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Sample records for pregnancy related complications

  1. Pregnancy Complications

    Science.gov (United States)

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

  2. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Complications & Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... this page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  3. Obesity-related complications in Danish single cephalic term pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Nilas, Lisbeth; Wøjdemann, Karen

    2005-01-01

    extraction. Obese women had an increased risk of delivering macrosomic but also low birth weight children. No differences existed among the 3 weight groups with regard to neonatal morbidity estimated by Apgar score, umbilical cord pH, or admittance to a neonatal intensive care unit. Nulliparous women had......OBJECTIVE: Our objective was to investigate the relationship between prepregnancy and obstetric body mass index (BMI) as well as fetal complications in a large, unselected cohort of Danish women with single cephalic pregnancies. METHODS: A cohort of 8,092 women from the Copenhagen First Trimester...

  4. Vascular related pregnancy complications: genetics and remote cardiovascular risk

    NARCIS (Netherlands)

    A.L. Berends (Anne)

    2008-01-01

    textabstractPreeclampsia and intrauterine growth restriction (IUGR) are common vascular related pregnancy syndromes of unknown cause. Both preeclampsia and IUGR are responsible for a significant maternal and perinatal morbidity and mortality worldwide. Preeclampsia affects approximately 2.5-3.0% of

  5. Obesity-related complications in Danish single cephalic term pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Nilas, Lisbeth; Wøjdemann, Karen

    2005-01-01

    OBJECTIVE: Our objective was to investigate the relationship between prepregnancy and obstetric body mass index (BMI) as well as fetal complications in a large, unselected cohort of Danish women with single cephalic pregnancies. METHODS: A cohort of 8,092 women from the Copenhagen First Trimester...... Study with a registered prepregnancy BMI and a single cephalic term delivery were stratified into 3 BMI groups: normal weight (BMI obese (BMI >/= 30 kg/m(2)). The effects of BMI and parity on the outcome were analyzed using multivariate logistic...... regression analyses. RESULTS: Overweight women had an odds ratio (OR) of 3.4 for diabetes, 1.9 for hypertension, 1.7 for preeclampsia, and 1.5 for cesarean delivery. The corresponding figures for obese women were 15.3, 4.8, 2.7, and 1.7, respectively. No relationship was found between BMI and vacuum...

  6. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  7. Thrombophilia in complicated pregnancies

    Directory of Open Access Journals (Sweden)

    Ayşe Şahin

    2013-12-01

    Full Text Available Objective: To investigate the incidence and etiology of pregnancy complications associated with thrombophilic factors. Methods: Fifty-four patients with complicated pregnancy and 40 healthy pregnant subjects were included the study. Factor V Leiden (FVL mutation, protein S, protein C, anti-thrombin deficiency levels were investigated. Results: Of the 54 patients with complicated pregnancy, 29 had preeclampsia, 18 had intra uterine growth retardation, and 7 had intrauterine fetal loss. The most common defect was FVL mutation. FVL mutations in patient group and the control group were 27.2% and 10%, respectively, which were statistically significant. The protein S, protein C, and anti-thrombin deficiencies were found higher in the patient group compared to control (p>0.05 for each. Conclusion: FVL mutation was found higher in patient group compared to the control group, Protein C deficiency and anti-thrombin deficiency were related to preeclampsia but not other pregnancy complications. Clinicians should take into account the thrombophilia in complicated pregnancy, especially preeclampsia. J Clin Exp Invest 2013; 4 (4: 497-502

  8. Shared constitutional risks for maternal vascular-related pregnancy complications and future cardiovascular disease

    NARCIS (Netherlands)

    A.L. Berends (Anne); C.J.M. de Groot (Christianne); E.J.G. Sijbrands (Eric); M.P.S. Sie (Mark); S.H. Benneheij (Sofie); R. Pal (Richard); R. Heydanus (Rogier); B.A. Oostra (Ben); P. Tikka-Kleemola (Päivi); R.P.M. Steegers-Theunissen (Régine)

    2008-01-01

    textabstractMaternal predisposition to vascular and metabolic disease may underlie both vascular-related pregnancy complications, such as preeclampsia and intrauterine growth restriction, as well as future maternal cardiovascular disease. We aimed to substantiate this hypothesis with biochemical and

  9. 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.

  10. 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.

  11. Pregnancy Complications: Preeclampsia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Preeclampsia Preeclampsia E-mail to a friend Please fill in ... even if you’re feeling fine. What is preeclampsia? Preeclampsia is a condition that can happen after ...

  12. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  13. Sigmoid volvulus complicating pregnancy

    Directory of Open Access Journals (Sweden)

    De Utpal

    2005-07-01

    Full Text Available Sigmoid volvulus complicating pregnancy is an extremely rare complication with fewer than 76 cases reported in literature. We report a case of sigmoid volvulus complicating pregnancy. The sigmoid colon was resected and Hartman′s colostomy was performed. The patient had a successful recovery. Aggressive resuscitation followed by early surgical intervention should be undertaken to reduce maternal and fetal morbidity and mortality.

  14. Assisted reproductive technology and pregnancy-related hypertensive complications: a systematic review.

    Science.gov (United States)

    Thomopoulos, C; Tsioufis, C; Michalopoulou, H; Makris, T; Papademetriou, V; Stefanadis, C

    2013-03-01

    Hypertensive complications in pregnancy are the leading cause of maternal morbidity, at least in the developed countries. In recent years, infertility issues are managed with ever growing therapeutic options namely assisted reproductive technologies (ART), which improve the ratio of successful induction of pregnancy. It is still debated whether various ART modalities are associated with adverse pregnancy outcomes, including hypertensive complications, particularly with higher incidence of preeclampsia. The main source of controversy stems from the diversity of effect modifiers modulating the association between ART-oriented pregnancy and hypertensive disorders. Indeed, women undergoing an ART procedure are affected by diverse causes of infertility, are frequently characterized by different genetic patterns with respect to their artificially conceived embryo and experienced multiple gestations. In order to investigate whether ART modalities are associated with increased incidence of hypertensive complications in pregnancy, we reviewed all published studies carried out before the end of 2010 and identified in the PubMed database. Among the 47 studies finally selected and by acknowledging the potential of shortcomings related to the different study design and populations, the overall evidence suggests that ART-oriented pregnancies-especially the in-vitro fertilization techniques-are accompanied by increased risk for gestational hypertension and preeclampsia as compared with non-ART pregnancies, even after adjustment for confounders. Multiple gestations, advanced age and underlying polycystic ovary syndrome resulted in constant confounders of the questioned association. Reducing multiple gestations by implementing single embryo techniques might be the therapeutic limiting step to lower the rate of hypertensive complications in assisted pregnancies.

  15. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    National Research Council Canada - National Science Library

    Yael Baumfeld; Reli Herskovitz; Zehavi Bar Niv; Salvatore Andrea Mastrolia; Adi Y. Weintraub

    2017-01-01

    Objectives: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications...

  16. 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.

  17. 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.

  18. Hematologic Complications of Pregnancy

    Science.gov (United States)

    Townsley, Danielle M.

    2013-01-01

    Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

  19. Hemodynamic Profiling in Complicated Pregnancies

    NARCIS (Netherlands)

    J.M.J. Cornette (Jérôme)

    2016-01-01

    textabstractIn order to permit a successful pregnancy outcome, the cardiovascular system must undergo substantial changes. This thesis addresses the hemodynamics in several pregnancy complications. A general overview of normal hemodynamic adaptation to pregnancy is provided . Several techniques of

  20. Pregnancy-related hemangioblastoma progression and complications in von Hippel-Lindau disease.

    NARCIS (Netherlands)

    Frantzen, C.; Kruizinga, R.C.; Asselt, S.J. van; Zonnenberg, B.A.; Lenders, J.W.M.; Herder, W.W. de; Walenkamp, A.M.; Giles, R.H.; Hes, F.J.; Sluiter, W.J.; Pampus, M.G. van; Links, T.P.

    2012-01-01

    OBJECTIVE: We studied the reciprocal effect of pregnancy and von Hippel-Lindau (VHL) disease by analyzing the influence of pregnancy on VHL disease-related lesions and VHL disease on pregnancy outcome. METHODS: Medical charts and imaging reports from the VHL disease expertise centers in the Netherla

  1. Lemierre's Syndrome Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    M. Thompson

    2007-01-01

    Full Text Available Lemierre's syndrome is an anaerobic suppurative thrombophlebitis involving the internal jugular vein secondary to oropharyngeal infection. There is only one previous case report in pregnancy which was complicated by premature delivery of an infant that suffered significant neurological damage. We present an atypical case diagnosed in the second trimester with a live birth at term. By reporting this case, we hope to increase the awareness of obstetricians to the possibility of Lemierre's syndrome when patients present with signs of unabating oropharyngeal infection and pulmonary symptoms.

  2. Pregnancy Complications: Placenta Previa

    Science.gov (United States)

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

  3. Pregnancy Complications: Chlamydia

    Science.gov (United States)

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

  4. Pregnancy Complications: Syphilis

    Science.gov (United States)

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

  5. Pregnancy Complications: Gonorrhea

    Science.gov (United States)

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

  6. Pregnancy Complications: Salmonellosis

    Science.gov (United States)

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

  7. Pregnancy Complications: Genital Herpes

    Science.gov (United States)

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

  8. Identification of a Monoclonal Antibody That Attenuates Antiphospholipid Syndrome-Related Pregnancy Complications and Thrombosis.

    Directory of Open Access Journals (Sweden)

    Chieko Mineo

    Full Text Available In the antiphospholipid syndrome (APS, patients produce antiphospholipid antibodies (aPL that promote thrombosis and adverse pregnancy outcomes. Current therapy with anticoagulation is only partially effective and associated with multiple complications. We previously discovered that aPL recognition of cell surface β2-glycoprotein I (β2-GPI initiates apolipoprotein E receptor 2 (apoER2-dependent signaling in endothelial cells and in placental trophoblasts that ultimately promotes thrombosis and fetal loss, respectively. Here we sought to identify a monoclonal antibody (mAb to β2-GPI that negates aPL-induced processes in cell culture and APS disease endpoints in mice. In a screen measuring endothelial NO synthase (eNOS activity in cultured endothelial cells, we found that whereas aPL inhibit eNOS, the mAb 1N11 does not, and instead 1N11 prevents aPL action. Coimmunoprecipitation studies revealed that 1N11 decreases pathogenic antibody binding to β2-GPI, and it blocks aPL-induced complex formation between β2-GPI and apoER2. 1N11 also prevents aPL antagonism of endothelial cell migration, and in mice it reverses the impairment in reendothelialization caused by aPL, which underlies the non-thrombotic vascular occlusion provoked by disease-causing antibodies. In addition, aPL inhibition of trophoblast proliferation and migration is negated by 1N11, and the more than 6-fold increase in fetal resorption caused by aPL in pregnant mice is prevented by 1N11. Furthermore, the promotion of thrombosis by aPL is negated by 1N11. Thus, 1N11 has been identified as an mAb that attenuates APS-related pregnancy complications and thrombosis in mice. 1N11 may provide an efficacious, mechanism-based therapy to combat the often devastating conditions suffered by APS patients.

  9. Obese pregnant women and complications in relation to pregnancy and birth

    DEFF Research Database (Denmark)

    Vinter, Christina Anne; Tanvig, Mette Honnens; Damm, Peter

    2012-01-01

    One third of the pregnant Danish women are overweight or obese. Maternal obesity is an independent risk factor for adverse maternal and foetal outcomes including infertility, miscarriage, congenital malformations, preeclampsia, gestational diabetes, complicated deliveries, caesarean section, macr......, macrosomia and childhood obesity. This article reviews the effect of maternal obesity on obstetric and neonatal outcomes and provides recommendations for management of obesity in pregnancy....

  10. Obesity, pregnancy complications, and birth outcomes.

    Science.gov (United States)

    Marshall, Nicole E; Spong, Catherine Y

    2012-12-01

    Obesity is an increasingly common complication of pregnancy with over half of all women in the United States starting pregnancy overweight or obese. Obese women face unique physiological changes during pregnancy, and these women and their neonates are at increased risk for perinatal morbidity and mortality. In this review, we discuss physiological alterations in obese pregnant women and examine obesity-related antepartum, intrapartum, and postpartum complications along with management options.

  11. Pregnancy Complications: Liver Disorders

    Science.gov (United States)

    ... pregnancy. It is rarely passed from mother to baby during delivery (6). Hepatitis B poses the greatest risk in ... pregnancy. It is rarely passed from mother to baby during delivery (6). Hepatitis B poses the greatest risk in ...

  12. Obese pregnant women and complications in relation to pregnancy and birth

    DEFF Research Database (Denmark)

    Vinter, Christina Anne; Tanvig, Mette Honnens; Damm, Peter

    2012-01-01

    One third of the pregnant Danish women are overweight or obese. Maternal obesity is an independent risk factor for adverse maternal and foetal outcomes including infertility, miscarriage, congenital malformations, preeclampsia, gestational diabetes, complicated deliveries, caesarean section, macr......, macrosomia and childhood obesity. This article reviews the effect of maternal obesity on obstetric and neonatal outcomes and provides recommendations for management of obesity in pregnancy.......One third of the pregnant Danish women are overweight or obese. Maternal obesity is an independent risk factor for adverse maternal and foetal outcomes including infertility, miscarriage, congenital malformations, preeclampsia, gestational diabetes, complicated deliveries, caesarean section...

  13. Pregnancy Complications: HELLP Syndrome

    Science.gov (United States)

    ... happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these ... side Enlarged liver High blood pressure Swelling in ...

  14. Genome-Wide Identification of Epigenetic Hotspots Potentially Related to Cardiovascular Risk in Adult Women after a Complicated Pregnancy.

    Directory of Open Access Journals (Sweden)

    Cees Oudejans

    Full Text Available The physiological demands of pregnancy on the maternal cardiovascular system can catapult women into a metabolic syndrome that predisposes to atherosclerosis in later life. We sought to identify the nature of the epigenomic changes associated with the increased cardiovascular disease (CVD risk in adult women following pre-eclampsia.We assessed the genome wide epigenetic profile by methyl-C sequencing of monozygotic parous twin sister pairs discordant for a severe variant of pre-eclampsia. In the adult twin sisters at risk for CVD as a consequence of a complicated pregnancy, a set of 12 differentially methylated regions with at least 50% difference in methylation percentage and the same directional change was found to be shared between the affected twin sisters and significantly different compared to their unaffected monozygous sisters.The current epigenetic marker set will permit targeted analysis of differentially methylated regions potentially related to CVD risk in large cohorts of adult women following complicated pregnancies.

  15. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions. METH

  16. Inherited thrombophilia and pregnancy complications

    NARCIS (Netherlands)

    de Jong, P.G.

    2015-01-01

    The research presented in this thesis addresses several aspects of the association between inherited thrombophilia and pregnancy complications. Antithrombotic therapy is prescribed to women with recurrent miscarriage and antiphospholipid syndrome to increase their chance of live birth in a subsequen

  17. Inherited thrombophilia and pregnancy complications

    NARCIS (Netherlands)

    de Jong, P.G.

    2015-01-01

    The research presented in this thesis addresses several aspects of the association between inherited thrombophilia and pregnancy complications. Antithrombotic therapy is prescribed to women with recurrent miscarriage and antiphospholipid syndrome to increase their chance of live birth in a

  18. Complicating Late Pregnancy

    Directory of Open Access Journals (Sweden)

    H. Mahesha Navada

    2011-01-01

    Full Text Available Chronic pelvic inflammatory disease (PID in the form of peritoneal abscess during pregnancy is almost unheard entity. Early and antenatal diagnosis may be difficult or may be revealed only during caesarean section. We report a case of peritoneal abscess secondary to pelvic inflammatory disease incidentally found at repeat caesarean section. It was managed by conservative surgical approach.

  19. Placenta associated pregnancy complications in pregnancies complicated with placenta previa.

    Science.gov (United States)

    Baumfeld, Yael; Herskovitz, Reli; Niv, Zehavi Bar; Mastrolia, Salvatore Andrea; Weintraub, Adi Y

    2017-06-01

    The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications (IUGR, preeclampsia, placental abruption and perinatal mortality). Our study included all deliveries that occurred at Soroka University Medical Center (Beer Sheva, Israel) between January 1998 and December 2013. Of them 1,249 were complicated by placenta previa and represented our study group. A composite outcome was created to include conditions associated with placental insufficiency. It included hypertensive disorders (i.e. gestational hypertension, mild and severe preeclampsia, HELLP and eclampsia), small for gestational age neonates and placental abruption. Patients with pregnancy complicated by placenta previa had significantly different obstetrical characteristics including bad obstetric history (8% vs. 4%, p placenta previa had higher rates of vaginal bleeding in the second half of pregnancy (3% vs. 0%, p placenta (4% vs. 0.5%, p placenta previa group (21% vs. 13%, p placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications. Copyright © 2017. Published by Elsevier B.V.

  20. Recurring complications in second pregnancy

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Paidas, Michael J; Langhoff-Roos, Jens

    2009-01-01

    OBJECTIVE: To clarify the obstetric consequences in a second pregnancy after a first singleton pregnancy complicated by spontaneous preterm delivery or preeclampsia and stratified by the variation in fetal growth. METHODS: In a registry-based cohort study, we identified women having a first...... pregnancies. RESULTS: Compared with a spontaneous first delivery at term, a delivery between 32 and 36 weeks of gestation increased the risk of preterm delivery in the second pregnancy from 2.7% to 14.7% (odds ratio [OR] 6.12, 95% confidence interval [CI] 5.84-6.42) and the risk of preeclampsia from 1.1% to 1.......8% (OR 1.60, 95% CI 1.41-1.81); a delivery before 28 weeks increased the risk of a second preterm delivery to 26.0% (OR 13.1, 95% CI 10.8-15.9) and a second pregnancy with preeclampsia to 3.2% (OR 2.96, 95% CI 1.80-4.88). A first delivery in preeclamptic women between 32 and 36 weeks, compared...

  1. Maternal Lifestyle and Pregnancy Complications: The Generation R Study

    NARCIS (Netherlands)

    R. Bakker (Rachel)

    2011-01-01

    textabstractAdverse maternal lifestyle habits during pregnancy are important modifiable risk factors for pregnancy complications in Western countries. Most common adverse maternal lifestyle habits include smoking, alcohol consumption, and caffeine consumption. Although not directly lifestyle related

  2. Pregnancy complications and birth outcomes of pregnant women with urinary tract infections and related drug treatments.

    Science.gov (United States)

    Bánhidy, Ferenc; Acs, Nándor; Puhó, Erzsébet H; Czeizel, Andrew E

    2007-01-01

    Maternal urinary tract infections in pregnancy showed an association with a higher rate of preterm birth in previous studies. The aim of this study was to check this relationship, and in addition to evaluate the efficacy of recent medical treatments. The population-based large control (without any defects) data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities was evaluated. Of 38,151 newborn infants, 2188 (5.7%) had mothers with urinary tract infections during pregnancy, and 90% of these maternal diseases were prospectively and medically recorded. The prevalence of pre-eclampsia and polyhydramnios showed an association with urinary tract infections during pregnancy. Pregnant women with urinary tract infections in pregnancy had a somewhat shorter gestational age (0.1 week) and a higher proportion of preterm births (10.4% vs 9.1%). These differences were correlated with the severity of urinary tract infections. However, the preterm-inducing effect of maternal urinary tract infections is preventable by some antimicrobial drugs such as ampicillin, cefalexin and cotrimoxazole. In conclusion, maternal urinary tract infections during pregnancy increase pre-eclampsia and polyhydramnios, and in addition the rate of preterm birth; however, the latter is preventable by appropriate drug treatments.

  3. Subcapsular hepatic hematoma. Serious complication during pregnancy

    Directory of Open Access Journals (Sweden)

    María Teresa Pérez Hernández

    2010-12-01

    Full Text Available Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe pre-eclampsia or HELLP syndrome (hemolysis, elevated liver enzymes and diminished platelets. Maternal and perinatal mortality in these cases is high, hence the importance of early diagnosis and timely and multidisciplinary treatment. This paper is a review on the subject, held in Ebsco, Hinari and Sci databases.

  4. Tests Related to Pregnancy

    Science.gov (United States)

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

  5. Placental exosomes in normal and complicated pregnancy.

    Science.gov (United States)

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

    2015-10-01

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

  6. Risk of placenta-mediated pregnancy complications or pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and heterozygosity for factor V Leiden or G20210 prothrombin mutation.

    Science.gov (United States)

    Cordoba, Iris; Pegenaute, Carlota; González-López, Tomás José; Chillon, Carmen; Sarasquete, Maria Eugenia; Martin-Herrero, Francisco; Guerrero, Carmen; Cabrero, Mónica; Garcia Sanchez, Maria Helena; Pabon, Pedro; Lozano, Francisco Santiago; Gonzalez, Marcos; Alberca, Ignacio; González-Porras, José Ramón

    2012-09-01

    Few studies have evaluated the risk of pregnancy-related adverse events in asymptomatic relatives of probands for VTE and factor V Leiden or the G20210A variant. The antepartum management of this population ranges from antepartum anticoagulation therapy to clinical surveillance. To evaluate the risk of placenta-mediated pregnancy complications and pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and who are heterozygous carriers of either factor V Leiden or PT-G20210A mutation. One hundred and fifty-eight relatives, who had 415 pregnancies, were retrospectively evaluated. Odds ratios and 95% confidence intervals were calculated to compare pregnancy outcomes between women with and without thrombophilia. In the factor V Leiden group, 22 placenta-mediated pregnancy events of 152 pregnancies (14.4%) were reported, compared with 25 adverse events of 172 pregnancies in the G20210A prothrombin group (14.5%) and 13 adverse events of 91 pregnancies in the non-carrier group (14.2%). Carriers of factor V Leiden or G20210A prothrombin were not associated with a higher risk of pregnancy-adverse outcomes compared with non-carriers: OR 1.02 (95% CI, 0.40-2.25) and 1.25 (95% CI, 0.48-3.24), respectively. Four episodes of pregnancy-associated VTE of 415 pregnancies (0.96%) were recorded. Two episodes of VTE in the G20210A group, one in the factor V Leiden group, and one episode in the non-carrier group were noted. In VTE-asymptomatic relatives of probands with VTE, the presence of factor V Leiden or the G20210A prothrombin mutation in heterozygosis should not lead to a decision to instigate antepartum prophylaxis. © 2012 John Wiley & Sons A/S.

  7. STUDY OF OBSTETRIC COMPLICATIONS & OUTCOME OF TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swati

    2014-10-01

    Full Text Available : INTRODUCTION: Twin pregnancy is a rare phenomenon and significantly related to increased maternal & fetal morbidity and mortality as compared to singleton pregnancy. It is important that every physician must know the complications related to twin pregnancy and how to manage these complications. DESIGN: Prospective observational study AIMS AND OBJECTIVE: (1 To study incidence of various obstetric complications in twin pregnancy (2 To study outcome of twin pregnancy in terms of average duration of gestation, mode of delivery & neonatal outcome. METHODS: 59 Patients with sonographically confirmed twin pregnancy attending ante-natal care outpatient department (ANC OPD & labor room at a tertiary care hospital in our Unit in specified period of 18 months as mentioned above were enrolled in this study and followed till delivery and thereafter in the neonatal period. RESULTS: In this study twin pregnancies were slightly more in multigravida. The rate of preterm delivery was 77.9%.PIH & Anaemia was more common in primigravida. Monochorionic twins had more complications than dichorionic twins. NICU admission rate in this study was 23.6%, perinatal mortality rate was 16.9% and neonatal mortality rate was 12.2%. CONCLUSION: Twinning in pregnancy is a high risk factor which can cause various maternal as well fetal complications. Prompt ANC care and timely intervention is required to avoid these complications.

  8. Sigmoid volvulus complicating pregnancy: a case report.

    Science.gov (United States)

    Atamanalp, Sabri Selcuk; Kisaoglu, Abdullah; Ozogul, Bunyami; Kantarci, Mecit; Disci, Esra; Bulut, O Hakan; Aksungur, Nurhak; Atamanalp, Refik Selim

    2015-02-01

    Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity.

  9. Sigmoid Volvulus Complicating Pregnancy: A Case Report

    OpenAIRE

    Atamanalp, Sabri Selcuk; Kisaoglu, Abdullah; Ozogul, Bunyami; Kantarci, Mecit; Disci, Esra; Bulut, O. Hakan; Aksungur, Nurhak; ATAMANALP, Refik Selim

    2015-01-01

    Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity.

  10. Multicystic Benign Mesothelioma Complicating Pregnancy.

    Science.gov (United States)

    Tamhankar, V A

    2015-01-01

    Multicystic benign mesothelioma (MBM) is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section.

  11. Multicystic Benign Mesothelioma Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    V. A. Tamhankar

    2015-01-01

    Full Text Available Multicystic benign mesothelioma (MBM is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section.

  12. Pregnancy complicating irradiation-induced constrictive pericarditis

    Energy Technology Data Exchange (ETDEWEB)

    Bakri, Younes N.; Martan, Ahmed; Amri, Aladin (King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Dept. of Obstetrics and Gynecology); Amri, M. (King Faisal Specialist Hospital and Research Centre, Riyadh (Saudi Arabia). Dept. of Cardiovascular Diseases)

    1992-01-01

    A case is reported of a 24 year-old primigravida who had severe effusive constrictive pericarditis secondary to mediastinal irradiation following chemotherapy for Hodgkins disease. Pregnancy was threatened by serious maternal cardiovascular complications and a non-viable fetus was born spontaneously and prematurely. Patient was completely asymptomatic before pregnancy. (au).

  13. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    Directory of Open Access Journals (Sweden)

    Yael Baumfeld

    2017-06-01

    Conclusions: Our study demonstrated an increased rate of placental insufficiency associated complications in women with placenta previa. This is of clinical relevance and suggests that a careful surveillance for women with placenta previa may help in minimizing maternal, fetal and neonatal complications.

  14. Invasive treatment in complicated monochorionic twin pregnancies

    DEFF Research Database (Denmark)

    Sundberg, Karin; Søgaard, Kirsten; Jensen, Lisa Neerup;

    2012-01-01

    Objective. Monochorionic twin pregnancies are associated with increased risk of severe complications. Umbilical cord occlusion (UCO) and fetoscopic selective laser coagulation (FSLC) are used as invasive treatment. The study aim was to document treatment indications and pregnancy outcome where UCO...... and FSLC were used for treating fetal discrepancies and twin-to-twin transfusion syndrome (TTTS). Design. Cohort study of all consecutively treated monochorionic twin pregnancies 2004-2010. Setting. Tertiary care center. Population. One hundred and twenty pregnancies treated by FSLC (55) or UCO (65...

  15. [Maternal autoimmune thyroid disease and pregnancy complication].

    Science.gov (United States)

    Gudović, Aleksandra; Spremović-Radjenović, Svetlana; Lazović, Gordana; Marinković, Jelena; Glisić, Andreja; Milićević, Srboljub

    2010-08-01

    Thyroid disorders exert a great impact on pregnancy course and outcome. The aim of the study was to investigate impact of autoimmune thyroid disorders on pregnancy course and outcome, frequency of pregnancy complications and pregnancy loss. We followed 63 pregnancies prospectively during the period 1985-2007, 28 with hyperthyroid and 15 with hypothyroid autoimmune disorders, and 20 healthy pregnancies. Follow up included clinical, sonographic and laboratory investigations, including OGTT and postprandial glicemia. There was no difference between previous preterm and term labor in the observed groups (chi2 = 2.309; p > 0.05). Analysis of previous early pregnancy loss showed no significance (chi2 = 4.918; p > 0.05), including varieties of spontaneous and missed abortion (Fisher, p 0.05), or between the groups with thyroid disorders (chi2 = 3.619; p > 0.05). There was no difference among the groups in developing pregnancy-induced hypertension (chi2 = 1.953; p > 0.05). Controlling thyroid diseases reduces pregnancy complications. Development of gestational diabetes in hypothyroid patients requires controlling glycoregulation in all pregnant women with hypothyroidism.

  16. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Richa

    2014-07-01

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

  17. Placental pathology in pregnancy complications.

    Science.gov (United States)

    Huppertz, Berthold

    2011-02-01

    Among pregnancy pathologies preeclampsia and fetal growth restriction are among the leading causes of maternal and perinatal mortality and morbidity. For both syndromes, the etiologies are still unclear in many facets. For the development of preeclampsia the presence of the placenta is a prerequisite, while for FGR a variety of other factors may be decisive. Cases with a combination of FGR and preeclampsia are the most severe cases and need clinical intervention. Studies on such cases have misled scientists and clinicians to hypothesize that a failure of trophoblast invasion is a specific feature of the early onset type of preeclampsia. Recent development in preeclampsia specific biomarkers and the intense use of Doppler ultrasound measurements already in the first trimester of pregnancy has resulted in a new understanding of the pathways leading to preeclampsia or FGR.

  18. Facility-based care for delivery and management of complications related to pregnancy and childbirth in Mexico

    Directory of Open Access Journals (Sweden)

    Bernardo Hernández

    2012-10-01

    Full Text Available OBJECTIVE: To describe the incidence and management of severe maternal and newborn complications in selected health facilities in Mexico. MATERIALS AND METHODS: As part of the WHO Multicountry Survey on Maternal and Newborn health, information was collected from medical records of women with deliveries and/or severe maternal complications during pregnancy or puerperium in 14 hospitals in Mexico City and the state of Guanajuato, Mexico. RESULTS: Of 13 311 women, 157 (12 per 1 000 live births had severe maternal complications including 4 maternal deaths. The most frequent complications were preeclampsia, postpartum hemorrhage, and chronic hypertension. Adverse perinatal outcomes were more frequent among women with severe maternal complications. A high use of uterotonics and parenteral antibiotics was found. A small proportion of women with eclampsia received magnesium sulfate. CONCLUSION: This study provides indicators on the incidence and management of maternal and neonatal complications in Mexico, which may be useful in studying and evaluating the performance of obstetric services.OBJETIVO: Describir la incidencia y manejo de complicaciones maternas y neonatales severas en hospitales seleccionados de México. MATERIAL Y MÉTODOS: En el marco de la Encuesta Multipaís de la OMS sobre Salud Materna y Neonatal, se recolectó información de los expedientes médicos de las mujeres que tuvieron su parto o experimentaron complicaciones maternas severas durante el embarazo o puerperio en 14 hospitales de la Ciudad de México y el estado de Guanajuato, México. RESULTADOS: De 13 311 mujeres, 157 (12/1 000 nacidos vivos tuvieron complicaciones maternas severas, incluyendo 4 muertes maternas. Las complicaciones más frecuentes fueron preeclampsia, hemorragia postparto e hipertensión crónica. Los resultados perinatales adversos fueron más frecuentes en las mujeres con complicaciones severas. Hubo un uso amplio de uterotónicos y antibi

  19. Appendicitis in Pregnancy: Presentation, Management and Complications

    Directory of Open Access Journals (Sweden)

    Abdoulhossein Davoodabadi

    2016-06-01

    Full Text Available Background Diagnosis of acute appendicitis in pregnancy is difficult. Delay operation, increase complications. Objectives This study focused on early operation on base of careful history, precise physical examination, and rational close observation and evaluates its results with conventional investigation in pregnant women suspected acute appendicitis. Materials and Methods A cross sectional study in100 pregnant women and 100 aged matched non pregnant women underwent appendectomy during Sep 2011 - Dec 2014. The data were analyzed by chi-square test through SPSS 16.0. Results Age 16 - 37 years, mean age in pregnant women and no pregnant women were24.75 ± 4.4 and 27.56 ± 6.53 years (P > 0.05, respectively. 20 - 25 years age group, were more frequent = 44%. 70% patients were gravid 1, mean hospital stay in pregnant women, and non-pregnant women were 48 ± 6 and 85.2 ± 43.19 hours (P value < 0.001. respectively. acute appendicitis was confirmed histological in non-pregnant was 72%, but In pregnant women 62%, most cases were in the third Trimester 66% (n = 41. Peri umbilical pain, with migration to the right lower quadrant, was in 75% of patients. Right-lower-quadrant pain was the most common presenting symptom. Diagnosis (62% was made on base care full history and precise physical examination and close observation of 12 ± 8 hours. there were no maternal and fetal complications related to all of the appendectomies during the all trimester up to delivery period. Conclusions There are no diagnostic laboratory findings in acute appendicitis during pregnancy. Careful history and physical examination and close observation of 12 ± 8 hours are sufficient for surgery decision making. In spite of high negative appendectomy since it has no Surgical and obstetric complication, early Appendectomy without aggressive investigation recommend.

  20. Neurocritical care complications of pregnancy and puerperum.

    Science.gov (United States)

    Frontera, Jennifer A; Ahmed, Wamda

    2014-12-01

    Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus.

  1. Exacerbations of asthma during pregnancy: Impact on pregnancy complications and outcome.

    Science.gov (United States)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-05-01

    Asthma is common among pregnant women, and the incidence of asthma exacerbations during pregnancy is high. This literature review provides an overview of the impact of exacerbations of asthma during pregnancy on pregnancy-related complications. The majority of published retrospective studies reveal that asthma exacerbations during pregnancy increase the risk of pre-eclampsia, gestational diabetes, placental abruption and placenta praevia. Furthermore, these women also have higher risk for breech presentation, haemorrhage, pulmonary embolism, caesarean delivery, maternal admission to the intensive care unit and longer postpartum hospital stay. Asthma has been associated with increased risk of intrauterine growth retardation, small-for-gestational age, low birth weight, infant hypoglycaemia and preterm birth, but more recent prospective studies have not revealed significant associations with regard to these outcomes. In conclusion, asthma exacerbations during pregnancy are associated with complications of pregnancy, labour and delivery. Prevention of exacerbations is essential to reduce the risk of complications and poor outcome.

  2. Cerebral hemodynamics in normal and complicated pregnancy

    NARCIS (Netherlands)

    van Veen, Teelkien

    2016-01-01

    During pregnancy, approximately 6-25% of women are diagnosed with some form of hypertension. These disorders are among the leading causes of maternal mortality and severe morbidity. While multiple maternal organs can be affected, cerebral involvement is one of the most feared complications as it can

  3. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    Bijlenga, D.; Boers, K.E.; Birnie, E.; Mol, B.W.J.; Vijgen, S.C.M.; van der Post, J.A.M.; de Groot, C.J.; Rijnders, R.J.P.; Pernet, P.J.; Roumen, F.J.; Stigter, R.H.; Delemarre, F.M.C.; Bremer, H.A.; Porath, M.; Scherjon, S.A.; Bonsel, G.J.

    2011-01-01

    Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Growth Intervention Trial

  4. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    Bijlenga, D.; Boers, K.E.; Birnie, E.; Mol, B.W.J.; Vijgen, S.C.M.; van der Post, J.A.M.; de Groot, C.J.; Rijnders, R.J.P.; Pernet, P.J.; Roumen, F.J.; Stigter, R.H.; Delemarre, F.M.C.; Bremer, H.A.; Porath, M.; Scherjon, S.A.; Bonsel, G.J.

    2011-01-01

    Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Growth Intervention Trial

  5. Vascular Complications of Systemic Sclerosis during Pregnancy

    Directory of Open Access Journals (Sweden)

    Eliza F. Chakravarty

    2010-01-01

    Full Text Available Systemic sclerosis (SSc is a chronic autoimmune disorder characterized by progressive fibrosis of the skin and visceral tissues as well as a noninflammatory vasculopathy. Vascular disease in systemic sclerosis is a major cause of morbidity and mortality among nonpregnant patients with SSc and is even a bigger concern in the pregnant SSc patient, as the underlying vasculopathy may prevent the required hemodynamic changes necessary to support a growing pregnancy. Vascular manifestations including scleroderma renal crisis and pulmonary arterial hypertension should be considered relative contraindications against pregnancy due to the high associations of both maternal and fetal morbidity and mortality. In contrast, Raynaud's phenomenon may actually improve somewhat during pregnancy. Women with SSc who are considering a pregnancy or discover they are pregnant require evaluation for the presence and extent of underlying vasculopathy. In the absence of significant visceral vasculopathy, most women with SSc can expect to have reasonable pregnancy outcomes.

  6. Deciduoma of the ovary complicating pregnancy

    Directory of Open Access Journals (Sweden)

    Rangaswamy Vedavalli

    2014-03-01

    Full Text Available A 24 yr old Primigravida who conceived spontaneously came with two months amenorrhea for confirmation of pregnancy and routine checkup. Her 1st trimester scan, showed a single intra – uterine viable pregnancy of 8-9 weeks, with a right adnexal mass of about 10.7x7.7x10.3 cm with solid and cystic areas with internal echoes. In view of the size of the tumor and its varying echogenicity, pathological condition of the ovary was suspected. She reported at 24 weeks with abdominal pain. Partial torsion was suspected and Laprotomy was done. Right ovary was enlarged to 10 cm with varying consistency. Right ovariotomy was done. Postoperative period was uneventful. Histopathological examination showed extensive decidual changes in the ovary, forming tumor like lesions in the cystic areas. The pregnancy progressed without any complication. At term, she delivered a healthy female baby. The case is being presented for its extreme rarity.

  7. Bochdaleck's hernia complicating pregnancy: Case report

    Institute of Scientific and Technical Information of China (English)

    Nikolaos Barbetakis; Andreas Efstathiou; Michalis Vassiliadis; Theocharis Xenikakis; Ioannis Fessatidis

    2006-01-01

    Diaphragmatic hernia complicating pregnancy is rare and results in a high mortality rate, particularly if early surgical intervention is not undertaken. We report a case in which a woman presenting at 23 wk's gestation was admitted with symptoms of respiratory failure and bowel obstruction due to incarceration of viscera through a left posterolateral defect of the diaphragm (Bochdalek's hernia). Surgery (left thoracoabdominal incision)demonstrated compression atelectasis, mediastinal shift, strangulation and gangrene of the herniated viscera which led to segmental resection of the involved portion of large intestine with re-establishment of bowel continuity by end to end anastomosis. The greater omentum was partly necrotic necessitating resection.The diaphragmatic defect was closed with interrupted sutures. Postoperative period was uncomplicated.Pregnancy was allowed to continue until 39 wk's gestation at which time elective cesarean delivery was performed. It is concluded that symptomatic maternal diaphragmatic hernia during pregnancy is a surgical emergency and requires a high index of suspicion.

  8. First-trimester vaginal bleeding and complications later in pregnancy

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Dideriksen, Katrine Lehrmann; Lidegaard, Øjvind

    2010-01-01

    To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy.......To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy....

  9. Pulmonary functions in pregnancy complicated with anemia

    Directory of Open Access Journals (Sweden)

    Subhalaxmi Dash

    2014-08-01

    Full Text Available Background: The aim of the present study was to find out the variation of pulmonary function parameters in different trimesters of pregnancy as well as variation according to severity of anemia in each trimester. Methods: The present case control study was carried out in the post-graduate department of obstetrics and gynecology, M.K.C.G. medical college and hospital, Berhampur, during the period from October 2012 to October 2013. This study entitled and ldquo;Pulmonary functions in pregnancy complicated with anemia and rdquo;, embodies the pulmonary functions of 60 anemic pregnant females (study group and 100 healthy pregnant females (control in different trimesters of pregnancy. The pulmonary function parameters, which were studied, are FVC, FEV1, FEV1/FVC, FEF25-75%, PEFR and MVV in both the study and control group. Results: Comparing the variation with advancing gestation in study and control, it was seen that FVC, FEV1, FEV1/FVC and FEF25-75% showed no significant alteration. With increasing severity of anemia compared to controls, FVC, FEV1, PEFR and MVV values reduce significantly. As FEF25-75% is not effort dependent, it shows no significant variation. Conclusion: Thus from this study, it can be concluded that moderate to severe anemia in pregnancy can adversely affect pulmonary functions. Hence nutritional anemia in early pregnancy should be provided with iron supplements in order to prevent adverse obstetric outcomes. [Int J Res Med Sci 2014; 2(4.000: 1431-1437

  10. Maternal postpartum complications according to delivery mode in twin pregnancies

    Directory of Open Access Journals (Sweden)

    Sonia Leme Stach

    2014-07-01

    Full Text Available OBJECTIVE:We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors.METHODS:This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008. The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated.RESULTS:A total of 90 complications were observed in 56/817 (6.9% deliveries: 7/131 (5.3% vaginal, 10/251 (4.0% elective cesarean and 39/435 (9.0% emergency cesarean deliveries. Significant predictors included high-risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34.CONCLUSIONS:Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.

  11. Pregnancy at 65, risks and complications

    Directory of Open Access Journals (Sweden)

    Shailja Verma

    2016-01-01

    Full Text Available A 65-year-old postmenopausal pregnant woman was referred with antepartum hemorrhage at 29 weeks of gestation. Postadmission diagnosed with chronic hypertension, gestational diabetes mellitus, valvular heart disease, and placenta previa. Her pregnancy was terminated by cesarean delivery at 32 weeks as she had a bout of bleeding per vaginum. Most of the placenta was adherent with no plane of cleavage; therefore, cesarean hysterectomy was performed. Baby birth weight was 1650 g and was shifted to nursery for observation and mother needed Intensive Care Unit care postcesarean. On the 15th day, both healthy mother and baby were discharged. Although pregnancy is possible in postmenopausal women with hormone support but the incidence of complications remain very high. It raises a need for developing well-laid guidelines for performing in vitro fertilization in older age group women.

  12. Maternal complications and the management of asthma in pregnancy.

    Science.gov (United States)

    Vanders, Rebecca L; Murphy, Vanessa E

    2015-03-01

    Pregnancy is a unique state requiring alterations in maternal physiology to accommodate the growing fetus. Whilst the maternal immune system is normally well adept at performing this task, the presence of immune disorders, such as asthma, often lead to pregnancy-related complications affecting both mother and baby. Australia has a high prevalence of asthma; with approximately 12% of pregnant women reported to have current asthma. Poor control of asthma is of far greater risk than the use of asthma medications. Being able to identify complications associated with asthma during pregnancy is of great importance in providing appropriate asthma management and medical care to these pregnant women, which may have lifelong consequences for their offspring.

  13. Pregnancy Complications: Cervical Insufficiency and Short Cervix

    Science.gov (United States)

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

  14. Pregnancy Complications: Group B Strep Infection

    Science.gov (United States)

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

  15. [Natural history, complications, safety and pregnancy in inflammatory bowel disease].

    Science.gov (United States)

    Chaparro, María

    2015-09-01

    Numerous studies were presented in Digestive Disease Week 2015 (DDW 2015) on the natural history, complications, and safety of treatments in inflammatory bowel disease (IBD), as well as novel findings on fertility, pregnancy, and breastfeeding. The present article reviews presentations on the natural history of IBD, the risk of complications and their prevention, treatment safety, aspects related to fertility, pregnancy, and breastfeeding, as well as the risk of cancer and its association with IBD and with drugs used in its treatment. In the next few years, more data will become available on treatment safety and the possible complications that can develop in IBD patients due to the disease itself and the drugs employed in its treatment, which will allow measures to be adopted to improve prognosis. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  16. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    D. Bijlenga (Denise); K.E. Boers (Kim); E. Birnie (Erwin); B.W.J. Mol (Ben); S.C.M. Vijgen (Sylvia); J.A.M. van der Post (Joris); C.J.M. de Groot (Christianne); R.J.P. Rijnders (Robbert); P.J. Pernet (Paula); F.J.M.E. Roumen (Frans); R.H. Stigter (Rob); F.M.C. Delemarre (Friso); H.A. Bremer (Henk); M. Porath (Martina); S.A. Scherjon (Sico); G.J. Bonsel (Gouke)

    2011-01-01

    textabstractObjective: Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Gr

  17. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    D. Bijlenga (Denise); K.E. Boers (Kim); E. Birnie (Erwin); B.W.J. Mol (Ben); S.C.M. Vijgen (Sylvia); J.A.M. van der Post (Joris); C.J.M. de Groot (Christianne); R.J.P. Rijnders (Robbert); P.J. Pernet (Paula); F.J.M.E. Roumen (Frans); R.H. Stigter (Rob); F.M.C. Delemarre (Friso); H.A. Bremer (Henk); M. Porath (Martina); S.A. Scherjon (Sico); G.J. Bonsel (Gouke)

    2011-01-01

    textabstractObjective: Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Gr

  18. Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

    NARCIS (Netherlands)

    D. Bijlenga (Denise); K.E. Boers (Kim); E. Birnie (Erwin); B.W.J. Mol (Ben); S.C.M. Vijgen (Sylvia); J.A.M. van der Post (Joris); C.J.M. de Groot (Christianne); R.J.P. Rijnders (Robbert); P.J. Pernet (Paula); F.J.M.E. Roumen (Frans); R.H. Stigter (Rob); F.M.C. Delemarre (Friso); H.A. Bremer (Henk); M. Porath (Martina); S.A. Scherjon (Sico); G.J. Bonsel (Gouke)

    2011-01-01

    textabstractObjective: Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine

  19. Acardiac Parabiotic Fetus: A Rare Complication of Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Sood S

    2015-10-01

    Full Text Available Acardiac parabiotic fetus is sequelae of complication of monochorionic monoamniotic twin pregnancy also known as Twin Reversed Arterial Perfusion Sequence (TRAP. It is rare affecting 1 in 35,000 births and 1 % of monozygotic twins. Acardiac parabiotic twin commonly known as parasite occurs rarely and may lead to high output cardiac failure, hydrops or premature delivery in the pump fetus. In this report, we present a 23 years old primigravida with twin pregnancy, with twin reversed arterial perfusion sequence with one of the twins being acardiac anceps and the other normal pump fetus. This association is relatively uncommon and therefore rarely documented.

  20. An analytic study on maternal and fetal complications as the pregnancy outcome in teenage pregnancy

    Directory of Open Access Journals (Sweden)

    Vidya A. Thobbi

    2017-01-01

    Full Text Available Background: The aim of the study is to find out the strategies on the maternal and fetal complications as the pregnancy outcome in teenage women. With modernization, teenage pregnancy rate is rapidly declining in developed countries, but it is still high in developing countries like India, and socially backward district like Vijayapur. Hence this prospective study was carried out at Al-Ameen Medical College, Vijayapur, Karnataka. Aims: (1 To find out strategies for prevention of problems of teenage pregnancies. (2 To find out strategies for prevention of perinatal mortality. Methodology: A prospective study of teenage pregnancy was carried out for two years period; all Teen Primigravidae admitted to the labour ward were taken for study. 150 cases of teenage primigravidae of 13yrs to 19yrs were studied. Cases were selected randomly and randomization was attained. Results: Teenage primigravidae who delivered comprised of 29.6% of the total term deliveries to the labour ward. In this study 72% teenage pregnancies were associated with mild to severe complications. The major maternal complications were Sever-Anemia 16%, Hypertensive Disorders of Pregnancy 18.66%, Premature Rupture of Membranes 18.21%, and. Low Birth Weight 20%, Pre-term births 6% and Stillbirths 1.33% was major adverse fetal outcome. Conclusion: Early childbearing is associated with various health risks for both mother and child. Teenage mothers are more likely to experience pregnancy related complications which often lead to raised MMR and adverse fetal outcome. But Teenage pregnancy is still a common occurrence.

  1. Research on recurrent pregnancy complications: a clinician's perspective.

    Science.gov (United States)

    Smulian, John C

    2007-07-01

    Research on recurrent pregnancy complications is essential to help clinicians provide appropriate counselling and guide the management of patients with a history of adverse pregnancy outcomes. However, recurrence research is complex, in both its execution and interpretation. The paucity of appropriate data sets accessible for study of recurrent pregnancy outcomes presents significant challenges in performing recurrence research. This is further compounded by the different perspectives on recurrence between epidemiologists and clinicians. The interpretation of risk, whether it is absolute risk, relative risk or population-attributable fraction, underlies the often opposing perspectives of researchers and clinicians. Because clinicians acutely feel the need to provide appropriate counselling and management strategies when there has been a previous pregnancy complication, it is necessary that all those involved in research and care for these women work together to address gaps in our knowledge for recurrent pregnancy outcomes. In this way, we can develop a better understanding of disease processes, counsel patients better, design management plans and, ultimately, achieve better outcomes for our patients.

  2. Relation between time to pregnancy and pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Hatave Ghasemi Tehrani

    2014-01-01

    Full Text Available Background: Studies have shown significant correlation between time to pregnancy (TTP and pregnancy  outcomes. But  understanding of these mechanisms may not be facilitated. The aim of this study was to determine the relation between TTP and pregnancy outcome. Materials and Methods: This study was a case cohort study that was done in Shahid Beheshti Educational Hospital during 2006-2007. Women aged 18-35 years, who had only one pregnancy without using any contraception method before pregnancy and delivered their first child, were enrolled in this study. Thus, 801 women were selected and followed up for pregnancy outcome and TTP until the end of pregnancy. All the participants filled in a special questionnaire. Finally the collected data were entered into computer and analyzed by SPSS ver. 20 software. Results: The frequency distribution of TTP-based pregnancy outcome showed that TTP >48 weeks was higher in normal delivery than in abnormal delivery (5.6% vs. 19.4%. According to Chi-square test, the frequency distribution of pregnancy outcome was related to TTP (P < 0.001. Conclusion: According to the results of this study, there is a significant relationship between TTP and pregnancy outcome, and TTP may lead to unwanted complications such as ectopic pregnancy, preterm labor, and abortion. Thus, all women with a long time of contraception, especially in the rural areas, mast be controlled.

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

    Science.gov (United States)

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

    2012-04-01

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

  4. Maternal and perinatal complications in triplet compared with twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); P. Bourdrez (Petra); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare maternal and perinatal complications in triplet and twin pregnancies. Study design: Case-controlled study in the setting of a University Hospital. Each pregnancy of a consecutive series of 40 triplet pregnancies of 20 weeks or more was matched for parity and materna

  5. Plasma concentrations of four pregnancy proteins in complications of pregnancy.

    Science.gov (United States)

    Lin, T M; Halbert, S P; Spellacy, W N; Berne, B H

    1977-08-01

    Toxemia of pregnancy was associated with an elevation of the pregnancy-associated plasma protein (PAPP)-A concentration, as compared to the level in normal pregnancy in the last month of gestation. The other pregnancy proteins measured were not altered in toxemia. In twin pregnancies, the PAPP-A, PAPP-C, and human placental lactogen levels were all increased, particularly PAPP-A. On the other hand, pregnancy zone protein was not affected by twinning. Pregnancy with diabetes showed normal levels of these proteins.

  6. Complications arising in twin pregnancy: findings of prenatal ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ah; Cho, Jeong Yeon; Lee, Young Ho; Song, Mi Jin; Min, Jee Yeon; Lee, Hak Jong; Han, Byoung Hee; Lee, Kyung Sang; Cho, Byung Jae; Chun, Yi Kyeong [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2003-03-01

    Multifetal gestations are high-risk pregnancies involving higher perinatal morbidity and mortality, and are subject to unique complications including twin oligohydramnios- polyhydramnios sequence, twin-to-twin transfusion syndrome, acardiac twins, conjoined twins, co-twin demise, and heterotopic pregnancies. The purpose of this study is to describe the prenatal ultrasonographic and pathologic findings of these complications.

  7. PERINATAL OUTCOME IN SEVERE ANAEMIA COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Nirmala Devi

    2015-06-01

    Full Text Available BACKGROUND: Anaemia is the commonest global public health problem and especially harmful when the pregnancy is complicated by anaemia. Women in reproductive age group are more vulnerable for iron deficiency anaemia with an estimated prevalence of around 70 to 80% in pregnant women. MATERIAL AND METHODS: The aim of the study was to analyse the foetal outcome in the hospitalised pregnant women with severe anaemia. This is a prospective study carried out at maternity ward of Government G eneral H ospital, Kurnool of Andhra Pradesh, India over a period of one year from October 2007 to September 2008. RESULTS: Total of 9731 deliveries occurred during the study period, 282 (2.89 % were severely anaemic at the time of delivery. Majority of the women w ere of 20 - 24 years age (68.4% with second gravidas 37.5%, term gestation 52.1%, preterm deliveries 47.9%, lower socio - economic status 87.6% and Unbooked cases 67.4% and low birth weight in 53.2% cases, intra uterine growth retardation and intra uterine foetal death contributes to 12.8% and 16.7% cases respectively. A total of 36 (12.8% neonates required admission in neonatal intensive care unit and 16(5.7% of them died. CONCLUSION: Severe anaemia during pregnancy has adverse perinatal outcome in the fo rm of low birth weight, preterm birth, intrauterine growth retardation and intrauterine death. Regular iron supplementation during the antenatal period, management of anaemia and improving the nutritional status of the mother will improve the adverse neona tal outcome and decreases perinatal morbidity and mortality.

  8. Endogenous Ouabain in Hypertensive Disorder Complicating Pregnancy

    Institute of Scientific and Technical Information of China (English)

    WU Li; XIONG Chengliang; SU Ping

    2007-01-01

    Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups (P<0.01). There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 (r=0.5567, P<0.01), while the correlation of endogenous ouabain and NO was significantly negative (r=-0.6895, P<0.01). As expected, the correlation between ET-1 and NO was negative (r=-0.7796, P<0.01). ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group (P<0.01). On the con- trast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as com- pared with healthy pregnant group (P<0.01). Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.

  9. Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Gustaf Rejnö

    Full Text Available BACKGROUND: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes. METHODS: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression. RESULTS: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4% pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24 and premature contractions (adj OR 1.52; 95% CI 1.29-1.80. There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34, low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33. The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes. CONCLUSION: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

  10. Diagnostic accuracy of the ultrasonography in complicated pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Kyung Soo; Kim, Kun Sang; Park, Soo Soung [Chungang University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Ultrasonography is an invaluable diagnostic method in Obstetrics. It provides safe, speedy and repeatable way to obtain image of normal and abnormal pregnancy. The ultrasonograms of 167 patients with suspicion of complicated pregnancy were analyzed. The results were as follows. 1. 86 patients showed normal ultrasonogram(50.9%). 100% in intrauterine fetal death and gross fetal anomaly, 100% in abnormal fetal position and number, 95% in pregnancy with pelvic mass, 83% in ectopic pregnancy, 81% in abortion, 78% in molar pregnancy, 74% in plancenta previa. 3. Ultrasonic diagnosis of abrupto placenta was difficult. 4. Diagnostic accuracy was 80% in bicornuate uterus and double vagina

  11. [Gigantomastia complicating pregnancy. A case report].

    Science.gov (United States)

    Rausky, J; Burin des Roziers, B; Daoud, G; Cartier, S

    2011-06-01

    The authors report a very rare case of gestational gigantomastia and the pregnancy could be carried out in term. The repetition being inescapable, the mastectomy is the advised intervention if there is a later desire of pregnancy, in other cases a post-partum mammoplasty can be discussed.

  12. Can an Aspirin a Day Keep a Pregnancy Complication Away?

    Science.gov (United States)

    ... gov/news/fullstory_166926.html Can an Aspirin a Day Keep a Pregnancy Complication Away? Odds of preeclampsia dropped 62 percent for high-risk women who took a daily pill, study finds To use the sharing ...

  13. Prospective risk of stillbirth and neonatal complications in twin pregnancies

    DEFF Research Database (Denmark)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David

    2016-01-01

    OBJECTIVE: To determine the risks of stillbirth and neonatal complications by gestational age in uncomplicated monochorionic and dichorionic twin pregnancies. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, and Cochrane databases (until December 2015). REVIEW METHODS: ...

  14. Spontaneous liver rupture in pregnancy complicating HELLP syndrome: case report

    Directory of Open Access Journals (Sweden)

    Sariyeh Golmahammadlou

    2014-10-01

    Conclusion: Spontaneous liver rupture associated with HELLP syndrome is a rare and life-threatening complication of pregnancy. Unruptured liver hematoma is also a rare condition during pregnancy with a very difficult diagnosis. Using clinical diagnostic tests such as CT scan or MRI would be helpful to improve clinical outcomes.

  15. Risk of inflammatory bowel disease according to self-rated health, pregnancy course, and pregnancy complications

    DEFF Research Database (Denmark)

    Harpsøe, Maria C; Jørgensen, Kristian Tore; Frisch, Morten;

    2013-01-01

    Poor self-rated health (SRH) has been connected to immunological changes, and pregnancy complications have been suggested in the etiology of autoimmune diseases including inflammatory bowel disease (IBD). We evaluated the impact of self-rated pre-pregnancy health and pregnancy course, hyperemesis......, gestational hypertension, and preeclampsia on risk of IBD....

  16. Management of a Pregnancy Complicated by Pompe Disease

    Directory of Open Access Journals (Sweden)

    Jennifer Weida

    2012-01-01

    Full Text Available Background. As more women with metabolic muscle diseases reach reproductive age, knowledge of these diseases and their impact on pregnancy is necessary. Case. 23-year-old G1P0 with juvenile-onset Pompe disease (PD delivered a viable infant by cesarean section at 32 weeks and 6 days. The pregnancy was complicated by worsening maternal pulmonary status, muscular strength, and mobility. Conclusion. The management of pregnancies complicated by Pompe disease requires a multidisciplinary approach, including expertise in neuromuscular disease, maternal-fetal medicine, biochemical genetics, pulmonology, anesthesia, and dietetics.

  17. OS013. Reduction of preeclampsia related complications with with theNO-donor penterythriltetranitrat (petn) in risk pregnancies - Aprospective randomized double-blind placebo pilot study.

    Science.gov (United States)

    Groten, T; Fitzgerald, J; Lehmann, T; Schneider, U; Kähler, C; Schleussner, E

    2012-07-01

    NO-donors reduce the impedance in uteroplacental vessels. Consequently Lees et al. pilot study demonstrated that transdermal nitroglycerin positively influences pregnancy outcome within a high-risk collective. Furthermore the NO-donor pentaerythriltetranitrate additionally expresses cell stabilizing effects in endothelial cells. Hypothesizing an effect on endothelial health and uterine perfusion in pregnancies presented with pathological uterine perfusion at 20weeks of gestation we performed a randomized, prospective, and placebo-controlled, double-blind study implemented with the aim to investigate whether the oral NO-donor Pentalong(®) (PETN) is suitable as a prophylactic drug in abnormal placentation. We included 111 pregnancies presenting with abnormal placental perfusion (bilateral notch or mean RI>0.7) between the 19th and 24thweek of gestation (w.o.g.). Further risk factors (high-risk group: history of HELLP/preeclampsia/IUGR/IUFD/placental abruption, type I diabetes mellitus, hypertension, thrombosis/thrombophilia) were identified in 78 study participants. Fifty-four women received PETN 57 received placebo. Doppler velocimetry measurements of uteroplacental and fetal vessels and fetal growth scans were monitored biweekly with primary endpoints being the occurrence of preeclampsia, IUGR and/or premature birth. Within the first week of intake, PETN improved uteroplacental perfusion significantly in comparison to placebo (mean PI 1.26±0.36 vs. 1.49±0.44; pPETN study group by reducing the frequency of IUGR (4 vs. 10), diagnosis of preeclampsia before 32 w.o.g. (3 vs. 7) and premature birth before 32 w.o.g. (1 vs. 6). Furthermore 4 fetal losses occurred in the study group all in the placebo group. NO-donors constitute an interesting option in the prophylaxis of adverse pregnancy outcome related to abnormal placentation. Copyright © 2012. Published by Elsevier B.V.

  18. Pulmonary functions in pregnancy complicated with anemia

    OpenAIRE

    Subhalaxmi Dash; Sudhanshu Sekhara Nanda; Ashok Kumar Behera

    2014-01-01

    Background: The aim of the present study was to find out the variation of pulmonary function parameters in different trimesters of pregnancy as well as variation according to severity of anemia in each trimester. Methods: The present case control study was carried out in the post-graduate department of obstetrics and gynecology, M.K.C.G. medical college and hospital, Berhampur, during the period from October 2012 to October 2013. This study entitled and ldquo;Pulmonary functions in pre...

  19. 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...

  20. COMPLICATIONS AND OUTCOMES OF PREGNANCY IN CHRONIC KIDNEY DISEASE

    Directory of Open Access Journals (Sweden)

    I. G. Nikol'skaya

    2015-01-01

    Full Text Available Pregnancy in women with kidney disorders, even with preserved renal function, is associated with higher than in the population rates of obstetric and perinatal complications, such as eclampsia, preterm delivery, surgical deliveries and intensive care for newborns.This article presents our own data on complications and outcomes of pregnancies in 156 women with various stages of chronic kidney disease (CKD. From these, 87 patients had CKD stage I, 29 with CKD stage II and 40 with CKD stages III, IV, V. For the first time in Russia, the authors summarize their unique experience in management of pregnancy with CKD, underline a high probability (27,5% of its primary detection during pregnancy, discuss the algorithms of assessment, prevention and treatment of various gestational complications in CKD (pre-eclampsia, urinary tract infections, feto-placental insufficiency, anemia, acute renal damage, as well as the influence of pregnancy on renal function at long-term post-delivery. A direct correlation between the CKD stage, frequency of pre-eclampsia, feto-placental insufficiency, preterm deliveries, surgical deliveries by caesarean section and babies’ status at birth is demonstrated.Based on their ample clinical material, they confirmprobability of favorable pregnancy outcomes in CKD patients with stable renal function without severe arterial hypertension during pregnancy: for a baby in 87%, for the mother in 90% (maintenance of the same CKD stage. The risk of persistent deterioration of renal function during pregnancy and puerperium in women with CKD is higher in CKD stage IV, as well as in the case of early development of pre-eclampsia; it also correlates with severity of the latter.The probability of a favorable obstetric and nephrological outcome is higher when the pregnancy is planned and intensively co-managed by an obstetrician/gynaecologist and a nephrologist from early weeks of gestation onwards.

  1. Pregnancy after kidney transplantation: high rates of maternal complications

    Directory of Open Access Journals (Sweden)

    Cristina Candido

    Full Text Available Abstract Introduction: Women regain fertility a few time after renal transplantation. However, viability of pregnancy and maternal complications are still unclear. Objective: To describe the outcomes of pregnancies in kidney transplanted patients, focusing on maternal complications. Methods: Retrospective study of pregnancies in kidney transplanted patients between 2004 and 2014, followed up 12 months after delivery. Each pregnancy was considered an event. Results: There were 53 pregnancies in 36 patients. Mean age was 28 ± 5years. Pregnancy occurred 4.4 ± 3.0 years post-transplant. Immunosuppression before conception was tacrolimus, azathioprine, and prednisone in 74% of the cases. There were 15% miscarriages in the 1st trimester and 8% in 2nd trimester. In 41% of the cases, it was necessary to induce labor. From all births, 22% were premature and 17% very premature. There were 5% stillbirths and 5% of neonatal deaths. De novo proteinuria occurred in 60%, urinary tract infection in 23%, preeclampsia in 11%, acute rejection in 6%, and graft loss in 2% of the cases. It was observed a significant increase in creatinine at preconception comparing to 3rd trimester and follow-up (1.17 vs. 1.46 vs. 1.59 mg/dL, p < 0.001. Conclusion: Although the sample is limited, the number of miscarriages was higher than in the general population, with high rates of maternal complications. Sustained increase of creatinine suggests increased risk of graft loss in long-term.

  2. Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Ming-Jie Yang

    2005-07-01

    Full Text Available Hyperthyroidism is one of the most common causes of cardiac failure. Blood volume expands greatly during pregnancy, especially after the last part of the second trimester. Such expansion exacerbates the symptoms of heart failure and accelerates the development of pulmonary edema when abnormal thyroid function is not well controlled. Two cases of pregnancy complicated with congestive heart failure and pulmonary edema due to hyperthyroidism are reported here. Both patients did not receive treatment for hyperthyroidism during pregnancy, and both sought clinical help during the third trimester. The clinical problems were resolved by medical management before delivery.

  3. Septic Arthritis of the Shoulder Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    Sara Raiser

    2014-01-01

    Full Text Available Septic arthropathy leads to rapid joint destruction, impairment, and disability. Staphylococcus can be particularly virulent to bone and joints leading to adverse obstetric events. At 28 of weeks gestation, a patient presented with pyelonephritis and progressive left shoulder pain. Magnetic resonance imaging indicated early clavicular destruction and acromial involvement. Glenohumeral joint aspiration produced Staphylococcus aureus. The patient then had premature rupture of membranes and progressed rapidly to preterm delivery. Placental pathology revealed chorioamnionitis and microabscesses. Treatment of the infected joint required further surgical drainage and bone resection as well as extended antibiotics. It is important to remember that joint pain in pregnancy may indicate infective arthritis, and pyelonephritis can be a source of such an infection. Evaluation includes magnetic resonance imaging and consultation for joint aspiration. Prompt recognition and treatment are necessary to prevent joint destruction.

  4. Inter-Pregnancy Weight Change and the Risk of Recurrent Pregnancy Complications.

    Directory of Open Access Journals (Sweden)

    Jacqueline M Wallace

    Full Text Available Women with specific adverse pregnancy outcomes in their first pregnancy may be receptive to inter-pregnancy weight management guidance aimed at preventing these complications reoccurring in subsequent pregnancies. Thus the association between inter-pregnancy weight change and the risk of recurrent pregnancy complications at the second pregnancy was investigated in a retrospective cohort study of 24,520 women with their first-ever and second consecutive deliveries in Aberdeen using logistic regression. Compared with women who were weight stable, weight loss (>2BMI units between pregnancies was associated with an increased risk of recurrent small for gestational age (SGA birth and elective Cesarean-section, and was protective against recurrent pre-eclampsia, placental oversize and large for gestational age (LGA birth. Conversely weight gain (>2BMI units between pregnancies increased the risk of recurrent gestational hypertension, placental oversize and LGA birth and was protective against recurrent low placental weight and SGA birth. The relationships between weight gain, and placental and birth weight extremes were evident only in women with a healthy weight at first pregnancy (BMI<25units, while that between weight gain and the increased risk of recurrent gestational hypertension was largely independent of first pregnancy BMI. No relationship was detected between inter-pregnancy weight change and the risk of recurrent spontaneous preterm delivery, labour induction, instrumental delivery, emergency Cesarean-section or postpartum hemorrhage. Therefor inter-pregnancy weight change impacts the risk of recurrent hypertensive disorders, SGA and LGA birth and women with a prior history of these specific conditions may benefit from targeted nutritional advice to either lose or gain weight after their first pregnancy.

  5. Fetal and maternal complications in macrosomic pregnancies

    Directory of Open Access Journals (Sweden)

    Cheng YK

    2014-03-01

    Full Text Available Yvonne Kwun-Yue Cheng, Terence T LaoDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongAbstract: The prediction and management of fetal macrosomia remains an obstetric challenge. Significant maternal and neonatal complications can result from the birth of a macrosomic infant, and include prolonged labor, operative delivery, postpartum hemorrhage, perineal trauma, shoulder dystocia, birth trauma, chorioamnionitis, meconium aspiration, perinatal asphyxia, low Apgar scores, neonatal hypoglycemia, and perinatal mortality. This review article discusses these maternal and perinatal risks and the management of suspected macrosomia.Keywords: macrosomia, large for gestational age, shoulder dystocia, birth trauma, perineal tear

  6. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes

    DEFF Research Database (Denmark)

    Ovesen, Per Glud; Jensen, Dorte Møller; Damm, Peter

    2015-01-01

    and delivery and fetal complications were classified according to the International Classification of Diseases 10th Revision. RESULTS: The final study population consisted of 398 623 women. Of these, 9014 (2.3%) had GDM. Data were adjusted for maternal age, parity, smoking, gestational age, birth weight, BMI......OBJECTIVE: To estimate the association between gestational diabetes mellitus (GDM) and adverse pregnancy and neonatal outcomes in Denmark. METHODS: A population-based cohort study including all singleton pregnancies in Denmark from 2004 to 2010 (n = 403 092). Maternal complications during pregnancy......, gender of the fetus and calendar year. The risk of preeclampsia, caesarean section (both planned and emergency) and shoulder dystocia was increased in women with GDM. In the unadjusted analysis, the risk of thrombosis was increased by a factor 2 in the GDM patients, but in the adjusted analysis...

  7. Weight-Loss Surgery May Lower Risk of Pregnancy Complications

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_161748.html Weight-Loss Surgery May Lower Risk of Pregnancy Complications Women ... Oct. 28, 2016 (HealthDay News) -- Women who undergo weight-loss surgery gain major benefits when it comes to ...

  8. Determinants Associated with Pregnancy Complications in Pregnant Women; (Case Study in Abepura, Jayapura City Health Center 2015

    Directory of Open Access Journals (Sweden)

    Rodinda Sihombing

    2016-03-01

    Full Text Available According to the World Health Organization (WHO in 2014, about 800 mothers die worldwide each day from complications related to pregnancy or childbirth. Each year approximately 20,000 women in Indonesia die from causes related to pregnancy and labor. The purpose of this study was to determine the incidence of pregnancy complications determinant in Abepura, Jayapura City Health Center in 2015. This study was an observational study design with "cross-sectional study", which is one type of the analytic study design. The sample in this study is the third trimester pregnant women who visited antenatal at health centers Abepura totaling 155 people using accidental sampling technique. All data in this study were collected through interviews using questionnaires. Analysis of the data in this study include univariate, bivariate (chi square and multivariate (logistic regression. Chi-square test results demonstrated an association iron tablet intake (p = 0.022; RP = 2, maternal age (p = 0.018; RP = 2.6, parity (p = 0.03; RP = 1.9, a history of pregnancy complications (p = 0.0001; RP = 2.9, and a history of birth complications (p = 0.002; RP = 2.6 and the incidence of pregnancy complications. While the history of infectious disease has no relationship with the incidence of pregnancy complications (p = 0.214; RP = 1.4. Multivariate analysis showed that maternal age and previous pregnancy complications are dominant factors on the incidence of pregnancy complications.

  9. Uterine prolapse in pregnancy: risk factors, complications and management.

    Science.gov (United States)

    Tsikouras, Panagiotis; Dafopoulos, Alexandros; Vrachnis, Nikolaos; Iliodromiti, Zoe; Bouchlariotou, Sofia; Pinidis, Petros; Tsagias, Nikolaos; Liberis, Vasileios; Galazios, Georgios; Von Tempelhoff, Georg Friedrich

    2014-02-01

    Presentation of uterine prolapse is a rare event in a pregnant woman, which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. Recommendations regarding the management of this infrequent but potentially harmful condition are scarce and outdated. This review will examine the causative factors of uterine prolapse and the antepartum, intrapartum and puerperal complications that may arise from this condition as well as therapeutic options available to the obstetrician. While early recognition and appropriate prenatal management of uterine prolapse during pregnancy is imperative, implementation of conservative treatment modalities throughout pregnancy, these applied in accordance with the severity of the uterus prolapse and the patient's preference, may be sufficient to achieve uneventful pregnancy and normal, spontaneous delivery.

  10. Previous Heart Disease Complications And Hypertension In Pregnancy

    Directory of Open Access Journals (Sweden)

    Nayer Pishnamaz

    2013-05-01

    Full Text Available Objective(sHypertensive disorders in pregnancy with incidence of 3/7% are one of the most severe complications. Cardiovascular diseases are apparent in 2% of the pregnancies. Physiologic changes during pregnancy intensify the underlying disorders and the severity of this problem. Researches indicate that pregnant women with heart disease greatly confront unfavorable maternal and fetal outcomes with increased risk of abortion, intra uterine fetal death, preterm labor and intra uterine growth retardation. This study aim was to magnify the outcomes of pregnancy accompaniment with cardiovascular diseases and hypertension.Materials and Methods: This is a retrospective descriptive study in which patient records of 2500 pregnant women referring to Alzahra hospital from 2006 to 2008 were assessed. Data was gatherated by medical files and analyzed by SPSS soft ware.Results: In this study incidence of moderate Aorta Stenosis (AS was about 45.5 % (10cases, Mitral valvuloplasty (MVP was about 22/73% (5cases and Mitral stenosis (MS was 18/18% (4 cases; two patient with MR(mitral regurgitation+MS had underwent valvuloplasty. 72/7% (16 of the mothers were hospitalized due to hypertension, 9/1% due to tachycardia and dyspnea and 18/2% showed mixed form of theses complains. They were using hydralazine and methyldopa as anti hypertensive drugs. Only 10% of the patients had history of anticoagulant using during pregnancy. We found only one patient with pulmonary stenosis (PS in these patients.Conclusion: Women with hypertension and previous heart disease showed many serious complications and high fetal mortality during pregnancy. Proper and on time care giving and support during pregnancy is dependent on the accurate diagnosis of the heart disease; any health problem should be seriously noted.

  11. A complicated multisystem flare of systemic lupus erythematosus during pregnancy.

    Science.gov (United States)

    Webster, Philip; Nelson-Piercy, Catherine; Lightstone, Liz

    2017-02-08

    We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy. We discuss the therapeutic options available in pregnancy, and highlight the importance of cross-specialty multidisciplinary care in these women.

  12. Hypertension complicating diabetic pregnancies: pathophysiology, management, and controversies.

    Science.gov (United States)

    Sullivan, Shannon D; Umans, Jason G; Ratner, Robert

    2011-04-01

    Hypertensive disorders of pregnancy (HDP), including pre-existing hypertension, gestational hypertension, and preeclampsia, further complicate already high-risk pregnancies in women with diabetes mellitus (DM). Women with both pre-existing and gestational diabetes are at increased risk for HDP, leading to higher maternal and fetal morbidity. Further, particularly in diabetic women and women with a history of gestational diabetes, HDP significantly increases the risk for future cardiovascular events. For clinicians, women with hypertension and diabetes during pregnancy pose a management challenge. Specifically, preconception management should stress strict control of glycemia, blood pressure, and prevention of diabetic complications, specifically nephropathy, which specifically increases the risk for preeclampsia. During gestation, clinicians must be aware of potential maternal and fetal complications associated with various anti-hypertensive therapies, including known fetotoxicity of ACE inhibitors and ARBs when given in the 2nd or 3rd trimester, and the risks and benefits of expectant management versus delivery in cases of severe gestational hypertension or preeclampsia. Indeed, diabetic women must be followed closely prior to conception and throughout gestation to minimize the risk of HDP and its associated complications. © 2011 Wiley Periodicals, Inc.

  13. A rare case of dengue encephalopathy complicating a term pregnancy.

    Science.gov (United States)

    Rajagopala, Lavanya; Satharasinghe, Ravindra L; Karunarathna, Madhava

    2017-02-02

    Dengue fever has an expanded clinical spectrum ranging from an asymptomatic infection to life threatening dengue hemorrhagic fever and refractory shock. Dengue infection in pregnancy can be a diagnostic dilemma, particularly considering the physiological changes in pregnancy and the obstetric complications encountered in clinical practice. Hence the knowledge of its diagnosis and management in its atypical presentations is of paramount importance. Here we report an unusual case of uncomplicated dengue encephalopathy in a term mother, probably the first to be reported from the Indian subcontinent. A 28 year old woman, 37 weeks of pregnancy presented with fever of four days duration. She eventually developed irritability, altered sensorium, somnolence, and unresponsiveness to commands by the 5th day of febrile illness without any circulatory compromise. Physical examination and investigations including serology confirmed dengue fever. After excluding all other possible causes, the transient neurological deterioration was finally attributed to dengue encephalopathy which is an uncommon manifestation of the disease, particularly in pregnancy. Her deteriorated neurological status which had lasted for 6 days improved spontaneously with the convalescence of dengue infection. Cautious fluid management was carried out in correlation to clinical and hematological parameters. The pregnancy was continued uncomplicated till the platelet count had risen to more than 50,000 cells/cumm. She delivered vaginally a healthy male baby. Dengue fever in pregnancy is increasingly being encountered due to its rising disease burden. Dengue encephalitis/encephalopathy must be suspected in the differential diagnosis of fever and altered sensorium, even in pregnancy, in the tropical countries where the infection is rampant. Management of dengue infection in term pregnancy is a challenge for both the clinician and obstetrician. Further discussion and research are mandatory to decide on

  14. [Pregnancies complicated by maternal syphilis and fetal death].

    Science.gov (United States)

    do Nascimento, Maria Isabel; Cunha, Alfredo de Almeida; Guimarães, Elisângela Victor; Alvarez, Felipe Silva; Oliveira, Sandra Regina Dos Santos Muri; Villas Bôas, Eduardo Loyola

    2012-02-01

    To describe the characteristics of pregnancies complicated by maternal syphilis and fetal death. Retrospective descriptive study performed by reviewing the medical records of 48 pregnant women with maternal syphilis and fetal death outcome admitted to Hospital Geral de Nova Iguaçu, Baixada Fluminense, State of Rio de Janeiro, during the period from 2005 to 2008. Birth weight >500 g and fetal death documented by Death Certificate were the inclusion criteria. The following aspects were analyzed: sociodemographic factors, reproductive history, aspects of the current pregnancy, prenatal care, Venereal Disease Research Laboratory (VDRL) testing, and other gestational conditions, in addition to syphilis. The fetal deaths were classified as maternal, placental or fetal. Percentage, mean, standard deviation (SD), maximum and minimum values were reported. The mean maternal age was 22.7 years (SD=0.9 years), and at least 50% of the patients had low educational level. At hospital admission, 68.8% of the subjects were in the third trimester, with a mean gestational age of 29.2 weeks (SD=0.5), and more than 50% were in labor. The vast majority of fetal deaths (93%) occurred before maternal hospitalization. Among the patients who received prenatal care (54.2%), 30.8% had no VDRL test, 30.8 and 15.4% had a reactive and non-reactive result, respectively, and none had more than one prenatal VDRL test. At the time of childbirth, most of the mothers (95.8%) carried out VDRL testing. Overall, the VDRL titers varied from 1:1 to 1:512, with predominant values >1:4 (91.7%). In 23% of cases other clinical conditions related to fetal death, in addition to syphilis, were found. The infection was the main clinically identified cause of fetal death in this patient series. Fetal death occurred during the preterm period and in the presence of high titers of maternal infection, suggesting recent syphilis infection.

  15. How I treat pregnancy-related venous thromboembolism

    NARCIS (Netherlands)

    Middeldorp, S.

    2011-01-01

    Venous thromboembolism (VTE) complicates ~ 1 to 2 of 1000 pregnancies, with pulmonary embolism being a leading cause of maternal mortality and deep vein thrombosis an important cause of maternal morbidity, also on the long term. However, a strong evidence base for the management of pregnancy-related

  16. Objective Measures for Pregnancy Related Low Back and Pelvic Pain

    NARCIS (Netherlands)

    M. de Groot (Mirthe)

    2005-01-01

    textabstractPain in the lumbar spine and pelvic region is a frequent complication of pregnancy and delivery. The prevalence of pregnancy related low back and pelvic pain (PLBP) varies between 14.2 and 56%. In 6 to 15% the pain is so severe that it impedes daily life activities. The symptoms of PL

  17. How I treat pregnancy-related venous thromboembolism

    NARCIS (Netherlands)

    S. Middeldorp

    2011-01-01

    Venous thromboembolism (VTE) complicates ~ 1 to 2 of 1000 pregnancies, with pulmonary embolism being a leading cause of maternal mortality and deep vein thrombosis an important cause of maternal morbidity, also on the long term. However, a strong evidence base for the management of pregnancy-related

  18. Induced abortion and placenta complications in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Zhou, Wei Jin; Nielsen, Gunnar Lauge; Larsen, Helle

    2001-01-01

    Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval. Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All...... primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted...... or the Medical Birth Registry records. Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting...

  19. Effects of obesity on women's reproduction and complications during pregnancy.

    Science.gov (United States)

    Linné, Y

    2004-08-01

    Obesity is increasing rapidly among women all over the world, and more women in fertile ages become overweight and obese. Among all other problems, women who are obese have higher rates of amenorrhoea and infertility. Obese women have a higher risk of complications during pregnancy such as hypertensive diagnoses and gestational diabetes, and delivery complications such as higher rates of caesarean sections and prolonged time of delivery. The aim of this article is to review the consequences of being obese during the reproductive life of a woman.

  20. Carbon Monoxide Poisoning during Pregnancy: Presentation of a Rare Severe Case with Fetal Bladder Complications

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    Myriam Delomenie

    2015-01-01

    Full Text Available Carbon monoxide poisoning during pregnancy is a rare and potentially serious condition. Fetal complications are uncommon, related to anoxic lesions. The severity of these complications does not depend on the level of maternal COHb. We report the case of a 22-year-old pregnant woman who at 30 weeks of gestation had carbon monoxide poisoning secondary to a fire in her home, complicated by cardiac arrest and severe fetal damage. The child had not brain damage, but presented bladder lesions not previously described, with urinary ascites complicating megacystis.

  1. Unique trophoblast stem cell- and pluripotency marker staining patterns depending on gestational age and placenta-associated pregnancy complications

    NARCIS (Netherlands)

    Weber, Maja; Goehner, Claudia; Martin, Sebastian San; Vattai, Aurelia; Hutter, Stefan; Parraga, Mario; Jeschke, Udo; Schleussner, Ekkehard; Markert, Udo R.; Fitzgerald, Justine S.

    2016-01-01

    Preeclampsia (PE) and intrauterine growth retardation (IUGR) are rare but severe pregnancy complications that are associated with placental insufficiency often resulting in premature birth. The clinical pathologies are related to gross placental pathologies and trophoblastic deficiencies that might

  2. A rare case of sigmoid volvulus complicating pregnancy in a Tertiary care centre: a case report

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    Rajarajeswari Ramalingam

    2016-04-01

    Full Text Available Intestinal obstruction complicating pregnancy is an extremely rare complication during pregnancy. Volvulus of the sigmoid colon is the most common cause of intestinal obstruction complicating pregnancy accounting for upto 44% of the aetiology. We report a case of sigmoid volvulus complicating pregnancy in a woman with 34 weeks amenorrhoea which was diagnosed early in spite of its late presentation and successfully managed with resection and primary anastamosis. Sigmoid volvulus complicating pregnancy carries a high maternal mortality and morbidity, fetal mortality and needs a high index of suspicion and early surgical intervention. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1273-1275

  3. Hereditary thrombophilia and recurrent pregnancy loss: a retrospective cohort study of pregnancy outcome and obstetric complications

    DEFF Research Database (Denmark)

    Lund, M; Nielsen, H S; Hviid, T V

    2010-01-01

    The association among hereditary thrombophilia, recurrent pregnancy loss (RPL) and obstetric complications is yet uncertain. The objective of the study was to assess the prognostic value of the factor V Leiden (FVL) and prothrombin (PT) mutations for the subsequent chance of live birth for women...

  4. Hereditary thrombophilia and recurrent pregnancy loss: a retrospective cohort study of pregnancy outcome and obstetric complications

    DEFF Research Database (Denmark)

    Lund, Marie; Nielsen, H S; Hviid, T V

    2010-01-01

    The association among hereditary thrombophilia, recurrent pregnancy loss (RPL) and obstetric complications is yet uncertain. The objective of the study was to assess the prognostic value of the factor V Leiden (FVL) and prothrombin (PT) mutations for the subsequent chance of live birth for women...

  5. Pregnancy related symptomatic vertebral hemangioma

    Directory of Open Access Journals (Sweden)

    Meena Gupta

    2014-01-01

    Full Text Available Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  6. Pregnancy related symptomatic vertebral hemangioma.

    Science.gov (United States)

    Gupta, Meena; Nayak, Rajeev; Singh, Hukum; Khwaja, Geeta; Chowdhury, Debashish

    2014-01-01

    Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI) revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

  7. Tretinoin in pregnancy complicated with acute promyelocytic leukaemia.

    Science.gov (United States)

    Leong, K W; Teh, A; Bosco, J J

    2000-06-01

    Acute promyelocytic leukemia (APL) in pregnancy poses serious danger to both the mother and fetus. Cytotoxic chemotherapy may cause teratogenicity to the fetus. APL is unique because it is usually associated with a coagulopathy that markedly increases the risk for the mother and fetus. A 21 year old lady with APL in her third trimester of pregnancy was treated with oral tretinoin. Tretinoin reversed the coagulopathy and normalised her blood counts without causing cytotoxic damage associated with cancer chemotherapy. Fetal distress occurred at 37 weeks of gestation and an emergency caesarean section was performed without complications and no blood transfusion support was needed as her coagulopathy and thrombocytopenia had resolved. A remission was achieved with only tretinoin induction. She subsequently had consolidation and maintenance chemotherapy. The mother and baby remain well at 4 years from completion of chemotherapy. A total of 10 pregnancies associated with APL have been reported in the current literature. Premature delivery and a fetal arrhythmia were the only complications. Although retinoin is considered teratogenic, its use so far in second and third trimester has been safe.

  8. A Prospective Study of Villous Capillary Lesions in Complicated Pregnancies

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    Anu Priyadharshini Srinivasan

    2014-01-01

    Full Text Available The vascularity of placental tissue is dependent on various factors of which fetomaternal hypoxia plays a major role. Hypoxia can be of different types and each type influences the vascularity of the villi, especially terminal villi, in its own way. In this study, we attempted to identify villous vascular changes in a group of term placentae from mothers with diseases complicating pregnancy. Chorangiosis was the most frequently identified lesion while chorangioma was found in only 2 cases. There were no cases of chorangiomatosis. A few cases had normal villous vasculature. Maternal diseases have a major role in disrupting the placental vasculogenesis and angiogenesis by creating a hypoxic environment that may affect the fetus adversely. Hence, such conditions need to be identified early in pregnancy and managed appropriately as it is possible to maintain a normal vasculature and prevent neonatal mortality and morbidity if prompt intervention is done.

  9. Fertility disorders and pregnancy complications in hairdressers - a systematic review

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    Peters Claudia

    2010-08-01

    Full Text Available Abstract Background Hairdressers often come into contact with various chemical substances which can be found in hair care products for washing, dyeing, bleaching, styling, spraying and perming. This exposure can impair health and may be present as skin and respiratory diseases. Effects on reproduction have long been discussed in the literature. Method A systematic review has been prepared in which publications from 1990 to 2010 were considered in order to specifically investigate the effects on fertility and pregnancy. The results of the studies were summarised separately in accordance with the type of study and the examined events. Results A total of 2 reviews and 26 original studies on fertility disorders and pregnancy complications in hairdressers were found in the relevant databases, as well as through hand searches of reference lists. Nineteen different outcomes concerning fertility and pregnancy are analysed in the 26 original studies. Most studies looked into malformation (n = 7, particularly orofacial cleft. Two of them found statistically significant increased risks compared to five that did not. Small for gestational age (SGA, low birth weight (LBW and spontaneous abortions were frequently investigated but found different results. Taken together the studies are inconsistent, so that no clear statements on an association between the exposure as a hairdresser and the effect on reproduction are possible. The different authors describe increased risks of infertility, congenital malformations, SGA, LBW, cancer in childhood, as well as effects from single substances. Conclusion On the basis of the identified epidemiological studies, fertility disorders and pregnancy complications in hairdressers cannot be excluded. Although the evidence for these risks is low, further studies on reproductive risks in hairdressers should be performed as there is a high public health interest.

  10. Fetal outcomes in pregnancies complicated by intrahepatic cholestasis of pregnancy in a Northern California cohort.

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    Michelle Rook

    Full Text Available BACKGROUND: Intrahepatic cholestasis of pregnancy (ICP has important fetal implications. There is increased risk for poor fetal outcomes, including preterm delivery, meconium staining of amniotic fluid, respiratory distress, fetal distress and demise. METHODS: One hundred and one women diagnosed with ICP between January 2005 and March 2009 at San Francisco General Hospital were included in this study. Single predictor logistic regression models were used to assess the associations of maternal clinical and biochemical predictors with fetal complications. Clinical predictors analyzed included age, race/ethnicity, gravidity, parity, history of liver or biliary disease, history of ICP in previous pregnancies, and induction. Biochemical predictors analyzed included serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin, albumin, total protein, and total bile acids (TBA. RESULTS: The prevalence of ICP was 1.9%. Most were Latina (90%. Labor was induced in the majority (87% and most were delivered by normal spontaneous vaginal delivery (84%. Fetal complications occurred in 33% of the deliveries, with respiratory distress accounting for the majority of complications. There were no statistically significant clinical or biochemical predictors associated with an increased risk of fetal complications. Elevated TBA had little association with fetal complications until reaching greater than 100 µmoL/L, with 3 out of 5 having reported complications. ICP in previous pregnancies was associated with decreased risk of fetal complications (OR 0.21, p = 0.046. There were no cases of late term fetal demise. CONCLUSIONS: Maternal clinical and laboratory features, including elevated TBA, did not appear to be substantial predictors of fetal complications in ICP.

  11. 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...

  12. Relation between acute kidney injury and pregnancy-related factors

    Institute of Scientific and Technical Information of China (English)

    Monchai Siribamrungwong; Pawadee Chinudomwong

    2016-01-01

    Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic micro-angiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.

  13. Relation between acute kidney injury and pregnancy-related factors

    Directory of Open Access Journals (Sweden)

    Monchai Siribamrungwong

    2016-01-01

    Full Text Available Acute kidney injury (AKI is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, leading to fetal losses. This article aims to review current studies with regards to obstetrics related AKI. Most of the studies in this review were carried out in observational, both prospective and retrospective, studies. Results demonstrated a variety of major PRAKI causes such as hypertensive disorders in pregnancy, obstetric hemorrhage, sepsis, thrombotic microangiopathy and acute fatty liver in pregnancy. Aside from awareness of the etiologies of PRAKI, understanding the physiological renal adaptation during pregnancy is crucial for early detection, diagnosis, and proper management to prevent the obstetric complications.

  14. Correlation between Body Mass Index and Central Adiposity with Pregnancy Complications in Pregnant Women

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    Mehrangiz Ebrahimi-Mameghani

    2013-06-01

    Full Text Available Background: The prevalence of obesity is increasing throughout the world. Obesity assessed by body mass index (BMI has shown to be associated with gestational complications while the relationship using waist circumference (WC is not clear yet. The present study was aimed to determine the relationship be-tween WC and adverse pregnancy complications.Methods: In this prospective cohort study, 1140 nulliparous pregnant women at 1st trimester of pregnancy referred to health care centers in Tabriz, Iran were enrolled in 2009-2010. Anthropometric indexes including (weight, height and WC were measured using standardized measures and methods. BMI was clas-sified into normal, overweight and obesity based on WHO classification. Ab-dominal obesity was defined as WC ≥ 88 cm. Pregnancy complication including gestational diabetes, hypertension and preeclamsia. Data were analyzed using SPSS, version 16.Results: Mean of BMI and WC were 24.32±4.08 kg/m2, 81.84±9.25cm at 1st trimester of pregnancy, respectively. Prevalence of overweight (BMI=25-29.9 kg/m2 and obesity (BMI>29.9 kg/m2 was 27.6%, 8.8%, respectively. Abdo-minal obesity based on WC was 34.8%. Significant correlations were found between BMI and WC (r=0.73, P =0.0001. Women with BMI>29.9 kg/m2 and WC>88 cm were more likely to suffer from gestational pregnancy and hyper-tension, as well as preeclampsia and preterm delivery.Conclusion: Early maternal WC similar to BMI is related with pregnancy complications.

  15. Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Meltzer, Helle Margrete; Brantsæter, Anne Lise; Nilsen, Roy M; Magnus, Per; Alexander, Jan; Haugen, Margareta

    2011-12-01

    There has been a thrilling development , as well as profound changes, in our understanding of the effect of fetal nutrition on the development and health of the child. The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing nationwide population-based pregnancy cohort study that between 1999 and 2008 recruited 90,723 women with 106,981 pregnancies and 108,487 children. The objective of MoBa is to test specific etiologic hypotheses by estimating the association between exposures and diseases with a special focus on disorders that may originate in early life. An important aspect in this regard is maternal diet and nutritional status during pregnancy. Nutritional factors have long been considered to be important determinants of maternal and fetal health, and dietary information is currently being collected in a number of pregnancy cohorts in Europe and the United States. Thus far, pregnancy complications studied in MoBa are preterm birth, preeclampsia, and fetal growth; and the aim of this article is to report results of recently published studies of dietary factors in relation to these outcomes. Numerous studies are planned using MoBa data, and the aim is to add to the knowledge of the interplay between dietary factors, nonnutrients, and toxic dietary substances and epigenetic modulation on fetal development and health later in life.

  16. MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

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    Rajendra

    2015-06-01

    Full Text Available AIMS AND OBJECTIVES: To evaluate the maternal and perinatal outcome of pregnancies complicated with placenta previa at tertiary care centre and to evaluate the potential risk factors involved in pregnancies complicated with placenta previa at tertiary care C ent re. METHOD: We carried out 2 year retrospective observational study during period from November 2009 to October 2011 Tertiary care hospital and medical college. ANC cases with history of bleeding per vaginum after 28 weeks attending ANC clinic and emergenc y ward were included in study with appropriate age parity matched controls with other complications like pregnancy induced hypertension, abruption placentae, multiple gestation were excluded. Demographic data, medical and surgical histories, all the events regarding maternal and perinatal mortality were recorded. Data was analysed by using appropriate software . RESULTS: 136 cases of placenta previa were analysed and found prevalence of placenta previa was 1.36%. During the present study 41.80% cases were bo oked and 58.20% cases were unbooked. Maximum number of cases in present study were in the age group of 18 - 24 years. Previous caesarean (57.49% and previous abortion (42.53% found important risk factors.41.04% cases were delivered at 33 - 36 weeks of gestat ion followed by 33.58% in 28 - 32 weeks of gestation. Expectant management was given to 37.32% of cases while 62.68% cases were managed on active basis. In present study maternal morbidity were postpartum hemorrhage (56.71%, sepsis (37.31%, urinary tract i nfection (5.22%, wound infection (5.22%,wound gape (4.47%, hysterectomy (2.23%, prolonged hospital stay >10 days (17.91%. There were two (1.49% maternal mortality in present study. Maximum number of infants i.e . 58.20% had bir th eight between 1.6 to 2.4kg. O ut of this 16.41% were of 1.6 - 2kg and 41.79% comprised of 2.1 - 2.4 kg. 39.55% infant required NICU admission and 60.45% of cases were with mother. Perinatal

  17. Age at menarche and pregnancy-related pelvic pain

    DEFF Research Database (Denmark)

    Kirkeby, Mette J; Biering, Karin; Olsen, Jørn

    2013-01-01

    AIM: Menarcheal age is a predictor of several complications related to pregnancy and diseases later in life. We aimed to study if menarcheal age is a risk factor for pregnancy-related pelvic pain. MATERIAL AND METHODS: A nested case-control study was conducted within the Danish National Birth...... Cohort, a cohort of pregnant women, recruited during 1996-2002, and their children. In the second trimester of pregnancy the women provided information about age at menarche and potential confounders. Selection of cases (n = 2227) was based on self-reported pelvic pain during pregnancy from an interview...... done 6 months post-partum. The controls (n = 2588) were randomly selected among women who did not report pelvic pain. We used logistic regression analysis to calculate odds ratios (OR) for pregnancy-related pelvic pain according to age at menarche. RESULTS: In the cohort, 18.5% of all pregnant women...

  18. OUTCOME OF PREGNANCIES COMPLICATED BY THREATENED ABORTION IN THE SECOND TRIMESTER OF PREGNANCY - PROSPECTIVE STUDY

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    Rajeswary

    2015-11-01

    Full Text Available AIM: To compare the outcome of pregnancies complicated by bleeding per vaginum between 14- 20 weeks with those not complicated by bleeding per vaginum before 20 weeks. To evaluate the potential determinants of outcome such as gestational age at bleeding, number of bleeding episodes, extent of placental separation or sub chorionic bleed, incidence of complications as placenta previa, abruptio placenta, development of gestational hypertension and pre eclampsia, intra uterine growth restriction, and neonatal outcomes as birth weight, mode of delivery, neonatal ICU admission, and congenital anomalies. SETTINGS AND DESIGN: This was a prospective, comparative study, for a duration of one year. STUDY POPULATION: Cases- 100 women admitted in IMCH with first episode of bleeding per vaginum between 14- 20 weeks and continuing their pregnancy after 20 weeks. CONTROLS: 200 uncomplicated pregnancies attending antenatal outpatient clinic which were followed up till delivery. EXCLUSION CRITERIA: 1. Women with history of threatened abortion in first trimester were not included in the study. 2. Subjects age more than 35 years. 3. Previous history of abortion. 4. Any significant medical, surgical or gynecological history. RESULTS: When patients who presented with bleeding pv after completion of 1st trimester were analyzed by USS, a significant number of them had evidence of sub chorionic bleed, heavier the bleed, more the likelihood of presence of sub placental hematoma. There was no significant difference in prevalence of development of hypertensive disorders of pregnancy in both study groups. There was no significant rise in ante partum hemorrhage between cases and controls. Incidence of IUGR, PPROM, PRE TERM LABOR was significantly increased in study group. LSCS rate was not significantly different in both groups. In this study, there was no significant difference in incidence of congenital anomalies in both groups. STUDY AREA: Tertiary health center

  19. [Interconnection between assisted reproductive technologies, pregnancy complications and risk of birth defects].

    Science.gov (United States)

    Grabar', V V

    2014-02-01

    The aim of the article was to investigate the relationship between pregnancy complications, infertility and assisted reproductive technologies (ART). The study was conducted on 1331 couples with complicated reproductive history. It is found that miscarriage and other complications of pregnancy depend rather on the etiopathogenesis of infertility than on the technique of ART. The highest frequency of complications of pregnancy was diagnosed in women with endocrine disorders. In case of congenital malformations in the fetus the frequency of birth defects was 3.6% after in vitro fertilization (IVF) and 1.8% in case of spontaneous pregnancy. It was found an increased risk of birth defects in singleton boys conceived by IVF.

  20. Placental lipases in pregnancies complicated by gestational diabetes mellitus (GDM.

    Directory of Open Access Journals (Sweden)

    Helen L Barrett

    Full Text Available Infants of women with gestational diabetes mellitus (GDM are more likely to be born large for gestational age with a higher percentage body fat. Elevated maternal lipids may contribute to this. Placental lipases such as lipoprotein lipase (LPL, endothelial lipase (EL and hormone sensitive lipase (HSL are involved in transferring lipids from mother to fetus. Previous studies of expression of these lipases in placentae in women with diabetes in pregnancy have reported divergent results. Intracellular lipases such as adipose triglyceride lipase (ATGL, and HSL are central to lipid droplet metabolism. The activities of these lipases are both influenced by Perilipin 1, and ATGL is also activated by a co-factor comparative gene identification-58 (CGI-58 and inhibited by G0/G1 switch gene 2 (GS02. None of these modifying factors or ATGL have been examined previously in placenta. The purpose of this study was therefore to examine the expression of ATGL, HSL, LPL, EL, as well as Perilipin 1, GS02 and CGI-58 in term pregnancies complicated by GDM. mRNA and protein expression of the lipases were measured in placentae from 17 women with GDM and 17 normoglycaemic pregnancies, matched for maternal BMI and gestational age of delivery. ATGL mRNA expression was increased and HSL mRNA expression reduced in placentae from GDM although there was no differences in protein expression of any of the lipases. All lipases were localised to trophoblasts and endothelial cells. The expression of Perilipin 1 and CGI-58 mRNA was increased and GS02 not altered in GDM. These results suggest that there is no difference in expression in these four lipases between GDM and normoglycaemic placentae, and therefore altered lipid transfer via these lipases does not contribute to large for gestational age in infants of women with GDM.

  1. Thrombophilia prevalence among women with placenta-mediated pregnancy complications

    DEFF Research Database (Denmark)

    Gils, Charlotte; Nybo, Mads

    2016-01-01

    OBJECTIVE: To evaluate the prevalence of thrombophilia in patients with placenta-mediated pregnancy complications (PMPC). METHODS: Patients referred for thrombophilia testing at Odense University Hospital, Denmark, owing to PMPC between January 1, 2010 and December 31, 2014, were included...... in the present retrospective study. Data collected from patient medical records included the type of PMPC, history of previous thrombosis, and arterial thrombosis risk factors. RESULTS: A total of 103 patients were included in the study; 25 (24.3%) were diagnosed with thrombophilia. Among the study population......, factor V Leiden was the most dominant thrombophilia and was diagnosed in 11 (10.7%) patients (compared with 7% prevalence in the general population). The prevalence of all thrombophilias (except prothrombin mutation) was significantly higher in patients with PMPC in comparison with the reported...

  2. Diagnosis and Management of IUGR in Pregnancy Complicated by Type 1 Diabetes Mellitus

    OpenAIRE

    Gutaj, Paweł; Wender-Ozegowska, Ewa

    2016-01-01

    This review discusses available literature on the diagnosis and management of intrauterine growth restriction (IUGR) in women with type 1 diabetes. IUGR is diagnosed when ultrasound-estimated fetal weight is below the 10th percentile for gestational age. IUGR diagnosis implies a pathologic process behind low fetal weight. IUGR in pregnancy complicated by type 1 diabetes is usually caused by placental dysfunction related to maternal vasculopathy. Prevention of IUGR should ideally start before ...

  3. Hydrogen inhibits cytotrophoblast cells apoptosis in hypertensive disorders complicating pregnancy.

    Science.gov (United States)

    Guo, L; Guan, Z; Li, H; Yang, X

    2016-05-30

    Hypertensive disorders complicating pregnancy (HDCP) is one of the most serious medical disorders during pregnancy. Hydrogen is a therapeutic antioxidant and used to treat HDCP effectively. However, the molecular mechanism about the effect of hydrogen on HDCP still remains unclear. In this study, we found ROS content in HDCP group was significantly higher than that in the control and was reduced markedly in the presence of 100μmol/L hydrogen. IL6, Caspase3, Bax1, P-JAK2, P-Stat3 and P-p38 expression was much higher than the control, and was notably decreasedby the application of 100μmol/L hydrogen. Bcl2 expression in HDCP group was notably lower than the control and was increased by 100 μmol/L hydrogen. The apoptosis rate of cytotrophoblast cells was decreased, andratio of cytotrophoblast cells at G1 and G2 phase was increased and decreased by hydrogen, respectively. All those data indicated a potential molecular mechanism of hydrogen-mediated treatment in HDCP.

  4. Causation between occupational prolonged standing time during progestation and pregnancy related complications%孕前职业久站行为与妊娠并发症的因果效应研究

    Institute of Scientific and Technical Information of China (English)

    翁婷婷; 徐叶清; 严双琴; 潘维君; 陶芳标

    2013-01-01

    目的 描述安徽省马鞍山地区孕妇在孕前和孕早期工作中站立时间以及长时间站立行为的分布特征,探索该职业暴露与妊娠高血压等常见并发症的相关性.方法 于2008年10月至2010年10月在马鞍山市妇幼保健机构招募初次建卡孕妇,建立孕产妇队列并随访至分娩.分别于孕早、中、晚期在产检医生指导下由孕产妇自填问卷,收集相关信息.结果 4644名孕妇孕前和孕早期持续站立时间百分位数P75值分别为4.0 h/d和3.0 h/d;孕前和孕早期久站行为主要分布于较低经济社会地位特征孕妇中;多因素分析结果显示,在调整可能混杂因素后,孕前久站行为与妊娠合并高血压和中度贫血均呈显著正相关,其OR值分别为2.05(95%CI:1.26~ 3.31)和1.38(95%CI:1.03~1.85).结论 孕前职业暴露于较重体力负荷的工作如长时间站立,可增加妊娠高血压等疾病的危险.%Objective To describe the epidemiological characteristics of profession related long-standing behavior during preconception and progestation,and to probe the relationship between prolonged standing jobs and the common pregnancy related complications among pregnant women,in Ma' anshan city,Anhui province.Methods In this cohort study,subjects who had their first antenatal examination at Ma' anshan Maternal and Child Care Centers were recruited under informed consent,from October 2008 to October 2010.All the information were collected through questionnaires in the first,second and third trimesters respectively.Three questionnaires were filled in by subjects under the guidance of healthcare takers.Results In the study,the 754 percentile of prolonged-standing times were 4.0 h/d and 3.0 h/d respectively in preconception and progestation.The characteristics of pregnant women with low social/economic status,prone to be involved in stand-long occupation.Results in logistic regression analysis,prolonged-standing jobs during preconception was the

  5. Liver synthetic function in predicting the prognosis of pregnancy complicating fulminant hepatitis

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-mao; DENG Liu-zhi; SHEN Hui-min; YANG Yue-bo; LI Meng-xiong; CHEN Xiao-wei; YIN Yu-zhu; ZHOU Shui-sheng

    2007-01-01

    @@ Pregnancy complicating fulminant hepatitis is characterized by rapid progress,complicated clinical symptoms,and association with blood coagulation dysfunction,hepatic encephalopathy,hepatorenal syndrome,toxic enteroparalysis and infection.

  6. Does fetal macrosomia affect umbilical artery Doppler velocity waveforms in pregnancies complicated by gestational diabetes?

    Science.gov (United States)

    Sirico, Angelo; Rizzo, Giuseppe; Maruotti, Giuseppe Maria; Aiello, Elisa; Morlando, Maddalena; Arduini, Domenico; Martinelli, Pasquale

    2016-10-01

    We aimed to establish whether macrosomic fetuses in pregnancies complicated by gestational diabetes (GDM) show different Pulsatility Index (PI) values in umbilical artery (UA) than in non-macrosomic fetuses. We considered 106 pregnant women with GDM. Doppler recordings of UA-PI were performed at 34-41 weeks and related to neonatal birthweight. Pregnancies were divided in two groups according to birthweight, macrosomic group (>4000 g) and controls (90th centile and 4000 g than in controls (PI = 0.69; 95% CI 0.64-0.74 versus PI = 0.87; 95% CI 0.84-0.90, p 90th centile than in controls (PI = 0.79; 95% CI 0.74-0.84 versus PI = 0.87; 95% CI 0.83-0.90; t = 2.653; p = 0.01). Linear regression analysis revealed a significant correlation between UA-PI and neonatal birthweight and between UA-PI and neonatal birthweight centile. Macrosomic fetuses of pregnancies complicated by GDM show lower values of UA-PI compared with controls. Despite UA-PI results, a variable related to macrosomia its role in the management of these pregnancies remains to be established.

  7. Pregnancy-related osteoporosis and spinal fractures

    Science.gov (United States)

    Yun, Ka Yeong; Han, Si Eun; Kim, Seung Chul; Lee, Kyu Sup

    2017-01-01

    Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain. The management and natural history are still poorly defined. Traditional medications for osteoporosis are calcium/vitamin D and bisphosphonate. Concerns with bisphosphonate include accumulation in bone and fetal exposure in subsequent pregnancies. The newly developed medication, teriparatide, has shown good results. We report six cases of pregnancy-related osteoporosis and spinal fracture with literature review. PMID:28217686

  8. Pregnancy-related myocardial infarction

    NARCIS (Netherlands)

    Lameijer, H.; Lont, M. C.; Buter, H.; van Boven, A. J.; Boonstra, P. W.; Pieper, P. G.

    Introduction The risk of acute myocardial infarction in young women is low, but increases during pregnancy due to the physiological changes in pregnancy, including hypercoagulability. Ischaemic heart disease during pregnancy is not only associated with increased maternal morbidity and mortality, but

  9. Non-cardiac complications during pregnancy in women with isolated congenital pulmonary valvar stenosis

    NARCIS (Netherlands)

    Drenthen, W.; Pieper, P. G.; Roos-Hesselink, J. W.; Schmidt, A. C. M.; Mulder, B. J. M.; van Dijk, A. P. J.; Vliegen, H. W.; Sollie, K. M.; Voors, A. A.; Ebels, T.; van Veldhuisen, D. J.

    2006-01-01

    Background: Information on the outcome of pregnancy in patients with pulmonary valvar stenosis is scarce, mostly limited to cardiac complications observed during pregnancy. Objectives: To investigate the magnitude and determinants of non-cardiac and fetal risks during pregnancy of women with isolate

  10. Non-cardiac complications during pregnancy in women with isolated congenital pulmonary valvar stenosis.

    NARCIS (Netherlands)

    Drenthen, W.; Pieper, P.G.; Roos-Hesselink, J.W.; Schmidt, A.C.; Mulder, B.J.M.; Dijk, A.P.J. van; Vliegen, H.W.; Sollie, K.M.; Voors, A.A.; Ebels, T.; Veldhuisen, D.J. van

    2006-01-01

    BACKGROUND: Information on the outcome of pregnancy in patients with pulmonary valvar stenosis is scarce, mostly limited to cardiac complications observed during pregnancy. OBJECTIVES: To investigate the magnitude and determinants of non-cardiac and fetal risks during pregnancy of women with isolate

  11. Management of reproduction and pregnancy complications in maternal obesity: which role for dietary polyphenols?

    Science.gov (United States)

    Santangelo, Carmela; Varì, Rosaria; Scazzocchio, Beatrice; Filesi, Carmelina; Masella, Roberta

    2014-01-01

    Obesity is a global and dramatic public health problem; maternal obesity represents one of the main risk factors of infertility and pregnancy complications as it is associated with adverse maternal and offspring outcomes. In the last few years, adipose tissue dysfunction associated with altered adipocytokine secretion has been suggested to play a critical role in all the phases of reproductive process. Obesity is a nutrition-related disorder. In this regard, dietary intervention strategies, such as high intake of fruit and vegetables, have shown significant effects in both preserving health and counteracting obesity-associated diseases. Evidence has been provided that polyphenols, important constituents of plant-derived food, can influence developmental program of oocyte and embryo, as well as pregnancy progression by modulating several cellular pathways. This review will examine the controversial results so far obtained on adipocytokine involvement in fertility impairment and pregnancy complications. Furthermore, the different effects exerted by polyphenols on oocyte, embryo, and pregnancy development will be also taken in account.

  12. Relationship between Stress Coping Styles and Pregnancy Complications among Women Exposed to Hurricane Katrina

    Science.gov (United States)

    Oni, Olurinde; Harville, Emily; Xiong, Xu; Buekens, Pierre

    2015-01-01

    Objective To examine the relationship between maternal stress exposure, stress coping styles, and pregnancy complications. Design Quantitative, cross-sectional, and prospective study. Setting Tulane-Lakeside Hospital, New Orleans, LA and Women's Hospital, Baton Rouge, LA. Participants The study included 146 women (122 from New Orleans and 24 from Baton Rouge), who were pregnant during or immediately after Hurricane Katrina. Methods Participants were interviewed regarding their hurricane experiences and perceived stress, and coping styles were assessed using the Brief COPE. Medical charts were also reviewed to obtain information about pregnancy outcomes. Logistic regression was performed to determine possible associations. Results Hurricane exposure was significantly associated with induction of labor (adjusted odds ratio (aOR) =1.39; 95% confidence interval (CI) =1.03, 1.86; P=0.03) and current perceived stress (aOR=1.50; CI=1.34, 1.99; P<0.01). Stress perception significantly predisposed to pregnancy-induced hypertension (aOR=1.16; CI=1.05, 1.30; P<0.01) and gestational diabetes (aOR=1.13; CI=1.02, 1.25; P=0.03). Use of planning, acceptance, humor, instrumental support, and venting coping styles were associated with a significantly reduced occurrence of pregnancy complications (P<0.05). Higher rates for gestational diabetes was found among women using the denial coping style (aOR=2.25; CI=1.14, 4.45; P=0.02). Conclusion Exposure to disaster-related stress may complicate pregnancy, while some coping styles may mitigate its effects. Further research should explore how coping styles may mitigate or exacerbate the effect of major stressors and how positive coping styles can be encouraged or augmented. PMID:25712783

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

    NARCIS (Netherlands)

    D. Berks (Durk)

    2017-01-01

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

  14. 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

  15. Comparison of magnesium and methyldopa for the control of blood pressure in pregnancies complicated with hypertension

    DEFF Research Database (Denmark)

    Rudnicki, M; Frølich, A; Pilsgaard, K;

    2000-01-01

    OBJECTIVES: Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. METHODS: A total of 33 patients with pregnancy-induced hypertension were...... demonstrates that magnesium treatment lowers blood pressure in pregnancies complicated with hypertension. The effect is without any adverse effect on maternal and neonatal well-being....

  16. Reduced placental telomere length during pregnancies complicated by intrauterine growth restriction.

    Directory of Open Access Journals (Sweden)

    Jérôme Toutain

    Full Text Available OBJECTIVES: Recent studies have shown that telomere length was significantly reduced in placentas collected at delivery from pregnancies complicated by intrauterine growth restriction secondary to placental insufficiency. Placental telomere length measurement during ongoing pregnancies complicated by intrauterine growth restriction has never been reported. This was the main objective of our study. METHODS: In our center, late chorionic villus samplings were performed between 18 and 37 weeks of amenorrhea in 24 subjects with severe intrauterine growth restriction (cases and in 28 subjects with other indications for prenatal diagnosis (controls. Placental insufficiency was assessed by histo-pathological examination. Relative measurement of telomere length was carried out prospectively by quantitative Fluorescent In Situ Hybridization using fluorescent Peptide Nucleic Acid probes on interphase nuclei obtained from long-term cultured villi and with an automated epifluorescent microscope. A quantitative Polymerase Chain Reaction technique was performed to confirm the quantitative Fluorescent In Situ Hybridization results. The number of copies of gene loci encoding the RNA template (hTERC and the catalytic subunit (hTERT of the enzyme complex telomerase were also estimated in these placentas by Fluorescent In Situ Hybridization. RESULTS: Mean fluorescence intensity of telomere probes estimated by quantitative Fluorescent In Situ Hybridization was significantly less for cases compared to controls (p<0.001. This result indicated that mean telomere length was significantly reduced in placentas during pregnancies complicated by intrauterine growth restriction. Reduced telomere length was confirmed by the quantitative Polymerase Chain Reaction technique. No copy number variation of the hTERC and hTERT loci was noticed for cases, or for controls. CONCLUSION: This study clearly demonstrates a reduction of placental telomere length in ongoing pregnancies

  17. [Tumor lysis syndrome in a pregnancy complicated with acute lymphoblastic leukemia].

    Science.gov (United States)

    Álvarez-Goris, M P; Sánchez-Zamora, R; Torres-Aguilar, A A; Briones Garduño, J C

    2016-04-01

    Acute leukemia is rare during pregnancy, affects about 1 in 75,000 pregnancies, of all leukemias diagnosed only 28% are acute lymphoblastic leukemia, this is a risk factor to develop spontaneous tumor lysis syndrome, it's a oncologic complication potentially deadly if the prophylactic treatment its avoided. Cases of acute lymphoblastic leukemia associated with pregnancy has been poorly documented in the literature the association of these two entities to pregnancy is the first report published worldwide, so the information is limited.

  18. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy.

    Science.gov (United States)

    Hauer, Beatrijs J A; Wessel, Ineke; Engelhard, Iris M; Peeters, Louis L; Dalgleish, Tim

    2009-07-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So far, no reported studies have tested the predictive value of memory specificity at the onset of a potentially traumatic situation. Therefore the aim of the present study was to investigate whether prenatal memory specificity would predict post-traumatic stress after complicated pregnancy. The results demonstrate that women who retrieved fewer specific memories with a pregnancy-related content to positive cues during pregnancy (i.e., directly after hospitalisation) reported more post-traumatic stress 6 weeks after giving birth. This relationship remained significant after controlling for variables that were related to both baseline autobiographical memory specificity and later post-traumatic stress. A similar pattern was found for depression symptomatology, even when somatic symptoms were excluded from the analyses. Taken together, these data suggest that the relationship of memory specificity with later depression can be generalised to post-traumatic stress symptoms.

  19. Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico.

    Science.gov (United States)

    Tinoco-Ojanguren, Rolando; Glantz, Namino M; Martinez-Hernandez, Imelda; Ovando-Meza, Ismael

    2008-03-01

    Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channeling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and we detail reasons why each approach has fallen short. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here center on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.

  20. Serum lipid levels in pregnancies complicated by preeclampsia

    Directory of Open Access Journals (Sweden)

    Valmir Jose de Lima

    Full Text Available CONTEXT AND OBJECTIVE: Pre-eclampsia is a disorder that occurs only during pregnancy. Postpartum changes relating to lipid metabolism may contribute towards the endothelial lesions observed in preeclampsia. Thus, the aim of the present study was to evaluate the lipid profile among patients who present preeclampsia and correlate these parameters with 24-hour proteinuria. DESIGN AND SETTING: Cross-sectional analytical study including 77 pregnant patients seen at Hospital Dório Silva. METHODS: This study involved 42 women with preeclampsia and 35 healthy pregnant women in the third trimester of pregnancy as controls. Blood samples were obtained from all the patients, and the serum levels of triglycerides, total cholesterol, low-density lipoproteins (LDL, high-density lipoproteins (HDL and very low density lipoproteins (VLDL were determined. Cases and controls were matched for maternal age, gestational week and body mass index. RESULTS: The VLDL and triglyceride values from the women with preeclampsia were significantly higher than those of the healthy women. There was a positive correlation between increased proteinuria and higher VLDL and triglyceride levels in patients with preeclampsia. CONCLUSION: Among the patients with preeclampsia, higher VLDL and triglyceride levels were positively correlated with proteinuria. These observations indicate that the pregnant women who presented elevated lipid levels were more susceptible to cardiovascular disorders and, consequently, pre-eclampsia.

  1. MRI of breast implant-related complications

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Hae; Kook, Shin Ho; Kim, Jong Wook; Ahn, Sung Yul; Cha, Dong Sup; Whang, Kwi Whan; Pae, Won Kil; Park, Yong Lai; Lee, Young Uk; Park, Hae Won; Kim, Myung Sook [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to assess the usefulness of MRI in the preoperative diagnosis of breast implant-related complications. Thirty four breast implants in 17 patients were examined. Eight breasts had a history of repeated surgery due to rupture and in eight others, simultaneous interstitial silicone injection had been performed. MR images of the 34 implants were prospectively analyzed for implant-related complications, without prior clinical information, and the findings were compared with the results of surgery. MRI was an effective and useful method for the preoperative evaluation of implant-related complications; degree of contracture was successfully predicted. (author). 18 refs., 2 tabs., 5 figs.

  2. [Pregnancy-related acute kidney injury].

    Science.gov (United States)

    Filipowicz, Ewa; Staszków, Monika

    Acute kidney injury (AKI) in obstetrics may be caused by the same disorders that are observed in the general population or may be specific for a pregnancy such as: preeclampsia, HELLP syndrome or acute fatty liver of pregnancy. The renal changes may be only temporary, and resolve within a few weeks postpartum, or may become irreversible leading to a progression of chronic kidney disease (CKD). In the article the most important pregnancy related syndromes associated with AKI have been shortly reviewed.

  3. 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...

  4. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient's age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management.

  5. Obstetric and neonatal complications in pregnancies conceived after oocyte donation

    DEFF Research Database (Denmark)

    Storgaard, M.; Loft, A.; Bergh, C.

    2017-01-01

    by conventional in-vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) or spontaneously. Search Strategy: A systematic search was performed in the PubMed, Cochrane and Embase databases from 1982–2016. Primary outcomes were hypertensive disorders of pregnancy, pre-eclampsia (PE), gestational diabetes......Background: Approximately 50 000 oocyte donation (OD) treatment cycles are now performed annually in Europe and the US. Objectives: To ascertain whether the risk of adverse obstetric and perinatal/neonatal outcomes is higher in pregnancies conceived by OD than in pregnancies conceived...... mellitus, postpartum haemorrhage, caesarean section, preterm birth, low birthweight and small for gestational age. Selection criteria: Inclusion criteria were original studies including at least five OD pregnancies with a control group of pregnancies conceived by conventional IVF/ICSI or spontaneous...

  6. Prevention of pregnancy complications in iran following implementing a national educational program.

    OpenAIRE

    Maryam Moghani Lankarani; Nasrin Changizi; Mohammadreza Rasouli; Mohammad Amir AmirKhani; Shervin Assari(Psychiatry Dept., Center for Research on Ethnicity, Culture and Health, University of Michigan, Ann Arbor, MI USA)

    2014-01-01

    Objective: To determine the impact of a national intervention program on some pregnancy complications in Iran. Materials and methods: This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies) and post- (3,958 pregnancies) measur...

  7. Immunological response in cases of complicated and uncomplicated bartonellosis during pregnancy

    OpenAIRE

    Erick Huarcaya; Ciro Maguina; Ivan Best; Nelson Solorzano; Lawrence Leeman

    2007-01-01

    Bartonellosis (Carrion's Disease) during pregnancy is associated with high rates of maternal and perinatal mortality. We report the immunological patterns in two cases of human bartonellosis during pregnancy. One patient had an uncomplicated course while the second patient developed life threatening anasarca and cardiac tamponade. The patient with a complicated course had a Th1 response with a higher elevation of IL-10. This elevation has been associated with poor outcome pregnancies during b...

  8. Pregnancy related pelvic pain is more frequent in women with increased body mass index

    DEFF Research Database (Denmark)

    Biering, Karin; Nøhr, Ellen Aagaard; Olsen, Jørn

    2011-01-01

    Objective. To investigate the association between pre-pregnancy overweight/obesity and pregnancy-related pelvic pain. Design: Nested case-control study. Setting and population. The Danish National Birth Cohort, a cohort of pregnant women and their children recruited 1996–2002. Methods. The women...... had not given birth before. Conclusion. The risk of pregnancy-related pelvic pain increasedwith pre-pregnancy BMI in an exposure–response relation and potentially adds another maternal complication to obesity....... were interviewed twice during pregnancy and twice after childbirth. The first pregnancy interview provided information on self-reported pre-pregnancy body mass index (BMI) and possible confounders, while data on pregnancy-related pelvic pain came from an interview sixmonths postpartum. Cases (n=2 271...

  9. Ultrasound-Guided Bipolar Umbilical Cord Occlusion in Complicated Monochorionic Pregnancies

    DEFF Research Database (Denmark)

    Schou, Katrine V; Jensen, Lisa N; Jørgensen, Connie

    2017-01-01

    INTRODUCTION: Ultrasound-guided bipolar umbilical cord occlusion (UCO) is used in complicated monochorionic multiple pregnancies in Denmark. The aim of this study was to assess a learning curve in the procedure of UCO. MATERIALS AND METHODS: One hundred and two monochorionic pregnancies treated...

  10. Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies : Systematic Review and Meta-analysis

    NARCIS (Netherlands)

    Cheong-See, Fiona; Schuit, Ewoud; Arroyo-Manzano, David; Khalil, Asma; Barrett, Jon; Joseph, K. S.; Asztalos, Elizabeth; Hack, Karien; Lewi, Liesbeth; Lim, Arianne; Liem, Sophie; Norman, Jane E.; Morrison, John; Combs, C. Andrew; Garite, Thomas J.; Maurel, Kimberly; Serra, Vicente; Perales, Alfredo; Rode, Line; Worda, Katharina; Nassar, Anwar; Aboulghar, Mona; Rouse, Dwight; Thom, Elizabeth; Breathnach, Fionnuala; Nakayama, Soichiro; Russo, Francesca Maria; Robinson, Julian N.; Dodd, Jodie M.; Newman, Roger B.; Bhattacharya, Sohinee; Tang, Selphee; Mol, Ben Willem J; Zamora, Javier; Thilaganathan, Basky; Thangaratinam, Shakila

    2017-01-01

    Twin pregnancies are at increased risk of stillbirth. Uncomplicated twin pregnancies are commonly delivered earlier to prevent stillbirth; however, there is a risk of neonatal complications associated with being born prior to 39 weeks’ gestation. The optimal gestational age for delivery in twin

  11. Fetal reduction by bipolar cord coagulation in managing complicated monochorionic multiple pregnancies: preliminary experience in China

    Institute of Scientific and Technical Information of China (English)

    HE Zhi-ming; FANG Qun; YANG Yong-zhong; LUO Yan-min; CHEN Jun-hong; CHEN Yong-zhen; ZHOU Yi; CHEN Min-ling

    2010-01-01

    Background Monochorionic multiple pregnancies (MMPs) are associated with higher rates of perinatal morbidity and mortality caused by interfetal vascular anastomoses in the monochorionic placenta, which can lead to fetal health interactions. In some circumstances, selective feticide of the affected fetus is necessary to save the healthy co-twin. We evaluated the effects and safety of our initial experiences using bipolar cord coagulation for the management of complicated MMPs. Methods Using ultrasound-guided bipolar cord coagulation, we performed selective feticide on 14 complicated MMPs (5 with twin-twin transfusion syndrome, 4 with acardia, 3 with discordant structural anomalies, and 2 with severe selective intrauterine growth restriction). One patient with monochorionic triplets received the procedure twice to terminate 2 affected fetuses for different indications. Data regarding the operations, complications and neonatal outcomes were analyzed. Results Cord occlusions were successfully performed in 13/14 (93%) cases. The failure happened in an acardiac fetus and the pregnancy was terminated by induction. The included cases delivered at a mean gestational age of 35.4 weeks with a perinatal survival rate of 11/13 (85%). Three operation-related complications occurred (21%), including membrane rupture of the terminated sac (1 case), preterm labor at 28 weeks gestation (1 case), and chorioamniotic membrane separation (1 case). Amnioinfusion was indicated in 11 procedures to expand the target sacs for entering the trocar and obtaining sufficient working space. However, in all 4 cases of acardia, the acardiac sacs showed extreme oligohydramnios and could not be well expanded by infusion; thus, the trocar had to be inserted from the sac of the preserved co-twin. Conclusions The application of bipolar cord coagulation in complicated MMPs is safe and improves the prognosis. Amnioinfusion is useful in helping to expand the target sac when the working space is limited.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  13. Prevention of pregnancy complications in iran following implementing a national educational program.

    Directory of Open Access Journals (Sweden)

    Maryam Moghani Lankarani

    2014-09-01

    Full Text Available To determine the impact of a national intervention program on some pregnancy complications in Iran.This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies and post- (3,958 pregnancies measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants.The following pregnancy complications were reduced significantly as compared to before intervention: 1 bleeding or spotting, 2 urinary tract complications, 3 blurred vision and severe headache, 4 premature labor pain, 5 anemia, 6 severe vomiting, 7 inappropriate weight gain, 8 endometritis, 9 urinary incontinence, 10 breast abscess or mastitis, 11 wound infection, and 12 bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1 hypertension, 2 fever and chills, 3 convulsion, shock, and loss of consciousness, and 4 obstetric fistula.National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries.

  14. Treatment of pregnancy related venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Mitić Gorana

    2009-01-01

    Full Text Available Introduction. Prevention and treatment of venous thromboembolism during pregnancy are complicated since the use of antithrombotic drugs carries a certain risk to the mother, the fetus or both. Coumarins cross the placental barrier and may be responsible for bleeding, teratogenicity and central nervous system abnormalities. The risk of embriopathy is particularly high between 6 and 12 weeks of gestation. Treatement. Heparin is the treatment of choice for thrombosis during pregnancy because it is entirely safe for the fetus, unlike oral anticoagulants. The frequency of heparin-induced thrombocytopenia and osteoporosis is significantly lower if LMWH is applied, so this heparin type is preferable to UFH during pregnancy. Treatment of women with VTE during pregnancy, especially those with thrombophilia, requires individualized dosing and duration of antithrombotic thrapy. Peripartal management. In order to avoid the peripartum anticoagulant heparin effect and possible bleeding, heparin should be discontinued prior to the delivery and reintroduced after the parturition. PROPHYLACTIC REGIMEn. Prophylactic antithrombotic regimen during subsequent pregnancies should also be individualized. The use of low molecular weight heparins is becoming more widespread. They have reliable pharmacokinetics, require less frequent injections than unfractionated heparin and carry a lower risk of treatment complications. LMW heparins are safe and effective and they are replacing UFH as the anticoagulant of choice during pregnancy. Both UFH and LMWH are not secreted into breast milk and can be safely given to nursing mothers. Warfarin does not induce an anticoagulant effect in the breast-fed infant, so it can be safely used in women who require postpartum anticoagulant therapy.

  15. Pregnancy complicated by triploidy: a comparison of the three karyotypes.

    Science.gov (United States)

    McWeeney, Dennis T; Munné, Santiago; Miller, Richard C; Cekleniak, Natalie A; Contag, Stephen A; Wax, Joseph R; Polzin, William J; Watson, William J

    2009-10-01

    We evaluated triploid pregnancy to determine whether there are clinically important differences between the three karyotypes: 69,XXX, 69,XXY, and 69,XYY. Prospectively maintained cytogenetic databases at five tertiary care centers were retrospectively reviewed over a 10-year period to identify all triploid pregnancies. Targeted ultrasounds were reviewed to identify fetal and placental findings. Sonographic findings were compared by karyotype. There was a total of 549 triploid gestations; preimplantation genetic diagnosis (PGD) detected 413 triploid embryos, and the cytogenetic databases provided 136 clinical pregnancies with triploidy. In triploid embryos with PGD, the frequency of the 69,XYY karyotype was 8.7% (36/413), compared with 0.74% (1/136) during the first trimester of clinical pregnancies (p = 0.002). In clinical pregnancies, 60% (36/60) of 69,XXY fetuses survived the first trimester of development compared with 69% (52/75) of 69,XXX fetuses (p = NS). No clinically important differences were observed between 69,XXX and 69,XXY karyotypes in terms of type, number, or severity of fetal or placental anomalies. Gestations with a 69,XYY karyotype are found less frequently compared with gestations with a 69,XXX or 69,XXY karyotype. The decline in fetal survival of the 69,XYY triploid karyotype needs further investigation. There are significant abnormalities detected during prenatal sonography in most all clinically recognized cases of triploidy. Sonography cannot reliably distinguish between the 69,XXY and 69,XXX karyotypes.

  16. Operative Complications During Pregnancy After Gastric Bypass—a Register-Based Cohort Study

    DEFF Research Database (Denmark)

    Andreasen, Lisbeth A; Nilas, Lisbeth; Kjær, Mette M

    2014-01-01

    BACKGROUND: Late complications to bariatric surgery during pregnancy have become an area of concern. Expansion of the uterus and the following displacement of the small intestine may increase the risk of internal herniation. We wanted to estimate the risk and consequences of surgical complications...... during pregnancy in a national cohort of women with a history of gastric bypass surgery. METHODS: A national, register-based cohort study of all Danish women with a history of gastric bypass surgery who had given birth from 2004 to 2010 was conducted. Surgical codes registered during pregnancy and until...... the puerperium. CONCLUSIONS: The incidence of internal herniation during pregnancy was 1 % in our study. Internal herniation may be a serious complication in pregnant women, and both the diagnosis and treatment requires handling by experienced obstetrical, radiological, and surgical staff....

  17. Serum 25(OH) Vitamin D Levels in Polish Women during Pregnancies Complicated by Hypertensive Disorders and Gestational Diabetes

    Science.gov (United States)

    Domaracki, Piotr; Sadlecki, Pawel; Odrowaz-Sypniewska, Grazyna; Dzikowska, Ewa; Walentowicz, Pawel; Siodmiak, Joanna; Grabiec, Marek; Walentowicz-Sadlecka, Malgorzata

    2016-01-01

    Background: An association between the level of vitamin D and the risk of pregnancy-related complications remains unclear. The aim of this study was to examine concentrations of 25(OH) vitamin D in Polish women with normal pregnancies and pregnancies complicated by gestational hypertension, preeclampsia or gestational diabetes mellitus (GDM). Moreover, we analyzed an association between maternal serum 25(OH)D and the risk of gestational hypertension, preeclampsia and GDM. Material and Methods: The study included 207 pregnant women, among them 171 with pregnancy-related complications: gestational hypertension (n = 45), preeclampsia (n = 23) or GDM (n = 103). The control group consisted of 36 women with normal pregnancies. Concentrations of serum 25(OH)D were measured at admission to the hospital prior to delivery Results: Patients with hypertension did not differ significantly from the controls in terms of their serum 25(OH)D concentrations (18.20 vs. 22.10 ng/mL, p = 0.15). Highly significant differences were found in 25(OH)D concentrations of women with preeclampsia and the controls (14.75 vs. 22.10 ng/mL, p = 0.0021). GDM was not associated with significant differences in 25(OH)D concentration. A low level of 25(OH)D turned out to be associated with an increased risk of preeclampsia during pregnancy on both univariate and multivariate regression analysis, and was a significant predictor of this condition on ROC (receiver operating characteristic) analysis (AUC = 0.70, p < 0.01). Conclusions: 25(OH)D deficiency is common among pregnant Polish women. Low concentrations of 25(OH)D may play a role in the etiopathogenesis of preeclampsia. Routine assessment of the 25(OH)D level during pregnancy may be crucial for the identification of women at increased risk of preeclampsia. PMID:27690002

  18. Association between polycystic ovary syndrome and the risk of pregnancy complications

    Science.gov (United States)

    Yu, Hai-Feng; Chen, Hong-Su; Rao, Da-Pang; Gong, Jian

    2016-01-01

    Abstract Background: Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications. Methods: We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios. Effect estimates were pooled using the random-effects model. The analysis was further stratified by factors that could affect these associations. Results: We included 40 observational studies that reported data on a total of 17,816 pregnancies with PCOS and 123,756 pregnancies without PCOS. Overall, PCOS in pregnancy was associated with greater risk of GDM, preeclampsia, PIH, preterm delivery, cesarean delivery, miscarriage, hypoglycemia, and perinatal death. However, PCOS in pregnancy had little or no effect on oligohydramnios, polyhydramnios, large-for-gestational age (LGA), small-for-gestational-age (SGA), fetal growth restriction (FGR), preterm premature membrane rupture, fasting blood glucose (FBG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, congenital malformation, macrosomia, and respiratory distress syndrome. Subgroup analysis suggested that these associations might be influenced by study design and pre-BMI. Conclusion: PCOS in pregnancy is associated with a significantly increased risk of adverse pregnancy, fetal, and neonatal outcomes. PMID:28002314

  19. Assessment of M2/ANXA5 haplotype as a risk factor in couples with placenta-mediated pregnancy complications.

    Science.gov (United States)

    Rogenhofer, Nina; Nienaber, Lara R M; Amshoff, Lea C; Bogdanova, Nadia; Petroff, David; Wieacker, Peter; Thaler, Christian J; Markoff, Arseni

    2017-09-13

    The aim of this study was to confirm the associated M2/ANXA5 carrier risk in women with placenta-mediated pregnancy complications (PMPC) and to test their male partners for such association. Further analysis evaluated the influence of maternal vs. paternal M2 alleles on miscarriage. Two hundred eighty-eight couples with preeclampsia (PE), intrauterine growth restriction (IUGR), or premature birth (PB) were recruited (n = 96 of each phenotype). The prevalence of the M2 haplotype was compared to two control cohorts. They included a group of women with a history of normal pregnancy without gestational pathology (Munich controls, n = 94) and a random population sample (PopGen controls, n = 533). Significant association of M2 haplotype and pregnancy complications was confirmed for women and for couples, where prevalence was elevated from 15.4 to 23.8% (p < 0.001). Post hoc analyses demonstrated an association for IUGR and PB individually. A strong link between previous miscarriages and M2 carrier status was identified which may explain the predisposition to placental pregnancy complication. M2/ANXA5 appears to be a risk factor for adverse pregnancy outcomes related, but not limited to miscarriages, with similar prevalence in women and their male partners. These findings support the proposed physiological function of ANXA5 as an embryonic anticoagulant that appears deficient in contiguous specter of thrombophilia-related pregnancy complications culminating more frequently in miscarriage in a maternal M2 carrier background.

  20. Circulating placental proteins in pregnancies complicated by RH isoimmunization.

    Science.gov (United States)

    Lee, J N; Huang, S C; Ouyang, P C; Chard, T

    1984-07-01

    Nine pregnant women with Rh isoimmunization who delivered newborns with hydrops fetalis were studied. The placental proteins, pregnancy specific beta 1-glycoprotein (SP1), human placental lactogen, and placental protein 5 (PP5) were measured in maternal serum by radioimmunoassays. The results indicate that both the serum human placental lactogen and PP5 levels were significantly higher than those observed in normal pregnancy. The strikingly higher circulating PP5 levels found in all nine patients with Rh isoimmunization studied suggests that serum PP5 may be specifically elevated in pregnant patients with Rh isoimmunization and hydrops fetalis.

  1. Gut microbiota-related complications in cirrhosis.

    Science.gov (United States)

    Gómez-Hurtado, Isabel; Such, José; Sanz, Yolanda; Francés, Rubén

    2014-11-14

    Gut microbiota plays an important role in cirrhosis. The liver is constantly challenged with commensal bacteria and their products arriving through the portal vein in the so-called gut-liver axis. Bacterial translocation from the intestinal lumen through the intestinal wall and to mesenteric lymph nodes is facilitated by intestinal bacterial overgrowth, impairment in the permeability of the intestinal mucosal barrier, and deficiencies in local host immune defences. Deranged clearance of endogenous bacteria from portal and systemic circulation turns the gut into the major source of bacterial-related complications. Liver function may therefore be affected by alterations in the composition of the intestinal microbiota and a role for commensal flora has been evidenced in the pathogenesis of several complications arising in end-stage liver disease such as hepatic encephalopathy, splanchnic arterial vasodilatation and spontaneous bacterial peritonitis. The use of antibiotics is the main therapeutic pipeline in the management of these bacteria-related complications. However, other strategies aimed at preserving intestinal homeostasis through the use of pre-, pro- or symbiotic formulations are being studied in the last years. In this review, the role of intestinal microbiota in the development of the most frequent complications arising in cirrhosis and the different clinical and experimental studies conducted to prevent or improve these complications by modifying the gut microbiota composition are summarized.

  2. Risk of complications during pregnancy in women with congenital aortic stenosis.

    NARCIS (Netherlands)

    Yap, S.C.; Drenthen, W.; Pieper, P.G.; Moons, P.; Mulder, B.J.M.; Mostert, B.; Vliegen, H.W.; Dijk, A.P.J. van; Meijboom, F.J.; Steegers, E.A.P.; Roos-Hesselink, J.W.

    2008-01-01

    BACKGROUND: Pregnancy in women with congenital aortic stenosis (AS) is associated with increased cardiac complications. Data on non-cardiac complications are limited, and this information is crucial for prenatal counselling and perinatal care. The aim of this study was to present the maternal and

  3. Teenage Pregnancy

    Science.gov (United States)

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

  4. [Hemoglobin level analysis in the pregnancy complicated by rhesus isoimmunization].

    Science.gov (United States)

    Wiczyńska-Zajac, A; Wielgoś, M; Bomba-Opoń, D; Marianowski, L

    2000-06-01

    In 19 red blood cell isoimmunized pregnancies with the Coombs' titer lower than 1:32, the haemoglobin level was measured. The values were compared to reference ranges of mean for gestational age. In four cases the intravascular transfusion was performed. Six fetuses were Rh negative.

  5. Cerebral autoregulation in pregnancies complicated by diabetes and overweight

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Panerai, Ronney B.; Haeri, Sina; van den Berg, Paul P.; Zeeman, Gerda G.; Belfort, Michael A.

    2015-01-01

    Aim: The aim of this study was to estimate the impact of diabetes and obesity on cerebral autoregulation in pregnancy. Methods: Cerebral autoregulation was evaluated in women with gestational diabetes, type 2 diabetes mellitus and/or overweight (body mass index >= 25kgm(-2)) and compared to a cohort

  6. PPAR-γ – a possible drug target for complicated pregnancies

    Science.gov (United States)

    McCarthy, Fergus P; Delany, Aoife C; Kenny, Louise C; Walsh, Sarah K

    2013-01-01

    Peroxisome proliferator activated receptors (PPARs) are ligand-activated transcription factors expressed in trophoblasts, which regulate both cell differentiation and proliferation. In recent years, evidence has linked PPARs to playing an integral role in pregnancy; specifically, PPAR-β and PPAR-γ have been shown to play an integral role in placentation, with PPAR-γ additionally serving to regulate trophoblast differentiation. Recent evidence has shown that PPAR-γ expression is altered in many complications of pregnancy such as intrauterine growth restriction (IUGR), preterm birth, pre-clampsia and gestational diabetes. Thus, at present, accumulating evidence from the literature suggests both a pivotal role for PPAR-γ in the progression of a healthy pregnancy and the possibility that PPAR-γ may act as a therapeutic target in complicated pregnancies. This review aims to provide a succinct and comprehensive assessment of the role of PPAR-γ in normal pregnancy and pregnancy complications, and finally its potential as a therapeutic target in the treatment and/or prevention of adverse pregnancy outcomes. PMID:23186152

  7. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  8. Pregnancy-related Health Behavior of Women with Congenital Heart Disease : Room for Behavioral Change Interventions

    NARCIS (Netherlands)

    Moons, Philip; Budts, Werner; Costermans, Els; Huyghe, Els; Pieper, Petronella G.; Drenthen, Wim

    2009-01-01

    Background. Pregnancy in women with congenital heart disease is associated with maternal and neonatal complications. In order to reduce risks for unfavorable outcomes, pregnant women need to adopt specific health behaviors. We investigated the pregnancy-related health behavior of women with congenit

  9. Work and work-related stress in pregnancy.

    Science.gov (United States)

    Katz, Vern L

    2012-09-01

    Work, in general, does not increase the risks of pregnancy complications. Work that is stressful, physically, psychologically, or both, has deleterious effects on pregnancy. Stressful work increases the risks of miscarriage, preterm labor, preterm birth, low birth weight, and preeclampsia. The greater the stress, the greater the risks of pregnancy complications. Women with a history of pregnancy complications should be counseled about reducing stressful work before pregnancy. Women with stressful jobs should be followed closely during pregnancy, and if signs of preterm labor or delayed fetal growth develop, then occupational stress should be decreased or eliminated. Some occupations expose pregnant women to teratogens such as organic solvents, heavy metals, or pesticides. A careful work history should be part of every preconception and early pregnancy visit.

  10. Characteristics of Mesiodens and Its Related Complications.

    Science.gov (United States)

    Nam, Ok Hyung; Lee, Hyo-Seol; Kim, Mi Sun; Yun, Kwan Hee; Bang, Jae-Beum; Choi, Sung Chul

    2015-01-01

    The purpose of this study was to evaluate the effect of mesiodens on adjacent permanent anterior teeth according to mesiodens characteristics. To evaluate complications associated with mesiodens, according to its characteristics, a total of 107 children were studied who had a chief complaint of mesiodens. The number, morphology, direction of eruption, position of mesiodens, root developmental stage and complications related to adjacent permanent maxillary central incisors (APMCIs) were evaluated by radiographic imaging. The final sample was 107 children and total number of mesiodens was 153. Among these patients, 67 percent showed clinical complications. The primary morphologic type was conical (96.1 percent) and the most common direction of eruption was inverted (56.2 percent). Most mesiodens (80.4 percent) were located on the palatal side of the APMCIs. The direction of mesiodens and the eruption period of adjacent permanent incisors affected the complication rate. The positional relationship between mesiodens and adjacent permanent central incisors had the strongest influence on both eruption disturbance and displacement of permanent central incisors.

  11. [Complications of multiple pregnancy in the 2nd and 3rd trimesters].

    Science.gov (United States)

    Poniedziałek-Czajkowska, E; Leszczyńska-Gorzelak, B; Oleszczuk, J

    2000-11-01

    Multiple pregnancy contributes to higher maternal and fetal risks than a single one. Complications typical only for multiple pregnancy such as PROM with preterm delivery, intrauterine death or IUGR of one of twins can occur during 2nd and 3rd trimester. Treatment in such situations is usually difficult and often controversial because of simultaneous presence of an alive and/or healthy fetus and possible risk for mother. The paper presents such situations and possible ways of treatment.

  12. Neonatal outcome after pregnancy complicated by abnormal velocity waveforms in the umbilical artery.

    OpenAIRE

    MCDONNELL, M; Serra-Serra, V; Gaffney, G; Redman, C W; Hope, P L

    1994-01-01

    The neonatal outcome of 61 infants born after pregnancies complicated by absent or reversed end diastolic flow velocities (AREDFV) in the fetal umbilical artery was compared with that of 61 controls matched for gestational age born after high risk pregnancies with documented forward end diastolic flow velocities (EDFV). The AREDFV group was significantly more growth retarded, had lower platelet counts at birth, and were more likely to become significantly thrombocytopenic in the first week af...

  13. Solitary luteinized follicle cyst of pregnancy complicated with persistent postpartum vaginal bleeding: case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Song-ying; HUANG He-feng; TONG Xiao-mei

    2007-01-01

    @@ Solitary luteinized follicle cyst, a rare cause of ovarian enlargement during pregnancy and puerperium, is a self-limited disease that can regress spontaneously after labor. The complications of the disease include ovarian torsion, intracystic hemorrhage, and rupture; endocrine disturbances have not been reported.1-4 Here we report a case of solitary luteinized follicle cyst of pregnancy,which required surgical intervention owing to persistent postpartum vaginal bleeding.

  14. Pregnancy complicated by obesity induces global transcript expression alterations in visceral and subcutaneous fat.

    Science.gov (United States)

    Bashiri, Asher; Heo, Hye J; Ben-Avraham, Danny; Mazor, Moshe; Budagov, Temuri; Einstein, Francine H; Atzmon, Gil

    2014-08-01

    Maternal obesity is a significant risk factor for development of both maternal and fetal metabolic complications. Increase in visceral fat and insulin resistance is a metabolic hallmark of pregnancy, yet not much is known how obesity alters adipose cellular function and how this may contribute to pregnancy morbidities. We sought to identify alterations in genome-wide transcription expression in both visceral (omental) and abdominal subcutaneous fat deposits in pregnancy complicated by obesity. Visceral and abdominal subcutaneous fat deposits were collected from normal weight and obese pregnant women (n = 4/group) at the time of scheduled uncomplicated cesarean section. A genome-wide expression array (Affymetrix Human Exon 1.0 st platform), validated by quantitative real-time PCR, was utilized to establish the gene transcript expression profile in both visceral and abdominal subcutaneous fat in normal weight and obese pregnant women. Global alteration in gene expression was identified in pregnancy complicated by obesity. These regions of variations led to identification of indolethylamine N-methyltransferase, tissue factor pathway inhibitor-2, and ephrin type-B receptor 6, not previously associated with fat metabolism during pregnancy. In addition, subcutaneous fat of obese pregnant women demonstrated increased coding protein transcripts associated with apoptosis as compared to lean counterparts. Global alteration of gene expression in adipose tissue may contribute to adverse pregnancy outcomes associated with obesity.

  15. Pregnancy Complicated by Obesity Induces Global Transcript Expression Alterations in Visceral and Subcutaneous Fat

    Science.gov (United States)

    Bashiri, Asher; Heo, Hye J.; Ben-Avraham, Danny; Mazor, Moshe; Budagov, Temuri; Einstein, Francine H.; Atzmon, Gil

    2014-01-01

    Maternal obesity is a significant risk factor for development of both maternal and fetal metabolic complications. Increase in visceral fat and insulin resistance is a metabolic hallmark of pregnancy, yet little is known how obesity alters adipose cellular function and how this may contribute to pregnancy morbidities. We sought to identify alterations in genome-wide transcription expression in both visceral (omental) and abdominal subcutaneous fat deposits in pregnancy complicated by obesity. Visceral and abdominal subcutaneous fat deposits were collected from normal weight and obese pregnant women (n=4/group) at time of scheduled uncomplicated cesarean section. A genome-wide expression array (Affymetrix Human Exon 1.0 st platform), validated by quantitative real-time PCR, was utilized to establish the gene transcript expression profile in both visceral and abdominal subcutaneous fat in normal weight and obese pregnant women. Global alteration in gene expression was identified in pregnancy complicated by obesity. These regions of variations lead to identification of indolethylamine N-methyltransferase (INMT), tissue factor pathway inhibitor-2 (TFPI-2), and ephrin type-B receptor 6 (EPHB6), not previously associated with fat metabolism during pregnancy. In addition, subcutaneous fat of obese pregnant women demonstrated increased coding protein transcripts associated with apoptosis compared to lean counterparts. Global alteration of gene expression in adipose tissue may contribute to adverse pregnancy outcomes associated with obesity. PMID:24696292

  16. Management Considerations for Ongoing Pregnancies Complicated by Trisomy 13 and 18.

    Science.gov (United States)

    Dotters-Katz, Sarah K; Kuller, Jeffrey A; Grace, Matthew R; Laifer, Steven A; Strauss, Robert A

    2016-05-01

    Pregnancies complicated by trisomy 13 (T13) or trisomy 18 (T18) present unique challenges for obstetric management. From the initial diagnosis, the task of counseling these women and families is difficult because fetal and neonatal outcomes vary depending on the phenotype and degree of intervention chosen by the family. A literature review was performed using PubMed to gather information regarding obstetric management and outcomes of pregnancies complicated by T13 and T18. Spontaneous abortion and in uterofetal demise occur at rates well above those seen in chromosomally normal pregnancies. In addition, infants with T13 or T18 frequently have structural anomalies, which lead to worse prognoses and long-term survival. In cases in which a woman and her family desire to continue the pregnancy, multidisciplinary consultation with obstetrics, social work, genetics, and pediatrics can optimize care of both the fetus and the mother. Most commonly, prenatal care does not differ from routine. A detailed delivery plan should be generated, specifically discussing interventions for the patient and her fetus. When managing pregnancies complicated by T13 and T18, active, open, and frequent communication between the patient, her family, and a multidisciplinary health care team throughout the pregnancy is crucial.

  17. Helicobacter pylori and pregnancy-related disorders

    Science.gov (United States)

    Cardaropoli, Simona; Rolfo, Alessandro; Todros, Tullia

    2014-01-01

    Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B12) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlation between H

  18. Relationship between ABO blood group and pregnancy complications: a systematic literature analysis.

    Science.gov (United States)

    Franchini, Massimo; Mengoli, Carlo; Lippi, Giuseppe

    2016-09-01

    Given the expression of ABO blood group antigens on the surface of a wide range of human cells and tissues, the putative interplay of the ABO system in human biology outside the area of transfusion and transplantation medicine constitutes an intriguing byway of research. Thanks to evidence accumulated over more than 50 years, the involvement of the ABO system in the pathogenesis of several human diseases, including cardiovascular, infectious and neoplastic disorders, is now acknowledged. However, there is controversial information on the potential association between ABO blood type and adverse pregnancy outcomes, including pre-eclampsia and related disorders (eclampsia, HELLP syndrome and intrauterine growth restriction), venous thromboembolism, post-partum haemorrhage and gestational diabetes. To elucidate the role of ABO antigens in pregnancy-related complications, we performed a systematic review of the literature published in the past 50 years. A meta-analytical approach was also applied to the existing literature on the association between ABO status and pre-eclampsia. The results of this systematic review are presented and critically discussed, along with the possible pathogenic implications.

  19. Late occurrence of a congenital diaphragmatic hernia complicating pregnancy: A case report

    Directory of Open Access Journals (Sweden)

    Jyoti Singh

    2012-12-01

    Full Text Available Diaphragmatic hernia complicating pregnancy is rare and results in a high fetal and maternal mortality particularly if early surgical intervention is not undertaken. A very high degree of suspicion in needed for diagnosis as the symptoms produced by this hernia are seen in normal pregnancy also. We present here a patient with CDH who became acutely symptomatic for the first time during the pregnancy and was managed successfully. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 47-49

  20. Necrotizing Fasciitis Complicating Pregnancy: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Marinos Nikolaou

    2014-01-01

    Full Text Available Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient’s postoperative course was uncomplicated and skin defect was closed with split thickness skin grafting. Our case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections.

  1. Major flood related strains and pregnancy outcomes.

    Science.gov (United States)

    Hilmert, Clayton J; Kvasnicka-Gates, Lexi; Teoh, Ai Ni; Bresin, Konrad; Fiebiger, Siri

    2016-11-01

    To assess the impact of experiencing a major flood during pregnancy on fetal growth and length of gestation, and to consider how flood-related strains might contribute to these effects. The Red River Pregnancy Project was a prospective study carried out for 3 months immediately after the historic 2009 crest of the Red River in Fargo, North Dakota. Pregnant community residents who were at least 18 years old with a singleton, intrauterine pregnancy participated in the study (N = 169). Analyses examined if birth weight and length of gestation were associated with residential distance from flooding and gestational age at time of the flood crest. For pregnancies earlier in gestation during the crest (-1 SD = 12 weeks), birth weight decreased as distance from flooding decreased (-42.29 g/mi, p .10). Biparietal growth trajectories showed a decrease in growth after the crest of the flood but only for women early in pregnancy. However, various measures of flood related and general stress or strain did not explain these effects. Length of gestation was not associated with distance from or the timing of the flood. Pregnant women in the first trimester who experience a major flood near their homes are at risk of having lower birth weight neonates due to a reduction in fetal growth. The mechanisms of this effect deserve further attention in rapidly mounted investigations after disaster. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Helicobacter pylori colonization and pregnancies complicated by preeclampsia, spontaneous prematurity, and small for gestational age birth.

    Science.gov (United States)

    den Hollander, Wouter J; Schalekamp-Timmermans, Sarah; Holster, I Lisanne; Jaddoe, Vincent W; Hofman, Albert; Moll, Henriëtte A; Perez-Perez, Guillermo I; Blaser, Martin J; Steegers, Eric A P; Kuipers, Ernst J

    2017-04-01

    Preeclampsia (PE), small for gestational age (SGA), and spontaneous preterm birth (PTB) each may be complications of impaired placental function in pregnancy. Although their exact pathogenesis is still unknown, certain infectious agents seem to play a role. Helicobacter pylori (H. pylori) colonization has been associated with increased risk for PE. Our aim was to assess the association between H. pylori colonization and PE, SGA, and PTB. We measured IgG anti-H. pylori and CagA antibodies in serum of pregnant women (median 20.5 weeks, range 16.5-29.4) who participated in a population-based prospective cohort study. Delivery and medical records were assessed. Information on demographics, education, and maternal risk factors was collected by questionnaire. We used multivariate logistic regression analyses to assess associations between H. pylori colonization and PE, SGA, and PTB. In total, 6348 pregnant women were assessed. H. pylori positivity was found in 2915 (46%) women, of whom 1023 (35%) also were CagA-positive. Pregnancy was complicated by PE, SGA, or PTB in 927 (15%) women. H. pylori colonization was associated with PE (aOR 1.51; 95%CI 1.03-2.25). Differentiation according to CagA status revealed the same risk. H. pylori was positively related with SGA, mainly explained by CagA-positive strains (aOR 1.34; 1.04-1.71). No association was observed between H. pylori and PTB. Our data suggest that H. pylori colonization may be a risk factor for PE and SGA. If these associations are confirmed by future studies and shown to be causal, H. pylori eradication may reduce related perinatal morbidity and mortality. © 2016 John Wiley & Sons Ltd.

  3. Fetal and Maternal Outcomes in Pregnancies Complicated with Fetal Macrosomia

    Science.gov (United States)

    Alsammani, Mohamed Alkahatim; Ahmed, Salah Roshdy

    2012-01-01

    Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%), perineal tear (7 cases, 1.7%), cervical lacerations (3 cases, 0.7%), and shoulder dystocia (40 cases, 9.6%) that resulted in 4 cases of Erb's palsy (0.96%), and 6 cases of bone fractures (1.4%). The rate of cesarean section among women delivering macrosomic babies was 47.6% (199), while 52.4% (219) delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition. PMID:22754881

  4. Fetal and maternal outcomes in pregnancies complicated with fetal macrosomia

    Directory of Open Access Journals (Sweden)

    Mohamed Alkhatim Alsammani

    2012-01-01

    Full Text Available Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%, perineal tear (7 cases, 1.7%, cervical lacerations (3 cases, 0.7%, and shoulder dystocia (40 cases, 9.6% that resulted in 4 cases of Erb′s palsy (0.96%, and 6 cases of bone fractures (1.4%. The rate of cesarean section among women delivering macrosomic babies was 47.6% (199, while 52.4% (219 delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition.

  5. Anticoagulants to prevent recurrent placenta-mediated pregnancy complications: Is it time to put the needles away?

    Science.gov (United States)

    Skeith, Leslie; Rodger, Marc

    2017-03-01

    Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use. This paper reviews the evidence, including recently published data from an individual patient level meta-analysis, which challenges the role of LMWH in preventing recurrent placenta-mediated pregnancy complications. Incorporating this recent evidence, we recommend against the use of LMWH to prevent recurrent placenta-mediated pregnancy complications in women with and without inherited thrombophilia.

  6. Pregnancy Outcomes and Surgical Management of Pregnancy Complicated By Appendicitis: Obstetrician View

    Directory of Open Access Journals (Sweden)

    Deniz Şimşek

    2015-08-01

    Full Text Available Objective: To evaluate the pregnancy outcomes of patients who underwent appendectomy during pregnancy. Materials and Methods: Patients who underwent appendectomy between years 2010 and 2014 were retrospectively evaluated. All patients’ pregnancy outcomes were followed-up by using university registry system and telephone interview. Patients were evaluated regarding age, gestational age, clinical and laboratory examinations, imaging studies, mean time interval between emergency department and operation, mean operative time, pregnancy outcome and pathologic results of the appendix. Results: Thirty-nine patients were included in the study. Sixteen of 39 patients were in the first, 15 of them in the second and 8 of them were in the third trimester of the pregnancy. Three patients underwent laparoscopic appendectomy and the rest underwent laparotomy. In pathologic evaluation of the appendix, seven patients (17% had normal appendix, 4 patients had perforated appendix, one patient had neuro-endocrine tumor and rest of the patients had appendicitis. Two missed abortion occurred after operation, rest of the patients had live birth. Six of them were preterm and 31 had term birth. Twelve patients delivered through vaginal birth and the rest via caesarean section. Twenty patients were in the first half of the pregnancy (group 1 and 19 patients were in the second half of the pregnancy (group 2. There were no significant differences between the groups in operation time and mean time interval between emergency administration and operation. Conclusion: Delayed operation and negative appendectomy can cause adverse pregnancy outcomes. Expectant management in suspected cases may decrease negative appendectomy rates but can also lead to perforation. Computed tomography and MRI ought to be considered if ultrasonography is inconclusive. Tocolytic regimens can be administered to prevent threatened preterm labor. Obstetric indications were valid for delivery mode.

  7. Hospital-based perinatal outcomes and complications in teenage pregnancy in India.

    Science.gov (United States)

    Mukhopadhyay, Prianka; Chaudhuri, R N; Paul, Bhaskar

    2010-10-01

    Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. A cross-sectional observational study was undertaken to compare the different sociodemographic characteristics and perinatal outcomes of teenage primigravida mothers with those of adult primigravida mothers in a tertiary-care hospital in eastern India. A sample of 350 each in cases and comparison group comprised the study subjects. Data were collected through interviews and by observations using a pretested and predesigned schedule. Results revealed that the teenage mothers had a higher proportion (27.7%) of preterm deliveries compared to 13.1% in the adult mothers and had low-birthweight babies (38.9% vs 30.4% respectively). Stillbirth rate was also significantly higher in teenage deliveries (5.1% vs 0.9% respectively). The teenage mothers developed more adverse perinatal complications, such as preterm births, stillbirths, neonatal deaths, and delivered low-birthweight babies, when compared with those of the adult primigravida mothers. Teenage pregnancy is still a rampant and important public-health problem in India with unfavourable perinatal outcomes and needs to be tackled on a priority basis.

  8. A combined ultrasound and clinical scoring model for the prediction of peripartum complications in pregnancies complicated by placenta previa.

    Science.gov (United States)

    Yoon, So-Yeon; You, Ji Yeon; Choi, Suk-Joo; Oh, Soo-Young; Kim, Jong-Hwa; Roh, Cheong-Rae

    2014-09-01

    To generate a combined ultrasound and clinical model predictive for peripartum complications in pregnancies complicated by placenta previa. This study included 110 singleton pregnant women with placenta previa delivered by cesarean section (CS) from July 2011 to November 2013. We prospectively collected ultrasound and clinical data before CS and observed the occurrence of blood transfusion, uterine artery embolization and cesarean hysterectomy. We formulated a scoring model including type of previa (0: partials, 2: totalis), lacunae (0: none, 1: 1-3, 2: 4-6, 3: whole), uteroplacental hypervascularity (0: normal, 1: moderate, 2: severe), multiparity (0: no, 1: yes), history of CS (0: none, 1: once, 2: ≥ twice) and history of placenta previa (0: no, 1: yes) to predict the risk of peripartum complications. In our study population, the risk of perioperative transfusion, uterine artery embolization, and cesarean hysterectomy were 26.4, 1.8 and 6.4%, respectively. The type of previa, lacunae, uteroplacental hypervascularity, parity, history of CS, and history of placenta previa were associated with complications in univariable analysis. However, no factor was independently predictive for any complication in exact logistic regression analysis. Using the scoring model, we found that total score significantly correlated with perioperative transfusion, cesarean hysterectomy and composite complication (pplacenta previa. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Lower Plasma Ghrelin Levels are Found in Women with Diabetes-Complicated Pregnancies

    Science.gov (United States)

    Gómez-Díaz, Rita Angélica; Gómez-Medina, Monica P.; Ramírez-Soriano, Eleazar; López-Robles, Lucio; Aguilar-Salinas, Carlos A.; Saucedo, Renata; Zarate, Arturo; Valladares-Salgado, Adan; Wacher, Niels H.

    2016-01-01

    Objective: To evaluate the associations of glycemic control and gestational age with ghrelin and proinsulin levels in cord blood and mothers’ peripheral blood during pregnancy. Methods: This is a cross-sectional comparative study of twenty-four pregnant women with gestational diabetes (GD), 18 with type 2 diabetes mellitus (T2DM), and 36 without diabetes, as well as their neonates. Levels of proinsulin, ghrelin, and glycated hemoglobin A1c (HbA1c) were measured from maternal blood during the last week before caesarian delivery and in neonatal umbilical cord blood samples. Results: Mothers with GD and T2DM had significantly lower ghrelin levels compared to the healthy mothers (p<0.001). Maternal proinsulin was lower in women with GD than in women without diabetes (p<0.001). Proinsulin was significantly elevated in the neonates of women with GD and in women with HbA1c ≥6.5% (p<0.001). However, maternal ghrelin levels were higher (p=0.031) and neonate proinsulin levels lower in the pre-term offspring of mothers with GD (p=0.033). There was a negative correlation between HbA1c levels and birth weight (r=–0.407, p<0.001). Conclusion: Ghrelin levels were lower in pregnant women with diabetes, although pre-term birth appeared to reverse this trend in GD. Proinsulin levels were also low in pregnant women with diabetes and even lower in pre-term vs. at-term births. Both ghrelin and proinsulin levels were lower in pregnant women with diabetes and HbA1c of <6.5%. Thus, ghrelin participates in the adaptation to the caloric imbalance of diabetic pregnancy and may play a similar role in pregnancy-related complications, since high ghrelin concentrations may be necessary for normal fetal development. PMID:27476441

  10. Relationships among stress coping styles and pregnancy complications among women exposed to Hurricane Katrina.

    Science.gov (United States)

    Oni, Olurinde; Harville, Emily; Xiong, Xu; Buekens, Pierre

    2015-01-01

    To examine the relationship between maternal stress exposure, stress coping styles, and pregnancy complications. Quantitative, cross-sectional, and prospective study. Tulane-Lakeside Hospital, New Orleans, LA and Women's Hospital, Baton Rouge, LA. The study included 146 women (122 from New Orleans and 24 from Baton Rouge), who were pregnant during or immediately after Hurricane Katrina. Participants were interviewed regarding their hurricane experiences and perceived stress, and coping styles were assessed using the Brief COPE. Medical charts were also reviewed to obtain information about pregnancy outcomes. Logistic regression was performed to determine possible associations. Hurricane exposure was significantly associated with induction of labor (adjusted odds ratio [aOR] = 1.39; 95% confidence interval [CI] [1.03, 1.86], P = .03) and current perceived stress (aOR = 1.50, CI [1.34, 1.99], P Stress perception significantly predisposed to pregnancy-induced hypertension (aOR = 1.16, CI [1.05, 1.30], P pregnancy complications (P stress may complicate pregnancy, whereas some coping styles may mitigate its effects. Further research should explore how coping styles may mitigate or exacerbate the effect of major stressors and how positive coping styles can be encouraged or augmented. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  11. Acid- and alkaline phosphatase in amniotic fluid in normal and complicated pregnancy.

    Science.gov (United States)

    Beckman, G; Beckman, L; Löfstrand, T

    1978-01-01

    171 samples of amniotic fluid were obtained by abdominal amniocentesis from 67 women with complicated pregnancies (isoimmunization, diabetes mellitus or toxaemia). The levels of heat-labile alkaline phosphatase (HLAP), heat-stable alkaline phosphatase (HSAP) and acid phosphatase (AcP) were determined and compared to the enzyme levels in 179 samples from women with normal pregnancies of corresponding gestational ages. HLAP showed two "peaks" of activity, one in the 5th-22nd week and the other at term. HSAP and AcP showed increased activity at term. HSAP was decreased (p less than 0.01) in isoimmunization between the 36th and 40th week. 11 cases of toxaemia with placental insufficiency showed no differences in the levels of HLAP and HSAP compared with normal pregnancy. AcP showed no differences between normal and complicated pregnancy. Samples contaminated by blood showed no significant increase in the acid- and alkaline phosphatase levels. Samples contaminated by meconium showed a complex pattern. Some samples had normal enzyme levels, some had high levels of HLAP only and some had high levels of HSAP and AcP. The origin of the enzymes is not known with certainty. HSAP in amniotic fluid is most likely not of placental but intestinal origin. Determinations of acid- and alkaline phosphatase in amniotic fluid seem to be of little values in the clinical management of complicated pregnancy.

  12. Acute pyelonephritis and associated complications during pregnancy in 2006 in US hospitals.

    Science.gov (United States)

    Jolley, Jennifer A; Kim, Soojin; Wing, Deborah A

    2012-12-01

    To describe the occurrence of hospitalization for acute pyelonephritis during pregnancy and associated complications in 2006 in USA. Cases were defined as those with ICD-9-CM codes corresponding to the infections of the genitourinary tract in pregnancy and pyelonephritis in the 2006 Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Additional analyses identified those cases also coupled with ICD-9-CM codes corresponding to obstetrical and medical complications. Calculations were weighted to produce national estimates and hospitalization rates were determined. Twenty-eight thousand nine hundred and twenty-three hospitalizations for pyelonephritis in pregnancy were identified. Women aged 8-19 had the highest hospitalization rate (175.06/10 000 cases) compared to other age groupings. Hispanic patients had the highest hospitalization rate of the recorded ethnicities (100.93/10 000 cases). Diabetes was a concomitant diagnosis in 3.7% of patients. Of the pregnant patients hospitalized with pyelonephritis, 3.77% had threatened preterm labor, 1.95% was diagnosed with sepsis, 0.77% had acute respiratory failure, and several deaths also occurred. The mean length of hospital stay was 2.8 days. The estimated annual cost of hospitalization for pyelonephritis in pregnancy was $263 million. Hospitalization for pyelonephritis in pregnancy is associated with recognizable characteristics including age and diabetes. Serious medical complications and even mortality can occur.

  13. Spontaneous labor curves in women with pregnancies complicated by diabetes

    Science.gov (United States)

    Timofeev, Julia; Huang, Chun-Chih; Singh, Jasbir; Driggers, Rita W.; Landy, Helain J.

    2013-01-01

    Objective To test the hypothesis that the first stage of labor will be longer in nulliparous and multiparous women with diabetes compared to non-diabetic counterparts. Methods A retrospective analysis was performed from 228,668 deliveries between 2002–2008 from the Consortium of Safe Labor (NICHD, NIH). Patients with spontaneous onset of labor from 37 0/7 – 41 6/7 weeks gestation were included (71,282) and classified as nulliparous or multiparous. Pregnancies were further subdivided regarding presence of preexisting diabetes (preDM) or gestational diabetes (GDM), and normal controls. Labor curves were created matching for body mass index (BMI) and neonatal birth weight. Statistical analysis was performed on descriptive variables using χ2 with significance designated as p<0.05. Results Among nulliparous patients, there were 118 women with preDM and 475 women with GDM; 25,771 patients served as normal controls. Among multiparous women, there were 311 with preDM and 1,079 with GDM and 43,528 in the control group. Although differences in dilatation rates were observed in nulliparous and multiparous women with and without diabetes, labor curves were similar between the subgroups when matched for maternal BMI and birth weight. Conclusions Labor curves of women with preDM and GDM approximate those of non-diabetics, regardless of BMI, birth weight, or parity. PMID:21955108

  14. Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany

    Directory of Open Access Journals (Sweden)

    Jacob, Louis

    2016-06-01

    Full Text Available Objectives: To analyze the impact of caesarean section (CS on mode of delivery, pregnancy-induced and pregnancy-associated disorders, as well as complications in the subsequent pregnancy within German gynecological practices.Methods: 1,801 women with CS and 1,801 matched women with vaginal delivery (VD from the IMS Disease Analyzer database were included. The impact of previous CS on the mode of delivery and pregnancy-associated disorders as well as complications prior to or during birth in the subsequent pregnancy were analyzed. Cox regressions were used to determine the influence of CS with regard to these outcomes.Results: Medical abortion and single spontaneous delivery were significantly less frequent in women with a history of CS compared to VD (OR equal to 0.52 and 0.04 respectively, whereas CS after CS was the significantly more common mode of delivery (79.0% versus 9.3%, OR=36.47. Gestational hypertension without significant proteinuria, gestational hypertension with significant proteinuria, and polyhydramnios were more frequent in women with CS than in women with VD (OR equal to 6.80, 1.71, and 2.29. Hemorrhage and maternal care for known or suspected disproportion were more common in the CS group than in the VD group (OR equal to 1.34 and 3.75. Prolonged pregnancy, preterm labor, abnormalities arising from forces of labor, and perineal laceration during delivery were significantly less frequent in women with CS than in women with VD (OR between 0.32 and 0.75, whereas long labor was more common (OR=2.09.Conclusion: Women with CS were more likely to undergo further CS and to develop major pregnancy-associated diseases in the following pregnancy compared to women with VD.

  15. Serial fetal blood sampling for the management of pregnancies complicated by severe rhesus (D) isoimmunization.

    Science.gov (United States)

    MacKenzie, I Z; Bowell, P J; Castle, B M; Selinger, M; Ferguson, J F

    1988-08-01

    Fifty-one pregnancies complicated by rhesus (D) isoimmunization have been managed by serial fetal blood sampling between 17 and 36 weeks gestation as an alternative to amniocentesis for delta OD453 measurements. In 36 pregnancies where the fetus was shown to be rhesus (D) positive and both measurements were made before any intrauterine fetal transfusions, the delta OD453 value gave misleading predictions on 13 of 63 occasions (21%). Fetal haematocrit estimations provided a direct assessment of the haemopoietic compensation occurring, but fetal bilirubin and albumin concentrations did not correlate directly with disease severity. It is proposed that pregnancies complicated by severe isoimmunization can be more precisely managed by serial fetal blood sampling for haematocrit estimation than amniocentesis for delta OD453 measurement thus avoiding unnecessary intervention or delayed treatment.

  16. Pregnancy complications in a patient with systemic lupus erythematosus and lupus nephritis

    DEFF Research Database (Denmark)

    Bisgaard, Helene; Jacobsen, Søren; Tvede, Niels

    2014-01-01

    A woman with systemic lupus erythematosus (SLE) and lupus nephritis had two pregnancies which both resulted in complications known to be associated with SLE, i.e. late abortion, preterm delivery and pre-eclampsia. We conclude that disease quiescence is important for a successful outcome...

  17. [Pregnancy complications in a patient with systemic lupus erythematosus and lupus nephritis].

    Science.gov (United States)

    Bisgaard, Helene; Jacobsen, Søren; Tvede, Niels; Langhoff-Roos, Jens

    2014-07-14

    A woman with systemic lupus erythematosus (SLE) and lupus nephritis had two pregnancies which both resulted in complications known to be associated with SLE, i.e. late abortion, preterm delivery and pre-eclampsia. We conclude that disease quiescence is important for a successful outcome and that pregnant women with SLE should be followed in a multidisciplinary setting.

  18. Hemorrhagic fever with renal syndrome complicated with pregnancy: a case report.

    Science.gov (United States)

    Kim, Baek-Nam; Choi, Byung-Don

    2006-06-01

    Hantaviruses cause two forms of human disease: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome. Hantavirus infection can occur in pregnant women and it can have an influence on the maternal and fetal outcomes, although this is a rare finding even in endemic areas. We describe here a recent case of HFRS complicating pregnancy.

  19. Hemorrhagic Fever with Renal Syndrome Complicated with Pregnancy: A Case Report

    OpenAIRE

    2006-01-01

    Hantaviruses cause two forms of human disease: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome. Hantavirus infection can occur in pregnant women and it can have an influence on the maternal and fetal outcomes, although this is a rare finding even in endemic areas. We describe here a recent case of HFRS complicating pregnancy.

  20. Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls

    Science.gov (United States)

    Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.

    2012-01-01

    The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

  1. Wernicke’s Encephalopathy Complicating Hyperemesis during Pregnancy

    Directory of Open Access Journals (Sweden)

    Mohamed Adnane Berdai

    2016-01-01

    Full Text Available Wernicke’s encephalopathy is caused by severe thiamine deficiency; it is mostly observed in alcoholic patients. We report the case of a 28-year-old woman, at 17 weeks of gestational age, with severe hyperemesis gravidarum. She presented with disturbance of consciousness, nystagmus, ophthalmoplegia, and ataxia. The resonance magnetic imagery showed bilaterally symmetrical hyperintensities of thalamus and periaqueductal area. The case was managed with very large doses of thiamine. The diagnosis of Wernicke’s encephalopathy was confirmed later by a low thiamine serum level. The patient was discharged home on day 46 with mild ataxia and persistent nystagmus. Wernicke’s encephalopathy is a rare complication of hyperemesis gravidarum. It should be diagnosed as early as possible to prevent long-term neurological sequela or death. Thiamine supplementation in pregnant women with prolonged vomiting should be initiated, especially before parenteral dextrose infusion. Early thiamine replacement will reduce maternal morbidity and fetal loss rate.

  2. Is thrombophilia a risk factor for placenta-mediated pregnancy complications?

    DEFF Research Database (Denmark)

    Hoffmann, Elise; Hedlund, Elisabeth; Perin, Trine

    2012-01-01

    PURPOSE: To determine if thrombophilia is a risk factor for placenta-mediated pregnancy complications (PMPC) (i.e., preeclampsia, intrauterine growth restriction (IUGR), placental abruption, intrauterine fetal death and recurrent pregnancy loss). METHODS: A 5-year retrospective cohort study....... Ongoing pregnancies in women with an antecedent PMPC with thrombophilia were compared with the pregnancies in similar women without thrombophilia. The main outcome measures were mean birth weight deviations, corrected for gestational age, and recurrence of PMPC. Low-molecular-weight heparin (LMWH......) was employed for thromboprophylaxis only. Mann-Whitney's, Fisher's and Chi-square tests were employed for comparison. RESULTS: PMPC recurred in 10/43 (23 %) in the thrombophilia group and in 7/41 (17 %) in the non-thrombophilia group, P

  3. [Maternal adrenal necrosis in the third trimester of pregnancy: a rare complication of antiphospholipid syndrome].

    Science.gov (United States)

    Legendre, G; Vauthier-Brouzes, D; Cornet, A; Al Hawari, M; Renard-Penna, R; Piette, J-C; Dommergues, M

    2008-04-01

    Adrenal necrosis, a rare life threatening complication of antiphospholipid syndrome, is difficult to diagnose during pregnancy. We report the case of a 33-year-old woman with bilateral adrenal necrosis which started during the third trimester of her second pregnancy. Antiphospholipid syndrome had been diagnosed few years ago, after a thrombotic event. The pregnancy was uneventful until 36 weeks plus five days, when the patient was admitted for bilateral back ache, initially considered as uterine contractions. Labour was induced because pain persisted and was associated with major thrombocytopenia. A healthy infant was delivered vaginally on the second day, adrenal failure was diagnosed based on intense asthenia, persistent severe lumbar pain, low blood sodium and cortisol. Bilateral adrenal oedema was documented by CT scan and MRI. Symptoms resolved following administration of hydrocortisone and fludrocortisone. This case illustrates the difficulty to diagnose adrenal necrosis in the third trimester of pregnancy.

  4. Relation between acute kidney injury and pregnancy-related factors

    OpenAIRE

    Monchai Siribamrungwong; Pawadee Chinudomwong

    2016-01-01

    Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it brings about devastating maternal and fetal outcomes. Among developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains one of the major health problems in the developing countries. Though some improvements have been observed, PRAKI still causes high maternal morbidity and mortality, le...

  5. ApoE Receptor 2 mediates trophoblast dysfunction and pregnancy complications induced by antiphospholipid antibodies in mice

    NARCIS (Netherlands)

    Ulrich, Victoria; Gelber, Shari E; Vukelic, Milena; Sacharidou, Anastasia; Herz, Joachim; Urbanus, Rolf T; de Groot, Philip G; Natale, David R; Harihara, Anirudha; Redecha, Patricia; Abrahams, Vikki M; Shaul, Philip W; Salmon, Jane E; Mineo, Chieko

    2016-01-01

    OBJECTIVE: Pregnancies in women with the antiphospholipid syndrome (APS) are frequently complicated by fetal loss and intrauterine growth restriction (IUGR). How circulating antiphospholipid antibodies (aPL) cause pregnancy complications in APS is poorly understood. We sought to determine if the LDL

  6. [The complications of systemic sclerosis in pregnancy - diagnostic and therapeutic difficulties].

    Science.gov (United States)

    Grygiel-Górniak, Bogna; Puszczewicz, Mariusz

    2016-01-01

    In the course of scleroderma numerous complications may occur caused by the endothelial vessel changes and organs' fibrosis. Pregnancy itself is associated with increased immunization caused by the microchimerism phenomenon. Pregnancy may be associated with increased dyspnea, hypertension, gastroesophageal reflux disease (GERD), renal complications and mother pre-eclampsia. In turn, the most common disorders of the fetus include low birth weight, premature delivery and heart block. The occurrence of organ complications in the mother needs urgent gynecological and rheumatologic care, which often requires the consultation of pulmonologist, cardiologist, nephrologists and gastroenterologist. In case of the development of fetal abnormalities neonatal care is needed. Considering the possible complications of mother and child in the course of scleroderma, pregnancy should be planned in the most optimal time and its course should be monitor, what increases the safety and positive outcome for mother and fetus. In case of complications, early interdisciplinary intervention prevents their development and reduces the risk of serious and prolonged health consequences for both mother and child.

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

    Science.gov (United States)

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

    2015-03-01

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

  8. Melanoma during pregnancy : a report of 60 pregnancies complicated by melanoma

    NARCIS (Netherlands)

    de Haan, Jorine; Lok, Christianne A.; de Groot, Christianne J.; Crijns, Marianne B.; Van Calsteren, Kristel; Steffensen, Karina Dahl; Halaska, Michael J.; Altintas, Sevilay; Boere, Ingrid A.; Fruscio, Robert; Kolawa, Wojciech; Witteveen, Petronella O.; Amant, Frederic

    The management of melanoma during pregnancy is challenging as maternal benefits and fetal risks need to be balanced. Here, we present an overview of the incidence, the demographic and clinical characteristics and the treatment modalities used. After analysis of obstetric, fetal and maternal outcome,

  9. The 2011 survey on hypertensive disorders of pregnancy (HDP in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Chun Ye

    Full Text Available Hypertensive disorders of pregnancy (HDP are a group of medical complications in pregnancy and also a risk factor for severe pregnancy outcomes, but it lacks a large-scale epidemiological investigation in recent years. This survey represents a multicenter cross-sectional retrospective study to estimate the prevalence and analyze the risk factors for HDP among the pregnant women who had referred for delivery between January 1st 2011 and December 31st 2011 in China Mainland. A total of 112,386 pregnant women were investigated from 38 secondary and tertiary specialized or general hospitals randomly selected across the country, of which 5,869 had HDP, accounting for 5.22% of all pregnancies. There were significant differences in the prevalence of HDP between geographical regions, in which the North China showed the highest (7.44% and Central China showed the lowest (1.23%. Of six subtypes of HDP, severe preeclampsia accounted for 39.96%, gestational hypertension for 31.40%, mild preeclampsia for 15.13%, chronic hypertension in pregnancy for 6.00%, preeclampsia superimposed on chronic hypertension for 3.68% and eclampsia for 0.89%. A number of risk factors for HDP were identified, including twin pregnancy, age of >35 years, overweight and obesity, primipara, history of hypertension as well as family history of hypertension and diabetes. The prevalence of pre-term birth, placental abruption and postpartum hemorrhage were significantly higher in women with HDP than those without HDP. The possible risk factors confirmed in this study may be useful for the development of early diagnosis and appropriate treatment of HDP.

  10. Case of twin pregnancy complicated by idiopathic thrombocytopenic purpura treated with intravenous immunoglobulin: Review of the literature.

    Science.gov (United States)

    Zhao, W X; Yang, X F; Lin, J H

    2017-01-01

    Idiopathic thrombocytopenic purpura (ITP) is an acquired thrombocytopenia without other clear cause of thrombocytopenia. It is not common in a singleton pregnancy and less common in twin pregnancy. We report a 33-year-old ITP pluripara whose first pregnancy was uneventful. She carried twin pregnancy, complicated by recurrent very low platelets, and gave birth to preterm twins. This patient received multiple courses of intravenous immunoglobulin (IVIG) and showed a significant platelet count improvement with IVIG therapy.

  11. The influence of maternal smoking habits before pregnancy and antioxidative supplementation during pregnancy on oxidative stress status in a non-complicated pregnancy.

    Science.gov (United States)

    Ardalić, Daniela; Stefanović, Aleksandra; Kotur-Stevuljević, Jelena; Vujović, Ana; Spasić, Slavica; Spasojević-Kaliomanvska, Vesna; Jelić-Ivanović, Zorana; Mandić-Marković, Vesna; Miković, Zeljko; Cerović, Nikola

    2014-01-01

    As a physiological condition closely linked with increased susceptibility to oxidative stress, pregnancy can be further compromised by cigarette smoking. Inadequate nutrition and reduced intake of antioxidants can also disrupt the prooxidant/antioxidant relationship and contribute to oxidative stress. Increased oxidative stress during pregnancy may be involved in several complications of pregnancy, such as preterm labor, fetal growth restriction, preeclampsia and miscarriage. The aim of this study was to investigate the influence of maternal smoking habits before pregnancy on the parameters of oxidative stress and the antioxidative defense system, lipid profile parameters and paraoxonase-1 (PON1) activity during the third trimester of uncomplicated pregnancies. Healthy pregnant women (n = 86) were divided into non-smoking and smoking groups, and into groups taking vitamin supplements and not taking them. Oxidative damage was measured through the levels of thiobarbituric acid-reacting substances (TBARS) and plasma antioxidant status was evaluated by measuring total antioxidant capacity (TAC). TBARS concetration was significantly higher (p pregnancy is associated with increased oxidative stress. Vitamin supplementation has no effect on the oxidative stress status of healthy pregnant women.

  12. Placental histopathology lesions and pregnancy outcome in pregnancies complicated with symptomatic vs. non-symptomatic placenta previa.

    Science.gov (United States)

    Weiner, Eran; Miremberg, Hadas; Grinstein, Ehud; Schreiber, Letizia; Ginath, Shimon; Bar, Jacob; Kovo, Michal

    2016-10-01

    The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed. Results were compared between PP who had elective cesarean delivery (CD) (previa group) and PP with bleeding necessitating emergent CD (symptomatic previa group). Placental lesions were classified to lesions consistent with maternal malperfusion or fetal thrombo-occlusive disease (vascular and villous changes), and inflammatory lesions. Compared to the previa group (n=63), the symptomatic previa group (n=74) was characterized by older patients (pPlacentas within the symptomatic previa group were smaller, with higher rates of weightplacenta previa is associated with increased placental malperfusion lesions suggesting an association of maternal malperfusion with abnormal placental separation. The coexisting finding of RPH with symptomatic placenta previa can be seen as a marker for more extensive/severe placental separation, hence the association with maternal transfusion requirements and poorer fetal outcome. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Web recruitment and internet use and preferences reported by women with postpartum depression after pregnancy complications.

    Science.gov (United States)

    Maloni, Judith A; Przeworski, Amy; Damato, Elizabeth G

    2013-04-01

    Nearly one million women each year have pregnancy complications that cause antepartum and postpartum anxiety and depression. This exploratory study determined 1) feasibility of using social media to recruit women with depressive symptoms following high risk pregnancy, 2) women's barriers to treatment, 3) use of online resources for assistance with PPD, and 4) preferences for internet treatment. Among a national sample of 53 women, nearly 70% had major depression. Common barriers were lack of time and stigma. Over 90% of women would use the internet to learn coping strategies for PPD. Women expressed interest in web-based PPD treatment and identified desired characteristics of an intervention.

  14. Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

    OpenAIRE

    Swati Sharma; Rupa Aherwar; Shashikala Jawade

    2016-01-01

    Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with jaundice. Methods: 30 antenatal patients with clinical /laboratory evidence of Jaundice were selected for study in period between august 2014 to august 2015. Results: The peak age of incidence in our study was 21-25 years (66.6%) and majority were primigravida (66.6%). All cases were in third trimester of pregnancy, 93.3% were unbooked, 73.3% were term, 60% were of lower socioeco...

  15. Preventing infective complications relating to induced abortion.

    Science.gov (United States)

    Mary, Nirmala; Mahmood, Tahir A

    2010-08-01

    Infective complications following induced abortions are still a common cause of morbidity and mortality. This review focusses on defining the strategies to improve care of women seeking an induced abortion and to reduce infective complications. We have considered the evidence for screening and cost-effectiveness for antibiotic prophylaxis. Current evidence suggests that treating all women with prophylactic antibiotics in preference to screening and treating is the most cost-effective way of reducing infective complications following induced abortions. The final strategy to prevent infective complications should be individualized for each region/area depending on the prevalence of organisms causing pelvic infections and the resources available.

  16. Dichorionic triamniotic triplet pregnancy complicated by twin anemia polycythemia sequence: the place of fetal therapy.

    Science.gov (United States)

    Griersmith, Thérèse H; Fung, Alison M; Walker, Susan P

    2014-12-01

    Monochorionic twins as part of a high order multiple pregnancy can be an unintended consequence of the increasingly common practice of blastocyst transfer for couples requiring in vitro fertilisation (IVF) for infertility. Dichorionic triamniotic (DCTA) triplets is the most common presentation, and these pregnancies are particularly high risk because of the additional risks associated with monochorionicity. Surveillance for twin-to-twin transfusion syndrome, including twin anemia polycythemia sequence, may be more difficult, and any intervention to treat the monochorionic pair needs to balance the proposed benefits against the risks posed to the unaffected singleton. Counseling of families with DCTA triplets is therefore complex. Here, we report a case of DCTA triplets, where the pregnancy was complicated by threatened preterm labour, and twin anemia polycythemia sequence (TAPS) was later diagnosed at 28 weeks. The TAPS was managed with a single intraperitoneal transfusion, enabling safe prolongation of the pregnancy for over 2 weeks until recurrence of TAPS and preterm labour supervened. Postnatal TAPS was confirmed, and all three infants were later discharged home at term corrected age, and were normal at follow-up. This case highlights that in utero therapy has an important role in multiple pregnancies of mixed chorionicity, and can achieve safe prolongation of pregnancy at critical gestations.

  17. 妊娠期高血压疾病患者外周血凋亡相关因子浓度变化研究%Study on Apoptosis-Related Factors in Peripheral Serum of Patients with Hypertensive Disorder Complicating Preg-nancy

    Institute of Scientific and Technical Information of China (English)

    孔祥玲; 吴维光; 初巍巍

    2014-01-01

    Objective To investigate the changes of apoptosis-related factors in peripheral serum of patients with hy-pertensive disorder complicating pregnancy. Methods A total of 38 patients who suffered from gestational hypertension were chosen as hypertensive disorder complicating pregnancy group and 24 normal pregnant women were chosen as normal pregnancy group. The patients in hypertensive disorder complicating pregnancy group were divided into three groups: gestational hyper-tension group (14 patients), mild preeclampsia group (14 patients) and severe preeclampsia group (10 patients). Before ce-sarean section, vascular endothelial growth factor ( VEGF) , placenta growth factor ( PLGF) and GATA-3 in the normal preg-nancy group and hypertensive disorder complicating pregnancy group were detected for comparisons. Results The concentra-tions of VEGF and PLGF were markedly lower in hypertensive disorder complicating pregnancy group than those in normal pregnancy group, but GATA-3 was higher than that in normal pregnancy group, and the differences were all significant ( P<0. 05 ) . Peripheral blood concentrations of VEGF and PLGF in the 3 groups of gestational hypertension disease decreased with the degree of the disease, but GATA-3 concentration increased, and the differences among the three groups showed signifi-cance (P<0. 05). Correlation analysis results showed that GATA-3 was negatively related to VEGF between the mild and se-vere preeclampsia group (r= -0. 681, P=0. 044; r= -0. 741, P=0. 041). Conclusion Unbalanced peripheral blood concentration of apoptosis-related factors may be related to gestational hypertension disease.%目的:探讨妊娠期高血压疾病患者外周血凋亡相关因子浓度的变化情况。方法选择我院妊娠期高血压疾病38例作为妊娠期高血压组,选择同期正常妊娠期妇女24例作为正常妊娠组;另根据病情严重程度将妊娠期高血压疾病患者分为妊娠期高血压组(14

  18. Pre-pregnancy and Early Prenatal Care are Associated with Lower Risk of Ectopic Pregnancy Complications in the Medicaid Population: 2004-08.

    Science.gov (United States)

    Stulberg, Debra B; Cain, Loretta; Hasham Dahlquist, Irma; Lauderdale, Diane S

    2017-01-01

    Ectopic pregnancy causes significant maternal morbidity and mortality. Complications are more common among women with Medicaid or no insurance compared to those with private insurance. It is unknown whether preventive care prior to pregnancy and prenatal care, which are covered by Medicaid, would decrease complications if they were more fully utilised. Medicaid claims were used to identify a clinical cohort of women who experienced an ectopic pregnancy during 2004-08 among all female Medicaid enrolees from a large 14-state population, ages 15-44. Diagnosis and procedure codes were used to identify ectopic pregnancies and associated complications. The primary outcomes were complications associated with ectopic pregnancy: blood transfusion, sterilisation, or hospitalisation with length of stay greater than 2 days. Independent variables were documentation of preventive care within 1 year prior to the ectopic pregnancy and prenatal care within 4 months prior. Controlling for race, age, and state of residence, women's risks of any ectopic pregnancy complication were independently higher among those who did not receive any Medicaid-covered preventive care within 1 year before the ectopic pregnancy compared to those who did (RR 1.12, 95% confidence interval (CI) 1.09, 1.16), and among those who did not receive any Medicaid-covered prenatal care within 4 months prior, compared to those who did (RR 1.89, 95% CI 1.83, 1.96). Pre-pregnancy and prenatal care are independently associated with decreased risk of ectopic pregnancy complications among Medicaid beneficiaries. © 2016 John Wiley & Sons Ltd.

  19. Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Nilas, Lisbeth; Ulrik, Charlotte Suppli

    2016-01-01

    BACKGROUND: Asthma in pregnancy have been associated with an increased risk of pregnancy complications. Our aim was to estimate incidence and describe risk factors for adverse obstetrical and perinatal outcomes in pregnant women with asthma. METHODS: Women enrolled in the Management of Asthma......, although women with asthma had a statistically significant higher risk of pre-eclampsia (5% vs. 3%, ORadj 1.60, 95% CI 1.07-2.38; p = 0.02) and small for gestational age neonates (SGA) (ORadj 1.30, 95% CI 1.10-1.54; p ... with a higher risk of SGA (60% vs 53%, ORadj. 1.30, 95% CI 1.10-1.54; p pre-eclampsia (ORadj 3.33 95% CI 0.96-11.65, p = 0.06) compared to pregnancies without any exacerbations. CONCLUSION: The overall risk...

  20. Impact of the 2008 Beijing Olympics on the risk of pregnancy complications.

    Science.gov (United States)

    Assibey-Mensah, Vanessa; Liu, Kaibo; Thurston, Sally W; Stevens, Timothy P; Zhang, Junfeng; Zhang, Jinliang; Kane, Cathleen; Pan, Ying; Weinberger, Barry; Ohman-Strickland, Pamela; Woodruff, Tracey; Rich, David Q

    2016-07-01

    Taking advantage of the natural experiment of the 2008 Beijing Olympics (August 8 to September 24), when air pollution levels decreased by 13% to 60%, the authors assessed whether having ≥1 pregnancy month during the Olympics was associated with decreased risks of hypertensive disorders (HDs) and/or fetal-placental conditions (FPCs). Singleton births to mothers with ≥1 pregnancy month in 2008 or 2009 (N = 56,155) were included. Using generalized additive models, the authors estimated the risk of HDs and FPCs associated with (1) the 2008 Olympics compared with the same dates in 2009, and (2) increased mean ambient PM10 (particulate matter with an aerodynamic diameter Olympic period was found. This may, in part, be due to a small number of pregnancy complications in this population.

  1. Lower uterine segment pregnancy with placenta increta complicating first trimester induced abortion: diagnosis and conservative management

    Institute of Scientific and Technical Information of China (English)

    刘欣燕; 范光升; 金征宇; 杨宁; 姜玉新; 盖铭英; 郭丽娜; 王友芳; 郎景和

    2003-01-01

    Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion during the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed "lower uterine segment pregnancy with placenta increta". Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.

  2. Food taboos and nutrition-related pregnancy concerns among Ethiopian women.

    Science.gov (United States)

    Vasilevski, Vidanka; Carolan-Olah, Mary

    2016-10-01

    To discuss Ethiopian food taboos during pregnancy and their relation to maternal nutritional status and pregnancy outcomes. Recent waves of migration have seen large groups of Ethiopian refugees moving to countries around the globe. This is of concern as Ethiopian women are at risk of a number of medical and pregnancy complications. Health is further compromised by poor diet and adherence to cultural food beliefs and taboos. In refugee women, many of these factors correspond with significantly higher rates of pregnancy complications and poor birth outcomes. This is a discussion paper informed by a literature review. A search of the Scopus, PubMed, Web of Science and Academic Search Premier databases for the keywords Ethiopian, pregnancy, food and taboos was conducted in the research literature published from 1998-2015. This time is contingent with Ethiopian migration trends. Ethiopian migrant women are at risk of inadequate nutrition during pregnancy. Risks include cultural factors associated with food taboos as well as issues associated with low socioeconomic status. Consequently, Ethiopian women are more likely to have nutritional deficiencies such as anaemia which have been associated with a range of pregnancy complications. There are many serious consequences of poor diet during pregnancy; however, most of these can be avoided by greater awareness about the role of nutrition during pregnancy and by adopting a balanced diet. There is an urgent unmet need for nutrition education among Ethiopian women. Research indicates that Ethiopian women are receptive to nutritional advice during pregnancy and also that pregnant women are generally motivated to act in the baby's interest. These factors suggest that this high-risk group would be amenable to culturally appropriate nutrition education, which would provide much-needed meaningful support in pregnancy. © 2016 John Wiley & Sons Ltd.

  3. Pregnancy-related low back pain.

    Science.gov (United States)

    Katonis, P; Kampouroglou, A; Aggelopoulos, A; Kakavelakis, K; Lykoudis, S; Makrigiannakis, A; Alpantaki, K

    2011-07-01

    Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article is to present a current review of the literature concerning this issue.By using PubMed database and low back pain, pelvic girdle pain, pregnancy as keywords, abstracts and original articles in English investigating the diagnosis treatment of back pain during pregnancy were searched and analyzedLow back pain could present as either a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The source of the pain should be diagnosed and differentiated early.The appropriate treatment aims to reduce the discomfort and the impact on the pregnant womans quality of life. This article reveals the most common risk factors, as well as treatment methods, which may help to alleviate the pain. Some suggestions for additional research are also discussed.

  4. Pregnancy related acute kidney injury: nondialytic management

    Directory of Open Access Journals (Sweden)

    Kaliki Hymavathi Reddy

    2015-04-01

    Full Text Available Acute Kidney Injury (AKI is associated with increased mortality and morbidity unless timely diagnosed and promptly managed. An understanding of the renal physiologic changes that occur during pregnancy is essential for Proper evaluation, diagnosis, and management of Pregnancy Related AKI (PRAKI. In the general population, AKI can occur from prerenal, intrinsic/renal, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management and prevention of adverse maternal/fetal outcomes. Sometimes PRAKI may require intensive management and even dialysis adding additional economical burden to the patient. We here, with report an interesting case of PRAKI diagnosed and managed in time by simple medical measures thus delivering an effective treatment at a much lesser cost. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 486-489

  5. Bilateral psoas and bilateral perinephric abscesses complicating acute pyelonephritis in pregnancy

    OpenAIRE

    2013-01-01

    Acute pyelonephritis complicates 1-2% of pregnancies and causes significant maternal and fetal morbidity and mortality. The diagnosis of renal tuberculosis (TB) is often delayed and commonly presents with sterile pyuria or along with other pyogenic organisms. We report a case where the diagnosis of renal TB was missed in a pregnant woman when she presented with acute pyelonephritis, septic shock, and acute renal failure. There was clinical recovery with antibiotics, but bilateral psoas and pe...

  6. The Association between Polymorphism of TNF-α Gene and Hypertensive Disorder Complicating Pregnancy

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yin; XIA Shu; ZOU Li

    2007-01-01

    To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G→A, -850C→T mutation at promoter of TNF-α gene, the -308G→A, -850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The re- sults showed that with -308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group (P<0.05). A significant difference in genotype distribution of -850C→T poly- morphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT geno- types were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of -850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.

  7. Pregnancy Complications

    Science.gov (United States)

    ... CDC conducted a study to assess associations between indicators of use of health care services and body- ... i.e., a healthy diet, exercise, and weight management) or medication. The ... Brigham and Women’s Hospital to develop a modified version of the DPP, ...

  8. Placental Fatty Acid ethyl esters are elevated with maternal alcohol use in pregnancies complicated by prematurity.

    Science.gov (United States)

    Gauthier, Theresa W; Mohan, Sowmya S; Gross, Teresa S; Harris, Frank L; Guidot, David M; Brown, Lou Ann S

    2015-01-01

    The accumulation of fatty acid ethyl esters (FAEEs) in meconium of term newborns has been described as one potential biomarker of maternal alcohol use during pregnancy. FAEEs accumulate in multiple alcohol-exposed fetal tissues and in the placenta. Limited research has focused on the identification of the premature newborn exposed to alcohol in utero. We hypothesized that maternal alcohol use occurs in a significant proportion of premature deliveries and that this exposure can be detected as elevated placental FAEEs. The goals of this study were to 1) determine the prevalence of maternal alcohol use in the premature newborn and 2) investigate whether placental FAEEs could identify those newborns with fetal alcohol exposure. This prospective observational study evaluated 80 placentas from 80 women after premature delivery. Subjects were interviewed for alcohol intake and placental FAEEs were quantified via GC/MS. Receiver Operator Characteristic (ROC) Curves were generated to evaluate the ability of placental FAEEs to predict maternal drinking during pregnancy. Adjusted ROC curves were generated to adjust for gestational age, maternal smoking, and illicit drug use. 30% of the subjects admitted to drinking alcohol during pregnancy and approximately 14% answered questions indicative of problem drinking (designated AUDIT+). The specific FAEEs ethyl stearate and linoleate, as well as combinations of oleate + linoleate + linolenate (OLL) and of OLL + stearate, were significantly (p<0.05) elevated in placentas from AUDIT+ pregnancies. Adjusted ROC Curves generated areas under the curve ranging from 88-93% with negative predictive values of 97% for AUDIT+ pregnancies. We conclude that nearly one third of premature pregnancies were alcohol-exposed, and that elevated placental FAEEs hold great promise to accurately determine maternal alcohol use, particularly heavy use, in pregnancies complicated by premature delivery.

  9. Placental Fatty Acid ethyl esters are elevated with maternal alcohol use in pregnancies complicated by prematurity.

    Directory of Open Access Journals (Sweden)

    Theresa W Gauthier

    Full Text Available The accumulation of fatty acid ethyl esters (FAEEs in meconium of term newborns has been described as one potential biomarker of maternal alcohol use during pregnancy. FAEEs accumulate in multiple alcohol-exposed fetal tissues and in the placenta. Limited research has focused on the identification of the premature newborn exposed to alcohol in utero. We hypothesized that maternal alcohol use occurs in a significant proportion of premature deliveries and that this exposure can be detected as elevated placental FAEEs. The goals of this study were to 1 determine the prevalence of maternal alcohol use in the premature newborn and 2 investigate whether placental FAEEs could identify those newborns with fetal alcohol exposure. This prospective observational study evaluated 80 placentas from 80 women after premature delivery. Subjects were interviewed for alcohol intake and placental FAEEs were quantified via GC/MS. Receiver Operator Characteristic (ROC Curves were generated to evaluate the ability of placental FAEEs to predict maternal drinking during pregnancy. Adjusted ROC curves were generated to adjust for gestational age, maternal smoking, and illicit drug use. 30% of the subjects admitted to drinking alcohol during pregnancy and approximately 14% answered questions indicative of problem drinking (designated AUDIT+. The specific FAEEs ethyl stearate and linoleate, as well as combinations of oleate + linoleate + linolenate (OLL and of OLL + stearate, were significantly (p<0.05 elevated in placentas from AUDIT+ pregnancies. Adjusted ROC Curves generated areas under the curve ranging from 88-93% with negative predictive values of 97% for AUDIT+ pregnancies. We conclude that nearly one third of premature pregnancies were alcohol-exposed, and that elevated placental FAEEs hold great promise to accurately determine maternal alcohol use, particularly heavy use, in pregnancies complicated by premature delivery.

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

    Science.gov (United States)

    Djelmis, J

    1998-01-01

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

  11. Management of gallstones and its related complications.

    Science.gov (United States)

    Portincasa, P; Di Ciaula, A; de Bari, O; Garruti, G; Palmieri, V O; Wang, D Q-H

    2016-01-01

    The majority of gallstone patients remain asymptomatic; however, interest toward the gallstone disease is continuing because of the high worldwide prevalence and management costs and the development of gallstone symptoms and complications. For cholesterol gallstone disease, moreover, a strong link exists between this disease and highly prevalent metabolic disorders such as obesity, dyslipidemia, type 2 diabetes, hyperinsulinemia, hypertriglyceridemia and the metabolic syndrome. Information on the natural history as well as the diagnostic, surgical (mainly laparoscopic cholecystectomy) and medical tools available to facilitate adequate management of cholelithiasis and its complications are, therefore, crucial to prevent the negative outcomes of gallstone disease. Moreover, some risk factors for gallstone disease are modifiable and some preventive strategies have become necessary to reduce the onset and the severity of complications.

  12. Obstetric complications in women with IVF conceived pregnancies and polycystic ovarian syndrome

    Directory of Open Access Journals (Sweden)

    Sunita R Tandulwadkar

    2014-01-01

    Full Text Available Polycystic ovarian syndrome (PCOS is often accompanied by infertility that necessitates ovulation induction using clomiphene citrate, gonadotropins or even in vitro fertilization (IVF. These treatment methods are known to increase the incidence of multiple pregnancies as well as some negative consequences, including a rise in the risk for gestational diabetes mellitus, pre-eclampsia, etc., Furthermore, pregnancies established after IVF carry an increased risk for maternal complications. However, the increased risk of developing adverse obstetric complications has been suggested to occur independently of obesity as well as in populations without assisted reproductive techniques. Many studies have been performed to study the effect of PCOS on pregnancy and the effect of pregnancy on PCOS. The hormonal milieu that is exaggerated in PCOS women is quite well understood at the biochemical and genetic levels. The maternal and neonatal outcomes of PCOS women who have undergone in vitro fertilization-embryo transfer (IVF-ET have not been widely studied till date. This review aims to evaluate the current evidence regarding adverse obstetric outcomes of PCOS women undergoing IVF-ET. The rationale of this review is to study whether the adverse obstetric outcomes are increased in PCOS women in general, or particularly in those PCOS women who are undergoing IVF-ET. It is also important to analyze via a literature review whether the increased adverse outcomes are due to infertility in general or PCOS per se. An attempt has been made to give evidence regarding preventive strategies for obstetric complications in PCOS women who have undergone IVF-ET.

  13. Mechanisms involved in the association between periodontitis and complications in pregnancy.

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    Marcela eYang

    2015-01-01

    Full Text Available The association between periodontitis and gestation complications such as premature delivery, low weight at birth and preeclampsia has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to review the current data on the association between gestation complications and periodontitis, and the mechanisms underlying this association. Shifts in the microbial composition of the subgingival biofilm may occur during pregnancy, leading to a potentially more hazardous microbial community. Pregnancy is characterized by physiological immune tolerance. However, the infection leads to a shift in maternal immune response to a pathogenic pro-inflammatory response, with production of inflammatory cytokines and toxic products. In women with periodontitis, the infected periodontal tissues may act as reservoirs of bacteria and their products which can disseminate to the fetus-placenta unit. In severe periodontitis patients, the infection agents and their products are able to activate inflammatory signaling pathways locally and in extra-oral sites, including the placenta-fetal unit, which may not only induce preterm labor, but also lead to preeclampsia and restrict intrauterine growth. Despite these evidences, the effectiveness of periodontal treatment in preventing gestational complications was still not established since it may be influenced by several factors such as severity of disease, composition of microbial community, treatment strategy, and period of treatment throughout pregnancy. This lack of scientific evidence does not exclude the need to control infection and inflammation in periodontitis patients during pregnancy, and treatment protocols should be validated.

  14. Osteonecrosis of the humerus related to pregnancy.

    OpenAIRE

    McGuigan, L; Fleming, A

    1983-01-01

    A case of osteonecrosis of the head of the humerus is described in which the only likely precipitant was pregnancy. The association of pregnancy and osteonecrosis is reviewed. This is the first reported case of osteonecrosis of the humerus alone associated with pregnancy.

  15. Complication related to colostomy orifice: intestinal evisceration

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    Valdemir José Alegre Salles

    2011-12-01

    Full Text Available Intestinal evisceration at the site of a stoma is a rare event, with high morbimortality. Its clinical manifestation often occurs between the sixth and seventh days after surgery. The risk factors most frequently related to evisceration are: increased intra-abdominal pressure, digestive tract cancer surgery, emergency surgery and stomas in the surgical incision. The authors report the case of a male patient, aged 62, suffering from adenocarcinoma of the rectum with obstructive acute abdomen, who underwent loop transversotomy for decompression. On the fourth day after surgery, he had a bronchospasm crisis, with evisceration of ileum and colon through the colostomic hole. The association of some triggering factors, such as emergency surgery, colorectal malignant neoplasm, increased intra-abdominal pressure and technical failure of colostomy were decisive in the development of this rare peri-colostomy complication.A evisceração intestinal desenvolvida no sítio de um estoma é um evento raro, tendo elevada morbimortalidade. Sua manifestação clínica ocorre frequentemente entre o sexto e o sétimo dias de pós-operatório. Os fatores de risco mais frequentemente relacionados à evisceração são: aumento da pressão intra-abdominal, câncer do aparelho digestório, cirurgia de urgência e estomias na incisão cirúrgica. Os autores relatam o caso de um paciente do sexo masculino, com 62 anos, portador de adenocarcinoma do reto médio com abdômen agudo obstrutivo, sendo submetido à transversostomia em alça, com finalidade descompressiva. No quarto dia de pós-operatório com crise de broncoespasmo, apresentou evisceração do cólon e íleo pelo orifício abdominal colostômico. A associação de alguns fatores desencadeantes, como a cirurgia de urgência, a doença neoplásica colorretal maligna, o aumento da pressão intra-abdominal e a falha técnica na confecção da colostomia, foram determinantes para o desenvolvimento desta rara

  16. Mechanisms Involved in the Association between Periodontitis and Complications in Pregnancy

    Science.gov (United States)

    Zi, Marcela Yang Hui; Longo, Priscila Larcher; Bueno-Silva, Bruno; Mayer, Marcia Pinto Alves

    2015-01-01

    The association between periodontitis and some of the problems with pregnancy such as premature delivery, low weight at birth, and preeclampsia (PE) has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to review the current data on the association between some of these problems with pregnancy and periodontitis, and the mechanisms underlying this association. Shifts in the microbial composition of the subgingival biofilm may occur during pregnancy, leading to a potentially more hazardous microbial community. Pregnancy is characterized by physiological immune tolerance. However, the infection leads to a shift in maternal immune response to a pathogenic pro-inflammatory response, with production of inflammatory cytokines and toxic products. In women with periodontitis, the infected periodontal tissues may act as reservoirs of bacteria and their products that can disseminate to the fetus-placenta unit. In severe periodontitis patients, the infection agents and their products are able to activate inflammatory signaling pathways locally and in extra-oral sites, including the placenta-fetal unit, which may not only induce preterm labor but also lead to PE and restrict intrauterine growth. Despite these evidences, the effectiveness of periodontal treatment in preventing gestational complications was still not established since it may be influenced by several factors such as severity of disease, composition of microbial community, treatment strategy, and period of treatment throughout pregnancy. This lack of scientific evidence does not exclude the need to control infection and inflammation in periodontitis patients during pregnancy, and treatment protocols should be validated. PMID:25688342

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

    Institute of Scientific and Technical Information of China (English)

    Chunfang Li; Wenli Gou; Xuelian Chen; Shuping Zhang

    2007-01-01

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

  18. Full-term abdominal extrauterine pregnancy complicated by post-operative ascites with successful outcome: a case report

    Directory of Open Access Journals (Sweden)

    Masukume Gwinyai

    2013-01-01

    Full Text Available Abstract Introduction Advanced abdominal (extrauterine pregnancy is a rare condition with high maternal and fetal morbidity and mortality. Because the placentation in advanced abdominal pregnancy is presumed to be inadequate, advanced abdominal pregnancy can be complicated by pre-eclampsia, which is another condition with high maternal and perinatal morbidity and mortality. Diagnosis and management of advanced abdominal pregnancy is difficult. Case presentation We present the case of a 33-year-old African woman in her first pregnancy who had a full-term advanced abdominal pregnancy and developed gross ascites post-operatively. The patient was successfully managed; both the patient and her baby are apparently doing well. Conclusion Because most diagnoses of advanced abdominal pregnancy are missed pre-operatively, even with the use of sonography, the cornerstones of successful management seem to be quick intra-operative recognition, surgical skill, ready access to blood products, meticulous post-operative care and thorough assessment of the newborn.

  19. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rebecca L. Wilson

    2016-10-01

    Full Text Available Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE; spontaneous preterm birth (sPTB; low birthweight (LBW; and gestational diabetes (GDM. Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed. In 10 out of 16 studies a difference was reported with respect to circulating zinc between women who gave birth to a LBW infant (≤2500 g and those who gave birth to an infant of adequate weight (>2500 g, particularly in populations where inadequate zinc intake is prevalent. In 16 of our 33 studies an association was found between hypertensive disorders of pregnancy and circulating zinc; particularly in women with severe PE (blood pressure ≥160/110 mmHg. No association between maternal zinc status and sPTB or GDM was seen; however; direct comparisons between the studies was difficult. Furthermore; only a small number of studies were based on women from populations where there is a high risk of zinc deficiency. Therefore; the link between maternal zinc status and pregnancy success in these populations cannot be established. Future studies should focus on those vulnerable to zinc deficiency and include dietary zinc intake as a measure of zinc status.

  20. Association between Maternal Zinc Status, Dietary Zinc Intake and Pregnancy Complications: A Systematic Review

    Science.gov (United States)

    Wilson, Rebecca L.; Grieger, Jessica A.; Bianco-Miotto, Tina; Roberts, Claire T.

    2016-01-01

    Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE); spontaneous preterm birth (sPTB); low birthweight (LBW); and gestational diabetes (GDM). Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed. In 10 out of 16 studies a difference was reported with respect to circulating zinc between women who gave birth to a LBW infant (≤2500 g) and those who gave birth to an infant of adequate weight (>2500 g), particularly in populations where inadequate zinc intake is prevalent. In 16 of our 33 studies an association was found between hypertensive disorders of pregnancy and circulating zinc; particularly in women with severe PE (blood pressure ≥160/110 mmHg). No association between maternal zinc status and sPTB or GDM was seen; however; direct comparisons between the studies was difficult. Furthermore; only a small number of studies were based on women from populations where there is a high risk of zinc deficiency. Therefore; the link between maternal zinc status and pregnancy success in these populations cannot be established. Future studies should focus on those vulnerable to zinc deficiency and include dietary zinc intake as a measure of zinc status. PMID:27754451

  1. [Hyperemesis gravidarum: a rare but potentially severe complication of the first trimester of pregnancy].

    Science.gov (United States)

    Macle, Lucie; Varlet, Marie-Noëlle; Cathébras, Pascal

    2010-06-20

    Although nausea and vomiting are common symptoms in early pregnancy, hyperemesis gravidarum (HG) is a rare complication of the first trimester of pregnancy. This condition is defined as intractable vomiting occurring before 20 weeks of gestation, with fluid and electrolyte disturbance, significant weight loss, and ketonuria, leading to hospitalization in the absence of other cause than pregnancy. Some biological disturbances found in HG, such as hyperthyroidism and hepatic cytolysis, which are correlated with the importance of vomiting, are without severe clinical consequences, but may represent diagnostic pitfalls. The aetiology is unknown, but human chorionic gonadotropin hormones likely play the first role. Psychological disturbance is currently seen as the result of the burden and stress of HG rather than a causal factor. Maternal outcome may be severe in the absence of treatment, but pregnancy outcome seems good, as far as the condition has been adequately controlled. The management of HG includes IV rehydration, thiamine supplementation, antiemetic drugs (doxylamine, metoclopramide and chlorpromazine being the first-line choices), and in severe cases, nasogastric or parenteral nutrition. A psychological support is often necessary.

  2. Poor Vitamin C Status Late in Pregnancy Is Associated with Increased Risk of Complications in Type 1 Diabetic Women: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Bente Juhl

    2017-02-01

    Full Text Available Vitamin C (vitC is essential for normal pregnancy and fetal development and poor vitC status has been related to complications of pregnancy. We have previously shown lower vitC status in diabetic women throughout pregnancy compared to that of non-diabetic controls. Here, we evaluate the relationship between vitC status late in diabetic pregnancy in relation to fetal outcome, complications of pregnancy, diabetic characteristics, and glycemic control based on data of 47 women from the same cohort. We found a significant relationship between the maternal vitC level > or ≤ the 50% percentile of 26.6 μmol/L, respectively, and the umbilical cord blood vitC level (mean (SD: 101.0 μmol/L (16.6 versus 78.5 μmol/L (27.8, p = 0.02; n = 12/16, while no relation to birth weight or Apgar score was observed. Diabetic women with complications of pregnancy had significantly lower vitC levels compared to the women without complications (mean (SD: 24.2 μmol/L (10.6 vs. 34.6 μmol/L (14.4, p = 0.01; n = 19 and 28, respectively and the subgroup of women (about 28% characterized by hypovitaminosis C (<23 μmol/L had an increased relative risk of complications of pregnancy that was 2.4 fold higher than the one found in the group of women with a vitC status above this level (p = 0.02, 95% confidence interval 1.2–4.4. No correlation between diabetic characteristics of the pregnant women and vitC status was observed, while a negative association of maternal vitC with HbA1c at delivery was found at regression analysis (r = −0.39, p < 0.01, n = 46. In conclusion, our results may suggest that hypovitaminosis C in diabetic women is associated with increased risk of complications of pregnancy.

  3. Relationship between serum trace elements and antioxidant capacity indexes in women of hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    Yang Liu; Mei Xu; Ying Jiang; Yan Zhang

    2016-01-01

    Objective:To analyze the relationship between serum trace elements, antioxidant capacity index and hypertensive disorder complicating pregnancy (HDCP). Methods: Forty cases of normal healthy pregnant women, twenty-one pregnant women with high blood pressure, twenty-eight pregnant women with early stage of mild preeclampsia and twenty-two pregnant women with early stage of severe preeclampsia were selected respectively. Then, the differences of blood routine examination and blood coagulation function of the four groups were compared. At the same time, the levels of the serum trace elements and oxidative stress related indexes in the placental villi tissue were determined by flame atomic absorption spectrometry. Results:The white blood cells and hematocrit of HDCP pregnant women were significantly higher than those of normal healthy pregnant women;platelet and fibrinogen levels were obviously lower than those of normal healthy pregnant women, while thrombin time was shorter than that of normal healthy pregnant women;levels of serum copper, zinc and manganese were also significantly lower than whose of normal healthy pregnant women, while iron level was distinctly higher than that of normal healthy pregnant women. The differences between groups were statistically significant. The activities of SOD and GSH-PX in the placental villi tissue of HDCP pregnant women were significantly smaller than those of normal healthy pregnant women, while the Hcy level was higher than that of normal healthy pregnant women. The differences between groups were statistically significant. Conclusions:Pregnant women with HDCP has both imbalance of trace elements and redox system equilibrium, so we should strengthen the determination of the trace elements and redox related indexes of HDCP pregnant women to ensure health of maternal and child.

  4. Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction.

    Science.gov (United States)

    Graatsma, E M; Mulder, E J H; Vasak, B; Lobmaier, S M; Pildner von Steinburg, S; Schneider, K T M; Schmidt, G; Visser, G H A

    2012-12-01

    To study fetal heart rate (FHR), its short term variability (STV), average acceleration capacity (AAC), and average deceleration capacity (ADC) throughout uncomplicated gestation, and to perform a preliminary comparison of these FHR parameters between small-for dates (SFD) and control fetuses. Prospective observational study of 7 h FHR-recordings obtained with a fetal-ECG monitor in the second half of uncomplicated pregnancies (n = 90) and pregnancies complicated by fetal SFD (n = 30). FHR and STV were calculated according to established analysis. True beat-to-beat FHR, recorded at 1 ms accuracy, was used to calculate AAC and ADC using Phase Rectified Signal Averaging (PRSA). Mean values of FHR, STV, AAC, and ADC derived from recordings in SFD fetuses were compared with the reference curves. Compared with the control group the mean z-scores for STV, AAC, and ADC in SFD fetuses were lower by 1.0 SD, 1.5 SD, and 1.7 SD, respectively (p < 0.0001 for all comparisons). In SFD fetuses, both the AAC and ADC z-scores were lower than the STV z-scores (p < 0.02 and p < 0.002, respectively). Analysis of the AAC and ADC as recorded with a high resolution fECG recorder may differentiate better between normal and SFD fetuses than STV.

  5. A STUDY OF SICKLE CELL TRAIT COMPLICATIONS IN PREGNANCY & DELIVERY AT TERTIARY LEVEL CENTER

    Directory of Open Access Journals (Sweden)

    Surekha Narayan

    2015-02-01

    Full Text Available OBJECTIVE : To study the outcome of pregnancy in women with sickle cell trait (SCT and compared with normal hemoglobin. METHODS : This is a comparative study consisted of 75 pregnant women with SCT who were attending the antenatal clinic & admitted in obs tetric ward were followed till 7 th day after delivery. The control group consisted of 150 age and gravidity matched pregnant women with normal hemoglobin recruited from same hospital. RESULTS: Statistically significant complications during pregnancy were p reeclampsia; UTI , eclampsia and severe anemia were observed. Incidence of adverse fetal outcome in terms of stillbirth and intrauterine death were significantly higher in the study group than control group. CONCLUSION: At tertiary level hospital which is a lso a regional centre for sickle cell hemoglobinopathy , still SCT was a important contributor for adverse maternal and fetal outcome. Hence vigilant observation & care is needed for SCT women.

  6. Multidisciplinary management of ornithine transcarbamylase (OTC) deficiency in pregnancy: essential to prevent hyperammonemic complications.

    Science.gov (United States)

    Lamb, Stephanie; Aye, Christina Yi Ling; Murphy, Elaine; Mackillop, Lucy

    2013-01-02

    Ornithine transcarbamylase (OTC) deficiency is the most common inborn error in the metabolism of the urea cycle with an incidence of 1 in 14,000 live births. Pregnancy can trigger potentially fatal hyperammonemic crises. We report a successful pregnancy in a 29-year-old primiparous patient with a known diagnosis of OTC deficiency since infancy. Hyperammonemic complications were avoided due to careful multidisciplinary management which included a detailed antenatal, intrapartum and postnatal plan. Management principles include avoidance of triggers, a low-protein diet and medications which promote the removal of nitrogen by alternative pathways. Triggers include metabolic stress such as febrile illness, particularly gastroenteritis, fasting and any protein loading. In our case the patient, in addition to a restricted protein intake, was prescribed sodium benzoate 4 g four times a day, sodium phenylbutyrate 2 g four times a day and arginine 500 mg four times a day to aid excretion of ammonia and reduce flux through the urea cycle.

  7. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J

    2010-01-01

    The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... complications on early maternal death in a registry-based retrospective cohort study of 782 287 women with a first singleton delivery in Denmark 1978-2007, followed for a median of 14.8 years (range 0.25-30.2) accruing 11.6 million person-years. We employed Cox proportional hazard models of early death from...... and small-for-gestational-age offspring 3.30 [2.25, 4.84]; preterm delivery, small-for-gestational-age offspring and pre-eclampsia 3.85 [2.07, 7.19]. Thus, we conclude that, separately and combined, preterm delivery and small-for-gestational-age are strong markers of early maternal death from both...

  8. Amniotic fluid cathepsin-G in pregnancies complicated by the preterm prelabor rupture of membranes.

    Science.gov (United States)

    Musilova, Ivana; Andrys, Ctirad; Drahosova, Marcela; Soucek, Ondrej; Pliskova, Lenka; Stepan, Martin; Bestvina, Tomas; Maly, Jan; Jacobsson, Bo; Kacerovsky, Marian

    2017-09-01

    The aim of this study was to evaluate the amniotic fluid cathepsin-G concentrations in women with preterm prelabor rupture of membranes (PPROM) based on the presence of the microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). A total of 154 women with singleton pregnancies complicated by PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. Amniotic fluid cathepsin-G concentrations were assessed by ELISA. MIAC was determined using a non-cultivation approach. IAI was defined as an amniotic fluid bedside interleukin-6 concentration ≥ 745 pg/mL. Women with MIAC had higher amniotic fluid cathepsin-G concentrations than women without MIAC (with MIAC: median 82.7 ng/mL, versus without MIAC: median 64.7 ng/mL; p = 0.0003). Women with IAI had higher amniotic fluid cathepsin-G concentrations than women without this complication (with IAI: median 103.0 ng/mL, versus without IAI: median 66.2 ng/mL; p G concentrations than women with colonization (MIAC without IAI) and women without both MIAC and IAI (p G concentrations in pregnancies complicated by PPROM. Amniotic fluid cathepsin-G appears to be a potential marker of IAI.

  9. Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador.

    Science.gov (United States)

    Phoa, K Y N; Chedraui, P; Pérez-López, F R; Wendte, J F; Ghiabi, S; Vrijkotte, T; Pinto, P

    2016-07-01

    Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia.

  10. Fresh look at the doppler changes in pregnancies with placental-based complications

    Directory of Open Access Journals (Sweden)

    S Dikshit

    2011-01-01

    Full Text Available Placental-based complications of pregnancy can be classified as acute and chronic. An example of acute placental complication is abruptio placenta. The chronic placental complications include pregnancy induced hypertension (PIH and idiopathic Intrauterine growth restriction (IUGR. The fetus is at risk for perinatal complications in both acute and chronic conditions. Here we take a look at the natural history of the Doppler parameters in chronic conditions. The techniques used for assessing the fetal well-being include, clinical methods, biophysical tests, conventional ultrasonography, and fetal Doppler studies. Arterial Doppler studies are used to assess the well-being of the fetus and to determine the timing of delivery. However, arterial Dopplers predict only the subset of fetuses at risk of having perinatal complications. Venous Dopplers have been used to improve upon the prognostication. However, by the time the commonly used venous Doppler signs, that is, ′A′ wave reversal in ductus venosus (DV is present, the fetus is likely to be already compromised. The fetus tries to adapt to the environment of deprivation by making a series of changes in the umbilical artery circulation, cerebral circulation, and hepatic circulation. As a result of these adaptations, the fetus overcomes the state of chronic hypoxia. This article takes a look at these changes and also the effect of these adaptations. It is suggested that serial comparisons of the venous flow characteristics of the DV and inferior vena cava (IVC can provide an early indication of the impending decompensation and can be used to predict the time the delivery.

  11. [Triplet pregnancy complicated by intrauterine death of two fetuses--case report].

    Science.gov (United States)

    Teliga-Czajkowska, Justyna; Dadalska, Ewa; Sopliński, Aleksander

    2003-10-01

    Multiple pregnancy still constitutes a difficult therapeutic problem in perinatology. The incidence of this phenomenon describes Hellin's formula: the number of twin pregnancy is 1/n, triplet--1/n 2 etc. Among complications observed in multiple pregnancy intrauterine death of one or more foetuses is not rare. Due to progressive disturbances in haemostasis the risk for a mother and remaining live foetus increases with gestation. The aim of this paper was to present a case report of triplet pregnancy complicated by an intrauterine death of two foetuses. 33 years old patient was diagnosed by ultrasound in the 19th week of her second gestation (1 child) a triplet pregnancy. Three live foetuses were seen then with biometry of about 14/15 gestational week There was one joint placenta on the back uterine wall and two children were sharing an amniotic sac. On the consecutive ultrasound examination the three foetuses were alive, but only one had a biometry for 21st week, two--were slowing down having measurements adequate for 19/20th week. After four weeks on usg the death of two siblings was confirmed (age 19/20 gestational week). One remaining live foetus was according to usg 24 weeks old. The patient was transferred to the II Dept. Even though no disturbances in coagulation were observed, low molecule heparin prophylaxis was introduced. During hospital stay a gestational diabetes was diagnosed well corrected by diet only. Coagulation parameters as well as infection indexes were regularly monitored. The foetal well-being was established by non-stress test, biophysical profile and Doppler vascular flows. After 39 days of hospitalisation an elevation of fibrin degradation products (FDP) was noted so the dosage of low molecule heparin was immediately increased to the therapeutic values. In spite of that FDP still were growing. It was decided to introduce a steroids treatment to accelerate the maturity of foetal lungs. In the 31st week according to usg, after PROM, the

  12. Long-term changes in sexual functions following complicated pregnancies and deliveries

    Directory of Open Access Journals (Sweden)

    Ali Özler

    2013-12-01

    Full Text Available Objective: The aim of this study is to evaluate the effects of complicated pregnancy and delivery (P/D on sexual functions and to determine possible risk factors that affect sexual functions. Methods: Women, who have the history of severe preeclampsia, placenta previa totalis, abruption placentae or postpartum uterine atonia, comprised the study group. The control group was comprised the women matched for age, parity, mode of delivery, vocation, the level of income and education status. Their fear of getting pregnant again and fear of death in the most recent delivery were measured by questionnaires. The Arizona Sexual Experience Scale was used to assess the sexual functions. We compared sexual functions of the women with and without suffering from complicated P/D. Results: Fear of death during the last delivery and fear of getting pregnant again were significantly more intense in the study group (p=0.002 and p<0.001, respectively. The rates of volunteers detected sexual dysfunction in the study and control groups were 55.1% and 38.7%, respectively (p=0.081. Fear of death during the last delivery was found to be significant risk factors for sexual dysfunction (odds ratio [OR] = 1.653; 95% CI = 1.131-2.415; p=0.009. Conclusion: In conclusion, sexual dysfunction rate of women with a history of complicated pregnancy and delivery, was almost equal that of women with a history of health pregnancy and delivery. Fear of death during the last delivery was found to be most important risk factor for sexual dysfunction. J Clin Exp Invest 2013; 4 (4: 429-435

  13. Relaxation Therapy on Fetal Outcomes in Complicated Pregnancies Suffering Sleep Disorders: A Randomized Clinical Trial

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    azar nematollahi

    2016-10-01

    Full Text Available Background: Sleep disorders like snoring, mouth breathing, and insomnia are frequent in pregnancy and studies have shown that poor sleep is linked to obstetric complications. Muscle relaxation technique is an effective method used for improving sleep quality. The purpose of this study was to determine the effect of muscle relaxation technique on fetal outcomes in complicated pregnancies with sleep disorders. Methods: This study was performed as a clinical trial on 160 pregnant women who suffered from preeclampsia and gestational diabetes. The participants filled the Pittsburgh Sleep Quality Index (PSQI in order to measure the quality and patterns of their sleep. The participants with the total score of 5 or more were included in the present study. Intervention group were asked to use muscle relaxation technique twice a week at home for 8 weeks alongside the routine care. Study variables included sleep quality, Apgar scores, birth weight, levels of Interleukin- 6 (IL- 6, as well as umbilical cord PH and PO2. Results: The mean score of PSQI before the intervention was 9.28±4.16 and 9.18±3.06 in the intervention and control groups without a significant difference (P=0.6, respectively. However, PSQI global score of the experimental group was smaller than the control group at the end of the study (P<0.001. Also, birth weight (P=0.04, Apgar score (P=0.01, and umbilical cord blood po2 (P=0.03 and PH (P=0.01 were higher, and IL-6 (P=0.04 was smaller in the experimental group compared to the control group. Conclusion: The results of this study showed that muscle relaxation, as a simple, inexpensive and safe method, can improve the fetal outcomes such as birth weight, Apgar score, cord blood po2, and cord blood PH, and also it leads to lower IL-6 in complicated pregnancies.

  14. Malignant ovarian tumors complicating pregnancy:a clinicopathological study of twenty-one cases

    Institute of Scientific and Technical Information of China (English)

    Zhao Xue-ying; Huang Hui-fang; Lian Li-juan

    2004-01-01

    Objective: To study the clinicopathological characters of malignant ovarian tumors during pregnancy. The rationale for appropriate management was discussed.Methods: Twenty-one cases of malignant ovarian tumors complicating pregnancy treated between 1985 and 2002 were reviewed retrospectively. In reference with the reports from the current literatures, the rationale of the treatment for the best outcome of both mother and child was discussed.Results:In the patients reviewed, 9 were found with malignant germ cell tumors of the ovary, 6 with low malignant potential tumors, 4 with invasive epithelial tumors, and 2 with sex cord-stromal tumors. Sixteen (76.2 %) of the patients diagnosed in stage I, and all had achieved complete response to the treatment. Three of the four patients in advanced stage died, of which two were invasive epithelial cancers and one stage Ⅳ endodermal sinus tumor. All patients had surgery, and fourteen of them got conservative surgery. All sixteen patients accepted for chemotherapy took adjuvant chemotherapies after abortions or deliveries. Fourteen healthy live births were recorded in this group and there were no documented birth defects, but one died of respiratory distress syndrome.Conclusion: The managements of malignant ovarian cancers during pregnancy differed in different histological types. In ovarian borderline tumors and malignant germ cell tumors including stage Ⅰ, Ⅱ, and Ⅲ, surgery can be conservative. For advanced epithelial cancers, aggressive surgery should be instituted. Chemotherapy could be considered for the malignant germ cell tumor during the second and third trimester. Ovarian borderline tumors should not take chemotherapy.Epithelial cancer should be given combination platinum-based chemotherapy. Hysterectomy during pregnancy is rarely indicated unless it contributes significantly to tumor debulking, and pregnancy often could be allowed to continue until near-term.

  15. SUDEP and epilepsy-related mortality in pregnancy.

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    Edey, Stephan; Moran, Nicholas; Nashef, Lina

    2014-07-01

    Although data are limited, research in 2004 estimated a 10-fold increase in mortality in pregnancy in the United Kingdom in women with epilepsy (WWE) compared to women without epilepsy. We highlight epilepsy mortality in pregnancy based on the 2011 report of the United Kingdom Confidential Enquiries into Maternal Deaths, relating its findings to previous reports and epilepsy-rates in pregnancy. Among 2,291,493 maternities (2006-2008), we estimated 0.6% or 13,978 were in WWE. Fourteen deaths were epilepsy-related, of which 11 (79%) were sudden and unexpected (SUDEP). Nine occurred during pregnancy and five were postpartum. Nine (64%) were in women taking lamotrigine, seven as monotherapy. We estimated that 1:1,000 women died from epilepsy (mostly SUDEP) during or shortly after pregnancy. Epilepsy-related mortality is a significant risk in pregnancy. Antiepileptic drug-related factors may be relevant. The high proportion of women taking lamotrigine may reflect United Kingdom prescribing practice. Recent observations from the European and International Registry of Antiepileptic Drugs and Pregnancy (EURAP), whereby women on lamotrigine, the levels of which significantly decrease in pregnancy, had more difficulties with epilepsy control, argue against this being the sole explanation. Given the potential risks, every attempt should be made to prevent seizures, particularly convulsive, during pregnancy and postpartum. This, we believe, includes being proactive in maintaining lamotrigine levels during pregnancy.

  16. S100B protein expression in the amnion and amniotic fluid in pregnancies complicated by pre-eclampsia.

    Science.gov (United States)

    Tskitishvili, E; Komoto, Y; Temma-Asano, K; Hayashi, S; Kinugasa, Y; Tsubouchi, H; Song, M; Kanagawa, T; Shimoya, K; Murata, Y

    2006-12-01

    Our aim was to investigate the expression of S100B protein in the amnion and to assess the amniotic fluid concentration in pregnancies complicated by pre-eclampsia. Samples were obtained from women who developed pre-eclampsia (n = 7), pre-eclampsia with intrauterine growth retardation (IUGR) (n = 4), normotensive IUGR (n = 7) and gestational hypertension (n = 4) during pregnancy and healthy controls who delivered at term (n = 35). To determine the difference in the expression of S100B in the amnion, we performed immunohistochemistry, western blot analysis and RT-PCR. Using enzyme-linked immunosorbent assay (ELISA), we assessed the S100B concentration in amniotic fluid. The S100B mRNA expression in the amnion of pre-eclamptic patients and patients with pre-eclampsia with IUGR was significantly higher than that in the control. The amniotic fluid S100B protein concentration of the pre-eclampsia and normotensive IUGR cases was significantly higher than that of the control. This study shows that amnion could be a source responsible for the increased concentration of S100B in amniotic fluid. In pre-eclampsia, reactive oxygen species (ROS) are generated by oxidative stress. Some pathological conditions that develop during pregnancy and are related to hypoxic stress can affect the elevation of S100B concentration in the amnion.

  17. Successful Vaginal Delivery despite a Huge Ovarian Mucinous Cystadenoma Complicating Pregnancy: A Case Report

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    Dipak Mandi

    2013-12-01

    Full Text Available A 22-year-old patient with 9 months of amenorrhea and a huge abdominal swelling was admitted to our institution with an ultrasonography report of a multiloculated cystic space-occupying lesion, almost taking up the whole abdomen (probably of ovarian origin, along with a single live intrauterine fetus. She delivered vaginally a boy baby within 4 hours of admission without any maternal complication, but the baby had features of intrauterine growth restriction along with low birth weight. On the 8th postpartum day, the multiloculated cystic mass, which arose from the right ovary and weighed about 11 kg, was removed via laparotomy. A mucinous cystadenoma with no malignant cells in peritoneal washing was detected in histopathology examination. This report describes a rare case of a successful vaginal delivery despite a huge cystadenoma of the right ovary complicating the pregnancy.

  18. Pregnancy-related characteristics and breast cancer risk.

    Science.gov (United States)

    Brasky, Theodore M; Li, Yanli; Jaworowicz, David J; Potischman, Nancy; Ambrosone, Christine B; Hutson, Alan D; Nie, Jing; Shields, Peter G; Trevisan, Maurizio; Rudra, Carole B; Edge, Stephen B; Freudenheim, Jo L

    2013-09-01

    Breast tissues undergo extensive physiologic changes during pregnancy, which may affect breast carcinogenesis. Gestational hypertension, preeclampsia/eclampsia, gestational diabetes, pregnancy weight gain, and nausea and vomiting (N&V) during pregnancy may be indicative of altered hormonal and metabolic profiles and could impact breast cancer risk. Here, we examined associations between these characteristics of a woman's pregnancy and her subsequent breast cancer risk. Participants were parous women that were recruited to a population-based case-control study (Western New York Exposures and Breast Cancer Study). Cases (n = 960), aged 35-79 years, had incident, primary, histologically confirmed breast cancer. Controls (n = 1,852) were randomly selected from motor vehicle records (pregnancy experiences. Multivariable-adjusted logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). N&V during pregnancy was inversely associated with breast cancer risk. Relative to those who never experienced N&V, ever experiencing N&V was associated with decreased risk (OR 0.69, 95% CI 0.56-0.84) as were increased N&V severity (p trend pregnancies (p trend pregnancies. Associations were stronger for more recent pregnancies (breast cancer subtype including estrogen receptor and HER2 expression status. Other pregnancy characteristics examined were not associated with risk. We observed strong inverse associations between pregnancy N&V and breast cancer risk. Replication of these findings and exploration of underlying mechanisms could provide important insight into breast cancer etiology and prevention.

  19. 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.

  20. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So

  1. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  2. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  3. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  4. The Salivary Scavenger and Agglutinin (SALSA in Healthy and Complicated Pregnancy.

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    Martin Parnov Reichhardt

    Full Text Available Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. The etiology is not clear, but an immune attack towards components of placenta or fetus has been indicated. This involves activation of the complement system in the placenta. We have previously described the presence of the complement-regulating protein salivary scavenger and agglutinin (SALSA in amniotic fluid. In this study we investigated the potential role of SALSA in pregnancy by analyzing its presence in amniotic fluid and placental tissue during healthy and complicated pregnancies. SALSA levels in amniotic fluid increased during pregnancy. Before 20 weeks of gestation the levels were slightly higher in patients who later developed pre-eclampsia than in gestation age-matched controls. In the placenta of pre-eclamptic patients syncytial damage is often followed by the formation of fibrinoid structures. SALSA was found clustered into these fibrinoid structures in partial co-localization with complement C1q and fibronectin. In vitro analysis showed direct protein binding of SALSA to fibronectin. SALSA binds also to fibrin/fibrinogen but did not interfere with the blood clotting process in vitro. Thus, in addition to antimicrobial defense and epithelial differentiation, the data presented here suggest that SALSA, together with fibronectin and C1q, may be involved in the containment of injured placental structures into fibrinoids.

  5. INTER-ACT: prevention of pregnancy complications through an e-health driven interpregnancy lifestyle intervention - study protocol of a multicentre randomised controlled trial.

    Science.gov (United States)

    Bogaerts, Annick; Ameye, Lieveke; Bijlholt, Margriet; Amuli, Kelly; Heynickx, Dorine; Devlieger, Roland

    2017-05-26

    Excessive maternal pre-pregnancy and gestational weight gain are related to pregnancy- and birth outcomes. The interpregnancy time window offers a unique opportunity to intervene in order to acquire a healthy lifestyle before the start of a new pregnancy. INTER-ACT is an e-health driven multicentre randomised controlled intervention trial targeting women at high risk of pregnancy- and birth related complications. Eligible women are recruited for the study at day 2 or 3 postpartum. At week 6 postpartum, participants are randomised into the intervention or control arm of the study. The intervention focuses on weight, diet, physical activity and mental well-being, and comprises face-to-face coaching, in which behavioural change techniques are central, and use of a mobile application, which is Bluetooth-connected to a weighing scale and activity tracker. The intervention is rolled out postpartum (4 coaching sessions between week 6 and month 6) and in a new pregnancy (3 coaching sessions, one in each trimester of pregnancy); the mobile app is used throughout the two intervention phases. Data collection includes data from the medical record of the participants (pregnancy outcomes and medical history), anthropometric data (height, weight, waist- and hip circumferences, skinfold thickness and body composition by bio-electrical impedance analysis), data from the mobile app (physical activity and weight; intervention group only) and questionnaires (socio-demographics, breastfeeding, food intake, physical activity, lifestyle, psychosocial factors and process evaluation). Medical record data are collected at inclusion and at delivery of the subsequent pregnancy. All other data are collected at week 6 and month 6 postpartum and every subsequent 6 months until a new pregnancy, and in every trimester in the new pregnancy. Primary outcome is the composite endpoint score of pregnancy-induced hypertension, gestational diabetes mellitus, caesarean section, and large

  6. Mid-gestational gene expression profile in placenta and link to pregnancy complications.

    Directory of Open Access Journals (Sweden)

    Liis Uusküla

    Full Text Available Despite the importance of placenta in mediating rapid physiological changes in pregnancy, data on temporal dynamics of placental gene expression are limited. We completed the first transcriptome profiling of human placental gene expression dynamics (GeneChips, Affymetrix®; ~47,000 transcripts from early to mid-gestation (n = 10; gestational weeks 5-18 and report 154 genes with significant transcriptional changes (ANOVA, FDR P<0.1. TaqMan RT-qPCR analysis (n = 43; gestational weeks 5-41 confirmed a significant (ANOVA and t-test, FDR P<0.05 mid-gestational peak of placental gene expression for BMP5, CCNG2, CDH11, FST, GATM, GPR183, ITGBL1, PLAGL1, SLC16A10 and STC1, followed by sharp decrease in mRNA levels at term (t-test, FDR P<0.05. We hypothesized that normal course of late pregnancy may be affected when genes characteristic to mid-gestation placenta remain highly expressed until term, and analyzed their expression in term placentas from normal and complicated pregnancies [preeclampsia (PE, n = 12; gestational diabetes mellitus (GDM, n = 12; small- and large-for-gestational-age newborns (SGA, LGA, n = 12+12]. STC1 (stanniocalcin 1 exhibited increased mRNA levels in all studied complications, with the most significant effect in PE- and SGA-groups (t-test, FDR P<0.05. In post-partum maternal plasma, the highest STC1 hormone levels (ELISA, n = 129 were found in women who had developed PE and delivered a SGA newborn (median 731 vs 418 pg/ml in controls; ANCOVA, P = 0.00048. Significantly higher expression (t-test, FDR P<0.05 of CCNG2 and LYPD6 accompanied with enhanced immunostaining of the protein was detected in placental sections of PE and GDM cases (n = 15. Our study demonstrates the importance of temporal dynamics of placental transcriptional regulation across three trimesters of gestation. Interestingly, many genes with high expression in mid-gestation placenta have also been implicated in adult complex disease, promoting the discussion on

  7. Overweight in epilepsy as a risk factor for pregnancy and delivery complications.

    Science.gov (United States)

    Kolstad, Eivind; Veiby, Gyri; Gilhus, Nils Erik; Bjørk, Marte

    2016-11-01

    To investigate whether prepregnancy overweight in women with epilepsy increases their risk for complications during pregnancy and delivery. This study is based on The Norwegian Mother and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. A diagnosis of epilepsy was reported in 706 pregnancies. Overweight was defined as body mass index ≥ 25 prepregnancy. Overweight women with epilepsy (n = 259) were compared to normal-weight women with epilepsy (n = 416), and to women without epilepsy with and without overweight (n = 30,516 and n = 67,977, respectively). The risks of pregnancy and delivery complications were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for adverse socioeconomic factors, age, parity, and smoking. Women with epilepsy were more often overweight than women without epilepsy (38.4% vs. 31.3%, p < 0.001). The majority of pregnancy and delivery complications were more frequent in overweight women with epilepsy. Compared to overweight women without epilepsy, the risk was increased for cesarean section (OR 1.6, CI 1.2-2.2, p < 0.001), excessive bleeding (OR 1.4, CI 1.0-1.8, p = 0.04), peripartum anxiety and depressive symptoms (OR 1.9, CI 1.3-2.8, p < 0.001), small for gestational age children (OR 2.4, CI 1.2-4.8, p = 0.02), and transfer of the infant to a neonatal ward (OR 1.5, CI 1.1-2.2, p = 0.02). Compared to normal-weight women with epilepsy, the risk of cesarean section (OR 1.6, CI 1.1-2.3, p < 0.05), gestational hypertension (OR 2.0, CI 1.1-3.5, p < 0.05), preeclampsia (OR 2.3, CI 1.2-4.5, p < 0.05), and transfer of the infant to a neonatal ward (OR 2.2, CI 1.3-3.6, p < 0.01) was increased. Prepregnancy overweight in combination with epilepsy entails a strong negative effect on risk of complications during pregnancy and delivery. In women with epilepsy and overweight referral to a nutritionist should be considered when an antiepileptic drug is started as well as

  8. MRI findings in multifetal pregnancies complicated by twin reversed arterial perfusion sequence (TRAP)

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Carolina V.A.; Kline-Fath, Beth M.; Linam, Leann E.; Calvo Garcia, Maria A.; Rubio, Eva I. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Division of Pediatric Surgery, Cincinnati, OH (United States)

    2011-06-15

    Twin reversed arterial perfusion sequence (TRAP) is a rare complication in multifetal monochorionic pregnancies in which a normal ''pump'' twin provides circulation to an abnormal acardiac co-twin, resulting in high-output cardiac dysfunction in the pump twin. To define fetal MRI findings of TRAP sequence. Fetal MR images were retrospectively reviewed in 35 pregnancies complicated by TRAP sequence. Abnormalities of the pump twin, acardiac twin, umbilical cord, placenta and amniotic fluid were reviewed. Acardiac twins were classified as: acephalus (51%), anceps (40%), amorphus (9%), acormus (0%). Common findings in acardiac twins include subcutaneous edema (77%), absent cardiac structures (86%), absent or abnormal thoracic cavity (100%), abnormal abdominal organs (100%), superior limbs absent (46%) or abnormal (51%), and inferior limbs present but abnormal (83%). There were pump twin findings of cardiac dysfunction in 43% and intracranial ischemic changes in 3%. Umbilical cord anomalies were present in 97%. Acardiac twins present with a predictable pattern of malformation with poorly developed superior structures, more normally formed inferior structures and absent or rudimentary heart. Although usually absent, abnormal heart structures can be seen and do not exclude TRAP sequence. Pump twins are commonly normal with exception of findings of cardiac dysfunction and possible brain ischemia. (orig.)

  9. Downregulation of notch signaling pathway in late preterm and term placentas from pregnancies complicated by preeclampsia.

    Directory of Open Access Journals (Sweden)

    Persefoni Fragkiadaki

    Full Text Available Preeclampsia (PE is a major cause of maternal mortality and morbidity, affecting 3-5% of all pregnancies. The Notch signaling pathway plays an important role during placental development, activating several target genes. Defects in the Notch pathway have adverse effect on placentation. The aim of this study was to investigate the expression of receptors NOTCH1,-2,-3,-4, ligands DLL1,-3,-4, JAG1,-2 and target genes HEY1,-2 in placental tissue samples from 20 late preterm or term pregnancies complicated by PE versus 20 normal pregnancies. mRNA levels of the studied molecules were measured by quantitative Real-Time PCR (qRT-PCR, while the protein expression of the intracellular domain of NOTCH2 (NICD2 and NOTCH3 (NICD3 was measured by Western Blot (WB. qRT-PCR analysis revealed that NOTCH1, NOTCH4 and DLL1 were not expressed in the placenta. On the contrary, NOTCH2, NOTCH3, DLL3, DLL4, JAG1, JAG2, HEY1 and HEY2 mRNA levels were downregulated in PE samples vs. controls (p<0.01. WB confirmed that NICD2 (p = 0.014 and NICD3 (p<0.001 protein levels were also lower in PE specimens. Statistical analysis revealed several significant associations: of NOTCH3 mRNA expression with smoking during pregnancy (p = 0.029, of NICD3 protein levels (p = 0.028 and DLL3 mRNA levels (p = 0.041 with birth weight centile, and of HEY2 transcript levels with parity (p = 0.034 and mode of delivery (p = 0.028. Our results suggest that Notch pathway downregulation is associated with PE. Further studies are required in order to determine the role of these molecules in PE pathogenesis and to evaluate their potential use for the early detection and treatment of PE.

  10. Downregulation of Notch Signaling Pathway in Late Preterm and Term Placentas from Pregnancies Complicated by Preeclampsia

    Science.gov (United States)

    Fragkiadaki, Persefoni; Soulitzis, Nikolaos; Sifakis, Stavros; Koutroulakis, Demetrios; Gourvas, Victor; Vrachnis, Nikolaos; Spandidos, Demetrios A.

    2015-01-01

    Preeclampsia (PE) is a major cause of maternal mortality and morbidity, affecting 3–5% of all pregnancies. The Notch signaling pathway plays an important role during placental development, activating several target genes. Defects in the Notch pathway have adverse effect on placentation. The aim of this study was to investigate the expression of receptors NOTCH1,-2,-3,-4, ligands DLL1,-3,-4, JAG1,-2 and target genes HEY1,-2 in placental tissue samples from 20 late preterm or term pregnancies complicated by PE versus 20 normal pregnancies. mRNA levels of the studied molecules were measured by quantitative Real-Time PCR (qRT-PCR), while the protein expression of the intracellular domain of NOTCH2 (NICD2) and NOTCH3 (NICD3) was measured by Western Blot (WB). qRT-PCR analysis revealed that NOTCH1, NOTCH4 and DLL1 were not expressed in the placenta. On the contrary, NOTCH2, NOTCH3, DLL3, DLL4, JAG1, JAG2, HEY1 and HEY2 mRNA levels were downregulated in PE samples vs. controls (p<0.01). WB confirmed that NICD2 (p = 0.014) and NICD3 (p<0.001) protein levels were also lower in PE specimens. Statistical analysis revealed several significant associations: of NOTCH3 mRNA expression with smoking during pregnancy (p = 0.029), of NICD3 protein levels (p = 0.028) and DLL3 mRNA levels (p = 0.041) with birth weight centile, and of HEY2 transcript levels with parity (p = 0.034) and mode of delivery (p = 0.028). Our results suggest that Notch pathway downregulation is associated with PE. Further studies are required in order to determine the role of these molecules in PE pathogenesis and to evaluate their potential use for the early detection and treatment of PE. PMID:25962154

  11. Outcomes in Critically Ill Patients with Cancer-Related Complications

    Science.gov (United States)

    Torres, Viviane B. L.; Vassalo, Juliana; Silva, Ulysses V. A.; Caruso, Pedro; Torelly, André P.; Silva, Eliezer; Teles, José M. M.; Knibel, Marcos; Rezende, Ederlon; Netto, José J. S.; Piras, Claudio; Azevedo, Luciano C. P.; Bozza, Fernando A.; Spector, Nelson; Salluh, Jorge I. F.; Soares, Marcio

    2016-01-01

    Introduction Cancer patients are at risk for severe complications related to the underlying malignancy or its treatment and, therefore, usually require admission to intensive care units (ICU). Here, we evaluated the clinical characteristics and outcomes in this subgroup of patients. Materials and Methods Secondary analysis of two prospective cohorts of cancer patients admitted to ICUs. We used multivariable logistic regression to identify variables associated with hospital mortality. Results Out of 2,028 patients, 456 (23%) had cancer-related complications. Compared to those without cancer-related complications, they more frequently had worse performance status (PS) (57% vs 36% with PS≥2), active malignancy (95% vs 58%), need for vasopressors (45% vs 34%), mechanical ventilation (70% vs 51%) and dialysis (12% vs 8%) (P<0.001 for all analyses). ICU (47% vs. 27%) and hospital (63% vs. 38%) mortality rates were also higher in patients with cancer-related complications (P<0.001). Chemo/radiation therapy-induced toxicity (6%), venous thromboembolism (5%), respiratory failure (4%), gastrointestinal involvement (3%) and vena cava syndrome (VCS) (2%) were the most frequent cancer-related complications. In multivariable analysis, the presence of cancer-related complications per se was not associated with mortality [odds ratio (OR) = 1.25 (95% confidence interval, 0.94–1.66), P = 0.131]. However, among the individual cancer-related complications, VCS [OR = 3.79 (1.11–12.92), P = 0.033], gastrointestinal involvement [OR = 3.05 (1.57–5.91), P = <0.001] and respiratory failure [OR = 1.96(1.04–3.71), P = 0.038] were independently associated with in-hospital mortality. Conclusions The prognostic impact of cancer-related complications was variable. Although some complications were associated with worse outcomes, the presence of an acute cancer-related complication per se should not guide decisions to admit a patient to ICU. PMID:27764143

  12. Pregnancy related listeriosis: treatment and control.

    Science.gov (United States)

    Allerberger, Franz; Huhulescu, Steliana

    2015-03-01

    Listeriosis during pregnancy usually presents as an unremarkable febrile illness in the mother but can be fatal for the fetus and newborn. Reliable laboratory testing for early diagnosis is lacking. Serological antibody tests and bacteriological stool tests are not helpful since Listeria-specific antibodies and stool cultures yielding the organism can be found in healthy pregnant women. Because early diagnosis is difficult, diagnosis is usually made by culturing the pathogen from blood, cerebrospinal fluid, placenta or meconium. The mortality rate for fetal and newborn listeriosis remains approximately 20%. Two to three cases of pregnancy-associated listeriosis are reported annually in Austria among approximately 79,000 births, 20-30 cases are reported annually in Germany among approximately 680,000 births and 50-100 cases are reported annually in the USA among approximately 4 million births. Although Listeria infections in pregnancy are rare, they should be considered as a cause of fever of unknown origin during pregnancy.

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

    Institute of Scientific and Technical Information of China (English)

    赵梅

    2011-01-01

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

  14. Hemodialysis among pregnancy related acute kidney injury patients: A single center experience in North-Western Nigeria.

    Science.gov (United States)

    Makusidi, A M; Liman, H M; Yakubu, A; Hassan, M; Isah, M D; Chijioke, A

    2016-09-01

    Pregnancy related acute kidney injury (PRAKI) patients that underwent hemodialysis (HD) between May 2007 and April 2015 were studied with specific reference to clinical features, laboratory values, duration of pregnancy at the diagnosis of acute kidney injury and outcome. It involved 38 patients aged between 15 and 30 years. The main clinical features were fever, edema and oliguria. The leading etiological factors included ante/postpartum hemorrhage, septic abortion, and toxemia of pregnancy. The majority of cases occurred during the third trimester. PRAKI is a dreaded complication of pregnancy with high morbidity and mortality. HD improved patient survival in our study.

  15. Color-dye injection of monochorionic placentas and correlation with pregnancy complications.

    Science.gov (United States)

    Lanna, Mariano Matteo; Consonni, Dario; Faiola, Stefano; Schena, Vito; Ratti, Martina; Ferrazzi, Enrico; Rustico, Maria Angela

    2015-10-01

    Vascular anastomoses in monochorionic (MC) twin placenta can be easily identified with color-dye injection. The aim of this study is to analyze the relationship between different type of anastomoses and twin pregnancy complications. From January 2011 to October 2014, MC placentas were analyzed with color-dye injection and five group of pregnancies were identified: those that were not complicated (NC), those complicated with selective intrauterine growth restriction (sIUGR), twin-twin transfusion syndrome (TTTS), or twin anemia-polycitemia sequence (TAPS) and those with amniotic fluid discordance (AFD) between twins. Cases of TTTS treated with endoscopic laser coagulation of placenta anastomoses or cases with in utero death of one twin were excluded. A total of 118 MC placentas were observed, 58 (49%) NC, 35 (30%) sIUGR, 10 (8%) TTTS, 13 (11%) AFD and 2 (2%) TAPS. The median number of anastomoses was 7 (range 1-15), 8 (2-18), 4 (2-11), 7 (2-13) and 1 (1-1), respectively. At least one artero-venous anastomoses was found in the placenta observed, while the prevalence of artero-arterial anastomoses was 95% for NC, 91% for sIUGR, 60% for TTTS, and 77% for AFD; no TAPS placenta had this type of anastomoses. The diameter of arteroarterial anastomoses was greater in the AFD group (3.3 mm), compared to the NC, sIUGR and TTTS groups (2.3, 2.5 and 1.4 respectively, p 0.04). In this large serie of MC placenta analyzed with color-dye injection, a specific distribution of anastomoses emerged for twins with amniotic fluid discordance, which points to a need for intensive surveillance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. MATERNAL AND FOETAL OUTCOME IN PREGNANCIES COMPLICATED WITH HYPOTHYROIDISM IN PUNJABI WOMEN

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    Manikant Singla

    2016-07-01

    Full Text Available Pregnancy is a state that places great physiological stress on both the mother and the foetus. When pregnancy is compounded by endocrine disorders such as hypothyroidism, the potential for maternal and foetal adverse outcomes can be immense. OBJECTIVE We performed a study to know the incidence of hypothyroidism in Punjab and to know the various maternal and foetal complications associated with it. MATERIAL AND METHODS A retrospective study was performed on pregnant patients delivered between 2010-2014 in Dayanand Medical College and Hospital, Ludhiana. The patients were evaluated for antenatal, intrapartum and postpartum maternal and foetal complications, period of gestation at delivery, mode of delivery and neonatal outcome. RESULTS Out of total 5400 pregnant women who delivered at DMCH, Ludhiana, 189 (3.5% women were hypothyroid. History of spontaneous abortions was present in 54 (28.57% women and gestational hypertension was present in 22 (11.64% women. Preterm rupture of membrane was present in 18 (9.52% women. GDM was present in 9 (4.76% women and oligohydramnios was present in 14 (7.40% women. Caesarean section was done in 37 (46.56% women, out of which 37 (19.58% had foetal distress. There were 94 (49.74% women who delivered between 33-37 wks. gestation. PPH was present in 8 (4.23% women. There were 87 (46.03% babies who were having low birth weight and there were 6 (3.17% neonatal deaths. There were 8 (4.23% still births. CONCLUSION As hypothyroidism is associated with various maternal and foetal complications, proper diagnosis and treatment should be done.

  17. Pregnancy in the Setting of Asymptomatic Non-Cirrhotic Chronic Portal Vein Thrombosis Complicated by Pre-Eclampsia

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    Işık Üstüner

    2013-01-01

    Full Text Available Portal vein thrombosis (PVT can be chronic or acute in nature; it is characterized by a thrombus formation in the main portal vein and/or its right or left branches. Herein, we present a 36-year-old woman with asymptomatic noncirrhotic chronic PVT who developed preeclampsia in the later stage of pregnancy. This report will emphasize the clinical differential diagnosis, outcome, and management of pregnancies complicated by noncirrhotic PVT.

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

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

    1979-09-01

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

  19. Poor Vitamin C Status Late in Pregnancy Is Associated with Increased Risk of Complications in Type 1 Diabetic Women: A Cross-Sectional Study

    DEFF Research Database (Denmark)

    Juhl, Bente; Lauszus, Finn Friis; Lykkesfeldt, Jens

    2017-01-01

    of 26.6 μmol/L, respectively, and the umbilical cord blood vitC level (mean (SD)): 101.0 μmol/L (16.6) versus 78.5 μmol/L (27.8), p = 0.02; n = 12/16), while no relation to birth weight or Apgar score was observed. Diabetic women with complications of pregnancy had significantly lower vitC levels...

  20. A novel epsilon gamma delta beta thalassemia presenting with pregnancy complications and severe neonatal anemia.

    Science.gov (United States)

    Shalev, Hanna; Landau, Daniela; Pissard, Serge; Krasnov, Tanya; Kapelushnik, Joseph; Gilad, Oded; Broides, Arnon; Dgany, Orly; Tamary, Hannah

    2013-02-01

    The epsilon gamma delta beta (εγδβ)-thalassemias are rare sporadic disorders caused by deletion of the β-globin gene cluster. The main clinical feature is marked prenatal and neonatal anemia that resolves spontaneously within a few months. Reports originating mainly from Europe have so far identified 30 such deletions The aim of the present work was to describe a novel 1.78-Mb deletion, the longest ever reported, and to detail the clinical features in 12 members of an extended Bedouin family. The deletion was identified by globin gene multiplex ligation-dependent probe amplification (MLPA) of the β-globin cluster and further characterized by comparative genomic hybridization. Past and present clinical and laboratory data of ten symptomatic and two asymptomatic patients were collected. A 1.78-Mb εγδβ-deletion, the largest ever described, was identified in all patients. Although other genes were included in the deletion, no other symptoms were observed. Of the ten symptomatic fetuses and neonates, three died of the disease. The remainder required packed cell transfusions during the first months of life. Pregnancy complications included intrauterine growth restriction and oligohydramnios, as well as additional neonatal complications including prematurity and persistent pulmonary hypertension of the neonate. We suggest that εγδβ-thalassemia be added to the list of hemoglobinopathies that can cause neonatal anemia and that MLPA of the β-globin cluster be used to confirm its diagnosis. Careful surveillance during pregnancy is important to reduce neonatal mortality and morbidity, especially given the dramatic improvement that occurs later. © 2012 John Wiley & Sons A/S.

  1. Aspirin: The Mechanism of Action Revisited in the Context of Pregnancy Complications

    Science.gov (United States)

    Cadavid, Angela P.

    2017-01-01

    Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS). The most recognized mechanism of action of aspirin is to inhibit the synthesis of prostaglandins but this by itself does not explain the repertoire of anti-inflammatory effects of aspirin. Later, another mechanism was described: the induction of the production of aspirin-triggered lipoxins (ATLs) from arachidonic acid by acetylation of the enzyme cyclooxygenase-2. The availability of a stable analog of ATL has stimulated investigations on the use of this analog and it has been found that, similar to endogenously produced lipoxins, ATL resolves inflammation and acts as antioxidant and immunomodulator. If we consider that in PE and in the obstetric APS, there is an underlying inflammatory process, aspirin might be used based on the induction of ATL. The objective of this review is to revisit the old and new mechanisms of action of aspirin. In particular, it intends to show other potential uses of this drug to prevent certain pregnancy complications in the light of its ability to induce anti-inflammatory and pro-resolving lipid-derived mediators. PMID:28360907

  2. Association between primary Sjögren's syndrome and pregnancy complications: a systematic review and meta-analysis.

    Science.gov (United States)

    Upala, Sikarin; Yong, Wai Chung; Sanguankeo, Anawin

    2016-08-01

    Systemic autoimmune disorders may interfere with normal reproductive function resulting in negative outcome of pregnancy. Primary Sjögren's syndrome (pSS) is a common rheumatic disease that mostly affects females. There are many reports that this condition may increase risk of pregnancy complications and fetal loss. However, data regarding these adverse outcomes are scarce and inconclusive. We performed a systematic review and meta-analysis of available articles that assess the association between pSS and adverse pregnancy outcome. We comprehensively searched the databases of MEDLINE and EMBASE from their dates of inception to March 2016 and reviewed papers with validity criteria. A random-effects model was used to evaluate pregnancy complications in patients with pSS and healthy controls. From 20 full-text articles, 7 studies involving 544 patients and 1586 pregnancies were included in the meta-analysis. Fetal complications included spontaneous abortion, stillbirth, neonatal deaths, and intrauterine growth retardation. Compared with healthy pregnancy, patients with pSS had significantly higher chance of neonatal deaths (pooled odds ratio (OR) = 1.77, 95 % confidence interval (CI) 1.28 to 1.46, p = 0.01). However, there were no significant associations between pSS and premature birth (OR = 2.10, 95 % CI 0.59-7.46, p = 0.25), spontaneous abortion (OR = 1.46, 95 % CI 0.72-2.93, p = 0.29), artificial abortion (OR = 1.12, 95 % CI 0.52-2.61, p = 0.71), or stillbirth (OR = 1.05, 95 % CI 0.38-2.97, p = 0.92). There is an increased risk of fetal loss in pregnant patients with pSS. The presented evidence further supports multidisciplinary care for these patients to prevent complications during pregnancy.

  3. Fetal volume measurements with three dimensional ultrasound in the first trimester of pregnancy, related to pregnancy outcome, a prospective cohort study

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    Smeets Nicol AC

    2012-05-01

    Full Text Available Abstract Background First trimester growth restriction is associated with an increased risk of adverse birth outcomes (preterm birth, low birth weight and small for gestational age at birth. The differences between normal and abnormal growth in early pregnancy are small if the fetal size is measured by the crown-rump-length. Three-dimensional ultrasound volume measurements might give more information about fetal development than two-dimensional ultrasound measurements. Detection of the fetus with a small fetal volume might result in earlier detection of high risk pregnancies and a better selection of high risk pregnancies. Methods A prospective cohort study, performed at the Máxima Medical Centre, in Eindhoven-Veldhoven, the Netherlands. During the routine first trimester scan with nuchal translucency measurement 500 fetal volumes will be obtained. The gestational age is based on the first day of the last menstrual period in a regular menstrual cycle and by the crown-rump-length. The acquired datasets are collected and stored on a hard disk for offline processing and volume calculation. The investigator who performs the volume measurements is blinded for the results of the first trimester scan. The manual mode will be used to outline the Region Of Interest, the fetal head and rump, in all cross sections. The fetal volumes are calculated with a rotational step of 9°. First, the relation between fetal volume and gestational age, for a set of participants with normal pregnancies (training set, will be assessed. This model will then be used to determine expected values of fetal volume for a normal pregnancy, which will be referred to as expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (together defined as validation set, the observed fetal volumes (FVobserved are compared with their expected normal values (FVexpected and expressed as a percentage of the

  4. Feto-maternal outcomes of pregnancy complicated by Krukenberg tumor: a systematic review of literature.

    Science.gov (United States)

    Kodama, Michiko; Moeini, Aida; Machida, Hiroko; Blake, Erin A; Grubbs, Brendan H; Matsuo, Koji

    2016-09-01

    Krukenberg tumor is a rare type of ovarian cancer with a poor prognosis, and little is known about its behavior during pregnancy. A systematic review was conducted to identify pregnancies complicated by Krukenberg tumor, correlated to oncologic and neonatal outcomes (n = 35). Mean age of cases was 30.4 years, and the most common origin of primary cancer was the stomach (68.6 %) followed by the colon (14.3 %). The two most common presenting symptoms were abdominal/pelvic pain (51.4 %) and nausea/vomiting (48.6 %). Two-thirds of tumors were bilateral (65.7 %) and the average size was 16.7 cm. Ascites (45.7 %), carcinomatosis (25.7 %) and non-ovarian distant metastases (14.3 %) were found at the time of surgery. Chemotherapy was administered in 20 cases, with fetal exposure in two of these. The ovarian tumor was identified prior to the primary cancer diagnosis in all 28 cases. The overall number of live births was 27 (81.8 %). The median survival was 6 months after Krukenberg tumor diagnosis. In univariate analysis, decreased overall survival was associated with dyspnea, ascites, carcinomatosis, non-radical surgery for the primary cancer, and residual disease at surgery (all, p < 0.05). On multivariate analysis, dyspnea and carcinomatosis remained independent prognostic factors for decreased overall survival after Krukenberg tumor diagnosis (2-year overall survival rates, dyspnea 0 vs. 56.6 %, adjusted-hazard ratio [HR] 9.74, 95 % confidence interval [CI] 2.04-46.2, p < 0.01; and carcinomatosis, 0 vs. 58.1 %, adjusted-HR 7.95, 95 % CI 1.76-36.0, p < 0.01). Our results showed that prognosis of Krukenberg tumor complicated pregnancies is extremely poor, however it may be improved if radical surgery is achievable.

  5. 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.

  6. Foetal outcome and frequency of seizure occurrence in epilepsy complicating pregnancy: a cross-sectional study from Madurai, India

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    Indumathi Sivaji

    2015-03-01

    Full Text Available Background Epilepsy during pregnancy is a complicated situation for the mother and the baby. It is also a major therapeutic challenge because most of the drugs treating epilepsy have adverse effects on the growing foetus. The main aim of the study was to evaluate the effect of epilepsy on pregnancy, the fetal outcome and frequency of seizure occurrence among pregnant women. Methods Epileptic patients admitted in department of Obstetrics and Gynecology (OBG, GRH, Madurai, Tamilnadu, was considered. Detailed obstetric history was recorded. History of seizures (age of onset, type, disease free interval, and history of status epilepticus were also obtained. Results Majority of the epileptic mothers newborns birth weight was between 2.5 -3 kg. followed by 2.49 kg, >3 kg and <2 kg. 94.6% of the babies had good 1 min Apgar score and 93.2% of the babies had good 5 min Apgar score. Increase in frequency of seizures occurrence were observed in 16(21.3% of cases. Conclusion Fetal outcome was relatively good among pregnant epileptic mothers in majority of the cases. Special importance should be given disease free interval and frequency of seizures. Regular intake of antiepileptic drug and more frequent antenatal visits should be continued.

  7. 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.

  8. 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.

  9. The change and significance of platelet parameters and blood coagulation function index in patients with hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    Yu-Xia Shi; Yi-Xin Yang; Qian Xu; Yanhua Zhu

    2015-01-01

    Objective:To explore the change and significance of platelet parameters and blood coagulation function index in patients with hypertensive disorder complicating pregnancy.Methods: Chose 89 patients with HDCP, they were set as HDCP group, chose another 60 cases health late pregnancy women and 42 cases non pregnant female, they were set as late pregnant group and non-pregnant control group, detected the platelet parameters: the average blood platelet count (PLT), platelet volume (MPV), platelet distribution width (PDW) and blood coagulation indexes, plasma prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), D-dimer (D-D), activated partial blood coagulation time (APTT) live enzymes in three groups.Results: (1) Compared with the non-pregnant group and late pregnant group, PLT was significantly lower, while the MPV and PDW were significantly higher in HDCP group; PLT in late pregnant group was significantly lower than that in non-pregnant group, and there were no significantly difference of MPV and PDW in the two groups; (2) Compared with the non-pregnant group and late pregnant group, PT and APTT levels were significantly lower, while FIB and D-D were significantly higher in HDCP group; The level of PT and APTT in late pregnant group were significantly lower, and FIB and D-D levels were significantly higher than that in non-pregnant group, However, The level of TT were no statistical significance difference among the three groups.Conclusion: HDCP existence phenomenon of platelet activation and apparent high coagulation state, dynamic detection of HDCP patients platelet parameters and blood coagulation indexes to prevent related complications, improve obstetrics safety is of great significance.

  10. Mid-trimester maternal ADAM12 levels differ according to fetal gender in pregnancies complicated by preeclampsia.

    Science.gov (United States)

    Myers, Jenny E; Thomas, Grégoire; Tuytten, Robin; Van Herrewege, Yven; Djiokep, Raoul O; Roberts, Claire T; Kenny, Louise C; Simpson, Nigel A B; North, Robyn A; Baker, Philip N

    2015-02-01

    An overrepresentation of adverse pregnancy outcomes has been observed in pregnancies associated with a male fetus. We investigated the association between fetal gender and candidate biomarkers for preeclampsia. Proteins were quantified in samples taken at 20 weeks from women recruited to the SCreening fOr Pregnancy Endpoints (SCOPE) study (preeclampsia n = 150; no preeclampsia n = 450). In contrast to placental growth factor, soluble endoglin, and insulin-like growth factor acid labile subunit, levels of metallopeptidase domain 12 (ADAM12) at 20 weeks were dependent on fetal gender in pregnancies complicated by preeclampsia, for male (n = 73) fetuses the multiples of the median (MoM; interquartile range [IQR] 1.1-1.5) was 1.3, whereas for female fetuses (n = 75) MoM was 1.1 (1.0-1.3); P preeclampsia using ADAM12 levels was improved for pregnancies associated with a male fetus (area under receiver-operator curve [AUC] 0.73 [95% confidence interval [CI] 0.67-0.80]) than that of a female fetus (AUC 0.62 [0.55-0.70]); P = .03. The data presented here fit a contemporary hypothesis that there is a difference between the genders in response to an adverse maternal environment and suggest that an alteration in ADAM12 may reflect an altered placental response in pregnancies subsequently complicated by preeclampsia. © The Author(s) 2014.

  11. Morphological Characteristics of Placental Complex in Pregnant Women without Complications in Pregnancy and in the Presence of Severe Preeclampsia

    Science.gov (United States)

    Umbetov, Turakbai Zh.; Berdalinova, Akzhenis K.; Tusupkalieyv, Akylbek B.; Koishybayev, Arip K.; Zharilkasynov, Karaman Ye.

    2016-01-01

    According to the WHO data, preeclampsia develops during late pregnancy in 2-8% of women. Preeclampsia is a major cause of maternal and perinatal morbidity and mortality, therefore, the study of the morphological features of placental complex, taking into account gestational complications in postpartum women with severe preeclampsia is an important…

  12. Are Postprandial Bile Acid Levels Helpful in Predicting Perinatal Complications in Patients with Intrahepatic Cholestasis of Pregnancy?

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    Kudret Erkenekli

    2015-06-01

    Results: Gestational diabetes and preterm delivery occurred more frequently in patients with intrahepatic cholestasis of pregnancy patients. The rate of primary cesarean delivery was more common in in patients with intrahepatic cholestasis of pregnancy patients. The rate of growth-restricted infants was higher in the patients who received ursodeoxycholic acid. Nenoatal intensive care unit admissions and overall neonatal complications, as well as spontaneous preterm deliveries, were similar among in patients with intrahepatic cholestasis of pregnancy regardless of ursodeoxycholic acid therapy. In the receiver operating characteristic analysis, the area under curve values for postprandial and fasting bile acids to predict neonatal complications were 0.64 and 0.70, respectively. Conclusion: Intrahepatic cholestasis of pregnancy patients increases certain perinatal complications, such as preterm deliveries and neonatal morbidity. Postprandial serum bile acid levels are inferior to fasting serum bile acid levels in the prediction of obstetric complications. ursodeoxycholic acid does not seem to improve perinatal outcomes. [Cukurova Med J 2015; 40(2.000: 212-220

  13. Perinatal survival and procedure-related complications after intrauterine transfusion for red cell alloimmunization.

    Science.gov (United States)

    Deka, Dipika; Dadhwal, Vatsla; Sharma, Aparna K; Shende, Unnati; Agarwal, Sumita; Agarwal, Ramesh; Vanamail, Perumal

    2016-05-01

    To study the perinatal survival and procedure-related (PR)complications after intrauterine transfusions in red cell alloimmunization. Prospective data of 102 women with Rh-alloimmunized pregnancy undergoing intrauterine intravascular transfusion for fetal anemia, from January 2011 to October 2014 were analyzed. Main outcome measures were perinatal survival and procedure-related (PR) complications. A total of 303 intrauterine transfusions were performed in 102 women. Of 102 fetuses, 22 were hydropic at first transfusion. The mean period of gestation and hematocrit at first transfusion was 26.9 ± 3.3 weeks (range 19.7-33.8 weeks) and 17 ± 7.82 % (range 5.7-30 %), respectively. Average number of transfusions was 2.97 (range 1-7) per patient. Overall survival was 93 % and mean period of gestation at delivery was 34.5 ± 1.94 (range 28.3-37.4) weeks. Mean hematocrit at delivery was 36.9 ± 8.77 % (range 10-66 %). Fetal death occurred in four cases (3PR), neonatal death occurred in three cases (2PR). Emergency cesarean delivery after transfusion was performed in four pregnancies. The total PR complication rate was 2.97 %, resulting in overall PR loss in 1.65 % per procedure. Our results compare favorably with other studies published in the literature. Intravascular transfusion is a safe procedure improving perinatal survival in fetuses with anemia due to Rh-alloimmunization.

  14. Improving the accuracy of maternal mortality and pregnancy related death.

    Science.gov (United States)

    Schaible, Burk

    2014-01-01

    Comparing abortion-related death and pregnancy-related death remains difficult due to the limitations within the Abortion Mortality Surveillance System and the International Statistical Classification of Diseases and Related Health Problems (ICD). These methods lack a systematic and comprehensive method of collecting complete records regarding abortion outcomes in each state and fail to properly identify longitudinal cause of death related to induced abortion. This article seeks to analyze the current method of comparing abortion-related death with pregnancy-related death and provide solutions to improve data collection regarding these subjects.

  15. Relationship between expression of hepatocyte grow factor and apoptosis of trophoblasts in hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    OUYANG Shan; QIAO Fuyuan; ZHANG Qinghua

    2007-01-01

    The aim of this study was to investigate the expression of hepatocyte growth factor(HGF)and Fas in placentas of uncomplicated pregnant women and those with hypertensive disorder complicating pregnancy(HDCP),and elucidate the possible relationship between HGF and apoptosis of trophoblasts.Reverse transcription-polymerase chain reaction(RT-PCR)was undertaken to examine the concentration of HGF mRNA and Fas mRNA obtained from 34 cases of HDCP and 30 cases of uncomplicated pregnancy.The expression of HGF mRNA in mild preeclampsia,severe preeclampsia and eclampsia cases was significantly lower than that in the uncomplicated cases(0.43±0.12,0.38±0.09,0.19±0.17 versus 0.67±0.19,P<0.05),while the expression of Fas mRNA in mild preeclampsia,severe preeclampsia and eclampisa cases was significantly higher than that in the uncomplicated cases(1.58±0.26,2.96±0.14,5.98±1.17versus 1.01±0.36,P<0.05).For HGF mRNA and Fas mRNA,there was no difference between gestational hypertension cases and control cases.Decreased HGF mRNA or increased Fas mRNA was found along with the progress of HDCP.Negative correlation was found between the expressions of HGF and Fas.These results indicate that HGF inhibits the apoptosis mediated by Fas,and the reduced expression of HGF in HDCP may be responsible for the apoptosis of trophoblasts.

  16. Impact of Scotland's smoke-free legislation on pregnancy complications: retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Daniel F Mackay

    Full Text Available BACKGROUND: Both active smoking and environmental tobacco smoke exposure are associated with pregnancy complications. In March 2006, Scotland implemented legislation prohibiting smoking in all wholly or partially enclosed public spaces. The aim of this study was to determine the impact of this legislation on preterm delivery and small for gestational age. METHODS AND FINDINGS: We conducted logistic regression analyses using national administrative pregnancy data covering the whole of Scotland. Of the two breakpoints tested, 1 January 2006 produced a better fit than the date when the legislation came into force (26 March 2006, suggesting an anticipatory effect. Among the 716,941 eligible women who conceived between August 1995 and February 2009 and subsequently delivered a live-born, singleton infant between 24 and 44 wk gestation, the prevalence of current smoking fell from 25.4% before legislation to 18.8% after legislation (p<0.001. Three months prior to the legislation, there were significant decreases in small for gestational age (-4.52%, 95% CI -8.28, -0.60, p = 0.024, overall preterm delivery (-11.72%, 95% CI -15.87, -7.35, p<0.001, and spontaneous preterm labour (-11.35%, 95% CI -17.20, -5.09, p = 0.001. In sub-group analyses, significant reductions were observed among both current and never smokers. CONCLUSIONS: Reductions were observed in the risk of preterm delivery and small for gestational age 3 mo prior to the introduction of legislation, although the former reversed partially following the legislation. There is growing evidence of the potential for tobacco control legislation to have a positive impact on health.

  17. Pattern of secretion of pregnancy-associated plasma protein-A (PAPP-A) during pregnancies complicated by fetal aneuploidy, in vivo and in vitro.

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    Leguy, Marie Clémence; Brun, Stephanie; Pidoux, Guillaume; Salhi, Houria; Choiset, Agnes; Menet, Marie Claude; Gil, Sophie; Tsatsaris, Vassilis; Guibourdenche, Jean

    2014-12-28

    Pregnancy-associated placental protein-A (PAPP-A) is a metalloprotease which circulates as an hetero-tetramer in maternal blood. Its maternal serum concentration in fetal trisomy 21 is decreased during the first trimester, so that PAPP-A is a useful screening biomarker. However, the regulation of PAPP-A placental secretion is unclear. We therefore investigated the secretion of PAPP-A in pregnancies complicated by fetal aneuploidies, both in vivo and in vitro. Maternal serum collected between 10 WG and 33 WG during 7014 normal pregnancies and 96 pregnancies complicated by fetal trisomy 21, 18, and 13 were assayed for PAPP-A using the Immulite 2000xpi system®. The pregnancies were monitored using ultrasound scanning, fetal karyotyping and placental analysis. Villous cytotrophoblasts were isolated from normal and trisomic placenta and cultured to investigate PAPP-A secretion in vitro (n=6). An increased nuchal translucency during the first trimester is a common feature of many chromosomal defect but each aneuploidy has its own syndromic pattern of abnormalities detectable at the prenatal ultrasound scanning and confirmed at the fetal examination thereafter. PAPP-A levels rise throughout normal pregnancy whereas in trisomy 21, PAPP-A levels were significantly decreased, but only during the first trimester. PAPP-A levels were decreased in trisomy 13 and sharply in trisomy 18, whatever the gestational age. In vitro, PAPP-A secretion was decreased in aneuploidy, and associated with decreased hCG secretion in Trisomy 21 and 18. These biochemical profiles did not appear to be linked to any specific histological lesions affecting the placenta. These profiles may reflect different quantitative and qualitative placental dysfunctions in the context of these aneuploidies.

  18. Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea

    Science.gov (United States)

    Lee, Sang Hyung; Lee, Seung Mi; Lim, Nam Gu; Kim, Hyun Joo; Bae, Sung-Hee; Ock, Minsu; Kim, Un-Na; Lee, Jin Yong; Jo, Min-Woo

    2016-01-01

    Abstract Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13–19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P teenage mothers had never received prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P Teenage mothers more often experienced preterm delivery and perineal laceration (P Teenage mothers (Teenage mothers had higher risk of inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001). PMID:27559960

  19. Valve-related complications after mechanical heart valve implantation.

    Science.gov (United States)

    Misawa, Yoshio

    2015-10-01

    The number of heart valve surgeries is increasing, and 19,164 patients underwent heart valve surgery in Japan in 2011. The early mortality rate has remained stable for more than 10 years. Many patients now survive for many years, with a reported 10-year survival rate of at least 60 %. However, unfavorable complications can occur after valve surgery. Valve-related complications include thromboembolisms, bleeding complications and prosthetic valve endocarditis, followed by structural and nonstructural prosthetic valve dysfunctions. Our review of studies published after 2000 revealed that the rate of all valve-related complications was 0.7-3.5 % per patient-year. Thromboembolisms occur at a rate of approximately 1 % per patient-year, and bleeding complications occur at almost 0.5 % per patient-year. Thromboembolic and hemorrhagic events related to anticoagulant therapy should be considered during life-long follow-up. The occurrence rate of endocarditis reaches 0.5 % per patient-year, with a poor postoperative survival. Structural dysfunctions have been largely overcome, and the nonstructural dysfunction rate is 0.4-1.2 % per patient-year. The nonstructural dysfunctions induced by paravalvular leaks and pannus ingrowth are also issues that need to be resolved.

  20. Changes in first trimester screening test parameters in pregnancies complicated by placenta previa and association with hyperemesis gravidarum.

    Science.gov (United States)

    Tülek, Fırat; Kahraman, Alper; Taşkın, Salih; Özkavukçu, Esra; Söylemez, Feride

    2014-01-01

    To assess the possible changes in first trimester screening test parameters in pregnancies complicated with placenta previa and to determine whether there is an association between hyperemesis gravidarum and placenta previa. A total of 131 singleton spontaneously conceived pregnancies that were complicated by placenta previa and delivered between May 2006 and May 2013 were evaluated from birth charts. Ninety patients without placenta previa were selected amongst patients who delivered within the same period of time as the control group. Cases of low lying placenta (n=52) within the study group were assessed as a separate group. The rest of the cases was considered to be in a different group. Beta human chorionic gonadotropin (BhCG) multiples of medians (MoMs) and nuchal translucency (NT) MoMs were significantly higher in the placenta previa group in comparison with the low lying placenta and control groups. Apgar scores at both the 1st and 5th minutes were significantly lower in the placenta previa group. Hyperemesis gravidarum was found to be significantly more frequent in the placenta previa group. The prevalence of hyperemesis gravidarum in the first trimester is higher in pregnancies complicated by placenta previa. Paying more attention to the development of placenta previa in the routine pregnancy follow-up of patients with hyperemesis gravidarum could be considered.

  1. Perinatal outcomes of Southeast Asians with pregnancies complicated by gestational diabetes mellitus or preeclampsia.

    Science.gov (United States)

    Cripe, Swee May; O'Brien, William; Gelaye, Bizu; Williams, Michelle A

    2012-10-01

    To examine risks for adverse perinatal outcomes among Southeast Asian women with pregnancies complicated by gestational diabetes mellitus (GDM) or preeclampsia. Perinatal outcomes of singleton births of Cambodian (3,489), Laotian (2,038), Vietnamese (11,605), Japanese (3,083) and non-Hispanic White women (33,088) were analyzed using Washington state linked birth certificate and hospitalization discharge records (1993-2006). Both Cambodian (aOR = 1.68) and Laotian (aOR = 1.71) women with GDM had increased odds of macrosomia when compared with Japanese women with GDM. Southeast Asian women with GDM had reduced odds of macrosomia when compared with White women. Southeast Asian women with preeclampsia had increased odds for preterm delivery when compared with Japanese and White women with preeclampsia. Research is needed to understand why Southeast Asian women with GDM are more likely to have better perinatal outcomes when compared with White women. Vigilant monitoring and culturally sensitive care for Southeast Asian women with preeclampsia is needed.

  2. Incidence and prevalence of pregnancy-related heart disease.

    Science.gov (United States)

    Sliwa, Karen; Böhm, Michael

    2014-03-15

    Worldwide, the numbers of women who have a pre-existing cardiovascular disease or develop cardiac problems during pregnancy are increasing and, due to the lack of evidenced-based data, this provides challenges for the treating physician. Cardiovascular disease in pregnancy is a complex topic as women can present either pre- or post-partum, due to a pre-existing heart disease such as operated on or unoperated on congenital heart disease, valvular heart disease, chronic hypertension, or familial dilated cardiomyopathy. Women often present with symptoms and signs of acute heart failure. On the other hand, there are diseases which are directly related to pregnancy, such as hypertensive disorders of pregnancy and peripartum cardiomyopathy, or where pregnancy increases risk of a disease as, for example, the risk of myocardial infarction. These diseases can have long-term implications to the life of the affected women and their families. There is, in particular, a paucity of data from developing countries of this unique disease pattern and its presentations. This review summarizes the current knowledge of the incidence and prevalence of pregnancy-related cardiovascular disease in women presenting pre- or post-partum.

  3. Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study

    Directory of Open Access Journals (Sweden)

    Hofman Albert

    2009-12-01

    Full Text Available Abstract Background The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts. Methods We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1 distance-weighted traffic density in a 150 meter radius, and 2 proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (preeclampsia, and gestational diabetes. Results There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses. Conclusions Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account.

  4. Does parity worsen diabetes-related chronic complications in women with type 1 diabetes?

    Institute of Scientific and Technical Information of China (English)

    Marilia; Brito; Gomes; Carlos; Antonio; Negrato; Ana; Almeida; Antonio; Ponce; de; Leon

    2016-01-01

    AIM: To determine the relationship between parity, glycemic control, cardiovascular risk factors and diabetesrelated chronic complications in women with type 1 diabetes.METHODS: This was a multicenter cross-sectional study conducted between December 2008 and December 2010 in 28 public clinics in 20 cities from the 4 Brazilian geographic regions. Data were obtained from 1532 female patients, 59.2% Caucasians, and aged 25.2 ± 10.6 years. Diabetes duration was of 11.5 ± 8.2 years. Patient’s information was obtained through a questionnaire and a chart review. Parity was stratified in five groups: Group 0(nulliparous), group 1(1 pregnancy), group 2(2 pregnancies), group 3(3 pregnancies), group 4(≥ 4 pregnancies). Test for trend and multivariate random intercept logistic and linear regression models were used to evaluate the effect of parity upon glycemic control, cardiovascular risk factors and diabetes-related complications. RESULTS: Parity was not related with glycemic control and nephropathy. Moreover, the effect of parity upon hypertension, retinopathy and macrovascular disease did not persist after adjustments for demographic and clinical variables in multivariate analysis. For retinopathy, the duration of diabetes and hypertension were the most important independent variables and for macrovascular disease, these variables were age and hypertension. Overweight or obesity was noted in a total of 538 patients(35.1%). A linear association was found between the frequency of overweight or obesity and parity(P = 0.004). Using a random intercept multivariate linear regression model with body mass index(BMI) as dependent variable a borderline effect for parity(P = 0.06) was noted after adjustment for clinical and demographic data. The observed variability of BMI was not attributable to differences between centers.CONCLUSION: Our results suggest that parity has a borderline effect on body mass index but does not have an important effect upon hypertension and micro or

  5. Strategies to Reduce Hemodialysis Catheter-related Complications

    NARCIS (Netherlands)

    Weijmer, M.C.

    2007-01-01

    The objective of the studies presented in this thesis was to reduce hemodialysis catheter-related complications by studying the influence of the following issues. In Chapter 3 we address the best cannulation site once the time period a hemodialysis catheter is needed has been estimated. We showed t

  6. Plasma homocysteine in late pregnancies complicated with preeclampsia and in newborns.

    Science.gov (United States)

    Baksu, Alparslan; Taskin, Mehtap; Goker, Nimet; Baksu, Basak; Uluocak, Aygul

    2006-01-01

    The aim of this study was to determine the relationship between maternal serum homocysteine levels in preeclampsia and the severity of the disease, neonatal serum homocysteine levels, maternal complications, and fetal outcome. Fifty pregnant women were included in this prospective study, of which 25 were severe (group I) and 25 were non-severe preeclamptic (group II). Maternal and neonatal serum homocysteine levels were measured by the fluorescence polarization immunoassay (FPIA) method. Maternal homocysteine levels in both groups were compared. The association of maternal and neonatal serum homocysteine levels with maternal complications and fetal outcome was investigated. When the maternal serum homocysteine cut-off value was accepted as 15 micromol/L, significant differences in relation to maternal (eclampsia; hemolysis, elevated liver enzymes, and low platelet count syndrome) and fetal (in utero mort fetalis, low birthweight) complications were observed between the group with maternal serum homocysteine level > 15 micromol/L and the group with maternal serum homocysteine level homocysteine would be valuable in the prevention of both maternal and fetal complications in preeclampsia should be designed.

  7. Thoracostomy tubes: A comprehensive review of complications and related topics

    Science.gov (United States)

    Kwiatt, Michael; Tarbox, Abigail; Seamon, Mark J.; Swaroop, Mamta; Cipolla, James; Allen, Charles; Hallenbeck, Stacinoel; Davido, H. Tracy; Lindsey, David E.; Doraiswamy, Vijay A.; Galwankar, Sagar; Tulman, David; Latchana, Nicholas; Papadimos, Thomas J.; Cook, Charles H.; Stawicki, Stanislaw P.

    2014-01-01

    Tube thoracostomy (TT) placement belongs among the most commonly performed procedures. Despite many benefits of TT drainage, potential for significant morbidity and mortality exists. Abdominal or thoracic injury, fistula formation and vascular trauma are among the most serious, but more common complications such as recurrent pneumothorax, insertion site infection and nonfunctioning or malpositioned TT also represent a significant source of morbidity and treatment cost. Awareness of potential complications and familiarity with associated preventive, diagnostic and treatment strategies are fundamental to satisfactory patient outcomes. This review focuses on chest tube complications and related topics, with emphasis on prevention and problem-oriented approaches to diagnosis and treatment. The authors hope that this manuscript will serve as a valuable foundation for those who wish to become adept at the management of chest tubes. PMID:25024942

  8. Timing of onset of CKD-related metabolic complications.

    Science.gov (United States)

    Moranne, Olivier; Froissart, Marc; Rossert, Jerome; Gauci, Cedric; Boffa, Jean-Jacques; Haymann, Jean Philippe; M'rad, Mona Ben; Jacquot, Christian; Houillier, Pascal; Stengel, Benedicte; Fouqueray, Bruno

    2009-01-01

    Chronic kidney disease (CKD) guidelines recommend evaluating patients with GFR acidosis from 2 to 39%, and hyperkalemia from 2 to 42%. Factors most strongly associated with metabolic complications, independent of mGFR, were younger age for acidosis and hyperphosphatemia, presence of diabetes for acidosis, diabetic kidney disease for anemia, and both male gender and the use of inhibitors of the renin-angiotensin system for hyperkalemia. mGFR thresholds for detecting complications with 90% sensitivity were 50, 44, 40, 39, and 37 ml/min per 1.73 m(2) for hyperparathyroidism, anemia, acidosis, hyperkalemia, and hyperphosphatemia, respectively. Analysis using estimated GFR produced similar results. In summary, this study describes the onset of CKD-related complications at different levels of GFR; anemia and hyperparathyroidism occur earlier than acidosis, hyperkalemia, and hyperphosphatemia.

  9. Proteomic analysis of pregnancy-related proteins from pig uterus endometrium during pregnancy

    Directory of Open Access Journals (Sweden)

    Kang Sunghyun

    2011-07-01

    Full Text Available Abstract Many important molecular events associated with implantation and development occur within the female reproductive tract, especially within the uterus endometrium, during pregnancy periods. The endometrium includes the mucosal lining of the uterus, which provides a suitable site for implantation and development of a fertilized egg and fetus. To date, the molecular cascades in the uterus endometrium during pregnancy periods in pigs have not been elucidated fully. In this study, we compared the functional regulated proteins in the endometrium during pregnancy periods with those in non-pregnant conditions and investigated changes in expression patterns during pregnancy (days 40, 70, and 93 using two-dimensional gel electrophoresis (2-DE and western blotting. The functional regulated proteins were identified and discovered from differentially expressed proteins in the uterus endometrium during pregnancy. We discovered 820 protein spots in a proteomic analysis of uterus endometrium tissues with 2-DE gels. We identified 63 of the 98 proteins regulated differentially among non-pregnant and pregnant tissues (matched and unmatched spots. Interestingly, 10 of these 63 proteins are development-, cytoskeleton- and chaperon-related proteins such as transferrin, protein DJ-1, transgelin, galectin-1, septin 2, stathmin 1, cofilin 1, fascin 1, heat shock protein (HSP 90β and HSP 27. The specific expression patterns of these proteins in the endometrium during pregnancy were confirmed by western blotting. Our results suggest that the expressions of these genes involved in endometrium function and endometrium development from early to late gestation are associated with the regulation of endometrium development for maintaining pregnancy.

  10. The utility of transvaginal ultrasound in the ED evaluation of complications of first trimester pregnancy.

    Science.gov (United States)

    Panebianco, Nova L; Shofer, Frances; Fields, J Matthew; Anderson, Kenton; Mangili, Alessandro; Matsuura, Asako C; Dean, Anthony J

    2015-06-01

    For patients with early intrauterine pregnancy (IUP), the sonographic signs of the gestation may be below the resolution of transabdominal ultrasound (TAU); however, it may be identified by transvaginal ultrasound (TVU). We sought to determine how often TVU performed in the emergency department (ED) reveals a viable IUP after a nondiagnostic ED TAU and the impact of ED TVU on patient length of stay (LOS). This was a retrospective cohort study of women presenting to our ED with complications of early pregnancy from January 1, 2007 to February 28, 2009 in a single urban adult ED. Abstractors recorded clinical and imaging data in a database. Patient imaging modality and results were recorded and compared with respect to ultrasound (US) findings and LOS. Of 2429 subjects identified, 795 required TVU as part of their care. Emergency department TVU was performed in 528 patients, and 267 went to radiology (RAD). Emergency department TVU identified a viable IUP in 261 patients (49.6%). Patients having initial ED US had shorter LOS than patients with initial RAD US (median 4.0 vs 6.0 hours; P < .001). Emergency department LOS was shorter for women who had ED TVU performed compared with those sent for RAD TVU regardless of the findings of the US (median 4.9 vs 6.7 hours; P < .001). There was no increased LOS for patients who needed further RAD US after an indeterminate ED TVU (7.0 vs 7.1 hours; P = .43). There was no difference in LOS for those who had a viable IUP confirmed on ED TAU vs ED (median 3.1 vs 3.2 hours, respectively; P < .32). When an ED TVU was performed, a viable IUP was detected 49.6% of the time. Emergency department LOS was significantly shorter for women who received ED TVU after indeterminate ED TAU compared with those sent to RAD for TVU, with more marked time savings among those with live IUP diagnosed on ED TVU. For patients who do not receive a definitive diagnosis of IUP on ED TVU, this approach does not result in increased LOS. Copyright © 2015

  11. Feto-maternal outcomes of pregnancy complicated by ovarian malignant germ cell tumor: a systematic review of literature.

    Science.gov (United States)

    Kodama, Michiko; Grubbs, Brendan H; Blake, Erin A; Cahoon, Sigita S; Murakami, Ryusuke; Kimura, Tadashi; Matsuo, Koji

    2014-10-01

    Malignant germ cell tumors (MGCT) are a rare type of ovarian cancer with poorly understood behavior during pregnancy. This systematic review evaluated feto-maternal outcomes and management patterns of 102 ovarian MGCT-complicated pregnancies identified in PubMed/MEDLINE. Mean age was 25.8. The most common histology type was dysgerminoma (38.2%) followed by yolk sac tumor (30.4%). Abdomino-pelvic pain (35.3%) was the most common symptom. The majority were stage I disease (76.4%) with a mean tumor size of 17.9cm. Most cases had live births (77.5%) at term (56.6%). Tumor surgery without fetal conservation took place in 22 (21.6%) cases (Group 1). This group was characterized by the first trimester tumor detection and intervention, non-viable pregnancy, and frequent concurrent hysterectomy. There were 59 (57.8%) cases which underwent expectant management of pregnancy: mean delay 16.4 weeks for 46 (45.1%) cases with tumor surgery and fetal conservation (Group 2); and 7.8 weeks for 13 (12.7%) cases with tumor surgery after delivery (Group 3). The live birth rate in Groups 2 and 3 was 98.3%. There were 21 (20.6%) cases in which the tumor was incidentally found intra/postpartum (Group 4). Group 2 showed the highest 5-year overall survival rate (92.8%) followed by Group 4 (79.5%), Group 3 (71.4%), and Group 1 (56.2%, p=0.028). Group 1 had more advanced-stage disease when compared to Group 2 (proportion of stages II-IV disease, 36.4% versus 11.4%, p=0.023). In multivariate analysis, age ≤20 (p=0.032) and stages II-IV (p=0.02) remained independent prognosticators for decreased overall survival in all cases. Expectant management of pregnancy was not associated with poor survival outcome in multivariate analysis (p=0.43). In conclusion, our analysis demonstrated that timing of tumor intervention and delivery significantly impacted feto-maternal outcome of ovarian MGCT-complicated pregnancies. It is suggested that early detection and tumor intervention with expectant

  12. [A case of Edwards' syndrome in pregnancy complicated by serologic incompatibility and preeclampsia].

    Science.gov (United States)

    Murawski, Marek; Gryboś, Marian; Zalewska, Dominika; Symonowicz, Krzysztof

    2006-12-01

    A case of Edwards' syndrome (trisomy 18) diagnosed in the third pregnancy trimester is described. The diagnosis was based on sonographic examination and cytogenetic amniocentesis. Lethal genetic fetal malformation determined the medical indication to preterm delivery. Additionally, serologic incompatibility during pregnancy was observed, as well as pregnancy induced hypertension turning into preeclampsia after the labour action was evoked. A caesarean section due to obstetric indications was done. Phenotype and lethal congenital malformations in the newborn have confirmed of the chromosome aberration prenatally diagnosed.

  13. The prevalence and incidence of perinatal anxiety disorders among women experiencing a medically complicated pregnancy.

    Science.gov (United States)

    Fairbrother, Nichole; Young, Allan H; Zhang, Areiyu; Janssen, Patricia; Antony, Martin M

    2017-04-01

    Over 20% of pregnancies involve medical difficulties that pose some threat to the health and well-being of the mother, her developing infant, or both. We report on the first comparison of the prevalence and incidence of maternal anxiety disorders (AD) in pregnancy and the postpartum, across levels of medical risk in pregnancy. Pregnant women (N = 310) completed postnatal screening measures for anxiety. Women who scored at or above cutoff on one or more of the screening measures were administered a diagnostic interview (n = 115) for AD. Pregnancies were classified into low, moderate, or high risk based on self-report and contact with high-risk maternity clinics. The incidence of AD in pregnancy was higher among women classified as experiencing a medically moderate or high-risk pregnancy, compared with women classified as experiencing a medically low-risk pregnancy. Across risk groups, there were no differences in AD prevalence or in the incidence of AD in the postpartum. Demographic characteristics and parity did not contribute meaningfully to outcomes. Pregnancies characterized by medical risks are associated with an increased likelihood of new onset AD. Women experiencing medically complex pregnancies should be screened for anxiety and offered appropriate treatment.

  14. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J;

    2010-01-01

    The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non...... cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes....

  15. Pregnancy complications in spontaneous and assisted conceptions of women with infertility and subfertility factors. A comprehensive review.

    Science.gov (United States)

    Palomba, Stefano; Santagni, Susanna; Gibbins, Karen; La Sala, Giovanni Battista; Silver, Robert M

    2016-11-01

    In the literature, there is growing evidence that assisted reproductive techniques increase the risk of pregnancy complications in subfertile couples. Moreover, many concomitant preconception risk factors for subfertility are frequently present in the same subject and increase the risk of pregnancy complications. This review aimed to summarize in a systematic fashion the best current evidence regarding the effects of preconception maternal factors on maternal and neonatal outcomes. A literature search up to March 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar. An evidence-based hierarchy was used to determine which articles to include and analyse. Available data show that the risk of pregnancy complications in spontaneous and assisted conceptions is likely multifactorial, and the magnitude of this risk is probably very different according specific subgroups of patients. Notwithstanding the only moderate level and quality of the available evidence, available data suggest that the presence and the treatment of specific preconception cofactors of subfertility should be always taken into account both in clinical practice and for scientific purposes.

  16. Effectiveness of combining plasma exchange with continuous hemodiafiltration on acute Fatty liver of pregnancy complicated by multiple organ dysfunction.

    Science.gov (United States)

    Chu, Yu-Feng; Meng, Mei; Zeng, Juan; Zhou, Hai-Yan; Jiang, Jin-Jiao; Ren, Hong-Sheng; Zhang, Ji-Cheng; Zhu, Wen-Ying; Wang, Chun-Ting

    2012-06-01

    Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic complications that induce significant maternal risk. The application of combining plasma exchange (PE) and continuous hemodiafiltration (CHDF) is a novel concept for patients with AFLP. Since 2002, we have utilized the combination of PE with CHDF as adjunctive medical therapy for 11 AFLP patients with multiple organ dysfunction. Before PE and CHDF initiation, four patients had signs and symptoms of encephalopathy, four required ventilatory support, and all 11 were developing liver failure, significant renal compromise, and coagulopathy. PE combined with CHDF for patients was initiated a mean of 2 days postpartum (range, days 0-3). Daily or every other day PE combined with CHDF was undertaken on two to eight occasions for each of the 11 patients. Ten patients responded with composite clinical and laboratory improvement and were discharged to the ward, then cured and discharged from hospital; one patient died of septic shock. Average duration of hospitalization was 17 days (range, days 9-38) from time of admission to discharge; the average duration of intensive care unit was 10 days (range, days 4-23). No significant PE- and CHDF-related complications occurred. These results indicate that combing PE and CHDF in a series-parallel circuit is an effective and safe treatment for patients with severe AFLP. This finding may have important implications for the development of an effective treatment for patients with AFLP suffering multiple organ dysfunction. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  17. [Non-Pharmacological Interventions for Pregnancy-Related Sleep Disturbances].

    Science.gov (United States)

    Hung, Hsuan-Man; Chiang, Hsiao-Ching

    2017-02-01

    Most women experience the worse sleep quality of their life during pregnancy and the early postpartum period. Although pregnancy typically accounts for a relatively short part of a woman's life, the related sleep disturbances may have a significant and negative impact on her long-term health. Approximately 78-80% of pregnant women experience sleep disturbances, including interruptions in deep sleep, decreased total sleep time, poor subjective sleep quality, frequent night waking, and reduced sleep efficacy. Sleep disturbances during pregnancy start during the first trimester and become prevalent during the third trimester. Related factors include physiological and psychosocial changes and an unhealthy lifestyle. As non-pharmacological interventions have the potential to improve sleep quality in 70% to 80% of patients with insomnia, this is the main approached that is currently used to treat pregnancy-related sleep disturbances. Examples of these non-pharmacological interventions include music therapy, aerobic exercise, massage, progressive muscle relaxation, multi-modal interventions, and the use of a maternity support belt. The efficacy and safety of other related non-pharmacological interventions such as auricular acupressure, cognitive therapy, tai chi, and aromatherapy remain uncertain, with more empirical research required. Additionally, non-pharmacological interventions do not effectively treat sleep disturbances in all pregnant women.

  18. Pregnancy following bariatric requires special attention

    DEFF Research Database (Denmark)

    Renault, Kristina; Andersen, Lise Lotte Fischer; Kjær, Mette Karie Mandrup

    2012-01-01

    In the latest years the number of pregnant women having undergone bariatric surgery before pregnancy has increased rapidly. In pregnancy, they seem to have a reduced risk of obesity-related complications but an increased risk of mechanical complications causing small bowel obstruction...... and complications due to malabsorption. This article reviews the effect of bariatric surgery before pregnancy on obstetric and neonatal outcomes and provides, based on the limited available evidence, recommendations for the management of pregnancy in these women....

  19. Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: The generation r study

    NARCIS (Netherlands)

    Hooven, E.H. van den; Kluizenaar, Y. de; Pierik, F.H.; Hofman, A.; Ratingen, S.W. van; Zandveld, P.Y.J.; MacKenbach, J.P.; Steegers, E.A.P.; Miedema, H.M.E.; Jaddoe, V.W.V.

    2011-01-01

    Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM10) and nitrogen dioxide (NO2) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced hype

  20. Air pollution, blood pressure, and the risk of hypertensive complications during pregnancy: The generation r study

    NARCIS (Netherlands)

    Hooven, E.H. van den; Kluizenaar, Y. de; Pierik, F.H.; Hofman, A.; Ratingen, S.W. van; Zandveld, P.Y.J.; MacKenbach, J.P.; Steegers, E.A.P.; Miedema, H.M.E.; Jaddoe, V.W.V.

    2011-01-01

    Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM10) and nitrogen dioxide (NO2) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced

  1. Preeclampsia and Blood Pressure Trajectory during Pregnancy in Relation to Vitamin D Status.

    Directory of Open Access Journals (Sweden)

    Linnea Bärebring

    Full Text Available Every tenth pregnancy is affected by hypertension, one of the most common complications and leading causes of maternal death worldwide. Hypertensive disorders in pregnancy include pregnancy-induced hypertension and preeclampsia. The pathophysiology of the development of hypertension in pregnancy is unknown, but studies suggest an association with vitamin D status, measured as 25-hydroxyvitamin D (25(OHD. The aim of this study was to investigate the association between gestational 25(OHD concentration and preeclampsia, pregnancy-induced hypertension and blood pressure trajectory. This cohort study included 2000 women. Blood was collected at the first (T1 and third (T3 trimester (mean gestational weeks 10.8 and 33.4. Blood pressure at gestational weeks 10, 25, 32 and 37 as well as symptoms of preeclampsia and pregnancy-induced hypertension were retrieved from medical records. Serum 25(OHD concentrations (LC-MS/MS in T1 was not significantly associated with preeclampsia. However, both 25(OHD in T3 and change in 25(OHD from T1 to T3 were significantly and negatively associated with preeclampsia. Women with a change in 25(OHD concentration of ≥30 nmol/L had an odds ratio of 0.22 (p = 0.002 for preeclampsia. T1 25(OHD was positively related to T1 systolic (β = 0.03, p = 0.022 and T1 diastolic blood pressure (β = 0.02, p = 0.016, and to systolic (β = 0.02, p = 0.02 blood pressure trajectory during pregnancy, in adjusted analyses. There was no association between 25(OHD and pregnancy-induced hypertension in adjusted analysis. In conclusion, an increase in 25(OHD concentration during pregnancy of at least 30 nmol/L, regardless of vitamin D status in T1, was associated with a lower odds ratio for preeclampsia. Vitamin D status was significantly and positively associated with T1 blood pressure and gestational systolic blood pressure trajectory but not with pregnancy-induced hypertension.

  2. Preeclampsia and Blood Pressure Trajectory during Pregnancy in Relation to Vitamin D Status.

    Science.gov (United States)

    Bärebring, Linnea; Bullarbo, Maria; Glantz, Anna; Leu Agelii, Monica; Jagner, Åse; Ellis, Joy; Hulthén, Lena; Schoenmakers, Inez; Augustin, Hanna

    2016-01-01

    Every tenth pregnancy is affected by hypertension, one of the most common complications and leading causes of maternal death worldwide. Hypertensive disorders in pregnancy include pregnancy-induced hypertension and preeclampsia. The pathophysiology of the development of hypertension in pregnancy is unknown, but studies suggest an association with vitamin D status, measured as 25-hydroxyvitamin D (25(OH)D). The aim of this study was to investigate the association between gestational 25(OH)D concentration and preeclampsia, pregnancy-induced hypertension and blood pressure trajectory. This cohort study included 2000 women. Blood was collected at the first (T1) and third (T3) trimester (mean gestational weeks 10.8 and 33.4). Blood pressure at gestational weeks 10, 25, 32 and 37 as well as symptoms of preeclampsia and pregnancy-induced hypertension were retrieved from medical records. Serum 25(OH)D concentrations (LC-MS/MS) in T1 was not significantly associated with preeclampsia. However, both 25(OH)D in T3 and change in 25(OH)D from T1 to T3 were significantly and negatively associated with preeclampsia. Women with a change in 25(OH)D concentration of ≥30 nmol/L had an odds ratio of 0.22 (p = 0.002) for preeclampsia. T1 25(OH)D was positively related to T1 systolic (β = 0.03, p = 0.022) and T1 diastolic blood pressure (β = 0.02, p = 0.016), and to systolic (β = 0.02, p = 0.02) blood pressure trajectory during pregnancy, in adjusted analyses. There was no association between 25(OH)D and pregnancy-induced hypertension in adjusted analysis. In conclusion, an increase in 25(OH)D concentration during pregnancy of at least 30 nmol/L, regardless of vitamin D status in T1, was associated with a lower odds ratio for preeclampsia. Vitamin D status was significantly and positively associated with T1 blood pressure and gestational systolic blood pressure trajectory but not with pregnancy-induced hypertension.

  3. Pregnancy, obesity and other risk factors for complications in influenza A(H1N1) pdm09 infection.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Paño-Pardo, José Ramón; Múñez Rubio, Elena; Segura Porta, Ferran

    2012-10-01

    Although influenza is usually a self-limited disease, patients who develop complications are at increased risk of hospitalization, intensive care unit admission and death. Since preventive and early therapeutic measures should be prioritized in higher risk patients, identification of the risk factors for severe infection is important from a public health perspective. Risk factors for complications in pandemics may show some differences with regard to seasonal influenza. During the influenza A(H1N1)pmd09 pandemic, although many cases occurred in younger adults, the risk factors identified for severe infections and complications were similar to those for seasonal influenza, including chronic respiratory, renal, liver, and heart diseases. Aged patients, although less frequently affected, were also at higher risk. Obesity, and particularly morbid obesity (>40 body mass index) has been noted as a significant risk factor for severe disease in the 2009 influenza pandemic. Some interesting recent studies provide insights into the biological reasons behind the poor outcomes in morbidly obese patients. In terms of pregnancy, the studies have shown contradictory results due to variations in methodology and medical care. However, it seems that pregnancy, particularly during the third trimester, increases the risk of complications, and that early antiviral treatment is associated with improved outcomes.

  4. Hypotension in pregnant women: a population-based case-control study of pregnancy complications and birth outcomes.

    Science.gov (United States)

    Bánhidy, Ferenc; Acs, Nándor; Puhó, Erzsébet H; Czeizel, Andrew E

    2011-01-01

    Hypotension is frequent in pregnant women; nevertheless, its association with pregnancy complications and birth outcomes has not been investigated. Thus, the aim of this study was to analyze the possible association of hypotension in pregnant women with pregnancy complications and with the risk for preterm birth, low birthweight and different congenital abnormalities (CAs) in the children of these mothers in the population-based data set of the Hungarian Case-Control Surveillance of CAs, 1980-1996. Prospectively and medically recorded hypotension was evaluated in 537 pregnant women who later had offspring with CAs (case group) and 1268 pregnant women with hypotension who later delivered newborn infants without CAs (control group); controls were matched to sex and birth week of cases (in the year when cases were born), in addition to residence of mothers. Over half of the pregnant women who had chronic hypotension were treated with pholedrine or ephedrine. Maternal hypotension is protective against preeclampsia; however, hypotensive pregnant women were at higher risk for severe nausea or vomiting, threatened abortion (hemorrhage in early pregnancy) and for anemia. There was no clinically important difference in the rate of preterm births and low birthweight newborns in pregnant women with or without hypotension. The comparison of the rate of maternal hypotension in cases with 23 different CAs and their matched controls did not show a higher risk for CAs (adjusted OR with 95% confidence intervals: 0.66, 0.49-0.84). In conclusion, a higher risk for CAs and other adverse birth outcomes was not found in the offspring of pregnant women with hypotension, but maternal hypotension was associated with a higher risk of some pregnancy complications.

  5. Impact of postprandial glucose control on diabetes-related complications

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2016-01-01

    Conflicting findings in the literature and lack of long-term definitive outcome studies have led to difficulty in drawing conclusions about the role of postprandial hyperglycemia in diabetes and its complications. Recent scientific publications support the role of postprandial glucose (PPG......) as a key contributor to overall glucose control and a predictor of microvascular and macrovascular events. However, the need remains for definitive evidence to support the precise relationship between PPG excursions and the development and progression of cardiovascular complications of diabetes. Drawing...... that more closely approximate 'normal' physiological postprandial responses, as well as technologies that advance the mode of insulin delivery or optimize methods to sense glycemic levels and variation. In conclusion, the precise role of postprandial hyperglycemia in relation to development of diabetic...

  6. Frequency and related factors of tubal patency after methotrexate treatment in women with ectopic pregnancy.

    Science.gov (United States)

    Seyedoshohadaei, Fariba; Mohammadbeigi, Robabeh; Tahmuri, Atefe; Ghaderi, Ebrahim

    2016-03-01

    Ectopic pregnancy is a medical emergency. The classic treatment for this condition is surgery but early diagnosis allows for non-surgical treatment. In recent years, intramuscular methotrexate has been considered, due to easy administration, its less invasive nature and low complications, but there are arguments about its effects. The aim of this study was to evaluate tubal patency after treatment of ectopic pregnancy with methotrexate and related factors. This cross-sectional study was conducted on 80 women with ectopic pregnancy who were admitted to Sanandaj Be'sat Hospital in 2014. Patients who had successful treatment for ectopic pregnancy with single or multiple doses of methotrexate 50 mL/m(2) were enrolled. Three to 6 months after treatment, the patients were evaluated for tubal patency by hysterosalpingography. Data were analyzed using spss, t-tests, χ(2) -test and logistic regression. The tubal patency rate after treatment of ectopic pregnancy with methotrexate was 75% in hysterosalpingography. The average size of the ectopic pregnancy mass of women with open fallopian tubes was 22.5 ± 7.0 mm and for women with closed fallopian tubes it was 34.7 ± 10.0 mm (P = 0.0001). β-human chorionic gonadotropin levels were 642.1 ± 850.5 in women with open fallopian tubes and 3816.3 ± 4487.3 for women with closed fallopian tubes (P = 0.0001). There was no significant correlation statistically between tubal patency with a history of stillbirth and number of pregnancies (P > 0.5). There was a statistically significant relation between tubal patency and the number of births and also methotrexate dose (P ectopic pregnancy with methotrexate is effective for saving tubal patency. Levels of human chorionic gonadotrophin-β ectopic pregnancy mass size smaller than 33.5 mm are significant predictors of tubal patency. © 2015 Japan Society of Obstetrics and Gynecology.

  7. Conception, complicated pregnancy, and labour of gods and heroes in Greek mythology.

    Science.gov (United States)

    Iavazzo, Christos; Trompoukis, Constantinos; Sardi, Thalia; Falagas, Matthew E

    2008-01-01

    Pregnancy and labour are holy moments in a woman's life. Even in Greek mythology we can find descriptions of them. We searched in the Greek myths to find descriptions of labours of ancient heroes and gods. We identified descriptions of extracorporeal fertilization, superfecundation, ectopic pregnancy, preterm labour, prolonged pregnancy and Caesarean section. The use of imagination could help the reader to find similarities in present or future developments in the field of obstetrics. It could be concluded that various aspects of modern obstetrical practice are described in Greek mythology.

  8. Early clinical outcome and complications related to balloon kyphoplasty

    Directory of Open Access Journals (Sweden)

    Martin Bergmann

    2012-06-01

    Full Text Available The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7% and 81 males (27.3%. Average patient age was 76.21 years (±10.71, range 35-98 years. Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 pre-operative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06% of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a

  9. Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

    Directory of Open Access Journals (Sweden)

    Swati Sharma

    2016-04-01

    Conclusions: Jaundice in pregnancy results in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1084-1087

  10. The amylase/creatinine clearance ratio in normal pregnancy and pregnancies complicated by pancreatitis, hyperemesis gravidarum, and toxemia.

    Science.gov (United States)

    DeVore, G R; Bracken, M; Berkowitz, R L

    1980-03-15

    The Cam/Ccr% has been suggested to be of value in the diagnosis of pancreatitis. The Cam/Ccr% was determined throughout gestation in normal pregnant and nonpregnant patients. The Cam/Ccr% was lower (p less than 0.05) throughout pregnancy and was a function of increased creatinine clearance. The Cam/Ccr% was increased in pregnant patients with pancreatitis. Two of four patients with the clinical diagnosis of hyperemesis gravidarum demonstrated elevations of the Cam/Ccr%. Toxemia with epigastric pain was noted to be associated with an elevated CamCcr% in all patients, whereas toxemia without epigastric pain was not routinely noted to be associated with an elevated ratio. The normal Cam/Ccr% in pregnancy is lower than the nonpregnant value, and this should be taken into consideration when evaluating a patient with suspected pancreatitis who is pregnant. Patients with the clinical diagnosis of hyperemesis gravidarum and toxemia should be screened with serial Cam/Ccr% for possible evolving pancreatitis.

  11. Changes in weight and health behaviors after pregnancies complicated by gestational diabetes mellitus: the CARDIA study.

    Science.gov (United States)

    Bennett, Wendy L; Liu, Su-Hsun; Yeh, Hsin-Chieh; Nicholson, Wanda K; Gunderson, Erica P; Lewis, Cora E; Clark, Jeanne M

    2013-06-01

    Prepregnancy to postpregnancy change in weight, body mass index (BMI), waist circumference, diet, and physical activity in women with and without gestational diabetes mellitus (GDM) were compared. Using the Coronary Artery Risk Development in Young Adults study, women with at least one pregnancy during 20 years of follow-up (n = 1,488 with 3,125 pregnancies) was identified. Linear regression with generalized estimating equations to compare prepregnancy to postpregnancy changes in health behaviors and anthropometric measurements between 137 GDM pregnancies and 1,637 non-GDM pregnancies, adjusted for parity, age at delivery, outcome measure at the prepregnancy exam, race, education, mode of delivery, and interval between delivery and postpregnancy examination were used. When compared with women without GDM in pregnancy, women with GDM had higher prepregnancy mean weight (158.3 vs. 149.6 lb, P = 0.011) and BMI (26.7 vs. 25.1 kg/m(2) , P = 0.002), but nonsignificantly lower total daily caloric intake and similar levels of physical activity. Both GDM and non-GDM groups had higher average postpartum weight of 7-8 lbs and decreased physical activity on average 1.4 years after pregnancy. Both groups similarly increased total caloric intake but reduced fast food frequency. Prepregnancy to postpregnancy changes in body weight, BMI, waist circumference, physical activity, and diet did not differ between women with and without GDM in pregnancy. Following pregnancy, women with and without GDM increased caloric intake, BMI, and weight and decreased physical activity, but reduced their frequency of eating fast food. Given these trends, postpartum lifestyle interventions, particularly for women with GDM, are needed to reduce obesity and diabetes risk. Copyright © 2013 The Obesity Society.

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

    Directory of Open Access Journals (Sweden)

    Nilajkumar D. Bagde

    2013-02-01

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

  13. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications

    Directory of Open Access Journals (Sweden)

    Joshua Halpern

    2016-01-01

    Full Text Available There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele.

  14. Hepatocellular carcinoma complicating cystic fibrosis related liver disease.

    LENUS (Irish Health Repository)

    O'Donnell, D H

    2012-02-01

    Early diagnosis and treatment of the respiratory and gastrointestinal complications of cystic fibrosis (CF) have led to improved survival with many patients living beyond the fourth decade. Along with this increased life expectancy is the risk of further disease associated with the chronic manifestations of their condition. We report a patient with documented CF related liver disease for which he was under routine surveillance that presented with histologically proven hepatocellular carcinoma (HCC). It is important that physicians are aware of this association as increased vigilance may lead to earlier diagnosis and perhaps, a better outcome.

  15. COMPLICATIONS RELATED TO GASTRIC BYPASS PERFORMED WITH DIFFERENT GASTROJEJUNAL DIAMETERS

    Science.gov (United States)

    SAMPAIO-NETO, José; BRANCO-FILHO, Alcides José; NASSIF, Luis Sérgio; BROSKA, Anne Caroline; KAMEI, Douglas Jun; NASSIF, André Thá

    2016-01-01

    ABSTRACT Background: Among the options for surgical treatment of obesity, the most widely used has been the Roux-en-Y gastric bypass. The gastrojejunal anastomosis can be accomplished in two ways: handsewn or using circular and linear stapled. The complications can be divided in early and late. Aim: To compare the incidence of early complications related with the handsewn gastrojejunal anastomosis in gastric bypass using Fouchet catheter with different diameters. Method: The records of 732 consecutive patients who had undergone the bypass were retrospectively analyzed and divided in two groups, group 1 with 12 mm anastomosis (n=374), and group 2 with 15 mm (n=358). Results: The groups showed anastomotic stenosis with rates of 11% and 3.1% respectively, with p=0.05. Other variables related to the anastomosis were also analyzed, but without statistical significance (p>0.05). Conclusion: The diameter of the anastomosis of 15 mm was related with lower incidence of stenosis. It was found that these patients had major bleeding postoperatively and lower surgical site infection, and in none was observed presence of anastomotic leak. PMID:27683767

  16. Postpartum posterior reversible encephalopathy syndrome (PRES) in a twin pregnancy complicated by preeclampsia-eclampsia: case report.

    Science.gov (United States)

    Papoutsis, D; El-Attabi, N; Sizer, A

    2014-01-01

    This is the second case in literature of posterior reversible encephalopathy syndrome (PRES) in a twin pregnancy complicated by preeclampsia-eclampsia. A 27-year-old primigravida with dichorionic diamniotic twin pregnancy was admitted at 36 weeks of gestation for induction of labour due to preeclampsia. On the second day postpartum, the patient developed severe hypertension, visual symptoms, confusion, headache, and eclamptic fits. Head computed tomography (CT) showed hypodense basal ganglia lesions. The patient was treated in the intensive treatment unit with hydralazine and labetalol infusions and anticonvulsants. Five days later, there was complete clinical improvement and follow-up magnetic resonance imaging (MRI) was normal. The patient was discharged 11 days post-delivery. Diagnosis of PRES is based on the presence of clinical features of acute neurologic compromise, abnormal neuroimaging findings, and complete reversibility of findings after prompt treatment. Early recognition and proper treatment result in complete reversibility of this condition.

  17. 疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局分析%Again uterine scar pregnancy complicated by hypertensive disorders in pregnancy Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    韩秀燕; 郑海霞

    2016-01-01

    Objective:To explore the analysis of uterine scar pregnancy complicated by gestational hypertension again pregnancy outcomes.Methods:June 2010 -June 2015 period,the hospital treated 60 cases of maternal hypertension during pregnancy was observed object,of which 28 cases of maternal history of cesarean section surgery,alternatively the same period 60 cases of normal birth mothers as controls group observed object.Observe and compare the three groups of mothers in the postpartum hemorrhage,mode of delivery,neonatal complications,differences on maternal complications.Results:postpartum hemorrhage and maternal hypertension during pregnancy maternal uterine scar,cesarean section rate,maternal complication rate was significantly higher (P <0.05 ).Conclusions:Maternal uterine scar with hypertension during pregnancy can adversely affect pregnancy outcomes,should strengthen surveillance in the perinatal period,select the appropriate mode of delivery,prevent complications.%目的:探究分析疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局。方法:选取2010年6月至2015年6月该院收治的60例妊娠期高血压产妇为观察对象,其中28例产妇有剖宫产手术史,另选同期60例正常分娩产妇为对照组观察对象。观察并对比三组产妇在产后出血、分娩方式、新生儿并发症、产妇并发症上的差异。结果:妊娠期高血压产妇及疤痕子宫产妇的产后出血量、剖宫产率、并发症发生率明显高于对照组产妇(P<0.05)。结论:疤痕子宫产妇在妊娠期间并发高血压,能够对妊娠结局产生不利影响,应在围产期加强观察,选择合适的分娩方式,预防并发症的发生。

  18. Association between polycystic ovary syndrome and the risk of pregnancy complications: A PRISMA-compliant systematic review and meta-analysis.

    Science.gov (United States)

    Yu, Hai-Feng; Chen, Hong-Su; Rao, Da-Pang; Gong, Jian

    2016-12-01

    Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications. We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios. Effect estimates were pooled using the random-effects model. The analysis was further stratified by factors that could affect these associations. We included 40 observational studies that reported data on a total of 17,816 pregnancies with PCOS and 123,756 pregnancies without PCOS. Overall, PCOS in pregnancy was associated with greater risk of GDM, preeclampsia, PIH, preterm delivery, cesarean delivery, miscarriage, hypoglycemia, and perinatal death. However, PCOS in pregnancy had little or no effect on oligohydramnios, polyhydramnios, large-for-gestational age (LGA), small-for-gestational-age (SGA), fetal growth restriction (FGR), preterm premature membrane rupture, fasting blood glucose (FBG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride, total cholesterol, congenital malformation, macrosomia, and respiratory distress syndrome. Subgroup analysis suggested that these associations might be influenced by study design and pre-BMI. PCOS in pregnancy is associated with a significantly increased risk of adverse pregnancy, fetal, and neonatal outcomes.

  19. Renal disease in pregnancy.

    Science.gov (United States)

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  20. 双胎妊娠与单胎妊娠的并发症及妊娠结局比较%The comparative observation of complications and pregnancy outcomes between twin pregnancy and singleton preg-nancies

    Institute of Scientific and Technical Information of China (English)

    魏景仙; 申更存; 霍强; 赵继广; 李存娟

    2014-01-01

    Objective To comparative observation the complications and pregnancy outcomes between twin pregnancy and singleton pregnancies .Methods Selected 100 patients with twin preanancy ,and 100 patients with singleton pregnancies . After treatment,compared the complications,postpartum hemorrhage,the incidence of low-weight children,neonatal asphyxia rate and the perinatal child mortality of 2 groups .Results The complication rate of twin pregnancy was higher than that of control group,the difference was statistically significant (P<0.05).The postpartum hemorrhage,the incidence of low-weight children,nenoatal asphyxia rate and the perinatal child mortality were higher than that of control group ,the difference was sta-tistically significant(P<0.05).Conclusion The twin pregnancy can improve the complication rate ,increase the adverse out-comes,Strengthen the Prenatal guidance and guardianship has an important significant .%目的:观察双胎妊娠与单胎妊娠孕产妇并发症和妊娠结局的差异。方法选择待产双胎妊娠孕产妇(双胎妊娠组)和单胎妊娠孕产妇(单胎妊娠组)各100例,比较2组孕产妇的并发症、产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率,评价单胎妊娠与双胎妊娠并发症、妊娠结局差异。结果双胎妊娠组的并发症发生率高于单胎妊娠组(P<0.05),产后出血量、低体质量儿发生率、新生儿窒息率、围生儿病死率明显高于单胎妊娠组(P<0.05)。结论双胎妊娠使孕产妇并发症增多,增加了新生儿预后不良的出现,加强对双胎妊娠的产前指导和监护,对双胎妊娠结局具有重要意义。

  1. The potential role of HPV vaccination in the prevention of infectious complications of pregnancy

    DEFF Research Database (Denmark)

    Bonde, Ulla; Jøergensen, Jan Stener; Mogensen, Ole

    2014-01-01

    outcomes of pregnancy. HPV may contribute to infertility and may increase the risk of miscarriage. Recent studies indicate a significant rate of vertical transmission of HPV between mother and child but whether the mode of delivery makes a difference to the risk of transmission remains unknown. HPV...

  2. Maternal obesity in females born small: Pregnancy complications and offspring disease risk.

    Science.gov (United States)

    Mahizir, Dayana; Briffa, Jessica F; Hryciw, Deanne H; Wadley, Glenn D; Moritz, Karen M; Wlodek, Mary E

    2016-01-01

    Obesity is a major public health crisis, with 1.6 billion adults worldwide being classified as overweight or obese in 2014. Therefore, it is not surprising that the number of women who are overweight or obese at the time of conception is increasing. Obesity during pregnancy is associated with the development of gestational diabetes and preeclampsia. The developmental origins of health and disease hypothesis proposes that perturbations during critical stages of development can result in adverse fetal changes that leads to an increased risk of developing diseases in adulthood. Of particular concern, children born to obese mothers are at a greater risk of developing cardiometabolic disease. One subset of the population who are predisposed to developing obesity are children born small for gestational age, which occurs in 10% of pregnancies worldwide. Epidemiological studies report that these growth-restricted children have an increased susceptibility to type 2 diabetes, obesity, and hypertension. Importantly during pregnancy, growth-restricted females have a higher risk of developing cardiometabolic disease, indicating that they may have an exacerbated phenotype if they are also overweight or obese. Thus, the development of early pregnancy interventions targeted to obese mothers may prevent their children from developing cardiometabolic disease in adulthood.

  3. Increasing pregnancy-related use of prescribed opioid analgesics

    Science.gov (United States)

    Epstein, Richard A.; Bobo, William V.; Martin, Peter R.; Morrow, James A.; Wang, Wei; Chandrasekhar, Rameela; Cooper, William O.

    2013-01-01

    Purpose To quantify the prevalence of prescribed opioid analgesics among pregnant women enrolled in Tennessee Medicaid from 1995 to 2009. Methods Retrospective cohort study of 277,555 pregnancies identified from birth and fetal death certificates, and linked to previously-validated computerized pharmacy records. Poisson regression was used to estimate trends over time, rate ratios and 95% confidence intervals. Results During the study period, 29% of pregnant women filled a prescription for an opioid analgesic. From 1995 to 2009, any pregnancy-related use increased 1.90-fold (95% CI = 1.83, 1.98), first trimester use increased 2.27-fold (95% CI = 2.14, 2.41), and second or third trimester use increased 2.02-fold (95% CI = 1.93, 2.12), after adjusting for maternal characteristics. Any pregnancy-related, first trimester, and second or third trimester use were each more likely among mothers who were at least 21 years old, white, non-Hispanic, prima gravid, resided in non-urban areas, enrolled in Medicaid due to disability, and who had less than a high school education. Conclusions Opioid analgesic use by Tennessee Medicaid-insured pregnant women increased nearly 2-fold from 1995 to 2009. Additional study is warranted in order to understand the implications of this increased use. PMID:23889859

  4. Vaginitis in pregnancy is related to adverse perinatal outcome.

    Science.gov (United States)

    Xu, Fengqiu; Du, Xiaodong; Xie, Lili

    2015-01-01

    To determine whether education level and occupation are risk factors of vaginitis in pregnant women and to investigate relationship between vaginitis occurrence during pregnancy and perinatal mortality rates. A total of 319 women of early pregnancy or mid-pregnancy were enrolled. Six specimens were collected from posterior fornix of each pregnant woman and then cultured for identification of Neisseria gonorrhoeae, intestinal bacteria, general bacteria, fungi, mycoplasma, and chlamydia, respectively. The pregnant women in the "elementary school or below" group and the "middle school" group had significantly higher incidences of vaginitis compared with the pregnant women in the groups of "high school", "skill education", and "college or above". The pregnant women in the groups of "Worker", "Government employee", "Company employee", and "Professionals" had significantly lower vaginitis incidences. The women with infections of Neisseria gonorrhoeae, intestinal bacteria, and general bacteria had higher perinatal mortalities (0.063 ± 0.011, 0.052 ± 0.012, and 0.017 ± 0.008, respectively) than women with infections of fungi, mycoplasma, and Chlamydia (0.002 ± 0.007, 0.003 ± 0.004, and 0.001 ± 0.001, respectively). Education level and occupation are risk factors related to incidences of vaginitis in pregnant women. The bacteria-related vaginitis is a major reason of perinatal mortality.

  5. Pregnancy following bariatric requires special attention

    DEFF Research Database (Denmark)

    Renault, Kristina; Andersen, Lise Lotte Fischer; Kjær, Mette Karie Mandrup

    2012-01-01

    In the latest years the number of pregnant women having undergone bariatric surgery before pregnancy has increased rapidly. In pregnancy, they seem to have a reduced risk of obesity-related complications but an increased risk of mechanical complications causing small bowel obstruction and complic...

  6. Making Pregnancy Safer-Birth Preparedness and Complication Readiness Study Among Antenatal Women Attendees of A Primary Health Center, Delhi

    Directory of Open Access Journals (Sweden)

    Anita Shankar Acharya

    2015-01-01

    Full Text Available Background: Every pregnancy is a joyful moment for all mothers who dream of a safe pregnancy and a healthy baby. However, every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. Birth preparedness and complication readiness (BPACR is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. It is a key component of globally accepted safe motherhood programs. Objectives: The objective of our study was to assess the status of BPACR among pregnant women and to study the socio-demographic factors affecting BPACR. Materials and Methods: We conducted a facility-based cross-sectional study among 417 antenatal attendees at a primary health center, Palam, New Delhi from January to April 2012. Knowledge about danger signs, planning for transport, place, and delivery by skilled birth attendant, financial management, and outcome were assessed. BPACR index was calculated. Results: Our study revealed that the BPACR index was very low (41% although the preparedness level was high. Majority (81.1% had identified a skilled attendant at birth for delivery. Nearly half of the women (48.9% had saved money for delivery and 44.1% women had also identified a mode of transportation for the delivery. However, only 179 (42.9% women were aware about early registration of pregnancy. Only one-third (33.1% of women knew about four or more antenatal visits during pregnancy. Overall, only 27.8% women knew about any one danger sign of pregnancy. Conclusion: The level of awareness regarding BPACR was very low (41%. Efforts should be targeted to increase the awareness regarding components of BPACR among pregnant women and their families at the Primary Health Center (PHC as well as at the community level. This will indeed go a long way in reducing morbidity as well as mortality in pregnant women, thus enabling

  7. Irisin在妊娠合并糖尿病中的研究进展%Research Progress of Irisin in Pregnancy Complicated with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    张宁娟; 李华萍

    2016-01-01

    , insulin resistance and insulin secretion capacity. Irisin can promote the burning of fat cells, inhibit gluconeogenesis and increase the islet cells regeneration. Irisin may be related to the occurrence and development of pregnancy complicated with diabetes. By improving the obesity and reducing insulin resistance, Irisin is expected to become a target in prevention and treatment of obesity related metabolic diseases.

  8. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

    Science.gov (United States)

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2015-04-01

    Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  9. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Satoko Matsuzaki

    2015-04-01

    Full Text Available Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta, the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM. Study Design - Case report and review of the literature. Results - A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion - Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  10. 妊娠合并羊水过少395例临床探讨%Pregnancy complicated by oligohydramnios, a clinical study of 395 cases

    Institute of Scientific and Technical Information of China (English)

    孔剑辉

    2012-01-01

      Objective:To explore the related factors of pregnancy complicated by oligohydramnios and perinatal influences, positive and correct treatment, to reduce the perinatal mortality rate.Methods:In our hospital from 2005 July to 2012 June inpatient treatment of pregnant women with oligohydramnios 395 cases as study group, the same period were randomly selected in our hospital delivery of amniotic fluid volume in normal pregnant women, 395 cases as the control group, comparative analysis of two groups of pregnancy complications and perinatal conditions.Results:The study group occurrence of contamination of amniotic fluid, fetal distress and neonatal asphyxia was significantly higher than that of control group (P<0.01).Conclusion:For the pregnant women in pregnancy complicated by oligohydramnios, comprehensive judgment, proper termination of pregnancy, to improve perinatal survival quality, reduce the perinatal mortality rate is of great significance.%  目的:探讨妊娠合并羊水过少的相关因素及对围生儿的影响,积极正确处理,以降低围生儿的病死率.方法:收集我院2005年7月~2012年6月住院治疗的羊水过少孕妇395例作为研究组,随机抽取同期我院分娩的羊水量正常的孕妇395例作为对照组,对比分析两组妊娠并发症及围生儿情况.结果:研究组发生羊水污染、胎儿窘迫及新生儿窒息明显高于对照组(P<0.01).结论:对于妊娠合并羊水过少的孕妇,综合判断,选择合理方式终止妊娠,对提高围生儿生存质量、降低围生儿病死率有很大意义.

  11. [Pregnancy-associated hormones and fetal-maternal relations].

    Science.gov (United States)

    Gailly-Fabre, E; Kerlan, V; Christin-Maitre, S

    2015-10-01

    Pregnancy is an immunological paradox that implies that a semi-allogeneic fetus is not rejected by the maternal immune system, from implantation of the embryo to delivery. Progesterone (P4), estradiol (E2) and human chorionic gonadotropin (hCG), contribute to the transformation of immune cells in a transient tolerance state, necessary to the maintenance of pregnancy. The effects of pregnancy hormones depend probably of their maternal plasma level. hCG is dangerous at high concentrations because it can stimulate autoantibodies production, whereas in physiological concentrations, hCG, P4 and E2 upregulate immune response expanding regulatory T and B cells, allowing the fetus to grow within the maternal uterus in a protective environment. A second example of fetal-maternal relation found recently is the role of maternal nutrition on development of the fetal hypothalamic neurons. Experiments in mice fed on a high fat diet reveal a critical timing when altered maternal metabolism affect formation of hypothalamic neurocircuits of the offspring and predispose him to long-term metabolic disorders.

  12. A RARE CASE OF FACTOR V LEIDEN MUTATION COMPLICATING PREGNANCY IN INDIA

    Directory of Open Access Journals (Sweden)

    Chitra

    2016-05-01

    Full Text Available Factor V Leiden mutation (Factor V Leiden is an autosomal dominant haemostatic disorder that predisposes affected persons to venous thromboembolic events (VTE. Although the mutation causing FVL is easily diagnosed using molecular DNA techniques, (1 patients who are heterozygous for this disorder often remain asymptomatic until they develop a concurrent prothrombotic condition. Pregnancy, which may increase an individual woman’s risk of venous thromboembolic events by 5- to 6-fold. (2 Because there are potentially serious effects of FVL for both the mother and the child, and availability of effective treatment strategies, early detection and treatment of this condition is warranted. (3 We are presenting this case in order to emphasise the existence of Factor V Leiden in Indian population and its approach during pregnancy.

  13. Mode of first delivery and severe maternal complications in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Colmorn, Lotte B.; Krebs, Lone; Klungsøyr, Kari

    2017-01-01

    INTRODUCTION: Severe obstetric complications increase by the number of previous cesarean deliveries. In the Nordic countries most women have two children. We present the risk of severe obstetric complications at the delivery following a first elective or emergency cesarean and the risk by intended...... mode of second delivery. MATERIAL AND METHOD: A two-year population-based data-collection of severe maternal complications in women with two deliveries in the Nordic countries (n=213 518). Denominators were retrieved from the national medical birth registers. RESULTS: Out of 35 450 first cesarean...... deliveries (17%), 75% were emergency and 25% elective. Severe complications at second delivery were more frequent in women with a first cesarean than a first vaginal delivery and rates of abnormally invasive placenta, uterine rupture and severe postpartum hemorrhage were higher after a first elective than...

  14. Validation of Iranian Version of Pregnancy Related Anxiety Questionnaire

    Science.gov (United States)

    Askarizadeh, Ghasem; Karamoozian, Mahsa; Darekordi, Ali

    2017-01-01

    Background: Pregnancy is an acute period in the lifetime of women, during which numerous excitatory physical and social changes occur. The purpose of this study is confirmatory factor analysis of Pregnancy Related Anxiety Questionnaire (PRAQ) that is designed in Iranian pregnant women population. Methods: A total of 170 pregnant women in health centers of Kerman city were chosen through random sampling method and completed PRAQ questionnaire and Beck Anxiety Inventory (BAI). In this study, confirmatory factor analysis and concurrent validity are used to evaluate the validity of models; and to test-retest and Cronbach alpha were used for evaluating external and internal reliability in SPSS-19 and the AMOS software to evaluate reliability of models. Results: Confirmatory factor analysis gave an acceptable value for the latent PRAQ in the question scale and 5 micro-scale level. Furthermore, significant correlation between the components and the overall scale of the PRAQ questionnaire with the BAI confirmed concurrent validity of questionnaire. The reliability of questionnaire is confirmed based on Cronbach's alpha coefficient value of 0.78 that calculated 0.69–0.76 for the five-factors. A month later, reliability coefficient amplitude of test-retest on forty pregnant women was between 0.65 and 0.72 which shows the reliability of PRAQ over time. Conclusions: The short form of anxiety during pregnancy questionnaire has the essential psychometric properties. In this study, five-factors extracted in the PRAQ were adapted with the factors extracted from the original version. This study introduces an instrument that can be benefit in measuring anxiety and concerns of women during pregnancy.

  15. Salmonella enterica Serotype Typhi Bacteremia Complicating Pregnancy in the Third Trimester

    Science.gov (United States)

    Patel, Krunal; Gittens-Williams, Lisa; Apuzzio, Joseph J.; Martimucci, Kristina; Williams, Shauna F.

    2017-01-01

    Background. Salmonella enterica serotype Typhi (S. Typhi) is an anaerobic gram-negative enteric rod that causes infection when contaminated food or water is ingested and may cause illness in pregnancy. Case. This is a patient who presented at 31 weeks' gestation with abdominal pain and fever and was diagnosed with S. Typhi bacteremia. Conclusion. S. Typhi should be considered in febrile patients with recent travel presenting with abdominal discomfort with or without elevated liver enzymes. PMID:28203469

  16. Mechanisms Involved in the Association between Periodontitis and Complications in Pregnancy

    OpenAIRE

    Zi, Marcela Yang Hui; Longo, Priscila Larcher; Bueno-Silva, Bruno; Marcia Pinto Alves MAYER

    2015-01-01

    The association between periodontitis and some of the problems with pregnancy such as premature delivery, low weight at birth, and preeclampsia (PE) has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to revie...

  17. Graves' disease in two pregnancies complicated by fetal goitrous hypothyroidism: successful in utero treatment with levothyroxine

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Rasmussen, Åse Krogh; Sundberg, Karin Milner

    2011-01-01

    Treatment of Graves' disease during pregnancy with antithyroid drugs (ATDs) poses a risk of inducing hypothyroidism and, thus, development of a goiter to the fetus. PATIENT FINDINGS: We report two patients referred to our department after discovery of a fetal goiter by ultrasound examination in t...... hypothyroidism as the cause of goiter development. Reduction of maternal ATD dose and injection of levothyroxine intra-amniotically quickly reduced the goiter size, and both babies were born euthyroid and without goiters....

  18. A successful gestational outcome in the presence of genitourinary abnormalities and severe medical complications of pregnancy.

    Science.gov (United States)

    Reece, E A; Husami, N; Baxi, L

    1982-01-01

    Müllerian duct dysgenesis may result in various genitourinary abnormalities and a high incidence of associated gestational losses. The bicornuate uterus (with either one or two cervices) and a single vagina are the most common genital variations, whereas an ectopic pelvic kidney and unilateral renal agenesis are the most common associated renal malformations. Inspite of the high incidence of fetal wastage resulting from pregnancies associated with congenital uterine abnormalities, aggressive perinatal and neonatal therapy may improve the gestational outcome.

  19. Haemodynamic resistance model of monochorionic twin pregnancies complicated by acardiac twinning

    Energy Technology Data Exchange (ETDEWEB)

    Umur, Asli [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam(Netherlands); Gemert, Martin J C van [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Wijngaard, Jeroen P H M van den [Laser Center and Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Ross, Michael G [Department of Obstetrics and Gynecology, Harbor University of California-Los Angeles Medical Center, Torrence, CA 9050 (United States); Nikkels, Peter G J [Department of Pathology, University Medical Center, Utrecht (Netherlands)

    2004-07-21

    An acardiac twin is a severely malformed monochorionic twin fetus that lacks most organs, particularly a heart. It grows during pregnancy, because it is perfused by its developmentally normal co-twin (called the pump twin) via a set of placental arterioarterial and venovenous anastomoses. The pump twin dies intrauterine or neonatally in about 50% of the cases due to congestive heart failure, polyhydramnios and prematurity. Because the pathophysiology of this pregnancy is currently incompletely understood, we modified our previous haemodynamic model of monochorionic twins connected by placental vascular anastomoses to include the analysis of acardiac twin pregnancies. We incorporated the fetoplacental circulation as a resistance circuit and used the fetal umbilical flow that perfuses the body to define fetal growth, rather than the placental flow as done previously. Using this modified model, we predicted that the pump twin has excess blood volume and increased mean arterial blood pressure compared to those in the acardiac twin. Placental perfusion of the acardiac twin is significantly reduced compared to normal, as a consequence of an increased venous pressure, possibly implying reduced acardiac placental growth. In conclusion, the haemodynamic analysis may contribute to an increased knowledge of the pathophysiologic consequences of an acardiac body mass for the pump twin. (note)

  20. Glucose Fluctuations during Gestation: An Additional Tool for Monitoring Pregnancy Complicated by Diabetes

    Directory of Open Access Journals (Sweden)

    M. G. Dalfrà

    2013-01-01

    Full Text Available Continuous glucose monitoring (CGM gives a unique insight into magnitude and duration of daily glucose fluctuations. Limited data are available on glucose variability (GV in pregnancy. We aimed to assess GV in healthy pregnant women and cases of type 1 diabetes mellitus or gestational diabetes (GDM and its possible association with HbA1c. CGM was performed in 50 pregnant women (20 type 1, 20 GDM, and 10 healthy controls in all three trimesters of pregnancy. We calculated mean amplitude of glycemic excursions (MAGE, standard deviation (SD, interquartile range (IQR, and continuous overlapping net glycemic action (CONGA, as parameters of GV. The high blood glycemic index (HBGI and low blood glycemic index (LBGI were also measured as indicators of hyperhypoglycemic risk. Women with type 1 diabetes showed higher GV, with a 2-fold higher risk of hyperglycemic spikes during the day, than healthy pregnant women or GDM ones. GDM women had only slightly higher GV parameters than healthy controls. HbA1c did not correlate with GV indicators in type 1 diabetes or GDM pregnancies. We provided new evidence of the importance of certain GV indicators in pregnant women with GDM or type 1 diabetes and recommended the use of CGM specifically in these populations.

  1. Glucose Fluctuations during Gestation: An Additional Tool for Monitoring Pregnancy Complicated by Diabetes

    Science.gov (United States)

    Dalfrà, M. G.; Chilelli, N. C.; Di Cianni, G.; Mello, G.; Lencioni, C.; Biagioni, S.; Scalese, M.; Sartore, G.; Lapolla, A.

    2013-01-01

    Continuous glucose monitoring (CGM) gives a unique insight into magnitude and duration of daily glucose fluctuations. Limited data are available on glucose variability (GV) in pregnancy. We aimed to assess GV in healthy pregnant women and cases of type 1 diabetes mellitus or gestational diabetes (GDM) and its possible association with HbA1c. CGM was performed in 50 pregnant women (20 type 1, 20 GDM, and 10 healthy controls) in all three trimesters of pregnancy. We calculated mean amplitude of glycemic excursions (MAGE), standard deviation (SD), interquartile range (IQR), and continuous overlapping net glycemic action (CONGA), as parameters of GV. The high blood glycemic index (HBGI) and low blood glycemic index (LBGI) were also measured as indicators of hyperhypoglycemic risk. Women with type 1 diabetes showed higher GV, with a 2-fold higher risk of hyperglycemic spikes during the day, than healthy pregnant women or GDM ones. GDM women had only slightly higher GV parameters than healthy controls. HbA1c did not correlate with GV indicators in type 1 diabetes or GDM pregnancies. We provided new evidence of the importance of certain GV indicators in pregnant women with GDM or type 1 diabetes and recommended the use of CGM specifically in these populations. PMID:24319455

  2. Prevention and treatment of biopsy-related complications.

    Science.gov (United States)

    Satyanarayana, Ramgopal; Parekh, Dipen

    2014-02-01

    Transrectal biopsy of the prostate is necessary in the diagnosis of prostate cancer (PC). Though generally considered safe, patients encounter minor complications such as bleeding and urinary symptoms, and uncommonly, serious infections that may require antibiotic therapy, visits to the emergency room (ER) or hospital admission, causing morbidity and rarely even mortality. It is concerning that infections are on the rise due to resistant bacteria. Urologists will have to be aware of bacterial susceptibility studies to reduce such complications. This review focuses on prostate biopsy and its complications, and measures to reduce these complications in our practice.

  3. Combined blood purification for treating acute fatty liver of pregnancy complicated by acute kidney injury: a case series.

    Science.gov (United States)

    Tang, Wan Xin; Huang, Zhong Ying; Chen, Ze Jun; Cui, Tian Lei; Zhang, Ling; Fu, Ping

    2012-06-01

    Acute fatty liver of pregnancy (AFLP) complicated by acute kidney injury (AKI) is serious and life-threatening for the mother. The present study aimed to determine the clinical efficacy of combined blood purification treatment (CBPT) in patients with AFLP complicated by AKI. The CBPT involves plasma exchange (PE) combined with continuous venovenous hemofiltration (CVVH). The subjects were 17 patients with AFLP complicated by AKI. The CBPT was implemented based on the timely termination of pregnancy and general treatment. Changes in clinical manifestations, laboratory tests, liver ultrasounds, as well as Sequential Organ Failure Assessment (SOFA) and Glasgow scores were evaluated. The efficacy and adverse reactions of the CBPT were also assessed. The CBPT was smoothly performed without any obvious adverse reaction. After treatment, the clinical manifestations, laboratory examinations, and liver ultrasonography significantly improved. Therefore, the SOFA scores correspondingly decreased 1 week after treatment [9 (range 5-11) vs. 3 (range 0-10), P = 0.002], and the median was close to normal by the second week. The clearance rate of the total bilirubin in PE was significantly higher than that in CVVH (37.2 vs. 7.9%, P = 0.000). The incidence of acute pulmonary edema in CVVH was less than that in PE (0 vs. 41.2%, P = 0.007). Finally, the maternal mortality was 5.88% (95% CI: 0-29%). Overall, we think that CBPT aids in the recovery of liver and kidney function. Different blood purification methods may be combined to integrate and maximize their advantages to improve the prognoses of patients with serious AFLP.

  4. 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....

  5. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Baby Caring for your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications ... Baby Caring for your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications ...

  6. Complications from Surgeries Related to Ovarian Cancer Screening.

    Science.gov (United States)

    Baldwin, Lauren A; Pavlik, Edward J; Ueland, Emma; Brown, Hannah E; Ladd, Kelsey M; Huang, Bin; DeSimone, Christopher P; van Nagell, John R; Ueland, Frederick R; Miller, Rachel W

    2017-03-08

    The aim of this study was to evaluate complications of surgical intervention for participants in the Kentucky Ovarian Cancer Screening Program and compare results to those of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. A retrospective database review included 657 patients who underwent surgery for a positive screen in the Kentucky Ovarian Cancer Screening Program from 1988-2014. Data were abstracted from operative reports, discharge summaries, and office notes for 406 patients. Another 142 patients with incomplete records were interviewed by phone. Complete information was available for 548 patients. Complications were graded using the Clavien-Dindo (C-D) Classification of Surgical Complications and considered minor if assigned Grade I (any deviation from normal course, minor medications) or Grade II (other pharmacological treatment, blood transfusion). C-D Grade III complications (those requiring surgical, endoscopic, or radiologic intervention) and C-D Grade IV complications (those which are life threatening) were considered "major". Statistical analysis was performed using SAS 9.4 software. Complications were documented in 54/548 (10%) subjects. For women with malignancy, 17/90 (19%) had complications compared to 37/458 (8%) with benign pathology (p Cancer Screening trial, 212 women had surgery for ovarian malignancy, and 95 had at least one complication (45%). Of the 1080 women with non-cancer surgery, 163 had at least one complication (15%). Compared to the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial, the Kentucky Ovarian Cancer Screening Program had significantly fewer complications from both cancer and non-cancer surgery (p Cancer Screening Program were infrequent and significantly fewer than reported in the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. Complications were mostly minor (93%) and were more common in cancer versus non-cancer surgery.

  7. Hysterectomy in women with obesity: complications related to surgical site.

    Science.gov (United States)

    Naveiro-Fuentes, Mariña; Rodríguez-Oliver, Antonio; Maroto-Martín, María T; González-Paredes, Aida; Aguilar-Romero, María T; Mozas-Moreno, Juan

    2017-02-01

    The aim of this study was to describe the trends in surgical routes in obese women who underwent hysterectomy for benign disease at our center and compare complications in different groups. Retrospective study done between 2011 and 2015 in women with a Body Mass Index≥30 who underwent hysterectomy for benign disease at Virgen de las Nieves Universitary Hospital in Granada, Spain. We studied three groups based on the surgical route chosen for hysterectomy: vaginal, abdominal or laparoscopic. The rates of intraoperative and postoperative complications, major complications, reintervention and days of hospital stay were compared. Abdominal hysterectomy was associated with the highest risk of postoperative complications and the longest hospital stay. Laparoscopic hysterectomy had a higher risk than vaginal hysterectomy of major complications. There were no significant differences between groups for any of the other variables. In obese women vaginal hysterectomy was associated with the lowest morbidity, and should be the approach of choice whenever feasible.

  8. [Maternal metabolic diseases related to pre-pregnancy overweight and obesity in mexican women with high risk pregnancy].

    Science.gov (United States)

    Hernández-Higareda, Salvador; Pérez-Pérez, Omar-Alejandro; Balderas-Peña, Luz-Ma-Adriana; Martínez-Herrera, Brenda-Eugenia; Salcedo-Rocha, Ana-Leticia; Ramírez-Conchas, Rosa-Emilia

    Pre-pregnancy obesity has been proposed as a risk factor related to gestational diabetes and hypertensive disorders during pregnancy. Identify pregnancy related diseases associated with pre-pregnancy obesity as a risk factor ina high risk preganancy patient population. 600 patients whose pre-pregnancy obesity had been assessed as a high risk factor were included in the study. The means, standard deviation, median, interquartile intervals, Pearson and Spearman correlation and logistic regression to estimate risk with the odds ratio and 95% confidence intervals were calculated. The mean pre-pregnancy body mass index was 29.59 ± 6.42 kg/m(2). The mean for recommended pregnancy weight gain was 2.31 ± 1.03 kg, but the mean of real weight gain was 8.91 ± 6.84 kg. A significant correlation between pre-pregnancy obesity and family history of diabetes mellitus (p=0.000), systemic hypertension (p=0.003), cardiac diseases (p=0.000), dyslipidemia (p=0.000) and obesity (p=0.000) was identified. Pre-pregnancy obesity was identified as a risk factor for the development of gestational diabetes (OR: 1.95; IC95%: 1.39 to 2.76; p=0.000) in this kind of patient. 75% of high risk pregnancy women in a high specialty hospital in West Mexico are overweight or obese when they become pregnant. These are risk factors in the development of gestational diabetes. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Endocrine disorders in pregnancy

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Mathiesen, Elisabeth R

    2011-01-01

    The endocrinology of pregnancy involves endocrine and metabolic changes as a consequence of physiological alterations at the foetoplacental boundary between mother and foetus. The vast changes in maternal hormones and their binding proteins complicate assessment of the normal level of most hormones...... during gestation. The neuroendocrine events and their timing in the placental, foetal and maternal compartments are critical for initiation and maintenance of pregnancy, for foetal growth and development, and for parturition. As pregnancy advances, the relative number of trophoblasts increase...

  10. Hypertension and pregnancy.

    Science.gov (United States)

    Deak, Teresa M; Moskovitz, Joshua B

    2012-11-01

    Hypertension in pregnancy is increasing in prevalence and incidence and its treatment becoming more commonplace. Associated complications of pregnancy, including end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia, are leading sources of maternal and fetal morbidity and mortality, requiring an emergency physician to become proficient with their identification and treatment. This article reviews hypertension in pregnancy as it relates to outcomes, with special emphasis on preeclampsia, eclampsia, and postpartum eclampsia.

  11. Maternal serum soluble CD30 is increased in pregnancies complicated with acute Pyelonephritis

    Science.gov (United States)

    Kusanovic, Juan Pedro; Romero, Roberto; Espinoza, Jimmy; Gotsch, Francesca; Edwin, Samuel; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Soto, Eleazar; Erez, Offer; Mazaki-Tovi, Shali; Than, Nandor Gabor; Friel, Lara; Yoon, Bo Hyun; Mazor, Moshe; Hassan, Sonia

    2007-01-01

    Objectives Normal pregnancy is characterized by activation of the innate immunity and suppression of the adaptive limb of the immune response. However, pregnant women are more susceptible to the effects of infection and microbial products than non-pregnant women. CD30 is a member of the tumor necrosis factor receptor superfamily and is preferentially expressed by activated T cells producing Th2-type cytokines. Its soluble form (sCD30) is proposed to be an index of Th2 immune response. High serum concentrations of sCD30 have been found in the acute phase of viral infections, such as HIV-1 and hepatitis B. There is, however, conflicting evidence about serum sCD30 concentration in patients with bacterial infections. The objective of this study was to determine whether there are changes in the serum concentration of sCD30 in pregnant women with pyelonephritis. Methods This cross-sectional study included normal pregnant women (N=89) and pregnant women with pyelonephritis (N=41). Maternal serum concentration of sCD30 was measured by a specific and sensitive enzyme-linked immunoassay. Non-parametric tests were used for comparisons. A p value pyelonephritis had a significantly higher median serum concentration of sCD30 than those with a normal pregnancy (median: 44.3 U/ml, range: 16–352.5 vs. median: 29.7 U/ml, range: 12.2–313.2, respectively; ppyelonephritis who had a positive blood culture compared to those with a negative blood culture (median:47.7 U/mL, range: 17.1–118.8 vs. median: 42.6 U/mL, range: 16–352.5, respectively; p=0.86). Conclusions Acute pyelonephritis during pregnancy is associated with a higher maternal serum concentration of sCD30 than normal pregnancy. This finding is novel, and suggests that pregnant women with pyelonephritis may have a complex immune state in which there is activation of some components of what is considered a Th2 immune response. PMID:17853184

  12. Sports-related concussions: diagnosis, complications, and current management strategies.

    Science.gov (United States)

    Hobbs, Jonathan G; Young, Jacob S; Bailes, Julian E

    2016-04-01

    Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes per year. The initial diagnosis and management is often instituted on the field of play by coaches, athletic trainers, and team physicians. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7-10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Advanced imaging techniques such as functional MRI, and detailed understanding of the complex pathophysiological process underlying SRCs and how they affect the athletes acutely and long-term, may change the way physicians treat athletes who suffer a concussion. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.

  13. Immunopathogenesis of Hepatitis B Virus Infection and Related Complications

    Directory of Open Access Journals (Sweden)

    Mankgopo M. Kgatle

    2016-05-01

    Full Text Available Chronic hepatitis B (CHB is a serious consequence of hepatitis B virus (HBV, which infects and replicates in the liver. It is characterised by prolonged hepatitis B surface antigen seropositivity; this can lead to both cirrhosis and hepatocellular carcinoma (HCC. The infection begins when HBV binds its only known functional receptor, sodium taurocholate cotransporting polypeptide (NTCP, which was identified recently. The discovery of NTCP was a significant breakthrough in the field of HBV research, and has facilitated the establishment of a susceptible hepatoma cell line model for studying the mechanisms underlying HBV pathogenesis. Following productive HBV infection, both cellular and humoral immune cells and molecules, such as T cells and chemokines, are activated to resolve infection by destroying HBV-infected hepatocytes. However, host immunity to HBV is not always protective, most likely due to immune evasion mechanisms employed by HBV. These mechanisms may result in viral persistence, accumulation of mutations, and aberrant epigenetic alterations that lead to HCC. Here we highlight our current understanding of the HBV replication cycle, immunopathogenesis, and related mechanisms underlying the progression of CHB to advanced liver disease, along with the attendant complications.

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

    Science.gov (United States)

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

    2017-01-01

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

  15. Relative rates and features of musculoskeletal complications in adult sicklers.

    Science.gov (United States)

    Bahebeck, Jean; Atangana, Réné; Techa, André; Monny-Lobe, Marcel; Sosso, Maurice; Hoffmeyer, Pierre

    2004-04-01

    The purpose of this study was to prospectively look for the relative rates and features of musculoskeletal complications in a sample of adult homozygous SS sicklers in Yaoundé. During a 3-year period, known homozygous SS sicklers aged sixteen years or more, with suspicion or evidence of locomotor system disease, including leg ulcer, were consecutively investigated through complete medical history, clinical examination, full blood count, C-reactive protein, standard radiographs of the area of complaint, and, when necessary, CT scan and pus analysis. Those patients with no definite diagnosis were excluded. The study group comprised 84 patients aged 16 to 51 years (mean age: 22 years), with a male/female ratio of 0.75. Four of them (4.5%) were older than 40 years. Thirty five (41.6%) presented a total of 50 lesions of aseptic osteonecrosis, which were located in the hips in 25 cases (50%), in the lumbar spine in 20 cases (40%), in the humeral head in four cases (10%) and in the talar body in one case. The hip necrosis was grade I in 6 cases, grade II in four, grade III in 11 and terminal in four. Multiple sites of necrosis were observed in six patients. Nineteen (22.6%) of the sicklers came on with 36 malleolar ulcers, more frequently in males (sex ratio: 5/1) and 28 (78%) located on the medial side. Fifteen sites of osteomyelitis were noted in 14 patients (17.8%) and septic arthritis in six (7%). Less frequent complications were impingement syndrome, gout osteoarthropathy, stress fracture, subtalar fusion, knee osteoarthritis, tendonitis of the anterior tibialis, and recurrent dislocation of the patella. All patients were managed conventionally, except for advanced aseptic necrosis in which the indication for arthroplasty was delayed till the terminal stage. As suggested by another recent report from Senegal, efforts should be made to improve the life expectancy of sicklers in Sub-Saharan African countries, by acting on education, social and medical care

  16. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    .01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p ... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  17. Mechanisms involved in the association between periodontitis and complications in pregnancy.

    OpenAIRE

    Marcela eYang; Longo, Priscila L; Bruno eBueno-Silva; Marcia Pinto Alves Mayer

    2015-01-01

    The association between periodontitis and gestation complications such as premature delivery, low weight at birth and preeclampsia has been suggested. Nevertheless, epidemiological data have shown contradictory data, mainly due to differences in clinical parameters of periodontitis assessment. Furthermore, differences in microbial composition and immune response between aggressive and chronic periodontitis are not addressed by these epidemiological studies. We aimed to review the current data...

  18. Recurrent pregnancy-related upper airway obstruction caused by intratracheal ectopic thyroid tissue

    DEFF Research Database (Denmark)

    Døssing, H; Jørgensen, K E; Oster-Jørgensen, E

    1999-01-01

    An unusual case of recurrent pregnancy-related thyroid growth stimulation is reported. A 27-year-old euthyroid woman had pulmonary symptoms, thought to be asthma during her first pregnancy, that improved postpartum. Bronchodilatators had no effect and symptoms recurred from gestational week 22 du...... intratracheal ectopic thyroid tissue diagnosed during pregnancy....

  19. Pregnancy outcomes of twin pregnancies complicated with growth discordance%双胎妊娠胎儿发育不均衡的妊娠结局

    Institute of Scientific and Technical Information of China (English)

    赫英东; 李雨利; 陈倩

    2014-01-01

    目的 探讨双胎妊娠胎儿发育不均衡的临床特点及预后.方法 回顾性分析2000年1月1日至2012年7月31日在北京大学第一医院产科分娩的576例双胎妊娠孕妇(除外双胎输血综合征病例)资料.根据胎儿腹围以及股骨长估计胎儿体重,分娩后记录新生儿出生体重,根据公式[(较大儿体重-较小儿体重)/较大儿体重×100%]计算双胎体重的差异,体重差异≥25%考虑存在胎儿发育不均衡,<25%为胎儿发育均衡.分析双胎妊娠胎儿发育不均衡的发生率;比较胎儿发育不均衡者(不均衡组,68例)与胎儿发育均衡者(均衡组,508例)的母体并发症(子痫前期、胎膜早破、妊娠期糖尿病、产后出血等)发生率、早产率、围产儿病死率、新生儿出生体重和新生儿合并症(心血管系统疾病和颅内病变)发生率.统计学分析采用t检验或卡方检验. 结果 576例双胎妊娠中,胎儿发育不均衡总体发生率为11.8%(68/576).单绒毛膜双胎胎儿发育不均衡发生率[17.6%(40/227)]高于双绒毛膜双胎[8.0%(28/349)],差异有统计学意义(x2=11.40,P<0.05).胎儿发育不均衡组分娩孕周小于均衡组[(35.6±4.1)周与(36.6±3.2)周,t=1.66,P<0.05],早产率高于均衡组[58.8%(40/68)与47.6% (242/508),x2=3.85,P<0.05].不均衡组围产儿病死率高于均衡组[9.6%(1 3/136)与4.7% (48/1 016),x2=5.84,P<0.05].胎儿发育不均衡者中,单绒毛膜双胎妊娠新生儿颅内病变的发生率明显高于双绒毛膜双胎组[20.9%(14/67)与6.8%(3/44),x2=4.06,P<0.05].结论 双胎妊娠胎儿发育不均衡孕妇较易发生不良妊娠结局.应加强产前保健,并及时评估胎儿的宫内状况,分娩后建议对新生儿进行全面检查并长期随访.%Objective To investigate clinical characteristics and outcomes of twin pregnancies complicated with growth discordance.Methods Five hundred and seventy-six twin pregnancies who delivered between January 1

  20. Increased Maternal Serum Interleukin-6 Concentrations at 11 to 14 Weeks of Gestation in Low Risk Pregnancies Complicated with Gestational Diabetes Mellitus: Development of a Prediction Model.

    Science.gov (United States)

    Hassiakos, D; Eleftheriades, M; Papastefanou, I; Lambrinoudaki, I; Kappou, D; Lavranos, D; Akalestos, A; Aravantinos, L; Pervanidou, P; Chrousos, G

    2016-01-01

    The aim of the study was to examine interleukin-6 (IL-6) maternal serum concentration at 11 to 14 gestational weeks in normal pregnancies and pregnancies complicated by gestational diabetes mellitus (GDM) and to create first trimester prediction models for GDM. Case-control study conducted in a Fetal Medicine Unit. Study population included 40 GDM cases and 94 controls. Maternal characteristics, first trimester ultrasound markers, biochemical indices, and IL-6 levels were used for our analysis. IL-6 was related to maternal weight among the maternal characteristics, (R(2)=0.0679, p=0.01). IL-6 was increased (p=0.001) in the GDM group (median=2 pg/ml) compared to the control group (median=1.5 pg/ml) even after adjustment for maternal weight. IL-6 was inversely related to birth weight adjusted for gestational age at delivery (r=-0.3382, poral glucose test. Maternal weight and age were the only predictors of GDM among the maternal characteristics [Detection Rate (DR)=59.4%; for 25% False Positive Rate (FPR); Area Under the Curve (AUC)=0.7291; Model R(2)=0.1096, p<0.001]. IL-6 alone was a significant predictor of GDM (DR=51.3%; for 25% FPR; AUC=0.6731; Model R(2)=0.0616, p<0.001). Combination of maternal characteristics with IL-6 yielded an improved prediction (DR=67.5%; for 25% FPR; AUC=0.7586; Model R(2)=0.1521, p<0.001). IL-6 concentrations are increased at 11-14 weeks in pregnancies with GDM. Combination of maternal characteristics and maternal serum IL-6 levels may provide effective first trimester screening for GDM.

  1. Complications associated with ureterorenoscopy (URS) related to treatment of urolithiasis

    DEFF Research Database (Denmark)

    Somani, B K; Giusti, G; Sun, Y

    2017-01-01

    INTRODUCTION: Ureterorenoscopy (URS) is a popular and growing option for management of ureteric and renal stones. The CROES URS Global Study was set up to assess the outcomes of URS in a large worldwide cohort of patients involving multiple centres. In this paper, we analysed the database for intra-operative...... and post-operative complications associated with ureterorenoscopy. METHODS: The CROES database was established via collaboration between 114 centres in 32 countries worldwide, and information on both intra-operative and post-operative complications was collected electronically between January 2010...... and October 2012. RESULT: On analysis of a total of 11,885 patients, the overall complication and stone-free rates were found to be 7.4 and 85.6 %, respectively. The intra-operative and post-operative complication rates were 4.2 and 2.6 %, respectively, and in total 5 deaths were reported in the study period...

  2. [Pregnancy-related pelvic ring disease and its treatment].

    Science.gov (United States)

    Wang, Y; Wu, X B; Yang, M H; Jiang, Y; Zhao, G; Zhang, Z A

    2015-04-18

    Pregnancy-related pelvic ring disease brings great suffering to pregnant women, including the separation of the pubic symphysis and sacroiliac joint pain. Hormonal changes leading to ligamentous laxity is the main reason for Pregnancy-related pelvic ring disease. In normal pregnant cases, and the physiologic widening at the symphysis is about 3-7 mm. When the widening of the symphysis is more than 10 mm, it may lead to symptoms and need active treatment. Currently the diagnosis of the pubic symphysis separation is based on the clinical symptoms and signs. The treatment of acute pubic symphysis separation bases on conservative therapy, includes bed rest and physical therapy. But when the widening of the symphysis is more than 4 cm, the surgery intervention may be a good treatment. If the conservative treatment is not obviously effective, the surgery consists of plate fixation in the pubic symphysis and sacroiliac screw fixation. Other indications for the surgical intervention include inadequate reduction, recurrent diastasis, intractable symptoms, and open rupture.

  3. Oral manifestations in type-2 diabetes and related complications

    OpenAIRE

    Sarita Bajaj; Suresh Prasad; Arvind Gupta; Vijay Bahadur Singh

    2012-01-01

    Background: Knowledge of the wide spectrum of the oral markers of diabetes is imperative as one frequently encounters individuals with undetected, untreated or poorly controlled diabetes. Objectives: The objective was to study the oral manifestations in type 2 diabetes mellitus (DM) and to establish an association between oral manifestations and associated microvascular and macrovascular complications. Materials and Methods: 50 cases of DM were selected who had oral complications. The control...

  4. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography

    Directory of Open Access Journals (Sweden)

    Weintraub Nealw F

    2009-04-01

    Full Text Available Abstract We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  5. Spontaneous left main coronary artery dissection complicated by pseudoaneurysm formation in pregnancy: role of CT coronary angiography.

    Science.gov (United States)

    Rahman, Shahid; Abdul-Waheed, Mohammed; Helmy, Tarek; Huffman, Lynn C; Koshal, Vipin; Guitron, Julian; Merrill, Walter H; Lewis, David F; Dunlap, Stephanie; Shizukuda, Yukitaka; Weintraub, Neal L; Meyer, Christopher; Cilingiroglu, Mehmet

    2009-04-01

    We report a case of a 26-year-old female, who presented at 34 weeks of an uncomplicated pregnancy with an acute ST elevation anterior wall myocardial infarction. Cardiac catheterization suggested a left main coronary artery dissection with pseudoaneurysm formation. The patient's course was complicated by congestive heart failure. She was initially managed conservatively by a multidisciplinary team including heart failure specialists, obstetricians, and cardiovascular surgeons. 4 days after admission, her LMC was imaged by dual-source 64 slice Cardiac computed tomography, coronary dissection was identified extending to the lumen, and the presence of pseudoaneurysm was confirmed. She underwent subsequently a staged procedure, which included placement of an intra-aortic balloon pump, cesarean section, and coronary artery bypass grafting. This case illustrates the utility of coronary artery CT imaging to assess the complexity and stability of coronary artery dissections, thereby helping to determine the need for, and timing of revascularization procedures.

  6. Appendectomy during the third trimester of pregnancy in a 27-year old patient: case report of a "near miss" complication

    Directory of Open Access Journals (Sweden)

    Holzer Thomas

    2011-05-01

    Full Text Available Abstract The management of acute appendicitis during pregnancy is not fully established, especially regarding the choice between open and laparoscopic surgery during the third trimester. We report herein the case of a major uterine variecele hemorrhage during a laparoscopic appendectomy in a 27-year old pregnant patient at 33 weeks of amenorrhea. After conversion to a Pfannenstiel incision, the baby was delivered, the bleeding stopped and the appendectomy completed. While both mother and child fully recovered, this «near miss» complication underlines the challenges linked to the management of acute appendicitis during pregnancy. Based on a literature review, we propose an algorithm favoring the laparoscopic approach during the first and second trimesters, and the open approach during the third trimester (especially after the 26th week of amenorrhea. In case of unclear pre-operative diagnosis, a laparoscopy should be conducted even during the third trimester with a Mc Burney conversion when the diagnosis of appendicitis is confirmed.

  7. The Emerging Role of Telemedicine in Managing Glycemic Control and Psychobehavioral Aspects of Pregnancy Complicated by Diabetes

    Directory of Open Access Journals (Sweden)

    Nino Cristiano Chilelli

    2014-01-01

    Full Text Available There is a gradual decline in concern of specialists who follow up the care of pregnant women with diabetes. In addition, due to the dwindling economic resources allocated to health services, access to specialized healthcare facilities is becoming more difficult. Telemedicine, or medicine practiced at a distance, is inserted in this context with applications differing for type of interaction (real-time or deferred, i.e., videoconferencing versus store-and-forward data transmission, type of monitoring (automatic versus requesting cooperation from the patient, and type of devices used (web connections and use of mobile phones or smartphones. Telemedicine can cope with the current lack of ability to ensure these patients frequent direct contact with their caregivers. This approach may have an impact not only on the classical maternal-fetal outcome, but also on some underestimated aspects of patients with diabetes in pregnancy, in this case their quality of life, the perception of “diabetes self-efficacy,” and the glycemic variability. In this paper, we will analyze the current evidence regarding the use of telemedicine in pregnancies complicated by diabetes, trying to highlight the main limitations of these studies and possible strategies to overcome them in order to improve the effectiveness of future clinical interventions with these medical applications.

  8. Reactivity of blood vessels in response to prostaglandin E2 in placentas from pregnancies complicated by fetal growth restriction.

    Science.gov (United States)

    Luria, Oded; Bar, Jacob; Barnea, Ofer; Golan, Abraham; Kovo, Michal

    2012-05-01

    The authors aimed to study the contractility responses of normal and fetal growth restriction (FGR) placentas to prostaglandin E(2) (PGE(2) ) and to correlate the results to subsequent placental histological analysis. A dual-perfused single cotyledon model was used. Placentas from pregnancies complicated by FGR and from normal pregnancies were obtained. Selected cotyledons were cannulated and dually perfused. Following stabilization, three concentrations of PGE(2) (0.05, 0.1, and 0.15 mg/mL) were administered to the fetal arterial side causing contraction/relaxation response. Fetal perfusion pressure was measured continuously during these contraction and relaxation phases. Following the perfusion experiments, the placentas were analyzed for fetal or maternal origin vascular lesions. A total of 21 complete experiments were performed (16 normal, 5 FGR). In response to PGE(2) , FGR placentas exhibited lower change in the perfusion pressure and lower relaxation time constant. Basal perfusion pressure did not differ significantly between the two groups. Placental histopathology lesions, fetal or maternal origin, were more common in the FGR compared with the controls placentas, 80% versus 25%, respectively, P=  0.047. The lower vascular reactivity in response to PGE(2) and the presence of fetal and maternal vascular placental lesions suggest a mechanism explaining the altered vascular supply in FGR. © 2012 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Terminal Pregnancy Complicated by Measles and Premature Labor:a Case Report

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Measles infection in pregnant women is a very dangerous clinical condition. Patients usually had complicated pneumonia, and virus could pass through the placenta to the fetus and lead to premature delivery, stillbirth, miscarriage and neonatal measles. In this report, one such case, which was diagnosed by clinical signs and symptoms, clinical and laboratory examination was described. After proper therapeutic treatment, the infection was well-controlled and a baby was born by nature labor.

  11. Oral manifestations in type-2 diabetes and related complications

    Directory of Open Access Journals (Sweden)

    Sarita Bajaj

    2012-01-01

    Full Text Available Background: Knowledge of the wide spectrum of the oral markers of diabetes is imperative as one frequently encounters individuals with undetected, untreated or poorly controlled diabetes. Objectives: The objective was to study the oral manifestations in type 2 diabetes mellitus (DM and to establish an association between oral manifestations and associated microvascular and macrovascular complications. Materials and Methods: 50 cases of DM were selected who had oral complications. The control group comprised 50 age- and sex-matched diabetic patients without any oral complications. Results: Oral manifestations in DM included periodontal disease in 34%, oral candidiasis in 24%, tooth loss in 24%, oral mucosal ulcers in 22%, taste impairment in 20%, xerostomia and salivary gland hypofunction in 14%, dental caries in 24%, and burning mouth sensation in 10% cases. Fasting [(FBG (P = 0.003] and postprandial blood glucose [(PPBG (P = 0.0003] levels were significantly higher among cases. The P values for neuropathy, retinopathy, nephropathy, cardiovascular disease, dyslipidemia, and sepsis were 0.0156, 0.0241, 0.68, 0.4047, 0.0278, and 0.3149, respectively, which were significant for neuropathy, retinopathy, and dyslipidemia. Conclusions: Several oral complications are seen among diabetics. Association of oral markers in DM and microvascular complications suggests that there is a significant association between the two.

  12. Perinatal and maternal complications related to postterm delivery

    DEFF Research Database (Denmark)

    Olesen, Annette Wind; Westergaard, Jes G; Olsen, Jorn

    2003-01-01

    OBJECTIVE: This study was undertaken to estimate the risk of fetal and maternal complications associated with postterm delivery in Denmark. STUDY DESIGN: A cross-sectional study that used records from the Danish Medical Birth Registry from 1978 to 1993 was performed. All women with registered...... to analyze data. RESULTS: The risk of perinatal and obstetric complications was high in postterm delivery compared with term delivery (adjusted odds ratios between 1.2 and 3.1). The risk of perinatal death was 1.33 (1.05-1.68). CONCLUSION: Postterm delivery was associated with significantly increased risks...... of perinatal and maternal complications in Denmark in the period from 1978 to 1993....

  13. The impact of close surveillance on pregnancy outcome among women with a prior history of antepartum complications attributed to thrombosis: a cohort study

    Directory of Open Access Journals (Sweden)

    Nachum Zohar

    2008-11-01

    Full Text Available Abstract Background There is limited evidence, so far, as to the optimal management of women with a prior obstetric history of antepartum complications attributed to thrombosis. We aimed to investigate the contribution of close antepartum surveillance on pregnancy outcome among women with prior antepartum complications attributed to thrombosis. Methods The study was conducted on all women who were delivered, conceived and delivered again between January 2000 and January 2006 at a university teaching hospital. Women included were managed in previous pregnancy at a low risk setting and had unpredicted antepartum complications occurring at a gestational age of 23 weeks or more. Antepartum complications considered were intrauterine fetal death, neonates who were small for gestational age, severe pre-eclampsia and placental abruption. All women were tested for the presence of thrombophilia after delivery. In the following pregnancy, only women found to have any thrombophilia (thrombophilic group were treated with enoxaparin. Both the thrombophilic group and the non-thrombophilic group (tested negatively for thrombophilia were managed and observed closely at our high-risk pregnancy clinic. Results Ninety-seven women, who conceived at least once after the diagnosis of the relevant antepartum complications, were included in this study. Forty-nine had any thrombophilia and 48 tested negatively. Composite antepartum complications (all antepartum complications considered were reduced significantly after close antepartum surveillance in both groups. Mean birth weight and mean gestational age improved significantly and were comparable between the groups. Conclusion Close antepartum surveillance may contribute to improvement in the perinatal outcomes of women with prior antepartum complications attributed to thrombosis.

  14. Review: Fetal-maternal communication via extracellular vesicles - Implications for complications of pregnancies.

    Science.gov (United States)

    Adam, Stefanie; Elfeky, Omar; Kinhal, Vyjayanthi; Dutta, Suchismita; Lai, Andrew; Jayabalan, Nanthini; Nuzhat, Zarin; Palma, Carlos; Rice, Gregory E; Salomon, Carlos

    2016-12-05

    The maternal physiology experiences numerous changes during pregnancy which are essential in controlling and maintaining maternal metabolic adaptations and fetal development. The human placenta is an organ that serves as the primary interface between the maternal and fetal circulation, thereby supplying the fetus with nutrients, blood and oxygen through the umbilical cord. During gestation, the placenta continuously releases several molecules into maternal circulation, including hormones, proteins, RNA and DNA. Interestingly, the presence of extracellular vesicles (EVs) of placental origin has been identified in maternal circulation across gestation. EVs can be categorised according to their size and/or origin into microvesicles (∼150-1000 nm) and exosomes (∼40-120 nm). Microvesicles are released by budding from the plasmatic membrane, whereas exosome release is by fusion of multivesicular bodies with the plasmatic membrane. Exosomes released from placental cells have been found to be regulated by oxygen tension and glucose concentration. Furthermore, maternal exosomes have the ability to stimulate cytokine release from endothelial cells. In this review, we will discuss the role of EVs during fetal-maternal communication during gestation with a special emphasis on exosomes.

  15. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shadi Rezai

    2015-01-01

    Full Text Available Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d’orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36–372 μg/L. The patient was treated with bromocriptine (2.5 mg twice daily, scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels.

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    朱秀君

    2015-01-01

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

  18. Pregnancy outcome in pulmonary hypertension complication pregnancy%妊娠合并肺动脉高压妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    陈一红; 胡继芬; 陈丽红; 吴建波

    2012-01-01

    目的 分析妊娠合并肺动脉高压(PH)临床特点,探讨其围生期监护及妊娠终止时机、方式.方法 收集福建医科大学附属第一医院2005年1月至2011年4月37例妊娠合并PH患者的临床资料,根据肺动脉压力情况分为轻度组19例[30~ <50 mmHg(1 mmHg=0.133 kPa)],中度组10例(50~<80 mmHg),重度组8例(≥80mmHg).分析心脏病情况及母婴结局.结果 (1)37例肺动脉高压患者中,风湿性心脏病18例,先天性心脏病11例,围生期心肌病5例,肥厚型心肌病1例,特发性肺动脉高压1例,未发现心脏器质性改变1例.(2)轻度组心功能Ⅰ~Ⅱ级占68.4%(13/19).中度组心功能Ⅱ~Ⅲ级占70%(7/10).重度组心功能Ⅲ~Ⅳ级占75%(6/8).(3)32例患者(86.5%)行剖宫产术.1例轻度肺动脉高压孕妇经阴道分娩.1例产妇死亡(2.7%).4例中期引产(12.1%).7例早产,新生儿窒息3例,低出生体重儿4例,新生儿死亡1例.结论 妊娠合并肺动脉高压属于高危妊娠,随着肺动脉压力升高心功能衰竭的发生率增加,围生儿疾病发生率和胎儿丢失率也明显增加,母儿预后取决于孕期是否伴有合并症.晚期妊娠患者以剖宫产终止妊娠为宜.%Objective To analysis the clinical characteristics of pulmonary hypertension( PH) complicating pregnancy,to explore the monitoring as well as the treatment during perinatal period, the delivery time and the way. Methods Clinical data of 37 cases of pregnant women with pulmonary hypertension between Jan. 2005 and Apr. 2011 were analyzed and theywere divided into three groups; 19 cases of slight group [ pulmonary hypertension from 30 mmHg (1 mmHg = 0. 133 kPa) to 49 mmHg] , 10 cases of moderate group ( pulmonary hypertension from 50 mmHg to 79 mmHg) and 8 cases of severe group (pulmonary hypertension equal to or higher than 80 mmHg). To analysis the heart condition and the maternal and fetal outcomes. Results (1) In these cases, 18 cases were rheumatic heart disease

  19. Evaluating Birth Preparedness and Pregnancy Complications Readiness Knowledge and Skills of Accredited Social Health Activists in India

    Directory of Open Access Journals (Sweden)

    Smitha Kochukuttan, BDS, MPH

    2013-07-01

    Full Text Available Background: The National Rural Health Mission (NRHM in India relies on Accredited Social Health Activists (ASHAs to act as a link between pregnant women and health facilities. All ASHAs are required to have a birth preparedness plan and be aware of danger signs of complications to initiate appropriate and timely referral to obstetric care. Objectives: To examine the extent to which Accredited Social Health Activists (ASHAs are equipped with necessary knowledge and skills and the adequacy of support they get from supervisors to carry out their assigned tasks in a rural district in Karnataka, (South India. Methods: A cross-sectional descriptive study was carried out among 225 ASHAs between June -July 2011. Quantitative and qualitative data were collected using pre-tested semi-structured interview schedule. The data were analyzed using SPSS version 17. Chi-square test was used to determine associations between categorical variables. Results: The response rate was 207(92%. In terms of knowledge of all key danger signs (Complication Readiness, 2(1%, 10(4.8%, and 15(7.2% ASHAs were aware of key danger signs for labor and child birth, postpartum period and pregnancy period, respectively. Knowledge of key danger signs was associated with repeated, recent and practical training (p <0.05. A majority (71% scored 4-7 of the maximum score out of 8 for knowledge regarding Birth Preparedness. Conclusion and Public health implications: ASHAs in rural Karnataka, India, are poorly equipped to identify obstetric complications and to help expectant mothers prepare a birth preparedness plan. There is critical need for the implementation of appropriate training and follow-up supervision of ASHAs within a supportive, functioning and responsive health care system.

  20. Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study : the GECKO Drenthe cohort

    NARCIS (Netherlands)

    Mutsaerts, M. A. Q.; Groen, H.; Buiter-Van der Meer, A.; Sijtsma, A.; Sauer, P. J. J.; Land, J. A.; Mol, B. W.; Corpeleijn, E.; Hoek, A.

    2014-01-01

    Do paternal and maternal lifestyle factors influence the risk of hypertensive pregnancy complications, gestational diabetes mellitus (GDM), spontaneous preterm birth and small-for-gestational-age (SGA)? Paternal lifestyle factors do not exert an independent effect on the investigated outcomes while

  1. How to monitor pregnancies complicated by fetal growth restriction and delivery before 32 weeks : Post-hoc analysis of TRUFFLE study

    NARCIS (Netherlands)

    Ganzevoort, W.; Van Charante, N. Mensing; Thilaganathan, B.; Prefumo, F.; Arabin, B.; Bilardo, C. M.; Brezinka, C.; Derks, J. B.; Diemert, A.; Duvekot, J. J.; Ferrazzi, E.; Frusca, T.; Hecher, K.; Marlow, N.; Martinelli, P.; Ostermayer, E.; Papageorghiou, A. T.; Schlembach, D.; Schneider, K. T. M.; Todros, T.; Valcamonico, A.; Visser, G. H. A.; Van Wassenaer-Leemhuis, A.; Lees, C. C.; Wolf, H.

    Objectives In the recent TRUFFLE study, it appeared that, in pregnancies complicated by fetal growth restriction (FGR) between 26 and 32 weeks' gestation, monitoring of the fetal ductus venosus (DV) waveform combined with computed cardiotocography (CTG) to determine timing of delivery increased the

  2. Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study : the GECKO Drenthe cohort

    NARCIS (Netherlands)

    Mutsaerts, M. A. Q.; Groen, H.; Buiter-Van der Meer, A.; Sijtsma, A.; Sauer, P. J. J.; Land, J. A.; Mol, B. W.; Corpeleijn, E.; Hoek, A.

    Do paternal and maternal lifestyle factors influence the risk of hypertensive pregnancy complications, gestational diabetes mellitus (GDM), spontaneous preterm birth and small-for-gestational-age (SGA)? Paternal lifestyle factors do not exert an independent effect on the investigated outcomes while

  3. 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.

  4. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Balkenzhe Imankulova

    2015-06-01

    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  5. Molar Pregnancy

    Science.gov (United States)

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

  6. [Pregnancy and labor complications--their significance in the development of schizophrenic psychoses].

    Science.gov (United States)

    Stöber, G; Franzek, E; Beckmann, H

    1993-10-01

    In a retrospective study of 80 chronic DSM III-R schizophrenics and 80 controls, the occurrence of obstetric complications (OCs) into the development of chronic schizophrenias was investigated using Leonhard's distinction in systematic schizophrenia (no obvious familial loading) and unsystematic schizophrenia (mainly genetically determined according to Leonhard). The Lewis & Murray and Fuchs scales were used for evaluation. In both scales, unsystematic schizophrenias did not differ from controls, but those with OCs were significantly (p schizophrenics had an increased frequency, severity and total score of OCs compared to controls in the Fuchs scale (p perinatal disturbances lead to an early onset of the disease, however, in systematic schizophrenias they seem to be of causal importance for the development of the disease.

  7. PP13, maternal ABO blood groups and the risk assessment of pregnancy complications.

    Directory of Open Access Journals (Sweden)

    Nandor Gabor Than

    Full Text Available BACKGROUND: Placental Protein 13 (PP13, an early biomarker of preeclampsia, is a placenta-specific galectin that binds beta-galactosides, building-blocks of ABO blood-group antigens, possibly affecting its bioavailability in blood. METHODS AND FINDINGS: We studied PP13-binding to erythrocytes, maternal blood-group effect on serum PP13 and its performance as a predictor of preeclampsia and intrauterine growth restriction (IUGR. Datasets of maternal serum PP13 in Caucasian (n = 1078 and Hispanic (n = 242 women were analyzed according to blood groups. In vivo, in vitro and in silico PP13-binding to ABO blood-group antigens and erythrocytes were studied by PP13-immunostainings of placental tissue-microarrays, flow-cytometry of erythrocyte-bound PP13, and model-building of PP13--blood-group H antigen complex, respectively. Women with blood group AB had the lowest serum PP13 in the first trimester, while those with blood group B had the highest PP13 throughout pregnancy. In accordance, PP13-binding was the strongest to blood-group AB erythrocytes and weakest to blood-group B erythrocytes. PP13-staining of maternal and fetal erythrocytes was revealed, and a plausible molecular model of PP13 complexed with blood-group H antigen was built. Adjustment of PP13 MoMs to maternal ABO blood group improved the prediction accuracy of first trimester maternal serum PP13 MoMs for preeclampsia and IUGR. CONCLUSIONS: ABO blood group can alter PP13-bioavailability in blood, and it may also be a key determinant for other lectins' bioavailability in the circulation. The adjustment of PP13 MoMs to ABO blood group improves the predictive accuracy of this test.

  8. PP13, Maternal ABO Blood Groups and the Risk Assessment of Pregnancy Complications

    Science.gov (United States)

    Than, Nandor Gabor; Romero, Roberto; Meiri, Hamutal; Erez, Offer; Xu, Yi; Tarquini, Federica; Barna, Laszlo; Szilagyi, Andras; Ackerman, Ron; Sammar, Marei; Fule, Tibor; Karaszi, Katalin; Kovalszky, Ilona; Dong, Zhong; Kim, Chong Jai; Zavodszky, Peter; Papp, Zoltan; Gonen, Ron

    2011-01-01

    Background Placental Protein 13 (PP13), an early biomarker of preeclampsia, is a placenta-specific galectin that binds beta-galactosides, building-blocks of ABO blood-group antigens, possibly affecting its bioavailability in blood. Methods and Findings We studied PP13-binding to erythrocytes, maternal blood-group effect on serum PP13 and its performance as a predictor of preeclampsia and intrauterine growth restriction (IUGR). Datasets of maternal serum PP13 in Caucasian (n = 1078) and Hispanic (n = 242) women were analyzed according to blood groups. In vivo, in vitro and in silico PP13-binding to ABO blood-group antigens and erythrocytes were studied by PP13-immunostainings of placental tissue-microarrays, flow-cytometry of erythrocyte-bound PP13, and model-building of PP13 - blood-group H antigen complex, respectively. Women with blood group AB had the lowest serum PP13 in the first trimester, while those with blood group B had the highest PP13 throughout pregnancy. In accordance, PP13-binding was the strongest to blood-group AB erythrocytes and weakest to blood-group B erythrocytes. PP13-staining of maternal and fetal erythrocytes was revealed, and a plausible molecular model of PP13 complexed with blood-group H antigen was built. Adjustment of PP13 MoMs to maternal ABO blood group improved the prediction accuracy of first trimester maternal serum PP13 MoMs for preeclampsia and IUGR. Conclusions ABO blood group can alter PP13-bioavailability in blood, and it may also be a key determinant for other lectins' bioavailability in the circulation. The adjustment of PP13 MoMs to ABO blood group improves the predictive accuracy of this test. PMID:21799738

  9. Successful laparoscopic management of a rare complication after embryo transfer: ovarian pregnancy. A case report and up-to-date literature review.

    Science.gov (United States)

    Aydin, Turgut; Yucel, Burak; Aksoy, Huseyin; Ekemen, Suheyla

    2016-01-01

    Ovarian pregnancy (OP) after embryo transfer is very rare. Due to the rarity and the asymptomatic nature, there are still difficulties in diagnosis and treatment. The traditional operative treatment for OP has been oophorectomy. However, the desire to maintain reproductive capability and improvements in laparoscopy have more recently led to conservative laparoscopic techniques. This rare complication could be diagnosed early and managed by a conservative laparoscopic approach. Here we present a survey of the literature and a case of successful laparoscopic management of ovarian pregnancy after intracytoplasmic sperm injection and embryo transfer. The current case is the first case in the literature in which ovarian pregnancy occurred after a single embryo transfer. We also summarize the literature about management of ovarian pregnancy after embryo transfer.

  10. Relation Between Stress During Pregnancy and Spontaneous Preterm Birth

    National Research Council Canada - National Science Library

    Ortiz Martínez, Roberth Alirio; Castillo, Alejandro

    2016-01-01

    ...; however, psychopathological components emerge as potentially important risk factors. To determine the relationship between the presence of stress during pregnancy and spontaneous preterm birth...

  11. Pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  12. Catheter-related Complications in Postoperative Intraperitoneal Chemotherapy for Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To analyze catheter-related complications during postoperative Intraperitoneal chemotherapy (IPCT) for gastric cancer. Methods: From December 2003 to April 2007, 80 patients with gastric cancer were treated with postoperative IPCT using central venous catheters (CVCs), during which the complications that occurred in association with CVCs were documented and analyzed. Results: Catheter-related complications were seen in 10 out of the 80 patients, yielding a total complication rate of 12.5%. Main complications included abdominal pain (3.8%), local infection (1.3%), catheter obstruction (2.5%), leakage (2.5%) and dislocation (2.5%). All patients successfully finished their IPCT, the success rate was 100%. There occurred no severe complications or treatment-related deaths. Conclusion: It is convenient and safe to carry out postoperative IPCT for gastric cancer using CVCs, which, with a low catheter-related complication rate, should be recommended for more clinic use.

  13. Ultrasonic evaluation of central retinal artery hemodynamics in patients with hypertensive disorder complicating pregnancy and the correlation with disease

    Institute of Scientific and Technical Information of China (English)

    Chen-Xia Liu; Jing-Mian Zhou

    2017-01-01

    Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI; XIAP, Survivin and Livin expression in placenta were positively

  14. Prenatal Lipid-Based Nutrient Supplements Do Not Affect Pregnancy or Childbirth Complications or Cesarean Delivery in Bangladesh: A Cluster-Randomized Controlled Effectiveness Trial.

    Science.gov (United States)

    Mridha, Malay K; Matias, Susana L; Paul, Rina Rani; Hussain, Sohrab; Sarker, Mostofa; Hossain, Mokbul; Peerson, Janet M; Vosti, Stephen A; Dewey, Kathryn G

    2017-09-01

    Background: Pregnancy and childbirth complications and cesarean delivery are common in Bangladesh.Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on pregnancy and childbirth complications and cesarean delivery.Methods: We conducted the Rang-Din Nutrition Study, a cluster-randomized controlled effectiveness trial within a community health program in rural Bangladesh. We enrolled 4011 pregnant women in early pregnancy. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe + 400 μg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing essential fatty acids and 22 vitamins and minerals. Pregnancy and childbirth complications and the cesarean delivery rate were secondary outcomes of the study.Results: Women in the LNS-PL group did not differ significantly from the IFA group with respect to mean systolic blood pressure at 36 wk gestation (113 and 112 mm Hg; P = 0.17), diastolic blood pressure at 36 wk gestation (68.9 and 68.7 mmHg; P = 0.88), or mean total number of pregnancy and childbirth complications (0.32 and 0.31; P = 0.86). They also did not differ significantly with respect to the prevalence of high blood pressure at 36 wk (1.74% and 2.03%; P = 0.62), antepartum hemorrhage (0.83% and 1.39%; P = 0.21), prolonged labor (8.34% and 8.79%; P = 0.68), early rupture of membranes (9.30% and 8.45%; P = 0.43), convulsions (1.57% and 1.08%; P = 0.24), high blood pressure in labor (1.54% and 1.19%; P = 0.46), obstructed labor (2.83% and 2.91%; P = 0.90), any complications during pregnancy or childbirth (35.9% and 37.1%; P = 0.64), episiotomy (6.31% and 6.44%; P = 0.90), or cesarean delivery (15.6% and 14.2%; P = 0.48).Conclusion: Compared with IFA, antenatal LNS-PL did not increase or decrease pregnancy and childbirth complications or cesarean delivery among women in rural Bangladesh. This trial was registered at clinicaltrials.gov as NCT01715038. © 2017 American

  15. Pregnancy

    Science.gov (United States)

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

  16. Acute kidney injury during pregnancy.

    Science.gov (United States)

    Van Hook, James W

    2014-12-01

    Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared.

  17. Lesser than diabetes hyperglycemia in pregnancy is related to perinatal mortality: a cohort study in Brazil

    Directory of Open Access Journals (Sweden)

    Wendland Eliana M

    2011-11-01

    Full Text Available Abstract Background Gestational diabetes related morbidity increases along the continuum of the glycemic spectrum. Perinatal mortality, as a complication of gestational diabetes, has been little investigated. In early studies, an association was found, but in more recent ones it has not been confirmed. The Brazilian Study of Gestational Diabetes, a cohort of untreated pregnant women enrolled in the early 1990's, offers a unique opportunity to investigate this question. Thus, our objective is to evaluate whether perinatal mortality increases in a continuum across the maternal glycemic spectrum. Methods We prospectively enrolled and followed 4401 pregnant women attending general prenatal care clinics in six Brazilian state capitals, without history of diabetes outside of pregnancy, through to birth, and their offspring through the early neonatal period. Women answered a structured questionnaire and underwent a standardized 2-hour 75-g oral glucose tolerance test (OGTT. Obstetric care was maintained according to local protocols. We obtained antenatal, delivery and neonatal data from hospital records. Odds ratios (OR were estimated using logistic regression. Results We ascertained 97 perinatal deaths (67 fetal and 31 early neonatal. Odds of dying increased according to glucose levels, statistically significantly so only for women delivering at gestational age ≥34 weeks (p Conclusions In settings of limited detection and treatment of gestational diabetes mellitus, women across a spectrum of lesser than diabetes hyperglycemia, experienced a continuous rise in perinatal death with increasing levels of glycemia after 34 weeks of pregnancy. Current GDM diagnostic criteria identified this increased risk of mortality.

  18. Preventive effects of ulinastatin on complications related to pancreaticoduodenectomy

    Science.gov (United States)

    Zhang, Hao; Tan, Chunlu; Wang, Xing; Kang, Deying; Chen, Yonghua; Xiong, Junjie; Tian, Bole; Li, Kezhou; Hu, Weiming; Chen, Xiaoli; Ke, Nengwen; Li, Ang; Liu, Xubao

    2016-01-01

    Abstract Postoperative pancreatic fistula (POPF) is one of the most common major complications after pancreaticoduodenectomy (PD). Ulinastatin is an intrinsic trypsin inhibitor and mainly used to treat acute pancreatitis, chronic recurrent pancreatitis, and acute circulatory failure. The study aims to investigate the efficacy of ulinastatin on pancreatic fistula and other complications after PD. This prospective, randomized, double-blind, placebo-controlled trial was conducted in West China Hospital of Sichuan University from December 2012 to December 2014. A total of 106 consecutive patients undergoing PD were randomly assigned to receive ulinastatin or placebo during and after the surgery for 5 days. Baseline clinical characteristics and outcomes of patients were recorded and analyzed. Ninety-two patients including 42 in the ulinastatin group and 50 in the placebo group were available for outcome assessment. The POPF rates were comparable between ulinastatin group (43%) and placebo group (26%), whereas the severe pancreatic fistula rate (grade B + C) was significantly less in ulinastatin group than that in placebo group (7% vs 24%, P = 0.045). For patients with small pancreatic duct diameter (≤3 mm), ulinastatin could significantly reduce the risk of POPF (P = 0.022). Ulinastatin had protective effects for patients undergoing PD on the prevention of severe postoperative pancreatic fistula. PMID:27310952

  19. Differences in pregnancy outcomes, prenatal care utilization, and maternal complications between teenagers and adult women in Korea: A nationwide epidemiological study.

    Science.gov (United States)

    Lee, Sang Hyung; Lee, Seung Mi; Lim, Nam Gu; Kim, Hyun Joo; Bae, Sung-Hee; Ock, Minsu; Kim, Un-Na; Lee, Jin Yong; Jo, Min-Woo

    2016-08-01

    Teenage mothers are at high risk for maternal and neonatal complications. This study aimed to evaluate the socioeconomic circumstances of teenage pregnancy, and determine whether these increased risks remained after adjustment for socioeconomic circumstances in Korea. Using the National Health Insurance Corporation database, we selected women who terminated pregnancy, by delivery or abortion, from January 1, 2010 to December 31, 2010. Abortion, delivery type, and maternal complications were defined based on the International Classification of Diseases-10th Revision. We compared teenagers (13-19 years at the time of pregnancy termination) with other age groups and investigated differences based on socioeconomic status, reflected by Medical Aid (MA) and National Health Insurance (NHI) beneficiaries. We used multivariate analysis to define the factors associated with preterm delivery. Among 463,847 pregnancies, 2267 (0.49%) involved teenagers. Teenage mothers were more likely to have an abortion (33.4%) than deliver a baby when compared with other age groups (20.8%; P prenatal care throughout pregnancy. Among teenage mothers, 61.7% of MA recipients made fewer than 4 prenatal care visits (vs 38.8% of NHI beneficiaries) (P inadequate prenatal care and subsequently of preterm delivery, which remained significantly higher after adjusting for socioeconomic confounding variables and adequacy of prenatal care in Korean teenagers (P < 0.001).

  20. The treatment with patients of acute promyelocytic leukemia complicating pregnancy%急性早幼粒细胞白血病合并妊娠处理

    Institute of Scientific and Technical Information of China (English)

    郁进

    2014-01-01

    aPl 是急性白血病中病情十分凶险的一种类型,除具有急性白血病的共同特点外,出血症状明显重于其他白血病。我们通过2例白血病合并妊娠患者的诊疗过程探讨白血病与妊娠的相互影响。白血病合并妊娠时孕妇及胎儿死亡率均增加。在治疗妊娠合并白血病的患者时,不仅要注意治疗母体,还有考虑对胎儿的影响。%aPl is a type of acute leukemia that is very dangerous, in addition to the common features of acute leukemia, bleeding symptoms were significantly heavier than other leukemia. We explored the interaction of leukemia and pregnancy through 2 cases of leukemia patients complicating pregnancy during their diagnosis and treatment of patients. the death incidence of patients with leukemia complicating pregnancy was increased. in the treatment of pregnancy complicated with leukemia patients, we should not only pay attention to treatment of the parent, but also consider the impact on the fetus.

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

    Directory of Open Access Journals (Sweden)

    Iva Tendais

    2011-02-01

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

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

    Science.gov (United States)

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

    2011-02-01

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

  3. Study on the relationship between retinopathy of prematurity and maternal age,smoking during pregnancy,drugs and pregnancy complications%早产儿视网膜病变与孕妇年龄、孕期吸烟、药物、妊娠并发症的关系研究

    Institute of Scientific and Technical Information of China (English)

    熊永强; 刘生荣; 陈立宇; 吕月娥; 陈美玲; 周俊楠

    2011-01-01

    Objective: To explore the relationship between the occurrence of retinopathy of prematurity (ROP) and hazard factorsduring pregnancy including maternal age, smoking during pregnancy, drugs and pregnancy complications. Methods: 829 premature infants visiting the hospital from January 2008 to April 2010 received fundus examination regularly. International staging system of ROP was used for diagnosis and staging of ROP. The related clinical data of pregnant women were collected. Results: Among 829 premature infants, 97 infants were diagnosed as ROP, the incidence was 11.7%. There was no significant difference in maternal age and drug use during pregnancy, there was significant difference in smoking during pregnancy and pregnancy complicationa, multivariate logistic analysis showed that there was a significant correlation between smoking, pregnancy complications and the occurrence of ROP. Conclusion: Smoking and pregnancy complications are important risk factors of ROP during pregnancy.%目的:探讨早产儿视网膜病变(ROP)的发生与孕妇年龄、孕期吸烟、药物、妊娠并发症等孕期危害因素的关系.方法:对2008年1月~2010年4月在厦门市妇幼保健院收治的829例早产儿定期进行眼底检查,根据ROP国际分期标准进行ROP的诊断和分期,并收集孕妇孕期相关临床资料.结果,829例早产儿中ROP的患儿为97例,患病率为11.70%.孕妇年龄、孕期服用药物无明显差异,而孕期吸烟和妊娠期并发症差异有统计学意义,经进一步多因素Logistic回归分析显示吸烟、妊娠并发症与ROP发生有显著相关性.结论:吸烟和妊娠并发症是孕期导致ROP发病的高危因素.

  4. The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.

    NARCIS (Netherlands)

    Damen, L.; Buyruk, H.M.; Guler-Uysal, F.; Lotgering, F.K.; Snijders, C.J.; Stam, H.J.

    2002-01-01

    STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum. SUMMARY OF BACKGROUND DATA: In a previous study, we observed a significant relation between asymmetric laxi

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

    Science.gov (United States)

    Singh, Abha G; Chowdhary, Vaidehi R

    2015-02-01

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

  6. Galectins: Double-edged Swords in the Cross-roads of Pregnancy Complications and Female Reproductive Tract Inflammation and Neoplasia

    Directory of Open Access Journals (Sweden)

    Nandor Gabor Than

    2015-05-01

    Full Text Available Galectins are an evolutionarily ancient and widely expressed family of lectins that have unique glycan-binding characteristics. They are pleiotropic regulators of key biological processes, such as cell growth, proliferation, differentiation, apoptosis, signal transduction, and pre-mRNA splicing, as well as homo- and heterotypic cell-cell and cell-extracellular matrix interactions. Galectins are also pivotal in immune responses since they regulate host-pathogen interactions, innate and adaptive immune responses, acute and chronic inflammation, and immune tolerance. Some galectins are also central to the regulation of angiogenesis, cell migration and invasion. Expression and functional data provide convincing evidence that, due to these functions, galectins play key roles in shared and unique pathways of normal embryonic and placental development as well as oncodevelopmental processes in tumorigenesis. Therefore, galectins may sometimes act as double-edged swords since they have beneficial but also harmful effects for the organism. Recent advances facilitate the use of galectins as biomarkers in obstetrical syndromes and in various malignancies, and their therapeutic applications are also under investigation. This review provides a general overview of galectins and a focused review of this lectin subfamily in the context of inflammation, infection and tumors of the female reproductive tract as well as in normal pregnancies and those complicated by the great obstetrical syndromes.

  7. 妊娠合并肺动脉高压的管理及治疗%Management and Treatment for Pregnancy Complicated with Pulmonary Arterial Hypertension

    Institute of Scientific and Technical Information of China (English)

    曾汝园; 殷玲; 王以新; 冯妍; 李晓蕾

    2015-01-01

    妊娠合并肺动脉高压发病率低、预后差,近年来妊娠合并肺动脉高压患者的母婴结局有所改善,但母婴病死率仍然较高。肺动脉高压仍是妊娠禁忌证,而对于坚持继续妊娠的肺动脉高压患者,多学科专业团队协作的孕期管理、风险评估及孕期和产褥期治疗至关重要,可最大限度地改善母婴结局。本文就妊娠合并肺动脉高压的管理及治疗进行综述。%Pulmonary arterial hypertension( PAH) is a rare complication of pregnancy,but its prognosis is bad. In recent years,the mother-infant prognosis of pregnant women complicated with PAH is improved,but the mortality is still high, PAH is one of the contraindications of pregnancy. For pregnant women complicated with PAH, gestation management, risk assessment and treatment guided by multidisciplinary professional team collaboration is very important,which can furthest improve the mother-infant prognosis. This paper reviewed the management and treatment for pregnancy complicated with PAH.

  8. Serum selenium concentration in maternal and umbilical cord blood. Relation to course and outcome of pregnancy

    DEFF Research Database (Denmark)

    Bro, S; Berendtsen, H; Nørgaard, J

    1988-01-01

    complications and selenium values. In mothers with uncomplicated pregnancies and deliveries serum selenium concentrations were 0.84 +/- 0.19 mumol/l (mean +/- SD), whereas in cord blood from full-term babies born adequate for gestational age and with no malformations serum selenium concentrations were 0...

  9. The relation of maternal blood arsenic to anemia during pregnancy.

    Science.gov (United States)

    Vigeh, Mohsen; Yokoyama, Kazuhito; Matsukawa, Takehisa; Shinohara, Atsuko; Ohtani, Katsumi

    2015-01-01

    To clarify the relationship of prenatal arsenic exposure to hemoglobin concentrations and anemia during pregnancy, a longitudinal study was conducted of 364 participants during early pregnancy from October 2006 to March 2011 in Tehran, Iran. Maternal whole blood (taken between 8-12 and 20-24 weeks of gestation, and at delivery) and umbilical cord blood samples were collected for arsenic measurement. The mean concentration of maternal blood arsenic in the first trimester of pregnancy was significantly lower in anemic women compared with non-anemic participants (mean ± SD: 12.4 ± 3.4 versus 14.8 ± 4.0 μg/L, respectively, p anemia during pregnancy (OR = 0.85, CI: 0.77-0.94, p anemia.

  10. plasmodium falciparium parasitemia in pregnancy in relation to ...

    African Journals Online (AJOL)

    Dr Oboro VO

    ... malaria parasite. Prevalence of malaria in pregnancy was highest amongst women ... advocacy for inclusion of malaria treatment in safe motherhood should be continued because of its beneficial ..... plasma corticosteroid levels may have an.

  11. An examination of pregnancy- related deaths among adolescents in ...

    African Journals Online (AJOL)

    transition into healthy and productive adults are a key social and .... Trends in maternal mortality ratio (MMR) by age of the mother and year of death, 2006 ..... adolescent pregnancies: The Global Network's Maternal Newborn Health Registry.

  12. Impact on quality of life and physical ability of pregnancy-related back pain in the third trimester of pregnancy.

    Science.gov (United States)

    Coban, Ayden; Arslan, Gülsah Gürol; Colakfakioglu, Arzu; Sirlan, Aygül

    2011-11-01

    The aim of the study was to evaluate the impact of pregnancy-related back pain on quality of life and physical ability in the third trimester of pregnancy. One hundred women in the 28th-40th week of pregnancy were asked to fill out questionnaires including: general questions about background factors, the Katz's Activity's Daily Living Index (ADL), and Short Form of WHO Quality of Life Questionnaire (WHOQOL-BREF). Back pain intensity was assessed by visual analog scale (VAS), and functional limitation was measured by Oswestry Low Back Disability Questionnaire (OSW). It was found that, in the third trimester, pregnant women with back pain (PBP) with low pain intensity and moderate functional limitation did not have an impact on quality of life but decreased physical ability when compared to pregnant women with no back pain (NBP). As the back pain intensity of pregnant women increases, physical ability decreases.

  13. Relationship between Unwanted Pregnancy and Health-Related Quality of Life in Pregnant Women.

    Science.gov (United States)

    Ali, Azizi

    2016-06-01

    To determine the relationship between unwanted pregnancy and health-related quality of life in pregnant women. Case-control study. Department of Community Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran, from October 2013 to July 2014. Of the pregnant women who presented to primary healthcare centers of Kermanshah, Iran to receive prenatal care at 6 - 10 weeks of their pregnancy, those with unwanted pregnancy were selected as cases and those with wanted pregnancy were selected as control group. The selection process was done using multi-stage stratified random sampling. Frequency matching was applied to match the two groups. Quality of life was measured by the SF-36 questionnaire and was compared by the t-test. Relationship power between pregnancy type (wanted or unwanted pregnancy) and impairment of quality of life subscales as the outcome was assessed using odds ratio (OR). Frequency distribution of matched variables was not statistically different between the two studied groups. Mean scores of mental component summary and physical component summary as well as eight subscales (physical functioning, role, bodily pain, general health, vitality, social functioning, role emotional, and mental health) were lower in the unwanted pregnancy group compared to women with wanted pregnancy (p women with unwanted pregnancy is affected more than their physical health. Mental health in women with unwanted pregnancy is 9.19 times more likely to be reduced. Among mental health subscales, vitality (energy/fatigue) showed the highest decrease.

  14. Provision of fertility services for women at increased risk of complications during fertility treatment or pregnancy: an Ethics Committee opinion.

    Science.gov (United States)

    2016-11-01

    This opinion addresses the ethics of providing fertility treatment to women at elevated risk from fertility treatment or pregnancy. Providers ethically may treat women at elevated risk provided that they are carefully assessed; that specialists in their medical condition are consulted as appropriate; and that patients are fully informed about risks, benefits, and alternatives, including oocyte and embryo donation, use of a gestational surrogate, not undergoing fertility care, and adoption. Providers also may conclude that the risks are too high for them to treat particular patients ethically; such determinations must be made in a medically objective and unbiased manner and patients must be fully informed of the decision. Counseling of women who wish to initiate fertility treatment with underlying medical conditions that confer increased risk during treatment or pregnancy should incorporate the most current knowledge available, being cognizant of the woman's personal determinants in relation to her reproductive desires. In such a way, both physician and patient will optimize decision making in an ethically sound, patient-supportive context. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. 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...

  16. Management of Systemic Lupus Erythematosus During Pregnancy.

    Science.gov (United States)

    Sammaritano, Lisa R

    2017-01-14

    Reproductive issues including contraception, fertility, and pregnancy are important components of the comprehensive care of women with systemic lupus erythematosus (SLE). SLE pregnancies are complicated due to risk for maternal disease exacerbation and potential for fetal and neonatal complications. Pre-pregnancy assessment is important to identify patients with severe disease-related damage who should avoid pregnancy, counsel patients to conceive when disease has been stable and inactive on appropriate medications, and assess relevant risk factors including renal disease, antiphospholipid antibody, and anti-Ro/SS-A and anti-La/SS-B antibodies. With careful planning, monitoring, and care, most women with SLE can anticipate a successful pregnancy.

  17. 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...

  18. Hypoxanthine in fetal umbilical venous blood and amniotic fluid from pregnancies complicated by rhesus isoimmunization.

    Science.gov (United States)

    Stangenberg, M; Legarth, J; Hong-Lie, C; Lingman, G; Persson, B; Rahman, F; Westgren, M

    1993-09-01

    Concentrations of hypoxanthine (HX) was determined in umbilical venous blood and amniotic fluid obtained at 74 instances in 36 rhesus immunized patients before the onset of labor. HX concentrations were related to gestational age, concentrations of hemoglobin and lactate, pH, and partial oxygen pressure in umbilical venous blood. Multiple regression analysis revealed hemoglobin concentration to be the only variable that had any explanatory power to HX in amniotic fluid. No one of the studied variables gave any significant contribution to a regression model to explain HX in umbilical venous blood. We conclude that HX levels in umbilical venous blood and in amniotic fluid from rhesus immunized patients were not associated with fetal blood gases before the onset of labor.

  19. Stress: pregnancy considerations.

    Science.gov (United States)

    Cardwell, Michael S

    2013-02-01

    Stress-induced pregnancy complications represent a significant cause of maternal and perinatal morbidity and mortality due to preterm labor, low-birth-weight babies, pregnancy-induced hypertension, and neuropsychological developmental delays of affected offspring. Psychosocial factors such as socioeconomic status, work status, marital status, level of education, access to prenatal care, substance abuse, ethnicity, cultural background, and quality of relationships with partners and parents have been identified as determinants of stress during pregnancy. The biopsychosocial model of health and disease aptly explains the interactions of these psychosocial factors in the genesis of stress-induced pregnancy complications. Prenatal screening and intervention for relevant biopsychosocial risk factors may be useful in preventing stress-related perinatal complications. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to describe how stress is manifested biologically, discuss stress and its impact from the biopsychosocial model of health and disease, recognize how stress may lead to pregnancy complications such as preterm labor, preeclampsia, and low-birth-weight infants, explain how stress may impact the neuropsychological development of children whose mothers experienced perinatal stress, and demonstrate how prenatal screening and appropriate interventions may reduce perinatal stress and associated pregnancy complications.

  20. Renal disease in pregnancy ambulatory issues.

    Science.gov (United States)

    Phelan, Sharon T

    2012-09-01

    Acute and chronic renal disease will complicate prenatal care. Normal physiological changes during pregnancy make the urinary tract system more vulnerable to infectious complications or worsening of preexisting disease. Much of the focus of prenatal care includes screening for these concerns both at the onset of prenatal care and through the pregnancy and postpartum course. With careful and attentive care, the pregnancy outcome for women with significant renal disease has improved and the occurrence of renal injury or obstetric complications due to infectious insults has decreased. This manuscript reviews the current ambulatory prenatal care as it relates to the urinary tract in pregnancy.

  1. 妊娠期膳食与妊娠期高血压疾病的关系%Association between diet during pregnancy and hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    汪晓翠; 吕红梅; 张微

    2016-01-01

    目的:探讨妊娠期膳食与妊娠期高血压疾病( HDCP)的关系,为妊娠期合理膳食提供理论依据。方法采用1∶2匹配病例对照研究方法,选取2014年1月至12月在合肥市妇幼保健院住院分娩的孕妇进行食物频率问卷调查,分析各类食物摄入频率与HDCP的关系。结果共纳入研究对象543例,其中病例组181例,对照组362例。 Mann-Whitney U检验结果显示,病例组和对照组畜禽鱼肉类、蛋类、豆类、干果类、奶类和腌菜泡菜类食物的食用频率不相同,差异均有统计学意义(均P<0.05);两组粮谷类、蔬菜类、水果类食物的食用频率比较差异无统计学意义(均P>0.05)。多元Logistic回归分析结果显示,豆类(OR=0.746,95% CI:0.645~0.862)、蛋类(OR=0.789,95% CI:0.693~0.898)、奶类(OR=0.822,95%CI:0.725~0.931)食物摄入频次越多,发生HDCP的风险越小;腌菜泡菜类(OR=1.190,95%CI:1.054~1.344)食物摄入频次越多,发生HDCP的风险越大。结论豆类、蛋类、奶类食物是HDCP的保护因素,腌菜泡菜类是HDCP的危险因素,妊娠期膳食应科学合理。%Objective To investigate the association between diet during pregnancy and hypertensive dis-order complicating pregnancy ( HDCP ) , so as to provide a theoretical basis guiding appropriate diet during pregnancy.Methods Using 1∶2 matched case-control study method, we selected pregnant women delivered in Anhui Women and Child Health Care Hospital from January to December 2014, and interviewed them with food frequency questionnaire.The relationship between intake frequency of various food and HDCP was analyzed. Results A total of 543 women were included in this study, including 181 cases and 362 controls.Mann-Whit-ney U test results showed that the frequencies of meat and fish, eggs, beans, nuts, milk, and pickled food con-sumption were

  2. [Liver transplantation and pregnancy].

    Science.gov (United States)

    Goarin, A-C; Homer, L

    2010-11-01

    Management during their sexual life of patients with a liver transplantation is a more or less common situation depending centers. Based on literature review, a focus on management of recipient women was conducted, from contraception to pregnancy, describing the complications related to the status of transplant recipient, but also those that may be related to immunosuppressive agents. If fertility and access to contraception are only slightly modified by graft, complications related to graft or immunosuppressive drugs can affect the pregnancy. On the maternal side, hypertension and preeclampsia are more common, as well as renal dysfunction, iatrogenic diabetes and bacterial or viral infections, acute rejection and graft loss do not appear to be influenced by pregnancy. The fetus is also exposed to risks such as induced prematurity and IUGR. Pregnancy in recipients of hepatic grafts therefore requires joint follow-up by transplant specialist and perinatologist, which leads in most cases to successful outcome for mother and child.

  3. Knowledge, attitudes, and behavior related to pregnancy in a rural teenage population.

    Science.gov (United States)

    Carter, Kimberly F; Spear, Hila J

    2002-01-01

    Despite recent declining national trends, teenage pregnancy continues to be a community health problem warranting attention, especially in rural areas of the southern United States. Communities are unique and require assessment of risk populations to develop appropriate initiatives. This pilot study examined consent strategies and survey procedures and tools. Additionally, descriptive statistics related to pregnancy and pregnancy prevention knowledge, attitudes, and behaviors were examined. The study sample consisted of 52 boys and girls who perceived themselves to be in the middle or upper levels of their 9th-grade class and who were predominantly college bound and fairly active in extracurricular activities. Often groups with similar demographics are not perceived as at risk for pregnancy and early sexual intercourse, but the findings suggest otherwise. Many girls were sexually active, several had already experienced pregnancy, and some were at risk for intentional pregnancy. Knowledge regarding pregnancy prevention was modest. School-based and peer-focused programs are promising intervention strategies in response to identified attitudes and reported information sources related to pregnancy and pregnancy prevention.

  4. 妊娠合并宫颈癌的诊治及预后%Diagnosis, treatment and prognosis of uterine cervical neoplasms complicated with pregnancy

    Institute of Scientific and Technical Information of China (English)

    强素凤; 黄勇

    2013-01-01

    妊娠合并宫颈癌的发生率随生育年龄推迟而呈上升趋势.由于妊娠早期细胞学筛查的普及,妊娠合并宫颈癌多被早期发现.细胞学异常患者必须行阴道镜检查,必要时行宫颈活检.宫颈锥切术仅用于排除浸润癌.孕12周前诊断的宫颈浸润癌需及时治疗;孕12周后诊断的宫颈浸润癌如为早期,可待胎儿成熟后延迟治疗.可使用新辅助化疗以稳定患者病情至胎儿分娩.妊娠合并宫颈癌治疗需依据临床分期、孕周及患者是否有继续妊娠的意愿,制定个性化方案.妊娠合并宫颈癌多为早期浸润癌,预后较好.%The incidence of cervical neoplasms complicated with pregnancy is rising,with delaying of reproouctive age.Because of the prevalence of cytology in pregnancy.eervical neoplasnis complicated with pregnancy are mostly detected early. All patients with cytological abnormalities should undergo colposcopy, and when necessary,they should undergo cervical biopsy.Conization is reserved for patients with suspected invasion.In cases of invasive carcinoma detected up to the 12th week of pregnancy,immediate treatment is prioritized.Regarding diagnoses made during the second trimester,in early-stage invasive cancers,delay of therapy seems to be safe.fetal pulmonary maturity can be awaited.And the use of neoadjuvant chemotherapy to stabilize the disease until the time of delivery appears to be viable.Doctors should draw up personalized program for the patients with cervical neoplasms complicated with pregnancy according to stage of disease, gestational weeks and the patient's desire for continued pregnancy.Cervical neoplasms complicated with pregnancy are mostly early-stage invasive cancers, so prognosis is good.

  5. Endovascular management of immediate procedure-related complications of failed hemodialysis access recanalization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun [Chosun University Hospital, Kwangju (Korea, Republic of); Goo, Dong Erk; Yang, Seung Boo; Choi, Deuk Lin; Moon Cheul [Soonchunhyang University Hospital, Chunan (Korea, Republic of)

    2005-09-15

    Endovascular procedures are becoming the standard type of care for the management of hemodialysis vascular access dysfunction. As with any type of medical procedure, these techniques can result in procedure-related complications, although the expected number of complications is low. The clinical extent of these complications varies from case to case. Management of these cases depends on the clinical presentation. Major complications such as vein rupture, arterial embolism, remote site bleeding or hematoma, symptomatic pulmonary embolism and puncture site complications necessitating treatment require major therapy. Minor complications such as non-flow compromising small puncture site hematoma or pseudoaneurysms require little or no therapy. It is essential that the interventionist be prepared to manage these complications appropriately when they arise.

  6. 妊娠合并糖尿病、高血压对子代的影响%Effects of Pregnancy Complications, Diabetes and Hypertension, on Offsprings

    Institute of Scientific and Technical Information of China (English)

    王晨(综述); 杨慧霞(审校)

    2013-01-01

    Pregnancy complications are very common in obstetrics, especially pregnancy with diabetes and hypertension, which seriously threaten the life safety and health of maternal, fetal and newborns. In recent years, several studies showed that pregnancy with diabetes and hypertension could also have long-term effects on offspring, such as adulthood obesity, type 2 diabetes and hypertension. Those effects were defined as the fetal origin of adult diseases. However, study on the long-term effects of pregnancy complications on offspring health is limited, especially in our country. We here reviewed the research progress on the effects of pregnancy complications on offsprings.%妊娠合并症是产科临床上时常面临的问题,而其中又以妊娠合并糖尿病和高血压疾病为主,严重威胁孕产妇、胎儿、新生儿的生命安全和健康。近年来的多项研究更提示,妊娠合并糖尿病和高血压疾病可影响子代远期的健康,如成年期肥胖、2型糖尿病、高血压等,国内外学者倾向于认为此现象为“胎源性疾病”。但目前关于妊娠合并症对子代远期健康影响的研究还很缺乏,中国更是处于研究的初始阶段。综合近几年国内外的相关研究报道,综述此领域的最新进展。

  7. The association of factor V leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies.

    Directory of Open Access Journals (Sweden)

    Marc A Rodger

    2010-06-01

    Full Text Available BACKGROUND: Factor V Leiden (FVL and prothrombin gene mutation (PGM are common inherited thrombophilias. Retrospective studies variably suggest a link between maternal FVL/PGM and placenta-mediated pregnancy complications including pregnancy loss, small for gestational age, pre-eclampsia and placental abruption. Prospective cohort studies provide a superior methodologic design but require larger sample sizes to detect important effects. We undertook a systematic review and a meta-analysis of prospective cohort studies to estimate the association of maternal FVL or PGM carrier status and placenta-mediated pregnancy complications. METHODS AND FINDINGS: A comprehensive search strategy was run in Medline and Embase. Inclusion criteria were: (1 prospective cohort design; (2 clearly defined outcomes including one of the following: pregnancy loss, small for gestational age, pre-eclampsia or placental abruption; (3 maternal FVL or PGM carrier status; (4 sufficient data for calculation of odds ratios (ORs. We identified 322 titles, reviewed 30 articles for inclusion and exclusion criteria, and included ten studies in the meta-analysis. The odds of pregnancy loss in women with FVL (absolute risk 4.2% was 52% higher (OR = 1.52, 95% confidence interval [CI] 1.06-2.19 as compared with women without FVL (absolute risk 3.2%. There was no significant association between FVL and pre-eclampsia (OR = 1.23, 95% CI 0.89-1.70 or between FVL and SGA (OR = 1.0, 95% CI 0.80-1.25. PGM was not associated with pre-eclampsia (OR = 1.25, 95% CI 0.79-1.99 or SGA (OR 1.25, 95% CI 0.92-1.70. CONCLUSIONS: Women with FVL appear to be at a small absolute increased risk of late pregnancy loss. Women with FVL and PGM appear not to be at increased risk of pre-eclampsia or birth of SGA infants. Please see later in the article for the Editors' Summary.

  8. The effect of combined inositol supplementation on maternal metabolic profile in pregnancies complicated by metabolic syndrome and obesity.

    Science.gov (United States)

    Ferrari, Francesca; Facchinetti, Fabio; Ontiveros, Alejandra E; Roberts, Robyn P; Saade, Mia M; Blackwell, Sean C; Sibai, Baha M; Refuerzo, Jerrie S; Longo, Monica

    2016-10-01

    Myoinositol and D-chiroinositol improve insulin resistance in women with obesity and gestational diabetes and in postmenopausal women with metabolic syndrome. We previously reported that offspring born to hypertensive dams lacking endothelial nitric oxide synthase and fed a high-fat diet develop metabolic-like syndrome phenotype. The objective of the study was to investigate the effect of a mixture of myoinositol/D-chiroinositol supplementation during pregnancy on the maternal metabolic profile in pregnancies complicated by the metabolic-like syndrome and obesity using a pregnant mouse model. Female heterozygous endothelial nitric oxide synthase(-/+) mice with moderate hypertension were placed on a high-fat diet for 4 weeks to induce a metabolic-like syndrome phenotype. Similarly, wild-type C57BL/6 mice were placed on a high-fat diet for 4 weeks to induce a murine obesity model. Mice were then bred with wild-type males. On gestational day 1, dams were randomly allocated to receive either a mixture of myoinositol/D-chiroinositol in water (7.2/0.18 mg/mL, respectively) or water as control (placebo). At term (gestational day 18), maternal weights, systolic blood pressure, and a glucose tolerance test were obtained. Dams were then killed; pups and placentas were weighed and maternal blood collected. Serum levels of metabolic biomarkers relevant to diabetes and obesity (ghrelin, gastric inhibitory peptide, glucagon-like peptide 1, glucagon, insulin, leptin, resistin) were measured by a multiplex enzyme-linked immunosorbent assay. Analysis was done comparing metabolic-like syndrome-myoinositol/D-chiroinositol-treated vs metabolic-like syndrome-nontreated mice and obese-myoinositol/D-chiroinositol-treated vs obese nontreated mice. Mean systolic blood pressure was lower in metabolic-like syndrome pregnant mice treated with myoinositol/D-chiroinositol compared with placebo (P = .04), whereas there was no difference in systolic blood pressure between treated and placebo

  9. 妊娠合并系统性红斑狼疮的诊治%Diagnosis and treatment of pregnancy complicated with systemic lupus erythematosus

    Institute of Scientific and Technical Information of China (English)

    綦春蕾; 陈必良

    2012-01-01

    系统性红斑狼疮是一种自身免疫性疾病,好发于育龄期女性,合并妊娠时可使系统性红斑狼疮病情复发或恶化,同时系统性红斑狼疮亦会增加妊娠合并症,并对胎儿产生不良影响.对于有生育要求的系统性红斑狼疮患者须选择适当的妊娠时机,孕期接受严密地监护和适当地治疗,方能获得良好的妊娠结局.该文就妊娠合并系统性红斑狼疮的诊断及治疗方法 作以综述.%Systemic lupus erythematosus ( SLE ) is an autoimmune disease that occurs predominantly among women at childbearing age. Pregnancy may lead to relapse or deterioration of SLE, meanwhile SLE also leads to various complications and adverse effects on fetus. SLE patients can have successful pregnancies and deliver healthy babies as the results of appropriate conditions to pregnancy, close monitoring and proper treatment. This article made a review of diagnosis and treatment of pregnancy complicated with SLE.

  10. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie;

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  11. Urinary Tract Infection as a Preventable Cause of Pregnancy Complications: Opportunities, Challenges, and a Global Call to Action

    OpenAIRE

    Gilbert, Nicole M.; O'Brien, Valerie P.; Hultgren, Scott; Macones, George; Lewis, Warren G.; Lewis, Amanda L.

    2013-01-01

    The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in...

  12. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  13. 农村孕产妇妊娠肥胖与妊娠并发症的关系研究%Relationship of pregnancy obesity and pregnancy complications among rural pregnant women

    Institute of Scientific and Technical Information of China (English)

    肖琼英

    2013-01-01

    目的:了解农村孕产妇妊娠肥胖与妊娠并发症的关系。方法:采用回顾性研究的方法,对658例足月单胎初产妇身高,体重计孕期体重增长情况进行整理,计算体重指数,将妊娠前BM I≥25以及妊娠期体质量增加≥15kg 的纳入观察组,其余纳入对照组,同时整理两组研究对象的妊娠并发症,分娩方式,产程以及产后出血,新生儿窒息,巨大儿的发生情况。结果:1)观察组孕妇妊娠期糖尿病,妊娠高血压疾病,产褥感染发生率明显高于对照组,差异有统计学意义。而产后出血及会阴裂伤,则两组差异无统计学意义;2)观察组总产程,产程异常以及阴道助产发生率明显高于对照组,而剖宫产发生率两组差异无统计学意义;3)两组新生儿体重,巨大儿,死胎及新生儿窒息发生率差异有统计学意义,观察组明显高于对照组。结论:孕期肥胖对孕妇和胎儿的影响都很大,增加孕期并发症及新生儿难产的发生率。应该在加强对肥胖孕产妇的围生期监护及产后随访的同时,积极预防妊娠肥胖的发生。%objective :To explore the relationship of pregnancy obesity and pregnancy complications among rural pregnant women .Meth-ods :The related variables of 658 eligible participants were calculated and sorted ,which included Body Mass Index (BMI) ,complications ,de-livery mode ,birth process ,postpartum hemorrhage ,neonatal asphyxia and macrosomia by retrospective study .Results :The prevalence of gestational diabetes mellitus (GDM ) ,hypertension ,puerperal infection ,abnormal birth process ,assisted labor ,macrosomia ,stillborn fetus and neonatal asphyxia in observation group was significantly higher than that in control group .Conclusions :The significant impact of pregnancy obesity was found .Not only to strengthen prenatal care and postpartum follow -up ,but also to prevent pregnancy obesity to occur .

  14. Coagulation and Placenta-Mediated Complications

    Directory of Open Access Journals (Sweden)

    Anat Aharon

    2014-10-01

    Full Text Available Pregnancy is a physiological hypercoagulable state, preparing the mother for the hemostatic challenge of delivery. However, this is associated with an increased risk of venous thrombosis and placenta-mediated complications, which present major challenges for mother and fetus. Although these conditions are heterogeneous in their pathophysiology, hereditary and acquired thrombophilia has been associated with recurrent pregnancy loss and gestational vascular complications, such as early-onset pre-eclampsia and placental abruption. Prevention of such placenta-mediated complications, which collectively complicate up to 15% of pregnancies, is a major issue for women’s health. Prospective interventional studies stratified by current knowledge of pathophysiological mechanisms related to placental and systemic hemostatic alterations will impact on the management of pregnancies at risk of these complications.

  15. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... anemia. Diseases such as sickle cell anemia or thalassemia affect the quality and number of red blood ... too soon or very sick and work on preventions. More contact donate © 2017 March of Dimes Foundation ...

  16. Pregnancy Complications: Shoulder Dystocia

    Science.gov (United States)

    ... begun. If your baby is very large (called macrosomia) before birth, your provider may recommend that you ... begun. If your baby is very large (called macrosomia) before birth, your provider may recommend that you ...

  17. Pregnancy Complications: Placental Abruption

    Science.gov (United States)

    ... wall of the uterus (womb) and supplies the baby with food and oxygen through the umbilical cord. Placental abruption ... wall of the uterus (womb) and supplies the baby with food and oxygen through the umbilical cord. Placental abruption ...

  18. The sociodemographic factors related with the adolescent pregnancy

    Institute of Scientific and Technical Information of China (English)

    Seva Oner; Gulcin Yapici; Ahmet Oner Kurt; Tayyar Sasmaz; Resul Bugdayci

    2012-01-01

    Objective:The adolescent pregnancy is one of the most important problems in the21st century. The adolescent pregnancies pose more health risks to both mothers and babies when compared with the adult pregnancies.Of all the births in the world,11% are given by the adolescents.The aim of the study was to determine the sociodemographic factors concerning with the adolescent pregnancy.Methods:This study was conducted at18 primary health care centers inMersin, Turkey.The adolescent group was comprised of pregnant women younger than19 years, the adult group was comprised of pregnants aged between20-29 years.The questionnaire was conducted with face-to-face interviews.Results:Respondents included107 pregnant adolescents and 110 pregnant adults.The median age of adolescent group and adult group was18 and26 years, respectively.About61.7% of the pregnant adolescents and94.5% of the pregnant adults were officially married.In the adolescent group, the family frequency without social security was more than that in the adult group.In the adult group, the frequency of opposing the adolescent pregnancy for their families was more than that in the adolescent group.The adolescent pregnancy among sisters and friends of the adolescent pregnants was more frequent compared with that in the adult group.Conclusions:The family frequency without social security was more in the adolescent group.This situation is certain to cause more problems for the adolescents in benefiting from the health care services.We are absolutely think that efforts should be made so as to improve the society in terms of social and cultural aspects.

  19. 妊娠合并子宫肌瘤对妊娠与分娩的影响%The effect of pregnancy complicated with leiomyoma on pregnancy and delivery

    Institute of Scientific and Technical Information of China (English)

    吴植红; 翟晓枝

    2013-01-01

    Objective: To explore the selections of delivery mode for pregnancy complicated with leiomyoma. Methods: From January 2008 to August 2011, 212 cases of late pregnancy complicated with leiomyoma in our hospital were selected as the observation group, 212 pregnant women without leiomyoma were as the control group. To compare the complications of late pregnancy, intrapartum and postpar-tum complications, delivery mode, intraoperative treatment between the two groups. Results: There were 187 cases of full -term pregnancy in 212 cases of the observation group. The incidence of fetal abnormalities, prematurity, low birth weight infants were higher than those of the control group (P < 0. 05) . The cesarean section rate in the observation group was higher than that in the control group, the difference was statistically significant (P < 0. 05) . Conclusion: The operation index may be appropriately relaxed for the pregnancy complicated with leiomyoma , it can reduce the happening of complication with maternal and infants. The Myomectomy during cesarean section is feasible.%目的:探讨妊娠合并子宫肌瘤妊娠晚期并发症及分娩方式的选择.方法:选取2008年1月~ 2011年8月收治的212例妊娠晚期合并子宫肌瘤的患者为观察组,选择同期分娩无子宫肌瘤的212例作为对照组,观察比较两组患者妊娠晚期并发症、产时和产后并发症、分娩方式及术中处理.结果:观察组212例妊娠足月187例,胎位异常、早产、低体重儿的发生率均高于对照组,差异有统计学意义(P<0.05);观察组剖宫产率高于对照组,差异有统计学意义(P<0.05).结论:妊娠合并子宫肌瘤时适当放宽手术指标可减少母婴并发症,剖宫产同时行子宫肌瘤剔除术是一种安全的手术方式.

  20. The investigation and study of the impact of standing time in pregnancy period for pregnancy complications%孕前站立时间对妊娠并发症影响的调查研究

    Institute of Scientific and Technical Information of China (English)

    张雁

    2014-01-01

    Objective To investigation and study the impact of standing time in pregnancy period for pregnancy complications. Methods To choose 460 cases of pregnant women who make card and had delivery from January 2010 to May 2013 in maternity and children's health care centers in zhuhai as the research objects, respectively took related questionnaire in pregnancy period of early,middle and late,then collected the results of the survey and statistical analysis. Results (1) The time of pregnant women continued standing and sitting in the early stages of pregnancy time was significantly reduced,the population distribution in different age,culture level and economic income had significant differences (P < 0.05).(2)The high degree of culture for pregnant women was the protection factor in gestational hypertension;The culture degree and the family economic income of pregnant women were the protection factor in gestational anemia;Older was a risk factor for gestational diabetes.(3)The incidence of hypertension and anemia were positively correlated with women sedentary long. Conclusion Standing long time in pregnancy period can increase the danger of high blood pressure,diabetes and anemia of pregnant women.%目的:调查研究孕早期的职业站立时间以及长时间站立对妊娠并发症的影响。方法分别对我市妇幼保健院2010年1月~2013年5月间建卡并分娩的460例妊娠妇女怀孕早期、中期和晚期进行相关问卷调查并进行统计学分析。结果(1)孕妇在孕早期的持续站立和坐着的时间均较孕前显著降低,其人群分布在不同年龄、文化程度和经济收入方面具有明显差异(P<0.05)。(2)孕妇文化程度高是妊娠期高血压的保护因素;孕妇文化程度和家庭经济收入是妊娠贫血的保护因素;年龄较大是妊娠糖尿病的危险因素。(3)妊娠高血压和贫血的发病率与孕妇久坐久站呈正相关。结论孕前久站久坐可增加孕妇病发

  1. Ureteric complications in live related donor renal transplantation - impact on graft and patient survival

    Directory of Open Access Journals (Sweden)

    A Srivastava

    2004-01-01

    Full Text Available Objective : The study was performed with an aim to determine the incidence of ureteric complications in live related donor renal transplantation, and to study the effect of ureteric complications on long term graft and patient survival. Patients And Methods: Records of 1200 consecutive live related renal transplants done from 1989-2002 were reviewed. Twenty-six ureteric complications were noted to occur and treatment modalities employed were documented. In the non complication group sufficient data for evaluation was available in 867 patients. Survival analysis were performed using Kaplan-Meier techniques. Results: The overall incidence of urological complications is 2.9%. Complications occurred at a mean interval of 31.9 days after renal transplantation. Ureteric complications occurred in 2% patients with stented and 7.7% patients with non stented anastomosis (p=0.001. Mean follow up following renal transplantation was 37.4 months. Survival analysis showed that ureteric complications did not increase the risk of graft fai lu re or patient death. Conclusions: Ureteric complications in live related donor renal transplantation occurred in 2.9 % patients and did not impair graft and patient survival.

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

    Institute of Scientific and Technical Information of China (English)

    蔡志伟

    2015-01-01

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

  3. Procedure-related complications of transjugular intrahepatic portosystemic shunt (TIPS) and its clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Hyun Han; Byun, Kyung Hwan; Kim, Tae Gwon; Kang, Duk Sik; Kim, Yong Joo [College of Medicine, Kyungpook National University Hospital, Daegu (Korea, Republic of)

    1995-07-15

    The purpose who to evaluate the procedure-related complications of the TIPS and its clinical significance. The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture (from hepatic vein to the portal vein), contrast material was injected with the with drawl of the puncture needle. Procedure-related complications occurred in 28 patients (54%) among 52 patients. The complications were biliary tree puncture (15 cases), transperitoneal puncture (14 cases), stent malposition (3 cases), stent migration (1 case), hepatic arteries puncture (1 case), splenic vein perforation (1 case), and paroxysmal ventricular tachycardia (1 case). Three patients had acute stent thrombosis with rebleeding immediately after the procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. The procedure related complications were clinically insignificant in most instances, except when stent thrombosis or proxysmal ventricular tachycardia was developed.

  4. Use of thyroid hormones in relation to pregnancy

    DEFF Research Database (Denmark)

    Gidén, Karin; Andersen, Jon Trærup; Torp-Pedersen, Arendse Lærke

    2015-01-01

    OBJECTIVE: To determine the rate of exposure of pregnant women to levothyroxine and to assess changes in these rates before, during and after pregnancy. DESIGN: Register-based cohort study. SETTING: Danish nationwide registers. POPULATION: All women having a live birth in Denmark between 1 Januar...

  5. Pregnancy-Related Lumbopelvic Pain: Listening to Australian Women

    Directory of Open Access Journals (Sweden)

    Heather Pierce

    2012-01-01

    Full Text Available Objective. To investigate the prevalence and nature of lumbo-pelvic pain (LPP, that is experienced by women in the lumbar and/or sacro-iliac area and/or symphysis pubis during pregnancy. Design. Cross-sectional, descriptive study. Setting. An Australian public hospital antenatal clinic. Sample population: Women in their third trimester of pregnancy. Method. Women were recruited to the study as they presented for their antenatal appointment. A survey collected demographic data and was used to self report LPP. A pain diagram differentiated low back, pelvic girdle or combined pain. Closed and open ended questions explored the experiences of the women. Main Outcome Measures. The Visual Analogue Scale and the Oswestry Disability Index (Version 2.1a. Results. There was a high prevalence of self reported LPP during the pregnancy (71%. An association was found between the reporting of LPP, multiparity, and a previous history of LPP. The mean intensity score for usual pain was 6/10 and four out of five women reported disability associated with the condition. Most women (71% had reported their symptoms to their maternity carer however only a small proportion of these women received intervention. Conclusion. LPP is a potentially significant health issue during pregnancy.

  6. The influence of psychosocial factors on pregnancy related pelvic symptoms

    NARCIS (Netherlands)

    Pol, G. van de

    2006-01-01

    This thesis encloses studies which are separate analyses of the PRIMIS Study. In the PRIMIS Study a cohort of healthy women who expected their first child was followed up from early pregnancy to one year after delivery. Self-report questionnaires regarding psychosocial factors, urogenital symptoms a

  7. Oral health-related quality of life and complications after treatment with partial removable dental prosthesis

    DEFF Research Database (Denmark)

    Al-Imam, H; Özhayat, E B; Benetti, A R;

    2016-01-01

    The aims of this study were to measure and describe the oral health-related quality of life (OHRQoL) and to identify the complications caused by partial removable dental prosthesis (RDPs) in patients 1-5 years after treatment. Complications were identified in 65 patients who were treated with 83...

  8. Complicated grief after death of a relative in the intensive care unit.

    Science.gov (United States)

    Kentish-Barnes, Nancy; Chaize, Marine; Seegers, Valérie; Legriel, Stéphane; Cariou, Alain; Jaber, Samir; Lefrant, Jean-Yves; Floccard, Bernard; Renault, Anne; Vinatier, Isabelle; Mathonnet, Armelle; Reuter, Danielle; Guisset, Olivier; Cohen-Solal, Zoé; Cracco, Christophe; Seguin, Amélie; Durand-Gasselin, Jacques; Éon, Béatrice; Thirion, Marina; Rigaud, Jean-Philippe; Philippon-Jouve, Bénédicte; Argaud, Laurent; Chouquer, Renaud; Adda, Mélanie; Dedrie, Céline; Georges, Hugues; Lebas, Eddy; Rolin, Nathalie; Bollaert, Pierre-Edouard; Lecuyer, Lucien; Viquesnel, Gérard; Léone, Marc; Chalumeau-Lemoine, Ludivine; Garrouste, Maïté; Schlemmer, Benoit; Chevret, Sylvie; Falissard, Bruno; Azoulay, Élie

    2015-05-01

    An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements.

  9. Cesarean scar pregnancy

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian

    2016-01-01

    OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...

  10. Pregnancy-related knowledge and information needs of women with epilepsy: a systematic review.

    Science.gov (United States)

    McGrath, Amanda; Sharpe, Louise; Lah, Suncica; Parratt, Kaitlyn

    2014-02-01

    For women with epilepsy (WWE), pregnancy is complicated by considerations such as the potential teratogenicity of antiepileptic drugs (AEDs) versus the risks of having seizures during pregnancy. However, qualitative research suggests that many WWE remain uninformed about the risks associated with epilepsy and pregnancy and may, therefore, be making uninformed decisions about their families. The objectives of this review were to determine the level of patient knowledge, their informational needs, and whether these needs concerning pregnancy and childbirth issues are met among WWE. Electronic databases searched were PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science. Studies were included if they used quantitative methods to survey WWE aged 16years or older about their knowledge, access to information, or informational needs specifically regarding epilepsy and pregnancy. Twelve studies were identified and assessed for research standards using the Quality Index. Overall Quality Index score was only 7.1 out of 14, indicating significant design limitations of many included studies, including highly selective sampling methods and the use of unvalidated outcome measures. There was a paucity of studies investigating specific areas of women's knowledge and information needs. Overall, WWE reported adequate awareness, but limited knowledge, of key issues regarding pregnancy and childbirth. Across studies, many women reported not receiving information about these issues. Evidence suggested that many WWE wanted to receive more information - particularly about the risks of AEDs for their offspring - well in advance of choosing an AED or planning pregnancy. Women aged under 35years wanted the most information. Preconception counseling received by many WWE appears insufficient, risking uninformed decision-making about pregnancy. Further research is needed to investigate the barriers that WWE face in accessing, receiving, and retaining appropriate information.

  11. Recurrent pregnancy-related upper airway obstruction caused by intratracheal ectopic thyroid tissue

    DEFF Research Database (Denmark)

    Døssing, H; Jørgensen, K E; Oster-Jørgensen, E

    1999-01-01

    An unusual case of recurrent pregnancy-related thyroid growth stimulation is reported. A 27-year-old euthyroid woman had pulmonary symptoms, thought to be asthma during her first pregnancy, that improved postpartum. Bronchodilatators had no effect and symptoms recurred from gestational week 22...... developed normally. We believe that this case illustrates the recurrent effect of pregnancy-related thyroid tissue stimulation by a combination of increasing human chorionic gonadotropin (hCG) stimulation and iodine deficiency in a borderline iodine-deficient region. This is the first report on symptomatic...

  12. Rheumatic diseases during pregnancy

    OpenAIRE

    Rahman YAVUZ

    2013-01-01

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

  13. Planning a pregnancy

    Science.gov (United States)

    ... on Twitter Facebook Pinterest Email Print Planning a pregnancy Lupus Foundation of America March 16, 2017 Resource ... History or presence of antiphospholipid antibodies Planning Your Pregnancy Although many lupus pregnancies will have no complications, ...

  14. Semen quality of fertile US males in relation to their mothers' beef consumption during pregnancy

    National Research Council Canada - National Science Library

    Swan, S.H; Liu, F; Overstreet, J.W; Brazil, C; Skakkebaek, N.E

    2007-01-01

    BACKGROUND To look at possible long-term risks from anabolic steroids and other xenobiotics in beef, we examined mens' semen quality in relation to their mother's self-reported beef consumption during pregnancy. METHODS...

  15. 29 CFR 1604.10 - Employment policies relating to pregnancy and childbirth.

    Science.gov (United States)

    2010-07-01

    ... COMMISSION GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.10 Employment policies relating to pregnancy..., or insurance program which is in effect on October 31, 1978, which does not treat women affected...

  16. Serious and life-threatening pregnancy-related infections: opportunities to reduce the global burden.

    Directory of Open Access Journals (Sweden)

    Courtney A Gravett

    Full Text Available Michael Gravett and colleagues review the burden of pregnancy-related infections, especially in low- and middle-income countries, and offer suggestions for a more effective intervention strategy.

  17. Intrahepatic cholestasis of pregnancy is common among patients' first-degree relatives.

    Science.gov (United States)

    Turunen, Kaisa; Helander, Kristiina; Mattila, Kari J; Sumanen, Markku

    2013-09-01

    Intrahepatic cholestasis of pregnancy has been shown to have a genetic predisposition. We studied whether Finnish women who had suffered from the disorder reported their first-degree relatives to have had liver dysfunction during their pregnancies. Questionnaires were sent in autumn 2010 to a total of 544 former intrahepatic cholestasis of pregnancy patients and 1235 controls, all having delivered during 1969-1988. The response rate was 66.2%. The incidence of intrahepatic cholestasis is 0.5-1.5% of pregnancies in Finland. In our survey, altogether 12.8% of mothers (odds ratio 9.2), 15.9% of sisters (odds ratio 5.3) and 10.3% of daughters (odds ratio 4.8) of women who had suffered from intrahepatic cholestasis of pregnancy had had liver dysfunction during pregnancy. Our findings strengthen the earlier knowledge of the genetic component in intrahepatic cholestasis of pregnancy. We suggest that all pregnant women are asked about their family history regarding liver dysfunction during pregnancy. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. Real-World Economic Burden Associated with Transplantation-Related Complications.

    Science.gov (United States)

    Perales, Miguel-Angel; Bonafede, Machaon; Cai, Qian; Garfin, Phillip M; McMorrow, Donna; Josephson, Neil C; Richhariya, Akshara

    2017-10-01

    Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed annually in the United States. Real-world data on the costs associated with post-transplantation complications are limited. Patients with hematologic malignancies aged ≥18 years undergoing autologous HCT (auto-HCT) or allogeneic HCT (allo-HCT) between January 1, 2011, and June 30, 2014, were identified in the Truven Health MarketScan Research Databases. Patients were required to have 12 months of continuous medical and pharmacy enrollment before and after HCT; patients who experience inpatient death within 12 months post-HCT were also included. Patients with previous HCT were excluded. Potential HCT-related complications were identified if they had a medical claim with a diagnosis code for relapse; infection; cardiovascular, renal, neurologic, pulmonary, hepatic, or gastrointestinal disease; secondary malignancy; thrombotic microangiopathy; or posterior reversible encephalopathy syndrome within 1 year post-HCT. Healthcare costs attributable to these complications were evaluated by comparing total costs in HCT recipients with complications and those without complications. The MarketScan Research Databases were further linked to the Social Security Administration's Master Death File to obtain patient death events in a subset of patients. A total of 2672 HCT recipients were included in the analysis. The mean ± SD age of recipients was 54.5 ± 11.6 years, and the majority of recipients (63.6%) underwent auto-HCT. Complications were identified in 81% of auto-HCT recipients and in 95.5% of allo-HCT recipients. Most complications occurred within 180 days post-HCT. Compared with Auto-HCT recipients without complications, those with complications incurred $51,475 higher adjusted total costs (P < .01). Compared with allo-HCT recipients without complications, those with complications incurred $181,473 higher adjusted total costs (P < .01). Among the patients with mortality data

  19. Pregnancy-related pelvic girdle pain: an update.

    Science.gov (United States)

    Kanakaris, Nikolaos K; Roberts, Craig S; Giannoudis, Peter V

    2011-02-15

    A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women.

  20. Human chorionic somatommamotropin (HCS) and pregnancy. Its relation with insulin.

    Science.gov (United States)

    Prieto Villapun, J C; Cifuentes de Castro, I; Serrano Rios, M

    1976-01-01

    Plasma HCS levels have been measured in normal and pathological pregnant women. In the normal group HCS levels increased from 6--8 weeks till 33-34 weeks and then felt significantly. HCS pattern in prediabetic and chemical diabetic pregnant women was similar to the normal group. However HCS levels in chemical diabetics were significantly higher during the first two trimesters. HCS levels increased in twin pregnancy, diminished in cases of eclampsia, hypertension, fetal growth retardation, mole and blighted ovum, and disappeared after intrauterine death. Nothing could be deduced from the obese and Rh-isoimmunization groups. It is confirmed the value of HCS determination as an index of placental maturation. Also, insulin/HCS ratio may be of some aid in the study of carbohydrate intolerance in pregnancy.