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Sample records for pregnancy significantly predicted

  1. Mid-trimester maternal serum HCG and alpha fetal protein levels: clinical significance and prediction of adverse pregnancy outcome.

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    Androutsopoulos, Georgios; Gkogkos, Panagiotis; Decavalas, Georgios

    2013-01-01

    Maternal serum human Chorionic Gonadotropin (hCG) and Alpha Fetal Protein (AFP) were originally introduced to detect trisomy 21 and neural tube defects. However, in the absence of aneuploidy or neural tube defects, mid-trimester maternal serum hCG and/or maternal serum AFP associated with adverse pregnancy outcomes. Pregnancies with unexplained mid-trimester elevation in maternal serum hCG and/or maternal serum AFP, are at increased risk for pregnancy complications resulting from placental insufficiency. Mid-trimester maternal serum hCG>2.5 MoM associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, intrauterine growth restriction (IUGR), preterm delivery and intrauterine fetal death(IUFD). Mid-trimester maternal serum AFP levels >2.5 MoM are thought to reflect a defect in placentation and associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD. Combined mid-trimester elevation in maternal serum hCG and AFP levels suggest a more complex type of placental pathology. They have stronger association with pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD. Mid-trimester maternal serum hCG or AFP levels alone cannot detect all pregnant women with increased risk to develop pregnancy complications. Multiparameter testing of placental function in mid-trimester (maternal serum hCG and AFP screening, uterine artery Doppler and placental morphology) may allow us to identify women with increased risk to develop severe placental insufficiency and pregnancy complications. However, future prospective studies are needed to confirm the prognostic significance of multiparameter testing of placental function in mid-trimester.

  2. A decrease in serum estradiol levels after human chorionic gonadotrophin administration predicts significantly lower clinical pregnancy and live birth rates in in vitro fertilization cycles.

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    Kondapalli, L A; Molinaro, T A; Sammel, M D; Dokras, A

    2012-09-01

    Although close observation of serum estradiol (E2) levels remains a mainstay of assessing clinical response to controlled ovarian stimulation, the prognostic value of any change in E2 levels after administration of hCG remains unclear. The objective of this study is to evaluate the relationship between serum E2 response after hCG administration and the clinical pregnancy and live birth rates in fresh IVF cycles. We conducted a retrospective cohort study of women aged 21-45 years undergoing their first IVF cycle from 1999 to 2008 at a single practice. We compared the post-hCG serum E2 level with values on the day of hCG trigger. IVF cycles were stratified by post-hCG E2 response and appropriate parametric and non-parametric statistics were performed. Clinical intrauterine pregnancy and live births were the primary outcomes of interest. Multivariable logistic regression models were created to identify predictive factors associated with outcomes while adjusting for potential confounders. Among the 1712 IVF cycles, 1065 exhibited a >10% increase (Group A), 525 had a plateau (± 10%, Group B) and 122 showed a >10% decrease (Group C) in post-hCG E2 levels. While the E2 levels on the day of hCG were similar across groups, Group C had more patients with diminished ovarian reserve, required higher gonadotrophin doses and had the lowest implantation rates. After adjusting for age, total gonadotrophin dose, infertility diagnosis, number of oocytes and number of transferred embryos, the associations between post-hCG E2 decline (Group C) and clinical pregnancy [adjusted odds ratio (aOR): 0.53; 95% confidence interval (CI): 0.33-0.84, P= 0.007] and live birth (aOR: 0.40; 95% CI: 0.22-0.71, P= 0.002) were significant. We also found significant associations between E2 plateau (Group B) and clinical pregnancy (aOR: 0.73; 95% CI: 0.57-0.94, P= 0.013) and live birth (aOR: 0.74; 95% CI: 0.56-0.97, P= 0.032) when adjusting for the same factors. In our study, >10% decrease in E2 levels

  3. Predicting significant torso trauma.

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    Nirula, Ram; Talmor, Daniel; Brasel, Karen

    2005-07-01

    Identification of motor vehicle crash (MVC) characteristics associated with thoracoabdominal injury would advance the development of automatic crash notification systems (ACNS) by improving triage and response times. Our objective was to determine the relationships between MVC characteristics and thoracoabdominal trauma to develop a torso injury probability model. Drivers involved in crashes from 1993 to 2001 within the National Automotive Sampling System were reviewed. Relationships between torso injury and MVC characteristics were assessed using multivariate logistic regression. Receiver operating characteristic curves were used to compare the model to current ACNS models. There were a total of 56,466 drivers. Age, ejection, braking, avoidance, velocity, restraints, passenger-side impact, rollover, and vehicle weight and type were associated with injury (p < 0.05). The area under the receiver operating characteristic curve (83.9) was significantly greater than current ACNS models. We have developed a thoracoabdominal injury probability model that may improve patient triage when used with ACNS.

  4. Serum hCG-β levels of postovulatory day 12 and 14 with the sequential application of hCG-β fold change significantly increased predictability of pregnancy outcome after IVF-ET cycle.

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    Sung, Nayoung; Kwak-Kim, Joanne; Koo, H S; Yang, K M

    2016-09-01

    To investigate hCG-β level on postovulatory day (POD) 12 and its fold increase as predictors for pregnancy outcome after in vitro fertilization (IVF) cycles. A retrospective cohort study was performed in total 1408 fresh and 598 frozen cycles between November 2008 and October 2011, which resulted in biochemical pregnancy, early pregnancy loss, or live birth of singleton pregnancy. The serum hCG-β levels of POD 12 and 14 were compared among biochemical pregnancy, early pregnancy loss, and live birth groups. The cutoff values of POD 12 and 14 hCG-β levels and the degree of hCG-β increase from POD 12 to 14 were determined for each pregnancy outcome. POD 12 and 14 hCG-β levels stratified based on pregnancy outcomes were significantly different among the biochemical pregnancy, early pregnancy loss, and live birth in both fresh and frozen cycles. Serum hCG-β levels of POD 12 and 14 and the fold increase of hCG-β levels from POD 12 to 14 significantly predict pregnancy outcomes after fresh and frozen cycles. Among these, the cutoff value of POD 14 hCG-β had the highest sensitivity and positive predictive value (PPV). In fresh cycles, the cutoff values of POD 12 and 14 serum hCG-β levels for clinical pregnancies were 30.2 mIU/mL (sensitivity 81.3 %, specificity 79.6 %, and PPV 92.3 %) and 70.5 mIU/mL (sensitivity 88.4 %, specificity 85.2 %, and PPV 94.7 %). In pregnancies with POD 12 serum hCG-β levels ≥30.2 mIU/mL, the cutoff level of increase of hCG-β for clinical pregnancy was 2.56 (sensitivity 73.6 %, specificity 72.4 %, and PPV 97.8 %). Sequential application of cutoff values such as POD 12 hCG-β and fold increase of hCG-β improved predictability of pregnancy outcome as compared with that of POD 12 hCG-β alone. The cutoff values of POD 12 and 14 serum hCG-β levels for live birth were 40.5 mIU/mL (sensitivity 75.2 %, specificity 72.6 %, PPV 78.9 %) and 104.5 mIU/mL (sensitivity 80.3 %, specificity 74.1 %, PPV 80.8 %). In the frozen

  5. Cluster analysis as a prediction tool for pregnancy outcomes.

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    Banjari, Ines; Kenjerić, Daniela; Šolić, Krešimir; Mandić, Milena L

    2015-03-01

    Considering specific physiology changes during gestation and thinking of pregnancy as a "critical window", classification of pregnant women at early pregnancy can be considered as crucial. The paper demonstrates the use of a method based on an approach from intelligent data mining, cluster analysis. Cluster analysis method is a statistical method which makes possible to group individuals based on sets of identifying variables. The method was chosen in order to determine possibility for classification of pregnant women at early pregnancy to analyze unknown correlations between different variables so that the certain outcomes could be predicted. 222 pregnant women from two general obstetric offices' were recruited. The main orient was set on characteristics of these pregnant women: their age, pre-pregnancy body mass index (BMI) and haemoglobin value. Cluster analysis gained a 94.1% classification accuracy rate with three branch- es or groups of pregnant women showing statistically significant correlations with pregnancy outcomes. The results are showing that pregnant women both of older age and higher pre-pregnancy BMI have a significantly higher incidence of delivering baby of higher birth weight but they gain significantly less weight during pregnancy. Their babies are also longer, and these women have significantly higher probability for complications during pregnancy (gestosis) and higher probability of induced or caesarean delivery. We can conclude that the cluster analysis method can appropriately classify pregnant women at early pregnancy to predict certain outcomes.

  6. Prediction and prognosis of hypertension in pregnancy

    NARCIS (Netherlands)

    Nijdam, M.E.

    2011-01-01

    Hypertensive disorders represent the most significant complication of pregnancy and affect about 10% of all pregnancies. Early referral for specialist care for those who are at risk might translate into improved management of these women, while the possibility to identify women at very low risk for

  7. Significance of tests of iron nutrition in pregnancy

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    Metz, J.; Turchetti, L.; Combrink, B.; Krawitz, S.

    1966-01-01

    Tests of iron and folate nutrition have been carried out in early pregnancy and at delivery in 63 Bantu females. Accepted normal values for serum iron, and percentage saturation of transferrin, but not for unsaturated iron-binding capacity, for non-pregnant subjects were found to apply equally well in pregnancy. Concomitant folate deficiency in early pregnancy did not render tests of iron deficiency less valid. The unsaturated iron-binding capacity, percentage saturation, and marrow iron stores in early pregnancy all showed a significant correlation with the haemoglobin value at term. Patients with normal marrow iron stores and a percentage saturation of transferrin of 20 or more at or before the 24th week are unlikely to become anaemic from iron deficiency during pregnancy. PMID:5909700

  8. Diagnostic significance of IL-6 and IL-8 in tubal ectopic pregnancy.

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    Rajendiran, Soundravally; Senthil Kumar, G P; Nimesh, Archana; Dhiman, Pooja; Shivaraman, K; Soundararaghavan, S

    2016-10-01

    As there are no specific non-invasive markers for the diagnosis of tubal ectopic pregnancy, our objective in the present study was to explore the role of inflammatory cytokines IL-6 and IL-8 in the diagnosis of ruptured tubal ectopic pregnancy. Twenty-eight women with tubal ectopic pregnancy, 31 patients with intrauterine abortion and 29 gestational age matched women having normal intrauterine pregnancy were included in the study. Five millilitre of blood was collected at the time of admission, serum was separated and stored at -70 °C for subsequent analysis of β hCG, IL-6 and IL-8 levels. The level of IL-6 was a significant increase in the women with tubal ectopic pregnancy compared to intrauterine abortion and normal pregnancy. IL-8 levels decrease significantly in the tubal ectopic pregnancy and in intrauterine abortion patients when compared with the normal pregnancy group. At the cutoff of 26.48 pg/ml IL-6 level predicted the tubal ectopic pregnancy with moderate accuracy. Therefore, it can be concluded that measurement of IL-6 may have relevance in the diagnosis of ectopic pregnancy as a novel inflammatory serum biomarkers.

  9. A 14-year retrospective maternal report of alcohol consumption in pregnancy predicts pregnancy and teen outcomes.

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    Hannigan, John H; Chiodo, Lisa M; Sokol, Robert J; Janisse, James; Ager, Joel W; Greenwald, Mark K; Delaney-Black, Virginia

    2010-01-01

    Detecting patterns of maternal drinking that place fetuses at risk for fetal alcohol spectrum disorders (FASDs) is critical to diagnosis, treatment, and prevention but is challenging because information on antenatal drinking collected during pregnancy is often insufficient or lacking. Although retrospective assessments have been considered less favored by many researchers due to presumed poor reliability, this perception may be inaccurate because of reduced maternal denial and/or distortion. The present study hypothesized that fetal alcohol exposure, as assessed retrospectively during child adolescence, would be related significantly to prior measures of maternal drinking and would predict alcohol-related behavioral problems in teens better than antenatal measures of maternal alcohol consumption. Drinking was assessed during pregnancy, and retrospectively about the same pregnancy, at a 14-year follow-up in 288 African-American women using well-validated semistructured interviews. Regression analysis examined the predictive validity of both drinking assessments on pregnancy outcomes and on teacher-reported teen behavior outcomes. Retrospective maternal self-reported drinking assessed 14 years postpartum was significantly higher than antenatal reports of consumption. Retrospective report identified 10.8 times more women as risk drinkers (≥ one drink per day) than the antenatal report. Antenatal and retrospective reports were moderately correlated and both were correlated with the Michigan Alcoholism Screening Test. Self-reported alcohol consumption during pregnancy based on retrospective report identified significantly more teens exposed prenatally to at-risk alcohol levels than antenatal, in-pregnancy reports. Retrospective report predicted more teen behavior problems (e.g., attention problems and externalizing behaviors) than the antenatal report. Antenatal report predicted younger gestational age at birth and retrospective report predicted smaller birth size

  10. Serum Beta-hCG of 11 Days after Embryo Transfer to Predict Pregnancy Outcome

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To assess the clinic value of a single maternal serum beta-human chorionic gonadotropin (β-hCG) assay 11 d after embryo transfer in ART pregnancies and to predict pregnancy outcome.Methods A total of 384 pregnancies after embryo transfer were included.Inviable pregnancies were defined as biochemical pregnancies,ectopic pregnancies and first trimester abortions.Ongoing pregnancies were defined as singleton pregnancies and multiple pregnancies whose gestation were achieved more than 12 weeks.Serum β-hCG concentrations were compared among different groups.Results On the post embryo transfer d 11,the mean β-hCG concentration of the ongoing pregnancy group (323.7±285.2 mIU/ml) was significantly higher than that of the inviable pregnancy group(81.4±68.1 mmIU/ml)(P<0.001).In multiple gestations,the levels of β-hCG were significantly higher compared with singleton pregnancies.If the β-hCG level was between 10 mIU/ml and 50 mIU/ml,the positive predictive value of biochemical pregnancies and ectopic pregnancies was 81.8%,the negative predictive value was 94.4%.If the level was less than 100 mIU/ml,the positive predictive value of first trimester abortions was 80.8% the negative predictive value was 77.8%.If the level was greater than 250 mIU/ml,the positive predictive value of multiple pregnancies was 83.3%.the negative predictive value was 74.4%.Conclusions A single serum β-hCG level on d 11 after embryo transfer has good predictive valuefor clinical pregnancy outcome in controlled ovarian stimulation cycles and helps to plan the subsequent follow-up.

  11. Late Pregnancy Thyroid-Binding Globulin Predicts Perinatal Depression

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    Pedersen, Cort; Leserman, Jane; Garcia, Nacire; Stansbury, Melissa; Meltzer-Brody, Samantha; Johnson, Jacqueline

    2016-01-01

    Previously we found that late pregnancy total and free thyroxine (TT4, FT4) concentrations were negatively related to greater pre and/or postpartum depressive symptoms. In a much larger cohort, the current study examined whether these thyroid indices measured earlier in the third trimester (31-33 weeks) predict subsequent perinatal depression and anxiety ratings as well as syndromal depression. Thyroid-binding globulin (TBG) concentrations increase markedly during pregnancy and may be an index of sensitivity to elevated estrogen levels. TBG was examined in this study because prior findings suggest that postpartum depression is related to sensitivity to mood destabilization by elevated sex hormone concentrations during pregnancy. Our cohort was 199 euthyroid women recruited from a public health obstetrics clinic (63.8% Hispanic, 21.6% Black). After screening and blood draws for hormone measures at pregnancy weeks 31-33, subjects were evaluated during home visits at pregnancy weeks 35-36 as well as postpartum weeks 6 and 12. Evaluations included psychiatric interviews for current and life-time DSM-IV psychiatric history (M.I.N.I.-Plus), subject self-ratings and interviewer ratings for depression and anxiety (Edinburgh Postnatal Depression Scale, Montgomery-Ǻsberg Depression Rating Scale; Spielberger State-Trait Anxiety Inventory, Hamilton Anxiety Inventory), as well as a standardized interview to obtain life-time trauma history. Numerous covariates were included in all regression analyses. Trauma and major depression history were robustly significant predictors of depression and anxiety ratings over the study period when these variables were analyzed individually or in a combined model including FT4 or TBG (pdepression and anxiety ratings (pdepression history, were significant individual predictors of syndromal depression during the study period (pdepression history, FT4 and TBG generally were not significantly predictive of depression or anxiety ratings, and FT4

  12. Helicobacter Infection Significantly Alters Pregnancy Success in Laboratory Mice.

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    Bracken, Tara C; Cooper, Caitlin A; Ali, Zil; Truong, Ha; Moore, Julie M

    2017-05-01

    Helicobacter spp. are gram-negative, helically shaped bacteria that cause gastric and enterohepatic infections in mammalian species. Although Helicobacter infection frequently is implicated to interfere with reproductive success, few experimental data support these claims. We therefore retrospectively investigated the effect of Helicobacter infection on murine pregnancy outcome after the identification of endemic Helicobacter infection in an animal research facility. Multiplex conventional PCR analysis was used to characterize Helicobacter infection status in one inbred and 2 transgenic strains of mice in 2 self-contained rooms assigned to the same investigator. Outcomes of timed-mating experiments were compared among Helicobacter spp.-infected and uninfected mice of the same strain; Helicobacter infection was eradicated from the colony through fostering with uninfected dams. Although Helicobacter infection affected fecundity in only one strain of transgenic mouse, the total number of embryos per gravid uterus was significantly reduced in C57BL/6J mice that were infected with a single Helicobacter species, H. typhlonius. Helicobacter infection was also associated with a significant increase in the number of resorbing embryos per uterus and significant decreases in pregnancy-associated weight gain relative to uninfected mice in C57BL6/J mice and one transgenic strain. Helicobacter spp.-infected mice of all tested strains exhibited higher frequency of intrauterine hemorrhaging relative to uninfected mice. These results indicate that naturally-acquired Helicobacter infection not only reduces the productivity of a research animal breeding colony, but also negatively impacts embryo health. Despite these deleterious effects, these data suggest that colonies can be rederived to be Helicobacter-free by Cesarean section and fostering with uninfected dams. This paper provides the first evidence that H. typhlonius infection is sufficient to interfere with reproductive success

  13. The clinical significance of pregnancy in Brugada syndrome.

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    Rodríguez-Mañero, Moisés; Casado-Arroyo, Rubén; Sarkozy, Andrea; Leysen, Eva; Sieira, Juan Antonio; Namdar, Mehdi; Conte, Gulio; Levinstein, Moisés; Chierchia, Gian-Battista; de Asmundis, Carlo; Brugada, Pedro

    2014-03-01

    Little is known about the risks and outcomes of pregnancy in women with Brugada syndrome. We therefore evaluated pregnancy outcomes and the influence of pregnancy in patients with Brugada syndrome. A retrospective analysis was performed in all pregnant women with Brugada syndrome. We included 104 women with a total of 219 deliveries. There were 15 spontaneous abortions. One infant died suddenly during the night 3 months after birth. Six pregnant women reported they had experienced at least 1 syncope during the pregnancy. Of the 3 women who received an implantable cardioverter-defibrillator before the pregnancy, none received arrhythmia episodes. There were no events during the pregnancy in 4 patients with a previously aborted sudden cardiac death. Of 24 patients with syncope when not pregnant, 18 were asymptomatic and 6 experienced a recurrent syncope during the pregnancy. During the follow-up (mean follow-up 298.9 days; 95% confidence interval, 289.6-308.2), 2 women received appropriate shocks. In this retrospective, single-center study, serious events were not more frequent during pregnancy and the peripartum period in women with Brugada syndrome. The occurrence of syncope during pregnancy was not associated with a worst outcome in the peri- and postpartum periods or during follow-up. The reported rate of miscarriage and sudden infant death will require further studies to confirm or rule out its association with Brugada syndrome. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  14. Can routine laboratory parameters predict adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy?

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    Oztas, Efser; Erkenekli, Kudret; Ozler, Sibel; Ersoy, Ali Ozgur; Kurt, Mevlut; Oztas, Erkin; Uygur, Dilek; Danisman, Nuri

    2015-11-01

    Our aim was to investigate whether any hematological changes readily detectable by simple complete blood count (CBC), as well as fasting and postprandial total serum bile acid (SBA) levels, have diagnostic values for the prediction of adverse pregnancy outcomes in intrahepatic cholestasis of pregnancy (ICP). A prospective, case control study was carried out including 217 pregnant women (117 women with ICP and 100 healthy controls). The main outcome measures investigated were preterm delivery, APGAR scores, and neonatal unit admission. A multivariate logistic regression model was used to identify the independent risk factors of adverse pregnancy outcomes. Compared with controls, women with ICP had significantly higher mean platelet volume (MPV) (mean 10.2±1.0 vs. 11.0±1.3; P<0.001) and platelet distribution width (PDW) (mean 13.1±2.3 vs. 14.7±2.8; P<0.001) values. Analysis with logistic regression revealed that the probability of preterm delivery did not increase until MPV levels exceeded 11.2 fL [odds ratio (OR)=2.68, 95% confidence interval (CI)=1.13-6.32, P=0.025], and total bilirubin levels exceeded 0.6 mg/dL (OR=3.13, 95% CI=1.21-8.09, P=0.019). Considering the low APGAR scores, only increased postprandial total SBA levels of ≥51 μmol/L were found to be predictive significantly (OR=3.02, 95% CI=1.07-8.53, P=0.037). Our study suggests that increased MPV and total bilirubin levels are associated with preterm delivery, and increased postprandial total SBA levels are predictive for low APGAR in ICP patients.

  15. Significant roles played by interleukin-10 in outcome of pregnancy.

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    Mobini, Masoud; Mortazavi, Maryam; Nadi, Somayeh; Zare-Bidaki, Mohammad; Pourtalebi, Somayeh; Arababadi, Mohammad Kazemi

    2016-02-01

    Imbalanced immune responses against fetus alloantigens can lead to abnormality in pregnancy. Interleukin-10 (IL-10) plays key roles in regulation of immune responses against self and foreign antigens to induce tolerance to these antigens. Therefore, alteration in expression of IL-10 during pregnancy may result in several pathologic conditions such as preterm labor. IL-10 leads to a normal pregnancy via several molecular mechanisms including development of tolerogenic dendritic cells, T regulatory lymphocytes and activation of the JAK1/STAT3 pathway in the target cells. This review has collected recent data regarding the status of IL-10 expression during term and preterm deliveries and also its molecular mechanisms that lead to a normal pregnancy.

  16. Significant roles played by interleukin-10 in outcome of pregnancy

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    Masoud Mobini

    2016-02-01

    Full Text Available Imbalanced immune responses against fetus alloantigens can lead to abnormality in pregnancy. Interleukin-10(IL-10 plays key roles in regulation of immune responses against self and foreign antigens to induce tolerance to these antigens. Therefore, alteration in expression of IL-10 during pregnancy may result in several pathologic conditions such as preterm labor. IL-10 leads to a normal pregnancy via several molecular mechanisms including development of tolerogenic dendritic cells, T regulatory lymphocytes and activation of the JAK1/STAT3 pathway in the target cells. This review has collected recent data regarding the status of IL-10 expression during term and preterm deliveries and also its molecular mechanisms that lead to a normal pregnancy.

  17. [Significance of transvaginal ultrasonic examination in the first pregnancy trimester].

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    Hernádi, L; Töröcsik, M; Farkas, M

    1990-12-09

    The authors report their results obtained by performing transvaginal sonography in 180 patients in the first trimester of pregnancy. It has been found that both normal and pathological cases could be diagnosed 1 week earlier than had been possible with transabdominal method. Minimum size of the intrauterin gestational sac was found to be 3 mm. Cardiac activity could be evaluated in embrios with a size of 7 mm or greater in all cases. According to them the diagnosis of blighted ovum and missed abortion seems to be confirmed when an "empty sac" is larger than 20 mm, or the absence of heart motion is detected in an embrio greater than 10 mm, without repeated scan. High sensitivity was found in ectopic pregnancies especially in unruptured cases. The possibility of qualitative analysis of "free fluid" in Douglas pouch and diagnosis of congenital anomalies in very early pregnancy are promising. Transvaginal sonography is recommended in all cases when transabdominal technique is equivocal.

  18. Changes and significance of coagulation function, hemodynamics and blood rheology in women with pregnancy induced hypertension

    Institute of Scientific and Technical Information of China (English)

    Bang-Zhi Zeng; Bo Zhang; Yu-Na Wang

    2016-01-01

    Objective:To observe the changes of coagulation function, hemodynamics and blood rheology in patients with pregnancy induced hypertension, and to explore its clinical significance. Methods: A total of 88 cases of women with pregnancy induced hypertension who were admitted in our hospital from July 2011 to February 2016 were selected as the research objects, at the same time, 90 normal pregnant women were selected as normal late pregnancy group. The coagulation parameters, hemodynamics, blood rheology indexes were detected in the two groups.Results:Before delivery, values of the PT and AT-Ⅲ in pregnancy induced hypertension group were significantly lower than those in the normal late pregnancy group, and the values of D-D and FIB were significantly higher than those in the normal late pregnancy group. After delivery, values of the PT and AT-Ⅲ in pregnancy induced hypertension group were significantly higher, and the FIB value was significantly lower, there were no significant differences between the two group. But the D-D value was still significantly higher than that in the normal late pregnancy group. The blood flow dynamics parameter in pregnancy induced hypertension group were significantly higher than that in the normal late pregnant group, the differences were statistically significant. The whole blood high and low shear viscosity, plasma viscosity, low shear reduction viscosity, hematocrit, erythrocyte deformation index, erythrocyte electrophoresis time and fibrinogen in pregnancy induced hypertension group were significantly higher than those in normal late pregnancy group.Conclusion:The blood indexes in patients with pregnancy induced hypertension showed a high coagulation state compared with the normal late pregnancy women. Timely detection of patients’ coagulation function, hemodynamics, and blood rheology indexes has important significance for the detection, auxiliary diagnosis and prevention of the disease.

  19. Pre-pregnancy high-risk factors at first antenatal visit: how predictive are these of pregnancy outcomes?

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    Tandu-Umba B

    2014-12-01

    Full Text Available Barthélémy Tandu-Umba, Muela Andy Mbangama, Kitenge Marc Brunel Kamongola , Tchawou Armel Georges Kamgang, Mawamfumu Perthus Kivuidi, Munene Sam Kasonga, Meke Irène Kambashi, Kabasele Oscar Kapuku, Bituemi Jackson Kondoli, Kibundila Rolly Kikuni, Kuzungu Simon KasikilaDepartment of Obstetrics and Gynecology, University Clinics of Kinshasa, Kinshasa, Democratic Republic of Congo Objective: To determine relationships between pre-pregnancy risk factors at first antenatal visit booking and pregnancy outcomes.Study design: This was a multicenter, cross-sectional study involving women admitted for singleton delivery from July 1 until October 31 (3 months, 2013, at nine major maternity clinics in Kinshasa, Democratic Republic of Congo. All women were checked for hereditary, community, and personal medical/surgical risk situations and mother/infant problems in previous pregnancies. Maternal and perinatal complications related to current/just-terminated pregnancy were analyzed according to pre-pregnancy risk factors in order to establish their prediction concerning maternal and perinatal complications related to current/just-terminated pregnancy (odds ratios. Results are given with 95% confidence intervals, and P<0.05 was considered significant.Results: The study sample comprised 2,086 women. Primiparity (36.5%, single relationship status (26.4%, and maternal age ≥35 years (18.3% were the most important non-pathologic risk factors, while arterial hypertension in family (34.3%, previous miscarriage (33.2%, overweight/obesity (21.9%, diabetes in family (21.1%, previous cesarean section (15.7%, previous postpartum hemorrhage (13.1%, low birth weight (10%, previous macrosomia (10%, and previous premature rupture of membranes (6.2% predominated among pathologic risk factors. Major adverse outcomes recurred in some women, with recurrence rates of 21/37 (57%, 111/208 (53%, 74/208 (36%, 191/598 (32%, 132/466 (28%, 24/130 (18%, and 4/65 (6% for prematurity

  20. Significance and changes of peripheral blood, placental tissue cytokines and NO in patients with hypertensive disorders of pregnancy

    Institute of Scientific and Technical Information of China (English)

    Jie-Ning Zou; Li Xiong; Jin-Tao Zhou

    2015-01-01

    Objective:To investigate significance and changes of placental tissue cytokines and NO levels in peripheral blood of patients with hypertensive disorders of pregnancy and their relationship. Methods: A total of 75 cases of hypertensive disorders of pregnancy were selected as researching objects, including 26 cases of pregnancy-induced hypertension subgroup, 29 cases of patients with mild preeclampsia and 20 cases of subgroups severe preeclampsia subgroups;another 45 cases of healthy pregnant women were also selected as the control group. The maternal blood and placental tissue factor (TNF-α, IL-6, hs-CRP) and NO levels of the four groups were compared.Results:Peripheral blood and placental tissue cytokine levels of patients with hypertensive disorders of pregnancy were significantly higher, NO levels were significantly lower than the control group (P<0.01). In subgroups peripheral blood and placenta cytokine levels were gradually increased, NO levels were increased with gestational hypertension disease degree (P<0.05); NO was significantly negatively correlated with TNF-α, IL-6, hs-CRP levels (P<0.01).Conclusions: During pregnancy, monitoring of TNF-α, IL-6, hs-CRP and NO in placental tissue is helpful in prediction and evaluation of early hypertensive disorders of pregnancy, and is also helpful in treatment.

  1. The Real World Significance of Performance Prediction

    Science.gov (United States)

    Pardos, Zachary A.; Wang, Qing Yang; Trivedi, Shubhendu

    2012-01-01

    In recent years, the educational data mining and user modeling communities have been aggressively introducing models for predicting student performance on external measures such as standardized tests as well as within-tutor performance. While these models have brought statistically reliable improvement to performance prediction, the real world…

  2. About the significance of biological factors affecting pregnancy a married couple

    Directory of Open Access Journals (Sweden)

    V. V. Yarman

    2013-01-01

    Full Text Available A brief review of the literature analysis of the importance and interdependence of the main factors influencing the occurrence of pregnancy as a pair in the treatment of infertility, such as the woman's age, ovarian reserve, the semen of a man and the duration of infertility. The review also presents the data concerning the practical implications of sexual constitution and sexual maturation in men and women in the pubertal period. When evaluating male fertility invariably significant factor in the prediction of pregnancy are, impregnating ability to ejaculate. Infertility is more common in males with delayed development in the pubertal period with a weak type of sexual constitution. Results of treatment of male infertility, the dynamics of the semen and pregnancy of the couple on the background of pathogenetic therapy correlates with the type of sexual constitution. Widely deployed discussion about the existence of the male equivalent of female menopause mainly concerns the problems of men's sexual health. Of exceptional importance for the prediction of treatment of infertility has ovarian reserve, which is closely associated with age women. Formation of menstrual function occurs in the pubertal period of sexual development, in this age of menarche is the leading symptom of type of sexual constitution of women that do not change throughout the life hereafter. The presence of menstrual function and even ovulation does not reflect the reproductive capacity of women. Insufficient information content of the chronological age of a woman, as an indicator of the reproductive capacity of ovarian dictates the necessity of the development of tests that determine individual biological age of a woman, perhaps connected with the type of sexual constitution. In this regard, the study of sexual constitution partners is of great scientific and practical interest.

  3. About the significance of biological factors affecting pregnancy a married couple

    Directory of Open Access Journals (Sweden)

    V. V. Yarman

    2014-11-01

    Full Text Available A brief review of the literature analysis of the importance and interdependence of the main factors influencing the occurrence of pregnancy as a pair in the treatment of infertility, such as the woman's age, ovarian reserve, the semen of a man and the duration of infertility. The review also presents the data concerning the practical implications of sexual constitution and sexual maturation in men and women in the pubertal period. When evaluating male fertility invariably significant factor in the prediction of pregnancy are, impregnating ability to ejaculate. Infertility is more common in males with delayed development in the pubertal period with a weak type of sexual constitution. Results of treatment of male infertility, the dynamics of the semen and pregnancy of the couple on the background of pathogenetic therapy correlates with the type of sexual constitution. Widely deployed discussion about the existence of the male equivalent of female menopause mainly concerns the problems of men's sexual health. Of exceptional importance for the prediction of treatment of infertility has ovarian reserve, which is closely associated with age women. Formation of menstrual function occurs in the pubertal period of sexual development, in this age of menarche is the leading symptom of type of sexual constitution of women that do not change throughout the life hereafter. The presence of menstrual function and even ovulation does not reflect the reproductive capacity of women. Insufficient information content of the chronological age of a woman, as an indicator of the reproductive capacity of ovarian dictates the necessity of the development of tests that determine individual biological age of a woman, perhaps connected with the type of sexual constitution. In this regard, the study of sexual constitution partners is of great scientific and practical interest.

  4. Predicting missing links via significant paths

    CERN Document Server

    Zhu, Xuzhen; Cai, Shimin; Huang, Junming; Zhou, Tao

    2014-01-01

    Link prediction plays an important role in understanding intrinsic evolving mechanisms of networks. With the belief that the likelihood of the existence of a link between two nodes is strongly related with their similarity, many methods have been proposed to calculate node similarity based on node attributes and/or topological structures. Among a large variety of methods that take into account paths connecting the target pair of nodes, most of which neglect the heterogeneity of those paths. Our hypothesis is that a path consisting of small-degree nodes provides a strong evidence of similarity between two ends, accordingly, we propose a so-called sig- nificant path index in this Letter to leverage intermediate nodes' degrees in similarity calculation. Empirical experiments on twelve disparate real networks demonstrate that the proposed index outperforms the mainstream link prediction baselines.

  5. Screening of obstructive sleep apnea during pregnancy: differences in predictive values of questionnaires across trimesters.

    Science.gov (United States)

    Tantrakul, Visasiri; Sirijanchune, Piyaporn; Panburana, Panyu; Pengjam, Janejira; Suwansathit, Worakot; Boonsarngsuk, Viboon; Guilleminault, Christian

    2015-01-15

    Evaluation of Berlin and Stop-Bang questionnaires in detecting obstructive sleep apnea (OSA) across trimesters of pregnancy. Pregnant women from a high-risk pregnancy clinic were recruited to complete sleep evaluations including Berlin and Stop-Bang Questionnaires. Overnight testing with Watch-PAT200 for diagnosis of OSA (cutoff point of apnea-hypopnea index ≥5 events/h) was performed. Seventy-two singleton pregnant women participated in the study. Enrollment consisted of 23, 24, and 25 women during first, second, and third trimesters, respectively. Of 72 pregnancies, 23 patients (31.9%) had OSA. Prevalence of OSA classified by trimesters from first to third was 30.4%, 33.33%, and 32.0%, respectively. Overall predictive values of Berlin and Stop-Bang questionnaires were fair (ROC area under curve, AUC 0.72 for Berlin, p = 0.003; 0.75 for Stop-Bang, p = 0.001). When categorized according to trimesters, predictive values substantially improved in second (AUC: 0.84 for Berlin; 0.78 for Stop-Bang) and third trimesters (AUC: 0.81 for Berlin; 0.75 for Stop-Bang), whereas performances of both questionnaires during first trimester were poorer (AUC: 0.49 for Berlin; 0.71 for Stop-Bang). Multivariate analyses show that pre-pregnancy body mass index (BMI) in first trimester, snore often in second trimester, and weight gain and pregnancy BMI in third trimester were significantly associated with OSA. In high-risk pregnancy, Berlin and Stop-Bang questionnaires were of limited usefulness in the first trimester. However their predictive values are acceptable as pregnancy progresses, particularly in second trimester. OSA in pregnancy seems to be a dynamic process with different predictors association during each trimester. © 2015 American Academy of Sleep Medicine.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-15

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

  7. PREDICTIVE VALUE OF CTG IN POST-DATED PREGNANCY

    Directory of Open Access Journals (Sweden)

    Suganthi

    2016-05-01

    Full Text Available AIM This study evaluates the usefulness of intrapartum cardiotocography in patients with post-dated pregnancy compared to intermittent auscultation. MATERIALS AND METHODS 100 patients with pregnancies beyond EDD and with no other risk factors were included in the study; 50 patients who underwent CTG on admission into labour ward formed the study group and 50 patients who underwent intermittent auscultation formed the control group. Antenatal foetal monitoring namely daily foetal movement count, twice-weekly non-stress test with amniotic fluid assessment and Doppler velocimetry using ultrasound were done in all patients until the onset of labour. Labour was induced whenever NST was non-reassuring or ultrasound showed oligohydramnios. Partogram was used to monitor the course of labour. RESULTS The foetal outcome was better in the study group than in the control group with fewer depressed babies. Cardiotocography had a positive predictive value of 36 36% and a negative predictive value of 94.04% with a P value of 0.010. CONCLUSION Cardiotocography is definitely superior to intermittent auscultation in intrapartum foetal monitoring. Despite the high number of false positives, CTG predicts the outcome of labour in every patient and especially in cases with prolonged pregnancy it serves as a valuable screening tool to pick up those cases that may be compromised by the events of labour.

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

    Science.gov (United States)

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

    1994-06-01

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

  9. Serum activin B concentration as predictive biomarker for ectopic pregnancy.

    Science.gov (United States)

    Dhiman, Pooja; Senthilkumar, G P; Rajendiran, Soundravally; Sivaraman, K; Soundararaghavan, S; Kulandhasamy, Maheshwari

    2016-05-01

    We evaluated the diagnostic accuracy of activin B in discriminating tubal ectopic pregnancy (tEP) from intrauterine miscarriages (IUM), and normal viable intrauterine pregnancy (IUP). We included 28 women with tEP, 31 women with IUM, and 29 normal IUP, confirmed both by clinical examination and ultrasonography. Serum activin B concentration was measured at the time of admission using the ELISA kit. The median serum activin B concentration was found to be significantly decreased in both tEP (p=0.004) and IUM (p=0.022) compared to normal IUP. When compared between tEP and IUM, activin B concentrations did not differ significantly. ROC analysis of activin B and free β-hCG demonstrated AUC of 0.722 and 0.805, respectively to discriminate tEP from viable IUP. The model including both activin B and free β-hCG improved the discriminating potential with greater AUC (0.824), and specificity (93%) than individual one. To discriminate tEP from IUM, activin B, free β-hCG and combination of both performed poorly. We conclude that serum activin B concentration is lower in tubal ectopic pregnancy, and can discriminate it from normal pregnancy with moderate accuracy. It also shows improved diagnostic potential along with free β-hCG, but cannot distinguish tEP from IUM reliably.

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

    Science.gov (United States)

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

    2009-07-01

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

  11. Significance of Immune Indexes in Predicting Pregnancy Outcomes of Pregnant Patients With Systemic Lupus ;Erythematosus%免疫指标对妊娠合并系统性红斑狼疮患者妊娠结局的指导意义研究

    Institute of Scientific and Technical Information of China (English)

    王慧英; 叶艺璇; 于莎莎; 赵绵松; 张蕊

    2016-01-01

    Objective To investigate the significance of immune indexes in predicting pregnancy outcomes of pregnant patients with systemic lupus erythematosus(SLE). Methods From January 2003 to December 2015,we enrolled 20 pregnant SLE patients who received treatment in Beijing Shijitan Hospital Affiliated to Capital Medical University. The patients all received regular examination and treatment during pregnancy. Antinuclear antibodies, serum complement level and erythrocyte sedimentation rate were selected as immune indexes. Pregnancy outcomes and the incidence of pregnancy complications were compared among patients with different positive conditions of immune indexes. Results Among the 20 patients,there were 13 patients with positive antinuclear antibodies, 5 patients whose serum complement level decreased, and 5 patients whose erythrocyte sedimentation rate increased. Compared with patients who had negative antinuclear antibodies,patients with positive antinuclear antibodies had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns( P﹤0. 05);the number of cases of stillbirth was not significantly different(P﹥0. 05). Compared with patients with normal serum complement level,patients whose serum complement level decreased had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns(P﹤0. 05);the number of cases of stillbirth was not significantly different(P﹥0. 05) . Compared with patients with normal erythrocyte sedimentation rate, patients whose erythrocyte sedimentation rate increased had more cases of premature delivery and stillbirth,less gestational weeks and lighter average body weight of newborns ( P﹤0. 05 ) . Patients with different titers of antinuclear antibodies, serum complement levels, and erythrocyte sedimentation rate were not significantly different in the incidence of complications(P﹥0. 05). Conclusion Pregnant patients with SLE have higher incidence of unfavorable

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

    Science.gov (United States)

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

    2014-01-01

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

  13. Predictive factors for pregnancy after intrauterine insemination: A prospective study of factors affecting outcome

    Directory of Open Access Journals (Sweden)

    Mohan S Kamath

    2010-01-01

    Full Text Available Objective : To determine the predictive factors for pregnancy after controlled ovarian hyperstimulation (COH/intrauterine insemination (IUI. Design : Prospective observational study. Setting : University-level tertiary care center. Patients and Methods : 366 patients undergoing 480 stimulated IUI cycles between November 2007 and December 2008. Interventions : Ovarian stimulation with gonadotrophins was initiated and a single IUI was performed 36 h after triggering ovulation. Main Outcome Measures : The primary outcome measures were clinical pregnancy and live birth rates. Predictive factors evaluated were female age, duration of infertility, indication for IUI, number of preovulatory follicles, luteinizing hormone level on day of trigger and postwash total motile fraction (TMF. Results : The overall clinical pregnancy rate and live birth rate were 8.75% and 5.83%, respectively. Among the predictive factors evaluated, the duration of infertility (5.36 vs. 6.71 years, P = 0.032 and the TMF (between 10 and 20 million, P = 0.002 significantly influenced the clinical pregnancy rate. Conclusion : Our results indicate that COH/IUI is not an effective option in couples with infertility due to a male factor. Prolonged duration of infertility is also associated with decreased success, and should be considered when planning treatment.

  14. Robust Early Pregnancy Prediction of Later Preeclampsia Using Metabolomic Biomarkers.

    LENUS (Irish Health Repository)

    Kenny, Louise C

    2010-09-13

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

  15. Robust early pregnancy prediction of later preeclampsia using metabolomic biomarkers.

    LENUS (Irish Health Repository)

    Kenny, Louise C

    2012-01-31

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

  16. Can prematurity risk in twin pregnancies after in vitro fertilization be predicted? A retrospective study

    Directory of Open Access Journals (Sweden)

    Barad David

    2009-01-01

    Full Text Available Abstract Background Assisted reproduction (ART contributes to world-wide increases of twin pregnancies, in turn raising prematurity risks. Whether characteristics of ART cycles, resulting in twin gestations, can predict prematurity risks was the subject of this study. Methods One-hundred-and-six women, ages 20 to 39 years, with consecutive dichorionic-diamniotic (DC/DA twin gestations were retrospectively investigated. All pregnancies investigated followed fresh ART cycles, with use of autologous gamets, and were delivered at a university-based high-risk, maternal-fetal medicine unit. Only premature deliveries (i.e., <37.0 weeks gestational age, with viable neonate(s of ≥ 500 grams, were considered for analysis. Results After 1.8 +/- 1.2 ART cycles, 11.0 +/- 5.4 oocytes were retrieved and 2.4 +/- 0.9 embryos transferred in 106 women aged 31.6 +/- 4.2 years. Indications for ART treatment were male factor in 51.9%, female infertility in 27.4% and combined infertility in 20.8%. Though maternal age significantly influenced prematurity risk (p < 0.05, paternal age, maternal body mass index, indications for fertility treatment, number of previous ART attempts, oocytes retrieved or embryos transferred, as well as stimulation protocols and previous ART pregnancies, were not associated with gestational duration in twin pregnancies. Summary Except for female age, baseline and ART cycle characteristics do not allow for prediction of prematurity risk in dichorionic twin gestations after assisted reproduction.

  17. Efficacy of the motile sperm organelle morphology examination (MSOME in predicting pregnancy after intrauterine insemination

    Directory of Open Access Journals (Sweden)

    Mauri Ana L

    2011-08-01

    Full Text Available Abstract Background Although the motile sperm organelle morphology examination (MSOME was developed merely as a selection criterion, its application as a method for classifying sperm morphology may represent an improvement in the evaluation of semen quality. The aim of this study was to determine the prognostic value of normal sperm morphology using MSOME with regard to clinical pregnancy (CP after intrauterine insemination (IUI. Methods A total of 156 IUI cycles that were performed in 111 couples were prospectively analysed. Each subject received 75 IU of recombinant FSH every second day from the third day of the cycle. Beginning on the 10th day of the cycle, follicular development was monitored by vaginal ultrasound. When one or two follicles measuring at least 17 mm were observed, recombinant hCG was administered, and IUI was performed 12-14 h and 36-40 h after hCG treatment. Prior to the IUI procedure, sperm samples were analysed by MSOME at 8400× magnification using an inverted microscope that was equipped with DIC/Nomarski differential interference contrast optics. A minimum of 200 motile spermatozoa per semen sample were evaluated, and the percentage of normal spermatozoa in each sample was determined. Results Pregnancy occurred in 34 IUI cycles (CP rate per cycle: 21.8%, per patient: 30.6%. Based on the MSOME criteria, a significantly higher percentage of normal spermatozoa was found in the group of men in which the IUI cycles resulted in pregnancy (2.6+/-3.1% compared to the group that did not achieve pregnancy (1.2+/-1.7%; P = 0.019. Logistic regression showed that the percentage of normal cells in the MSOME was a determining factor for the likelihood of clinical pregnancy (OR: 1.28; 95% CI: 1.08 to 1.51; P = 0.003. The ROC curve revealed an area under the curve of 0.63 and an optimum cut-off point of 2% of normal sperm morphology. At this cut-off threshold, using the percentage of normal sperm morphology by MSOME to predict pregnancy

  18. The prediction of intra-partum fetal compromise in prolonged pregnancy.

    Science.gov (United States)

    Singh, T; Sankaran, S; Thilaganathan, B; Bhide, A

    2008-11-01

    This is a prospective study conducted in a dedicated post-dates clinic to investigate the importance of antenatal ultrasound, Doppler and cardiotocographic (CTG) indices in the prediction of adverse intra-partum events in prolonged pregnancy. Operative delivery for abnormal fetal ECG-ST segment analysis and/or an arterial cord pH pregnancies with 87 adverse intra-partum events included in the analysis. Intra-partum adverse events were associated with nulliparity, oligohydramnios and induction of labour. The birth weight of fetuses was significantly less in the group with adverse intra-partum events. Logistic regression analysis showed that only nulliparity, birth weight and oligohydramnios had a significant independent influence on the risk of an adverse intra-partum event. Nulliparity was associated with five-fold increase in risk of an adverse intra-partum event. Oligohydramnios was associated with a three-fold increase in the risk. The risk decreased with increasing birth weight.

  19. Ductus venosus Doppler at 11 to 13 weeks of gestation in the prediction of outcome in twin pregnancies.

    Science.gov (United States)

    Maiz, Nerea; Staboulidou, Ismini; Leal, Antonio M; Minekawa, Ryoko; Nicolaides, Kypros H

    2009-04-01

    To examine the independent contribution of abnormal flow in the ductus venosus at 11 to 13 weeks of gestation in the prediction of adverse pregnancy outcome in relation to chorionicity. This was a prospective study in 516 dichorionic and 179 monochorionic twin pregnancies in which the fetal ductus venosus flow was assessed at 11 0/7 to 13 6/7 weeks of gestation. The prevalence of reversed a-wave in the fetal ductus venosus was compared between monochorionic and dichorionic pregnancies and between those with and without pregnancy complications. Comparisons between each of the pregnancy outcomes and the normal outcome group and between monochorionic and dichorionic pregnancies were made using the Mann-Whitney U-test for continuous variables and the chi2 test and Fisher exact test for categorical variables. The prevalence of reversed a-wave in at least one of the fetuses was significantly higher in monochorionic than in dichorionic pregnancies (18.4% compared with 8.3%, P<.001) and in pregnancies complicated by miscarriage (28.6%, P=.005), fetal aneuploidy (70.0%, P<.001), and twin-twin transfusion syndrome (38.5%, P<.001) compared with the pregnancies with two healthy live births (7.7%). Pregnancy outcome was normal in 33 of the 43 (76.7%) dichorionic and in 14 of the 33 (42.4%) monochorionic twins with reversed a-wave in at least one of the fetuses. In twins, reversed a-wave in the ductus venosus at 11 to 13 weeks of gestation is associated with increased risk for aneuploidies, miscarriage, and development of severe twin-twin transfusion syndrome. However, in about 75% of dichorionic twins and 40% of monochorionic twins with reversed a-wave, the pregnancy outcome is normal. II.

  20. Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

    OpenAIRE

    Amanda Johnson; Bethany Cluskey; Nina Hooshvar; Daphne Tice; Courtney Devin; Elaine Kao; Suhalia Nawabi; Steven Jones; Lihua Zhang; Chi Dola

    2015-01-01

    Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting bu...

  1. Clinical significance of DVM and its prevalence in pre-gestational diabetes cases versus normal pregnancies

    Directory of Open Access Journals (Sweden)

    Farideh Akhlaghi

    2015-06-01

    Full Text Available Pre-gestational diabetes mellitus affects less than 1% of all pregnancies and is a significant cause of fetal morbidity and mortality. It is hypothesized that impaired placental function, in the form of abnormal placental weight and/or abnormal placental histology, may be responsible for this event in such pregnancies. Delayed villous maturation of placental villi, which is one of the findings associated with pre-gestational diabetes increases the rate of perinatal mortality. There is limited literature regarding the delayed maturation of placental villous. This review included trials (randomized and non-randomized, cohort and case-control studies registered in Medline/PubMed database, from January 2001 to September 2012 that evaluated the clinical significance of delayed villous maturation and its prevalence in pre-gestational diabetic cases compared to normal pregnancies.It emphasizes that further studies with focus on possible clinical or ultrasound markers of placental delayed villous maturation, especially in a high risk-group such as women with pre-gestational diabetes mellitus are highly recommended.

  2. Preovulatory progesterone concentration associates significantly to follicle number and LH concentration but not to pregnancy rate

    DEFF Research Database (Denmark)

    Yding Andersen, Claus; Bungum, Leif; Nyboe Andersen, Anders

    2011-01-01

    Using data from a large prospective randomized controlled trial that evaluated the effect of recombinant LH (rLH)co-administration for ovarian stimulation, the present study assessed whether progesterone concentration on the day of human chorionic gonadotrophin (HCG) administration was associated...... with pregnancy outcome. Progesterone concentration was measured on stimulation day 1 and on the day of HCG administration in 475 patients who underwent IVF/intracytoplasmic sperm injection treatment following ovarian stimulation with gonadotrophin-releasing hormone (GnRH) agonist and recombinant FSH...... with or without rLH administration from day 6 of stimulation. There was no significant association between the late-follicular-phase progesterone concentration and the clinical pregnancy rate. However, progesterone concentration was strongly associated with the number of follicles and retrieved oocytes. Late...

  3. Transvaginal cervical length measurement at 22- to 26-week pregnancy in prediction of preterm births in twin pregnancies.

    Science.gov (United States)

    El-Gharib, Mohamed Nabih; Albehoty, Sherin Barakat

    2017-03-01

    To investigate the predictive role of transvaginal ultrasonographic measurement of cervical length (CL) at 22-26 weeks of gestation in determining preterm deliveries in twin pregnancies. The study included 150 twin pregnancies. CL was measured by transvaginal ultrasonography at 22-26 weeks. Signs of preterm labor, ruptured membranes, vaginal bleeding, patients with systemic disease, and cervical incompetencies were excluded. The patients had monthly digital cervical examinations but no routine TVCL ultrasound examinations. The primary outcome was spontaneous preterm birth at before 37 weeks of gestation. Ninety-two percent of twin pregnancies delivered by cesarean section and 16% babies had a neonatal intensive care unit requisitioned. Ninety-two patients were delivered in smaller than 37 gestational weeks and the mean CL measurement (CLM) was twin pregnancy, the risk of preterm birth can be evaluated using the ultrasonographic measurement of CL at 22-26 weeks of gestation.

  4. Parental attitudes about a pregnancy predict birth weight in a low-income population.

    Science.gov (United States)

    Keeley, Robert D; Birchard, Alison; Dickinson, Perry; Steiner, John; Dickinson, L Miriam; Rymer, Susan; Palmer, Blake; Derback, Torri; Kempe, Allison

    2004-01-01

    Low birth weight remains the primary cause of neonatal morbidity and mortality in the United States. We examined whether maternal happiness about a pregnancy, in addition to her report of the father's happiness, predicts birth weight and risk for low birth weight (happiness about the pregnancy was measured before 21 weeks' gestation on a scale from 1 to 10 (1 to 3 unhappy, 4 to 7 ambivalent, or 8 to 10 happy). "Mother reports partner happier" occurred when the mother perceived the father's happiness score at least 5 points greater than her own. Information on birth weights and maternal sociodemographic, medical, and psychosocial factors were obtained from surveys and medical records. Of 162 live births, 9 were low birth weight (5.6%). Compared with women who reported happiness with the pregnancy, risk for low birth weight was greater when the mother reported partner happier about the pregnancy (relative risk 10.0, 95% confidence interval, 3.1-32.4). This predictor of birth weight remained significant in multivariate linear regression analyses (coefficient = -472 g, SE = 171 g, P = .007) after adjustment for other known predictors of birth weight. Maternal report of greater partner happiness about a pregnancy is associated with birth weight and appears to define low- and high-risk subgroups for low birth weight in a low-income population. Further study in larger samples is needed to confirm our findings and to assess whether maternal report of greater partner happiness is itself a modifiable factor or is a marker for other factors that might be modified with targeted interventions.

  5. Doppler ultrasound screening predicts recurrence of poor pregnancy outcome in subsequent pregnancies, but not the recurrence of PIH or preeclampsia

    NARCIS (Netherlands)

    Aardema, MW; Lander, M; De Wolf, BTHM; Aarnoudse, JG; Oosterhof, H.

    2000-01-01

    Objective: To assess the role of Doppler uterine artery screening in the prediction of recurring hypertensive disorders in a high-risk population. Methods: Ninety-four women with a history of hypertensive disorders in previous pregnancies underwent ultrasound color Doppler to analyze blood flow in t

  6. Predictive value of maternal serum β-hCG concentration in the ruptured tubal ectopic pregnancy.

    Science.gov (United States)

    Faraji Darkhaneh, Roya; Asgharnia, Maryam; Farahmand Porkar, Nastaran; Alipoor, Ali Akbar

    2015-02-01

    Measurement of serum β-hCG concentration commonly used to diagnose tubal ectopic pregnancy (EP) and follow up patients treated conservatively. The aim of this study was to determine the predictive value of maternal serum β-hCG concentration in ruptured tubal ectopic pregnancy to help physicians identify those women who are at greatest risk. This is a cross-sectional study conducted on all women with a diagnosis of tubal ectopic pregnancy who were treated in Alzahra Hospital, in Rasht, from March 2002 to February 2011. The data was collected for each woman from medical records and included age, parity, gravidia, gestational age, primary level of serum β-hCG, rupture status, past history of pelvic inflammation disease, EP, abortion, and intrauterine contraceptive device use. Women with tubal rupture were compared to those without rupture. Statistical analysis was conducted by SPSS 19 for Windows. A total of 247 cases of tubal ectopic pregnancy were recorded during the study period. One hundred and ninety seven (79.8%) were cases with unruptured EP and 50 patients (20.2 %) were cases with ruptured EP. The mean level of β-hCG was significantly higher in patients with ruptured EP compared to patients with unruptured EP (p=0.03). Logistic regression analysis revealed that >1750 IU/ml of β-hCG levels (OR: 1.41; 95% CI: 1.18-1.68) was the significant risk factors for tubal rupture. Higher β-hCG levels seem to be significant risk factors for rupture of a tubal EP.

  7. 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

  8. Does a history of hypertensive disorders of pregnancy help predict future essential hypertension? Findings from a prospective pregnancy cohort study.

    Science.gov (United States)

    Callaway, L K; Mamun, A; McIntyre, H D; Williams, G M; Najman, J M; Nitert, M D; Lawlor, D A

    2013-05-01

    Hypertensive disorder of pregnancy (HDP) is considered an important determinant in the prediction of future hypertension. The aim of this study is to examine whether HDP improves prediction of future hypertension, over prediction based on established risk factors measured during pregnancy. We used a community based cohort study of 2117 women who received antenatal care at a major hospital in Brisbane between 1981 and 1983 and had blood pressure assessed 21 years after the index pregnancy. Of these 2117 women, 193 (9.0%) experienced HDP and 345 (16.3%) had hypertension at 21 years postpartum. For women with HDP, the odds of being hypertensive at 21 years postpartum were 2.46 (95% CI 1.70, 3.56), adjusted for established risk factors including age, education, race, alcohol, cigarettes, exercise and body mass index. Addition of HDP did not improve the prediction model that included these established risk factors, with the area under the curve of receiver operator (AUROC) increasing from 0.710 to 0.716 (P-value for difference in AUROC=0.185). Our findings suggest that HDP is strongly and independently associated with future hypertension, and women who experience this condition should be counselled regarding lifestyle modification and careful ongoing blood pressure monitoring. However, the development of HDP during pregnancy does not improve our capacity to predict future hypertension, over risk factors identifiable at the time of pregnancy. This suggests that counseling regarding lifestyle modification and ongoing blood pressure monitoring might reasonably be provided to all pregnant and postpartum women with identifiable risk factors for future hypertension.

  9. Prediction of Extreme Significant Wave Height from Daily Maxima

    Institute of Scientific and Technical Information of China (English)

    刘德辅; 李华军; 温书勤; 宋艳; 王树青

    2001-01-01

    For prediction of the extreme significant wave height in the ocean areas where long term wave data are not available, the empirical method of extrapolating short term data (1 ~ 3 years) is used in design practice. In this paper two methods are proposed to predict extreme significant wave height based on short-term daily maxima. According to the daa recorded by the Oceanographic Station of Liaodong Bay at the Bohai Sea, it is supposed that daily maximum wave heights are statistically independent. The data show that daily maximum wave heights obey log-normal distribution, and that the numbers of daily maxima vary from year to year, obeying binomial distribution. Based on these statistical characteristics, the binomial-log-normal compound extremum distribution is derived for prediction of extreme significant wave heights (50~ 100 years). For examination of its accuracy and validity, the prediction of extreme wave heights is based on 12 years′ data at this station, and based on each 3 years′ data respectively. The results show that with consideration of confidence intervals, the predicted wave heights based on 3 years′ data are very close to those based on 12 years′data. The observed data in some ocean areas in the Atlantic Ocean and the North Sea show it is not correct to assume that daily maximum wave heights are statistically independent; they are subject to Markov chain condition, obeying log-normal distribution. In this paper an analytical method is derived to predict extreme wave heights in these cases. A comparison of the computations shows that the difference between the extreme wave heights based on the assumption that daily maxima are statistically independent and that they are subject to Markov Chain condition is smaller than 10%.

  10. Two logistic models for the prediction of hypothyroidism in pregnancy

    National Research Council Canada - National Science Library

    Mbah, Anthony U; Ejim, Emmanuel C; Onodugo, Obinna D; Ezugwu, Francis O; Eze, Matthew I; Nkwo, Peter O; Ugbajah, Winston C

    2011-01-01

    .... In this study the variables compared between the hypothyroid and non-hypothyroid pregnant women were maternal age, the number of the pregnancy or gravidity, gestational age, social class, body weight...

  11. The Application of First‑Trimester Volumetry in Predicting Pregnancy ...

    African Journals Online (AJOL)

    filled spaces, sonography‑based automated volume count[44] and extended imaging .... [54] Sono AVC is automatic, but ... an efficient method for the early and simple identification of ... pregnancies, logistic regression models for the detection.

  12. Clinical significance of an isolated choroid plexus cysts in the second trimester of pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye; Lee, You Me; Son, Jung Ryun; Shin, Yong Won; Kim, Ji Hye; Lee, Sook Hwan [Pochon CHA University College of Medicine, Pochon (Korea, Republic of)

    2001-03-15

    To evaluate the significance of fetal choroid plexus cysts (CPCs) in the second trimester of pregnancy. Eighty-nine cases of isolated CPCs were prospectively followed up and 5 consecutive pregnancies of trisomy 18 were analyzed. Isolated CPCs were defined as follows: 1)there were no other abnormalities except CPCs on the detailed ultrasound. 2) the mother did not have any risk factors requiring amniocentesis. We compared maternal age, gestational age at time of detection, and the characteristics of CPCs in the groups of isolated CPCs and trisomy 18. We evaluated the autopsy findings or sonographic abnormalities in the group of trisomy 18. Material and gestational age were not different in both groups (29 +- 2.1 vs 31 +- 3.9 years old; 19 +- 1.8 vs 19 +- 1.3 week; p>0.05). The size of isolated CPCs was smaller than that of trisomy 18 (6.5 +- 2.5 vs 12.6 +- 4.6 mm; p<0.01). All of isolated CPCs had disappeared and there was no trisomy 18. In the group of trisomy 18, all of them had CPCs and at least one other associated abnormalities. The risk of trisomy 18 in cases of isolated CPCs was very low. In this setting, the detailed ultrasound examination rather than the routine karyotyping is mandatory.

  13. Metabolomic Prediction of Pregnancy Viability in Superovulated Cattle Embryos and Recipients with Fourier Transform Infrared Spectroscopy

    Directory of Open Access Journals (Sweden)

    Marta Muñoz

    2014-01-01

    Full Text Available We analyzed embryo culture medium (CM and recipient blood plasma using Fourier transform infrared spectroscopy (FTIR metabolomics to identify spectral models predictive of pregnancy outcome. Embryos collected on Day 6 from superovulated cows in 2 countries were individually cultured in synthetic oviduct fluid medium with BSA for 24 h before embryo transfer. Spent CM, blank controls, and plasma samples (Day 0 and Day 7 were evaluated using FTIR. The spectra obtained were analyzed. The discrimination capability of the classifiers was assessed for accuracy, sensitivity (pregnancy, specificity (nonpregnancy, and area under the ROC curve (AUC. Endpoints considered were Day 60 pregnancy and birth. High AUC was obtained for Day 60 pregnancy in CM within individual laboratories (France AUC=0.751±0.039, Spain AUC=0.718±0.024, while cumulative data decreased the AUC (AUC=0.604 ± 0.029. Predictions for CM at birth were lower than Day 60 pregnancy. Predictions with plasma at birth improved cumulative over individual results (Day 0: France AUC=0.690±0.044; Spain AUC<0.55; cumulative AUC=0.747±0.032. Plasma generally predicted pregnancy and birth better than CM. These first results show that FTIR metabolomics could allow the identification of embryos and recipients with improved pregnancy viability, which may contribute to increasing the efficiency of selection schemes based on ET.

  14. Analysis of significant factors for dengue fever incidence prediction.

    Science.gov (United States)

    Siriyasatien, Padet; Phumee, Atchara; Ongruk, Phatsavee; Jampachaisri, Katechan; Kesorn, Kraisak

    2016-04-16

    Many popular dengue forecasting techniques have been used by several researchers to extrapolate dengue incidence rates, including the K-H model, support vector machines (SVM), and artificial neural networks (ANN). The time series analysis methodology, particularly ARIMA and SARIMA, has been increasingly applied to the field of epidemiological research for dengue fever, dengue hemorrhagic fever, and other infectious diseases. The main drawback of these methods is that they do not consider other variables that are associated with the dependent variable. Additionally, new factors correlated to the disease are needed to enhance the prediction accuracy of the model when it is applied to areas of similar climates, where weather factors such as temperature, total rainfall, and humidity are not substantially different. Such drawbacks may consequently lower the predictive power for the outbreak. The predictive power of the forecasting model-assessed by Akaike's information criterion (AIC), Bayesian information criterion (BIC), and the mean absolute percentage error (MAPE)-is improved by including the new parameters for dengue outbreak prediction. This study's selected model outperforms all three other competing models with the lowest AIC, the lowest BIC, and a small MAPE value. The exclusive use of climate factors from similar locations decreases a model's prediction power. The multivariate Poisson regression, however, effectively forecasts even when climate variables are slightly different. Female mosquitoes and seasons were strongly correlated with dengue cases. Therefore, the dengue incidence trends provided by this model will assist the optimization of dengue prevention. The present work demonstrates the important roles of female mosquito infection rates from the previous season and climate factors (represented as seasons) in dengue outbreaks. Incorporating these two factors in the model significantly improves the predictive power of dengue hemorrhagic fever forecasting

  15. Predictive value of serum HCG concentrations in pregnancies achieved after single fresh or vitrified-warmed blastocyst transfer.

    Science.gov (United States)

    Oron, Galia; Shavit, Tal; Esh-Broder, Efrat; Weon-Young, Son; Tulandi, Togas; Holzer, Hananel

    2017-09-01

    Possible differences between serum HCG levels in pregnancies achieved after transfer of a single fresh or a vitrified-warmed blastocyst were evaluated. Out of 1130 single blastocyst transfers resulting in positive HCG results, 789 were single fresh blastocyst transfers and 341 single vitrified-warmed blastocyst transfers. The initial serum HCG levels of 869 clinical intrauterine pregnancies were evaluated, 638 after the transfer of a single fresh blastocysts and 231 after the transfer of a single vitrified-warmed blastocysts. The HCG levels from cycles resulting in a clinical intrauterine pregnancy were significantly higher after the transfer of a single vitrified-warmed blastocyst (383 ± 230 IU/l) versus a fresh transfer (334 ± 192 IU/l; P = 0.01). Threshold values for predicting a clinical pregnancy for a fresh blastocyst were 111 IU/l and for a vitrified-warmed blastocyst 137 IU/l. Our study shows that the overall beta-HCG levels are comparable after the transfer of a fresh or vitrified-warmed blastocyst, suggesting that vitrification most probably does not affect the ability of the embryos to produce beta-HCG. This study further shows that when clinicians counsel patients, they should take into account that higher HCG levels are needed after a vitrified-warmed blastocyst transfer to predict a clinical intrauterine pregnancy. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-10-01

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

  17. Abnormal vaginal colonization by gram-negative bacteria is significantly higher in pregnancy conceived through infertility treatment compared to natural pregnancy.

    Science.gov (United States)

    Kim, Ji Y; Sung, Ji-Hee; Chang, Kylie Hae-Jin; Choi, Suk-Joo; Oh, Soo-Young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2017-03-01

    To compare abnormal vaginal colonization between natural pregnancy and pregnancy by infertility treatment in high-risk parturient women and to examine the association between abnormal vaginal colonization and early-onset neonatal sepsis (EONS). The clinical characteristics, vaginal culture result, and delivery outcome of patients who admitted to our high-risk unit between 2005 and 2014 were retrospectively reviewed and compared. We investigated the prevalence of EONS according to maternal vaginal colonization and examined the concordance between maternal vaginal bacteria and etiologic microorganism causing EONS. Among 1096 pregnancies, the rate of vaginal colonization by gram-negative bacteria, especially Escherichia coli was significantly higher in pregnancies by infertility treatment after adjustment of confounding variables (E. coli, OR [95% CI]: 2.47 [1.33-4.57], p = 0.004). The rate of EONS was significantly higher in neonates with maternal abnormal vaginal bacteria colonization (OR [95% CI]: 3.38 [1.44-7.93], p = 0.005) after adjusting for confounding variables. Notably, among microorganisms isolated from maternal vagina, E. coli and Staphylococcus aureus were consistent with the results from neonatal blood culture in EONS. Our data implicate a possible association between gram-negative bacteria colonization and infertility treatment and suggest that maternal vaginal colonization may be associated with EONS of neonates in high-risk pregnancy.

  18. 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....

  19. Iron deficiency predicts poor maternal thyroid status during pregnancy

    NARCIS (Netherlands)

    Zimmermann, M.B.; Burgi, H.; Hurrell, R.F.

    2007-01-01

    Context: Pregnant women are often iron deficient, and iron deficiency has adverse effects on thyroid metabolism. Impaired maternal thyroid function during pregnancy may cause neurodevelopmental delays in the offspring. Objective: Our objective was to investigate whether maternal iron status is a det

  20. Iron deficiency predicts poor maternal thyroid status during pregnancy

    NARCIS (Netherlands)

    Zimmermann, M.B.; Burgi, H.; Hurrell, R.F.

    2007-01-01

    Context: Pregnant women are often iron deficient, and iron deficiency has adverse effects on thyroid metabolism. Impaired maternal thyroid function during pregnancy may cause neurodevelopmental delays in the offspring. Objective: Our objective was to investigate whether maternal iron status is a det

  1. Iron deficiency predicts poor maternal thyroid status during pregnancy

    NARCIS (Netherlands)

    Zimmermann, M.B.; Burgi, H.; Hurrell, R.F.

    2007-01-01

    Context: Pregnant women are often iron deficient, and iron deficiency has adverse effects on thyroid metabolism. Impaired maternal thyroid function during pregnancy may cause neurodevelopmental delays in the offspring. Objective: Our objective was to investigate whether maternal iron status is a

  2. Two logistic models for the prediction of hypothyroidism in pregnancy.

    Science.gov (United States)

    Mbah, Anthony U; Ejim, Emmanuel C; Onodugo, Obinna D; Ezugwu, Francis O; Eze, Matthew I; Nkwo, Peter O; Ugbajah, Winston C

    2011-06-18

    The mounting evidence linking hypothyroidism during pregnancy with poor pregnancy outcome underscores the need for screening and, therefore, a search for more reliable and cheaper screening methods. The study was conducted in two phases. The phase one study comprised of healthy women in different stages of pregnancy who attended routine antenatal clinic at St Theresa's Maternity Hospital, Enugu, Nigeria from September 6 to October 18 1994. In this study the variables compared between the hypothyroid and non-hypothyroid pregnant women were maternal age, the number of the pregnancy or gravidity, gestational age, social class, body weight, height, the clinically assessed size of the thyroid gland, serum free thyroxin (FT4) and serum thyrotrophin (TSH). Based on the parameter differences between the two comparison groups of pregnant women two Logistic models, Model I and Model 11, were derived to differentiate the hypothyroid group from their non-hypothyroid counterparts. The two logistic models were then applied in a prospective validation study involving 197 pregnant women seen at presentation in Mother of Christ Specialist Hospital and Maternity, Ogui Road, Enugu from March 2002 to November 2007 The findings were that 82 (50.3%) of the 163 pregnant women had thyroid gland enlargement while 60 (36.8%) had hypothyroidism as defined by FT4 values below and/or TSH above their laboratory reference ranges. The pregnant subjects with hypothyroidism, compared with their non-hypothyroid counterparts, were characterized by a higher gravidity (p hypothyroidism during pregnancy. There is, however, a need for further independent confirmation of these findings.

  3. Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

    Directory of Open Access Journals (Sweden)

    Amanda Johnson

    2015-01-01

    Full Text Available Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. They were found to have severely elevated lipase levels over 1,000 units/liter. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels. Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis. Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis.

  4. Significance of bioindicators to predict survival in irradiated minipigs.

    Science.gov (United States)

    Moroni, Maria; Port, Matthias; Koch, Amory; Gulani, Jatinder; Meineke, Viktor; Abend, Michael

    2014-06-01

    The minipig is emerging as a potential alternative non-rodent animal model. Several biological markers (e.g., blood counts, laboratory parameters, and clinical signs) have been proposed for rapid triage of radiation victims. Here, the authors focus on the significance of bio-indicators for prediction of survivors after irradiation and compare it with human data; the relationship between these biomarkers and radiation dose is not part of this study. Male Göttingen minipigs (age 4-5 mo, weight 9-10 kg) were irradiated (or sham-irradiated) bilaterally with gamma-photons (⁶⁰Co, 0.5-0.6 Gy min⁻¹) in the dose range of 1.6-12 Gy. Peripheral blood cell counts, laboratory parameters, and clinical symptoms were collected up to 10 d after irradiation and analyzed using logistic regression analysis and calculating ROC curves. In moribund pigs, parameters such as decreased lymphocyte/granulocyte counts, increased C-reactive protein, alkaline phosphatase values, as well as increased citrulline values and body temperature, significantly (p 0.8). However, most predictive within the first 3 d after exposure was a combination of decreased lymphocyte counts and increased body temperature observed as early as 3 h after radiation exposure (ROC: 0.93-0.96, p < 0.0001). Sham-irradiated animals (corresponding to "worried wells") could be easily discriminated from dying pigs, thus pointing to the diagnostic significance of this analysis. These data corroborate with earlier findings performed on human radiation victims suffering from severe hematological syndrome and provide further evidence for the suitability of the minipig model as a potential alternative non-rodent animal model.

  5. Use of Sperm Parameters to Predict Clinical Pregnancy with Intrauterine Insemination.

    Science.gov (United States)

    Butcher, Michael J; Janoo, Jabin; Broce, Mike; Seybold, Dara J; Gantt, Pickens; Randall, Gary

    2016-01-01

    To test the hypothesis that morphology is the best predictor of clinical pregnancy (CP) when employing intrauterine insemination (IUI). We retrospectively reviewed a registry of 527 couples who collectively underwent 1,027 IUI cycles, testing sperm parameters and other variables with univariate and multivariate analyses for association with CP. With the literature scant regarding the impact of sperm morphology on IUI outcome, we determined semen parameter threshold values in our patient population and compared them to published reference range values. A logistic regression model was used to determine predictors of CP. Fecundity was 12.9% per cycle and fertility was 23.3% by the third attempted cycle. Morphology was the most significant parameter predicting CP with IUI. Motility was also significant when employing our new threshold values. Using receiver operator characteristic curve analysis, values 16% morphology and 69% motility were found to be the optimal threshold values for achieving CP. Morphology was the best predictor of CP. When considering IUI, the best chance of clinical pregnancy occurs when both motility and morphology values are above normal thresholds.

  6. The presence of a sponsoring embryo in a batch of poor quality thawed embryos significantly increases pregnancy and implantation rate.

    Science.gov (United States)

    Lightman, A; Kol, S; Wayner, V; Vertman, D; Manor, D; Itskovitz-Eldor, J

    1997-04-01

    To evaluate quantitatively the effect of one good-quality (sponsoring) embryo in a batch of low-quality thawed embryos on the implantation and pregnancy rates (PR). Retrospective analysis of data. Tertiary care center IVF clinic affiliated with a university medical school. Between March 1988 and April 1995, 392 IVF patients underwent a total of 440 thawing and ET cycles of 1,436 multicellular embryos. Implantation, clinical pregnancy, and multiple pregnancy rates. In the absence of sponsoring embryos in the thawed batch of embryos, a PR of 9.8% with an implantation rate of 3.1% was achieved. In the presence of a single sponsoring embryo, the PR nearly doubled (18.2%), with a significantly higher implantation rate of 7.0%. Only singleton pregnancies were achieved in the absence of sponsoring embryos compared with 21.7% multiple pregnancies in the single sponsoring embryo group. The presence of a sponsoring embryo in a batch of poor quality thawed embryos is an important factor that significantly increased pregnancy and implantation rates. The optimal strategy for planning batches of multicellular frozen embryos is to include at least one sponsoring embryo in each batch when possible. We speculate that the sponsoring embryo may favorably influence the chances of low-quality embryos to undergo successful implantation.

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

    Science.gov (United States)

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

    2004-08-01

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

  8. Formalized prediction of clinically significant prostate cancer: is it possible?

    Institute of Scientific and Technical Information of China (English)

    Carvell T Nguyen; Michael W Kattan

    2012-01-01

    Greater understanding of the biology and epidemiology of prostate cancer in the last several decades have led to significant advances in its management.Prostate cancer is now detected in greater numbers at lower stages of disease and is amenable to multiple forms of efficacious treatment.However,there is a lack of conclusive data demonstrating a definitive mortality benefit from this earlier diagnosis and treatment of prostate cancer.It is likely due to the treatment of a large proportion of indolent cancers that would have had little adverse impact on health or lifespan if left alone.Due to this overtreatment phenomenon,active surveillance with delayed intervention is gaining traction as a viable management approach in contemporary practice.The ability to distinguish clinically insignificant cancers from those with a high risk of progression and/or lethality is critical to the appropriate selection of patients for surveillance protocols versus immediate intervention.This chapter will review the ability of various prediction models,including risk groupings and nomograms,to predict indolent disease and determine their role in the contemporary management of clinically localized prostate cancer.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  12. Pregnancy prediction by free sperm DNA and sperm DNA fragmentation in semen specimens of IVF/ICSI-ET patients.

    Science.gov (United States)

    Bounartzi, Theofania; Dafopoulos, Konstantinos; Anifandis, George; Messini, Christina I; Koutsonikou, Chrysoula; Kouris, Spyros; Satra, Maria; Sotiriou, Sotirios; Vamvakopoulos, Nicholas; Messinis, Ioannis E

    2016-04-01

    The purpose of this study was to evaluate the predictive value of free sperm plasma DNA (f-spDNA) and sperm DNA fragmentation (SDF), in semen specimens from men undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) treatments. Fifty-five semen samples were evaluated during 55 consecutive IVF/ICSI-ET cycles. F-spDNA was determined by conventional quantitative real-time PCR-Sybr green detection approach, while evaluation of sperm DNA damage was performed using the sperm chromatin dispersion (SCD) assay. While f-spDNA only correlated with total sperm count, SDF correlated with many semen parameters (including sperm concentration, total sperm count and the per cent of non-progressive sperm). Neither SDF nor the proportion of sperm with small or no halos correlated with f-spDNA. Interestingly, smoking status correlated with f-spDNA but not with SDF. Although these two factors seem to interact for the prediction of pregnancy, receiver-operating characteristics (ROC) analysis revealed that SDF had a stronger predictive value (AUC = 0.7, p  0.05). SDF and f-spDNA may not be associated together but they interact at a significant level in order to exert their actions on pregnancy outcome. Among the two markers, SDF appears to have stronger and significantly predictive value for pregnancy success.

  13.  The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Hala Abdul Qadir Al-Moayed

    2012-03-01

    Full Text Available  Objective: To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P,ß-HCG, and estradiol (E2 in the early diagnosis of ectopic pregnancy.Methods: Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011.Results: The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively. When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7�20specificity 100�20the positive predictive value was100�0and the negative predictive value 71.4�onclusion: The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

  14. Significantly enhanced pregnancy rates per cycle through cryopreservation and thaw of pronuclear stage oocytes.

    Science.gov (United States)

    Veeck, L L; Amundson, C H; Brothman, L J; DeScisciolo, C; Maloney, M K; Muasher, S J; Jones, H W

    1993-06-01

    To examine the results of a 5-year trial using cryopreservation to limit multiple pregnancy and optimize overall pregnancy per cycle. Retrospective clinical evaluation of pregnancy rates (PRs) per cycle after freezing pronuclear stage human oocytes. Tertiary care academic center. Six hundred seventeen patients treated in 776 IVF-ET cycles from January 1987 to December 1991 (less oocyte donation cycles). Pregnancy rate per cycle after transfer of pre-embryos developed from thawed pronuclear stage oocytes. Three thousand seven hundred thirty-one oocytes were frozen. Of these, 2,039 were thawed. One thousand three hundred seventy-seven survived thawing (68%), and 1,370 were transferred after passing through syngamy to at least the first cleavage (68%). Of patients with thawing, 359 of 401 (90%) (449 of 505 cycles [89%]) received intrauterine transfer. One hundred thirty-three separate clinical pregnancies were established from 128 different cycles (128/449; 29%); 5 cycles had two thaws, each of which resulted in pregnancy. This PR is less than the overall fresh PR observed in patients who had excess pronucleate oocytes frozen (279/776; 36%) but is remarkably similar when adjusted for the number of pre-embryos transferred per cycle. The age of the patient at the time of cryopreservation and the number of quality of pre-embryos ultimately available for transfer were important factors in the establishment of pregnancy. The mode of ovarian stimulation and duration of cryostorage did not prove meaningful. Cryopreserved pronucleate oocytes that survive freezing, thawing, and progress through syngamy demonstrate a similar potential for implantation and pregnancy when compared with fresh conceptuses, the cumulative effect of which is an enhanced total PR per cycle.

  15. Prediction of prolonged pregnancy in nulliparous women by transvaginal ultrasonographic measurement of cervical length at 20-24 weeks and 37 weeks.

    Science.gov (United States)

    Suh, Young Hoon; Park, Kyo Hoon; Hong, Joon-Seok; Noh, Jae Hong

    2007-02-01

    This study was done to evaluate transvaginal ultrasonographic measurement of cervical length at 20 to 24 weeks and 37 weeks as a predictor of prolonged pregnancy (defined as a pregnancy that extended beyond 41+2 weeks of gestation [289 days]) in nulliparous women. This prospective observational study enrolled 149 consecutive nulliparous women with singleton gestation at 37 weeks. Cervical length was measured by transvaginal ultrasonography at 20 to 24 weeks and 37 weeks. Cervical length at 37 weeks, but not at 20 to 24 weeks, was significantly longer in women delivered at >41+2 weeks than in those delivered at prolonged pregnancy was 30 mm, with a sensitivity of 78% and a specificity of 62%. Cervical length assessed by transvaginal ultrasonography at 37 weeks can predict the likelihood of prolonged pregnancy in nulliparous women. However, there is no association between cervical length at 20 to 24 weeks and the occurrence of prolonged pregnancy.

  16. Macronutrient Balance and Dietary Glycemic Index in Pregnancy Predict Neonatal Body Composition

    Directory of Open Access Journals (Sweden)

    Nathalie V. Kizirian

    2016-05-01

    Full Text Available The influence of maternal macronutrient balance and dietary glycemic index (GI on neonatal body composition has received little study. We hypothesized that the overall quantity and quality of macronutrients, particularly carbohydrate, in the maternal diet could have trimester-specific effects on neonatal growth and body composition in women at risk of gestational diabetes. Maternal diet was assessed using 3-day food records in mid (n = 96 and late (n = 88 pregnancy as part of the GI Baby 3 study. Neonatal body composition was assessed by air-displacement plethysmography within 48 h of birth, adjusted for length, and expressed as fat mass index (FMI and fat-free mass index (FFMI. In mid pregnancy, higher maternal intake of carbohydrate energy was negatively correlated with infant FFMI (p = 0.037. In late pregnancy, higher dietary GI was associated with lower FFMI (p = 0.010 and higher carbohydrate energy predicted lower FMI (p = 0.034. Higher fat intake (%E and saturated fat, but not protein, also predicted neonatal body composition (higher FFMI in mid pregnancy and higher FMI in late pregnancy. Depending on pregnancy stage, a high carbohydrate-low fat diet, particularly from high glycemic sources, may reduce neonatal indices of both lean mass and adiposity.

  17. Macronutrient Balance and Dietary Glycemic Index in Pregnancy Predict Neonatal Body Composition

    Science.gov (United States)

    Kizirian, Nathalie V.; Markovic, Tania P.; Muirhead, Roslyn; Brodie, Shannon; Garnett, Sarah P.; Louie, Jimmy C. Y.; Petocz, Peter; Ross, Glynis P.; Brand-Miller, Jennie C.

    2016-01-01

    The influence of maternal macronutrient balance and dietary glycemic index (GI) on neonatal body composition has received little study. We hypothesized that the overall quantity and quality of macronutrients, particularly carbohydrate, in the maternal diet could have trimester-specific effects on neonatal growth and body composition in women at risk of gestational diabetes. Maternal diet was assessed using 3-day food records in mid (n = 96) and late (n = 88) pregnancy as part of the GI Baby 3 study. Neonatal body composition was assessed by air-displacement plethysmography within 48 h of birth, adjusted for length, and expressed as fat mass index (FMI) and fat-free mass index (FFMI). In mid pregnancy, higher maternal intake of carbohydrate energy was negatively correlated with infant FFMI (p = 0.037). In late pregnancy, higher dietary GI was associated with lower FFMI (p = 0.010) and higher carbohydrate energy predicted lower FMI (p = 0.034). Higher fat intake (%E) and saturated fat, but not protein, also predicted neonatal body composition (higher FFMI in mid pregnancy and higher FMI in late pregnancy). Depending on pregnancy stage, a high carbohydrate-low fat diet, particularly from high glycemic sources, may reduce neonatal indices of both lean mass and adiposity. PMID:27164136

  18. Evaluating the sensitivity and predictive value of tests of recent infection: toxoplasmosis in pregnancy.

    Science.gov (United States)

    Ades, A E

    1991-12-01

    The diagnosis of maternal infection in early pregnancy depends on tests which are sensitive to recent infection, such as specific IgM. Two types of test are considered: those where the response persists for a period following infection and then declines, such as IgM, and those whose response increases with time since infection, such as IgG-avidity. However, individuals vary in their response to infection, and it may not always be possible to determine whether an infection occurred during pregnancy or before it. Mathematical methods are developed to evaluate the performance of these tests, and are applied to the diagnosis of toxoplasmosis in pregnancy. It is shown that, based on existing information, tests of recent infection are unlikely to be both sensitive and predictive. More data on these tests are required, before they can be reliably used to determine whether infection has occurred during pregnancy or before it.

  19. Evidence for No Significant Impact of Müllerian Anomalies on Reproductive Outcomes of Twin Pregnancy in Korean Women.

    Science.gov (United States)

    Shim, Sohyun; Hur, Yoon-Mi; Kim, Da Hee; Seong, Seok Ju; Kim, Mi-La; Shin, Joong Sik

    2016-04-01

    The present article aimed to evaluate the impact of congenital Müllerian anomalies (MA) on twin pregnancy after 24 gestational weeks in Korean women. All records of twin pregnancies in a large maternity hospital in Korea between January 2005 and July 2013 were analyzed. Patients with monochorionic monoamniotic (MCMA) twins, non-Korean patients, patients with twins delivered prior to 24 gestational weeks, and patients with miscarriage of one fetus or intrauterine fetal death (IUFD) before 24 gestational weeks were excluded from data analysis. In total, 1,422 women with twin pregnancy were eligible for data analysis, including 17 (1.2%) who had a known congenital MA (septate uterus, bicornuate uterus, arcuate uterus, and unicornuate uterus). Except for the mode of conception, baseline demographics were similar between women with MA and those without MA. No significant differences were found in pregnancy outcomes of gestational age at delivery (p = .86), birth weight of smaller and larger twins (p = .54 and p = .65), and number of twins with birth weight <5th percentile for gestational age (p = .43).The rates of obstetrical complications such as pre-eclampsia, gestational diabetes mellitus (GDM), placenta previa, cerclage, IUFD, and postpartum hemorrhage were not significantly different between the two groups either. We concluded that the presence of congenital MA may not increase obstetrical risks in outcomes of pregnancy of twins delivered after 24 gestational weeks.

  20. Prediction of spontaneous preterm delivery in asymptomatic twin pregnancies using cervical length and granulocyte elastase.

    Science.gov (United States)

    Tanaka, Kei; Yamada, Kenji; Matsushima, Miho; Izawa, Tomoko; Furukawa, Seishi; Kobayashi, Yoichi; Iwashita, Mitsutoshi

    2017-04-01

    The purpose of this study was to evaluate sonographic cervical length (CL) and granulocyte elastase (GE) in cervical secretion as predictors of preterm delivery in asymptomatic twin pregnancies. This study prospectively enrolled asymptomatic twin pregnancies with CL preterm labor, and the cervical secretion was obtained for GE testing on admission. The results of CL measurement and GE testing were reviewed, and the relationship between each variables and preterm delivery prior to 34 weeks of gestation was assessed. Overall, we included 54 women with twin pregnancies, of which 12 (22.2%) had preterm deliveries prior to 34 weeks of gestation. A CL of preterm delivery with an odds ratio of 4.88 (95% confidence limit, 1.15-20.73). GE was not an independent predictive marker for preterm delivery. We also performed a subgroup analysis on the combination of CL and GE for predicting preterm delivery. Among the patients with GE(-), CL preterm delivery with an odds ratio of 10.89 (95% confidence limit, 1.40-77.10). CL was not associated with preterm delivery among those with GE(+). Those with negative GE and shorter CL demonstrated the shortest duration of pregnancy after admission. The combination of sonographic CL and GE of cervical secretion is useful to predict the risk of preterm delivery in asymptomatic twin pregnancies. Copyright © 2017. Published by Elsevier B.V.

  1. Predictive factors for the methotrexate treatment outcome in ectopic pregnancy: A comparative study of 400 cases.

    Science.gov (United States)

    Bonin, Lucie; Pedreiro, Cécile; Moret, Stéphanie; Chene, Gautier; Gaucherand, Pascal; Lamblin, Géry

    2017-01-01

    We sought to evaluate the global success rate of intramuscular methotrexate for the treatment of ectopic pregnancy, identify factors predictive of treatment success or failure, and study methotrexate tolerability in a large patient cohort. For this single-center retrospective observational study, we retrieved the records of all women who had a clinically or echographically confirmed ectopic pregnancy with a Fernandez score ectopic pregnancy. The medical treatment protocol was effective for 314 patients, i.e., an overall success rate of 78.5%. A single methotrexate dose was sufficient for 63.5% of the women and a second dose was successful for 73.2% of the remaining women. The medical treatment success rate fell as initial hCG levels climbed. The main factors associated with methotrexate failure included day (D) 0, D4 and D7 hCG levels, pretherapeutic blood progesterone, hematosalpinx at D0 and pain at D7. Early favorable kinetics of hCG levels was predictive of success. Methotrexate treatment was successful in 90% of women who had D0 hCG ectopic pregnancy was 80.7%. In this study, we showed that an initial hCG value ectopic pregnancy by methotrexate, and hematosalpinx and pretherapeutic blood progesterone >5ng/ml at diagnosis were predictive of its failure. We also confirmed good tolerability for single-dose methotrexate protocols. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. [Predictive tools of preterm birth in asymptomatic high-risk pregnancy].

    Science.gov (United States)

    Blanc, J; Bretelle, F

    2016-12-01

    Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3). The literature data are insufficient to recommend systematic cervical examination at each prenatal visit in asymptomatic high-risk pregnancy (multiple pregnancy, uterine malformations, history of spontaneous preterm birth, excisional cervical procedure or at least two voluntary first trimester abortion) (professional consensus). Regular recording of uterine activity and home visits for asymptomatic high-risk pregnancy did not predict nor reduce the risk of preterm birth (LE2) and are not recommended (grade B). In asymptomatic high-risk pregnancy, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). Shorter is the cervical length higher is the risk of preterm birth (LE3). In asymptomatic patient with prior preterm birth, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). The strategy of ultrasound indicated cerclage are discussed in dedicated chapter. The measurement of cervical length by transvaginal ultrasonography in asymptomatic pregnancy with uterine malformation, a history of cervical treatment, at least two voluntary abortions or having a multiple pregnancy would estimate the risk of preterm birth (LE3). A shortening of more than 10% of the cervical length at 3-week interval is associated with an increased risk of preterm birth (LE3). Systematic detection of fetal fibronectin is not recommended in

  3. Sonographic findings and clinical significance of uterine synechiae in pregnancy: Report of 6 cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Hyung; Kim, Jung Sik [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    1994-12-15

    We analyzed the sonograms of 6 cases with uterine synechiae in pregnancy. The diagnosis was based on the clinical and sonographic findings. Previous curret age during the artificial abortion and/or after the spontaneous abortion had been done in 5 cases (83.3%). In all cases, uterine synechia in pregnancy was recognized asintra-amniotic sheet containing hypoechoic central zone and an hyperechoic outer layers. Y-shaped splitting of thehyperechoic outer layers was seen against the uterine wall. The placenta extended along the sheet in 4 cases. Uterine synechiae in pregnancy should be distinguished from amniotic band syndrome by the characteristic snographic findings, and unwarranted abortion of normal fetus should be avoided

  4. Correlation of Serum CA-125 and Progesterone Levels with Ultrasound Markers in The Prediction of Pregnancy Outcome in Threatened Miscarriage

    Science.gov (United States)

    Al Mohamady, Maged; Fattah, Ghada Abdel; Elkattan, Eman; Bayoumy, Rasha; Hamed, Dalia Ahmed

    2016-01-01

    Background The aim of this study was to evaluate the relationship between ultrasonographic findings and serum progesterone and cancer antigen-125 (CA-125) levels in threatened miscarriage and to predict pregnancy outcome. Materials and Methods In a prospective comparative case-control study, serum CA-125 and progesterone levels were measured for 100 pregnant women with threatened miscarriage who attended the outpatient clinic or the causality department of Obstetrics and Gynecology at Kasr El-Aini Hospital, Giza, Egypt, during the period from March 2013 to October 2013. Ultrasound was performed for fetal viability, crown-rump length (CRL), gestational sac diameter (GSD) and fetal heart rate (FHR). The patients were followed up and divided into two groups based on the outcome: 20 women who miscarried (group 1), and 80 women who continued pregnancy (group 2). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were tested for CA-125 and progesterone levels in prediction of the pregnancy outcome. Correlation of these chemical markers with the ultrasound markers was also examined. Results In the group that miscarried, CA-125 level was significantly higher (P<0.001) and serum progesterone level was significantly lower (P<0.001). For prediction of the outcome of pregnancy, the cut-off limit of 31.2 IU/ml for CA-125 level yielded sensitivity, specificity and an overall accuracy of 96.2, 100 and 99.4% respectively. The cut-off limit of 11.5 ng/ml for progesterone level yielded sensitivity, specificity and an overall accuracy of 97.5, 100 and 99.8% respectively. CA-125 level had a negative correlation with progesterone level and FHR levels (r=-0.716, P<0.001) and (r=-0.414, P<0.001) respectively. Serum progesterone level correlated with GSD (r=0.521, P<0.001) and with CRL (r=0.407, P<0.001) and FHR (r=0.363, P<0.001). CA-125 level was significantly higher in the group that showed hematoma as compared with the

  5. 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....

  6. Risk indicators predictive for severe hypoglycemia during the first trimester of type 1 diabetic pregnancy

    NARCIS (Netherlands)

    Evers, IM; van der Schoot, B; ter Braak, EWMT; Janssen, N; de Valk, HW; Visser, GHA

    2002-01-01

    OBJECTIVES- To investigate the frequency of severe hypoglycemia (SH) and hypoglycemic coma during the first trimester of type 1 diabetic pregnancy and in the 4 months before gestation and to identify risk indicators predicting first trimester SH in a nonselected nationwide cohort of pregnant women w

  7. Prospective validation of two models predicting pregnancy leading to live birth among untreated subfertile couples.

    Science.gov (United States)

    Hunault, Claudine C; Laven, Joop S E; van Rooij, Ilse A J; Eijkemans, Marinus J C; te Velde, Egbert R; Habbema, J Dik F

    2005-06-01

    Models predicting clinical outcome need external validation before they can be applied safely in daily practice. This study aimed to validate two models for the prediction of the chance of treatment-independent pregnancy leading to live birth among subfertile couples. The first model uses the woman's age, duration and type of subfertility, percentage of progressive sperm motility and referral status. The second model in addition uses the result of the post-coital test (PCT). For validation, these characteristics were collected prospectively in two University hospitals for 302 couples consulting for subfertility. The models' ability to distinguish between women who became pregnant and women who did not (discrimination) and the agreement between predicted and observed probabilities of treatment-independent pregnancy (calibration) were assessed. The discrimination of both models was slightly lower in the validation sample than in the original sample which provided the model. Calibration was good: the observed and predicted probabilities of treatment-independent pregnancy leading to live birth did not differ for both models. The chance of pregnancy leading to live birth was reliably estimated in the validation sample by both models. The use of PCT improved the discrimination of the models. These models can be useful in counselling subfertile couples.

  8. Significance of Classification Techniques in Prediction of Learning Disabilities

    CERN Document Server

    Balakrishnan, Julie M David And Kannan

    2010-01-01

    The aim of this study is to show the importance of two classification techniques, viz. decision tree and clustering, in prediction of learning disabilities (LD) of school-age children. LDs affect about 10 percent of all children enrolled in schools. The problems of children with specific learning disabilities have been a cause of concern to parents and teachers for some time. Decision trees and clustering are powerful and popular tools used for classification and prediction in Data mining. Different rules extracted from the decision tree are used for prediction of learning disabilities. Clustering is the assignment of a set of observations into subsets, called clusters, which are useful in finding the different signs and symptoms (attributes) present in the LD affected child. In this paper, J48 algorithm is used for constructing the decision tree and K-means algorithm is used for creating the clusters. By applying these classification techniques, LD in any child can be identified.

  9. 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.

  10. 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 ...

  11. Predictive value of semen parameters and age of the couple in pregnancy outcome after Intrauterine insemination

    Directory of Open Access Journals (Sweden)

    Marjan Sabbaghian

    2013-11-01

    Full Text Available Background: Intrauterine insemination (IUI is one the most common methods in infertility treatment, but its efficiency in infertile couples with male factor is controversial. This study is a retrospective study about correlation between semen parameters and male and female age with successful rate of IUI in patients attending to Royan Institute.Methods: A total of 998 consecutive couples in a period of 6 months undergoing IUI were included. They were classified into two groups: couples with successful and unsuccessful pregnancy. Main outcome was clinical pregnancy. Data about male and female ages and semen analysis including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology was extracted from patients’ records. Semen samples were collected by masturbation or coitus after 2 to 7 days of abstinence. Their female partners were reported to have no chronic medi-cal conditions and have normal menstrual cycles.Results: One hundred and fifty seven of total 998 cycles (15.7% achieved pregnancy. The average of female age in successful and unsuccessful group was 28.95±4.19 and 30.00±4.56 years, respectively. Mean of male age was 33.97±4.85 years in successful group and 34.44±4.62 years in unsuccessful group. In successful and unsuccessful groups, average of sperm concentration was 53.62±38.45 and 46.26±26.59 (million sperm/ml, normal morphology of sperm was 8.98±4.31 (% and 8.68±4.81 (%, sperm total motility was 47.24±18.92 (% and 43.70±20.22 (% and total motile sperm count was 80.10±63.61 million and 78.57±68.22 million, respectively.Conclusion: There was no significant difference in mean of females’ age and males’ age between successful and unsuccessful groups (P<0.05. In addition, there was no significant difference in semen parameters including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology between two

  12. Predicted vitamin D status during pregnancy in relation to offspring forearm fractures in childhood

    DEFF Research Database (Denmark)

    Petersen, Sesilje B; Strøm, Marin; Maslova, Ekaterina

    2015-01-01

    and supplementary vitamin D intake, tanning bed use and outdoor physical activity) in pregnancy and offspring forearm fractures. Likewise, measured 25(OH)D, tanning bed use and dietary vitamin D intake were not associated with offspring forearm fractures. In mid-pregnancy, 91 % of the women reported intake...... of vitamin D from dietary supplements. Offspring of women who took >10 µg/d in mid-pregnancy had a significantly increased risk for fractures compared with the reference level of zero intake (hazard ratios (HR) 1·31; 95 % CI 1·06, 1·62), but this was solely among girls (HR 1·48; 95 % CI 1·10, 2......In a prospective cohort study, the association between maternal vitamin D status during pregnancy and offspring forearm fractures during childhood and adolescence was analysed in 30 132 mother and child pairs recruited to the Danish National Birth Cohort between 1996 and 2002. Data...

  13. Immune status parameters significance in pregnancy interruption on type of missed abortion in first trimester

    Directory of Open Access Journals (Sweden)

    Nagima Mamedaliyeva

    2012-10-01

    Full Text Available The paper explores the system immunity role of the first trimester missed abortion using the study of maintenance in populations and subpopulations of lymphocytes in the peripheral blood.Immune system disorders might cause self-regulation failure and immune response change. Recognition and removal of these disorders allow successful performing of implantation and increasing the probability for the pregnancy carriage. Survey of certain systemic immunity indicators dynamics and their contribution into the missed abortion progression, as well as development of early forecasting methods and prevention of such pregnancy complication aimed to reduce tissue-destroying responses towards a growing embryo and immunologic reactivity defects regeneration are of scientific and practical interest.

  14. Predictive Maintenance (PdM) Centralization for Significant Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Dale

    2010-09-15

    Cost effective predictive maintenance (PdM) technologies and basic energy calculations can mine energy savings form processes or maintenance activities. Centralizing and packaging this information correctly empowers facility maintenance and reliability professionals to build financial justification and support for strategies and personnel to weather global economic downturns and competition. Attendees will learn how to: Systematically build a 'pilot project' for applying PdM and tracking systems; Break down a typical electrical bill to calculate energy savings; Use return on investment (ROI) calculations to identify the best and highest value options, strategies and tips for substantiating your energy reduction maintenance strategies.

  15. Cervical length and maternal factors in expectantly managed prolonged pregnancy: prediction of onset of labor and mode of delivery.

    Science.gov (United States)

    Rao, A; Celik, E; Poggi, S; Poon, L; Nicolaides, K H

    2008-10-01

    To examine the value of combining cervical length and maternal characteristics in a prolonged-pregnancy clinic in the prediction of the probability of firstly, spontaneous onset of labor within the subsequent 10 days and secondly, the need for Cesarean section. This was a prospective study of women with singleton pregnancies attending an ultrasound-based prolonged-pregnancy clinic at 40 + 4 to 41 + 6 weeks of gestation. The policy was to delay induction of labor by 7-10 days unless there was evidence of a specific medical or obstetric indication or the mother wanted earlier delivery. The measurement of cervical length was not given to the obstetrician, midwife or patient. Regression analysis was used to determine which of the following factors had a significant contribution in predicting induction of labor: maternal age, body mass index (BMI), ethnic origin, parity and cervical length. Regression analysis was also used to determine which of the factors amongst the maternal characteristics, onset of labor and cervical length provided significant prediction of Cesarean section. We examined 2316 pregnancies but we excluded from further analysis 452 (19.5%) cases because iatrogenic delivery was carried out within the subsequent 6 days, including 427 cases of induction of labor (340 at the request of the mother and 87 for medical indications) and 25 cases of Cesarean section. In the remaining 1864 cases there was spontaneous onset of labor and delivery within 10 days in 1536 (82.4%) and induction of labor in 7-10 days in 328 (17.6%). The rate of Cesarean section was 15.2% (233 of 1536) in those with spontaneous onset of labor and 36.0% (118 of 328) in those whose labor was induced. Regression analysis demonstrated that in the prediction of induction of labor there were significant contributions from cervical length, BMI, parity and gestational age, and in the prediction of Cesarean section there were significant contributions from onset of labor, cervical length, BMI

  16. Second harmonic generation imaging as a potential tool for staging pregnancy and predicting preterm birth

    Science.gov (United States)

    Akins, Meredith L.; Luby-Phelps, Katherine; Mahendroo, Mala

    2010-03-01

    We use second harmonic generation (SHG) microscopy to assess changes in collagen structure of murine cervix during cervical remodeling of normal pregnancy and in a preterm birth model. Visual inspection of SHG images revealed substantial changes in collagen morphology throughout normal gestation. SHG images collected in both the forward and backward directions were analyzed quantitatively for changes in overall mean intensity, forward to backward intensity ratio, collagen fiber size, and porosity. Changes in mean SHG intensity and intensity ratio take place in early pregnancy, suggesting that submicroscopic changes in collagen fibril size and arrangement occur before macroscopic changes become evident. Fiber size progressively increased from early to late pregnancy, while pores between collagen fibers became larger and farther apart. Analysis of collagen features in premature cervical remodeling show that changes in collagen structure are dissimilar from normal remodeling. The ability to quantify multiple morphological features of collagen that characterize normal cervical remodeling and distinguish abnormal remodeling in preterm birth models supports future studies aimed at development of SHG endoscopic devices for clinical assessment of collagen changes during pregnancy in women and for predicting risk of preterm labor which occurs in 12.5% of all pregnancies.

  17. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie;

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  18. Persistent ectopic pregnancy after linear salpingotomy: a non-predictable complication to conservative surgery for tubal gestation

    DEFF Research Database (Denmark)

    Lund, Claus Otto; Nilas, Lisbeth; Bangsgaard, Nannie

    2002-01-01

    BACKGROUND: The drawback of conservative surgery for ectopic pregnancy (EP) is the risk of persistent trophoblast. The purpose was to characterize patients who develop persistent ectopic pregnancy (PEP) after salpingotomy for EP and to assess prognostic factors. METHODS: The medical records of 417...... surgery, ruptured EP, pelvic adhesions, absence of products of conception at microscopy and hemoperitoneum. CONCLUSIONS: Persistent ectopic pregnancy can neither be predicted from clinical variables nor from single measurements of hCG with an accuracy sufficient for clinical use....

  19. Preovulatory progesterone concentration associates significantly to follicle number and LH concentration but not to pregnancy rate

    DEFF Research Database (Denmark)

    Yding Andersen, Claus; Bungum, Leif; Nyboe Andersen, Anders

    2011-01-01

    Using data from a large prospective randomized controlled trial that evaluated the effect of recombinant LH (rLH)co-administration for ovarian stimulation, the present study assessed whether progesterone concentration on the day of human chorionic gonadotrophin (HCG) administration was associated...... with pregnancy outcome. Progesterone concentration was measured on stimulation day 1 and on the day of HCG administration in 475 patients who underwent IVF/intracytoplasmic sperm injection treatment following ovarian stimulation with gonadotrophin-releasing hormone (GnRH) agonist and recombinant FSH...

  20. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study.

    Directory of Open Access Journals (Sweden)

    Signe K Dørheim

    Full Text Available BACKGROUND: Insomnia and depression are strongly interrelated. This study aimed to describe changes in sleep across childbirth, and to evaluate whether insomnia in pregnancy is a predictor of postpartum depression. METHODS: A longitudinal, population-based study was conducted among perinatal women giving birth at Akershus University Hospital, Norway. Women received questionnaires in weeks 17 and 32 of pregnancy and eight weeks postpartum. This paper presents data from 2,088 of 4,662 women with complete data for insomnia and depression in week 32 of pregnancy and eight weeks postpartum. Sleep times, wake-up times and average sleep durations were self-reported. The Bergen Insomnia Scale (BIS was used to measure insomnia. The Edinburgh Postnatal Depression Scale (EPDS was used to measure depressive symptoms. RESULTS: After delivery, sleep duration was reduced by 49 minutes (to 6.5 hours, and mean sleep efficiency was reduced from 84% to 75%. However, self-reported insomnia scores (BIS improved from 17.2 to 15.4, and the reported prevalence of insomnia decreased from 61.6% to 53.8%. High EPDS scores and anxiety in pregnancy, fear of delivery, previous depression, primiparity, and higher educational level were risk factors for both postpartum insomnia and depression. Insomnia did not predict postpartum depression in women with no prior history of depression, whereas women who recovered from depression had residual insomnia. LIMITATIONS: Depression and insomnia were not verified by clinical interviews. Women with depressive symptoms were less likely to remain in the study. CONCLUSIONS: Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased. Insomnia in pregnancy may be a marker for postpartum recurrence of depression among women with previous

  1. [Predictive significance of tissue eosinophilia for nasal polyp recurrence].

    Science.gov (United States)

    Wang, C S; Lou, H F; Meng, Y F; Piao, Y S; Zhang, L

    2016-04-07

    To evaluate the association between clinical parameters, especially tissue eosinophilia, and chronic sinusitis with nasal polyps (CRSwNP) recurrence. To identify optimal criteria of tissue eosinophilia as a predictor for recurrence. Two hundred and forty-eight CRSwNP patients were enrolled in this study. The demographic and clinical features were compared between recurrence and no recurrence groups. Mucosal specimens were assessed for the presence of tissue inflammatory cells. Factors associated with polyp recurrence were analyzed by Logistic regression analysis and optimal cutoff point of the predictor for nasal polyp recurrence was determined by receiver operating characteristic curve. SPSS 19.0 software was used to analyze the data. The recurrence rate was 55.6%(138/248 patients) in this cohort. Tissue and peripheral eosinophilia, comorbid asthma, olfactory score and Lund-Mackay score were significantly correlated with polyp recurrence(all Peosinophilia provides valuable information regarding to polyp recurrence. Tissue eosinophil proportion equal to or over 27% may be regarded as the prognostic criterion for nasal polyp recurrence.

  2. Immunohistochemistry Study of P53 and C-erbB-2 Expression in Trophoblastic Tissue and Their Predictive Values in Diagnosing Malignant Progression of Simple Molar Pregnancy

    Science.gov (United States)

    Hasanzadeh, Malihe; Sharifi, Norrie; Farazestanian, Marjaneh; Nazemian, Seyed Saman; Madani Sani, Faezeh

    2016-01-01

    Background Finding a tumor marker to predict the aggressive behavior of molar pregnancy in early stages has yet been a topic for studies. Objectives In this survey we planned to study patients with molar pregnancy to 1) assess the p53 and c-erbB-2 expression in trophoblastic tissue, 2) to study the relationship between their expression intensity and progression of a molar pregnancy to gestational trophoblastic neoplasia, and 3) to determine a cut off value for the amount of p53 and c-erbB-2 expression which might correlate with aggressive behavior of molar pregnancy. Patients and Methods In a prospective cross sectional study by using a high accuracy technique EnVision Tm system for immunohistochemistry staining of molar pregnancy samples, we evaluated p53 and c-erbB-2 expression in cytotrophoblast and syncytiotrophoblast and the correlation of their expression with progression of molar pregnancy to gestational trophoblastic neoplasia (GTN). Normal prostatic tissue and Breast cancer tissue were used as positive controls. Results We studied 28 patients with simple molar pregnancy (SMP) and 30 with GTN. Cytotrophobalst had significantly higher expression of p53 and c-erbB-2 and syncytiotrophoblast had greater expression of p53 in GTN group as compared to SMP group. The cut off values for percentage of p53 positive immunostained cytotrophoblast and syncytiotrophoblast were 5.5% and 2.5%. In c-erbB-2 positive membranous stained cytotrophoblast the cut off was 12.5%. Conclusions Our data suggests that over expression of p53 and c-erbB-2 is associated with malignant progression of molar pregnancy. We encountered that high expression of p53 and c-erbB-2 in trophoblastic cells could predict gestational trophoblastic neoplasia during the early stages. PMID:27703642

  3. Prediction of adverse pregnancy outcome in patients with antiphospholipid antibodies

    Directory of Open Access Journals (Sweden)

    Sarita Chaudhary

    2016-05-01

    Results: Antiphospholipid antibodies in patients of obstetric and fetal complications were abnormally high. IgG antibody was found in pre-eclampsia (62%, prematurity (54%, recurrent fetal loss (44% and intrauterine growth retardation (54%, IgM antibody was also found in pre-eclampsia (54%, prematurity (32%, recurrent fetal loss (30% and intrauterine growth retardation (40%. Presence of IgG antiphospholipid antibody in comparison with controls is statistically significant in patient of preeclampsia and recurrent fetal loss. Conclusions: Early autoimmune screening for antiphospholipid antibodies (IgM, IgG of pregnant ladies was found to be effective tool in predilection of obstetric and fetal complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1613-1616

  4. Predicted vitamin D status in mid-pregnancy and child allergic disease

    DEFF Research Database (Denmark)

    Maslova, Ekaterina; Hansen, Susanne; Thorne-Lyman, Andrew L

    2014-01-01

    BACKGROUND: Vitamin D deficiency in pregnancy may be a risk factor for child allergic disease. However, less is known about disease risk across different levels of vitamin D. OBJECTIVE: We aimed to examine the relation between a maternal vitamin D prediction score and child allergic disease...... prediction score examined in quintiles or by restricted categories (≥75 nmol/l and maternal vitamin D prediction score ≥100 nmol/l(vs. 50-79.9 nmol/l) was associated with increased risks of child asthma at 18 months (RR: 1.36, 95% CI: 1....... Similar results were found for plasma 25(OH)D. CONCLUSIONS: Our study provided little evidence for an association between maternal vitamin D prediction score and child allergic disease for scores ≥75 nmol/l. However, increased risks were observed for vitamin D prediction score ≥100 nmol...

  5. Use of metformin earlier in pregnancy predicts supplemental insulin therapy in women with gestational diabetes.

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    McGrath, Rachel T; Glastras, Sarah J; Hocking, Samantha; Fulcher, Gregory R

    2016-06-01

    The use of metformin in gestational diabetes is safe and effective, yet some women require additional insulin therapy to achieve glycaemic targets. We found a significant association between earlier gestational age at initiation of metformin therapy and the necessity for supplemental insulin in women treated with metformin during pregnancy.

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2013-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

  10. Pattern of perceived stress and anxiety in pregnancy predicts preterm birth.

    Science.gov (United States)

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

    2008-01-01

    To determine whether the pattern of prenatal stress, as compared to prenatal stress assessed at a single gestational time point, predicts preterm delivery (PTD). Perceived stress and anxiety were assessed in 415 pregnant women at 18-20 and 30-32 weeks' gestation. Gestational length was determined by last menstrual period and confirmed by early pregnancy ultrasound. Births were categorized as preterm (< 37 weeks) or term. At neither assessment did levels of anxiety or perceived stress predict PTD. However, patterns of anxiety and stress were associated with gestational length. Although the majority of women who delivered at term exhibited declines in stress and anxiety, those who delivered preterm exhibited increases. The elevated risk for PTD associated with an increase in stress or anxiety persisted when adjusting statistically for obstetric risk, pregnancy-related anxiety, ethnicity, parity, and prenatal life events. These data suggest that the pattern of prenatal stress is an important predictor of PTD. More generally, the findings support the possibility that a decline in stress responses during pregnancy may help to protect mother and fetus from adverse influences associated with PTD.

  11. Factors predictive of alcohol use during pregnancy in three rural states

    Directory of Open Access Journals (Sweden)

    Struck Judy

    2007-02-01

    Full Text Available Abstract Background A substance use screening instrument was used to determine factors predictive of drinking during pregnancy. Alcohol consumption during pregnancy can lead to negative birth outcomes. Methods The participants (n = 4,828 for the study were sampled from pregnant women attending prenatal clinics in Montana, South Dakota, and North Dakota. Clinic sites for the administration of the screening instrument were selected in each state, based on geographic and known population characteristics. Univariate and multivariate statistical procedures were used to determine factors predictive of drinking during pregnancy. Results Women who drank tended to: be single, be between 21–25 years old, have had fewer children, have had abortions, and be unemployed. Demographic factors that were protective of drinking when pregnant were married and full-time housewife status. Other variables associated with maternal alcohol use were: past sexual abuse, current or past physical abuse, tobacco use, other drug use, lived with substance users, and had mates who were substance users. Other contributing factors for alcohol use included: feeling sad, believing that drinking any amount of alcohol while pregnant was acceptable, had been in treatment, could use treatment now, and were able to hold four or more drinks. Conclusion Because drinking rates were high and factors correlated with drinking are known, alcohol screening for this population is essential.

  12. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes

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    Mojgan Barati

    2014-01-01

    Full Text Available Background : Increased impedance to flow in the uterine arteries assessed by value of the Doppler is associated with adverse pregnancy outcomes, especially pre-eclampsia. We investigated the predictive value of a uterine artery Doppler in the identification of adverse pregnancy outcomes such as ′pre-eclampsia′ and ′small fetus for gestational age′ (SGA. Materials and Methods: Three hundred and seventy-nine women, with singleton pregnancy, between 18 and 40 years of age, without risk factors, randomly underwent Doppler interrogation of the uterine arteries, between 16-22 weeks of gestation. Those who had a mean pulsatility index (PI of >1.45 were considered to have an abnormal result, and were evaluated and compared with those who had normal results for adverse pregnancy outcomes, including pre-eclampsia and small for gestational age. The relationship between the variables was assessed with the use of the chi-square test. Results : There were 17 cases (4.5% of abnormal uterine artery Doppler results and 15 of them (88.2% developed pre-eclampsia and four cases (23.5% had neonates small for gestational age. For predicting pre-eclampsia, the mean uterine artery PI had to be >1.45, had to have a specificity of 95.5% (95% CI, 70-92%, a sensitivity of 79% (95% CI, 43-82%, a negative predictive value (NPV of 98.9% (95% CI, 72-96%, and a positive predictive value (PPV of 88.2% (95% CI, 68-98%. In the case of ′small for gestational age′ it had to have a specificity of 96.5% (95% CI, 42-68%, a sensitivity of 57% (95% CI, 53-76%, an NPV of 99.2% (95% CI, 70-92%, and a PPV of 23.5% (95% CI, 30-72%. Conclusion : Uterine artery Doppler evaluation at 16-22 weeks of gestation might be an appropriate tool for identifying pregnancies that may be at an increased risk for development of pre-eclampsia and small fetus for gestational age.

  13. Identification and replication of prediction models for ovulation, pregnancy and live birth in infertile women with polycystic ovary syndrome.

    Science.gov (United States)

    Kuang, Hongying; Jin, Susan; Hansen, Karl R; Diamond, Michael P; Coutifaris, Christos; Casson, Peter; Christman, Gregory; Alvero, Ruben; Huang, Hao; Bates, G Wright; Usadi, Rebecca; Lucidi, Scott; Baker, Valerie; Santoro, Nanette; Eisenberg, Esther; Legro, Richard S; Zhang, Heping

    2015-09-01

    Can we build and validate predictive models for ovulation and pregnancy outcomes in infertile women with polycystic ovary syndrome (PCOS)? We were able to develop and validate a predictive model for pregnancy outcomes in women with PCOS using simple clinical and biochemical criteria particularly duration of attempting conception, which was the most consistent predictor among all considered factors for pregnancy outcomes. Predictive models for ovulation and pregnancy outcomes in infertile women with polycystic ovary syndrome have been reported, but such models require validation. This is a secondary analysis of the data from the Pregnancy in Polycystic Ovary Syndrome I and II (PPCOS-I and -II) trials. Both trials were double-blind, randomized clinical trials that included 626 and 750 infertile women with PCOS, respectively. PPCOS-I participants were randomized to either clomiphene citrate (CC), metformin, or their combination, and PPCOS-II participants to either letrozole or CC for up to five treatment cycles. Linear logistic regression models were fitted using treatment, BMI, and other published variables as predictors of ovulation, conception, clinical pregnancy, and live birth as the outcome one at a time. We first evaluated previously reported significant predictors, and then constructed new prediction models. Receiver operating characteristic (ROC) curves were constructed and the area under the curves (AUCs) was calculated to compare performance using different models and data. Chi-square tests were used to examine the goodness-of-fit and prediction power of logistic regression model. Predictive factors were similar between PPCOS-I and II, but the two participant samples differed statistically significantly but the differences were clinically minor on key baseline characteristics and hormone levels. Women in PPCOS-II had an overall more severe PCOS phenotype than women in PPCOS-I. The clinically minor but statistically significant differences may be due to the

  14. Significant correlation of angiotensin converting enzyme and glycoprotein IIIa genes polymorphisms with unexplained recurrent pregnancy loss in north of Iran

    Directory of Open Access Journals (Sweden)

    Shokoufeh Fazelnia

    2016-05-01

    Full Text Available Background: Spontaneous abortion is considered as the most complex problem during pregnancy. Thrombophilia is resumed as a cause of recurrent pregnancy loss (RPL. Glycoprotein IIIa (GPIIIa gene is involved in thrombosis and abortion. Angiotensin converting enzyme (ACE converts angiotensin I to angiotensin II and is involved in thrombosis. The most common polymorphism in this gene is the insertion/deletion (I/D. Objective: In this study, we analyzed the association between ACE I/D and GPIIIa c.98C >T polymorphisms in women with unexplained RPL from the north of Iran. Materials and Methods: Sample population consisted of 100 women with unexplained RPL and 100 controls. The ACE I/D and GPIIIa c.98C>T polymorphisms were genotyped by TETRA-ARMS PCR. The association between genotypes frequency and RPL were analyzed using χP2P and exact fisher tests. Associated risk with double genotype combinations was also investigated by binary logistic regression. Results: There was significant association between ACE DD genotype and RPL (OR=2.04; 95% CI=0.94-4.44; p=0.036. ACE D Allele was also significantly associated with the RPL (OR=1.59; 95% CI=1.05-2.41; p=0.013. No significant association was observed between GPIIIa c.98C>T polymorphism and RPL. Conclusion: ACE I/D polymorphism may probably be a prognostic factor in female family members of women with the history of recurrent abortion

  15. Prediction of cardiovascular risk by electrocardiographic changes in women with intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Biberoglu, Ebru Hacer; Kirbas, Ayse; Kirbas, Ozgur; Iskender, Cantekin; Daglar, Halil Korkut; Koseoglu, Cemal; Uygur, Dilek; Danisman, Nuri

    2015-01-01

    We aimed to investigate P wave characteristics in pregnant women with and without intrahepatic cholestasis of pregnancy (ICP). In this case-control study, including 59 pregnant women with intrahepatic cholestasis and 28 with healthy uncomplicated pregnancies, electrocardiographic maximum (Pmax) and minimum (Pmin) P-wave durations and P-wave dispersion (Pd) parameters were investigated. While Pmin and Pd values were significantly lower in women both with mild and severe ICP when compared to healthy pregnant women (p Intrahepatic cholestasis predisposes to cardiovascular complications. P-wave durations and Pd constitute a recent contribution to the field of noninvasive electrocardiology. Our data clearly demonstrated that these parameters were significantly altered in pregnant women with ICP when compared to the normal ones. This important association can be used to screen for women with an increased risk to better target counseling on lifestyle modifications and to closer follow-up and management of women with a history of ICP.

  16. Prediction of neonatal metabolic acidosis in women with a singleton term pregnancy in cephalic presentation.

    Science.gov (United States)

    Westerhuis, Michelle E M H; Schuit, Ewoud; Kwee, Anneke; Zuithoff, Nicolaas P A; Groenwold, Rolf H H; Van Den Akker, Eline S A; Van Beek, Erik; Van Dessel, Hendrikus J H M; Drogtrop, Addy P; Van Geijn, Herman P; Graziosi, Guiseppe C M; Van Lith, Jan M M; Nijhuis, Jan G; Oei, S Guid; Oosterbaan, Herman P; Porath, Martina M; Rijnders, Robert J P; Schuitemaker, Nico W E; Wijnberger, Lia D E; Willekes, Christine; Wouters, Maurice G A J; Visser, Gerard H A; Mol, Ben Willem J; Moons, Karel G M

    2012-03-01

    We sought to predict neonatal metabolic acidosis at birth using antepartum obstetric characteristics (model 1) and additional characteristics available during labor (model 2). In 5667 laboring women from a multicenter randomized trial that had a high-risk singleton pregnancy in cephalic presentation beyond 36 weeks of gestation, we predicted neonatal metabolic acidosis. Based on literature and clinical reasoning, we selected both antepartum characteristics and characteristics that became available during labor. After univariable analyses, the predictors of the multivariable models were identified by backward stepwise selection in a logistic regression analysis. Model performance was assessed by discrimination and calibration. To correct for potential overfitting, we (internally) validated the models with bootstrapping techniques. Of 5667 neonates born alive, 107 (1.9%) had metabolic acidosis. Antepartum predictors of metabolic acidosis were gestational age, nulliparity, previous cesarean delivery, and maternal diabetes. Additional intrapartum predictors were spontaneous onset of labor and meconium-stained amniotic fluid. Calibration and discrimination were acceptable for both models (c-statistic 0.64 and 0.66, respectively). In women with a high-risk singleton term pregnancy in cephalic presentation, we identified antepartum and intrapartum factors that predict neonatal metabolic acidosis at birth.

  17. Actual and predicted prevalence of alcohol consumption during pregnancy in the WHO African Region.

    Science.gov (United States)

    Popova, Svetlana; Lange, Shannon; Probst, Charlotte; Shield, Kevin; Kraicer-Melamed, Hannah; Ferreira-Borges, Carina; Rehm, Jürgen

    2016-10-01

    To estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population in the World Health Organization (WHO) African Region, by country. First, a comprehensive systematic literature search was performed to identify all published and unpublished studies. Then, several meta-analyses, assuming a random-effects model, were conducted to estimate the prevalence of alcohol consumption and binge drinking during pregnancy among the general population for countries in the WHO African Region with two or more studies available. Lastly, for countries with less than two studies or no known data predictions were obtained using regression modelling. The estimated prevalence of alcohol consumption during pregnancy among the general population ranged from 2.2% (95% confidence interval [CI]: 1.6-2.8%; Equatorial Guinea) to 12.6% (95% CI: 9.9-15.4%; Cameroon) in Central Africa, 3.4% (95% CI: 2.6-4.3%; Seychelles) to 20.5% (95% CI: 16.4-24.7%; Uganda) in Eastern Africa, 5.7% (95% CI: 4.4-7.1%; Botswana) to 14.2% (95% CI: 11.1-17.3%; Namibia) in Southern Africa, 6.6% (95% CI: 5.0-8.3%; Mauritania) to 14.8% (95% CI: 11.6-17.9%; Sierra Leone) in Western Africa, and 4.3% (95% CI: 3.2-5.3%; Algeria) in Northern Africa. The high prevalence of alcohol consumption and binge drinking during pregnancy in some African countries calls for educational campaigns, screening and targeted interventions for women of childbearing age. © 2016 John Wiley & Sons Ltd.

  18. INVESTIGATION OF THROMBOMODULIN AND PLASMINOGEN ACTIVATOR INHIBITOR TYPE-I IN PREGNANCY INDUCED HYPERTENSION AND ITS CLINICAL SIGNIFICANCE

    Institute of Scientific and Technical Information of China (English)

    马水清; 白春梅; 边旭明

    2001-01-01

    Objective. To measure tbe circulating levels of thrombomodulin (TM) and plasminogen activator inhibitor type-Ⅰ(PAI-I) in women with pregnancy induced hypertension (PIH).``Methods. Blood samples were drawn from 97 pregnant women in their third trimester, grouped as 25 mild PIH, 26 moderate PIH, 22 severe PIH and 24 normotensive healthy pregnant women for determining levels of TM by ELISA, PAI-I by colorimetric assay methods, and creatinine (Cr) in serum by biochemical method.``Results. Circulating levels of TM, PAId and TM/Cr ratio increased with increasing severity of PIH. There were no significant differences between mild and normotensive pregnant women. The parameters were significantly changed in the moderate and severe PIH groups.``Conclv, sion. TM and PAI-Ⅰ may serve as meaningful clinical markers for the assessment of the endothelial damage in PIH,which is very important in evaluating and following the development of PIH.

  19. INVESTIGATION OF THROMBOMODULIN AND PLASMINOGEN ACTIVATOR INHIBITOR TYPE-I IN PREGNANCY INDUCED HYPERTENSION AND ITS CLINICAL SIGNIFICANCE

    Institute of Scientific and Technical Information of China (English)

    马水清; 白春梅; 边旭明

    2001-01-01

    Objective. To measure the circulating levels of thrombomodulin (TM) and plasminogen activator inhibitor type-I (PAI-I) inwomen with pregnancy induced hypertension (PIH). Methods. Blood samples were drawn from 97 pregnant women in their third trimester, grouped as 25 mild PIH, 26 moderate PIH, 22 severe PIH and 24 normotensive healthy pregnant women for determining levels of TM by ELISA, PAI-I by colorimetric assay methods, and creatinine (Cr) in serum by biochemical method. Results. Circulating levels of TM, PAI-I and TM/Cr ratio increased with increasing severity of PIH. There were no significant differences between mild and normotensive pregnant women. The parameters were significantly changed in the moderate and severe PIH groups. Conclusion. TM and PAI-I may serve as meaningful clinical markers for the assessment of the endothelial damage in PIH,which is very important in evaluating and following the development of PIH.

  20. Predicting sulfotyrosine sites using the random forest algorithm with significantly improved prediction accuracy

    Directory of Open Access Journals (Sweden)

    Yang Zheng

    2009-10-01

    Full Text Available Abstract Background Tyrosine sulfation is one of the most important posttranslational modifications. Due to its relevance to various disease developments, tyrosine sulfation has become the target for drug design. In order to facilitate efficient drug design, accurate prediction of sulfotyrosine sites is desirable. A predictor published seven years ago has been very successful with claimed prediction accuracy of 98%. However, it has a particularly low sensitivity when predicting sulfotyrosine sites in some newly sequenced proteins. Results A new approach has been developed for predicting sulfotyrosine sites using the random forest algorithm after a careful evaluation of seven machine learning algorithms. Peptides are formed by consecutive residues symmetrically flanking tyrosine sites. They are then encoded using an amino acid hydrophobicity scale. This new approach has increased the sensitivity by 22%, the specificity by 3%, and the total prediction accuracy by 10% compared with the previous predictor using the same blind data. Meanwhile, both negative and positive predictive powers have been increased by 9%. In addition, the random forest model has an excellent feature for ranking the residues flanking tyrosine sites, hence providing more information for further investigating the tyrosine sulfation mechanism. A web tool has been implemented at http://ecsb.ex.ac.uk/sulfotyrosine for public use. Conclusion The random forest algorithm is able to deliver a better model compared with the Hidden Markov Model, the support vector machine, artificial neural networks, and others for predicting sulfotyrosine sites. The success shows that the random forest algorithm together with an amino acid hydrophobicity scale encoding can be a good candidate for peptide classification.

  1. Prediction of pregnancy-induced hypertension by a shift of blood pressure class according to the JSH 2009 guidelines.

    Science.gov (United States)

    Jwa, Seung Chik; Arata, Naoko; Sakamoto, Naoko; Watanabe, Noriyoshi; Aoki, Hiroaki; Kurauchi-Mito, Asako; Dongmei, Qiu; Ohya, Yukihiro; Ichihara, Atsuhiro; Kitagawa, Michihiro

    2011-11-01

    Elevated blood pressure (BP) at early or mid pregnancy is a known risk factor for pregnancy-induced hypertension (PIH). However, the association between BP changes during the first half of pregnancy and subsequent PIH development is unknown. We used changes in maternal BP between 16 and 20 weeks of gestation to evaluate the risk of PIH. A total of 976 pregnant women with BP estimations recorded before 16 weeks and at 20 weeks of gestation participated in this study. BPs were classified by the Japanese Society of Hypertension 2009 Hypertension Treatment Guidelines (JSH 2009). There was a significant trend for future PIH in women whose JSH 2009 BP class increased between 16 and 20 weeks of gestation, and the risk of PIH was highest among women whose BP was Class IV Hypertension (systolic BP≥140 mm Hg and/or diastolic BP≥90 mm Hg). The risk of PIH increased in women whose BPs shifted from Classes I Optimal (systolic BP<120 mm Hg and diastolic BP<80 mm Hg) and II Normal (systolic BP 120-129 mm Hg and/or diastolic BP 80-84 mm Hg) before 16 weeks to Class III High-Normal (systolic BP 130-139 mm Hg and/or diastolic BP 85-89 mm Hg) at 20 weeks of gestation. These shifts in BP class were significantly correlated with the risk of PIH after adjustments for variables (P-value for trend <0.05). Within JSH 2009 Classes I, II and III, a shift in BP from a low to a high class between 16 and 20 weeks of gestation predicts the subsequent development of PIH.

  2. Sensitivity, specificity, predictive value and accuracy of ultrasonography in pregnancy rate prediction in Sahelian goats after progesterone impregnated sponge synchronization

    Directory of Open Access Journals (Sweden)

    Justin Kouamo

    2014-09-01

    Full Text Available Aim: This study was aimed to evaluate the sensitivity, specificity, predictive value and accuracy of ultrasonography in pregnancy rate (PR prediction in Sahelian goats after progesterone impregnated sponge synchronization within the framework of caprine artificial insemination (AI program in Fatick (Senegal. Materials and Methods: Of 193 candidate goats in AI program, 167 were selected (day 50 in six villages. Estrus was synchronized by progesterone impregnated sponges installed for 11 days. Two days before the time of sponge removal (day 4, each goat was treated with 500 IU of equine chorionic gonadotropin and 50 μg of dcloprostenol. All goats were inseminated (day 0 with alpine goat semen from France at 45±3 h after sponge removal (day 2. Real-time B-mode ultrasonography was performed at day 50, day 13, day 0, day 40 and day 60 post-AI. Results: Selection rate, estrus response rate, AI rate, PR at days 40 and days 60 were 86.53%; 71.85%; 83.34%; 51% and 68% (p<0.05 respectively. Value of sensitivity, specificity, positive and negative predictive value, accuracy, total conformity, conformity of correct positive, conformity of correct negative and discordance of pregnancy diagnosis by trans-abdominal ultrasonography (TU were 98.03%; 63.26%; 73.52%; 3.12%; 81%; 81%; 50%; 31% and 19%, respectively. Conclusion: These results indicate that the TU can be performed in goats under traditional condition and emphasized the importance of re-examination of goats with negative or doubtful TU diagnoses performed at day 40 post-AI.

  3. Ultrasound assessment of cervical length in prolonged pregnancy: prediction of spontaneous onset of labor and successful vaginal delivery.

    Science.gov (United States)

    Vankayalapati, P; Sethna, F; Roberts, N; Ngeh, N; Thilaganathan, B; Bhide, A

    2008-03-01

    To evaluate the usefulness of sonographic assessment of cervical length in the prediction of spontaneous onset of labor and of vaginal delivery. Two hundred and six women who attended a dedicated postdates clinic at 41 + 3 weeks of pregnancy and agreed to the assessment of cervical length using transvaginal ultrasound imaging were included in the study. Those who had not delivered at 42 weeks were offered induction of labor. The labor details were recorded prospectively, and the onset of spontaneous labor and mode of delivery were correlated with cervical length data. Women who underwent spontaneous onset of labor (n = 112) had a significantly shorter cervical length (mean (SD) 25.0 (8.3) mm) than had women whose labor was induced (n = 67; mean (SD) 29.7 (8.5) mm). Logistic regression analysis showed that cervical length was an independent predictor of the likelihood of spontaneous labor in nulliparous women, and of vaginal delivery in both nulliparous and parous women. Parity had no independent effect on the onset of spontaneous labor, but was an independent predictor of the likelihood of vaginal delivery. Sonographic assessment of cervical length is a significant independent predictor of the likelihood of the onset of spontaneous labor in nulliparous women, and of successful vaginal delivery in both nulliparous and parous women with prolonged pregnancy. Copyright (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.

  4. Perceived partner support in pregnancy predicts lower maternal and infant distress.

    Science.gov (United States)

    Stapleton, Lynlee R Tanner; Schetter, Christine Dunkel; Westling, Erika; Rini, Christine; Glynn, Laura M; Hobel, Calvin J; Sandman, Curt A

    2012-06-01

    Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  5. Psychosocial Stress During First Pregnancy Predicts Infant Health Outcomes in the First Postnatal Year.

    Science.gov (United States)

    Phelan, A L; DiBenedetto, M R; Paul, I M; Zhu, J; Kjerulff, K H

    2015-12-01

    To evaluate the impact of psychosocial stress during pregnancy on infant health outcomes in the first postnatal year. A sample of 3000 women completed a stress inventory (the Psychosocial Hassles Scale) during their third trimester before first childbirth. Infant health outcomes were measured via maternal report at 1, 6 and 12 months postpartum. Poisson regression was used to model the effect of maternal stress during pregnancy on infant health outcomes in the first year, controlling for age, race/ethnicity, education, insurance coverage, marital status, and cigarette smoking during pregnancy. Women who were younger, minority, unmarried, publicly insured and without a college degree were more likely to report high levels of prenatal stress. High prenatal stress was a significant predictor of maternal reporting of gastrointestinal illness (p stress was also a significant predictor of urgent care visits (p stress is associated with increased maternal reporting of infant illness, as well as increased frequency of both urgent care visits and emergency department visits.

  6. Predicting survival outcomes using subsets of significant genes in prognostic marker studies with microarrays

    Directory of Open Access Journals (Sweden)

    Matsui Shigeyuki

    2006-03-01

    Full Text Available Abstract Background Genetic markers hold great promise for refining our ability to establish precise prognostic prediction for diseases. The development of comprehensive gene expression microarray technology has allowed the selection of relevant marker genes from a large pool of candidate genes in early-phased, developmental prognostic marker studies. The primary analytical task in such studies is to select a small fraction of relevant genes, typically from a list of significant genes, for further investigation in subsequent studies. Results We develop a methodology for predicting survival outcomes using subsets of significant genes in prognostic marker studies with microarrays. Key components in this methodology include building prediction models, assessing predictive performance of prediction models, and assessing significance of prediction results. As particular specifications, we assume Cox proportional hazard models with a compound covariate. For assessing predictive accuracy, we propose to use the cross-validated log partial likelihood. To assess significance of prediction results, we apply permutation procedures in cross-validated prediction. As an additional key component peculiar to prognostic prediction, we also consider incorporation of standard prognostic factors. The methodology is evaluated using both simulated and real data. Conclusion The developed methodology for prognostic prediction using a subset of significant genes can provide new insights based on predictive capability, possibly incorporating standard prognostic factors, in selecting a fraction of relevant genes for subsequent studies.

  7. Prediction of adherent placenta in pregnancy with placenta previa using ultrasonography and magnetic resonance imaging.

    Science.gov (United States)

    Tanimura, Kenji; Yamasaki, Yui; Ebina, Yasuhiko; Deguchi, Masashi; Ueno, Yoshiko; Kitajima, Kazuhiro; Yamada, Hideto

    2015-04-01

    Adherent placenta is a life-threatening condition in pregnancy, and is often complicated by placenta previa. The aim of this prospective study was to determine prenatal imaging findings that predict the presence of adherent placenta in pregnancies with placenta previa. The study included 58 consecutive pregnant women with placenta previa who underwent both ultrasonography and magnetic resonance imaging prenatally. Ultrasonographic findings of anterior placental location, grade 2 or higher placental lacunae (PL≥G2), loss of retroplacental hypoechoic clear zone (LCZ) and the presence of turbulent blood flow in the arteries were evaluated, in addition to MRI findings. Forty-three women underwent cesarean section alone; 15 women with adherent placenta underwent cesarean section followed by hysterectomy with pathological examination. To determine imaging findings that predict adherent placenta, univariate and multivariate logistic regression analyses were performed. Univariate logistic regression analyses demonstrated that anterior placental location, PL≥G2, LCZ, and MRI were associated with the presence of adherent placenta. Multivariate analyses revealed that LCZ (pplacenta in women with placenta previa. This prospective study demonstrated for the first time that US findings, especially LCZ, might be useful for identifying patients at high risk for adherent placenta among pregnant women with placenta previa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-02-01

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

  9. [Pregnancy and labor complications--their significance in the development of schizophrenic psychoses].

    Science.gov (United States)

    Stöber, G; Franzek, E; Beckmann, H

    1993-10-01

    In a retrospective study of 80 chronic DSM III-R schizophrenics and 80 controls, the occurrence of obstetric complications (OCs) into the development of chronic schizophrenias was investigated using Leonhard's distinction in systematic schizophrenia (no obvious familial loading) and unsystematic schizophrenia (mainly genetically determined according to Leonhard). The Lewis & Murray and Fuchs scales were used for evaluation. In both scales, unsystematic schizophrenias did not differ from controls, but those with OCs were significantly (p schizophrenics had an increased frequency, severity and total score of OCs compared to controls in the Fuchs scale (p perinatal disturbances lead to an early onset of the disease, however, in systematic schizophrenias they seem to be of causal importance for the development of the disease.

  10. Temporal course of pregnancy-associated plasma protein-A in angioplasty-treated ST-elevation myocardial infarction patients and potential significance of concomitant heparin administration

    DEFF Research Database (Denmark)

    Terkelsen, Christian J; Oxvig, Claus; Nørgaard, Bjarne L

    2009-01-01

    Pregnancy-associated plasma protein-A (PAPP-A) is a putative plaque instability marker. In acute coronary syndromes, the disrupted culprit plaque contains abundant PAPP-A, and circulating PAPP-A levels predict clinical outcomes. Determinants of circulating PAPP-A levels, however, are not fully...

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. Platelet reactivity changes significantly throughout all trimesters of pregnancy compared with the nonpregnant state: a prospective study.

    LENUS (Irish Health Repository)

    Burke, N

    2013-12-01

    Platelets play an important role in the pathophysiology of uteroplacental disease and platelet reactivity may be an important marker of uteroplacental disease activity. However, platelet reactivity has not been evaluated comprehensively in normal pregnancy. We sought to evaluate platelet reactivity using a number of agonists at defined time points in pregnancy using a novel platelet assay and compare these with a nonpregnant cohort.

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  14. The value of MR angiography in predicting the risk of torsion of a pelvic spleen during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Karantanas, A.H. [Department of CT-MRI, Larissa General Hospital (Greece); Stagianis, K.D. [Department of Obstetrics and Gynecology, University Hospital, Larissa (Greece)

    2002-02-01

    A case of an enlarged pelvic spleen, studied with MRI and MR angiography (MRA), is presented in a 32-year-old female wishing to become pregnant. An ectopic located spleen may be complicated by an acute abdomen due to torsion of the splenic vascular pedicle, resulting in splenic infarction. Displacement of the spleen and splenic pedicle during pregnancy may further increase the risk of torsion. Urgent splenectomy during pregnancy is associated with a high fetal and maternal mortality and morbidity. On the other hand, elective splenectomy of a pelvic spleen before pregnancy can result in adhesion formation, compromising the patient's fertility. The abilities of MRI and MRA in predicting the risk of these life-threatening complications during pregnancy are discussed, in order to evaluate the benefit-risk ratio of surgical treatment by splenectomy of splenopexia. (orig.)

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  17. Atypia of undetermined significance and follicular lesions of undetermined significance: sonographic assessment for prediction of the final diagnosis.

    Science.gov (United States)

    Kamaya, Aya; Lewis, Gloria Huang; Liu, Yi; Akatsu, Haruko; Kong, Christina; Desser, Terry S

    2015-05-01

    To determine whether radiologic assessment of thyroid nodules can potentially help guide clinical management after a cytologic diagnosis of atypia of undetermined significance or a follicular lesion of undetermined significance. We identified 41 patients with 41 thyroid nodules initially diagnosed as atypia or follicular lesions of undetermined significance on fine-needle aspiration that were subsequently definitively diagnosed by either surgical resection or repeated fine-needle aspiration. All sonograms of nodules were reviewed by 2 blinded board-certifiedradiologists. Lesions were assessed in 3 ways: (1) Mayo pattern classification as benign, indeterminate, or worrisome for malignancy (Ultrasound Q 2005; 21:157-165); (2) thyroid imaging reporting and data system scores (scale of 1-5) based on 2 different previously published scoring criteria (Park et al [Thyroid 2009; 19:1257-1264] and Kwak et al [Radiology 2011; 260:892-899]); and (3) binary classification as benign or malignant. Of the 41 nodules, 25 had benign histologic findings, and 16 were malignant. Mayo pattern classification was 100% accurate for the benign score. Lesions with a Mayo score of indeterminate were malignant in 21% of cases (6 of 28) and benign in 79% (22 of 28). Lesions with a Mayo score of malignant were malignant in 91% of cases (10 of 11) and benign in 9% (1 of 11). Thyroid imaging reporting and data system scores had area under the receiver operating characteristic curve values of 0.827 for Park scores and 0.822 for Kwak scores. Radiologist binary classification of thyroid nodules showed 88% overall accuracy. Radiologist assessment of thyroid nodules in cases of atypia of undetermined significance or follicular lesions of undetermined significance is highly predictive of the final diagnosis and can help guide management of thyroid nodules of these pathologic types. © 2015 by the American Institute of Ultrasound in Medicine.

  18. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.

    Science.gov (United States)

    Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

    2011-01-01

    Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

  19. Follicle stimulating hormone and anti-Mullerian hormone per oocyte in predicting in vitro fertilization pregnancy in high responders: a cohort study.

    Directory of Open Access Journals (Sweden)

    Andrea Weghofer

    Full Text Available BACKGROUND: Follicle stimulating hormone (FSH and Anti-Müllerian hormone (AMH are utilized to differentiate between good and poor response to controlled ovarian hyperstimulation. Their respective roles in defining functional ovarian reserve remain, however, to be elucidated. To better understand those we investigated AMH and FSH per oocyte retrieved (AMHo and FSHo. METHODOLOGY/PRINCIPAL FINDINGS: Three-hundred and ninety-six women, undergoing first in vitro fertilization cycles, were retrospectively evaluated. Women with oocyte yields >75(th percentile for their age group were identified as high responders. In a series of logistic regression analyses, AMHo and FSHo levels were then evaluated as predictive factors for pregnancy potential in high responders. Patients presented with a mean age of 38.0±5.0 years, mean baseline FSH of 11.8±8.7 mIU/mL and mean AMH of 1.6±2.1 ng/mL. Those 88 women, who qualified as high responders, showed mean FSH of 9.7±6.5 mIU/mL, AMH of 3.1±3.1 ng/mL and oocyte yields of 15.8±7.1. Baseline FSH and AMH did not predict pregnancy in high responders. However, a statistically significant association between FSHo and pregnancy was observed in high responders, both after univariate regression (p = 0.02 and when adjusted for age, percentage of usable embryos, and number of embryos transferred (p = 0.03. Rate of useable embryos also significantly affected pregnancy outcome independently of FSHo (p = 0.01. AMHo was also associated with clinical pregnancy chances in high responders (p = 0.03 and remained significant when adjusted for usable embryos and number of embryos transferred (p = 0.04. CONCLUSIONS: AMHo and FSHo are predictive of pregnancy potential in high responders, but likely reflect different responsibilities in recruitment and maturation of growing follicle cohorts.

  20. Prediction of recurrence of hypertensive disorders of pregnancy between 34 and 37 weeks of gestation: a retrospective cohort study

    NARCIS (Netherlands)

    Oostwaard, M.F. van; Langenveld, J.; Bijloo, R.; Wong, K.M.; Scholten, I.; Loix, S.; Hukkelhoven, C.W.; Vergouwe, Y.; Papatsonis, D.N.; Mol, B.W.; Ganzevoort, W.

    2012-01-01

    OBJECTIVE: To assess the recurrence risk of late-preterm hypertensive disease of pregnancy, and to determine whether potential risk factors are predictive. DESIGN: Retrospective cohort study. SETTING: Three secondary and three tertiary care hospitals in the Netherlands. POPULATION: We identified wom

  1. PREDICTION OF FETAL DISTRESS AND POOR OUTCOME OF PREGNANCY BEYOND 40 WEEKS USING DOPPLER ULTRASOUND COMPARED WITH FETAL HEART RATE MONITORING WITH NST

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    Supriya

    2015-06-01

    Full Text Available OBJECTIVES: Postdate pregnancy is the most common indication for Antepartum . F etal heart rate testing because of its increased perinatal morbidity and perinatal mortality. Complications are stillbirth , meconium aspiration , asphyxia , and the dysmaturity syndrome , is increased in post - term pregnancies. The most recent ACOG review of the subject of "post - term" pregnancy cites estimates of 3 - 14 % of all pregna n cies . MATERIALS AND METHODS: 55 patients with pregnancy beyond 40 weeks attending antenatal out - patient department of the Rajiv Gandhi medical college in the period between October 2014 to March 2015 were included. In present study , patients were monitored with twice weekly NST and once a week Doppler. In those with either NST nonreactive or Doppler abnormal , induction was done. Cases with normal results were monitored till 42 weeks when routine induction was done . RESULTS: A reactive non stress test in prolonged pregnancy has good negative predictive value – i.e. adverse outcomes are unlikely to occur in the setting of a reactive non - stress test – but that the positive predictive values are low . W eekly measurement of Doppler waveforms from umbilical artery (PI p=0.02 for Apgar <7 at 5 min , p=0.02 NICU admissions , p=0.003 for meconium staining of amniotic fluid and S/d ratio p=0.02 for Apgar <7 at 5 min , p=0.04 for NICU admission and biweekly NST(p=0.005 for Apgar <7 at 5 min , p=0.0219 for NICU admission , p=0.0039 for meconium staining of amniotic fluid appears to be reliable method of establishing fetal health in pregnancy beyond 40 weeks. CONCLUSION: The most sensitive tests to assess the risks to the fetus of prolonged pregnancy app ear to be combinations of fetal heart rate monitoring with NST combined with umbilical PI and S/D ratio. Reactive NST is reassuring and indicates fetal wellbeing, but non - reactive NST alone cannot be taken as an indicator of fetal jeopardy. Although individual randomized trials

  2. Obstetrician-assessed maternal health at pregnancy predicts offspring future health.

    Directory of Open Access Journals (Sweden)

    Debbie A Lawlor

    Full Text Available BACKGROUND: We aimed to examine the association between obstetrician assessment of maternal physical health at the time of pregnancy and offspring cardiovascular disease risk. METHODS AND PRINCIPAL FINDINGS: We examined this association in a birth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariable regression models in which we adjusted for a range of indicators of socioeconomic position and we explored the specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5 hazard ratio comparing those described as having poor or very poor health at the time of pregnancy to those with good or very good health was 1.55 (95%CI: 1.05, 2.28 for coronary heart disease, 1.91 (95%CI: 0.99, 3.67 for stroke and 1.57 (95%CI: 1.13, 2.18 for either coronary heart disease or stroke. However, this association was not specific. There were strong associations for other outcomes that are known to be related to socioeconomic position (3.61 (95%CI: 1.04, 12.55 for lung cancer and 1.28 (95%CI:1.03, 1.58 for unintentional injury, but not for breast cancer (1.10 (95%CI:0.48, 2.53. CONCLUSIONS AND SIGNIFICANCE: These findings demonstrate that a simple assessment of physical health (based on the appearance of eyes, skin, hair and teeth of mothers at the time of pregnancy is a strong indicator of the future health risk of their offspring for common conditions that are associated with poor socioeconomic position and unhealthy behaviours. They do not support a specific biological link between maternal health across her life course and

  3. Stress in African American pregnancies: testing the roles of various stress concepts in prediction of birth outcomes.

    Science.gov (United States)

    Dominguez, Tyan Parker; Schetter, Christine Dunkel; Mancuso, Roberta; Rini, Christine M; Hobel, Calvin

    2005-02-01

    The persistently higher rates of adverse birth outcomes among African American women are a major public health concern. The purpose of this study was to explore the relations among psychosocial stress, socioeconomic status, and birth outcomes in African American women. A prospective survey research design was used to measure stress exposure, subjective responses to stressors, including intrusive effects of life events, and medical and sociodemographic variables in a sample of 178 pregnant African American women. Birth outcomes were obtained from medical charts. Life event exposure was high, but levels of perceived stress and negative emotional responses were low to moderate. Lower income African American women reported significantly greater pregnancy undesirability than higher income African American women. Educational attainment was not related to any of the stress variables, and neither income nor educational attainment was significantly related to birth outcomes. Number of stressful life events significantly predicted 3% additional variance in gestational age after controlling for potential confounders. Psychosocial stress variables altogether accounted for 7% additional variance in gestational age-adjusted birth weight, with event distress and intrusive thoughts concerning severe life events emerging as the significant independent stress predictors. These results contribute to our understanding of the complex etiological processes involved in African American birth outcomes and set the stage for further research into their reproductive health status.

  4. Blood coagulation parameters and platelet indices: changes in normal and preeclamptic pregnancies and predictive values for preeclampsia.

    Directory of Open Access Journals (Sweden)

    Lei Han

    Full Text Available Preeclampsia (PE is an obstetric disorder with high morbidity and mortality rates but without clear pathogeny. The dysfunction of the blood coagulation-fibrinolysis system is a salient characteristic of PE that varies in severity, and necessitates different treatments. Therefore, it is necessary to find suitable predictors for the onset and severity of PE.We aimed to evaluate blood coagulation parameters and platelet indices as potential predictors for the onset and severity of PE.Blood samples from 3 groups of subjects, normal pregnant women (n = 79, mild preeclampsia (mPE (n = 53 and severe preeclampsia (sPE (n = 42, were collected during early and late pregnancy. The levels of coagulative parameters and platelet indices were measured and compared among the groups. The receiver-operating characteristic (ROC curves of these indices were generated, and the area under the curve (AUC was calculated. The predictive values of the selected potential parameters were examined in binary regression analysis.During late pregnancy in the normal pregnancy group, the activated partial thromboplastin time (APTT, prothrombin time (PT, thrombin time (TT and platelet count decreased, while the fibrinogen level and mean platelet volume (MPV increased compared to early pregnancy (p<0.05. However, the PE patients presented with increased APTT, TT, MPV and D-dimer (DD during the third trimester. In the analysis of subjects with and without PE, TT showed the largest AUC (0.743 and high predictive value. In PE patients with different severities, MPV showed the largest AUC (0.671 and ideal predictive efficiency.Normal pregnancy causes a maternal physiological hypercoagulable state in late pregnancy. PE may trigger complex disorders in the endogenous coagulative pathways and consume platelets and FIB, subsequently activating thrombopoiesis and fibrinolysis. Thrombin time and MPV may serve as early monitoring markers for the onset and severity of PE

  5. Significance of pregnancy test false negative results due to elevated levels of β-core fragment hCG.

    Science.gov (United States)

    Johnson, Sarah; Eapen, Saji; Smith, Peter; Warren, Graham; Zinaman, Michael

    2017-01-01

    Very high levels of β-core fragment human chorionic gonadotrophin (βcf-hCG) are reported to potentially cause false negative results in point-of-care (POC)/over-the-counter (OTC) pregnancy tests. To investigate this further, women's daily early morning urine samples, collected prior to conception and during pregnancy, were analysed for intact, free β-, and βcf-hCG. The proportion of βcf-hCG was found to be related to that of hCG produced and in circulation. Therefore, best practice for accuracy testing of POC/OTC pregnancy tests would be to test devices against clinical samples containing high levels of βcf-hCG as well as standards spiked with biologically relevant ratios.

  6. Predicting success of labor induction in singleton term pregnancies by combining maternal and ultrasound variables.

    Science.gov (United States)

    Prado, Caio Antonio de Campos; Araujo Júnior, Edward; Duarte, Geraldo; Quintana, Silvana Maria; Tonni, Gabriele; Cavalli, Ricardo de Carvalho; Marcolin, Alessandra Cristina

    2016-11-01

    To assess pre-induction maternal and ultrasonographic factors in the prediction of the onset of labor within 12 h, and vaginal delivery (VD) irrespective of the induction-to-delivery interval in term pregnancies. We performed a prospective cohort study with 204 singleton pregnant women between 37 and 42 weeks of gestation. The following maternal and ultrasonographic variables were assessed: parity, marital status, height, body mass index (BMI), previous cesarean section (Cs), Bishop score, variety of fetal position, single deepest pocket (SDP), fetal middle cerebral and umbilical artery resistance indices, cervical length (CL) measurement, posterior cervical angle (PCA), head circumference (HC) and estimated fetal weight (EFW). χ(2) test and logistic regression analysis were applied to compare the groups. Receiver operating characteristics (ROC) curves were determined. VD occurred in 116 (56.9%) women. Prediction of the onset of labor within 12 h was provided by the BMI and resistance index of the fetal middle cerebral artery. Prediction of the VD irrespective of the induction-to-delivery interval was provided by height, BMI, parity, number of prenatal visits, consistency, effacement and dilation of uterine cervix, PCA, oligohydramnios, HC and EFW. Area under ROC curve for PCA and EFW were 63.5 (sensibility: 66.4%, specificity: 59.1%) and 60.2 (sensibility: 54.3%, specificity: 70.4%), respectively. Several pre-induction maternal and ultrasonographic factors can increase the chance of achieving a successful VD. PCA and EFW were the best ultrasonographic predictors for the success of induction of labor; however, with limited potential to be used in the clinical practice.

  7. Measurement and evaluation of fetal fat layer in the prediction of fetal macrosomia in pregnancies complicated by gestational diabetes.

    Science.gov (United States)

    Elessawy, Mohamed; Harders, Christina; Kleinwechter, Helmut; Demandt, Norbert; Sheasha, Ghada Abu; Maass, Nicolai; Pecks, Ulrich; Eckmann-Scholz, Christel

    2017-06-19

    To explore the predictive power of measuring the abdominal fetal fat layer (FFL) as a soft tissue marker at 31, 34, and 37 weeks' gestation to improve the detection of fetal macrosomia in pregnant women with GDM, in addition to the biometric values with close monitoring of maternal blood sugar level and BMI changes. We conducted a prospective observational study at the Department of Obstetrics, University Hospitals, Campus Kiel, Germany, in collaboration with diabetic clinic staff. Participants underwent a third-trimester scan and extra FFL measurements were performed at 31, 34, and 37 weeks of gestation. The clinical outcomes of pregnancy and birth weight were collected from the obstetric record. All of the enrolled women had an early pregnancy ultrasound scan to confirm gestational age. The FFL at 34 and 37 weeks, with respective cutoff values of >0.48 cm and >0.59 cm, showed a very good sensitivity of 60% for both gestational points, and specificity of 89.3 and 90.6%, respectively. The probability of fetal macrosomia could be more than doubled if the FFL at 34 weeks was more than 0.48 cm. However, the probability of macrosomia dropped to 16% if the FFL was ≤0.48 cm. The median FFLs of macrosomic fetuses at 34 and 37 weeks were 0.50 (IQR 0.10) and 0.60 (IQR 0.25) cm, respectively. The mean age of the study population (n = 80) was 32.26 (SD = 5.06) years. In our study population, ten newborns were born with birth weight >4000 g. The body mass index (BMI) for the mothers of later-onset macrosomic newborns showed higher median values of 30 (IQR 8), 32 (IQR 5), and 33 (IQR 9) at 31, 34, and 37 weeks, respectively, in comparison to mothers of non-macrosomic newborn. However, the BMI did not show any statistically significant difference from those with normal-weight newborn and did not show any specific sensitivity for predicting macrosomia. Measuring the FFL at 34 and 37 weeks of gestation, in addition to the standard measurement, might be useful

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  9. Mitral annular calcification and aortic valve calcification may help in predicting significant coronary artery disease.

    Science.gov (United States)

    Acartürk, Esmeray; Bozkurt, Abdi; Cayli, Murat; Demir, Mesut

    2003-01-01

    Mitral annular calcification (MAC) and aortic valve calcification (AVC) are manifestations of atherosclerosis. To determine whether mitral annular calcification and aortic valve calcification detected by transthoracic echocardiography (TTE) might help in predicting significant coronary artery disease (CAD), 123 patients with significant CAD and 93 patients without CAD detected by coronary angiography were investigated. MAC and AVC identified CAD with a sensitivity and specificity of 60.2%, 55.9% and 74.8%, 52.7%, respectively, and with a negative and a positive predictive values of 51.5%, 64.3% and 61.3% and 67.6%, respectively. The positive predictive value of MAC was greater than gender, hypertension, and hypercholesterolemia. AVC showed a positive predictive value greater than gender, hypertension, family history, and hypercholesterolemia. The negative predictive values of MAC and AVC for CAD were greater than those of all risk factors except diabetes mellitus. In conclusion, presence of MAC and AVC on TTE may help in predicting CAD and should be added to conventional risk factors. Absence of MVC and AVC is a stronger predictor for absence of CAD than all conventional risk factors, except diabetes mellitus. Patients with MAC and AVC should be taken into consideration for the presence of significant CAD and thereby for diagnostic and therapeutic interventions in order to improve the prognosis.

  10. Maternal Snoring May Predict Adverse Pregnancy Outcomes: A Cohort Study in China.

    Directory of Open Access Journals (Sweden)

    Xing Ge

    Full Text Available To examine the prevalence of snoring during pregnancy and its effects on key pregnancy outcomes.Pregnant women were consecutively recruited in their first trimester. Habitual snoring was screened by using a questionnaire in the 1st and 3rd trimester, respectively. According to the time of snoring, participants were divided into pregnancy onset snorers, chronic snorers and non-snorers. Logistic regressions were performed to examine the associations between snoring and pregnancy outcomes.Of 3 079 pregnant women, 16.6% were habitual snorers, with 11.7% were pregnancy onset snorers and 4.9% were chronic snorers. After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM (RR 1.66, 95%CI 1.09-2.53. Both pregnancy onset and chronic snorers were independently associated with placental adhesion (RR 1.96, 95%CI 1.17-3.27, and RR 2.33, 95%CI 1.22-4.46, respectively. Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09-1.73 and having macrosomia (RR 1.54, 95%CI 1.05-2.27 and large for gestational age (LGA (RR 1.71, 95%CI 1.31-2.24 infants. In addition, being overweight or obese before pregnancy plays an important role in mediating snoring and adverse pregnancy outcomes.Maternal snoring may increase the risk of adverse pregnancy outcomes, and being overweight or obese before pregnancy with snoring is remarkable for researchers. Further studies are still needed to confirm our results.

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

    Directory of Open Access Journals (Sweden)

    Kudret Erkenekli

    2015-06-01

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

  12. Physical activity of relatively high intensity in mid-pregnancy predicts lower glucose tolerance levels.

    Science.gov (United States)

    Medek, Helga; Halldorsson, Thorhallur; Gunnarsdottir, Ingibjörg; Geirsson, Reynir T

    2016-09-01

    Physical activity (PA) is recommended as part of therapy for patients with impaired glucose tolerance. Whether such recommendations are also justified for pregnant women is less well established. We investigated the association between PA and glucose tolerance in pregnancy. A non-selective sample of 217 pregnant women was recruited at a routine 20 week ultrasound examination. Participants answered the International Physical Activity Questionnaire (IPAQ) about frequency, intensity and duration of daily physical activity in the past 7 days and underwent oral glucose tolerance testing (OGTT) between 24 and 28 weeks. A subset of 72 overweight/obese pregnant women wore a pedometer for 1 week with assessment of IPAQ score and pedometric correlations to this. Of the sample, 177 attended for OGTT; 51% were overweight or obese. The mean (SD) fasting glucose was 4.5 (0.4) mmol/L, and 12% had gestational diabetes mellitus. Only one-third engaged in vigorous PA. After adjustment for pre-pregnancy BMI, age and parity, those engaging in vigorous PA had significantly lower fasting glucose levels (by 0.15 mmol/L, 95% CI 0.03-0.27) compared with those not vigorously active. This decrease was similar in both normal and overweight/obese women. There were fewer cases of gestational diabetes (p = 0.03) among the vigorously active women (3/56; 5%) than among those who were not active (19/121; 16%). No association with glucose tolerance was observed for physical activity of moderate intensity. Only vigorous physical activity appears beneficial with respect to maternal glucose tolerance, both among normal, overweight and obese women. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. Exploring the significance of human mobility patterns in social link prediction

    KAUST Repository

    Alharbi, Basma Mohammed

    2014-01-01

    Link prediction is a fundamental task in social networks. Recently, emphasis has been placed on forecasting new social ties using user mobility patterns, e.g., investigating physical and semantic co-locations for new proximity measure. This paper explores the effect of in-depth mobility patterns. Specifically, we study individuals\\' movement behavior, and quantify mobility on the basis of trip frequency, travel purpose and transportation mode. Our hybrid link prediction model is composed of two modules. The first module extracts mobility patterns, including travel purpose and mode, from raw trajectory data. The second module employs the extracted patterns for link prediction. We evaluate our method on two real data sets, GeoLife [15] and Reality Mining [5]. Experimental results show that our hybrid model significantly improves the accuracy of social link prediction, when comparing to primary topology-based solutions. Copyright 2014 ACM.

  14. Does Statistical Significance Help to Evaluate Predictive Performance of Competing Models?

    Directory of Open Access Journals (Sweden)

    Levent Bulut

    2016-04-01

    Full Text Available In Monte Carlo experiment with simulated data, we show that as a point forecast criterion, the Clark and West's (2006 unconditional test of mean squared prediction errors does not reflect the relative performance of a superior model over a relatively weaker one. The simulation results show that even though the mean squared prediction errors of a constructed superior model is far below a weaker alternative, the Clark- West test does not reflect this in their test statistics. Therefore, studies that use this statistic in testing the predictive accuracy of alternative exchange rate models, stock return predictability, inflation forecasting, and unemployment forecasting should not weight too much on the magnitude of the statistically significant Clark-West tests statistics.

  15. Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers: the Screening for Pregnancy Endpoints (SCOPE) international cohort study.

    Science.gov (United States)

    Kenny, Louise C; Black, Michael A; Poston, Lucilla; Taylor, Rennae; Myers, Jenny E; Baker, Philip N; McCowan, Lesley M; Simpson, Nigel A B; Dekker, Gus A; Roberts, Claire T; Rodems, Kelline; Noland, Brian; Raymundo, Michael; Walker, James J; North, Robyn A

    2014-09-01

    More than half of all cases of preeclampsia occur in healthy first-time pregnant women. Our aim was to develop a method to predict those at risk by combining clinical factors and measurements of biomarkers in women recruited to the Screening for Pregnancy Endpoints (SCOPE) study of low-risk nulliparous women. Forty-seven biomarkers identified on the basis of (1) association with preeclampsia, (2) a biological role in placentation, or (3) a role in cellular mechanisms involved in the pathogenesis of preeclampsia were measured in plasma sampled at 14 to 16 weeks' gestation from 5623 women. The cohort was randomly divided into training (n=3747) and validation (n=1876) cohorts. Preeclampsia developed in 278 (4.9%) women, of whom 28 (0.5%) developed early-onset preeclampsia. The final model for the prediction of preeclampsia included placental growth factor, mean arterial pressure, and body mass index at 14 to 16 weeks' gestation, the consumption of ≥3 pieces of fruit per day, and mean uterine artery resistance index. The area under the receiver operator curve (95% confidence interval) for this model in training and validation cohorts was 0.73 (0.70-0.77) and 0.68 (0.63-0.74), respectively. A predictive model of early-onset preeclampsia included angiogenin/placental growth factor as a ratio, mean arterial pressure, any pregnancy loss preeclampsia in populations of mixed parity and risk. In nulliparous women, combining multiple biomarkers and clinical data provided modest prediction of preeclampsia. © 2014 American Heart Association, Inc.

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Application of neural networks and support vector machine for significant wave height prediction

    Directory of Open Access Journals (Sweden)

    Jadran Berbić

    2017-07-01

    Full Text Available For the purposes of planning and operation of maritime activities, information about wave height dynamics is of great importance. In the paper, real-time prediction of significant wave heights for the following 0.5–5.5 h is provided, using information from 3 or more time points. In the first stage, predictions are made by varying the quantity of significant wave heights from previous time points and various ways of using data are discussed. Afterwards, in the best model, according to the criteria of practicality and accuracy, the influence of wind is taken into account. Predictions are made using two machine learning methods – artificial neural networks (ANN and support vector machine (SVM. The models were built using the built-in functions of software Weka, developed by Waikato University, New Zealand.

  18. Elsevier Trophoblast Research Award Lecture: Searching for an early pregnancy 3-D morphometric ultrasound marker to predict fetal growth restriction.

    Science.gov (United States)

    Collins, S L; Stevenson, G N; Noble, J A; Impey, L

    2013-03-01

    Fetal growth restriction (FGR) is a major cause of perinatal morbidity and mortality, even in term babies. An effective screening test to identify pregnancies at risk of FGR, leading to increased antenatal surveillance with timely delivery, could decrease perinatal mortality and morbidity. Placental volume, measured with commercially available packages and a novel, semi-automated technique, has been shown to predict small for gestational age babies. Placental morphology measured in 2-D in the second trimester and ex-vivo post delivery, correlates with FGR. This has also been investigated using 2-D estimates of diameter and site of cord insertion obtained using the Virtual Organ Computer-aided AnaLysis (VOCAL) software. Data is presented describing a pilot study of a novel 3-D method for defining compactness of placental shape. We prospectively recruited women with a singleton pregnancy and BMI of <35. A 3-D ultrasound scan was performed between 11 and 13 + 6 weeks' gestation. The placental volume, total placental surface area and the area of the utero-placental interface were calculated using our validated technique. From these we generated dimensionless indices including sphericity (ψ), standardised placental volume (sPlaV) and standardised functional area (sFA) using Buckingham π theorem. The marker for FGR used was small for gestational age, defined as <10th customised birth weight centile (cSGA). Regression analysis examined which of the morphometric indices were independent predictors of cSGA. Data were collected for 143 women, 20 had cSGA babies. Only sPlaV and sFA were significantly correlated to birth weight (p < 0.001). Regression demonstrated all dimensionless indices were inter-dependent co-factors. ROC curves showed no advantage for using sFA over the simpler sPlaV. The generated placental indices are not independent of placental volume this early in gestation. It is hoped that another placental ultrasound marker based on vascularity can improve the

  19. Three-Versus Two-Dimensional Sonographic Biometry for Predicting Birth Weight and Macrosomia in Diabetic Pregnancies.

    Science.gov (United States)

    Tuuli, Methodius G; Kapalka, Kristen; Macones, George A; Cahill, Alison G

    2016-09-01

    The purpose of this study was to test the hypothesis that a formula incorporating 3-dimensional (3D) fractional thigh volume would be superior to the conventional 2-dimensional (2D) formula of Hadlock et al (Am J Obstet Gynecol 1985; 151:333-337) for predicting birth weight and macrosomia. We conducted a prospective cohort study of pregnancies complicated by pregestational or gestational diabetes and delivered after 38 weeks. Two-dimensional and 3D sonographic examinations were performed for fetal biometry and factional thigh volumes at 34 to 37 weeks. Fetal weight was estimated by Hadlock's 2D formula IV, which uses only 2D biometry, and formula 6 from Lee et al (Ultrasound Obstet Gynecol 2009; 34:556-565), which incorporates 3D fractional thigh volume and 2D biometry. The gestation-adjusted projection method was used to estimate predicted birth weights from 2D and 3D estimates. The primary outcome was fetal macrosomia, which was defined as birth weight of 4000 g or higher. A total of 115 women with diabetes met inclusion criteria, and 17 (14.8%) delivered macrosomic neonates. The mean percentage error was significantly lower for the 2D than the 3D projected estimate (1.0% versus 12.0%; P macrosomia (area under the receiver operating characteristic curve, 0.88 versus 0.75; P = .03). Specificity was significantly higher for 2D biometry (85% versus 66%; P macrosomia in diabetic women when used approximately 2 weeks before delivery, based on the gestation-adjusted projection method.

  20. Sixth hour transcutaneous bilirubin predicting significant hyperbilirubinemia in ABO incompatible neonates

    Institute of Scientific and Technical Information of China (English)

    Ramesh Y Bhat; Pavan CG Kumar

    2014-01-01

    Background: Neonates with ABO hemolytic disease are at greater risk for developing significant hyperbilirubinemia. We aimed to determine whether sixth hour transcutaneous bilirubin (TcB) could predict such a risk. Methods: TcB measurements were obtained at the 6th hour of life in blood group A or B neonates born to blood group O, rhesus factor compatible mothers. Subsequent hyperbilirubinemia was monitored and considered significant if a neonate required phototherapy/exchange transfusion. The predictive role of sixth hour TcB was estimated. Results: Of 144 ABO incompatible neonates, 41(OA, 24; O-B, 17) had significant hyperbilirubinemia. Mean sixth hour TcB was significantly higher among neonates who developed significant hyperbilirubinemia than those who did not (5.83±1.35 mg/dL vs. 3.65±0.96 mg/dL, P4 mg/dL had the highest sensitivity of 93.5% and >6 mg/dL had the highest specifi city of 99%. Area under receiver operating characteristic curve was 0.898. Conclusion: Sixth hour TcB predicts subsequent significant hyperbilirubinemia in ABO incompatible neonates.

  1. Increased expression of heat shock protein 105 in rat uterus of early pregnancy and its significance in embryo implantation

    Directory of Open Access Journals (Sweden)

    Hu Zhao-Yuan

    2009-03-01

    Full Text Available Abstract Background Heat shock proteins (Hsps are a set of highly conserved proteins, Hsp105, has been suggested to play a role in reproduction. Methods Spatio-temporal expression of Hsp105 in rat uterus during peri-implantation period was examined by immunohistochemistry and Western blot, pseudopregnant uterus was used as control. Injection of antisense oligodeoxynucleotides to Hsp105 into pregnant rat uteri was carried out to look at effect of Hsp105 on embryo implantation. Results Expression of Hsp105 was mainly in the luminal epithelium on day 1 of pregnancy, and reached a peak level on day 5, whereas in stroma cells, adjacent to the implanting embryo, the strongest expression of Hsp105 was observed on day 6. The immunostaining profile in the uterus was consistent with that obtained by Western blot in the early pregnancy. In contrast, no obvious peak level of Hsp105 was observed in the uterus of pseudopregnant rat on day 5 or day 6. Furthermore, injection of antisense oligodeoxynucleotides to Hsp105 into the rat uterine horn on day 3 of pregnancy obviously suppressed the protein expression as expected and reduced number of the implanted embryos as compared with the control. Conclusion Temporal and spatial changes in Hsp105 expression in pregnant rat uterus may play a physiological role in regulating embryo implantation.

  2. Role of postprandial bile acids in prediction of perinatal outcome in intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Sargın Oruç, Ayla; Seçkin, Berna; Özcan, Nagihan; Özyer, Sebnem; Uzunlar, Özlem; Danışman, Nuri

    2014-07-01

    The aim of this study was to investigate the role of fasting and postprandial total bile acids (fTBA, ppTBA) in prediction of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP). A total of 111 patients, 57 with ICP and 54 controls, were evaluated for preterm birth (PTB), meconium-stained amnion (MSA), neonatal intensive-care unit admission and asphyxia. We further classified the ICP group as mild and severe. Logistic regression was performed to evaluate the associated biochemical and clinical parameters with adverse perinatal outcomes. In the ICP group, PTB, asphyxia, admission to neonatal intensive-care unit, and MSA were more frequently observed (P = 0.001, P = 0.027, P = 0.006 and P = 0.030, respectively). In subgroup analysis, PTB was more frequent in severe ICP cases than in mild cases (P = 0.028). Fasting and ppTBA were positively correlated with serum aspartate aminotransferase and alanine aminotransferase levels. Postprandial TBA and difference between fasting and postprandial TBA levels were associated with asphyxia (P = 0.014 and P = 0.023, respectively). Gestational age at diagnosis and fTBA were associated with adverse perinatal outcomes (P = 0.001 and P = 0.025, respectively). Postprandial TBA and difference of fasting and postprandial TBA are associated with asphyxia in ICP. The gestational age at diagnosis and fTBA are associated with adverse perinatal outcomes. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    PURPOSE: The purpose of this study is to evaluate the prevalence and possible clinical predictors of preeclampsia present in early pregnancy among women with type 1 diabetes. METHODS: A systematic search of PubMed was conducted in April 2017. Inclusion criteria were largely unselected cohort......, including at least 100 women with type 1 diabetes, dealing with either the prevalence of preeclampsia or possible clinical predictors of preeclampsia identified in early pregnancy. RESULTS: Based on 11,518 pregnancies in 11 articles, the prevalence of preeclampsia in women with type 1 diabetes was 17%, five...... to six times more than in the background population. In early pregnancy, the following clinical predictors were associated with increased prevalence of preeclampsia: diabetic nephropathy (OR 3.7-23.5), microalbuminuria (OR 3.8-11.7), diabetic retinopathy (OR 1.9-2.9) and pre-existing hypertension (OR 3...

  5. Risk Prediction Models for Hypertensive Disorders of Pregnancy: Role of 12-Lead Electrocardiography

    Directory of Open Access Journals (Sweden)

    Angeli Fabio

    2016-06-01

    Full Text Available Hypertensive disorders represent the most common medical complications of pregnancy, affecting 6 to 8 percent of gestations. They may lead to severe maternal and fetal complications.

  6. Atypia of undetermined significance and follicular lesions of undetermined significance: sonographic assessment for prediction of the final diagnosis

    National Research Council Canada - National Science Library

    Kamaya, Aya; Lewis, Gloria Huang; Liu, Yi; Akatsu, Haruko; Kong, Christina; Desser, Terry S

    2015-01-01

    To determine whether radiologic assessment of thyroid nodules can potentially help guide clinical management after a cytologic diagnosis of atypia of undetermined significance or a follicular lesion...

  7. Prediction of pregnancy success rate through in vitro fertilization based on maternal age

    Directory of Open Access Journals (Sweden)

    Soegiharto Soebijanto

    2009-12-01

    Full Text Available Aim To evaluate the correlation between the success of pregnancy through in vitro fertilization and maternal age. Methods Assessment of pregnancy was performed in eight in vitro fertilization centers in Indonesia: Harapan Kita Pediatric and Obstetric Hospital from 1997 to 2001, and seven in vitro fertilization centers in Indonesia. Follicular induction was performed through the long protocol, short protocol and natural cycle. Insemination was performed through ICSI (intra cytoplasmic sperm injection on petri dish. Spermatozoa were obtained through masturbation, testicular biopsy and epididimical biopsy. A successful pregnancy was indicated chemically, with the presence of fetal heart beat and the birth of a baby (take home baby. Results There was a 34% pregnancy rate for the age group below 30 years, 33.75% for those between 31 and 35 years olds, and 26% for the age group 36 to 40 years old, and 8% for the age group above 40 years. Conclusion The higher the maternal age, the lower pregnancy rate. In other words, the higher the maternal age, the higher the rate of miscarriage. (Med J Indones 2009; 18: 244-8Keywords: pregnancy, in vitro fertilization

  8. The Risk Factors That Predict Chronic Hypertension After Delivery in Women With a History of Hypertensive Disorders of Pregnancy.

    Science.gov (United States)

    Hwang, Ji-Won; Park, Sung-Ji; Oh, Soo-Young; Chang, Sung-A; Lee, Sang-Chol; Park, Seung Woo; Kim, Duk-Kyung

    2015-10-01

    Hypertensive disorders of pregnancy (HDP) is one of the most important lethal complications in pregnant mothers. It is also associated with the subsequent development of chronic hypertension. The objective of this study was to identify the clinical risk factors of postpartum chronic hypertension in women diagnosed with HDP.Six hundred patients as HDP, who diagnosed and followed-up at least 6 month after delivery, were included in the study. We divided the included subjects in 2 groups based on the development of postpartum chronic hypertension: presenting with the chronic hypertension, "case group" (n = 41) and without chronic hypertension, "control group" (n = 559).Clinical and demographic factors were evaluated. By multiple regression analysis, early onset hypertension with end-organ dysfunction, smoking, higher prepregnancy body mass index (BMI), and comorbidities, systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APLS), were associated with progression to chronic hypertension in the postpartum period. The value of area under the curves (AUC) for the 5 models, that generated to combine the significant factors, increased from 0.645 to 0.831, which indicated improved prediction of progression to the chronic hypertension. Additional multivariate analysis revealed significant specific risk factors.This retrospective single hospital-based study demonstrated that the clinical risk factors, that is early onset hypertension with end-organ dysfunction, smoking, and higher prepregnancy BMI, were significant independent predictors of chronic hypertension in women after delivery. Identification of risk factors allowed us to narrow the subject field for monitoring and managing high blood pressure in the postpartum period.

  9. The Role of Infertility Etiology in Success Rate of Intrauterine Insemination Cycles: An Evaluation of Predictive Factors for Pregnancy Rate

    Science.gov (United States)

    Ashrafi, Mahnaz; Rashidi, Mandana; Ghasemi, Afsaneh; Arabipoor, Arezoo; Daghighi, Sara; Pourasghari, Parisa; Zolfaghari, Zahra

    2013-01-01

    Background: The objective of this study was to identify the prognostic factors that influence the outcome of ovarian stimulation with intrauterine insemination (IUI) cycles in couples with different infertility etiology. Materials and Methods: This retrospective study was performed in data of 1348 IUI cycles with ovarian stimulation by clomiphene citrate (CC) and/or gonadotropins in 632 women with five different infertility etiology subgroups at Akbarabbadi Hospital, Tehran, Iran. Results: The pregnancy rate (PR)/ cycle was highest (19.9%) among couples with unexplained infertility and lowest (10.6%) in couples with multiple factors infertility. In cases of unexplained infertility, the best PRs were seen after CC plus gonadotropins stimulation (26.3%) and with inseminated motile sperm count>30×106 (21.9%), but the tendency didn’t reach statistical significant. In the ovarian factor group, the best PRs were observed in women aged between 30 and 34 years (20.8%), with 2-3 preovulatory follicles (37.8%) and infertility duration between 1and 3 years (20.8%), while only infertility duration (p=0.03) and number of preovulatory follicles (p=0.01) were statistically significant. Multiple logistic regression analysis determined that number of preovulatory follicles (p=0.02), duration of infertility (p=0.015), age (p=0.019), infertility etiology (p=0.05) and stimulation regimen (p=0.01) were significant independent factors in order to predict overall clinical PR. Conclusion: The etiology of infertility is important to achieve remarkable IUI success. It is worth mentioning that within different etiologies of infertility, the demographic and cycles characteristics of couples did not show the same effect. Favorable variables for treatment success are as follows: age infertility ≤5 years and a cause of infertility except of multiple factors. PMID:24520471

  10. Predicting Unprotected Sex and Unplanned Pregnancy among Urban African-American Adolescent Girls Using the Theory of Gender and Power.

    Science.gov (United States)

    Rosenbaum, Janet E; Zenilman, Jonathan; Rose, Eve; Wingood, Gina; DiClemente, Ralph

    2016-06-01

    Reproductive coercion has been hypothesized as a cause of unprotected sex and unplanned pregnancies, but research has focused on a narrow set of potential sources of reproductive coercion. We identified and evaluated eight potential sources of reproductive coercion from the Theory of Gender and Power including economic inequality between adolescent girls and their boyfriends, cohabitation, and age differences. The sample comprised sexually active African-American female adolescents, ages 15-21. At baseline (n = 715), 6 months (n = 607), and 12 months (n = 605), participants completed a 40-min interview and were tested for semen Y-chromosome with polymerase chain reaction from a self-administered vaginal swab. We predicted unprotected sex and pregnancy using multivariate regression controlling for demographics, economic factors, relationship attributes, and intervention status using a Poisson working model. Factors associated with unprotected sex included cohabitation (incidence risk ratio (IRR) 1.48, 95 % confidence interval (1.22, 1.81)), physical abuse (IRR 1.55 (1.21, 2.00)), emotional abuse (IRR 1.31 (1.06, 1.63)), and having a boyfriend as a primary source of spending money (IRR 1.18 (1.00, 1.39)). Factors associated with unplanned pregnancy 6 months later included being at least 4 years younger than the boyfriend (IRR 1.68 (1.14, 2.49)) and cohabitation (2.19 (1.35, 3.56)). Among minors, cohabitation predicted even larger risks of unprotected sex (IRR 1.93 (1.23, 3.03)) and unplanned pregnancy (3.84 (1.47, 10.0)). Adolescent cohabitation is a marker for unprotected sex and unplanned pregnancy, especially among minors. Cohabitation may have stemmed from greater commitment, but the shortage of affordable housing in urban areas could induce women to stay in relationships for housing. Pregnancy prevention interventions should attempt to delay cohabitation until adulthood and help cohabiting adolescents to find affordable housing.

  11. Significantly lower pregnancy rates in the presence of progesterone elevation in patients treated with GnRH antagonists and gonadotrophins: a systematic review and meta-analysis.

    Science.gov (United States)

    Kolibianakis, E M; Venetis, C A; Bontis, J; Tarlatzis, B C

    2012-03-01

    The current meta-analysis aimed to answer the following research question: is progesterone elevation on the day of hCG administration associated with the probability of clinical pregnancy in women undergoing ovarian stimulation for IVF using GnRH antagonists? A literature search in MEDLINE, EMBASE and CENTRAL electronic databases followed by extensive hand-searching from two independent reviewers was performed to identify relevant studies. Eventually five eligible studies (n=585 patients) were identified. No significant differences were present between patients with and those without progesterone elevation regarding female age, duration of stimulation and total dose of gonadotrophins required. However, patients with progesterone elevation were characterized by higher serum estradiol levels on the day of hCG administration (+956 pg/ml, 95% +248 to +1664, random effects model, p=0.008) and more COCs retrieved (+2.9, 95% CI +1.5 to +4.4, fixed effects model, p decreased probability of clinical pregnancy per cycle (-9%, 95% CI -17 to -2, fixed model effects, p). In conclusion, in patients treated with GnRH antagonists and gonadotrophins, progesterone elevation on the day of hCG administration is significantly associated with a lower probability of clinical pregnancy.

  12. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis

    DEFF Research Database (Denmark)

    Silverberg, Michael J.; Thorsen, Poul; Lindeberg, Henning

    2003-01-01

    OBJECTIVE: To assess the risk of juvenile-onset recurrent respiratory papillomatosis conferred by a maternal history of genital warts in pregnancy, and to identify additional cofactors such as the method of delivery (cesarean versus vaginal) and procedures or complications during pregnancy. METHODS......: A retrospective cohort design was used to evaluate maternal and infant characteristics associated with respiratory papillomatosis among Danish births between 1974 and 1993. Using data from Danish registries, we identified 3033 births with a maternal history of genital warts during pregnancy. Fifty......-seven respiratory papillomatosis cases were identified by review of medical records from ear, nose, and throat departments. RESULTS: Seven of every 1000 births with a maternal history of genital warts resulted in disease in the offspring, corresponding to a 231.4 (95% confidence interval 135.3, 395.9) times higher...

  13. Predictive factors of plasma HIV suppression during pregnancy: a prospective cohort study in Benin.

    Directory of Open Access Journals (Sweden)

    Lise Denoeud-Ndam

    Full Text Available OBJECTIVE: To investigate the factors associated with HIV1 RNA plasma viral load (pVL below 40 copies/mL at the third trimester of pregnancy, as part of prevention of mother-to-child transmission (PMTCT in Benin. DESIGN: Sub study of the PACOME clinical trial of malaria prophylaxis in HIV-infected pregnant women, conducted before and after the implementation of the WHO 2009 revised guidelines for PMTCT. METHODS: HIV-infected women were enrolled in the second trimester of pregnancy. Socio-economic characteristics, HIV history, clinical and biological characteristics were recorded. Malaria prevention and PMTCT involving antiretroviral therapy (ART for mothers and infants were provided. Logistic regression helped identifying factors associated with virologic suppression at the end of pregnancy. RESULTS: Overall 217 third trimester pVLs were available, and 71% showed undetectability. Virologic suppression was more frequent in women enrolled after the change in PMTCT recommendations, advising to start ART at 14 weeks instead of 28 weeks of pregnancy. In multivariate analysis, Fon ethnic group (the predominant ethnic group in the study area, regular job, first and second pregnancy, higher baseline pVL and impaired adherence to ART were negative factors whereas higher weight, higher antenatal care attendance and longer ART duration were favorable factors to achieve virologic suppression. CONCLUSIONS: This study provides more evidence that ART has to be initiated before the last trimester of pregnancy to achieve an undetectable pVL before delivery. In Benin, new recommendations supporting early initiation were well implemented and, together with a high antenatal care attendance, led to high rate of virologic control.

  14. UTERINE ARTERY DOPPLER STUDY FOR PREDICTION OF ADVERSE OUTCOME IN HIGH RISK PREGNANCY

    Directory of Open Access Journals (Sweden)

    Gunjan

    2015-07-01

    Full Text Available AIM : To detect abnormal waveforms in uterine artery in pregnancies at risk between 20 to 24 weeks of gestation and to measure Resistance index (RI and systolic/diastolic ratio(S/D of these waveforms in study population and to study correlation of Doppler dat a with adverse pregnancy outcome. METHODS : This is a prospective study included Doppler analysis of uterine artery waveforms in 107 normotensive women with singleton pregnancy between 20 to24 weeks of period of gestation who were considered to be at increa sed risk of developing pregnancy complications. Women with Multiple gestation, with congenital anomaly of fetus, chronic hypertension, renal disease, cardiac disease, Diabetes Mellitus were excluded from the study. Bilateral uterine artery Doppler was done and Parameters studied were S/D ratio and RI in uterine artery. Early diastolic notch in uterine artery was watched for. The flow velocity waveforms considered abnormal if there was an early diastolic notch in uterine artery in either right or left uterin e artery was watched for abnormal pregnancy outcomes considered are Gestational hypertension, Pre - eclampsia IUGR, Abruptio placentae, IUD and preterm deliveries. RESULTS : minimum women were aged 21 – 25 year with minimum of 18 years and maximum of 36 years, 28% were primigravidae while 72% were multigravidae mean gestational age of which scan was done was 22 wks 1 day (20 - 24 minimum gestational age at time of delivery was 28 wks of gestation 70% women were delivered vaginally and 30% LSCS. 7% women developed Gestational Hypertension, 5% developed Preeclampsia, 8% neonates with IUGR, 3% developed Placental Abruption while 4% had IUD and 8% had Preterm deliveries. CONCLUSION : Abnormal uterine artery Doppler studies in second trimester have been associated with subsequent adverse pregnancy out comes including Preeclampsia IUGR and perinatal mortality. Doppler velocimetry is a primary tool for fetomaternal surveillance in high

  15. Increased Maternal Serum Interleukin-6 Concentrations at 11 to 14 Weeks of Gestation in Low Risk Pregnancies Complicated with Gestational Diabetes Mellitus: Development of a Prediction Model.

    Science.gov (United States)

    Hassiakos, D; Eleftheriades, M; Papastefanou, I; Lambrinoudaki, I; Kappou, D; Lavranos, D; Akalestos, A; Aravantinos, L; Pervanidou, P; Chrousos, G

    2016-01-01

    The aim of the study was to examine interleukin-6 (IL-6) maternal serum concentration at 11 to 14 gestational weeks in normal pregnancies and pregnancies complicated by gestational diabetes mellitus (GDM) and to create first trimester prediction models for GDM. Case-control study conducted in a Fetal Medicine Unit. Study population included 40 GDM cases and 94 controls. Maternal characteristics, first trimester ultrasound markers, biochemical indices, and IL-6 levels were used for our analysis. IL-6 was related to maternal weight among the maternal characteristics, (R(2)=0.0679, p=0.01). IL-6 was increased (p=0.001) in the GDM group (median=2 pg/ml) compared to the control group (median=1.5 pg/ml) even after adjustment for maternal weight. IL-6 was inversely related to birth weight adjusted for gestational age at delivery (r=-0.3382, poral glucose test. Maternal weight and age were the only predictors of GDM among the maternal characteristics [Detection Rate (DR)=59.4%; for 25% False Positive Rate (FPR); Area Under the Curve (AUC)=0.7291; Model R(2)=0.1096, p<0.001]. IL-6 alone was a significant predictor of GDM (DR=51.3%; for 25% FPR; AUC=0.6731; Model R(2)=0.0616, p<0.001). Combination of maternal characteristics with IL-6 yielded an improved prediction (DR=67.5%; for 25% FPR; AUC=0.7586; Model R(2)=0.1521, p<0.001). IL-6 concentrations are increased at 11-14 weeks in pregnancies with GDM. Combination of maternal characteristics and maternal serum IL-6 levels may provide effective first trimester screening for GDM.

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

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2014-01-01

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

  17. Analytic Methods for Predicting Significant Multi-Quanta Effects in Collisional Molecular Energy Transfer

    Science.gov (United States)

    Bieniek, Ronald J.

    1996-01-01

    Collision-induced transitions can significantly affect molecular vibrational-rotational populations and energy transfer in atmospheres and gaseous systems. This, in turn. can strongly influence convective heat transfer through dissociation and recombination of diatomics. and radiative heat transfer due to strong vibrational coupling. It is necessary to know state-to-state rates to predict engine performance and aerothermodynamic behavior of hypersonic flows, to analyze diagnostic radiative data obtained from experimental test facilities, and to design heat shields and other thermal protective systems. Furthermore, transfer rates between vibrational and translational modes can strongly influence energy flow in various 'disturbed' environments, particularly where the vibrational and translational temperatures are not equilibrated.

  18. Don't worry, be (moderately) happy: Mothers' anxiety and positivity during pregnancy independently predict lower mother-infant synchrony.

    Science.gov (United States)

    Moore, Ginger A; Quigley, Kelsey M; Voegtline, Kristin M; DiPietro, Janet A

    2016-02-01

    Maternal positivity and mother-infant synchrony have been linked, independently, to beneficial infant outcomes; however, research that has examined relations between the two has found that higher positivity is associated with lower synchrony. Methodological issues may inform this counter-intuitive association and clinical theory supports its validity. This study examined the theory that heightened positivity associated with anxiety is a way of avoiding negative emotion and contributes to lower synchrony because it interferes with appropriate responding to infant cues. We examined mothers' (N=75) self-reported anxiety and verbal expression of positivity during pregnancy in relation to mother-infant synchrony at 6 months post-partum. Verbal positivity was assessed using linguistic analysis of interviews about pregnancy experiences. Mother and infant affect and gaze were coded during interaction and synchrony was computed as the correlation between mother and infant behaviors. Higher verbal positivity and anxiety during pregnancy independently predicted lower mother-infant synchrony, suggesting distinct pathways to the same degree of synchrony with potentially different consequences for infant development.

  19. Ethnic discrimination predicts poor self-rated health and cortisol in pregnancy: insights from New Zealand.

    Science.gov (United States)

    Thayer, Zaneta M; Kuzawa, Christopher W

    2015-03-01

    Despite growing research emphasis on understanding the health effects of ethnic discrimination, little work has focused on how such exposures may influence a woman's biology and health during pregnancy. Understanding such effects is important given evidence that maternal stress experience in pregnancy can have long term effects on offspring health. Here we present data evaluating the relationship between perceived discrimination, self-rated health, and the stress hormone cortisol measured in late pregnancy among a diverse sample of women living in Auckland, New Zealand (N = 55). We also evaluated possible intergenerational impacts of maternal discrimination on stress reactivity in a subset of offspring (N = 19). Pregnant women were recruited from two antenatal care clinics in Auckland. Women were met in their homes between 34 and 36 weeks gestation, during which time a prenatal stress questionnaire was administered and saliva samples (morning and evening from two days) were obtained. Offspring cortisol reactivity was assessed at the standard six week postnatal vaccination visit. We found that 34% of women reported having experienced ethnic discrimination, with minority and immigrant women being more likely to report being angry or upset in response to discrimination experience compared with NZ-born women of European descent. Women reporting discrimination experience had worse self-rated health, higher evening cortisol and gave birth to infants with higher cortisol reactivity, all independent of ethnicity and material deprivation. These findings suggest that discrimination experience can have biological impacts in pregnancy and across generations, potentially contributing to the ethnic gradient in health.

  20. Mercury and psychosocial stress exposure interact to predict maternal diurnal cortisol during pregnancy.

    Science.gov (United States)

    Schreier, Hannah M C; Hsu, Hsiao-Hsien; Amarasiriwardena, Chitra; Coull, Brent A; Schnaas, Lourdes; Téllez-Rojo, Martha María; Tamayo y Ortiz, Marcela; Wright, Rosalind J; Wright, Robert O

    2015-03-27

    Disrupted maternal prenatal cortisol production influences offspring development. Factors influencing the hypothalamic-pituitary-adrenal axis include social (e.g., stressful life events) and physical/chemical (e.g., toxic metals) pollutants. Mercury (Hg) is a common contaminant of fish and exposure is widespread in the US. No prior study has examined the joint associations of stress and mercury with maternal cortisol profiles in pregnancy. To investigate potential synergistic influences of prenatal stress and Hg exposures on diurnal cortisol in pregnant women. Analyses included 732 women (aged 27.4 ± 5.6 years) from a Mexico City pregnancy cohort. Participants collected saliva samples on two consecutive days (mean 19.52 ± 3.00 weeks gestation) and reported life stressors over the past 6 months. Hg was assessed in toe nail clippings collected during pregnancy. There were no main effects of Hg or psychosocial stress exposure on diurnal cortisol (ps > .20) but strong evidence of interaction effects on cortisol slope (interaction B = .006, SE = .003, p = .034) and cortisol at times 1 and 2 (interaction B = -.071, SE = .028, p = .013; B = -.078, SE = .032, p = .014). Women above the median for Hg and psychosocial stress exposure experienced a blunted morning cortisol response compared to women exposed to higher stress but lower Hg levels. Social and physical environmental factors interact to alter aspects of maternal diurnal cortisol during pregnancy. Research focusing solely on either domain may miss synergistic influences with potentially important consequences to the offspring.

  1. Prediction of Time to Delivery Week-by-Week in Women with a Triplet Pregnancy

    NARCIS (Netherlands)

    de Mheen, L. van; Ravelli, A. C.; Oudijk, M. A.; Bijvank, S. Nij; Porath, M. M.; Duvekot, J. J.; Scholtenhuis, M. A. G. Holswilder-Olde; Bloemenkamp, K. W. M.; Scheepers, H. C. J.; Woiski, M.; van Pampus, M. G.; de Groot, C. J.; Pajkrt, E.; Mol, B. W. J.

    2016-01-01

    Objective Some clinicians advise prophylactic administration of antenatal steroids for fetal lung maturation in women with a triplet pregnancy. However, the effect of corticosteroids is limited to 10 to 14 days after administration. The aim of this study was to assess the natural course of triplet

  2. Prediction of Time to Delivery Week-by-Week in Women with a Triplet Pregnancy

    NARCIS (Netherlands)

    van de Mheen, L; Ravelli, A C; Oudijk, M A; Bijvank, S Nij; Porath, M M; Duvekot, J J; Scholtenhuis, M A G Holswilder-Olde; Bloemenkamp, K W M; Scheepers, H C J; Woiski, M; Pampus, M G van; Groot, C J de; Pajkrt, E; Mol, B W J

    2016-01-01

    Objective Some clinicians advise prophylactic administration of antenatal steroids for fetal lung maturation in women with a triplet pregnancy. However, the effect of corticosteroids is limited to 10 to 14 days after administration. The aim of this study was to assess the natural course of triplet

  3. Development and internal validation of a multivariable model to predict perinatal death in pregnancy hypertension

    NARCIS (Netherlands)

    Payne, Beth A.; Groen, Henk; Ukah, U. Vivian; Ansermino, J. Mark; Bhutta, Zulfiqar; Grobman, William; Hall, David R.; Hutcheon, Jennifer A.; Magee, Laura A.; von Dadelszen, Peter

    2015-01-01

    Objective: To develop and internally validate a prognostic model for perinatal death that could guide community-based antenatal care of women with a hypertensive disorder of pregnancy (HDP) in low-resourced settings as part of a mobile health application. Study design: Using data from 1688 women (11

  4. Higher Facebook use predicts greater body image dissatisfaction during pregnancy: The role of self-comparison.

    Science.gov (United States)

    Hicks, S; Brown, A

    2016-09-01

    poor body image during pregnancy is a growing issue. Similarly, emerging evidence is suggesting that social media use may increase the risk of poor well-being e.g. depression, anxiety and body image concerns amongst users. Research has not examined how social media use may influence women during pregnancy. The aim of this study was to therefore to explore the relationship between body image during pregnancy and Facebook use. a cross sectional self-report questionnaire. two hundred and sixty nine pregnant women. community groups and online forums. a self-report questionnaire exploring maternal body image, use of Facebook and how mothers perceived Facebook affected their body image. Descriptive statistics were used to explore body image perceptions. Partial correlations (controlling for maternal age, education, parity and gestation) were used to explore the association between Facebook use and body image during pregnancy. negative body image was common in the sample, increased with gestation and was unrelated to pre pregnancy weight. Mothers with a Facebook account had higher body image concerns than those without a Facebook account. Of those with an account, increased Facebook use was associated with increased body image dissatisfaction, particularly in terms of postnatal concerns for how their body would look with 56.5% reporting that they frequently compared their pregnant body to other pregnant women on the site. Facebook access was frequent with 85% of participants checking it at least once per day and the average participant spending over an hour per day on the site. although causality cannot be fully explained, Facebook use may increase mother's risk of poor body image dissatisfaction during pregnancy. Mothers with already poor body image may also be drawn to the site in order to make comparisons of their appearance. the potential impact of Facebook on increasing the risk of, or promoting existing poor body image is an important message for those working to

  5. The long sunspot cycle 23 predicts a significant temperature decrease in cycle 24

    CERN Document Server

    Solheim, Jan-Erik; Humlum, Ole

    2012-01-01

    Relations between the length of a sunspot cycle and the average temperature in the same and the next cycle are calculated for a number of meteorological stations in Norway and in the North Atlantic region. No significant trend is found between the length of a cycle and the average temperature in the same cycle, but a significant negative trend is found between the length of a cycle and the temperature in the next cycle. This provides a tool to predict an average temperature decrease of at least 1.0 "C from solar cycle 23 to 24 for the stations and areas analyzed. We find for the Norwegian local stations investigated that 25-56% of the temperature increase the last 150 years may be attributed to the Sun. For 3 North Atlantic stations we get 63-72% solar contribution. This points to the Atlantic currents as reinforcing a solar signal.

  6. Position Weight Matrix, Gibbs Sampler, and the Associated Significance Tests in Motif Characterization and Prediction

    Directory of Open Access Journals (Sweden)

    Xuhua Xia

    2012-01-01

    Full Text Available Position weight matrix (PWM is not only one of the most widely used bioinformatic methods, but also a key component in more advanced computational algorithms (e.g., Gibbs sampler for characterizing and discovering motifs in nucleotide or amino acid sequences. However, few generally applicable statistical tests are available for evaluating the significance of site patterns, PWM, and PWM scores (PWMS of putative motifs. Statistical significance tests of the PWM output, that is, site-specific frequencies, PWM itself, and PWMS, are in disparate sources and have never been collected in a single paper, with the consequence that many implementations of PWM do not include any significance test. Here I review PWM-based methods used in motif characterization and prediction (including a detailed illustration of the Gibbs sampler for de novo motif discovery, present statistical and probabilistic rationales behind statistical significance tests relevant to PWM, and illustrate their application with real data. The multiple comparison problem associated with the test of site-specific frequencies is best handled by false discovery rate methods. The test of PWM, due to the use of pseudocounts, is best done by resampling methods. The test of individual PWMS for each sequence segment should be based on the extreme value distribution.

  7. Can Preterm Labour Be Predicted in Low Risk Pregnancies? Role of Clinical, Sonographic, and Biochemical Markers

    Directory of Open Access Journals (Sweden)

    Reva Tripathi

    2014-01-01

    Full Text Available Background and Objectives. This is a prospective nested cohort study conducted over a period of 3 years. 2644 women were recruited, out of which final analysis was done for 1884 women. Methods. Cervicovaginal and blood samples were collected for all recruited women. Out of these, 137 women who delivered before 35 weeks were treated as cases and equal number of matched controls were chosen. Analysis of samples for serum G-CSF, AFP, ferritin, and cervicovaginal interleukin-6 and IGFBP-1 was done. Results. Poor orodental hygiene, which can be a social marker, was significantly more common in women who delivered preterm (P=0.008. Serum alkaline phosphatase and serum ferritin were found to be significantly associated with preterm deliveries. The 90th percentile value of these parameters was considered as cut-off as there is no specific cut-off. Conclusions. Our study did not prove usefulness of any predictive marker. Serum ferritin and alkaline phosphatase were found to have correlation but their values are affected in many conditions and need to be elucidated with caution. Larger studies are needed for predicting preterm labour in asymptomatic women.

  8. Mapping Soil Properties of Africa at 250 m Resolution: Random Forests Significantly Improve Current Predictions.

    Science.gov (United States)

    Hengl, Tomislav; Heuvelink, Gerard B M; Kempen, Bas; Leenaars, Johan G B; Walsh, Markus G; Shepherd, Keith D; Sila, Andrew; MacMillan, Robert A; Mendes de Jesus, Jorge; Tamene, Lulseged; Tondoh, Jérôme E

    2015-01-01

    80% of arable land in Africa has low soil fertility and suffers from physical soil problems. Additionally, significant amounts of nutrients are lost every year due to unsustainable soil management practices. This is partially the result of insufficient use of soil management knowledge. To help bridge the soil information gap in Africa, the Africa Soil Information Service (AfSIS) project was established in 2008. Over the period 2008-2014, the AfSIS project compiled two point data sets: the Africa Soil Profiles (legacy) database and the AfSIS Sentinel Site database. These data sets contain over 28 thousand sampling locations and represent the most comprehensive soil sample data sets of the African continent to date. Utilizing these point data sets in combination with a large number of covariates, we have generated a series of spatial predictions of soil properties relevant to the agricultural management--organic carbon, pH, sand, silt and clay fractions, bulk density, cation-exchange capacity, total nitrogen, exchangeable acidity, Al content and exchangeable bases (Ca, K, Mg, Na). We specifically investigate differences between two predictive approaches: random forests and linear regression. Results of 5-fold cross-validation demonstrate that the random forests algorithm consistently outperforms the linear regression algorithm, with average decreases of 15-75% in Root Mean Squared Error (RMSE) across soil properties and depths. Fitting and running random forests models takes an order of magnitude more time and the modelling success is sensitive to artifacts in the input data, but as long as quality-controlled point data are provided, an increase in soil mapping accuracy can be expected. Results also indicate that globally predicted soil classes (USDA Soil Taxonomy, especially Alfisols and Mollisols) help improve continental scale soil property mapping, and are among the most important predictors. This indicates a promising potential for transferring pedological

  9. Significance of preoperative neutrophil–lymphocyte count ratio on predicting postoperative sepsis after percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Volkan Sen

    2016-10-01

    Full Text Available We evaluated the usefulness of preoperative neutrophil–lymphocyte count ratio (NLCR in predicting postoperative sepsis after percutaneous nephrolithotomy (PCNL. In total, 487 patients who underwent PCNL for renal stones were included in the present retrospective study. The stone burden, number of tracts and location, operation time, fluoroscopy time, presence of residual stones, and blood transfusion rates were postoperatively recorded in all patients. All patients were followed up for signs of systemic inflammatory response syndrome (SIRS and sepsis. The association of sepsis/SIRS with the risk factors of infectious complications, including NLCR, was evaluated. SIRS was detected in 91 (18.7% patients, 25 (5.1% of whom were diagnosed with sepsis. Stone burden, operation time, irrigation rate, previous surgery, nephrostomy time, access number, blood transfusion, residual stone, postoperative urinary culture, renal pelvis urinary culture, and stone culture were found to be predictive factors for SIRS and sepsis development. Receiver operating characteristic curve analysis revealed an NLCR cutoff of 2.50 for predicting the occurrence of SIRS/sepsis. We found that the incidence of sepsis was significantly higher in patients with NLCR ≥ 2.50 than in patients with NLCR < 2.50 (p = 0.006. Preoperative and postoperative urine culture positivity were associated with high NLCR (p = 0.039 and p = 0.003, respectively. We believe that preoperative NLCR may be a promising additive predictor of bacteremia and postoperative sepsis in patients who undergo PCNL for renal stones. This marker is simple, easily measured, and easy to use in daily practice without extra costs.

  10. Two new prediction rules for spontaneous pregnancy leading to live birth among subfertile couples, based on the synthesis of three previous models.

    NARCIS (Netherlands)

    C.C. Hunault; J.D.F. Habbema (Dik); M.J.C. Eijkemans (René); J.A. Collins (John); J.L.H. Evers (Johannes); E.R. te Velde (Egbert)

    2004-01-01

    textabstractBACKGROUND: Several models have been published for the prediction of spontaneous pregnancy among subfertile patients. The aim of this study was to broaden the empirical basis for these predictions by making a synthesis of three previously published models. METHODS: We u

  11. Two new prediction rules for spontaneous pregnancy leading to live birth among subfertile couples, based on the synthesis of three previous models.

    NARCIS (Netherlands)

    C.C. Hunault; J.D.F. Habbema (Dik); M.J.C. Eijkemans (René); J.A. Collins (John); J.L.H. Evers (Johannes); E.R. te Velde (Egbert)

    2004-01-01

    textabstractBACKGROUND: Several models have been published for the prediction of spontaneous pregnancy among subfertile patients. The aim of this study was to broaden the empirical basis for these predictions by making a synthesis of three previously published models. METHODS: We u

  12. Serum antimüllerian hormone measurements with second generation assay at two distinct menstrual cycle phases for prediction of cycle cancellation, pregnancy and live birth after in vitro fertilization.

    Science.gov (United States)

    Rezende, Carolina P; Rocha, Ana L; Dela Cruz, Cynthia; Borges, Lavinia E; Del Puerto, Helen L; Reis, Fernando M

    2014-10-01

    This study investigated the usefulness of serum antimüllerian hormone (AMH) measurements at two distinct menstrual cycle phases to predict in vitro fertilization (IVF) outcomes. This was a prospective observational study enrolling 135 consecutive patients referred for conventional IVF or ICSI in a university hospital. Blood samples were obtained for serum AMH measurements on days 3 and 18-20, while transvaginal ultrasound was performed for antral follicle count (AFC) at day 3 of the menstrual cycle immediately before treatment. AMH was measured with the new Beckman Coulter Generation II (GenII) assay. The main outcome measures were cycle cancellation due to poor ovarian response, clinical pregnancy, and live birth. There was a strong correlation between AMH levels measured at day 3 and day 18-20 of the menstrual cycle (r = 0.837; P live birth (area under ROC curve 0.71 for both), which was comparable to that of day 3 AMH; however, AFC had no predictive value for these outcomes. Day 18-20 AMH was comparable to day 3 AMH for the prediction of cycle cancellation, clinical pregnancy, and live birth after IVF. Both AMH measurements were accurate for the prediction of cancellation but were significantly less useful for the prediction of pregnancy or live birth.

  13. The value of HCG serum concentrations after trigger in predicting pregnancy and live birth rates in IVF-ICSI.

    Science.gov (United States)

    Zhou, Jianjun; Wang, Shanshan; Wang, Bin; Wang, Junxia; Chen, Hua; Zhang, Ningyuan; Hu, Yali; Sun, Haixiang

    2015-06-01

    The aim of this study was to determine if an association existed between serum human chorionic gonadotrophin (HCG) level at 12 h after trigger and IVF and intracytoplasmic sperm (ICSI) treatment outcomes. Women undergoing initial IVF-ICSI and embryo transfer treatment using the long luteal phase gonadotrophin-releasing hormone agonist protocol between April 2012 and March 2013 for tubal factor were included (n = 699). In the clinical pregnancy group, HCG after trigger was significantly elevated (276.0 ± 5.1 versus 198.5 ± 6.1 mIU/mL; P HCG was 201.2 mIU/ml. Compared with the lower HCG group, the clinical pregnancy rate in the higher HCG group was increased in obese and non-obese patients (77.8% versus 57.3%, P HCG was associated with a better IVF-ICSI treatment outcome (OR 4.39, 95% CI 2.99 to 6.45). Clinical pregnancy rate was significantly higher across increasing quartiles of HCG. An elevated level of serum HCG at 12 h after trigger was associated with a better IVF-ICSI outcome. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  14. The prognostic significance of UCA1 for predicting clinical outcome in patients with digestive system malignancies.

    Science.gov (United States)

    Liu, Fang-Teng; Dong, Qing; Gao, Hui; Zhu, Zheng-Ming

    2017-06-20

    Urothelial Carcinoma Associated 1 (UCA1) was an originally identified lncRNA in bladder cancer. Previous studies have reported that UCA1 played a significant role in various types of cancer. This study aimed to clarify the prognostic value of UCA1 in digestive system cancers. The meta-analysis of 15 studies were included, comprising 1441 patients with digestive system cancers. The pooled results of 14 studies indicated that high expression of UCA1 was significantly associated with poorer OS in patients with digestive system cancers (HR: 1.89, 95 % CI: 1.52-2.26). In addition, UCA1 could be as an independent prognostic factor for predicting OS of patients (HR: 1.85, 95 % CI: 1.45-2.25). The pooled results of 3 studies indicated a significant association between UCA1 and DFS in patients with digestive system cancers (HR = 2.50; 95 % CI = 1.30-3.69). Statistical significance was also observed in subgroup meta-analysis. Furthermore, the clinicopathological values of UCA1 were discussed in esophageal cancer, colorectal cancer and pancreatic cancer. A comprehensive retrieval was performed to search studies evaluating the prognostic value of UCA1 in digestive system cancers. Many databases were involved, including PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure and Wanfang database. Quantitative meta-analysis was performed with standard statistical methods and the prognostic significance of UCA1 in digestive system cancers was qualified. Elevated level of UCA1 indicated the poor clinical outcome for patients with digestive system cancers. It may serve as a new biomarker related to prognosis in digestive system cancers.

  15. CAN INITIAL βHCG VALUES PREDICT THE NEED FOR SECOND DOSE OF METHOTREXATE IN MEDICAL MANAGEMENT OF ECTOPIC PREGNANCY?

    Directory of Open Access Journals (Sweden)

    Priya Narayanan

    2016-09-01

    Full Text Available INTRODUCTION Prediction of requirement of second dose of methotrexate in patients treated with single dose would help in guiding treatment and counseling. The aim of this study is to determine whether pretreatment beta HCG values can predict the need for second dose of methotrexate in medically managed ectopic pregnancy. MATERIALS AND METHODS 46 women with ectopic pregnancies who were managed medically were included. The median of beta HCG titres on day 1, day 4 and day 7 was assessed in patients who responded to single dose methotrexate and those who required a second dose. RESULTS Out of the 46 patients studied, 41 responded to medical treatment (success 91%. 14 out of 41 required second dose of methotrexate (34%. Two patients required third dose of methotrexate. Five patients required surgery. DISCUSSION The median of day 1 and day 4 beta HCG values were not statistically different between those who responded to single dose methotrexate and those who required a second dose. Only day 7 values were found to be different. CONCLUSION The beta-hCG titre on day 1 and day 4 is not a predictor of requirement of second dose of methotrexate.

  16. Predicting healthy eating intention and adherence to dietary recommendations during pregnancy in Australia using the Theory of Planned Behaviour.

    Science.gov (United States)

    Malek, Lenka; Umberger, Wendy J; Makrides, Maria; ShaoJia, Zhou

    2017-09-01

    This study aims to aid in the development of more effective healthy eating intervention strategies for pregnant women by understanding the relationship between healthy eating intention and actual eating behaviour. Specifically, the study explored whether Theory of Planned Behaviour (TPB) constructs [attitude, subjective-norm, perceived-behavioural-control (PBC)] and additional psychosocial variables (perceived stress, health value and self-identity as a healthy eater) are useful in explaining variance in women's 1) intentions to consume a healthy diet during pregnancy and 2) food consumption behaviour (e.g. adherence to food group recommendations) during pregnancy. A cross-sectional sample of 455 Australian pregnant women completed a TPB questionnaire as part of a larger comprehensive web-based nutrition questionnaire. Women's perceived stress, health value and self-identity as a healthy eater were also measured. Dietary intake was assessed using six-items based on the 2013 Australian Dietary Guidelines. Hierarchical multiple linear regression models were estimated (significance level behaviour. Further research is required to understand this weak relationship between healthy eating intention and behaviour during pregnancy. Alternative behavioural frameworks, particularly those that account for the automatic nature of most dietary choices, should also be considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Predicting the Risk of Macrosomia at Mid-Pregnancy Among Non-Diabetics: A Retrospective Cohort Study.

    Science.gov (United States)

    Jeffers, Elizabeth; Dodds, Linda; Allen, Victoria; Woolcott, Christy

    2017-08-02

    To identify factors known in mid-pregnancy to be associated with risk of macrosomia (≥4000 g) among non-diabetic women and to develop a risk score to allow early identification of women at high risk. Data were obtained from a population-based perinatal database and a hospital laboratory database in Nova Scotia, Canada. The study included singleton live births born to non-diabetic women between 1998 and 2005. Logistic regression was used to identify risk factors significantly associated with macrosomia. Risk scoring systems were developed for nulliparous and parous women separately and validated using the C-statistic. Of the 23 857 mother-infant pairs included in the study, 16.7% of the infants were macrosomic. In nulliparous women, seven risk factors were identified, of which pre-pregnancy weight ≥90 kg with an OR of 4.8 (95% CI: 3.9 to 6.0) contributed a greater number of points to the risk score. The resulting risk score corresponded to a range of estimated risk of 0.2% to 47.0% and had a C-statistic of 0.70. In parous women, the most points were assigned to women with a previous large birth (OR: 3.7; 95% CI: 3.2-4.0) and a pre-pregnancy weight ≥90 kg (OR: 3.8; 95% CI: 3.1-4.7). The resulting risk score corresponded to a range of estimated risk of 0.4% to 88.0% and had a C-statistic of 0.75. Macrosomia risk can be estimated by a simple calculation based on a woman's risk factor profile at mid-pregnancy. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  18. Predicting Intentions of a Familiar Significant Other Beyond the Mirror Neuron System

    Directory of Open Access Journals (Sweden)

    Stephanie Cacioppo

    2017-08-01

    Full Text Available Inferring intentions of others is one of the most intriguing issues in interpersonal interaction. Theories of embodied cognition and simulation suggest that this mechanism takes place through a direct and automatic matching process that occurs between an observed action and past actions. This process occurs via the reactivation of past self-related sensorimotor experiences within the inferior frontoparietal network (including the mirror neuron system, MNS. The working model is that the anticipatory representations of others' behaviors require internal predictive models of actions formed from pre-established, shared representations between the observer and the actor. This model suggests that observers should be better at predicting intentions performed by a familiar actor, rather than a stranger. However, little is known about the modulations of the intention brain network as a function of the familiarity between the observer and the actor. Here, we combined functional magnetic resonance imaging (fMRI with a behavioral intention inference task, in which participants were asked to predict intentions from three types of actors: A familiar actor (their significant other, themselves (another familiar actor, and a non-familiar actor (a stranger. Our results showed that the participants were better at inferring intentions performed by familiar actors than non-familiar actors and that this better performance was associated with greater activation within and beyond the inferior frontoparietal network i.e., in brain areas related to familiarity (e.g., precuneus. In addition, and in line with Hebbian principles of neural modulations, the more the participants reported being cognitively close to their partner, the less the brain areas associated with action self-other comparison (e.g., inferior parietal lobule, attention (e.g., superior parietal lobule, recollection (hippocampus, and pair bond (ventral tegmental area, VTA were recruited, suggesting that the

  19. Cervical length measurement for the prediction of preterm birth in symptomatic women with a twin pregnancy: a systematic review and meta-analysis.

    Science.gov (United States)

    Liem, S M S; van de Mheen, L; Bekedam, D J; van Pampus, M G; Opmeer, B C; Lim, A C; Mol, B W J

    2013-01-01

    Objective. The aim of this study was to assess whether cervical length measurement (CL) could predict preterm birth (PTB) in symptomatic women with a twin pregnancy. Methods. We searched MEDLINE and EMBASE to identify studies investigating the accuracy of CL measurement in predicting PTB in symptomatic women with a twin pregnancy. We extracted data to construct two-by-two tables and used bivariate meta-analysis to generate point estimates of sensitivity and specificity. Results. Five studies (N = 226) were included. Variation in definition of PTB and cut-off points for CL was strong. One study investigated delivery within seven days, demonstrating a sensitivity of 1.0 (95% CI: 0.83-1.0) and a specificity of 0.31 (95% CI 0.2-0.43) for a CL cutoff at 25 mm. Three studies reported on predicting PTB twin pregnancy, especially on the most important outcome, that is, delivery within 7 days.

  20. Integrating trans-abdominal ultrasonography with fecal steroid metabolite monitoring to accurately diagnose pregnancy and predict the timing of parturition in the red panda (Ailurus fulgens styani).

    Science.gov (United States)

    Curry, Erin; Browning, Lissa J; Reinhart, Paul; Roth, Terri L

    2017-02-23

    Red pandas (Ailurus fulgens styani) exhibit a variable gestation length and may experience a pseudopregnancy indistinguishable from true pregnancy; therefore, it is not possible to deduce an individual's true pregnancy status and parturition date based on breeding dates or fecal progesterone excretion patterns alone. The goal of this study was to evaluate the use of transabdominal ultrasonography for pregnancy diagnosis in red pandas. Two to three females were monitored over 4 consecutive years, generating a total of seven profiles (four pregnancies, two pseudopregnancies, and one lost pregnancy). Fecal samples were collected and assayed for progesterone (P4) and estrogen conjugate (EC) to characterize patterns associated with breeding activity and parturition events. Animals were trained for voluntary transabdominal ultrasound and examinations were performed weekly. Breeding behaviors and fecal EC data suggest that the estrus cycle of this species is 11-12 days in length. Fecal steroid metabolite analyses also revealed that neither P4 nor EC concentrations were suitable indicators of pregnancy in this species; however, a secondary increase in P4 occurred 69-71 days prior to parturition in all pregnant females, presumably coinciding with embryo implantation. Using ultrasonography, embryos were detected as early as 62 days post-breeding/50 days pre-partum and serial measurements of uterine lumen diameter were documented throughout four pregnancies. Advances in reproductive diagnostics, such as the implementation of ultrasonography, may facilitate improved husbandry of pregnant females and allow for the accurate prediction of parturition. © 2017 Wiley Periodicals, Inc.

  1. Parameter definition using vibration prediction software leads to significant drilling performance improvements

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Dalmo; Hanley, Chris Hanley; Fonseca, Isaac; Santos, Juliana [National Oilwell Varco, Houston TX (United States); Leite, Daltro J.; Borella, Augusto; Gozzi, Danilo [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    The understanding and mitigation of downhole vibration has been a heavily researched subject in the oil industry as it results in more expensive drilling operations, as vibrations significantly diminish the amount of effective drilling energy available to the bit and generate forces that can push the bit or the Bottom Hole Assembly (BHA) off its concentric axis of rotation, producing high magnitude impacts with the borehole wall. In order to drill ahead, a sufficient amount of energy must be supplied by the rig to overcome the resistance of the drilling system, including the reactive torque of the system, drag forces, fluid pressure losses and energy dissipated by downhole vibrations, then providing the bit with the energy required to fail the rock. If the drill string enters resonant modes of vibration, not only does it decreases the amount of available energy to drill, but increases the potential for catastrophic downhole equipment and drilling bit failures. In this sense, the mitigation of downhole vibrations will result in faster, smoother, and cheaper drilling operations. A software tool using Finite Element Analysis (FEA) has been developed to provide better understanding of downhole vibration phenomena in drilling environments. The software tool calculates the response of the drilling system at various input conditions, based on the design of the wellbore along with the geometry of the Bottom Hole Assembly (BHA) and the drill string. It identifies where undesired levels of resonant vibration will be driven by certain combinations of specific drilling parameters, and also which combinations of drilling parameters will result in lower levels of vibration, so the least shocks, the highest penetration rate and the lowest cost per foot can be achieved. With the growing performance of personal computers, complex software systems modeling the drilling vibrations using FEA has been accessible to a wider audience of field users, further complimenting with real time

  2. Comparative Analysis of Normal versus Fetal Growth Restriction in Pregnancy: The Significance of Maternal Body Mass Index, Nutritional Status, Anemia, and Ultrasonography Screening

    Directory of Open Access Journals (Sweden)

    Laxmichaya D. Sawant

    2013-01-01

    Full Text Available Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. The objective of this study was twofold: first to examine the correlation between maternal parameters such as body mass index (BMI, nutritional status, anemia, and placental weight and diameter, and their effects on fetal growth and then to evaluate the effect of early screening by ultrasonography (USG on the outcome of growth restricted pregnancies. In this study, 53 cases of fetal growth restriction were compared to 53 normal fetuses delivered in consecutive sequence. Growth restricted fetuses were delivered earlier in gestation, when compared with normal growth fetuses. Maternal anemia and malnutrition have significant association with the fetal growth restriction. Maternal anthropometry, such as low BMI, had effects on placental diameter and weight, which, in turn, adversely affected fetal weight. Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction.

  3. 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 ...

  4. 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 ...

  5. Serotonin Reuptake Inhibitors in Pregnancy: Can Genes Help Us in Predicting Neonatal Adverse Outcome?

    Directory of Open Access Journals (Sweden)

    Valentina Giudici

    2014-01-01

    Full Text Available Lots has been written on use of SSRI during pregnancy and possible short and long term negative outcomes on neonates. the literature so far has described a various field of peripartum illness related to SSRI exposure during foetal life, such as increased incidence of low birth weight, respiratory distress, persistent pulmonary hypertension, poor feeding, and neurobehavioural disease. We know that different degrees of outcomes are possible, and not all the newborns exposed to SSRIs during pregnancy definitely will develop a negative outcome. So far, still little is known about the possible etiologic mechanism that could not only explain the adverse neonatal effects but also the degree of clinical involvement and presentation in the early period after birth. Pharmacogenetics and moreover pharmacogenomics, the study of specific genetic variations and their effect on drug response, are not widespread. This review describes possible relationship between SSRIs pharmacogenetics and different neonatal outcomes and summarizes the current pharmacogenetic inquiries in relation to maternal-foetal environment.

  6. Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?

    DEFF Research Database (Denmark)

    Tolstrup, J S; Kjær, S. K.; Munk, C

    2003-01-01

    BACKGROUND: Consumption of caffeine and alcohol is suspected to affect pregnancy outcome. Use of both stimulants is widespread and even minor effects on fetal viability are of public health interest. METHODS: We performed a nested case-control study using prospective data from a population......-based cohort comprising 11088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n = 303) or who gave birth (n = 1381) during follow-up [mean time: 2.1 years (range: 1.6-3.4)] were selected. Associations between self-reported exposures to caffeine and/or alcohol...... at enrolment and spontaneous abortion were analysed by means of logistic regression. RESULTS: Compared with women with a pre-pregnancy intake of caffeine per day, the adjusted odds ratio (95% confidence interval) for spontaneous abortion was 1.26 (0.77-2.06), 1.45 (0.87-2.41), 1.44 (0.87-2.37) and 1...

  7. Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy.

    Science.gov (United States)

    Spicer, Julie; Werner, Elizabeth; Zhao, Yihong; Choi, Chien Wen; Lopez-Pintado, Sara; Feng, Tianshu; Altemus, Margaret; Gyamfi, Cynthia; Monk, Catherine

    2013-10-01

    Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. We present a prospective, longitudinal study of pregnant adolescents assessing associations between maternal psychobiological stress indices and offspring gestational age at birth and birthweight. Healthy nulliparous pregnant adolescents were recruited (n=205) and followed during pregnancy. Ambulatory assessments over 24h of perceived psychological stress (collected every 30 min) and salivary cortisol (6 samples) and a summary questionnaire, the Perceived Stress Scale, were collected at three time points (13-16, 24-27, and 34-37 gestational weeks). Corticotropin-releasing hormone, C-reactive protein, and interleukin 6 were assayed from blood taken at the latter 2 sessions. A final sample of 119 participants was selected for analyses. The ambulatory assessment of perceived psychological stress was positively correlated with the Perceived Stress Scale (r=.20, p=.03) but neither was associated with any of the biological assays (all ps>.20). Based on backward selection regression models that included all stress variables and relevant covariates, the ambulatory assessments of perceived psychological stress and cortisol - though not the Perceived Stress Scale - were negatively associated with gestational age at birth (F(4, 107)=3.38, p=.01) while cortisol was negatively related to birthweight (F(5, 107)=14.83, pstress during pregnancy may have positive public health benefits for the offspring given the associations of shortened gestation and lower birthweight with risk for poor mental and physical health outcomes. © 2013. Published by Elsevier Inc. All rights reserved.

  8. Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?

    DEFF Research Database (Denmark)

    Tolstrup, J S; Kjær, S. K.; Munk, C

    2003-01-01

    BACKGROUND: Consumption of caffeine and alcohol is suspected to affect pregnancy outcome. Use of both stimulants is widespread and even minor effects on fetal viability are of public health interest. METHODS: We performed a nested case-control study using prospective data from a population......-based cohort comprising 11088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n = 303) or who gave birth (n = 1381) during follow-up [mean time: 2.1 years (range: 1.6-3.4)] were selected. Associations between self-reported exposures to caffeine and/or alcohol...... at enrolment and spontaneous abortion were analysed by means of logistic regression. RESULTS: Compared with women with a pre-pregnancy intake of caffeine per day, the adjusted odds ratio (95% confidence interval) for spontaneous abortion was 1.26 (0.77-2.06), 1.45 (0.87-2.41), 1.44 (0.87-2.37) and 1...

  9. Serum nucleosomes during neoadjuvant chemotherapy in patients with cervical cancer. Predictive and prognostic significance

    Directory of Open Access Journals (Sweden)

    Cetina Lucely

    2005-06-01

    Full Text Available Abstract Background It has been shown that free DNA circulates in serum plasma of patients with cancer and that at least part is present in the form of oligo- and monucleosomes, a marker of cell death. Preliminary data has shown a good correlation between decrease of nucleosomes with response and prognosis. Here, we performed pre- and post-chemotherapy determinations of serum nucleosomes with an enzyme-linked immunosorbent assay (ELISA method in a group of patients with cervical cancer receiving neoadjuvant chemotherapy. Methods From December 2000 to June 2001, 41 patients with cervical cancer staged as FIGO stages IB2-IIIB received three 21-day courses of carboplatin and paclitaxel, both administered at day 1; then, patients underwent radical hysterectomy. Nucleosomes were measured the day before (baseline, at day seven of the first course and day seven of the third course of chemotherapy. Values of nucleosomes were analyzed with regard to pathologic response and to time to progression-free and overall survival. Results All patients completed chemotherapy, were evaluable for pathologic response, and had nucleosome levels determined. At a mean follow-up of 23 months (range, 7–26 months, projected progression time and overall survival were 80.3 and 80.4%, respectively. Mean differential values of nucleosomes were lower in the third course as compared with the first course (p >0.001. The decrease in the third course correlated with pathologic response (p = 0.041. Survival analysis showed a statistically significant, better progression-free and survival time in patients who showed lower levels at the third course (p = 0.0243 and p = 0.0260, respectively. Cox regression analysis demonstrated that nucleosome increase in the third course increased risk of death to 6.86 (95% confidence interval [CI 95%], 0.84–56.0. Conclusion Serum nucleosomes may have a predictive role for response and prognostic significance in patients with cervical cancer

  10. 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.

  11. 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.

  12. Designing an artificial neural network for prediction of pregnancy outcomes in women with systemic lupus erythematosus in Iran

    Directory of Open Access Journals (Sweden)

    Mahmoud Akbarian

    2015-07-01

    Results: Twelve features with P<0.05 and four features with P<0.1 were identified by using binary logistic regression as effective features. These sixteen features were used as input variables in artificial neural networks. The accuracy, sensitivity and specificity of the test data for the MLP network were 90.9%, 80.0%, and 94.1% respectively and for the total data were 97.3%, 93.5%, and 99.0% respectively. Conclusion: According to the results, we concluded that feed-forward Multi-Layer Perceptron (MLP neural network with scaled conjugate gradient (trainscg back propagation learning algorithm can help physicians to predict the pregnancy outcomes (spontaneous abortion and live birth among pregnant women with lupus by using identified effective variables.

  13. Cervical assessment at 22 and 27 weeks for the prediction of spontaneous birth before 34 weeks in twin pregnancies: is transvaginal sonography more accurate than digital examination?

    Science.gov (United States)

    Vayssière, C; Favre, R; Audibert, F; Chauvet, M P; Gaucherand, P; Tardif, D; Grangé, G; Novoa, A; Descamps, P; Perdu, M; Andrini, E; Janse-Marec, J; Maillard, F; Nisand, I

    2005-12-01

    This study compared the accuracy of ultrasound cervical assessment (cervical length and cervical index) and digital examination (Bishop score and cervical score) in the prediction of spontaneous birth before 34 weeks in twin pregnancies. In a prospective multicenter study, digital examination and transvaginal sonography were performed consecutively in twin pregnancies attending for routine sonography at either 22 weeks (175 women) or 27 weeks (153 women). The digital examination took place first, and the Bishop score and cervical score (cervical length minus cervical dilatation) were calculated. Ultrasound measurements were then made of cervical length and funnel length to yield the cervical index (1 + funnel length/cervical length). The association between each variable and delivery before 34 weeks was tested by the Mann-Whitney U-test. The receiver-operating characteristics (ROC) curves of the ultrasound and digital indicators were determined for both gestational age periods, and the areas under the ROC curves compared. The best cut-off values for each indicator were used to determine predictive values for delivery before 34 weeks. The median gestational age at delivery among the women included in the 22-week examination period was 36.0 (range, 21-40) weeks; 10.9% (19) gave birth spontaneously before 34 weeks. The median cervical length was 40 (range, 6-65) mm. All four parameters were predictors of delivery before 34 weeks. The areas under the ROC curves for cervical index, cervical length, Bishop score and cervical score did not differ significantly. The median gestational age at delivery among the women in the 27-week examination period was 36.0 (range, 27-40) weeks; 9.2% (14) gave birth spontaneously before 34 weeks. The median cervical length was 35 (range, 1-57) mm. All parameters except the Bishop score were predictors of delivery before 34 weeks. The likelihood ratio of the positive and negative tests for cervical length digital examination at the 27-week

  14. Five-point Likert scaling on MRI predicts clinically significant prostate carcinoma.

    Science.gov (United States)

    Harada, Taisuke; Abe, Takashige; Kato, Fumi; Matsumoto, Ryuji; Fujita, Hiromi; Murai, Sachiyo; Miyajima, Naoto; Tsuchiya, Kunihiko; Maruyama, Satoru; Kudo, Kohsuke; Shinohara, Nobuo

    2015-09-04

    To clarify the relationship between the probability of prostate cancer scaled using a 5-point Likert system and the biological characteristics of corresponding tumor foci. The present study involved 44 patients undergoing 3.0-Tesla multiparametric MRI before laparoscopic radical prostatectomy. Tracing based on pathological and MRI findings was performed. The relationship between the probability of cancer scaled using the 5-point Likert system and the biological characteristics of corresponding tumor foci was evaluated. A total of 102 tumor foci were identified histologically from the 44 specimens. Of the 102 tumors, 55 were assigned a score based on MRI findings (score 1: n = 3; score 2: n = 3; score 3: n = 16; score 4: n = 11 score 5: n = 22), while 47 were not pointed out on MRI. The tracing study revealed that the proportion of >0.5 cm(3) tumors increased according to the upgrade of Likert scores (score 1 or 2: 33%; score 3: 68.8%; score 4 or 5: 90.9%, χ(2) test, p 7 also increased from scale 2 to scale 5 (scale 2: 0%; scale 3: 56.3%; scale 4: 72.7%; 5: 90.9%, χ(2) test, p = 0.0001). On using score 3 or higher as the threshold of cancer detection on MRI, the detection rate markedly improved if the tumor volume exceeded 0.5 cm(3) (Likert scale favobably reflected the corresponding tumor's volume and Gleason score. Our observations show that "score 3 or higher" could be a useful threshold to predict clinically significant carcinoma when considering treatment options.

  15. Expression of vascular endothelial growth factor (VEGF) under hypoxia in placenta with intrahepatic cholestasis of pregnancy and its clinically pathological significance.

    Science.gov (United States)

    Zhang, Rong; Pan, Xiao-Hong; Xiao, Li

    2015-01-01

    The expression of vascular endothelial growth factor (VEGF) under hypoxia in the placenta with intrahepatic cholestasis of pregnancy (ICP) was observed, and mechanisms of ICP fetal distress were discussed. Different culturing times were established in hypoxia incubator, and protein expressions of VEGF in placental tissue were observed using immunohistochemical S-P method. After 4 h hypoxic culture, VEGF protein expression in ICP group was higher than the normal group with significant difference (P < 0.05). With the extension of hypoxic exposure, VEGF protein expression in both groups was suppressed, but no distinction in-between. Regression analyses indicated a noticeable effect of CG on VEGF expression, the higher the CG was, the lower the VEGF protein expression was (P < 0.05). Short term hypoxia induces up-regulation of VEGF expression in ICP placenta, and this adaptive change is probably a protective mechanism of fetus in ICP.

  16. Parameter definition using vibration prediction software leads to significant drilling performance improvements

    Energy Technology Data Exchange (ETDEWEB)

    Amorim, Dalmo; Hanley, Chris Hanley; Fonseca, Isaac; Santos, Juliana [National Oilwell Varco, Houston TX (United States); Leite, Daltro J.; Borella, Augusto; Gozzi, Danilo [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil)

    2012-07-01

    The understanding and mitigation of downhole vibration has been a heavily researched subject in the oil industry as it results in more expensive drilling operations, as vibrations significantly diminish the amount of effective drilling energy available to the bit and generate forces that can push the bit or the Bottom Hole Assembly (BHA) off its concentric axis of rotation, producing high magnitude impacts with the borehole wall. In order to drill ahead, a sufficient amount of energy must be supplied by the rig to overcome the resistance of the drilling system, including the reactive torque of the system, drag forces, fluid pressure losses and energy dissipated by downhole vibrations, then providing the bit with the energy required to fail the rock. If the drill string enters resonant modes of vibration, not only does it decreases the amount of available energy to drill, but increases the potential for catastrophic downhole equipment and drilling bit failures. In this sense, the mitigation of downhole vibrations will result in faster, smoother, and cheaper drilling operations. A software tool using Finite Element Analysis (FEA) has been developed to provide better understanding of downhole vibration phenomena in drilling environments. The software tool calculates the response of the drilling system at various input conditions, based on the design of the wellbore along with the geometry of the Bottom Hole Assembly (BHA) and the drill string. It identifies where undesired levels of resonant vibration will be driven by certain combinations of specific drilling parameters, and also which combinations of drilling parameters will result in lower levels of vibration, so the least shocks, the highest penetration rate and the lowest cost per foot can be achieved. With the growing performance of personal computers, complex software systems modeling the drilling vibrations using FEA has been accessible to a wider audience of field users, further complimenting with real time

  17. Plasma concentrations of pregnancy-associated glycoproteins measured using anti-bovine PAG-2 antibodies on day 120 of gestation predict abortion in dairy cows naturally infected with Neospora caninum.

    Science.gov (United States)

    García-Ispierto, I; Almería, S; Serrano, B; de Sousa, N M; Beckers, J F; López-Gatius, F

    2013-08-01

    The present study sought to determine: (i) the effects of Neospora caninum infection and twin pregnancy on plasma pregnancy-associated glycoprotein-2 (PAG-2) concentrations throughout pregnancy and (ii) whether plasma PAG-2 concentrations could predict abortion in N. caninum-infected cows. The study was performed on a commercial Holstein-Friesian dairy herd in northeastern Spain and the final data included those recorded in 53 non-aborting and 19 aborting animals. Blood samples were collected immediately before pregnancy diagnosis (on Days 40, 90, 120, 150, 180 and 210 post-insemination) in non-aborting cows or until the time of abortion detection in aborting cows. General lineal models (GLM) repeated measures anova revealed the different behaviour of PAG-1 and PAG-2, and significant effects of Neospora seropositivity, cool season and twin pregnancy on plasma PAG-2 concentrations throughout gestation (between-subject effects). In addition, based on the odds ratios, the likelihood of abortion increased in Neospora-seropositive cows (by a factor of 7.0) compared to seronegative animals and decreased in cows with a high plasma PAG-2 concentration (>4.5 ng/ml) on Day 120 of pregnancy (by a factor of 0.24), compared to the remaining cows. In conclusion, there is a relationship between plasma PAG-2 concentrations and the risk of abortion in Neospora-infected dairy cows. Thus, plasma PAG concentrations measured using anti-boPAG-2 antiserum on Day 120 of gestation could serve as an indicator of the abortion risk in N. caninum infected animals; values <4.5 ng/ml indicating a high risk of abortion in chronically infected animals.

  18. 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...

  19. Use of single nucleotide polymorphisms in candidate genes associated with daughter pregnancy rate for prediction of genetic merit for reproduction in Holstein cows

    Science.gov (United States)

    We evaluated 69 SNPs in genes previously related to fertility and production traits for relationship to daughter pregnancy rate (DPR), cow conception rate (CCR) and heifer conception rate (HCR) in a separate population of Holstein cows grouped according to their predicted transmitting ability for DP...

  20. [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.

  1. Significance of High Resolution GHRSST on prediction of Indian Summer Monsoon

    KAUST Repository

    Jangid, Buddhi Prakash

    2017-02-24

    In this study, the Weather Research and Forecasting (WRF) model was used to assess the importance of very high resolution sea surface temperature (SST) on seasonal rainfall prediction. Two different SST datasets available from the National Centers for Environmental Prediction (NCEP) global model analysis and merged satellite product from Group for High Resolution SST (GHRSST) are used as a lower boundary condition in the WRF model for the Indian Summer Monsoon (ISM) 2010. Before using NCEP SST and GHRSST for model simulation, an initial verification of NCEP SST and GHRSST are performed with buoy measurements. It is found that approximately 0.4 K root mean square difference (RMSD) in GHRSST and NCEP SST when compared with buoy observations available over the Indian Ocean during 01 May to 30 September 2010. Our analyses suggest that use of GHRSST as lower boundary conditions in the WRF model improve the low level temperature, moisture, wind speed and rainfall prediction over ISM region. Moreover, temporal evolution of surface parameters such as temperature, moisture and wind speed forecasts associated with monsoon is also improved with GHRSST forcing as a lower boundary condition. Interestingly, rainfall prediction is improved with the use of GHRSST over the Western Ghats, which mostly not simulated in the NCEP SST based experiment.

  2. Significant increase of Echinococcus multilocularis prevalencein foxes, but no increased predicted risk for humans

    NARCIS (Netherlands)

    Maas, M.; Dam-Deisz, W.D.C.; Roon, van A.M.; Takumi, K.; Giessen, van der J.W.B.

    2014-01-01

    The emergence of the zoonotic tapeworm Echinococcus multilocularis, causative agent ofalveolar echinococcosis (AE), poses a public health risk. A previously designed risk mapmodel predicted a spread of E. multilocularis and increasing numbers of alveolar echinococ-cosis patients in the province of L

  3. Predictive role of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for diagnosis of acute appendicitis during pregnancy

    Directory of Open Access Journals (Sweden)

    Fatih Mehmet Yazar

    2015-11-01

    Full Text Available Acute appendicitis (AA is not uncommon during pregnancy but can be difficult to diagnose. This study evaluated the neutrophil-to-lymphocyte ratio (NLR and platelet-to-lymphocyte ratio (PLR in addition to conventional diagnostic indicators of the disease to diagnose AA during pregnancy. Age, gestational age, white blood cell (WBC count, Alvarado scores, C-reactive protein (CRP, lymphocyte count, NLR and PLR were compared among 28 pregnant women who underwent surgery for AA, 35 pregnant women wrongly suspected as having AA, 29 healthy pregnant women, and 30 nonpregnant healthy women. Mean WBC counts and CRP levels were higher in women with proven AA than in those of control groups (all p < 0.05. Among all the groups, the median NLR and PLR were significantly different in women with proven AA (all p < 0.05. Receiver operating characteristic analysis was used to determine cut-off values for WBC count, CRP, lymphocyte count, NLR and PLR, and multiple logistic regression analysis showed that NLR and PLR used with routine methods could diagnose AA with 90.5% accuracy. Used in addition to routine diagnostic methods, NLR and PLR increased the accuracy of the diagnosis of AA in pregnant women.

  4. Significantly improved HIV inhibitor efficacy prediction employing proteochemometric models generated from antivirogram data.

    Directory of Open Access Journals (Sweden)

    Gerard J P van Westen

    Full Text Available Infection with HIV cannot currently be cured; however it can be controlled by combination treatment with multiple anti-retroviral drugs. Given different viral genotypes for virtually each individual patient, the question now arises which drug combination to use to achieve effective treatment. With the availability of viral genotypic data and clinical phenotypic data, it has become possible to create computational models able to predict an optimal treatment regimen for an individual patient. Current models are based only on sequence data derived from viral genotyping; chemical similarity of drugs is not considered. To explore the added value of chemical similarity inclusion we applied proteochemometric models, combining chemical and protein target properties in a single bioactivity model. Our dataset was a large scale clinical database of genotypic and phenotypic information (in total ca. 300,000 drug-mutant bioactivity data points, 4 (NNRTI, 8 (NRTI or 9 (PI drugs, and 10,700 (NNRTI 10,500 (NRTI or 27,000 (PI mutants. Our models achieved a prediction error below 0.5 Log Fold Change. Moreover, when directly compared with previously published sequence data, derived models PCM performed better in resistance classification and prediction of Log Fold Change (0.76 log units versus 0.91. Furthermore, we were able to successfully confirm both known and identify previously unpublished, resistance-conferring mutations of HIV Reverse Transcriptase (e.g. K102Y, T216M and HIV Protease (e.g. Q18N, N88G from our dataset. Finally, we applied our models prospectively to the public HIV resistance database from Stanford University obtaining a correct resistance prediction rate of 84% on the full set (compared to 80% in previous work on a high quality subset. We conclude that proteochemometric models are able to accurately predict the phenotypic resistance based on genotypic data even for novel mutants and mixtures. Furthermore, we add an applicability domain to

  5. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    .01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p ... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  6. 胚胎移植术后14 d血清β-HCG对妊娠结局的预测%The prediction of serum β-HCG on pregnancy outcome after 14 days in vitro fertilization-embryo transfer

    Institute of Scientific and Technical Information of China (English)

    李晓霞; 罗海娇; 邵小光

    2015-01-01

    Objective To analyze the prediction of serumβ-HCG on pregnancy outcome after 14 days in vitro fertiliza-tion-embryo transfer. Methods 275 patients who received in vitro fertilization-embryo transfer treatment from June to December 2013 in our hospital were retrospectively analyzed,including 192 cases of in vitro fertilization-embryo trans-fer,83 cases of intracytoplasmic sperm injection.Serum β-HCG was detected after 14 days mbryo transfer.Pregnancy was divided into single pregnancy,twin pregnancy and three pregnancy.Pregnancy outcome was divided into ectopic pregnancy,abortion,premature delivery,full-term delivery. Results The serum β-HCG value between single pregnancy group and twin pregnancy group,three pregnancy group had significant difference (P=0.000).The serumβ-HCG value of premature delivery between ectopic pregnancy,abortion,full-term delivery had significant difference (P=0.014, 0.000,0.002).In three pregnancy group,the serum β-HCG value between premature delivery and full-term had signifi-cant difference (t=3.552,P=0.005);In premature delivery group,the serum β-HCG value between single pregnancy and twin pregnancy had significant difference (P=0.004);In full-term delivery,the serumβ-HCG value between single preg-nancy group and twin pregnancy group,three pregnancy group had significant difference (P=0.000). Conclusion The serum β-HCG value after 14 days embryo transfer may some kind of forecast of embryo number,but can not forecast the pregnancy result effectively.%目的:探讨试管婴儿胚胎移植术后14 d血清人绒毛膜促性腺激素(β-HCG)值对妊娠结局的预测作用。方法回顾性分析本中心2013年6~12月新鲜胚胎移植的275例临床妊娠患者,其中常规体外受精-胚胎移植192例,卵胞质内单精子注射83例。检测胚胎移植后14 d血清β-HCG值。妊娠分为单胎妊娠、双胎妊娠和三胎妊娠。妊娠结局分为异位妊娠、流产、早产、足月。结果单胎妊娠与双胎妊娠

  7. 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 ...

  8. The significance of the ProtDeform score for structure prediction and alignment.

    Directory of Open Access Journals (Sweden)

    Jairo Rocha

    Full Text Available BACKGROUND: When a researcher uses a program to align two proteins and gets a score, one of her main concerns is how often the program gives a similar score to pairs that are or are not in the same fold. This issue was analysed in detail recently for the program TM-align with its associated TM-score. It was shown that because the TM-score is length independent, it allows a P-value and a hit probability to be defined depending only on the score. Also, it was found that the TM-scores of gapless alignments closely follow an Extreme Value Distribution (EVD. The program ProtDeform for structural protein alignment was developed recently and is characterised by the ability to propose different transformations of different protein regions. Our goal is to analyse its associated score to allow a researcher to have objective reasons to prefer one aligner over another, and carry out a better interpretation of the output. RESULTS: The study on the ProtDeform score reveals that it is length independent in a wider score range than TM-scores and that PD-scores of gapless (random alignments also approximately follow an EVD. On the CASP8 predictions, PD-scores and TM-scores, with respect to native structures, are highly correlated (0.95, and show that around a fifth of the predictions have a quality as low as 99.5% of the random scores. Using the Gold Standard benchmark, ProtDeform has lower probabilities of error than TM-align both at a similar speed. The analysis is extended to homology discrimination showing that, again, ProtDeform offers higher hit probabilities than TM-align. Finally, we suggest using three different P-values according to the three different contexts: Gapless alignments, optimised alignments for fold discrimination and that for superfamily discrimination. In conclusion, PD-scores are at the very least as valuable for prediction scoring as TM-scores, and on the protein classification problem, even more reliable.

  9. Significance of Bioindicators for Early Predictions on Diagnosis and Therapy of Irradiated Minipigs.

    Science.gov (United States)

    Moroni, Maria; Port, Matthias; Gulani, Jatinder; Chappell, Mark; Abend, Michael

    2016-08-01

    Decisions on whether to start a therapeutic intervention for management of the Acute Radiation Syndrome (ARS) should be made early after exposure, and it should be based on readily available clinical signs and laboratory parameters. Here, the authors use the minipig to assess if early prediction of the later developing clinical outcome and necessity of therapeutic interventions can be determined within the first 3 d after exposure and whether it is comparable to human data. Retrospective analysis of data accumulated in the period 2009-2012 was used. Male Göttingen minipigs (age 4-5 mo, weight 9-10 kg) were irradiated (or sham-irradiated) bilaterally with gamma-photons (Co, 0.5-0.6 Gy min) in the dose range of 1.6-12 Gy. Complete blood counts, serum chemistry, and clinical symptoms were collected up to 60 d after irradiation in untreated minipigs. Changes in these early parameters (up to 3 d after exposure) were correlated with later occurrence (10-60 d after irradiation) of (1) hematological severity scores, (2) severe thrombocytopenia, (3) severe neutropenia, as well as need for (4) therapeutic intervention, (5) administration of cytokines/antibiotics, or (6) thrombocyte transfusions. Binary endpoints were analyzed using logistic regression analysis and calculating receiver operating characteristic (ROC) curves. Most predictive were decreased lymphocyte counts and increases in body temperature at 3 h after irradiation. These data corroborate earlier findings performed on human radiation victims suffering from severe hematological syndrome and provide further evidence for the suitability of the minipig model as a potential alternative non-rodent animal model.

  10. Predictive significance of tissue eosinophilia for nasal polyp recurrence in the Chinese population.

    Science.gov (United States)

    Lou, Hongfei; Meng, Yifan; Piao, Yingshi; Wang, Chengshuo; Zhang, Luo; Bachert, Claus

    2015-01-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. Tissue eosinophilia is a hallmark of CRSwNP, and its role in polyp recurrence is a subject of much investigation. The aim of this study was to evaluate the association between clinical parameters, especially tissue eosinophilia and polyp recurrence, and to identify the optimal cutoff value of tissue eosinophilia as a predictor for polyp recurrence in Chinese subjects. Overall, 387 patients with CRSwNP were enrolled in this retrospective analysis and postoperative follow-up for polyp recurrence was over a period that lasted >24 months (mean [standard deviation], 34.03 ± 4.95 months). The baseline demographic and clinical features and the preoperative computed tomography were compared, and mucosal specimens obtained at endoscopic sinus surgery were assessed for inflammatory cells by using histocytologic staining. Predictive factors associated with polyp recurrence were analyzed by logistic regression analysis, and optimal cutoff points of the predictors were determined by receiver operating characteristic curves and the Youden index. A total of 55.3% patients (214/387) experienced recurrence. Tissue eosinophilia markedly outweighed other parameters and correlated with polyp recurrence. Receiver operating characteristic curves indicated that a cutoff value of 27% tissue eosinophils predicted recurrence with 96.7% sensitivity and 92.5% specificity (area under the curve = 0.969; p 27% of total cells or a tissue eosinophil absolute count of >55 eosinophils per high power field may act as a reliable prognostic indicator for nasal polyp recurrence within 2 years after surgery.

  11. Prediction of Fetal Hypertrophic Cardiomyopathy in Diabetic Pregnancies Compared with Postnatal Outcome

    Science.gov (United States)

    Elmekkawi, Sherif F.; Mansour, Ghada M.; Elsafty, Mohammed S.E.; Hassanin, Alaa S.; Laban, Mohamed; Elsayed, Heba M.

    2015-01-01

    OBJECTIVE The aim of this study was to estimate the accuracy of prenatal assessment of interventricular septum (IVS) thickness, right myocardial wall thickness (RMWT), and left myocardial wall thickness (LMWT) by two-dimensional (2D) ultrasound for the prediction of perinatal mortality and postnatal diagnosis of hypertrophic cardiomyopathy (HCM) among diabetic pregnant women. SUBJECTS AND METHODS A total of 120 diabetic pregnant women at 35 weeks or more were enrolled in this study from January 1, 2012, to June 30, 2014, at Ain Shams Maternity Hospital, Cairo, Egypt. The 2D ultrasound was done once for all the participants at the time of recruitment; IVS thickness, RMWT, and LMWT were measured. The glycosylated hemoglobin (HbA1c) levels of the participants were recorded. Neonatal assessment including postnatal echocardiography was done after 48 hours. Postnatal results were compared with the prenatal predictive results. RESULTS Higher thickness values for IVS, RMW, and LMW were obtained in the uncontrolled diabetic cases (HbA1c > 6.5%) than in the controlled diabetic cases (HbA1c < 6.5%; P < 0.01). Of the included 120 neonates, 10 (8.3%) were stillborn, 99 (82.5%) had a five-minute Apgar score ≥7, and 4 (3.3%) had a five-minute Apgar score ≤3. The four neonates with severe neonatal distress died after admission to neonatal intensive care unit within one week after delivery. Out of 110 live-born neonates, 4 (3.6%) neonates had a low ejection fraction (EF) (<50%) due to HCM; of them 2 (1.8%) died within one week after delivery, while 2 (1.8%) survived. Another two (1.8%) neonates died from severe respiratory distress syndrome. A cutoff value of ≥4.5 mm for prenatal IVS thickness was predictive of neonatal distress due to HCM with a sensitivity of 82%, specificity of 68%, and diagnostic accuracy of 72%. A cutoff value of <1.18 for the ratio of IVS thickness to LMWT had a sensitivity of 82%, specificity of 72%, and diagnostic accuracy of 74% for the prediction of

  12. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation.

    Science.gov (United States)

    Hsieh, Yu-wei; Lin, Keh-chung; Wu, Ching-yi; Lien, Hen-yu; Chen, Jean-lon; Chen, Chih-chi; Chang, Wei-han

    2014-02-01

    To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT). Observational cohort study. Outpatient rehabilitation clinics. A cohort of outpatients with stroke (N=55). Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks. Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score. Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272). The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Using the IAT to predict ethnic and racial discrimination: small effect sizes of unknown societal significance.

    Science.gov (United States)

    Oswald, Frederick L; Mitchell, Gregory; Blanton, Hart; Jaccard, James; Tetlock, Philip E

    2015-04-01

    Greenwald, Banaji, and Nosek (2015) present a reanalysis of the meta-analysis by Oswald, Mitchell, Blanton, Jaccard, and Tetlock (2013) that examined the effect sizes of Implicit Association Tests (IATs) designed to predict racial and ethnic discrimination. We discuss points of agreement and disagreement with respect to methods used to synthesize the IAT studies, and we correct an error by Greenwald et al. that obscures a key contribution of our meta-analysis. In the end, all of the meta-analyses converge on the conclusion that, across diverse methods of coding and analyzing the data, IAT scores are not good predictors of ethnic or racial discrimination, and explain, at most, small fractions of the variance in discriminatory behavior in controlled laboratory settings. The thought experiments presented by Greenwald et al. go well beyond the lab to claim systematic IAT effects in noisy real-world settings, but these hypothetical exercises depend crucially on untested and, arguably, untenable assumptions. (c) 2015 APA, all rights reserved).

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

    OpenAIRE

    Takemura, Takashi; Okabe, Midori

    2016-01-01

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

  15. Predicting Postpartum Depressive Symptoms in New Mothers: The Role of Optimism and Stress Frequency during Pregnancy

    Science.gov (United States)

    Grote, Nancy K.; Bledsoe, Sarah E.

    2007-01-01

    During the transition to motherhood, women typically show favorable psychological adjustment after the first child is born, whereas 10 percent to 26 percent of women are at risk of developing clinically significant postpartum depressive symptoms. Little is known about which individuals are especially protected against the emergence of postpartum…

  16. The predictive significance of CD20 expression in B-cell lymphomas

    Directory of Open Access Journals (Sweden)

    Horvat Mateja

    2011-04-01

    Full Text Available Abstract Background In our recent study, we determined the cut-off value of CD20 expression at the level of 25 000 molecules of equivalent soluble fluorochrome (MESF to be the predictor of response to rituximab containing treatment in patients with B-cell lymphomas. In 17.5% of patients, who had the level of CD20 expression below the cut-off value, the response to rituximab containing treatment was significantly worse than in the rest of the patients with the level of CD20 expression above the cut-off value. The proportion of patients with low CD20 expression who might not benefit from rituximab containing treatment was not necessarily representative. Therefore the aim of this study was to quantify the CD20 expression in a larger series of patients with B-cell lymphomas which might allow us to determine more reliably the proportion of patients with the CD20 expression below the cut-off. Methods Cytological samples of 64 diffuse large B-cell lymphomas (DLBCL, 56 follicular lymphomas (FL, 31 chronic lymphocytic leukemias (CLL, 34 mantle cell lymphomas (MCL, 18 marginal zone lymphomas (MZL and 15 B-cell lymphomas unclassified were analyzed for CD20 expression by quantitative four-color flow cytometric measurements using FACSCalibur flow cytometer (BD Biosciences. Results The range of CD20 expression in different B-cell lymphomas was very broad, varying from 2 737 to 115 623 MESF in CLL and 3 549 to 679 577 MESF in DLBCL. However, when we compared the CD20 expression in the groups of patients with DLBCL, FL, MCL, MZL, CLL and B-cell lymphomas unclassified, it was found to be significantly lower (p = 0.002 only in CLL but did not significantly differ in other lymphoma types (p = NS. Fifty-three out of 218 (24.3% patients with B-cell lymphomas had the CD20 expression below the cut-off value. Conclusions The CD20 expression in CLL is significantly lower than in most histological types of mature B-cell lymphomas in which it appears to be comparable

  17. Change of Serum B-type Natriuretic Peptide in Patients with Pre-eclampsia Pregnancy and Its Clinical Significance%子痫前期患者血清脑利钠肽水平的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    李小叶; 李晨辉; 曾红卫

    2013-01-01

    cases of late pregnancy ) were also collected .Serum BNP in pregnant women was analyzed retrospec-tively .[Results]Serum BNP in severe pre-eclampsia[(225 .31 ± 43 .7)pg/mL] was markedly higher than that in mild pre-eclampsia[(28 .31 ± 3 .8)pg/mL] and patients with normal pregnancy [(17 .5 ± 3 .2)pg/mL] ,and there was significant difference(all P0 .05) .With the increasing of pregnancy time ,serum BNP in nor-mal pregnancy was stable in all pregnancy ,and those in middle pregnancy and late pregnancy were (17 .8 ± 1 .2)pg/mL and (17 .6 ± 1 .5)pg/mL respectively ,but there was no significant difference( P >0 .05) .Serum BNP of mild pre-eclampsia in middle pregnancy and late pregnancy were (27 .8 ± 1 .2)pg/mL and (28 .6 ± 1 .5) pg/mL respectively ,but there was no significant difference( P>0 .05) .Serum BNP of severe pre-eclampsia in middle pregnancy and late pregnancy were (178 .8 ± 1 .2)pg/mL and (265 .6 ± 1 .5)pg/mL respectively ,and increased with pregnancy time ,and there was significant difference( P<0 .05) .[Conclusion]The change of se-rum BNP in patients during pregnancy is related to the disease severity of patients .The increasing of serum BNP in patients during pregnancy may be related to the occurrence and development of pre-eclampsia .Serum BNP can be used as the early prediction index of severe pre-eclampsia .

  18. 妊娠及分娩进程中评估及临床意义%Evaluation and clinical significance in the process of pregnancy and childbirth

    Institute of Scientific and Technical Information of China (English)

    万莉; 安晓惠; 谢莉玲; 李晓燕; 王龙琼; 漆洪波

    2015-01-01

    目的:探讨妊娠分娩过程中的遗传现象。方法收集2013年1~12月在重庆医科大学附属第一医院、金山医院进行常规产前检查及住院分娩,符合纳入标准的孕产妇及其母亲的妊娠分娩资料进行关联分析。结果孕产妇和母亲在孕周、孕期体质量增长、新生儿出生体质量、产程时间和延期妊娠经历等方面具有关联性。结论妊娠及分娩过程存在遗传性。%Objective To explore hereditary phenomenon in the process of pregnancy and childbirth .Methods Pregnancy and delivery data of pregnant women and their mothers conformed to the standard was collected from January 2013 to December 2013 for correlation analysis .Results An association existed between pregnant women and their mothers in gestational age ,weight gain during pregnancy ,child′s birth weight ,duration of labor ,delayed pregnancy experience .Conclusion Hereditary exists in the process of pregnancy and childbirth .

  19. Life Assets in Teenage Pregnancy

    Directory of Open Access Journals (Sweden)

    Thatsanee Soontrapirom

    2017-05-01

    Full Text Available Background: Teenage pregnancy is an evolving global public health problem. Level of life assets could predict behaviors and take effect to less sexual risk behaviors in teenagers. Objective: To compare life assets between pregnant and non-pregnant teenagers and to evaluate the relationship between basic factors and teenage pregnancy. Methods: A total of 172 female teenagers aged 12-19 years were included. The control group was matched with the case group by age with mean age of 17.07 years old. The case group consisted of 86 pregnant teenagers who attended the Teenage Antenatal Care Unit at Siriraj Hospital. The control group consisted of 86 teenagers who were not pregnant and who had never been pregnant. The research instruments were general information and life assets inventory questionnaires developed by Suriyadeo Tripathi with Cronbach’s Alpha coefficient at 0.890. Results: Mean life assets scores were significantly higher in the control group than in the case group (T-test analysis: Mean = 94.70/87.65, SD = 17.45/22.68, p-value =.024, respectively. The control group scored more favorably than the case group on 16 items. In addition, the case group could not meet the minimum assessment criteria on 21 items, which indicated their status as an at risk group. A total of 12 factors were found to be statistically significantly associated with teenage pregnancy. Conclusion: Overall life assets were significantly higher among teenagers who had not experienced pregnancy. The risk factors included level of education, GPA, family income, mothers or family members of teenagers having experience of teenage pregnancy, main guardians, father education, mother occupation, parental relationship, family warmth and smoking were found to be significantly associated with risk of teenage pregnancy in this study. These results will help to facilitate preventive interventions and the development of policies and guidelines to control and perhaps reverse current

  20. A Simplified PBPK Modeling Approach for Prediction of Pharmacokinetics of Four Primarily Renally Excreted and CYP3A Metabolized Compounds During Pregnancy

    OpenAIRE

    Xia, Binfeng; Heimbach, Tycho; Gollen, Rakesh; Nanavati, Charvi; He, Handan

    2013-01-01

    During pregnancy, a drug’s pharmacokinetics may be altered and hence anticipation of potential systemic exposure changes is highly desirable. Physiologically based pharmacokinetics (PBPK) models have recently been used to influence clinical trial design or to facilitate regulatory interactions. Ideally, whole-body PBPK models can be used to predict a drug’s systemic exposure in pregnant women based on major physiological changes which can impact drug clearance (i.e., in the kidney and liver) ...

  1. 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.

  2. Phylogenomic analyses predict sistergroup relationship of nucleariids and Fungi and paraphyly of zygomycetes with significant support

    Directory of Open Access Journals (Sweden)

    Steenkamp Emma

    2009-01-01

    Full Text Available Abstract Background Resolving the evolutionary relationships among Fungi remains challenging because of their highly variable evolutionary rates, and lack of a close phylogenetic outgroup. Nucleariida, an enigmatic group of amoeboids, have been proposed to emerge close to the fungal-metazoan divergence and might fulfill this role. Yet, published phylogenies with up to five genes are without compelling statistical support, and genome-level data should be used to resolve this question with confidence. Results Our analyses with nuclear (118 proteins and mitochondrial (13 proteins data now robustly associate Nucleariida and Fungi as neighbors, an assemblage that we term 'Holomycota'. With Nucleariida as an outgroup, we revisit unresolved deep fungal relationships. Conclusion Our phylogenomic analysis provides significant support for the paraphyly of the traditional taxon Zygomycota, and contradicts a recent proposal to include Mortierella in a phylum Mucoromycotina. We further question the introduction of separate phyla for Glomeromycota and Blastocladiomycota, whose phylogenetic positions relative to other phyla remain unresolved even with genome-level datasets. Our results motivate broad sampling of additional genome sequences from these phyla.

  3. First-trimester screening in pregnancies conceived by assisted reproductive technology: significance of gestational dating by oocyte retrieval or sonographic measurement of crown-rump length

    DEFF Research Database (Denmark)

    Gjerris, A.C.; Loft, A.; Pinborg, A.

    2008-01-01

    OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers or the perfo......OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers......-trimester screening. The correct method of GA dating for other purposes (e.g. estimated time of delivery) in IVF/ICSI pregnancies is still unresolved Udgivelsesdato: 2008/10...

  4. Serum NX-DCP as a New Noninvasive Model to Predict Significant Liver Fibrosis in Chronic Hepatitis C.

    Science.gov (United States)

    Saito, Masaya; Yano, Yoshihiko; Hirano, Hirotaka; Momose, Kenji; Yoshida, Masaru; Azuma, Takeshi

    2015-02-01

    Finding a noninvasive method to predict liver fibrosis using inexpensive and easy-to-use markers is important. We aimed to clarify whether NX-des-γ-carboxyprothrombin (NX-DCP) could become a new noninvasive model to predict liver fibrosis in hepatitis C virus (HCV) related liver disease. We performed a prospective cohort study on a consecutive group of 101 patients who underwent liver biopsy for HCV-related liver disease at Kobe University Hospital. Laboratory measurements were performed on the same day as the biopsy. Factors associated with significant fibrosis (F3-4) were assessed by multivariate analyses. A comparison of predictive ability between multivariate factors and abovementioned noninvasive models was also performed. Increase in serum NX-DCP was significantly related to increase in fibrosis stage (P = 0.006). Moreover, NX-DCP was a multivariate factor associated with the presence of significant fibrosis F 3-4 (median 21 of F0-2 group vs. median 22 of F3-4 group with P = 0.002). The AUC of NX-DCP showed no significant differences compared with those of the AST-to-platelet ratio index (APRI), modified-APRI, the Göteborg University Cirrhosis Index (GUCI), the Lok index, the Hui score, cirrhosis discriminating score (CDS) and the Pohl score (P > 0.05). NX-DCP correlated positively with fibrosis stage and could discriminate well between HCV-related patients with or without significant fibrosis. Moreover, NX-DCP had a similar predictive ability to the abovementioned models, and thereby could be a new noninvasive prediction tool for fibrosis.

  5. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy?

    Directory of Open Access Journals (Sweden)

    Sargın MA

    2016-04-01

    Full Text Available Mehmet Akif Sargın, Murat Yassa, Bilge Dogan Taymur, Ayhan Celik, Emrah Ergun, Niyazi Tug Department of Obstetrics and Gynecology, Fatih Sultan Mehmet Research and Training Hospital, Istanbul, Turkey Objective: We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR and platelet-to-lymphocyte ratio (PLR could be utilized to screen for gestational diabetes mellitus (GDM.Subjects and methods: NLR and PLR were assessed by retrospective analysis of 762 healthy and pregnant women with GDM. The patients were stratified into four groups, as follows: GDM (n=144, impaired glucose tolerance (n=76, only screen positive (n=238, and control (n=304.Results: The leukocyte, neutrophil, and lymphocyte counts were significantly higher in the study groups compared with the control group (P=0.001; P<0.01. There were no statistically significant differences between the groups with respect to the NLR and PLR (P>0.05.Conclusion: We do not recommend that blood NLR and PLR can be used to screen for GDM. However, increase in the leukocyte count is an important marker for GDM as it provides evidence of subclinical inflammation. Keywords: inflammation, lymphocytes, neutrophils, platelets, pregnancy

  6. The Prediction Effect of Serological Screening Index in Prediction of Adverse Pregnancy Outcomes%妊娠中期血清学三联筛查指标异常对孕妇发生不良妊娠结局的预测效果

    Institute of Scientific and Technical Information of China (English)

    张欣萍

    2016-01-01

    目的:研究妊娠中期血清学三联筛查指标异常对孕妇发生不良妊娠结局的预测效果。方法随机选取我院单胎妊娠1500例为研究对象,分析检测结果。结果比较两组不良妊娠结局,高危组妊娠期糖尿病、新生儿窒息、新生儿死亡的发生率低于低危组,其他不良结局的发生率均高于低危组,差异均有统计学意义。结论中孕期血清学筛查有助于预测不良妊娠结局,提高新生儿健康率。%Objective To study the trimester serological screening index for pregnant women of adverse pregnancy outcomes and predictive effect.Methods Randomly selected 1 500 cases of singleton pregnancy as the research object in our hospital,analysis of test results.Results They were compared between the two groups in adverse pregnancy outcome in high risk group pregnancy with gestational diabetes melitus(GDM),neonatal asphyxia, neonatal death occurred rate were lower than that of the low-risk group. The incidence of other adverse outcomes were higher than those in low risk group,the differences were statisticaly significant.ConclusionPrenatal serological screening helps predict adverse pregnancy outcomes,and improve neonatal health rate.

  7. 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 , ...

  8. PREDICTIVE SIGNIFICANCE OF ANTI-HLA AUTOANTIBODIES IN HEART TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2013-01-01

    Full Text Available Aim. The aim of this study was to define the role of preformed anti-HLA antibodies (anti-HLA in antibody-mediated rejection (AMR and cardiac allograft vasculopathy (CAV after heart transplantation. Materials and Methods. 140 heart transplant recipients were followed after heart transplantation performed for 106 dilated and 34 – ischemic cardiomyopathy. Anti-HLA was determined before transplantation by ELISA. Results. Recipients were divided into 2 groups: anti-HLA positive (n = 45, 32,1% and anti-HLA negative (n = 95, 67,9%. The incidence of AMR in anti-HLA positive group was 12 (26,67% and 11 (11,58% in anti-HLA negative group. Risk of AMR was significantly higher in anti-HLA positive recipients (RR 2,3: 95% CI 1,02–4,81, р = 0,03. During first three years after transplantation CAV was diagnosed in 9 (20% of anti-HLA positive recipients and in 7 (6,8% of patients without anti-HLA. (RR 2,7: 95% CI 1,08–6,82, р = 0,03. Survival in freedom from CAV in anti-HLA negative recipients was much higher than in anti-HLA positive recipients (0,89 ± 0,07, 0,72 ± 0,06, resp. (p = 0,02.Conclusions. The presence of preformed anti-HLA antibodies in candidates for heart transplantation increase the risk of AMR and CAV post transplantation in 2,3 and 2,7 times, respectively. 

  9. A six-month longitudinal evaluation significantly improves accuracy of predicting incipient Alzheimer's disease in mild cognitive impairment.

    Science.gov (United States)

    Mubeen, Asim M; Asaei, Ali; Bachman, Alvin H; Sidtis, John J; Ardekani, Babak A

    2017-07-01

    Early prediction of incipient Alzheimer's disease (AD) dementia in individuals with mild cognitive impairment (MCI) is important for timely therapeutic intervention and identifying participants for clinical trials at greater risk of developing AD. Methods to predict incipient AD in MCI have mostly utilized cross-sectional data. Longitudinal data enables estimation of the rate of change of variables, which along with the variable levels have been shown to improve prediction power. While some efforts have already been made in this direction, all previous longitudinal studies have been based on observation periods longer than one year, hence limiting their practical utility. It remains to be seen if follow-up evaluations within shorter intervals can significantly improve the accuracy of prediction in this problem. Our aim was to determine the added value of incorporating 6-month longitudinal data for predicting progression from MCI to AD. Using 6-months longitudinal data from 247 participants with MCI, we trained two Random Forest classifiers to distinguish between progressive MCI (n=162) and stable MCI (n=85) cases. These models utilized structural MRI, neurocognitive assessments, and demographic information. The first model (cross-sectional) only used baseline data. The second model (longitudinal) used data from both baseline and a 6-month follow-up evaluation allowing the model to additionally incorporate biomarkers' rate of change. The longitudinal model (AUC=0.87; accuracy=80.2%) performed significantly better (P<0.05) than the cross-sectional model (AUC=0.82; accuracy=71.7%). Short-term longitudinal assessments significantly enhance the performance of AD prediction models. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Ultrasound pregnancy

    Science.gov (United States)

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

  11. Faculty Decisions on Serials Subscriptions Differ Significantly from Decisions Predicted by a Bibliometric Tool.

    Directory of Open Access Journals (Sweden)

    Sue F. Phelps

    2016-03-01

    of the faculty choices. The p-value for this relationship was less than 0.0001, also indicating that the result was not by chance. A quadratic model plotted alongside the previous linear model follows a similar pattern. The p-value of the comparison is 0.0002, which indicates the quadratic model’s fit cannot be explained by random chance. Main Results – The authors point out three outstanding findings. First, the match rate between faculty valuations and bibliometric scores for serials is 65%. This exceeds the 50% rate that would indicate random association, but also indicates a statistically significant difference between faculty and bibliometric valuations. Secondly, the match rate with the bibliometric scores for titles that faculty chose to keep (73% was higher than those they chose to cancel (54%. Thirdly, the match rate increased with higher bibliometric scores. Conclusions – Though the authors identify only a modest degree of similarity between faculty and bibliometric valuations of serials, it is noted that there is more agreement in the higher valued serials than the lower valued serials. With that in mind, librarians might focus faculty review on the lower scoring titles in the future, taking into consideration that unique faculty interests may drive selection at that level and would need to be balanced with the mission of the library.

  12. Total number of oocytes and zygotes are predictive of live birth pregnancy in fresh donor oocyte in vitro fertilization cycles.

    Science.gov (United States)

    Hariton, Eduardo; Kim, Keewan; Mumford, Sunni L; Palmor, Marissa; Bortoletto, Pietro; Cardozo, Eden R; Karmon, Anatte E; Sabatini, Mary E; Styer, Aaron K

    2017-08-01

    To evaluate the association of oocyte donor-recipient characteristics, oocyte donor response, and live birth pregnancy rate following fresh donor oocyte IVF-ET. Retrospective cohort study. Academic reproductive medicine practice. Two hundred thirty-seven consecutive fresh donor oocyte IVF-ET cycles from January 1, 2007 to December 31, 2013 at the Massachusetts General Hospital Fertility Center. None. Live birth rate per cycle initiated. The mean (±SD) age of oocyte donors and recipients was 27.0 ± 3.7 and 41.4 ± 4.6 years, respectively. Oocyte donor demographic/reproductive characteristics, ovarian reserve testing, and peak serum E2 during ovarian stimulation were similar among cycles which did and did not result in live birth, respectively. Overall implantation, clinical pregnancy, and live birth pregnancy rates per cycle initiated were 40.5%, 60.8%, and 54.9%, respectively. The greatest probability of live birth was observed in cycles with >10 oocytes retrieved, mature oocytes, oocytes with normal fertilization (zygote-two pronuclear stage), and cleaved embryos. The number of oocytes (total and mature), zygotes, and cleaved embryos are associated with live birth following donor oocyte IVF cycles. These findings suggest that specific peri-fertilization factors may be predictive of pregnancy outcomes following donor oocyte IVF cycles. Copyright © 2017 American Society for Reproductive Medicine. All rights reserved.

  13. 血清β人绒毛膜促性腺激素与孕早期血脂对预测妊娠高血压疾病的价值%Value of Serum β Human Chorionic Gonadotropin and Blood Lipid in Early Pregnancy in Predicting Pregnancy-induced Hypertension Disease

    Institute of Scientific and Technical Information of China (English)

    邝清梅; 张文慧; 陈文英; 李银芳

    2015-01-01

    目的:探讨血清β人绒毛膜促性腺激素(β-HCG)与孕早期血脂对预测妊娠高血压疾病的价值。方法选取2011年1月至2014年1月入住我院的妊娠高血压产妇150例,设为妊娠高血压组,另选取同期入住我院的正常健康产妇150例为正常对照组。比较两组孕妇一般性资料、孕早期(37~60天)血脂水平以及妊娠中期血清β-HCG水平,分析孕妇并发妊娠高血压的危险因素。结果妊高组患者的β-HCG、甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白水平均明显高于正常组,差异具有统计学意义(P<0.05)。 Logistic回归分析显示,甘油三酯(OR =2.561)、高密度脂蛋白(OR =2.023)、β-HCG (OR =1.347)和低密度脂蛋白(OR =1.248)均是导致妊娠高血压的危险因素。结论血清β人绒毛膜促性腺激素与孕早期血脂均是导致妊娠高血压的危险因素,可以作为妊高症诊断的临床参考。%Objective To explore the value of serumβhuman chorionic gonadotropin (β-HCG) and blood lipid in early pregnancy in predicting pregnancy-induced hypertension disease. Methods 150 cases of pregnant women with pregnancy-induced hypertension disease admitted to our hospital from January 2011 to January 2014 were selected as gestational hypertension group, 150 cases of healthy pregnant women admitted to our hospital in same period were set as normal group. The general information, levels of blood lipid in early pregnancy (37 ~ 60 d) and serum β-HCG level in second trimester of pregnancy were compared between two groups, the risk factors of pregnancy-induced hypertension was analyzed. Results The levels ofβ-HCG, triglyceride, cholesterol, high-density lipoprotein, low density lipoprotein in gestational hypertension group were significantly higher than those in control group, with statistical difference (P<0.05). The analysis of Logistic regression showed that triglyceride (OR =2.561), high-density lipoprotein (OR =2

  14. Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks: the Feeding Your Baby (FYB) cohort study

    Science.gov (United States)

    Donnan, Peter T; Dalzell, Janet; Symon, Andrew; Rauchhaus, Petra; Monteith-Hodge, Ewa; Kellett, Gillian; Wyatt, Jeremy C; Whitford, Heather M

    2013-01-01

    Objective To derive prediction models for both initiation and cessation of breastfeeding using demographic, psychological and obstetric variables. Design A prospective cohort study. Setting Women delivering at Ninewells Hospital, Dundee, UK. Data sources Demographic data and psychological measures were obtained during pregnancy by questionnaire. Birth details, feeding method at birth and at hospital discharge were obtained from the Ninewells hospital database, Dundee, UK. Breastfeeding women were followed up by text messages every 2 weeks until 16 weeks or until breastfeeding was discontinued to ascertain feeding method and feeding intentions. Participants Pregnant women over 30 weeks gestation aged 16 years and above, living in Dundee, booked to deliver at Ninewells Hospital, Dundee, and able to speak English. Main outcome measure Initiation and cessation of breastfeeding. Results From the total cohort of women at delivery (n=344) 68% (95% CI 63% to 73%) of women had started breastfeeding at discharge. Significant predictors of initiating breastfeeding were older age, parity, greater intention to breastfeed from a Theory of Planned Behaviour (TPB)-based questionnaire, higher Iowa Infant Feeding Assessment Scale (IIFAS) score as well as living with a husband or partner. For the final model, the AUROC was 0.967. For those who initiated breastfeeding (n=233), the strongest predictors of stopping were low intention to breastfeed from TPB, low IIFAS score and non-managerial/professional occupations. Conclusions The findings from this study will be used to inform the protocol for an intervention study to encourage and support prolonged breastfeeding as intentions appear to be a key intervention focus for initiation. The predictive models could be used to identify women at high risk of not initiating and also women at high risk of stopping for interventions to improve the longevity of breastfeeding. PMID:23906958

  15. Surface tensions of multi-component mixed inorganic/organic aqueous systems of atmospheric significance: measurements, model predictions and importance for cloud activation predictions

    Directory of Open Access Journals (Sweden)

    D. O. Topping

    2006-11-01

    Full Text Available In order to predict the physical properties of aerosol particles, it is necessary to adequately capture the behaviour of the ubiquitous complex organic components. One of the key properties which may affect this behaviour is the contribution of the organic components to the surface tension of aqueous particles in the moist atmosphere. Whilst the qualitative effect of organic compounds on solution surface tensions has been widely reported, our quantitative understanding on mixed organic and mixed inorganic/organic systems is limited.  Furthermore, it is unclear whether models that exist in the literature can reproduce the surface tension variability for binary and higher order multi-component organic and mixed inorganic/organic systems of atmospheric significance. The current study aims to resolve both issues to some extent. Surface tensions of single and multiple solute aqueous solutions were measured and compared with predictions from a number of model treatments. On comparison with binary organic systems, two predictive models found in the literature provided a range of values resulting from sensitivity to calculations of pure component surface tensions.  Results indicate that a fitted model can capture the variability of the measured data very well, producing the lowest average percentage deviation for all compounds studied.  The performance of the other models varies with compound and choice of model parameters. The behaviour of ternary mixed inorganic/organic systems was unreliably captured by using a predictive scheme and this was composition dependent. For more "realistic" higher order systems, entirely predictive schemes performed poorly. It was found that use of the binary data in a relatively simple mixing rule, or modification of an existing thermodynamic model with parameters derived from binary data, was able to accurately capture the surface tension variation with concentration. Thus, it would appear that in order to model

  16. Can DNA fragmentation of neat or swim-up spermatozoa be used to predict pregnancy following ICSI of fertile oocyte donors?

    Science.gov (United States)

    Gosálvez, Jaime; Caballero, Pedro; López-Fernández, Carmen; Ortega, Leonor; Guijarro, José Andrés; Fernández, José Luís; Johnston, Stephen D; Nuñez-Calonge, Rocío

    2013-01-01

    This study compared the potential of assessing sperm DNA fragmentation (SDF) from neat semen and the subsequent swim-up (SU) procedure to predict pregnancy when conducting ICSI of fertile donor oocytes. Infertile females (n=81) were transferred embryos resulting from intracytoplasmic sperm injection (ICSI) of their partner's spermatozoa and proven donor oocytes. This model normalized the impact of female factor in putative sperm DNA repair. Semen was blindly assessed for SDF using Halosperm immediately following ejaculation (NS) and after swim-up at the time of ICSI fertilisation. There was a decrease in SDF values of the ejaculated semen sample following the swim-up protocol (P=0.000). Interestingly, pregnancy could be equally predicted from SDF values derived from either neat or swim-up semen samples. Receiver operator curves and the derived Youden's indices determined SDF cutoff values for NS and SU of 24.8% and 17.5%, respectively. Prediction of pregnancy from NS SDF had a sensitivity of 75% and a specificity of 69%, whereas for SU SDF was 78% and 73%, respectively. While increased levels of SDF negatively impact reproductive outcome, we have shown that a reduction in SDF following sperm selection using ICSI with proven donor oocytes is not mandatory for achieving pregnancy. This suggests that a certain level of DNA damage that is not detectable using current technologies could be impacting on the relative success of assisted reproductive technology (ART) procedures. Consequently, we propose a modification of the so called ‘iceberg model' as a possible rationale for understanding the role of SDF in reproductive outcome. PMID:24121979

  17. Clinical significance of thrombocytosis before preoperative chemoradiotherapy in rectal cancer: predicting pathologic tumor response and oncologic outcome.

    Science.gov (United States)

    Kim, Hye Jin; Choi, Gyu-Seog; Park, Jun Seok; Park, SooYeun; Kawai, Kazushige; Watanabe, Toshiaki

    2015-02-01

    Thrombocytosis is considered an adverse prognostic factor in various malignancies. However, the clinical significance of thrombocytosis in rectal cancer patients is unknown. We investigated the predictive value of thrombocytosis for pathologic tumor response to preoperative chemoradiotherapy (CRT) and oncologic outcomes in patients with rectal cancer. A total of 314 patients who underwent preoperative CRT and subsequent rectal resection for rectal cancer were retrospectively evaluated at two tertiary institutions. Univariate and multivariate analyses of the clinical parameters were performed to identify markers predictive of a pathologic complete response (pCR). The Kaplan-Meier method was used to estimate 3-year disease-free and overall survival rates. Sixty-nine patients (22 %) had thrombocytosis before CRT, which significantly correlated with a large tumor size and advanced tumor depth. Thirty-nine patients (12.4 %) achieved a pCR. In the multivariate analyses, a platelet count of thrombocytosis had lower 3-year disease-free (P = 0.037) and overall survival (P = 0.001) rates than patients with normal pretreatment platelet counts. Thrombocytosis is a negative predictive factor for a pCR and has an adverse impact on survival in rectal cancer. The predictive value of this easily available clinical factor should not be underestimated, and better therapeutic strategies for these tumors are required.

  18. Significance of uncertainties derived from settling tank model structure and parameters on predicting WWTP performance - A global sensitivity analysis study

    DEFF Research Database (Denmark)

    Ramin, Elham; Sin, Gürkan; Mikkelsen, Peter Steen

    2011-01-01

    Uncertainty derived from one of the process models – such as one-dimensional secondary settling tank (SST) models – can impact the output of the other process models, e.g., biokinetic (ASM1), as well as the integrated wastewater treatment plant (WWTP) models. The model structure and parameter...... uncertainty of settler models can therefore propagate, and add to the uncertainties in prediction of any plant performance criteria. Here we present an assessment of the relative significance of secondary settling model performance in WWTP simulations. We perform a global sensitivity analysis (GSA) based....... The outcome of this study contributes to a better understanding of uncertainty in WWTPs, and explicitly demonstrates the significance of secondary settling processes that are crucial elements of model prediction under dry and wet-weather loading conditions....

  19. Data on clinical significance of second trimester inflammatory biomarkers in the amniotic fluid in predicting preterm delivery

    Directory of Open Access Journals (Sweden)

    Assaad Kesrouani

    2016-12-01

    Data includes ROC curves for glucose (Fig. 1, IL-6 (Fig. 2 and MMP-9 (Fig. 3, aiming to search for sensitivity and specificity in the prediction of premature delivery. Statistical analyses are performed with SPSS v20.0 software. Statistical significance is determined using the Mann–Whitney and one way ANOVA test. The association with preterm delivery is performed using a two proportions test. Correlations are measured using the Pearson׳’s coefficient. A p value<0.05 is considered statistically significant. The data is presented in the figures provided. Data relied on a previous publication “Prediction of preterm delivery by second trimester inflammatory biomarkers in the amniotic fluid” (A. Kesrouani, E. Chalhoub, E. El Rassy, M. Germanos, A. Khazzaka, J. Rizkallah, E. Attieh, N. Aouad, 2016 [1].

  20. Angiogenic factors vs Doppler surveillance in the prediction of adverse outcome among late-pregnancy small-for- gestational-age fetuses.

    Science.gov (United States)

    Lobmaier, S M; Figueras, F; Mercade, I; Perello, M; Peguero, A; Crovetto, F; Ortiz, J U; Crispi, F; Gratacós, E

    2014-05-01

    To compare the value of Doppler surveillance with maternal blood angiogenic factors at diagnosis for the prediction of adverse outcome in late-pregnancy small-for-gestational-age (SGA) fetuses. In a cohort of 198 SGA fetuses we evaluated the association of Doppler indices (mean uterine artery pulsatility index (UtA-PI) and cerebroplacental ratio (CPR)) and angiogenic factors (maternal serum levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF)) with the development of pre-eclampsia and adverse perinatal outcome (operative delivery for non-reassuring fetal status or neonatal metabolic acidosis). In SGA fetuses subsequently developing pre-eclampsia, mean UtA-PI (P < 0.001), sFlt-1 MoM (P < 0.001) and sFlt-1/PlGF MoM ratio (P < 0.001) were higher, while PlGF MoM was lower (P = 0.004). In SGA fetuses with adverse perinatal outcome, CPR (P < 0.002) and PlGF MoM (P < 0.001) were lower, and sFlt-1/PlGF MoM ratio was higher (P = 0.001). For predicting pre-eclampsia, the areas under the receiver-operating characteristics (ROC) curves for mean UtA-PI, sFlt-1 MoM and the combination of both were 0.852, 0.839 and 0.860, respectively. For adverse perinatal outcome, the areas under the ROC curves for CPR, PlGF MoM and the combination of both were 0.652, 0.656 and 0.684, respectively. The combination of Doppler indices and angiogenic factors did not significantly improve prediction of either pre-eclampsia (P = 0.851) or adverse outcome (P = 0.579). In SGA fetuses, angiogenic factors at diagnosis and follow-up with Doppler ultrasound both predict adverse outcome with a similar performance. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  1. 妊娠期骨密度检测对孕期的指导作用%Guiding Significance of Bone Mineral Density Testing During Pregnancy for Pregnant Women

    Institute of Scientific and Technical Information of China (English)

    胡丽萍

    2016-01-01

    Objective To investigate the significance of Bone Mineral Density testing during pregnancy for pregnant women through the study of bone mineral density changes.Methods Broadband ultrasound attenuation (BUA),Bone Mineral Density(BMD),speed of sound(SOS)were recorded for 498 pregnant women of different gestational age and compared the data.ResultsThe bone density detection results of BUA,BMD,SOS and Z-Score Value for Pregnant Women showed a downward trend with the increase of the gestational age and the incidence of osteoporosis had a tendency to increase with the gestational age.Conclusion Bone Mineral Density Testing during Pregnancy which is convenient and effective,can predict the body lack of nutrition timely,and then ensure the pregnant women and fetus healthy through the appropriate nutritional intervention.%目的:通过对孕期骨密度变化的研究,探讨骨密度检测对孕期的指导作用。方法检测不同孕期498例孕妇的超声振幅衰减(BUA)、骨密度(BMD)、超声传导速度(SOS),并进行比较分析。结果孕妇跟骨BUA、BMD、SOS及Z-Score值随着月份的增加而表现出下降的趋势;与孕早期组相比,孕中期组和孕晚期组的骨量减少和骨质疏松的发生率均提高,骨质疏松的发生率随着孕周的增加而增加。结论妊娠期骨密度检测方便有效,可及时预测出机体的营养缺失情况,进而通过合适的营养干预,保证孕妇和胎儿的健康。

  2. Accuracy of erythrogram and serum ferritin for the maternal anemia diagnosis (AMA): a phase 3 diagnostic study on prediction of the therapeutic responsiveness to oral iron in pregnancy.

    Science.gov (United States)

    Bresani, Cristiane Campello; Braga, Maria Cynthia; Felisberto, Daniel Falcão; Tavares-de-Melo, Carlos Eduardo Lopes; Salvi, Debora Bresani; Batista-Filho, Malaquias

    2013-01-16

    Pregnancy anemia remains as a public health problem, since the official reports in the 70's. To guide the treatment of iron-deficiency anemia in pregnancy, the haemoglobin concentration is the most used test in spite of its low accuracy, and serum ferritin is the most reliable test, although its cutoff point remains an issue. The aim of this protocol is to verify the accuracy of erythrocyte indices and serum ferritin (studied tests) for the diagnosis of functional iron-deficiency in pregnancy using the iron-therapy responsiveness as the gold-standard. This is an ongoing phase III accuracy study initiated in August 2011 and to be concluded in April 2013. The subjects are anemic pregnant women (haemoglobin concentration iron during 90 days and will be analyzed as a delayed-type cross-sectional study. Women at the second trimester of pregnancy are being evaluated with clinical and laboratorial examinations at the enrollment and monthly. The 'responsiveness to therapeutic test with oral iron' (gold-standard) was defined to an increase of at least 0.55 Z-score in haemoglobin after 4 weeks of treatment and a total dose of 1200 mg of iron. At the study conclusion, sensitivities, specificities, predictive values, likelihood ratios and areas under the ROC (Receiver Operating Characteristic) curves of serum ferritin and erythrocyte indices (red blood cell count, haematocrit, haemoglobin concentration, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red blood cell distribution width, reticulocyte count) will be tested. The compliance and adverse effects are considered confounding variables, since they are the main obstacles for the iron-therapy responsiveness. This study protocol shows a new approach on iron-deficiency anemia in pregnancy from a functional point of view that could bring some insights about the diagnostic misclassifications arising from the dynamic physiologic changes during the gestational cycle. WHO

  3. Surface tensions of multi-component mixed inorganic/organic aqueous systems of atmospheric significance: measurements, model predictions and importance for cloud activation predictions

    Directory of Open Access Journals (Sweden)

    D. O. Topping

    2007-01-01

    Full Text Available In order to predict the physical properties of aerosol particles, it is necessary to adequately capture the behaviour of the ubiquitous complex organic components. One of the key properties which may affect this behaviour is the contribution of the organic components to the surface tension of aqueous particles in the moist atmosphere. Whilst the qualitative effect of organic compounds on solution surface tensions has been widely reported, our quantitative understanding on mixed organic and mixed inorganic/organic systems is limited. Furthermore, it is unclear whether models that exist in the literature can reproduce the surface tension variability for binary and higher order multi-component organic and mixed inorganic/organic systems of atmospheric significance. The current study aims to resolve both issues to some extent. Surface tensions of single and multiple solute aqueous solutions were measured and compared with predictions from a number of model treatments. On comparison with binary organic systems, two predictive models found in the literature provided a range of values resulting from sensitivity to calculations of pure component surface tensions. Results indicate that a fitted model can capture the variability of the measured data very well, producing the lowest average percentage deviation for all compounds studied. The performance of the other models varies with compound and choice of model parameters. The behaviour of ternary mixed inorganic/organic systems was unreliably captured by using a predictive scheme and this was dependent on the composition of the solutes present. For more atmospherically representative higher order systems, entirely predictive schemes performed poorly. It was found that use of the binary data in a relatively simple mixing rule, or modification of an existing thermodynamic model with parameters derived from binary data, was able to accurately capture the surface tension variation with concentration. Thus

  4. Cut-off value of initial serum β-hCG level predicting a successful MTX therapy in tubal ectopic pregnancy: a retrospective cohort study.

    Science.gov (United States)

    Helmy, S; Bader, Y; Pablik, E; Tiringer, D; Pils, S; Laml, T; Kölbl, H; Koch, M

    2014-08-01

    To determine the optimal serum β-hCG cut-off level to predict MTX treatment success in tubal ectopic pregnancy (EP). Data of 240 women, who presented between 2003 and 2011 at the Department of Gynecology and Obstetrics, Medical University of Vienna, with tubal EP and who received MTX as primary treatment, were retrieved from the hospital information system (KIS). 198 patients could be included for final evaluation. Statistical analysis included area under the ROC curve, maximal Euclidean and Youden index, chi-squared and a five-fold cross validation. The serum β-hCG level cut-off value was calculated at 2121mlU/ml with a specificity of 76.54% and sensitivity of 80.56% (AUC 0.789; phCG level below 2121mlU/ml (n=131) experienced MTX treatment failure in 5.3% (n=7), compared to 43.3% (n=29) of patients with an initial serum β-hCG level equal to or above 2121mlU/ml (n=67). There was no statistically significant correlation between clinical symptoms and the MTX therapy outcome (p=0.580; likelihood quotient p=0.716). The correct decision of therapy in patients with tubal ectopic pregnancy still represents a challenge. In this study we can conclude that, according to our results there is no endpoint of initial serum β-hCG levels, which can be clearly used as cut-off value for the optimal management of tubal EP. However, an initial serum β-hCG level of less than 2121mlU/ml seems to be a good value to expect a successful MTX treatment. Limitations are the retrospective study design and the inability of classifying clinical symptoms like pain as an objective parameter. Wider implications of the findings may include more detailed patient information and more accurate selection of suitable patients for MTX therapy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Usefulness of clinical observations and blood chemistry values for predicting clinical outcomes in dairy goats with pregnancy toxaemia.

    Science.gov (United States)

    Lima, Miguel S; Silveira, Júlia M; Carolino, Nuno; Lamas, Luis P; Pascoal, Rita A; Hjerpe, Charles A

    2016-01-01

    Pregnancy toxaemia (PT) is a disease that affects pregnant goats during their last month of gestation and is characterized by a high case fatality rate. This study involved 32 does maintained on a commercial dairy goat farm that were diagnosed with PT. A physical examination was performed on and haematology parameters obtained from each doe, at the time of diagnosis. The data from the 24 PT goats that died was compared with the corresponding data from the 8 PT goats that survived. Polypnea, swollen limbs, anorexia with absence of ruminal motility, recumbency, nervous signs and drooping ears were the most frequently observed clinical manifestations. Nineteen out of 21 recumbent goats died. Sixteen out of 17 goats with anorexia and absence of ruminal motility died. Mean beta-hydroxybutyric acid (BHBA) values in the goats that died were not significantly different from those in goats that survived. The blood values for pH and pCO2 (p < 0.005) as well as for HCO3(-), BE and K(+) (p < 0.001) were significantly lower in the goats that died than in those that survived. The clinical signs most indicative of a poor prognosis are anorexia with absence of ruminal motility and recumbency. Among the blood parameters to be considered, hypokalaemia and metabolic acidosis are the most relevant. Goats with PT have a high mortality and their condition can deteriorate very fast. Based on the authors's experience, a good strategy to minimize the economic losses caused by PT is to focus on the offspring survival rate since an early decision (induction of kidding or caesarian surgery) can increase the number of alive kids.

  6. The use of prediction models of spontaneous pregnancy in in vitro fertilization units reveals differences between the expected results of public and private clinics in Spain.

    Science.gov (United States)

    Gabbanini, Massimo; Privitera, Laura; Monzó, Ana; Higueras, Gemma; Fuster, Sonia; Garrido, Nicolás; Bosch, Ernesto; Pellicer, Antonio

    2010-11-01

    To evaluate the applicability of prediction models (PM) of spontaneous pregnancy (SP) in a population of infertile patients from a university-affiliated private assisted reproductive technology center (Instituto Valenciano de Infertilidad) and in the reproductive medicine section of a public university hospital (La Fe), both belonging to the same city (Valencia, Spain) between January and December 2008. We calculated the probability of SP using the PM developed by Hunault et al. in our two populations, and observed an estimated probability of SP<40% or the PM applicable in approximately 97% of the studied couples, and statistical differences between pregnancy probabilities in the two settings that were mainly a result of different age, sperm quality, and referral policies, leading us to conclude that the usefulness of PMs is limited in our environment. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  8. Spatially unassociated galaxies contribute significantly to the blended submillimetre galaxy population: predictions for follow-up observations of ALMA sources

    CERN Document Server

    Hayward, Christopher C; Somerville, Rachel S; Primack, Joel R; Moreno, Jorge; Wechsler, Risa H

    2013-01-01

    There is anecdotal evidence that spatially and physically unassociated galaxies blended into a single submillimetre (submm) source contribute to the submm galaxy (SMG) population. However, the significance of this subpopulation has neither been observationally constrained nor theoretically predicted. This work is the first to theoretically predict the contribution of spatially unassociated components to the SMG population. We generate mock SMG catalogues using lightcones derived from the Bolshoi cosmological simulation; to assign submm flux densities to the mock galaxies, we use a fitting function previously derived from the results of dust radiative transfer performed on hydrodynamical simulations of isolated disc and merging galaxies. We then calculate submm number counts for different beam sizes and without blending. Our model suggests that there are a sufficient number of blended SMGs to account for the observed number counts of submm sources with 850-{\\mu}m flux density S_850 >~12 mJy. Furthermore, we pr...

  9. The significance of Bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Muckle, Marianne; Sabet, Amir; Biermann, Kim; Haslerud, Torjan; Biersack, Hans-Juergen; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Wilhelm, Kai [University Hospital Bonn, Department of Radiology, Bonn (Germany); Kuhl, Christiane [University Hospital Aachen, Department of Radiology, Aachen (Germany)

    2012-02-15

    Unwanted deposition of {sup 90}Y microspheres in organs other than the liver during radioembolization of liver tumours may cause severe side effects such as duodenal ulcer. The aim of this study was to evaluate the significance of posttherapy bremsstrahlung (BS) SPECT/CT images of the liver in comparison to planar and SPECT images in the prediction of radioembolization-induced extrahepatic side effects. A total of 188 radioembolization procedures were performed in 123 patients (50 women, 73 men) over a 2-year period. Planar, whole-body and BS SPECT/CT imaging were performed 24 h after treatment as a part of therapy work-up. Any focally increased extrahepatic accumulation was evaluated as suspicious. Clinical follow-up and gastroduodenoscopy served as reference standards. The studies were reviewed to evaluate whether BS SPECT/CT imaging was of benefit. In the light of anatomic data obtained from SPECT/CT, apparent extrahepatic BS in 43% of planar and in 52% of SPECT images proved to be in the liver and hence false-positive. The results of planar scintigraphy could not be analysed further since 12 images were not assessable due to high scatter artefacts. On the basis of the gastrointestinal (GI) complications and the results of gastroduodenoscopy, true-positive, true-negative, false-positive and false-negative results of BS SPECT and SPECT/CT imaging in the prediction of GI ulcers were determined. The sensitivity, specificity, positive and negative predictive values and the accuracy of SPECT and SPECT/CT in the prediction of GI ulcers were 13%, 88%, 8%, 92% and 82%, and 87%, 100%, 100%, 99% and 99%, respectively. Despite the low quality of BS images, BS SPECT/CT can be used as a reliable method to confirm the safe distribution of {sup 90}Y microspheres and in the prediction of GI side effects. (orig.)

  10. The clinical significance of MiR-148a as a predictive biomarker in patients with advanced colorectal cancer.

    Directory of Open Access Journals (Sweden)

    Masanobu Takahashi

    Full Text Available AIM: Development of robust prognostic and/or predictive biomarkers in patients with colorectal cancer (CRC is imperative for advancing treatment strategies for this disease. We aimed to determine whether expression status of certain miRNAs might have prognostic/predictive value in CRC patients treated with conventional cytotoxic chemotherapies. METHODS: We studied a cohort of 273 CRC specimens from stage II/III patients treated with 5-fluorouracil-based adjuvant chemotherapy and stage IV patients subjected to 5-fluorouracil and oxaliplatin-based chemotherapy. In a screening set (n = 44, 13 of 21 candidate miRNAs were successfully quantified by multiplex quantitative RT-PCR. In the validation set comprising of the entire patient cohort, miR-148a expression status was assessed by quantitative RT-PCR, and its promoter methylation was quantified by bisulfite pyrosequencing. Lastly, we analyzed the associations between miR-148a expression and patient survival. RESULTS: Among the candidate miRNAs studied, miR-148a expression was most significantly down-regulated in advanced CRC tissues. In stage III and IV CRC, low miR-148a expression was associated with significantly shorter disease free-survival (DFS, a worse therapeutic response, and poor overall survival (OS. Furthermore, miR-148a methylation status correlated inversely with its expression, and was associated with worse survival in stage IV CRC. In multivariate analysis, miR-148a expression was an independent prognostic/predictive biomarker for advanced CRC patients (DFS in stage III, low vs. high expression, HR 2.11; OS in stage IV, HR 1.93. DISCUSSION: MiR-148a status has a prognostic/predictive value in advanced CRC patients treated with conventional chemotherapy, which has important clinical implications in improving therapeutic strategies and personalized management of this malignancy.

  11. The IL-6 -634C/G polymorphism: a candidate genetic marker for the prediction of idiopathic recurrent pregnancy loss

    Directory of Open Access Journals (Sweden)

    Zarnegar Rasti

    2016-02-01

    Full Text Available Background: Recurrent pregnancy loss (RPL is defined as two or more miscarriages before the 20th week of gestation and its etiology is unknown in 50% of the cases. Interleukin 6 is an immune mediator, plays a regulatory role in embryo implantation and placental development. Objective: The purpose was to assess the association between IL-6 -634C/G polymorphism and, susceptibility to idiopathic RPL for the first time in Iran. Materials and Methods: In total 121 women with RPL and 121 healthy women as control group were enrolled in this case-control study. This study was performed from August 2013 to October 2014 in the Molecular Genetics Laboratory of Arsanjan University. Candidate polymorphism was evaluated by PCR-RFLP method on extracted genomic DNA. Data was analyzed using the statistical SPSS package. Results: Our results showed an increased risk of RPL in patients with GG + GC genotype (OR=5.1, 95%CI: 1.04-25.3, p=0.04 in comparison to CC genotype. The frequency of mutant allele G in patients and controls was 0.75 and 0.66 respectively. The mutant allele G predisposes women to miscarriage 1.5 times greater than controls (OR=1.5, 95%CI: 1.03-2.27, p=0.036. The mean number of live births in RPL women (1.3±2.3 was significantly lower compared to control women (4.8±2.3. Conclusion: This study indicated that the promoter polymorphism (-634C/G of the IL-6 gene has likely influence on individual susceptibility to RPL.

  12. Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: findings from a US cohort study

    Directory of Open Access Journals (Sweden)

    Rifas-Shiman Sheryl L

    2008-12-01

    Full Text Available Abstract Background Excessive gestational weight gain promotes poor maternal and child health outcomes. Weight misperception is associated with weight gain in non-pregnant women, but no data exist during pregnancy. The purpose of this study was to examine the association of misperceived pre-pregnancy body weight status with excessive gestational weight gain. Methods At study enrollment, participants in Project Viva reported weight, height, and perceived body weight status by questionnaire. Our study sample comprised 1537 women who had either normal or overweight/obese pre-pregnancy BMI. We created 2 categories of pre-pregnancy body weight status misperception: normal weight women who identified themselves as overweight ('overassessors' and overweight/obese women who identified themselves as average or underweight ('underassessors'. Women who correctly perceived their body weight status were classified as either normal weight or overweight/obese accurate assessors. We performed multivariable logistic regression to determine the odds of excessive gestational weight gain according to 1990 Institute of Medicine guidelines. Results Of the 1029 women with normal pre-pregnancy BMI, 898 (87% accurately perceived and 131 (13% overassessed their weight status. 508 women were overweight/obese, of whom 438 (86% accurately perceived and 70 (14% underassessed their pre-pregnancy weight status. By the end of pregnancy, 823 women (54% gained excessively. Compared with normal weight accurate assessors, the adjusted odds of excessive gestational weight gain was 2.0 (95% confidence interval [CI]: 1.3, 3.0 in normal weight overassessors, 2.9 (95% CI: 2.2, 3.9 in overweight/obese accurate assessors, and 7.6 (95% CI: 3.4, 17.0 in overweight/obese underassessors. Conclusion Misperceived pre-pregnancy body weight status was associated with excessive gestational weight gain among both normal weight and overweight/obese women, with the greatest likelihood of excessive

  13. 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...

  14. Consistent CMT solutions from Harvard University before great earthquakes in Kurile Islands and its significance for earthquake prediction

    Institute of Scientific and Technical Information of China (English)

    WANG Jun-guo; DIAO Gui-ling

    2005-01-01

    In the paper, we use the Central Moment Tensor (CMT) solution acquired by Harvard University for the earthquakes occurred in Kurile Islands to analyze the consistent focal mechanism in the area and propose the idea of making earthquake prediction based on the consistent parameter a of focal mechanism and stress field. The results from the study indicate that before MW≥7.5 earthquakes, the consistent parameter a decreases, which starts about 10~110 days and ends about 30~2 days before the great earthquakes. Although the phenomenon is not totally the same for individual earthquake, the difference is not large. Certainly, the phenomenon should be tested by time for its reliability. However, it should not be random that the focal mechanism of MW≥5.3 earthquakes are consistent successively with the stress field in an area of several hundreds kilometers in length. It should be a phenomenon of predictive significance. When the accumulated earthquake examples are sufficient, uniform judgment criteria and prediction principles can be stipulated then.

  15. Physiologically-based, predictive analytics using the heart-rate-to-Systolic-Ratio significantly improves the timeliness and accuracy of sepsis prediction compared to SIRS.

    Science.gov (United States)

    Danner, Omar K; Hendren, Sandra; Santiago, Ethel; Nye, Brittany; Abraham, Prasad

    2017-04-01

    Enhancing the efficiency of diagnosis and treatment of severe sepsis by using physiologically-based, predictive analytical strategies has not been fully explored. We hypothesize assessment of heart-rate-to-systolic-ratio significantly increases the timeliness and accuracy of sepsis prediction after emergency department (ED) presentation. We evaluated the records of 53,313 ED patients from a large, urban teaching hospital between January and June 2015. The HR-to-systolic ratio was compared to SIRS criteria for sepsis prediction. There were 884 patients with discharge diagnoses of sepsis, severe sepsis, and/or septic shock. Variations in three presenting variables, heart rate, systolic BP and temperature were determined to be primary early predictors of sepsis with a 74% (654/884) accuracy compared to 34% (304/884) using SIRS criteria (p sepsis identification via detection of variations in HR-to-systolic ratio. This approach may lead to earlier sepsis workup and life-saving interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. 妊娠高血压疾病产前预测及预防%Prediction and Prevention in Prenatal Hypertension of Pregnancy Disease

    Institute of Scientific and Technical Information of China (English)

    吴淑荣

    2015-01-01

    Objective To investigate the risk factors and preventions of hypertension of pregnancy disease. Methods 30 cases of hypertension of pregnancy had predicted the risk factors,in order to be avoided the happening of the disease and prevented the complications. Results Total 30 patients were analyzed, 9 cases were adopt artificial midwifery,21 cases were adopt cesarean section. Conclusion The effective prevention and treatment intervention are given in early pregnancy,in order to prevent the happening of the complications caused by disease.%目的:探讨妊娠期高血压疾病有关的危险因素及预防。方法对妊娠期高血压疾病患者30例进行高危因素预测,避免疾病的发生及预防疾病所致并发症的发生。结果30例患者,生产时行人工助产9例,剖宫产21例。结论早期妊娠时需发挥有效的预防和治疗干预,清楚了解疾病的病因并避免疾病的发生。

  17. Study of prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves

    Directory of Open Access Journals (Sweden)

    Divya Bhadoo

    2015-01-01

    Full Text Available Aims: Study on prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. Materials and Methods: Antenatally diagnosed hydronephrosis patients were included. Postnatally, they were divided into two groups, posterior urethral valve (PUV and non-PUV. The studied parameters were: Gestational age at detection, surgical intervention, ultrasound findings, cord blood and follow up plasma renin activity (PRA values, vesico-ureteric reflux (VUR, renal scars, and glomerular filtration rate (GFR. Results: A total of 25 patients were included, 10 PUV and 15 non-PUV. All infants with PUV underwent primary valve incision. GFR was less than 60 ml/min/1.73 m 2 body surface area in 4 patients at last follow-up. Keyhole sign, oligoamnios, absent bladder cycling, and cortical cysts were not consistent findings on antenatal ultrasound in PUV. Cord blood PRA was significantly higher (P < 0.0001 in PUV compared to non-PUV patients. Gestational age at detection of hydronephrosis, cortical cysts, bladder wall thickness, and amniotic fluid index were not significantly correlated with GFR while PRA could differentiate between poor and better prognosis cases with PUV. Conclusions: Ultrasound was neither uniformly useful in diagnosing PUV antenatally, nor differentiating it from cases with non-PUV hydronephrosis. In congenital hydronephrosis, cord blood PRA was significantly higher in cases with PUV compared to non-PUV cases and fell significantly after valve ablation. Cord blood PRA could distinguish between poor and better prognosis cases with PUV.

  18. TVS卵泡监测序贯尿LH试纸预测排卵在计划妊娠中的指导意义%The guiding significances of follicular monitoring by transvaginal ultrasonography and sequential urine LH test-paper in prognosis of ovulation during planning pregnancy

    Institute of Scientific and Technical Information of China (English)

    王艳华; 吴琳; 李墨林

    2011-01-01

    women in group A received transvaginal ultrasonography and sequential urine LH test - paper to monitor the ovulation and pregnancy outcomes, and 50 women in group B (control group) didn't receive any monitoring method. Results: In group A, 84 menstrual cycles were monitored, 67 cycles of mature follicles were monitored by ultrasonography, 63 cycles were found as ovulatory cycles definitely, accounting for 75.0%. Urine LH peak appeared in 71 menstrual cycles, the positive rate was 84. 5%. There was no significant difference in coincidence rate of ovulatory cycles between the two groups. Among 46 women, 15 women got pregnancy during monitoring cycle, the pregnancy rate was 32. 6% ( 15/46), 4 women got pregnancy at 4 ~ 6 months, the natural pregnancy rate was 8.7%. In group B, 4 women got pregnancy within 3 months, accounting for 8. 0%; 6 women got pregnancy at 4 ~ 6 months, the natural pregnancy rate was 12. 0%. There was significant difference in pregnancy rate within 3 months between the two groups (P <0. 05 ) . Conclusion: Transvaginal ultrasonography is direct, dynamic and scientific in monitoring of follicles; urine LH test- paper detection is simple, convenient, accurate and reliable, transvaginal ultrasonography combined with urine LH test - paper detection can monitor the dynamic process of follicles from growth to maturity, which can predict the ovulatory time and find the optimal opportunity of pregnancy as quickly as possible. Thus, follicular monitoring by transvaginal ultrasonography and ovulation prediction by urine LH test - paper detection have active and scientific directive significances in planning pregnancy, and they play important roles in bearing and rearing better children.

  19. Measuring physical activity during pregnancy

    Directory of Open Access Journals (Sweden)

    Teede Helena J

    2011-03-01

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

  20. Prior illicit drug use and missed prenatal vitamins predict nonadherence to antiretroviral therapy in pregnancy: adherence analysis A5084.

    Science.gov (United States)

    Cohn, Susan E; Umbleja, Triin; Mrus, Joseph; Bardeguez, Arlene D; Andersen, Janet W; Chesney, Margaret A

    2008-01-01

    Adherence to antiretroviral therapy (ART) in pregnancy is crucial to optimize its efficacy and minimize mother-to-child transmission. Our objective was to examine adherence patterns to ART and health behaviors during and after pregnancy among HIV-positive women enrolled in A5084, a prospective, observational, multisite study. Between 2002-2005, HIV-infected women between 20 and 34 weeks'gestation completed at least 1 self-reported adherence questionnaire antepartum (AP), and were followed through 12 weeks' postpartum (PP). Questionnaires also addressed tobacco, alcohol, and illicit drugs use. Adherence was defined as reporting not having missed any doses for more than 3 months. Exact McNemar's tests were used for paired binary data and exact logistic regression was used for predictors of nonadherence. We report on 149 women (55% black, 26% Hispanic, 32% less than 25 years, 9% with AIDS, 100% on ART). PP, 31 (21%) women stopped ART and 18 (12%) withdrew from the study. AP, 57% reported adherence to ART and PP, 45% (p = 0.03, n = 87). AP, 11% reported ongoing alcohol use and 23% tobacco use compared to 37% and 30% PP (p vitamins had 4.84 times higher odds (p = 0.001) of ART nonadherence. Women reporting a history of illicit drug use and/or having missed prenatal vitamins should be targeted for programs to enhance adherence to ART during pregnancy.

  1. 凝血指标检测在妊娠高血压综合征的临床意义%Clinical Significance of Blood Coagulation Index Detection in Pregnancy Induced Hypertension Syndrome

    Institute of Scientific and Technical Information of China (English)

    罗婵

    2016-01-01

    Objective Clinical signiifcance of analysis of blood coagulation indexes in pregnancy induced hypertension syndrome.Methods From December 2014 to December 2015, 38 cases of pregnant women with pregnancy induced hypertension were selected as the research objects, the same period 38 cases of normal pregnant women as control group, coagulation parameters were detected in all patients.Results Compared with the two groups of pregnant women in the second trimester of pregnancy and the blood coagulation index, compared with the normal control group, the pregnant women with pregnancy induced hypertension syndrome were compared with the normal control group. The difference was not statistically significant,P>0.05. Compared with the normal control group, the pregnant women with pregnancy induced hypertension syndrome were compared with the normal control group, the difference was statistically signiifcant,P<0.05ConclusionIn terms of normal pregnancy, if at the end of pregnancy, the coagulation index is presented in a highly condensed state, will be conducive to the bleeding of pregnant women postpartum, but the high coagulation status can’t occur in pregnant women with pregnancy induced hypertension syndrome, prone to thrombosis, therefore, for pregnant women with pregnancy induced hypertension need to pay attention to prevention.%目的:分析凝血指标检测在妊娠高血压综合征的临床意义。方法选取本院2014年12月~2015年12月收治的38例妊高征孕妇作为研究对象,将同期38例普通孕妇作为对照组。所有患者均进行凝血指标检测。结果对比两组孕妇在妊娠中期与妊娠晚期的凝血指标情况,患有妊娠高血压综合征的观察组孕妇与普通对照组孕妇在妊娠中期的各项指标相对比,差异无统计学意义,P>0.05;妊娠高血压综合征观察组孕妇与对照组孕妇妊娠晚期的各项指标相对比,差异有统计学意义,P<0.05。结论就正常孕妇的妊娠

  2. Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Duan, X-Y.; Wang, W.; Li, M.; Li, Y.; Guo, Y-M. [PET-CT Center, The First Affiliated Hospital of Xi' an, Jiaotong University, Xi' an, Shaanxi (China)

    2015-02-03

    {sup 18}F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. {sup 18}F-FDG PET/CT scans were performed and different SUV parameters (SUV{sub max}, SUV{sub avg}, SUV{sub T/L}, and SUV{sub T/A}) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUV{sub max}, SUV{sub avg}, and SUV{sub T/L} of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUV{sub T/L} was the primary predictor for tumor differentiation. However, in adenocarcinoma, SUV{sub max} was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUV{sub T/L} appeared to be most useful overall, but SUV{sub max} was the best index for adenocarcinoma tumor differentiation.

  3. 妊娠期高血压疾病血清胱抑素C检测的临床意义%The clinical significance of serum levels of cysc detected in patients with hypertensive disorders of pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈丹

    2011-01-01

    目的:探讨妊娠期高血压疾病(妊高病)患者血清中胱抑素C(cystatin C,CysC)的临床意义.方法:测定90例妊高病患者观察组血清中CysC、血清肌酐(Cr)、尿素氮(BUN)、尿酸(UA)水平,并同正常未孕组30名、正常晚孕组30名血清中的CysC、Cr、BUN、UA水平进行对比.结果:妊娠各组血清中CysC值均较未孕者高(P<0.01),子痫前期重度组均较妊高病组、子痫前期轻度组及正常晚孕组明显增高(P<0.01).结论:妊高病血清中CysC的水平可以反映妊高病早期肾功能损害情况,为其在产科的临床应用提供实验依据.%Objective:To investigate the clinical significance of serum levels of serum cystatin C (CysC) determination in patients with hypertensive disorders of pregnancy. Methods:The patients were divided into three groups (hypertensive disorders of pregnancy, healthy nonpregnancy and late pregnancy). The serum levels of CysC,creafinine, urea nitrogen and uric acid were determined, and the results were statistically analyzed. Results:The serum levels of CysC in pregnancy were higher than nonpregnancy( P < 0.01 ). The serum levels of CysC in serious preeclampsia were higher than hypertensive disorders of pregnancy, mild preeclampsia and late pregnancy( P <0.01 ). Conclusions :The serum levels of CysC were meaningful for the diagnosis of early kidney function damage.

  4. 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.

  5. 妊娠期高血压疾病患者NT-proBNP检测的临床意义%Clinical significance of NT-proBNP detection in patients with hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    黄晓涓

    2016-01-01

    Objective To investigate the relationship between NT-proBNP and severity of disease and cardiac insufficiency in patients with hypertensive disorder complicating pregnancy.Methods 80 cases of hypertensive disorder complicating pregnancy were selected according to the severity of the disease in pregnancy induced hypertension, mild preeclampsia, severe preeclampsia, eclampsia, according to the heart function were divided into cardiac insufficiency group and normal group , determined NT-proBNP concentration. Results NT-proBNP was correlated with the severity of hypertensive disorder complicating pregnancy, and was positively correlated with cardiac insufficiency.Conclusion In patients with hypertensive disorder complicating pregnancy, NT-proBNP is a laboratory biochemical indicator that predicts cardiac insufficiency and is a good indicator of the severity of the disease, as well as guidance for treatment.%目的:探讨妊娠期高血压疾病患者NT-proBNP与病情严重程度、心功能不全相关性。方法选取80例妊娠期高血压疾病患者,主要表现为妊娠期高血压疾病、轻度子痫前期、重度子痫前期、子痫,按心功能不全分为心功能不全异常组和正常组,测定NT-proBNP浓度。结果 NT-proBN与妊娠期高血压疾病严重程度有相关性,与心功能不全呈正相关。结论妊娠期高血压疾病患者中,NT-proBNP是预测心功能不全、反映病情严重程度很好的一项实验室生化指标,同时可以指导治疗。

  6. Additional Value of Transluminal Attenuation Gradient in CT Angiography to Predict Hemodynamic Significance of Coronary Artery Stenosis

    Science.gov (United States)

    Stuijfzand, Wynand J.; Danad, Ibrahim; Raijmakers, Pieter G.; Marcu, C. Bogdan; Heymans, Martijn W.; van Kuijk, Cornelis C.; van Rossum, Albert C.; Nieman, Koen; Min, James K.; Leipsic, Jonathon; van Royen, Niels; Knaapen, Paul

    2015-01-01

    OBJECTIVES The current study evaluates the incremental value of transluminal attenuation gradient (TAG), TAG with corrected contrast opacification (CCO), and TAG with exclusion of calcified coronary segments (ExC) over coronary computed tomography angiogram (CTA) alone using fractional flow reserve (FFR) as the gold standard. BACKGROUND TAG is defined as the contrast opacification gradient along the length of a coronary artery on a coronary CTA. Preliminary data suggest that TAG provides additional functional information. Interpretation of TAG is hampered by multiple heartbeat acquisition algorithms and coronary calcifications. Two correction models have been proposed based on either dephasing of contrast delivery by relating coronary density to corresponding descending aortic opacification (TAG-CCO) or excluding calcified coronary segments (TAG-ExC). METHODS Eighty-five patients with intermediate probability of coronary artery disease were prospectively included. All patients underwent step-and-shoot 256-slice coronary CTA. TAG, TAG-CCO, and TAG-ExC analyses were performed followed by invasive coronary angiography in conjunction with FFR measurements of all major coronary branches. RESULTS Thirty-four patients (40%) were diagnosed with hemodynamically-significant coronary artery disease (i.e., FFR ≤0.80). On a per-vessel basis (n = 253), 59 lesions (23%) were graded as hemodynamically significant, and the diagnostic accuracy of coronary CTA (diameter stenosis ≥50%) was 95%, 75%, 98%, and 54% for sensitivity, specificity, negative predictive value, and positive predictive value, respectively. TAG and TAG-ExC did not discriminate between vessels with or without hemodynamically significant lesions (−13.5 ± 17.1 HU [Hounsfield units] × 10 mm−1 vs. −11.6 ± 13.3 HU × 10 mm−1, p = 0.36; and 13.1 ± 15.9 HU × 10 mm−1 vs. −11.4 ± 11.7 HU × 10 mm−1, p = 0.77, respectively). TAG-CCO was lower in vessels with a hemodynamically-significant lesion (−0

  7. 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.

  8. Two new prediction rules for spontaneous pregnancy leading to live birth among subfertile couples, based on the synthesis of three previous models.

    Science.gov (United States)

    Hunault, C C; Habbema, J D F; Eijkemans, M J C; Collins, J A; Evers, J L H; te Velde, E R

    2004-09-01

    Several models have been published for the prediction of spontaneous pregnancy among subfertile patients. The aim of this study was to broaden the empirical basis for these predictions by making a synthesis of three previously published models. We used the original data from the studies of Eimers et al. (1994), Collins et al. (1995) and Snick et al. (1997) on couples consulting for various forms of subfertility. We developed a so-called three-sample synthesis model for predicting spontaneous conception leading to live birth within 1 year after intake based on the three data sets. The predictors used are duration of subfertility, women's age, primary or secondary infertility, percentage of motile sperm, and whether the couple was referred by a general practitioner or by a gynaecologist (referral status). The performance of this model was assessed according to a 'jack-knife' analysis. Because the post-coital test (PCT) was not assessed in one of the samples, a synthesis model including the PCT was based on two samples only. The ability of the synthesis models to distinguish between women who became pregnant and those who did not was comparable to the ability of the one-sample models when applied in the other samples. The reliability of the predictions by the three-sample synthesis model was somewhat better. Predictions improved considerably by including the PCT. The synthesis models performed better and had a broader empirical basis than the original models. They are therefore better suitable for application in other centres.

  9. NGAL和血清胱抑素C在预测妊高征肾脏损伤中的诊断价值%Diagnostic Value of NGAL and Serum Cystatin C in Predicting Hypertensive Disease of Pregnancy Renal Injury

    Institute of Scientific and Technical Information of China (English)

    陈小英; 贾海红; 李晓丽

    2016-01-01

    Objective To investigate the diagnostic value of NGAL and serum cystatin C in predicting hypertensive disease of pregnancy renal injury. Method 100 patients with hypertensive disorder complicating pregnancy as the experimental group,select the same period admitted in our hospital and pregnancy outcome of normal pregnant women 50 cases as the control group. Detection of two serum NGAL and serum cystatin C levels within 24 h after admission and pregnancy after 72 h. Results Within 24 hours after admission,the experimental group in patients with serum NGAL levels,which was significantly higher than that in the control group,the two groups compared with statistical significance. Patients in the experimental group serum Cys-C levels was significantly higher than that in the control group, the two groups compared with statistical significance ( t=2. 256,P0. 05). Using the diagnostic value of ROC curve in the evaluation of NGAL and Cys-C. Among them,the area under the ROC curve of NGAL value is 0. 841,showed that NGAL is high diagnostic accuracy rate,Cys-C under the ROC curve area of 0. 810,showed that Cys-C diagnosis accurate medium,NGAL diagnosis accurate rate is higher than that of Cys-C. Conclusion NGAL and cystatin C may be as a predictor of pregnancy hypertension disease early renal damage index,in the disease early detection of pregnancy women with stage renal function, early detection of early treatment,can effectively reduce the maternal and perinatal mortality,improve maternal and child quality,worthy of clinical promotion.%目的:研究NGAL和血清胱抑素C在预测妊娠高血压疾病肾脏损伤中的诊断价值.方法选取妊娠高血压疾病患者100例作为实验组,另选取同期住院且妊娠结局正常的孕妇50例作为对照组.入院24 h内及产后72 h后检测两组血清NGAL和血清胱抑素C水平,并进行比较.结果入院24 h内,实验组患者血NGAL水平、血Cys-C水平显著高于对照组,两组比较

  10. Integrated analysis of microRNA and mRNA expression: Adding biological significance to microRNA target predictions

    NARCIS (Netherlands)

    M. van Iterson (Mat); S. Bervoets (Sander); E.J. de Meijer (Emile); H.P. Buermans (Henk); P.A.C. 't Hoen (Peter); R.X. Menezes (Renée); J.M. Boer (Judith)

    2013-01-01

    textabstractCurrent microRNA target predictions are based on sequence information and empirically derived rules but do not make use of the expression of microRNAs and their targets. This study aimed to improve microRNA target predictions in a given biological context, using in silico predictions, mi

  11. Poor Pre-Pregnancy and Antepartum Mental Health Predicts Postpartum Mental Health Problems among US Women: A Nationally Representative Population-Based Study

    Science.gov (United States)

    Witt, Whitney P.; Wisk, Lauren E.; Cheng, Erika R.; Hampton, John M.; Creswell, Paul; Hagen, Erika W.; Spear, Hilary A.; Maddox, Torsheika; DeLeire, Thomas

    2011-01-01

    Purpose Mental health problems disproportionately affect women, particularly during childbearing years. However, there is a paucity of research on the determinants of postpartum mental health problems using representative US populations. Taking a life course perspective, we determined the potential risk factors for postpartum mental health problems, with a particular focus on the role of mental health before and during pregnancy. Methods We examined data on 1,863 mothers from eleven panels of the 1996-2006 Medical Expenditure Panel Survey (MEPS). Poor postpartum mental health was defined using self-reports of mental health conditions, symptoms of mental health conditions, or global mental health ratings of “fair” or “poor.” Results 9.5% of women reported experiencing postpartum mental health problems, with over half of these women reporting a history of poor mental health. Poor pre-pregnancy mental health and poor antepartum mental health both independently increased the odds of having postpartum mental health problems. Staged multivariate analyses revealed that poor antepartum mental health attenuated the relationship between pre-pregnancy and postpartum mental health problems. Additionally, significant disparities exist in women's report of postpartum mental health status. Conclusions While poor antepartum mental health is the strongest predictor of postpartum mental health problems, pre-pregnancy mental health is also important. Accordingly, health care providers should identify, treat, and follow women with a history of poor mental health, as they are particularly susceptible to postpartum mental health problems. This will ensure that women and their children are in the best possible health and mental health during the postpartum period and beyond. PMID:21349740

  12. Incorporating significant amino acid pairs and protein domains to predict RNA splicing-related proteins with functional roles

    Science.gov (United States)

    Hsu, Justin Bo-Kai; Huang, Kai-Yao; Weng, Tzu-Ya; Huang, Chien-Hsun; Lee, Tzong-Yi

    2014-01-01

    Machinery of pre-mRNA splicing is carried out through the interaction of RNA sequence elements and a variety of RNA splicing-related proteins (SRPs) (e.g. spliceosome and splicing factors). Alternative splicing, which is an important post-transcriptional regulation in eukaryotes, gives rise to multiple mature mRNA isoforms, which encodes proteins with functional diversities. However, the regulation of RNA splicing is not yet fully elucidated, partly because SRPs have not yet been exhaustively identified and the experimental identification is labor-intensive. Therefore, we are motivated to design a new method for identifying SRPs with their functional roles in the regulation of RNA splicing. The experimentally verified SRPs were manually curated from research articles. According to the functional annotation of Splicing Related Gene Database, the collected SRPs were further categorized into four functional groups including small nuclear Ribonucleoprotein, Splicing Factor, Splicing Regulation Factor and Novel Spliceosome Protein. The composition of amino acid pairs indicates that there are remarkable differences among four functional groups of SRPs. Then, support vector machines (SVMs) were utilized to learn the predictive models for identifying SRPs as well as their functional roles. The cross-validation evaluation presents that the SVM models trained with significant amino acid pairs and functional domains could provide a better predictive performance. In addition, the independent testing demonstrates that the proposed method could accurately identify SRPs in mammals/plants as well as effectively distinguish between SRPs and RNA-binding proteins. This investigation provides a practical means to identifying potential SRPs and a perspective for exploring the regulation of RNA splicing.

  13. Incorporating significant amino acid pairs and protein domains to predict RNA splicing-related proteins with functional roles.

    Science.gov (United States)

    Hsu, Justin Bo-Kai; Huang, Kai-Yao; Weng, Tzu-Ya; Huang, Chien-Hsun; Lee, Tzong-Yi

    2014-01-01

    Machinery of pre-mRNA splicing is carried out through the interaction of RNA sequence elements and a variety of RNA splicing-related proteins (SRPs) (e.g. spliceosome and splicing factors). Alternative splicing, which is an important post-transcriptional regulation in eukaryotes, gives rise to multiple mature mRNA isoforms, which encodes proteins with functional diversities. However, the regulation of RNA splicing is not yet fully elucidated, partly because SRPs have not yet been exhaustively identified and the experimental identification is labor-intensive. Therefore, we are motivated to design a new method for identifying SRPs with their functional roles in the regulation of RNA splicing. The experimentally verified SRPs were manually curated from research articles. According to the functional annotation of Splicing Related Gene Database, the collected SRPs were further categorized into four functional groups including small nuclear Ribonucleoprotein, Splicing Factor, Splicing Regulation Factor and Novel Spliceosome Protein. The composition of amino acid pairs indicates that there are remarkable differences among four functional groups of SRPs. Then, support vector machines (SVMs) were utilized to learn the predictive models for identifying SRPs as well as their functional roles. The cross-validation evaluation presents that the SVM models trained with significant amino acid pairs and functional domains could provide a better predictive performance. In addition, the independent testing demonstrates that the proposed method could accurately identify SRPs in mammals/plants as well as effectively distinguish between SRPs and RNA-binding proteins. This investigation provides a practical means to identifying potential SRPs and a perspective for exploring the regulation of RNA splicing.

  14. Predictive value on premature delivery of fFN combined with cervical canal length in twin pregnancy%fFN联合宫颈管长度对双胎妊娠早产的预测价值

    Institute of Scientific and Technical Information of China (English)

    梁梅芬; 石雪金

    2016-01-01

    目的:研究胎儿纤维连接蛋白(fFN)联合宫颈管长度对双胎妊娠早产的预测价值。方法选择2014年9月~2015年9月在我院进行产检和住院安胎的双胎妊娠孕妇91例,入选孕妇在24~34周测定宫颈管长度(CL)和fFN,并追踪统计孕妇的妊娠结局。结果卡方检验结果表明在CL≤25mm的40例孕妇中, fFN阳性孕妇的早产率89.3%显著高于fFN阴性孕妇早产率50%(x2=7.431,P<0.05);在CL>25mm的51例孕妇中,fFN阳性孕妇早产率28.6%显著高于fFN阴性孕妇16.2%(x2=5.251,P<0.05)。fFN和宫颈管长度联合检测预测双胎妊娠早产的敏感性和特异度分别为89.3%和74.0%。结论 fFN联合宫颈管长度对双胎妊娠早产具有较高的预测价值,能够满足临床应用,值得在产科临床推广应用。%Objective To study the predictive value on premature delivery of fFN (fetal fibronectin) combined with cervical canal length in twin pregnancy.Methods 91 pregnant women with twin pregnancy, who were carried out prenatal examination and hospitalization miscarriage prevention in our hospital from September 2014 to September 2015, were selected to mensurate the cervical canal length(CL) and fFN at 24-34 weeks, to tracking statistics the pregnancy outcome of pregnant women.Results The Chi-square test result showed that, of the 40 pregnant women of CL≤25mm, the premature delivery rate of fFN in positive pregnant women(89.3%) was significantly higher than which in negative pregnant women (50%)(x2=7.431,P25mm, the premature delivery rate of fFN in positive pregnant women(28.6%) was significantly higher than which in negative pregnant women(16.2%)(x2=5.251,P<0.05). The sensitivity and specificity of fFN and cervical canal length joint detection and prediction on premature delivery in twin pregnancy were respectively 89.3% and 74.0%. Conclusion FFN combined with cervical canal length on premature delivery in twin pregnancy has higher predictive

  15. 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

  16. 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.

  17. Preoperative Metabolic Syndrome Is Predictive of Significant Gastric Cancer Mortality after Gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA) Study.

    Science.gov (United States)

    Hu, Dan; Peng, Feng; Lin, Xiandong; Chen, Gang; Zhang, Hejun; Liang, Binying; Ji, Kaida; Lin, Jinxiu; Chen, Lin-Feng; Zheng, Xiongwei; Niu, Wenquan

    2017-02-01

    Metabolic syndrome (MetS) has been shown to be associated with an increased risk of gastric cancer. However, the impact of MetS on gastric cancer mortality remains largely unknown. Here, we prospectively examined the prediction of preoperative MetS for gastric cancer mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. This study was conducted among 3012 patients with gastric cancer who received radical gastrectomy between 2000 and 2010. The latest follow-up was completed in 2015. Blood/tissue specimens, demographic and clinicopathologic characteristics were collected at baseline. During 15-year follow-up, 1331 of 3012 patients died of gastric cancer. The median survival time (MST) of patients with MetS was 31.3months, which was significantly shorter than that of MetS-free patients (157.1months). The coexistence of MetS before surgery was associated with a 2.3-fold increased risk for gastric cancer mortality (P<0.001). The multivariate-adjusted hazard ratios (HRs) were increased with invasion depth T1/T2 (HR=2.78, P<0.001), regional lymph node metastasis N0 (HR=2.65, P<0.001), positive distant metastasis (HR=2.53, P<0.001), TNM stage I/II (HR=3.00, P<0.001), intestinal type (HR=2.96, P<0.001), negative tumor embolus (HR=2.34, P<0.001), and tumor size ≤4.5cm (HR=2.49, P<0.001). Further survival tree analysis confirmed the top splitting role of TNM stage, followed by MetS or hyperglycemia with remarkable discrimination ability. In this large cohort study, preoperative MetS, especially hyperglycemia, was predictive of significant gastric cancer mortality in patients with radical gastrectomy, especially for early stage of gastric cancer. Copyright © 2016. Published by Elsevier B.V.

  18. Pregnancy outcome after fetal reduction in women with a dichorionic twin pregnancy

    NARCIS (Netherlands)

    van de Mheen, L.; Everwijn, S. M. P.; Knapen, M. F. C. M.; Haak, M. C.; Engels, M. A. J.; Manten, G. T. R.; Zondervan, H. A.; Wirjosoekarto, S. A. M.; van Vugt, J. M. G.; Erwich, J. J. H. M.; Bilardo, C. M.; van Pampus, M. G.; de Groot, C. J. M.; Mol, B. W. J.; Pajkrt, E.

    2015-01-01

    STUDY QUESTION: What are the pregnancy outcomes for women with a twin pregnancy that is reduced to a singleton pregnancy? summary answer: Fetal reduction of a twin pregnancy significantly improves gestational age at birth and neonatal birthweight, however at an increased risk of pregnancy loss and p

  19. Pregnancy outcome after fetal reduction in women with a dichorionic twin pregnancy

    NARCIS (Netherlands)

    Mheen, L. van de; Everwijn, S.M.; Knapen, M.F.; Haak, M.C.; Engels, M.A.J.; Manten, G.T.; Zondervan, H.A.; Wirjosoekarto, S.A.; Vugt, J.M.G. van; Erwich, J.J.; Bilardo, C.M.; Pampus, M.G. van; Groot, C.J. de; Mol, B.W.; Pajkrt, E.

    2015-01-01

    STUDY QUESTION: What are the pregnancy outcomes for women with a twin pregnancy that is reduced to a singleton pregnancy? SUMMARY ANSWER: Fetal reduction of a twin pregnancy significantly improves gestational age at birth and neonatal birthweight, however at an increased risk of pregnancy loss and p

  20. Maternal diet during early childhood, but not pregnancy, predicts diet quality and fruit and vegetable acceptance in offspring.

    Science.gov (United States)

    Ashman, Amy M; Collins, Clare E; Hure, Alexis J; Jensen, Megan; Oldmeadow, Christopher

    2016-07-01

    Studies have identified prenatal flavour exposure as a determinant of taste preferences in infants; however, these studies have focused on relatively small samples and limited flavours. As many parents struggle with getting children to accept a variety of nutritious foods, a study of the factors influencing food acceptance is warranted. The objective of this study was to determine whether exposure to a wider variety of fruit and vegetables and overall higher diet quality in utero results in acceptance of a greater variety of these foods and better diet quality for offspring during childhood. This study is a secondary data analysis of pregnant women (n = 52) and their resulting offspring recruited for the Women and Their Children's Health study in NSW, Australia. Dietary intake of mothers and children was measured using food frequency questionnaires. Diet quality and vegetable and fruit variety were calculated using the Australian Recommended Food Score and the Australian Child and Adolescent Recommended Food Score. Associations between maternal and child diet quality and variety were assessed using Pearson's correlations and the total effect of in utero maternal pregnancy diet on childhood diet was decomposed into direct and indirect effect using mediation analysis. Maternal pregnancy and post-natal diet were both correlated with child diet for overall diet quality and fruit and vegetable variety (P habits of offspring.

  1. Factors predictive of macrosomia in pregnancies with a positive oral glucose challenge test: importance of fasting plasma glucose.

    Science.gov (United States)

    Legardeur, H; Girard, G; Journy, N; Ressencourt, V; Durand-Zaleski, I; Mandelbrot, L

    2014-02-01

    The study aimed to determine the factors associated with fetal macrosomia following a positive oral glucose challenge test (OGCT). In this retrospective single-centre study of 1268 pregnancies with positive 50-g OGCTs (plasma glucose≥130mg/dL, or 7.2mmol/L), gestational diabetes mellitus (GDM) was defined as fasting plasma glucose (FPG)≥95mg/dL (5.3mmol/L) and/or postprandial glucose (PPG)≥120mg/dL (6.7mmol/L). In GDM pregnancies, the odds ratios adjusted for confounders (age, BMI, ethnicity, parity and weight gain) were 2.02 for macrosomia (Z score≥1.28) and 2.62 for severe macrosomia (Z score≥1.88). For each 10-mg/dL increase in FPG, the mean birth-weight increase was 60g. Macrosomia risk did not differ between GDM patients with normal FPG (macrosomia risk were strongly correlated with FPG, suggesting that it is a simple and efficient marker for the risk of macrosomia. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  2. The use of predictive lithostratigraphy to significantly improve the ability to forecast reservoir and source rocks? Final CRADA report.

    Energy Technology Data Exchange (ETDEWEB)

    Doctor, R. D.; Moore, T. L.; Energy Systems

    2010-06-29

    The purpose of this CRADA, which ended in 2003, was to make reservoir and source rock distribution significantly more predictable by quantifying the fundamental controls on stratigraphic heterogeneity. To do this, the relationships among insolation, climate, sediment supply, glacioeustasy, and reservoir and source rock occurrence were investigated in detail. Work current at the inception of the CRADA had uncovered previously unrecognized associations among these processes and properties that produce a phenomenon that, when properly analyzed, will make lithostratigraphic variability (including texture, porosity, and permeability) substantially more understandable. Computer climate simulations of selected time periods, compared with the global distribution of paleoclimatic indicators, documented spatial and temporal climate changes as a function of insolation and provided quantitative changes in runoff, lake level, and glacioeustasy. The effect of elevation and climate on sediment yield was assessed numerically by analyzing digital terrain and climate data. The phase relationships of climate, yield, and glacioeustatic cycles from the Gulf of Mexico and/or other sedimentary basins were assessed by using lacunarity, a statistical technique.

  3. Data on clinical significance of second trimester inflammatory biomarkers in the amniotic fluid in predicting preterm delivery.

    Science.gov (United States)

    Kesrouani, Assaad; Chalhoub, Elie; El Rassy, Elie; Germanos, Mirna; Khazzaka, Aline; Rizkallah, Jamale; Attieh, Elie; Aouad, Norma

    2016-12-01

    In this article second trimester amniotic fluid biomarkers are measured for correlation with preterm delivery. One additional milliliter of amniotic fluid is collected during amniocentesis for dosages of IL-6, MMP-9, CRP and glucose levels, along with maternal serum CRP and glucose. MMP-9 and Il-6 levels were measured with the corresponding Human Quantikine(R) ELISA Kit (R&D systems) according to the instructions provided by the manufacturer. Cut-off values for AF MMP-9 and IL-6 were fixed by the kit sensitivity thresholds. Data includes ROC curves for glucose (Fig. 1), IL-6 (Fig. 2) and MMP-9 (Fig. 3), aiming to search for sensitivity and specificity in the prediction of premature delivery. Statistical analyses are performed with SPSS v20.0 software. Statistical significance is determined using the Mann-Whitney and one way ANOVA test. The association with preterm delivery is performed using a two proportions test. Correlations are measured using the Pearson׳'s coefficient. A p valueamniotic fluid" (A. Kesrouani, E. Chalhoub, E. El Rassy, M. Germanos, A. Khazzaka, J. Rizkallah, E. Attieh, N. Aouad, 2016) [1].

  4. SIGNIFICANCE OF LACTATE DEHYDROGENASE AND ASPARTATE TRANSAMINASE AS BIOCHEMICAL MARKERS AND AS PREDICTORS OF SEVERITY OF PREGNANCY-INDUCED HYPERTENSION AND ITS COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Ramesh Sonowal

    2017-03-01

    Full Text Available BACKGROUND To compare serum Lactate Dehydrogenase (LDH and serum Aspartate Transaminase (AST of normotensive pregnant women with those of preeclamptic and eclamptic women. To determine the relationship of levels of serum lactate dehydrogenase and serum aspartate transaminase with severity of pregnancy-induced hypertension and its complications. MATERIALSAND METHODS The study was carried out on pregnant hypertensive patients attending outpatient department of Obstetrics and Gynaecology department, AMCH, Dibrugarh, Assam from 1 st July 2013 to 30 th June 2014. Normotensive pregnant women were taken as controls. Each serum sample from both the control group as well as study group was estimated for lactate dehydrogenase and aspartate transaminase using standard methods and a comparison is drawn and analysed using t-test and Chi-square test. RESULTS Serum lactate dehydrogenase and serum aspartate transaminase levels were higher in the study group in comparison to the study groups. The mean serum LDH was 198±30.03U/L in control group, whereas in preeclampsia and eclampsia, mean serum levels of LDH were 817±114U/L and 927±108U/L, respectively. The levels of the serum AST were found to be less than 600U/L in normotensive and preeclampsia patients and more than 600 U/L in eclampsia and other complications of PIH. CONCLUSION Serum lactate dehydrogenase and serum aspartate transaminase levels in patients suffering from preeclampsia and its complications are consistently higher compared to the normotensive pregnant patients. To determine the usefulness of inclusion of these enzymes along with other cardiac enzymes in the panel of investigations of pregnant women universally needs further large scale comparative studies.

  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. Significance of peak height velocity as a predictive factor for curve progression in patients with idiopathic scoliosis

    Science.gov (United States)

    2015-01-01

    progression in patients with IS. Conclusions These findings indicate that 31.5 degrees of spinal curvature when patients are at PHV is a significant predictive indicator for progression of the curve to a magnitude requiring surgery. We suggest that the curve-progression risk assessment in patients with IS should include PHV, along with measures of skeletal and non-skeletal maturities. PMID:25815057

  7. Significance of Vestibular Testing on Distinguishing the Nerve of Origin for Vestibular Schwannoma and Predicting the Preservation of Hearing

    Institute of Scientific and Technical Information of China (English)

    Yu-Bo He; Chun-Jiang Yu; Hong-Ming Ji; Yan-Ming Qu; Ning Chen

    2016-01-01

    Background:Determining the nerve of origin for vestibular schwannoma (VS),as a method for predicting hearing prognosis,has not been systematically considered.The vestibular test can be used to investigate the function of the superior vestibular nerve (SVN) and the inferior vestibular nerve (IVN).This study aimed to preoperatively distinguish the nerve of origin for VS patients using the vestibular test,and determine if this correlated with hearing preservation.Methods:A total of 106 patients with unilateral VS were enrolled in this study prospectively.Each patient received a caloric test,vestibular-evoked myogenic potential (VEMP) test,and cochlear nerve function test (hearing) before the operation and 1 week,3,and 6 months,postoperatively.All patients underwent surgical removal of the VS using the suboccipital approach.During the operation,the nerve of tumor origin (SVN or IVN) was identified by the surgeon.Tumor size was measured by preoperative magnetic resonance imaging.Results:The nerve of tumor origin could not be unequivocally identified in 38 patients (38/106,35.80%).These patients were not subsequently evaluated.In 26 patients (nine females,seventeen males),tumors arose from the SVN and in 42 patients (18 females,24 males),tumors arose from the IVN.Comparing with the nerve of origins (SVN and IVN) of tumors,the results of the caloric tests and VEMP tests were significantly different in tumors originating from the SVN and the IVN in our study.Hearing was preserved in 16 of 26 patients (61.54%) with SVN-originating tumors,whereas hearing was preserved in only seven of 42 patients (16.67%) with IVN-originating tumors.Conclusions:Our data suggest that caloric and VEMP tests might help to identify whether VS tumors originate from the SVN or IVN.These tests could also be used to evaluate the residual function of the nerves after surgery.Using this information,we might better predict the preservation of hearing for patients.

  8. 妊娠期高血压疾病血浆凝血酶生成活性检测的意义%The clinical significance of thrombin detection in hypertensive disorders complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    龚波; 杜景云; 俞菁; 张昕明; 李海川; 李俊; 谭美玉; 王萍

    2011-01-01

    Objective To approach a method of evaluating and predicting the severity and the prognosis of HDP cases by detecting the plasma thrombin formation.Methods Automated fluorogenic substrate analysis was used to analyze thrombin formation rate and amount in 32 cases of gestational hypertension, 35 cases of moderate pre-eclampsia, 38 cases of severe pre-eclampsia, and 50 cases of midterm or late-term normal pregnancy in the Shanghai Changning Miaternity & Infant Health Hospital between January 2004 and December 2009.Results Normal pregnancy thrombin peaked at (362.0 ± 29.6) mol/L, in HDP was ( 385.0 ± 33.5 ) nmol/L, in mild pre-eclampsia thrombin was ( 412.0 ± 41.5 )nmol/L, severe pre-eclampsia thrombin was (624.0 ± 67.6)nmol/L.mild and severe pre-eclampsia thrombin was substantially elevated when compared with normal pregnancy ( P < 0.05, P < 0.01 ).Thrombin elevation also accompanied with fibrinogen and decomposed D-dimer(D-D) change, in severe pre-eclampsia thrombin formation amount peaked and fibrinogen showed significant correlation ( r = 0.894, P < 0.05 ).Conclusion Mild and severe pre-eclampsia patients showed different degree of Prethrombotic state, especially in severe pre-eclampsia.Special precaution should be taken for these patients to prevent DIC occurrence.%目的 探讨妊娠期高血压疾病(HDP)患者应用血浆凝血酶生成活性.判断HDP患者病情发展及预后.方法 2004年1月至2009年12月对上海市长宁区妇幼保健院、上海市宝山区罗店医院住院的妊娠妇女应用荧光发色底物分析方法,对妊娠期高血压疾病患者32例、轻度子痫前期35例、重度子痫前期38例(其中4例围产期发生急性DIC)和正常晚期孕妇50例血浆凝血酶生成活性进行检测.测定分析各组研究对象凝血酶生成的量和速度,并进行比较研究.结果 正常孕妇凝血酶生成峰值为(362.0±29.6)nmoL/L,妊娠期高血压疾病为(385.0±33.5)nmol/L,轻度子痫前期为(412.0±41.5)nmoL

  9. Non-invasive prediction of blastocyst implantation, ongoing pregnancy and live birth, by mass spectrometry lipid fingerprinting.

    Science.gov (United States)

    Borges, Edson; Braga, Daniela P A F; Setti, Amanda Souza; Montanni, Daniela A; Cabral, Elaine Cristina; Eberlin, Marcos N; Turco, Edson G Lo; Iaconelli, Assumpto

    2016-12-01

    To identify lipid markers of blastocyst implantation and ongoing pregnancy by day three culture medium mass spectrometry (MS) fingerprinting. For this study, 33 culture media samples were harvested on day three, from 22 patients undergoing day five embryo transfers. All embryos achieved the blastocyst stage and were split into groups based on their implantation (Negative Implantation, n= 14 and Positive Implantation, n= 19). The positive implantation cycles resulted in successful ongoing pregnancies. The lipid extraction was performed by the Bligh-Dyer protocol and mass spectra were obtained with a direct infusion into a Q-Tof mass spectrometer. The data obtained was analyzed by Principal Component Analysis (PCA) and Partial Least Square Discrimination Analysis (PLS-DA). The statistical analysis was performed using the Metabo-Analyst 2.0. The variable importance in the projection (VIP) plot of the PLS-DA provided a list of four ions, in the positive mode, with an area under the curve (AUC) of 73.5%; and eight ions, in the negative mode, with and AUC of 72.0%. For both positive and negative modes, possible biomarkers for the negative implantation were identified by the lipidmaps: phosphoethanolamine, dicarboxylic acids, glycerophosphoglycerol, glycerophosphocholine, glicerophosphoinositol, phosphoethanolamine and unsaturated fat acids. The other ions were not identified. These lipids are involved in the GPI anchor biosynthesis and synthesis of lycerophospholipids and phosphate inositol. MS fingerprinting is useful to identify blastocysts that fail to implant, and therefore this technique could be incorporated into the laboratory routine, adjunct to morphology evaluation to identify embryos that should not be transferred.

  10. Non-invasive prediction of blastocyst implantation, ongoing pregnancy and live birth, by mass spectrometry lipid fingerprinting

    Science.gov (United States)

    Borges Jr., Edson; Braga, Daniela P.A.F.; Setti, Amanda Souza; Montanni, Daniela A.; Cabral, Elaine Cristina; Eberlin, Marcos N.; Turco, Edson G. Lo; Iaconelli Jr, Assumpto

    2016-01-01

    Objective To identify lipid markers of blastocyst implantation and ongoing pregnancy by day three culture medium mass spectrometry (MS) fingerprinting. Methods For this study, 33 culture media samples were harvested on day three, from 22 patients undergoing day five embryo transfers. All embryos achieved the blastocyst stage and were split into groups based on their implantation (Negative Implantation, n= 14 and Positive Implantation, n= 19). The positive implantation cycles resulted in successful ongoing pregnancies. The lipid extraction was performed by the Bligh-Dyer protocol and mass spectra were obtained with a direct infusion into a Q-Tof mass spectrometer. The data obtained was analyzed by Principal Component Analysis (PCA) and Partial Least Square Discrimination Analysis (PLS-DA). The statistical analysis was performed using the Metabo-Analyst 2.0. Results The variable importance in the projection (VIP) plot of the PLS-DA provided a list of four ions, in the positive mode, with an area under the curve (AUC) of 73.5%; and eight ions, in the negative mode, with and AUC of 72.0%. For both positive and negative modes, possible biomarkers for the negative implantation were identified by the lipidmaps: phosphoethanolamine, dicarboxylic acids, glycerophosphoglycerol, glycerophosphocholine, glicerophosphoinositol, phosphoethanolamine and unsaturated fat acids. The other ions were not identified. These lipids are involved in the GPI anchor biosynthesis and synthesis of lycerophospholipids and phosphate inositol. Conclusion MS fingerprinting is useful to identify blastocysts that fail to implant, and therefore this technique could be incorporated into the laboratory routine, adjunct to morphology evaluation to identify embryos that should not be transferred. PMID:28050958

  11. Patient-specific metrics of invasiveness reveal significant prognostic benefit of resection in a predictable subset of gliomas.

    Directory of Open Access Journals (Sweden)

    Anne L Baldock

    Full Text Available Malignant gliomas are incurable, primary brain neoplasms noted for their potential to extensively invade brain parenchyma. Current methods of clinical imaging do not elucidate the full extent of brain invasion, making it difficult to predict which, if any, patients are likely to benefit from gross total resection. Our goal was to apply a mathematical modeling approach to estimate the overall tumor invasiveness on a patient-by-patient basis and determine whether gross total resection would improve survival in patients with relatively less invasive gliomas.In 243 patients presenting with contrast-enhancing gliomas, estimates of the relative invasiveness of each patient's tumor, in terms of the ratio of net proliferation rate of the glioma cells to their net dispersal rate, were derived by applying a patient-specific mathematical model to routine pretreatment MR imaging. The effect of varying degrees of extent of resection on overall survival was assessed for cohorts of patients grouped by tumor invasiveness.We demonstrate that patients with more diffuse tumors showed no survival benefit (P = 0.532 from gross total resection over subtotal/biopsy, while those with nodular (less diffuse tumors showed a significant benefit (P = 0.00142 with a striking median survival benefit of over eight months compared to sub-totally resected tumors in the same cohort (an 80% improvement in survival time for GTR only seen for nodular tumors.These results suggest that our patient-specific, model-based estimates of tumor invasiveness have clinical utility in surgical decision making. Quantification of relative invasiveness assessed from routinely obtained pre-operative imaging provides a practical predictor of the benefit of gross total resection.

  12. The effect of pregnancy on metabolic responses during rest, immersion, and aerobic exercise in the water.

    Science.gov (United States)

    McMurray, R G; Katz, V L; Berry, M J; Cefalo, R C

    1988-03-01

    To examine the effects of advancing pregnancy on metabolic responses, 12 women, who were recruited early in pregnancy, were studied during 20 minutes of immersion in 30 degrees C water, followed by 20 minutes of exercise in the water (60% of predicted maximal capacity) and 20 minutes of lateral supine recovery. Each subject completed the trials during the fifteenth, twenty-fifth, and thirty-fifth weeks of pregnancy, as well as a control period 8 to 10 weeks post partum. Resting oxygen uptake increased with advancing pregnancy. Resting oxygen uptake was higher in the water than on land but was not altered by pregnancy. Exercise oxygen uptakes were similar for all trials, but the work load required to elicit the VO2 decreased during the thirty-fifth week of pregnancy. Exercise heart rates followed the same pattern as oxygen uptake. Lactate concentrations declined with advancing pregnancy after exercise. Blood glucose levels were normal for pregnancy but declined slightly during exercise. Blood triglyceride levels were elevated with exercise, with a tendency to increase with advancing pregnancy. Resting plasma cortisol concentrations increased with pregnancy but remained lower during immersion and exercise. These results suggest that pregnancy significantly alters metabolic responses to exercise in the water.

  13. 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 ...

  14. 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. ...

  15. 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 ...

  16. 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 ...

  17. 孕妇外周血中有核红细胞数与妊娠期高血压疾病的关系%To Predict Hypertention by Pregnancy in Counting Nuclear Red Blood Cells in Peripheral Blood

    Institute of Scientific and Technical Information of China (English)

    刘丽平; 龚瑞龙; 周洁琼; 戴翔; 宋晓婕

    2016-01-01

    目的:通过比较正常孕妇和妊娠期高血压疾病孕妇外周血中胎儿有核红细胞数量,了解孕妇外周血中胎儿有核红细胞数量变化与妊娠期高血压疾病之间的关系。方法:收集69例孕12~18周孕妇外周血,采用密度梯度离心法分离外周单个核细胞后使用 PE-GPA/FITC-CD71单克隆抗体标记胎儿有核红细胞后进行流式细胞计数,分析其与妊娠期高血压疾病之间的关联性。结果:妊娠期高血压疾病患者外周血中胎儿有核红细胞较正常妊娠者增多,对照组和病例组中 GPA+/CD71+百分比分别为(0.89±0.81)%和(3.57±3.48)%,其差异具有统计学意义(P <0.05)。结论:妊娠期高血压疾病患者外周血中胎儿有核红细胞增多,孕妇外周血中胎儿有核红细胞增加提示有患妊娠期高血压疾病的可能,应积极采取干预措施。%Objective To predict the Hypertention by pregnancy in counting nuclear red blood cells pe-ripheral blood. Methods Blood samples were obtained from 69 pregnant women with the gestational age from 12 to 18 weeks. Peripheral blood mononuclear cells were isolated by density gradient centrifugation and then analyzed the cells marked with PE-GPA/FITC-CD71 monoclonal antibodies on the flow cytometer. Correlations between them were analyzed after tracking of hypertention by pregnancy. Results Percentage of GPA+/CD71+ cells in healthy pregnant women was 0.89 ± 0.81%, while that in pregnant women with hypertention was 3.57 ± 3.48%. There was a significant difference between the two groups (P<0.05), and the percentage of GPA+/CD71+cells in the group of hypertention by pregnancy was much higher than that in the healthy group. Conclusions The increased nuclear red blood cells in maternal peripheral blood related to hypertention by pregnancy. The counting of nuclear red blood cells in maternal peripheral blood have potential value to predict hypertention by

  18. Short inter-pregnancy intervals, parity, excessive pregnancy weight gain and risk of maternal obesity.

    Science.gov (United States)

    Davis, Esa M; Babineau, Denise C; Wang, Xuelei; Zyzanski, Stephen; Abrams, Barbara; Bodnar, Lisa M; Horwitz, Ralph I

    2014-04-01

    To investigate the relationship among parity, length of the inter-pregnancy intervals and excessive pregnancy weight gain in the first pregnancy and the risk of obesity. Using a prospective cohort study of 3,422 non-obese, non-pregnant US women aged 14-22 years at baseline, adjusted Cox models were used to estimate the association among parity, inter-pregnancy intervals, and excessive pregnancy weight gain in the first pregnancy and the relative hazard rate (HR) of obesity. Compared to nulliparous women, primiparous women with excessive pregnancy weight gain in the first pregnancy had a HR of obesity of 1.79 (95% CI 1.40, 2.29); no significant difference was seen between primiparous without excessive pregnancy weight gain in the first pregnancy and nulliparous women. Among women with the same pregnancy weight gain in the first pregnancy and the same number of inter-pregnancy intervals (12 and 18 months or ≥18 months), the HR of obesity increased 2.43-fold (95% CI 1.21, 4.89; p = 0.01) for every additional inter-pregnancy interval of pregnancy intervals. Among women with the same parity and inter-pregnancy interval pattern, women with excessive pregnancy weight gain in the first pregnancy had an HR of obesity 2.41 times higher (95% CI 1.81, 3.21; p obesity risk unless the primiparous women had excessive pregnancy weight gain in the first pregnancy, then their risk of obesity was greater. Multiparous women with the same excessive pregnancy weight gain in the first pregnancy and at least one additional short inter-pregnancy interval had a significant risk of obesity after childbirth. Perinatal interventions that prevent excessive pregnancy weight gain in the first pregnancy or lengthen the inter-pregnancy interval are necessary for reducing maternal obesity.

  19. The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy-related morbidity.

    LENUS (Irish Health Repository)

    Khalid, S

    2012-05-01

    The aim of this study was to determine if the individual physical characteristics of the extirpated transformation zone after large loop excision of the transformation zone (LLETZ) might predict the relative risk of adverse obstetric outcome, specifically preterm labour (PTL).

  20. Dopplervelocimetria do ducto venoso na predição da acidemia fetal Ductus venosus Doppler velocimetry to predict acidemia at birth in pregnancies with placental insufficiency

    Directory of Open Access Journals (Sweden)

    Francisco Herlânio C. Carvalho

    2005-08-01

    investigate the possibility of predicting acidemia at birth in pregnancies with placental insufficiency by Doppler velocimetry of the ductus venosus and to establish the best parameter and cut-off points in this prediction. METHODS: This was a prospective cross-sectional study, involving 47 single pregnancies with placental insufficiency after 26 weeks of gestation, carried out at the "Hospital São Paulo (UNIFESP and Maternidade-Escola Assis Chateaubriand (UFC". Placental insufficiency was defined as the umbilical artery pulsatility index above the 95th percentile for gestational age. Fetuses with chromosomal or structural anomalies were excluded. The time interval between the Doppler velocimetry and the birth was of less than 24 hours. The umbilical arterial blood samples were collected immediately after birth. Acidemia was defined as umbilical arterial pH < 7.2 in the absence of uterine contractions and < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth was considered pathological. Receiver operating characteristics (ROC curves were calculated for S, D and A-velocities, pulsatility index for veins and the S/A ratio and (S-A/S ratio of the ductus venosus. Parameters were compared using the MacNemar Test RESULTS: S, D and A-velocities of the ductus venosus were poor predictors of acidemia at birth. The pulsatility index for veins (area under the curve 0.79, p=0.003, S/A ratio and (S-A/S ratio (area under the curve 0.818, p=0.001 of the DV were strongly related to fetal acidemia. The cut-off points calculated were: pulsatility index for veins = 0.76; S/A ratio = 2.67 and (S-A/S ratio = 0.63. CONCLUSIONS: The angle-independent indices of the DV Doppler are adequate for the diagnosis of fetal acidemia in gestations with placental insufficiency. No statistically significant differences were observed between these parameters.

  1. The Research Development Summary of Predicting Ectopic Pregnancy with Serum Markers%血清标志物预测异位妊娠的研究进展综述

    Institute of Scientific and Technical Information of China (English)

    冯静

    2016-01-01

    临床上异位妊娠就是指在妊娠的过程中,受精卵在子宫腔外着床,为妊娠早期孕妇死亡的主要危险因素。对异位妊娠实施早期准确诊断可有效降低死亡率。现阶段对血清标志物进行检测在异位妊娠早期预测和诊断中研究不断深入。本文从人绒毛膜促性腺激素、CA125抗原2个血清指标对异位妊娠的早期预测价值方面进行了阐述。%Clinically,ectopic pregnancy refers to that,in the process of pregnancy,the fertilized egg im-plants outside the uterine cavity,which is a main risk factor for the death of pregnant women in early preg-nancy.Early diagnosis of ectopic pregnancy can effectively reduce the mortality rate.At the present stage,the detection of serum markers in the early diagnosis and early diagnosis of ectopic pregnancy has been studied.In this paper,the early predictive value of human chorionic gonadotropin and CA125 antigen to the early predic-tion of ectopic pregnancy were described in this paper.

  2. Significance of vapor phase chemical reactions on CVD rates predicted by chemically frozen and local thermochemical equilibrium boundary layer theories

    Science.gov (United States)

    Gokoglu, Suleyman A.

    1988-01-01

    This paper investigates the role played by vapor-phase chemical reactions on CVD rates by comparing the results of two extreme theories developed to predict CVD mass transport rates in the absence of interfacial kinetic barrier: one based on chemically frozen boundary layer and the other based on local thermochemical equilibrium. Both theories consider laminar convective-diffusion boundary layers at high Reynolds numbers and include thermal (Soret) diffusion and variable property effects. As an example, Na2SO4 deposition was studied. It was found that gas phase reactions have no important role on Na2SO4 deposition rates and on the predictions of the theories. The implications of the predictions of the two theories to other CVD systems are discussed.

  3. Late pregnancies outcome: assessment of the obstetrical risks at the university hospital of gynaecology and obstetrics, Befelatanana, Madagascar

    Directory of Open Access Journals (Sweden)

    Val and eacute;ry B. Andriantoky

    2014-04-01

    Conclusions: Advanced maternal age is a significant risk factor of bad pregnancy outcome. Therefore, monitoring of pregnancy for these women should be far more rigorous in order to identify and manage often predictable complications in this situation. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 310-316

  4. 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 ...

  5. 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? ...

  6. 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.

  7. Detecting reliable non interacting proteins (NIPs) significantly enhancing the computational prediction of protein-protein interactions using machine learning methods.

    Science.gov (United States)

    Srivastava, A; Mazzocco, G; Kel, A; Wyrwicz, L S; Plewczynski, D

    2016-03-01

    Protein-protein interactions (PPIs) play a vital role in most biological processes. Hence their comprehension can promote a better understanding of the mechanisms underlying living systems. However, besides the cost and the time limitation involved in the detection of experimentally validated PPIs, the noise in the data is still an important issue to overcome. In the last decade several in silico PPI prediction methods using both structural and genomic information were developed for this purpose. Here we introduce a unique validation approach aimed to collect reliable non interacting proteins (NIPs). Thereafter the most relevant protein/protein-pair related features were selected. Finally, the prepared dataset was used for PPI classification, leveraging the prediction capabilities of well-established machine learning methods. Our best classification procedure displayed specificity and sensitivity values of 96.33% and 98.02%, respectively, surpassing the prediction capabilities of other methods, including those trained on gold standard datasets. We showed that the PPI/NIP predictive performances can be considerably improved by focusing on data preparation.

  8. Hypertension in pregnancy.

    Science.gov (United States)

    Lindheimer, Marshall D; Taler, Sandra J; Cunningham, F Gary

    2010-01-01

    Hypertension complicates 5% to 7% of all pregnancies. A subset of preeclampsia, characterized by new-onset hypertension, proteinuria, and multisystem involvement, is responsible for substantial maternal and fetal morbidity and is a marker for future cardiac and metabolic disease. This American Society of Hypertension (ASH) position paper summarizes the clinical spectrum of hypertension in pregnancy, focusing on preeclampsia. Recent research breakthroughs relating to etiology are briefly reviewed. Topics include classification of the different forms of hypertension during pregnancy, and status of the tests available to predict preeclampsia, and strategies to prevent preeclampsia and to manage this serious disease. The use of antihypertensive drugs in pregnancy, and the prevention and treatment of the convulsive phase of preeclampsia, eclampsia, with intravenous MgSO(4) is also highlighted. Of special note, this guideline article, specifically requested, reviewed, and accepted by ASH, includes solicited review advice from the American College of Obstetricians and Gynecologists.

  9. Variation of DNA Fragmentation Levels During Density Gradient Sperm Selection for Assisted Reproduction Techniques: A Possible New Male Predictive Parameter of Pregnancy?

    Science.gov (United States)

    Muratori, Monica; Tarozzi, Nicoletta; Cambi, Marta; Boni, Luca; Iorio, Anna Lisa; Passaro, Claudia; Luppino, Benedetta; Nadalini, Marco; Marchiani, Sara; Tamburrino, Lara; Forti, Gianni; Maggi, Mario; Baldi, Elisabetta; Borini, Andrea

    2016-05-01

    Predicting the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) is one main goal of the present research on assisted reproduction. To understand whether density gradient centrifugation (DGC), used to select sperm, can affect sperm DNA integrity and impact pregnancy rate (PR), we prospectively evaluated sperm DNA fragmentation (sDF) by TUNEL/PI, before and after DGC. sDF was studied in a cohort of 90 infertile couples the same day of IVF/ICSI treatment. After DGC, sDF increased in 41 samples (Group A, median sDF value: 29.25% [interquartile range, IQR: 16.01-41.63] in pre- and 60.40% [IQR: 32.92-93.53] in post-DGC) and decreased in 49 (Group B, median sDF value: 18.84% [IQR: 13.70-35.47] in pre- and 8.98% [IQR: 6.24-15.58] in post-DGC). PR was 17.1% and 34.4% in Group A and B, respectively (odds ratio [OR]: 2.58, 95% confidence interval [CI]: 0.95-7.04, P = 0.056). After adjustment for female factor, female and male age and female BMI, the estimated OR increased to 3.12 (95% CI: 1.05-9.27, P = 0.041). According to the subgroup analysis for presence/absence of female factor, heterogeneity in the association between the Group A and B and PR emerged (OR: 4.22, 95% CI: 1.16-15.30 and OR: 1.53, 95% CI: 0.23-10.40, respectively, for couples without, n = 59, and with, n = 31, female factor).This study provides the first evidence that the DGC procedure produces an increase in sDF in about half of the subjects undergoing IVF/ICSI, who then show a much lower probability of pregnancy, raising concerns about the safety of this selection procedure. Evaluation of sDF before and after DGC configures as a possible new prognostic parameter of pregnancy outcome in IVF/ICSI. Alternative sperm selection strategies are recommended for those subjects who undergo the damage after DGC.

  10. 国家免费孕前优生检查及风险评估的意义%The state of free pre pregnancy examination and risk assessment of the significance of

    Institute of Scientific and Technical Information of China (English)

    周峰

    2015-01-01

    Objective To explore the content and effect of risk assessment of free national pre-pregnancy eugenics. Methods 1025 couples who planned pregnancy in our county were provided with pre-pregnancy eugenics service, their pregnancy risk factors were evaluated, and the satisfaction survey was also conducted. Results Among 1025 females in the examination, 168 females had a history of adverse pregnancy. 111 males and 90 females had abnormal indicators. Diseases leading to high pregnancy risk included:2 cases of TB infection and 1 case of epilepsy among males;38 cases of gynecologic inflammation, 3 cases of thyroid disease, 35 cases of hypertension, 17 cases of diabetes and fasting blood glucose, 47 cases of obesity, and 41 cases of advanced age among females. 60 males and 66 females had high risk factors of family history;118 males and 49 females had high environmental risk factors. The follow-up visits lasted for 6 months to 2 years, and 86 cases of follow-up visits were lost. The follow up results:541 cases of unpregnancy, 398 cases of pregnancy, 176 cases of delivery, 161 cases of full term, 2 cases of premature delivery, 7 cases of spontaneous abortion, and 6 cases of induced abortion. The satisfaction survey was conducted among 100 patients and the total satisfaction was 67.2%, with 81.2%selecting convenience, 76.1%selecting comprehensive examination, 61.7% selecting good communication, 64.2% selecting good technology, 70.5%selecting good service attitude, and 49.7%selecting high service efficiency. Conclusion The promotion of free national pre-pregnancy eugenics inspection and risk assessment can improve the effect of eugenics work and protect the safety of mothers and newborns, and has positive significance for society and families. The communication and service efficiency of the pre-pregnancy eugenics need to be improved.%目的:探讨国家免费孕前优生中的风险评估内容和效果。方法对我县1025对计划妊娠的夫妇提供了孕前优生服

  11. Ursodeoxycholic acid therapy in intrahepatic cholestasis of pregnancy: Results in real-world conditions and factors predictive of response to treatment.

    Science.gov (United States)

    Bacq, Yannick; le Besco, Matthieu; Lecuyer, Anne-Isabelle; Gendrot, Chantal; Potin, Jérôme; Andres, Christian R; Aubourg, Alexandre

    2017-01-01

    Ursodeoxycholic acid (UDCA) therapy is commonly used in intrahepatic cholestasis of pregnancy (ICP). To evaluate the efficacy and tolerance of UDCA in real-world conditions and to search for factors predictive of response to treatment. This observational study included 98 consecutive patients suffering from pruritus during pregnancy associated with increased ALT levels or total bile acid (TBA) concentrations, without other causes of cholestasis. The entire ABCB4 gene coding sequence was analyzed by DNA sequencing. UDCA was prescribed until delivery in all patients (mean dose 14.0mg/kg/day; mean duration 30.4 days). Pruritus improved in 75/98 (76.5%) patients, and totally disappeared before delivery in 25/98 (25.5%). After 2-3 weeks of treatment, ALT levels decreased by more than 50% of base line in 67/86 (77.9%) patients and normalized in 34/86 (39.5%), and TBA concentrations decreased in 28/81 (34.6%). Only one patient stopped the treatment before delivery. On multivariate analysis, ALT >175IU/l before treatment was associated with improvement of pruritus (OR 2.97, 95% CI 1.12-7.89, P=0.029) and with decreased ALT (OR 18.61, 95% CI 3.94-87.99, P=0.0002). ABCB4 gene mutation was not associated with response to treatment. This study supports the use of UDCA as first line therapy in ICP. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort.

    Directory of Open Access Journals (Sweden)

    Lesley M E McCowan

    Full Text Available OBJECTIVE: Small for gestational age (SGA infants comprise up to 50% of all stillbirths and a minority are detected before birth. We aimed to develop and validate early pregnancy predictive models for SGA infants. METHODS: 5628 participants from SCOPE, a prospective study of nulliparous pregnant women, were interviewed at 15 ± 1 weeks' gestation. Fetal anthropometry, uterine and umbilical Doppler studies were performed at 20 ± 1 weeks'. The cohort was divided into training (n = 3735 and validation datasets (n = 1871. All-SGA (birthweight 12 months to conceive, university student, cigarette smoking, proteinuria, daily vigorous exercise and diastolic blood pressure ≥ 80. Recreational walking ≥ 4 times weekly, rhesus negative blood group and increasing random glucose were protective. AUC for clinical risk factors was 0.63. Fetal abdominal or head circumference z scores <10(th centile and increasing uterine artery Doppler resistance at 20 ± 1 weeks' were associated with increased risk. Addition of these parameters increased the AUC to 0.69. Clinical predictors of Normotensive and Hypertensive-SGA were sub-groups of All-SGA predictors and were quite different. The combined clinical and ultrasound AUC for Normotensive and Hypertensive-SGA were 0.69 and 0.82 respectively. CONCLUSION: Predictors for SGA of relevance to clinical practice were identified. The identity and predictive potential differed in normotensive women and those who developed hypertension.

  13. Changes and clinical significance of concentration of serum total homocysteine in patients with pregnancy induced hypertension%妊娠高血压综合征患者血清总同型半胱氨酸的变化

    Institute of Scientific and Technical Information of China (English)

    韦淑琴; 郑建华; 刘亚星; 邹丽红; 石大维

    2001-01-01

    目的 检测妊娠高血压综合征(妊高征)患者外周血中总同型半胱氨酸(tHcy)的水平,并探讨其与妊高征发病的关系。方法 应用高效液相色谱电化学检测(HPLC-ED)法检测未妊娠妇女、正常妊娠妇女以及妊高征患者血清中tHcy的水平。结果 ①非妊娠组的tHcy水平[(7.89±2.62)mol/L]与正常妊娠组[(5.91±1.96)μmol/L]相比较,差异有极显著性(P<0.001);正常妊娠组在孕中期tHcy水平[(5.23±1.88)μmol/L]降至最低。②妊高征组tHcy水平[(9.40±3.06)μmol/L]明显高于正常妊娠组(P<0.001),与非妊娠组妇女相比较,tHcy水平呈逐渐升高趋势(P值分别小于0.05,0.01,0.001);并随妊高征病情的加重,tHcy水平呈逐渐上升趋势,重度妊高征明显高于轻度妊高征(P<0.05)。结论 妊娠后tHcy水平显著升高可能是妊高征发病机制中的一个重要因素。%Objective To determine the changes in serum total homocysteine(tHcy) concentration that occur in patients with pregnancy induced hypertension (PIH),to explore the relationship between serum tHcy and pathogenesis of PIH.Methods Serum tHcy concentrations were measured in 30 healthy nonpregnant women (nonpregnancy group),36 normal pregnant women (normal pregnancy group) and 42 women with PIH (PIH group) by high-pressure liquid chromatography (HPLC) with electrochemical detection.Results ① Serum tHcy concentrations were significantly lower in normal pregnancy group,(5.91±1.96)μmol/L than those in nonpregnancy group,(7.89±2.62)μmol/L (P<0.001),the lowest level in the second trimester of pregnancy,(5.23±1.88)μmol/L.②Serum tHcy concentrations,(9.40±3.06)μmol/L in PIH group were significantly higher than those in normal pregnancy group,(5.91±1.96)μmol/L(P<0.001).There was a trend that serum tHcy concentrations in PIH group gradually increased as compared with nonpregnancy group(P<0.05,0.01,0

  14. Spatially resolved flux measurements of NOX from London suggest significantly higher emissions than predicted by inventories

    OpenAIRE

    Vaughan, Adam R.; Lee, James D; Misztal, Pawel K.; Metzger, Stefan; Shaw, Marvin D.; Alastair C. Lewis; Purvis, Ruth M.; Carslaw, David C.; Allen H. Goldstein; Hewitt, C. Nicholas; Davison, Brian; Beevers, Sean D.; Karl, Thomas G.

    2016-01-01

    To date, direct validation of city-wide emissions inventories for air pollutants has been difficult or impossible. However, recent technological innovations now allow direct measurement of pollutant fluxes from cities, for comparison with emissions inventories, which are themselves commonly used for prediction of current and future air quality and to help guide abatement strategies. Fluxes of NOx were measured using the eddy-covariance technique from an aircraft flying at low altitude over Lo...

  15. Do uterine natural killer cell numbers in peri-implantation endometrium predict hypertensive disorder in pregnancy in women with a history of reproductive failure?

    Science.gov (United States)

    Wong, Alice Wai Yee; Archer, Bethan; Mariee, Najat; Li, Tin Chiu; Laird, Susan M

    2014-12-01

    The aim of this study was to investigate whether or not increased uterine natural killer (uNK) cell numbers in the peri-implantation endometrium are associated with an increased risk of hypertensive disorders in a subsequent pregnancy. This is a retrospective study including 80 women with a history of unexplained recurrent miscarriage or recurrent implantation failure. Precisely timed endometrial biopsies were obtained from women 7-9 days after the luteinising hormone surge. uNK cells were immunostained for CD56+ and expressed as a percentage of total stromal cells. Patients were defined as having a high uNK cell count if the percentage of total stromal cells was more than 13.9%. Five out of 29 (17.2%) women in the high uNK cell count group and 5 out of 51 (9.8%) women in the normal uNK cell count group developed gestational hypertension. Pre-eclampsia was diagnosed in 2 (6.9%) patients in the high uNK cell count group and 1 (2.0%) patient from the normal uNK cell count group. There was no significant difference in the incidence of either gestational hypertension (P=0.483) and pre-eclampsia (P=0.296) between groups. The overall incidence of hypertensive disease in women with high uNK cell count (24.1%) was two times higher than women with normal uNK cell count (11.8%), but it was not statistically significant (P=0.208). An increased uNK cells count in the peri-implantation period in a cycle prior to conception did not appear to significantly increase the likelihood of hypertensive disease of pregnancy.

  16. Teenage pregnancy: the impact of maternal adolescent childbearing and older sister's teenage pregnancy on a younger sister.

    Science.gov (United States)

    Wall-Wieler, Elizabeth; Roos, Leslie L; Nickel, Nathan C

    2016-05-25

    Risk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother's teenage childbearing or an older sister's teenage pregnancy more strongly predicts teenage pregnancy. This study used linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP). The original cohort consisted of 17,115 women born in Manitoba between April 1, 1979 and March 31, 1994, who stayed in the province until at least their 20(th) birthday, had at least one older sister, and had no missing values on key variables. Propensity score matching (1:2) was used to create balanced cohorts for two conditional logistic regression models; one examining the impact of an older sister's teenage pregnancy and the other analyzing the effect of the mother's teenage childbearing. The adjusted odds of becoming pregnant between ages 14 and 19 for teens with at least one older sister having a teenage pregnancy were 3.38 (99 % CI 2.77-4.13) times higher than for women whose older sister(s) did not have a teenage pregnancy. Teenage daughters of mothers who had their first child before age 20 had 1.57 (99 % CI 1.30-1.89) times higher odds of pregnancy than those whose mothers had their first child after age 19. Educational achievement was adjusted for in a sub-population examining the odds of pregnancy between ages 16 and 19. After this adjustment, the odds of teenage pregnancy for teens with at least one older sister who had a teenage pregnancy were reduced to 2.48 (99 % CI 2.01-3.06) and the odds of pregnancy for teen daughters of teenage mothers were reduced to 1.39 (99 % CI 1.15-1.68). Although both were significant, the relationship between an older sister's teenage pregnancy and a younger sister's teenage pregnancy is much stronger than that between a mother's teenage childbearing and a younger daughter's teenage pregnancy. This study contributes to understanding of the broader topic "who is

  17. 胎儿纤维连接蛋白联合宫颈长度检测对双胎妊娠早产的预测价值%Study on the predictive value of fetal fibronectin combined with measurement of cervical length in detection of premature birth of twin ;pregnancy

    Institute of Scientific and Technical Information of China (English)

    郝静; 李彦军

    2016-01-01

    Objective To explore the predictive value of combined detection of fetal fibronectin( fFN)and measurement of length of cer-vical tube( CL)in detecion of premature birth of twin pregnancy. Methods The clinical data of 64 cases of twin pregnancy in pregnant women with vaginal fornix secretion for detection of fetal fibronectin( fFN)during 26 to 32 weeks,and color Doppler ultrasound had been applied for de-tection of length of cervical tube in this hospital were collected and their outcomes of pregnancy were predicted. The sensitivity,specificity and pos-itive predictive value of fFN and CL were observed and combined with prediction of preterm delivery in twin pregnancy. Results In the positive predictive value of fFN and CL in twin pregnancy and preterm delivery,its sensitivity was 73. 33%,specificity was 65. 31%,and positive predic-tive value was 39. 29%. The significance of length of cervical tube equal to or less than 25 mm had been applied for prediction of premature birth of twin pregnancy and its sensitivity for preterm delivery was 68. 42%,its specificity was 62. 22% and its positive predictive value was 43. 33%. The sensitivity of combination detection was 84. 62%,its specificity was 94. 74%,and its positive predictive value was 91. 67%,and the differ-ence in sensitivitty of detection with combination of positive fFN and CL≤25 was not significant,and the difference in specificity and positive pre-dictive value was statistically significant( P ﹤0. 05). Conclusion For twin pregnancy,the specificity and positive predictive value of fFN detec-tion combined with ultrasound measurement of length of cervical tube have been applied for prediction of premature birth of twin pregnancy,al-though the difference in sensitivity is not significant,but their specificity and positive predictive value in prediction of preterm delivery have statisti-cal difference and clinical significance in application for prediction of preterm delivery. of twin pregnancy.%目的:探

  18. 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.

  19. Dreams of Tigers and Flowers: Child Gender Predictions and Preference in an Urban Mainland Chinese Sample during Pregnancy

    Science.gov (United States)

    Loo, Kek Khee; Luo, Xiying; Su, Hong; Presson, Angela; Li, Yan

    2009-01-01

    In an urban, mainland Chinese sample, we investigated expectant mothers’ stated gender preference for a boy or girl child, their conjectures on the fetal gender, the culture-specific beliefs for making their predictions, and their relations to sociodemographic variables. A total of 174 women were interviewed at 12–19 weeks gestation. Among 84 women who made a prediction on gender, 56 (67%) thought they were carrying a boy, and 28 (33%) expected a girl. The most frequent reasons cited for their speculation were personal feelings (36%), food/taste preference (13%), feedback from others (13%), somatic responses (13%) and dreams (7%). Out of 63 women who stated a wish for a boy or girl child, 45 (71%) wished for a girl and 18 (29%) wished for a boy. Women with undergraduate or graduate degrees were more likely to indicate a preference for boys. Older expectant mothers were more likely to report that they thought they were carrying boys. In conclusion, the majority of the women did not state a distinct choice for gender of the child. When they expressed a gender preference, more mothers expressed a desire to have a girl. However, boy child conjectures were more frequent than girl child conjectures. Greater boy child preference and prediction among the most highly educated and older expectant mothers might be reflective of implicit social status in having sons in urban China. PMID:19485234

  20. Dreams of tigers and flowers: child gender predictions and preference in an urban mainland Chinese sample during pregnancy.

    Science.gov (United States)

    Loo, Kek Khee; Luo, Xiying; Su, Hong; Presson, Angela; Li, Yan

    2009-01-01

    In an urban, mainland Chinese sample, we investigated expectant mothers' stated gender preference for a boy or girl child, their conjectures on the fetal gender, the culture-specific beliefs for making their predictions, and their relations to sociodemographic variables. A total of 174 women were interviewed at 12-19 weeks gestation. Among 84 women who made a prediction on gender, 56 (67%) thought they were carrying a boy, and 28 (33%) expected a girl. The most frequent reasons cited for their speculation were personal feelings (36%), food/taste preference (13%), feedback from others (13%), somatic responses (13%), and dreams (7%). Out of 63 women who stated a wish for a boy or girl child, 45 (71%) wished for a girl and 18 (29%) wished for a boy. Women with undergraduate or graduate degrees were more likely to indicate a preference for boys. Older expectant mothers were more likely to report that they thought they were carrying boys. In conclusion, the majority of the women did not state a distinct choice for gender of the child. When they expressed a gender preference, more mothers expressed a desire to have a girl. However, boy child conjectures were more frequent than girl child conjectures. Greater boy child preference and prediction among the most highly educated and older expectant mothers might be reflective of implicit social status in having sons in urban China.

  1. The Significance of CXCR4 Expression for the Prediction of Lymph Node Metastasis in Breast Cancer Patients

    Institute of Scientific and Technical Information of China (English)

    Yongxing Ding; Chenghua Li; Qingling Yang; Changjie Chen; Zenong Cheng

    2008-01-01

    OBJECTIVE The chemokine receptor (CXCR4) CXC chemokine receptor 4) plays an important role in cancer metastasis. We therefore studied differential expression of the CXCR4, as well as that of the biomarker HER2, so as to evaluate whether these biomarkers can be used to predict axillary lymph node metastasis in breast cancer patients.METHODS Immunohistochemistry was used to evaluate the CXCR4 and HER2 expressions and to examine the paraffin sections of the breast cancers at various stages. Positive lymph node expression was found in 80 of the cases, and in 7 there was negative expression.RESULTS Compared to the cases with negative lymph nodes,there was a high expression of CXCR4 (26.3% vs. 14.3%, P = 0.013),and an over-expression of HER2 (28.8% vs. 14.3%, P = 0.011).Moreover, there was a direct correlation between the CXCR4 and HER2 expressions and the tumor staging (P = 0.000) and lymph node metastasis (P = 0.032). When the two biomarkers, I.e. CXCR4 and HER2, were concurrently labeled, a high expression of one of the biomarkers could be seen in the cases with positive lymph nodes (51.3% vs. 28.6%, P < 0.003).CONCLUSION The chemokine receptor, CXCR4, is a new-type biomarker in predicting axillary lymph-node metastasis in breast cancers. Compared with the other markers, such as HER2 etc.,assessment of CXCR4 can improve the prediction of the presence and extent of lymph node involvement.

  2. Significance of the local sheet curvature in the prediction of sheet metal forming limits by necking instabilities and cracks

    OpenAIRE

    Hora Pavel; Tong Longchang; Gorji Maysam; Manopulo Niko; Berisha Bekim

    2016-01-01

    The industrial based prediction in sheet metal forming bases still on the Forming Limit Diagrams (FLD) as formally proposed by Keeler 1. The FLD are commonly specified by the Nakajima tests and evaluated with the so called cross section method. Although widely used, the FLC concept has numerous serious limitations. In the paper the influences of bending on the FLC as well as the later crack limits will be discussed. Both criteria will be combined to an extended FLC concept (X-FLC). The new co...

  3. Significance of Nursing Intervention on Pregnancy Outcome of Gestational Diabetes Mellitus Pregnant Women%护理干预对于妊娠糖尿病孕妇妊娠结局的意义

    Institute of Scientific and Technical Information of China (English)

    石璇; 陈丹

    2014-01-01

    Objective To study on gestational diabetes mel itus pregnant women to take the ef ect of nursing intervention. Methods 80 cases of diabetes in 2012 January ~ 2013 January pregnancy (GDM) were retrospectively analyzed the clinical data of pregnant women. Results The maternal and neonatal complications in treatment group was significantly lower than that of the control group, the dif erence was statistical y significant ( < 0.05). Conclusion Early detection, and give the clinical intervention of diet control, exercise therapy, blood glucose monitoring and insulin therapy, health education and appropriate, is the key to improving the outcome of pregnancy.%目的:对妊娠糖尿病孕妇采取护理干预的效果探讨。方法对2012年1月~2013年1月80例妊娠糖尿病(GDM)孕妇临床资料进行回顾性分析。结果治疗组的孕产妇及新生儿并发症发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论早期筛查发现,并给予饮食控制、血糖监测、运动疗法、胰岛素治疗、健康教育等正确的临床干预,是改善妊娠结局的关键。

  4. 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...

  5. Acetylcholine-Provoked Coronary Spasm at Site of Significant Organic Stenosis Predicts Poor Prognosis in Patients With Coronary Vasospastic Angina.

    Science.gov (United States)

    Ishii, Masanobu; Kaikita, Koichi; Sato, Koji; Tanaka, Tomoko; Sugamura, Koichi; Sakamoto, Kenji; Izumiya, Yasuhiro; Yamamoto, Eiichiro; Tsujita, Kenichi; Yamamuro, Megumi; Kojima, Sunao; Soejima, Hirofumi; Hokimoto, Seiji; Matsui, Kunihiko; Ogawa, Hisao

    2015-09-08

    Coronary artery spasm contributes to the pathogenesis of variant angina and ischemic heart disease and may play a role in the progression of atherosclerosis. It is unclear whether the location of spasm is related to outcome. This study compared the clinical features and prognosis of patients with coronary spasm at the site of significant atherosclerotic stenosis with patients with spasm at sites without stenosis or nonsignificant stenosis. This was a retrospective, observational study of 1,877 consecutive patients with typical or atypical angina-like chest pain undergoing acetylcholine (ACh)-provocation testing. A total of 1,760 patients were eligible for analysis. ACh-provoked coronary spasm and significant organic stenosis were observed in 873 and 358 patients, respectively. In patients with significant atherosclerotic stenosis, ACh-positive patients (n = 233) were younger and without diabetes mellitus compared with nonspasm patients (n = 125). In patients without organic stenosis, ACh-positive patients (n = 640) were older, had dyslipidemia, and were more likely to have a family history of ischemic heart disease than nonspasm patients (n = 762). Multiple logistic regression analysis identified ST-segment elevation during anginal attacks, organic stenosis of the left anterior descending artery, and multivessel spasm as correlates of spasm at sites of significant organic stenosis (n = 192). Multivariate analysis identified ACh-provoked spasm at the site of significant stenosis and use of nitrates as the 2 prognostic factors for major adverse cardiac events. The clinical features and prognosis of patients with ACh-provoked coronary spasm were different when it occurred at the site of significant atherosclerotic stenosis compared with patients with spasm elsewhere. Both spasm at the site of significant organic stenosis and nitrate use were significant predictors of major adverse cardiac events. Copyright © 2015 American College of Cardiology Foundation. Published

  6. Assessment of hemodynamic parameters of uterus during physiological pregnancy

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya M.L.

    2015-06-01

    Full Text Available The aim of the article is to analysis of the hemodynamic parameters of the uterus and cervix during the second and third trimesters of pregnancy. Material and methods. It was conducted dynamic ultrasound in 240 women with physiological course for singleton pregnancies in the period from 12 weeks of gestation until term labor. Results. For the second trimester of pregnancy redistribution of total uterine blood flow in the direction of increasing blood flow in more of the body than the cervix has been considered to be typical. From the third trimester of pregnancy until term labor a significant increase of blood supply to the cervix has been found; there has been a tendency to increase the capacity of the vascular channel and the reduction in peripheral resistance vessels of cervix. Conclusions. Early detection of disorders of uterine and cervical hemodynamics allows to predict the occurrence of various pathological conditions.

  7. Significance of the local sheet curvature in the prediction of sheet metal forming limits by necking instabilities and cracks

    Directory of Open Access Journals (Sweden)

    Hora Pavel

    2016-01-01

    Full Text Available The industrial based prediction in sheet metal forming bases still on the Forming Limit Diagrams (FLD as formally proposed by Keeler 1. The FLD are commonly specified by the Nakajima tests and evaluated with the so called cross section method. Although widely used, the FLC concept has numerous serious limitations. In the paper the influences of bending on the FLC as well as the later crack limits will be discussed. Both criteria will be combined to an extended FLC concept (X-FLC. The new concept demonstrates that the Nakajima tests are not only appropriate for the evaluation of the necking instability but for the detection of the real crack strains too. For the evaluation of the crack strains a new local thinning method is proposed and tested for special 6xxx Al-alloys.

  8. Significant correlation between spleen volume and thrombocytopenia in liver transplant patients: a concept for predicting persistent thrombocytopenia.

    Science.gov (United States)

    Ohira, Masahiro; Ishifuro, Minoru; Ide, Kentaro; Irei, Toshimitsu; Tashiro, Hirotaka; Itamoto, Toshiyuki; Ito, Katsuhide; Chayama, Kazuaki; Asahara, Toshimasa; Ohdan, Hideki

    2009-02-01

    Interferon (IFN) therapy with or without ribavirin treatment is well established as a standard antiviral treatment for hepatitis C virus (HCV)-infected patients. However, susceptibility to thrombocytopenia is a major obstacle for initiating or continuing this therapy, particularly in liver transplant (LTx) recipients with HCV. Studies have reported that splenectomy performed concurrently with LTx is a feasible strategy for conditioning patients for anti-HCV IFN therapy. However, the relationship between the severity of splenomegaly and alterations in the blood cytopenia in LTx recipients remains to be clarified. Here, we analyzed the relationship between spleen volume (SV) and thrombocytopenia in 45 patients who underwent LTx at Hiroshima University Hospital. The extent of pre-LTx splenomegaly [the SV to body surface area (BSA) ratio in an individual] was inversely correlated with both the post-LTx white blood cell count and platelet (PLT) count (P or= 400), persistent thrombocytopenia is predictable after LTx.

  9. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy.

    Science.gov (United States)

    Donders, G G; Van Calsteren, K; Bellen, G; Reybrouck, R; Van den Bosch, T; Riphagen, I; Van Lierde, S

    2009-09-01

    Abnormal vaginal flora (AVF) before 14 gestational weeks is a risk factor for preterm birth (PTB). The presence of aerobic microorganisms and an inflammatory response in the vagina may also be important risk factors. The primary aim of the study was to investigate the differential influences of AVF, full and partial bacterial vaginosis, and aerobic vaginitis in the first trimester on PTB rate. The secondary aim was to elucidate why treatment with metronidazole has not been found to be beneficial in previous studies. Unselected women with low-risk pregnancies attending the prenatal unit of the Heilig Hart General Hospital in Tienen, Belgium, were included in the study. At the first prenatal visit, 1026 women were invited to undergo sampling of the vaginal fluid for wet mount microscopy and culture, of whom 759 were fully evaluable. Abnormal vaginal flora (AVF; disappearance of lactobacilli), bacterial vaginosis (BV), aerobic vaginitis (AV), increased inflammation (more than ten leucocytes per epithelial cell) and vaginal colonisation with Candida (CV) were scored according to standardised definitions. Partial BV was defined as patchy streaks of BV flora or sporadic clue cells mixed with other flora, and full BV as a granular anaerobic-type flora or more than 20% clue cells. Vaginal fluid was cultured for aerobic bacteria, Mycoplasma hominis and Ureaplasma urealyticum. Outcome was recorded as miscarriage vaginal flora in the first trimester had a 75% lower risk of delivery before 35 weeks compared with women with AVF [odds ratio (OR) 0.26; 95% confidence interval (CI) 0.12-0.56]. The absence of lactobacilli (AVF) was associated with increased risks of PTB (OR 2.4; 95% CI 1.2-4.8), EPTB (OR 6.2; 95% CI 2.7-14) and miscarriage (OR 4.9; 95% CI 1.4-17). BV was associated with increased risks of PTB (OR 2.4; 95% CI 1.1-4.7), EPTB (OR 5.3; 95% CI 2.1-12.9) and miscarriage (OR 6.6; 95% CI 2.1-20.9) and coccoid AV was associated with increased risks of EPTB (OR 3.2; 95% CI 1

  10. Importance of Exercise Capacity in Predicting Outcomes and Determining Optimal Timing of Surgery in Significant Primary Mitral Regurgitation

    Science.gov (United States)

    Naji, Peyman; Griffin, Brian P.; Barr, Tyler; Asfahan, Fadi; Gillinov, A. Marc; Grimm, Richard A.; Rodriguez, L. Leonardo; Mihaljevic, Tomislav; Stewart, William J.; Desai, Milind Y.

    2014-01-01

    Background In primary mitral regurgitation (MR), exercise echocardiography aids in symptom evaluation and timing of mitral valve (MV) surgery. In patients with grade ≥3 primary MR undergoing exercise echocardiography followed by MV surgery, we sought to assess predictors of outcomes and whether delaying MV surgery adversely affects outcomes. Methods and Results We studied 576 consecutive such patients (aged 57±13 years, 70% men, excluding prior valve surgery and functional MR). Clinical, echocardiographic (MR, LVEF, indexed LV dimensions, RV systolic pressure) and exercise data (metabolic equivalents) were recorded. Composite events of death, MI, stroke, and congestive heart failure were recorded. Mean LVEF was 58±5%, indexed LV end‐systolic dimension was 1.7±0.5 mm/m2, rest RV systolic pressure was 32±13 mm Hg, peak‐stress RV systolic pressure was 47±17 mm Hg, and percentage of age‐ and gender‐predicted metabolic equivalents was 113±27. Median time between exercise and MV surgery was 3 months (MV surgery delayed ≥1 year in 28%). At 6.6±4 years, there were 53 events (no deaths at 30 days). On stepwise multivariable survival analysis, increasing age (hazard ratio of 1.07 [95% confidence interval, 1.03 to 1.12], P100% predicted metabolic equivalents (n=399), delaying surgery by ≥1 year (median of 28 months) did not adversely affect outcomes (P=0.8). Conclusion In patients with primary MR that underwent exercise echocardiography followed by MV surgery, lower achieved metabolic equivalents were associated with worse long‐term outcomes. In those with preserved exercise capacity, delaying MV surgery by ≥1 year did not adversely affect outcomes. PMID:25213567

  11. 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.

  12. 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.

  13. Urologic Issues During Pregnancy

    Directory of Open Access Journals (Sweden)

    Jeffrey P. Weiss

    2004-01-01

    Full Text Available Pregnancy induces a variety of physiologic changes in the urinary tract. When such changes become accentuated the physiologic becomes the pathologic and symptoms arise, at times of significance enough to threaten the well being of mother and/or fetus. This article intends to describe the basis for urinary physiology and its pathologic counterparts during pregnancy. Such a background may then facilitate a rational management protocol for various urologic problems in the gravid state.

  14. [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.

  15. Relation between time to pregnancy and pregnancy outcome

    Directory of Open Access Journals (Sweden)

    Hatave Ghasemi Tehrani

    2014-01-01

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

  16. Poor pregnancy outcome in women with type 1 diabetes is predicted by elevated HbA1c and spikes of high glucose values in the third trimester

    DEFF Research Database (Denmark)

    Damm, Peter; Mersebach, Henriette; Råstam, Jacob

    2014-01-01

    late-pregnancy outcomes included: composite endpoint including pre-eclampsia, preterm delivery and perinatal death (n=78); preterm delivery (n=63); and excessive fetal growth (n=88). RESULTS: 18 patients experienced a malformed/lost fetus in early pregnancy - none preceded by severe hypoglycaemia...

  17. Predictive significance of residual ischemia proved by dobutamine stress: Echocardiography test in patients early after the first uncomplicated myocardial infarction

    Directory of Open Access Journals (Sweden)

    Karanović Nevena

    2004-01-01

    Full Text Available Background. To evaluate the long-term prognostic value of dobutamine stress-echocardiography (ECG test for new coronary events (new episodes of angina pectoris, cardiac-related deaths, and reinfarctions early after the first uncomplicated myocardial infarction. Methods. Dobutamine stress-echocardiography tests were performed in all of 104 patients 10-20 days after the first myocardial infarction. Patients were followed-up for 36 (29 ± 7 months. Kaplan-Meier cumulative survival curves were tested by Breslow test (Log Rank. Results. Two cardiac deaths (1.92%, nine nonfatal myocardial infarctions (8.65%, and three cases of recurrent angina pectoris (2.88% occurred during the prospective follow-up. Cumulative survival curves showed that in patients with negative findings of dobutamine stress-echocardiography test, survival time without significant events was 35.31 months, while in the group with positive findings of dobutamine stress-echocardiography test it was 30.91 months (log Rank 7.22; p<0.01. Prognostic value of dobutamine stress-echocardiography test was analyzed by Cox regression model and was 2.92, meaning that the risk of significant events was 2.92 times higher in the group of patients with positive findings of dobutamine stress-echocardiography test. Conclusion. Patients with negative findings of dobutamine stress-echocardiography test were with significantly higher possibility of surviving without significant events in comparison with the patients in whom the findings of dobutamine stress-echocardiography test were positive. In combination with clinical signs and ECG results, the results of dobutamine stress-echocardiography test improved prognostic value in the patients with the first uncomplicated myocardial infarction, and in that way influenced the strategy of their further treatment.

  18. Performance on a computerized shopping task significantly predicts real world functioning in persons diagnosed with bipolar disorder.

    Science.gov (United States)

    Laloyaux, Julien; Pellegrini, Nadia; Mourad, Haitham; Bertrand, Hervé; Domken, Marc-André; Van der Linden, Martial; Larøi, Frank

    2013-12-15

    Persons diagnosed with bipolar disorder often suffer from cognitive impairments. However, little is known concerning how these cognitive deficits impact their real world functioning. We developed a computerized real-life activity task, where participants are required to shop for a list of grocery store items. Twenty one individuals diagnosed with bipolar disorder and 21 matched healthy controls were administered the computerized shopping task. Moreover, the patient group was assessed with a battery of cognitive tests and clinical scales. Performance on the shopping task significantly differentiated patients and healthy controls for two variables: Total time to complete the shopping task and Mean time spent to consult the shopping list. Moreover, in the patient group, performance on these variables from the shopping task correlated significantly with cognitive functioning (i.e. processing speed, verbal episodic memory, planning, cognitive flexibility, and inhibition) and with clinical variables including duration of illness and real world functioning. Finally, variables from the shopping task were found to significantly explain 41% of real world functioning of patients diagnosed with bipolar disorder. These findings suggest that the shopping task provides a good indication of real world functioning and cognitive functioning of persons diagnosed with bipolar disorder. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Should a Study of Monoclonal Gammopathy of Undetermined Significance Be of Clinical Interest to Predict Myeloma Overcome?

    Directory of Open Access Journals (Sweden)

    J Véronique-Baudin

    2016-02-01

    Full Text Available The majority of monoclonal gammopathy of undetermined significance (MGUS are benign forms that require no treatment but can be considered as a pre-cancerous state. Monoclonal gammopathy of undetermined significance is quite frequent, and related to age. The risk of progression to multiple myeloma or another type of malignant lymphoproliferation is estimated at 1% per year. Monoclonal gammopathy of undetermined significance is twice as frequent in patients of African descent, and prevalence is higher for men. Diagnosis of MGUS is made on evidence of a monoclonal component < 30 g/L and no CRAB criteria (hypercalcaemia, renal insufficiency, anaemia, bone lesions. Regular monitoring is required for all MGUS because they can develop into other lymphoproliferative disorders such as multiple myeloma and lymphoma and other haematologic malignancies. In view of the genetic, insular and environmental context specificities of Caribbean populations of African descent, and according to haemophilia trends of the French West Indies cancer registry, it will be interesting to determine incidence and prevalence of MGUS in a country in the Caribbean. No such study has been performed to date. There is a hypothesis for a possible geographic distribution of these blood disorders linked to environmental exposure to pesticides. The expected findings and their potential repercussions will have major public health interest, and should form the basis for a wider prognostic study to determine risk factors for MGUS in the French Caribbean. In a real life exhaustive study, the Martinique Cancer Registry proposes an epidemiological focus on MGUS in Martinique.

  20. Quantification of left coronary bifurcation angles and plaques by coronary computed tomography angiography for prediction of significant coronary stenosis: A preliminary study with dual-source CT

    Science.gov (United States)

    Cui, Yue; Zeng, Wenjuan; Yu, Jie; Lu, Jing; Hu, Yuannan; Diao, Nan; Liang, Bo; Han, Ping; Shi, Heshui

    2017-01-01

    Purpose To evaluate the diagnostic performance of left coronary bifurcation angles and plaque characteristics for prediction of coronary stenosis by dual-source CT. Methods 106 patients suspected of coronary artery disease undergoing both coronary computed tomography angiography (CCTA) and invasive coronary angiography (CAG) within three months were included. Left coronary bifurcation angles including the angles between the left anterior descending artery and left circumflex artery (LAD-LCx), left main coronary artery and left anterior descending artery (LM-LAD), left main coronary artery and left circumflex artery (LM-LCx) were measured on CT images. CCTA plaque parameters were calculated by plaque analysis software. Coronary stenosis ≥ 50% by CAG was defined as significant. Results 106 patients with 318 left coronary bifurcation angles and 126 vessels were analyzed. The bifurcation angle of LAD-LCx was significantly larger in left coronary stenosis ≥ 50% than stenosis coronary stenosis (OR = 1.423, P = 0.002). In ROC curve analysis, LAD-LCx predicted significant left coronary stenosis with a sensitivity of 66.7%, specificity of 78.4%, positive predictive value of 85.2% and negative predictive value of 55.8%. The lipid plaque volume improved the diagnostic performance of CCTA diameter stenosis (AUC: 0.854 vs. 0.900, P = 0.045) in significant coronary stenosis. Conclusions The bifurcation angle of LAD-LCx could predict significant left coronary stenosis. Wider LAD-LCx is related to non-calcified lesions. Lipid plaque volume could improve the diagnostic performance of CCTA for coronary stenosis prediction. PMID:28346530

  1. Cervical Length: Why Does It Matter during Pregnancy?

    Science.gov (United States)

    Healthy Lifestyle Pregnancy week by week During pregnancy, what's the significance of cervical length? Answers from Shannon K. Laughlin-Tommaso, ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/cervical-length/faq- ...

  2. Significance of cardiac sympathetic nervous system abnormality for predicting vascular events in patients with idiopathic paroxysmal atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Kawamura, Mitsuharu; Asano, Taku; Hamazaki, Yuji; Tanno, Kaoru; Kobayashi, Youichi [Showa University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo (Japan); Suyama, Jumpei; Shinozuka, Akira; Gokan, Takehiko [Showa University School of Medicine, Department of Radiology, Tokyo (Japan)

    2010-04-15

    Neuronal system activity plays an important role for the prognosis of patients with atrial fibrillation (AF). Using {sup 123}I metaiodobenzylguanidine ({sup 123}I-MIBG) scintigraphy, we investigated whether a cardiac sympathetic nervous system (SNS) abnormality would be associated with an increased risk of vascular events in patients with paroxysmal AF. {sup 123}I-MIBG scintigraphy was performed in 69 consecutive patients (67 {+-} 13 years, 62% men) with paroxysmal AF who did not have structural heart disease. SNS integrity was assessed from the heart to mediastinum (H/M) ratio on delayed imaging. Serum concentration of C-reactive protein (CRP) was measured before {sup 123}I-MIBG study. During a mean of 4.5 {+-} 3.6 years follow-up, 19 patients had myocardial infarction, stroke or heart failure (range: 0.2-11.5 years). SNS abnormality (H/M ratio <2.7) and high CRP ({>=}0.3 mg/dl) were associated with the vascular events (58.3% in 14 of 24 patients with SNS abnormality vs 11.1% in 5 of 45 patients without SNS abnormality, p < 0.0001, 52.4% in 11 of 21 patients with high CRP vs 16.7% in 8 of 48 patients without high CRP, p < 0.0001). After adjustment for potential confounding variables such as age, left atrial dimension and left ventricular function, SNS abnormality was an independent predictor of vascular events with a hazard ratio of 4.1 [95% confidence interval (CI): 1.3-12.6, p = 0.014]. Further, SNS abnormality had an incremental and additive prognostic power in combination with high CRP with an adjusted hazard ratio of 4.1 (95% CI: 1.5-10.9, p = 0.006). SNS abnormality is predictive of vascular events in patients with idiopathic paroxysmal AF. (orig.)

  3. Significance of physicochemical forms of storage in microalgae in predicting copper transfer to filter-feeding oysters (Crassostrea gigas).

    Science.gov (United States)

    Amiard-Triquet, Claude; Berthet, Brigitte; Joux, Lamia; Perrein-Ettajani, Hanane

    2006-02-01

    Copper distribution has been examined in two microalgae (Haslea ostrearia, Diatom; Tetraselmis suecica, Prasinophyceae) exposed to Cu at 30 microg/L(-1). Exchangeable copper linked at the cell surface was desorbed using 8-hydroxyquinoline-5-sulfonate as complexing agent. Then, incorporated copper was separated between soluble and insoluble fractions. In addition, algae were resuspended in acid solutions, the pHs of which covered the range existing in the digestive tract of bivalves. Considering that the soluble fraction is the most easily transferred in the food chain and that exchangeable Cu is easily desorbed, the percentages of Cu potentially available in microalgae have been assessed. These percentages have been compared with those retained in oysters Crassostrea gigas fed with contaminated microalgae in previous studies. In H. ostrearia, the potentially available fraction of Cu (90%) was very similar to the percentage retained by oysters (93%) when the bivalves were acclimated to this food for 3 weeks. Only half (21%) of the potentially available Cu of T. suecica (42%) was readily assimilated in oysters after 3 weeks. This is in agreement with the results of the desorption tests at physiological pHs which showed that only 15-25% of Cu was lost, despite solubilization of other constituents of T. suecica as demonstrated by the decrease in their dry weight. Bioavailability determined from metal speciation in food allows a relevant prediction of the trophic transfer in the case of H. ostrearia, but caution is recommended in generalizing this mode of assessment as shown in the case of T. suecica.

  4. 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)

  5. 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....

  6. 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 ...

  7. 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)

  8. 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 ...

  9. 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: ...

  10. 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 ...

  11. Cytologic subclassification of atypia of undetermined significance may predict thyroid nodules more likely to be malignant at surgery.

    Science.gov (United States)

    Shrestha, Rupendra T; Hennessey, James V

    2016-06-01

    The atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) category in the Bethesda System of reporting thyroid fine-needle aspiration (FNA) includes various cytological findings considered to have a low risk of malignancy. It is still unclear if any particular subset of the cytological findings within this category carries a higher risk for malignancy requiring a more aggressive treatment plan. We reviewed 221 AUS/FLUS FNAs performed between January of 2006 and May of 2012. Histopathological data from surgery was available in 101 nodules and characteristics of these nodules were analyzed. We reviewed the initial cytology report and subclassified the nodules into one of four groups: architectural atypia (AA, includes abnormal follicular arrangement but no cellular abnormalities), cellular atypia (CA, atypical cellular findings) with or without AA, Hurthle cells Predominant and Others that included otherwise unspecified AUS categories. The surgical pathology confirmed malignancy rate for each group was calculated. Papillary thyroid carcinoma was the most common malignancy identified (26 of 29 or 90%). We found that in the AA only category, 2/21 (10%) nodules were malignant, whereas when CA with or without AA was present, 23/66 (35%) were malignant, significantly higher than the former group (P values of 0.025). CA seen on initial AUS/FLUS had a higher malignancy rate compared to AA group. Further research is required to consider subclassification of this category to assign appropriate risk of malignancy for AUS nodules. Diagn. Cytopathol. 2016;44:492-498. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Hyperthyroidism and pregnancy.

    Science.gov (United States)

    Gargallo Fernández, Manuel

    2013-11-01

    Association of hyperthyroidism and pregnancy is not an unusual event, and has an impact on both the mother and fetus. After delivery, it may also affect the newborn and the nursing mother. Clinical management of this situation is quite different from that required by non-pregnant hyperthyroid women and poses significant diagnostic and therapeutic challenges. This review addresses aspects related to the unique characteristics of biochemical assessment of thyroid function in pregnancy, the potential causes of hyperthyroidism in pregnancy, and the clinical and therapeutic approach in each case. Special attention is paid to pregnancy complicated with Graves' disease and its different the maternal, fetal, neonatal, and postnatal consequences. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-03-15

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

  14. [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.

  15. Nutrition During Pregnancy and Screening for Diabetes for the Prediction of Gestational Diabetes Mellitus%孕期营养及糖尿病筛查对妊娠期糖尿病发病的预测

    Institute of Scientific and Technical Information of China (English)

    李静; 赵丽

    2015-01-01

    Objective To analyze and discuss the effect of nutrition during pregnancy and screening for diabetes on predicting the incidence of gestational diabetes mellitus(GDM). Methods An analysis was conducted on the status of pregnancy and childbirth in 500 cases with GDM admitted in our hospital from 2011 to 2013. Results The screening for diabetes showed that, 25%of the total 500 pregnant women, 125 cases, had positive result, and they were given oral glucose tolerance test, and among them, 20 cases were diagnosed with GDM confirmedly, accounting for 4%, 30 cases were diagnosed with impaired glucose tolerance confirmedly, accounting for 6%. The analysis of the outcome of 30 pregnant women with impaired glucose tolerance found that there were 9 cases(30%) with natural childbirth, 20 cases(66.7%) with caesarean section, 1 case(3.3%) with perineal side cut;7 cases with neonatal hypoglycemia, 4 cases with pregnancy induced hypertension, 5 cases with postpartum hemorrhage, 2 premature babies, 2 cases of neonatal asphyxia, and 6 cases of fetal distress. Conclusion Screening for diabetes can accurately diagnose gestational diabetes mellitus, and timely discover and treatment can reduce the incidence of postpartum complications of GDM. Scientific pregnancy nutrition guidance is of great significance in dieting healthily, controlling BMI and reducing the incidence of GDM.%目的:分析并探讨孕期营养及糖尿病筛查对妊娠期糖尿病发病的预测情况。方法选取2011年—2013年收治于该院的500例妊娠期糖尿病患者,并分析其孕期和分娩期情况。结果对500例孕妇行糖筛查发现,其中125例孕妇显示阳性,所占比率为25%,该125例孕妇再次行口服糖耐量检测,其中有20例孕妇确诊为妊娠期糖尿病,所占比例为4%,其中30例孕妇确诊为糖耐量受损,所占比例为6%。30例糖耐量受损孕妇进行妊娠结局分析发现,自然分娩9例,占30%,剖腹产20例,占66.7%

  16. 胎儿纤维连接蛋白联合宫颈长度预测无症状双胎妊娠早产%Fetal Fibronectin combined with cervical length to predict preterm delivery in asymptomatic twin pregnancy

    Institute of Scientific and Technical Information of China (English)

    郭雪箐; 莫慧芬

    2015-01-01

    目的探讨无症状的双胎妊娠应用阴道分泌物胎儿纤维连接蛋白(fFN)联合经腹宫颈长度预测早产的价值。方法共纳入98例双胎妊娠孕妇,于妊娠24周~35周检测孕妇宫颈阴道分泌物fFN、经腹B超检测宫颈长度并随访妊娠结局。结果 fFN联合宫颈长度检测预测双胎妊娠早产较两项单独检测预测早产的敏感度、阴性预测值均有所提高。结论 fFN及宫颈长度联合检测可用于筛查无症状的双胎妊娠孕妇早产,具有较高的临床应用价值。%Objective To evaluate transabdominal cervical length measurements and fetal fibronectin detection in the maternal vaginal secretions as predictors of preterm delivery in asymptomatic twin pregnancy. Methods A total of 98 cases of twin pregnancy were recruited. Transabdominal ultrasound assessments of cervical length and fetal bronectin detection were performed from 24 to 35 weeks of gestation. The pregnancy outcomes were followed up. Results The sensitivity of detection of cervical length combined with fetal bronectin as predictors of preterm delivery in asymptomatic twin pregnancies was 82.0%, specificity 76.7%, positive predictive value 49.3%and negative predictive value 91.7%. The sensitivity and negative predictive value of the joint tests were higher than that of the respective detection for predicting preterm delivery. Conclusion For asymptomatic twin pregnancy, fetal bronectin detection combined with cervical length measurements can be used for screening of asymptomatic twin pregnancy.

  17. 应用时间序列分析法在医院双胎妊娠情况统计中的预测研究%Prediction Research of Applied time series analysis method in twin pregnancy statistical analysis

    Institute of Scientific and Technical Information of China (English)

    莫佳琪; 朱淳; 黄艳

    2014-01-01

    目的:探索时间序列分析法ARIMA预测模型在医院双胎妊娠情况统计中的应用。方法运用时间序列分析法ARIMA模型预测医院双胎妊娠情况的发展趋势。结果建立ARIMA(3,1,1)(1,1,1)模型,预测医院未来2年在双胎妊娠情况中有向上的趋势性和季节性,预测数据在5月、8月和12月双胎妊娠情况中呈现高峰。结论 ARIMA(3,1,1)(1,1,1)模型可以较好的拟合2009-2012年湖南省妇幼保健院双胎妊娠情况统计的时间变化趋势。应用时间序列分析法ARIMA模型在医院双胎妊娠情况统计的预测研究精度较高,是一种理想的研究方法,能够为医院管理提供科学依据。%Objective To explore the application of applied time series analysis method ARIMA modeling in twin preg-nancy statistical analysis .Method To predict the development trend of twin pregnancy by using applied time series analysis method ARIMA modeling Results Predicted the rising trend and seasonal feature of the twin pregnancy in the next two years by building ARIMA (1,1,1)(0,1,1),the prediction statistic showed that the twin pregnancy situation will be at the peak time on May, Autumn and December. Conclusion ARIMA(3,1,1)(0,1,1)modeling fitted the time varia-tion trend of twin pregnancy statistic well during 2009 to 2012 in MCH hospital of Hunan province. It is proved that ap-plied time series analysis method ARIMA modeling can provide satisfied predictions of the twin pregnancy in the hospi-tal and to be thought as the ideal research method.for providing scientific support for hospital management.

  18. 子痫前期孕妇血清和胎盘组织脂联素的表达及意义%Expression and significance of adiponectin in serum and placenta tissue in preeclampsia pregnancy women

    Institute of Scientific and Technical Information of China (English)

    陈震宇; 李巨; 陈静; 裴丽鹏

    2014-01-01

    目的 分析子痫前期孕妇血清和胎盘组织脂联素的表达及意义.方法 采用酶联免疫吸附法检测52例无妊娠并发症孕妇(对照组)、58例轻度子痫前期孕妇(轻度子痫前期组)、55例重度子痫前期孕妇(重度子痫前期组)血清脂联素,并计算稳态模型评估法胰岛素抵抗指数(HOMA-IR);采用免疫组织化学SP法检测三组孕妇胎盘组织脂联素表达情况.结果 重度子痫前期组空腹血糖明显高于对照组和轻度子痫前期组[(5.56±1.37) mmol/L比(4.55±0.51),(4.68±0.66) mmol/L],轻度子痫前期组、重度子痫前期组空腹胰岛素及HOMA-IR均高于对照组[(14.19±3.42),(14.90±6.64) mU/L比(9.87±1.75) mU/L,1.04±0.37,1.18±0.56比0.67±0.21],重度子痫前期组血清脂联素明显高于对照组和轻度子痫前期组[(15.79±4.86) mg/L比(11.47± 3.50),(11.92±2.96) mg/L],差异均有统计学意义(P<0.05).三组胎盘组织脂联素水平比较差异均无统计学意义(P>0.05).血清脂联素水平与HOMA-IR及胎盘组织脂联素表达无相关性(P>0.05).结论 重度子痫前期孕妇血清脂联素、HOMA-IR明显增高,血清脂联素升高可能是子痫前期孕妇的一种适当的反馈性调节.%Objective To analyze the expression and significance of adiponectin in serum and placenta tissue in preeclampsia pregnancy women.Methods Serum adiponectin levels were measured by Enzyme-linked immuno sorbent assay (ELISA) in 52 cases of normal pregnant women (control group),58 cases of mild preeclampsia pregnancy women (mild preeclampsia group),and 55 cases of severe preeclampsia pregnancy women (severe preeclampsia group).Insulin resistance was estimated using the homeostatic model assessment-insulin resistance index (HOMA-IR).The expression of adiponectin in placenta tissue was detected by immunohistochemical SP methods in three groups.Results Fasting glucose level in severe preeclampsia group was higher than that in control group and mild

  19. Maternal nutrition in twin pregnancy.

    Science.gov (United States)

    Campbell, D M; MacGillivray, I; Tuttle, S

    1982-01-01

    Energy and protein intake as measured by 24-hour urinary nitrogen values are similar in twin and singleton pregnancies. The relationship between urinary nitrogen and nitrogen intake is equally significant in twin and singleton pregnancies. Dietary zinc, copper, and iron are not different in women with twins, nor are the levels of these elements in plasma. These observations are surprising in view of the extra fetal demands on the mother and the different adaptation of twin pregnancies.

  20. 超声诊断剖宫产切口瘢痕妊娠的临床指导意义%Guiding significance of ultrasound diagnosis caesarean scar pregnancy for clinical treatment

    Institute of Scientific and Technical Information of China (English)

    马悦霞; 李玲玲; 向红; 张鸿雁

    2015-01-01

    目的:探讨超声诊断剖宫产切口瘢痕妊娠对临床选择治疗方案的指导意义。方法回顾性分析43例剖宫产切口瘢痕妊娠患者的超声声像图特点并分型,对超声诊断与临床选择诊疗方法的相关性进行分析。结果根据超声声像图特点43例剖宫产切口瘢痕妊娠患者分为孕囊型18例(内生型8例,外生型10例)和包块型25例(血窦型15例,不均质型10例),4种类型中孕囊外生型的病灶距浆膜层的肌层厚度最薄(P <0.05)。根据治疗方法分为非手术治疗(24例)和手术治疗组(19例),非手术治疗组病灶最大径(3.2±1.6)cm,小于手术治疗组(4.4±1.8)cm,两组差异有统计学意义(P <0.05);在孕囊型中,非手术治疗组病灶距浆膜层的肌层厚度为(0.51±0.11)cm,大于手术治疗组(0.34±0.09)cm,两组差异有统计学意义(P <0.05);在包块型中,非手术治疗组与手术治疗组病灶距浆膜层的肌层厚度差异无统计学意义(P >0.05)。结论超声诊断剖宫产切口瘢痕妊娠对临床选择个体化综合治疗方法具有重要指导意义。%Objective To investigate the guiding significance of ultrasound diagnosis of caesarean scar preg-nancy for clinical individual comprehensive treatment scheme selection.Methods The sonographic charac-teristics and classification of 43 cases of caesarean scar pregnancy and the relevance between the ultrasonic diagnosis and clinical treatment method choice were analyzed retrospectively.Results Among 43 cases,18 cases were simple sac-Type (8 cases were endogenous type,10 cases were exogenous type),25 cases were enclosed mass type (15 cases were sinus type,10 cases were uneven block mass type).And,the muscular thickness between the lesion and the serosal layer of exogenous simple sac type was the thinnest (P 0.05).Conclusion Caesarean scar pregnancy diagnosed by ultrasound is of

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

    Directory of Open Access Journals (Sweden)

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

    2011-01-01

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

  2. Aortopathy in pregnancy.

    Science.gov (United States)

    Smok, Dorothy A

    2014-08-01

    Up to half of all aortic dissections and ruptures in women younger than 40 years are associated with pregnancy. In pregnancy, women with aortic disease such as arteritis and aortitis are at significant risk of aneurysmal formation and dissection with potential for catastrophic outcomes. Pregnancy places predisposed women at an increased risk of dissection due to physiological and hormonal changes that occur, particularly those with connective tissue disorders, genetic syndromes, congenital heart disease, and other heritable and acquired conditions involving the aorta. Thus, preconception counseling and preparation are advised to determine which patients may cautiously pursue pregnancy, to optimize medical management prior to conception (antihypertensive medications and anticoagulants in the setting of mechanical valves), to identify women in whom aortic root repair should occur prior to pregnancy, and lastly, those in whom pregnancy is contraindicated. Additionally, discussion of the heritable nature of many aortic conditions and associated syndromes is indicated. Preconception and genetic counseling, management by a multidisciplinary team, along with close echocardiographic surveillance and medical management, are recommended if precursors of dissection are identified.

  3. 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.

  4. Pregnancy and renal transplantation.

    Science.gov (United States)

    Başaran, O; Emiroğlu, R; Seçme, S; Moray, G; Haberal, M

    2004-01-01

    Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia.

  5. Stress: pregnancy considerations.

    Science.gov (United States)

    Cardwell, Michael S

    2013-02-01

    Stress-induced pregnancy complications represent a significant cause of maternal and perinatal morbidity and mortality due to preterm labor, low-birth-weight babies, pregnancy-induced hypertension, and neuropsychological developmental delays of affected offspring. Psychosocial factors such as socioeconomic status, work status, marital status, level of education, access to prenatal care, substance abuse, ethnicity, cultural background, and quality of relationships with partners and parents have been identified as determinants of stress during pregnancy. The biopsychosocial model of health and disease aptly explains the interactions of these psychosocial factors in the genesis of stress-induced pregnancy complications. Prenatal screening and intervention for relevant biopsychosocial risk factors may be useful in preventing stress-related perinatal complications. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to describe how stress is manifested biologically, discuss stress and its impact from the biopsychosocial model of health and disease, recognize how stress may lead to pregnancy complications such as preterm labor, preeclampsia, and low-birth-weight infants, explain how stress may impact the neuropsychological development of children whose mothers experienced perinatal stress, and demonstrate how prenatal screening and appropriate interventions may reduce perinatal stress and associated pregnancy complications.

  6. Renal markers in normal and hypertensive disorders of pregnancy in Indian women: a pilot study

    Directory of Open Access Journals (Sweden)

    Padma Y

    2013-08-01

    Conclusion: The maternal serum cystatin C, creatinine and uric acid were all significantly elevated at the end of pregnancy in pre-eclampsia compared to those of healthy pregnant women. If this rise in the above markers during early pregnancy could predict the onset of PIH/PE, needs to be investigated. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 514-520

  7. 妊娠期高血压疾病患者血清瘦素水平的变化及意义%The clinical significance of serum leptin level in patients with hypertensive disorders in pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘建; 廖宗敏; 胡红波; 钟梅

    2015-01-01

    Objective To study the relationship between serum leptin level and the generation with hypertensive disor-ders in pregnancy. Methods Normal pregnant women (20 cases),gestational hypertension patients (20 cases),mild preeclampsia (20 cases),severe preeclampsia (20 cases) in our hospital from October 2010 to June 2014 were studied by measuring serum leptin content with radioimmunoassay. Results Maternal serum leptin levels and systolic and diastolic blood pressure of each group was positively correlated (P0.05);Leptin was significantly increased in severe preeclampsia group than that of the mild preeclampsia group and gestational hypertension group (P0.05);重度子痫前期组较轻度子痫前期组、妊娠期高血压组孕妇的血瘦素水平均增高,差异有统计学意义(P<0.05);轻度子痫前期组较妊娠期高血压组孕妇的血瘦素水平增高,差异有统计学意义(P<0.05)。结论瘦素参与妊娠期高血压疾病的发生、病情发展,并且在疾病进展中有升高的倾向,瘦素是妊娠期高血压疾病的发病机制之一。

  8. Validity of lamellar body count as a fetal lung maturity assessment in twin pregnancy.

    Science.gov (United States)

    Tsuda, Hiroyuki; Kotani, Tomomi; Sumigama, Seiji; Kawabata, Ichiro; Takahashi, Yuichiro; Iwagaki, Shigenori; Kigoshi, Kaori; Kikkawa, Fumitaka

    2012-08-01

    Fetal lung maturity assessment in twin pregnancy has been discussed, but is still controversial. The purpose of this study is to predict the occurrence of respiratory distress syndrome (RDS) using lamellar body count (LBC) and analyze the validity of LBC for fetal lung maturity assessment in twin pregnancy. Three-hundred two amniotic fluid samples were obtained at cesarean section from 29 to 38 weeks of gestation. Samples were analyzed immediately with no centrifugation and the number of lamellar bodies was counted using a platelet channel on the Sysmex SF-3000. There were 18 neonates (6.0%) suffering from RDS. An LBC cut-off value of 2.95×10⁴/μL resulted in 91.5% sensitivity and 83.3% specificity for predicting RDS. This cut-off value for predicting RDS was the same as that in singleton pregnancy. Moreover, the median LBC value in RDS cases was significantly lower than in non-RDS cases (1.50±1.1×10⁴/μL vs. 10.6±7.5×10⁴/μL; ptwin pregnancy and also the largest study on fetal lung maturity assessment in twin pregnancy. An LBC value of >2.95×10⁴/μL means reassuring findings for RDS even in twin pregnancy. We believe the data in this study provide valuable, new information for the management of twin pregnancies.

  9. 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.

  10. Do Endometrial Movements Affect The Achievement of Pregnancy during Intrauterine Insemination?

    Directory of Open Access Journals (Sweden)

    Ari Kim

    2015-02-01

    Full Text Available Background: This study was aimed to assess the effect of endometrial movements on pregnancy achievement in intrauterine insemination (IUI cycles. Materials and Methods: The population of this observational study was composed of unexplained infertility couples undergoing first-time IUI with clomiphene citrate between September 2010 and October 2011. Not only endometrial movements, but also thickness, volume, pattern, and echogenic change of endometrium were analyzed prospectively in prediction of pregnancy. Results: The total number of 241 cycles of IUI with 49 intrauterine pregnancies (20.3% was analyzed. Pregnancy was not related to endometrial thickness and endometrial volume, but significantly related to endometrial movements associated with the number of contraction, strong movement, cervicofundal direction, and hyperechoic change (p<0.05. Pregnant group showed higher cervicofundal movement rate (89.8 vs. 75.5%. Conclusion: For IUI cycles stimulated by clomiphene citrate in unexplained infertility women, endometrial movements on the day of IUI could be a predictor of pregnancy.

  11. 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...

  12. 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 ...

  13. 溶血磷脂酸与抗心磷脂抗体联合检测在妊高症患者中的临床意义%Clinical significance of combined detection of LPA and ACA in patients with pregnancy-induced hypertension

    Institute of Scientific and Technical Information of China (English)

    邢建琴; 郭兆荣; 王忠叶

    2014-01-01

    with pregnancyinduced hypertension syndrome increased successively with the progression of the disease and were higher than that in the control group (P < 0.05) ; the anticardiolipin antibody positive rate of severe PIH group was higher than that of other groups (P < 0.05).The plasma level of LPA of the patients whose anticardiolipin antibody was positive in severe PIH group increased significantly,and the gestational age was small when onset,weight of perinatal low,and neonatal Apgar score low,which statistically differed from those of the negative group (P < 0.05 or 0.01).Conclusions The severity of pregnancy-induced hypertension correlates with plasma LPA level; the more severe the disease becomes,the level of LPA is higher.Anticardiolipin antibody correlates with the pathogenesis of severe PIH.The combined detection of LPA and ACA can predict the severity of pregnancyinduced hypertension syndrome and pregnancy outcome,and it is expected to become the important measure of disease monitoring and prognosis.

  14. 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.

  15. Pre-pregnancy and pregnancy predictors of obesity.

    Science.gov (United States)

    Melzer, K; Schutz, Y

    2010-12-01

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

  16. 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.

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

    Science.gov (United States)

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

    2011-12-01

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

  18. The macrophage activation marker sCD163 combined with markers of the Enhanced Liver Fibrosis (ELF) score predicts clinically significant portal hypertension in patients with cirrhosis

    DEFF Research Database (Denmark)

    Sandahl, T D; McGrail, R; Møller, Holger Jon

    2016-01-01

    BACKGROUND: Noninvasive identification of significant portal hypertension in patients with cirrhosis is needed in hepatology practice. AIM: To investigate whether the combination of sCD163 as a hepatic inflammation marker and the fibrosis markers of the Enhanced Liver Fibrosis score (ELF) can...... predict portal hypertension in patients with cirrhosis. METHODS: We measured sCD163 and the ELF components (hyaluronic acid, tissue inhibitor of metalloproteinase-1 and procollagen-III aminopeptide) in two separate cohorts of cirrhosis patients that underwent hepatic vein catheterisation. To test...... the predictive accuracy we developed a CD163-fibrosis portal hypertension score in an estimation cohort (n = 80) and validated the score in an independent cohort (n = 80). A HVPG ≥10 mmHg was considered clinically significant. RESULTS: Both sCD163 and the ELF components increased in a stepwise manner...

  19. Organ-specific systemic lupus erythematosus activity during pregnancy is associated with adverse pregnancy outcomes.

    Science.gov (United States)

    Tedeschi, Sara K; Guan, Hongshu; Fine, Alexander; Costenbader, Karen H; Bermas, Bonnie

    2016-07-01

    Systemic lupus erythematosus (SLE) is a disease of reproductive-age women, and thus questions regarding how disease influences pregnancy outcomes arise. We investigated whether five specific types of SLE activity during the 6 months before conception or during pregnancy (nephritis, cytopenias, skin disease, arthritis, serositis) were associated with adverse pregnancy outcomes. We performed a retrospective cohort study of pregnancy outcomes among women with SLE at the Brigham and Women's Hospital Lupus Center. Adverse pregnancy outcomes included pre-eclampsia, pre-term delivery, elective termination due to SLE, spontaneous miscarriage at weeks 12-20, and stillbirth. SLE and obstetric history, laboratories, and medications were obtained from electronic medical records. Generalized linear mixed models adjusting for potential confounders were used to identify predictors of any adverse pregnancy outcome. Most pregnancies resulted in a live term delivery (76.5 %). After adjustment for Hispanic ethnicity, prior adverse pregnancy outcome and medication use 6 months before conception, nephritis during pregnancy (odds ratio (OR) 3.6, 95 % confidence interval (CI) 1.0-12.8), cytopenias during pregnancy (OR 3.9, 95 % CI 1.3-11.4), and serositis during pregnancy (OR 5.9, 95 % CI 1.0-34.0) were significantly associated with adverse pregnancy outcome. Specific types of SLE disease activity during pregnancy were related to adverse pregnancy outcome. Nephritis, cytopenias, and serositis carried a higher risk of adverse pregnancy outcome, suggesting that these abnormalities should be carefully monitored during pregnancy.

  20. Predicting the Significance of Injuries Potentially Caused by Non-Lethal Weapons: Tympanic Membrane Rupture (TMR), Permanent Threshold Shift (PTS), and Photothermal Retinal Lesions

    Science.gov (United States)

    2016-06-21

    Membrane Rupture (TMR), Permanent Threshold Shift (PTS), and Photothermal Retinal Lesions Shelley M. Cazares Allison L. King Leon R. Hirsch Jenny R...and Photothermal Retinal Lesions Shelley M. Cazares Allison L. King Leon R. Hirsch Jenny R. Holzer Michael S. Finnin Predicting the Significance... Lesions Shelley Cazares, Allison King, Lee Hirsch, Jenny R. Holzer, Michael Finnin Institute for Defense Analyses 21 June 2016 IDA is a set of

  1. Fetal growth potential and pregnancy outcome.

    Science.gov (United States)

    Bukowski, Radek

    2004-02-01

    Although the association of fetal growth restriction and adverse pregnancy outcomes is well known, lack of sensitivity limits its clinical value. To a large extent, this limitation is a result of traditionally used method to define growth restriction by comparing fetal or birth weight to population norms. The use of population norms, by virtue of their inability to fully consider individual variation, results in high false positive and negative rates. An alternative, calculating fetal individually optimal growth potential, based on physiological determinants of individual growth, is superior in predicting adverse outcomes of pregnancy. Impairment of fetal growth potential identifes some adverse pregnancy outcomes that are not associated with growth restrction defined by population norms. When compared with traditional population-based norms, fetal growth potential is a better predictor of several important adverse outcomes of pregnancy which include: stillbirth, neonatal mortality and morbidity, and long-term adverse neonatal outcomes like neonatal encephalopathy, cerebral palsy and cognitive abilities. Impairment of individual growth potential is also strongly associated with spontaneous preterm delivery. Although definitive interventional trials have not been conducted as yet to validate the clinical value of fetal growth potential, many observational studies, conducted in various populations, indicate its significant promise in this respect.

  2. Liver diseases in pregnancy: diseases not unique to pregnancy.

    Science.gov (United States)

    Almashhrawi, Ashraf A; Ahmed, Khulood T; Rahman, Rubayat N; Hammoud, Ghassan M; Ibdah, Jamal A

    2013-11-21

    Pregnancy is a special clinical state with several normal physiological changes that influence body organs including the liver. Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Few challenges arise in reaching an accurate diagnosis in light of such physiological changes. Laboratory test results should be carefully interpreted and the knowledge of what normal changes to expect is prudent to avoid clinical misjudgment. Other challenges entail the methods of treatment and their safety for both the mother and the baby. This review summarizes liver diseases that are not unique to pregnancy. We focus on viral hepatitis and its mode of transmission, diagnosis, effect on the pregnancy, the mother, the infant, treatment, and breast-feeding. Autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson's disease, Budd Chiari and portal vein thrombosis in pregnancy are also discussed. Pregnancy is rare in patients with cirrhosis because of the metabolic and hormonal changes associated with cirrhosis. Variceal bleeding can happen in up to 38% of cirrhotic pregnant women. Management of portal hypertension during pregnancy is discussed. Pregnancy increases the pathogenicity leading to an increase in the rate of gallstones. We discuss some of the interventions for gallstones in pregnancy if symptoms arise. Finally, we provide an overview of some of the options in managing hepatic adenomas and hepatocellular carcinoma during pregnancy.

  3. [Hypertension In pregnancy: practical considerations].

    Science.gov (United States)

    Jaafar, Jaafar; Pechère-Bertschi, Antoinette; Ditisheim, Agnès

    2014-09-10

    Hypertension is the most frequent medical disorder of pregnancy. Whether in the form of a chronic hypertension or a pregnancy induced-hypertension, or preeclampsia, it is associated with major maternal and neonatal morbidity and mortality. Improvement of prenatal care allowed a reduction in the number of poor outcomes. However, our partial understanding of the origin of gestational hypertension and preeclampsia limits the establishment of robust prediction models and efficient preventive interventions. This review discusses actual considerations on the clinical approach to hypertension in pregnancy.

  4. Changes of blood lipid in intrahepatic cholestasis of pregnancy and its clinical significance%妊娠期肝内胆汁淤积症血脂变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    文春蓉; 刘敏利

    2015-01-01

    Objective To explore the changes of blood lipid in intrahepatic cholestasis of pregnancy (ICP) patients and its clinical significance. Methods Collected empty stomach serum of 49 ICP patients in third trimester of pregnancy (ICP group) and 50 healthy pregnant women (control group) who gave birth in this hospital from 2010 to 2011. Measured and compared their blood lipid parameter. Divided ICP group′s patients into normal blood lipid group and abnormal blood lipid group ,and observed their liver function change. Results (1) ICP group′s total cholesterol,triacylglycerol and low density lipoprotein were all higher than control group′s while the high density lipoprotein was lower,differences showing statistical significance(P<0.05). (2)Abnor-mal blood lipid group′s alanine aminotransferase,aspartic transaminase amino acids,total bilirubin and direct bilirubin were all higher than normal blood lipid group′s,while the albumin was lower,and the amniotic fluid pollution and newborn complication′s incidence rate were higher,differences showing statistical significance(P<0.05). Conclusion The abnormal blood lipid of ICP patients is different from physiologic change of blood lipid during gestation period. It reflects the severe state of the illness and should be ICP patients′important monitoring index.%目的:探讨妊娠期肝内胆汁淤积症(ICP)患者血脂变化及其临床意义。方法收集2010~2011年在该院分娩的49例妊娠晚期ICP患者(ICP组)和50例健康孕妇(对照组)的空腹血清,测定血脂指标并进行比较。将ICP组患者分为血脂正常组(15例)和血脂异常组(34例),观察两组患者肝功能变化。结果(1)ICP组患者总胆固醇、三酰甘油、低密度脂蛋白均高于对照组,高密度脂蛋白低于对照组,差异均有统计学意义(P<0.05);(2)血脂异常组患者丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素及结合胆红素均

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

    Science.gov (United States)

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

    2014-10-01

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

  6. Correlates of urinary incontinence in pregnancy

    DEFF Research Database (Denmark)

    Hvidman, Lone; Foldspang, Anders; Mommsen, S.

    2002-01-01

    for the nulliparous and the primiparous, respectively. The present data suggest pregnancy UI not to be provoked by the mere onset of pregnancy, but by increasing hormonal concentrations or local tissue changes caused by hormones, whereas there was no support for a theory based on increasing pressure on the bladder......In a population sample, the period prevalence of urinary incontinence (UI) during pregnancy was found to be 19.9% and 24.1% among 352 nulliparous and 290 primiparous women, respectively. The first UI episode ever was experienced by 16.7% and 7.0% during the two last trimesters of the first...... and second pregnancies, respectively. None of the pregnancy-specific risk factors, such as emesis and birthweight, was significantly associated with UI during pregnancy. Previous UI was a significant risk factor for period prevalent UI during pregnancy, explaining 34% and 83% of pregnancy UI...

  7. Short-term variability of fetal heart rate in cholestasis of pregnancy.

    Science.gov (United States)

    Ammälä, P; Kariniemi, V

    1981-09-15

    Maternal cholestasis affects about 1% of pregnancies in Finland. Although maternal prognosis in obstetric cholestasis is always good, an increased fetal risk has been reported by several authors. In this paper the differential index (DI), describing the short-term variability of fetal heart rate, was measured in 64 pregnancies with colestasis of pregnancy by a microprocessor-based "on-line" method, which uses abdominal fetal electrocardiogram as a triggering signal. The analysis was successfull in 117 of 131 trials. In five pregnancies no successful analysis was obtained. Fetal distress developed in five fetuses of 59 but not perinatal deaths occurred. The sensitivity of the antepartum DI in predicting fetal distress in labor was 80% and the predictive value was 44%. The relative risk for intrapartum fetal distress in labor after a pathologic antepartal DI compared with normal DI was 22, which is highly significant (p less than 0.001).

  8. Thrombocytopenia in early pregnancy predicting partial haemolysis, elevated liver enzyme and low platelet count syndrome: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Kavitha Nagandla

    2016-08-01

    Full Text Available The incidence of thrombocytopenia in pregnancy is 6-10% and is classically defined as a platelet count of less than 150,000/ L. Counts less than 100,000 to 150,000/L are considered mild, 50,000 to 100,000/L as moderate, and less than 50,000/L are considered as severe thrombocytopenia. It is the second most common hematological condition in pregnancy with anaemia being the leading cause. Thrombocytopenia may be related to disorders that are intrinsic to pregnancy such as gestational thrombocytopenia that is seen in three-fourths of all cases. The second common cause is hypertensive disorders in pregnancy more commonly seen in severe pre-eclampsia in 21% and in HELLP (haemolysis, elevated liver enzyme and low platelet count that accounts for 12% of thrombocytopenia cases in pregnancy. This case report revisits the diagnosis of partial HELLP under the background of preeclampsia that warrants aggressive treatment like complete HELLP syndrome to optimize the maternal and fetal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2847-2850

  9. IIB期骨肉瘤XIAP表达及其预后预测的意义%XIAP expression and its predictive significance of prognosis in stage IIB osteosarcomas

    Institute of Scientific and Technical Information of China (English)

    Yunfa Yang; Hong Du; Pin Huang; Jianwei Wang; Guangming Zhang; Zhonghe Xu

    2008-01-01

    Objective:To evaluate X-linked inhibitor of apoptosis protein (XIAP) expression in biopsy specimens from the patients with stage IIB osteosarcomas before chemotherapy to study XIAP expression and its predictive significance of prognosis in stage IIB osteosarcomas.Methods:The expression of XIAP was retrospectively detected by SP immunohistochemistry in 31 cases biopsy specimens from stage IIB osteosarcomas before chemotherapy,and the relationship between XIAP expression and clinicopathologic features of the patients with stage IIB osteosarcomas was analyzed.Results:The osteosarcoma specimens showed strong cell nucleus immunoreaction of XIAP while normal bone specimens showed weak.High XIAP positive expression independently predicted the patient's poor outcome and had no relationship with clinicopathologic variables such as age,gender,location,tumor size,rate of tumor necrosis to preoperative chemotherapy,local recurrence (P>0.05).Significant correlations were found between high XIAP expression and metastasis (P=0.022),and also between high XIAP expression and final survival (P=0.011).Conclusion:XIAP plays an important role in the development of stage IIB osteosarcomas and XIAP expression of biopsy specimens before chemotherapy can be seen as a promising prognostic marker in early predicting the outcome of patlenta suffering from stage IIB osteosarcomas.

  10. PREDICTION OF SIGNIFICANT NEONATAL HYPERBILIRUBINAEMIA IN HEALTHY TERM NEW BORNS USING 22-26 HOURS’ SPECIFIC SERUM BILIRUBIN – A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Reddy

    2016-03-01

    Full Text Available INTRODUCTION Hyperbilirubinemia invariably occurs in the newborns and is discerned as clinical jaundice in nearly 50% of infants. It is a cause of concern not only for the parents but also for the paediatricians. Bilirubin production is 2-3 times higher in normal term newborns compared with adults. The colour in jaundice usually results from accumulation of unconjugated, non-polar, lipid soluble, bilirubin pigment in the skin which is formed from haemoglobin by the action of heme oxygenase, biliverdin reductase and non-enzymatic reducing agents in the reticulo-endothelial cells. AIMS & OBJECTIVE To determine hour specific serum bilirubin (22-26 hrs which will predict, subsequent significant hyperbilirubinemia in healthy term newborns. MATERIALS & METHODS A total of 250 healthy full term newborns were enrolled into the study. First bilirubin estimation (TSB 1 was estimated at 22- 26 hrs. The neonates were followed up clinically every 12 hrs for 72 hrs (till discharge. Second bilirubin estimation (TSB S was done whenever clinical suspicion of jaundice was present (usually at 72 hours. Depending upon the TSB 1 value, the infants were evaluated by using two available protocols (Arbitrary cut off value of 5 mg/dl and average value of 4.06 mg%. Sensitivity, specificity, negative and positive predictive values and likelihood ratio of the test were calculated. P-value was used to determine the level of significance. RESULTS Of 250 neonates included in the study, 13 neonates developed hyperbilirubinemia and were subjected to phototherapy. No infants with average bilirubin value of ≤4.06 mg% developed subsequent hyperbilirubinemia. However, 2 infants with arbitrary cut off value of ≤5 mg/dl developed hyperbilirubinemia. There was significant difference in TSB I value of neonates who subsequently did and those who did not developed significant hyperbilirubinemia (P-value-<0.01. The negative predictive value to these two applied protocol is very high

  11. 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.

  12. 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 & ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 & ...

  17. 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 ...

  18. 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 & ...

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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 ...

  18. 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 ...

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. 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. ...

  6. 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 & ...

  7. 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 ...

  8. 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 & ...

  9. Preimplantation genetic screening for all 24 chromosomes by microarray comparative genomic hybridization significantly increases implantation rates and clinical pregnancy rates in patients undergoing in vitro fertilization with poor prognosis

    Directory of Open Access Journals (Sweden)

    Gaurav Majumdar

    2016-01-01

    Full Text Available CONTEXT: A majority of human embryos produced in vitro are aneuploid, especially in couples undergoing in vitro fertilization (IVF with poor prognosis. Preimplantation genetic screening (PGS for all 24 chromosomes has the potential to select the most euploid embryos for transfer in such cases. AIM: To study the efficacy of PGS for all 24 chromosomes by microarray comparative genomic hybridization (array CGH in Indian couples undergoing IVF cycles with poor prognosis. SETTINGS AND DESIGN: A retrospective, case–control study was undertaken in an institution-based tertiary care IVF center to compare the clinical outcomes of twenty patients, who underwent 21 PGS cycles with poor prognosis, with 128 non-PGS patients in the control group, with the same inclusion criterion as for the PGS group. MATERIALS AND METHODS: Single cells were obtained by laser-assisted embryo biopsy from day 3 embryos and subsequently analyzed by array CGH for all 24 chromosomes. Once the array CGH results were available on the morning of day 5, only chromosomally normal embryos that had progressed to blastocyst stage were transferred. RESULTS: The implantation rate and clinical pregnancy rate (PR per transfer were found to be significantly higher in the PGS group than in the control group (63.2% vs. 26.2%, P = 0.001 and 73.3% vs. 36.7%, P = 0.006, respectively, while the multiple PRs sharply declined from 31.9% to 9.1% in the PGS group. CONCLUSIONS: In this pilot study, we have shown that PGS by array CGH can improve the clinical outcome in patients undergoing IVF with poor prognosis.

  10. Clinical Significance of the Prognostic Nutritional Index for Predicting Short- and Long-Term Surgical Outcomes After Gastrectomy: A Retrospective Analysis of 7781 Gastric Cancer Patients.

    Science.gov (United States)

    Lee, Jee Youn; Kim, Hyoung-Il; Kim, You-Na; Hong, Jung Hwa; Alshomimi, Saeed; An, Ji Yeong; Cheong, Jae-Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong-Bai

    2016-05-01

    To evaluate the predictive and prognostic significance of the prognostic nutritional index (PNI) in a large cohort of gastric cancer patients who underwent gastrectomy.Assessing a patient's immune and nutritional status, PNI has been reported as a predictive marker for surgical outcomes in various types of cancer.We retrospectively reviewed data from a prospectively maintained database of 7781 gastric cancer patients who underwent gastrectomy from January 2001 to December 2010 at a single center. From this data, we analyzed clinicopathologic characteristics, PNI, and short- and long-term surgical outcomes for each patient. We used the PNI value for the 10th percentile (46.70) of the study cohort as a cut-off for dividing patients into low and high PNI groups.Regarding short-term outcomes, multivariate analysis showed a low PNI (odds ratio [OR] = 1.505, 95% CI = 1.212-1.869, P cancer recurrence.

  11. Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analysis of outcome data at 12 months posttreatment.

    Science.gov (United States)

    Espie, C A; Inglis, S J; Harvey, L

    2001-02-01

    The clinical efficacy of cognitive behavior therapy (CBT) for chronic insomnia has been established, yet clinical effectiveness is less clear. This study presents data on 109 patients from general practice during a formal evaluation of clinical effectiveness. Two thirds achieved normative values of or =50%. Logistic regression revealed that initial severity did not contraindicate good outcome. Rather, greater sleep disturbance was positively associated with large symptom reduction, although lower endpoint scores were less likely. Similarly, symptoms of anxiety, depression, and thinking errors positively predicted good outcome. Hypnotic using patients responded equally well to CBT, and demographic factors were of no significant predictive value. It is concluded that CBT is clinically and durably effective for persistent insomnia in routine practice.

  12. 妊娠高血压患者血清淀粉样蛋白 A、血浆内皮素1和一氧化氮水平变化及其相互关系%Significance of serum amyloid A,endothelin-1 and nitric oxide in patients with pregnancy-induced hypertension

    Institute of Scientific and Technical Information of China (English)

    李峻; 王小娟

    2015-01-01

    Objective To observe the significance of serum amyloid A (SAA),endothelin-1 (ET-1)and nitric oxide (NO)in patients with pregnancy-induced hypertension and their relationship.Methods A total of 65 patients with pregnancy-induced hypertension were selected as pregnancy-induced hypertension group,including 24 cases with solely pregnancy-induced hypertension, 1 9 cases with mild preeclampsia and 22 cases with severe preeclampsia according to disease severity.At the same period,30 healthy pregnant women and 20 healthy women were selected as normal pregnancy control group and healthy control group,respectively.The levels of SAA,ET-1 and NO in pregnancy-induced hypertension group,normal pregnancy group and healthy control group were detected and their relationship with disease severity was observed.Results ① The levels of SAA and ET-1 in pregnancy-induced hypertension group and normal pregnancy group were significantly higher than those of healthy control group,and the levels of SAA and ET-1 were significantly higher in pregnancy-induced hypertension group than in normal pregnancy group (P <0.01);while the level of NO was significantly decreased,and the level of NO was significantly decreased in pregnancy-induced hypertension group than in normal pregnancy group (P <0.01).②The levels of SAA and ET-1 in severe preeclampsia and mild preeclampsia group were significantly higher than in pregnancy-induced hypertension group,and the indexes in severe preeclampsia group were significantly higher than those of mild preeclampsia group;while NO level was significantly decreased,and NO level was significantly decreased in severe preeclampsia group than in mild preeclampsia group (P < 0.05 ).③ The SAA level in patients with pregnancy-induced hypertension was positively correlated with ET-1 (r =0.876,P <0.05),while the SAA level was negatively correlated with NO (r =-0.761,P <0.05).Conclusion Endothelial dysfunction is found in pregnancy-induced hypertension,the markers of SAA

  13. 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...

  14. Accuracy of erythrogram and serum ferritin for the maternal anemia diagnosis (AMA): a phase 3 diagnostic study on prediction of the therapeutic responsiveness to oral iron in pregnancy

    OpenAIRE

    Bresani, Cristiane Campello; Braga, Maria Cynthia; Felisberto, Daniel Falcão; Tavares-de-Melo, Carlos Eduardo Lopes; Salvi, Debora Bresani; Batista-Filho,Malaquias

    2013-01-01

    Background Pregnancy anemia remains as a public health problem, since the official reports in the 70’s. To guide the treatment of iron-deficiency anemia in pregnancy, the haemoglobin concentration is the most used test in spite of its low accuracy, and serum ferritin is the most reliable test, although its cutoff point remains an issue. Methods/design The aim of this protocol is to verify the accuracy of erythrocyte indices and serum ferritin (studied tests) for the diagnosis of functional ir...

  15. Trauma in pregnancy

    Directory of Open Access Journals (Sweden)

    A Rudra

    2007-01-01

    Full Text Available Trauma is the most common non-obstetrical cause of death in pregnant women. Pregnancy must always be suspected in any female trauma patient of childbearing age until proved otherwise. Unique changes in anatomy and physiology that takes place during pregnancy alter the pathophysiology and location of maternal injuries in pregnancy, which may be significantly different from the non-pregnant state. Trauma from road traffic accidents, falls and domestic violence are the most common causes of abdominal blunt trauma. As pregnancy progresses, the change of accidental injury increases. Head and neck injuries, respiratory failure, and hypovolemic shock constitute the most frequent causes of trauma related maternal death in pregnancy. Even the pregnant woman with minor injuries should be carefully observed. Initial management is directed at resuscitation and stabilization of the mother that takes precedence over that of the fetus, unless vital signs cannot be maintained and perimortem cesarean section decided upon. Fetal monitoring should be maintained after satisfactory resuscitation and stabilization of the mother. Preventive measures include proper seat belt use and identifying and counseling victims of suspected domestic violence.

  16. Thrombophilia in complicated pregnancies

    Directory of Open Access Journals (Sweden)

    Ayşe Şahin

    2013-12-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  18. [Colpocytology and pregnancy].

    Science.gov (United States)

    Jiménez Cordero, A A; Echeveste García de Alba, E

    1995-01-01

    The relationship between cervical infection, cervical intraepithelial neoplasia (CIN), cervical cancer risk factors and pregnancy was studied in a group of 460 pregnant women at the time of their first prenatal examination, each woman was examined by Papanicolaou smear collected with cervexbrush. A total of 301 women (65.4%) with diagnosis of cervical infection was recorded, 4 cases of human papilomavirus infection and two women with CIN I and CIN II. 40 patients were identified with significant risk factors for the development of CIN. CIN prevalence knowledge and pregnancy cervical infection should be considered to prevent the neonates, male partner and women potential risk for cervix invasive carcinoma.

  19. 妊高征肾病患者血清TGF-β1、IL-8和VEGF检测的临床意义%Clinical Significance of Determination of Changes of Serum TGF-β1, IL-8 and VEGF Levels in Patients with Pregnancy Induced Hypertension Complicated with Nephropathy

    Institute of Scientific and Technical Information of China (English)

    李明; 吴玲; 陈海霞

    2011-01-01

    Objective To explore the significance of changes of serum TGF-β1, IL-8 and VEGF levels in patients with hyper tensive disorder complicating pregnancy. Methods Serum IL-8 ( with RiA ), serum TGF-β1, VEGF ( with ELISA ) levels were measured in 33 patients with pregnancy induced hypertension complicated with nephropathy, as well as in 35 healthy controls. Results The serum TGF-β1, IL-8 and VEGF levels in patients were significantly higher than those in controls ( P <0.01 ). Serum TGF-β1 levels were positively correlated to IL-8 ( r = 0. 6132, 0. 5834, P < 0.01 ). Conclusion VEGF levels were closely related with the diseases process of PIH. Determination of their changes might be useful for clinical diagnosis and predicting therapeutic effects in patients with PIH.%目的:探讨了妊高征肾病患者血清TGF-β1、IL-8和VEGF水平的变化及临床意义.方法:应用放射免疫分析和酶联法对33例妊高征肾病患者进行了血清TGF-β1、IL-8和VEGF测定,并与35名正常健康人作比较.结果:妊高征肾病患者血清TGF-β1、IL-8和VEGF水平均非常显著地高于正常人组(P<0.01),且血清TGF-β1水平与IL-8和VEGF水平呈正相关(r=0.6132、0.5834,P<0.01).结论:检测妊高征患者血清TGF-β1、IL-8和VEGF水平的变化对患者的病情的判断、临床治疗效果均有重要的临床价值.

  20. Neurosurgery and pregnancy

    Directory of Open Access Journals (Sweden)

    Rajkumar Subramanian

    2014-01-01

    Full Text Available Pregnant patients rarely present with neurosurgical emergencies, but can cause significant morbidity and mortality to the mother and the foetus. Physiological changes of pregnancy in relevance to neurosurgery, effects of anaesthetic agents on the foetus, common neurosurgical emergencies, and anaesthetic implications both from obstetric and neurosurgical point of view are discussed in this review.

  1. The prognostic significance of β-catenin, cyclin D1 and PIN1 in minor salivary gland carcinoma: β-catenin predicts overall survival.

    Science.gov (United States)

    Schneider, Sven; Thurnher, Dietmar; Seemann, Rudolf; Brunner, Markus; Kadletz, Lorenz; Ghanim, Bahil; Aumayr, Klaus; Heiduschka, Gregor; Lill, Claudia

    2016-05-01

    Minor salivary gland carcinoma is a rare and heterogeneous type of cancer. Molecular prognostic and predictive markers are sparse. The aim of this study was to identify new prognostic and predictive markers in minor salivary gland carcinoma. 50 tissue samples of carcinomas of the minor salivary glands (adenoid cystic carcinoma n = 23, mucoepidermoid carcinoma n = 12, adenocarcinoma n = 10, carcinoma ex pleomorphic adenoma n = 2, salivary duct carcinoma n = 1, clear cell carcinoma n = 1, basal cell carcinoma n = 1) were immunohistochemically stained for β-catenin, cyclin D1 and PIN1. Expression patterns were analyzed and correlated to clinical outcome of 37 patients with complete clinical data. High expression of membranous β-catenin was linked to significantly better overall survival in patients with adenoid cystic carcinoma (log rank test, χ (2) = 13.3, p = .00397, Bonferroni corrected p = .024). PIN1 and cyclin D1 did not show any significant correlation to patients' clinical outcome. Expression of β-catenin in adenoid cystic carcinoma of the minor salivary glands significantly correlates with better overall survival. Hence, evaluation of β-catenin might serve as a clinical prognostic marker.

  2. The management of hypertension in pregnancy.

    Science.gov (United States)

    Kattah, Andrea G; Garovic, Vesna D

    2013-05-01

    Hypertensive pregnancy disorders complicate 6% to 8% of pregnancies and cause significant maternal and fetal morbidity and mortality. The goal of treatment is to prevent significant cerebrovascular and cardiovascular events in the mother without compromising fetal well-being. Current guidelines differentiate between the treatment of women with acute hypertensive syndromes of pregnancy and women with preexisting chronic hypertension in pregnancy. This review will address the management of hypertension in pregnancy, review the various pharmacologic therapies, and discuss the future directions in this field.

  3. Serum copeptin and pregnancy outcome in preeclampsia

    Directory of Open Access Journals (Sweden)

    Kehinde Sola Akinlade

    2015-01-01

    Full Text Available Background: A number of biochemical predictors of preeclampsia have been reported, but little is known about their possible relationship with maternal and fetal outcomes. This study determined serum copeptin in pregnant women with preeclampsia and assessed its relationship with pregnancy outcomes. Materials and Methods: Thirty women with severe preeclampsia (SP, 30 with mild preeclampsia (MP, and 30 with uncomplicated pregnancy were enrolled into this study. Serum copeptin, creatinine, and liver function were determined using enzyme-linked immunosorbent assay and colorimetry as appropriate. Pregnancy outcomes, both maternal and fetal, were taken using standard methods. Results: Copeptin was significantly elevated in preeclampsia subjects compared with controls and in SP compared with MP. Assessing the diagnostic property of copeptin for preeclampsia, the area under the curve for copeptin was 0.99. Nine (30% and 3 (10% of SP and MP, respectively had abruptio placenta while 6 (20%, 2 (6.7%, and 1 (3.3% still births were recorded in SP, MP, and controls, respectively. Neonates of mothers with preeclampsia had significantly lower birth weight, infant length, ponderal index, and head circumference compared with neonates of the controls. Copeptin had a significant inverse relationship with birth weight, ponderal index, head circumference, Apgar score, and infant length in neonates of mothers with preeclampsia. Conclusion: Serum copeptin level in the third trimester could predict preeclampsia and its elevation is associated with adverse perinatal outcome.

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

    Science.gov (United States)

    Goswami, Deepti; Agrawal, Nidhi; Arora, Vrinda

    2015-11-01

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

  5. Quantum mechanically based estimation of perturbed-chain polar statistical associating fluid theory parameters for analyzing their physical significance and predicting properties.

    Science.gov (United States)

    Nhu, Nguyen Van; Singh, Mahendra; Leonhard, Kai

    2008-05-08

    We have computed molecular descriptors for sizes, shapes, charge distributions, and dispersion interactions for 67 compounds using quantum chemical ab initio and density functional theory methods. For the same compounds, we have fitted the three perturbed-chain polar statistical associating fluid theory (PCP-SAFT) equation of state (EOS) parameters to experimental data and have performed a statistical analysis for relations between the descriptors and the EOS parameters. On this basis, an analysis of the physical significance of the parameters, the limits of the present descriptors, and the PCP-SAFT EOS has been performed. The result is a method that can be used to estimate the vapor pressure curve including the normal boiling point, the liquid volume, the enthalpy of vaporization, the critical data, mixture properties, and so on. When only two of the three parameters are predicted and one is adjusted to experimental normal boiling point data, excellent predictions of all investigated pure compound and mixture properties are obtained. We are convinced that the methodology presented in this work will lead to new EOS applications as well as improved EOS models whose predictive performance is likely to surpass that of most present quantum chemically based, quantitative structure-property relationship, and group contribution methods for a broad range of chemical substances.

  6. Thyroid disease and pregnancy.

    Science.gov (United States)

    Becks, G P; Burrow, G N

    1991-01-01

    Thyroid disease is common in younger women and may be a factor in reproductive dysfunction. This probably only applies to severe cases of hyper- or hypothyroidism. Once adequately treated, neither of these disorders significantly impacts on fertility. The key is to recognize and to treat thyroid disorders in the reproductive-age woman before conception. Thyroxine therapy and even antithyroid drug therapy should be continued during pregnancy as necessary. Pregnancy is a euthyroid state that is normally maintained by complex changes in thyroid physiology. The fetal and neonatal hypothalamic-pituitary-thyroid system develops independently, but it may be influenced by thyroid disease in the mother. Early pregnancy is characterized by an increase in maternal T4 secretion stimulated by hCG and an increase in TBG, resulting in the elevated total serum T4 in pregnancy. The debate continues as to whether maternal T4 is important in early or late fetal brain development. If so, the physiologic changes in thyroid hormone secretion and transport in early pregnancy would help to ensure that a sufficient amount of thyroid hormone was available. There is new evidence in human subjects that substantial maternal T4 can cross the placenta during pregnancy, and this may be particularly important when fetal thyroid function is compromised as a result of congenital hypothyroidism. Maternal and fetal/neonatal outcomes in pregnancy are adversely affected if severe hypothyroidism is undiagnosed or inadequately treated. Thyroid function tests should be obtained during gestation in women taking T4 and appropriate dose adjustments should be made for TSH levels outside a normal range. The TSH-receptor blocking antibodies from the mother are a recognized cause of congenital hypothyroidism in the fetus and neonate that can be permanent or transient. If neonatal hypothyroidism is detected through neonatal screening programs, and prompt and adequate T4 replacement therapy is instituted as soon as

  7. Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles

    Directory of Open Access Journals (Sweden)

    Ari Kim

    2014-09-01

    Conclusion: Three dimensional PD-US was a useful and effective method for assessing endometrial blood flow in IVF cycles. Good endometrial blood flow on the day of embryo transfer might be associated with high pregnancy success with a GnRH long protocol, because this is indicative of endometrial receptivity in fresh IVF cycles.

  8. The usefulness of endometrial thickness, morphology and vasculature by 2D Doppler ultrasound in prediction of pregnancy in IVF/ICSI cycles

    Directory of Open Access Journals (Sweden)

    Moustafa Abdel Kader

    2016-03-01

    Conclusion: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line and non-favorable blood flow zone on day of hCG in IVF/ICSI cycles, pregnancy is unlikely and embryo transfer should be canceled with freezing of all embryos for future transfer to increase the success rate.

  9. 基层医院孕期保健与产程专人负责制临床意义探讨%Primary Hospital Pregnancy Nursing and Bring Process Time Personnel Responsibility Clinical Significance

    Institute of Scientific and Technical Information of China (English)

    鲁刚美

    2015-01-01

    Primary hospital pregnancy nursing and bring process management level still need to be improved, pregnancy nursing and bring process personnel responsibility, maternal pregnancy nursing and bring process charged by medical professional labor system, helps to improve the quality of pregnancy nursing, ensuring the nursing professional, improve maternal clinical psychologi-cal state, safeguard the seamless link of pregnancy health and labor, decrease the rate of cesarean delivery, help to effectively i-dentify risk factors and management of high risk, improve the efficiency of medical work in labor, avoid delay in diagnosis and treatment time, guarantee labor smoothly, and improve the level of maternal and child health.%基层医院孕期保健与产程管理水平亟待提高,孕期保健与产程专人负责制是指由专人一个孕产妇整个孕期保健、产程均由一名专业医师负责的制度,有助于提高孕期保健专业性、保障保健质量、改善产妇临床心理状态、保障妊娠保健与分娩的无缝链接,降低剖宫产率,有助于有效识别与管理高危风险因素、提高临产医护工作效率、避免延误诊治时机、保障产程顺利,提高母婴健康水平。

  10. 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.

  11. 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 ...

  12. 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 ...

  13. 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.

  14. Mid-Treatment Sleep Duration Predicts Clinically Significant Knee Osteoarthritis Pain reduction at 6 months: Effects From a Behavioral Sleep Medicine Clinical Trial.

    Science.gov (United States)

    Salwen, Jessica K; Smith, Michael T; Finan, Patrick H

    2017-02-01

    To determine the relative influence of sleep continuity (sleep efficiency, sleep onset latency, total sleep time [TST], and wake after sleep onset) on clinical pain outcomes within a trial of cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid knee osteoarthritis and insomnia. Secondary analyses were performed on data from 74 patients with comorbid insomnia and knee osteoarthritis who completed a randomized clinical trial of 8-session multicomponent CBT-I versus an active behavioral desensitization control condition (BD), including a 6-month follow-up assessment. Data used herein include daily diaries of sleep parameters, actigraphy data, and self-report questionnaires administered at specific time points. Patients who reported at least 30% improvement in self-reported pain from baseline to 6-month follow-up were considered responders (N = 31). Pain responders and nonresponders did not differ significantly at baseline across any sleep continuity measures. At mid-treatment, only TST predicted pain response via t tests and logistic regression, whereas other measures of sleep continuity were nonsignificant. Recursive partitioning analyses identified a minimum cut-point of 382 min of TST achieved at mid-treatment in order to best predict pain improvements 6-month posttreatment. Actigraphy results followed the same pattern as daily diary-based results. Clinically significant pain reductions in response to both CBT-I and BD were optimally predicted by achieving approximately 6.5 hr sleep duration by mid-treatment. Thus, tailoring interventions to increase TST early in treatment may be an effective strategy to promote long-term pain reductions. More comprehensive research on components of behavioral sleep medicine treatments that contribute to pain response is warranted.

  15. Predictive significance of DNA damage and repair biomarkers in triple-negative breast cancer patients treated with neoadjuvant chemotherapy: An exploratory analysis.

    Science.gov (United States)

    Vici, Patrizia; Di Benedetto, Anna; Ercolani, Cristiana; Pizzuti, Laura; Di Lauro, Luigi; Sergi, Domenico; Sperati, Francesca; Terrenato, Irene; Dattilo, Rosanna; Botti, Claudio; Fabi, Alessandra; Ramieri, Maria Teresa; Mentuccia, Lucia; Marinelli, Camilla; Iezzi, Laura; Gamucci, Teresa; Natoli, Clara; Vitale, Ilio; Barba, Maddalena; Mottolese, Marcella; De Maria, Ruggero; Maugeri-Saccà, Marcello

    2015-12-15

    Response of cancer cells to chemotherapy-induced DNA damage is regulated by the ATM-Chk2 and ATR-Chk1 pathways. We investigated the association between phosphorylated H2AX (γ-H2AX), a marker of DNA double-strand breaks that trigger the ATM-Chk2 cascade, and phosphorylated Chk1 (pChk1), with pathological complete response (pCR) in triple-negative breast cancer (TNBC) patients treated with neoadjuvant chemotherapy. γ-H2AX and pChk1 were retrospectively assessed by immunohistochemistry in a series of pretreatment biopsies related to 66 patients. In fifty-three tumors hormone receptor status was negative in both the diagnostic biopsies and residual cancers, whereas in 13 cases there was a slight hormone receptor expression that changed after chemotherapy. Internal validation was carried out. In the entire cohort elevated levels of γ-H2AX, but not pChk1, were associated with reduced pCR rate (p = 0.009). The association tested significant in both uni- and multivariate logistic regression models (OR 4.51, 95% CI: 1.39-14.66, p = 0.012, and OR 5.07, 95% CI: 1.28-20.09, p = 0.021, respectively). Internal validation supported the predictive value of the model. The predictive ability of γ-H2AX was further confirmed in the multivariate model after exclusion of tumors that underwent changes in hormone receptor status during chemotherapy (OR 7.07, 95% CI: 1.39-36.02, p = 0.018). Finally, in residual diseases a significant decrease of γ-H2AX levels was observed (p predict pCR in TNBC and deserves larger, prospective studies.

  16. 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

  17. Contraceptive practices and pregnancy intendedness among pregnant adolescents

    Directory of Open Access Journals (Sweden)

    Lanjakornsiripan W

    2015-03-01

    Full Text Available Wakul Lanjakornsiripan, Siriruthai Amnatbuddee, Kanok Seejorn, Yuthapong Werawatakul, Pilaiwan Kleebkaow, Ratana Komwilaisak, Sanguanchoke Luanratanakorn Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Background: Adolescent pregnancy is a major health problem in many developing countries.Objective: To assess contraceptive practices and pregnancy intendedness in pregnant adolescents.Materials and methods: This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR and 95% confidence interval (CI of independent predictors.Results: Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0% were currently in school. Seventy-five (37.5% participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%. Only two participants (1.0% had ever used an intrauterine device or implant. Participants’ age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94–14.04. Of the 200 participants, 132 (66.0% declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27–13.75 and participants’ age (aOR, 5.76; 95% CI, 2.42–13.70.Conclusion: Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants’ age was an independent factor

  18. [Study on the relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis].

    Science.gov (United States)

    Lu, Junling; Kuang, Jingxia; Cheng, Xiaolin

    2014-11-01

    To investigate the association between prenatal monitoring index in intrahepatic cholestasis of pregnancy and the perinatal prognosis, as well as the characteristics of perinatal situations. A retrospective study on the clinical data of 88 cases intrahepatic cholestasis of pregnancy and prognosis that were treated in our hospital from Jan. 2011 to Jan. 2014 was carried out. Relationship between prenatal monitoring index in intrahepatic cholestasis of pregnancy and perinatal prognosis, together with the epidemiological features of infants were analyzed. The incidence rates of perinatal meconium stained amniotic fluid, asphyxia neonatorum, premature and fetal distress were significantly higher in the study group than those in the controls, with differences statistically significant (P intrahepatic cholestasis of pregnancy, with most frequently seen as meconium stained amniotic fluid. It was necessary to monitor the level of prenatal CG, ALT, AST, TBIL and TBA in puerperant in predicting the perinatal prognosis.

  19. Hemostatic changes in pregnancy

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    Paolo Simioni

    2013-08-01

    Full Text Available Normal pregnancy is associated with changes in all aspects of haemostasis, including increase in concentrations of most clotting factors, decreasing concentrations of some of the natural anticoagulants and diminishing fibrinolytic activity. These changes help in maintaining placental function during pregnancy but result in a state of hypercoagulability that may predispose to thrombosis and placental vascular complications. During pregnancy, the concentrations of coagulation factors V, VII, VIII, IX, X, XII and von Willebrand factor rise significantly, accompanied by a pronounced increase in fibrinogen levels which increases up to two-fold from non-pregnant levels. Furthermore, there is a decrease in physiological anticoagulants manifested by a significant reduction in protein S activity and by acquired activated protein C resistance. The overall fibrinolytic activity is impaired during pregnancy, but returns rapidly to normal following delivery. This is largely due to placental derived plasminogen activator inhibitor type 2 (PAI-2, which is present in substantial quantities during pregnancy. D-Dimer levels increase in pregnancy but are not thought to indicate intravascular coagulation as fibrinolysis is depressed. These D-Dimers may originate from the uterus. Finally, the platelet count decreases in normal pregnancy possibly due to increased destruction and haemodilution with a maximal decrease in the third trimester. Immediately after delivery there is an increase in platelet count, especially in patients undergoing cesarean section. During treatment of severe post-partum hemorrhage, it is absolutely essential to have the knowledge that the starting values of the platelets are very different as compared to a non-pregnant patient. Moreover, after delivery, also the levels of fibrinogen increase. Since the value of fibrinogen represents a crucial parameter for the management of acute bleeding, it is essential to administer the proper amount of

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

    Science.gov (United States)

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

    2015-03-01

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

  1. The Level of Serum and Urinary Nephrin in Normal Pregnancy and Pregnancy with Subsequent Preeclampsia

    Science.gov (United States)

    Jung, Yun Ji; Cho, Hee Young; Cho, SiHyun; Kim, Young Han; Jeon, Jin-Dong; Kim, Young-Jin; Lee, Sanghoo; Park, Jimyeong; Kim, Ha Yan; Park, Yong-Won

    2017-01-01

    Purpose The aim of this study was to evaluate serum and urinary nephrin levels of normal pregnancy to establish a standard reference value and to compare them with patients who subsequently developed preeclampsia (PE). Materials and Methods In this prospective study, 117 healthy singleton pregnancies were enrolled between 6 to 20 weeks of gestation at 2 participating medical centers during October 2010 to March 2012. Urine and serum samples were collected at the time of enrollment, each trimester, and at 4 to 6 weeks postpartum. Enzyme-linked immunosorbent assay for nephrin was performed and samples from patients who subsequently developed PE were compared to the normal patients. Results Of 117 patients initially enrolled, 99 patients delivered at the study centers and of those patients, 12 (12.1%) developed PE at a median gestational age of 34+4 weeks (range 29+5–36+6). In the normal patients (n=68), serum nephrin level decreased and urinary nephrin level increased during the latter of pregnancy. In 12 patients who subsequently developed PE, a significant rise in the 3rd trimester serum and urinary nephrin levels, compared to the controls, was observed (p<0.001), and this increase occurred 9 days prior to the onset of clinical disease. Conclusion As the onset of PE was preceded by the rise in the serum and urinary nephrin in comparison to normal pregnancy, serum and urinary nephrin may be a useful predictive marker of PE. PMID:28120572

  2. Quantifying Proteinuria in Hypertensive Disorders of Pregnancy

    Directory of Open Access Journals (Sweden)

    Sapna V. Amin

    2014-01-01

    Full Text Available Background. Progressive proteinuria indicates worsening of the condition in hypertensive disorders of pregnancy and hence its quantification guides clinician in decision making and treatment planning. Objective. To evaluate the efficacy of spot dipstick analysis and urinary protein-creatinine ratio (UPCR in hypertensive disease of pregnancy for predicting 24-hour proteinuria. Subjects and Methods. A total of 102 patients qualifying inclusion criteria were evaluated with preadmission urine dipstick test and UPCR performed on spot voided sample. After admission, the entire 24-hour urine sample was collected and analysed for daily protein excretion. Dipstick estimation and UPCR were compared to the 24-hour results. Results. Seventy-eight patients (76.5% had significant proteinuria of more than 300 mg/24 h. Dipstick method showed 59% sensitivity and 67% specificity for prediction of significant proteinuria. Area under curve for UPCR was 0.89 (95% CI: 0.83 to 0.95, P<0.001 showing 82% sensitivity and 12.5% false positive rate for cutoff value of 0.45. Higher cutoff values (1.46 and 1.83 predicted heavy proteinuria (2 g and 3 g/24 h, resp.. Conclusion. This study suggests that random urinary protein : creatine ratio is a reliable investigation compared to dipstick method to assess proteinuria in hypertensive pregnant women. However, clinical laboratories should standardize the reference values for their setup.

  3. 妊娠期高血压病患者血清多指标检测的临床意义%Clinical significance of serum parameters detection in the diagnosis of hypertension disorders complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    郑强; 刘世平; 苟莉; 王逊; 王凡

    2015-01-01

    Objective To explore the diagnostic value of combined detection of serum calcium ion (Ca2+ ) ,C‐reaction protein (CRP) ,uric acid(UA) ,homocysteine(Hcy) and complement C3 ,C4 in hypertension disorders complicating pregnancy(HDCP) . Methods Patients with HDCP were enrolled as HDCP group ,and pregnant women without HDCP were enrolled as control group . Serum parameters ,mentioned above ,were detected and compared between the two groups .Diagnostic performance of the parameters was also analyzed .Results Serum levels of Ca2+ ,CRP ,UA ,Hcy and complement C3 ,C4 in HDCP group were significantly differ‐ent from those in control group(P0 .05) .Serum lev‐els of CRP ,UA and Hcy increased with the progress of HDCP disease condition ,but serum levels of Ca2+ ,C3 and C4 decreased .Be‐tween different sub‐group of HDCP patients ,serum levels of the six parameters were with significant differences(P<0 .05) .Conclu‐sion Early combined detection of serum Ca2+ ,CRP ,UA ,Hcy and complement C3 ,C4 could be with significance for the early diag‐nosis and treatment of HDCP ,and also for the condition assessment of HDCP .%目的:探讨血清钙离子(Ca2+)、C反应蛋白(CRP)、尿酸(UA)、同型半胱氨酸(Hcy)及补体C3、C4联合检测对妊娠期高血压病(HDCP)的诊断价值。方法以HDCP确诊患者作为HDCP组,以未合并 HDCP的孕妇作为对照组,检测并比较血清Ca2+、CRP、UA、Hcy及补体C3、C4水平,分析各指标单独检测及联合检测对 HDCP的诊断性能。结果 HDCP组与对照组血清Ca2+、CRP、UA、Hcy及补体C3、C4水平比较差异有统计学意义(P<0.05)。6项指标联合检测的灵敏度、符合率及正确诊断率高于各指标单独检测(P<0.05),但特异度比较差异无统计学意义(P>0.05)。血清CRP、UA和Hcy水平随着 HDCP患者病情进展逐渐升高,而血清Ca2+、补体C3和C4水平逐渐降低,且 HDCP患者各亚组间不同

  4. The expression and significance of syncytin in placenta of normal pregnancy and pre-eclampsia%Syncytin在正常妊娠及子痫前期胎盘组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    李春芳; 苟文丽; 李雪兰; 杨婷

    2012-01-01

    目的 探讨syncytin在正常妊娠及子痫前期胎盘组织中的表达及意义.方法 采用荧光实时定量PCR( Realtime FQ-PCR)方法检测正常晚期妊娠(20例)、晚发型子痫前期轻度(20例)、重度(25例)及早发型重度子痫前期(15例)胎盘组织中syncytin mRNA表达.结果 Syncytin mRNA在正常妊娠晚期及子痫前期胎盘组织中均有表达;晚发型子痫前期与正常晚孕比较,胎盘组织syncytin mRNA表达降低,且与病情严重程度相关;早发型与晚发型比较,早发型重度子痫前期表达降低更为明显,差异有统计学意义(P<0.01).结论Syncytin mRNA在子痫前期胎盘组织中表达降低,早发型降低更为明显,而syncytin与滋养细胞融合有关,提示滋养细胞融合障碍可能在子痫前期发病中发挥作用.%Objective To detect the expression and significance of syncytin mRNA in placenta of pre-eclampsia and normal pregnancy. Methods The expression of syncytin mRNA in placenta of 45 late-onset pre-eclampsia patients (20 cases of mild pre-eclampsia and 25 cases of severe pre-eclampsia), 15 early-onset severe pre-eclampsia and 20 normal pregnant women was determined by Real-time FQ-PCR. Results Syncytin mRNA was expressed in placenta of normal and pre-eclanjpsia; it was significantly decreased in late-onset pre-eclampsia than in normal placenta, and the expression level was related to the severity of pre-eclampsia. Syncytin mRNA was significantly lower in early-onset severe pre-eclampsia than in late-onset pre-eclampsia placenta (P<0. 01). Conclusion Syncytin mRNA has a lower expression in placenta of pre-eclampsia, especially in early-onset severe pre-eclampsia; and expression of syncytin is related to trophocyte fusion, suggesting that disorder of trophocyte fusion may play a role in the pathogenesis of pre-eclampsia.

  5. The association between HIV (treatment), pregnancy serum lipid concentrations and pregnancy outcomes : a systematic review

    NARCIS (Netherlands)

    Harmsen, Marissa J; Browne, Joyce L; Venter, Francois; Klipstein-Grobusch, Kerstin; Rijken, Marcus J|info:eu-repo/dai/nl/343154757

    2017-01-01

    BACKGROUND: Observed adverse effects of antiretroviral therapy (ART) on the lipid profile could be of significance in pregnancy. This systematic review aims to summarize studies that investigated the association between HIV, ART and serum lipids during pregnancy and adverse pregnancy outcomes.

  6. Down-regulated microRNA-375 expression as a predictive biomarker in non-small cell lung cancer brain metastasis and its prognostic significance.

    Science.gov (United States)

    Chen, Li-Juan; Li, Xing-Ya; Zhao, Yan-Qiu; Liu, Wen-Jing; Wu, Hui-Juan; Liu, Jie; Mu, Xiao-Qian; Wu, Hong-Bo

    2017-08-01

    Brain metastases (BM) are common among patients with non-small cell lung cancer (NSCLC) and have been associated with significant morbidity and limited survival. Early and sensitive detection of BM is essential for improving prognosis. Recently, microRNA-375(miR-375) which is specifically expressed in the brain has been found significantly dysregulated in many human cancers. However, there is still no data whether miR-375 is associated with higher risk of BM development in NSCLC. In this study, we detected the miR-375 expression using quantitative real-time PCR (qRT-PCR) and assessed its predictive and prognostic significance. Our result showed that miR-375 expression was significantly down-regulated in NSCLC patients with BM(BM+, N=30) compared with NSCLC without BM(BM-, N=30) (P<0.001). Statistical analysis indicated that low miR-375 expression was linked to advanced disease stage (P<0.001) and brain metastasis (P<0.001) in NSCLC patient. Survival analysis suggested that low-expression group had significantly shorter overall survival than high-expression group in NSCLC patients with BM(log-rank test: P<0.05) as well as the total cases(log-rank test: P<0.01). Multivariate Cox proportional hazards model analysis indicated that low miR-375 expression was independently linked to poor survival of patients with NSCLC (HR=5.48, 95% CI: 1.93-15.56, P=0.001). In addition, we found that VEGF and MMP-9 were over-expressed in down-regulated miR-375 expression cases. Collectively, this study demonstrated that miR-375 may play an important role as a predictive biomarker in brain metastasis and an independent prognostic factor in NSCLC. Over-expression of VEGF and MMP-9 may be the reason for poor prognosis of NSCLC patients with low miR-375 expression. Copyright © 2017 Elsevier GmbH. All rights reserved.

  7. [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.

  8. [Predictive factors of clinically significant drug-drug interactions among regimens based on protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir].

    Science.gov (United States)

    Cervero, Miguel; Torres, Rafael; Jusdado, Juan José; Pastor, Susana; Agud, Jose Luis

    2016-04-15

    To determine the prevalence and types of clinically significant drug-drug interactions (CSDI) in the drug regimens of HIV-infected patients receiving antiretroviral treatment. retrospective review of database. Centre: Hospital Universitario Severo Ochoa, Infectious Unit. one hundred and forty-two participants followed by one of the authors were selected from January 1985 to December 2014. from their outpatient medical records we reviewed information from the last available visit of the participants, in relation to HIV infection, comorbidities, demographics and the drugs that they were receiving; both antiretroviral drugs and drugs not related to HIV infection. We defined CSDI from the information sheet and/or database on antiretroviral drug interactions of the University of Liverpool (http://www.hiv-druginteractions.org) and we developed a diagnostic tool to predict the possibility of CSDI. By multivariate logistic regression analysis and by estimating the diagnostic performance curve obtained, we identified a quick tool to predict the existence of drug interactions. Of 142 patients, 39 (29.11%) had some type of CSDI and in 11.2% 2 or more interactions were detected. In only one patient the combination of drugs was contraindicated (this patient was receiving darunavir/r and quetiapine). In multivariate analyses, predictors of CSDI were regimen type (PI or NNRTI) and the use of 3 or more non-antiretroviral drugs (AUC 0.886, 95% CI 0.828 to 0.944; P=.0001). The risk was 18.55 times in those receiving NNRTI and 27,95 times in those receiving IP compared to those taking raltegravir. Drug interactions, including those defined as clinically significant, are common in HIV-infected patients treated with antiretroviral drugs, and the risk is greater in IP-based regimens. Raltegravir-based prescribing, especially in patients who receive at least 3 non-HIV drugs could avoid interactions. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  9. 孕早期规范性系统化营养体重管理对妊娠结局临床意义%The clinical significance of trimester normative systematic nutrition weight management on pregnancy outcomes

    Institute of Scientific and Technical Information of China (English)

    吴秋英

    2015-01-01

    Objective Analysis the clinical and social value of nutrition and weight management in early pregnancy.Methods 486 cases of first and single tire pregnant woman whose gestational age <13 weeks were collected, randomly divided into intervention and control groups, intervention group take individualized integrated management through three dietary, lifestyle, regular activities; the control group did not implement nutrition weight management; observed and recorded the dynamic changes of BMI during pregnancy, the incidence of complications and pregnancy outcomes. Results Weight control were better than control group in intervention group (P<0.05), and cesarean section rate and complication rates were lower than the control group (P<0.05). Conclusion Normative systematic nutrition weight management can reduce pregnancy complications and cesarean section rate,improve the occurrence of adverse outcomes of pregnancy, worthy of clinical application.%目的 探讨孕早期进行营养体重管理的临床价值及社会效益.方法 收集自2012年1月~2014年6月孕周<13周开始到我院产检的初产单胎妇女486例,随机平均分为干预组和对照组,干预组通过膳食营养、生活方式、适量活动等三个方面进行个体化的综合管理;对照组不实施营养体重管理;观察记录两组孕妇孕期BMI动态变化、并发症发生情况和妊娠结局.结果 干预组体重控制较对照组好(P<0.05),剖宫产率和并发症发生率都较对照组低(P<0.05).结论 孕早期规范性系统化营养体重管理可以减少妊娠并发症降低剖宫产率,改善妊娠不良结局的发生,值得在临床推广应用.

  10. Managing antiepileptic drugs during pregnancy and lactation

    DEFF Research Database (Denmark)

    Sabers, Anne; Tomson, Torbjörn

    2009-01-01

    PURPOSE OF REVIEW: This review discusses data on the pharmacokinetics of antiepileptic drugs (AEDs) in pregnancy and lactation, and the clinical consequences thereof, thus providing a basis for a rational management of AEDs during pregnancy and lactation. RECENT FINDINGS: Studies have confirmed...... of AEDs in pregnancy</