This research article examines alterations in reproductive hormones during pregnancy and the risk of preeclampsia. The study followed 79 preeclamptic women and 80 healthy pregnant controls longitudinally from the third trimester through 6 weeks postpartum. Blood samples were taken at each visit and analyzed for beta-hCG, oestriol, progesterone and prolactin levels. Results showed beta-hCG and oestriol levels were significantly altered in the preeclamptic group compared to controls in the first and third trimesters respectively, indicating these hormones may help identify risk of preeclampsia earlier in pregnancy. The study aims to determine the gestational age at which hormonal changes occur that are associated with developing preecl
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Current point of view in preterm labor management in albania (2)Alexander Decker
This study examined the use of maintenance tocolysis therapy to prevent preterm labor in Albania. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks (n=200) had greater benefits, with pregnancy prolonged by 6-8 weeks on average. The authors conclude maintenance tocolysis therapy can considerably prolong pregnancy for women diagnosed with preterm labor between 28-32 weeks gestation, though larger studies are still needed.
Introduction: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn,
research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1
rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl.
Influence of perinatal factors on thyroid stimulating hormone level in cord b...amir mohammad Armanian
This study examined the effects of various perinatal factors on cord blood thyroid stimulating hormone (TSH) levels in 440 newborns in Iran. The researchers found that only the method of delivery had a statistically significant relationship with cord blood TSH levels - vaginal births were associated with higher TSH levels than cesarean sections. Other factors like birth weight, gestational age, gestational diabetes, Apgar scores, newborn sex, and maternal age did not have statistically significant relationships with cord TSH levels. The study concluded that among the factors examined, only the method of delivery impacted cord blood TSH levels in newborns.
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Neonatal and Obstetric Risk Assessment (NORA) Pregnancy Cohort Study in Singa...Premier Publishers
The Neonatal and Obstetric Risk Assessment (NORA) pregnancy cohort study was set up to assess clinical, biochemical and biophysical markers for risk assessment and prediction of the outcomes early in pregnancy. A total of 3271 patients who were in KK Women’s and Children’s Hospital between September 2010 and October 2014 were screened and 1013 patients consented to participate in the study. Women were followed at 18 to 22 weeks, 28 to 32 weeks and 34 weeks and above, till their postnatal discharge from the hospital. Finally, 926 patients remained for studying the outcome. In NORA study, we established locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters. Higher serum progesterone levels at 28–32 weeks of pregnancy were observed in women who had preterm deliveries compared with women with term deliveries in the cohort. We also found that extracellular vesicle (EV) biomarkers enhanced the predictive robustness of an existing pre-eclampsia (PE) biomarker sufficiently to justify PE screening in a low-risk general obstetric population. We plan to further conduct a range of serial assessments from the biosamples which will provide a comprehensive and valuable information of the dynamics of maternal conditions and fetal development during pregnancy.
This cross-sectional study examined gestational weight gain and perinatal outcomes in 1462 pregnant women in southern India. The study found that 37.41% of women gained less than the recommended weight based on IOM guidelines, while 21.41% gained more. Less than optimal weight gain was associated with a higher risk of preterm delivery (adjusted odds ratio 3.58). However, gestational weight gain was not significantly associated with other maternal or neonatal outcomes. This suggests the IOM guidelines may not be an appropriate standard for monitoring gestational weight gain in this population.
Demographic Profile, anemia status and fetal outcome of the pregnant women at...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Current point of view in preterm labor management in albania (2)Alexander Decker
This study examined the use of maintenance tocolysis therapy to prevent preterm labor in Albania. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks (n=200) had greater benefits, with pregnancy prolonged by 6-8 weeks on average. The authors conclude maintenance tocolysis therapy can considerably prolong pregnancy for women diagnosed with preterm labor between 28-32 weeks gestation, though larger studies are still needed.
Introduction: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn,
research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1
rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl.
Influence of perinatal factors on thyroid stimulating hormone level in cord b...amir mohammad Armanian
This study examined the effects of various perinatal factors on cord blood thyroid stimulating hormone (TSH) levels in 440 newborns in Iran. The researchers found that only the method of delivery had a statistically significant relationship with cord blood TSH levels - vaginal births were associated with higher TSH levels than cesarean sections. Other factors like birth weight, gestational age, gestational diabetes, Apgar scores, newborn sex, and maternal age did not have statistically significant relationships with cord TSH levels. The study concluded that among the factors examined, only the method of delivery impacted cord blood TSH levels in newborns.
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Neonatal and Obstetric Risk Assessment (NORA) Pregnancy Cohort Study in Singa...Premier Publishers
The Neonatal and Obstetric Risk Assessment (NORA) pregnancy cohort study was set up to assess clinical, biochemical and biophysical markers for risk assessment and prediction of the outcomes early in pregnancy. A total of 3271 patients who were in KK Women’s and Children’s Hospital between September 2010 and October 2014 were screened and 1013 patients consented to participate in the study. Women were followed at 18 to 22 weeks, 28 to 32 weeks and 34 weeks and above, till their postnatal discharge from the hospital. Finally, 926 patients remained for studying the outcome. In NORA study, we established locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters. Higher serum progesterone levels at 28–32 weeks of pregnancy were observed in women who had preterm deliveries compared with women with term deliveries in the cohort. We also found that extracellular vesicle (EV) biomarkers enhanced the predictive robustness of an existing pre-eclampsia (PE) biomarker sufficiently to justify PE screening in a low-risk general obstetric population. We plan to further conduct a range of serial assessments from the biosamples which will provide a comprehensive and valuable information of the dynamics of maternal conditions and fetal development during pregnancy.
This cross-sectional study examined gestational weight gain and perinatal outcomes in 1462 pregnant women in southern India. The study found that 37.41% of women gained less than the recommended weight based on IOM guidelines, while 21.41% gained more. Less than optimal weight gain was associated with a higher risk of preterm delivery (adjusted odds ratio 3.58). However, gestational weight gain was not significantly associated with other maternal or neonatal outcomes. This suggests the IOM guidelines may not be an appropriate standard for monitoring gestational weight gain in this population.
Demographic Profile, anemia status and fetal outcome of the pregnant women at...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
COVID-19 affects different people in different ways. Information about the virus and COVID-19 continues to accrue, and interim guidance by multiple organizations is constantly being updated and expanded.
PATTERN OF DRUG PRESCRIBING DURING PREGNANCY IN NEPALESE WOMENPriyanka Shrestha
This study assessed the pattern of drug prescribing for 94 pregnant women in Nepal. The majority of women were aged 15-25 years. Most drugs prescribed were categorized by the FDA as category B, meaning they have been shown to have no evidence of risk in humans. The most commonly prescribed drugs were nutritional supplements like iron and folic acid, followed by antibiotics and antacids. Some category X drugs like oxytocin and dydrogesterone were prescribed, indicating potential teratogenic risk. Overall, the study provides insight into prescribing practices for pregnant women in Nepal.
Estimation of Fetal Size and Weight using Various Formulasijtsrd
Birth weight is an important factor in delivery management. Antenatal ultrasound has turned out to be one of the clinicians most vital devices for surveying fetal age, growth and prosperity. Contrasted Physical examination of the pregnant uterus is the most precise strategy for evaluating fetal size and growth along with the utilization of ultrasound imaging and estimating of the different fetal parameters. Objective To evaluates the antenatal assessments of fetal weight in pregnancies by using Johnsons formula, Hadlocks formula and Ultrasonography. Comparison of these different methods with the actual birth weight of these babies after delivered. Material and methods Two hundred singleton term pregnancies within 48 hours were randomly selected to participate in this prospective cohort study. Variables included such as abdominal circumference, Biparietal diameter, and Femur length. Parameters to obtain estimated fetal weight Results The mean birth weight of Hadlock formula is closest to the mean of actual birth weight. In the study population, more primigravida delivered babies with very low birth weight and more multigravida delivered babies of birth weight 3500 gms. Johnsons and ultrasound Hadlocks formula had a marked tendency to overestimate the fetal weight. Error was within 350 Gms in 84.7 , 70.8 and 84 of cases by Dares, Johnsons and ultrasound Hadlocks formula. Dr. Pushpamala Ramaiah | Dr. Lamiaa Ahmed Elsayed | Dr. Grace Lindsey | Dr. Ayman Johargy ""Estimation of Fetal Size and Weight using Various Formulas"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23231.pdf
Paper URL: https://www.ijtsrd.com/medicine/nursing/23231/estimation-of-fetal-size-and-weight-using-various-formulas/dr-pushpamala-ramaiah
Pregnancy outcome in women presenting with reduced fetal movements.
The study aims to evaluate maternal and perinatal outcomes in pregnant women presenting primarily with reduced fetal movements in the third trimester. Women experiencing reduced fetal movements will undergo assessments including CTG, ultrasound, and Doppler to evaluate fetal well-being. Pregnancy outcomes such as gestational age at delivery, mode of delivery, birthweight, and complications will be analyzed. The results could help improve management of reduced fetal movement cases in the future.
This study evaluated the clinical and perinatal outcomes of 100 teenage pregnancies at a tertiary referral center in South India. The study found that teenage pregnancies had higher rates of complications like anemia (43%), preeclampsia (21%), preterm labor (21%), and emergency c-sections (33%) compared to adult pregnancies. Neonatal outcomes were also worse, with 38% of babies being low birth weight (<2.5 kg) and 21% being preterm. The study concluded that teenage pregnancy poses significant health risks to both mother and baby due to the biological immaturity of teenage mothers.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
“A Study on Coagulation Profile in Pregnancy Induced Hypertension Cases”iosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
This study examined the relationship between maternal consumption of polyphenol-rich foods late in pregnancy and fetal ductus arteriosus flow dynamics. Doppler ultrasound was used to compare ductal velocities and right-to-left ventricular dimensions in 102 fetuses exposed to high maternal polyphenol intake versus 41 unexposed fetuses. Exposed fetuses had higher ductal velocities and right-to-left ventricular ratios, suggesting maternal polyphenol-rich food intake may influence fetal ductal dynamics by inhibiting prostaglandin synthesis, similarly to non-steroidal anti-inflammatory drugs. As polyphenol-rich foods are commonly consumed during pregnancy, their effects on the fetal ductus warrant further consideration.
This document summarizes a study that examined the relationship between the drug domperidone, which is commonly used off-label to stimulate lactation, and the risk of ventricular arrhythmia and mortality during the postpartum period. The study used a retrospective cohort of over 225,000 women in British Columbia between 2002-2011. It found a possible doubling of the risk of hospitalization for ventricular arrhythmia among those exposed to domperidone, though the results were not statistically significant. Larger studies are needed to confirm any association.
A Study to Identify the Post Partum Complications among Post Natal Mothers in...ijtsrd
Complications in early post natal periods may lead many issues such as breast engorgement, perineal pain, constipation, and urine incontinence. Postpartum complications contribute to a lot of maternal morbidity. A Descriptive study was conducted to identify the post partum complications among post natal mothers. The study was conducted on 120 post natal mothers who were selected using convenient sampling technique. The study was explained to participants and consent was taken. Data were collected by using structured knowledge questionnaire and self reported practice check list. Homogeneity was maintained for demographic variables. The result showed Identification of post partum complications shows that that in perineal pain, pain in perineal area 45 . In constipation, difficulty to express stool 33.33 , a sense that everything didn’t come out 33.33 , hard or small stool 20.83 . In breast engorgement, 20.83 mothers reported pain and swelling in breast, hardness in breast 20 and flat nipple 15 . In urine incontinence, intense urge of urine 2.5 . Himani Bora | Kanchan Bala | Laxmi Kumar "A Study to Identify the Post-Partum Complications among Post Natal Mothers in Selected Hospital of Dehradun, Uttarakhand" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33524.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/33524/a-study-to-identify-the-postpartum-complications-among-post-natal-mothers-in-selected-hospital-of-dehradun-uttarakhand/himani-bora
This document discusses guidelines for improving antenatal and postnatal care. It emphasizes the importance of antenatal care screening for risk factors, treating conditions, and providing patient education. For postnatal care, it stresses monitoring for complications, providing screening and information, and ensuring follow-up of high-risk mothers after discharge. The overall goal is to reduce maternal and neonatal mortality through continuous, risk-based care during and after pregnancy.
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Role of Diet and Exercise in infertility and IVFShivani Sachdev
The document discusses the role of diet and exercise in fertility and IVF outcomes. It notes that diet can influence fertility through providing necessary nutrients for egg and sperm health and fetal growth. Certain diets like the Mediterranean diet are highlighted as being beneficial for fertility outcomes. Maintaining a healthy BMI and lifestyle factors like avoiding smoking and excessive alcohol are also emphasized. The document outlines dietary considerations for specific fertility issues like PCOS, endometriosis, and male factor infertility.
Obesity in pregnancy by dr alka mukherjee dr apurva mukherjee nagpur m.s. indiaalka mukherjee
Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood.
The evidence available on short- and long-term health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more long-term investigation.
This retrospective study analyzed 477 cases of neonatal hypoglycemia over one year and compared maternal glycemic parameters to neonatal outcomes. 33.1% of mothers had abnormal glucose challenge test (GCT) screens while there was no significant difference between those with abnormal GCTs and one or two abnormal oral glucose tolerance tests. Babies born to mothers with abnormal GCTs had lower birth weights but no differences in APGAR scores or C-section rates. The study concludes that abnormal GCTs can identify mothers at risk of having babies with hypoglycemia and higher risks of obesity, and that earlier detection of at-risk mothers could help reduce NICU admissions and long-term childhood obesity.
This document summarizes key findings from several studies on exposures during pregnancy and lactation. The studies found:
- Teratogen information services receive thousands of calls annually regarding exposures to medications, infections, herbs and other substances during pregnancy and breastfeeding. The majority of calls concern analgesics, cold medications, herbs and dietary supplements.
- Most calls are made by exposed individuals themselves, highlighting a need for more education during prenatal care about risks of nonprescription drugs and vaccines.
- While some drugs used to treat autoimmune diseases like methotrexate and leflunomide can cause harm if taken during early pregnancy, others like sulfasalazine, azathioprine and antimalarials are
Risk factors and treatment seeking behavior of Tuberculosis In Selected Stat...PRAKASAM C P
This document analyzes risk factors and treatment seeking behavior for tuberculosis (TB) in four Indian states using data from the National Family Health Survey 3 (NFHS-3). The key points are:
1. The prevalence of TB was highest in Tamil Nadu and among males, older age groups, and rural populations.
2. Risk factors for TB included poor housing conditions, cooking with biomass fuels, and behaviors like smoking and drinking. Wealth, education, and urban residence were protective.
3. Treatment seeking varied by state, with households in Andhra Pradesh least likely to use government facilities for TB care. Private providers remained the primary source of care overall.
Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy
J Man, JC Hutchinson, M Ashworth, AE Heazell, S Levine and NJ Sebire
Volume 47, Issue 11; Date: November, pages 574–578
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16018/full
Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors
J Man, JC Hutchinson, M Ashworth, I Jeffrey, AE Heazell, and NJ Sebire
Volume 48, Issue 5; Date: November, pages 585–590
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16017/full
A COMPARATIVE ANALYSIS OF HEMATOLOGICAL INDICES IN PREGNANT WOMEN AND NON PR...FidelityP
Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood. Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly. The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs123
Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Pre...Samir elsayed
This study aimed to assess the accuracy of combined maternal serum interleukin-8 and salivary estriol levels in predicting preterm labor in Egyptian pregnant females. The study found that maternal serum interleukin-8 alone had the highest accuracy at a cut-off of 965 pg/ml, with an overall accuracy of 79%, sensitivity of 92.5%, and specificity of 42.5%. Combined interleukin-8 and estriol had an overall accuracy of 68% and salivary estriol alone had an accuracy of 58%. The study concluded that maternal serum interleukin-8 is a more accurate, effective, and relatively non-invasive strategy for predicting preterm labor compared to salivary estriol alone.
COVID-19 affects different people in different ways. Information about the virus and COVID-19 continues to accrue, and interim guidance by multiple organizations is constantly being updated and expanded.
PATTERN OF DRUG PRESCRIBING DURING PREGNANCY IN NEPALESE WOMENPriyanka Shrestha
This study assessed the pattern of drug prescribing for 94 pregnant women in Nepal. The majority of women were aged 15-25 years. Most drugs prescribed were categorized by the FDA as category B, meaning they have been shown to have no evidence of risk in humans. The most commonly prescribed drugs were nutritional supplements like iron and folic acid, followed by antibiotics and antacids. Some category X drugs like oxytocin and dydrogesterone were prescribed, indicating potential teratogenic risk. Overall, the study provides insight into prescribing practices for pregnant women in Nepal.
Estimation of Fetal Size and Weight using Various Formulasijtsrd
Birth weight is an important factor in delivery management. Antenatal ultrasound has turned out to be one of the clinicians most vital devices for surveying fetal age, growth and prosperity. Contrasted Physical examination of the pregnant uterus is the most precise strategy for evaluating fetal size and growth along with the utilization of ultrasound imaging and estimating of the different fetal parameters. Objective To evaluates the antenatal assessments of fetal weight in pregnancies by using Johnsons formula, Hadlocks formula and Ultrasonography. Comparison of these different methods with the actual birth weight of these babies after delivered. Material and methods Two hundred singleton term pregnancies within 48 hours were randomly selected to participate in this prospective cohort study. Variables included such as abdominal circumference, Biparietal diameter, and Femur length. Parameters to obtain estimated fetal weight Results The mean birth weight of Hadlock formula is closest to the mean of actual birth weight. In the study population, more primigravida delivered babies with very low birth weight and more multigravida delivered babies of birth weight 3500 gms. Johnsons and ultrasound Hadlocks formula had a marked tendency to overestimate the fetal weight. Error was within 350 Gms in 84.7 , 70.8 and 84 of cases by Dares, Johnsons and ultrasound Hadlocks formula. Dr. Pushpamala Ramaiah | Dr. Lamiaa Ahmed Elsayed | Dr. Grace Lindsey | Dr. Ayman Johargy ""Estimation of Fetal Size and Weight using Various Formulas"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23231.pdf
Paper URL: https://www.ijtsrd.com/medicine/nursing/23231/estimation-of-fetal-size-and-weight-using-various-formulas/dr-pushpamala-ramaiah
Pregnancy outcome in women presenting with reduced fetal movements.
The study aims to evaluate maternal and perinatal outcomes in pregnant women presenting primarily with reduced fetal movements in the third trimester. Women experiencing reduced fetal movements will undergo assessments including CTG, ultrasound, and Doppler to evaluate fetal well-being. Pregnancy outcomes such as gestational age at delivery, mode of delivery, birthweight, and complications will be analyzed. The results could help improve management of reduced fetal movement cases in the future.
This study evaluated the clinical and perinatal outcomes of 100 teenage pregnancies at a tertiary referral center in South India. The study found that teenage pregnancies had higher rates of complications like anemia (43%), preeclampsia (21%), preterm labor (21%), and emergency c-sections (33%) compared to adult pregnancies. Neonatal outcomes were also worse, with 38% of babies being low birth weight (<2.5 kg) and 21% being preterm. The study concluded that teenage pregnancy poses significant health risks to both mother and baby due to the biological immaturity of teenage mothers.
— This study was conducted to find out if AFI ≤ 5 cms has any clinical significance in identifying the subsequent fetal distress & associated maternal & perinatal outcomes, in pregnancies beyond 37 weeks. Methodology: This is a prospective case control study done from July 2010 to July 2012 (24 months) at Dr Vasantrao Pawar Medical College, Hospital and Research Center. Adgaon, Nashik. It study the pregnancy outcome comparison of 58 Anenatal Cases(ANCs)as Study Group with diangosis of oligohydramnios (AFI ≤ 5 cms) by ultrasound after 37 completed weeks of gestation w e r e compared with 58 ANCs (Control Group) with no oligohydramnios (AFI > 5 cms). These two groups were matched for other variables like age, parity, gestational age and any pregnancy complication. Results: There was significant difference between two groups. Hypertension and Preeclampsia were found significantly more in ANCs with oligohydramnios. FHR deceleration was also significantly higher in women with oligohydramnios. Women require LSCS were also significantly more in women with oligohydramnios. Newborn borned by women with oligohydramnios had significantly more chances to admit in NICU than in newborn born by women without oligohydramnios. Conclusion: It can be concluded from this study that women with oligohydramnios poor pregancy outcomes. Determination of AFI can be used as an adjunct to other fetal surveillance methods. Determination of AFI can be used as valuable screening test for predicting fetal distress in labour, requiring caesarean section.
“A Study on Coagulation Profile in Pregnancy Induced Hypertension Cases”iosrjce
IOSR Journal of Biotechnology and Biochemistry (IOSR-JBB) covers studies of the chemical processes in living organisms, structure and function of cellular components such as proteins, carbohydrates, lipids, nucleic acids and other biomolecules, chemical properties of important biological molecules, like proteins, in particular the chemistry of enzyme-catalyzed reactions, genetic code (DNA, RNA), protein synthesis, cell membrane transport, and signal transduction. IOSR-JBB is privileged to focus on a wide range of biotechnology as well as high quality articles on genetic engineering, cell and tissue culture technologies, genetics, microbiology, molecular biology, biochemistry, embryology, cell biology, chemical engineering, bioprocess engineering, information technology, biorobotics.
Does Utilization of Antenatal Care Reduces Reproductive Risk? A Case Study o...PRAKASAM C P
This paper examines the utilization of antenatal care and out come of pregnancy and delivery complications (Reproductive risk) among currently married women in Andhra Pradesh, India. Data for this study were collected from DLHS-RCH-3 for Andhra Pradesh. Pregnancy outcome has been collected for all deliveries from the currently married women and the utilisation of ANC, health seeing behavior, pregnancy problems during and problems during delivery which have been considered as reproductive risk and analysed for the last child data. Reproductive history of 19825 deliveries for Andhra Pradesh form data set. Analysis has been carried out in three stages. Initially Pregnancy loss and its ANC and treatment seeking behavior have been analysed. At the second stage pregnancy complications and delivery complications for the last delivery in relation to outcome has been analysed for Andhra Pradesh data. At the third stage interrelation between Pregnancy out come and reproductive risk has been analysed by using logistic regression. Further influence of background variables on reproductive loss and treatment seeking behavior has been analysed. The results revealed that women experience still birth in Andhra Pradesh found to be around 2.9. Further results revealed that women who had utilized antenatal care services found to have less risk in delivering last child than other. Maternal age and husband occupation played significant influence in utilization of health care services leading to safe delivery in these two selected states.
This study examined the relationship between maternal consumption of polyphenol-rich foods late in pregnancy and fetal ductus arteriosus flow dynamics. Doppler ultrasound was used to compare ductal velocities and right-to-left ventricular dimensions in 102 fetuses exposed to high maternal polyphenol intake versus 41 unexposed fetuses. Exposed fetuses had higher ductal velocities and right-to-left ventricular ratios, suggesting maternal polyphenol-rich food intake may influence fetal ductal dynamics by inhibiting prostaglandin synthesis, similarly to non-steroidal anti-inflammatory drugs. As polyphenol-rich foods are commonly consumed during pregnancy, their effects on the fetal ductus warrant further consideration.
This document summarizes a study that examined the relationship between the drug domperidone, which is commonly used off-label to stimulate lactation, and the risk of ventricular arrhythmia and mortality during the postpartum period. The study used a retrospective cohort of over 225,000 women in British Columbia between 2002-2011. It found a possible doubling of the risk of hospitalization for ventricular arrhythmia among those exposed to domperidone, though the results were not statistically significant. Larger studies are needed to confirm any association.
A Study to Identify the Post Partum Complications among Post Natal Mothers in...ijtsrd
Complications in early post natal periods may lead many issues such as breast engorgement, perineal pain, constipation, and urine incontinence. Postpartum complications contribute to a lot of maternal morbidity. A Descriptive study was conducted to identify the post partum complications among post natal mothers. The study was conducted on 120 post natal mothers who were selected using convenient sampling technique. The study was explained to participants and consent was taken. Data were collected by using structured knowledge questionnaire and self reported practice check list. Homogeneity was maintained for demographic variables. The result showed Identification of post partum complications shows that that in perineal pain, pain in perineal area 45 . In constipation, difficulty to express stool 33.33 , a sense that everything didn’t come out 33.33 , hard or small stool 20.83 . In breast engorgement, 20.83 mothers reported pain and swelling in breast, hardness in breast 20 and flat nipple 15 . In urine incontinence, intense urge of urine 2.5 . Himani Bora | Kanchan Bala | Laxmi Kumar "A Study to Identify the Post-Partum Complications among Post Natal Mothers in Selected Hospital of Dehradun, Uttarakhand" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33524.pdf Paper Url: https://www.ijtsrd.com/other-scientific-research-area/other/33524/a-study-to-identify-the-postpartum-complications-among-post-natal-mothers-in-selected-hospital-of-dehradun-uttarakhand/himani-bora
This document discusses guidelines for improving antenatal and postnatal care. It emphasizes the importance of antenatal care screening for risk factors, treating conditions, and providing patient education. For postnatal care, it stresses monitoring for complications, providing screening and information, and ensuring follow-up of high-risk mothers after discharge. The overall goal is to reduce maternal and neonatal mortality through continuous, risk-based care during and after pregnancy.
A Clinical Study on Maternal and Fetal Outcome in Multiple Pregnancies in Wom...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Role of Diet and Exercise in infertility and IVFShivani Sachdev
The document discusses the role of diet and exercise in fertility and IVF outcomes. It notes that diet can influence fertility through providing necessary nutrients for egg and sperm health and fetal growth. Certain diets like the Mediterranean diet are highlighted as being beneficial for fertility outcomes. Maintaining a healthy BMI and lifestyle factors like avoiding smoking and excessive alcohol are also emphasized. The document outlines dietary considerations for specific fertility issues like PCOS, endometriosis, and male factor infertility.
Obesity in pregnancy by dr alka mukherjee dr apurva mukherjee nagpur m.s. indiaalka mukherjee
Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood.
The evidence available on short- and long-term health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more long-term investigation.
This retrospective study analyzed 477 cases of neonatal hypoglycemia over one year and compared maternal glycemic parameters to neonatal outcomes. 33.1% of mothers had abnormal glucose challenge test (GCT) screens while there was no significant difference between those with abnormal GCTs and one or two abnormal oral glucose tolerance tests. Babies born to mothers with abnormal GCTs had lower birth weights but no differences in APGAR scores or C-section rates. The study concludes that abnormal GCTs can identify mothers at risk of having babies with hypoglycemia and higher risks of obesity, and that earlier detection of at-risk mothers could help reduce NICU admissions and long-term childhood obesity.
This document summarizes key findings from several studies on exposures during pregnancy and lactation. The studies found:
- Teratogen information services receive thousands of calls annually regarding exposures to medications, infections, herbs and other substances during pregnancy and breastfeeding. The majority of calls concern analgesics, cold medications, herbs and dietary supplements.
- Most calls are made by exposed individuals themselves, highlighting a need for more education during prenatal care about risks of nonprescription drugs and vaccines.
- While some drugs used to treat autoimmune diseases like methotrexate and leflunomide can cause harm if taken during early pregnancy, others like sulfasalazine, azathioprine and antimalarials are
Risk factors and treatment seeking behavior of Tuberculosis In Selected Stat...PRAKASAM C P
This document analyzes risk factors and treatment seeking behavior for tuberculosis (TB) in four Indian states using data from the National Family Health Survey 3 (NFHS-3). The key points are:
1. The prevalence of TB was highest in Tamil Nadu and among males, older age groups, and rural populations.
2. Risk factors for TB included poor housing conditions, cooking with biomass fuels, and behaviors like smoking and drinking. Wealth, education, and urban residence were protective.
3. Treatment seeking varied by state, with households in Andhra Pradesh least likely to use government facilities for TB care. Private providers remained the primary source of care overall.
Effects of intrauterine retention and postmortem interval on body weight following intrauterine death: implications for assessment of fetal growth restriction at autopsy
J Man, JC Hutchinson, M Ashworth, AE Heazell, S Levine and NJ Sebire
Volume 47, Issue 11; Date: November, pages 574–578
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16018/full
Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors
J Man, JC Hutchinson, M Ashworth, I Jeffrey, AE Heazell, and NJ Sebire
Volume 48, Issue 5; Date: November, pages 585–590
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.16017/full
A COMPARATIVE ANALYSIS OF HEMATOLOGICAL INDICES IN PREGNANT WOMEN AND NON PR...FidelityP
Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood. Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly. The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs123
Accuracy of Combined Maternal Serum Interleukin-8 and Salivary Estriol in Pre...Samir elsayed
This study aimed to assess the accuracy of combined maternal serum interleukin-8 and salivary estriol levels in predicting preterm labor in Egyptian pregnant females. The study found that maternal serum interleukin-8 alone had the highest accuracy at a cut-off of 965 pg/ml, with an overall accuracy of 79%, sensitivity of 92.5%, and specificity of 42.5%. Combined interleukin-8 and estriol had an overall accuracy of 68% and salivary estriol alone had an accuracy of 58%. The study concluded that maternal serum interleukin-8 is a more accurate, effective, and relatively non-invasive strategy for predicting preterm labor compared to salivary estriol alone.
Obstetric outcomes associated with second trimester unexplained abnormal mate...Apollo Hospitals
1) To compare the adverse obstetrical outcomes in the patient population with normal blood MoMs.
2) To determine the probability of occurrence of an adverse obstetric event in relation with abnormal maternal blood
analytes.
Background: We conducted this study to identify outcomes of pregnancies complicated by pre-eclampsia and eclampsia in
Cameroon.
Methods: This was a cohort study at the Regional Hospital, Maroua-Cameroon between June 2005 and May 2007. The outcome of pre-eclamptic and ecliptic patients were compared. The level of significance was 0.05.
This study examined pregnancy outcomes for 152 women in Cameroon with pre-eclampsia or eclampsia. It found that eclampsia was associated with higher rates of cesarean delivery (27% vs 9%) and maternal death (9% vs 1%) compared to pre-eclampsia. The overall maternal mortality rate was 4% and fetal mortality rate was 27%. Among women with eclampsia, induction of labor was linked to greater risk of fetal death (50% vs 13%). The study concludes that outcomes of hypertensive disorders in pregnancy in this region of Cameroon remain serious, and improved national guidelines, education, training and drug availability are needed.
Except in association with molar or hydropic degeneration of the placenta, with or without a coexistent fetus, eclampsia before 20 weeks of gestation is rare and only few cases have been described. The case reported was that of a 24 year old primipara who had tonic-clonic seizures at 19 weeks gestation without prior Preeclampsia. She remained stable and was managed closely up to 36 weeks gestation. She had spontaneous vaginal delivery of a live baby at 38 weeks with good outcome. Atypical eclampsia may develop before 20 weeks of gestation and could pose serious management challenges. Such patients if carefully selected and closely monitored may have satisfactory outcome. This case deserves reporting because of its rare nature as several literature search did not reveal any reported case of eclampsia before 20 weeks that was successfully managed to term.
Aim: To predict the probability of stone free status calculated by CROES nomogram and to test the accuracy of our fi tted regression model to predict outcomes of PCNL. Methods: From July 2018 to May 2019, data of 100 patients underwent PCNL procedure for renal stones at Urology department at Menoufi a University was collected and postoperative results were compared to the preoperative predicted stone free status. The CROES nomogram was applied to the data of all cases using its scale to calculate the total score and corresponding percent of stone free status after the procedure. We used binary logistic regression to test whether the six factors in the study can predict the PCNL outcome. We compared the calculated probabilities of stone free by our fitted regression model to the traditional method using the whole 6 parameters on the scale of nomogram.
Dr. Ankit Jain et al conducted a study to evaluate neonatal outcomes in mothers with premature rupture of membranes (PROM) at a tertiary care hospital. They analyzed 85 neonates born to mothers with PROM. Most neonates were born at 35-36 weeks gestation to primigravid mothers aged 21-25 years via normal vaginal delivery. The most common neonatal complications were jaundice, respiratory distress, and hypoglycemia. Over half of neonates were admitted to the NICU. Most had normal CBC and CRP reports, and the majority exhibited no complications. Common issues during hospitalization included decreased activity, fever, and feeding difficulties.
Current Point of View in Preterm Labor Management in AlbaniaRustem Celami
The document discusses a study conducted in Albania on the use of maintenance tocolysis therapy to prevent preterm labor. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks gestation saw more prolonged pregnancies compared to the 30-32 weeks group. The study concluded that maintenance tocolysis therapy can considerably benefit women diagnosed with preterm labor and help prolong their singleton pregnancies when medical intervention is not urgently needed. However, more research is still required.
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
This document summarizes a study that evaluated the effects of various maternal, fetal, and technical factors on the accuracy of sonographic fetal weight estimation (SFWE). The study analyzed over 9,000 SFWEs performed within a week of delivery. It found that several maternal factors, including higher weight, height, BMI, older age, diabetes, and multiparity were associated with underestimation of fetal weight. Fetal factors like male sex were also linked to underestimation, while breech presentation slightly improved accuracy. Experience level of the sonographer had little effect. Overall, the models assessed explained less than 10% of errors, suggesting most inaccuracy comes from limitations of SFWE formulas themselves.
This document analyzes histomorphologic changes in placentas from pregnancies complicated by hypertension. Placentas from 50 normal pregnancies and 50 pregnancies with hypertension were examined. Microscopic analysis found significantly increased villous abnormalities in placentas from pregnancies with hypertension, including higher rates of syncytial knots, decreased vasculo-syncytial membranes, more fibrinoid necrosis, thicker basement membranes, and more villous stromal fibrosis. These findings suggest reduced blood flow in the placenta among pregnancies with hypertension, which can impact fetal and maternal health.
The comparison of dinoprostone and vagiprost for induction of lobar in post t...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
This study validated a food frequency questionnaire (FFQ) used to measure fruit, vegetable, and tea intake in pregnant women in Norway. The FFQ estimates were compared to biomarkers (urinary flavonoids and plasma carotenoids) and a 4-day weighed food diary. Correlations between the FFQ and biomarkers provided evidence that the FFQ could reliably estimate intake of certain foods, with validity coefficients of 0.65 for citrus fruit/juice and 0.59 for cooked vegetables. Overall, the validation study demonstrated the FFQ's ability to estimate fruit, juice, vegetable and tea intake in pregnant Norwegian women.
This study examined 73 pregnant patients in Pakistan who presented with signs of liver disease. Laboratory testing found that 50 (68.5%) patients had acute hepatitis E virus (HEV) infection. The study aimed to evaluate maternal and fetal outcomes. It found that acute HEV during pregnancy predicted poor outcomes. 10% of HEV-infected mothers developed fulminant hepatic failure and did not survive. There were also high rates of fetal complications, including 8% intrauterine death, 10% neonatal death, and 12% preterm delivery due to maternal or fetal distress. The study concludes that acute HEV infection during pregnancy carries significant health risks for both mother and baby.
This proposal aims to develop a logistic model incorporating maternal factors and inflammatory biomarkers during the first trimester of pregnancy to better predict preeclampsia and pregnancy outcomes. A prospective cohort study of 1,500 pregnant women in India will collect data on maternal risk factors and biomarker levels during the first trimester and follow the women through pregnancy to observe outcomes. The results will be analyzed using logistic regression to create a predictive model. This study hopes to improve early detection of preeclampsia through a multi-factorial approach combining traditional risk factors and novel biomarkers.
This study evaluated the endometrial receptivity array (ERA) test in patients with recurrent implantation failure. The study found:
- Of 2110 patients with moderate recurrent implantation failure, those who underwent embryo transfer of euploid embryos after preimplantation genetic testing for aneuploidy (PGT-A) had higher implantation and ongoing pregnancy rates than those without PGT-A.
- For 488 patients with severe recurrent implantation failure, no statistically significant improvements were seen with PGT-A.
- The use of the ERA test did not significantly improve outcomes for either group.
- PGT-A may be beneficial for moderate recurrent implantation failure cases but not severe cases.
-
Introduction
Pregnancy is a normal physiological process and any intervention that is offered to the pregnant or expectant mother should have known benefits and should be acceptable to the woman
Screening in pregnancy is the process of surveying a population of women with markers and defined screening cut-off levels, to identify those at higher risk for a particular disorder
All pregnant women, regardless of age, should be offered, through an informed counselling process, the option of a prenatal screening test for the most common clinically significant fetal aneuploidies
This study assessed oral microbiota in different trimesters of pregnancy. Samples were taken from 70 pregnant women divided into groups by trimester and 15 non-pregnant controls. The amount of colony forming units (CFU)/ml was highest in the first trimester, decreased in the second, and was higher again in the third trimester compared to non-pregnant women. Higher CFU/ml positively correlated with worse periodontal diagnoses. The study concluded that oral bacteria levels increase in the first and third trimesters of pregnancy, which can negatively impact oral and overall health of the mother and developing fetus.
This study analyzed 200 cases of typhoid intestinal perforation (TIP) in children seen over a 10-year period at a teaching hospital in Nigeria. The researchers found that TIP accounted for 35.7% of pediatric surgeries during this period, with most cases occurring in males aged 6-15 years old. Common presenting symptoms were fever, abdominal pain, and distension. Surgical findings typically included a single perforation in the terminal ileum. The most common procedure was primary closure of the perforation. Post-operative complications and a mortality rate of 8.5% highlighted that TIP remains a significant problem in developing countries due to poor sanitation and access to clean water.
Similar to International Journal of Reproductive Medicine & Gynecology (20)
A 5-year old boy, with an established diagnosis of a topic
dermatitis, previously treated by topical corticosteroids and emollient cream with a good improvement, developed widespread papules on his legs, hands and forearm that appeared 5 months ago.
Methods: Retrospectively, the file records of the patients who underwent sleeve gastrectomy were examined. Demographic features, Body Mass Index (BMI), the mouth opening, Mallampati score, thyromental distance, sternomental distance, neck circumference measurements and videolaryngoscopic examination results were recorded Results: In a total of 140 consecutive patients (58 male, 82 female) were included in the study. The mean age of the study participants was 35.40 ± 9.78 and the mean BMI of the patients was 44.33 ± 7.52 kg/m2
. The mean mouth opening of the patients was 4.82 ± 0.54 cm
and the mean neck circumference was 43.52 ± 4.66 cm. The mean thyromental distance was 8.02 ± 1.00 cm and the mean sternomental distance was16.58 ± 1.53 cm. Difficult intubation was determined in 8 (5.7%) patients. In logistic regression analysis, age (p : 0.446), gender (p : 0.371), BMI (p : 0.947), snoring (p : 0.567), sleep apnea (p : 0.218), mouth opening (p : 0.687), thyromental distance (p :0.557), sternomental (p : 0.596) and neck circumference (p : 0.838) were not the independent predictors of difficult intubation. However, Mallampati score (p : 0.001) and preoperative direct laryngoscopy findings (p : 0.037) performed in outpatient clinic were the significant
predictors of difficult intubation. Interestingly, all patients with grade 4 laryngoscopy findings had difficult intubation.
Introduction: Laparoscopic surgery has been performed in Mexico since 1989, but no reports about training tendencies exist. We conducted a national survey in 2015, and here we report the results concerning training characteristics during the surgical residence of the respondents. Materials and Methods: A prospective study was conducted through a survey questioning demographic data, laparoscopic training during pre and post surgical residency and other of areas of laparoscopic practice. The sample was calculated and survey piloted before
application. Special interest in this report was placed on type and quality of training received. Data are reported in percentages.
Heterotopic Ossification (HO) is defined as pathological bone formation at locations where bone normally does not exist. The
presence of HO has been found to be a rare complication after stroke in several studies, whereas there are only sporadic references relating HO to Cerebral Palsy (CP) and few for CP and stroke. No effective treatment for HO has yet been found, whereas the cellular and molecular mechanisms have not been completely understood. Therefore, increased awareness among physicians is required, as a challenge for early diagnosis and treatment. A case of a male patient with CP, who developed HO on the paretichip joint following an ischemic stroke is presented.
Objectives: To assess the practice of food hygiene and safety, and its associated factors among street food vendors in urban areas of Shashemane, West Arsi Zone, Oromia Ethiopia, 2019.
Methods: Cross-sectional study design was applied from December 28, 2019 to January 27, 2020. Data was collected from 120 food handlers, which were selected by purposive sampling techniques. Information was gathered from interview and field observation by conducting food safety survey and using questionnaires via face to face interview. The collected data was entered using Epi Data 3.1 and finally, it was analyzed using SPSS VERSION 20.
A Division I football player experienced acute posterior leg pain while playing. An ultrasound examination revealed an unusual injury - a complete rupture of the plantaris tendon mid-substance. This type of isolated plantaris tendon injury has rarely been reported. Ultrasound was useful for diagnosis and guided rehabilitation by monitoring healing over time. The athlete was able to return to full competition within 3 weeks through a progressive rehabilitation program focused on restoring range of motion and strength. This case suggests isolated plantaris tendon injuries may allow for faster return to play than other potential causes of posterior leg pain.
Type 1 Diabetes (T1D), is a severe disease, representing 5-10% of all reported cases of diabetes worldwide. Fulminant Type 1 Diabetes Mellitus (FT1D) is a subtype of type 1 diabetes mellitus that is largely characterized by the abrupt onset of Diabetic Ketoacidosis (DKA) and severe hyperglycemia without insulin defi ciency. Viral infections have been hypothesized to play a major role in the pathogenesis of Fulminant Type 1 Diabetes Mellitus (FT1D) through the complete and rapid destruction of pancreatic beta cells. Coxsackie viral infection has been detected in islets of 50% of the pancreatic tissue recovered from recent-onset Type 1 Diabetes (T1D) patients. In this report we have highlighted a case where the patient developed a Group B Coxsackie virus infection culminating in the development of Fulminant Type 1 Diabetes Mellitus (FT1D).
Methods: Cercariae are released by infected water snails. To determine the occurrence of cercariae-emitting snails in SchleswigHolstein, 155 public bathing places were visited and searched for fresh water snails. Family and genus of the collected snails were determined and the snails were examined for the shedding of cercariae, using a standard method and a newly developed method.
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Femoral hernias, comprise 2% to 4% of all hernias in the inguinal region, and occur most commonly in women. Th ey present typically with a mass below the level of the inguinal ligament. The sac may contain preperitoneal fat, omentum, small bowel, or other structures and have a high rate of incarceration and strangulation due to the small size of the hernia neck orifice, requiring emergency surgery. We present the case of a 54-year-old female patient with intestinal occlusion due to incarcerated femoral hernia, repaired by laparoscopic approach, that gave the patient the opportunity to attend her daughter’s wedding the same day.
Small Supernumerary Marker Chromosome (sSMC) is a rare genetic condition marked by the presence of an extra chromosome to the 46 human chromosomes. This case report describes a 4 year old child with SSMC on the 46th chromosome. The child presented with delayed speech and language development, seizures and mild developmental delay. Speech and Language evaluation was carried out and management options are discussed.
A catheter is a thin tube made from medical grade materials that serve a broad range of functions, but mainly catheters are medical devices that can be inserted in the body to treat disease or perform surgical procedures. Catheters have been inserted into body cavities, ducts, or vessels to allow for drainage, administration of therapeutic fluids or gases, operational access for surgery. Catheters help perform tasks in various systems such as cardiovascular, urological, gastrointestinal, neurovascular, and ophthalmic systems. A dataset of 12 patients with varying “weights” and “heights” was recorded along with the lengths of their catheter tubes. This data set was found from two revered statistical textbooks on linear regression and the Department of Scientific Computing at Florida State University. This data set was not able to be linked to any particular clinical or experimental research studies, but the data set can be used to help catheter manufacturers and medical professionals better decide on what particular catheter lengths to use for patients knowing only their height & weight. These research insights could be helpful to healthcare professionals that have patients with incomplete or no healthcare records
to decide what catheter length to use. The main investigative inquiry that needed to be answered was how does patient weight & height influence catheter length together and separately? We conducted linear regression and other statistical analysis procedures in R program & Microsoft Excel and discovered that this data exhibited a quality called multi collinearity. With multi collinearity, all predictors (2 or more
independent variables) are not significant in an all encompassing linear aggression, but the predictors might be significant in their own individual linear regressions. Individual linear regression analyses were conducted for both patient height & weight to see how much they both contribute to varying catheter length. Patient weight was found to be more impatful than patient height in relationship to catheter length, even though height and weight are a classical example of multi collinearity predictors.
Bovine mastitis has a negative impact through economic losses in the dairy sector across the globe. A cross sectional study was carried out from September 2015 to July 2016 to determine the prevalence of bovine mastitis, associated risk factors and isolation of major causative bacteria in lactating dairy cows in selected districts of central highland of Ethiopia. A total of 304 lactating cows selected randomly from five districts were screened by California Mastitis Test (CMT) for subclinical mastitis. Based on CMT result and clinical examination, over all prevalence of mastitis at cow level was 70.62% (214/304).
Two hundred fourteen milk samples collected from CMT positive cows were cultured for isolation of major causative bacteria. From 214 milk samples,187 were culture positive and the most prevalent isolates were Staphylococcus aureus 42.25% (79/187) followed by Streptococcus agalactiae 14.43%
(27/187). Other bacterial isolates were included Coagulase Negative Staphylococcus species 12.83% (24/187), Streptococcus dysgalactiae 5.88% (11/187), Escherichia coli 13.38% (25/187) and Entrococcus feacalis 11.23% (21/187) were also isolated. Moreover, age, parity number, visible teat abnormalities,husbandry practice, barn fl oor status and milking hygiene were considered as risk factors for the occurrence of bovine mastitis and they were found significantly associated with the occurrence of mastitis (p < 0.05). The findings of this study warrants the need for strategic approach including dairy extension that focus on enhancing dairy farmers’ awareness and practice of hygienic milking, regular screening for subclinical mastitis, dry cow therapy and culling of chronically infected cows.
A 36-year-old female developed right upper quadrant pain and nausea after taking the herbal supplement kratom for two weeks to manage back pain. Laboratory tests showed elevated liver enzymes. A liver biopsy ruled out other causes and determined she had drug-induced liver injury from kratom use. Her symptoms and liver enzymes gradually returned to normal over six weeks after stopping kratom. The case report discusses kratom's potential for hepatotoxicity and advises clinicians to consider its effects on patient health.
The assessment, diagnosis and treatment of critically ill patients is extremely challenging. Patients often deteriorate whilst being
reviewed and their rapidly changing pathophysiology barrages healthcare professionals with new data. Furthermore, comprehensive assessments must be postponed until the patient has been stabilised. So, important data and interventions are often missed in the heat of the moment. In emergency situations, suboptimal management decisions may cause signifi cant morbidity and mortality. Fortunately, standardisation and careful design of documentation (i.e. proformas and checklists) can enhance patient safety. So, I have developed a series of checklist proformas to guide the assessment of critically ill patients. These proformas also promote the systematic recording and presentation of information to facilitate the retrieval of the precise data required for the management for critically ill patients. The proformas have been modifi ed extensively over the last twenty years based on my personal experience and extensive consultation with colleagues in several world-renowned centres of excellence. The proformas were originally developed for use in the intensive therapy unit
or high dependency unit. However, they have been adapted for use by outreach teams reviewing patients admitted outside of critical care areas. The use of these tools can direct eff orts to provide appropriate organ support and provides a framework for diagnostic reasoning.
This review article discusses microvascular and macrovascular disease in systemic hypertension. It summarizes that:
1) Cardiac imaging plays a crucial role in risk stratifying hypertensive patients and identifying management strategies by properly diagnosing microvascular and coronary artery disease.
2) The nitric oxide synthase (eNOS) G298 gene allele may be a marker for microvascular angina in hypertensive patients, as studies have found it to be more prevalent in hypertensive patients with chest pain and reversible myocardial defects but normal coronary arteries.
3) Both structural changes like capillary rarefaction and functional changes like endothelial dysfunction can cause microvascular dysfunction and angina in hypertensive individuals in the absence of
This study characterized dengue infections in Pakistan by analyzing hematological and serological markers in 154 suspected dengue cases and 146 control patients with other febrile illnesses. NS1 antigen was detected in 55% of dengue cases, IgM antibodies in 30%, and both in 15%. Control groups primarily had malaria (71%) and enteric fever (20%). Hematological markers (platelet count, hematocrit, WBC) measured before and after treatment showed significant differences for platelet count and hematocrit but not WBC count between the groups. Analysis of clinical symptoms and serological/hematological markers helps diagnose dengue, assess prognosis, and inform prevention efforts to reduce morbidity, mortality and spread of the disease.
Researchers from Utrecht recently published yet another paper on the use of Magnetic Resonance Imaging (MRI)demonstrating an additional failed attempt to understand the importance of qualitative versus quantitative imaging, and anatomic versus physiologic imaging. Th e implications of this failure here cannot be overstated.
Introduction: Stroke is an even more dramatic major public health problem in young people. Goal of the study: Contribute to the knowledge of strokes in young people. Methodology: This was a retrospective study carried out over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Neurology department of the University Hospital
Center of the Sino-Central African Friendship (CHUSCA) of Bangui.
Background: This report describes a unique case of a patient that developed psychotic symptoms believed to be secondary
to a tentorial meningioma with associated hydrocephalus. These psychotic symptoms subsequently abated with placement of a
ventriculoperitoneal shunt. Case description: 60-year-old female was admitted to an inpatient psychiatric facility on a psychiatric involuntary commitment petition due to progressive paranoia, homicidal ideation and psychosis. The work up showed a calcified six cm tentorial meningioma with associated hydrocephalus. The patient initially rejected treatment but later became amenable to placement of Ventriculoperitoneal Shunt
(VPS).
More from SciRes Literature LLC. | Open Access Journals (20)
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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2. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 060
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
INTRODUCTION
Preeclampsia (PE), Eclampsia (EP) and other hypertensive
disorders in Pregnancy represent the highest portion of maternal
mortalityandperinatalmorbidityinNigeriaasinmostdeveloping
countries around the world [1]. PE was defined by [2] as the
increase in arterial pressure levels after 20 weeks of gestation
(pressure level ≥ 140×90 mmHg in two measurements with
an interval of 6 hours followed by the presence of proteinuria
(1+ or more in the measurement of proteinuria with test strips
or 24- hour proteinuria > 0.3 g/24 hours). Studies show that
the incidence of preeclampsia is about 4-8% of pregnancies in
developing countries [3] but in southern Nigeria, the prevalence
is put at 5.6- 7.6% [4,5] and is 40% in northern Nigeria [6].
Untreated PE progresses to eclampsia which portends substantial
risks for the fetus and the mother [7,8]. The causes of PE are not
yet completely understood, however, accumulated evidences
implicated abnormal placenta as the site of origin of the disease
[9-11].
The search for clinically useful screening tests to identify
women in whom it will develop is ongoing [12] while previous
studies directed at finding the aetiologies of pre-eclampsia are
inconclusive because studies are either cross-sectional or semi
-longitudinal in design with very limited potential to determine
precisely the age of pregnancy to suspect the development of
preeclampsia [13]. Our previous study on evaluation of aetiology
of pre-eclampsia identified significant hormone alterations as
probable features of pre-eclampsia but could not determine
the age of pregnancy at which hormone alterations became
significant to precipitate pre-eclampsia [13]. This present study
is the continuation of our previous work [13] and is aimed at
filling this research gap through a longitudinal study of pregnancy
from the first trimester to the post-delivery period. This is very
desirable to identify the gestation age at which the alterations of
the implicated biomolecules became significant to suspect the
onset of pre-eclampsia in pregnancy and thus reduce attendant
maternal and foetal death in our communities.
MATERIALS AND METHODS
Study design
The study was longitudinally conducted in two phases; semi
and full longitudinal phases. The study and control subjects were
followed up from the early pre-delivery pregnancy period to
six weeks postpartum through antenatal and post-natal clinic
appointments.
Study setting
The study was conducted between January 2018- March
2019. The participants were recruited from the antenatal clinics
and wards of a Tertiary Teaching Hospital in Ile-Ife- Southwest
Nigeria. Whole blood was collected into a plain bottle at each
trimester of the pregnancy during the antenatal and postnatal
clinic appointments. Serum was harvested after clot retraction
and preserved for the β hCG, Oestriol, Progesterone and Prolactin
assays using standard enzyme immunoassay method described
by Sachidhanandam, et al. [14].
Baseline values
Baseline values of biophysical clinical and biochemical
indices for statistical analyses were taken at a mean gestation
age of 10.9 ± 0.3 weeks for the full longitudinal phase and at
mean gestation age 35.7 ± 0.0.4 weeks for the semi-longitudinal
phase. The biophysical and clinical data were obtained from the
patients’ case notes while biochemical data were results from the
assay of the reproductive hormones.
DIAGNOSIS OF PRE-ECLAMPSIA
PE was diagnosed according to the criteria defined by the
National high blood pressure education program working group
on high blood pressure in pregnancy [15].
ABSTRACT
Introduction: Preeclampsia is a medical emergency implicated in maternal and foetal morbidity and mortality. Research directed at
finding the aetiologies of pre-eclampsia is inconclusive because most studies are either cross-sectional or semi -longitudinal in design
with very limited potentials to determine precisely the age of pregnancy to suspect the development of preeclampsia with an absolute
biomarker.
Objectives and Aim: The main aim of this study was to establish the gestational age of pregnancy at which serum hormones
alterations became significant to suspect the development of preeclampsia in pregnancy.
Study design: The study was longitudinal undertaken at the antenatal clinics of a teaching hospital and conducted in two phases.
The cross-sectional study was conducted among 79 pre-eclamptic pregnancy and 80 normotensive healthy pregnant women monitored
from 3rd
trimester to 3 days post-partum., while the longitudinal study involved 10 preeclamptics and 20 normotensive healthy pregnant
women monitored from the first trimester of pregnancy to six weeks post-delivery.
Methods: Venous blood samples obtained from the participants at each point of contact during the study period were placed into
none anti-coagulated specimen bottles. The serum harvested after clot retraction was assayed for β human chorionic gonadotrophic
hormones, oestrogen, progesterone, and prolactin by Enzyme Immunosorbent Assay Method (EIA) described by immunometric, Atlanta
SW6 6TU (UK) LTD.
Result: β-hCG (Odd Ratio = 0.995, confidence interval = 0.998-0.999, p < 004) and oestriol (Odd Ratio = 1.056, confidence interval
= 1.011-1.103 =, p < 0.01) only were significantly elevated in the preeclamptic pregnancies compared with the controls. The alteration
predicted the development of preeclampsia at first and third trimesters of pregnancy respectively.
Conclusions: Early pregnancy significant alterations of serum level of β-hCG and oestriol and is associated with the risk of
development of preeclampsia in gravid women.
Keywords: Preeclampsia; Predictors; β-hCG; Oestriol
3. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 061
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
Ethical consideration
Recruitment of participants for the 2- year study started after
study protocol was approved by the local Ethics and Research
committee of a tertiary hospital (Obafemi Awolowo University
Teaching Hospitals Complex Ile-Ife.
Statistical analysis
The data from the study were analyzed using SPSS version
21.0. Continuous variables were presented as the mean and
standard error of the mean. While categorical variables were
presented as percentages. Differences between groups were
compared using a two-tail independent t-test of significance at
95% confidence limit, p < 0.05 was considered significant for the
variables. Logistic regression model to predict a dichotomous
outcome from one or more predictor variables and the
significance of each predictor in the model was tested while all
other predictors were held constant. The effect of size for the
individual predictor was expressed as an Odds Ratio (OR).
The study experienced loss of patients at both phases of
the study but this was curbed by educating the patients further
about the study and reaffirmation of consent participation. Data
of participants who declined consent before and during the study
period were completely deleted from the statistical analysis of
the results obtained from this research. Therefore the analyzed
data excluded incomplete information or data of participants
who were not able to fulfill the study criteria as described in the
study design and eligibility conditions.
RESULTS
The eligibility criteria included normotensive and non-
proteinuric antenatal cases registered before 13 weeks of
gestation that voluntarily gave consent to participate and
completed the study.
Exclusion criteria: This comprises hypertensive and
proteinuric pregnancy before or at 13 weeks of gestation and
recruited subjects who declined consent during the study period.
Sources and methods of selection of participants: The
study was undertaken at the Obafemi Awolowo University
Teaching Hospital Ile -Ife southwest Nigeria and was conducted
in two phases; phases one and two.
Phase one: semi-longitudinal study: Three hundred and
fifty pregnant women in the third trimester of pregnancy (28-
40 weeks gestation (15) with a mean age of 30 ± 0.7 years were
selected for the study through the antenatal clinics of the hospital
after obtaining informed consent. From the 350 pregnant women,
79 of them only at the mean gestation age of 35.7 ± 0.0.4 weeks
had features of pre-eclampsia [15] and served as the study group.
Eighty out of the remaining 271 pregnant women who were
physically healthy and normotensive after the screening using the
criteria [15] of National High Blood Pressure education program
working group on high blood pressure in pregnancy were used
as controls. The study and control group were followed up from
the point of selection( mean gestation age of 35.7 ± 0.0.4-38.4 ±
0.2 weeks respectively up to 3 days postpartum through their
antenatal and postnatal clinic day appointments The remaining
191 subjects did not meet the study criteria or could not complete
the study were exempted from the study.
Phase two: This was the longitudinal phase of the study
which was a follow up of phase one study to detect the onset
of the abnormalities observed in phase one of this study. One
hundred physically healthy normotensive pregnant women with
mean gestation age between 8-13 weeks and non-proteinuric
were recruited from the antenatal clinics of the Tertiary Teaching
Hospital after obtaining their informed consent. They were
screenedforearly pregnancy abnormalities using the criteria[15]
described above and were followed up from mean gestation age
10.9 ± 0 weeks to 6 weeks post-delivery through their antenatal
and postnatal clinic day appointments. During the study period,
thirty (30) participants met the study criteria while ten (10)
out of these 30 participants developed pre-eclampsia and were
grouped as cases of interest while twenty (20) who remained
normotensive and non- proteinuric throughout the study served
as controls for the study. The remaining seventy (70) subjects
were excluded because they did not meet the study criteria. Blood
samples obtained from the participants at each point of contact
in the study period were assayed for the reproductive hormones
using standard enzyme immunoassay method.
Sample size calculation: The sample size was calculated
using the formula described by (Rendon-Macias, et al. 2017).
[16].
Sample size = Pq (z) 2 /e2 [16].
Where: Z = Standard deviation, e = Margin of error, p =
prevalence of preeclampsia in the study area.
Phase one
Three hundred and fifty subjects participated in this phase of
the study, from this figure seventy-nine were preeclamptic and
met the eligibility criteria and as well gave consent to participate
in the study. Eighty subjects had sustained normotensive blood
pressure throughout the study period gave consent and served
as control. The study and control groups were followed up from
the point of recruitment (35-38 weeks) up to 3 days postpartum.
The remaining one hundred and ninety-one subjects were
excluded due to the decline of consent sequel to doubt of
completing antenatal care at the study centre, and some having
other pregnancy complications like diabetes, renal disease,
hypertension and anaemia hence their data were excluded.
Table 1 shows the demographic characteristics of pre-
eclamptic and normotensive pregnancies. The incidence of
pre-eclampsia was higher (p < 0.05) within the age bracket of
25-34. Gestational age at delivery among the preeclamptics
was significantly lower compared with the controls (p < 0.05).
Delivery by Caesarian Section in preeclampsia was 57 (81.4%)
and 17 (24.3%) progressed to eclampsia. Two maternal 2 (2.9%)
and nine neonatal deaths 9 (12.9%) b were recorded among the
preeclamptics. Baseline and postpartum values BMI and blood
pressure of cases and controls are presented (Table 2). Systolic
and diastolic blood pressures were higher (p < 0.001) among the
preeclamptics when compared with normotensive pregnancy
(Table 2). Reproductive hormones level at pre and postpartum
were compared between preeclampsia and normotensive
pregnancy (Table 3). β- hCG and Oestriol only at prepartum
were significantly lower and higher respectively (p < 0.001) in
preeclampsia when compared with the normotensive controls.
Comparison of baseline clinical and biochemical characters of
mild and severe preeclampsia are presented in table 4. Systolic
and diastolic blood pressures in severe preeclampsia were
4. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 062
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
Table 1: Demographic data in preeclamptic patients' controls and their Babies.
Variables
Study
(n = 79)
Controls
(n = 80)
t-value p-value X2 -
value p-value
mean ± sem mean ± sem
Mothers
Age (years *30 ± 0.7 *29 ± 0.5 .739 084
Age distribution (15-24) years 6 (8.6%) 9 (11.3% )
2.969 0.05Age distribution (25-34) years 49 (70%) 62 (77.5%)
Age distribution ≥ (35years) 15 (21.4%) 9 (11.3%)
Gestation age (at term)(weeks) *35.7 ± 0.0.4 *38.4 ± 0.2 5.696 0.000
Occupation:
Civil servant 35 (43.8%) 36 (51.4%)
17.252 0.101
Self employed 23 (32.9%) 21 (26.3%)
Students 17 (21.3%) 7 (10%)
Applicants 0 (0%) 5 (6.3%)
House wife 4 (5.7%) 2 (2.5%)
Parity *0.84 ± 0.1 *0.68 ± 0.1 0.978 0.33
Mode of Delivery:
Safe Vaginal Delivery 13 (18.6%) 56 (70%) 39.752 0.000
Caesarian Section 57 (81.4%) 24 (30%)
Progression to Eclampsia 17 (24.3%) 0 (0%) 140.0 0.000
Mortality(Mother) 2 (2.9%) 0 (0%) 2.317 0.05
No of life babies 61 (87.1%) 79 (98.8%) 8.084 0.05
No of dead babies 9 (12.9%) 1 (1.3%)
Babies
Gender: 1.56 0.251
Male 31 (44.2%) 43 (53.8%)
Female 39 (55.7%) 37 (46.3%)
Table 2: Baseline and post-partum Anthropometric and Clinical Characteristics of Pre-eclamptic and Normotensive Pregnant Women.
Variables Pre eclamptics Normotensives t-value p-value
n = 79 n = 80
Anthropometry
BMI at 3rd
trimester 29.6 ± 6.4 28.3 ± 5.0 p > 0.17
BMI at 3 days postpartum 26.8 ± 6.1 26.1 ± 4.9 p > 0.47
Clinical Blood Pressure
SBP at 3rd
trimester 166 ± 3.0 122 ± 1.0 p < 0.001*
DBP at 3rd
trimester 107 ± 2.0 78 ± 9.0 p < 0.001*
SBP at 3 days postpartum 142 ± 2.0 114 ± 1.0 p < 0.001*
DBP at 3 days postpartum 89 ± 11.0 70 ± 10.0 p < 0.001*
Table 3: Comparative analysis of baseline values of Hormones of Pre-eclamptic and Normotensive (Control) Pregnant Women at 3rd trimester and post-partum.
Variables
β-hCG (IU/L)
mean ± sem
Prolactin (mIU/L)
Mean ± sem
Progesterone
Mean ± sem
Oestriol
mean ± sem
Gestation
age
Study control p value study Control p value study control p value study control Pv alue
3rd
Trimester
565.4 ±
45.8
750 ± 28.7
p <
0.001*
1274 ±
114.8
1226.2 ±
109.6
p > 0.76 94.3 ± 2.3 97.1 ± 1.5 p > 0.29 137.4 ± 8.1
135.2 ±
6.7
P > 0.83
3days post-
partum
434.1 ±
45.0
288.1 ±
30.5
p < 0.01*
1337.6 ±
116.1
793 ±
102.9
p <
0.001*
20.4 ± 3.0 32.9 ± 3.2
p <
0.01*
32.7 ± 5.9 47.3 ± 5.6
P >
0.075
significantly elevated (p < 0.001) while the differences in the
levels of the reproductive hormones between the two groups
were not significant (p > 0.05)
Phase two: Table 5 shows the comparative analysis of
anthropometric and clinical indices in both study and control
subjects from the first trimester to six weeks postpartum. There
was no significant difference in the anthropometric indices (p >
0.05) between study and control groups throughout gestation
and postpartum. Mean systolic and diastolic blood pressures in
preeclamptic patients were significantly elevated (p < 0.000)
when compared with the normotensive controls except in the 1st
trimester. The alterations in the mean values of micro-albumin
in preeclamptic patients throughout the study periods have a
similar pattern with that of the blood pressures (p < 0.001).
Steady and progressive changes in the mean values of
reproductive hormones among the pre-eclamptic group studied
5. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 063
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
Table 4: Baseline value of Clinical and Biochemical Parameters of Mild and Severe Preeclampsia.
Variables
Mild (n = 34)
Mean ± sem
Severe Preeclampsia (n = 45)
Mean ± sem
t-value p-value
Age 29..96 ± 1.01 30.51 ± 0.84 -0.407 p > 0.05
Gestation age 36.84 ± 0.61 35.13 ± 0.56 1.94 p > 0.05
Systolic blood pressure 168.18 ± 20.85 184.44 ± 12.92 5.67 p < 0.005
Diastolic blood pressure 110.91 ± 3.22 120.00 ± 8.17 7.65 p < 0.001
BMI 29.82 ± 1.45 29.43 ± 0.87 0.241 p > 0.05
Serum β-hCG(IU/L) 499.80 ± 78.93 601.87 ± 56.08 -1.07 p > 0.05
Serum Prolactin (mIU/L) 1097.44 ± 190.48 1371.29 ± 143.21 -1.15 p > 0.05
Serum Progesterone(nmol/L) 92.12 ± 4.88 95.58 ± 2.24 0.734 p > 0.05
Serum Oestriol (ng/ml) 147.24 ± 13.83 131.91 ± 10.05 0.903 p > 0.05
Table 5: Anthropometry and Clinical Characteristics of Pre-eclamptic (study) and Normotensive (Controls) Pregnant Women at 1st
, 2nd
, 3rd
Trimester, day 3 and 6
Weeks Post Delivery.
Variable Body Mass Index
Systolic blood pressure (mm/
hg)
Microalbuminuria (g/L)
Gest.
Age
Study
[10]
Control
[20] p
value
Study
[10]
Control
[11]
p value
Study
[10]
Control
[11]
p value
Study
[10]
Control
[11]
p value
Mean ±
sem
Mean ±
sem
Mean ±
sem
Mean ±
sem
Mean ±
sem
Mean ±
sem
Mean ±
sem
mean ±
sem
1st
trimester
28.7 ±
2.4
27.1 ± 1.3 p > 0.05
116.0 ±
3.4
111.5 ± 2.2 p > 0.05
69.0 ±
3.5
67.5 ± 2.2 p > 0.05 2.7 ± 0.5 3.9 ± 0.6 p > 0.05
2nd
trimester
30.6 ±
2.7
29.3 ± 1.4 p > 0.05
145.0 ±
6.2
111.0 ± 3.8 p < 0.00*
93.0 ±
6.0
65.0 ± 2.0 p < 0.05*
96.0 ±
15.6
8.6 ± 0.7 p < 005*
3rd
trimester
31.8 ±
2.7
30.5 ± 1.3 p > 0.05
149.0 ±
3.8
109.0 ± 3.7 p < 0.00*
98.0 ±
3.3
65.0 ± 2.0 p < .000*
263.5 ±
23.1
31.4 ± 6.4
p <
0.005*
3 days post
29.8 ±
2.8
28.4 ± 1.3 p > 0.05
130.0 ±
3.7
115.0 ± 2.0 p < 0.00*
89.0 ±
3.8
69.5 ± 2.2 p < .000*
103 ±
14.3
11.3 ± 2.5 p < 000*
6 days post 29. ± 2.8 28.3 ± 1.3 p > 0.05
100.0 ±
3.7
119.0 ± 2.3 p < 0.05*
63.0 ±
2.8
74.0 ± 1.9 p < .002* 7.4 ± 1.5 1.4 ± 0.2 p < 000*
from 1st
trimester to 6weeks postpartum were evaluated and
compared with the normotensive control pregnant women
(Table 6, figures 1,2). The mean values of β human chorionic
gonadotropin, prolactin, progesterone, oestriol increased
steadily and significantly from the first trimester, peaking in the
third trimester and declined sharply soon after birth to almost
pre-pregnancy level at six weeks post-delivery. (p < 0.05, p <
0.001). β hCG levels in the study group at 1st
and 2nd
trimesters
were significantly lower. (p < 0.05, p < 0.001) relative with the
controls. Oestriol concentration at the 3rd
trimester only in
preeclampsia was observed to be significantly higher (p < 0.001)
when compared to the control. The differences in progesterone
and prolactin levels throughout the study period between the
controls and the preeclamptics were not significant (p > 0.05).
The result of the logistic regression analysis to validate the
predictive potentials of the reproductive hormones throughout
the study period is presented in Table 7. β hCG (OR = 0.995, CI
= 0.998-0.999, p < 0.004) and oestriol (OR = 1.056, CI = 1.011-
1.103, p < 0.013) have significant predictive potentials of pre-
eclampsia at first and third trimesters respectively. (p < 0.004,
p < 0.013).
DISCUSSION
Pre-eclampsia and eclampsia which present mostly late in
pregnancy are medical emergencies in Nigeria and in most of
the world [17]. They are one of the major causes of maternal
-perinatal morbidity and mortality worldwide [18] yet no
single or combination of pregnancy indices have been found to
reliably suspect and prevent this disease [18-20]. Identification
of markers of pre-eclampsia is very desirable for ease of early
intervention, close monitoring, and prompt diagnosis to reduce
the negative consequences of preeclampsia on the nation’s
women population.
Phase one of this present study recorded low mean gestation
age at term, delivery by caesarian section, neonatal and maternal
death were recorded more often among the preeclamptic when
compared with the normotensive controls (Table 1). These
observations suggest that preeclampsia is associated with
adverse pregnancy complications as observed in this study
and comparable with the reports of previous studies [21,22].
Preeclampsia can degenerate to mild or severe complications
if poorly managed or when intervention is delayed [23]. We
compared clinical and biochemical parameters of the mild and
server preeclamptics (Table 4). Blood pressure values of severe
preeclamptics were significantly elevated compared to the mild
form of the disease while serum β -hCG level only in severe
preeclampsia was higher but not statistically significant. This
observation is at variance with the report of Kanika, et al. [24]
who reported elevated serum β-hCG among severe preeclamptics.
Our observations in phase one of the present study show that
β-hCG and oestriol were significantly reduced (p < 0.001) and
elevated (p < 0.05) respectively in the 3rd
trimester among the
preeclamptics population when compared with normotensive
controls (Table 3). Pre-eclampsia is reported be a multi-organ
disease that induces tissue and organ defects to the liver, kidney,
6. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 064
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
Table 6: Serum levels of the reproductive hormones in Preeclamptics and Normotensive pregnancy from 1st
Trimester to 6 weeks postpartum.
Variable β-hCg(i.u/L) Oestrio (ng/ml) Progesterone(nmol/L) Prolactin(MIU/L)
Gest.Age Study Control
p-
value
Study Control
p-
value
Study Control
p-
value
Study Control
p-value
Week
mean ±
sem
mean ±
sem
mean ±
sem
mean ±
sem
mean ±
sem
mean ±
sem
mean ±
sem
mean ± sem
1st
trimester 388.1 ±
101.7
762.2 ±
65.7
p <
0.01
46.70 ±
13.2
23.8 ± 7.6
p >
0.05
94.50 ±
2.9
85.4 ± 5.5
p >
0.05
697.30 ±
175.7
784.4 ± 189.1 p > 0.05
(10.9 ± 0.3)
2nd
trimester 573.1 ±
100.7
790.7 ±
44.8
p <
0.05
87.4 ±
13.3
64.3 ± 9.3
p >
0.05
100.0 ±
0.0
99.9 ± 0.1
p >
0.05
1048.6 ±
314.1*
1400.2 ± 169.4 p > 0.05
(23.2 ± 0.7)
3rd
trimester 834.7 ±
28.0
743.3 ±
57.5
p >
0.05
166.8 ±
44.84
87.5 ± 7.0
p <
0.000
101.5 ±
0.8
100.0 ±
0.0
p >
0.05
1913.1 ±
219.9
1602.4 ± 185.1 p > 0.05
(34.5 ± 1.0)
3 days post
532.2 ±
94.9
175.1 ±
33.8
p <
0.000
38.7 ±
15.2
14.0 ± 1.7
p <
0.05
30.7 ±
2.0
26.2 ± 4.4
p >
0.05
1632.4 ±
254.4
1513.1 ± 221.6 p > 0.05
6 weeks post 21.1 ± 12.9 24.0 ± 6.7
p >
0.05
16.1 ±
5.6
52.5 ±
13.1
p >
0.05
6.90 ±
3.281
5.60 ±
4.17
p >
0.05
1609.8 ±
266.6
1956.35 ± 176.7 p > 0.05
Figure 1: Line graph showing the pattern of serum oestriol in both control and
study subjects from 1st trimester to 6 weeks post-partum.v.
Figure 2: Line graph showing the pattern of serum oestriol in both control and
study subjects from 1st trimester to 6 weeks post-partum.
placenta, and heart [24,25] The effect of the damaged organs
particularly the liver and the placenta arising as a secondary
complication of pre-eclampsia and the associated metabolic
abnormalities may be the major contributory factors to the
significant alterations of β-hCG and oestriol concentrations
observed in the pre-eclamptic subjects. We observed that β-hCG
and oestriol alteration implicated as possible risk factors pre-
eclampsia in phase one of this study was inconclusive because
of the gestation age of pregnancy at which β-hCG and oestriol
became significant to precipitate pre-eclampsia could not be
determined. The outcome of the longitudinal assessment of the
reproductive hormones in the pregnant subjects in phase two of
this study was designed to fill this missing gap.
Normal endocrine physiological processes in normotensive
pregnancy are associated with rising β -hCG rapidly soon after
fertilization and implantation and continued throughout the
first trimester of pregnancy and peaks at 6.8-10 weeks of
pregnancy [26,27]. In the longitudinal phase of this study, we
observed significant reduction (p < 0.001), of β hCG in the 1st
and 2nd
trimesters among the preeclamptics when compared
with the control group (Table 6, figure 1). The causes of low
β-hCG in the preeclamptics observed at 10.9 weeks of pregnancy
that precipitated preeclampsia in our study may be attributed
hyperemesis gravidarum in the second trimester induced by
high levels of hCG as a compensatory mechanism to low β-hCG
early in pregnancy [28-31]. The multi-organ disease nature of
preeclampsia that induces disorders of placental dysfunction and
abnormal placentation has also been implicated in the cause of
significant alteration of β-hCG in complicated pregnancy [32,33].
We also analyzed the changes in β hCG concentration among
the preeclamptics only within the study duration. Result revealed
a significant progressive increase in β hCG level throughout
gestation (p < 0.001). This observation aligned with Kanika, et
al [24] and Camilla, et al. [34] findings who reported a consensus
that the placenta remains the main source of excess hCG
production in patients with pre-eclampsia and other associated
pregnancy disorders. Similarly our observation of significant (p <
0.001) progressive rise in β-hCG concentration from 10.9th
week
of gestation within the preeclamptics in a longitudinal study is an
improvement on earlier reports that observed the rise in β-hCG
concentration after 15 weeks of gestation which precipitated the
development of preeclampsia [31,35,36].
Progressive increase in oestriol levels throughout gestation
is a characteristic of pregnancy. In this study, we observed higher
values of oestriol concentration among the pre-eclampsia in the
34.5th
week of gestation compared with the controls (p < 0.001).
Our observation is similar to the reports of Tongprasertet, al. [38],
Settiyanan, et al. [39] and Singh, et al. [39] who established the
usefulness of oestriol assay in the 3rd
trimester in the diagnosis
7. SCIRES Literature - Volume 5 Issue 2 - www.scireslit.com Page - 065
International Journal of Reproductive Medicine & Gynecology ISSN: 2640-0944
of pregnancies complicated by post maturity, moderate and
severe pre-eclampsia, intrauterine growth retardation, diabetes
mellitus, chronic hypertension, intrauterine growth retardation.
The pathological alterations of β hCG and oestriol in preeclampsia
suggest that these hormones are associated with pregnancy-
specific diseases and might serve as an effective biomarker
for predicting and diagnosing preeclampsia. Furthermore, the
result of the logistic regression analysis conducted to evaluate
the potentials of reproductive hormones to predict future
development of pre-eclampsia in pregnant women strongly
suggested that β hCG and oestriol might serve as an effective
biomarker for suspecting and diagnosing pre-eclampsia (Table
6). β hCG (Odd Ratio of 0.995, CI of 0.998 - 0.999 , at p < 004)
predicted the development of preeclampsia as early as at 10.9th
week of gestation, while oestriol (Odd ratio of 1.056, CI of 1.011-
1.103 at p < 0.01) predicted the development of pre-eclampsia
at 34.5th
week of gestation. The prediction of pre-eclampsia at
10.9th
week of gestation by β hCG in this study is an improvement
on the previous reports by Gurmandeep, et al. and Goetzinger, et
al. [31,40] who have earlier reported that maternal low serum β
hCG level at 13-20 weeks and 15 weeks gestation respectively is
a predictor of pre-eclampsia.
CONCLUSION
This study concluded that alterations of serum β-hCG and
oestriol in pregnancy is pathologic and is associated with the risk
of developing preeclampsia. β- hCG and oestriol may constitute
a panel of biomarkers for the disease. Early alteration of serum
β-hCG observed in the first trimester preceded the onset of
preeclampsia most often detected in the third trimester hence
pregnancy at the risk of preeclampsia can be identified at early
gestation for quick intervention and management.
ACKNOWLEDGMENT
The authors are grateful for the support and the cooperation
oftheEthical and ResearchCommittee,theConsultantsObstetrics
and Gynaecologist and Nurses of the centre used for this
study for granting us access to the patients. We appreciate the
professional staff in the laboratory and as well as the cooperation
of the pregnant women who obliged and consented to partake
throughout the research period.
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2nd
Trimester (23.2nd
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