Search results for: Second trimester

Authors: S. Chhabra, C. Tickoo, P. Kalra

Abstract:

Background: Bleeding during first half of pregnancy mostly originates from placenta, some abort, others are at risk of complications. Objective: Study was done to know perinatal outcome with bleeding up to 20 weeks in singleton pregnancy. Material Methods: Subjects were 1020, equal controls managed over 2 years, 435 had viable pregnancy at admission, 135 excluded, 300 followed for perinatal outcome, 99 (19.52% up to 10 weeks), 201 (39.18% of 11-20 weeks). Results: Hypertensive disorders occurred in 24% cases of bleeding within 10 weeks, 22% 11-20 weeks 14.79% controls, placenta previa 4% in 10 weeks, 0.9% 11-20 weeks, 0.97% controls, prelabor rupture of membranes in 16%, 7.45% controls. 20% up to 10 weeks, 35% 11-20 weeks, 18% controls had fetal growth restriction, 34.34% up to 10 weeks 30.35% of 11-20 weeks 17.17% controls had preterm births, perinatal mortality rate in study was 118.62, in controls 68.16 (Uneventful pregnancy in 13.52% study, 46.11% controls). Conclusion: Once bleeding occurs, one third continue pregnancy, maternal neonatal outcome gets affected with variations in cases of bleeding within first 10 weeks & 11-20 weeks.

Keywords: First, Second trimester, bleeding, Disorders, Perinatal Outcome.

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Authors: Yahia M., Chaoui N., Chaouch A., Massinissa Yahia

Abstract:

Our study was designed to determine the metabolic  changes of some biochemical parameters (cholesterol, triglyceride,  Iron, uric acid, Urea and folic acid) and highlight their changes in 57  women of the region Batna, during the first trimester of pregnancy.  This practical work was done with 27 women with missed  miscarriage, compared with 30 control subjects of normal pregnant  women. The assay results revealed a highly significant difference (P  = 0.0006) between the two groups in serum iron (64.00 vs 93.54) and  in the rate of folate (6.70 vs 9.22) (P <0.001) but no difference was  found regarding the rate of Ca (9.69 vs 10.20), urea (0.19 vs 0.17),  UA (33.96 vs 32.76), CH (1.283 vs 1.431), and TG (0.8852 vs  0.8290). The present study indicates that iron deficiency and folate  are associated with missed miscarriage, but no direct  pathophysiological link has been determined. Further in-depth studies  are needed to determine the exact mechanism by which these deficits  lead to a missed miscarriage.

Keywords: Biochemical parameters, pregnant women, missed miscarriage.

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Authors: Dib Djalel, Haddouche Ali, Chellali Benachiba

Abstract:

When a lightning strike falls near an overhead power line, the intense electromagnetic field radiated by the current of the lightning return stroke coupled with power lines and there induced transient overvoltages, which can cause a back-flashover in electrical network. The indirect lightning represents a major danger owing to the fact that it is more frequent than that which results from the direct strikes. In this paper we present an analysis of the electromagnetic coupling between an external electromagnetic field generated by the lightning and an electrical overhead lines, so we give an important and original contribution: We are based on our experimental measurements which we carried in the high voltage laboratories of EPFL in Switzerland during the last trimester of 2005, on the recent works of other authors and with our mathematical improvement a new particular analytical expression of the electromagnetic field generated by the lightning return stroke was developed and presented in this paper. The results obtained by this new electromagnetic field formulation were compared with experimental results and give a reasonable approach.

Keywords: Lightning, overhead lines, electromagneticcoupling, return stroke, models, induced overvoltages.

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Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

Abstract:

Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: Zika Virus, polymerase chain reaction, microcephaly, amniotic fluid.

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

Abstract:

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: Antinuclear antibody, Subclinical hypothyroidism, Thyroxin, TPO antibody.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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