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Sample records for pregnancy remains unclear

  1. Holotranscobalamin remains unchanged during pregnancy. Longitudinal changes of cobalamins and their binding proteins during pregnancy and postpartum

    DEFF Research Database (Denmark)

    Mørkbak, Anne Louise; Hvas, Anne-Mette; Milman, Nils

    2007-01-01

    We confirm a decrease in cobalamins during pregnancy, and report that the active part of cobalamins (holotranscobalamin, holoTC) remains unchanged. The decrease in cobalamins is explained by a decreased holohaptocorrin (holoHC), suggesting that holoTC rather than cobalamins should be used as a ma...... as a marker of vitamin B12 deficiency during pregnancy. Udgivelsesdato: 2007-Dec......We confirm a decrease in cobalamins during pregnancy, and report that the active part of cobalamins (holotranscobalamin, holoTC) remains unchanged. The decrease in cobalamins is explained by a decreased holohaptocorrin (holoHC), suggesting that holoTC rather than cobalamins should be used...

  2. [Hypothyroidism during pregnancy risks the child's neurocognitive development. New guidelines and remaining knowledge gaps].

    Science.gov (United States)

    Skalkidou, Alkistis; Bixo, Marie; Sköldebrand Sparre, Ann-Charlotte; Strandell, Annika; Lindén Hirschberg, Angelica; Filipsson Nyström, Helena

    2016-02-05

    Thyroid abnormalities are common during pregnancy and can affect pregnancy outcome. In 2012, the working group for endocrinology was assigned by SFOG to develop evidence based guidelines for their management. There is high quality evidence that untreated clinical hypothyroidism increases the risk of pregnancy and fetal complications. Subclinical hypothyroidism is associated with pregnancy complications. The presence of TPO-antibodies is linked to miscarriage and premature birth. It is uncertain whether subclinical hypothyroidism/maternal TPO-antibodies adversely affect the child's neurocognitive development. Reference intervals for TSH among pregnant women in Sweden need to be established.

  3. [Abdominal pregnancy: hormon concentrations during the postpartal period with placenta remaining intra-abdominal (author's transl)].

    Science.gov (United States)

    Gethmann, U; Mönkemeier, D

    1977-07-01

    It is reported of an abdominal pregnancy at term. The placenta was left in situ because of the high risk of intraabdominal bleedings. Thereby it was possible to measure hormon concentrations of the fetoplacental unit without the fetal compartment. Within 10 days after delivery we determined the plasma levels of estradiol-17 beta, estriol, progesterone, HCS, alpha1fetoprotein, and the excretion of the total estrogens in the urines. There was near the same decrease of hormon concentrations in the post partal time comparable with that of a normal pregnancy. Only the HCS concentrations didn't change in the first 9 days after delivery.

  4. SMFM Statement: benefit of antihypertensive therapy for mild-to-moderate chronic hypertension during pregnancy remains uncertain.

    Science.gov (United States)

    2015-07-01

    Chronic hypertension is present in up to 5% of pregnant women and constitutes a major cause of maternal and neonatal morbidity and mortality. The purpose of this document is to summarize the current recommendations regarding use of antihypertensive medications during pregnancy for women with mild-to-moderate chronic hypertension in the setting of the recently published Control of Hypertension in Pregnancy Study (CHIPS). The recently published CHIPS trial was a multicenter international randomized controlled trial comparing "less tight control" to "tight control" of blood pressure for pregnant women with hypertension. The most updated recommendations regarding management of pregnant women with hypertension are found from the American Congress of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy, which are endorsed by the Society of Maternal-Fetal Medicine (SMFM). SMFM recommends that clinicians continue to follow existing guidelines for management of pregnant women with mild-to-moderate chronic hypertension due to the fact that the benefits and risks of pharmacologic treatment for these women remain uncertain, and adequately powered randomized controlled trials are needed to address the less common but clinically significant nonsurrogate perinatal outcomes.

  5. The Performance of Public Organization: Still Unclear

    Directory of Open Access Journals (Sweden)

    Bacanu B.

    2014-12-01

    Full Text Available Nowadays, the present discussions about the organisation’s performance have revealed the fact that the concept is unclear. The use of the concept is more difficult in public organisations. The paper presents the case of Romanian SOE Hidroelectrica and the case of public universities, to pinpoint the fact that ambiguous objectives are the cause of a dilemmatic management. The general opinion is that the results of the public organisations management reflect a poor performance of the latter.

  6. Teen pregnancy. Why it remains a serious social, economic, and educational problem in the U.S.

    Science.gov (United States)

    Caldas, S J

    1994-01-01

    Although there are fewer teenage pregnancies in the US today than was the case prior to 1970, this fact should not be used to claim that the problem of adolescent pregnancy has been exaggerated. In the earlier period, the majority of adolescent pregnancies were to married couples; moreover, early childbearing was a social norm. In the present period, the availability of effective contraception and legal abortion has enabled women to postpone marriage and childbearing into their late twenties or early thirties and to focus instead on education that enhances their marketability and wages. Under prevailing social norms, teen pregnancy represents a clear deviation. By 1990, 68% of births to women under 20 years of age involved unmarried mothers. Under current socioeconomic conditions, unmarried adolescent mothers are likely to live in poverty and their offspring are at high risk of learning disabilities, child abuse, and foster care placements. Although young people are bombarded with images of sexuality in the mass media, school-based sex education programs tend to promote abstinence and withhold information on or access to contraception. It is essential that material on human sexuality is integrated into the curriculum as early as kindergarten if the teen pregnancy rate and the intergenerational transmission of early childbearing under conditions of poverty are to be reduced.

  7. Pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. 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....

  9. 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 ...

  10. Obamacare 2012: prognosis unclear for interventional pain management.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2012-01-01

    The Patient Protection and Affordable Care Act (ACA), informally referred to as ObamaCare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. ACA has substantially changed the landscape of medical practice in the United States and continues to influence all sectors, in particular evolving specialties such as interventional pain management. ObamaCare has been signed into law amidst major political fallouts, has sustained a Supreme Court challenge and emerged bruised, but still very much alive. While proponents argue that ObamaCare will provide insurance for almost everyone, with an improvement in the quality of and reduction in the cost of health care,, opponents criticize it as being a massive bureaucracy laden with penalties and taxes, that will ultimately eliminate personal medicine and individual practices. Based on the 2 years since the passage of ACA in 2010, the prognosis for interventional pain management is unclear. The damage sustained to interventional pain management and the majority of medicine practices is irreparable. ObamaCare may provide insurance for all, but with cuts in Medicare to fund Obamacare, a limited expansion of Medicaid, the inadequate funding of exchanges, declining employer health insurance coverage and skyrocketing disability claims, the coverage will be practically nonexistent. ObamaCare is composed of numerous organizations and bureaucracies charged with controlling the practice of medicine through the extension of regulations. Apart from cutting reimbursements and reducing access to interventional pain management, administration officials are determined to increase the role of midlevel practitioners and reduce the role of individual physicians by liberalizing the scope of practice regulations and introducing proposals to reduce medical education and training.

  11. Advice on exercise for pregnant women with hypertensive disorders of pregnancy.

    Science.gov (United States)

    Chawla, Shalini; Anim-Nyame, Nick

    2015-03-01

    Reports on advice about exercise for women with hypertensive disorders of pregnancy are reviewed and how exercise could influence long-term cardiovascular risk is assessed. Exercise in pregnancy seems to be beneficial in pregnancies complicated by hypertension. However, the intensity of the exercise to be recommended remains unclear. Further research is required to inform national and international guidelines for women who develop hypertension during pregnancy.

  12. Diabetes and obesity in pregnancy.

    Science.gov (United States)

    Simmons, David

    2011-02-01

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

  13. Eisenmenger Syndrome in Pregnancy

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    Full Text Available Abstract Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Epidural analgesia is preferred for Cesarean section as it alleviates perioperative pain and reduces the pulmonary and systemic vascular resistances. Maternal mortality in the presence of Eisenmenger syndrome is reported as 30-50% and even up to 65% in those with Cesarean section. The major causes of death could be hypovolemia, thromboembolism and preeclampsia. Pregnancy should ideally be avoided in a woman with Eisenmenger syndrome concerning the high maternal mortality rate and probable poor prognosis of the baby. A short labour and an atraumatic delivery under epidural block are preferred in the women with a strong desire of pregnancy. The purpose of this article is to discuss the debates of Eisenmenger syndrome in pregnancy and the possible resolutions.

  14. Prepregnancy dietary patterns and risk of developing hypertensive disorders of pregnancy: results from the Australian Longitudinal Study on Women’s Health

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Soedamah-Muthu, S.S.; Callaway, L.K.; Mishra, G.D.

    2015-01-01

    Background: Hypertensive disorders of pregnancy (HDPs), including gestational hypertension and pre-eclampsia, are common obstetric complications associated with adverse health outcomes for the mother and child. It remains unclear how dietary intake can influence HDP risk. Objective: We investigated

  15. Fish intake in pregnancy and child growth: A pooled analysis of 15 European and US birth cohorts

    NARCIS (Netherlands)

    N. Stratakis (Nikos); T. Roumeliotaki (Theano); E. Oken (Emily); A.I. Barros (Ana); M. Basterrechea (Mikel); M.-A. Charles (Marie-Aline); M. Eggesbø (Merete); F. Forastiere (Francesco); R. Gaillard (Romy); U. Gehring (Ulrike); E. Govarts (Eva); W. Hanke (Wojciech); B. Heude (Barbara); N. Iszatt (Nina); V.W.V. Jaddoe (Vincent); J.F. Kelleher (Joseph); M. Mommers (Monique); M. Murcia (Mario); A. Oliveira (Andreia); C. Pizzi (Costanza); K. Polanska (Kinga); D. Porta (Daniela); L. Richiardi (Lorenzo); S.L. Rifas-Shiman (Sheryl); G. Schoeters (Greet); J. Sunyer (Jordi); C. Thijs (Carel); K. Viljoen (Karien); M. Vrijheid (Martine); T.G.M. Vrijkotte (Tanja); A.H. Wijga (Alet); M.P.A. Zeegers (Maurice); M. Kogevinas (Manolis); L. Chatzi (Leda)

    2016-01-01

    textabstractIMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood

  16. Fish Intake in Pregnancy and Child Growth A Pooled Analysis of 15 European and US Birth Cohorts

    NARCIS (Netherlands)

    Stratakis, Nikos; Roumeliotaki, Theano; Oken, Emily; Barros, Henrique; Basterrechea, Mikel; Charles, Marie-Aline; Eggesbo, Merete; Forastiere, Francesco; Gaillard, Romy; Gehring, Ulrike; Govarts, Eva; Hanke, Wojciech; Heude, Barbara; Iszatt, Nina; Jaddoe, Vincent W.; Kelleher, Cecily; Mommers, Monique; Murcia, Mario; Oliveira, Andreia; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Rifas-Shiman, Sheryl L.; Schoeters, Greet; Sunyer, Jordi; Thijs, Carel; Viljoen, Karien; Vrijheid, Martine; Vrijkotte, Tanja G. M.; Wijga, Alet H.; Zeegers, Maurice P.; Kogevinas, Manolis; Chatzi, Leda

    2016-01-01

    IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight

  17. Fish intake in pregnancy and child growth

    DEFF Research Database (Denmark)

    Stratakis, N.; Roumeliotaki, T.; Oken, E.

    2016-01-01

    IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight...... through middle childhood compared with women with lower fish intake (3 times/week or less). High fish intake during pregnancy (>3 times/week) was associated with increased risk of rapid infant growth, with an adjusted odds ratio (aOR) of 1.22 (95%CI, 1.05-1.42) and increased risk of offspring overweight/obesity...... among boys (aOR, 1.11 [95%CI, 0.92-1.34]; P = .02 for interaction). CONCLUSIONS AND RELEVANCE High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity. Our findings are in line with the fish intake limit proposed by the US Food...

  18. Surgical resection for hepatocellular carcinoma in pregnancy: A case report

    Directory of Open Access Journals (Sweden)

    Chih-Chiang Hung

    2012-07-01

    Full Text Available Hepatocellular carcinoma (HCC occurring in pregnancy is very rare. The prognosis is usually poor because of unclear clinical presentation. A 30-year-old woman who suffered from HCC during pregnancy underwent hepatectomy twice, and resection for pulmonary metastasis once. A healthy infant was delivered after the first hepatectomy. Currently, she remains disease free 55 months after the second hepatectomy and 39 months after pulmonary metastatectomy. Moreover, she had another healthy infant 37 months after pulmonary metastatectomy. Aggressive resection of recurrent HCC may prolong life, and pregnancy should not alter the treatment strategy for HCC.

  19. [Adolescent pregnancy].

    Science.gov (United States)

    Lachcar, P

    1990-01-01

    The number of adolescent pregnancies brought to term in France has continued to decline while the number of abortions remains stable. Adolescent pregnancies cannot be considered "accidents" either in their social or psychological aspects. Pregnant adolescents carrying to term tend to be more disadvantaged than those seeking abortions. Early pregnancy may be a response to difficult life conditions. Despite appearing to constitute an infraction of a social code, adolescent pregnancy may in fact represent an attempt at social integration through motherhood. Adolescents failing in school, with poor employment prospects and feeling family pressures may view pregnancy as a means of social recognition. But such factors by themselves do not explain pregnancy; the primordial role of psychological factors must be examined. For some adolescents, pregnancy may represent an attempt to understand their own sexual identity as the transformations of puberty unsettle their previous self-images. Or they may be failing to perceive or actively denying the possibility of pregnancy. Adolescent pregnancies may be the result of transgressions of prohibitions. The traditional prohibition of sexual activity has relaxed to the degree that it is being replaced by a new prohibition on adolescent pregnancy and a prescription to use contraception. But contraception deprives an adolescent in search of sexual identity of proof of fertility as well as of the image of spontaneity and naturalness. Use of contraception is in conflict with the questions, doubts, and anxieties of adolescence. For adolescents in a reactivated oedipal stage, heterosexuality is often at the service of incestuous fantasies involving the mother. Abortion and perhaps pregnancy itself may assume the character of a rite of passage into adulthood for some adolescents. The important thing for many is the ability to become pregnant, to be a mother like their own mother.

  20. Maternal smoking during pregnancy and offspring IQ

    National Research Council Canada - National Science Library

    Breslau, Naomi; Paneth, Nigel; Lucia, Victoria C; Paneth-Pollak, Rachel

    2005-01-01

    Maternal smoking in pregnancy lowers birthweight. It is unclear, however, whether smoking during pregnancy lowers offspring IQ, and, if it does, whether it is through the smoking effect on fetal growth...

  1. Antenatal coffee and tea consumption and the effect on birth outcome and hypertensive pregnancy disorders

    NARCIS (Netherlands)

    Van Der Hoeven, Timothy; Browne, Joyce L.; Uiterwaal, Cuno S.P.M.|info:eu-repo/dai/nl/136603947; Van Der Ent, Cornelis K.|info:eu-repo/dai/nl/164028536; Grobbee, Diederick E.|info:eu-repo/dai/nl/071889256; Dalmeijer, Geertje W.

    2017-01-01

    Background and objective: Coffee and tea are commonly consumed during pregnancy. While several of their components, like caffeine, have strong pharmacological effects, the effect on the unborn fetus remains unclear. Caffeine intake has been associated with abortion, preterm birth and fetal growth

  2. Multiple Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Multiple Pregnancy Home For Patients Search FAQs Multiple Pregnancy Page ... Multiple Pregnancy FAQ188, July 2015 PDF Format Multiple Pregnancy Pregnancy How does multiple pregnancy occur? What are ...

  3. 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 ...

  4. Risk of ectopic pregnancy following day-5 embryo transfer compared with day-3 transfer.

    Science.gov (United States)

    Smith, Laura P; Oskowitz, Selwyn P; Dodge, Laura E; Hacker, Michele R

    2013-10-01

    The incidence of ectopic pregnancy after IVF is increased approximately 2.5-5-fold compared with natural conceptions; however, the aetiology for this increased risk remains unclear. One proposed practice change to decrease the incidence of ectopic pregnancy is blastocyst embryo transfer on day 5 rather than cleavage-stage embryo transfer on day 3. A retrospective cohort study was conducted to compare the risk of ectopic pregnancy following fresh day-5 embryo transfer with day-3 embryo transfer among women who underwent IVF and achieved pregnancy from 1998 to 2011. There were 13,654 eligible pregnancies; 277 were ectopic. The incidence of ectopic pregnancy was 2.1% among day-3 pregnancies and 1.6% among day-5 pregnancies. The adjusted risk ratio for ectopic pregnancy from day-5 compared with day-3 transfer was 0.71 (95% confidence interval 0.46-1.10). Although this analysis included 13,654 cycles, with a two-sided significance level of 0.05, it had only 21.9% power to detect a difference between the low incidence of ectopic pregnancy among both day-3 and day-5 transfers. In conclusion, this study was not able to demonstrate a difference in the risk of ectopic pregnancy among day-3 compared with day-5 transfers.

  5. Teenage pregnancy.

    Science.gov (United States)

    Dryburgh, H

    2000-10-01

    This article examines trends in teenage pregnancy in Canada, focussing on induced abortions, live births and fetal loss among women aged 15 to 19 in 1997. The data come from the Hospital Morbidity Data Base and the Canadian Vital Statistics Data Base at Statistics Canada, and the annual Therapeutic Abortion Survey, conducted by the Canadian Institute for Health Information. Data on abortions performed on Canadian residents in the United States are from an annual survey of selected states. International data are from the Alan Guttmacher Institute. Pregnancy rates, abortion rates, live birth rates and fetal loss rates are calculated using population counts of women in the age groups 15 to 17, 18 to 19, and 15 to 19. The percentages of pregnancies that ended in the three outcomes are also calculated for these years. The teenage pregnancy rate declined from 1994 to 1997, reflecting lower teenage birth and fetal loss rates. Through this period the abortion rate remained stable, with the result that slightly more than half of all teenage pregnancies ended in abortion by 1997. Younger teens are more likely to have an abortion than to give birth. The majority of pregnancies among older teens end in a live birth, although the number of live births is decreasing.

  6. Pre-pregnancy transabdominal cerclage

    DEFF Research Database (Denmark)

    Thuesen, Lea Langhoff; Diness, Birgitte Rode; Langhoff-Roos, Jens

    2009-01-01

    abortions, none in second trimester abortions or deliveries, and six were on-going pregnancies. In the remaining 37 pregnancies the fetal salvage rate was 100%, and cesarean section was performed after 34 weeks (mean 36+5 weeks) in 36 (97%) pregnancies. One woman had three successful pregnancies following...

  7. SPECT/spiral-CT hybrid imaging in unclear foci of increased bone metabolism: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, W.; Kuwert, T. [Nuklearmedizinische Klinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Beckmann, M.W. [Frauenklinik, Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany); Forst, R. [Lehrstuhl fuer Orthopaedie mit Orthopaedischer Chirurgie, Friedrich-Alexander Univ. Erlangen/Nuernberg (Germany); Bautz, W. [Radiologisches Inst., Friedrich-Alexander-Univ. Erlangen/Nuernberg (Germany)

    2005-07-01

    In bone scintigraphy, the differentiation between degenerative processes and bone metastases is still difficult. Therefore, additional radiological studies are regularly needed after bone scintigraphy. The now introduced hybrid-cameras combining single-photon emission computed tomography (SPECT) and spiral-CT are unique in the sense that they offer the opportunity to correlate the functional information with morphology in one session. We herein present two patients in whom this technological setup allowed a definite diagnosis in scintigraphically unclear vertebral lesions. In a patient with breast cancer, hypermetabolic lesions were clearly correlated with osteolyses. In another patient with synovial carcinoma, spondylosis and spondylarthrosis caused focal tracer uptake in the lumbar spine. In addition to an improved diagnostic accuracy, SPECT/Spiral-CT will considerably abbreviate the diagnostic process. (orig.)

  8. Treating Hypertension in Pregnancy.

    Science.gov (United States)

    Schlembach, Dietmar; Homuth, Volker; Dechend, Ralf

    2015-08-01

    Hypertension is present in about 10 % of all pregnancies. The frequency of chronic hypertension and that of gestational hypertension is increasing. The management of pregnant women with hypertension remains a significant, but controversial, public health problem. Although treatment of hypertension in pregnancy has shown to reduce maternal target organ damage, considerable debate remains concerning treatment. We review current evidence regarding treatment goals, the ideal treatment starting time, and which drugs are available for the treatment of hypertension in pregnancy.

  9. Fish remains and humankind

    Directory of Open Access Journals (Sweden)

    Andrew K G Jones

    1997-08-01

    Full Text Available The four papers in this issue represent a trawl of the reports presented to the Fourth meeting of the International Council for Archaeozoology (ICAZ Fish Remains Working Group, which met at the University of York in 1987. The conference discussed material from many parts of the world - from Australasia to the north-west coast of America - and many eras, ranging in date from the early Pleistocene to the 1980s. It demonstrated both the variety of work being carried out and the growing interest in ancient fish remains. Internet Archaeology plans to publish other batches of papers from this conference. These reports will demonstrate the effort being made to distinguish between assemblages of fish remains which have been deposited by people and those which occur in ancient deposits as a result of the action of other agents. To investigate this area, experiments with modern material and observations of naturally occurring fish bone assemblages are supplemented with detailed analysis of ancient and modern fish remains. The papers published here illustrate the breadth of research into osteology, biogeography, documentary research, and the practicalities of recovering fish remains. Read, digest and enjoy them! Using the Internet for publishing research papers is not only ecologically sound (saving paper, etc. it disseminates scholarship to anyone anywhere on the planet with access to what is gradually becoming necessary technology in the late 20th century. Hopefully, future groups of papers will include video and audio material recorded at the conference, and so enable those who could not attend to gain further insights into the meeting and the scholarship underpinning this area of research.

  10. [PALEOPATHOLOGY OF HUMAN REMAINS].

    Science.gov (United States)

    Minozzi, Simona; Fornaciari, Gino

    2015-01-01

    Many diseases induce alterations in the human skeleton, leaving traces of their presence in ancient remains. Paleopathological examination of human remains not only allows the study of the history and evolution of the disease, but also the reconstruction of health conditions in the past populations. This paper describes the most interesting diseases observed in skeletal samples from the Roman Imperial Age necropoles found in urban and suburban areas of Rome during archaeological excavations in the last decades. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumours, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, the palaeopathological study allowed to highlight the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

  11. White-tailed deer response to vehicle approach: evidence of unclear and present danger.

    Directory of Open Access Journals (Sweden)

    Bradley F Blackwell

    Full Text Available The fundamental causes of animal-vehicle collisions are unclear, particularly at the level of animal detection of approaching vehicles and decision-making. Deer-vehicle collisions (DVCs are especially costly in terms of animal mortality, property damage, and safety. Over one year, we exposed free-ranging white-tailed deer (Odocoileus virginianus to vehicle approach under low ambient light conditions, from varying start distances, and vehicle speeds from 20 km/h to approximately 90 km/h. We modeled flight response by deer to an approaching vehicle and tested four hypotheses: 1 flight-initiation distance (FID would correlate positively with start distance (indicating a spatial margin of safety; 2 deer would react to vehicle speed using a temporal margin of safety; 3 individuals reacting at greater FIDs would be more likely to cross the path of the vehicle; and 4 crossings would correlate positively with start distance, approach speed, and distance to concealing/refuge cover. We examined deer responses by quantiles. Median FID was 40% of start distance, irrespective of start distance or approach speed. Converting FID to time-to-collision (TTC, median TTC was 4.6 s, but uncorrelated with start distance or approach speed. The likelihood of deer crossing in front of the vehicle was not associated with greater FIDs or other explanatory variables. Because deer flight response to vehicle approach was highly variable, DVCs should be more likely with increasing vehicle speeds because of lower TTCs for a given distance. For road sections characterized by frequent DVCs, we recommend estimating TTC relative to vehicle speed and candidate line-of-sight distances adjusted downward by (1-P, where P represents our findings for the proportion of start distance by which >75% of deer had initiated flight. Where road design or conservation goals limit effectiveness of line-of-sight maintenance, we suggest incorporation of roadway obstacles that force drivers to slow

  12. 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.

  13. Pregnancy Tests

    Science.gov (United States)

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

  14. Ultrasound pregnancy

    Science.gov (United States)

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

  15. Mothers' pre-pregnancy BMI and weight gain during pregnancy and risk of breast cancer in daughters.

    Science.gov (United States)

    Wilson, Kathryn M; Willett, Walter C; Michels, Karin B

    2011-11-01

    Previous studies have established that higher birthweight is associated with increased risk of breast cancer. However, the mechanisms underlying this association remain unclear. We explored whether maternal pregnancy weight gain and pre-pregnancy body mass index (BMI), which influence birthweight, are associated with risk of breast cancer in offspring. The Nurses' Mothers case-control study of breast cancer was nested in the Nurses' Health Study I and II cohorts. Mothers of 814 nurses with and 1,809 nurses without breast cancer completed questionnaires with information on pre-pregnancy height and weight, pregnancy weight gain, and other aspects of their pregnancies with the nurse daughters. We calculated odds ratios for breast cancer using conditional logistic regression. Mean pregnancy weight gain was 23 lb, and average pre-pregnancy BMI was 21 kg/m². Mothers' weight gain during pregnancy was not associated with the daughters' risk of breast cancer. Compared to women whose mothers gained 20-29 lb, women whose mothers gained less than 10 lb had a relative risk of 0.92 (95% confidence interval [CI]: 0.62-1.36), adjusting for the age of the nurses. Women whose mothers gained 40 or more pounds had a relative risk of 0.82 (95% CI: 0.55-1.23). Mothers' pre-pregnancy BMI was not associated with the daughters' risk of breast cancer. Women whose mothers had a pre-pregnancy BMI of 30 or more had a relative risk of 0.77 (95% CI: 0.34-1.74) compared to those with BMI less than 20. Additional adjustment for prenatal factors or for nurses' characteristics later in life had no effect on the results. The association between birthweight and breast cancer risk is likely due to factors independent of mothers' weight gain during pregnancy or pre-pregnancy BMI. Because BMIs and pregnancy weight gains were lower in this population than today, we cannot rule out associations for very high pre-pregnancy BMIs or pregnancy weight gains.

  16. Spontaneous Rupture of Uterine Vein in Twin Pregnancy

    Directory of Open Access Journals (Sweden)

    Emek Doger

    2013-01-01

    Full Text Available Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs.

  17. Prevention of Defective Placentation and Pregnancy Loss by Blocking Innate Immune Pathways in a Syngeneic Model of Placental Insufficiency.

    Science.gov (United States)

    Gelber, Shari E; Brent, Elyssa; Redecha, Patricia; Perino, Giorgio; Tomlinson, Stephen; Davisson, Robin L; Salmon, Jane E

    2015-08-01

    Defective placentation and subsequent placental insufficiency lead to maternal and fetal adverse pregnancy outcome, but their pathologic mechanisms are unclear, and treatment remains elusive. The mildly hypertensive BPH/5 mouse recapitulates many features of human adverse pregnancy outcome, with pregnancies characterized by fetal loss, growth restriction, abnormal placental development, and defects in maternal decidual arteries. Using this model, we show that recruitment of neutrophils triggered by complement activation at the maternal/fetal interface leads to elevation in local TNF-α levels, reduction of the essential angiogenic factor vascular endothelial growth factor, and, ultimately, abnormal placentation and fetal death. Blockade of complement with inhibitors specifically targeted to sites of complement activation, depletion of neutrophils, or blockade of TNF-α improves spiral artery remodeling and rescues pregnancies. These data underscore the importance of innate immune system activation in the pathogenesis of placental insufficiency and identify novel methods for treatment of pregnancy loss mediated by abnormal placentation.

  18. Hypertensive Emergencies in Pregnancy.

    Science.gov (United States)

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders.

  19. Iron chelation therapy of transfusion-dependent β-thalassemia during pregnancy in the era of novel drugs: is deferasirox toxic?

    Science.gov (United States)

    Diamantidis, Michael D; Neokleous, Nikolaos; Agapidou, Aleka; Vetsiou, Evaggelia; Manafas, Achilles; Fotiou, Paraskevi; Vlachaki, Efthymia

    2016-05-01

    The life expectancy of thalassemic patients has increased, and now approaches that of healthy individuals, thanks to improved treatment regimens. However, pregnancy in women with β-Thalassemia Μajor remains a challenging condition. Recent advances in managing this haemoglobinopathy offer the potential for safe pregnancies with favorable outcome. However, clinical data regarding the use of chelation therapy during pregnancy are limited, and it is unclear whether these agents impose any risk to the developing fetus. Successful pregnancies following unintentional treatment with deferoxamine or deferasirox have rarely been reported. Generally, chelators are not recommended during pregnancy. Regarding the new oral chelators, data on fetotoxicity are lacking. In the present study, we describe the evolution and successful outcome of nine pregnancies in six Greek thalassemic women who received deferasirox inadvertently during early pregnancy, and review the literature regarding fetal anomalies due to chelators. Use of chelation before embarking upon a non-programmed pregnancy remains a difficult and unresolved question. In our study, chelation treatment during pregnancy did not prevent the delivery of healthy children. Nonetheless, the use of deferasirox is contraindicated in pregnant women, based on the product label. Deferasirox should only be used during pregnancy if the potential benefit outweighs the potential fetal risk.

  20. Blood Clotting and Pregnancy

    Medline Plus

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

  1. Blood Clotting and Pregnancy

    Medline Plus

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

  2. Childhood consequences of maternal obesity and excessive weight gain during pregnancy.

    Science.gov (United States)

    Gaillard, Romy; Felix, Janine F; Duijts, Liesbeth; Jaddoe, Vincent W V

    2014-11-01

    Obesity is a major public health concern. In western countries, the prevalence of obesity in pregnant women has strongly increased, with reported prevalence rates reaching 30%. Also, up to 40% of women gain an excessive amount of weight during pregnancy. Recent observational studies and meta-analyses strongly suggest long-term impact of maternal obesity and excessive weight gain during pregnancy on adiposity, cardiovascular and respiratory related health outcomes in their children. These observations suggest that maternal adiposity during pregnancy may program common health problems in the offspring. Currently, it remains unclear whether the observed associations are causal, or just reflect confounding by family-based sociodemographic or lifestyle-related factors. Parent-offspring studies, sibling comparison studies, Mendelian randomization studies and randomized trials can help to explore the causality and underlying mechanisms. Also, the potential for prevention of common diseases in future generations by reducing maternal obesity and excessive weight gain during pregnancy needs to be explored.

  3. Teen pregnancy: an update.

    Science.gov (United States)

    McCracken, Katherine A; Loveless, Meredith

    2014-10-01

    To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention as one of its top six priorities, which is increasing research and intervention data. Long-acting contraceptive methods are acceptable to teens and have been shown to reduce teen birth rates. Pregnant teens need special attention to counseling on pregnancy options and reducing risk during pregnancy with regular prenatal care. Postpartum teens should be encouraged and supported to breastfeed, monitored for depression, and have access to reliable contraception to avoid repeat undesired pregnancy. This review highlights important issues for all providers caring for female adolescents and those who may encounter teen pregnancy. Foremost prevention of teen pregnancy by comprehensive sexual education and access to contraception is the priority. Educating patients and healthcare providers about safety and efficacy of long-acting reversible contraception is a good step to reducing undesired teen pregnancies. Rates of postpartum depression are greater in adolescents than in adults, and adolescent mothers need to be screened and monitored for depression. Strategies to avoid another undesired pregnancy shortly after delivery should be implemented.

  4. Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

    Science.gov (United States)

    Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

    2013-12-31

    While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

  5. Intrahepatic cholestasis of pregnancy

    Institute of Scientific and Technical Information of China (English)

    Victoria Geenes; Catherine Williamson

    2009-01-01

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

  6. Maternal cigarette smoking during pregnancy and cognitive performance in adolescence

    National Research Council Canada - National Science Library

    Kafouri, S; Leonard, G; Perron, M; Richer, L; Séguin, JR; Veillette, S; Pausova, Z; Paus, T

    2009-01-01

    Background The incidence of cigarette smoking during pregnancy remains high. Maternal smoking during pregnancy is known to be associated with cognitive and behavioural sequelae in childhood and adolescence...

  7. [Facial pain- a rare cause. Impacted lower third molars causing primarily "unclear" facial pain: a case report].

    Science.gov (United States)

    Gander, Thomas; Dagassan-Berndt, Dorothea; Mascolo, Luana; Kruse, Astrid L; Grätz, Klaus W; Lübbers, Heinz-Theo

    2013-01-01

    Orofacial pain often causes special difficulties to patients and dentists. Numerous differential diagnoses require the utilization of a coordinated diagnostic concept. Often, multiple causes lead to the need for a complex treatment plan. Impacted third molars are a potential cause of a variety of complications. Caries, pulp necrosis, and periapical infection are some of the infrequent causes of such pain. The presented case shows just such a constellation, resulting in primarily "unclear" orofacial pain. A diagnostic sequence generally leads to the correct diagnosis and thereby allows for fast and effective therapy. This shows how important structured diagnostics are, especially in cases of "unclear" pain.

  8. [Pregnancy experiences of women with pregnancy-induced hypertension].

    Science.gov (United States)

    Rauchfuß, Martina; Enderwitz, Judith; Klapp, Burghard; Maier, Barbara; Bölter, Annette; Frommer, Jörg

    2012-01-01

    The study assesses the experience of pregnancy of women who have pregnancy induced hypertension (PIH) compared to women with an uncomplicated course of pregnancy. 21 women were retrospectively investigated between 5 and 13 months after giving birth via a semistandardised interview focussing on the personal experience of pregnancy. The interviews were analysed by means of qualitative content analysis. The categories "development and course," "coping with anxiety," "image of one's mother" and "relationship with partner" were determined and described. Finally, we developed data-driven, ideal-type models of pregnancies with pregnancy-induced hypertension versus normal pregnancies by detecting the similarities and contrasts between the groups. Interviewees with pregnancy-induced hypertension showed an ambivalence with regard to their pregnancy, which was more often than not unplanned and/or unwanted. Conflicts with significant others, especially with their partners, were also reported more often. Emotions tended to be understated. The results can be employed in the operationalisation of future projects in a hitherto unclear research field. They should also be considered in the care of patients with pregnancy-induced hypertension.

  9. Quantifying the mediating effect of body mass index in the relationship between a Mediterranean diet and development of maternal pregnancy complications: Australian Longitudinal Study on Women’s Health

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Soedamah-Muthu, S.S.; Mishra, G.D.

    2016-01-01

    Background: The contribution of body mass index (BMI) to the observed associations between dietary patterns and risk of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) remains unclear. Objective: The objective of this study was to formally quantify the mediating eff

  10. Quantifying the mediating effect of body mass index in the relationship between a Mediterranean diet and development of maternal pregnancy complications: Australian Longitudinal Study on Women’s Health

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Soedamah-Muthu, S.S.; Mishra, G.D.

    2016-01-01

    Background: The contribution of body mass index (BMI) to the observed associations between dietary patterns and risk of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) remains unclear. Objective: The objective of this study was to formally quantify the mediating

  11. Pregnancy anxiety and prenatal cortisol trajectories.

    Science.gov (United States)

    Kane, Heidi S; Dunkel Schetter, Christine; Glynn, Laura M; Hobel, Calvin J; Sandman, Curt A

    2014-07-01

    Pregnancy anxiety is a potent predictor of adverse birth and infant outcomes. The goal of the current study was to examine one potential mechanism whereby these effects may occur by testing associations between pregnancy anxiety and maternal salivary cortisol on 4 occasions during pregnancy in a sample of 448 women. Higher mean levels of pregnancy anxiety over the course of pregnancy predicted steeper increases in cortisol trajectories compared to lower pregnancy anxiety. Significant differences between cortisol trajectories emerged between 30 and 31 weeks of gestation. Results remained significant when adjusted for state anxiety and perceived stress. Neither changes in pregnancy anxiety over gestation, nor pregnancy anxiety specific to only a particular time in pregnancy predicted cortisol. These findings provide support for one way in which pregnancy anxiety may influence maternal physiology and contribute to a growing literature on the complex biological pathways linking pregnancy anxiety to birth and infant outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Functional testing strategy for coding genetic variants of unclear significance in MLH1 in Lynch syndrome diagnosis.

    Science.gov (United States)

    Hinrichsen, Inga; Schäfer, Dieter; Langer, Deborah; Köger, Nicole; Wittmann, Margarethe; Aretz, Stefan; Steinke, Verena; Holzapfel, Stefanie; Trojan, Jörg; König, Rainer; Zeuzem, Stefan; Brieger, Angela; Plotz, Guido

    2015-02-01

    Lynch syndrome is caused by inactivating mutations in the MLH1 gene, but genetic variants of unclear significance frequently preclude diagnosis. Functional testing can reveal variant-conferred defects in gene or protein function. Based on functional defect frequencies and clinical applicability of test systems, we developed a functional testing strategy aimed at efficiently detecting pathogenic defects in coding MLH1 variants. In this strategy, tests of repair activity and expression are prioritized over analyses of subcellular protein localization and messenger RNA (mRNA) formation. This strategy was used for four unclear coding MLH1 variants (p.Asp41His, p.Leu507Phe, p.Gln689Arg, p.Glu605del + p.Val716Met). Expression was analyzed using a transfection system, mismatch repair (MMR) activity by complementation in vitro, mRNA formation by reverse transcriptase-PCR in carrier lymphocyte mRNA, and subcellular localization with dye-labeled fusion constructs. All tests included clinically meaningful controls. The strategy enabled efficient identification of defects in two unclear variants: the p.Asp41His variant showed loss of MMR activity, whereas the compound variant p.Glu605del + p.Val716Met had a defect of expression. This expression defect was significantly stronger than the pathogenic expression reference variant analyzed in parallel, therefore the defect of the compound variant is also pathogenic. Interestingly, the expression defect was caused additively by both of the compound variants, at least one of which is non-pathogenic when occurring by itself. Tests were neutral for p.Leu507Phe and p.Gln689Arg, and the results were consistent with available clinical data. We finally discuss the improved sensitivity and efficiency of the applied strategy and its limitations in analyzing unclear coding MLH1 variants.

  13. [Diabetic retinopathy during pregnancy.

    DEFF Research Database (Denmark)

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

    2008-01-01

    (62%) women with type 1 and three (17%) with type 2 diabetes at the first examination. In 26 (34%) retinopathy progressed; four women developed proliferations, three macular oedema and three reduction of visual acuity >/=0.2 on Snellen's chart in at least one eye. HbA1c in early pregnancy was the only...... among women with high HbA1c values in early pregnancy. A few women developed proliferations, macular oedema and reduction of visual acuity. Development of sight-threatening alterations during pregnancy remains a clinical problem Udgivelsesdato: 2008/12/8...

  14. Pregnancy issues in scleroderma.

    Science.gov (United States)

    Lidar, Merav; Langevitz, Pnina

    2012-05-01

    Systemic sclerosis is a systemic, inflammatory, autoimmune disease affecting the skin and viscera, manifesting pathologically with microvascular lesions, perivascular infiltration by mononuclear cells and increased deposition of extracellular collagen. The rarity of the disease as well as its propensity to appear in the early 1940s, explain the low frequency of concurrent scleroderma and pregnancy. However, the marked female excess, as well as the trend for increasing maternal age due to social change and assisted reproductive technologies, renders heightened significance to issues of fertility, pregnancy course and pregnancy outcomes. In the past, scleroderma patients were thought to be at high risk for poor fetal and maternal outcome, but more current retrospective studies show that despite an increased frequency of prematurity and small for gestational age infants, overall maternal and neonatal survival is good. Hence, at present, with close monitoring and appropriate therapy most scleroderma patients can sustain a successful pregnancy. Therapy with hydroxychloroquine and low dose steroids as well as judicious use of intravenous immunoglobulins is permitted. Renal crisis remains the most dreaded complication of a scleroderma pregnancy and necessitates prompt institution of ACE inhibitor therapy despite its potential teratogenicity. In order minimize the risk for renal crisis, pregnancies should be avoided in rapidly progressive diffuse disease as such patients are at a greater risk for developing serious cardiopulmonary and renal problems early in the disease. This review shall focus on the bi-directional effects of scleroderma on fertility and pregnancy as well as on the management of pregnancy and delivery in the scleroderma patient.

  15. Heterotopic pregnancy: Sonographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Tae Hee [CHA General Hospital of Seoul, Pochon CHA University College of Medicine, Seoul (Korea, Republic of)

    1999-03-15

    To evaluate the sonographic findings of the heterotopic pregnancy which is increasing recently. Thirty-nine cases of heterotopic pregnancy after ovulation induction and IVF-ET (In Vitro Fertilization-Embryo Transfer) during the recent 3 years were analyzed. They were diagnosed by ultrasonography and proved surgically afterwards. Sonographic findings were analyzed focusing on gestational week of intrauterine pregnancy and location of ectopic pregnancy. In particular, adnexal mass was evaluated with regard to size and the characteristic findings such as ectopic gestational sac (echogenic ring). Also, overian cyst and fluid collection in cul-de-sac space were reviewed carefully. Heterotopic pregnancy was proved surgically by salpingectomy in 33 cases and by resection of cornus in six cases. Sonographic diagnosis using transvaginal ultrasound was made from five weeks to nine weeks two days (six weeks and four days in average) from last menstral period in all 39 cases. Ectopic pregnancy was identified in ampullary part in 29 cases, in the isthmic portion of tube in four cases and in the cornus of uterus in six cases. The intrauterine pregnancy was diagnosed by identifying the intrauterine gestational saccontaining a yolk sac in seven cases and the embryo with fetal heart beat in the remaining 32 cases. Adnexal masses of heterotopic pregnancy were less than 3 cm in diameter in 2 cases (57%), 3-4 cm in 11 cases (28%) and more than 4 cm in 6 cases (15%). A characteristic finding of ectopic mass was echogenic ring which was visible in 33 (84.6%) cases by transvaginal ultrasound. Six cases had pelvic hematosalpinx and two had pelvic hematoma. Of 10 cases (26%) which were identified to have ovarian hyperstimulation syndrome, eight (21%) had large amount of fluid collection in cul-de-sac and abdomen. Ultrasonographic identification of the intrauterine pregnancy and the ectopic chorion ring is effective for the early diagnosis of the heterotopic pregnancy.

  16. 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 ...

  17. Ectopic Pregnancy

    Science.gov (United States)

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

  18. 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 ...

  19. Ectopic Pregnancy

    Science.gov (United States)

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

  20. Diffuse pulmonary meningotheliomatosis: A literature review of a rare diffuse parenchymal lung disease with unclear clinical significance

    Directory of Open Access Journals (Sweden)

    James B Gleason

    2017-01-01

    Full Text Available Introduction: Diffuse pulmonary meningotheliomatosis is a rare disease, with unclear clinical significance and very few reported cases in the literature. In this study, we review the demographics, presentation, imaging, diagnostic workup, and histologic findings of the 25 patients previously published in the literature with an outline of the disease history. Materials and Methods: We conducted a review of the literature through July 2016 for studies reporting cases of diffuse pulmonary meningotheliomatosis by searching multiple scholarly databases. Results: Of the 25 cases identified 2 were male (8%, and 23 were female (92%. Ages ranged from 37 to 73 with a median age of 59.5 years at diagnosis. 15 (60% were asymptomatic and imaging abnormalities were discovered incidentally. 8 (32% had unexplained respiratory complaints. 11 (44% had history of or active malignancy. 3 (12% were diagnosed by transbronchial biopsy while the remainder had surgical lung biopsies. Conclusion: Diffuse pulmonary meningotheliomatosis should be considered in all patients with diffuse bilateral pulmonary nodules on HRCT. The condition is more prevalent in females and its clinical significance is unclear, although nearly half of those diagnosed had a history of malignancy. CT imaging and surgical lung biopsy are the modalities of choice for diagnosis but transbronchial biopsies have recently been used obtain the diagnosis. Additional research needs to be done to further characterize the nature of this condition and the clinical scenarios in which is presents.

  1. Parasite remains in archaeological sites.

    Science.gov (United States)

    Bouchet, Françoise; Guidon, Niéde; Dittmar, Katharina; Harter, Stephanie; Ferreira, Luiz Fernando; Chaves, Sergio Miranda; Reinhard, Karl; Araújo, Adauto

    2003-01-01

    Organic remains can be found in many different environments. They are the most significant source for paleoparasitological studies as well as for other paleoecological reconstruction. Preserved paleoparasitological remains are found from the driest to the moistest conditions. They help us to understand past and present diseases and therefore contribute to understanding the evolution of present human sociality, biology, and behavior. In this paper, the scope of the surviving evidence will be briefy surveyed, and the great variety of ways it has been preserved in different environments will be discussed. This is done to develop to the most appropriated techniques to recover remaining parasites. Different techniques applied to the study of paleoparasitological remains, preserved in different environments, are presented. The most common materials used to analyze prehistoric human groups are reviewed, and their potential for reconstructing ancient environment and disease are emphasized. This paper also urges increased cooperation among archaeologists, paleontologists, and paleoparasitologists.

  2. Parasite remains in archaeological sites

    Directory of Open Access Journals (Sweden)

    Françoise Bouchet

    2003-01-01

    Full Text Available Organic remains can be found in many different environments. They are the most significant source for paleoparasitological studies as well as for other paleoecological reconstruction. Preserved paleoparasitological remains are found from the driest to the moistest conditions. They help us to understand past and present diseases and therefore contribute to understanding the evolution of present human sociality, biology, and behavior. In this paper, the scope of the surviving evidence will be briefly surveyed, and the great variety of ways it has been preserved in different environments will be discussed. This is done to develop to the most appropriated techniques to recover remaining parasites. Different techniques applied to the study of paleoparasitological remains, preserved in different environments, are presented. The most common materials used to analyze prehistoric human groups are reviewed, and their potential for reconstructing ancient environment and disease are emphasized. This paper also urges increased cooperation among archaeologists, paleontologists, and paleoparasitologists.

  3. Pregnancy and rheumatoid arthritis.

    Science.gov (United States)

    Tandon, Vishal R; Sharma, Sudhaa; Mahajan, Annil; Khajuria, Vijay; Kumar, Ajay

    2006-08-01

    Pregnancy in most cases, is associated with remission of rheumatoid arthritis (RA), but a quarter of patients continue to have active disease or even worsening of the disease and most patients who improve, relapse in the postpartum period. The pathophysiology of this improvement in disease activity during pregnancy remains unknown, but hormonal, cell-mediated immunological and humoral immunological changes during pregnancy, have been proposed responsible for this. Most of the pregnant women with RA have an uneventful course, with no significant complications. In general, no significant increase in maternal or fetal morbidity seems to be attributable to RA. Patients with RA do not have decreased fertility. A majority of patients with RA may go in remission and anti-rheumatic treatment may not be required as soon as women become pregnant. But other patients who continue with the disease activity require treatment. The preferred disease-modifying agents during pregnancy are sulfasalazine and hydroxychloroquine. Azathioprine and cyclosporine can be used if the benefits outweigh the risks. Paracetamol and low dose prednisone are preferred and considered safe, both for mother and fetus. Methotrexate and lefunomide are contraindicated and must be prophylactically withdrawn before a planned pregnancy. Biologics generally should be stopped when pregnancy is discovered. An overall rational approach is highly warranted to treat RA during pregnancy.

  4. Hyperthyroidism in pregnancy.

    Science.gov (United States)

    Mestman, Jorge H

    2012-10-01

    Successful outcome in pregnancy hyperthyroidism depends on the cause, interpretation of laboratory tests, and careful use of antithyroid drug (ATD) therapy. Planning of a pregnancy in a woman with active or past history of Graves' hyperthyroidism is mandatory in order to avoid complications. Fetal health may be affected by three factors: poor control of maternal hyperthyroidism, titer of maternal TRAb, and inappropriate use of ATD. Careful assessment of thyroid function through pregnancy and evaluation of fetal development by ultrasonography is the cornerstone for a successful outcome. In a subgroup of women previously treated with ablation therapy, those whose serum TSRAb titers remained elevated, are at risk of having a fetus/neonate with Graves' hyperthyroidism. Use of ATD during lactation is well tolerated, if recommended guidelines are followed. Women during their childbearing age with active Graves' hyperthyroidism should plan their pregnancy. Causes of hyperthyroidism in pregnancy include Graves' disease or autonomous adenoma, and transient gestational thyrotoxicosis as a consequence of excessive production of human chroionic gonadotropin by the placenta. Careful interpretation of thyroid function tests and frequent adjustment of ATD is of utmost importance in the outcome of pregnancy. Graves' hyperthyroidism may relapse early in pregnancy or at the end of the first year postpartum.

  5. Pregnancy and kidney transplantation.

    Science.gov (United States)

    Josephson, Michelle A; McKay, Dianne B

    2011-01-01

    Despite decades of experience with child bearing in women with kidney transplants, these pregnancies remain high risk with an increased prevalence of hypertension and pre-eclampsia. Infertility, common in women with end-stage renal disease, is rapidly restored after transplant although pregnancy rates appear lower in transplant recipients than the general public. Many unanswered questions exist, some old questions such as what is the optimal timing of pregnancy after transplant, whether breast feeding is safe, the long-term impact if any on the offspring, and whether pregnancy negatively affects the kidney graft; and some new questions such as whether to modify immunosuppression in a patient taking a mycophenolic acid-containing drug, whether kidney donation has a deleterious impact on future pregnancies, whether to use erythropoietin-stimulating agents, and the role of BK virus. Counseling about contraception and pregnancy after transplant should be initiated during the pretransplant evaluation process. It is important because of the rapid restoration of fertility that occurs after transplant as well as the many risks and unanswered questions that remain.

  6. Ultrasound-guided biopsy of greater omentum: An effective method to trace the origin of unclear ascites

    Energy Technology Data Exchange (ETDEWEB)

    Que Yanhong [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: quebaobao@yahoo.com.cn; Wang Xuemei [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: wxmlmt@yahoo.com.cn; Liu Yanjun [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: lyj7512@sina.com; Li Ping [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: liping7213@sina.com; Ou Guocheng [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: yang9951@126.com; Zhao Wenjing [Department of Ultrasound, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001 (China)], E-mail: awk999@163.com

    2009-05-15

    Objectives: Thickened greater omentum is encountered with high frequency in patients with ascites. The purpose of our study was to assess the utility of greater omentum biopsy under the guidance of ultrasound (US) in tracing the origin of unclear ascites and differentiating benign and malignant ascites. Materials and methods: We retrospectively reviewed our institutional database for all records of greater omentum biopsy cases. One hundred and ninety-four patients with unclear ascites and thickened greater omentum were included in the study. The sonograms of greater omentum were evaluated before undergoing the ultrasound-guided biopsy and a biopsy was considered successful if a specific benign or malignant diagnosis was rendered by the pathologist. Results: Successful biopsy was rendered for 182 biopsy procedures (93.8%, 182/194) including tuberculosis (n = 114), chronic inflammation (n = 3), metastases (n = 58), malignant mesothelioma (n = 6) and pseudomyxoma peritonei (n = 1). Twelve biopsies were non-diagnostic. According to the results of biopsy and follow-up, the sensitivity and specificity of biopsy in distinguishing malignant ascites from benign ascities were respectively 95.6% (65/68) and 92.9% (117/126). The greater omentum of 84 cases of tuberculous peritonitis showed 'cerebral fissure' sign and was well seen as an omental cake infiltrated with irregular nodules when involved by carcinomatosis. No 'cerebral fissure' sign was observed in peritoneal carcinomatosis. The sensitivity and specificity of this sign in indicating the existence of tuberculous peritonitis were 73.5% (89/121) and 100% (73/73). Moreover, if the specific 'cerebral fissure' sign was combined with the biopsy results, the specificity of biopsy in distinguishing malignant ascites from benign ascits increased to 96.8% (122/126). Conclusion: Ultrasound-guided biopsy of greater omentum is an important and effective method to diagnose the unclear ascites for

  7. Dopamine transporter imaging in clinically unclear cases of parkinsonism and the importance of Scans Without Evidence of Dopaminergic Deficit (SWEDDs

    Directory of Open Access Journals (Sweden)

    Marco A. T. Utiumi

    2012-09-01

    Full Text Available The clinical diagnosis of Parkinson's disease (PD is susceptible to misdiagnosis, especially in the earlier stages of the disease. Recently, in vivo imaging techniques assessing the presynaptic dopamine transporter (DAT have emerged as a useful tool in PD diagnosis, improving its accuracy. OBJECTIVE: It was to illustrate the clinical usefulness of a brain single-photon emission computed tomography (SPECT DAT ligand, and highlight relevant aspects of scans without evidence of dopaminergic deficit (SWEDDs in this context. CASES: We described four representative patients with clinically unclear parkinsonian syndromes who underwent [99mTc]-TRODAT-1 SPECT and reviewed the clinical implications. CONCLUSION: DAT-SPECT is an important, cost-effective, technique for the differential diagnosis of parkinsonian syndromes. Additionally, SWEDD cases present clinical and paraclinical peculiarities that may retrospectively identify them as essential/dystonic tremor. The lack of histopathological data limits further conclusions.

  8. Dental Care in Pregnancy

    Science.gov (United States)

    Share with Women Dental Care in Pregnancy Why is dental care in pregnancy important? During pregnancy, you are more likely to have problems ... There are 2 major reasons women can have dental problems during pregnancy: Pregnancy gingivitis— During pregnancy, changes ...

  9. Exercise during Pregnancy

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Exercise During Pregnancy Home For Patients Search FAQs Exercise During Pregnancy ... Pregnancy FAQ119, May 2016 PDF Format Exercise During Pregnancy Pregnancy Is it safe to exercise during pregnancy? ...

  10. Nutrition in pregnancy and lactation

    Science.gov (United States)

    Optimal maternal health during pregnancy reduces the risk of suboptimal fetal development. Obesity prevalence is increasing among women of childbearing age in both developed and developing countries. Although teenage pregnancies remain common in some countries, generally women are getting pregnant a...

  11. Implication of low level inflammation in the insulin resistance of adipose tissue at late pregnancy.

    Science.gov (United States)

    de Castro, J; Sevillano, J; Marciniak, J; Rodriguez, R; González-Martín, C; Viana, M; Eun-suk, O H; de Mouzon, S Hauguel; Herrera, E; Ramos, M P

    2011-11-01

    Insulin resistance is a characteristic of late pregnancy, and adipose tissue is one of the tissues that most actively contributes to the reduced maternal insulin sensitivity. There is evidence that pregnancy is a condition of moderate inflammation, although the physiological role of this low-grade inflammation remains unclear. The present study was designed to validate whether low-grade inflammation plays a role in the development of insulin resistance in adipose tissue during late pregnancy. To this end, we analyzed proinflammatory adipokines and kinases in lumbar adipose tissue of nonpregnant and late pregnant rats at d 18 and 20 of gestation. We found that circulating and tissue levels of adipokines, such as IL-1β, plasminogen activator inhibitor-1, and TNF-α, were increased at late pregnancy, which correlated with insulin resistance. The observed increase in adipokines coincided with an enhanced activation of p38 MAPK in adipose tissue. Treatment of pregnant rats with the p38 MAPK inhibitor SB 202190 increased insulin-stimulated tyrosine phosphorylation of the insulin receptor (IR) and IR substrate-1 in adipose tissue, which was paralleled by a reduction of IR substrate-1 serine phosphorylation and an enhancement of the metabolic actions of insulin. These results indicate that activation of p38 MAPK in adipose tissue contributes to adipose tissue insulin resistance at late pregnancy. Furthermore, the results of the present study support the hypothesis that physiological low-grade inflammation in the maternal organism is relevant to the development of pregnancy-associated insulin resistance.

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

    Directory of Open Access Journals (Sweden)

    Jack R. Wall

    2015-01-01

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

  13. Analysis of Stage-Specific Gene Expression Profiles in the Uterine Endometrium during Pregnancy in Pigs.

    Science.gov (United States)

    Kim, Mingoo; Seo, Heewon; Choi, Yohan; Yoo, Inkyu; Seo, Minseok; Lee, Chang-Kyu; Kim, Heebal; Ka, Hakhyun

    2015-01-01

    The uterine endometrium plays a critical role in regulating the estrous cycle and the establishment and maintenance of pregnancy in mammalian species. Many studies have investigated the expression and function of genes in the uterine endometrium, but the global expression pattern of genes and relationships among genes differentially expressed in the uterine endometrium during gestation in pigs remain unclear. Thus, this study investigated global gene expression profiles using microarray in pigs. Diverse transcriptome analyses including clustering, network, and differentially expressed gene (DEG) analyses were performed to detect endometrial gene expression changes during the different gestation stages. In total, 6,991 genes were found to be differentially expressed by comparing genes expressed on day (D) 12 of pregnancy with those on D15, D30, D60, D90 and D114 of pregnancy, and clustering analysis of detected DEGs distinguished 8 clusters. Furthermore, several pregnancy-related hub genes such as ALPPL2, RANBP17, NF1B, SPP1, and CST6 were discovered through network analysis. Finally, detected hub genes were technically validated by quantitative RT-PCR. These results suggest the complex network characteristics involved in uterine endometrial gene expression during pregnancy and indicate that diverse patterns of stage-specific gene expression and network connections may play a critical role in endometrial remodeling and in placental and fetal development to establish and maintenance of pregnancy in pigs.

  14. Analysis of Stage-Specific Gene Expression Profiles in the Uterine Endometrium during Pregnancy in Pigs.

    Directory of Open Access Journals (Sweden)

    Mingoo Kim

    Full Text Available The uterine endometrium plays a critical role in regulating the estrous cycle and the establishment and maintenance of pregnancy in mammalian species. Many studies have investigated the expression and function of genes in the uterine endometrium, but the global expression pattern of genes and relationships among genes differentially expressed in the uterine endometrium during gestation in pigs remain unclear. Thus, this study investigated global gene expression profiles using microarray in pigs. Diverse transcriptome analyses including clustering, network, and differentially expressed gene (DEG analyses were performed to detect endometrial gene expression changes during the different gestation stages. In total, 6,991 genes were found to be differentially expressed by comparing genes expressed on day (D 12 of pregnancy with those on D15, D30, D60, D90 and D114 of pregnancy, and clustering analysis of detected DEGs distinguished 8 clusters. Furthermore, several pregnancy-related hub genes such as ALPPL2, RANBP17, NF1B, SPP1, and CST6 were discovered through network analysis. Finally, detected hub genes were technically validated by quantitative RT-PCR. These results suggest the complex network characteristics involved in uterine endometrial gene expression during pregnancy and indicate that diverse patterns of stage-specific gene expression and network connections may play a critical role in endometrial remodeling and in placental and fetal development to establish and maintenance of pregnancy in pigs.

  15. URINARY TRACT INFECTIONS IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    N Sivalingam

    2007-01-01

    Full Text Available Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

  16. Organic Chemicals Remain High Prices

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Phenol In early April 2007, China's phenol price remained bullish, and with the restart of phenol/acetone units in Sinopec Beijing Yanhua Petrochemical being ahead of schedule, there were few trading actions in the market, and the price of phenol dropped considerably afterwards.

  17. Structural and Functional Brain Remodeling during Pregnancy with Diffusion Tensor MRI and Resting-State Functional MRI.

    Directory of Open Access Journals (Sweden)

    Russell W Chan

    Full Text Available Although pregnancy-induced hormonal changes have been shown to alter the brain at the neuronal level, the exact effects of pregnancy on brain at the tissue level remain unclear. In this study, diffusion tensor imaging (DTI and resting-state functional MRI (rsfMRI were employed to investigate and document the effects of pregnancy on the structure and function of the brain tissues. Fifteen Sprague-Dawley female rats were longitudinally studied at three days before mating (baseline and seventeen days after mating (G17. G17 is equivalent to the early stage of the third trimester in humans. Seven age-matched nulliparous female rats served as non-pregnant controls and were scanned at the same time-points. For DTI, diffusivity was found to generally increase in the whole brain during pregnancy, indicating structural changes at microscopic levels that facilitated water molecular movement. Regionally, mean diffusivity increased more pronouncedly in the dorsal hippocampus while fractional anisotropy in the dorsal dentate gyrus increased significantly during pregnancy. For rsfMRI, bilateral functional connectivity in the hippocampus increased significantly during pregnancy. Moreover, fractional anisotropy increase in the dentate gyrus appeared to correlate with the bilateral functional connectivity increase in the hippocampus. These findings revealed tissue structural modifications in the whole brain during pregnancy, and that the hippocampus was structurally and functionally remodeled in a more marked manner.

  18. Structural and Functional Brain Remodeling during Pregnancy with Diffusion Tensor MRI and Resting-State Functional MRI.

    Science.gov (United States)

    Chan, Russell W; Ho, Leon C; Zhou, Iris Y; Gao, Patrick P; Chan, Kevin C; Wu, Ed X

    2015-01-01

    Although pregnancy-induced hormonal changes have been shown to alter the brain at the neuronal level, the exact effects of pregnancy on brain at the tissue level remain unclear. In this study, diffusion tensor imaging (DTI) and resting-state functional MRI (rsfMRI) were employed to investigate and document the effects of pregnancy on the structure and function of the brain tissues. Fifteen Sprague-Dawley female rats were longitudinally studied at three days before mating (baseline) and seventeen days after mating (G17). G17 is equivalent to the early stage of the third trimester in humans. Seven age-matched nulliparous female rats served as non-pregnant controls and were scanned at the same time-points. For DTI, diffusivity was found to generally increase in the whole brain during pregnancy, indicating structural changes at microscopic levels that facilitated water molecular movement. Regionally, mean diffusivity increased more pronouncedly in the dorsal hippocampus while fractional anisotropy in the dorsal dentate gyrus increased significantly during pregnancy. For rsfMRI, bilateral functional connectivity in the hippocampus increased significantly during pregnancy. Moreover, fractional anisotropy increase in the dentate gyrus appeared to correlate with the bilateral functional connectivity increase in the hippocampus. These findings revealed tissue structural modifications in the whole brain during pregnancy, and that the hippocampus was structurally and functionally remodeled in a more marked manner.

  19. Malaria in Pregnancy

    Directory of Open Access Journals (Sweden)

    E E Okpere

    2010-01-01

    Full Text Available Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10, 000 maternal deaths and to at least 200, 000 newborn deaths annually. Malaria is a contributor or aetiologic factor in pregnancy complications including anaemia, spontaneous abortion, prematurity and stillbirths. Pregnancy results in increased incidence and severity of malaria. Cerebral malaria, acute renal failure and severe anaemia, rare complications in adults living in malaria endemic areas, may complicate malaria in pregnancy. Research implicate reduced maternal immunity from increased steroid levels in pregnancy, increased attractiveness of pregnant women to mosquito bites and increased adherence of parasitized erythrocytes to Chondroitin sulphate A expressed in the placentae. This is worse in the first and second pregnancies. With infection with the Human Immunodeficiency Virus [HIV], the effects of malaria in pregnancy are even worse. Over the decades, there have been concerted worldwide collaborative efforts, spearheaded by the World Health Organization [WHO] and including governments and allied agencies to tackle the scourge of malaria in pregnancy. The main thrusts of such efforts have been: to increase the use of insecticide treated mosquito bed nets [ITN]; intermittent preventive treatment of malaria [IPT]; and adequate case treatment of acute malaria attacks in pregnancy. While for IPT, Sulfadoxine-Pyrimethamine [SP] combination has been proven to be of benefit in preventing acute and latent malaria in pregnancy and its associated complications, the WHO has introduced the use of Artemisinin-Combination Therapy [ACT] for the first-line treatment of uncomplicated malaria in pregnancy, the need to confirm malaria before treatment and the enforcement of completion of therapy once started. The Roll Back

  20. Families and health-care professionals' perspectives and expectations of family-centred care: hidden expectations and unclear roles.

    Science.gov (United States)

    Coyne, Imelda

    2015-10-01

    Family-centred care (FCC) is viewed as a pivotal concept in the provision of high-quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives. Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7-16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland. Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under-staffing and inappropriate documentation as key factors which resulted in over-reliance on parents and hindered their efforts to negotiate and work alongside parents. Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family-centred care. © 2013 John Wiley & Sons Ltd.

  1. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... prevent blood clots during pregnancy: Be aware of risk factors. Know your family history. Make sure your doctor knows about any ... blood clots or blood clotting disorders in your family. Remain active, with ... doctor about your risks and prevention. Depending on your condition, your OB- ...

  2. Pharmacological management of hypertension in pregnancy.

    Science.gov (United States)

    Easterling, Thomas R

    2014-12-01

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

  3. 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.

  4. Diabetes mellitus and pregnancy

    Directory of Open Access Journals (Sweden)

    Fathi I Abourawi

    2006-07-01

    Full Text Available Diabetes mellitus is the most common medical complication of pregnancy and it carries a significant risk to the foetus and the mother. Congenital malformations and perinatal morbidity remain common compared with the offspring of non diabetic pregnancies. Diabetic mothers are at risk of progression of micro-vascular diabetic complications as well as early pregnancy loss, pre-eclampsia, polyhydramnios and premature labour. Glycaemic control before and during pregnancy is critical and the benefit may result in a viable, healthy offspring. Gestational diabetes mellitus (GDM which manifests for the first time during pregnancy is common and on the increase, its proper management will reduce the risk of neonatal macrosomia and hypoglycaemia. Post-partum evaluation of glucose tolerance and appropriate counselling in women with GDM may help decrease the high risk of subsequent type 2 diabetes in the long-term. The article will briefly review the changes in the carbohydrate metabolism that characterise normal pregnancy and will focus on a practical approach to the care of patients with pre-existing diabetes as well as GDM.

  5. 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.

  6. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  7. [Hereditary thrombophilia and pregnancy: thrombotic risk and pregnancy outcome].

    Science.gov (United States)

    Fonseca, Ana Glória

    2012-01-01

    Thromboembolic disease and obstetric complications related to ischemia of the placenta are currently the major causes of maternal mortality and morbidity. Thrombophilia been implicated in their aetiology and the magnitude of the risk depends on the type of thrombophilia. As the evidence is still unclear and controversial, questions about the clinical management of pregnant women with thrombophilia are a daily issue. We aim to review, bearing in mind the consensus and controversies, the impact of inherited thrombophilia in the risk of thrombosis related to pregnancy and of obstetric complications. Moreover, the diagnostic, preventive and therapeutic approach during pregnancy and puerperium, including the role of antithrombotic pharmacopoeia available, will be discussed.

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

    Directory of Open Access Journals (Sweden)

    Jin-ling Chen

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

  9. Alarms Remain,Efforts Continue

    Institute of Scientific and Technical Information of China (English)

    Alice

    2007-01-01

    @@ China must come to terms with the fact that it has quality problems in at least 1% of its products.Though there is no country in the world that can completely avoid problems,given the responsible role China plays on the intemational stage,China should stop to take a look at itself and find ways to improve.China must examine herself carefully,when looking at the production chain;we have to keep aware that some alarms still remain.

  10. Protocol for the Smoking, Nicotine and Pregnancy (SNAP trial: double-blind, placebo-randomised, controlled trial of nicotine replacement therapy in pregnancy

    Directory of Open Access Journals (Sweden)

    Coughtrie Michael WH

    2007-01-01

    Full Text Available Abstract Background Smoking in pregnancy remains a public health challenge. Nicotine replacement therapy (NRT is effective for smoking cessation in non-pregnant people, but because women metabolise nicotine and cotinine much faster in pregnancy, it is unclear whether this will be effective for smoking cessation in pregnancy. The NHS Health Technology Assessment Programme (HTA-funded smoking, nicotine and pregnancy (SNAP trial will investigate whether or not nicotine replacement therapy (NRT is effective, cost-effective and safe when used for smoking cessation by pregnant women. Methods/Design Over two years, in 5 trial centres, 1050 pregnant women who are between 12 and 24 weeks pregnant will be randomised as they attend hospital for ante-natal ultrasound scans. Women will receive either nicotine or placebo transdermal patches with behavioural support. The primary outcome measure is biochemically-validated, self-reported, prolonged and total abstinence from smoking between a quit date (defined before randomisation and set within two weeks of this and delivery. At six months after childbirth self-reported maternal smoking status will be ascertained and two years after childbirth, self-reported maternal smoking status and the behaviour, cognitive development and respiratory symptoms of children born in the trial will be compared in both groups. Discussion This trial is designed to ascertain whether or not standard doses of NRT (as transdermal patches are effective and safe when used for smoking cessation during pregnancy.

  11. A pragmatic and evidence-based management of ectopic pregnancy.

    Science.gov (United States)

    Oron, Galia; Tulandi, Togas

    2013-01-01

    The incidence of ectopic pregnancy is approximately 2% of all pregnancies, and it remains the leading cause of death in early pregnancy. Over 95% of ectopic pregnancies are tubal pregnancies, and the remainders are nontubal pregnancies. The highest risk factor for ectopic pregnancy is a previous tubal pregnancy followed by previous tubal surgery, tubal sterilization, tubal pathology, and current intrauterine device use. The apparent increase in the incidence of nontubal ectopic pregnancy including heterotopic pregnancy may be attributed to the increasing number of pregnancies because of in vitro fertilization treatment. In most cases, an ectopic pregnancy can be treated medically with a single dose of methotrexate. Surgical treatment is still needed in women who are hemodynamically unstable and in those who do not fulfill the criteria for methotrexate treatment. Usually surgical treatment can be performed by laparoscopy and in some cases by hysteroscopy. Laparotomy is rarely needed even in women with intraperitoneal bleeding.

  12. And the Dead Remain Behind

    Directory of Open Access Journals (Sweden)

    Peter Read

    2013-08-01

    Full Text Available In most cultures the dead and their living relatives are held in a dialogic relationship. The dead have made it clear, while living, what they expect from their descendants. The living, for their part, wish to honour the tombs of their ancestors; at the least, to keep the graves of the recent dead from disrepair. Despite the strictures, the living can fail their responsibilities, for example, by migration to foreign countries. The peripatetic Chinese are one of the few cultures able to overcome the dilemma of the wanderer or the exile. With the help of a priest, an Australian Chinese migrant may summon the soul of an ancestor from an Asian grave to a Melbourne temple, where the spirit, though removed from its earthly vessel, will rest and remain at peace. Amongst cultures in which such practices are not culturally appropriate, to fail to honour the family dead can be exquisitely painful. Violence is the cause of most failure.

  13. Toxoplasmosis in pregnancy.

    Science.gov (United States)

    Kravetz, Jeffrey D; Federman, Daniel G

    2005-03-01

    Pregnant women who acquire infection from Toxoplasma gondii usually remain asymptomatic, although they can still transmit the infection to their fetuses with severe consequences. Given the asymptomatic nature of most Toxoplasma infections, primary prevention in pregnant women may lower the risk of congenital toxoplasmosis. Both consumption of undercooked meat and unprotected contact with soil are independent risk factors for T. gondii seroconversion during pregnancy, while contact with cat litter may pose a risk in certain situations. However, many pregnant women lack knowledge of these risk factors. This article reviews toxoplasmosis infection in pregnancy, with an emphasis on risk factors and appropriate counseling of pregnant women.

  14. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

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

  15. Twin pregnancy

    DEFF Research Database (Denmark)

    Sperling, Lene; Tabor, A

    2001-01-01

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

  16. Pregnancy test

    Science.gov (United States)

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

  17. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

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

  18. HIV and Pregnancy

    Science.gov (United States)

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

  19. Pregnancy and IC

    Science.gov (United States)

    ... Profile Home About IC Women & IC Pregnancy & IC Pregnancy & IC How Pregnancy Affects IC Unfortunately, there is limited scientific data ... 2009 issue of the ICA Update . Planning Your Pregnancy Planning ahead for your pregnancy will let you: ...

  20. Travel during Pregnancy

    Science.gov (United States)

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

  1. Folic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Saccone, Gabriele; Berghella, Vincenzo

    2016-04-01

    Folic acid (FA) may have a role in the prevention of pregnancy complications. However, the efficacy of FA supplementation in reducing the risk of preterm birth (PTB) is still unclear. The aim of this systematic review with meta-analysis was to evaluate the efficacy of folic acid supplementation during pregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomized trials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementation or control (placebo or no treatment). The primary outcome was the incidence of PTB pregnancy does not prevent PTB <37 weeks. Daily FA supplementation remains the most important intervention to reduce the risk of neural tube defects.

  2. Non-tubal ectopic pregnancy.

    Science.gov (United States)

    Parker, Victoria Louise; Srinivas, M

    2016-07-01

    11 per 1000 pregnancies are ectopic (NICE Guidelines, 2012) with 95 % of ectopic pregnancies being tubal in origin, and 80 % of these occurring within the ampulla (The Ectopic Pregnancy Trust). 5% therefore are non-tubal. In this review we aim to collate literature relevant to non-tubal ectopic pregnancy. Literature regarding cornual, ovarian, abdominal, interstitial, cervical and Caesarean scar ectopic pregnancy was reviewed using EMBASE and Medline databases. Non-tubal ectopic pregnancies are often overlooked, diagnosed late and are associated with higher maternal morbidity and mortality. Ultrasound remains the mainstay of diagnosis in corroboration with clinical features. Management may include medical treatment with methotrexate, surgery or expectancy. There is also an increasing interest in the use of minimally invasive radiological approaches. Non-tubal ectopic pregnancy is a rare but potentially life-threatening and often misdiagnosed condition. This is particularly pertinent for Caesarean scar ectopic pregnancies, the prevalence of which is increasing due to the rising proportion of women having Caesarean sections (Litwicka and Greco, 2011). Practitioners should be aware of non-tubal pregnancies to aid more efficient diagnosis, optimise management and increase patient safety.

  3. Teenage Pregnancy in Canada and Quebec: The role of prevention in reducing teenage pregnancy

    OpenAIRE

    Guilbert, Edith; Forget,Gilles

    1991-01-01

    In 1987, there were 36 694 known pregnancies in Canada among women aged 15 to 19. Although the Canadian teenage pregnancy rate decreased from 1980 to 1987, it remains three times higher than that of the industrialized country with the lowest rate. Health professionals, social workers, and educators can have an important role in preventing teenage pregnancy.

  4. Teenage Pregnancy in Canada and Quebec: The role of prevention in reducing teenage pregnancy

    OpenAIRE

    Guilbert, Edith; Forget,Gilles

    1991-01-01

    In 1987, there were 36 694 known pregnancies in Canada among women aged 15 to 19. Although the Canadian teenage pregnancy rate decreased from 1980 to 1987, it remains three times higher than that of the industrialized country with the lowest rate. Health professionals, social workers, and educators can have an important role in preventing teenage pregnancy.

  5. Silicon photonics: some remaining challenges

    Science.gov (United States)

    Reed, G. T.; Topley, R.; Khokhar, A. Z.; Thompson, D. J.; Stanković, S.; Reynolds, S.; Chen, X.; Soper, N.; Mitchell, C. J.; Hu, Y.; Shen, L.; Martinez-Jimenez, G.; Healy, N.; Mailis, S.; Peacock, A. C.; Nedeljkovic, M.; Gardes, F. Y.; Soler Penades, J.; Alonso-Ramos, C.; Ortega-Monux, A.; Wanguemert-Perez, G.; Molina-Fernandez, I.; Cheben, P.; Mashanovich, G. Z.

    2016-03-01

    This paper discusses some of the remaining challenges for silicon photonics, and how we at Southampton University have approached some of them. Despite phenomenal advances in the field of Silicon Photonics, there are a number of areas that still require development. For short to medium reach applications, there is a need to improve the power consumption of photonic circuits such that inter-chip, and perhaps intra-chip applications are viable. This means that yet smaller devices are required as well as thermally stable devices, and multiple wavelength channels. In turn this demands smaller, more efficient modulators, athermal circuits, and improved wavelength division multiplexers. The debate continues as to whether on-chip lasers are necessary for all applications, but an efficient low cost laser would benefit many applications. Multi-layer photonics offers the possibility of increasing the complexity and effectiveness of a given area of chip real estate, but it is a demanding challenge. Low cost packaging (in particular, passive alignment of fibre to waveguide), and effective wafer scale testing strategies, are also essential for mass market applications. Whilst solutions to these challenges would enhance most applications, a derivative technology is emerging, that of Mid Infra-Red (MIR) silicon photonics. This field will build on existing developments, but will require key enhancements to facilitate functionality at longer wavelengths. In common with mainstream silicon photonics, significant developments have been made, but there is still much left to do. Here we summarise some of our recent work towards wafer scale testing, passive alignment, multiplexing, and MIR silicon photonics technology.

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

    Directory of Open Access Journals (Sweden)

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

    2011-01-01

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

  7. Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Maraka, Spyridoula; Ospina, Naykky M Singh; O'Keeffe, Derek T; Espinosa De Ycaza, Ana E; Gionfriddo, Michael R; Erwin, Patricia J; Coddington, Charles C; Stan, Marius N; Murad, M Hassan; Montori, Victor M

    2016-04-01

    The impact of subclinical hypothyroidism (SCH) and of levothyroxine replacement in pregnant women with SCH is unclear. The aims of this study were to assess (i) the impact of SCH during pregnancy on maternal and neonatal outcomes, and (ii) the effect of levothyroxine replacement therapy in these patients. Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, the Cochrane Controlled Trials Register, Ovid EMBASE, Web of Science, and Scopus were searched from inception to January 2015. Randomized trials and cohort studies of pregnant women with SCH that examined adverse pregnancy and neonatal outcomes were included. Reviewers extracted data and assessed methodological quality in duplicate. Eighteen cohort studies at low-to-moderate risk of bias were included. Compared with euthyroid pregnant women, pregnant women with SCH were at higher risk for pregnancy loss (relative risk [RR] 2.01 [confidence interval (CI) 1.66-2.44]), placental abruption (RR 2.14 [CI 1.23-3.70]), premature rupture of membranes (RR 1.43 [CI 1.04-1.95]), and neonatal death (RR 2.58 [CI 1.41-4.73]). One study at high risk of bias compared pregnant women with SCH who received levothyroxine to those who did not and found no significant decrease in the rate of pregnancy loss, preterm delivery, gestational hypertension, low birth weight, or low Apgar score. SCH during pregnancy is associated with multiple adverse maternal and neonatal outcomes. The value of levothyroxine therapy in preventing these adverse outcomes remains uncertain.

  8. Relationship between social support during pregnancy and postpartum depressive state: a prospective cohort study.

    Science.gov (United States)

    Morikawa, Mako; Okada, Takashi; Ando, Masahiko; Aleksic, Branko; Kunimoto, Shohko; Nakamura, Yukako; Kubota, Chika; Uno, Yota; Tamaji, Ai; Hayakawa, Norika; Furumura, Kaori; Shiino, Tomoko; Morita, Tokiko; Ishikawa, Naoko; Ohoka, Harue; Usui, Hinako; Banno, Naomi; Murase, Satomi; Goto, Setsuko; Kanai, Atsuko; Masuda, Tomoko; Ozaki, Norio

    2015-01-01

    Although the association between social support and postpartum depression has been previously investigated, its causal relationship remains unclear. Therefore, we examined prospectively whether social support during pregnancy affected postpartum depression. Social support and depressive symptoms were assessed by Japanese version of Social Support Questionnaire (J-SSQ) and Edinburgh Postnatal Depression Scale (EPDS), among 877 pregnant women in early pregnancy and at one month postpartum. First, J-SSQ was standardized among peripartum women. The J-SSQ was found to have a two-factor structure, with Number and Satisfaction subscales, by exploratory and confirmatory factor analyses. Analysis of covariance was performed to examine how EPDS and J-SSQ scores during pregnancy affected the EPDS score at postpartum. Significant associations were found between postpartum EPDS score and both EPDS and total scores on the Number subscales during pregnancy (β = 0.488 and -0.054, ps supportive persons during pregnancy helps protect against postpartum depression, and that this effect is greater in depressive than non-depressive pregnant women. This finding is expected to be vitally important in preventive interventions.

  9. Delayed Interval Delivery in a Triplet Pregnancy

    Directory of Open Access Journals (Sweden)

    Sheng-Po Kao

    2006-02-01

    Full Text Available Due to a surge in the availability of assisted reproductive techniques (ART, the incidence of multiple pregnancies is increasing. Preterm labor is a major complication in such pregnancies. Preterm delivery of the first fetus is often followed by delivery of the remaining fetuses. However, conservative management and delayed interval delivery in the remaining fetuses might allow for fetal lung maturity and would reduce perinatal morbidities. A 32-year-old female had a quadruplet pregnancy after receiving ART. Fetal reduction to triplet pregnancy was performed at 11 weeks of gestation. The remaining triplet pregnancy was stable until 29 weeks of gestation, when the first triplet was delivered after spontaneous rupture of membranes. Under intensive monitoring, the remaining 2 fetuses were delivered by cesarean section at 31 weeks of gestation. Only the first fetus had retinopathy after discharge. In conclusion, delayed interval delivery of the remaining fetuses should be attempted after preterm delivery of the first fetus.

  10. Kidney stones during pregnancy.

    Science.gov (United States)

    Semins, Michelle J; Matlaga, Brian R

    2014-03-01

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

  11. Early pregnancy azathioprine use and pregnancy outcomes.

    LENUS (Irish Health Repository)

    Cleary, Brian J

    2012-02-01

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

  12. Successful renal transplantation during pregnancy.

    Science.gov (United States)

    Hold, Phoebe M; Wong, Christopher F; Dhanda, Raman K; Walkinshaw, Steve A; Bakran, Ali

    2005-09-01

    Little is known about the implications of performing a renal transplant on a patient who is already pregnant. This case study reports a successful outcome of pregnancy, diagnosed coincidentally following renal transplantation at 13 weeks gestation. The recipient was a 23-year-old woman with chronic kidney disease who received a live-related renal transplant from her father. Pregnancy was discovered at routine ultrasound scanning of the renal allograft at 5 days posttransplant and estimated at 13 weeks gestation. She received ciclosporin monotherapy as immunosuppression throughout the pregnancy, and was given valacyclovir as prophylaxis against cytomegalovirus (CMV) infection. Renal function remained stable throughout the pregnancy, which progressed normally, resulting in the vaginal delivery of a healthy, liveborn male infant at 37 weeks gestation. This case study demonstrates that transplantation during pregnancy can have a successful outcome.

  13. Risk factors for the development of stress urinary incontinence during pregnancy in primigravidae: a review of the literature.

    Science.gov (United States)

    Sangsawang, Bussara

    2014-07-01

    The most common type of urinary incontinence (UI) in pregnant women is stress urinary incontinence (SUI). The number of pregnant women with SUI was variable, the prevalence ranged from 18.6% to 75% and increased with gestational age. It can affect the quality of life (QoL) of approximately 54.3% of all pregnant women in four domains including physical activity, travel, social relationships and emotional health. Pregnancy is one of the main risk factors for the development of SUI in young women. Physiological changes during pregnancy, such as increasing pressure of the growing uterus and fetal weight on the pelvic floor muscle (PFM) throughout pregnancy, together with pregnancy-related hormonal changes such as increased progesterone, decreased relaxin, and decreased collagen levels, may lead to reduced strength and supportive and sphincteric function of the PFM. Pregnancy may associate with the reduction of the PFM strength which can develop the SUI. However, the exact causes of pregnancy-related SUI remain unclear. Multiple factors have been found to be associated with the development of SUI during pregnancy. In genetic risk factors, aging is an important role in SUI development. The other risk factors such as obesity, smoking, constipation, pre-pregnancy SUI, gestational diabetes mellitus (GDM), and pelvic floor muscle exercise (PFME) that utilized preventive strategies can reduce SUI in pregnant women. The purpose of this review is to identify the risk factors for the development of SUI in pregnant women. These understanding can be useful for health professions to inform and counsel the pregnant women to prevent and reduce the risk factors that contribute to the development of SUI during pregnancy and postpartum period.

  14. Occurrence of pregnancy and pregnancy outcomes during isotretinoin therapy

    Science.gov (United States)

    Henry, David; Dormuth, Colin; Winquist, Brandace; Carney, Greg; Bugden, Shawn; Teare, Gary; Lévesque, Linda E.; Bérard, Anick; Paterson, J. Michael; Platt, Robert W.

    2016-01-01

    Background: Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4 provinces: British Columbia, Saskatchewan, Manitoba and Ontario. Methods: Using administrative data, we identified 4 historical cohorts of female users of isotretinoin (aged 12–48 yr) for the period 1996 to 2011. We defined pregnancy using International Statistical Classification of Diseases and billing codes. One definition included only cases with documented pregnancy outcomes (high-specificity definition); the other definition also included individuals recorded as receiving prenatal care (high-sensitivity definition). We studied new courses of isotretinoin and detected pregnancies in 2 time windows: during isotretinoin treatment only and up to 42 weeks after treatment. Live births were followed for 1 year to identify congenital malformations. Results: A total of 59 271 female patients received 102 308 courses of isotretinoin. Between 24.3% and 32.9% of participants received prescriptions for oral contraceptives while they were taking isotretinoin, compared with 28.3% to 35.9% in the 12 months before isotretinoin was started. According to the high-specificity definition of pregnancy, there were 186 pregnancies during isotretinoin treatment (3.1/1000 isotretinoin users), compared with 367 (6.2/1000 users) according to the high-sensitivity definition. By 42 weeks after treatment, there were 1473 pregnancies (24.9/1000 users), according to the high-specificity definition. Of these, 1331 (90.4%) terminated spontaneously or were terminated by medical intervention. Among the 118 live births were 11 (9.3%) cases of congenital malformation. Pregnancy rates during isotretinoin treatment remained constant between 1996 and 2011

  15. Pregnancy-specific beta-1-glycoprotein (SP1) in cultured amniotic fluid cells.

    Science.gov (United States)

    Heikinheimo, M; Wahlström, T; Aula, P; Virtanen, I; Seppälä, M

    1980-12-01

    The synthesis of pregnancy-specific beta-1-glycoprotein (SP1) was studied in amniotic fluid cell cultures using RIA, immunoperoxidase, and immunofluorescence techniques. SP1 was found by RIA in all 11 sonicates and in 21 of 26 culture media. The SP1-immunoreactive material was immunologically similar to maternal serum SP1. Immunoperoxidase and indirect immunofluorescence staining were positive in large cells identified as epithelial amniotic cells by labeling with antikeratin antibodies. Fibroblast-like cells were occasionally found in cultures, but they did not contain demonstrable amounts of SP1. The physiological significance of the findings presented remains unclear.

  16. Fever and pregnancy.

    Science.gov (United States)

    Le Gouez, Agnès; Benachi, Alexandra; Mercier, Frédéric J

    2016-10-01

    Severe infections during pregnancy and postpartum are rare, despite a high frequency of bacteraemia, but remain on of the leading cause of maternal death. Therapeutic guidelines validated in general population should be applied to pregnant women, with regards to their specificities: insidious clinical signs and rapid onset, clinical presentation often as respiratory failure due to physiological changes during pregnancy; most frequent causes: pneumonia, pyelonephritis, genitary tract infections; sensibility to virus, Listeria, malaria, due to immunological changes during pregnancy; caesarean section is the single most important risk factor of postpartum infection; aggressive treatment should be started promptly, including fluid infusion and early administration of vasoactive agents (Norepinephrine); broad-spectrum intravenous empirical antibiotic therapy must be established immediately (within the first hour), and chosen according to frequent microorganisms involved in sepsis during pregnancy; infectious source, mostly pelvic, is often accessible to surgery; if foetal extraction does not improve maternal outcomes, it remains necessary for obstetrical or foetal reasons and mandatory if chorioamnionitis is confirmed; specific attention should be drawn to streptococcus A invasive infection which experiments a recent resurgence and is correlated to a high morbidity and mortality for both the mother and the foetus; protocols should be written in every maternity.

  17. The unfortunate sufferer: discursive dynamics around pregnancy loss in Cameroon

    NARCIS (Netherlands)

    E. van der Sijpt

    2013-01-01

    Pregnancy losses are ambiguous affairs in East Cameroon. Childbearing is not always people's primary aim within their fragile sexual and marital relationships, and it is often unclear to outsiders whether a pregnancy interruption is intended or unintended. Drawing on 15 months of fieldwork, I explor

  18. Teenage pregnancy

    National Research Council Canada - National Science Library

    Mora-Cancino, María; Hernández-Valencia, Varcelino

    2015-01-01

    .... Pregnancy in adolescents puts at risk mother and child health. This risk is major while the woman is younger, especially when the social and economic conditions are not favorable, which is decisive in later psychosocial development...

  19. Teenage Pregnancy

    Science.gov (United States)

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

  20. Factors associated with teenage pregnancy in the European Union countries: a systematic review.

    Science.gov (United States)

    Imamura, Mari; Tucker, Janet; Hannaford, Phil; da Silva, Miguel Oliveira; Astin, Margaret; Wyness, Laura; Bloemenkamp, Kitty W M; Jahn, Albrecht; Karro, Helle; Olsen, Jørn; Temmerman, Marleen

    2007-12-01

    As part of the REPROSTAT2 project, this systematic review aimed to identify factors associated with teenage pregnancy in 25 European Union countries. The search strategy included electronic bibliographic databases (1995 to May 2005), bibliographies of selected articles and requests to all country representatives of the research team for relevant reports and publications. Primary outcome measure was conception. Inclusion criteria were quantitative studies of individual-level factors associated with teenage (13-19 years) pregnancy in EU countries. Of 4444 studies identified and screened, 20 met the inclusion criteria. Most of the included studies took place in UK and Nordic countries. The well-recognized factors of socioeconomic disadvantage, disrupted family structure and low educational level and aspiration appear consistently associated with teenage pregnancy. However, evidence that access to services in itself is a protective factor remains inconsistent. Although further associations with diverse risk-taking behaviours and lifestyle, sexual health knowledge, attitudes and behaviour are reported, the independent effects of these factors too remain unclear. Included studies varied widely in terms of methods and definitions used. This heterogeneity within the studies leaves two outstanding issues. First, we cannot synthesize or generalize key findings as to how all these factors interact with one another and which factors are the most significant. Second, it is not possible to examine potential variation between countries. Future research ensuring comparability and generalizability of results related to teenage sexual health outcomes will help gain insight into the international variation in observed pregnancy rates and better inform interventions.

  1. Denied pregnancy.

    Science.gov (United States)

    Habek, Dubravko

    2010-06-01

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

  2. IL-17 producing innate lymphoid cells 3 (ILC3) but not Th17 cells might be the potential danger factor for preeclampsia and other pregnancy associated diseases.

    Science.gov (United States)

    Barnie, Prince A; Lin, Xin; Liu, Yueqin; Xu, Huaxi; Su, Zhaoliang

    2015-01-01

    In pregnancy, the immunologic system plays an important role that ensures normal pregnancy development and can as well promote the development of complications. Pregnancy success appears to rely on a discrete balance between the Th cytokines, which are involved in fetal growth and development. Preeclampsia and gestational diabetes are known complications associated with pregnancy. However, the source of the increased IL-17 cytokine in preeclampsia and other pregnancy associated diseases still remains unclear amidst numerous inconsistencies. The recent identification of innate lymphoid cells (ILC) has raised more doubts about the sources of most of the Th associated cytokines. We investigated the source of peripheral IL-17 levels in preeclamptic, gestational diabetics and chronic diabetics compared to healthy pregnancy subjects. To evaluate the source of the increased IL-17 cytokine among preeclampsia, chronic diabetic and gestational diabetic patients we investigated the proportion of Th17 cell populations in peripheral blood mononuclear cells using flow cytometry as well as analyzing levels of IFN-γ, IL-17, IL-1β and HMGB1. This study found that the Th17 cell populations in peripheral blood of preeclamptic, gestational nor chronic diabetes during pregnancy did not correlate with the increased IL-17. We report that the increased IL-17 levels observed in patients with preeclampsia, gestational diabetes and chronic diabetes are associated with innate lymphoid cells 3 (ILC3) and may pose threats to the fetus if disregulated.

  3. Systemic Lupus Erythematosus and Pregnancy.

    Science.gov (United States)

    Lateef, Aisha; Petri, Michelle

    2017-05-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease with a strong female predilection. Pregnancy remains a commonly encountered but high-risk situation in this setting. Both maternal and fetal mortality and morbidity are still significantly increased despite improvements in outcomes. Maternal morbidity includes higher risk of disease flares, preeclampsia and other pregnancy-related complications. Fetal issues include higher rates of preterm birth, intrauterine growth restriction, and neonatal lupus syndromes. Treatment options during pregnancy are also limited and maternal benefit has to be weighed against fetal risk. A coordinated approach, with close monitoring by a multidisciplinary team, is essential for optimal outcomes.

  4. [Pregnancy and acute ischemic stroke].

    Science.gov (United States)

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  5. Pregnancy intention, demographic differences, and psychosocial health.

    Science.gov (United States)

    Maxson, Pamela; Miranda, Marie Lynn

    2011-08-01

    We explore the psychosocial, demographic, and maternal characteristics across wanted, mistimed, and unwanted pregnancies. Data from 1321 women from a prospective cohort study of pregnant women in Durham, NC, are analyzed. Psychosocial correlates were obtained through prenatal surveys; electronic medical records were used to ascertain maternal health and pregnancy outcomes. Sixty-two percent of the women indicated an unintended pregnancy, with 44% (578) mistimed and 18% (245) unwanted. Only 38% of the pregnancies were characterized as wanted. Women with unwanted and with mistimed pregnancies were similar demographically, but they differed significantly on psychosocial profiles and maternal characteristics. Women with mistimed and with wanted pregnancies differed in demographics and psychosocial profiles. Wanted pregnancies had the healthiest, mistimed an intermediate, and unwanted the poorest psychosocial profile. Women with unwanted pregnancies had the highest depression, perceived stress, and negative paternal support scores (ppsychosocial profiles had higher odds of being in the unwanted category. Controlling for psychosocial and demographic variables, perceived stress and positive paternal support remained significant predictors of belonging to the unwanted and mistimed groups. Fully characterizing pregnancy intention and its relationship to psychosocial profiles may provide a basis for identifying women with highest risk during pregnancy and early motherhood. Women with unwanted and mistimed pregnancies may appear similar demographically but are different psychosocially. Women with unwanted pregnancies have multiple risk factors and would benefit from targeted interventions.

  6. Diagnosis and management of ectopic pregnancy.

    Science.gov (United States)

    Barash, Joshua H; Buchanan, Edward M; Hillson, Christina

    2014-07-01

    Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination, and imaging with transvaginal ultrasonography can usually confirm the diagnosis. When ultrasonography does not clearly identify the pregnancy location, the physician must determine whether the pregnancy is intrauterine (either viable or failing) or ectopic. Use of the beta subunit of human chorionic gonadotropin (ß-hCG) discriminatory level, the ß-hCG value above which an intrauterine pregnancy should be visualized by transvaginal ultrasonography, may be helpful. Failure to visualize an intrauterine pregnancy when ß-hCG is above the discriminatory level suggests ectopic pregnancy. In addition to single measurements of ß-hCG levels, serial levels can be monitored to detect changes. ß-hCG values in approximately 99% of viable intrauterine pregnancies increase by about 50% in 48 hours. The remaining 1% of patients have a slower rate of increase; these patients may have pregnancies that are misdiagnosed as nonviable intrauterine or ectopic. After an ectopic pregnancy has been confirmed, treatment options include medical, surgical, or expectant management. For patients who are medically unstable or experiencing life-threatening hemorrhage, a surgical approach is indicated. For others, management should be based on patient preference after discussion of the risks, benefits, and monitoring requirements of all approaches.

  7. Predictors of Ramadan fasting during pregnancy

    NARCIS (Netherlands)

    van Bilsen, Lily A.; Savitri, Ary I.; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E.; Uiterwaal, Cuno S P M

    2016-01-01

    Although the health effects of Ramadan fasting during pregnancy are still unclear, it is important to identify the predictors and motivational factors involved in women's decision to observe the fast. We investigated these factors in a cross sectional study of 187 pregnant Muslim women who attended

  8. Predictors of Ramadan fasting during pregnancy

    NARCIS (Netherlands)

    van Bilsen, Lily A.; Savitri, Ary I.; Amelia, Dwirani; Baharuddin, Mohammad; Grobbee, Diederick E.; Uiterwaal, Cuno S P M

    2016-01-01

    Although the health effects of Ramadan fasting during pregnancy are still unclear, it is important to identify the predictors and motivational factors involved in women's decision to observe the fast. We investigated these factors in a cross sectional study of 187 pregnant Muslim women who attended

  9. Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review

    Directory of Open Access Journals (Sweden)

    Michael Gleeson

    2014-09-01

    [Gleeson M, Sherrington C, Keay L (2014 Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review. Journal of Physiotherapy 60: 130–135

  10. Exercise during Pregnancy

    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 & ...

  11. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  12. Sex during Pregnancy

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy A A ... safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during all stages ...

  13. Sex during Pregnancy

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy ... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ...

  14. 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 & ...

  15. Back Pain During Pregnancy

    Science.gov (United States)

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

  16. Exercise during Pregnancy

    Medline Plus

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

  17. Smoking during Pregnancy

    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 ...

  18. Cystic Fibrosis and Pregnancy

    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 ...

  19. 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 ...

  20. 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 ...

  1. Exercise during Pregnancy

    Medline Plus

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

  2. Back Pain During Pregnancy

    Science.gov (United States)

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

  3. Abuse during Pregnancy

    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. Radiation and Pregnancy

    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. Mercury and Pregnancy

    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: 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 ...

  7. Acute Pancreatitis and Pregnancy

    Science.gov (United States)

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  8. Pregnancy and Reproductive Issues

    Science.gov (United States)

    ... Relationships Pregnancy Share this page Facebook Twitter Email Pregnancy and Reproductive Issues Tahirah Diagnosed in 2003 Pregnancy ... in control groups without the disease. Effects of pregnancy on MS Before 1950, most women with MS ...

  9. Alcohol during Pregnancy

    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 ...

  10. 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 ...

  11. 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 ...

  12. Exercise After Pregnancy

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Exercise After Pregnancy Home For Patients Search FAQs Exercise After Pregnancy ... Pregnancy FAQ131, June 2015 PDF Format Exercise After Pregnancy Labor, Delivery, and Postpartum Care What are some ...

  13. Street Drugs and Pregnancy

    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 ...

  14. Pregnancy week by week

    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 ...

  15. Getting Fit Before Pregnancy

    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 ...

  16. Alcohol and pregnancy

    Science.gov (United States)

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

  17. Heroin and Pregnancy

    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 ...

  18. Prescription Opioids during Pregnancy

    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 ...

  19. Weight Gain during Pregnancy

    Science.gov (United States)

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

  20. Cravings during Pregnancy

    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 ...

  1. Alcohol and Pregnancy

    Science.gov (United States)

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

  2. Exercise during Pregnancy

    Science.gov (United States)

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

  3. Having a Healthy Pregnancy

    Science.gov (United States)

    ... Week of Healthy Breakfasts Shyness Having a Healthy Pregnancy KidsHealth > For Teens > Having a Healthy Pregnancy A ... or she can help you to get treatment. Pregnancy Discomforts Pregnancy can cause some uncomfortable side effects. ...

  4. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... 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 & ...

  5. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Pregnancy Home For Patients Zika Virus and Pregnancy Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to ...

  6. Exercise during Pregnancy

    Medline Plus

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

  7. Recurrent Pregnancy Loss

    Directory of Open Access Journals (Sweden)

    Véronique Piroux

    1997-01-01

    Full Text Available Antiphospholipid antibodies (APA are associated with thrombosis, thrombocytopenia and fetal loss but they occur in a variety of diseases. Despite many efforts, a correlation between the specificity of particular subgroups of APA and particular clinical situations remains to be established. The antigens at the origin of APA remain to be identified. We discuss here the possible links between cell apoptosis or necrosis, leading to plasma membrane alterations, and the occurrence of APA in response to sustained stimulation. The pathogenic potential of APA is also considered with respect to recurrent pregnancy loss.

  8. Pregnancy scares and subsequent unintended pregnancy

    OpenAIRE

    Heather Gatny; Yasamin Kusunoki; Jennifer Barber

    2014-01-01

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

  9. Successful Pregnancies Post Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Alfi Adnan

    2008-01-01

    Full Text Available To evaluate the maternal and fetal outcomes in renal transplant female recipients who became pregnant from 1989 to 2005 in our center, we retrospectively studied 20 incident pregnancies in 12 renal transplant recipients; 5 (41.7 % of them from living related, 4 (33.3% from deceased, and 3 (25% from living unrelated donors. The mean age at pregnancy was 30.5 ± 4.5 years and mean interval from transplantation to pregnancy was 21 ± 5.7 months with the interval was < 1 year in one patient. The mean serum creatinine (SCr before pregnancy vs 6 months post delivery was 110 ± 24.3, and 156 ± 190 µmol/ L, respectively, (p = 0.2. All patients were normotensive during the prenatal period except two who were hypertensive, none was markedly proteinuric, and only one acute rejection episode occurred during one pregnancy. Graft loss one year post delivery occurred in 2 patients; one with elevated prenatal SCr > 132 µmol/L, and another with short interval from transplantation to pregnancy < 1 year, while the remaining 10 patients revealed current mean SCr of 105 ± 18.2 µmol/L. Complications during pregnancy inclu-ded pre-eclampsia in (25%, UTI (25%, preterm delivery < 37 weeks (30%, however, none of the pregnancies ended by abortion. Normal vaginal delivery vs cesarean section was 70% vs 30%, respectively. Gestational age at delivery was 36.3 ± 3.9 weeks, and mean fetal birth weight was 2349 ± 574 gm. Apgar score was 9-10 in all of the 20 babies, and none revealed intrauterine growth retardation or congenital anomalies. We conclude that consecutive pregnancies demons-trate long-term maternal and fetal survival and function. The major risk factors are elevated starting serum creatinine, hypertension, and short time interval from transplantation to pregnancy.

  10. Teenage pregnancy.

    Science.gov (United States)

    Molina Cartes, Ramiro; González Araya, Electra

    2012-01-01

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

  11. The management of rheumatic diseases in pregnancy

    OpenAIRE

    Mitchell, K; Kaul, M; Clowse, MEB

    2010-01-01

    Pregnancy can create a challenge for physicians caring for women with rheumatic diseases. For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission and will continue to need medication. Systemic lupus erythematosus (SLE) may remain quiet in some women, but in others may become more aggressive during pregnancy, putting both mother and foetus at risk. Women with limited scleroderma can do ...

  12. Acute kidney injury in pregnancy-current status.

    Science.gov (United States)

    Acharya, Anjali; Santos, Jolina; Linde, Brian; Anis, Kisra

    2013-05-01

    Pregnancy-related acute kidney injury (PR-AKI) causes significant maternal and fetal morbidity and mortality. Management of PR-AKI warrants a thorough understanding of the physiologic adaptations in the kidney and the urinary tract. Categorization of etiologies of PR-AKI is similar to that of acute kidney injury (AKI) in the nonpregnant population. The causes differ between developed and developing countries, with thrombotic microangiopathies (TMAs) being common in the former and septic abortion and puerperal sepsis in the latter. The incidence of PR-AKI is reported to be on a decline, but there is no consensus on the exact definition of the condition. The physiologic changes in pregnancy make diagnosis of PR-AKI difficult. Newer biomarkers are being studied extensively but are not yet available for clinical use. Early and accurate diagnosis is necessary to improve maternal and fetal outcomes. Timely identification of "at-risk" individuals and treatment of underlying conditions such as sepsis, preeclampsia, and TMAs remain the cornerstone of management. Questions regarding renal replacement therapy such as modality, optimal prescription, and timing of initiation in PR-AKI remain unclear. There is a need to systematically explore these variables to improve care of women with PR-AKI.

  13. Risk factors of teenage pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Siettou

    2011-01-01

    Full Text Available Teenage pregnancy is a worldwide medical and social issue, associated with many physical, psychological and social consequences and can result in birth, miscarriage or abortion. Aim: The aim of the present study is to find those risk factors that contribute to teenage pregnancy. Results: In U.S.A., according to data from Unicef, the birth rate among teenagers touches the 52.1% and it is four times higher, than the corresponding rate recorded in the countries of Western Europe. The United Kingdom has the highest rate of teenage pregnancy in Europe and in contrast to the decline in the rate of teenage pregnancy, recorded in the remaining countries of Western Europe, this figure has remained relatively stable, especially in adolescents aged 16 years and below. In Greece, according to National Statistics Office, in 2007, we had 3.129 births by teenagers under 18, with 75 births by teenagers under 15. The main factors contributing to the incidence of teenage pregnancy are socioeconomic factors, the family, the education and the sexual behavior of teenagers. Conclusions.It is necessary the state, through the health services and the education programs, to provide modern sex education in schools, as well as programs of prevention and health education in primary health care. The cooperation of these authorities is essential, to better address the extent and consequences of teenage pregnancy.

  14. Pregnancy care

    Science.gov (United States)

    ... Avoid all alcohol and drug use and limit caffeine. Quit smoking, if you smoke. Go for prenatal visits and tests: You will see your provider many times during your pregnancy for prenatal care. The number of visits and types of exams you receive will change, depending on where you ...

  15. Multiple Pregnancy

    Science.gov (United States)

    ... more frequently and are likely to have their babies by cesarean delivery . How can multiple pregnancy affect my risk of ... the result of a recognized disease. Cesarean Delivery: Delivery of a baby through surgical incisions made in the mother’s abdomen ...

  16. Teen Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2014-04-16

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

  17. [Thyroid dysfunction during pregnancy].

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro; Donnay, Sergio

    2015-10-21

    Recent clinical practice guidelines on thyroid dysfunction and pregnancy have changed health care provided to pregnant women, although their recommendations are under constant revision. Trimester- and area-specific reference ranges for serum thyroid-stimulating hormone are required for proper diagnosis of hypothyroidism and hyperthyroidism. There is no doubt on the need of therapy for overt hypothyroidism, while therapy for subclinical hypothyroidism is controversial. Further research is needed to settle adverse effects of isolated hypothyroxinemia and thyroid autoimmunity. Differentiation between hyperthyroidism due to Graves' disease and the usually self-limited gestational transient thyrotoxicosis is critical. It is also important to recognize risk factors for postpartum thyroiditis. Supplementation with iodine is recommended to maintain adequate iodine nutrition during pregnancy and avoid serious consequences in offspring. Controversy remains about universal screening for thyroid disease during pregnancy or case-finding in high-risk women. Opinions of some scientific societies and recent cost-benefit studies favour universal screening. Randomized controlled studies currently under development should reduce the uncertainties that still remain in this area. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  18. PREGNANCY DERMATOSES

    Directory of Open Access Journals (Sweden)

    Tina Priscilla Katta

    2016-11-01

    Full Text Available BACKGROUND Pregnancy is a physiological status of a woman. Every organ is adapting in order to accept another human body. The main changes occur in the endocrine, immune, metabolic and vascular systems. The skin is no exception. Many skin changes during pregnancy are considered to be normal or physiological including striae gravidarum or melasma. These physiological skin changes are usually well tolerated by the pregnant woman. There is no balance between these systems, however, and abnormalities can appear. Immunologic status of the woman plays an important role in the manifestations exhibited in the skin. Alterations of the skin during pregnancy can be classified as physiologic skin changes, changes in pre-existing skin diseases and specific dermatoses of pregnancy. MATERIALS AND METHODS 200 pregnant women with skin manifestations attending Dermatology and Obstetric departments attached to Government General Hospital, Kurnool, were studied. 1. A detailed proforma was taken, which included: a. Detailed history including chief complaints related to skin. b. Onset in relation to duration of pregnancy. c. Complete general physical and systemic examination. d. Associated skin/medical disorders. 2. Investigations-CBP, CUE, RBS, LFT, HBsAg, VDRL, HIV 1 and 2 were done routinely. 3. KOH mount, saline mount and skin biopsy performed wherever required. Inclusion criteria- All pregnant women having skin lesions were included in the study irrespective of the duration of pregnancy and gravidity. Exclusion criteria- Pregnant women having any underlying medical diseases. All pregnant women attending antenatal OPD and those admitted into wards having symptoms related to skin and mucosa, at KIMS Hospital are studied. 1. Detailed history including chief complaints related to skin. 2. Onset in relation to duration of pregnancy. 3. Complete general physical and systemic examination. 4. Associated skin/medical disorders. 5. Investigations-CBP, CUE, RBS, LFT, HBs

  19. Subsequent pregnancy outcome after previous foetal death

    NARCIS (Netherlands)

    Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.

    2013-01-01

    Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to

  20. Managing Epilepsy in Pregnancy

    LENUS (Irish Health Repository)

    O Dwyer, V

    2017-02-01

    Epilepsy is one of the commonest medical conditions affecting women of childbearing age1. In the most recent triennial report into maternal deaths in Ireland and the UK, two thirds of women who died had a medical condition. In this report, 14 maternal deaths during pregnancy and up to 42 days postpartum were attributable to epilepsy or seizures; a rate of 0.4 per 100,000 maternities. In 12 of these women’ the cause was sudden unexplained death in epilepsy. Thus, epilepsy remains a high-risk condition in pregnancy. The gold standard of care is a multidisciplinary approach involving obstetricians, a neurologist and an epilepsy nurse specialist2. Like other units in Ireland this multidisciplinary service is currently provided in the National Maternity Hospital’s maternal medicine clinic, in conjunction with neurology services in Beaumont Hospital.

  1. Vitamin D supplementation for women during pregnancy

    Directory of Open Access Journals (Sweden)

    Luz Maria De-Regil

    0.83; four trials, 638 women. Vitamin D and calcium versus no supplementation or a placebo Women who received vitamin D with calcium had a lower risk of pre-eclampsia than those not receiving any intervention (RR 0.51; 95% CI 0.32 to 0.80; three trials; 1114 women, moderate quality, but also an increased risk of preterm birth (RR 1.57; 95% CI 1.02 to 2.43, three studies, 798 women, moderate quality. Maternal vitamin D concentration at term, gestational diabetes, adverse effects and low birthweight were not reported in any trial or reported only by one study. AUTHORS CONCLUSIONS: New studies have provided more evidence on the effects of supplementing pregnant women with vitamin D alone or with calcium on pregnancy outcomes. Supplementing pregnant women with vitamin D in a single or continued dose increases serum 25-hydroxyvitamin D at term and may reduce the risk of pre-eclampsia, low birthweight and preterm birth. However, when vitamin D and calcium are combined, the risk of preterm birth is increased. The clinical significance of the increased serum 25-hydroxyvitamin D concentrations is still unclear. In light of this, these results need to be interpreted with caution. Data on adverse effects were lacking in all studies. The evidence on whether vitamin D supplementation should be given as a part of routine antenatal care to all women to improve maternal and infant outcomes remains unclear. While there is some indication that vitamin D supplementation could reduce the risk of pre-eclampsia and increase length and head circumference at birth, further rigorous randomized trials are required to confirm these effects.

  2. Vitamin D supplementation for women during pregnancy.

    Science.gov (United States)

    De-Regil, Luz Maria; Palacios, Cristina; Lombardo, Lia K; Peña-Rosas, Juan Pablo

    2016-01-14

    with calcium had a lower risk of pre-eclampsia than those not receiving any intervention (RR 0.51; 95% CI 0.32 to 0.80; three trials; 1114 women, moderate quality), but also an increased risk of preterm birth (RR 1.57; 95% CI 1.02 to 2.43, three studies, 798 women, moderate quality). Maternal vitamin D concentration at term, gestational diabetes, adverse effects and low birthweight were not reported in any trial or reported only by one study. New studies have provided more evidence on the effects of supplementing pregnant women with vitamin D alone or with calcium on pregnancy outcomes. Supplementing pregnant women with vitamin D in a single or continued dose increases serum 25-hydroxyvitamin D at term and may reduce the risk of pre-eclampsia, low birthweight and preterm birth. However, when vitamin D and calcium are combined, the risk of preterm birth is increased. The clinical significance of the increased serum 25-hydroxyvitamin D concentrations is still unclear. In light of this, these results need to be interpreted with caution. Data on adverse effects were lacking in all studies.The evidence on whether vitamin D supplementation should be given as a part of routine antenatal care to all women to improve maternal and infant outcomes remains unclear. While there is some indication that vitamin D supplementation could reduce the risk of pre-eclampsia and increase length and head circumference at birth, further rigorous randomised trials are required to confirm these effects.

  3. Hypertension in pregnancy: The endocrine and metabolic aspect

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2011-01-01

    Full Text Available Hypertension is the most common medical disorder complicating pregnancy. However, how pregnancy incites or aggravates hypertension remains unsolved despite decades of intensive research. Various endocrine and metabolic mechanisms have been postulated to contribute to the pathogenesis of hypertension in pregnancy. Understanding the endocrine aspect of the possible pathophysiological mechanism might open new vistas in prediction, prevention and management of this condition.

  4. Minireview: Fetal-Maternal Hormonal Signaling in Pregnancy and Labor

    National Research Council Canada - National Science Library

    Mendelson, Carole R

    2009-01-01

    ...). Although in most mammals, parturition is associated with a marked decline in maternal progesterone, in humans, circulating progesterone and uterine PR remain elevated throughout pregnancy, suggesting...

  5. Minireview: Fetal-Maternal Hormonal Signaling in Pregnancy and Labor

    Science.gov (United States)

    Mendelson, Carole R.

    2009-01-01

    Mechanisms underlying the initiation of parturition remain unclear. Throughout most of pregnancy, uterine quiescence is maintained by elevated progesterone acting through progesterone receptor (PR). Although in most mammals, parturition is associated with a marked decline in maternal progesterone, in humans, circulating progesterone and uterine PR remain elevated throughout pregnancy, suggesting a critical role for functional PR inactivation in the initiation of labor. Both term and preterm labor in humans and rodents are associated with an inflammatory response. In preterm labor, intraamniotic infection likely provides the stimulus for increased amniotic fluid interleukins and migration of inflammatory cells into the uterus and cervix. However, at term, the stimulus for this inflammatory response is unknown. Increasing evidence suggests that the developing fetus may produce physical and hormonal signals that stimulate macrophage migration to the uterus, with release of cytokines and activation of inflammatory transcription factors, such as nuclear factor κB (NF-κB) and activator protein 1 (AP-1), which also is activated by myometrial stretch. We postulate that the increased inflammatory response and NF-κB activation promote uterine contractility via 1) direct activation of contractile genes (e.g. COX-2, oxytocin receptor, and connexin 43) and 2) impairment of the capacity of PR to mediate uterine quiescence. PR function near term may be compromised by direct interaction with NF-κB, altered expression of PR coregulators, increased metabolism of progesterone within the cervix and myometrium, and increased expression of inhibitory PR isoforms. Alternatively, we propose that uterine quiescence during pregnancy is regulated, in part, by PR antagonism of the inflammatory response. PMID:19282364

  6. Efficacy and safety of once daily low molecular weight heparin (tinzaparin sodium) in high risk pregnancy.

    LENUS (Irish Health Repository)

    Ní Ainle, Fionnuala

    2008-10-01

    Low molecular weight heparin (LMWH) is widely regarded as the anticoagulant treatment of choice for the prevention and treatment of venous thromboembolism during pregnancy. However, previous studies have demonstrated that the pharmacokinetic profiles of LMWH vary significantly with increasing gestation. Consequently, it remains unclear whether LMWH regimens recommended for use in nonpregnant individuals can be safely extrapolated to pregnant women. The aims of this study were to assess the safety and the efficacy of tinzaparin sodium (Innohep) administered only once daily during pregnancy. A systematic retrospective review identified a cohort of 37 high-risk pregnancies which had been managed using tinzaparin 175 IU\\/kg once daily. In 26 cases, the index pregnancy had been complicated by development of an acute venous thromboembolism (17 deep vein thrombosis and nine pulmonary embolism). For each individual, case notes were examined and data extracted using a predetermined questionnaire. No episodes of recurrent venous thromboembolism were identified amongst this cohort of pregnancies managed using once daily LMWH administration. However, two unusual thrombotic complications were observed, including a parietal infarct in one patient, and a postpartum cerebral venous thrombosis in another. Once daily tinzaparin was well tolerated, with no cases of heparin-induced thrombocytopaenia, symptomatic osteoporosis, or foetal malformations. Tinzaparin dose modification based upon peak anti-Xa levels occurred in 45% of the cases examined. The present study is the largest study to have examined the clinical efficacy of once daily LMWH for use in pregnant women at high risk of venous thromboembolism. Our data support the safety and efficacy of antenatal tinzaparin at a dose of 175 IU\\/kg. In order to determine whether this once daily regimen provides equivalent (or indeed greater) thromboprophylaxis to twice daily LMWH regimens during pregnancy will require highly powered

  7. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design.

    Science.gov (United States)

    Chen, Qi; Sjölander, Arvid; Långström, Niklas; Rodriguez, Alina; Serlachius, Eva; D'Onofrio, Brian M; Lichtenstein, Paul; Larsson, Henrik

    2014-02-01

    High maternal pre-pregnancy body mass index (BMI) is associated with increased risk of offspring attention deficit hyperactivity disorder (ADHD). However, the role of unmeasured familial confounding for this association remains unclear. We conducted a population-based cohort study via linkage of Swedish national and regional registers to investigate maternal pre-pregnancy BMI (underweight: BMI ADHD. We followed 673 632 individuals born in Sweden between 1992 and 2000, with prospectively collected information on maternal pre-pregnancy BMI, until they received an ADHD diagnosis or ADHD medication, death, emigration or 31 December 2009. Hazard ratios (HRs) were estimated by Cox proportional hazards models. Stratified Cox proportional hazards models were applied to data on full siblings to control for unmeasured familial confounding. At the population level, pre-pregnancy overweight/obesity was associated with increased risk of offspring ADHD (HR(overweight) = 1.23, 95% CI = 1.18-1.27, P = 0.01; HR(obesity) = 1.64, 95% CI = 1.57-1.73, P = 0.01), after adjustment for measured covariates. In full sibling comparisons, however, previously observed associations no longer remained (HR(overweight) = 0.98, 95% CI = 0.83-1.16, P = 0.82; HR(obesity) = 1.15, 95% CI = 0.85-1.56, P = 0.38). The results suggested that the association between maternal pre-pregnancy overweight/obesity and offspring ADHD could be ascribed to unmeasured familial confounding.

  8. Pregnancy outcomes in patients with systemic autoimmunity.

    Science.gov (United States)

    Canti, Valentina; Castiglioni, Maria Teresa; Rosa, Susanna; Franchini, Stefano; Sabbadini, Maria Grazia; Manfredi, Angelo A; Rovere-Querini, Patrizia

    2012-03-01

    The impact of maternal systemic autoimmune diseases on pregnancy outcome is not unequivocally defined. We analysed the pregnancy outcome of 221 pregnancies from 181 autoimmune patients, consecutively followed in a single Italian reference centre from 2001 to 2009. All patients were prospectively followed with monthly visits. Pregnancy outcome was compared with the previous obstetrical history. The patient population comprised five groups: primary antiphospholipid syndrome (PAPS, 39 pregnancies), antiphospholipid syndrome associated with a rheumatic disease (APS/RD, 17 pregnancies), other RD (92 pregnancies), isolated autoantibodies (autoAbs) in the absence of a definite autoimmune disease (aAbs, 38 pregnancies) and reactive arthritis or spondyloarthropathies (35 pregnancies). Of these patients, 50.6% had previous pregnancy complications with an anamnestic live-birth rate of 43.4%. In these patients, complications dropped to 28.2% (44/156). This percentage was very similar to that observed in the 221 pregnancies (29.9%, 66/221) with a live-birth rate of 87.3%. Mean neonatal weight was 3018 ± 611 g; mean gestational age at delivery was 38.17 ± 2.79 weeks. Thus, 10.4% of pregnancies resulted in preterm delivery and 10.9% newborns had low weight at delivery. APS/RD patients had the worse outcome: 17.6% resulted in miscarriage, 14.3% resulted in growth restriction and 50% resulted in preterm delivery. This result was mainly due to patients with APS/systemic lupus erythematosus (SLE) that had the lowest gestational age at delivery (30.8 ± 3.56 weeks) and the lowest newborn weight (1499 ± 931 g). Results confirm that a strict follow-up and targeted treatments significantly improve pregnancy outcomes in autoimmune patients with PAPS, SLE and isolated autoAbs. The pregnancy outcome in patients with APS/SLE remains unsatisfactory.

  9. [Teenage pregnancy].

    Science.gov (United States)

    Mora-Cancino, María; Hernández-Valencia, Varcelino

    2015-05-01

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

  10. 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.

  11. Epilepsy and Pregnancy

    Science.gov (United States)

    ... staffPregnancy and ChildbirthPregnancy: Should I Use a Seat Belt?March 2016January 1995familydoctor.org editorial staffPregnancy and ChildbirthChanges in Your Body During Pregnancy: Third TrimesterMarch 2016October 2009familydoctor.org editorial staffPregnancy and ChildbirthLabor ...

  12. Flu Vaccine during Pregnancy

    Science.gov (United States)

    ... staffPregnancy and ChildbirthChanges in Your Body During Pregnancy: Third TrimesterMarch 2016October 2009familydoctor.org editorial staffPregnancy and ChildbirthPregnancy: Should I Use a Seat Belt?March 2016January 1995familydoctor.org editorial staffPregnancy and ChildbirthLabor ...

  13. Ending a Pregnancy

    Science.gov (United States)

    ... staffPregnancy and ChildbirthChanges in Your Body During Pregnancy: Third TrimesterMarch 2016October 2009familydoctor.org editorial staffPregnancy and ChildbirthPregnancy: Should I Use a Seat Belt?March 2016January 1995familydoctor.org editorial staffPregnancy and ChildbirthLabor ...

  14. Advances in interspecific pregnancy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  15. Management of pregnancy in systemic lupus erythematosus.

    Science.gov (United States)

    Lateef, Aisha; Petri, Michelle

    2012-12-01

    Systemic lupus erythematosus (SLE) is an autoantibody-mediated systemic autoimmune disease, predominantly affecting young females. Pregnancy is increasingly common in the setting of SLE, as survival and quality of life of patients improve. Although live births can be achieved in the most cases, pregnancy in patients with SLE remains a high-risk condition. Maternal and fetal mortality and morbidity are considerably increased, compared with the general population. Aberrations in pregnancy-related maternal immune adaptations are likely contributors. Active maternal disease, renal involvement, specific autoantibody subsets and advanced organ damage are predictors of poor outcome. Therapeutic options are limited during pregnancy as maternal benefit has to be weighed against fetal risk. Prevention of preterm birth and refractory pregnancy loss, as well as management of established neonatal heart block remain unmet needs. Further research should address these important issues that affect young patients with SLE and their babies.

  16. [Hypertension during pregnancy: Epidemiology, definition].

    Science.gov (United States)

    Fauvel, Jean-Pierre

    2016-01-01

    Hypertension in pregnancy has several forms that differ by their mechanisms and their consequences for mothers and fetus. Chronic hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg before pregnancy or before the 20th week of amenorrhea. Gestational hypertension is defined by SBP≥140mm Hg or DBP≥90mm Hg during or after the 20th week of amenorrhea. Preeclampsia is the occurrence of hypertension and proteinuria after 20weeks of amenorrhea. Severe preeclampsia is accompanied by clinical signs and symptoms indicating visceral pain. The HELLP syndrome is a severe preeclampsia accompanied by intravascular hemolysis and hepatic cytolysis. Eclampsia is characterized by seizures of the tonic-clonic type. A chronic hypertension is observed in 1-5% of pregnancies. Gestational hypertension without proteinuria appears in 5-6% of pregnancies. A preeclampsia develops in 1-2% of pregnancies, but much more frequently (up 34%) in the presence of risk factors. High blood pressure during pregnancy remains, by its complications, the leading cause of maternal morbidity and mortality.

  17. Clinical study of ectopic pregnancy.

    Science.gov (United States)

    Chhabra, S; Aher, K; Jaiswal, M

    1992-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  19. Diabetes and the kidney in pregnancy.

    Science.gov (United States)

    Powe, Camille E; Thadhani, Ravi

    2011-01-01

    The prevalence of diabetes in pregnant women is increasing, with 4% of deliveries in the United States occurring in women with pregestational or gestational diabetes. The proteinuria of late pregnancy is exaggerated in women with diabetes. However, diabetic women with preserved renal function before pregnancy appear to have little risk of deterioration of kidney function during pregnancy. Women with impaired renal function before pregnancy may be at risk for permanent decline of renal function during pregnancy, although it is unclear whether this represents the effect of pregnancy or the natural history of their diabetic renal disease. Preeclampsia, which is more common in women with diabetes, may be difficult to diagnose in this group of women. From the currently available literature, there appears to be no negative effect of pregnancy on the long-term progression of diabetic renal disease if renal function is normal and marked proteinuria is absent, but in light of recent findings in which preeclampsia appears to be associated with an increased risk of end-stage renal disease, large cohort studies will be necessary before this question can be definitively answered.

  20. 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

  1. Scott's Lake Excavation Letters on Human Remains

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is two letters written about the repatriation of Santee Indian human remains and funerary objects to Santee Sioux Tribe. Includes an inventory of human remains...

  2. Isoimmunization in pregnancy.

    Science.gov (United States)

    Shaver, Susan M

    2004-06-01

    Isoimmunization to the Rh(D) antigen and to other red cell antigens remains a potentially severe complication of pregnancy. Although management of this complication is performed best by perinatologists, nurses often are the ones who provide further explanations, answer questions, and assist patients who are trying to understand complex physiology and management plans. Nurses should understand current controversies related to isoimmunization and function as patient advocates if needed. To meet these demands, nurses must continue to refresh their knowledge of isoimmunization and its potential complications and review ever-changing management regimens.

  3. The pregnancy-induced increase in baseline circulating growth hormone in rats is not induced by ghrelin.

    Science.gov (United States)

    El-Kasti, M M; Christian, H C; Huerta-Ocampo, I; Stolbrink, M; Gill, S; Houston, P A; Davies, J S; Chilcott, J; Hill, N; Matthews, D R; Carter, D A; Wells, T

    2008-03-01

    The elevation in baseline circulating growth hormone (GH) that occurs in pregnant rats is thought to arise from increased pituitary GH secretion, but the underlying mechanism remains unclear. Distribution, Fourier and algorithmic analyses confirmed that the pregnancy-induced increase in circulating GH in 3-week pregnant rats was due to a 13-fold increase in baseline circulating GH (P hormone mRNA expression in the arcuate nuclei (P produce 'pituitary' GH. Although not excluding the possibility that the pregnancy-associated elevation in baseline circulating GH could arise from alternative extra-pituitary sources (e.g. the ovary), our data indicate that this phenomenon is most likely to result from a direct alteration of somatotroph function.

  4. Pregnancy and Fifth Disease

    Science.gov (United States)

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

  5. Nutrition during Pregnancy

    Science.gov (United States)

    ... can food poisoning affect my pregnancy? • What is listeriosis and how can it affect my pregnancy? •Glossary ... cooked to a safe internal temperature. What is listeriosis and how can it affect my pregnancy? Listeriosis ...

  6. 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.

  7. Vaccinations during Pregnancy

    Science.gov (United States)

    ... X Home > Pregnancy > Prenatal care > Vaccinations and pregnancy Vaccinations and pregnancy E-mail to a friend Please ... date before you get pregnant. What is a vaccination? A vaccination is a shot that contains a ...

  8. 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 ...

  9. Pregnancy test via milk

    NARCIS (Netherlands)

    Siemes, H.; Woelders, H.

    2011-01-01

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

  10. 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, ...

  11. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and Pregnancy Page ... Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your fetus if you ...

  12. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy Print ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  13. Medicine and Pregnancy

    Science.gov (United States)

    ... Consumer Information by Audience For Women Medicine and Pregnancy Share Tweet Linkedin Pin it More sharing options ... reporting problems to FDA . Sign Up for a Pregnancy Registry Pregnancy Exposure Registries are research studies that ...

  14. Pregnancy and IBD

    Science.gov (United States)

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

  15. 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 ...

  16. 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 ...

  17. Perineal Massage in Pregnancy

    Science.gov (United States)

    PERINEAL MASSAGE IN PREGNANCY S HARE W ITH W OMEN PERINEAL MASSAGE IN PREGNANCY What Is My “Perineum”? Your perineum ... research studies. Several studies have found that perineal massage during the last weeks of pregnancy can reduce ...

  18. Gestational Diabetes and Pregnancy

    Science.gov (United States)

    ... Arrives Trouble Getting Pregnant Avoiding Pregnancy Articles Gestational Diabetes and Pregnancy Language: English (US) Español (Spanish) ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  19. Antidepressants: Safe during Pregnancy?

    Science.gov (United States)

    ... you need to know about antidepressants and pregnancy. Pregnancy hormones were once thought to protect women from depression, but researchers now say this isn't true. In addition, pregnancy can trigger a range of emotions that make ...

  20. Medical Care during Pregnancy

    Science.gov (United States)

    ... 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During Pregnancy A ... both moms and their babies. Prenatal Care Before Pregnancy Prenatal care should start before you get pregnant. ...

  1. Caffeine in Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Nutrition, weight & fitness > Caffeine in pregnancy Caffeine in pregnancy E-mail to a friend Please ... two cups of coffee a day. What is caffeine? Caffeine is a drug found in things like ...

  2. Pregnancy and Thyroid Disease

    Science.gov (United States)

    ... to both pregnancy and thyroid disorders. Hyperthyroidism What causes hyperthyroidism in pregnancy? Hyperthyroidism in pregnancy is usually caused ... is believed to be an autoimmune condition and causes mild hyperthyroidism that usually lasts 1 to 2 months. Many ...

  3. Common Discomforts of Pregnancy

    Science.gov (United States)

    ... Home > Pregnancy > Prenatal care > Common discomforts of pregnancy Common discomforts of pregnancy E-mail to a friend ... like back ache and being really tired are common and shouldn’t make you worry. For most ...

  4. 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.

  5. Lupus Activity in Pregnancy

    OpenAIRE

    Clowse, Megan E. B.

    2007-01-01

    Pregnancy in a woman with Systemic Lupus Erythematosus (SLE) can be complicated by both lupus activity and pregnancy mishaps. The majority of recent studies demonstrate an increase in lupus activity during pregnancy, perhaps exacerbated by hormonal shifts required to maintain pregnancy. Increased lupus activity, in turn, prompts an elevated risk for poor pregnancy outcomes, including stillbirth, preterm birth, low birth weight, and preeclamspsia. Fortunately, the majority of pregnancies in wo...

  6. Breast cancer in pregnancy.

    Science.gov (United States)

    Krishna, Iris; Lindsay, Michael

    2013-09-01

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy or in the first postpartum year. Breast cancer is one of the more common malignancies to occur during pregnancy and, as more women delay childbearing, the incidence of breast cancer in pregnancy is expected to increase. This article provides an overview of diagnosis, staging, and treatment of pregnancy-associated breast cancer. Recommendations for management of breast cancer in pregnancy are discussed.

  7. Narcolepsy and pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. Adolescent pregnancy and substance use.

    Science.gov (United States)

    Flanagan, P; Kokotailo, P

    1999-03-01

    The question of just what is the relationship of early pregnancy and childbearing and substance use among adolescents remains unanswered. From a public health perspective, both behaviors are unwanted, and populations that are at risk are often at high risk for both. Perhaps prevention of one behavior may be expected to prevent the other. This, however, may be too simplistic a notion, grounded in misconception of the role of early pregnancy and specific cultural context. Furthermore, several studies have documented a decline of drug use during pregnancy and just after delivery among adolescent mothers. Does this trend continue through the parenting years? If so, for whom? What are the individual maternal, child, and family environmental characteristics that predict a decline in use or continued abstinence after early childbearing? Within the context of poverty, lower educational attainment, minority status, and high prevalence of alcohol and drug use, pregnancy may play a positive role. With a change in role, young women may be less likely than nonparenting peers and less likely than prior to their own pregnancy to become deeply involved in the negative behaviors, such as smoking, drinking, and substance use. Perhaps this is a potential opportunity to intervene. To summarize, the health risk behaviors of substance use and adolescent pregnancy and childbearing appear to be linked. Youths who become pregnant before they complete high school represent a particular group of young women who may be at higher risk than the general population for substance use, at least cigarettes, alcohol, and marijuana. Yet, most pregnant teenagers are not substance users. Among those who are, frequency and amounts of use in most samples were low compared with adult samples of pregnant women. Furthermore, there is evidence that teenagers perceive substance use as a risk to their pregnancies and their unborn children. Among users, there is a decrease in use and increase in quit rates

  9. Data linkage between the National Birth Defects Prevention Study and the Occupational Information Network (O*NET) to assess workplace physical activity, sedentary behaviors, and emotional stressors during pregnancy.

    Science.gov (United States)

    Lee, Laura J; Symanski, Elaine; Lupo, Philip J; Tinker, Sarah C; Razzaghi, Hilda; Pompeii, Lisa A; Hoyt, Adrienne T; Canfield, Mark A; Chan, Wenyaw

    2016-02-01

    Knowledge of the prevalence of work-related physical activities, sedentary behaviors, and emotional stressors among pregnant women is limited, and the extent to which these exposures vary by maternal characteristics remains unclear. Data on mothers of 6,817 infants without major birth defects, with estimated delivery during 1997 through 2009 who worked during pregnancy were obtained from the National Birth Defects Prevention Study. Information on multiple domains of occupational exposures was gathered by linking mother's primary job to the Occupational Information Network Version 9.0. The most frequent estimated physical activity associated with jobs during pregnancy was standing. Of 6,337 mothers, 31.0% reported jobs associated with standing for ≥75% of their time. There was significant variability in estimated occupational exposures by maternal age, race/ethnicity, and educational level. Our findings augment existing literature on occupational physical activities, sedentary behaviors, emotional stressors, and occupational health disparities during pregnancy. © 2015 Wiley Periodicals, Inc.

  10. 孕妇碘缺乏对子代神经系统发育的影响%Impact of iodine deficiency during pregnancy on nervous system development of children

    Institute of Scientific and Technical Information of China (English)

    陈伯尼; 陈志辉

    2015-01-01

    Serious iodine deficiency during pregnancy could lead to adverse pregnancy outcomes and serious damages to the fetus'development of nervous system .However ,it remains unclear that whether moderate iodine deficiency during pregnancy could influence cognitive functions . This article reviews the related researches conducted in China and abroad during recent years .%孕期严重碘缺乏可造成极其不良的妊娠结局并对子代的神经系统发育带来严重损害,然而母亲轻中度碘缺乏是否对子代认知功能产生影响,目前尚不完全明确。本文对近年来国内外碘缺乏相关研究加以阐述。

  11. Are biological drugs safe in pregnancy?

    Directory of Open Access Journals (Sweden)

    A. Calligaro

    2015-03-01

    Full Text Available The introduction of biological therapies has significantly improved the outcome of inflammatory rheumatic diseases. As most of these diseases affect women and men in childbearing age, some concerns have been voiced as to the safety of these drugs in relation to reproduction and pregnancy. Data from many hundreds of pregnancies in patients affected by inflammatory bowel disease and inflammatory arthritis have suggested that exposure to anti-TNF therapies at conception and/or during pregnancy is not associated with adverse pregnancy outcomes or any increase in congenital abnormalities. However, the exposure to anti-TNFα agents, particularly to monoclonal antibodies, in late pregnancy is associated with high drug levels in the newborn and their long-term effects on children remain unknown. Therefore, limiting the use of anti-TNFα to the first 30 weeks of pregnancy is recommended to reduce fetal exposure. Live-virus vaccines should be given only when levels of anti-TNFα drugs are undetectable in the serum of infants. Studies suggest that many of these drugs do enter breast milk in small amounts, but the extent to which the infant absorbs them is less clear. Limited reports have not suggested adverse pregnancy outcomes in women whose partners were exposed to anti-TNF therapies at the time of conception. Pregnancy data for rituximab, abatacept, anakinra, tocilizumab and belimumab are limited and their use in pregnancy cannot currently be recommended.

  12. Are biological drugs safe in pregnancy?

    Science.gov (United States)

    Calligaro, A; Hoxha, A; Ruffatti, A; Punzi, L

    2015-03-31

    The introduction of biological therapies has significantly improved the outcome of inflammatory rheumatic diseases. As most of these diseases affect women and men in childbearing age, some concerns have been voiced as to the safety of these drugs in relation to reproduction and pregnancy. Data from many hundreds of pregnancies in patients affected by inflammatory bowel disease and inflammatory arthritis have suggested that exposure to anti-TNF therapies at conception and/or during pregnancy is not associated with adverse pregnancy outcomes or any increase in congenital abnormalities. However, the exposure to anti-TNFα agents, particularly to monoclonal antibodies, in late pregnancy is associated with high drug levels in the newborn and their long-term effects on children remain unknown. Therefore, limiting the use of anti-TNFα to the first 30 weeks of pregnancy is recommended to reduce fetal exposure. Live-virus vaccines should be given only when levels of anti-TNFα drugs are undetectable in the serum of infants. Studies suggest that many of these drugs do enter breast milk in small amounts, but the extent to which the infant absorbs them is less clear. Limited reports have not suggested adverse pregnancy outcomes in women whose partners were exposed to anti-TNF therapies at the time of conception. Pregnancy data for rituximab, abatacept, anakinra, tocilizumab and belimumab are limited and their use in pregnancy cannot currently be recommended.

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

    OpenAIRE

    2012-01-01

    Background: Cigarette smoking has been associated with acute myeloid leukemia but hypothesis on the association between maternal smoking during pregnancy and childhood leukemia is unclear. Objectives: To investigate the association between maternal exposure to tobacco smoking during pregnancy and early age (< 2 yr.) leukemia (EAL). Methods: A hospital-based multicenter case-control study aiming to explore EAL risk factors was carried out in Brazil during 1999-2007. Data were collected by ...

  14. Seropositivity of cytomegalovirus in patients with recurrent pregnancy loss

    OpenAIRE

    Roya Sherkat; Mohsen Meidani; Hossein Zarabian; Abbas Rezaei; Ali Gholamrezaei

    2014-01-01

    Background: Some evidence has shown a relationship between human cytomegalovirus (CMV) infection and pregnancy loss. However, whether recurrent or latent CMV infection or altered immune response to CMV is related to recurrent pregnancy loss (RPL) is unclear. We evaluated CMV infection and avidity of antibodies to CMV in women with RPL. Materials and Methods: This case-control study was conducted on 43 women with RPL referred to a clinical immunology out-patient clinic in Isfahan (Iran), and 4...

  15. Transient osteoporosis of the hip associated with pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Rabia Terzi

    2015-10-01

    Full Text Available Transient osteoporosis of the hip associated with pregnancy is a clinical condition with an unclear etiology seen in pregnant women in the 3rd trimester that may lead to severe pain and disability. In this article we present a case getting transient osteoporosis associated with pregnancy based on clinical and radiological findings and discussed it under the guidance of the literature. [Int J Res Med Sci 2015; 3(10.000: 2860-2862

  16. Pregnancy management following bariatric surgery.

    Science.gov (United States)

    Uzoma, A; Keriakos, R

    2013-02-01

    Bariatric surgery is gaining in popularity, due to globally increasing rates of obesity. In the UK, this has manifested as a 14-fold increase in bariatric surgery between 2004 and 2010, making it necessary to develop strategies to manage women who become pregnant following bariatric surgery. This review paper has explored all the current evidence in the literature and provided a comprehensive management strategy for pregnant women following bariatric surgery. The emphasis is on a multidisciplinary team approach to all aspects of care. Adequate pre-conception and antenatal and postnatal care is essential to good pregnancy outcomes with emphasis on appropriate nutritional supplementation. This is especially important following malabsorptive procedures. There is no evidence to suggest that pregnancy outcome is worse after bariatric surgery, though women who remain obese are prone to obesity-related risks in pregnancy. Neonatal outcome post-bariatric surgery is no different from the general population.

  17. Vitamin D supplementation for women during pregnancy.

    Science.gov (United States)

    De-Regil, Luz Maria; Palacios, Cristina; Lombardo, Lia K; Peña-Rosas, Juan Pablo

    2016-01-01

    Vitamin D deficiency or insufficiency is thought to be common among pregnant women. Vitamin D supplementation during pregnancy has been suggested as an intervention to protect against adverse pregnancy outcomes. To examine whether oral supplements with vitamin D alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes. In this updated review we included 15 trials assessing a total of 2833 women, excluded 27 trials, and 23 trials are still ongoing or unpublished. Nine trials compared the effects of vitamin D alone versus no supplementation or a placebo and six trials compared the effects of vitamin D and calcium with no supplementation. Risk of bias in the majority of trials was unclear and many studies were at high risk of bias for blinding and attrition rates.Vitamin D alone versus no supplementation or a placeboData from seven trials involving 868 women consistently show that women who received vitamin D supplements alone, particularly on a daily basis, had higher 25-hydroxyvitamin D than those receiving no intervention or placebo, but this response was highly heterogeneous. Also, data from two trials involving 219 women suggest that women who received vitamin D supplements may have a lower risk of pre-eclampsia than those receiving no intervention or placebo (8.9% versus 15.5%; risk ratio (RR) 0.52; 95% CI 0.25 to 1.05, low quality). Data from two trials involving 219 women suggest a similar risk of gestational diabetes among those taking vitamin D supplements or no intervention/placebo (RR 0.43; 95% CI 0.05, 3.45, very low quality). There were no clear differences in adverse effects, with only one reported case of nephritic syndrome in the control group in one study (RR 0.17; 95% CI 0.01 to 4.06; one trial, 135 women, low quality). Given the scarcity of data for this outcome, no firm conclusions can be drawn. No other adverse effects were reported in any of the other

  18. Unintended Pregnancy and Abortion Access in the United States

    Directory of Open Access Journals (Sweden)

    Marshall H. Medoff

    2012-01-01

    Full Text Available This study examines the relationship between state restrictive abortion laws and the incidence of unintended pregnancy. Using 2006 data about pregnancy intentions, the empirical results found that no Medicaid funding, mandatory counseling laws, two-visit laws, and antiabortion attitudes have no significant effect on the unintended pregnancy rate, unwanted pregnancy rate, unintended pregnancy ratio, or the unwanted pregnancy ratio. Parental involvement laws have a significantly negative effect on the unintended and unwanted pregnancy rates and ratios. This latter result suggests that parental involvement laws alter teen minors' risky sexual activity and that behavioral modification has a cumulative effect on the pregnancy avoidance behavior of adult women of childbearing age. The empirical results remain robust even after controlling for regional effects, outliers, and the two different types of parental involvement laws.

  19. Luminescence of thermally altered human skeletal remains

    NARCIS (Netherlands)

    Krap, Tristan; Nota, Kevin; Wilk, Leah; van de Goot, Frank; Ruijter, Jan; Duijst, Wilma; Oostra, Roelof Jan

    2017-01-01

    Literature on luminescent properties of thermally altered human remains is scarce and contradictory. Therefore, the luminescence of heated bone was systemically reinvestigated. A heating experiment was conducted on fresh human bone, in two different media, and cremated human remains were recovered

  20. Mammalian Remains from Indian Sites on Aruba

    NARCIS (Netherlands)

    Hooijer, D.A.

    1960-01-01

    Mr. H. R. VAN HEEKEREN and Mr. C. J. DU RY, of the Rijksmuseum voor Volkenkunde at Leiden, entrusted me with the identification of some animal remains collected from Indian sites on Aruba by Professor J. P. B. DE JOSSELIN DE JONG in 1923. These remains relate for the most part to marine turtles (Che

  1. Herpes simplex virus infection during pregnancy.

    Science.gov (United States)

    Stephenson-Famy, Alyssa; Gardella, Carolyn

    2014-12-01

    Genital herpes in pregnancy continues to cause significant maternal morbidity, with an increasing number of infections being due to oral-labial transmission of herpes simplex virus (HSV)-1. Near delivery, primary infections with HSV-1 or HSV-2 carry the highest risk of neonatal herpes infection, which is a rare but potentially devastating disease for otherwise healthy newborns. Prevention efforts have been limited by lack of an effective intervention for preventing primary infections and the unclear role of routine serologic testing.

  2. Circulating Betatrophin Is Strongly Increased in Pregnancy and Gestational Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Lana Kosi Trebotic

    Full Text Available Betatrophin has recently been introduced as a novel hormone and promotor of beta cell proliferation and improved glucose tolerance in mouse models of insulin resistance. In obese and diabetic humans altered levels were reported and a role in pathophysiology of metabolic diseases was therefore hypothesized. However its release and regulation in women with gestational diabetes mellitus (GDM, as well as its associations with markers of obesity, glucose and lipid metabolism during pregnancy still remain unclear.Circulating betatrophin was quantified in 21 women with GDM and 19 pregnant body mass index-matched women with normal glucose tolerance (NGT as well as 10 healthy age-matched non-pregnant women by enzyme-linked immunosorbent assay. Additionally we performed radioimmunassay (RIA to confirm the results.Betatrophin concentrations measured by ELISA were significantly higher in GDM than in NGT (29.3±4.4 ng/ml vs. 18.1±8.7 ng/ml, p<0.001 which was confirmed by RIA. Betatrophin did not correlate with BMI or insulin resistance but showed a weak association with leptin levels in pregnancy and negative relationship with fasting C-peptide levels in all women. Moreover it correlated significantly with lipid parameters including triglycerides and total cholesterol in pregnancy, as well as estrogen, progesteron and birth weight.Circulating betatrophin concentrations are dramatically increased in pregnancy and are significantly higher in GDM versus pregnant NGT. In the light of the previously reported role in lipid metabolism, betatrophin may represent a novel endocrine regulator of lipid alterations in pregnancy. However additional studies are needed to elucidate whether hormonal factors, such as estrogen, control the production of betatrophin and if targeting betatrophin could hold promise in the fight against metabolic disease.

  3. Antenatal coffee and tea consumption and the effect on birth outcome and hypertensive pregnancy disorders.

    Science.gov (United States)

    van der Hoeven, Timothy; Browne, Joyce L; Uiterwaal, Cuno S P M; van der Ent, Cornelis K; Grobbee, Diederick E; Dalmeijer, Geertje W

    2017-01-01

    Coffee and tea are commonly consumed during pregnancy. While several of their components, like caffeine, have strong pharmacological effects, the effect on the unborn fetus remains unclear. Caffeine intake has been associated with abortion, preterm birth and fetal growth restriction, but a general consensus on caffeine restriction is still lacking. We aimed to investigate antenatal coffee, tea and caffeine consumption and the effect on birth weight and length, gestational age at birth and hypertensive disorders in pregnancy. A total of 936 healthy pregnancies from the WHISTLER birth cohort with data on coffee and tea consumption were included. Maternal and child characteristics as well as antenatal coffee and tea consumption were obtained through postpartum questionnaires. Reported consumption was validated using available preconceptional data. Caffeine intake was calculated from coffee and tea consumption. Linear and logistic regression was used to assess the association with birth outcome and hypertensive disorders. After adjustment for smoking and maternal age, a daily consumption of more than 300mg of caffeine compared to less than 100mg of caffeine was significantly associated with an increased gestational age (linear regression coefficient = 2.00 days, 95%CI = 0.12-4.21, P = 0.03). Tea consumption was significantly related to a higher risk of pregnancy induced hypertension (OR = 1.13, 95%CI = 1.04-1.23, P = 0.004). No associations concerning coffee consumption or birth weight and birth length were observed. Daily caffeine consumption of more than 300mg is possibly associated with an increase in gestational age at birth. A possible relation between high tea consumption and increased risk for pregnancy induced hypertension warrants further research. For most outcomes, we found no significant associations with coffee or tea intake.

  4. 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.

  5. 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.

  6. Bleeding during Pregnancy

    Science.gov (United States)

    ... FAQ090 “Early Pregnancy Loss”). What is an ectopic pregnancy? An ectopic pregnancy occurs when the fertilized egg does not implant ... vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder ...

  7. Hyaluronan-CD44 interaction promotes growth of decidual stromal cells in human first-trimester pregnancy.

    Directory of Open Access Journals (Sweden)

    Rui Zhu

    Full Text Available Hyaluronan (HA and its receptor CD44 are expressed at the maternal-fetal interface, but its role in early pregnancy remains unclear. Here, we found that primary decidual stromal cells (DSCs continuously secreted HA and expressed its receptor CD44. Pregnancy-associated hormones up-regulated HA synthetase (HAS 2 transcription and HA release from DSCs. High molecular weight-HA (HMW-HA, but not medium molecular weight (MMW-HA or low molecular weight (LMW-HA, promoted proliferation and inhibited apoptosis of DSCs in a CD44-dependent manner. The in-cell Western analysis revealed HMW-HA activated PI3K/AKT and mitogen-activated protein kinase (MAPK/ERK1/2 signaling pathways time-dependently. Blocking these pathways by specific inhibitor LY294002 or U0126 abrogated HMW-HA-regulated DSc proliferation and apoptosis. Finally, we have found that HA content, HA molecular weight, HAS2 mRNA level, and CD44 expression were significantly decreased in DSCs from unexplained miscarriage compared with the normal pregnancy. Collectively, our results indicate that higher level and greater molecular mass of HA at maternal-fetal interface contributes to DSc growth and maintenance of DSCs in human early pregnancy.

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

    Directory of Open Access Journals (Sweden)

    Ming Ku

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

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

    Science.gov (United States)

    Ku, Ming; Guo, Shuiming; Shang, Weifeng; Li, Qing; Zeng, Rui; Han, Min; Ge, Shuwang; Xu, Gang

    2016-01-01

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

  10. By the numbers: Structure-seeking individuals prefer quantitative over qualitative representations of personal value to compensate for the threat of unclear performance contingencies.

    Science.gov (United States)

    Rothschild, Zachary K; Landau, Mark J; Sullivan, Daniel

    2011-11-01

    What combination of dispositional and situational factors leads people to represent their personal value in quantitative terms (e.g., salary) rather than qualitative terms (e.g., virtue)? Integrating research on quantitative information seeking, dispositional epistemic motivation, and learned helplessness, the current article hypothesized that individuals high, but not low, in uncertainty avoidance (measured with the Personal Need for Structure Scale [PNS]) would prefer quantitative (over qualitative) value representations to compensate for the diminished self-esteem certainty caused by exposure to unclear performance contingencies. Accordingly, in Study 1 high-PNS participants exposed to unclear (vs. clear) performance contingencies in one domain (visual intelligence) preferred a quantitative value representation in another domain (verbal intelligence). Study 2 showed that this effect is mediated by self-esteem certainty, not self-esteem level. Study 3 included a failure feedback condition to further isolate the role of epistemic motivation, as distinct from self-enhancement motivation, in driving the tendency to quantify personal value.

  11. Therapeutic impact of [{sup 18}F]fluoride positron-emission tomography/computed tomography on patients with unclear foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Dorothee Rita; Hesselmann, Rolf; Johayem, Anass; Hany, Thomas F.; Schulthess, Gustav K. von; Strobel, Klaus [University Hospital of Zurich, Department of Nuclear Medicine, Zurich (Switzerland); Maquieira, Gerardo J.; Espinosa, Norman [University of Zurich, Foot and Ankle Surgery, Department of Orthopaedics, Zurich (Switzerland); Zanetti, Marco [University of Zurich, Department of Radiology, Zurich (Switzerland)

    2010-10-15

    To evaluate the therapeutic impact of [{sup 18}F]fluoride positron-emission tomography/computed tomography ([{sup 18}F]fluoride PET/CT) imaging on patients with unclear foot pain. Twenty-eight patients were prospectively included in this study. Therapeutic management was defined by two experienced dedicated foot surgeons before and after [{sup 18}F]fluoride PET/CT imaging. Twenty-six patients underwent cross-sectional imaging [CT, magnetic resonance (MR)] prior to PET/CT. A retrospective analysis of the magnetic resonance imaging (MRI) diagnoses was performed when a therapy change occurred after PET/CT imaging. In 13/28 (46%) patients therapeutic management was changed due to PET/CT results. Management changes occurred in patients with the following diagnoses: os trigonum syndrome; sinus tarsi syndrome; os tibiale externum syndrome; osteoarthritis of several joints; non-consolidated fragments; calcaneo-navicular coalition; plantar fasciitis; insertional tendinopathy; suggestion of periostitis; neoarticulations between metatarsal bones. Os trigonum, os tibiale externum, subtalar osteoarthritis and plantar fasciitis were only seen to be active on PET/CT images but not on MR images. [{sup 18}F]fluoride PET/CT has a substantial therapeutic impact on management in patients with unclear foot pain. (orig.)

  12. The management of rheumatic diseases in pregnancy.

    Science.gov (United States)

    Mitchell, K; Kaul, M; Clowse, Megan E B

    2010-03-01

    Pregnancy can create a challenge for physicians caring for women with rheumatic diseases. For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission and will continue to need medication. Systemic lupus erythematosus (SLE) may remain quiet in some women, but in others may become more aggressive during pregnancy, putting both mother and foetus at risk. Women with limited scleroderma can do remarkably well, but scleroderma renal crises can be difficult to manage. A third of pregnancies in women with antiphospholipid syndrome (APS) may be refractory to our best therapy. In general, active inflammation from rheumatic diseases poses a stronger threat to the well-being of both mother and foetus than many immunosuppressant medications. Therefore, continued immunosuppression with the least risky medications will allow for the most optimal pregnancy outcomes.

  13. The dermatoses of pregnancy

    Directory of Open Access Journals (Sweden)

    Sachdeva Silonie

    2008-01-01

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

  14. The predictive value of ovarian reserve tests for spontaneous pregnancy in subfertile ovulatory women

    NARCIS (Netherlands)

    Haadsma, M. L.; Groen, H.; Fidler, V.; Bukman, A.; Roeloffzen, E. M. A.; Groenewoud, E. R.; Broekmans, F. J. M.; Heineman, M. J.; Hoek, A.

    2008-01-01

    BACKGROUND: The predictive value of ovarian reserve tests (ORTs) for spontaneous pregnancy is unclear. Our study aimed to determine whether ORTs have added value to previously identified prognostic factors for spontaneous pregnancy in subfertile ovulatory couples. METHODS: A prospective cohort study

  15. Hypertensive Disorders of Pregnancy

    OpenAIRE

    Mammaro, Alessia; Carrara, Sabina; Cavaliere, Alessandro; Ermito, Santina; Dinatale, Angela; Pappalardo, Elisa Maria; Militello, Mariapia; Pedata, Rosa

    2009-01-01

    Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories, as recommended by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy: 1) chronic hypertension, 2) preeclampsia-eclampsia, 3) preeclampsia superimposed on chronic hypertension, and 4) gestational hypertension (transient hypertension of pregnancy or chronic hyper...

  16. NUTRITION DURING PREGNANCY

    OpenAIRE

    Banjari, Ines

    2015-01-01

    The health of the new-born is largely a function of the mother's nutritional, general and reproductive health status. Therefore, pregnancy is considered as a critical window in child’s growth and development. Several characteristics of a woman prior or in early pregnancy, as well as external, environmental factors affect pregnancy outcomes. External factors account for 30% of the pregnancy outcome and infant's birth weight, and mother’s diet during pregnancy is one of the most important ones....

  17. Smoking and Pregnancy

    OpenAIRE

    1982-01-01

    SUMMARY. Maternal smoking during pregnancy is considered to be one of the most significant causes of complications in pregnancy and is associated with an unfavourable outcome in childbirth compared with pregnancy in non-smokers. Specifically, smoking during pregnancy increases the likelihood of placenta praevia, abruptio placentae, ectopic gestation and premature rupture of the membranes (PRM). In addition, research has established that smoking during pregnancy increases the rates of low birt...

  18. Remaining Life Expectancy With and Without Polypharmacy

    DEFF Research Database (Denmark)

    Wastesson, Jonas W; Canudas-Romo, Vladimir; Lindahl-Jacobsen, Rune

    2016-01-01

    OBJECTIVES: To investigate the remaining life expectancy with and without polypharmacy for Swedish women and men aged 65 years and older. DESIGN: Age-specific prevalence of polypharmacy from the nationwide Swedish Prescribed Drug Register (SPDR) combined with life tables from Statistics Sweden...... was used to calculate the survival function and remaining life expectancy with and without polypharmacy according to the Sullivan method. SETTING: Nationwide register-based study. PARTICIPANTS: A total of 1,347,564 individuals aged 65 years and older who had been prescribed and dispensed a drug from July 1...... to September 30, 2008. MEASUREMENTS: Polypharmacy was defined as the concurrent use of 5 or more drugs. RESULTS: At age 65 years, approximately 8 years of the 20 remaining years of life (41%) can be expected to be lived with polypharmacy. More than half of the remaining life expectancy will be spent...

  19. Risk of tuberculosis during pregnancy in Mongolia, a high incidence setting with low HIV prevalence.

    Science.gov (United States)

    Rendell, N L; Batjargal, N; Jadambaa, N; Dobler, C C

    2016-12-01

    To investigate the epidemiology and the relative risk of tuberculosis (TB) in pregnant women in Mongolia, a high TB incidence setting with a low rate of human immunodeficiency virus co-infection, where active case finding for TB in pregnancy is implemented. We retrospectively collected data on pregnant women diagnosed with TB during 2013. Data were collected through doctors at central TB dispensaries who extracted the relevant information from patients' clinical records. The overall incidence of TB among pregnant women was 228 (95%CI 187276) per 100000 person-years, resulting in an incidence rate ratio of 1.31 (95%CI 1.081.59) in pregnant women compared to the general population. Twelve per cent of the pregnant women with TB chose to have an abortion. In this study, pregnant women had a 1.3-fold higher risk of developing TB than the general population. Based on a moderately increased risk of TB during pregnancy in our study and the potential for adverse health outcomes, TB screening among pregnant women can currently be justified, but the cost-effectiveness of this intervention remains unclear. Patients and doctors need to be educated about the safety of standard TB treatment in pregnancy to reduce the rate of abortions.

  20. NLRP3 Deficiency Improves Angiotensin II-Induced Hypertension But Not Fetal Growth Restriction During Pregnancy.

    Science.gov (United States)

    Shirasuna, Koumei; Karasawa, Tadayoshi; Usui, Fumitake; Kobayashi, Motoi; Komada, Tadanori; Kimura, Hiroaki; Kawashima, Akira; Ohkuchi, Akihide; Taniguchi, Shun'ichiro; Takahashi, Masafumi

    2015-11-01

    Preeclampsia is a pregnancy-specific syndrome characterized by elevated blood pressure, proteinuria, and intrauterine growth restriction (IUGR). Although sterile inflammation appears to be involved, its pathogenesis remains unclear. Recent evidence indicates that sterile inflammation is mediated through the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasomes, composed of NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), and caspase-1. Here we investigated the role of the NLRP3 inflammasomes in the pathogenesis of preeclampsia using Nlrp3(-/-) and Asc(-/-) (Nlrp3 and Asc deficient) pregnant mice. During pregnancy in mice, continuous infusion of high-dose angiotensin II (AngII) induced hypertension, proteinuria, and IUGR, whereas infusion of low-dose AngII caused hypertension alone. AngII-induced hypertension was prevented in Nlrp3(-/-) mice but not in Asc(-/-), indicating that NLRP3 contributes to gestational hypertension independently of ASC-mediated inflammasomes. Although NLRP3 deficiency had no effect on IUGR, it restored the IL-6 up-regulation in the placenta and kidney of AngII-infused mice. Furthermore, treatment with hydralazine prevented the development of gestational hypertension but not IUGR or IL-6 expression in the placenta and kidney. These findings demonstrate that NLRP3 contributes to the development of gestational hypertension independently of the inflammasomes and that IUGR and kidney injury can occur independent of blood pressure elevation during pregnancy.

  1. Non-communicating Rudimentary Uterine Horn Pregnancy

    Directory of Open Access Journals (Sweden)

    I Upadhyaya

    2011-12-01

    Full Text Available Pregnancy in a non-communicating rudimentary horn is an extremely rare form of ectopic gestation. The rudimentary horn may or may not communicate with the uterine cavity with the majority of cases being non-communicating. The patient exhibits features of acute abdomen and carries a high risk of maternal death. Even modern scans remain elusive whereas laparatomy remains the confi rmatory procedure for the diagnosis. Because of the varied muscular constitution in the thickness and distensibility of the wall of the rudimentary horn, pregnancy is accommodated for a variable period of gestation. Here, we report three cases of pregnancy in a non-communicating rudimentary horn of the uterus in different periods of gestation, their outcome and a review of the available literature. Keywords: Mullerian anomalies, non-communicating rudimentary horn pregnancy, surgical management.

  2. Smoking in pregnancy, where are we now?

    Science.gov (United States)

    Ashwin, Cathy; Marshall, Jayne; Standen, Penny

    2013-01-01

    The harmful effects of smoking during pregnancy have been well documented within the literature (Eastham and Gosakan 2010; British Medical Association (BMA) 2004). However, although the number of women smoking during pregnancy has fallen over the last few years, this still remains a major health concern for both women and their families. This paper aims to explore recent media campaigns and social policies focusing on smoking in pregnancy and the general population. Midwives need to be aware of current policies with regard to smoking cessation to enable high quality evidence based information and support to be provided at an optimum time in women's lives.

  3. Rubella and pregnancy: diagnosis, management and outcomes.

    Science.gov (United States)

    Bouthry, Elise; Picone, Olivier; Hamdi, Ghada; Grangeot-Keros, Liliane; Ayoubi, Jean-Marc; Vauloup-Fellous, Christelle

    2014-12-01

    Rubella is a mild viral disease that typically occurs in childhood. Rubella infection during pregnancy causes congenital rubella syndrome, including the classic triad of cataracts, cardiac abnormalities and sensorineural deafness. Highly effective vaccines have been developed since 1969, and vaccination campaigns have been established in many countries. Although there has been progress, the prevention and diagnosis of rubella remain problematic. This article reviews the implications and management of rubella during pregnancy.

  4. What's pregnancy got to do with it? Late presentation to HIV/AIDS services in Northeastern Brazil.

    Science.gov (United States)

    Dourado, Inês; MacCarthy, Sarah; Lima, Carlos; Veras, Maria Amélia; Kerr, Ligia; de Brito, Ana Maria; Gruskin, Sofia

    2014-01-01

    Despite the known benefits of early treatment initiation for individual morbidity and mortality, as well as for reducing the risk of transmission, late presentation (LP) to HIV/AIDS services remains a major concern in many countries. There is little information on LP from middle- and low-income countries and studies that do evaluate LP commonly disaggregate data by sex. It is rare, however, for researchers to further disaggregate the data by pregnancy status so it remains unclear if pregnancy status modifies the effects associated with sex. The study was conducted at the only State Reference Center for HIV/AIDS in Salvador, Brazil's third largest city. LP was defined as a patient accessing services with a CD4 difference between men and nonpregnant women (APR 1.04; 95%CI 0.92-1.19), but the APR of LP for nonpregnant women was 53% less than men (APR 0.47; 95%CI 0.33-0.68). These results highlight the importance of analyzing data disaggregated not only by sex but also by pregnancy status to accurately identify the risk factors associated with LP so that programs and policies can effectively and efficiently address LP in Brazil and beyond.

  5. Luminescence of thermally altered human skeletal remains.

    Science.gov (United States)

    Krap, Tristan; Nota, Kevin; Wilk, Leah S; van de Goot, Franklin R W; Ruijter, Jan M; Duijst, Wilma; Oostra, Roelof-Jan

    2017-07-01

    Literature on luminescent properties of thermally altered human remains is scarce and contradictory. Therefore, the luminescence of heated bone was systemically reinvestigated. A heating experiment was conducted on fresh human bone, in two different media, and cremated human remains were recovered from a modern crematory. Luminescence was excited with light sources within the range of 350 to 560 nm. The excitation light was filtered out by using different long pass filters, and the luminescence was analysed by means of a scoring method. The results show that temperature, duration and surrounding medium determine the observed emission intensity and bandwidth. It is concluded that the luminescent characteristic of bone can be useful for identifying thermally altered human remains in a difficult context as well as yield information on the perimortem and postmortem events.

  6. Fish remains and humankind: part two

    Directory of Open Access Journals (Sweden)

    Andrew K G Jones

    1998-07-01

    Full Text Available The significance of aquatic resources to past human groups is not adequately reflected in the published literature - a deficiency which is gradually being acknowledged by the archaeological community world-wide. The publication of the following three papers goes some way to redress this problem. Originally presented at an International Council of Archaeozoology (ICAZ Fish Remains Working Group meeting in York, U.K. in 1987, these papers offer clear evidence of the range of interest in ancient fish remains across the world. Further papers from the York meeting were published in Internet Archaeology 3 in 1997.

  7. Exercise and pregnancy: a review.

    Science.gov (United States)

    Bell, R; O'Neill, M

    1994-06-01

    The effects of pregnancy on the maternal cardiorespiratory system include increases in oxygen consumption, cardiac output, heart rate, stroke volume, and plasma volume. The increase in oxygen reserve seen in early pregnancy is reduced later, suggesting that maternal exercise may present a greater physiologic stress in the third trimester. Evidence suggests that weight-bearing exercise produces a greater decrease in oxygen reserve than nonweight-bearing exercise. Furthermore, to maintain a heart rate below 140 beats per minute during pregnancy, the intensity of weight-bearing exercise must be reduced. Nonweight-bearing, water-based exercise results in smaller fetal heart rate changes and a lower maternal heart rate than the same exercise performed on land. Exercising in the supine position in late pregnancy has raised concerns because cardiac output in the supine position is lower than in the lateral position at rest, presumably because the gravid uterus partially obstructs the inferior vena cava. Sustained exercise produces a training effect on the mother, although reported associations between this effect and the experience of labor are not consistent. Short-term changes in fetal heart rate provide circumstantial evidence that physical activity can influence the fetus. Acute effects of exercise that can potentially affect the fetus include hyperthermia, changes in uteroplacental flow, reduced levels of maternal glucose, and increased uterine contractions. Moderate to high levels of sustained maternal exercise have been associated with reduced birthweight. Much research remains to be done on the effects of specific exercise regimens during pregnancy, the effects on previously sedentary women, and the long-term health consequences to the offspring of women who perform vigorous exercise during pregnancy.

  8. Teratogen update: lead and pregnancy.

    Science.gov (United States)

    Bellinger, David C

    2005-06-01

    This review focuses on the impacts of lead exposure on reproductive health and outcomes. High levels of paternal lead exposure (>40 microg/dl or >25 microg/dl for a period of years) appear to reduce fertility and to increase the risks of spontaneous abortion and reduced fetal growth (preterm delivery, low birth weight). Maternal blood lead levels of approximately 10 microg/dl have been linked to increased risks of pregnancy hypertension, spontaneous abortion, and reduced offspring neurobehavioral development. Somewhat higher maternal lead levels have been linked to reduced fetal growth. Some studies suggest a link between increased parental lead exposure and congenital malformations, although considerable uncertainty remains regarding the specific malformations and the dose-response relationships. Common methodological weaknesses of studies include potential exposure misclassifications due to the frequent unavailability of exposure biomarker measurements at biologically appropriate times and uncertainty regarding the best exposure biomarker(s) for the various outcomes. A special concern with regard to the pregnant woman is the possibility that a fetus might be exposed to lead mobilized from bone stores as a result of pregnancy-related metabolic changes, making fetal lead exposure the result of exposure to exogenous lead during pregnancy and exposure to endogenous lead accumulated by the woman prior to pregnancy. By reducing bone resorption, increased calcium intake during the second half of pregnancy might reduce the mobilization of lead from bone compartments, even at low blood lead levels. Subgroups of women who incurred substantial exposures to lead prior to pregnancy should be considered to be at increased risk.

  9. Predicting the remaining service life of concrete

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, J.F.

    1991-11-01

    Nuclear power plants are providing, currently, about 17 percent of the U.S. electricity and many of these plants are approaching their licensed life of 40 years. The U.S. Nuclear Regulatory Commission and the Department of Energy`s Oak Ridge National Laboratory are carrying out a program to develop a methodology for assessing the remaining safe-life of the concrete components and structures in nuclear power plants. This program has the overall objective of identifying potential structural safety issues, as well as acceptance criteria, for use in evaluations of nuclear power plants for continued service. The National Institute of Standards and Technology (NIST) is contributing to this program by identifying and analyzing methods for predicting the remaining life of in-service concrete materials. This report examines the basis for predicting the remaining service lives of concrete materials of nuclear power facilities. Methods for predicting the service life of new and in-service concrete materials are analyzed. These methods include (1) estimates based on experience, (2) comparison of performance, (3) accelerated testing, (4) stochastic methods, and (5) mathematical modeling. New approaches for predicting the remaining service lives of concrete materials are proposed and recommendations for their further development given. Degradation processes are discussed based on considerations of their mechanisms, likelihood of occurrence, manifestations, and detection. They include corrosion, sulfate attack, alkali-aggregate reactions, frost attack, leaching, radiation, salt crystallization, and microbiological attack.

  10. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  11. Identification of ancient remains through genomic sequencing

    Science.gov (United States)

    Blow, Matthew J.; Zhang, Tao; Woyke, Tanja; Speller, Camilla F.; Krivoshapkin, Andrei; Yang, Dongya Y.; Derevianko, Anatoly; Rubin, Edward M.

    2008-01-01

    Studies of ancient DNA have been hindered by the preciousness of remains, the small quantities of undamaged DNA accessible, and the limitations associated with conventional PCR amplification. In these studies, we developed and applied a genomewide adapter-mediated emulsion PCR amplification protocol for ancient mammalian samples estimated to be between 45,000 and 69,000 yr old. Using 454 Life Sciences (Roche) and Illumina sequencing (formerly Solexa sequencing) technologies, we examined over 100 megabases of DNA from amplified extracts, revealing unbiased sequence coverage with substantial amounts of nonredundant nuclear sequences from the sample sources and negligible levels of human contamination. We consistently recorded over 500-fold increases, such that nanogram quantities of starting material could be amplified to microgram quantities. Application of our protocol to a 50,000-yr-old uncharacterized bone sample that was unsuccessful in mitochondrial PCR provided sufficient nuclear sequences for comparison with extant mammals and subsequent phylogenetic classification of the remains. The combined use of emulsion PCR amplification and high-throughput sequencing allows for the generation of large quantities of DNA sequence data from ancient remains. Using such techniques, even small amounts of ancient remains with low levels of endogenous DNA preservation may yield substantial quantities of nuclear DNA, enabling novel applications of ancient DNA genomics to the investigation of extinct phyla. PMID:18426903

  12. Kadav Moun PSA (:60) (Human Remains)

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This is an important public health announcement about safety precautions for those handling human remains. Language: Haitian Creole.  Created: 2/18/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/18/2010.

  13. The case for fencing remains intact.

    Science.gov (United States)

    Packer, C; Swanson, A; Canney, S; Loveridge, A; Garnett, S; Pfeifer, M; Burton, A C; Bauer, H; MacNulty, D

    2013-11-01

    Creel et al. argue against the conservation effectiveness of fencing based on a population measure that ignores the importance of top predators to ecosystem processes. Their statistical analyses consider, first, only a subset of fenced reserves and, second, an incomplete examination of 'costs per lion.' Our original conclusions remain unaltered.

  14. Removing the remaining ridges in fingerprint segmentation

    Institute of Scientific and Technical Information of China (English)

    ZHU En; ZHANG Jian-ming; YIN Jian-ping; ZHANG Guo-min; HU Chun-feng

    2006-01-01

    Fingerprint segmentation is an important step in fingerprint recognition and is usually aimed to identify non-ridge regions and unrecoverable low quality ridge regions and exclude them as background so as to reduce the time expenditure of image processing and avoid detecting false features. In high and in low quality ridge regions, often are some remaining ridges which are the afterimages of the previously scanned finger and are expected to be excluded from the foreground. However, existing segmentation methods generally do not take the case into consideration, and often, the remaining ridge regions are falsely classified as foreground by segmentation algorithm with spurious features produced erroneously including unrecoverable regions as foreground. This paper proposes two steps for fingerprint segmentation aimed at removing the remaining ridge region from the foreground. The non-ridge regions and unrecoverable low quality ridge regions are removed as background in the first step, and then the foreground produced by the first step is further analyzed for possible remove of the remaining ridge region. The proposed method proved effective in avoiding detecting false ridges and in improving minutiae detection.

  15. Why Agricultural Educators Remain in the Classroom

    Science.gov (United States)

    Crutchfield, Nina; Ritz, Rudy; Burris, Scott

    2013-01-01

    The purpose of this study was to identify and describe factors that are related to agricultural educator career retention and to explore the relationships between work engagement, work-life balance, occupational commitment, and personal and career factors as related to the decision to remain in the teaching profession. The target population for…

  16. Essential Qualities of Math Teaching Remain Unknown

    Science.gov (United States)

    Cavanagh, Sean

    2008-01-01

    According to a new federal report, the qualities of an effective mathematics teacher remain frustratingly elusive. The report of the National Mathematics Advisory Panel does not show what college math content and coursework are most essential for teachers. While the report offered numerous conclusions about math curriculum, cognition, and…

  17. Juveniles' Motivations for Remaining in Prostitution

    Science.gov (United States)

    Hwang, Shu-Ling; Bedford, Olwen

    2004-01-01

    Qualitative data from in-depth interviews were collected in 1990-1991, 1992, and 2000 with 49 prostituted juveniles remanded to two rehabilitation centers in Taiwan. These data are analyzed to explore Taiwanese prostituted juveniles' feelings about themselves and their work, their motivations for remaining in prostitution, and their difficulties…

  18. Pruritus in pregnancy

    Science.gov (United States)

    Bergman, Hagit; Melamed, Nir; Koren, Gideon

    2013-01-01

    Abstract Question Some of my pregnant patients complain about pruritus. Are there conditions in pregnancy that present with pruritus that might put the mother or fetus at risk? Answer Although most cases of pruritus can be attributed to itchy dry skin, there are conditions unique to pregnancy that involve pruritus as a leading symptom. These include pemphigoid gestationis, pruritic urticarial papules and plaques of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. These conditions are associated with severe pruritus and some might be associated with adverse fetal outcomes. Clinical history and physical examination are the most important diagnostic clues when evaluating pruritus in pregnancy. PMID:24336540

  19. Adolescent pregnancy and contraception.

    Science.gov (United States)

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena

    2014-09-01

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

  20. Maternal obesity and pregnancy.

    Science.gov (United States)

    Johnson, S R; Kolberg, B H; Varner, M W; Railsback, L D

    1987-05-01

    We examined the risk of maternal obesity in 588 pregnant women weighing at least 113.6 kilograms (250 pounds) during pregnancy. Compared with a control group matched for age and parity, we found a significantly increased risk in the obese patient for gestational diabetes, hypertension, therapeutic induction, prolonged second stage of labor, oxytocin stimulation of labor, shoulder dystocia, infants weighing more than 4,000 grams and delivery after 42 weeks gestation. Certain operative complications were also more common in obese women undergoing cesarean section including estimated blood loss of more than 1,000 milliliters, operating time of more than two hours and wound infection postoperatively. These differences remained significant after controlling for appropriate confounding variables. We conclude that maternal obesity should be considered a high risk factor.

  1. Functional electrical stimulation cycling does not improve mobility in people with acquired brain injury and its effects on strength are unclear: a randomised trial

    Directory of Open Access Journals (Sweden)

    Davide G de Sousa

    2016-10-01

    Full Text Available Question: Does 4 weeks of active functional electrical stimulation (FES cycling in addition to usual care improve mobility and strength more than usual care alone in people with a sub-acute acquired brain injury caused by stroke or trauma? Design: Multi centre, randomised, controlled trial. Participants: Forty patients from three Sydney hospitals with recently acquired brain injury and a mean composite strength score in the affected lower limb of 7 (SD 5 out of 20 points. Intervention: Participants in the experimental group received an incremental, progressive, FES cycling program five times a week over a 4-week period. All participants received usual care. Outcome measures: Outcome measures were taken at baseline and at 4 weeks. Primary outcomes were mobility and strength of the knee extensors of the affected lower limb. Mobility was measured with three mobility items of the Functional Independence Measure and strength was measured with a hand-held dynamometer. Secondary outcomes were strength of the knee extensors of the unaffected lower limb, strength of key muscles of the affected lower limb and spasticity of the affected plantar flexors. Results: All but one participant completed the study. The mean between-group differences for mobility and strength of the knee extensors of the affected lower limb were –0.3/21 points (95% CI –3.2 to 2.7 and 7.5 Nm (95% CI –5.1 to 20.2, where positive values favoured the experimental group. The only secondary outcome that suggested a possible treatment effect was strength of key muscles of the affected lower limb with a mean between-group difference of 3.0/20 points (95% CI 1.3 to 4.8. Conclusion: Functional electrical stimulation cycling does not improve mobility in people with acquired brain injury and its effects on strength are unclear. Trial registration: ACTRN12612001163897. [de Sousa DG, Harvey LA, Dorsch S, Leung J, Harris W (2016 Functional electrical stimulation cycling does not improve

  2. Intrahepatic cholestasis of pregnancy: When should you look further?

    NARCIS (Netherlands)

    Hardikar, W.; Kansal, S.; Oude Elferink, R.P.J.; Angus, P.

    2009-01-01

    Pruritis with abnormal liver function tests is the classical presentation of intrahepatic cholestasis of pregnancy (ICP), a condition associated with significant fetal complications. Although the etiology of ICP is unclear in many cases, certain features of the clinical presentation should alert the

  3. Intrahepatic cholestasis of pregnancy: When should you look further?

    NARCIS (Netherlands)

    Hardikar, W.; Kansal, S.; Oude Elferink, R.P.J.; Angus, P.

    2009-01-01

    Pruritis with abnormal liver function tests is the classical presentation of intrahepatic cholestasis of pregnancy (ICP), a condition associated with significant fetal complications. Although the etiology of ICP is unclear in many cases, certain features of the clinical presentation should alert the

  4. E1. Risk of chronic hypertension in women with a history of hypertensive disorders of pregnancy - a nationwide cohort study

    DEFF Research Database (Denmark)

    Behrens, I; Basit, S; Melbye, M;

    2016-01-01

    BACKGROUND: Women with a history of hypertensive disorders of pregnancy (HDP) are known to have an increased risk of hypertension years after their pregnancy. However, how soon after an affected pregnancy the risk of hypertension increases and how/whether this risk evolves over time, is unclear....... METHOD: Using national health register data, we identified all women giving birth in Denmark from 1978 to 2011. Cox regression analysis was used to compare the rates of incident post-pregnancy hypertension requiring treatment with medication after pregnancy in women with and without a history of HDP......, by the number of years since pregnancy. FINDINGS: In the first 3 years after a woman's latest pregnancy, rates of chronic hypertension were 4- to 9-fold higher in women with an HDP in that pregnancy than in women with a normotensive pregnancy. The difference in rates between the two groups declined...

  5. Glucose screening tests during pregnancy

    Science.gov (United States)

    Oral glucose tolerance test - pregnancy; OGTT - pregnancy; Glucose challenge test - pregnancy; Gestational diabetes - glucose screening ... screening test between 24 and 28 weeks of pregnancy. The test may be done earlier if you ...

  6. Antibiotics and Pregnancy: What's Safe?

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week Is it safe to take antibiotics during pregnancy? Answers from Roger W. Harms, M. ... 2014 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/antibiotics-and-pregnancy/ ...

  7. Remaining Phosphorus Estimate Through Multiple Regression Analysis

    Institute of Scientific and Technical Information of China (English)

    M. E. ALVES; A. LAVORENTI

    2006-01-01

    The remaining phosphorus (Prem), P concentration that remains in solution after shaking soil with 0.01 mol L-1 CaCl2 containing 60 μg mL-1 P, is a very useful index for studies related to the chemistry of variable charge soils. Although the Prem determination is a simple procedure, the possibility of estimating accurate values of this index from easily and/or routinely determined soil properties can be very useful for practical purposes. The present research evaluated the Premestimation through multiple regression analysis in which routinely determined soil chemical data, soil clay content and soil pH measured in 1 mol L-1 NaF (pHNaF) figured as Prem predictor variables. The Prem can be estimated with acceptable accuracy using the above-mentioned approach, and PHNaF not only substitutes for clay content as a predictor variable but also confers more accuracy to the Prem estimates.

  8. [Improved diagnosis of extrauterine pregnancy by endosonography].

    Science.gov (United States)

    Funk, A; Fendel, H

    1988-01-01

    Between July 1987 and January 1988, 44 patients with a tentative diagnosis of ectopic pregnancy underwent sonographic examination by means of vaginal probe at the Department of Gynecology and Obstetrics of the RWTH Aachen. The sonographic findings, all of which were confirmed by subsequent clinical and or surgical clarification, were as follows: an ectopic pregnancy was diganosed in 16 cases, an early intrauterine pregnancy in seven, an intrauterine abortion in seven, and in one case a uterine malformation-a dermoid cyst and a functional cyst. In 11 cases sonographic examination showed the interior genital region to be normal, with no sign of pregnancy. In the 16 ectopic pregnancies diagnosed, it was possible in 13 cases to visualize the pregnancy directly by sonography, including the amniotic sac, and to make measurements. In one case a normally developed ectopic pregnancy with living embryo was seen at the end of the seventh week of gestation post menstruationem. In the remaining three cases the diagnosis was established on the basis of an empty cavum uteri associated with a slightly enlarged uterus and demonstration of fluid in the pouch of Douglas. In two cases the ectopic pregnancy was correctly localized by "feeling" with the intravaginal probe to establish the cause of circumscribed pain. In three case the tentative diagnosis of an ectopic pregnancy made on the basis of sonographic findings was not confirmed by subsequent clarification procedures. The results described show that in most cases ectopic pregnancies can be demonstrated directly by sonography using an intravaginal probe.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Contact allergy to rubber accelerators remains prevalent

    DEFF Research Database (Denmark)

    Schwensen, J F; Menné, T; Johansen, J D

    2016-01-01

    INTRODUCTION: Chemicals used for the manufacturing of rubber are known causes of allergic contact dermatitis on the hands. Recent European studies have suggested a decrease in thiuram contact allergy. Moreover, while an association with hand dermatitis is well established, we have recently observ.......2% (19/54) and 35.4% (17/48) of the cases respectively. CONCLUSION: Contact allergy to rubber accelerators remains prevalent. Clinicians should be aware of the hitherto unexplored clinical association with facial dermatitis....

  10. [Professional confidentiality: speak out or remain silent? ].

    Science.gov (United States)

    Daubigney, Jean-claude

    2014-01-01

    People who work with children, in their daily tasks, must choose whether to disclose information entrusted to them. However, they are subject to the law, which authorises or imposes speaking out or remaining silent. In terms of ethics, they can seek the best possible response while respecting professional secrecy when meeting an individual, in a situation, in a place or at a particular time. They must then take responsibility for that decision.

  11. Terminology for houses and house remains

    OpenAIRE

    Rosberg, Karin

    2013-01-01

    In order to obtain lucidity, it is essential to choose adequate terminology when speaking of prehistoric houses. The understanding of house construction requires a terminology with a focus on construction. Very often, archaeologists instead use a terminology with a focus on the remains, and use an inadequate terminology for constructions, indicating that they do not fully consider how the constructions work. The article presents some suggestions for adequate construction terminology.

  12. Why do some cores remain starless ?

    CERN Document Server

    Anathpindika, S

    2016-01-01

    Physical conditions that could render a core starless(in the local Universe) is the subject of investigation in this work. To this end we studied the evolution of four starless cores, B68, L694-2, L1517B, L1689, and L1521F, a VeLLO. The density profile of a typical core extracted from an earlier simulation developed to study core-formation in a molecular cloud was used for the purpose. We demonstrate - (i) cores contracted in quasistatic manner over a timescale on the order of $\\sim 10^{5}$ years. Those that remained starless did briefly acquire a centrally concentrated density configuration that mimicked the density profile of a unstable Bonnor Ebert sphere before rebounding, (ii) three of our test cores viz. L694-2, L1689-SMM16 and L1521F remained starless despite becoming thermally super-critical. On the contrary B68 and L1517B remained sub-critical; L1521F collapsed to become a VeLLO only when gas-cooling was enhanced by increasing the size of dust-grains. This result is robust, for other cores viz. B68, ...

  13. Prenatal diagnosis in multiple pregnancy.

    Science.gov (United States)

    Taylor, M J; Fisk, N M

    2000-08-01

    Fetal abnormality is more common in multiple than in singleton pregnancies. This, together with the requirement to consider the risks with at least two babies to sample correctly each fetus and to undertake accurately-targeted selective termination, amounts to a major challenge for obstetricians involved in prenatal diagnosis. Early determination of chorionicity should be routine, since this influences not only the genetic risks but also the invasive procedure chosen for karyotyping or genotyping. Assessment of nuchal translucency identifies individual fetuses at risk of trisomy. Contrary to expectation, invasive procedures in twins appear to have procedure-related miscarriage rates that are similar to those in singletons. Instead, contamination remains a concern at chorionic villus sampling. Elective late karyotyping of fetuses may have a role in some countries. Whereas management options for discordant fetal abnormality are relatively straightforward in dichorionic pregnancies, monochorionic pregnancies are at risk of co-twin sequelae after any single intrauterine death. Techniques have now been developed to occlude completely the cord vasculature by laser and/or ultrasound guided bipolar diathermy. Given the complexities associated with prenatal diagnosis, all invasive procedures in multiple pregnancies should be performed in tertiary referral centres. Copyright 2000 Harcourt Publishers Ltd.

  14. MRI Safety during Pregnancy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z MRI Safety During Pregnancy Magnetic resonance imaging (MRI) Illness ... during the exam? Contrast material MRI during pregnancy Magnetic resonance imaging (MRI) If you are pregnant and your doctor ...

  15. Zika Virus and Pregnancy

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus ... Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your ...

  16. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus ... Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your ...

  17. Fluconazole and Pregnancy

    Science.gov (United States)

    Fluconazole and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to fluconazole may increase the risk for birth defects over ...

  18. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a

  19. Marijuana and Pregnancy

    Science.gov (United States)

    Marijuana and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to marijuana may increase the risk for birth defects over ...

  20. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus ... Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your ...

  1. Zika Virus and Pregnancy

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus ... Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your ...

  2. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and ... Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your fetus ...

  3. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... My ACOG ACOG Departments Donate Shop Career Connection Home Resources & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and Pregnancy Page Navigation ▼ ...

  4. Cravings during Pregnancy

    Science.gov (United States)

    ... crave. Don’t buy a whole bag of chocolate candy. Just buy one or two pieces. Plan ... baby is born. Last reviewed: October, 2012 Pregnancy Nutrition, weight & fitness Other Pregnancy topics ') document.write(' Before ...

  5. Pregnancy and HIV

    Science.gov (United States)

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

  6. Intrahepatic cholestasis of pregnancy

    National Research Council Canada - National Science Library

    Geenes, Victoria; Williamson, Catherine

    2009-01-01

    Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus in the third trimester, raised serum bile acids and increased rates of adverse fetal outcomes...

  7. Staphylococcus aureus and Pregnancy

    Science.gov (United States)

    Staphylococcus aureus and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having a ... This sheet talks about whether exposure to staphylococcus aureus may increase the risk for birth defects over ...

  8. Anemia and Pregnancy

    Science.gov (United States)

    ... Advocacy Toolkit Home For Patients Blood Disorders Anemia Anemia and Pregnancy Your body goes through significant changes ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...

  9. Gynecologic oncology in pregnancy.

    NARCIS (Netherlands)

    Amant, F.; Calsteren, K Van; Vergote, I.; Ottevanger, N.

    2008-01-01

    In this review current knowledge on prevalence, diagnosis, treatment and prognosis of gynaecological malignancies during pregnancy is discussed. After a general overview of surgery, chemotherapy and radiotherapy during pregnancy, tumor specific diagnosis and treatment options are described for breas

  10. Getting Ready for Pregnancy

    Science.gov (United States)

    ... boss about changing job duties before and during pregnancy. Lower your stress. High levels of stress can cause problems during pregnancy, so find ways to manage stress before you get pregnant. Being active, eating healthy ...

  11. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... at risk? Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how ... inspired by stories from the families at the heart of our mission or share your own story ...

  12. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since the ... and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce your ...

  13. Health Problems in Pregnancy

    Science.gov (United States)

    Every pregnancy has some risk of problems. The causes can be conditions you already have or conditions you develop. ... pregnant with more than one baby, previous problem pregnancies, or being over age 35. They can affect ...

  14. Tumors and Pregnancy

    Science.gov (United States)

    Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. ...

  15. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... For Patients Blood Disorders Blood Clots Blood Clotting & Pregnancy If you are pregnant, or you have just ... The risk of developing a blood clot during pregnancy is increased by the following: Previous blood clots ...

  16. Familiy Planning and Pregnancy

    Science.gov (United States)

    ... Storage Pool Deficiencies Home About Bleeding Disorders Family planning and pregnancy Carriers should receive genetic counselling about ... Diagnosis When to Test for Carrier Status Family Planning and Pregnancy Conception Options Prenatal Diagnosis Fetal Sex ...

  17. Vaginal bleeding in pregnancy

    Science.gov (United States)

    ... may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away. During ... Cervical polyp or growth Early labor (bloody show) Ectopic pregnancy Infection of the cervix Trauma to the cervix ...

  18. Ectopic pregnancy (image)

    Science.gov (United States)

    An ectopic pregnancy is one in which the fertilized egg implants in tissue outside of the uterus and the placenta ... common site is within a Fallopian tube, however, ectopic pregnancies can occur in the ovary, the abdomen, and ...

  19. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Shop Career Connection Home Resources & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ... and Pregnancy Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September ...

  20. 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 ...

  1. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... harming your baby. Jump To: Am I at Risk? The risk of developing a blood clot during pregnancy is ... prevent blood clots during pregnancy: Be aware of risk factors. Know your family history. Make sure your ...

  2. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy ... Council on Patient Safety For Patients Patient FAQs Spanish Pamphlets Teen Health About ACOG About Us Leadership & ...

  3. Pesticides and Pregnancy

    Science.gov (United States)

    Pesticides and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to pesticides may increase the risk for birth defects over ...

  4. Have a Healthy Pregnancy

    Science.gov (United States)

    ... moderate aerobic activity, like walking fast, dancing, or swimming. Do aerobic activity for at least 10 minutes at a time. Get more information about exercise during pregnancy: Stay Active During Pregnancy: Quick tips Health Tips ...

  5. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... From Puerto Rico Meet our National Ambassador for 2017 Read and share stories Become inspired by stories ... Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  6. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy ... Council on Patient Safety For Patients Patient FAQs Spanish Pamphlets Teen Health About ACOG About Us Leadership & ...

  7. Sertraline (Zoloft) and Pregnancy

    Science.gov (United States)

    Sertraline (Zoloft®) and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of ... risk. This sheet talks about whether exposure to sertraline may increase the risk for birth defects over ...

  8. E. Coli and Pregnancy

    Science.gov (United States)

    ... best live chat Live Help Fact Sheets Share E. coli and Pregnancy Thursday, 20 November 2014 In ... pregnancy and while breastfeeding. Donate Sign Up For E-Newsletter Full Name * Email Address * Enter The Code: ...

  9. Diphenhydramine and Pregnancy

    Science.gov (United States)

    ... few reports of withdrawal symptoms in infants whose mothers took diphenhydramine daily throughout pregnancy. Is there anyone who should avoid taking diphenhydramine during pregnancy? A single human report and animal data have suggested that ...

  10. High-Risk Pregnancy

    Science.gov (United States)

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

  11. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... in | my dashboard | sign out our cause health topics stories & media research & professionals get involved Search Our ... Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness ...

  12. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Collaboratives Launch Prematurity research centers What is team science? More than 75 years of solving problems March ... Global Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & ...

  13. 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 ...

  14. Problems sleeping during pregnancy

    Science.gov (United States)

    ... trips to the bathroom. Increased heart rate. Your heart rate increases during pregnancy to pump more blood. This may make it harder to sleep. Shortness of breath. At first, pregnancy hormones can ...

  15. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Education & Events Advocacy For Patients About ACOG Zika Virus and Pregnancy Home For Patients Zika Virus and ... Education Pamphlets - Spanish Share: PEV002, September 2016 Zika Virus and Pregnancy There are risks to your fetus ...

  16. Zika Virus and Pregnancy

    Medline Plus

    Full Text Available ... Shop Career Connection Home Resources & Publications Practice Management Education & Events Advocacy For Patients About ACOG Zika Virus ... and Pregnancy Page Navigation ▼ ACOG Pregnancy Book Patient Education FAQs Patient Education Pamphlets - Spanish Share: PEV002, September ...

  17. Benzodiazepines and Pregnancy

    Science.gov (United States)

    Benzodiazepines and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to benzodiazepines may increase the risk for birth defects over ...

  18. Immunology of neuromyelitis optica during pregnancy

    Science.gov (United States)

    Davoudi, Vahid; Keyhanian, Kiandokht; Bove, Riley M.

    2016-01-01

    Anti–aquaporin-4 (AQP4) autoantibody plays a key role in the pathogenesis of neuromyelitis optica (NMO). Studies have shown increased relapse rates in patients with NMO during pregnancy and postpartum. High estrogen levels during pregnancy can increase activation-induced cytidine deaminase expression, which is responsible for immunoglobulin production. Additionally, sex hormones may influence antibody glycosylation, with effects on antibody function. Estrogen decreases apoptosis of self-reactive B cells, through upregulation of antiapoptotic molecules. Furthermore, high estrogen levels during pregnancy can boost B-cell activating factor and type 1 interferon (IFN) production, facilitating development of self-reactive peripheral B cells in association with increased disease activity. Elevated levels of estrogen during pregnancy decrease IFN-γ generation, which causes a shift toward T helper (Th) 2 immunity, thereby propagating NMO pathogenesis. Women with NMO have an elevated rate of pregnancy complications including miscarriage and preeclampsia, which are associated with increased Th17 cells and reduction of T-regulatory cells. These in turn can enhance inflammation in NMO. Increased regulatory natural killer cells (CD56−) during pregnancy can enhance Th2-mediated immunity, thereby increasing inflammation. In the placenta, trophoblasts express AQP4 antigen and are exposed to maternal blood containing anti-AQP4 antibodies. Animal models have shown that anti-AQP4 antibodies can bind to AQP4 antigen in placenta leading to complement deposition and placental necrosis. Reduction of regulatory complements has been associated with placental insufficiency, and it is unclear whether these are altered in NMO. Further studies are required to elucidate the specific mechanisms of disease worsening, as well as the increased rate of complications during pregnancy in women with NMO. PMID:27761482

  19. Regulatory T cells protect from autoimmune arthritis during pregnancy

    OpenAIRE

    Munoz-Suano, Alba; Kallikourdis, Marinos; Sarris, Milka; Alexander G Betz

    2012-01-01

    Pregnancy frequently has a beneficial effect on the autoimmune disease Rheumatoid Arthritis, ranging from improvement in clinical symptoms to complete remission. Despite decades of study, a mechanistic explanation remains elusive. Here, we demonstrate that an analogous pregnancy-induced remission can be observed in a mouse model of arthritis. We demonstrate that during pregnancy mice are protected from collagen-induced arthritis, but are still capable of launching normal immune responses to i...

  20. Splenectomy during pregnancy: treatment of refractory immune thrombocytopenic purpura

    OpenAIRE

    Mahey, Reeta; Kaur, Simran Deep; Chumber, Sunil; Kriplani, Alka; Bhatla, Neerja

    2013-01-01

    Immune thrombocytopenic purpura (ITP) complicates 1–2/10 000 pregnancies and accounts for 5% of cases of pregnancy-associated thrombocytopenia. Corticosteroids and intravenous immunoglobulin remain the first-line therapy in pregnancy, and a majority of pregnant women respond to this conventional therapy. Other cytotoxic and immunosuppressive agents used for treatment in non-pregnant patients, for example, danazol, cyclophosphamide, vinca alkaloids and azathioprine, are potential teratogens an...

  1. Does anticoagulant therapy improve pregnancy outcome equally, regardless of specific thrombophilia type?

    Science.gov (United States)

    Kovac, Mirjana; Mikovic, Zeljko; Mitic, Gorana; Djordjevic, Valentina; Mandic, Vesna; Rakicevic, Ljiljana; Radojkovic, Dragica

    2014-03-01

    The study was conducted to evaluate the effect of anticoagulant therapy in women with thrombophilia and to detect the possible differences among carriers of mutations (factor V [FV] Leiden and FIIG20210) and those with natural anticoagulant deficiency. The 4-year prospective investigation included 85 pregnant women, with a history of recurrent fetal loss (RFL). They were treated with prophylactic doses of low-molecular-weight heparin (nadroparin) starting from 6 to 8 weeks of gestation. Pregnancy outcomes were evaluated based on the thrombophilia type. Carriers of thrombophilic mutations had a live birth rate of 93%, compared to 41.6% for women with natural anticoagulant deficiencies. Significant differences between the groups were also observed for intrauterine fetal death, intrauterine growth restriction, and postpartum thrombosis. The optimal therapy for women with natural anticoagulant deficiency and RFL remains unclear and future prospective study with a large number of patients is required to determine the best treatment for these severe thrombophilic conditions.

  2. [Mosquito-borne arboviruses and pregnancy: pathological consequences for the mother and infant. A general review].

    Science.gov (United States)

    Tran, A; Chastel, C

    2008-12-01

    Vertical transmission of arboviruses, mainly those transmitted by mosquitoes, was considered for a long time as an exceptional event in pregnant women. However, during the recent years, as a result of the global upsurge of these viral infections, several surveys and reports clearly demonstrated that the resulting pathologies were increasing in both severity and frequency in endemic countries where pregnant women are at risk. In order to better assess such new epidemiological trends, the authors performed a general review as exhaustive as possible of the pathological consequences of the infection during pregnancy caused by the four dengue viruses and Japanese encephalitis, West Nile and Chikungunya viruses. At the therapeutic and preventive levels we are quite unarmed in the face of such severe accidents as their pathogenesis remains presently unclear

  3. [Dopplerometry at prolonged pregnancy].

    Science.gov (United States)

    Salii-Prenichi, L; Milchev, N; Markova, D; Apiosjan, Zh

    2010-01-01

    Prolonged pregnancy, associated with low amniotic fluid is a reason for the increase of fetal mortality and morbidity. There is no a define test at prolonged pregnancy which can determine which pregnancy are at a risk for adverse outcome and complications. Dopplerometry as a noninvasive method for examination of blood circulation, and especially a. cerebri media and a. umbilicalis can be used for the prediction of the outcome of prolonged pregnancy.

  4. Hypertensive disorders in pregnancy

    OpenAIRE

    Berry, Casey; Atta, Mohamed G.

    2016-01-01

    Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease...

  5. Weight management in pregnancy

    OpenAIRE

    Olander, E. K.

    2015-01-01

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

  6. Carnitine Deficiency and Pregnancy

    OpenAIRE

    Anouk de Bruyn; Yves Jacquemyn; Kristof Kinget; François Eyskens

    2015-01-01

    We present two cases of carnitine deficiency in pregnancy. In our first case, systematic screening revealed L-carnitine deficiency in the first born of an asymptomatic mother. In the course of her second pregnancy, maternal carnitine levels showed a deficiency as well. In a second case, a mother known with carnitine deficiency under supplementation was followed throughout her pregnancy. Both pregnancies had an uneventful outcome. Because carnitine deficiency can have serious complications, su...

  7. Distribution of albatross remains in the Far East regions during the Holocene, based on zooarchaeological remains.

    Science.gov (United States)

    Eda, Masaki; Higuchi, Hiroyoshi

    2004-07-01

    Many albatross remains have been found in the Japanese Islands and the surrounding areas, such as Sakhalin and South Korea. These remains are interesting for two reasons: numerous sites from which albatross remains have been found are located in coastal regions of the Far East where no albatrosses have been distributed recently, and there are some sites in which albatross remains represent a large portion of avian remains, although albatrosses are not easily preyed upon by human beings. We collected data on albatross remains from archaeological sites in the Far East regions during the Holocene and arranged the remains geographically, temporally and in terms of quantity. Based on these results, we showed that coastal areas along the Seas of Okhotsk and Japan have rarely been used by albatrosses in Modern times, though formerly there were many albatrosses. We proposed two explanations for the shrinkage of their distributional range: excessive hunting in the breeding areas, and distributional changes of prey for albatrosses.

  8. Abuse during Pregnancy

    Science.gov (United States)

    ... can trigger abuse during pregnancy? For many families, pregnancy can bring about feelings of stress, which is normal. But it's not okay for your partner to react violently to stress. Some partners become abusive during pregnancy because they feel: Upset because this was an ...

  9. Pregnancy After Age 35

    Science.gov (United States)

    ... provider can help you find ways to reduce stress so it doesn’t affect your pregnancy. During pregnancy Go to all of your prenatal ... be harmful to your baby and reduce your stress . Last reviewed: April, 2016 ... complications Other Complications & Loss topics ') document.write(' Pregnancy ...

  10. Liver disease in pregnancy

    Institute of Scientific and Technical Information of China (English)

    Noel M Lee; Carla W Brady

    2009-01-01

    Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Hyperemesis gravidarum, preeclampsia/eclampsia, syndrome of hemolysis, elevated liver tests and low platelets (HELLP), acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy are pregnancy-specific disorders that may cause elevations in liver tests and hepatic dysfunction. Chronic liver diseases, including cholestatic liver disease, autoimmune hepatitis, Wilson disease, and viral hepatitis may also be seen in pregnancy. Management of liver disease in pregnancy requires collaboration between obstetricians and gastroenterologists/hepatologists. Treatment of pregnancy-specific liver disorders usually involves delivery of the fetus and supportive care, whereas management of chronic liver disease in pregnancy is directed toward optimizing control of the liver disorder. Cirrhosis in the setting of pregnancy is less commonly observed but offers unique challenges for patients and practitioners. This article reviews the epidemiology, pathophysiology, diagnosis, and management of liver diseases seen in pregnancy.

  11. Leukemia in pregnancy.

    Science.gov (United States)

    Firas, Al Sabty; Demeckova, E; Mistrik, M

    2008-01-01

    Pregnancy complicated with leukemia is rare. Validated data, out of which conclusions may be drawn regarding the management of pregnancy with leukemia are sparse. We report 5 cases of leukemia diagnosed during pregnancy with an overview of published literature (Ref. 19). Full Text (Free, PDF) www.bmj.sk.

  12. Vanishing tumor in pregnancy

    Directory of Open Access Journals (Sweden)

    M V Vimal

    2012-01-01

    Full Text Available A patient with microprolactinoma, who had two successful pregnancies, is described for management issues. First pregnancy was uneventful. During the second pregnancy, the tumor enlarged to macroprolactinoma with headache and blurring of vision which was managed successfully with bromocriptine. Post delivery, complete disappearance of the tumor was documented.

  13. Diagnosis and management of intramural ectopic pregnancy.

    Science.gov (United States)

    Bannon, Kimberly; Fernandez, Carlos; Rojas, David; Levine, Elliot M; Locher, Stephen

    2013-01-01

    Intramural pregnancy, a gestation completely surrounded by the myometrium located within the uterine wall with separation from the uterine cavity, is an extremely unusual form of pregnancy. Complications resulting from intramural pregnancy include inevitable uterine rupture with resultant hemorrhage and possible hysterectomy if diagnosis is not made early and treatment is not initiated. An asymptomatic patient was initially diagnosed with a missed abortion at approximately 6 weeks of gestation after a routine ultrasound. Suction curettage was performed approximately 1 month after the initial diagnosis. The pathology specimen failed to reveal placental villi. Ultimately, the diagnosis of intramural pregnancy was made via ultrasound and a computed tomography scan. She was treated with a single dose of systemically administered methotrexate. Over a period of 4 months, β-human chorionic gonadotropin levels trended downward; however, the intramural pregnancy failed to resolve completely, and a persistent mass remained. The intramural pregnancy was removed using the da Vinci laparoscopic procedure (Intuitive Surgical, Sunnyvale, CA). If the diagnosis of intramural ectopic pregnancy is made sufficiently early, conservative measures can be taken, which can preserve a patient's future fertility.

  14. Postpartum depression among women with unintended pregnancy

    Directory of Open Access Journals (Sweden)

    Cynthia Nunes de Oliveira Brito

    2015-01-01

    Full Text Available OBJECTIVE To analyze the association between unintended pregnancy and postpartum depression. METHODS This is a prospective cohort study conducted with 1,121 pregnant aged 18 to 49 years, who attended the prenatal program devised by the Brazilian Family Health Strategy, Recife, PE, Northeastern Brazil, between July 2005 and December 2006. We interviewed 1,121 women during pregnancy and 1,057 after childbirth. Unintended pregnancy was evaluated during the first interview and postpartum depression symptoms were assessed using the Edinburgh Postnatal Depression Screening Scale. The crude and adjusted odds ratios for the studied association were estimated using logistic regression analysis. RESULTS The frequency for unintended pregnancy was 60.2%; 25.9% presented postpartum depression symptoms. Those who had unintended pregnancies had a higher likelihood of presenting this symptoms, even after adjusting for confounding variables (OR = 1.48; 95%CI 1.09;2.01. When the Self Reporting Questionnaire (SRQ-20 variable was included, the association decreased, however, remained statistically significant (OR = 1.42; 95%CI 1.03;1.97. CONCLUSIONS Unintended pregnancy showed association with subsequent postpartum depressive symptoms. This suggests that high values in Edinburgh Postnatal Depression Screening Scale may result from unintended pregnancy.

  15. Does the number of oocytes retrieved influence pregnancy after fresh embryo transfer?

    Directory of Open Access Journals (Sweden)

    Qianfang Cai

    Full Text Available BACKGROUND: The nature of the association between the number of oocytes retrieved and in vitro fertilization (IVF outcomes after fresh embryo transfer remains unclear because of conflicting results reported in the studies on this subject. In addition, the influence of the quality of the embryos transferred is usually neglected. The objective of this study is to assess the relationships of the number of oocytes retrieved, the number and quality of embryos transferred, and the prospects of pregnancy after fresh embryo transfer. METHODS: The data on 3131 infertile women undergoing their first IVF treatment cycle between January 2009 and December 2010 were collected retrospectively. Restricted cubic splines and stratified analyses were used to explore the relationships between the number of oocytes retrieved, the number and quality of embryos transferred, and the IVF outcomes. RESULTS: When stratified by the number and quality of transferred embryos, no significant differences in the chances for clinical pregnancy and live birth were found in three groups of oocytes yielded (≤6, 7-14, or ≥15. The relationship between the number of oocytes retrieved and pregnancy is nearly a reflection of the pattern of the relationship between the number of oocytes retrieved and the probability of having two good-quality embryos transferred. The patients with the "optimal" number of oocytes were not only younger but also had the highest probability of having two good-quality embryos replaced. CONCLUSIONS: Similarly aged patients have similar pregnancy prospects after fresh embryo transfer when the same number and quality of embryos are replaced, irrespective of their number of oocytes. Selecting the desired number of good-quality embryos for transfer is the key to IVF success. Thus, aiming at retrieving an optimal number of oocytes to maximize IVF outcomes in a fresh cycle could place undue stress on the patients and may not be the best medical decision.

  16. So close: remaining challenges to eradicating polio.

    Science.gov (United States)

    Toole, Michael J

    2016-03-14

    The Global Polio Eradication Initiative, launched in 1988, is close to achieving its goal. In 2015, reported cases of wild poliovirus were limited to just two countries - Afghanistan and Pakistan. Africa has been polio-free for more than 18 months. Remaining barriers to global eradication include insecurity in areas such as Northwest Pakistan and Eastern and Southern Afghanistan, where polio cases continue to be reported. Hostility to vaccination is either based on extreme ideologies, such as in Pakistan, vaccination fatigue by parents whose children have received more than 15 doses, and misunderstandings about the vaccine's safety and effectiveness such as in Ukraine. A further challenge is continued circulation of vaccine-derived poliovirus in populations with low immunity, with 28 cases reported in 2015 in countries as diverse as Madagascar, Ukraine, Laos, and Myanmar. This paper summarizes the current epidemiology of wild and vaccine-derived poliovirus, and describes the remaining challenges to eradication and innovative approaches being taken to overcome them.

  17. Current knowledge of the aetiology of human tubal ectopic pregnancy

    Science.gov (United States)

    Shaw, J.L.V.; Dey, S.K.; Critchley, H.O.D.; Horne, A.W.

    2010-01-01

    BACKGROUND An ectopic pregnancy is a pregnancy which occurs outside of the uterine cavity, and over 98% implant in the Fallopian tube. Tubal ectopic pregnancy remains the most common cause of maternal mortality in the first trimester of pregnancy. The epidemiological risk factors for tubal ectopic pregnancy are well established and include: tubal damage as a result of surgery or infection (particularly Chlamydia trachomatis), smoking and in vitro fertilization. This review appraises the data to date researching the aetiology of tubal ectopic pregnancy. METHODS Scientific literature was searched for studies investigating the underlying aetiology of tubal ectopic pregnancy. RESULTS Existing data addressing the underlying cause of tubal ectopic pregnancy are mostly descriptive. There are currently few good animal models of tubal ectopic pregnancy. There are limited data explaining the link between risk factors and tubal implantation. CONCLUSIONS Current evidence supports the hypothesis that tubal ectopic pregnancy is caused by a combination of retention of the embryo within the Fallopian tube due to impaired embryo-tubal transport and alterations in the tubal environment allowing early implantation to occur. Future studies are needed that address the functional consequences of infection and smoking on Fallopian tube physiology. A greater understanding of the aetiology of tubal ectopic pregnancy is critical for the development of improved preventative measures, the advancement of diagnostic screening methods and the development of novel treatments. PMID:20071358

  18. 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.

  19. Juvenile Dermatomyositis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Anthony Emeka Madu

    2013-01-01

    Full Text Available Juvenile dermatomyositis has variable clinical presentations both in and outside of pregnancy. A literature review indicated that optimal maternal and fetal outcomes can be anticipated when the pregnancy is undertaken while the disease is in remission. Poorer outcomes are associated with flare-up of the disease in early pregnancy compared with exacerbation in the second or third trimester, when fetal prognosis is usually good. We present a case of JDM in pregnancy with disease exacerbation late in pregnancy and review of the relevant literature.

  20. Juvenile dermatomyositis in pregnancy.

    Science.gov (United States)

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

    2013-01-01

    Juvenile dermatomyositis has variable clinical presentations both in and outside of pregnancy. A literature review indicated that optimal maternal and fetal outcomes can be anticipated when the pregnancy is undertaken while the disease is in remission. Poorer outcomes are associated with flare-up of the disease in early pregnancy compared with exacerbation in the second or third trimester, when fetal prognosis is usually good. We present a case of JDM in pregnancy with disease exacerbation late in pregnancy and review of the relevant literature.

  1. Hypertensive disorders in pregnancy.

    Science.gov (United States)

    Berry, Casey; Atta, Mohamed G

    2016-09-06

    Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease presenting coincidentally requiring knowledge of the physiologic changes and potential renal disorders that may be encountered during pregnancy.

  2. Anemia in pregnancy.

    Science.gov (United States)

    Horowitz, Kari M; Ingardia, Charles J; Borgida, Adam F

    2013-06-01

    Hemodynamic changes occur in pregnancy to prepare for expected blood loss at delivery. Physiologic anemia occurs in pregnancy because plasma volume increases more quickly than red cell mass. Anemia is most commonly classified as microcytic, normocytic, or macrocytic. Iron deficiency anemia accounts for 75% of all anemias in pregnancy. Oral iron supplementation is the recommended treatment of iron deficiency anemia in pregnancy. Parenteral iron and erythropoietin can also be used in severe or refractory cases. Outcomes and treatments for other forms of inherited and acquired anemias in pregnancy vary by disease, and include nutritional supplementation, corticosteroids, supportive transfusions, and splenectomy.

  3. Carnitine Deficiency and Pregnancy

    Directory of Open Access Journals (Sweden)

    Anouk de Bruyn

    2015-01-01

    Full Text Available We present two cases of carnitine deficiency in pregnancy. In our first case, systematic screening revealed L-carnitine deficiency in the first born of an asymptomatic mother. In the course of her second pregnancy, maternal carnitine levels showed a deficiency as well. In a second case, a mother known with carnitine deficiency under supplementation was followed throughout her pregnancy. Both pregnancies had an uneventful outcome. Because carnitine deficiency can have serious complications, supplementation with carnitine is advised. This supplementation should be continued throughout pregnancy according to plasma concentrations.

  4. [Hyperthyroidism in molar pregnancy].

    Science.gov (United States)

    Boufettal, H; Mahdoui, S; Noun, M; Hermas, S; Samouh, N

    2014-03-01

    Hyperthyroidism is a rare complication of molar pregnancy. We report a 39-year-old woman who presented a thyrotoxic syndrome accompanying a molar pregnancy. Serum thyroid hormones were elevated and returned to normal level after uterine evacuation of a molar pregnancy. The authors detail the role of thyroid stimulating property of human gonadotropin chorionic hormone and its structural changes during the gestational trophoblastic diseases. These changes give the latter the thyroid stimulating properties and signs of hyperthyroidism. Molar pregnancy may be a cause of hyperthyroidism. The diagnosis of molar pregnancy should be a mention to thyrotoxicosique syndrome in a woman of childbearing age. Copyright © 2013. Published by Elsevier SAS.

  5. Prenatal diagnosis of congenital malformations in 500 pregnancies

    NARCIS (Netherlands)

    Leschot, N.J.; Treffers, P.E.; Verjaal, M.; Weduwen, J.J. der; Bennebroek Gravenhorst, J.; Coelingh Bennink, H.J.T.

    1979-01-01

    The organization, techniques used and diagnostic findings of 500 prenatal diagnoses are reported in detail. In 15 cases the pregnancy was terminated because of abnormal laboratory findings. Follow-up of the remaining pregnancies revealed a perinatal mortality of 1.7%, and the risk of an abortion ind

  6. Key Concepts in Pregnancy of Unknown Location: Identifying Ectopic Pregnancy and Providing Patient-Centered Care.

    Science.gov (United States)

    Fields, Loren; Hathaway, Alison

    2017-03-01

    Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL. In some cases, the location of the pregnancy is never determined and the PUL is categorized as resolving or persisting. Evidence suggests expectant management is a safe and effective approach for most women with PUL and should be the mainstay of care. However, in the case of persisting PUL, continued concern for ectopic pregnancy remains. Strategies for deciding when to intervene when a woman has a PUL are reviewed. A variety of clinical tools, including serum beta human chorionic gonadotropin (β-hCG), repeat ultrasonography, dilation and curettage (D&C), and empiric methotrexate therapy are discussed. Finally, a proposal is made that women with persisting PUL can be presented with the option of choosing expectant management, diagnostic D&C, or empiric methotrexate treatment. © 2016 by the American College of Nurse-Midwives.

  7. Does hypertension remain after kidney transplantation?

    Directory of Open Access Journals (Sweden)

    Gholamreza Pourmand

    2015-05-01

    Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

  8. [Abdominal pregnancy, institutional experience].

    Science.gov (United States)

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  9. Probiotics and pregnancy.

    Science.gov (United States)

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

    2015-01-01

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

  10. Diabetes insipidus and pregnancy.

    Science.gov (United States)

    Chanson, Philippe; Salenave, Sylvie

    2016-06-01

    Diabetes insipidus (DI) is a rare complication of pregnancy. It is usually transient, being due to increased placental production of vasopressinase that inactivates circulating vasopressin. Gestational, transient DI occurs late in pregnancy and disappears few days after delivery. Acquired central DI can also occur during pregnancy, for example in a patient with hypophysitis or neuroinfundibulitis during late pregnancy or postpartum. Finally, pre-existing central or nephrogenic DI may occasionally be unmasked by pregnancy. Treatment with dDAVP (desmopressin, Minirin(®)) is very effective on transient DI of pregnancy and also on pre-existing or acquired central DI. Contrary to vasopressin, dDAVP is not degraded by vasopressinase. Nephrogenic DI is insensitive to dDAVP and is therefore more difficult to treat during pregnancy if fluid intake needs to be restricted.

  11. Diabetes insipidus during pregnancy.

    Science.gov (United States)

    Ananthakrishnan, Sonia

    2016-03-01

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

  12. Recurrent pregnancy loss

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  13. Pruritic folliculitis of pregnancy*

    Science.gov (United States)

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

    2016-01-01

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

  14. Endocrinology in Pregnancy

    DEFF Research Database (Denmark)

    Laurberg, Peter; Andersen, Stine Linding

    2016-01-01

    Thyroid hormones are essential developmental factors, and Graves' disease (GD) may severely complicate a pregnancy. This review describes how pregnancy changes the risk of developing GD, how early pregnancy by several mechanisms leads to considerable changes in the results of the thyroid function...... tests used to diagnose hyperthyroidism, and how these changes may complicate the diagnosing of GD. Standard therapy of GD in pregnancy is antithyroid drugs. However, new studies have shown considerable risk of birth defects if these drugs are used in specific weeks of early pregnancy, and this should...... be taken into consideration when planning therapy and control of women who may in the future become pregnant. Early pregnancy is a period of major focus in GD, where pregnancy should be diagnosed as soon as possible, and where important and instant change in therapy may be warranted. Such change may...

  15. [Diagnosis of toxoplasmosis in pregnancy].

    Science.gov (United States)

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

    1989-07-01

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

  16. Removal of an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy.

    Science.gov (United States)

    Peleg, David; Latta, Richard

    2013-06-01

    A woman with a viable intrauterine 12-week pregnancy and an intraabdominal levonorgestrel-releasing intrauterine device had the device successfully removed under local anesthesia. The pregnancy continued without complication. The decision to remove an intraabdominal levonorgestrel-releasing intrauterine device during pregnancy remains controversial.

  17. Pregnancy with prosthetic heart valves - 30 years' nationwide experience in Denmark

    DEFF Research Database (Denmark)

    Sillesen, Martin; Hjortdal, Vibeke; Vejlstrup, Niels;

    2011-01-01

    Pregnancy in women with prosthetic heart valves remains a risk factor for both mother and fetus, but unselected and unbiased outcome and complication data remain scarce. We analyzed nationwide outcome data from 1977 to 2007 for all pregnancies in women with prosthetic valves.......Pregnancy in women with prosthetic heart valves remains a risk factor for both mother and fetus, but unselected and unbiased outcome and complication data remain scarce. We analyzed nationwide outcome data from 1977 to 2007 for all pregnancies in women with prosthetic valves....

  18. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study

    National Research Council Canada - National Science Library

    Chen, Xi-Kuan; Wen, Shi Wu; Fleming, Nathalie; Demissie, Kitaw; Rhoads, George G; Walker, Mark

    2007-01-01

    Background Whether the association between teenage pregnancy and adverse birth outcomes could be explained by deleterious social environment, inadequate prenatal care, or biological immaturity remains controversial...

  19. Remaining Useful Lifetime (RUL - Probabilistic Predictive Model

    Directory of Open Access Journals (Sweden)

    Ephraim Suhir

    2011-01-01

    Full Text Available Reliability evaluations and assurances cannot be delayed until the device (system is fabricated and put into operation. Reliability of an electronic product should be conceived at the early stages of its design; implemented during manufacturing; evaluated (considering customer requirements and the existing specifications, by electrical, optical and mechanical measurements and testing; checked (screened during manufacturing (fabrication; and, if necessary and appropriate, maintained in the field during the product’s operation Simple and physically meaningful probabilistic predictive model is suggested for the evaluation of the remaining useful lifetime (RUL of an electronic device (system after an appreciable deviation from its normal operation conditions has been detected, and the increase in the failure rate and the change in the configuration of the wear-out portion of the bathtub has been assessed. The general concepts are illustrated by numerical examples. The model can be employed, along with other PHM forecasting and interfering tools and means, to evaluate and to maintain the high level of the reliability (probability of non-failure of a device (system at the operation stage of its lifetime.

  20. The Human Remains from HMS Pandora

    Directory of Open Access Journals (Sweden)

    D.P. Steptoe

    2002-04-01

    Full Text Available In 1977 the wreck of HMS Pandora (the ship that was sent to re-capture the Bounty mutineers was discovered off the north coast of Queensland. Since 1983, the Queensland Museum Maritime Archaeology section has carried out systematic excavation of the wreck. During the years 1986 and 1995-1998, more than 200 human bone and bone fragments were recovered. Osteological investigation revealed that this material represented three males. Their ages were estimated at approximately 17 +/-2 years, 22 +/-3 years and 28 +/-4 years, with statures of 168 +/-4cm, 167 +/-4cm, and 166cm +/-3cm respectively. All three individuals were probably Caucasian, although precise determination of ethnicity was not possible. In addition to poor dental hygiene, signs of chronic diseases suggestive of rickets and syphilis were observed. Evidence of spina bifida was seen on one of the skeletons, as were other skeletal anomalies. Various taphonomic processes affecting the remains were also observed and described. Compact bone was observed under the scanning electron microscope and found to be structurally coherent. Profiles of the three skeletons were compared with historical information about the 35 men lost with the ship, but no precise identification could be made. The investigation did not reveal the cause of death. Further research, such as DNA analysis, is being carried out at the time of publication.

  1. Smart Point Cloud: Definition and Remaining Challenges

    Science.gov (United States)

    Poux, F.; Hallot, P.; Neuville, R.; Billen, R.

    2016-10-01

    Dealing with coloured point cloud acquired from terrestrial laser scanner, this paper identifies remaining challenges for a new data structure: the smart point cloud. This concept arises with the statement that massive and discretized spatial information from active remote sensing technology is often underused due to data mining limitations. The generalisation of point cloud data associated with the heterogeneity and temporality of such datasets is the main issue regarding structure, segmentation, classification, and interaction for an immediate understanding. We propose to use both point cloud properties and human knowledge through machine learning to rapidly extract pertinent information, using user-centered information (smart data) rather than raw data. A review of feature detection, machine learning frameworks and database systems indexed both for mining queries and data visualisation is studied. Based on existing approaches, we propose a new 3-block flexible framework around device expertise, analytic expertise and domain base reflexion. This contribution serves as the first step for the realisation of a comprehensive smart point cloud data structure.

  2. SMART POINT CLOUD: DEFINITION AND REMAINING CHALLENGES

    Directory of Open Access Journals (Sweden)

    F. Poux

    2016-10-01

    Full Text Available Dealing with coloured point cloud acquired from terrestrial laser scanner, this paper identifies remaining challenges for a new data structure: the smart point cloud. This concept arises with the statement that massive and discretized spatial information from active remote sensing technology is often underused due to data mining limitations. The generalisation of point cloud data associated with the heterogeneity and temporality of such datasets is the main issue regarding structure, segmentation, classification, and interaction for an immediate understanding. We propose to use both point cloud properties and human knowledge through machine learning to rapidly extract pertinent information, using user-centered information (smart data rather than raw data. A review of feature detection, machine learning frameworks and database systems indexed both for mining queries and data visualisation is studied. Based on existing approaches, we propose a new 3-block flexible framework around device expertise, analytic expertise and domain base reflexion. This contribution serves as the first step for the realisation of a comprehensive smart point cloud data structure.

  3. Turbidite plays` immaturity means big potential remains

    Energy Technology Data Exchange (ETDEWEB)

    Pettingill, H.S. [Repsol Exploracion SA, Madrid (Spain)

    1998-10-05

    The international exploration and production industry is increasingly focusing on deepwater plays. Turbidites are not the only reservoir type that occurs in deepwater frontiers, but they are the primary reservoir type of those plays. A worldwide data base assembled from published information on 925 fields and discoveries with deepwater clastic reservoirs (turbidites sensu lato) has been employed to investigate the large-scale exploration and production trends. Coverage of the Former Soviet Union, China, and the Indian subcontinent has been minor, but with the large data base of fields and discoveries from the rest of the world, the broad conclusions should remain valid. This article describes the global turbidite play in terms of: (1) basins of the world where turbidite fields have been discovered; (2) the five largest basins in terms of total discovered resources; and (3) a summary of trap type, which is a critical geological factor in turbidite fields. The second article will summarize a population of the world`s 43 largest turbidite fields and discoveries.

  4. The impact of psychological distress during pregnancy on the developing fetus: biological mechanisms and the potential benefits of mindfulness interventions.

    Science.gov (United States)

    Isgut, Monica; Smith, Alicia K; Reimann, Eduardo Schuch; Kucuk, Omer; Ryan, Joanne

    2017-01-31

    The in utero environment plays an essential role in shaping future growth and development. Psychological distress during pregnancy has been shown to perturb the delicate physiological milieu of pregnancy, and has been associated with negative repercussions in the offspring, including adverse birth outcomes, long-term defects in cognitive development, behavioral problems during childhood and high baseline levels of stress-related hormones. Fetal epigenetic programming, involving epigenetic processes, may help explain the link between maternal prenatal stress and its negative effects on the child. Given the potential long-term effects of early-life stress on a child's health, it is crucial to minimize maternal distress during pregnancy. A number of recent studies have examined the usefulness of mindfulness-based programs to reduce prenatal psychological stress and improve maternal psychological health, and these are reviewed here. Overall, the findings are promising, but more research is needed with large studies using randomized controlled study designs. It remains unclear whether or not such interventions could also improve child health outcomes, and whether these changes are modulated at the epigenetic level during fetal development. Further studies in this area are needed.

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

    Science.gov (United States)

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

    2016-05-01

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

  6. A case of spontaneous tubal pregnancy with caesarean scar pregnancy.

    Science.gov (United States)

    Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang

    2014-01-01

    Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured.

  7. Nutrition and multifetal pregnancy.

    Science.gov (United States)

    Brown, J E; Carlson, M

    2000-03-01

    Largely because of assisted reproduction, the rate of multifetal pregnancy is rising rapidly in the United States. Accordingly, dietitians are increasingly being called upon to provide nutrition services for these high-risk pregnancies. This article gives an overview of the incidence of and risks associated with multifetal pregnancy and reviews studies that contribute to our knowledge of nutrition and multifetal pregnancy. Practice guidelines for promoting healthy outcomes based on the best available scientific data are suggested. Guidelines for weight gain for twin and triplet pregnancy, dietary intake, and supplement use are included. Suggested practice guidelines for multifetal pregnancy include a positive rate of weight gain early in pregnancy, the use of prepregnancy weight status to determine total weight gain goals in twin pregnancy, a 50-lb weight gain goal for triplet pregnancy, and higher minimal number of servings of foods from several of the Food Guide Pyramid groups. The need for additional information on the effects of nutritional status on the course and outcome of multifetal pregnancy is critical. Preliminary evidence of the benefits of nutrition services suggests that both the incorporation of dietetics services into care programs and additional research on nutrition and multifetal gestation are warranted.

  8. Remaining phosphorus estimated by pedotransfer function

    Directory of Open Access Journals (Sweden)

    Joice Cagliari

    2011-02-01

    Full Text Available Although the determination of remaining phosphorus (Prem is simple, accurate values could also be estimated with a pedotransfer function (PTF aiming at the additional use of soil analysis data and/or Prem replacement by an even simpler determination. The purpose of this paper was to develop a pedotransfer function to estimate Prem values of soils of the State of São Paulo based on properties with easier or routine laboratory determination. A pedotransfer function was developed by artificial neural networks (ANN from a database of Prem values, pH values measured in 1 mol L-1 NaF solution (pH NaF and soil chemical and physical properties of samples collected during soil classification activities carried out in the State of São Paulo by the Agronomic Institute of Campinas (IAC. Furthermore, a pedotransfer function was developed by regressing Prem values against the same predictor variables of the ANN-based PTF. Results showed that Prem values can be calculated more accurately with the ANN-based pedotransfer function with the input variables pH NaF values along with the sum of exchangeable bases (SB and the exchangeable aluminum (Al3+ soil content. In addition, the accuracy of the Prem estimates by ANN-based PTF were more sensitive to increases in the experimental database size. Although the database used in this study was not comprehensive enough for the establishment of a definitive pedotrasnfer function for Prem estimation, results indicated the inclusion of Prem and pH NaF measurements among the soil testing evaluations as promising ind order to provide a greater database for the development of an ANN-based pedotransfer function for accurate Prem estimates from pH NaF, SB, and Al3+ values.

  9. Ghost Remains After Black Hole Eruption

    Science.gov (United States)

    2009-05-01

    NASA's Chandra X-ray Observatory has found a cosmic "ghost" lurking around a distant supermassive black hole. This is the first detection of such a high-energy apparition, and scientists think it is evidence of a huge eruption produced by the black hole. This discovery presents astronomers with a valuable opportunity to observe phenomena that occurred when the Universe was very young. The X-ray ghost, so-called because a diffuse X-ray source has remained after other radiation from the outburst has died away, is in the Chandra Deep Field-North, one of the deepest X-ray images ever taken. The source, a.k.a. HDF 130, is over 10 billion light years away and existed at a time 3 billion years after the Big Bang, when galaxies and black holes were forming at a high rate. "We'd seen this fuzzy object a few years ago, but didn't realize until now that we were seeing a ghost", said Andy Fabian of the Cambridge University in the United Kingdom. "It's not out there to haunt us, rather it's telling us something - in this case what was happening in this galaxy billions of year ago." Fabian and colleagues think the X-ray glow from HDF 130 is evidence for a powerful outburst from its central black hole in the form of jets of energetic particles traveling at almost the speed of light. When the eruption was ongoing, it produced prodigious amounts of radio and X-radiation, but after several million years, the radio signal faded from view as the electrons radiated away their energy. HDF 130 Chandra X-ray Image of HDF 130 However, less energetic electrons can still produce X-rays by interacting with the pervasive sea of photons remaining from the Big Bang - the cosmic background radiation. Collisions between these electrons and the background photons can impart enough energy to the photons to boost them into the X-ray energy band. This process produces an extended X-ray source that lasts for another 30 million years or so. "This ghost tells us about the black hole's eruption long after

  10. A Prospective Study of Doppler Velocimetry in Pregnancy-induced ...

    African Journals Online (AJOL)

    Mubeen

    Background: Pregnancy-induced hypertension (PIH) remains a great ... predicts most occurrences of early-onset preeclampsia ... the cause of previous caesarean section done, having ... Meconium staining of liquor during labor for which.

  11. Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Cohen, Jacqueline M; Beddaoui, Margaret; Kramer, Michael S; Platt, Robert W; Basso, Olga; Kahn, Susan R

    2015-01-01

    Oxidative stress in preeclampsia and small for gestational age (SGA) birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies. To conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA. We searched PubMed, Embase, and several other databases from 1970-2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids) during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD) across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression. We reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58) and SGA (n = 9), 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely. Small, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous observational studies measuring antioxidant levels

  12. Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jacqueline M Cohen

    Full Text Available Oxidative stress in preeclampsia and small for gestational age (SGA birth suggests antioxidant supplementation could prevent these conditions. However, it remains unclear whether maternal antioxidant levels are systematically lower in these pregnancies.To conduct a systematic review of the association between maternal antioxidant levels during pregnancy and preeclampsia or SGA.We searched PubMed, Embase, and several other databases from 1970-2013 for observational studies that measured maternal blood levels of non-enzymatic antioxidants (vitamins A, C, E, and carotenoids during pregnancy or within 72 hours of delivery. The entire review process was done in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale and additional questions. We pooled the standardized mean difference (SMD across studies, stratified by outcome and pregnancy trimester, and investigated heterogeneity using meta-regression.We reviewed 1,882 unique citations and 64 studies were included. Most studies were small with important risk of bias. Among studies that addressed preeclampsia (n = 58 and SGA (n = 9, 16% and 66%, respectively, measured levels prior to diagnosis. The SMDs for vitamins A, C, and E were significantly negative for overall preeclampsia, but not for mild or severe preeclampsia subtypes. Significant heterogeneity was observed in all meta-analyses and most could not be explained. Evidence for lower carotenoid antioxidants in preeclampsia and SGA was limited and inconclusive. Publication bias appears likely.Small, low-quality studies limit conclusions that can be drawn from the available literature. Observational studies inconsistently show that vitamins C and E or other antioxidants are lower in women who develop preeclampsia or SGA. Reverse causality remains a possible explanation for associations observed. New clinical trials are not warranted in light of this evidence; however, additional rigorous observational studies measuring antioxidant

  13. Common skin conditions during pregnancy.

    Science.gov (United States)

    Tunzi, Marc; Gray, Gary R

    2007-01-15

    Common skin conditions during pregnancy generally can be separated into three categories: hormone-related, preexisting, and pregnancy-specific. Normal hormone changes during pregnancy may cause benign skin conditions including striae gravidarum (stretch marks); hyperpigmentation (e.g., melasma); and hair, nail, and vascular changes. Preexisting skin conditions (e.g., atopic dermatitis, psoriasis, fungal infections, cutaneous tumors) may change during pregnancy. Pregnancy-specific skin conditions include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. Pruritic urticarial papules and plaques of pregnancy are the most common of these disorders. Most skin conditions resolve postpartum and only require symptomatic treatment. However, there are specific treatments for some conditions (e.g., melasma, intrahepatic cholestasis of pregnancy, impetigo herpetiformis, pruritic folliculitis of pregnancy). Antepartum surveillance is recommended for patients with intrahepatic cholestasis of pregnancy, impetigo herpetiformis, and pemphigoid gestationis.

  14. [Systemic lupus erythematosus and antiphospholipid syndrome: How to manage pregnancy?].

    Science.gov (United States)

    Guettrot-Imbert, G; Le Guern, V; Morel, N; Vauthier, D; Tsatsaris, V; Pannier, E; Piette, J-C; Costedoat-Chalumeau, N

    2015-03-01

    Pregnancy in systemic lupus erythematosus patients is a common situation that remains associated with higher maternal and fetal mortality/morbidity than in the general population. Complications include lupus flares, obstetrical complications (fetal loss, in utero growth retardation, prematurity) and neonatal lupus syndrome. The association with antiphospholipid antibodies or antiphospholipid syndrome increases the risk of obstetrical complications. Improving the care of these pregnancies depends upon a systematic pregnancy planning, ideally during a preconception counseling visit and a multidisciplinary approach (internist/rheumatologist, obstetrician and anesthetist). The absence of lupus activity, the use of appropriate medications during pregnancy adjusted to the patient's medical history and risk factors, and a regular monitoring are the best tools for a favorable outcome for these high-risk pregnancies. The aim of this review article is to perform an update on the medical care of pregnancy in systemic lupus erythematosus or antiphospholipid syndrome to reduce the risk of complications and to ensure the best maternal and fetal prognosis.

  15. Psychological stress during pregnancy and stillbirth: prospective study

    DEFF Research Database (Denmark)

    Wisborg, K.; Barklin, A.; Hedegaard, M.

    2008-01-01

    ) in the population studied. Compared with women with an intermediate level of psychological stress during pregnancy, women with a high level of stress had 80% increased risk of stillbirth (relative risk = 1.8; 95% CI 1.1-3.2). Adjustment for maternal age, parity, maternal pre-pregnancy body mass index, smoking......OBJECTIVE: To study the association between psychological stress during pregnancy and stillbirth. DESIGN: Prospective follow-up study. SETTING: Aarhus University Hospital, Skejby, Denmark,1989-98. POPULATION: A total of 19 282 singleton pregnancies in women with valid information about...... habits, alcohol and caffeine intake during pregnancy, education and cohabitation failed to change the result. The results remained essentially unchanged after exclusion of preterm deliveries. Exclusion of women with complications during pregnancy such as diabetes, hypertension, vaginal bleeding...

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

    OpenAIRE

    Christine Sävervall; Freja Lærke Sand; Simon Francis Thomsen

    2015-01-01

    Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.

  17. Heterotopic pregnancy in HIV women.

    Science.gov (United States)

    Savasi, Valeria; Antonazzo, Patrizio; Personeni, Carlo

    2016-01-01

    Heterotopic pregnancy occurs when intrauterine and ectopic pregnancy are concomitant; overall rate rises from 1/30.000 to 1.5/1000 in assisted reproductive technology pregnancies. HIV (human immunodeficiency virus) patients are at increased risk of heterotopic pregnancies due to the greater frequency of assisted reproductive technology and pelvic inflammatory disease. We report the first case of heterotopic pregnancy in HIV woman.

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

    Science.gov (United States)

    Sävervall, Christine; Sand, Freja Lærke; Thomsen, Simon Francis

    2015-01-01

    Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy. PMID:26609305

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

    Directory of Open Access Journals (Sweden)

    Christine Sävervall

    2015-01-01

    Full Text Available Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy.

  20. Dermatological Diseases Associated with Pregnancy

    DEFF Research Database (Denmark)

    Sävervall, Christine; Sand, Freja Lærke; Thomsen, Simon Francis

    2015-01-01

    Dermatoses unique to pregnancy are important to recognize for the clinician as they carry considerable morbidity for pregnant mothers and in some instances constitute a risk to the fetus. These diseases include pemphigoid gestationis, polymorphic eruption of pregnancy, intrahepatic cholestasis...... of pregnancy, and atopic eruption of pregnancy. This review discusses the pathogenesis, clinical importance, and management of the dermatoses of pregnancy....

  1. Liver abnormalities in pregnancy.

    Science.gov (United States)

    Than, Nwe Ni; Neuberger, James

    2013-08-01

    Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Hormones in pregnancy

    Directory of Open Access Journals (Sweden)

    Pratap Kumar

    2012-01-01

    Full Text Available The endocrinology of human pregnancy involves endocrine and metabolic changes that result from physiological alterations at the boundary between mother and fetus. Progesterone and oestrogen have a great role along with other hormones. The controversies of use of progestogen and others are discussed in this chapter. Progesterone has been shown to stimulate the secretion of Th2 and reduces the secretion of Th1 cytokines which maintains pregnancy. Supportive care in early pregnancy is associated with a significant beneficial effect on pregnancy outcome. Prophylactic hormonal supplementation can be recommended for all assisted reproduction techniques cycles. Preterm labor can be prevented by the use of progestogen. The route of administration plays an important role in the drug′s safety and efficacy profile in different trimesters of pregnancy. Thyroid disorders have a great impact on pregnancy outcome and needs to be monitored and treated accordingly. Method of locating review: Pubmed, scopus

  3. Melanoma during pregnancy

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  4. Pregnancy and Eye

    Directory of Open Access Journals (Sweden)

    Anubhav Chauhan

    2016-03-01

    Full Text Available Visual obscurations are common during pregnancy. The ocular effects of pregnancy may be physiological,pathological or may be modifications of pre-existing conditions. While most of the described changes are transient in nature, others extend beyond delivery and may lead to permanent visual impairment. Also, pregnancy can affect vision through systemic disease that are either specific to the pregnancy itself or systemic diseases that occur more frequently in relation to pregnancy. Neuro-ophthalmological disorders should be kept in mind in pregnant women presenting with visual acuity or field loss. Therefore, it is important to be aware of the ocular changes in pregnancy in order to counsel and advice women who currently are, or are planning to become pregnant. [Archives Medical Review Journal 2016; 25(1.000: 1-13

  5. [Pregnancy in Gaucher disease].

    Science.gov (United States)

    Boufettal, H; Quessar, A; Jeddaoui, Z; Mahdoui, S; Noun, M; Hermas, S; Samouh, N

    2014-05-01

    Gaucher disease is a lysosomal storage disorder due to deficiency of glucocerebrosidase. The association with pregnancy exposes the worsening of the disease and complications of pregnancy and puerperium. We report a case of pregnancy in a woman of 35 years, suffering from Gaucher disease type 1. Pregnancy had a favorable outcome. Complications occurred. They were kept under control. The outcome was favorable. The authors discuss the evolution of the disease during pregnancy and management of complications. They can occur during pregnancy, post-partum and breastfeeding. Support begins with preconception consultation. It involves finding and correcting the biological problems and deficiencies, and management of complications. Genetic counseling is important, it helps prevent inbreeding. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. Prolonged uterine artery nitric oxide synthase inhibition modestly alters basal uteroplacental vasodilation in the last third of ovine pregnancy.

    Science.gov (United States)

    Rosenfeld, Charles R; Roy, Timothy

    2014-10-15

    Mechanisms regulating uteroplacental blood flow (UPBF) in pregnancy remain unclear, but they likely involve several integrated signaling systems. Endothelium-derived nitric oxide (NO) is considered an important contributor, but the extent of its involvement is unclear. Bolus intra-arterial infusions of nitro-l-arginine methyl ester (l-NAME) modestly decrease ovine basal UPBF; however, the doses and duration of infusion may have been insufficient. We, therefore, examined prolonged uterine artery (UA) NO synthase inhibition with l-NAME throughout the last third of ovine pregnancy by performing either continuous 30-min UA infusion dose responses (n = 4) or 72-h UA infusions (0.01 mg/ml) at 104-108, 118-125, and 131-137 days of gestation (n = 7) while monitoring mean arterial pressure (MAP), heart rate (HR), and UPBF. Uteroplacental vascular resistance (UPVR) was calculated, and uterine cGMP synthesis was measured. Thirty-minute UA l-NAME infusions did not dose dependently decrease UPBF, increase UPVR, or decrease uterine cGMP synthesis (P > 0.1); however, MAP rose and HR fell modestly. Prolonged continuous 72-h UA l-NAME infusions decreased UPBF ∼32%, increased UPVR ∼68% (P ≤ 0.001), and decreased uterine cGMP synthesis 70% at 54-72 h (P ≤ 0.004); the noninfused uterine horn was unaffected. These findings were associated with ∼10% increases in MAP and decreases in HR that were greater at 104-108 than 118-125 and 131-137 days of gestation (P = 0.006). Although uterine and UA NO and cGMP synthesis increase severalfold during ovine pregnancy, they contribute modestly to the maintenance and rise in UPBF in the last third of gestation. Thus, local UA NO may primarily modulate vasoconstrictor responses. Notably, the systemic vasculature appears more sensitive than the uterine vasculature to NO synthase inhibition.

  7. Uterine torsion in term pregnancy

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Introduction Uterine torsion has been defined as a rotation of more than 45 degrees of the uterus around its long axis that occurs at the junction between the cervix and the corpus. The extent of the rotation is usually 180 degrees, although cases with torsion from 60 to 720 degrees have been reported. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important for reducing maternal and fetal morbidity and mortality. Clinical symptoms are either absent or nonspecific, and the diagnosis is usually made at laparotomy. Case outlineA 31-year old patient was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, as an emergency, seven days upon the established intrauterine fetal demise in the 40th gestation week. On uterine examination, the cervical length of 1.5 cm and dilatation of 3 cm were determined, as well as a palpable soft tissue formation, not resembling placenta praevia. Ultrasound examination confirmed fetal demise and exclusion of the presence of placenta praevia. The labor was completed by caesarean section. During surgery, uterine torsion of 180 degrees to the right was diagnosed. There was a stillborn male baby, and the cause of death was intrauterine asphyxia. A fibrosing and calcified accessory lobe 9x6x2.5 cm in size was observed on placental examination, which is a possible sign of initial gemellary pregnancy. Conclusion The clinical presentation of uterine torsion is variable and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. The method of choice for establishing the diagnosis is magnetic resonance imaging. Once the diagnosis of uterine torsion in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to surgically remove all the anatomical causes of torsion, and rotate the uterus back to its normal position. There are some

  8. Exercise in Pregnancy

    OpenAIRE

    2015-01-01

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

  9. [Rheumatic diseases in pregnancy].

    Science.gov (United States)

    Märker-Hermann, E; Bauer, H; Gromnica-Ihle, E

    2008-11-01

    Rheumatic diseases can influence the reproduction, the course of pregnancy and the development of the fetus. The inflammatory rheumatic disease itself can be modulated in its activity in terms of amelioration or exacerbation of the rheumatic symptoms. The associations between rheumatic diseases and pregnancy will be illustrated with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and systemic lupus erythematosus as examples. Antirheumatic drug therapy during pregnancy and the breast feeding period has to be adapted critically.

  10. 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...

  11. 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.

  12. Impact of pregnancy on underlying renal disease.

    Science.gov (United States)

    Baylis, Chris

    2003-01-01

    Normal pregnancy involves marked renal vasodilation and large increases in glomerular filtration rate (GFR). Studies in rats reveal that the gestational renal vasodilation is achieved by parallel reductions in tone in afferent and efferent arterioles so GFR rises without a change in glomerular blood pressure. There is some evidence from animal studies that increased renal generation of nitric oxide (NO) may be involved. Although chronic renal vasodilation has been implicated in causing progression of renal disease in nonpregnant states by glomerular hypertension, there are no long-term deleterious effects of pregnancies on the kidney when maternal renal function is normal because glomerular blood pressure remains normal. When maternal renal function is compromised before conception, there are no long-term adverse effects on renal function in most types of renal disease, providing that the GFR is well maintained before conception. When serum creatinine exceeds approximately 1.4 mg/dL, pregnancy may accelerate the renal disease increases and when serum creatinine >2 mg/dL, the chances are greater than 1 in 3 that pregnancy will hasten the progression of the renal disease. The available animal studies suggest that glomerular hypertension does not occur despite diverse injuries. Thus, the mechanisms of the adverse interaction between pregnancy and underlying renal disease remain unknown.

  13. Mitral Valve Prolapse in Pregnancy

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    Full Text Available Abstract Mitral valve prolapse is a benign condition. Mitral regurgitation is only complicated in patients with severe mitral valve prolapse. Women with mitral valve prolapse in the absence of other cardiovascular disorders tolerate pregnancy well and do not develop remarkable cardiac complications. Nevertheless, serious complications of mitral valve prolapse, including arrhythmia, infective endocarditis and cerebral ischemic events, can be present in pregnancy. Debates remain with regard to the use of prophylactic antibiotics and β-blockers in the pregnant women with mitral valve prolapse. The prognosis of the pregnant patients might be closely related to the pathological and (or functional changes of the mitral valve. Non-myxomatous mitral valve prolapse poses no or little obstetric risks in terms of pregnancy, labor and neonatal complications; whereas myxomatous mitral valve prolapse is a major etiology of valvular heart disease in women of childbearing age. In the pregnant patients with mitral valve prolapse progressing into major complications, surgical interventions are considered. Medicinal treatment of such patients with β-blockers should be a concern for the fetal safety.

  14. Antiepileptic drugs and pregnancy outcomes.

    Science.gov (United States)

    Wlodarczyk, Bogdan J; Palacios, Ana M; George, Timothy M; Finnell, Richard H

    2012-08-01

    The treatment of epilepsy in women of reproductive age remains a clinical challenge. While most women with epilepsy (WWE) require anticonvulsant drugs for adequate control of their seizures, the teratogenicity associated with some antiepileptic drugs (AEDs) is a risk that needs to be carefully addressed. Antiepileptic medications are also used to treat an ever broadening range of medical conditions such as bipolar disorder, migraine prophylaxis, cancer, and neuropathic pain. Despite the fact that the majority of pregnancies of WWE who are receiving pharmacological treatment are normal, studies have demonstrated that the risk of having a pregnancy complicated by a major congenital malformation is doubled when comparing the risk of untreated pregnancies. Furthermore, when AEDs are used in polytherapy regimens, the risk is tripled, especially when valproic acid (VPA) is included. However, it should be noted that the risks are specific for each anticonvulsant drug. Some investigations have suggested that the risk of teratogenicity is increased in a dose-dependent manner. More recent studies have reported that in utero exposure to AEDs can have detrimental effects on the cognitive functions and language skills in later stages of life. In fact, the FDA just issued a safety announcement on the impact of VPA on cognition (Safety Announcement 6-30-2011). The purpose of this document is to review the most commonly used compounds in the treatment of WWE, and to provide information on the latest experimental and human epidemiological studies of the effects of AEDs in the exposed embryos.

  15. Pregnancy and Lupus Nephritis.

    Science.gov (United States)

    Kattah, Andrea G; Garovic, Vesna D

    2015-09-01

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

  16. Pregnancy and melanoma.

    Science.gov (United States)

    Driscoll, Marcia S; Martires, Kathryn; Bieber, Amy Kalowitz; Pomeranz, Miriam Keltz; Grant-Kels, Jane M; Stein, Jennifer A

    2016-10-01

    Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma. The impact of hormonal changes during pregnancy and from iatrogenic hormones on melanoma is controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. In addition, hormone receptors are found on some melanomas. In spite of these observations, the preponderance of evidence does not support a poorer prognosis for pregnancy-associated melanomas. There is also a lack of evidence that oral contraceptives or hormone replacement therapy worsens melanoma prognosis.

  17. Pregnancy and Rheumatic Disease

    Science.gov (United States)

    ... diseases vary by condition. Rheumatoid arthritis (RA) , systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) typically are modified by pregnancy. For example, RA symptoms often improve in pregnant ...

  18. Intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Williamson, Catherine; Geenes, Victoria

    2014-07-01

    Intrahepatic cholestasis of pregnancy is the most common pregnancy-specific liver disease that typically presents in the third trimester. The clinical features are maternal pruritus in the absence of a rash and deranged liver function tests, including raised serum bile acids. Intrahepatic cholestasis of pregnancy is associated with an increased risk of adverse perinatal outcomes, including spontaneous preterm delivery, meconium staining of the amniotic fluid, and stillbirth. It is commonly treated with ursodeoxycholic acid. There is accumulating evidence to suggest that intrahepatic cholestasis of pregnancy has a lasting influence on both maternal and fetal health. We review the etiology, diagnosis, and management of this intriguing condition.

  19. Pregnancy following bilateral salpingectomy

    DEFF Research Database (Denmark)

    Oturai, Annette Bang

    2008-01-01

    This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

  20. Neuromuscular disorders in pregnancy.

    Science.gov (United States)

    Guidon, Amanda C; Massey, E Wayne

    2012-08-01

    Preexisting and coincident neuromuscular disorders in pregnancy are challenging for clinicians because of the heterogeneity of disease and the limited data in the literature. Many questions arise regarding the effect of disease on the pregnancy, delivery, and newborn in addition to the effect of pregnancy on the course of disease. Each disorder has particular considerations and possible complications. An interdisciplinary team of physicians is essential. This article discusses the most recent literature on neuromuscular disorders in pregnancy including acquired root, plexus, and peripheral nerve lesions; acquired and inherited neuropathies and myopathies; disorders of the neuromuscular junction; and motor neuron diseases.

  1. 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.

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

    OpenAIRE

    Yi Wang; Fan Yu; Li-Qin Zeng

    2015-01-01

    Ectopic pregnancy is commonly located in the fallopian tube. Nevertheless, two unusual types of ectopic pregnancy, intramural pregnancy and rudimentary horn pregnancy, seriously threaten maternal life. The diagnosis and treatment of these unusual implantation sites present a clinical challenge. In this study, we illustrated the two unusual types of ectopic pregnancy and summarized the current data regarding diagnosis and optimal treatment from our experience.

  3. Factors Associated with Young Adults’ Pregnancy Likelihood

    Science.gov (United States)

    Kitsantas, Panagiota; Lindley, Lisa L.; Wu, Huichuan

    2014-01-01

    OBJECTIVES While progress has been made to reduce adolescent pregnancies in the United States, rates of unplanned pregnancy among young adults (18–29 years) remain high. In this study, we assessed factors associated with perceived likelihood of pregnancy (likelihood of getting pregnant/getting partner pregnant in the next year) among sexually experienced young adults who were not trying to get pregnant and had ever used contraceptives. METHODS We conducted a secondary analysis of 660 young adults, 18–29 years old in the United States, from the cross-sectional National Survey of Reproductive and Contraceptive Knowledge. Logistic regression and classification tree analyses were conducted to generate profiles of young adults most likely to report anticipating a pregnancy in the next year. RESULTS Nearly one-third (32%) of young adults indicated they believed they had at least some likelihood of becoming pregnant in the next year. Young adults who believed that avoiding pregnancy was not very important were most likely to report pregnancy likelihood (odds ratio [OR], 5.21; 95% CI, 2.80–9.69), as were young adults for whom avoiding a pregnancy was important but not satisfied with their current contraceptive method (OR, 3.93; 95% CI, 1.67–9.24), attended religious services frequently (OR, 3.0; 95% CI, 1.52–5.94), were uninsured (OR, 2.63; 95% CI, 1.31–5.26), and were likely to have unprotected sex in the next three months (OR, 1.77; 95% CI, 1.04–3.01). DISCUSSION These results may help guide future research and the development of pregnancy prevention interventions targeting sexually experienced young adults. PMID:25782849

  4. The kidney in pregnancy: A journey of three decades.

    Science.gov (United States)

    Prakash, J

    2012-05-01

    The spectrum of kidney disease occurring during pregnancy includes preeclampsia, hypertensive disorders of pregnancy, urinary tract infection, acute kidney injury, and renal cortical necrosis (RCN). Preeclampsia affects approximately 3-5% of pregnancies. We observed preeclampsia in 5.8% of pregnancies, and 2.38% of our preeclamptic women developed eclampsia. Severe preeclampsia and the eclampsia or hemolysis, elevated liver enzymes levels, and low platelets count (HELLP) syndrome accounted for about 40% of cases of acute kidney injury (AKI) in pregnancy. Preeclampsia/eclampsia was the cause of acute renal failure (ARF) in 38.3% of the cases. Preeclampsia was the most common (91.7%) cause of hypertension during pregnancy, and chronic hypertension was present in 8.3% of patients. We observed urinary tract infection (UTI) in 9% of pregnancies. Sepsis resulting from pyelonephritis can progress to endotoxic shock, disseminated intravascular coagulation, and AKI. The incidence of premature delivery and low birth weight is higher in women with UTI. The incidence of AKI in pregnancy with respect to total ARF cases has decreased over the last 30 years from 25% in 1980s to 5% in 2000s. Septic abortion-related ARF decreased from 9% to 3%. Prevention of unwanted pregnancy and avoidance of septic abortion are key to eliminate abortion-associated ARF in early pregnancy. The two most common causes of ARF in third trimester and postpartum periods were puerperal sepsis and preeclampsia/HELLP syndrome. Pregnancy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome and acute fatty liver of pregnancy were rare causes of ARF. Despite decreasing incidence, AKI remains a serious complication during pregnancy.

  5. 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...

  6. Depression During and After Pregnancy

    Science.gov (United States)

    ... Depression during and after pregnancy fact sheet ePublications Depression during and after pregnancy fact sheet This information in Spanish (en español) Print this fact sheet Depression during and after pregnancy fact sheet (PDF, 260 ...

  7. The Flu Vaccine and Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG The Flu Vaccine and Pregnancy Home For Patients Search FAQs The ... Pamphlets - Spanish FAQ189, October 2015 PDF Format The Flu Vaccine and Pregnancy Pregnancy What is influenza (the flu)? ...

  8. Understanding Pregnancy and Birth Issues

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table ... turn Javascript on. What is a High-Risk Pregnancy? All pregnancies involve a certain degree of risk ...

  9. A Partner's Guide to Pregnancy

    Science.gov (United States)

    ... For Patients About ACOG A Partner's Guide to Pregnancy Home For Patients Search FAQs A Partner's Guide ... May 2016 PDF Format A Partner's Guide to Pregnancy Pregnancy Why is it important to be supportive ...

  10. 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

  11. The role of cytokines in first trimester pregnancy losses with fetal chromosomal anomaly.

    Science.gov (United States)

    Kasap, Esin; Karaarslan, Serap; Gene, Mine; Gur, Esra B; Sahin, Nur; Guclu, Serkan

    2015-11-01

    The contribution of local inflammation to the pathophysiology of abnormal choromosomally miscarriages remains unclear The objective of this study was to investigate the inflammatory response at the maternofetal interface of women presenting with first trimester miscarriage with abnormal choromosomally Level of TNF-α , IL-6 ve IL-17 were asseyed using immunohistochemistry technique at decidual and placental bed biopsy samples from 23 women with elective termination of pregnancy 21 euploid and 18 aneuploid missed miscarriages. Immunostainig for TNF-α, IL-6 ve IL-17 has been evaluated semi-quantitatively by 'quickscore' method. We found that the intensity of TNF-α staining was high in the miscarriage group, and this has been found in previous studies. Unlike some previous studies, the intensity of IL-6 staining was higher in the miscarriage groups only in decidual glandular epithelium. The intensity of IL-6 staining was found to be higher in the miscarriage group with chromosome anomaly than in the miscarriage group without chromosome anomaly. There was no significant difference in IL-17 levels between any of the groups. Cytokines are considered to play an important role in the maintenance of pregnancy but the exact mechanism between them and the mutual regulation relationship were not been fully understood, which need our further study.

  12. Smoking and Pregnancy

    Science.gov (United States)

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

  13. Pregnancy After Age 35

    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. Signs of ... to decide if they’re right for you. If you’re older than 35, ...

  14. 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 ...

  15. Intrahepatic cholestasis in pregnancy

    Directory of Open Access Journals (Sweden)

    Savić Ž.

    2014-01-01

    Full Text Available Abnormal liver function tests occur in 3-5% of pregnancies, with many potential causes, including coincidental liver disease (most commonly viral hepatitis or gallstones and underlying chronic liver disease. Pruritus in pregnancy is common, affecting 23% of pregnancies, of which a small proportion will have obstetric cholestasis. Intrahepatic cholestasis of pregnancy (ICP is a cholestatic disorder characterized by pruritus with onset in the second or third trimester of pregnancy, elevated serum aminotransferases and bile acid levels, and spontaneous relief of signs and symptoms within two to three weeks after delivery. ICP is observed in 0.4-1% of pregnancies in most areas of Central and Western Europe and North America. Genetic and hormonal factors, but also environmental factors may contribute to the pathogenesis of ICP. Intrahepatic cholestasis of pregnancy increases the risk of preterm delivery (19­60%, meconium staining of amniotic fluid (27%, fetal bradycardia (14%, fetal distress (22-41%, and fetal loss (0.4-4.1%, particularly when associated with fasting serum bile acid levels >40 μmol/L. Important ICP-induced changes in serum profiles of amidated bile acids were observed, involving both a marked increase in cholic acid concentration and a shift towards a higher proportion of taurine-conjugated species. Ursodeoxycholic acid (10-20 mg/kg/d is today regarded as the first line treatment for intrahepatic cholestasis of pregnancy. Delivery has been recommended in the 37-38th week when lung maturity has been established.

  16. [Intact cervical pregnancy].

    Science.gov (United States)

    Habek, D; Bobic, M V; Dosen, L

    2003-01-01

    The authors describe a case of intact cervical pregnancy in a 24-year-old secundigravida. The patient was treated successfully with Methotrexate. Conservative treatment is the first choice in the therapy of uncomplicated cervical pregnancy. Conservative and operative therapeutic procedures are discussed.

  17. Diabetes and Pregnancy

    Science.gov (United States)

    ... worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy You are the most important member of the ... to see your dietitian every few months during pregnancy as your dietary needs ... relieve stress, strengthen your heart and bones, improve muscle strength, ...

  18. Asthma and Pregnancy

    Science.gov (United States)

    ... increase the risk for birth defects over that background risk. This information should not take the place of medical care ... RL, Murphy VE. 2015. Maternal complications and the management of asthma in pregnancy. Womens Health (Lond Engl);11(2):183-91. ... "When I called MotherToBaby looking for information on medication to use during pregnancy, I was ...

  19. Valproic Acid and Pregnancy

    Science.gov (United States)

    ... increase the risk for birth defects over that background risk. This information should not take the place of medical care ... 81(11):999-1003. Yonkers KA et al. Management of bipolar disorders during pregnancy and the postpartum period. Am J Psych 161:608-20. ... "When I called MotherToBaby looking for information on medication to use during pregnancy, I was ...

  20. Cancer in pregnancy

    DEFF Research Database (Denmark)

    Pedersen, Berit Woetmann; Storgaard, Lone; Clausen, Mette Borg

    2015-01-01

    Cancer in pregnancy occurs in about one in 1,000 pregnancies. Recent reports have shown that most treatment regimes in second and third trimester are safe for the mother and the child. This has led to a paradigm shift in treating pregnant women with cancer. The management of the pregnant woman...

  1. Pregnancy and Psychopathology

    NARCIS (Netherlands)

    Verbeek, Tjitte

    2016-01-01

    For a lot of people, because of the joy and happiness of a new life, pregnancy means being on cloud nine. The general population may not be aware that this does not apply to every woman. Psychopathology during and after pregnancy should not be underrated. For as much as 10-20% of all pregnant women,

  2. Planning for Pregnancy

    Science.gov (United States)

    ... this? Submit Button Information For... Media Policy Makers Planning for Pregnancy Language: English Español (Spanish) Recommend on ... it’s time to nurture and love yourself by planning and preparing your body for pregnancy. Follow some ...

  3. Pregnancy and pulmonary hypertension

    NARCIS (Netherlands)

    Pieper, Petronella G.; Lameijer, Heleen; Hoendermis, Elke S.

    2014-01-01

    Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension during pregnancy indicates a considerable decrease of mortality since a pre

  4. [Hypertension during pregnancy

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Johansen, M.; Kamper, A.L.;

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...... and disadvantages of different classes of antihypertensive drugs during pregnancy and lactation are described Udgivelsesdato: 2009/6/15...

  5. Sleeping during Pregnancy

    Science.gov (United States)

    ... your body. shortness of breath: The increase of pregnancy hormones will cause you to breathe in more deeply. ... to pains in your legs or back. During pregnancy, the body also makes a hormone called relaxin, which helps prepare it for childbirth. ...

  6. Cancer in pregnancy

    DEFF Research Database (Denmark)

    Pedersen, Berit Woetmann; Storgaard, Lone; Clausen, Mette Borg

    2015-01-01

    Cancer in pregnancy occurs in about one in 1,000 pregnancies. Recent reports have shown that most treatment regimes in second and third trimester are safe for the mother and the child. This has led to a paradigm shift in treating pregnant women with cancer. The management of the pregnant woman...

  7. Pregnancy nutrition surveillance system.

    Science.gov (United States)

    2003-01-01

    The Pregnancy Nutrition Surveillance System is a useful tool in monitoring Healthy People 2010 objectives and is intended to provide a framework for analyzing data on the nutritional status and behavioral risk factors of pregnant women and the association to birth outcome. The data are useful to health professionals in providing prenatal care and developing programs to reduce pregnancy-related health risks.

  8. Ciprofloxacin and Pregnancy

    Science.gov (United States)

    ... infections. It is part of a group of antibiotics called “quinolones or fluoroquinolones.” Is there an increased chance for miscarriage if ... al. 1998. Pregnancy outcome following gestational exposure to fluoroquinolones: a ... G, et al. 2006. Antibiotic use in pregnancy and lactation. Obstet Gynecol 107( ...

  9. Recurrent Gliosarcoma in Pregnancy

    OpenAIRE

    2014-01-01

    Gliosarcoma is a rare tumor of the central nervous system and it constitutes about 1 to 8% of all malignant gliomas. In this report we are presenting a recurrent gliosarcoma case during a pregnancy in a 30-year-old woman. This is the first report presenting gliosarcoma in the pregnancy.

  10. Physiological changes in pregnancy

    OpenAIRE

    SOMA-PILLAY, Priya; Catherine, Nelson-Piercy; Tolppanen, Heli; Mebazaa, Alexandre

    2016-01-01

    Abstract Physiological changes occur in pregnancy to nurture the developing foetus and prepare the mother for labour and delivery. Some of these changes influence normal biochemical values while others may mimic symptoms of medical disease. It is important to differentiate between normal physiological changes and disease pathology. This review highlights the important changes that take place during normal pregnancy.

  11. Skin Conditions during Pregnancy

    Science.gov (United States)

    ... appear on the skin during pregnancy? • What are stretch marks? • Is acne common during pregnancy? • How can I ... runs from the navel to the pubic hair • Stretch marks •Acne • Spider veins • Varicose veins • Changes in nail ...

  12. Venous thromboembolism and pregnancy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2010-03-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Giuseppe De Placido1Department of Obstetrics and Gynecology and Human Reproduction, “Federico II” University of Naples, Naples, Italy; 2Internal Medicine Division, Buonconsiglio Fatebenefratelli Hospital of Naples, Naples, ItalyAbstract: In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods.Keywords: thrombophilia, venous thromboembolism, recurrent pregnancy loss, factor V Leiden

  13. Hypertension in pregnancy.

    Science.gov (United States)

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

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

  14. Cancer in pregnancy

    DEFF Research Database (Denmark)

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

    2013-01-01

    OBJECTIVE: To evaluate physicians' attitudes and knowledge regarding the treatment possibilities for patients with cancer in pregnancy. STUDY DESIGN: A 30-item questionnaire was mailed electronically to physicians across Europe, who were potentially involved in care of pregnant patients and....../or cancer, using the membership directories of different professional societies. RESULTS: 142 surveys were eligible for analysis. A median of 2 (range 0-100) patients with cancer in pregnancy were treated per center in 2010. The vast majority of respondents (94%) agreed that management of pregnant patients......% of respondents. Univariate logistic regression analysis found a trend that non-academic hospitals prefer termination of pregnancy (odds ratio [OR]=0.68; 95% CI, 0.28-1.63; P=0.39), and also no treatment during pregnancy (OR=0.70; 95% CI, 0.33-1.50; P=0.36). CONCLUSION: Termination of pregnancy, delay of maternal...

  15. PREGNANCY AND THYROID

    Directory of Open Access Journals (Sweden)

    Simona Gaberšček

    2004-01-01

    Full Text Available Background. In conditions with appropriate iodine intake, thyroid gland adapts to changes during pregnancy without any consequences. Fetal need for thyroid hormones in the first trimester is directly connected with transplacental transport of thyroid hormones. Fetal synthesis of thyroid hormones depends on availability of iodine in the feto-placental unit. Hypo- and hyperthyroidism during pregnancy are risk factors for pregnant woman and for normal development of fetus and child.Conclusions. Pregnant women with appropriately treated thyroid diseases have the same outcome of pregnancy as healthy women, and neuroendocrinological development of children is not impaired. If the disease is unrecognized or untreated, complications of pregnancy and delivery occur more frequently. Therefore, timely recognition and treatment of the diseases with appropriate drugs during pregnancy and, also, after delivery is very important.

  16. Managing hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Laurberg, Peter

    2016-01-01

    -associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development...... of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management...... involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering...

  17. Thyroid diseases and pregnancy

    Directory of Open Access Journals (Sweden)

    Marco Grandi

    2013-05-01

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

  18. Telocytes in Pregnancy-Induced Physiological Liver Growth

    Directory of Open Access Journals (Sweden)

    Fei Wang

    2015-05-01

    Full Text Available Background/Aims: We previously documented the presence of Telocytes (TCs in liver and further indicated the potential roles of TCs in liver regeneration after hepatectomy. Pregnancy-induced liver growth, other than liver regeneration after hepatectomy, is a physiological hepatic adaption to meet the enhanced nutritional and metabolic demands. However, the possible roles of TCs in pregnancy-induced liver growth remain unknown. Methods: Pregnant mice were sacrificed at different time points (pregnancy day 0.5, 4.5, 8.5, 10.5, 12.5, 14.5, 16.5, and 18.5. The liver weight was used to evaluate the liver growth during pregnancy. Hepatocytes proliferation was determined by albumin and 5-ethynyl-2'- deoxyuridine (EdU double immunostaining while TCs were counted by double immunolabeling for CD34/PDGFR-α. Results: Pregnancy-induced liver growth was preceded by increased proliferation of hepatocytes at pregnancy day 4.5, 8.5, 14.5 and 16.5. Furthermore, the number of TCs in liver detected by double immunolabeling for CD34/PDGFR-α was significantly increased at pregnancy day 4.5 and day 14.5, that was coincident with the occurrence of two peaks of hepatic cell proliferation during pregnancy. Conclusion: Our results suggest a possible relationship between TCs and hepatocyte proliferation in pregnancy-induced liver growth.

  19. Pregnancy, maternal tobacco smoking and early age leukemia in Brazil

    Directory of Open Access Journals (Sweden)

    Sergio eKoifman

    2012-11-01

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

  20. Transient diabetes insipidus in pregnancy

    Science.gov (United States)

    Gunawardana, Kavinga; Grossman, Ashley

    2015-01-01

    Summary Gestational diabetes insipidus (DI) is a rare complication of pregnancy, usually developing in the third trimester and remitting spontaneously 4–6 weeks post-partum. It is mainly caused by excessive vasopressinase activity, an enzyme expressed by placental trophoblasts which metabolises arginine vasopressin (AVP). Its diagnosis is challenging, and the treatment requires desmopressin. A 38-year-old Chinese woman was referred in the 37th week of her first single-gestation due to polyuria, nocturia and polydipsia. She was known to have gestational diabetes mellitus diagnosed in the second trimester, well-controlled with diet. Her medical history was unremarkable. Physical examination demonstrated decreased skin turgor; her blood pressure was 102/63 mmHg, heart rate 78 beats/min and weight 53 kg (BMI 22.6 kg/m2). Laboratory data revealed low urine osmolality 89 mOsmol/kg (350–1000), serum osmolality 293 mOsmol/kg (278–295), serum sodium 144 mmol/l (135–145), potassium 4.1 mmol/l (3.5–5.0), urea 2.2 mmol/l (2.5–6.7), glucose 3.5 mmol/l and HbA1c 5.3%. Bilirubin, alanine transaminase, alkaline phosphatase and full blood count were normal. The patient was started on desmopressin with improvement in her symptoms, and normalisation of serum and urine osmolality (280 and 310 mOsmol/kg respectively). A fetus was delivered at the 39th week without major problems. After delivery, desmopressin was stopped and she had no further evidence of polyuria, polydipsia or nocturia. Her sodium, serum/urine osmolality at 12-weeks post-partum were normal. A pituitary magnetic resonance imaging (MRI) revealed the neurohypophyseal T1-bright spot situated ectopically, with a normal adenohypophysis and infundibulum. She remains clinically well, currently breastfeeding, and off all medication. This case illustrates some challenges in the diagnosis and management of transient gestational DI. Learning points Gestational DI is a rare complication of

  1. Chronic exposure to bisphenol a impairs progesterone receptor-mediated signaling in the uterus during early pregnancy

    Science.gov (United States)

    Li, Quanxi; Davila, Juanmahel; Bagchi, Milan K.; Bagchi, Indrani C.

    2016-01-01

    Environmental and occupational exposure to endocrine disrupting chemicals (EDCs) is a major threat to female reproductive health. Bisphenol A (BPA), an environmental toxicant that is commonly found in polycarbonate plastics and epoxy resins, has received much attention due to its estrogenic activity and high risk of chronic exposure in human. Whereas BPA has been linked to infertility and recurrent miscarriage in women, the impact of its exposure on uterine function during early pregnancy remains unclear. In a recent publication in Endocrinology, we demonstrated that prolonged exposure to an environmental relevant dose of BPA disrupts progesterone receptor-regulated uterine functions, thus affecting uterine receptivity for embryo implantation and decidua morphogenesis, two critical events for establishment and maintenance of early pregnancy. In particular we reported a marked impairment of progesterone receptor (PGR) expression and its downstream effector HAND2 in the uterine stromal cells in response to chronic BPA exposure. In an earlier study we have shown that HAND2 controls embryo implantation by repressing fibroblast growth factor (FGF) expression and the MAP kinase signaling pathway, thus inhibiting epithelial proliferation. Interestingly we observed that downregulation of PGR and HAND2 expression in uterine stroma upon BPA exposure was associated with an enhanced activation of FGFR and MAPK signaling, aberrant proliferation, and lack of uterine receptivity in the epithelium. In addition, the proliferation and differentiation of endometrial stromal cells to decidual cells, an event critical for the maintenance of early pregnancy, was severely compromised in response to BPA. This research highlight will provide an overview of our findings and discuss the potential mechanisms by which chronic BPA impairs PGR-HAND2 pathway and adversely affects implantation and the establishment of pregnancy.

  2. Pregnancy after Bariatric Surgery: A Review

    Directory of Open Access Journals (Sweden)

    N. L. Hezelgrave

    2011-01-01

    Full Text Available Maternal obesity is a major cause of obstetric morbidity and mortality. With surgical procedures to facilitate weight loss becoming more widely available and demanded and increasing number of women becoming pregnant after undergoing bariatric surgery, it is important and timely to consider the outcome of pregnancy following bariatric surgery. This paper aims to synthesize the current evidence regarding pregnancy outcomes after bariatric surgery. It concludes that bariatric surgery appears to have positive effects on fertility and reduces the risk of gestational diabetes and preeclampsia. Moreover, there appears to be a reduced incidence of fetal macrosomia post-bariatric procedure, although there remains uncertainty about the increased rates of small-for-gestational age and intrauterine growth restricted infants, as well as premature rupture of membranes in this group. A number of case reports highlight that pregnancy following bariatric surgery is not without complications and it must be managed as high risk by the multidisciplinary team.

  3. End-stage renal disease and pregnancy.

    Science.gov (United States)

    Nadeau-Fredette, Annie-Claire; Hladunewich, Michelle; Hui, Dini; Keunen, Johannes; Chan, Christopher T

    2013-05-01

    Pregnancy in patients with ESRD is rare and remains especially challenging. Because endocrine abnormalities and sexual dysfunction decrease fertility, conception rates have been remarkably low in this patient population. Moreover, when pregnancy does occur, hypertension, preeclampsia, anemia, intrauterine growth restriction, preterm delivery, stillbirth, and other complications can decrease the rate of a successful outcome. However, recent experiences with intensive hemodialysis managed by a multidisciplinary team are encouraging with respect to better overall outcomes for mothers and infants. In this article, we discuss the main causes of decreased fertility in dialysis-dependent women, review outcomes and complications of pregnancy among dialysis patients with a special focus on recent intensive hemodialysis data, and summarize the current best strategy to manage pregnant women on dialysis.

  4. 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.

  5. Pregnancy Precautions: FAQs on Pregnancy Hazards

    Science.gov (United States)

    ... Here a few tips to help keep household chemicals use safe during your pregnancy: Talk to your doctor about ... whitened and others say that the procedures are safe. The concern is mostly about the chemicals used in teeth whitening products that could be ...

  6. Decision making in hyperglycaemia seen in pregnancy

    Directory of Open Access Journals (Sweden)

    Kavitha Nagandla

    2014-01-01

    Full Text Available Delay in childbearing, family history of type 2 diabetes mellitus and obesity in childbearing years increases a possibility of glucose intolerance or overt diabetes in pregnancy which may remain unrecognised unless an oral glucose tolerance test is done. The International Association of Diabetes and Pregnancy Study Group (IADPSG, 2010 recommended the detection and diagnosis of hyperglycaemic disorders in pregnancy at two stages of pregnancy, the first stage looking for ‘overt diabetes’ in early pregnancy based on risk factors like age, past history of gestational diabetes and obesity and the second stage where ‘gestational diabetes’ at 24-28 weeks with 75 g oral glucose tolerance test. Although the one step approach with 75 g of glucose offers operational convenience in diagnosing gestational diabetes, there are concerns raised by the National Institute of Health in the recent consensus statement, supporting the two step approach (50-g, 1-hour loading test screening 100-g, 3-hour oral glucose tolerance test as the recommended approach for detecting gestational diabetes. Medical nutrition therapy (MNT with well-designed meal plan and appropriate exercise achieves normoglycemia without inducing ketonemia and weight loss in most pregnant women with glucose intolerance. Rapidly acting insulin analogues, such as insulin lispro and aspart are safe in pregnancy and improve postprandial glycemic control in women with pre-gestational diabetes. The long acting analogues (Insulin detemir and glargine though proven to be safe in pregnancy, do not confer added advantage if normoglycemia is achieved with intermediate insulin (NPH. Current evidence indicates the safe use of glyburide and metformin in the management of Type 2 diabetes and gestational diabetes as other options. However, it is prudent to communicate to the women that there is no data available on the long-term health of the offspring and the safety of these oral hypoglycemic drugs are

  7. Pregnancy: an immune challenge

    Directory of Open Access Journals (Sweden)

    Maria Angelica Ehara Watanabe

    2014-12-01

    Full Text Available Several studies demonstrate the importance of immunological aspects of pregnancy. During pregnancy, the embryo is implanted in the womb, where it will develop until the end of pregnancy. Amongst the immune aspects, the importance of the modulation of T lymphocytes, natural killers (NK cells and many cytokines in maternal organism can be mentioned. The maternal tolerance to the fetus appears to be mediated by specific maternal hormones and by the expression of human leukocyte antigen G (HLA-G - characteristic in pregnancy. Other studies suggest that fetal rejection and complications during pregnancy may occur because of the presence of minor histocompatibility antigens (mHAg, acquired by blood sharing of the mother with the fetus, and because of the presence of maternal antibodies against the sperm and against the fetus. The purpose of this review is to describe the immunological aspects that allow maternal tolerance to the fetus during pregnancy, as well as possible causes for rejection of the embryo and complications during pregnancy.

  8. Pregnancy and rheumatoid arthritis.

    Science.gov (United States)

    Ince-Askan, Hilal; Dolhain, Radboud J E M

    2015-01-01

    Fertility is impaired in female patients with rheumatoid arthritis (RA), which is related to disease activity and the use of certain medication. During pregnancy, disease activity usually improves, but less than previously thought. Especially in women with high disease activity, the pregnancy outcome is also impaired. All of this underscores the importance of strict control of disease activity in RA patients who wish to conceive. Management of RA disease activity during pregnancy might be a challenge as the treatment options are limited. Evidence is accumulating that tumor necrosis factor (TNF) blockers can be safely used during pregnancy, particularly during the first trimester and the beginning of the second trimester. Far less is known about the problems faced by male RA patients who wish to conceive, in terms of not only fertility and pregnancy outcome but also the safety of medication. In this paper, the fertility issues in patients with RA, the pregnancy-associated improvement of RA, the pregnancy outcomes, including the long-term effects on the offspring, and treatment options, including those during lactation and for male patients wishing to conceive, will be reviewed.

  9. Malaria in pregnancy.

    Science.gov (United States)

    Seal, Subrata Lall; Mukhopadhay, Sima; Ganguly, Rajendra Prasad

    2010-08-01

    Malaria during pregnancy is a recognised risk factor for maternal and foetal complications and it is endemic in certain areas of our country. Pregnancy also enhances the severity of malaria particularly with P falciparum infestation. The outcome of effects of malaria in pregnancy on the mother and foetus is studied here. This is a prospective observational study conducted in the department of obstetrics and gynaecology of RG Kar Medical College during the period from 1st January 2001 to 31st December 2006. Forty pregnant women with malaria in pregnancy were studied. Another 40 non- pregnant women during the same period were served as control. The maternal complications were compared with the controls and the outcome of pregnancy was studied. There was statistically significant (p renal failure, hepatic failure, hypoglycaemia, hypotension and death in the pregnant women in comparison to non-pregnant women. P falciparum infection was also more during pregnancy. There was also increased incidence of abqrtion, preterm labour, intra-uterine growth restriction and intra-uterine foetal death. Treatment with antimalarial drugs particularly in cerebral malaria does not give good results as there were 12 maternal deaths in this series. Every attempt should be made to prevent malaria during pregnancy by various measures as it is associated with high maternal morbidity and mortality and adversely affects the neonatal outcome.

  10. Smoking and pregnancy

    Directory of Open Access Journals (Sweden)

    Panagiotis Behrakis

    2010-01-01

    Full Text Available SUMMARY. Maternal smoking during pregnancy is considered to be one of the most significant causes of complications in pregnancy and is associated with an unfavourable outcome in childbirth compared with pregnancy in non-smokers. Specifically, smoking during pregnancy increases the likelihood of placenta praevia, abruptio placentae, ectopic gestation and premature rupture of the membranes (PRM. In addition, research has established that smoking during pregnancy increases the rates of low birth weight (LBW, perinatal mortality, premature birth and sudden infant death syndrome (SIDS. As these children grow up they present a variety of health problems, including respiratory illness, behaviour disturbances, attention deficit hyperactivity disorder (ADHD and high arterial blood pressure. LBW is also associated with an increased incidence of health problems in the neonatal period. Effects have been documented of maternal smoking during pregnancy on the future fertility of male infants and the occurrence of congenital abnormalities, and a connection has been reported between daily maternal smoking in early pregnancy and infantile autism. Pneumon 2010, 23(2:153-167.

  11. 高血糖对不良妊娠结局的影响%The impact of hyperglycemia on adverse pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    潘燕飞; 沈洁

    2012-01-01

    糖尿病合并妊娠、妊娠期糖尿病以及轻微妊娠高血糖均可引起不良妊娠结局的风险增加.并且,不良妊娠结局的发生及转归受血糖代谢异常的类型、严重程度、持续时间以及血糖水平等因素的影响.高血糖增加不良妊娠结局风险的机制仍不明确,有效的并发症预测因素仍需证实.此外,母婴并发症的血糖阈值存在很大争议.基于既往多为回顾性研究,因此需要大规模前瞻性研究去进一步探讨高血糖与不良妊娠结局的关系.%Diabetes mellitus with pregnancy,gestational diabetes mellims,as well as mild pregnant hyperglycemia could increase the risk of adverse pregnancy outcomes.And the incidence and prognosis of adverse pregnancy outcomes relate to the type,severity,duration of abnormal glucose metabolism,and the level of blood glucose,etc.The mechanism of hyperglycemia on the higher risk of adverse pregnancy outcomes remains unclear.Reliable predictors of complications need to be investigated.In addition,it is rather controversial to determine the blood glucose threshold for maternal and fetal complications.Due to the known results mostly deriving from retrospective studies,large-scale prospective studies are required to further explore the relationship of hyperglycemia and adverse pregnancy outcomes.

  12. FACTORS ASSOCIATED WITH PREGNANCY AMONG UNMARRIED WOMEN IN MALAYSIA.

    Science.gov (United States)

    Zain, Norhasmah Mohd; Low, Wah Yun; Othman, Sajaratulnisah

    2015-05-01

    Pregnancy among unmarried women may have negative social and health implications in Malaysia. The number of pregnancies among unmarried women has increased in Malaysia, but the socio-demographic profile of these women is unclear. This study aims to evaluate the characteristics of unmarried pregnant women and the factors associated with unmarried pregnancies among young women in Malaysia. We conducted a cross sectional study at six hospitals and six women's shelters in Peninsular Malaysia during 2011-2012. Unmarried pregnant women were compared with married pregnant women. Participants were interviewed using a structured questionnaire asking for socio-demographic data, family background, risky sexual behavior, social support and pregnancy details. A total of 484 women (239 unmarried and 245 married) were included in the study. Most unmarried subjects were adolescents, from urban areas, from a low socioeconomic group, and lived with parents prior to pregnancy. Age (OR=0.67; 95% CI: 0.61-0.74), studying status (OR=17.33; 95% CI: 2.65-113.19), alcohol use (OR=40.46; 95% CI: 2.51-652.38) exposure to pornographic material (OR=13.48; 95% CI: 3.24-56.01), contraceptive use (OR=0.20; 95% CI: 0.08-0.51), and social support (OR=0.90; 95% CI: 0.86-0.94) were all associated with unmarried pregnancy. These factors need to be considered when.designing an intervention program.

  13. 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.

  14. Pregnancy Intentions and Teenage Pregnancy Among Latinas: A Mediation Analysis

    Science.gov (United States)

    Rocca, Corinne H.; Doherty, Irene; Padian, Nancy S.; Hubbard, Alan E.; Minnis, Alexandra M.

    2010-01-01

    CONTEXT The extent to which pregnancy intentions mediate the relationship between individual, familial and cultural characteristics and adolescent pregnancy is not well understood. The role of intentions may be particularly important among Latina teenagers, whose attitudes toward pregnancy are more favorable than those of other groups and whose pregnancy rates are high. METHODS Prospective, time-varying data from 2001–2004 were used to investigate whether two measures of pregnancy intentions, wantedness and happiness, mediated associations between risk factors and pregnancy among 213 Latina adolescents in San Francisco. Participants were tested for pregnancy and interviewed about pregnancy intentions, partnerships, family characteristics and activities every six months for two years. Associations and mediation were examined using logistic regression. RESULTS Neither pregnancy intention variable mediated relationships between participant characteristics and pregnancy. After adjustment for other measures, wantedness was strongly associated with pregnancy (odds ratio, 2.6), while happiness was not. Having a strong family orientation was associated with happiness (3.7) but unrelated to pregnancy. Low sexual relationship power with a main partner was associated with an elevated risk of pregnancy (3.3). If the pregnancy intentions of all participants were changed to definitely not wanting pregnancy, the estimated decline in pregnancy risk would be 16%. CONCLUSIONS Pregnancy intentions were important not as mediators but rather as independent risk factors for pregnancy. Differences in pregnancy rates between groups of Latinas may be less a function of intentional choice than of situational factors. Interventions and research should focus on identifying and targeting factors that hinder effective contraceptive use among teenagers who want to avoid pregnancy. PMID:20887287

  15. Pregnancy intentions and teenage pregnancy among Latinas: a mediation analysis.

    Science.gov (United States)

    Rocca, Corinne H; Doherty, Irene; Padian, Nancy S; Hubbard, Alan E; Minnis, Alexandra M

    2010-09-01

    The extent to which pregnancy intentions mediate the relationship between individual, familial and cultural characteristics and adolescent pregnancy is not well understood. The role of intentions may be particularly important among Latina teenagers, whose attitudes toward pregnancy are more favorable than those of other groups and whose pregnancy rates are high. Prospective, time-varying data from 2001-2004 were used to investigate whether two measures of pregnancy intentions, wantedness and happiness, mediated associations between risk factors and pregnancy among 213 Latina adolescents in San Francisco. Participants were tested for pregnancy and interviewed about pregnancy intentions, partnerships, family characteristics and activities every six months for two years. Associations and mediation were examined using logistic regression. Neither pregnancy intention variable mediated relationships between participant characteristics and pregnancy. After adjustment for other measures, wantedness was strongly associated with pregnancy (odds ratio, 2.6), while happiness was not. Having a strong family orientation was associated with happiness (3.7) but unrelated to pregnancy. Low power in a sexual relationship with a main partner was associated with an elevated risk of pregnancy (3.3). If the pregnancy intentions of all participants were changed to definitely not wanting pregnancy, the estimated decline in pregnancy risk would be 16%. Pregnancy intentions were important not as mediators but rather as independent risk factors for pregnancy. Differences in pregnancy rates between groups of Latinas may be less a function of intentional choice than of situational factors. Interventions and research should focus on identifying and targeting factors that hinder effective contraceptive use among teenagers who want to avoid pregnancy. Copyright © 2010 by the Guttmacher Institute.

  16. How I treat leukemia during pregnancy.

    Science.gov (United States)

    Milojkovic, Dragana; Apperley, Jane F

    2014-02-13

    Leukemia in pregnancy remains a challenging therapeutic prospect. The prevalence is low at ∼1 in 10 000 pregnancies, and as a result data are limited to small retrospective series and case reports, rendering evidence-based recommendations for management strategies difficult. The management of the leukemias in pregnancy requires close collaboration with obstetric and neonatology colleagues as both the maternal and fetal outcomes must be taken into consideration. The decision to introduce or delay chemotherapy must be balanced against the impact on maternal and fetal survival and morbidity. Invariably, acute leukemia diagnosed in the first trimester necessitates intensive chemotherapy that is likely to induce fetal malformations. As delaying treatment in this situation is usually inappropriate, counseling with regard to termination of pregnancy is often essential. For chronic disease and acute leukemia diagnosed after the second trimester, therapeutic termination of the pregnancy is not inevitable and often, standard management approaches similar to those in nongravid patients can be used. Here, the management of the acute and chronic leukemias will be addressed.

  17. A Comprehensive Review of Hypertension in Pregnancy

    Directory of Open Access Journals (Sweden)

    Reem Mustafa

    2012-01-01

    Full Text Available Hypertension is the most common medical disorder encountered during pregnancy. Hypertensive disorders are one of the major causes of pregnancy-related maternal deaths in the United States. We will present a comprehensive update of the literature pertinent to hypertension in pregnancy. The paper begins by defining and classifying hypertensive disorders in pregnancy. The normal vascular and renal physiological changes which occur during pregnancy are detailed. We will summarize the intriguing aspects of pathophysiology of preeclampsia, emphasizing on recent advances in this field. The existing diagnostic tools and the tests which have been proposed for screening preeclampsia are comprehensively described. We also highlight the short- and long-term implications of preeclampsia. Finally, we review the current management guidelines, goals of treatment and describe the potential risks and benefits associated with various antihypertensive drug classes. Preeclampsia still remains an enigma, and the present management focuses on monitoring and treatment of its manifestations. We are hopeful that this in depth critique will stimulate the blossoming research in the field and assist practitioners to identify women at risk and more effectively treat affected individuals.

  18. Hypertensive disorders in twin pregnancy

    NARCIS (Netherlands)

    J.G. Santema (Job); E. Koppelaar (Elin); H.C.S. Wallenburg (Henk)

    1995-01-01

    textabstractObjective: To compare the incidence and severity of pregnancy-induced hypertensive disorders in twin pregnancy and in singleton gestation. Study design: Case-control study in the setting of a University Hospital. Each pregnancy of a consecutive series of 187 twin pregnancies attending th

  19. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

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

  20. The unwanted pregnancy.

    Science.gov (United States)

    Diggory, P

    1977-01-01

    Unwanted pregnancy is a measure of contraceptive failure - either method failure, motivation failure, or contraceptive inaccessibility. Unwanted pregnancies can end in criminal abortion, therapeutic abortion, forced marriage, or illegitimate birth. Figures for these occurrences in Great Britain in 1969 are cited. The figures make no allowance for unsuccessful attempts at self-abortion and unwanted but accepted pregnancies within marriage. It is estimated that approximately 1/4 of all British and American women married more than 10 years have at least 1 unwanted child. Contraception must be provided by the British National Health Service.

  1. Scar Ectopic Pregnancy.

    Science.gov (United States)

    Patel, Madhuri Arvind

    2015-12-01

    Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

  2. [Rheumatic diseases during pregnancy].

    Science.gov (United States)

    Fischer-Betz, R

    2012-09-01

    The treatment of inflammatory rheumatic diseases, such as rheumatoid arthritis, spondylitis ankylosans and systemic lupus erythematosus, is improving continuously. This has lead to an increasing number of young patients with a wish to have children. Greater insight into the course of rheumatic diseases during pregnancy and post partum has enabled optimized support for women with rheumatic diseases wishing to have children. To ensure a favorable outcome, pregnancy should be started during a period of disease stability and should be monitored closely. A careful assessment of possible risks and the justified use of antirheumatic drugs before, during and after pregnancy are key issues for success.

  3. Progestogens and Pregnancy

    Directory of Open Access Journals (Sweden)

    Schindler AE

    2015-01-01

    Full Text Available Based upon the intensive research by E. Diczfalusy and his scholars with the concept of the “feto-placental-unit”, the development of diagnostic procedures by hormone measurements in pregnancy, therapeutic and preventive effects of the use of progestogens (progesterone, dydrogesterone, 17-alpha-hydroxyprogesterone caproate were developed and are at present to be further evaluated in order to be used for prevention and treatment of pregnancy disorders such as threatened miscarriage, recurrent (habitual miscarriage, preterm labor and preeclampsia (hypertension in pregnancy.

  4. Treating Psoriasis During Pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Rørbye, Christina; Skov, Lone

    2015-01-01

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

  5. Hypertension in pregnancy.

    Science.gov (United States)

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

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

  6. Anorexia nervosa during pregnancy.

    OpenAIRE

    Goldman, Ran D.; Koren, Gideon

    2003-01-01

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

  7. The unplanned teenage pregnancy

    Directory of Open Access Journals (Sweden)

    S.M. Ross

    1979-09-01

    Full Text Available Surveys conducted in the Durban area of Natal showed that 18 per cent of all pregnancies occurred amongst teenagers with the incidence amongst the various population groups varying bëtween Whites 14 per cent, Indians 17 per cent, Coloureds and Blacks 20 per cent. This compares with a world-wide teenage pregnancy rate of 10-15 per cent. Amongst primigravid pregnancies 33 per cent Indians and 53 per cent of Africans were found to be 18 years of age or less.

  8. [Urolithiasis and pregnancy].

    Science.gov (United States)

    Saussine, C; Lechevallier, E; Traxer, O

    2008-12-01

    Diagnosis of urolithiasis during pregnancy is a common condition not more frequent than in non pregnant women. Ultrasonography will be the main tool of diagnosis. If sonography fails, ionizing radiation will be used only if MRI is not available. One must take care of the mother and the foetus because preterm delivery is increased in case of lithiasis during pregnancy. Conservative treatment is favoured taking care of specific contraindications of medical therapy related to pregnancy. In case of complications, drainage of the urinary system by retrograde or antegrade approach will be considered. Endoscopic treatment is realized only in case of failure of drainage or in the post-partum with etiologic investigations.

  9. Factors to consider in pregnancy of unknown location.

    Science.gov (United States)

    Bobdiwala, Shabnam; Al-Memar, Maya; Farren, Jessica; Bourne, Tom

    2017-08-01

    The management of women with a pregnancy of unknown location (PUL) can vary significantly and often lacks a clear evidence base. Intensive follow-up is usually required for women with a final outcome of an ectopic pregnancy. This, however, only accounts for a small proportion of women with a pregnancy of unknown PUL location. There remains a clear clinical need to rationalize the follow-up of PUL so women at high risk of having a final outcome of an ectopic pregnancy are followed up more intensively and those PUL at low risk of having an ectopic pregnancy have their follow-up streamlined. This review covers the main management strategies published in the current literature and aims to give clinicians an overview of the most up-to-date evidence that they can take away into their everyday clinical practice when caring for women with a PUL.

  10. CONSERVATIVE MANAGEMENT OF TWIN PREGNANCY WITH SINGLE FETAL DEATH

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death.Method.A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998.Result.During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died during second or third trimester. The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained.Conclusion.Our results support conservative management in twin pregnancies complicated by single fetal death.

  11. Metastatic Colorectal Cancer Resembling Severe Preeclampsia in Pregnancy

    Directory of Open Access Journals (Sweden)

    Raminder Kaur Khangura

    2015-01-01

    Full Text Available Although colorectal cancer (CRC is the third most common cancer in women, it is a rare malignancy in pregnancy. Symptoms of CRC such as fatigue, malaise, nausea, vomiting, rectal bleeding, anemia, altered bowel habits, and abdominal mass are often considered typical symptoms of pregnancy. Many cases of CRC are diagnosed in advanced stages due to missed warning signs of CRC, which may be misinterpreted as normal symptoms related to pregnancy. This report reviews 2 cases of CRC diagnosed within a 4-month interval at our institution. Both cases were initially thought to be atypical presentations of preeclampsia. Prenatal history, hospital course, and postpartum course were reviewed for both patients. CRC is often diagnosed at advanced stages in pregnancy. Common physiological symptoms of pregnancy should be scrutinized carefully and worked up appropriately, especially if symptoms remain persistent or increase in intensity or severity.

  12. CONSERVATIVE MANAGEMENT OF TWIN PREGNANCY WITH SINGLE FETAL DEATH

    Institute of Scientific and Technical Information of China (English)

    刘俊涛; 杨佳欣; 边旭明; 张羽

    2000-01-01

    Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death. Method. A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998. Result. During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died dm-ing second or third trimester.The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained. Condosion. Our results suptmrt conservative management in twin pregnancies complicated by single fetal death.

  13. Contraception and unwanted pregnancy.

    Science.gov (United States)

    Adler, N E

    1984-01-01

    An overview of research findings in the US on the psychological and social variables associated with unwanted pregnancy and on the consequences of unwanted pregnancy was provided. Studies which examined personality differences between women and adolescent females who practicaed effective contraception and thesse who experienced unwanted pregnancy consistently found that the latter group, compared to the former group, had lower self-esteem, were more passive, tended to engage in more risk taking behavior, and were less achievement and future oriented. Several studies found that those who experienced unwanted pregnancies were often poorly informed about sex and contraception. Sex education, however, did not always lead to an increase in the knowledge and use of contraception. Sex education was unable to overcome the effects of male and female sexual socialization processes in which adolescents were inculcated with a double sex standard and females with a sense of guilt concerning the use of contraception. Numerous studies showed that unperceived or denied motives played a role in the occurence of unwanted pregnancies. Unwanted pregnancies were associated with loss, and these pregnancies probably represented an attempt to replace the loss of a loved person. Women who were in conflict about their work and mothering roles, and women who did not want to work but felt pressured to do so, frequently had inappropriate pregnancies. Teenagers who were not interested in school or in future careers often had unwanted pregnancies. These pregnancies probably represented an attempt to establish a social identity. W.B. Miller identified 8 stages in the reproductive life span when unwanted pregnancies were most likely to occur. These stages were 1) the initial stage of adolescence when the individual may not be fully aware of her fertility, 2) the 1st 6 months following the initiation of sexual activity, 3) at the beginning of a new relationship, 4) during the initial stage of

  14. Increasing Use of Long-Acting Reversible Contraception to Decrease Unplanned Pregnancy.

    Science.gov (United States)

    Lotke, Pamela S

    2015-12-01

    Unintended pregnancy remains high in the United States, accounting for one-half of pregnancies. Both contraceptive nonuse and imperfect use contribute to unplanned pregnancies. Long-acting reversible contraception (LARC) have greater efficacy than shorter acting methods. Data from large studies show that unplanned pregnancy rates are lower among women using LARC. However, overall use of LARC is low; of the reproductive age women using contraception, less than 10% are LARC users. Barriers include lack of knowledge and high up-front cost, and prevent more widespread use. Overcoming these barriers and increasing the number of women using LARC will decrease unplanned pregnancies and abortions.

  15. Acute appendicitis in pregnancy: literature review

    Directory of Open Access Journals (Sweden)

    Antônio Henriques de Franca Neto

    2015-04-01

    Full Text Available Introduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms “acute appendicitis” and “pregnancy”, in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases. Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video- assisted surgery in these cases remains controversial.

  16. Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study

    NARCIS (Netherlands)

    Menaca, A.; Pell, C.; Manda-Taylor, L.; Chatio, S.; Afrah, N.A.; Were, F.; Hodgson, A.; Ouma, P.; Kalilani, L.; Tagbor, H.; Pool, R.

    2013-01-01

    Background: In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores

  17. Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study

    NARCIS (Netherlands)

    Menaca, A.; Pell, C.; Manda-Taylor, L.; Chatio, S.; Afrah, N.A.; Were, F.; Hodgson, A.; Ouma, P.; Kalilani, L.; Tagbor, H.; Pool, R.

    2013-01-01

    Background: In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores

  18. Heterotopic pregnancy in HIV women

    Directory of Open Access Journals (Sweden)

    Valeria Savasi

    2016-11-01

    Full Text Available Heterotopic pregnancy occurs when intrauterine and ectopic pregnancy are concomitant; overall rate rises from 1/30.000 to 1.5/1000 in assisted reproductive technology pregnancies. HIV (human immunodeficiency virus patients are at increased risk of heterotopic pregnancies due to the greater frequency of assisted reproductive technology and pelvic inflammatory disease. We report the first case of heterotopic pregnancy in HIV woman.

  19. Hypertensive disorders in twin pregnancy

    OpenAIRE

    Santema, Job; Koppelaar, Elin; Wallenburg, Henk

    1995-01-01

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

  20. Maternal 27-hydroxycholesterol concentrations during the course of pregnancy and in pregnancy pathologies.

    Science.gov (United States)

    Winkler, Brigitte Sophia; Pecks, Ulrich; Najjari, Laila; Kleine-Eggebrecht, Nicola; Maass, Nicolai; Mohaupt, Markus; Escher, Geneviève

    2017-04-04

    The oxysterol 27-hydroxycholesterol (27-OHC) plays an important role in the regulation of cholesterol homeostasis. Pregnancy pathologies like preeclampsia (PE), HELLP-syndrome (HELLP), intrauterine growth restriction (IUGR) and intrahepatic cholestasis in pregnancy (ICP) are linked to disturbances in lipid metabolism. In the present study, we hypothesized a specific gestational regulation of 27-OHC and compromised 27-OHC levels due to placental and hepatic diseases in pregnancy resulting in a dysregulation of lipid metabolism. The 27-OHC was measured by gas-chromatography-mass spectrometry (GC-MS) and related to cholesterol concentrations. In the longitudinal cohort, a complete set of samples of healthy patients (n = 33) obtained at three different time points throughout gestation and once post-partum was analyzed. In the cross sectional cohort, patients with pregnancy pathologies (IUGR n = 14, PE n = 14, HELLP n = 7, ICP n = 7) were matched to a control group (CTRL) of equal gestational ages. The 27-OHC levels already increased in the first trimester despite lower TC concentrations (p < 0.05). During the course of pregnancy, a subtle rise in 27-OHC concentrations results in an overall decrease of 27-OHC/TC ratio in between the first (p < 0.05) and second trimester. The ratio remains stable thereafter including the post-partum period. No significant differences have been observed in pregnancy pathologies as compared to the CTRL group. In conclusion, 27-OHC may have a compensatory role in cholesterol metabolism early in pregnancy. The conserved 27-OHC/TC ratio in pregnancy pathologies suggest that neither the placenta nor the liver is majorly involved in the regulation of 27-OHC metabolism.