Articles de revues : « Outcome gravidici »

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Santow, Gigi, et Michael Bracher. « Do gravidity and age affect pregnancy outcome ? » Biodemography and Social Biology 36, n^o 1-2 (mars 1989) : 9–22. http://dx.doi.org/10.1080/19485565.1989.9988716.

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Akther, Rabeya. « Outcome of grand multi-gravidity & ; multiparity A retrospective study ». Journal of Dhaka Medical College 22, n^o 1 (8 juillet 2013) : 67–71. http://dx.doi.org/10.3329/jdmc.v22i1.15629.

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Objective: To examine the obstetric outcome in grand multi-parous and the effect of high parity among young women, aged 18-34 years vs. older women, aged 35years and above. Methods: This is a retrospective study done in DMCH from 1st August 2007 to 31st August 2008. For study purpose 98 patients were selected randomly whose gravidity 6th and more. To see peri-natal outcome, the cut-off point of 28 weeks was taken. Results: Mean age of the study group was 32(22-45) years. Mean gravidity and parity of the study group was 6.7 (6-11) and 4(1-8) respectively. Ninety percent pregnancy affected by different complications. Hypertensive disorder of pregnancy (14.3%) and ante-partum hemorrhage (14.3%) was more common. Bad obstetric history (12.35%), mal-presentation (11.23%) and intra-partum complications were also common. Twenty two percent (22.46%) pregnancies complicated by gestational diabetes, maternal medical disease and multi-fetal gestation. Regarding fetal outcome, peri-natal loss was 10(14%). Preterm delivery, ante partum hemorrhage, bad obstetric history, gestational diabetes and mal presentation were the cause of peri natal loss. Lack of reproductive knowledge, unmet need for contraception, poor obstetric performance and too early marriage are the main cause of grand multi-gravidity and multi-parity Conclusion: Diabetes mellitus, hypertension, ante partum hemorrhage, mal-presentation was more common in grand multi-parous irrespective of age. There was no significant difference in the incidence of obstetric complications and in perinatal outcome among both groups. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15629 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 67-71

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Reime, B., B. A. Schuecking et P. Wenzlaff. « Perinatal outcomes of teenage pregnancies according to gravidity and obstetric history ». Annals of Epidemiology 14, n^o 8 (septembre 2004) : 619. http://dx.doi.org/10.1016/j.annepidem.2004.07.074.

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Abbasi, Noureen, Quratulain Qureshi, Urooj Abbasi, Noor ul ain Aziz, Feriha Fatima Khidri et Sehrish Rasool. « Fetomaternal Outcome in Antepartum Hemorrhage ; A Cross Sectional Study at Feto-Tertiary Care Hospital of Sindh, Pakistan ». International Journal of Current Research and Review 14, n^o 10 (2022) : 103–7. http://dx.doi.org/10.31782/ijcrr.2022.141018.

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Introduction: Antepartum hemorrhage is the bleeding from the genital tract following the completion of 28 weeks of pregnancy till full term. It is an obstetrical emergency and a leading cause of maternal and perinatal death and morbidity. Objectives: This study was conducted to determine the frequency of maternal and fetal complications in women with antepartum hemorrhage. Methods: It was a cross sectional study held at the Department of Gynecology and Obstetrics unit IV, Liaquat University of Medical and Health Sciences, Jamshoro between 2017 and 2019. This study enrolled 158 women with a history of antepartum hemorrhage using non- probability consecutive sampling. The fetal and maternal outcomes of the patients were recorded. Maternal outcomes were assessed according to age, gravidity and gestational week. Data was analyzed in SPSS 20. Results: The average age of the women was 25.77±4.15 years. Anemia was the most common maternal outcome 102(64.6%) followed by disseminated intravascular coagulation (DIC) 24(15.2%), shock 12(7.6%), postpartum hemorrhage (PPH) 11(7%) and maternal mortality 5 (3.1%). Preterm birth and low APGAR score were the most frequently fetal outcomes that were observed in 69 (43.7%) and 50 (31.6%) cases, respectively. There was significant association of DIC with gravidity and gestational age. Anemia was significantly associated with gestational age more frequently among mothers with <37 weeks of gestational age. Conclusion: In conclusion, anemia was the most frequently encountered complication of antepartum hemorrhage, followed by DIC and shock. Multigravidity was a significant etiological factor in antepartum hemorrhage.

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Jones, Mary Elaine, Suzanne Kubelka et Mary Lou Bond. « Acculturation Status, Birth Outcomes, and Family Planning Compliance Among Hispanic Teens ». Journal of School Nursing 17, n^o 2 (avril 2001) : 83–89. http://dx.doi.org/10.1177/105984050101700205.

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This study examined acculturation status, selected demographic and pregnancy indices, and the relationship to birth outcomes and family planning patterns among a convenience sample of 63 Hispanic adolescents aged 13 to 19 years and attending community-based prenatal clinics. Findings suggest that Hispanic teenagers who are the first generation in the United States and traditional in their world view are compliant with prenatal and postpartum care and have healthy babies and birth outcomes. Gravidity and gestational age of the infant were significant predictors of birth weight, accounting for 30% of the variability in birth weight. Generation in the United States accounted for 8% of the variance in family planning compliance. Higher gravidity was associated with increased infant birth weight and a decreased likelihood for return for family planning visits during the 1st year postbirth. Teens who were first generation in the United States were more likely to return for family planning visits during the 1st year. School nurses are in a pivotal position to design intervention programs that build on traditional cultural prescriptions for healthy behaviors during and after pregnancy.

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Sharhaeva, N. V. « PERINATAL OUTCOMES AT PLACENTAL INSUFFICIENCY AND INTRAUTERINE INFECTION ». Health and Ecology Issues, n^o 3 (28 septembre 2007) : 72–78. http://dx.doi.org/10.51523/2708-6011.2007-4-3-13.

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We have made a contemporary analysis of clinical presence, distinctive features of the pregnancy, delivery, post-delivery and earlier neonatal periods, morphological changes of afterbirth in 90 pregnant women examined for the presence of intrauterine infection markers. It was revealed that risk factors for the appearance and development of severe perinatal diseases of the newborns were placental insufficiency and intrauterine infection. Newborns who were born in medium and heavy asphyxia state should be examined for the presence of congenital dartrous and chlamidia infections the first hours of their lives to conduct an adequate therapy in postnatal period. Screening of women from the delivery reserve group for sexually transmitted infections, pre-gravidic preparation will allow to prevent complications of pregnancy, delivery, to reduce perinatal losses.

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Shah, Farhana Jabeen, Abdul Matin Qaisar, Iftikhar Ali Malik et Ruqqia Jahangir. « Practices of Pica among Pregnant Females and Associated Outcomes in Newborn and Pregnant Women ». Pakistan Journal of Medical and Health Sciences 16, n^o 5 (26 mai 2022) : 317–18. http://dx.doi.org/10.53350/pjmhs22165317.

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Aim: To find out the females practicing pica and its effects in newborns. Study Design: Cross-sectional descriptive study Place and Duration of Study: Department of Community Medicine, Kabir Medical College Peshawar from 1st May 2021 to 31st December 2021. Methodology: Three hundred and eighty six pregnant women from 15 to 49 years were enrolled. The WHO standards for new born weight were used to measure normal and underweight babies and associated factors causing anemia and pica practicing among females. A semi-structured questionnaire was used to collect data on socioeconomic conditions, family size, maternal education, parity, gravidity and complication during and after delivery. Results: The prevalence of maternal anemia 73.3% in mothers of aged 15 to 49 years. Antenatal visits, medications used during pregnancy, and intake of non-food (pica) items showed significant results with p<0.05 and showed strong association between maternal factors and newborn weight. Age, ethnicity, socioeconomic status, parity, gravidity, body mass index, history of genetic disorder factors showed non-significant results. Conclusions: The practicing pica and other factors causing anemia cause low birth weight in new born while location or place of living did not affect the weight of the new born. Keywords: Practices, Pica, Pregnant females, Outcome

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Pipek, Barbora, Dana Ďuricová, Katarína Mitrová, Martin Bortlík, Luděk Bouchner, Jan Březina, Tomáš Douda et al. « Safety of vedolizumab and ustekinumab in the treatment of pregnant women with inflammatory bowel disease – a multicentre retrospective-prospective observational study ». Gastroenterologie a hepatologie 76, n^o 1 (28 février 2022) : 46–54. http://dx.doi.org/10.48095/ccgh202246.

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Background: Inflammatory bowel disease (IBD) is mostly diagnosed in young women of fertile age, and a significant number of patients become pregnant while they have the disease. The remission of the illness, which is often achieved by intensive anti inflammatory treatment, has been found to be the most important factor of a successful pregnancy. Vedolizumab (VDZ) and ustekinumab (UST) are newer types of monoclonal antibodies with different mechanisms of effect when compared to anti-TNF treatment. VDZ is a monoclonal antibody against the α4ß7 integrin receptor, and UST against interleukin 12/23; both have expanded the spectrum of the biological treatment of IBD in recent years. Aims: To present the results of a multicentre observational study. The primary aim was to assess the safety of vedolizumab and ustekinumab for pregnancy, foetal development and the neonatal outcome. The secondary aim was to measure the drug concentration in maternal and cord blood at the time of delivery. Methods: It was a multicentre, retrospective-prospective observational study. Data on patients’ demographics, clinical characteristics and pregnancy were collected by the treating physician using a predefined questionnaire, data on newborn outcome were obtained from medical documentation. The ELISA method was used to measure the VDZ and UST concentrations. Results: The study took place in 15 IBD clinical centres in the Czech Republic. 79 women with 85 completed pregnancies were included in the study, and they were exposed to VDZ or UST during pregnancy. 36 women were treated with vedolizumab (median age 32 years) and 49 with ustekinumab (median age 30.5 years). In the group with VDZ, live births occurred with 32 women (88.9%), and there were two early spontaneous abortions up to the eighth week of gestation in addition to two instrumentally aborted pregnancies (4, 11.1%). 31 children (93.9%) in the group with VDZ were born at term with a median birth weight of 3,097.5 grams. In the ustekinumab group, 39 women (79.6%) had live births, there were nine early abortions and one instrumentally aborted pregnancy (10, 20.4%). 38 (97.4%) children were born at term with a median birth weight of 3,265 grams. The drug levels of VDZ and UST at birth were measured in 44 neonate-mother pairs (21 VDZ, 23 UST). The median level of VDZ in maternal venous blood was 7.2 mg/l, and in cord blood it was 4.7 mg/l (infant / maternal ratio 0.66). With UST, the median maternal level was 4.7 mg/l, and in neonates it was 7.9 mg/l (infant / maternal ratio 1.65). Conclusion: The results found in a group of women that were being treated for IBD and were exposed to at least one dose of biologic treatment with UST or VDZ during pregnancy are consistent with previously published evidence showing no adverse events, and they confirm the safety profile of new biologics in pregnancy. Due to the still limited number of enrolled patients, further studies are needed on the outcomes of pregnancies with new biologics drugs. Keywords vedolizumab, ustekinumab, pregnancy, transplacentární přenos

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Talundzic, Eldin, Stephen Scott, Simon O. Owino, David S. Campo, Naomi W. Lucchi, Venkatachalam Udhayakumar, Julie M. Moore et David S. Peterson. « Polymorphic Molecular Signatures in Variable Regions of the Plasmodium falciparum var2csa DBL3x Domain Are Associated with Virulence in Placental Malaria ». Pathogens 11, n^o 5 (28 avril 2022) : 520. http://dx.doi.org/10.3390/pathogens11050520.

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The Plasmodium falciparum protein VAR2CSA allows infected erythrocytes to accumulate within the placenta, inducing pathology and poor birth outcomes. Multiple exposures to placental malaria (PM) induce partial immunity against VAR2CSA, making it a promising vaccine candidate. However, the extent to which VAR2CSA genetic diversity contributes to immune evasion and virulence remains poorly understood. The deep sequencing of the var2csa DBL3X domain in placental blood from forty-nine primigravid and multigravid women living in malaria-endemic western Kenya revealed numerous unique sequences within individuals in association with chronic PM but not gravidity. Additional analysis unveiled four distinct sequence types that were variably present in mixed proportions amongst the study population. An analysis of the abundance of each of these sequence types revealed that one was inversely related to infant gestational age, another was inversely related to placental parasitemia, and a third was associated with chronic PM. The categorization of women according to the type to which their dominant sequence belonged resulted in the segregation of types as a function of gravidity: two types predominated in multigravidae whereas the other two predominated in primigravidae. The univariate logistic regression analysis of sequence type dominance further revealed that gravidity, maternal age, placental parasitemia, and hemozoin burden (within maternal leukocytes), reported a lack of antimalarial drug use, and infant gestational age and birth weight influenced the odds of membership in one or more of these sequence predominance groups. Cumulatively, these results show that unique var2csa sequences differentially appear in women with different PM exposure histories and segregate to types independently associated with maternal factors, infection parameters, and birth outcomes. The association of some var2csa sequence types with indicators of pathogenesis should motivate vaccine efforts to further identify and target VAR2CSA epitopes associated with maternal morbidity and poor birth outcomes.

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Tayade, Surekha, Ritu Singh, Jaya Kore, Neha Gangane et Noopur Singh. « Maternal hemoglobin : socio-demographic and obstetric determinants in rural Central India ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n^o 3 (27 février 2018) : 1179. http://dx.doi.org/10.18203/2320-1770.ijrcog20180914.

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Background: Maternal Anemia is a global health problem with adverse implications on materno-fetal outcome. Various socio-demographic and obstetric factors affect prevalence of anemia.Methods: A hospital based, cross-sectional, observational study was carried out among pregnant women seeking antenatal care at Kasturba Hospital of MGIMS, Sewagram, a rural tertiary care institute in central India. Information was collected about demographic variables, age, gravidity, parity, literacy, area of residence and socioeconomic status. Hemoglobin levels in first trimester and pre delivery were measured by coulter and correlated with socio-demographic and obstetric factors.Results: Among 500 pregnant women of first trimester, 249 (49.8%) had anemia, 154 (30.8%) mild, 86 (17.2%) moderate and 9 (1.8%) severe anemia. More women with anemia were of lesser age, resided in rural area, belonged to middle and lower economic class, lived with joint families and had less than 12 years of formal education.Conclusions: Anemia is prevalent in pregnant women in this geographic region of central India. Age, higher gravidity, higher parity, rural residence, low socioeconomic status and less than 12 years of formal education, are risk factors. Appropriate age at marriage, small family norm, education of girl child, anemia prevention strategy in adolescent girls and financial empowerment of women are suggested strategies for prevention of anemia and improved maternofetal outcome.

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S, Sandeep, et Shanthi E. « Study on Impact of Maternal Age on Pregnancy Outcome At A Tertiary Care Hospital ». International Journal of Research in Pharmaceutical Sciences 11, SPL2 (30 avril 2020) : 235–38. http://dx.doi.org/10.26452/ijrps.v11ispl2.2235.

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This was a study to find a correlation between the maternal age and obstetric and fetal outcome. This was a retrospective study conducted at Saveetha Medical College and Hospital. The study groups were women delivering over 2 months. Data was collected from the parturition register in the Department of Obstetrics and Gynecology. The study group were divided into 5 groups from 1 to 5 based on age as, less than 20 years, 20-24 years , 25-29 years , 30-34 years and 35 years of age and above, respectively. The obstetric data collected were entered in micro soft excel sheet and analyzed. The total number of deliveries during the study period was 251. The average age of the woman delivered was 23.8 years. The percentage of women under different age groups were as follows: 2.79 % were teenagers and 2.79% of women were more than 35 years of age. 46.61%, 36.65% and 11.15 % were between 20-24 yrs, 25-29 years of age and 30 to 34 years of age. As age increased, gravidity increased. 71.43%, 45.61%, 39.65%, 11.5% and 28% were vaginal deliveries in each group. The proportion of caesarian deliveries increased as age advanced. In group one all were term deliveries, where as in other groups, the percentages were 76.92, 76.09, 75 and 71.42% respectively. The average weights of the babies were 2.6 kg, 2.868 kg, 2.873 kg, 2.841 kg and 2.8 kg, respectively. There were 14.28%, 23.93%, 34.78% and 25 % NICU admissions among the first 4 groups, respectively. There were 1.09%, 3.5% and 14.28% of intrauterine deaths in groups 3, 4 and 5, respectively. Majority of the study group belonged to 20-24 yrs. As maternal age increased, there was increase in gravidity, caesarean deliveries, increased preterm deliveries, neonatal admissions and intrauterine deaths

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Darder, Michael C., Yakov M. Epstein, Susan L. Treiser, Cynthia E. Comito, Helane S. Rosenberg et Larisa Dzingala. « The effects of prior gravidity on the outcomes of ovum donor and own oocyte cycles ». Fertility and Sterility 65, n^o 3 (mars 1996) : 578–82. http://dx.doi.org/10.1016/s0015-0282(16)58157-6.

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Çakar, Erbil, Meral Meryem Yavuz, Tayfun Kutlu, Habibe Ayvacı Taşan, Ebru Cogendez, Gülay Beydilli Nacak, Enis Özkaya et Semra Kayataş Eser. « Ivf versus spontan singleton pregnancies fetal and maternal outcomes in a tertiary care hospital ». International Journal Of Medical Science And Clinical Invention 5, n^o 3 (6 mars 2018) : 3583–87. http://dx.doi.org/10.18535/ijmsci/v5i3.04.

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Background: We aimed to compare perinatal outcomes of intracytoplasmicsperm injection (ICSI) versus naturally (spontaneously) concieved age and parity matched group of singleton pregnants. Methods: Two hundred and sixteen singleton pregnancies aged between 18-45 years old were included in this study. Among all study group, 106 cases were ICSI pregnancies (study group) and 110 cases were spontaneously concieved singleton pregnancies (control group). Pregnancy outcome parameters were: the incidence of chronic hypertension, preeclampsia, gestational hypertension, placenta previa, placental abruption, preterm birth, intrahepatic cholestasis of pregnancy, gestational diabetes, preterm premature rupture of membranes, caesarean delivery. Results: There were no differences in terms of maternal age, BMI, gravidity, parity, gestational weeks at birth and birth weight between ICSI and spontaneously concieved pregnancy groups. Placental abruption, gestational diabetes and cesarean section rates were significantly higher in ICSI pregnancies than spontaneously conceived pregnancies (4.7% vs 0%, 21.7% vs 11.8% and 82.1% vs 68.2%, respectively). There wereno statistically significant differences in terms of chronic hypertension, preeclampsia, gestational hypertension, preterm labor, placenta previa, intrahepatic cholestasis of pregnancy, preterm and term premature rupture of the membranes. Conclusion: ICSI pregnancies have higher adverse perinatal outcomes than spontaneously conceived singleton pregnancies which were matched with age and parity. That’s why ICSI pregnancies should be given a detailed counseling about the adverse perinatal outcomes and should be followed up more carefully through the pregnancy.

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Perera, Sudheesha, Cynthia Maung, Sophia Hla, Hsa Moo Moo, Saw Than Lwin, Catherine Bruck, Terrence Smith, Menno Bakker, Cassim Akhoon et Indra Neil Sarkar. « Access to community-based reproductive health services and incidence of low birthweight delivery among refugee and displaced mothers : a retrospective study in the Thailand-Myanmar border region ». BMJ Open 12, n^o 1 (janvier 2022) : e052571. http://dx.doi.org/10.1136/bmjopen-2021-052571.

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ObjectivesOver 2.4 million people have been displaced within the Thailand-Myanmar border region since 1988. The efficacy of community-driven health models within displaced populations is largely unstudied. Here, we examined the relationship between maternal healthcare access and delivery outcomes to evaluate the impact of community-provided health services for marginalised populations.SettingStudy setting was the Thailand-Myanmar border region’s single largest provider of reproductive health services to displaced mothers.ParticipantsAll women who had a delivery (n=34 240) between 2008 and 2019 at the study clinic were included in the performed retrospective analyses.Primary and secondary outcome measuresLow birth weight was measured as the study outcome to understand the relationship between antenatal care access, family planning service utilisation, demographics and healthy deliveries.ResultsFirst trimester (OR=0.86; 95% CI=0.81 to 0.91) and second trimester (OR=0.86; 95% CI=0.83 to 0.90) antenatal care visits emerged as independent protective factors against low birthweight delivery, as did prior utilisation of family planning services (OR=0.82; 95% CI=0.73 to 0.92). Additionally, advanced maternal age (OR=1.36; 95% CI=1.21 to 1.52) and teenage pregnancy (OR=1.27, 95% CI=1.13 to 1.42) were notable risk factors, while maternal gravidity (OR=0.914; 95% CI=0.89 to 0.94) displayed a protective effect against low birth weight.ConclusionAccess to community-delivered maternal health services is strongly associated with positive delivery outcomes among displaced mothers. This study calls for further inquiry into how to best engage migrant and refugee populations in their own reproductive healthcare, in order to develop resilient models of care for a growing displaced population globally.

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Kim, Catherine, Naji Younes, Marinella Temprosa, Sharon Edelstein, Ronald B. Goldberg, Maria G. Araneta, Amisha Wallia et al. « Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study ». Journal of Clinical Endocrinology & ; Metabolism 105, n^o 3 (19 janvier 2020) : e358-e367. http://dx.doi.org/10.1210/clinem/dgaa013.

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Abstract Objective The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known. Research Design And Methods We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as > 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates. Results Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC. Conclusions Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women.

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Kumar, Naina, et Ashu Yadav. « High-risk Pregnancy and Perinatal Outcome : An Observational Study ». Current Women s Health Reviews 16, n^o 4 (9 septembre 2020) : 318–26. http://dx.doi.org/10.2174/1573404816999200421100553.

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Background: High-risk pregnancies are associated with adverse perinatal and maternal outcomes. Aim: To know the overall perinatal outcome in high-risk pregnancies. Methods: Present observational study was conducted in the Obstetrics and Gynecology department of a rural tertiary center of Northern India over eight months (February-October 2018) on 3,085 antenatal women at gestation ≥ 28 weeks with 1,309 high-risk cases and 1,776 normal pregnancy cases after Institutional ethical committee approval and informed written consent from the participants. The demographic features including age, gravidity, parity, gestation, high-risk factors, the onset of labor, mode of delivery of all the selected antenatal women at gestation ≥ 28 weeks were recorded on a preformed datasheet by trained staff. All the participants were observed till delivery and the perinatal outcome was recorded. Statistical analysis was done using software SPSS 22.0 version and a p-value <0.05 was considered statistically significant. Results: Of total 1,309 high-risk pregnancies, 365(27.9%) were preterm, 936(71.5%) term and eight (0.6%) post-term cases. Of 1,309 neonates delivered, 66(5.04%) were intra-uterine dead fetuses, 1,243 live fetuses, of which nine (0.7%) had intrapartum still-birth, 278(22.4%) required neonatal intensive care unit admission, 70(5.6%) intubated, 238(19.1%) needed oxygen support, 343(27.6%) developed complications, while 11(0.9%) had early neonatal deaths. The average birth weight of neonates delivered to high-risk mothers was 2.47±0.571 Kg with 271(20.7%) neonates having low birth weight (<2.5 Kg). Of all high-risk factor Hypertensive disorders of pregnancy, Antepartum hemorrhage, Anemia, Gestational diabetes mellitus, Intra-uterine growth restriction, oligohydramnios was significantly associated with adverse perinatal outcomes (p<0.05). High-risk pregnancy was associated with preterm births, low birth weight, NICU admission, intubation, complications, neonatal deaths, still-births as compared to normal pregnancy. Most common neonatal complication was the low birth weight (20.7%) followed by Respiratory distress syndrome (17.6%), prematurity (13.1%). Conclusion: High-risk pregnancy was associated with an adverse overall perinatal outcome with increased risk of perinatal morbidities and mortalities.

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Rahim, Shamama, Shazia Mahmood Awan, Faiza Khanum, Erum Pervaiz, Saira Saeed et Neelum Zahir. « Maternal and Fetal Outcome among Women having Pre Eclampsia with Hyperuricemia ». Pakistan Journal of Medical and Health Sciences 16, n^o 1 (30 janvier 2022) : 371–73. http://dx.doi.org/10.53350/pjmhs22161371.

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Objective: To find out the frequency of some common maternal and fetal outcomes among women having pre eclampsia with hyperuricemia. Study design: Cross sectional study. Place and duration of study: Department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar from April 2019 to Oct 2019. Patients and methods: A total of 161 women with singleton pregnancy irrespective of gravity and party, in age group ranging from 20-35 years having pre eclampsia with hyperuricemia were included in consective manner. All patients signed informed written consent for study and its outcome. Detailed history taking and examination were performed and standard lab investigations were sent. All patients were followed up till 40th day of delivery for maternal (caesarean section, eclampsia and maternal death) and fetal outcome [intrauterine fetal death, (small for gestational age) SGA and APGAR score]. Data was analyzed using SPSS version 20. Results: Maternal complications in patients of pre eclampsia with hyperuricemia were eclampsia 15.5%, caesarean section 18% and death 19.3%. Fetal complications included SGA 11.8%, intrauterine death 16.8% and APGAR score at 5 minutes 24.2%. The mean age and standard deviation of sample were 28.4 + 4.8 years, mean gravidity (2.7±1.1), mean parity (2.4±0.9) and mean BMI (24.37±2.4 kg/m2). Conclusion: Hyperuricemia in pre-eclampsia is a poor prognostic factor with increased maternal and fetal deaths, worsening of pre eclampsia to eclampsia and low APGAR scores of fetus. Key words: Pre eclampsia, hyperuricemia, maternal death, caesarean section, small for gestational age, APGAR score

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Ferrari, Barbara, Luca Andrea Lotta, Andrea Artoni, Silvia Pontiggia, Silvia Trisolini, Danijela Mikovic, Frits R. Rosendaal et Flora Peyvandi. « Complications of Pregnancy in Women with Thrombotic Thrombocytopenic Purpura ». Blood 120, n^o 21 (16 novembre 2012) : 3322. http://dx.doi.org/10.1182/blood.v120.21.3322.3322.

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Abstract Abstract 3322 Background Thrombotic Thrombocytopenic Purpura (TTP) occurring in association with pregnancy or puerperium accounts for 12–25% of all TTP acute episodes. Pregnancy leads to acute TTP in women affected by congenital TTP in the absence of periodic prophylactic plasma infusions, while the risk of acute TTP during pregnancy for women with the acquired form is not well known. Moreover, it is not known whether the presence of anti-ADAMTS13 antibodies that characterize acquired TTP affect the outcome of subsequent pregnancies. The aim of this study was to evaluate maternal-foetal outcome of pregnancies started after the diagnosis of TTP. Methods We analyzed clinical and laboratory features of 25 pregnancies of 22 women with TTP (all acquired TTP) out of 320 TTP patients in our cohort, all referred to the Milan TTP Registry, Milan (Italy), from 1994 to 2012. We tested the available biological samples for ADAMTS13 activity using FRET method, anti-ADAMTS13 autoantibodies by Western Blotting and ultra-large von Willebrand Factor (ULVWF) multimers ratio. Results We found that 18 out of 25 pregnancies (72%) were complicated by either TTP recurrence (11/25, 44%) or spontaneous abortion in the first trimester (7/25, 28%). The incidence of TTP recurrence was 0.02 cases/week gestation (median duration of pregnancy at event: 32 weeks). The incidence of spontaneous abortion was 0.01 cases/week gestation (median duration of pregnancy at event: 6 weeks). Women's parity was associated with spontaneous abortion, with a relative rate of 2.8 (95% confidence interval: 0.5–14.2) for multigravidae versus primigravidae. Interestingly, almost all miscarriages (6/7, 86%) occurred in women who experienced a pregnancy-related TTP episode during a previous pregnancy. To understand if this high rate of spontaneous abortion could be related to TTP, we analyzed ADAMTS13 activity levels, anti-ADAMTS13 antibodies and ULVWF multimers pattern. In the pregnancies complicated by TTP relapse, ADAMTS13 activity was severely reduced in the acute phase, in association with the presence of antiADAMTS13 antibodies and reduction of ULVWF multimers (ULVWF ratio < 0.85); in the cases of pregnancies complicated by spontaneous abortion, the mean ADAMTS13 activity level in the first trimester was 31%, with the presence of antiADAMTS13 antibodies and excess of ULVWF multimers (ULVWF ratio > 1.21); in the group of uncomplicated pregnancies, the mean ADAMTS13 activity levels was 97% in the first trimester and remained > 35% until delivery, with absence of antiADAMTS13 antibodies and normal ULVWF multimers. Conclusions Obstetric complications are frequent during pregnancies in women affected with acquired TTP. ADAMTS13 activity levels > 35% in the absence of antiADAMTS13 antibodies seem to confer little or no risk, while lower ADAMTS13 activity levels and the presence of antiADAMTS13 antibodies during pregnancy are predictive of poor gravidic outcome, either with acute TTP or spontaneous abortion in the first trimester. Surprisingly, although confidence intervals were wide, miscarriage rates were highest in multigravidae. Pre-gravidic and gravidic monitoring of ADAMTS13 activity levels and anti-ADAMTS13 autoantibodies is crucial in the management of pregnancies in TTP patients. Disclosures: No relevant conflicts of interest to declare.

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Vicco, Miguel Hernán, Luz Rodeles, Gabriela Soledad Capovilla, Melina Perrig, Ana Gabriela Herrera Choque, Iván Marcipar, Oscar Bottasso, Celeste Rodriguez et Washington Cuña. « IgG Autoantibodies Induced by T. cruzi During Pregnancy : Correlation with Gravidity Complications and Early Outcome Assessment of the Newborns ». Maternal and Child Health Journal 20, n^o 10 (18 juin 2016) : 2057–64. http://dx.doi.org/10.1007/s10995-016-2035-8.

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Wilson, JL, RR Kalagiri, T. Carder, MR Beeram, TJ Kuehl, MN Uddin, SH Afroze et DC Zawieja. « ID : 18 : DIABETES AND PRE-ECLAMPSIA : A RETROSPECTIVE CROSS-SECTIONAL STUDY OF PREGNANCY OUTCOMES ». Journal of Investigative Medicine 64, n^o 4 (22 mars 2016) : 931.1–931. http://dx.doi.org/10.1136/jim-2016-000120.42.

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ObjectiveDespite growing knowledge of the pathophysiology leading to the development of preeclampsia (PreE) and diabetes mellitus (DM), the interaction between the two disease processes needs to be further examined. This study compared normal pregnancies to those complicated with preE, gestational diabetes mellitus (GDM), and/or pre-existing diabetes in order to assess the effects of elevated glucose on placental development and its potential role in the pathogenesis of preE.MethodsThe chart review was performed in an IRB approved retrospective cross-sectional study of live born singleton deliveries. A total 621 subjects were randomly selected from deliveries occurring between 2008 to 2011 at Baylor Scott & White Memorial hospital. Statistical analysis was performed using Duncan's post-hoc test and ANOVA.ResultsPatients who developed preE had higher systolic and diastolic blood pressures than those who did not develop preE (p<0.05). Patients with either pre-existing diabetes or GDM were older. There was no difference among groups for gravidity (p=0.21) with an average gravidity of 2.7 (1.8SD) for 621 subjects and a range of 1 to 14 pregnancies. Patients with preE delivered earlier in pregnancy than those without preE regardless of diabetes status. However, those with preE and pre-existing diabetes delivered significantly earlier at 35.0+/−0.4 than the other two preE groups (*p<0.05 for each), suggesting more severe condition. Additionally, patients with pre-existing diabetes who developed preE delivered smaller babies than those with pre-existing diabetes without preE (1.00±0.03, p<0.05 for each). However, the development of GDM did not result in smaller babies for those pregnancies with preE.ConclusionsThe development of preE in those with pre-existing diabetes led to growth restriction and more severe disease as evidenced by lower birth weights and earlier gestational ages at delivery. These differences were not seen in GDM pregnancies. This supports the concept that elevated glucose levels during placental development in the first trimester may alter the placenta and lead to restriction later in pregnancy when a second stimulus triggers preE.

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Ahn, HK, JS Choi, JY Han, MH Kim, JH Chung, HM Ryu, MY Kim et al. « Pregnancy outcome after exposure to oral contraceptives during the periconceptional period ». Human & ; Experimental Toxicology 27, n^o 4 (avril 2008) : 307–13. http://dx.doi.org/10.1177/0960327108092290.

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To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0–41.0) weeks in the exposed group and 39.3 (27.4–42.0) weeks in the control group ( P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group ( P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% ( n = 3/99) versus 3.6% ( n = 7/193) in the control group ( P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.

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Senturk, Mehmet, Mesut Polat, Ozan Doğan, Çiğdem Pulatoğlu, Oğuz Yardımcı, Resul Karakuş et Ahter Tayyar. « Outcome of Cesarean Myomectomy : Is it a Safe Procedure ? » Geburtshilfe und Frauenheilkunde 77, n^o 11 (novembre 2017) : 1200–1206. http://dx.doi.org/10.1055/s-0043-120918.

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Abstract Objective Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. Method A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p < 0.01 and p < 0.05 were considered statistically significant. Results While maternal age and gravidity were similar in both groups (p > 0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p < 0.05). The reduction in hemoglobin level, rate of complications, and number of transfusions were similar in both groups (p > 0.05). Conclusion This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.

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Elkheir, Sirelkhatim M., Zahir OE Babiker, Sabah K. Elamin, Mohammed IA Yassin, Khidir E. Awadalla, Mohamed A. Bealy, Ahmed A. Agab Eldour et al. « Seroprevalence of maternal HIV, hepatitis B, and syphilis in a major maternity hospital in North Kordofan, Sudan ». International Journal of STD & ; AIDS 29, n^o 13 (27 juillet 2018) : 1330–36. http://dx.doi.org/10.1177/0956462418784687.

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Routine infectious diseases screening of Sudanese pregnant women has been patchy due to scarcity of healthcare resources and social stigma. We sought to determine the seroprevalence of HIV, hepatitis B, and syphilis among pregnant women attending antenatal care (ANC) at El Obeid Maternity Hospital in western Sudan. We also explored the association between these infections and a set of socio-demographic and maternal variables. Unlinked anonymous testing for HIV-1/2 antibodies, hepatitis B surface antigen, and Treponema pallidum antibodies was performed on residual blood samples collected during routine ANC (August 2016–March 2017). Seroprevalence of HIV was 1.13% (5/444; 95% CI 0.37–2.61%), hepatitis B 2.93% (13/444; 95% CI 1.57–4.95%), and syphilis 7.43% (33/444; 95% CI 5.17–10.28%). On bivariate analysis, there were no statistically significant associations between hepatitis B, syphilis, or a composite outcome including any of the three infections and age, stage of pregnancy, gravidity, parity, previous mode of delivery, history of blood transfusion, or husband polygamy. Urgent action is needed to scale up routine maternal screening for HIV, hepatitis B, and syphilis on an opt-out basis. Further research into the socio-demographic and behavioural determinants of these infections as well as their clinical outcomes is needed.

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Kori, Shreedevi, Dayanand Biradar, Aruna Biradar, Rajasri Yaliwal, Subhashchandra R. Mudanur, Neelamma Patil et Shivakumar Pujeri. « Study of maternal and fetal outcome in pregnancy beyond 40 weeks : a prospective observational study at a tertiary institute ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, n^o 10 (25 septembre 2020) : 3959. http://dx.doi.org/10.18203/2320-1770.ijrcog20203993.

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Background: Prolonged pregnancy is one that exceeds 42 0/7weeks. Management of prolonged pregnancy is very challenging in modern obstetrics.Methods: It is prospective observational study in department of Obstetrics and Gynecology, Shri B.M Patil medical college and Research center, deemed to be University, Vijayapur, North karnataka. Study period was from January 2018 to January 2019.Results: Total of 186 pregnant women were included in the study. Results in terms of age, gravidity, gestational age, time of induction, mode of delivery, neonatal outcome and maternal complications.Conclusion: Pregnancies beyond 40 weeks require early detection, effective fetal monitoring and proper planning of labour. In pregnancies beyond 40 weeks, decision of induction should be taken cautiously as early induction leads to failure of induction and increased rates of lower (uterine) segment Caesarean section (LSCS), while delayed induction leads to increased fetal complications.

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Khattak, Samina Naseem, Umbreen Akram, Erum Pervaiz, Maria Anayat, Tahir Ahmad Munir, Naheed Akhter et Athar Ahmad Jan. « Incidence And Risk Factors Of Maternal And Fetal Outcomes Among Patients Of Placenta Previa With And Without Placenta Accreta ». Journal of Bahria University Medical and Dental College 09, n^o 01 (27 décembre 2018) : 57–61. http://dx.doi.org/10.51985/jbumdc2018064.

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Objective: The aim of the study was to evaluate maternal and fetal outcomes among patients of placenta previa (PP) with and without placenta accreta (PA). Methodology: All patients who underwent cesarean section for PP and PA were analyzed retrospectively at a tertiary care Combined Military Hospital Kharian, Pakistan, from February 2015 to March 2018. Maternal and neonatal data were obtained from medical records and the hospital database system. Results: PA was found in 37 patients from 111 patients of PP and 74 were without PA with the rate of approximately 2/1000 and 4/1000 respectively were included in the study. The mean age was 31.16±2.65 (range 22–37) years, mean gravidity of 3.69 ±1.40 (range 1 - 9), mean parity 2.57±1.01 (range 1–5), mean number of cesarean sections 2.10±0.66, (range 1-3) and a mean gestational age at the time of cesarean section was 35.65±2.46 (range 28–41) weeks. The maternal risk factors revealed marked differences between placenta previa with accreta and without accrete. The mean intraoperative blood loss in PA was 3,000ml, with a loss of 2,000ml occurring in 60%, and 3,000 ml in 21% of the PA cases. The mean pRBC transfusion was 4 units, while 17% received 6 units. Fetal growth restriction was not seen. A total of 12 neonates were admitted in NICU, with 03 neonatal deaths. There was no maternal death. Neonates born to women with placenta accreta had significantly lower birth weight, Apgar scores at 1 min and 12% required admission to NICU with 3 neonatal deaths. Conclusion: The advanced maternal age, past cesarean or uterine surgery, high parity as well as multiple gravidity were the risk factors for adverse fetal and maternal outcomes.

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Dawood, Faiza, Sadia Hanif, Sidra Pervaiz, Komal Farooqi, Maria Rehman et Nighat Afridi. « Frequency of Placenta Previa in Patients with Repeated C-Section ». Pakistan Journal of Medical and Health Sciences 16, n^o 10 (30 octobre 2022) : 550–52. http://dx.doi.org/10.53350/pjmhs221610550.

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Objective: The purpose of this study is to determine the prevalence of placenta previa and adverse outcomes in patients with repeated C-sections. Study Design: Descriptive/Observational study Place and Duration: Gynaecology and Obstetrics Department, Combined Military Hospital, Peshawar for the period from February 2021 to January 2022. Methods: There were 60 pregnant women had age 20-50 years were presented. Pregnant women with the history of c-section were included in this study. After getting informed written consent demographics of included patients i.e age, body mass index, gestational age, parity and gravidity were recorded. After delivery, association of placenta previa was recorded. Maternal and fetus outcomes were also assessed in this study. SPSS 21.0 was used to analyze all data. Results: Majority of the cases 28 (46.7%) were aged between 20-30 years, 20 (33.3%) had age 31-40 years and 12 (20%) patients were aged between 41-50 years. 34 (56.7%) cases had BMI >25kg/m2 and 26 (43.3%) patients had BMI <25kg/m2. Mean parity of the patients was 4.7±3.21 and mean gestational age was 36.13±14.61 weeks. Frequency of placenta previa was found in 15 (25%) cases in which majority 9 (60%) were males and 6 (40%) were females. Among 15 cases of placenta previa, low apgar score, low birth weight and ICU admission were the adverse outcomes among new borns. In mothers, frequent bleeding, pre-eclampsia and gestational diabetes were the adverse events. Conclusion: The results of this research led us to the conclusion that the prevalence of placenta previa rises with an increasing number of prior caesarean sections and the associated negative fetomaternal outcome. Keywords: C-section, Placenta Previa, Adverse Events, Parity

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Kayastha, S., et A. Pradhan. « Obstetric Outcome of Teenage Pregnancy ». Nepal Journal of Obstetrics and Gynaecology 7, n^o 2 (21 septembre 2014) : 29–32. http://dx.doi.org/10.3126/njog.v7i2.11139.

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Aims: To assess the prevalence of teenage pregnancies and to compare the obstetric performance of teenage pregnant woman with that of adult pregnant woman. Methods: A prospective study was conducted in Nepal Medical College Teaching Hospital from August, 2010 to February, 2012 (one and half year duration). All the teenage pregnancies were included and outcomes were compared with adult (20-24 years) pregnancies, selected randomly who had delivered during the same period of time. The patient characteristics (age, gravidity, parity, gestation age) and obstetric outcome (medical and obstetrical complications, mode of delivery, complications during delivery, fetal outcome, birth weight) were compared between the two groups. Statistical analysis was preformed using PHSTATZ and Z test for proportion. Results: There were total 2708 deliveries during the study period, out of which teenage pregnancy was 264 (9.7%). There were 69(26.1%0) teenage mothers of age 16 to 17 years and 195(73.9%) of age group 18 to 19 years. As expected, maximum patients in the test group i.e. teenagers were primigravida as compared to control group. (90.1% vs. 68.5%). As for mode of delivery, normal delivery in test and control was 82.9% vs 81.1% (p=0.56) and rate of cesarean delivery was similar 10.2% and 10.7%, (p=0.84) in both the groups. The incidence of instrumental delivery was more in control group although it was not statistically significant( 0.7% vs 2.2%, p=0.16). Preterm delivery was 3.0% in teenage as compared to control which is 2.2%. The percentage of intrauterine fetal death was 0.7% vs 0% in test and control group (p=0.15). Proportion of low birth weight babies in test and control group was 7.2% vs 5.9% (p=0.55). Similarly pregnancy related complications were also compared in teenage and control groups. It was found that postpartum hemorrhage occurred more in teenage pregnancy 1.8% vs 0.7% (p=0.84) but statistically not significant. Incidence of hypertensive disorders was 6.4% and 5.6% (p=0.66) in test and control group. Proportion of babies with intrauterine growth restriction was 3.0% in test and 1.1% (p=0.009) in control, the only parameter that is statistically significant. Fetal congenital anomaly was 0.7% vs 0.4% (p=0.54) Conclusions: Teenage pregnancy can have an equally good outcome if we give good obstetric care and encourage institutional delivery. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11139 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 29-32

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Igboeli, Nneka U., Maxwell O. Adibe, Chinwe V. Ukwe et Nze C. Aguwa. « Prevalence of Low Birth Weight before and after Policy Change to IPTp-SP in Two Selected Hospitals in Southern Nigeria : Eleven-Year Retrospective Analyses ». BioMed Research International 2018 (2018) : 1–5. http://dx.doi.org/10.1155/2018/4658106.

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Background. In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP). Indicators of impact of effective prevention and control of malaria on pregnancy (MIP) are low birth weight (LBW) and maternal anaemia by parity. This study determined the prevalence of LBW for different gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods. Eleven-year data were abstracted from the delivery registers of two hospitals. Study outcomes calculated for both pre- (2000–2004) and post-IPTp-SP-policy (2005–2010) years were prevalence of LBW for different gravidity groups and risk of LBW in primigravidae compared to multigravidae. Results. Out of the 11,496 singleton deliveries recorded within the 11-year period, the prevalence of LBW was significantly higher in primigravidae than in multigravidae for both prepolicy (6.3% versus 4%) and postpolicy (8.6% versus 5.1%) years. The risk of LBW in primigravidae compared to multigravidae increased from 1.62 (1.17–2.23) in the prepolicy years to 1.74 (1.436–2.13) during the postpolicy years. Conclusion. The study demonstrated that both the prevalence and risk of LBW remained significantly higher in primigravidae even after the change in policy to IPTp-SP.

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Iqbal, Suhail, Mehak Ayub Malik, Heena Kaurani et Divya Chauhan. « Effect of oral L- arginine versus intravenous hydration on maternal and fetal outcome in idiopathic oligohydramnios ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, n^o 5 (23 avril 2021) : 1943. http://dx.doi.org/10.18203/2320-1770.ijrcog20211516.

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Background: Adequate amount of amniotic fluid was required for normal growth of fetus. Oligohydramnios or reduced amount of amniotic fluid is associated with adverse maternal and perinatal outcome due to increase in induced labour and operative deliveries. Idiopathic oligohydramnios is a condition in which no other risk factors are associated with pregnancy. This study was done to compare the effect of L-arginine and IV hydration on improvement of amniotic fluid index and fetal growth.Methods: Total 50 patients were included in the study according to inclusion criteria and divided equally into two groups randomly. IV hydration was given to one group and other group received L- arginine sachet orally. The effect on AFI and fetal outcome was compared.Result: The result was compared with respect to age, gravidity, gestational age and AFI at the time of study and after giving treatment. Maternal and fetal outcome was compared which shows that L-arginine was more effective in increasing the AFI and thereby leading to favorable results in the form of increase in gestational age at time of delivery and fetal weight.Conclusion: This study shows that both IV hydration and L-arginine are useful in treatment of oligohydramnios. But L-arginine appears more advantageous over IV hydration in improving pregnancy outcome and reducing perinatal morbidity and mortality.

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Dixit, Monica, Shital N. Kapadia et Kartikeya G. Parmar. « Pregnancy with diabetes : The study of fetomaternal outcome in a tertiary care teaching centre in western India ». Indian Journal of Obstetrics and Gynecology Research 10, n^o 1 (15 février 2023) : 12–16. http://dx.doi.org/10.18231/j.ijogr.2023.003.

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To study the fetomaternal outcome in cases of pregnancy with diabetes and the measures to combat the consequences.A prospective observational study was conducted in a tertiary care centre with 70 patients taken under study, being carried out in a period of July-2020 to June- 2021 at Civil Hospital, Ahmedabad.Increasing gravidity, age and past history of GDM was found to be one of the risk factor for such cases. 44% patients had polyhydramnios, 8% had uteroplacental insufficiency and there were 6%intrauterine deaths. 52 patients were managed by Insulin, 10 patients by oral antidiabetic agents and remaining 8 patients were manged alone with dietary therapy. 48% patients underwent emergency caesarean section, 28% delivered normally and 8% patients required instrumental vaginal delivery. 10 cases of pregnancy with diabetes developed hypertension, also there were 6% cases of macrosomia. Birth weight > 3.5 kg was 32% in incidence. Most of the neonates were taken to NICU for 24 hours of observation. Perinatal mortality was observed in 6 cases of pregnancy with diabetes mellitus.

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Elkafrawi, Deena, Giovanni Sisti, Sarah Araji, Aldo Khoury, Jacob Miller et Brian Rodriguez Echevarria. « Risk Factors for Neonatal/Maternal Morbidity and Mortality in African American Women with Placental Abruption ». Medicina 56, n^o 4 (13 avril 2020) : 174. http://dx.doi.org/10.3390/medicina56040174.

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Background and Objectives: Risk factors for neonatal/maternal morbidity and mortality in placental abruption have been incompletely studied in the current literature. Most of the research overlooked the African American population as mostly Caucasian populations are selected. We aimed to find which risk factor influence the neonatal and maternal outcome in cases of placental abruption occurring in African American pregnant women in an inner-city urban setting. Materials and Methods: We performed a retrospective cohort study at St. Joseph’s Regional Medical Center, NJ United States of America (USA), between 1986 and 1996. Inclusion criteria were African American race, singleton pregnancy with gestational age over 20 weeks and placental abruption. Maternal age, gravidity, parity, gestational age at delivery/occurrence of placental abruption and mode of delivery were collected. Risk factors for placental abruption such as placenta previa, hypertensive disorders of pregnancy, cigarette smoking, crack/cocaine and alcohol use, mechanical trauma, preterm premature rupture of membranes (PPROM), and premature rupture of membranes (PROM) were recorded. Poor neonatal outcome was considered when anyone of the following occurred: 1st and 5th minute Apgar score lower than 7, intrauterine fetal demise (IUFD), perinatal death, and neonatal arterial umbilical cord pH less than 7.15. Poor maternal outcome was considered if any of the following presented at delivery: hemorrhagic shock, disseminated intravascular coagulation (DIC), hysterectomy, postpartum hemorrhage (PPH), maternal intensive care unit (ICU) admission, and maternal death. Results: A population of 271 singleton African American pregnant women was included in the study. Lower gestational age at delivery and cesarean section were statistically significantly correlated with poor neonatal outcomes (p = 0.018; p < 0.001; p = 0.015) in the univariate analysis; only lower gestational age at delivery remained significant in the multivariate analysis (p = < 0.001). Crack/cocaine use was statistically significantly associated with poor maternal outcome (p = 0.033) in the univariate analysis, while in the multivariate analysis, hemolysis, elevated enzymes, low platelet (HELLP) syndrome, crack/cocaine use and previous cesarean section resulted significantly associated with poor maternal outcome (p = 0.029, p = 0.017, p = 0.015, p = 0.047). PROM was associated with better neonatal outcome in the univariate analysis, and preeclampsia was associated with a better maternal outcome in the multivariate analysis. Conclusions: Lower gestational age at delivery is the most important risk factor for poor neonatal outcome in African American women with placental abruption. Poor maternal outcome correlated with HELLP syndrome, crack/cocaine use and previous cesarean section. More research in this understudied population is needed to establish reliable risk factors and coordinate preventive interventions.

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AMJAD, NAZIA, TAYYBA IMRAN et AHSEN NAZIR AHMED. « FETOMATERNAL OUTCOME OF PREGNANCY BETWEEN 40 AND 42 WEEKS ». Professional Medical Journal 15, n^o 03 (10 mars 2008) : 317–22. http://dx.doi.org/10.29309/tpmj/2008.15.03.2846.

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.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profileand non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were dividedinto two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweeklyantenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode ofdelivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety sixpercent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group comparedto 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rateof instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery wasfound to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas foundin 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery instudy group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while therewas no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to bestatistically insignificant which concluded the validity of either mode of management.

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Singh, Smita, et Dharitri Swain. « Factors associated with spontaneous abortion and to implement a home based post abortion care protocol from a prevention perspective in a rural part of Odisha, South-Eastern India : a hospital based cross-sectional study ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, n^o 1 (28 décembre 2022) : 152. http://dx.doi.org/10.18203/2320-1770.ijrcog20223487.

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Background: Spontaneous abortion (SA) is one of the most common unfavourable reproductive outcomes among women around the world, making maternal health promotion a major challenge. The aim of the current study was to identify the potential predictors associated with SA and recognized the need for providing home-based post-abortion care counselling to lower post abortion complications.Methods: A hospital-based cross-sectional study was conducted among the rural women ages of 18 and 45 years who had experienced at least one spontaneous miscarriage of less than 20 weeks of pregnancy. Participants were interviewed using a standardized questionnaire that included demographic, socioeconomic, and reproductive health information. Home based post abortion care protocol was introduced among the target populations for prevention of post abortion complications and maternal satisfaction was assessed after one week of implementation.Results: Of the 485 patients screened for eligibility, 24.12% had a history of at least one SA. The multivariate analysis revealed that occurrence of SA in our study is significantly associated with gravidity, multiparity, previous pregnancy complications, with a history of unfavourable fetal outcome and maternal comorbidities. Home based post abortion care protocol resulted higher maternal satisfaction and lower post abortion infection rate.Conclusions: The findings of our study reveals multiple modifiable factors may increase the risk of spontaneous abortion. One of the community participatory interventions in terms of providing home based post abortion care module resulted a significant impact on improving maternal satisfaction and lower post abortion infection rate among rural women.

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Senkoro, Elizabeth Eliet, Amasha H. Mwanamsangu, Fransisca Seraphin Chuwa, Sia Emmanuel Msuya, Oresta Peter Mnali, Benjamin G. Brown et Michael Johnson Mahande. « Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania ». Journal of Pregnancy 2017 (2017) : 1–7. http://dx.doi.org/10.1155/2017/5936309.

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Background and Objective. Placenta previa (PP) is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania.Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs) with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models.Result. A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death.Conclusion.The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications.

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González, Raquel, Tacilta Nhampossa, Ghyslain Mombo-Ngoma, Johannes Mischlinger, Meral Esen, André-Marie Tchouatieu, Clara Pons-Duran et al. « Evaluation of the safety and efficacy of dihydroartemisinin–piperaquine for intermittent preventive treatment of malaria in HIV-infected pregnant women : protocol of a multicentre, two-arm, randomised, placebo-controlled, superiority clinical trial (MAMAH project) ». BMJ Open 11, n^o 11 (novembre 2021) : e053197. http://dx.doi.org/10.1136/bmjopen-2021-053197.

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IntroductionMalaria infection during pregnancy is an important driver of maternal and neonatal health especially among HIV-infected women. Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine–pyrimethamine is recommended for malaria prevention in HIV-uninfected women, but it is contraindicated in those HIV-infected on cotrimoxazole prophylaxis (CTXp) due to potential adverse effects. Dihydroartemisinin–piperaquine (DHA–PPQ) has been shown to improve antimalarial protection, constituting a promising IPTp candidate. This trial’s objective is to determine if monthly 3-day IPTp courses of DHA–PPQ added to daily CTXp are safe and superior to CTXp alone in decreasing the proportion of peripheral malaria parasitaemia at the end of pregnancy.Methods and analysisThis is a multicentre, two-arm, placebo-controlled, individually randomised trial in HIV-infected pregnant women receiving CTXp and antiretroviral treatment. A total of 664 women will be enrolled at the first antenatal care clinic visit in sites from Gabon and Mozambique. Participants will receive an insecticide-treated net, and they will be administered monthly IPTp with DHA-PPQ or placebo (1:1 ratio) as directly observed therapy from the second trimester of pregnancy. Primary study outcome is the prevalence of maternal parasitaemia at delivery. Secondary outcomes include prevalence of malaria-related maternal and infant outcomes and proportion of adverse perinatal outcomes. Participants will be followed until 6 weeks after the end of pregnancy and their infants until 1 year of age to also evaluate the impact of DHA–PPQ on mother-to-child transmission of HIV. The analysis will be done in the intention to treat and according to protocol cohorts, adjusted by gravidity, country, seasonality and other variables associated with malaria.Ethics and disseminationThe protocol was reviewed and approved by the institutional and national ethics committees of Gabon and Mozambique and the Hospital Clinic of Barcelona. Project results will be presented to all stakeholders and published in open-access journals.Trial registration numberNCT03671109.

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Friis, Henrik, Exnevia Gomo, Norman Nyazema, Patricia Ndhlovu, Henrik Krarup, Pernille Kæstel et Kim Fleischer Michaelsen. « Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe ». British Journal of Nutrition 92, n^o 5 (novembre 2004) : 833–40. http://dx.doi.org/10.1079/bjn20041275.

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The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd–35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66·3%) women, of which 360 (32·5%) had HIV infection. Mean gestation length was 39·1 weeks with 16·6% <37 weeks, mean birth weight was 3030 g with 10·5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0·005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.

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K., Kruthika, Sharavanan Eshwaran Udayar et M. D. Mallapur. « An epidemiological study of postnatal depression among women availing maternal health services in rural areas of Belagavi, Karnataka, India ». International Journal Of Community Medicine And Public Health 4, n^o 3 (22 février 2017) : 759. http://dx.doi.org/10.18203/2394-6040.ijcmph20170754.

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Background: Postnatal depression is an important public health issue exhibiting the strongest link to adverse child outcomes and also maternal morbidity. Objectives were to study the prevalence of Postnatal depression among mothers and to identify the factors associated with depressive symptoms among post-natal mothers.Methods: The present cross sectional study was conducted from January 2016 to June 2016 in two rural areas among 300 women attending immunisation clinics in the Primary health centre with postpartum period less than 3 months were included in the study. Edinburgh Postnatal depression scale was used to for identifying mothers at risk of postnatal depression. A score of ≥13 was considered as positive for depressive symptoms.Results: The prevalence of Post-natal depression 41 (13.6%). Factors like age, literacy status, socio economic status, gravidity, sex of newborn, mode of delivery and unplanned pregnancy were significantly associated with the prevalence of postnatal depression.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.

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Acharya, Niraj, et Sumita Poudel. « Incidence, Risk Factors and Immediate Outcome of Preterm Neonates : A Hospital Based Study ». Journal of Nepalgunj Medical College 18, n^o 1 (31 décembre 2020) : 18–21. http://dx.doi.org/10.3126/jngmc.v18i1.35152.

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Introduction: Preterm birth is defined as birth before 37 completed weeks of gestation. It is one of the leading cause of infant morbidity and mortality in the world. Aims: The study was aimed to find out the incidence, possible risk factors and outcome of inborn preterm babies till they were discharged from the hospital. Methods: This is a prospective hospital based study. A total of 100 preterm babies delivered in Nepalgunj Medical College Teaching Hospital, Kohalpur and admitted in Neonatal Intensive Care Unit (NICU) were studied. Preterms were divided into 2 groups extremely to very preterm (<32 weeks) and moderate to late preterm (≥ 32 weeks). The preterm babies were evaluated for various morbidities sand mortality till they were discharged from the hospital. Results: Data of 100 babies was analyzed. Out of 100 preterm babies 40 were extremely to very preterm babies (<32 weeks) and 60 were moderate to late preterm babies (≥32 weeks). Significant risk factors associated with preterm deliveries were inadequate antenatal visits (73%), primi gravidity (58%), preterm premature rupture of membrane (55%), urinary tract infection (54%), anemia (53%), teenage pregnancy (43%), antepartum hemorrhage (41%) and pregnancy induced hypertension (33%). The total mortality was higher in extremely to late preterm than in moderate to late preterm. The most common causes of mortality were Neonatal sepsis (NNS), Hyaline Membrane Disease (HMD) and Birth Asphyxia. Conclusion: The hospital incidence of preterm neonates is still very high. The major risk factor seen in the study was inadequate antenatal visit. Preventive measures, early identification of risk factors will improve the outcome.

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Shankar, Prerna, et Vikas Pathania. « Epidemiological predictor variables in relation to the outcome of pregnancy in an urban setting ». International Journal Of Community Medicine And Public Health 5, n^o 10 (24 septembre 2018) : 4489. http://dx.doi.org/10.18203/2394-6040.ijcmph20183998.

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Background: Fetal weight at birth is the singular parameter resonant of maternal health and is measured with reasonable precision, while measuring preterm birth or IUGR requires a valid estimate of gestational age. Notwithstanding the relevance of mortality and morbidity as measures of adverse pregnancy outcome, proxy markers like low birth weight (LBW), preterm birth, intrauterine growth restriction (IUGR) and congenital anomalies have been used in the past. This exercise aims to study the epidemiological predictor variables in pregnant women attending ante-natal clinic and its association with birth outcome.Methods: This prospective study was carried out over a one-year period at a tertiary care teaching hospital. Data was collected using structured questionnaire, investigation reports and ante-natal cards. The outcome of delivery in all registered women was recorded by following them up till delivery.Results: The variables having a statistically significant association with an adverse pregnancy outcome were maternal and paternal education, family income, socioeconomic status (SES), gravidity, maternal complications, level of physical activity, rest during pregnancy, trimester of initiation of ANC visits, diet, iron supplementation, maternal weight gain, exposure to tobacco/environmental tobacco smoke and gestational age.Conclusions: Parental education, good antenatal care, early detection of high risk pregnancy, light physical activity and adequate rest, adequate nutrition with supplementation and exposure to ETS markedly influence the pregnancy outcome and intervention in these areas would result in an improved birth outcome. Factors having marginal scope of intervention include age of the pregnant women, adequate inter-pregnancy interval, maternal weight gain and socioeconomic status.

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C., Mohammed Sidhiq. « Maternal and fetal outcome of Placenta Previa at a tertiary centre in North Kerala, India ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, n^o 5 (28 avril 2018) : 1723. http://dx.doi.org/10.18203/2320-1770.ijrcog20181415.

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Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.Methods: This study was conducted in the Department of Obstetrics and Gynaecology during the period from June 2016 to May 2017 including antenatal patients of 24 weeks of gestation regardless of their parity. They would be selected from the same O.P day as that of case in a 1:4 case: control manner. Statistical analysis was done using SPSS version 16.0 for Windows.Results: Age, booking status, Gestational age at delivery and gravidity was comparable between the two groups. The risk for placenta praevia was more among patients with a previous history of CS. Risk for antepartum bleeding was significantly higher among cases of placenta praevia. CS rate and proportion of patients who required blood transfusion was significantly high among cases. Intraoperative and postoperative complications were significantly higher among cases. There was no significant difference in neonatal death rate and NICU admission rate between the two groups.Conclusions: Incidence of placenta previa is 0.78%. There is significant association with placenta previa and maternal morbidity, first trimester and second trimester bleeding increased blood transfusions, need for caesarean section, prolonged hospital stay, previous caesarean section, previous dilatation and curettage, placenta accreta, postoperative complications and NICU admission. Measures to reduce the primary caesarean section rate should be adopted.

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Shuaibu, Samaila Adavuruku, Usman Haruna, Rabiu Ayyuba, Suleiman Daneji Muhammad, Raphael Avidime Attah et Idris Usman Takai. « Cervical Cerclage For Cervical Incompetence : Indication, Complication And Pregnancy Outcome At Aminu Kano Teaching Hospital, Kano : A Five-year Review ». Jewel Journal of Medical Sciences 2, n^o 2 (août 2021) : 114–23. http://dx.doi.org/10.56167/jjms.2021.0202.15.

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Background: Cervical cerclage has salvaged so many pregnancies complicated by cervical incompetence. Objective: This study was carried out to determine the indications and pregnancy outcomes after cervical cerclage insertion. Methodology: This was a five-year retrospective study carried out in the department of Obstetrics and Gynecology of the Aminu Kano Teaching Hospital, Kano. The study covered the period of 1st January 2013 to 31st December 2017. The case notes of women who had cervical cerclage insertion during this period were retrieved and information such as age, gravidity, parity, indication for the cerclage and outcome of the pregnancy were extracted. This was entered into a proforma and analyzed using the SPSS Version 23 Computer software. Results:The mean age of the patients was 31.7±5.3years. Cervical cerclage was inserted between 13 and 32 weeks of gestation with a mean gestational age at insertion of 15.6 ± 3.6weeks. Mc Donald procedure accounted for 98.6% and only 1.4% had Shirodkar procedure. Cervical cerclage was history indicated in 62(87.3%), emergency cerclage was 8(11.3%) and ultrasound indicated in 1 (1.4%) of the women. Following the procedure, 64(80.28%) of the women took the pregnancy to term, however, Equal numbers of pregnancies were complicated by both preterm delivery and miscarriage, 7 (9.85%). Only seven patients had complication and out of that 4(57.1%) had pelvic pain, 2(28.6) had liquor drainage and 1(14.3%) had vaginal bleeding. Conclusion:Cervical cerclage for cervical incompetence is majorly history indicated and most of the patients carried the pregnancies to term after cerclage insertion. The complication rate is low.

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Leelawai, Sumonthip, Pornchai Sathirapanya et Chitkasaem Suwanrath. « Bell’s Palsy in Pregnancy : A Case Series ». Case Reports in Neurology 12, n^o 3 (26 novembre 2020) : 452–59. http://dx.doi.org/10.1159/000509682.

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The association between pregnancy-associated Bell’s palsy (PABP) and gestational hypertension (GHT), preeclampsia (PE), and eclampsia (EC) remains inconclusive. We aimed to study the characteristics of PABP cases and the neonatal outcomes at our institution. All cases diagnosed with PABP from 2006 to 2016 were identified. Demographic and clinical characteristics including maternal age, previous medical and obstetric illnesses, gestational age at the onset of PABP, the development of PE/EC, GHT, gestational diabetes mellitus (GDM), treatment and outcomes, as well as neonatal health indices and anomalies were described. Eight patients with PABP were identified. Most of the cases were first- or second-gravidity pregnancies. PABP occurred during the third trimester except for one case in whom PABP developed 2 days postpartum. No PABP case associated with EC was found. PE was found in only one case in whom GHT occurred in a previous pregnancy. Moreover, GHT combined with GDM was found in a case with previous GHT. The recovery of PABP was satisfactory. Previous obstetric complications are associated with the current PE, GHT and GDM. Facial weakness recovers favorably regardless of treatment and the neonatal outcomes are overall satisfactory.

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Musa, Abubakar U., Aisha I. Mamman, Abubakar A. Panti, Abdul Wahab Alhassan et Anas F. Rabi'u. « Clinical correlates of plasma antithrombin and protein C levels in patients with pre-eclampsia and eclampsia in Sokoto, Northwest Nigeria ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, n^o 10 (27 septembre 2021) : 3715. http://dx.doi.org/10.18203/2320-1770.ijrcog20213834.

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Background: Hypertensive disorders of pregnancy complicate 17% of pregnancies in Sokoto, Nigeria with pre-eclampsia and eclampsia accounting for 6% and 4.29% respectively. Pre-eclampsia and eclampsia stand out as major causes of poor pregnancy outcomes with eclampsia contributing 46% of adolescent maternal mortality in Sokoto. These disorders increase risk of venous thromboembolism, DIC, placental abruption, IUGR, premature delivery and recurrent pregnancy loss. The roles of antithrombin and protein C in disease severity and outcomes of pregnancies in pre-eclampsia/eclampsia are subject of recent researches albeit with conflicting findings. The aim of the study was to determine the plasma antithrombin and protein C levels of pre-eclampsia and eclampsia in Sokoto with a view to assessing any relationship with clinical severity and pregnancy outcomes.Methods: Prospective comparative study involving 31 each of pregnant women with pre-eclampsia, eclampsia and normotensive pregnancy. Plasma antithrombin and protein C levels were determined via kinetic method using S4 Nortek semi-automated coagulometer. Data analysis was performed using SPSS version 21.0. Results: The mean plasma antithrombin and protein C levels for eclampsia, pre-eclampsia and normotensive pregnancy were (61.17±9.13 and 60.00±5.76) vs (71.24±13.15 and 71.06±6.16) vs (85.54±8.77 and 89.64±7.61) respectively; p=0.0001. Severe pre-eclampsia when compared with mild pre-eclampsia had lower antithrombin (70.21±13.58 vs 73.74±12.43; p=0.507) and protein C (70.52±6.27 vs 72.40±6.00; p=0.451) levels respectively, though without statistical significance. Pre-eclampsia with low plasma antithrombin levels had increased risk of preterm delivery when age, gravidity and booking status were factored (OR, 1.2, 95% CI 0.035 to 0.348, p=0.017).Conclusions: Lower plasma antithrombin and protein C levels were found with eclampsia and severe pre-eclampsia suggesting consumptive depletion of anticoagulants with disease progression. Women with pre-eclampsia and low plasma antithrombin levels were found to have increased odds of having preterm delivery when age, gravidity and booking status were considered.

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GÜVEY, Huri, Samettin ÇELİK, Canan SOYER ÇALIŞKAN, Burak YAŞAR, Bahadır YAZICIOĞLU, Eda TÜRE et Hasan ULUBAŞOĞLU. « Does recurrent pregnancy loss have an inflammatory background ? » Journal of Experimental and Clinical Medicine 38, n^o 4 (30 août 2021) : 420–24. http://dx.doi.org/10.52142/omujecm.38.4.4.

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Although several pathophysiological mechanisms are defined in etiology recurrent pregnancy loss, still causes of half of the cases haven’t revealed yet. It is reported that inflammatory processes take place in the etiology of the disease. In our study, we aimed to reveal the relationship between recurrent pregnancy loss with white blood cell count (WBC), C-reactive protein (CRP) and ferritin levels. We included our study 90 pregnant women having recurrent miscarriage history and 101 pregnant women without recurrent miscarriages, 191 patients in total. Maternal and gestational age, height, weight, body mass index (BMI), gravidity, parity, abortion and living children count and WBC, CRP and ferritin levels of these pregnant were evaluated retrospectively. According to outcomes, while the age (p = 0.01; p<0.05), gravidity (p = 0.00; p<0.01) and abortion counts (p = 0.004; p<0.01) of the study group were found significantly to be higher than that of the control group, weight measurement of them was significantly lower than that of the control group (p = 0.04; p <0.05). Height and BMI measurements, parity and living children counts of the groups showed no statistically significant difference (p>0.05). While WBC levels of the study group was found to be lower (p=0.045, p<0,05) than that of control group, there was no significant difference regarding ferritin and CRP levels (p> 0.05). In our study, WBC, CRP and ferritin parameters did not indicate the inflammatory background in recurrent pregnancy loss. We think that further prospective randomized controlled studies are required regarding these parameters.

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Shalev-Ram, Hila, Gal Cohen, Shai Ram, Lior Heresco, Hanoch Schreiber, Tal Biron-Shental, Michal Kovo et Dorit Ravid. « Are There Similarities in Pregnancy Complications and Delivery Outcomes among Sisters ? » Journal of Clinical Medicine 11, n^o 22 (13 novembre 2022) : 6713. http://dx.doi.org/10.3390/jcm11226713.

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This retrospective cohort study evaluated pregnancy outcomes and similarities between pairs of nulliparous sisters with a singleton fetus who delivered between 2013 and 2020. The “Sister-1 group” was defined as the sibling who delivered first, while the “Sister-2 group” included the siblings who gave birth after Sister-1. Obstetrical complications and delivery outcomes were compared. The relative risk for recurrence of a complication in Sister-2 was calculated. The study included 743 sister pairs. There were no between-group differences in maternal BMI, gestational age at delivery, gravidity, smoking, or epidural rates. The Sister-2 group was older than the Sister-1 group (26.4 ± 5 vs. 25.8 ± 4.7 years, respectively, p = 0.05). Higher birthweights and more large-for-gestational-age infants characterized the Sister-2 group compared with the Sister-1 group (3241 ± 485 g vs. 3148 ± 536 g, p < 0.001 and 7.7% vs. 4.8%, p = 0.025, respectively). There were no between-group differences in the rate of small-for-gestational-age, gestational diabetes, hypertensive disorders, pre-term births, vacuum extraction, or cesarean deliveries. Logistic regression analysis found that if Sister-1 underwent vacuum extraction, her sibling had an increased risk for vacuum delivery (adjusted RR 3.03, 95% CI 1.4–6.7; p = 0.003) compared with those whose sibling (Sister-1) did not. There was a three-fold risk of vacuum extraction delivery between sisters. This finding could be related to biological inheritance, environmental factors, and/or psychological issues that may affect similarities between siblings’ delivery outcomes.

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Gaffer, Ahmed A., Duria A. Rayis, Osama G. Elhussein et Ishag Adam. « Vitamin D status in Sudanese pregnant women : a cross-sectional study ». Transactions of The Royal Society of Tropical Medicine and Hygiene 113, n^o 9 (4 juillet 2019) : 569–71. http://dx.doi.org/10.1093/trstmh/trz054.

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Abstract Background Maternal vitamin D deficiency is associated with maternal and perinatal adverse effects. This study was conducted to assess the vitamin D status among pregnant Sudanese women. Methods A total of 180 pregnant women were enrolled in a cross-sectional study in Saad Abualila Hospital, Khartoum, Sudan. The medical history of each woman was collected and 25-hydroxyvitamin D [25(OH)D] was measured using an electrochemiluminescence immunoassay. Results The median age, gravidity and gestational age was 27.7 y, 1.0 and 10.7 weeks, respectively. Of the 180 woman, 169 (93.9%) had vitamin D deficiency (≤20 ng/ml). There was no correlation between the 25(OH)D level and body mass index (r=−0.135, p=0.071) or haemoglobin level (r= 0.001, p=0.999). Conclusions The current study showed a high prevalence of vitamin D deficiency. Further studies investigating the risk factors for vitamin D deficiency and the outcome of pregnancy are needed.

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Broumand, Farzaneh, Fatemeh Bahadori, Tahereh Behrouzilak, Zahra Yekta et Farkhondeh Ashrafi. « Viable Extreme Preterm Birth and Some Neonatal Outcomes in Double Cerclage versus Traditional Cerclage : A Randomized Clinical Trial ». Scientific World JOURNAL 11 (2011) : 1660–66. http://dx.doi.org/10.1100/2011/486259.

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The pregnant women at higher risk of preterm labor, referred to the perinatal clinic of Kosar University Hospital in Urmia district of Iran, were enrolled into a parallel randomized clinical trial. In the investigational arm of the clinical trial, a double cervical cerclage procedure was performed addition to McDonald cerclage. In the control group however, only McDonald cerclage was performed. Extreme preterm labor (GA < 33 weeks) was the primary endpoint of this clinical trial. Age, gestational age at cerclage time, and gravidity were not found to be statistically different between the groups. Means of gestational age were 37.4 and 36.2 weeks, respectively, for the investigational and control groups. The gestational age was 1.2 weeks longer for double cerclage group but the difference was not found to be statistically significant. Preterm birth before 33 weeks of gestation was not experienced by any of the patients who received double cerclage, but five women in control group developed such an extreme preterm labor (). The absolute risk reduction in using double cerclage over traditional method was 18 percent (95% confidence interval, 4%–32%). Double cerclage appeared to have higher efficacy than traditional cerclage in preventing preterm labor <33 weeks of gestation.

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Nossent, Johannes, Warren Raymond, Helen Keen, Charles Inderjeeth et David Preen. « Pregnancy outcomes in women with a history of immunoglobulin A vasculitis ». Rheumatology 58, n^o 5 (24 décembre 2018) : 884–88. http://dx.doi.org/10.1093/rheumatology/key408.

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Abstract Objectives Case series suggest an increased risk of pregnancy complications in women with a history of IgA vasculitis (IgAV); however, no large quantitative studies have examined this possible association to date. We compared pregnancy rates and outcomes between female IgAV patients and controls and assessed flare risk of IgAV during pregnancy. Methods Using state-wide hospital morbidity data we compared rates for live birth, preterm birth, abortive outcome and gestational complications between female IgAV patients (International Classification of Diseases-9-Clinical Modification 287.0; International Classification of Diseases-10-Australian Modification D69.0) (n = 121) and non-exposed age-matched controls (n = 284) in Western Australia. Results presented are means compared by Kruskal–Wallis test and proportions with odds ratios (ORs) (95% CI) compared by χ2 testing. Results There were 247 pregnancies in IgAV patients during which no disease flares were recorded and 556 pregnancies in controls. IgAV patients were younger at first pregnancy (24.7 vs 27.0 years, P < 0.01) and had 43 unsuccessful pregnancies (17.4%) and 204 live births with 17 preterm deliveries (8.3%). Women with IgAV had increased odds of spontaneous abortion (OR 1.9, 95% CI 1.1, 3.1, P = 0.04), preterm delivery (OR 2.0, 95% CI 1.1, 3.9, P = 0.02) and gestational hypertension (OR 4.7, 95% CI 2.3, 9.8). While gravidity did not differ (mean pregnancy number 2.4 vs 2.3, P = 0.36), IgAV patients had over a two-fold greater number of obstetric visits than controls (5.1 vs 2.5, P < 0.01). Conclusions Hospitalization for IgAV has little impact on fertility and IgAV rarely flares during pregnancy. However, a history of IgAV associates with increased odds of spontaneous abortions, gestational hypertension and preterm delivery.

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Al Sulaimani, Ruqaiya, Lovina Machado et Munira Al Salmi. « Do Large Uterine Fibroids Impact Pregnancy Outcomes ? » Oman Medical Journal 36, n^o 4 (15 juillet 2021) : e292-e292. http://dx.doi.org/10.5001/omj.2021.93.

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Objectives: We sought to assess the prevalence of fibroids complicating pregnancy among Omani women who delivered and were followed-up at Sultan Qaboos University Hospital (SQUH) and correlate the presence of large fibroids (> 5 cm) with maternal and neonatal outcomes. Methods: This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, SQUH, from 1 January 2011 to 31 December 2016. Demographic data included maternal age, gravidity, parity, body mass index (BMI), and history of preterm delivery. Ultrasonographic data included the total number of fibroids, number of fibroids > 5 cm in diameter, and location. The main outcomes measured were preterm delivery, preterm premature rupture of membranes (PPROM), malpresentation, intrauterine growth restriction (IUGR), mode of delivery, postpartum hemorrhage, retained placenta, and cesarean myomectomy. Fetal outcomes included birth weight and Apgar score. We used the chi-square test and t-test to calculate significant outcomes. Results: The total number of deliveries over the study period was 24 800. Among these, 62 women had fibroids complicating pregnancy, giving an overall prevalence of 0.3%. Of the 62 women with documented uterine fibroids, 41 had fibroids > 5 cm in diameter and formed the study group, while the control group included 88 women with no fibroids and normal singleton pregnancies. The mean age, parity, BMI, and history of preterm delivery were comparable. The mean age of the study group was 32.6 years. There was no statistically significant difference in obstetric outcomes between the study and control group in terms of preterm labor (p =0.381), PPROM (p =0.536), malpresentation (p =0.237), IUGR (p =0.059), and retained placenta (p =0.296). Postpartum hemorrhage was significantly higher in the study group (p =0.018), the commonest cause was uterine atony (p =0.007). Women with large fibroids had a significantly increased cesarean section rate (p =0.002), the main indications were obstructed labor and failure to progress (62.5%). Five of the 44 women in the study group (12.8%) underwent cesarean myomectomy. Regarding neonatal outcomes, a statistically significant difference was noted in the Apgar scores. Conclusions: Fibroids measuring > 5 cm in diameter are more likely to cause obstetric complications and are associated with higher cesarean rates. Pre-conception myomectomy is recommended for women with large fibroids.

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S., Sneha, Sreelatha S. et Renuka Ramaiah. « Comparison of placental grading at different periods of gestation in PIH patients and their outcome ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, n^o 12 (26 novembre 2019) : 4747. http://dx.doi.org/10.18203/2320-1770.ijrcog20195313.

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Background: The current study follows grannum grading of placenta. It is well known that there is accelerated placental maturation in PIH patients and the ultrasonic appearance of grade 3 placenta before 37 weeks may signify placental dysfunction and is associated with development of low birth weight babies, IUGR meconium stained liquor, low APGAR score. Hence this study was conducted to emphasize on placental grading at different periods of gestation to predict and prevent increased obstetric and fetal compromise and to compare the outcomes.Methods: Obstetric scans were performed in all PIH patients attending antenatal OPD and inpatients at ESIC and PGIMSR medical college, Bangalore to know the placental grading and biophysical profile. These women were followed till their delivery for obstetric and fetal outcomes.Results: Grade 3 placenta is seen in 17 patients in group 1(50%) and 39 patients (59%) in group 2. For statistical analysis grade 1 and 2 were combined and compared with grade 3. P-value 0.198 which was not statistically significant. There was no statistically significant difference in age and gravidity between two groups. The medical disorders were more in group 2 i.e., between 37 - 40 weeks. The complications of PIH were also more in group 2. There were more number of LSCS (n=19 versus 14) in 34-36 weeks group which was not statistically significant. Fetal outcomes like IUGR and IUD were more in group 2 which was not statistically significant. The mean birth weight in group 1 was 2 kg as compared to 2.7 kg in group 2. All associated medical disorders were more in group 2.Conclusions: In hypertensive women there is accelerated placental maturation leading to maternal and fetal complications. Hence women with accelerated placental maturity in ultrasound should be closely monitored and appropriately managed. However, we recommend larger randomized studies are necessary.

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