal dosing and schedule, as well as the relative

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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…

  16. Keishibukuryogan Reduces Renal Injury in the Early Stage of Renal Failure in the Remnant Kidney Model

    Directory of Open Access Journals (Sweden)

    Takako Nakagawa

    2011-01-01

    Full Text Available The effects of keishibukuryogan on the early stage of progressive renal failure were examined in rats subjected to 5/6 nephrectomy. Keishibukuryogan, one of the traditional herbal formulations, was given orally at a dose of 1% (w/w and 3% (w/w in chow. Administration of keishibukuryogan was started at 1 week after 5/6 nephrectomy and was continued for 4 weeks. At the end of the experiment, Azan staining did not reveal any severe histological changes in the kidneys of the nephrectomized rats. On the other hand, significant increases in mRNA expressions of transforming growth factor-β1 and fibronectin related to tissue fibrosis, as examined by Reverse Transcriptase-Polymerase Chain Reaction, were observed in nephrectomized rats, and they were significantly suppressed by 3% keishibukuryogan treatment. Against gene expressions related to macrophage infiltration, 3% keishibukuryogan treatment significantly suppressed osteopontin mRNA levels, and monocyte chemoattractant protein-1 and vascular cell adhesion molecule-1 mRNA levels showed a tendency to decrease, but without statistical significance. It was also observed that 3% keishibukuryogan attenuated serum urea nitrogen and urinary protein excretion levels. From these results, it was suggested that keishibukuryogan exerts beneficial effects that result in slowing the progression of chronic renal failure.

  17. Early renal failure after domino liver transplantation using organs from donors with primary hyperoxaluria type 1.

    Science.gov (United States)

    Saner, Fuat H; Treckmann, Juergen; Pratschke, Johann; Arbogast, Helmut; Rahmel, Axel; Vester, Udo; Paul, Andreas

    2010-10-15

    Organ shortage is responsible for high mortality rates of patients awaiting liver transplantation (LT). Domino transplantation has had reported success in patients with metabolic disorders. Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder. There are a few case reports that suggest that PH1 livers originating from donors that have undergone combined liver-kidney transplantation can be successfully used for domino transplantation. In the last decade, five patients received a domino liver transplant from patients with PH1 in the EUROTRANSPLANT region. In this study, we report the clinical course and outcome of these five patients who were received a domino graft transplant. All patients, with the exception of one, suffered from multifocal hepatocellular carcinoma and underwent domino LT from patients undergoing combined liver-kidney transplantation for PH1. Within the first 4 weeks, all the domino recipients developed dialysis-dependent kidney failure despite good liver function. Four of the five patients died. The only survivor underwent retransplantation due to hepatic artery thrombosis. Twenty months after transplantation, this patient is doing well and has had no recurrence of hepatocellular carcinoma. Domino LT using donors with PH1 results in early renal failure and cannot be recommended for transplantation unless preventive strategies have been identified.

  18. Renin-Angiotensin Activation and Oxidative Stress in Early Heart Failure with Preserved Ejection Fraction

    Directory of Open Access Journals (Sweden)

    Smita I. Negi

    2015-01-01

    Full Text Available Animal models have suggested a role of renin-angiotensin system (RAS activation and subsequent cardiac oxidation in heart failure with preserved ejection fraction (HFpEF. Nevertheless, RAS blockade has failed to show efficacy in treatment of HFpEF. We evaluated the role of RAS activation and subsequent systemic oxidation in HFpEF. Oxidative stress markers were compared in 50 subjects with and without early HFpEF. Derivatives of reactive oxidative metabolites (DROMs, F2-isoprostanes (IsoPs, and ratios of oxidized to reduced glutathione (Eh GSH and cysteine (Eh CyS were measured. Angiotensin converting enzyme (ACE levels and activity were measured. On univariate analysis, HFpEF was associated with male sex (p=0.04, higher body mass index (BMI (p=0.003, less oxidized Eh CyS (p=0.001, lower DROMs (p=0.02, and lower IsoP (p=0.03. Higher BMI (OR: 1.3; 95% CI: 1.1–1.6 and less oxidized Eh CyS (OR: 1.2; 95% CI: 1.1–1.4 maintained associations with HFpEF on multivariate analysis. Though ACE levels were higher in early HFpEF (OR: 1.09; 95% CI: 1.01–1.05, ACE activity was similar to that in controls. HFpEF is not associated with significant systemic RAS activation or oxidative stress. This may explain the failure of RAS inhibitors to alter outcomes in HFpEF.

  19. Selective Uterine Artery Embolization for Management of Interstitial Ectopic Pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Lee, Sang Jin; Joe, Hwan Sung; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University Gumi Hospital, Gumi (Korea, Republic of); Kim, Dong Hun [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-04-15

    Interstitial pregnancy is defined as any gestation that develops in the uterine portion of the fallopian tubes lateral to the round ligament. Interstitial pregnancies account for 2-4% of all ectopic pregnancies and have been reported to have an associated 2% to 2.5% maternal mortality rate. The traditional treatment for interstitial pregnancy using surgical cornual resection may cause infertility or uterine rupture in subsequent pregnancies. Recently, the early identification of intact interstitial pregnancy has been made possible in many cases with high resolution transvaginal ultrasound as well as more sensitive assays for betahuman chorionic gonadotropin ({beta}-hCG). The treatment includes: hysteroscopic transcervical currettage, local and systemic methotrexate (MTX) therapy and prostaglandin or potassium chloride injection of the ectopic mass under sonographic guidance. We describe a case of successful treatment of interstitial pregnancy using uterine artery embolization, after failure of methotrexate treatment.

  20. Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast.

    Science.gov (United States)

    Wurtz, Nathalie; Pascual, Aurélie; Marin-Jauffre, Adeline; Bouchiba, Housem; Benoit, Nicolas; Desbordes, Marc; Martelloni, Maryse; Pommier de Santi, Vincent; Richa, Georges; Taudon, Nicolas; Pradines, Bruno; Briolant, Sébastien

    2012-05-02

    The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone-proguanil (Malarone®) has shown high efficacy against Plasmodium falciparum with only mild side-effects. Treatment failures have been attributed to suboptimal dosages or to parasite resistance resulting from a point mutation in the cytochrome b gene. In this paper, a case of early treatment failure was reported in a patient treated with atovaquone-proguanil; this failure was not associated with a mutation in the parasite cytochrome b gene, with impaired drug bioavailability, or with re-infection.

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

    Science.gov (United States)

    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.

  2. Chronic exposure to bisphenol a impairs progesterone receptor-mediated signaling in the uterus during early pregnancy

    Science.gov (United States)

    Li, Quanxi; Davila, Juanmahel; Bagchi, Milan K.; Bagchi, Indrani C.

    2016-01-01

    Environmental and occupational exposure to endocrine disrupting chemicals (EDCs) is a major threat to female reproductive health. Bisphenol A (BPA), an environmental toxicant that is commonly found in polycarbonate plastics and epoxy resins, has received much attention due to its estrogenic activity and high risk of chronic exposure in human. Whereas BPA has been linked to infertility and recurrent miscarriage in women, the impact of its exposure on uterine function during early pregnancy remains unclear. In a recent publication in Endocrinology, we demonstrated that prolonged exposure to an environmental relevant dose of BPA disrupts progesterone receptor-regulated uterine functions, thus affecting uterine receptivity for embryo implantation and decidua morphogenesis, two critical events for establishment and maintenance of early pregnancy. In particular we reported a marked impairment of progesterone receptor (PGR) expression and its downstream effector HAND2 in the uterine stromal cells in response to chronic BPA exposure. In an earlier study we have shown that HAND2 controls embryo implantation by repressing fibroblast growth factor (FGF) expression and the MAP kinase signaling pathway, thus inhibiting epithelial proliferation. Interestingly we observed that downregulation of PGR and HAND2 expression in uterine stroma upon BPA exposure was associated with an enhanced activation of FGFR and MAPK signaling, aberrant proliferation, and lack of uterine receptivity in the epithelium. In addition, the proliferation and differentiation of endometrial stromal cells to decidual cells, an event critical for the maintenance of early pregnancy, was severely compromised in response to BPA. This research highlight will provide an overview of our findings and discuss the potential mechanisms by which chronic BPA impairs PGR-HAND2 pathway and adversely affects implantation and the establishment of pregnancy.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  5. Urinary Phthalate Metabolites and Biomarkers of Oxidative Stress in a Mexican-American Cohort: Variability in Early and Late Pregnancy

    Directory of Open Access Journals (Sweden)

    Nina Holland

    2016-03-01

    Full Text Available People are exposed to phthalates through their wide use as plasticizers and in personal care products. Many phthalates are endocrine disruptors and have been associated with adverse health outcomes. However, knowledge gaps exist in understanding the molecular mechanisms associated with the effects of exposure in early and late pregnancy. In this study, we examined the relationship of eleven urinary phthalate metabolites with isoprostane, an established marker of oxidative stress, among pregnant Mexican-American women from an agricultural cohort. Isoprostane levels were on average 20% higher at 26 weeks than at 13 weeks of pregnancy. Urinary phthalate metabolite concentrations suggested relatively consistent phthalate exposures over pregnancy. The relationship between phthalate metabolite concentrations and isoprostane levels was significant for the sum of di-2-ethylhexyl phthalate and the sum of high molecular weight metabolites with the exception of monobenzyl phthalate, which was not associated with oxidative stress at either time point. In contrast, low molecular weight metabolite concentrations were not associated with isoprostane at 13 weeks, but this relationship became stronger later in pregnancy (p-value = 0.009 for the sum of low molecular weight metabolites. Our findings suggest that prenatal exposure to phthalates may influence oxidative stress, which is consistent with their relationship with obesity and other adverse health outcomes.

  6. Osteopontin is expressed in the mouse uterus during early pregnancy and promotes mouse blastocyst attachment and invasion in vitro.

    Directory of Open Access Journals (Sweden)

    Qian-Rong Qi

    Full Text Available Embryo implantation into the maternal uterus is a decisive step for successful mammalian pregnancy. Osteopontin (OPN is a member of the small integrin-binding ligand N-linked glycoprotein family and participates in cell adhesion and invasion. In this study, we showed that Opn mRNA levels are up-regulated in the mouse uterus on day 4 and at the implantation sites on days 5 and 8 of pregnancy. Immunohistochemistry localized the OPN protein to the glandular epithelium on day 4 and to the decidual zone on day 8 of pregnancy. OPN mRNA and proteins are induced by in vivo and in vitro decidualization. OPN expression in the endometrial stromal cells is regulated by progesterone, a key regulator during decidualization. As a secreted protein, the protein level of OPN in the uterine cavity is enriched on day 4, and in vitro embryo culturing has indicated that OPN can facilitate blastocyst hatching and adhesion. Knockdown of OPN attenuates the adhesion and invasion of blastocysts in mouse endometrial stromal cells by suppressing the expression and enzymatic activity of matrix metalloproteinase-9 in the trophoblast. Our data indicated that OPN expression in the mouse uterus during early pregnancy is essential for blastocyst hatching and adhesion and that the knockdown of OPN in mouse endometrial stroma cells could lead to a restrained in vitro trophoblast invasion.

  7. Low expression of soluble human leukocyte antigen G in early gestation and subsequent placenta-mediated complications of pregnancy.

    Science.gov (United States)

    Marozio, Luca; Garofalo, Anna; Berchialla, Paola; Tavella, Anna Maria; Salton, Loredana; Cavallo, Franco; Benedetto, Chiara

    2017-07-10

    Abnormal placentation is a common pathogenic mechanism of many placenta-mediated complications of late pregnancy, including pre-eclampsia, fetal growth restriction, stillbirth, and placental abruption. During successful placentation, the trophoblast (which is a semi-allograft) is not rejected by decidual immune cells because of maternal immune tolerance, mainly induced by human leukocyte antigen G (HLA-G). Deficient HLA-G expression seems to be associated with the development of complications of pregnancy. The aim of this study was to determine whether low soluble HLA-G (sHLA-G) levels in maternal blood at the beginning of pregnancy may be associated with subsequent placenta-mediated complications. For this retrospective case-control study, 117 cases of placenta-mediated complications of pregnancy and 234 controls with uneventful pregnancy were selected. Plasma sHLA-G levels were measured at 11-13 weeks' gestation by the enzyme-linked immunosorbent assay method in blood samples previously obtained at first-trimester prenatal screening for chromosomal fetal abnormalities. Women who subsequently developed placenta-mediated complications had significantly lower sHLA-G levels at the beginning of pregnancy (median, 43.08 IU/mL) than controls (median, 49.10 IU/mL; P = 0.008). An sHLA-G level lower than 43.50 IU/mL at the end of the first trimester was associated with a twofold increased risk of developing a pregnancy complication (odds ratio, 1.82; 95% confidence interval, 1.22-2.73). The strongest association, although only moderately strong, was observed with severe pre-eclampsia (odds ratio, 2.66; 95% confidence interval, 1.08-6.56). Placenta-mediated complications of pregnancy may be associated with low sHLA-G levels in the first trimester, suggesting a potential role of sHLA-G in the early stages of placentation. © 2017 Japan Society of Obstetrics and Gynecology.

  8. Remission, continuation, and incidence of eating disorders during early pregnancy: A validation study on a population-based birth cohort

    Science.gov (United States)

    Watson, Hunna J.; Von Holle, Ann; Hamer, Robert M.; Berg, Cecilie Knoph; Torgersen, Leila; Magnus, Per; Stoltenberg, Camilla; Sullivan, Patrick; Reichborn-Kjennerud, Ted; Bulik, Cynthia M.

    2014-01-01

    Background The objective of this study was to validate previously published rates of remission, continuation, and incidence of broadly defined eating disorders during pregnancy. The previous rate modeling was done by our group (Bulik et al. 2007) and yielded participants halfway into recruitment of the planned 100,000 pregnancies in the Norwegian Mother and Child (MoBa) Cohort at the Norwegian Institute of Public Health. This study aimed to internally validate the findings with the completed cohort. Methods 77267 pregnant women enrolled at 17 weeks gestation between 2001 and 2009 were included. Participants were split into a “training” sample (n=41243) based on participants in the MoBa version 2 dataset of the original study and a “validation” sample (n=36024) comprising individuals in the MoBa version 5 dataset that were not in the original study (Bulik et al. 2007). Internal validation of all original rate models involved fitting a calibration model to compare model parameters between the “training” and “validation” samples as well as bootstrap estimates of bias in the entire version 5 dataset. Results Remission, continuation, and incidence estimates from the “training” sample remained stable when evaluated via a split sample validation procedure. Pre-pregnancy prevalence estimates in the “validation” sample were 0.1% for anorexia nervosa, 1.0% for bulimia nervosa (BN), 3.3% for binge eating disorder (BED), and 0.1% for purging disorder (EDNOS-P). In early pregnancy, estimates were 0.2% for BN, 4.8% for BED, and eating disorders during pregnancy. Eating disorders during pregnancy were relatively common, occurring in nearly 1 in every 20 women, although almost all were cases of BED. Pregnancy was a window of remission from BN but a window of vulnerability for onset and continuation of BED. Training to detect the signs and symptoms of eating disorders by obstetricians/gynecologists and interventions to enhance pregnancy and neonatal outcomes

  9. Early induction of labor in high-risk intrahepatic cholestasis of pregnancy: what are the costs?

    Science.gov (United States)

    Friberg, Anne Katrine; Zingmark, Vera; Lyndrup, Jens

    2016-10-01

    Induction of labor among pregnant women with high levels of total bile acid (TBA) is common among clinicians. We examined, if women with intrahepatic cholestasis of pregnancy (ICP) and TBA ≥ 40 μmol/l have a higher risk of maternal-fetal complications, when labor is induced at 37 weeks of gestation, compared with induction of labor at term in women with low-risk ICP. Retrospective cohort study of 16,185 women delivering at Roskilde University Hospital in the period 2006-2011. Women with high-risk ICP (TBA ≥ 40 μmol/l) had labor induced at 37 weeks of gestation; women with low-risk ICP (TBA < 40 μmol/l) at term. Mode of delivery, duration of induction procedures, highest level of TBA and alanine aminotransferase (ALT) and for the neonates: Apgar scores at 5 min, umbilical cord pHs and SBEs, NICU admissions and birthweights. The incidences of ICP was 1.2 % (95 % CI 1.05-1.39 %) altogether and for high-risk ICP 0.4 % (95 % CI 0.27-0.46 %). No difference was found in mode of delivery, length of induction of labor nor in neonatal outcomes, except for an expected difference in birthweight. In high-risk ICP, ALT was not raised in 10.3 % (95 % CI 2.5-18.2 %). Early induction of labor at 37 weeks of gestation seems justified in high-risk ICP, as, except for abbreviating gestational age by 9 days with 296 g smaller babies, induction of labor was not followed by detectable maternal-fetal disadvantages and is favored by an expected major reduction in ICP stillbirth risk.

  10. Recurrent early pregnancy loss and antiphospholipid antibodies: where do we stand?

    Science.gov (United States)

    Wong, L F; Porter, T F; de Jesús, G R

    2014-10-01

    Evidence from basic science studies supports a causative relationship between antiphospholipid antibodies (aPL) and recurrent early miscarriage (REM) (prior to 10 weeks of gestation). However, human studies have not consistently found a relationship between aPL and REM. Members of the Obstetric Task Force of the 14th International Congress on Antiphospholipid Antibodies performed a literature review of the association of aPL and REM and searched for clinical trials in women with REM who tested positive for aPL. Of the 46 studies that investigated the relationship between aPL and REM, 27 found a positive association, seven found no association, and the remaining 12 papers could not report an association (lack of control group). The main identified problems for such conflicting results were varying definitions of REM (two or three abortions, not necessarily consecutive; different gestational age at which pregnancy losses occurred); analysis of patients with previous fetal death (>10 weeks) in the same group of REM; and different definitions of "positive aPL" (cutoffs not following international recommendations; small number of studies confirmed persistence of positive aPL after six to 12 weeks). The 10 identified randomized trials with proposed treatments for women with REM who test positive for aPL also had heterogeneous inclusion criteria, with only one trial limited to subjects who would meet the current criteria for antiphospholipid syndrome (APS) by both clinical and laboratory criteria. Against this background, we conclude that the association between REM and aPL remains inconclusive and that the findings of treatment trials are at best inconsistent and at worst misleading. More convincing data are critically needed. Studies that identify, or at least stratify, according to international consensus criteria and include standardized core laboratory testing results are crucial if we are to establish an evidence-based association between aPL and REM and treatment

  11. Mice endometrium receptivity in early pregnancy is impaired by maternal hyperinsulinemia

    Science.gov (United States)

    Li, Runqin; Wu, Juan; He, Junlin; Wang, Yingxiong; Liu, Xueqing; Chen, Xuemei; Tong, Chao; Ding, Yubin; Su, Yan; Chen, Wenqi; Zhang, Chen; Gao, Rufei

    2017-01-01

    Previous studies have investigated the lower embryo implantation rates in women with polycystic ovary syndrome, obesity and type 2 diabetes, and specifically the association between the abnormal oocyte and embryo and hyperinsulinemia. The importance of hyperinsulinemia on maternal endometrium receptivity remains to be elucidated. The present study used a hyperinsulinemic mouse model to determine whether hyperinsulinemia may affect endometrial receptivity. An insulin intervention mouse model was first established. The serum levels of insulin, progesterone and estradiol were subsequently detected by ELISA assay analysis. The number of implantation sites was recorded using Trypan blue dye and the morphology of mice uteri was investigated using hematoxylin and eosin staining. The expression levels of molecular markers associated with endometrial receptivity were detected by reverse transcription-quantitative polymerase chain reaction, western blotting and immunohistochemistry analyses. Finally, the importance of mechanistic target of rapamycin (mTOR) expression following insulin treatment was determined. Mice treated with insulin developed insulin resistance and hyperinsulinemia. The number of implantation sites following insulin treatment did not differ between the control and insulin-treated groups. Additionally, no significant morphological alterations in mice uteri between control and insulin-treated groups were observed. However, the expression levels of estrogen receptor (Esr) 1, Esr2, progesterone receptor and homeobox A10 associated with endometrial receptivity, were imbalanced during endometrium receptivity when maternal hyperinsulinemia was induced. Western blot analysis revealed that expression levels of endometrial phosphorylated (p)-mTOR and p-ribosomal protein S6 kinase β-1 were significantly greater in the insulin-treated group. These results demonstrated that although an embryo may implant into endometrium, mice endometrium receptivity in early

  12. In vivo quantification of {sup 18}F-Fdg uptake in human placenta during early pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P.; Jan, S.; Trebossen, R.; Maroy, R. [CEA, DSV, I2BM, SHFJ, F-91401 Orsay (France); Champion, C. [Univ Paul Verlaine Metz, Lab Phys Mol et Collis, Inst Phys, Metz (France); Hindie, E. [Hop St Antoine, AP-HP, F-75571 Paris (France); Hindie, E. [Univ Paris 07, IMDCT, IUH, Ecole Doctorale B2T, F-75221 Paris (France)

    2008-07-01

    {sup 18}F-FDG is the most widely used PET radiopharmaceutical. Nevertheless, no data for {sup 18}F-FDG uptake in the human placenta have been reported. We recently reported on embryo dosimetry in a woman who underwent an {sup 18}F-FDG PET/CT scan during early pregnancy. In the present work we attempt an in vivo quantification of the {sup 18}F-FDG uptake by the placenta. The 27-y-old woman received 320 MBq of {sup 18}F-FDG for a follow-up study for Hodgkin's lymphoma and was later discovered to be pregnant (embryo age 8 wk). Imaging started 1 h after injection. The maximum placental tissue uptake (SUVmax) was 2.5. This value was conservatively attributed to the entire placental volume, i.e., 45 mL, a value representative of the average dimensions of a normal placenta at 8 wk. On the basis of these measurements, placenta {sup 18}F-FDG uptake in our patient was 0.19% of the injected activity. A Monte Carlo simulation was used to derive the photon dose to the embryo from the placenta (0.022 * 10{sup -2} mGy per MBq of injected {sup 18}F-FDG) and from the surrounding amniotic fluid (0.017 * 10{sup -2} mGy MBq{sup -1}). This increases our previously calculated dose (3.3 * 10{sup -2} mGy MBq{sup -1}) by only a small fraction (1.18%), which does not justify modifying the previous estimate given the overall uncertainties. (authors)

  13. Marriage season, promptness of successful pregnancy and first-born sex ratio in a historical natural fertility population - evidence for sex-dependent early pregnancy loss?

    Science.gov (United States)

    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.

  14. Marriage season, promptness of successful pregnancy and first-born sex ratio in a historical natural fertility population--evidence for sex-dependent early pregnancy loss?

    Science.gov (United States)

    Nonaka, K; Desjardins, B; Charbonneau, H; Légaré, J; Miura, T

    1998-12-01

    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.

  15. The SAFE project: community-driven partnerships in health, mental health, and education to prevent early school failure.

    Science.gov (United States)

    Poole, D L

    1997-11-01

    This article presents a case study of an innovative school-based health and mental health project that prevents early school failure in one county in Oklahoma. Success is attributed to social work development of broad-based partnerships involving families, schools, communities, and public policy officials. Citizen-driven, these partnerships have meshed previously fixed institutional boundaries in health, mental health, and education to prevent early school failure. The article describes school-family partnerships that form the core of the project's service intervention model. Statistics on service activities and outcomes are presented, along with a discussion of lessons learned for implementation of the project.

  16. New phenotypic aspects of the decidual spiral artery wall during early post-implantation mouse pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Elia, Artemis; Charalambous, Fotini [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus); Georgiades, Pantelis, E-mail: pgeor@ucy.ac.cy [Department of Biological Sciences, University of Cyprus, University Campus, P.O. Box 20537, 1678 Nicosia (Cyprus)

    2011-12-09

    Highlights: Black-Right-Pointing-Pointer Spiral artery (SA) wall remodeling (SAR) is ill-defined and clinically important. Black-Right-Pointing-Pointer SA muscular phenotype prior to and during SAR in mice is underexplored. Black-Right-Pointing-Pointer SA muscular wall consists of contractile and non-contractile components. Black-Right-Pointing-Pointer SA wall non-contractile component may be synthetic smooth muscle. Black-Right-Pointing-Pointer Timing and extent of SA wall contractile component loss is revealed. -- Abstract: During pregnancy the walls of decidual spiral arteries (SAs) undergo clinically important structural modifications crucial for embryo survival/growth and maternal health. However, the mechanisms of SA remodeling (SAR) are poorly understood. Although an important prerequisite to this understanding is knowledge about the phenotype of SA muscular wall prior to and during the beginning of mouse SAR, this remains largely unexplored and was the main aim of this work. Using histological and immunohistochemical techniques, this study shows for the first time that during early mouse gestation, from embryonic day 7.5 (E7.5) to E10.5, the decidual SA muscular coat is not a homogeneous structure, but consists of two concentric layers. The first is a largely one cell-thick sub-endothelial layer of contractile mural cells (positive for {alpha}-smooth muscle actin, calponin and SM22{alpha}) with pericyte characteristics (NG2 positive). The second layer is thicker, and evidence is presented that it may be of the synthetic/proliferative smooth muscle phenotype, based on absence ({alpha}-smooth muscle actin and calponin) or weak (SM22{alpha}) expression of contractile mural cell markers, and presence of synthetic smooth muscle characteristics (expression of non-muscle Myosin heavy chain-IIA and of the cell proliferation marker PCNA). Importantly, immunohistochemistry and morphometrics showed that the contractile mural cell layer although prominent at E7.5-E8

  17. Pregnancy after azathioprine therapy for ulcerative colitis in a woman with autoimmune premature ovarian failure and Addison's disease: HLA haplotype characterization.

    Science.gov (United States)

    Ferraù, Francesco; Gangemi, Sebastiano; Vita, Giuseppe; Trimarchi, Francesco; Cannavò, Salvatore

    2011-06-01

    To present a case of fertility restored by azathioprine treatment in a woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis, and to study the genetic background of the three autoimmune diseases. Case report. Endocrinology and Immunology Units of an university hospital. A 30-year-old woman with autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis. Azathioprine has been administered as immunosuppressive treatment. We performed analysis of human leukocyte antigens expression on lymphocytes and genomic haplotype of the patient. The human leukocyte antigen haplotype of the patient was consistent with the haplotypes predisposing for the three autoimmune diseases, as reported in the literature. The administration of azathioprine restored regular menses and allowed uneventful pregnancy. This is the first clinical evidence of association of immunosuppressive azathioprine treatment and restored ovarian function and fertility in a woman with autoimmune premature ovarian failure. In this patient, the haplotype was associated with susceptibility to autoimmune premature ovarian failure, Addison's disease, and ulcerative colitis. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Relationship between early onset severe intrahepatic cholestasis of pregnancy and higher risk of meconium-stained fluid.

    Science.gov (United States)

    Estiú, Maria C; Frailuna, Maria A; Otero, Carla; Dericco, Marcela; Williamson, Catherine; Marin, Jose J G; Macias, Rocio I R

    2017-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disease. The risk of adverse fetal outcome has been associated with the severity of maternal hypercholanemia after diagnosis. To investigate whether there is a relationship between the severity and timing of onset of hypercholanemia and the risk of meconium-stained amniotic fluid (MSAF) and adverse neonatal events. The study included 382 pregnancies complicated by ICP managed at a referral hospital in Buenos Aires (Argentina) between June 2009 and December 2013. The patients were classified into three groups according to the severity of hypercholanemia at diagnosis; mild (10-19.9 μmol/L), moderate (20-39.9 μmol/L) and severe (≥40 μmol/L). Their clinical characteristics and pregnancy outcomes were investigated in a prospective observational study. Higher risk of MSAF was observed when ICP appeared early in gestation or when hypercholanemia was more severe. Taking both parameters into account an MSAF risk factor (MRF) was defined. Based on a model of positive/negative predictive values, a cut-off point of MRF = 3 was selected, which prioritized sensitivity versus specificity. In ICP patients with MRF>3, the probability of MSAF was enhanced 4-fold. An increase in the frequency of MSAF was also associated with higher serum levels at diagnosis of alanine transaminase, alkaline phosphatase and direct bilirubin. The risk of MSAF is associated not only with the magnitude of hypercholanemia at diagnosis but also with the early gestational onset of raised maternal serum bile acids.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Impact of the Kenya Cash Transfer for Orphans and Vulnerable Children on early pregnancy and marriage of adolescent girls.

    Science.gov (United States)

    Handa, Sudhanshu; Peterman, Amber; Huang, Carolyn; Halpern, Carolyn; Pettifor, Audrey; Thirumurthy, Harsha

    2015-09-01

    There is promising evidence that poverty-targeted cash transfer programs can have positive impacts on adolescent transitions to adulthood in resource poor settings, however existing research is typically from small scale programs in diverse geographic and cultural settings. We provide estimates of the impact of a national unconditional cash transfer program, the Kenya Cash Transfer for Orphans and Vulnerable Children, on pregnancy and early marriage among females aged 12 to 24, four years after program initiation. The evaluation was designed as a clustered randomized controlled trial and ran from 2007 to 2011, capitalizing on the existence of a control group, which was delayed entry to the program due to budget constraints. Findings indicate that, among 1549 females included in the study, while the program reduced the likelihood of pregnancy by five percentage points, there was no significant impact on likelihood of early marriage. Program impacts on pregnancy appear to work through increasing the enrollment of young women in school, financial stability of the household and delayed age at first sex. The Kenyan program is similar in design to most other major national cash transfer programs in Eastern and Southern Africa, suggesting a degree of generalizability of the results reported here. Although the objective of the program is primarily poverty alleviation, it appears to have an important impact on facilitating the successful transition of adolescent girls into adulthood.

  1. Influence of insemination conditions on early pregnancy in pigs, with emphasis on embryonic diversity.

    NARCIS (Netherlands)

    Soede, N.M.

    1992-01-01

    In pig husbandry, reproductive performance (litter size, pregnancy rate) after either artificial insemination or natural mating is considered to be similar. However, under experimental conditions, boar stimulation around insemination has been found to influence reproductive performance. For the pres

  2. Chronic renal failure and pregnancy: a report of 3 cases Insuficiencia renal crónica avanzada y embarazo: presentación de 3 casos

    Directory of Open Access Journals (Sweden)

    Ramiro Castrillón

    1989-03-01

    Full Text Available

    There are many reports on pregnancy In chronic renal failure with creatinine (Cr levels ≤ 1.5 mg/dl, but pregnancy is uncommon when the levels are above this limit and specially over 3 mg/dl. It is likely that hormonal abnormalities involving low progesterone and high prolactine levels playa key role. We report on three cases with Cr levels equal to or greater than 6 mg/dl during pregnancy or after delivery. We recommend that Cr levels be determined in the initial follow-up of any woman who wishes to become pregnant.

    Se han publicado numerosos reportes de embarazo en pacientes con insuficiencia renal crónica, con creatinina (Cr ≤ 1.5 mg/dl, pero el embarazo es poco común con niveles de Cr mayores, principalmente ≥: 3 mg/dl. Es probable que los niveles bajos de progesterona o altos de prolactina jueguen un papel clave aquí. Publicamos tres casos con Cr ≥: 6 mg/dl durante el embarazo o el postparto. Recomendamos que en toda mujer embarazada o que planee embarazarse se determine la Cr.

  3. Influence of early pregnancy on reproductive rate in lines of mice selected for litter size.

    Science.gov (United States)

    Eisen, E J

    1980-09-01

    The influence of male-induced early puberty on female reproductive rate was determined in three lines of mice differing in litter size and body weight. The lines originated from a single base population and had undergone 20 generations of selection for the following criteria: large litter size at birth (L(+)), large litter size and small 6-week body weight (L(+)W(-)), or small litter size and large 6-week body weight (L(-)W(+)). Females were paired with a mature intact male of the same line at 3, 5 or 7 weeks of age. Mean mating age, averaged over lines, was 26.5 ± .3, 38.3 ± .3 and 52.7 ± .3 days. Exposure to a mature male accelerated female sexual maturation in each line. When contrasted with their sibs mated at a later age, early-pregnant females from each line exhibited a decline in one or more component of reproductive performance, suggesting that the physiological state of the very young female was not optimum for normal pregnancy. In comparisons of early and later mating ages, all three lines showed a decreased littering rate at first mating, number born alive, and individual birth weight of progeny adjusted for litter size; L(+) and L(+)W(-) mice showed an increased perinatal mortality rate; L(+) and L(-)W(+) had a reduction in litter size at birth. When the L(+), L(+)W(-) and L(-)W(+) lines were compared with an unselected strain and a line selected for high postweaning gain in similar experiments, a genotype by environment interaction was apparent since all lines did not respond in a similar manner to early mating. The line ranking for litter size at birth for each age at male-exposure was L(+)>L(+)W(-)>L(-)W(+), despite the significant line by age interaction. When litter size was adjusted by covariance for body weight at mating, the significant effects of age at male-exposure and line by age interaction were eliminated. All fertile females were remated after they had weaned their first litter to obtain information on litter size in parity two. Line

  4. Maternal early pregnancy lipid profile and offspring's lipids and glycaemic control at age 5-6 years: The ABCD study.

    Science.gov (United States)

    van Lieshout, Noekie; Oostvogels, Adriëtte J J M; Gademan, Maaike G J; Vrijkotte, Tanja G M

    2016-10-15

    Maternal early pregnancy lipid profile might influence offspring's lipids and glycaemic control, through an increased offspring's fat percentage. This explorative study investigates whether maternal early pregnancy lipid profile is associated with offspring's lipids and glycaemic control independently of offspring's fat percentage and if these associations are mediated by offspring's fat percentage. Possible sex differences in these associations are also examined. 1133 mother-child pairs of the prospective ABCD-study were included. Maternal non-fasting lipids were collected in early pregnancy: triglycerides, total cholesterol (TC), Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB) and free fatty acids (FFA). Fasting triglycerides, TC, high density lipoprotein (HDL), low density lipoprotein (LDL), glucose and C-peptide were assessed in offspring aged 5-6 years and HOMA2-IR was calculated. After adjustment for covariates, strongest associations were found between maternal TC and offspring's TC (boys β(95%CI) = 0.141 (0.074-0.207); girls β(95%CI) = 0.268 (0.200; 0.336)) and LDL (boys β(95%CI) = 0.114 (0.052; 0.176); girls β(95%CI) = 0.247 (0.181-0.312)), maternal ApoB and offspring's TC (boys β(95%CI) = 0.638 (0.311-0.965); girls β(95%CI) = 1.121 (0.766-1.475)) and LDL (boys β(95%CI) = 0.699 (0.393-1.005); girls β(95%CI) = 1.198 (0.868-1.529)), and maternal ApoA1 and offspring's HDL (only boys β(95%CI) = 0.221 (0.101-0.341)). No significant association was found between maternal lipids and offspring's glycaemic control, and offspring's fat percentage played no mediating role. Maternal early pregnancy lipid profile is associated with offspring's lipid profile in childhood, with overall stronger associations in girls. This study provides further evidence that lowering lipid levels during pregnancy might be beneficial for the long term health of the offspring. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and

  5. Study about the Function of the Thyroid Gland in Early Pregnancy%妊娠早期甲状腺激素变化观察

    Institute of Scientific and Technical Information of China (English)

    任晓坤; 余红星

    2013-01-01

    Objective:To evaluate the hormone about the function of thyroid gland in early pregnancy.Method:The information parameters of thyroid function in the non pregnant and the early pregnancy women,including serum free triiodothyronine(FT3),free thyroxin(FT4),total triiodothyronine(TT3),total thyroxin(TT4)and TSH,were measured with radioimmunoassay methods.Result:Serum TT3 and TT4 concentration in early pregnancy were all above that of non-pregnancy,moreover,serum concentration of TSH in early pregnancy was below that of non-pregnancy. Conclusion:Parameters of thyroid function in early pregnancy is different from that of non-pregnancy,it is valuable for bear and rear better children to evaluate thyroid function by examinating the concentration related thyroid function during pregnancy.%  目的:观察妊娠早期甲状腺激素变化,为相关疾病的诊治提供理论依据。方法:测定孕前及妊娠早期的血清甲状腺激素水平,比较分析其变化。结果:妊娠早期血清 TT3、TT4均高于妊娠前水平,血清 TSH 水平在孕早期低于孕前的测定值。结论:妊娠早期血清甲状腺激素不同于非妊娠时水平,检测妊娠时甲状腺功能变化有助于防治相关疾病及优生优育。

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

    Directory of Open Access Journals (Sweden)

    Ensieh Shahrokh-Tehraninejad

    2016-12-01

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

  7. Maternal diet in early and late pregnancy in relation to weight gain.

    Science.gov (United States)

    Olafsdottir, A S; Skuladottir, G V; Thorsdottir, I; Hauksson, A; Steingrimsdottir, L

    2006-03-01

    To identify dietary factors related to the risk of gaining weight outside recommendations for pregnancy weight gain and birth outcome. An observational study with free-living conditions. Four hundred and ninety five healthy pregnant Icelandic women. The dietary intake of the women was estimated with a semiquantitative food frequency questionnaire covering food intake together with lifestyle factors for the previous 3 months. Questionnaires were filled out at between 11 and 15 weeks and between 34 and 37 weeks gestation. Comparison of birth outcome between the three weight gain groups was made with ANOVA and Bonferroni post hoc tests. Dietary factors related to at least optimal and excessive weight gain during pregnancy were represented with logistic regression controlling for potential confounding. Of the women, 26% gained suboptimal and 34% excessive weight during pregnancy. Women in late pregnancy with at least optimal, compared with women with suboptimal, weight gain were eating more (OR = 3.32, confidence interval (CI)=1.81-6.09, P lifestyle modifications affecting consequent weight gain during pregnancy. They are most likely to gain excessive weight and therefore most likely to suffer pregnancy and delivery complications and struggle with increasing overweight and obesity after giving birth.

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

    Science.gov (United States)

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

    2014-09-01

    More than half of all cases of preeclampsia occur in healthy first-time pregnant women. Our aim was to develop a method to predict those at risk by combining clinical factors and measurements of biomarkers in women recruited to the Screening for Pregnancy Endpoints (SCOPE) study of low-risk nulliparous women. Forty-seven biomarkers identified on the basis of (1) association with preeclampsia, (2) a biological role in placentation, or (3) a role in cellular mechanisms involved in the pathogenesis of preeclampsia were measured in plasma sampled at 14 to 16 weeks' gestation from 5623 women. The cohort was randomly divided into training (n=3747) and validation (n=1876) cohorts. Preeclampsia developed in 278 (4.9%) women, of whom 28 (0.5%) developed early-onset preeclampsia. The final model for the prediction of preeclampsia included placental growth factor, mean arterial pressure, and body mass index at 14 to 16 weeks' gestation, the consumption of ≥3 pieces of fruit per day, and mean uterine artery resistance index. The area under the receiver operator curve (95% confidence interval) for this model in training and validation cohorts was 0.73 (0.70-0.77) and 0.68 (0.63-0.74), respectively. A predictive model of early-onset preeclampsia included angiogenin/placental growth factor as a ratio, mean arterial pressure, any pregnancy loss preeclampsia in populations of mixed parity and risk. In nulliparous women, combining multiple biomarkers and clinical data provided modest prediction of preeclampsia. © 2014 American Heart Association, Inc.

  9. Psychosocial factors associated with broadly defined bulimia nervosa during early pregnancy: findings from the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Knoph Berg, Cecilie; Bulik, Cynthia M; Von Holle, Ann; Torgersen, Leila; Hamer, Robert; Sullivan, Patrick; Reichborn-Kjennerud, Ted

    2008-05-01

    The purpose of the present study was to investigate the relationship between psychosocial characteristics and broadly defined bulimia nervosa during early pregnancy, including factors associated with continuation, incidence and remission. A total of 41 157 women completed questionnaires at approximately gestation week 18, including items on eating disorders and psychosocial characteristics as a part of Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Incident bulimia nervosa during the first trimester was significantly associated with symptoms of anxiety and depression and low self-esteem and life satisfaction, whereas remission was significantly associated with higher self-esteem and life satisfaction. Continuation was not significantly related to any of the psychosocial variables tested. Onset of bulimia nervosa during pregnancy is associated with mood and anxiety symptoms. Remission of bulimic symptoms and new onset of bulimia nervosa are associated with opposite profiles of self-esteem, and life satisfaction measures.

  10. Occupational pesticide exposure in early pregnancy associated with sex-specific neurobehavioral deficits in the children at school age

    DEFF Research Database (Denmark)

    Andersen, Helle Raun; Debes, Frodi; Wohlfahrt-Veje, Christine

    2015-01-01

    categorized as occupationally exposed to pesticides were moved to unexposed work functions or went on paid leave, while women without any exposure were considered unexposed controls. Of the resulting birth cohort of 203 children, 133 (65%) were examined at age 6 to 11years together with 44 newly recruited...... children of same age whose mothers were not occupationally exposed to pesticides in pregnancy. All children underwent a standardized examination including a battery of neurodevelopmental tests. Maternal occupational pesticide exposure in early pregnancy was associated with prolonged brainstem auditory...... function was also seen for other neuropsychological outcomes. A structural equation model that combined all these test results showed an overall impaired neuropsychological function in girls prenatally exposed to pesticides. Thus, our findings suggest an adverse effect of maternal occupational pesticide...

  11. Predictors of Early Failure After Fecal Microbiota Transplantation for the Therapy of Clostridium Difficile Infection: A Multicenter Study.

    Science.gov (United States)

    Fischer, Monika; Kao, Dina; Mehta, Shama R; Martin, Tracey; Dimitry, Joseph; Keshteli, Ammar H; Cook, Gwendolyn K; Phelps, Emmalee; Sipe, Brian W; Xu, Huiping; Kelly, Colleen R

    2016-07-01

    Fecal microbiota transplant (FMT) is a highly efficacious treatment for recurrent or refractory Clostridium difficile infection (CDI); however, 10-20% of patients fail to achieve cure after a single FMT. The aim of this study was to identify risk factors associated with FMT failure and to develop and validate a prediction model for FMT failure. Patient characteristics, CDI history, FMT characteristics, and outcomes data for patients treated between 2011 and 2015 at three academic tertiary referral centers were prospectively collected. Early FMT failure was defined as non-response or recurrence of diarrhea associated with positive stool C. difficile toxin or PCR within 1 month of FMT. Late FMT failure was defined as recurrence of diarrhea associated with positive stool C. difficile toxin or PCR between 1 and 3 months of the FMT. Patient data from two centers were used to determine independent predictors of FMT failure and to build a prediction model. A risk index was constructed based on coefficients of final predictors. The patient cohort from the third center was used to validate the prediction model. Of 328 patients in the developmental cohort, 73.5% (N=241) were females with a mean age of 61.4±19.3 years; 19.2% (N=63) had inflammatory bowel disease (IBD), and 23.5% (N=77) were immunocompromised. The indication for FMT was recurrent CDI in 87.2% (N=286) and severe or severe-complicated in 12.8% (N=42). FMT was performed as an inpatient in 16.7% (N=54). The stool source was patient-directed donors in 40% (N=130) of cases. The early FMT failure rate was 18.6%, and the late failure rate was 2.7%. In the multivariable analysis, predictors of early FMT failure included severe or severe-complicated CDI (odds ratio (OR) 5.95, 95% confidence interval (CI): 2.26-15.62), inpatient status during FMT (OR 3.78, 95% CI: 1.55-9.24), and previous CDI-related hospitalization (OR 1.43, 95% CI: 1.18-1.75); with each additional hospitalization, the odds of failure increased by 43

  12. Effect of nicotinamide on early graft failure following intraportal islet transplantation

    Science.gov (United States)

    Jung, Da-Yeon; Park, Jae Berm; Joo, Sung-Yeon; Joh, Jae-Won; Kwon, Choon-Hyuck; Kwon, Ghee-Young

    2009-01-01

    Intraportal islet transplantation (IPIT) may potentially cure Type 1 diabetes mellitus; however, graft failure in the early post-transplantation period presents a major obstacle. In this study, we tested the ability of nicotinamide to prevent early islet destruction in a syngeneic mouse model. Mice (C57BL/6) with chemically-induced diabetes received intraportal transplants of syngeneic islet tissue in various doses. Islets were cultured for 24 h in medium with or without 10 mM nicotinamide supplementation. Following IPIT, islet function was confirmed by an intraperitoneal glucose tolerance test (IPGTT) and hepatectomy. The effects of nicotinamide were evaluated by blood glucose concentration, serum monocyte chemoattractant protein-1 (MCP-1) concentration, and immunohistology at 3 h and 24 h after IPIT. Among the various islet doses, an infusion of 300 syngeneic islets treated with nicotinamide exhibited the greatest differences in glucose tolerance between recipients of treated and untreated (i.e., control) islets. One day after 300 islet equivalent (IEQ) transplantation, islets treated with nicotinamide were better granulated than the untreated islets (P = 0.01), and the recipients displayed a slight decrease in serum MCP-1 concentration, as compared to controls. After 15 days, recipients of nicotinamide-pretreated islets showed higher levels of graft function (as measured by IPGTT) than controls. The pretreatment also prolonged graft survival (> 100 days) and function; these were confirmed by partial hepatectomy, which led to the recurrence of diabetes. Pretreatment of islet grafts with nicotinamide may prevent their deterioration on the early period following IPIT in a syngeneic mouse model. PMID:19641379

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...... = 37,315). After adjustment for maternal education, psychiatric diagnoses, age and smoking, children exposed to binge drinking in early and late pregnancy had significantly higher mean externalizing scores at age seven than unexposed children, an effect albeit much less for early binge drinking......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...

  14. A randomized crossover trial on the effect of compression stockings on nausea and vomiting in early pregnancy.

    Science.gov (United States)

    Mendoza, Erika; Amsler, Felix

    2017-01-01

    This study aimed to assess the impact of wearing compression stockings on women's quality of life (QoL) associated with nausea and vomiting in early pregnancy (NVP). In this randomized, open, single-center, crossover study, 74 women were assigned 1:1 to 2 weeks with compression stockings followed by 2 weeks without or vice versa. The main outcomes were NVP-associated QoL, leg-related QoL, and dizziness, as assessed by the Nausea and Vomiting in Pregnancy Quality of Life (NVPQOL) questionnaire, Chronic Venous Disease Quality of Life (CIVIQ) questionnaire, and questions on dizziness at baseline and after each 2-week period, respectively. Daily NVP was assessed using the modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) questionnaire. Data were analyzed using Pearson's chi-square and independent t-tests. Fifty-eight women completed the study. QoL scores improved with compression treatment; changes in mean total scores were as follows: NVPQOL, -36.7 with compression vs -21.7 without (P<0.0001); and CIVIQ, -4.5 with compression vs +1.4 without (P=0.001). Mean dizziness scores were -3.2 with compression vs -0.4 without (P<0.0001). PUQE mean total score (standard deviation) was 4.9 (2.3) with compression vs 5.5 (2.2) without (P=0.042). Wearing of compression stockings in early pregnancy may improve nausea and vomiting-associated symptoms in addition to improving QoL factors.

  15. Maternal serum heme-oxygenase-1 (HO-1 concentrations in early pregnancy and subsequent risk of gestational diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Chunfang Qiu

    Full Text Available BACKGROUND: Heme oxygenase-1 (HO-1 concentrations have been recently reported to be elevated in impaired glucose tolerance and type 2 diabetes mellitus (T2DM. However, no study has examined the association between HO-1 concentrations and gestational diabetes mellitus (GDM. METHODS: In a case-control study, nested within a prospective cohort of pregnant women (186 GDM cases and 191 women who remained eu-glycemic through pregnancy, we assessed the association of maternal serum HO-1 concentrations, measured in samples collected at 16 weeks gestation, on average, with subsequent risk of GDM. Maternal serum HO-1 concentrations were determined using ELISA. We fitted multivariate logistic regression models to derive estimates of odds ratios (ORs and 95% confidence intervals (CIs. RESULTS: Median serum HO-1 concentrations in early pregnancy were lower in women who subsequently developed GDM compared with those who did not (1.60 vs. 1.80 ng/mL, p-value=0.002. After adjusting for maternal age, race, family history of T2DM and pre-pregnancy body mass index, women with HO-1 ≥ 3.05 ng/mL (highest decile experienced a 74% reduction of GDM risk (95% CI; 0.09-0.77 compared with women whose concentrations were<1.23 ng/mL (lowest quartile. CONCLUSION: Serum HO-1 concentrations were inversely associated with subsequent GDM risk. These findings underscore the role of oxidative stress in the pathogenesis of GDM. Additional studies are warranted to confirm the clinical utility of serum HO-1 in diagnosis of GDM, particularly in the early pregnancy.

  16. Clarithromycin in early pregnancy and the risk of miscarriage and malformation: a register based nationwide cohort study.

    Directory of Open Access Journals (Sweden)

    Jon Trærup Andersen

    Full Text Available BACKGROUND: The antibiotic clarithromycin has been associated with fetal loss in animals and a study has found a doubling in the frequency of miscarriages among women using clarithromycin in pregnancy. The aim of the study was to investigate whether clarithromycin use in early pregnancy was associated with an increased risk for miscarriages and major malformations. METHODS: We conducted a nationwide cohort study including all women in Denmark with a known conception between 1997 and 2007. The Fertility Database was used to identify all women giving birth and the National Hospital Register was used to identify all women with a record of miscarriage or induced abortion. Prescription data was obtained from the National Prescription Register. The primary outcome was the number of miscarriages and offspring with major congenital malformations among users of clarithromycin compared to non-users. RESULTS: We identified 931 504 pregnancies (705 837 live births, 77 553 miscarriages, and 148 114 induced abortions. 401 women redeemed a prescription of clarithromycin in the first trimester of which 40 (10.0% experienced a miscarriage and among the live born nine (3.6% had offspring with malformations. The hazard ratio (HR of having a miscarriage after exposure to clarithromycin was 1.56 (CI95% 1.14-2.13. There was no increased hazard of having a miscarriage when being exposed to penicillin or erythromycin. There was no increased prevalence (OR = 1.03 (CI95% 0.52-2.00 of having offspring with malformations after exposure to clarithromycin. CONCLUSIONS: We found an increased hazard of miscarriage but no increased prevalance of having offspring with malformations among women redeeming a prescription of clarithromycin in early pregnancy. This is supported by previous studies in animals and humans. However, further research is required to explore the possible effect of treatment indication on the associations found.

  17. Early diagnosis of the urofacial syndrome is essential to prevent irreversible renal failure

    Directory of Open Access Journals (Sweden)

    Francisco A. Nicanor

    2005-10-01

    Full Text Available INTRODUCTION: The urofacial or Ochoa syndrome is a rare disease characterized by the presence of functional obstructive uropathy associated with peculiar facial features when patients attempt to smile or laugh. Unfortunately, many of these patients remain without proper diagnosis or adequate treatment due to lack of recognition of the disease. This can ultimately result in upper tract deterioration and eventual renal failure. We present our experience with this rare syndrome. MATERIALS AND METHODS: We identified 3 patients who presented initially with acute renal failure, urinary tract infection (UTI and severe dysfunctional elimination. All patients were thoroughly evaluated, including screening for spinal cord anomalies, and were subsequently diagnosed with urofacial syndrome. RESULTS: At the outset, the two older patients (aged 4 and 9 years presented with the typical facial features when attempting to smile or laugh. One patient in the newborn period presented with urinary and fecal retention and septicemia and, to our knowledge, represents the youngest case of urofacial syndrome reported so far. All patients were evaluated with ultrasonography, renal scan, voiding cystourethrogram (VCUG and urodynamics. Findings included hydronephrosis and a thick-walled, trabeculated bladder with poor compliance and detrusor hypereflexia respectively in each patient. All were subsequently treated with clean intermittent catheterization (CIC, antibiotic prophylaxis and anticholinergic therapy. One patient required appendicovesicostomy for CIC due to discomfort secondary to a sensate urethra. CONCLUSIONS: Our series demonstrates that early recognition of this rare syndrome is necessary to adequately treat and prevent upper tract deterioration in these unique individuals. Although the urofacial is difficult to diagnose in infants, cognizance must be maintained in order to prevent severe subsequent sequalae.

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

    Science.gov (United States)

    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.

  19. Early primary graft failure after a pediatric heart transplant and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab

    Directory of Open Access Journals (Sweden)

    Shashi Raj

    2017-01-01

    Full Text Available Early primary graft failure after pediatric orthotopic heart transplantation (OHT has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant. Cardiac arrest before ECMO initiation in these patients is associated with adverse neurologic outcome although those surviving to hospital discharge generally have excellent long-term outcome. We report a case of early primary graft failure after OHT who required ECMO support and successful rescue with plasmapheresis, immunoglobulins, and alemtuzumab.

  20. Bleeding during Pregnancy

    Science.gov (United States)

    ... FAQ090 “Early Pregnancy Loss”). What is an ectopic pregnancy? An ectopic pregnancy occurs when the fertilized egg does not implant ... vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder ...

  1. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae; Kang, Dae Hwan [Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

    2013-11-15

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  2. Antenatal weight management: Diet, physical activity, and gestational weight gain in early pregnancy.

    Science.gov (United States)

    Swift, Judy A; Langley-Evans, Simon C; Pearce, Jo; Jethwa, Preeti H; Taylor, Moira A; Avery, Amanda; Ellis, Sarah; McMullen, Sarah; Elliott-Sale, Kirsty J

    2017-06-01

    to investigate women's physical activity levels, diet and gestational weight gain, and their experiences and motivations of behavior change. analysis of cross-sectional data collected during a longitudinal, cohort study examining physiological, psychological, sociodemographic, and self-reported behavioural measures relating to bodyweight. women recruited from routine antenatal clinics at the Nottingham University Hospitals NHS Trust. 193 women ≤27 weeks gestation and aged 18 years or over. MEASUREMENTS & FINDINGS: measurements included weight and height, the Dietary Instrument for Nutrition Education (Brief Version), the International Physical Activity Questionnaire (Short Form), and open questions of perceptions of behaviour change. 50.3% (n=97) were overweight/obese, and women gained 0.26kg/wk (IQR 0.34kg/wk) since conception. The majority consumed low levels of fat (n=121; 63.4%), high levels of unsaturated fat (n=103; 53.9%), and used a dietary supplement (n=166; 86.5%). However, 41% (n=76) were inactive, 74.8% (n=143) did not consume high levels of fibre, and 90.0% (n=171) consumed less than 5 portions of fruit and vegetables a day. Body mass index category was not associated with diet, physical activity levels, or gestational weight gain. Themes generated from open-questions relating to behaviour change were: (1) Risk management, (2) Coping with symptoms, (3) Self-control, (4) Deviation from norm, (5) Nature knows best. early pregnancy is a period of significant and heterogeneous behaviour change, influenced by perceptions of risk and women's lived experience. Behaviour was influenced not only by perceptions of immediate risk to the fetus, but also by the women's lived experience of being pregnant. There are exciting opportunities to constructively reframe health promotion advice relating to physical activity and diet in light of women's priorities. The need for individualized advice is highlighted, and women across all body mass index categories would

  3. Pregnancy hypertension and the risk for neuropsychological difficulties across early development: A brief report.

    Science.gov (United States)

    Wade, Mark; Jenkins, Jennifer M

    2016-01-01

    Despite documented effects on fetal brain development, little is currently known about the relationship between maternal pregnancy hypertension and child neuropsychological outcomes. This brief report examined the association between maternal hypertension during pregnancy and children's social cognition and executive functioning when children were 18 months, 3 years, and 4.5 years. A community sample of 501 families (23 hypertensive mothers; 478 nonhypertensive) was recruited when children were newborns. Social cognition (including theory of mind [ToM]) and executive functioning (EF) were measured using a battery of age-appropriate standardized and/or observational tasks. Information on pregnancy and prenatal factors were measured via maternal report when children were newborns. After controlling for prenatal and demographic covariates, the presence of hypertension difficulties during pregnancy was associated with all measures of social cognition, ToM, and EF. A secondary analysis comparing the hypertension group (n = 23) to a nonhypertensive matched control group (n = 23) supported the effect of pregnancy hypertension on children's social-cognitive and EF development. Future studies using obstetrical records are encouraged based on these preliminary findings.

  4. 妊娠合并心力衰竭的处理和分娩时机的临床研究%Management of heart failure and timing of delivety in pregnancy

    Institute of Scientific and Technical Information of China (English)

    彭可; 胡冰梅; 林静吟

    2009-01-01

    目的 探讨妊娠合并心力衰竭(心衰)的孕期处理、分娩时机的选择及其对母婴预后的影响.方法 回顾性分析356例奸娠期心脏病患者的发病情况、心衰的发生率、治疗效果、分娩方式与时机等资料.结果 356例妊娠期心脏病中有136例(38.20%)发生心衰,其中中重度心衰76例(55.88%);风湿性心脏病(风心病)较先天性心脏病(先心病)易发生心衰;孕前未行心脏手术治疗的风心病患者较先心病易发生心衰,孕前已行心脏手术治疗的风心病孕妇中重度心衰发生率明显较孕前未行手术治疗者下降(P<0.05);孕期心衰控制良好组与不良组比较,前者对妊娠、分娩的耐受性好,能顺利度过妊娠、分娩、产褥期.结论 风心病和先心病是妊娠期心力衰竭的主要原因,孕前特别是风心病患者行心脏手术治疗,可显著改善妊娠期心功能,妊娠期密切监视心功能,妊娠晚期控制心衰后及时终止妊娠,有利于孕妇和围产儿的预后.%Objective To explore the management of heart failure, the timing of delivery in pregnancy, and the influencce on pregnant prognosis. Methods We retrospectively analyzed the incidence of heart failure,treatment results, pattern of termination, and time of termination in 356 cases of pregnancy with heart disease.Results One hundred and thirty-six(38.20%) cases were diagnosed as heart failure and 76(55.88%) were moderate or severe heart failure. Heart failure tensd to occur more easily in rheumatic heart diseases than in congenital heart diseases. Heart failure occurred more ferquently in pregnancy with rheumatic heart diseases without the heart opeartion before pregnancy than that of pregnancy with congenital heart diseases. The occurrence of the moderate and severe heart failure in pregnancy decreased in rheumatic heart diseases with surgical therapies compared with those without surgical therapise(P< 0.05). Compatred with pregnancy with heart failure

  5. Folate deficiency during early-mid pregnancy affects the skeletal muscle transcriptome of piglets from a reciprocal cross.

    Directory of Open Access Journals (Sweden)

    Yi Li

    Full Text Available Folate deficiency (FD during pregnancy can cause fetal intrauterine growth restriction in pigs, of which the skeletal dysplasia is a major manifestation. Factors influencing muscle development are very important in the formation of porcine meat quality trait. However, the effect of folate deficiency on skeletal muscle development and its molecular mechanisms are unknown. The objective of this study is to determine the effect of maternal folate deficiency on the skeletal muscle transcriptome of piglets from a reciprocal cross, in which full-sibling Landrace (LR and full-sibling Chinese local breed Laiwu (LW pigs were used for reciprocal cross matings, and sows were fed either a folate deficient or a normal diet during early-mid gestation. In addition, the difference in the responsiveness of the piglets to folate deficiency during early-mid pregnancy between reciprocal cross groups was investigated. Longissimus dorsi (LD muscle samples were collected from newborn piglets and a 4 × 44K Agilent porcine oligo microarray was used for transcriptome analysis of porcine LD muscle. The results showed that folate deficiency during early-mid pregnancy affected piglet body weight, LD muscle fiber number and content of intramuscular triglyceride. The microarray results indicated that 3154 genes were differentially expressed between folate deficient and normal piglets from the LR♂ × LW♀ cross, and 3885 differentially expressed genes (DEGs in the ones from the LW♂ × LR♀ cross. From functional analyses, sow folate deficiency affected almost all biological processes in the progeny. Lipid metabolism-related genes and associated metabolic pathways were regulated extensively by folate deficiency, especially in LR♂ × LW♀ cross piglets. Most of the genes that are regulated by folate deficiency in the LD muscle of piglets were different between LR♂ × LW♀ and LW♂ × LR♀ crosses, suggesting some epigenetic effects of FD exist in genes underlying

  6. 药物流产对妇女再次妊娠早孕期的影响探讨%IMPACT OF MEDICAL ABORTION ON EARLY PREGNANCY OF WOMEN WITH SUBSEQUENT PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    金翠红

    2011-01-01

    [Objective]To explore the medical abortion on subsequent pregnancy.[Methods]A retrospective study was used to analyze the 368 pregnant women aged 23-33 years, among whom 126 cases with medical abortion history, 242 healthy pregnant women without medical abortion history.Compared the situations at early pregnancy (embryos whether to slop growing, whether with inevitable abortion or threatened abortion, the degree of response at early pregnancy, incidence rale of ectopie pregnancy).[Results]The situations al early pregnancy in medical abortion group and control group were not significantly different (P> 0.05).[Conclusion]Medical abortion has no significant adverse effects on early pregnancy of subsequent pregnancy, which is a safe, convenient and effective remedial measure after failed contraception.%[目的]探讨药物流产对再次妊娠的影响.[方法]采用回顾性研究,分析年龄在23~33岁有药物流产史后再次妊娠的健康妇女126例和无药物流产史的健康妊娠妇女242例,对早孕期(胚胎有无停育、难免流产有无、先兆流产有无、早孕反应程度、异位妊娠发生率)情况进行比较.[结果]药物流产组与无药物流产组妇女早孕期情况差异无统计学意义(P>0.05).[结论]药物流产对再次妊娠孕早期无明显不良影响,是一种安全、方便、有效的避孕失败后的补救措施.

  7. Morphological evaluation of the placenta and fetal membranes during canine pregnancy from early implantation to term.

    Science.gov (United States)

    Aralla, Marina; Groppetti, Debora; Caldarini, Laura; Cremonesi, Fausto; Arrighi, Silvana

    2013-08-01

    To describe the histological changes of fetal adnexa throughout the physiological pregnancy, canine samples were obtained during natural delivery and caesarean section, as well as during ovariohysterectomy performed at any stage of undesired pregnancies (N=12). The first period of pregnancy (multiple samples collected at 10, 12, 14 days) was consistent with pre- and peri-implantation events, i.e. apposition and initial invasion steps into the endometrium. The second period (multiple samples collected at 18, 38, 40, 45 days) was related to the development of extra-embryonic structures, placenta establishment and labyrinth formation. At the end of this period the maximum morphological complexity of the endotheliochorial placenta was achieved, characterized by complete erosion of the endometrial epithelium and underlying interstitium with exposure of maternal capillaries to the chorial cells. The third period of gestation (multiple samples collected at 50, 53, 57, 60, 63 days) was characterized by enhancement either of placental and extra-embryonic tissues.

  8. Pattern of thyroid function during early pregnancy in women diagnosed with subclinical hypothyroidism and treated with l-thyroxine is similar to that in euthyroid controls.

    Science.gov (United States)

    De Geyter, Christian; Steimann, Sabine; Müller, Beat; Kränzlin, Marius E; Meier, Christian

    2009-01-01

    Subclinical hypothyroidism (SCH) is associated with a higher miscarriage rate. It is unclear how the thyroid function in SCH differs from that in euthyroidism during early pregnancy. We intended to determine the regulation of thyroid function in women with SCH receiving constant l-thyroxine (T4) replacement during early pregnancy as compared to euthyroid controls. This was a prospective cohort study with weekly serum sampling in eight women in early pregnancy with SCH and eight euthyroid women from week 5 to week 12 of pregnancy. Thyroid function was assessed before pregnancy. Women with SCH were treated with T4 (50 microg daily) and continued on an unchanged dose until week 12. The following parameters were measured weekly: thyrotropin (TSH), thyroglobulin, thyroxine, triiodothyronine, free thyroxine (FT4), free triiodothyronine (FT3), estradiol, progesterone, human chorionic gonadotropin, and prolactin. Although the pregestational levels of TSH were significantly higher among women with SCH as compared to euthyroid controls, the self-limited estrogen-induced increment of TSH during early pregnancy was similar in both groups. Although both SCH and ovarian hyperstimulation were associated with an intermediate rise in TSH, the pattern of thyroid function followed similar changes as in euthyroid controls and is unlikely to cause the higher miscarriage rate observed in SCH.

  9. Serum microRNA expression patterns that predict early treatment failure in prostate cancer patients

    Science.gov (United States)

    Singh, Prashant K.; Preus, Leah; Hu, Qiang; Yan, Li; Long, Mark D.; Morrison, Carl D.; Nesline, Mary; Johnson, Candace S.; Koochekpour, Shahriar; Kohli, Manish; Liu, Song; Trump, Donald L.

    2014-01-01

    We aimed to identify microRNA (miRNA) expression patterns in the serum of prostate cancer (CaP) patients that predict the risk of early treatment failure following radical prostatectomy (RP). Microarray and Q-RT-PCR analyses identified 43 miRNAs as differentiating disease stages within 14 prostate cell lines and reflectedpublically available patient data. 34 of these miRNA were detectable in the serum of CaP patients. Association with time to biochemical progression was examined in a cohort of CaP patients following RP. A greater than two-fold increase in hazard of biochemical progression associated with altered expression of miR-103, miR-125b and miR-222 (p <.0008) in the serum of CaP patients. Prediction models based on penalized regression analyses showed that the levels of the miRNAs and PSA together were better at detecting false positives than models without miRNAs, for similar level of sensitivity. Analyses of publically available data revealed significant and reciprocal relationships between changes in CpG methylation and miRNA expression patterns suggesting a role for CpG methylation to regulate miRNA. Exploratory validation supported roles for miR-222 and miR-125b to predict progression risk in CaP. The current study established that expression patterns of serum-detectable miRNAs taken at the time of RP are prognostic for men who are at risk of experiencing subsequent early biochemical progression. These non-invasive approaches could be used to augment treatment decisions. PMID:24583788

  10. Oxygen Kinetics and Heart Rate Response during Early Recovery from Exercise in Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Charalampos D. Kriatselis

    2012-01-01

    Full Text Available Background. The purpose of this study was to assess the post-exercise O2 uptake and heart rate response in patients with heart failure (HF in comparison to healthy individuals. Methods and Results. Exercise testing of all subjects was conducted according to the RITE-protocol. The study subjects were classified according to their peak oxygen uptake (peak VO2 in four groups: healthy individuals with a peak VO2 >22 mL/kg/min (group 1, : 50, and patients with HF and a peak VO2 of 18–22 mL/kg/min, (group 2, : 48, 14–18 mL/kg/min (group 3, : 57, and <14 mL/kg/min (group 4, : 31. Both peak VO2 and HR declined more slowly in the patients with HF than in the normal subjects. Recovery of VO2 and HR followed monoexponential kinetics in the early post-recovery phase. This enabled the determination of a time constant for both HR and VO2 (TC VO2 and TC HR. From group 1 to 4 there was a prolongation of the time constant for VO2 and HR: TC VO2 (group 1: 110±34, group 2: 197±43, group 3: 238±80, and group 4: 278±50 sec, and TC HR (group 1: 148±82, group 2: 290±65, group 3: 320±58, and group 4: 376±55 sec. Conclusion. The rate of decline of VO2 and HR in the early post-exercise phase is inversely related to the peak VO2. The time constant for oxygen uptake (TC VO2 and heart rate (TC HR might prove a useful parameter for more precise monitoring and grading of HF.

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

    Directory of Open Access Journals (Sweden)

    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

  12. The Effect of Lilopristone (ZK 98.734) on Early Pregnancy in the Human

    Institute of Scientific and Technical Information of China (English)

    B.A.Resch; L.Kovacs; M.Bygdeman; P.F.A.vanlook; E.belsey; M.L.swahn; GY.Ugocsai

    1992-01-01

    A two-centre dose-finding study was carried out to evaluate the efficacy and side-effects of the antiprogestin lilop ristone (ZK 98,734) when used,for the termina-tion of early pregnancy, Pregnant women with amenorrhoea of not more than 49 days'duration were treated orally jot.four days with 12.5, 25 or 50 mg of lilopristone twicedaily. All women were reviewed at the hospital on each day of treatment and on furtherfollow-up visits at one, two and six weeks after the start of treatment.

  13. [The IUD in pregnancy].

    Science.gov (United States)

    Rapisarda, V; Revelli, E

    1980-06-01

    The incidence of pregnancy with IUD in situ varies from 1 to 3.8%. Apparently IUD failure is often due to abnormalities of the uterine cavity, or to a disproportion between the size of the uterine cavity and the size of the IUD. This article reports on the case of a woman, pregnant with a Gravigard in situ, who delivered at term a perfectly healthy 3500 g baby. The IUD, whose strings were invisible, had not been removed, and was found embedded in placental tissue at delivery. When IUD failure occurs it is necessary to ascertain whether the device is still in situ; ultrasound is the best suited tool even if not always accurate. When the IUD strings are visible and the woman intends to continue the pregnancy, a phsyician should try very gently to remove the device; should the removal prove difficult, it would be better to leave the device within the uterine cavity. A review of the published literature shows that 48 to 56% of women pregnant with IUD in situ will spontaneously abort, that risk of early delivery is 10%, and that risk of ectopic pregnancy is about 3.4%, higher with a Progestasert device. Doctor should regularly examine the patient for septic conditions. Risk of neonatal malformation is extremely low; the possible influence of the copper component of many IUDs on the development of the fetus is still not clear.

  14. Increased expression of heat shock protein 105 in rat uterus of early pregnancy and its significance in embryo implantation

    Directory of Open Access Journals (Sweden)

    Hu Zhao-Yuan

    2009-03-01

    Full Text Available Abstract Background Heat shock proteins (Hsps are a set of highly conserved proteins, Hsp105, has been suggested to play a role in reproduction. Methods Spatio-temporal expression of Hsp105 in rat uterus during peri-implantation period was examined by immunohistochemistry and Western blot, pseudopregnant uterus was used as control. Injection of antisense oligodeoxynucleotides to Hsp105 into pregnant rat uteri was carried out to look at effect of Hsp105 on embryo implantation. Results Expression of Hsp105 was mainly in the luminal epithelium on day 1 of pregnancy, and reached a peak level on day 5, whereas in stroma cells, adjacent to the implanting embryo, the strongest expression of Hsp105 was observed on day 6. The immunostaining profile in the uterus was consistent with that obtained by Western blot in the early pregnancy. In contrast, no obvious peak level of Hsp105 was observed in the uterus of pseudopregnant rat on day 5 or day 6. Furthermore, injection of antisense oligodeoxynucleotides to Hsp105 into the rat uterine horn on day 3 of pregnancy obviously suppressed the protein expression as expected and reduced number of the implanted embryos as compared with the control. Conclusion Temporal and spatial changes in Hsp105 expression in pregnant rat uterus may play a physiological role in regulating embryo implantation.

  15. Field use of ultrasonography to characterize the reproductive tract and early pregnancy in a phocid, the Weddell seal (Leptonychotes weddellii).

    Science.gov (United States)

    Shero, Michelle R; Adams, Gregg P; Burns, Jennifer M

    2015-12-01

    The utility of transrectal ultrasonography was tested in a field setting to characterize the reproductive tract and detect early pregnancy (embryonic vesicles body, ovaries with follicles and corpora lutea) using a 5-10 MHz linear-array probe with a 70 cm-long extension. A single pregnancy was detected in 14 of 17 seals (82.4%) as a circular or guitar-pick shaped nonechogenic (black) vesicle with a clearly visible echogenic border within the lumen of the uterus. The stage of embryonic development (ostensibly the gestational age) varied markedly among individuals, ranging from a vesicle with no embryo proper to a large fetus with an ocular orbit, nose/mouth, limb buds, spinal column, umbilical cord, and prominent vasculature. Two of the pregnant seals were re-examined 3-6 days after the initial examination to obtain longitudinal growth rates. Images of one or both ovaries were obtained in nine and seven of the 19 examinations, respectively. Numerous ovarian follicles (3 to 12 mm diameter) were detected and animals typically had a single well-perfused corpus luteum (determined by Doppler color-flow) ipsilateral to the uterine horn containing the pregnancy. We conclude that real-time transrectal ultrasonography is an effective tool for characterizing reproductive events in phocids including ovarian dynamics, and for elucidating the nature of embryonic diapause.

  16. Further Evidence for the Role of Pregnancy-induced Hypertension and Other Early Life Influences in the Development of ADHD

    DEFF Research Database (Denmark)

    Pohlabeln, Hermann; Rach, Stefan; De Henauw, Stefaan

    2017-01-01

    -deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2–11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical...... during pregnancy and a child’s risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3–4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from...... pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09–3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05–4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate...

  17. 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

  18. [Pregnancy in pulmonary arterial hypertension patients].

    Science.gov (United States)

    Rosengarten, Dror; Kramer, Mordechai R

    2013-09-01

    Pulmonary arterial hypertension (PAH) is a disorder defined by elevated mean pulmonary arterial pressure. PAH can be idiopathic or associated with a variety of medical conditions such as scleroderma, congenital heart disease, left heart failure, lung disease or chronic pulmonary thromboembolism. This progressive disease can cause severe right heart failure and death. Normal physiologic changes that occur during pregnancy may produce fatal consequences in PAH patients. Current guidelines recommend that pregnancy be avoided or terminated early in women with PAH. During the past decade, new advanced therapies for PAH have emerged gathering reports of successful pregnancies in patients with pulmonary hypertension. Substantial risk still exists and current recommendations have not changed. Nevertheless, in selected cases, if a patient insists on continuing the pregnancy, being fully aware of the risks involved, an intensive treatment approach should be implemented in experienced centers. This is necessary in order to control pulmonary hypertension during pregnancy and reduce the risk so as to improve outcomes. This review will focus on the pathophysiology of PAH in pregnancy and appropriate management during pregnancy, delivery and the post-partum period.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Sanchez, Sixto E; Islam, Suhayla; Zhong, Qiu-Yue; Gelaye, Bizu; Williams, Michelle A

    2016-01-01

    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.

  1. Twin pregnancy in a liver transplant recipient with HIV infection.

    Science.gov (United States)

    Van Schalkwyk, McI; Westbrook, R H; O'Beirne, J; Wright, A; Gonzalez, A; Johnson, M A; Kinloch-de Loës, S

    2016-10-05

    We are not aware of a report detailing the complex obstetrical and medical management of twin pregnancy in the context of HIV infection and early post-liver transplantation period. Here we describe the successful outcome of a twin pregnancy in a 28-year-old HIV-positive female receiving antiretroviral therapy and immunosuppressive therapy who was the recipient of a liver transplant for previous drug-induced liver failure.

  2. Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation.

    Science.gov (United States)

    Cameron, Sharon T; Glasier, Anna; Dewart, Helen; Johnstone, Anne; Burnside, Audrey

    2012-07-01

    Telephone follow-up with a self-performed low-sensitivity urine pregnancy (LSUP) test was introduced at the Royal Infirmary of Edinburgh, Scotland, as an alternative to routine ultrasonography for confirming successful abortion at 2 weeks following early medical abortion (ultrasound. A service evaluation was conducted of the first 8 months of telephone follow-up consisting of a review of the numbers choosing this method of follow-up, the proportion successfully contacted and the efficacy for detecting ongoing pregnancies. In the last 3 months of the study, women were surveyed about their satisfaction with this method of follow-up. Opting for telephone follow-up were 476 out of 619 women (77%). Four women (1%) attended the clinic before telephone follow-up because of pain or bleeding. A total of 410 (87%) of the remaining 472 women were successfully contacted by telephone. Sixty women (15%) screened 'positive', three of whom had ongoing pregnancies, and one woman falsely screened 'negative'. The sensitivity of the telephone follow-up was 75% [95% confidence interval (CI) 30.1-95.4], and specificity was 86% (95% CI 82.2-89). The negative predictive value was 99.7% (95% CI 98.4-99.9), and positive predictive value was 5% (95% CI 1.7-13.7). All women surveyed (n=75) would recommend telephone follow-up to a friend. A telephone follow-up and an LSUP test at 2 weeks are effective for detecting ongoing pregnancy, have good follow-up rates and are popular choices for women. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Case study Early psychomotor development of children from triple pregnancy – case study

    Directory of Open Access Journals (Sweden)

    Łucja Bieleninik

    2014-08-01

    Full Text Available The aim of this study was to analyze the specificity and dynamics of psychomotor development in children from triplet pregnancy. The studied group was composed of siblings from triple pregnancy (T1, T2, T3, including two girls and one boy. This longitudinal study comprised three stages: stage I – children aged 25 months, stage II – children aged 29 months, and stage III – children aged 38 months. At each stage, the psychomotor development of children was examined with the Third Edition of Bayley Scales of Infant and Toddler Development (BSID-III and subjectively by their mother. Additionally, medical and nursing documentation was analyzed. Individual psychomotor development of children from triple pregnancy is different with regards to various spheres, and has different rates and dynamics throughout consecutive years. Psychomotor development of children from triple pregnancies is determined by gender and postnatal clinical parameters, i.e. birth weight, head circumference, postnatal morbidity, and prematurity-related conditions.

  4. Uterine artery remodeling in pseudopregnancy is comparable to that in early pregnancy.

    NARCIS (Netherlands)

    Heijden, O.W. van der; Essers, Y.P.; Spaanderman, M.E.A.; Mey, J.G. de; Eys, G. van; Peeters, L.L.

    2005-01-01

    During pregnancy, the lumenal diameter and wall mass of the uterine artery (UA) increase, most likely in response to the increased hemodynamic strain resulting from the chronically elevated uterine blood flow (UBF). In this remodeling process, the phenotype of vascular smooth-muscle cells (VSMC) is

  5. Early Pregnancy Cravings, Dietary Intake, and Development of Abnormal Glucose Tolerance.

    Science.gov (United States)

    Farland, Leslie V; Rifas-Shiman, Sheryl L; Gillman, Matthew W

    2015-12-01

    Little is known about the relationships between pregnancy cravings, maternal diet, and development of abnormal glucose tolerance. We examined relationships of pregnancy cravings with dietary intake and risk of developing isolated hyperglycemia (IH), impaired glucose tolerance (IGT), or gestational diabetes (GDM) later in pregnancy. Among 2,022 mothers in Project Viva, a prospective birth cohort recruited from medical practices in eastern Massachusetts between 1999 and 2002, we assessed type of pregnancy craving based on self-report at mean gestation of 10.9 weeks. The outcomes were cross-sectional dietary intake from a food frequency questionnaire and incident IH, IGT, or GDM determined by glucose tolerance screening at 26 to 28 weeks. We used linear regression to analyze the cross-sectional relationships between pregnancy cravings and dietary intake and multinomial logistic regression to analyze the prospective relationships among pregnancy cravings and development of IH, IGT, or GDM. During the first trimester, 443 (22%) women craved sweets, 225 (11%) craved salty foods, 261 (13%) craved savory foods, and 100 (4.9%) craved starchy foods. Sweet cravings were associated with increased intake of sucrose (1.9 g/day; 95% CI 0.1 to 3.7), total fat (1.5 g/day; 95% CI 0.1 to 2.9), and saturated fat (0.8 g/day; 95% CI 0.2 to 1.4); salty cravings were associated with increased fiber (0.7 servings/day; 95% CI -0.1 to 1.6); savory cravings were associated with increased n-3 fatty acids (0.10 g/day; 95% CI 0.02 to 0.17); and starchy cravings were associated with increased carbohydrates (8.0 g/day; 95% CI 0.3 to 15.7) and decreased total fat (-2.6 g/day; 95% CI -5.2 to -0.1). Salty cravings were associated with lower risk of GDM (adjusted odds ratio 0.34, 95% CI 0.12-0.97). New cravings in the first trimester of pregnancy were associated with dietary intake. Craving salty foods may predict reduced risk of developing GDM, whereas craving sweet food does not appear to alter one

  6. Cardiovascular Complications of Pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Carolina Gongora

    2015-10-01

    Full Text Available Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia, gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  7. Fever and pregnancy.

    Science.gov (United States)

    Le Gouez, Agnès; Benachi, Alexandra; Mercier, Frédéric J

    2016-10-01

    Severe infections during pregnancy and postpartum are rare, despite a high frequency of bacteraemia, but remain on of the leading cause of maternal death. Therapeutic guidelines validated in general population should be applied to pregnant women, with regards to their specificities: insidious clinical signs and rapid onset, clinical presentation often as respiratory failure due to physiological changes during pregnancy; most frequent causes: pneumonia, pyelonephritis, genitary tract infections; sensibility to virus, Listeria, malaria, due to immunological changes during pregnancy; caesarean section is the single most important risk factor of postpartum infection; aggressive treatment should be started promptly, including fluid infusion and early administration of vasoactive agents (Norepinephrine); broad-spectrum intravenous empirical antibiotic therapy must be established immediately (within the first hour), and chosen according to frequent microorganisms involved in sepsis during pregnancy; infectious source, mostly pelvic, is often accessible to surgery; if foetal extraction does not improve maternal outcomes, it remains necessary for obstetrical or foetal reasons and mandatory if chorioamnionitis is confirmed; specific attention should be drawn to streptococcus A invasive infection which experiments a recent resurgence and is correlated to a high morbidity and mortality for both the mother and the foetus; protocols should be written in every maternity.

  8. Cardiovascular Complications of Pregnancy.

    Science.gov (United States)

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  9. Use of All-polyethylene Tibial Components in Unicompartmental Knee Arthroplasty Increases the Risk of Early Failure.

    Science.gov (United States)

    Koh, In Jun; Suhl, Kyung Hwan; Kim, Min Woo; Kim, Man Soo; Choi, Keun Young; In, Yong

    2017-01-13

    All-polyethylene (all-poly) tibial designs in primary total knee arthroplasty (TKA) have been reconsidered with excellent clinical outcomes, survivorship, and cost-effectiveness. However, whether all-poly tibial components provided comparable results to metal-backed modular components during unicompartmental knee arthroplasty (UKA) remains unclear. This study compared the clinical outcomes and prevalence of early failure between all-poly and metal-backed modular components in UKA. We retrospectively reviewed the records and radiographs of 101 consecutive UKAs. In total, 51 UKAs were performed using all-poly tibial components; 50 others used metal-backed modular components. Clinical and radiographic outcomes, adaptive bone remodeling assessed by radiographic bone density, and early failure prevalence rates were compared. Despite a lack of group differences in clinical and radiographic outcomes (p > 0.1 in all comparisons), adaptive bone remodeling at 2 years after surgery of all-poly UKAs was more progressive compared with metal-backed UKAs (1.2 in all-poly UKA group vs. 0.9 in metal-backed UKA group, p In addition, 6 of 51 all-poly UKAs failed within 2 years postoperatively, whereas no metal-backed UKAs failed (11% in all-poly UKA group vs. 0% in metal-backed UKA group, p = 0.027). All-poly tibial component use during UKA increased the risk of early failure, which may be due to a failure in tibial loading distribution.

  10. Endometrial caspase 1 and interleukin-18 expression during the estrous cycle and peri-implantation period of porcine pregnancy and response to early exogenous estrogen administration

    Directory of Open Access Journals (Sweden)

    Stein Daniel R

    2010-04-01

    Full Text Available Abstract Background The role for endometrial secretion of cytokines during the establishment of pregnancy in a number of mammals is well established. The current study determined endometrial expression of caspase 1 (CASP1 and interleukin-18 (IL18 during the estrous cycle and early pregnancy, and following early estrogen administration, which induces conceptus loss during early development in pigs. Methods Gilts were hysterectomized on either D 0, 5, 10, 12, 15 and 18 of the estrous cycle, or D 10, 12, 15 or 18 of pregnancy. The abundance of endometrial CASP1 mRNA was unaffected by day of the estrous cycle, however there was a 6 and 10-fold increase in expression on D 15 and 18 of pregnancy. Endometrial expression of IL18 mRNA increased 5-fold between D 10 to 18 in cyclic and pregnant gilts. Total recoverable IL18 in uterine flushings was greater in pregnant compared to cyclic gilts on D 15 and 18. In the second experiment, mated gilts were treated with either corn oil (CO or estrogen (E on D 9 and 10 and hysterectomized on either D 10, 12, 13, 15 or 17 of pregnancy. The current study localizes the presence of CASP1 to the epithelial layer of the endometrium for the first time. Further, a day × treatment interaction was detected for endometrial CASP1 mRNA and protein abundance as E stimulated an earlier increase on D 13 compared to CO gilts. Although IL18 mRNA expression remained unaltered from the E treatment, protein abundance was significantly attenuated on D 15 and 18 in response to E treatment. Conclusions Endometrial expression of CASP1 and IL18 is associated with establishment of pregnancy in pigs. Alteration of CASP1 and IL18 following premature exposure of the uterus to estrogen during early pregnancy may contribute to conceptus loss between Days 15 to 18 of pregnancy.

  11. Maternal Diabetes in Pregnancy: Early and Long-Term Outcomes on the Offspring and the Concept of “Metabolic Memory”

    OpenAIRE

    Akadiri Yessoufou; Kabirou Moutairou

    2011-01-01

    The adverse outcomes on the offspring from maternal diabetes in pregnancy are substantially documented. In this paper, we report main knowledge on impacts of maternal diabetes on early and long-term health of the offspring, with specific comments on maternal obesity. The main adverse outcome on progenies from pregnancy complicated with maternal diabetes appears to be macrosomia, as it is commonly known that intrauterine exposure to hyperglycemia increases the risk and programs the offspring t...

  12. Maternal Mild Thyroid Hormone Insufficiency in Early Pregnancy and Attention-Deficit/Hyperactivity Disorder Symptoms in Children.

    Science.gov (United States)

    Modesto, Thiago; Tiemeier, Henning; Peeters, Robin P; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Ghassabian, Akhgar

    2015-09-01

    Maternal thyroid hormone insufficiency during pregnancy can affect children's cognitive development. Nevertheless, the behavioral outcomes of children exposed prenatally to mild thyroid hormone insufficiency are understudied. To examine whether exposure to maternal mild thyroid hormone insufficiency in early pregnancy was related to symptoms of attention-deficit/hyperactivity disorder (ADHD) in children at 8 years of age. The study was embedded within the Generation R, a population-based birth cohort in the Netherlands. Children in the Generation R Study are followed up from birth (April 1, 2002, through January 31, 2006) until young adulthood. Of the 4997 eligible mother-child pairs with data on maternal thyroid levels (excluding twins), 3873 pairs of children and caregivers (77.5%) visited the Generation R research center for in-depth assessments and were included in the main analyses. Data collection in Generation R started December 1, 2001 (enrollment of pregnant women), and is ongoing. For this study, we used the data that were collected until January 1, 2014. Data analyses started on January 31 and finished June 30, 2014. Maternal hypothyroxinemia, characterized by low levels of free thyroxine coexisting with reference thyrotropin levels, and children's symptoms of ADHD. Maternal thyroid hormone levels (thyrotropin, free thyroxine, thyroid peroxidase antibodies) were measured at a mean (SD) of 13.6 (1.9) weeks of gestation. Children's ADHD symptoms were assessed at 8 years of age using the Conners' Parent Rating Scale-Revised Short Form; higher scores indicate more ADHD symptoms (possible range, 0-36). Maternal hypothyroxinemia (n = 127) in early pregnancy was associated with higher scores for ADHD symptoms in children at 8 years of age after adjustments for child and maternal factors (ie, sex, ethnicity, maternal age, maternal educational level, and income) (increase in ADHD scores, 7% [95% CI, 0.3%-15%]). The results remained essentially unchanged when

  13. A case of spontaneous tubal pregnancy with caesarean scar pregnancy.

    Science.gov (United States)

    Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang

    2014-01-01

    Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured.

  14. The regular distribution and expression pattern of immunosuppressive cytokine IL-35 in mouse uterus during early pregnancy.

    Science.gov (United States)

    Jin, Erhui; Wang, Chenfang; Hu, Qianqian; Jin, Guangming; Li, Shenghe

    2014-01-01

    Cytokines within the uterus are critical in the maternal-fetal immune regulation. Immunosuppressive cytokine IL-35 was recently discovered inhibitory cytokine, which were pivotal in the establishment of immune tolerance against self-antigens and antigens encountered in foreign implantation. In order to analyze the role of IL-35 in maternal-fetal immune tolerance, the expression patterns of IL-35 in mouse endometrium were studied during early pregnancy by immunohistochemistry, ELISA and quantitative real-time PCR. As results, we found that IL-35 positive cells in the uterus showed significant distribution difference after fetal implantation, which mainly distributed in luminal epithelium and glandular epithelium of mouse uterus from gestational day 1 to 2, and glandular epithelium and stroma from gestational day 4 to 7. The number of positive cells, immunoreactive scores, protein and mRNA expression of IL-35 showed firstly increased and then decreased with the increase of pregnancy day. The largest contents of IL-35 in the uterus were detected on gestational day 4. Compared with non-pregnant mice, pregnant mice showed the significantly increased mRNA expression of Ebi3 (Epstein-Barr virus-induced gene 3, IL-35 subunit) in the endometrium on gestational day 2 and the highest level of expression on gestational day 4. The mRNA expression of p35 (IL-35 subunit) was significantly lower than that of Ebi3 gene and showed the inconsistent change from gestational day 5 to 7. However, the significant correlation existed between the immunohistochemical expression, contents and mRNA expression of IL-35. These results indicated that IL-35 contributed to the establishment and maintenance of maternal-fetal tolerance during early pregnancy.

  15. Evolution of the human brain, chorionic gonadotropin and hemochorial implantation of the placenta: insights into origins of pregnancy failures, preeclampsia and choriocarcinoma.

    Science.gov (United States)

    Cole, Laurence A; Khanlian, Sarah A; Kohorn, Ernest I

    2008-08-01

    Hyperglycosylated chorionic gonadotropin (CG-H) signals placental cytotrophoblast cell growth and invasion, and chorionic gonadotropin (CG) promotes uterine vascularization. A hypothesis is presented relating the evolution of these molecules to the evolution of human hemochorial implantation and that of the human brain. Deep placental invasion, vascularization and hemochorial placentation, under the influence of CG and CG-H, are a critical part of the nutrition and energy-generating mechanisms needed for human brain development and thus for the evolution of humans. Insufficient CG-H production and the resulting inappropriate implantation is associated with an unduly high incidence of pregnancy failures in humans. Low levels of CG-H and inappropriate hemochorial placentation also appear to be associated with subsequent preeclampsia. It is also of note that human CG-H drives invasion by gestational trophoblastic neoplasms that have been described only in humans.

  16. 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...... 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...... 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

  17. Hypertensive disorders in pregnancy

    OpenAIRE

    Berry, Casey; Atta, Mohamed G.

    2016-01-01

    Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease...

  18. Low levels of corticotropin-releasing hormone during early pregnancy are associated with precocious maturation of the human fetus.

    Science.gov (United States)

    Class, Quetzal A; Buss, Claudia; Davis, Elysia Poggi; Gierczak, Matt; Pattillo, Carol; Chicz-DeMet, Aleksandra; Sandman, Curt A

    2008-01-01

    Elevation in placental corticotropin-releasing hormone (pCRH) during the last trimester of pregnancy has been associated with an increased risk for preterm delivery. Less is known about the consequences for the human fetus exposed to high levels of pCRH early in pregnancy. pCRH levels were measured in 138 pregnant women at least once at 15, 20 and 25 weeks of gestation. At 25 weeks of gestation, fetal heart rate (FHR) responses to a startling vibroacoustic stimulus (VAS) were recorded as an index of maturity. pCRH levels at 15 weeks of gestation, but at no later point, predicted FHR responses to the VAS. Fetuses exposed to the lowest concentrations of pCRH at 15 weeks of gestation exhibited a distinguishable response to the VAS, whereas fetuses exposed to higher levels of pCRH did not respond. The findings suggest that exposure to low levels of pCRH early in gestation may be optimal and associated with a response pattern indicating greater maturity. (c) 2009 S. Karger AG, Basel.

  19. Low Levels of Corticotropin-Releasing Hormone during Early Pregnancy Are Associated with Precocious Maturation of the Human Fetus

    Science.gov (United States)

    Class, Quetzal A.; Buss, Claudia; Davis, Elysia Poggi; Gierczak, Matt; Pattillo, Carol; Chicz-DeMet, Aleksandra; Sandman, Curt A.

    2010-01-01

    Elevation in placental corticotropin-releasing hormone (pCRH) during the last trimester of pregnancy has been associated with an increased risk for preterm delivery. Less is known about the consequences for the human fetus exposed to high levels of pCRH early in pregnancy. pCRH levels were measured in 138 pregnant women at least once at 15, 20 and 25 weeks of gestation. At 25 weeks of gestation, fetal heart rate (FHR) responses to a startling vibroacoustic stimulus (VAS) were recorded as an index of maturity. pCRH levels at 15 weeks of gestation, but at no later point, predicted FHR responses to the VAS. Fetuses exposed to the lowest concentrations of pCRH at 15 weeks of gestation exhibited a distinguishable response to the VAS, whereas fetuses exposed to higher levels of pCRH did not respond. The findings suggest that exposure to low levels of pCRH early in gestation may be optimal and associated with a response pattern indicating greater maturity. PMID:19127063

  20. [Air pollutant exposure during pregnancy and fetal and early childhood development. Research protocol of the INMA (Childhood and Environment Project)].

    Science.gov (United States)

    Esplugues, Ana; Fernández-Patier, Rosalía; Aguilera, Inma; Iñíguez, Carmen; García Dos Santos, Saúl; Aguirre Alfaro, Amelia; Lacasaña, Marina; Estarlich, Marisa; Grimalt, Joan O; Fernández, Marieta; Rebagliato, Marisa; Sala, María; Tardón, Adonina; Torrent, Maties; Martínez, María Dolores; Ribas-Fitó, Núria; Sunyer, Jordi; Ballester, Ferran

    2007-01-01

    The INMA (INfancia y Medio Ambiente [Spanish for Environment and Childhood]) project is a cooperative research network. This project aims to study the effects of environment and diet on fetal and early childhood development. This article aims to present the air pollutant exposure protocol during pregnancy and fetal and early childhood development of the INMA project. The information to assess air pollutant exposure during pregnancy is based on outdoor measurement of air pollutants (nitrogen dioxide [NO2], volatile organic compounds [VOC], ozone, particulate matter [PM10, PM2,5 ] and of their composition [polycyclic aromatic hydrocarbons]); measurement of indoor and personal exposure (VOC and NO2); urinary measurement of a biological marker of hydrocarbon exposure (1-hydroxypyrene); and data gathered by questionnaires and geographic information systems. These data allow individual air pollutant exposure indexes to be developed, which can then be used to analyze the possible effects of exposure on fetal development and child health. This protocol and the type of study allow an approximation to individual air pollutant exposure to be obtained. Finally, the large number of participants (N = 4,000), as well as their geographic and social diversity, increases the study's potential.

  1. Human chorionic gonadotropin potentially affects pregnancy outcome in women with recurrent implantation failure by regulating the homing preference of regulatory T cells.

    Science.gov (United States)

    Diao, Liang-Hui; Li, Guan-Gui; Zhu, Yuan-Chang; Tu, Wen-Wei; Huang, Chun-Yu; Lian, Ruo-Chun; Chen, Xian; Li, Yu-Ye; Zhang, Tao; Huang, Yong; Zeng, Yong

    2017-03-01

    Human chorionic gonadotropin (hCG) and regulatory T cells (Tregs) have been suggested to play important roles during the initial stage of pregnancy. However, the clinical relevance and mechanism of the effects of hCG on Treg functions in women with recurrent implantation failure (RIF) remain to be elucidated. Thirty-four RIF and twenty-three control women were included in the study. Endometrial and peripheral Tregs were analyzed by immunohistochemistry and flow cytometry, respectively. Tregs were generated from naïve CD4(+) T cells by stimulation with anti-CD3/CD28 in the presence or absence of hCG, and the subsets were analyzed by flow cytometry, Western blotting, and qPCR. The percentages of endometrial FOXP3(+) Tregs and peripheral CCR4(+) FOXP3(+) Tregs were significantly lower in the women with RIF than in the healthy controls. In addition, the percentages of CCR4(+) FOXP3(+) Tregs and TGF-β-expressing FOXP3(+) Tregs were increased following the stimulation of naïve CD4(+) T cells with anti-CD3/CD28, and these increases were concomitant with AKT and ERK dephosphorylation. The results of this study provide novel evidence supporting a role of hCG in regulating the differentiation of peripheral FOXP3(+) Tregs. The alterations of circulating Tregs may positively affect the pregnancy outcomes of patients with a history of RIF. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. NUTRITION DURING PREGNANCY

    OpenAIRE

    Banjari, Ines

    2015-01-01

    The health of the new-born is largely a function of the mother's nutritional, general and reproductive health status. Therefore, pregnancy is considered as a critical window in child’s growth and development. Several characteristics of a woman prior or in early pregnancy, as well as external, environmental factors affect pregnancy outcomes. External factors account for 30% of the pregnancy outcome and infant's birth weight, and mother’s diet during pregnancy is one of the most important ones....

  3. Pregnancy and HIV

    Science.gov (United States)

    ... 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 ...

  4. Vaginal bleeding in pregnancy

    Science.gov (United States)

    ... may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away. During ... Cervical polyp or growth Early labor (bloody show) Ectopic pregnancy Infection of the cervix Trauma to the cervix ...

  5. Device diagnostics and early identification of acute decompensated heart failure: a systematic review.

    Science.gov (United States)

    Blair, Tara Leslie

    2014-01-01

    Traditional methods of heart failure (HF) management are based on reactive strategies to treat late indicators of decompensated HF. Advances in monitoring methods have become availa