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Nigerian Journal of Medicine : Journal... 2015Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery.
BACKGROUND
Normal pregnancy is a hypercoagulable state; a physiological safety valve aimed at preventing excessive maternal blood loss at delivery.
OBJECTIVE
To evaluate the influence of normal pregnancy on blood coagulation and to explore changes in activity from the first through the third trimester.
SUBJECT AND METHODS
Sixty (60) apparently healthy pregnant women (20 from each trimester) and 20 healthy non-pregnant age-matched controls were recruited. Each participant had Prothrombin time (PT). Activated partial thromboplastin time (APTT) and platelet count done. Multiple comparisons were made between control values and coagulation profile at different stages of pregnancy using the Bonferroni statistics. Results were expressed as means and standard deviations, p < 0.01 was significant at 95 % CI. Ethical approval for the study was obtained from the Institutional review board.
RESULTS
The means of the APTT were significantly lower in the first, second and third trimesters compared with controls (35.59 ± 4.95 seconds, 32.22 ± 5.79 seconds and 29.60 ± 3.66 seconds, respectively, vs. 40.55 ± 5.95 seconds; p = 0.01). Correspondingly, the platelet count was significantly lower in the 3 trimester of pregnancy compared with controls (178.35 ± 41.52 x 10(9)/L vs. 233.86 ± 55.34 x 10(9)/L; p < 0.01) and equally with level in the 2nd trimester (178.35 ± 41.52 x 10(9)/L vs. 232.10 ± 48.67 x 10(9)/L; p < 0.01).
CONCLUSION
The APTT and platelet counts are significantly lower in the 3 trimester of normal pregnancy.
Topics: Adult; Blood Coagulation; Female; Humans; Partial Thromboplastin Time; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Young Adult
PubMed: 25807675
DOI: No ID Found -
JPMA. the Journal of the Pakistan... Feb 2021To investigate the relationship between vitamin C intake and IL-6 level as a biomarker of oxidative stress during pregnancy.
OBJECTIVE
To investigate the relationship between vitamin C intake and IL-6 level as a biomarker of oxidative stress during pregnancy.
METHODS
Fourty pregnant women during third trimester were grouped into preeclampsia and non-preeclampsia, and surveyed using a Food Frequency Questionnaire. The ELISA assay for IL-6 expression was performed. Univariate and bivariate analyses were conducted using SPSS software ver. 20.
RESULTS
Subjects in preeclampsia group were shown to consume slightly more vitamin C than the non-preeclampsia group, with median values of 76.37 (28.05 - 96.88) mg and 68.87 (8.57 - 198.53) mg, respectively (p = 0.36). A nonparametric correlation test showed no significant association between vitamin C and total IL-6 level, with p = 0.36 and r = -0.15. There was also no difference between vitamin C consumption and IL-6 level for each group, with r = -0.14 and r = -0.20, respectively.
CONCLUSIONS
There was no statistically significant association between vitamin C intake and IL-6 level in women during third trimester of pregnancy (p = 0.36).
Topics: Ascorbic Acid; Case-Control Studies; Female; Humans; Interleukin-6; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, Third; Vitamins
PubMed: 33785949
DOI: No ID Found -
Reproductive Biomedicine Online Sep 2020Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains...
RESEARCH QUESTION
Does the length of the anogenital distance (AGD), an anthropometric biomarker of fetal androgen exposure, change across pregnancy? It has been suggested that AGD remains stable during adulthood with no changes across the menstrual cycle. No studies, however, have been carried out during pregnancy, during which women are exposed to important hormonal and anthropometric variations.
DESIGN
A cohort study of 186 singleton pregnant women recruited in the first trimester of pregnancy. Measurements from the anterior clitoral surface to the upper verge of the anus (AGD), and from the posterior fourchette to the upper verge of the anus (AGD) and body mass index (BMI) were obtained in each trimester. Generalized linear model for repeated measures was carried out to assess differences in AGDs and BMI across the three trimesters of the pregnancy.
RESULTS
In crude analyses, AGD was progressively and significantly longer as the pregnancy developed (first trimester: 87.69 ± 13.14mm; second trimester: 89.69 ± 13.47mm; third trimester: 91.95 ± 13.25 mm; P < 0.001), whereas AGD did not significantly change throughout pregnancy (first trimester: 28.37 ± 6.94 mm; second trimester: 28.09 ± 7.66 mm; third trimester: 28.94 ± 6.7 mm). In the multivariable mixed-effect models for fixed effect (trimester) and time-covariate (BMI), AGDs did not show significant associations with trimesters of pregnancy when BMI was included in the model.
CONCLUSIONS
Our results suggest that AGD and AGD, when adjusted by BMI, do not change throughout gestation despite maternal anthropometric variations during pregnancy. AGD may be a meaningful measurement at any time during pregnancy without considering BMI. Therefore, maternal AGD may be used as a prenatal biomarker of the mother's in-uteru hormonal exposure even during pregnancy.
Topics: Adult; Anal Canal; Anthropometry; Biomarkers; Body Mass Index; Case-Control Studies; Female; Genitalia, Female; Humans; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third
PubMed: 32586732
DOI: 10.1016/j.rbmo.2020.05.009 -
Sleep Health Aug 2019Despite high prevalence and clinical implications of disturbed sleep during pregnancy, information on changes in sleep across pregnancy and postpartum is incomplete....
BACKGROUND
Despite high prevalence and clinical implications of disturbed sleep during pregnancy, information on changes in sleep across pregnancy and postpartum is incomplete. Moreover, predictors of differential patterns of sleep quality across the perinatal period are poorly defined.
METHODS
This study examined subjective sleep quality using the Pittsburgh Sleep Quality Index during each trimester of pregnancy and at 4-11 weeks postpartum among 133 women inclusive of nulliparous and multiparous African Americans and Whites.
RESULTS
At any given assessment, 53%-71% of women reported poor overall sleep quality (Pittsburgh Sleep Quality Index total score > 5). Moreover, 92% reported poor overall sleep quality during at least 1 assessment, including 88% at some time during gestation. Compared to nulliparous women, multiparous women reported poorer overall sleep quality, shorter sleep duration, and poorer sleep efficiency during the first trimester; poorer overall sleep quality and longer sleep latency in the second trimester; and more frequent sleep disturbances (eg, night time and early morning awakenings) during the third trimester. Among nulliparous as well as multiparous women, specific aspects of sleep (eg, subjective sleep quality, sleep disturbances, sleep efficiency) were poorer in African American compared to White women at different time points during pregnancy. No effects of race or parity were observed on sleep parameters at postpartum.
CONCLUSIONS
Poor sleep quality during pregnancy as well as early postpartum is highly prevalent among both African American and White women. Both multiparous status and African American race are associated with more disturbed sleep at some time points during pregnancy. These individual differences should be considered in future research and clinical efforts to promote perinatal sleep health.
Topics: Adult; Black or African American; Female; Humans; Parity; Postpartum Period; Pregnancy; Pregnancy Trimesters; Risk Factors; Sleep Wake Disorders; White People; Young Adult
PubMed: 31122875
DOI: 10.1016/j.sleh.2019.03.005 -
International Journal of Gynaecology... Oct 2023To perform a longitudinal assessment of B-type natriuretic peptide (BNP) and its association with cardiac function in low-risk pregnant women and in pregnant women with...
OBJECTIVE
To perform a longitudinal assessment of B-type natriuretic peptide (BNP) and its association with cardiac function in low-risk pregnant women and in pregnant women with congenital heart disease (CHD).
METHODS
Longitudinal study in low-risk pregnancy and pregnancy in women with CHD seen at 10-14, 18-22, and 30-34 weeks of pregnancy for BNP quantification and exercise studies using impedance cardiography (ICG).
RESULTS
Forty-three low-risk women with longitudinal samples (129 samples, 43 in each trimester) and 30 pregnant women with CHD with convenience samples (first trimester, five samples; second trimester, 20 samples; third trimester, 21 samples) were included. Women with CHD delivered earlier by 6 days (P = 0.002) and their newborns had lower birth weight independent of gestational age (birth weight centile 30.0 vs 55.0, P = 0.005). In low-risk women, BNP levels were lower in the third trimester (P < 0.001). There were no statistically significant differences in BNP concentrations across trimesters in the CHD group, no differences in BNP concentrations between the two groups, and no significant correlations between BNP concentration in each trimester with cardiac output, stroke volume, or heart rate (at rest/with exercise).
CONCLUSION
This study assessed BNP longitudinally in the first, second and third trimesters in singleton low-risk pregnancy, and showed that BNP concentration decreased with advancing gestational age, with no participants with levels greater than 40.0 pg/mL in the third trimester. BNP concentrations were similar in women with and without congenital heart disease. We found no correlation between circulating levels of BNP and maternal hemodynamics at rest or with exercise measured by ICG to support its use as a marker of cardiac function.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Natriuretic Peptide, Brain; Longitudinal Studies; Birth Weight; Heart Defects, Congenital; Pregnancy Trimester, Third
PubMed: 37185795
DOI: 10.1002/ijgo.14807 -
European Journal of Medical Research Aug 2023Pregnancy and childbirth are considered natural events in the life cycle of women. However, it is also a stressful experience along with physiological and psychological...
BACKGROUND
Pregnancy and childbirth are considered natural events in the life cycle of women. However, it is also a stressful experience along with physiological and psychological changes. Therefore, it is important to study the dimensions that cause more worry in each of the pregnant trimesters. This study aimed to determine and compare the dimensions of worry of Iranian primiparous women in each trimester of pregnancy.
METHODS
This cross-sectional study was conducted on 300 primiparous women (n = 100 in each trimester) referred to seven health centers affiliated with the Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage. We collected data from a demographic and fertility questionnaire and the Cambridge Worry Scale (CWS).
RESULTS
The mean score of worry during the entire pregnancy was 28.16. The mean and standard deviation of the worry score in the first trimester was (27.35 ± 12.22). The second trimester was (27.80 ± 12.53) and the third trimester was (29.34 ± 11.11). The highest mean score of worry in the first and third trimmers was the dimension of own health. The second trimester was the dimension of socio-medical. The lowest mean score of worry in all trimmers was the dimension of relationships. Among CWS-related items, the highest mean score of worry in the first trimester was giving birth (3.34) and the possibility of miscarriage (3.22). In the second trimester was the possibility of going into labour too early (3.3) and the possibility of miscarriage (3.12), and in the third trimester was the possibility of going into labour too early (3.33) and giving birth (3.27). The lowest mean score of worry in all three trimesters was related to problems with the law.
CONCLUSION
pregnancy worry in the third trimester was more than the other two trimesters, and worrying about own health was the most important dimension of worry for pregnant women. Paying attention to the dimensions of worry of pregnant women helps design appropriate interventions to increase the mental and physical health of pregnant women.
Topics: Pregnancy; Female; Humans; Iran; Abortion, Spontaneous; Cross-Sectional Studies; Pregnancy Trimester, First; Labor, Obstetric
PubMed: 37587539
DOI: 10.1186/s40001-023-01258-5 -
Revista Da Associacao Medica Brasileira... 2023The aim of this study was to investigate serum afamin levels in the first and third trimesters in preeclampsia.
OBJECTIVE
The aim of this study was to investigate serum afamin levels in the first and third trimesters in preeclampsia.
METHODS
Serum samples from 118 patients in the first and third trimesters were analyzed. Serum samples were collected from pregnant women who had enrolled in the first trimester. Blood was then collected from pregnant women who had developed preeclampsia and from healthy controls in the third trimester. The collected blood samples were resolved for analysis, and serum afamin concentrations were measured in the first and third trimesters. Preeclampsia and healthy controls were compared.
RESULTS
There was no significant difference between the control and preeclampsia groups in terms of age, body mass index, and smoking. Afamin levels in the first and third trimesters were higher in the preeclampsia group than in the control group (p<0.05). In the subgroup analysis of the preeclampsia group, afamin levels were higher in the early-onset preeclampsia group than in the late-onset preeclampsia group in the first and third trimesters (p<0.05). In the receiver operating characteristic analysis afamin levels were 96.23 ng/mL in the first trimester and 123.57 ng/mL in the third trimester as cut-off values for preeclampsia.
CONCLUSION
Serum afamin levels are useful for predicting preeclampsia in the first trimester in pregnant women and can be used in clinical practice as a supportive biomarker for the diagnosis of preeclampsia in the third trimester. Meta-analyzes are needed to investigate the effect of afamin levels in the prediction and diagnosis of preeclampsia and to determine the cut-off value.
Topics: Female; Humans; Pregnancy; Biomarkers; Pre-Eclampsia; Pregnancy Trimester, First; Pregnancy Trimester, Third; ROC Curve
PubMed: 36921197
DOI: 10.1590/1806-9282.20221115 -
International Journal of Environmental... Mar 2022The incidence of twin pregnancy is estimated at 1 per 80 single pregnancies. As the topic of sexual function among women with multiple pregnancy is insufficiently...
INTRODUCTION
The incidence of twin pregnancy is estimated at 1 per 80 single pregnancies. As the topic of sexual function among women with multiple pregnancy is insufficiently developed, we believe it is appropriate to raise this subject.
METHODS
A prospective study was conducted on 100 women during subsequent trimesters of pregnancy.
RESULTS
From a group of 100 women, 54 women were primiparous, while 46 women had a history of previous delivery. The mean overall FSFI (female sexual function index) was found to be 24.3 ± 6.1. Mean FSFI was the highest in the first trimester at 25.6. The result decreased successively to 24.8 ± 7 and 22.6 ± 8.4 in the second and third trimesters, respectively. The patient's place of residence had a crucial impact on their FSFI score. The results were considerably higher for residents of small and medium towns or cities-24.4 ± 3.8 and 25.9 ± 4.9, respectively-while for those living in rural areas, the FSFI reached only 21.7 ± 5.4.
CONCLUSIONS
The present study shows that the FSFI decreased throughout twin pregnancy. The lowest observed FSFI occurred in the third trimester, while the highest FSFI occurred during the first trimester.
Topics: Female; Humans; Male; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Third; Pregnancy Trimesters; Pregnancy, Twin; Prospective Studies; Sexual Behavior; Surveys and Questionnaires
PubMed: 35329228
DOI: 10.3390/ijerph19063546 -
Gait & Posture Oct 2018Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of...
BACKGROUND
Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of falling. A clear understanding of these mechanisms is important to improve pre-natal care and reduce the fall risk in this population.
OBJECTIVES
This study focused on investigating how pregnancy affects postural control in each trimester of pregnancy by analyzing pelvic inclination and body sway behavior. Our main hypothesis was that balance control and posture would change during pregnancy. More specifically, pregnancy would increase sway amplitude, anterior pelvic tilt, and body sway regularity in time.
STUDY DESIGN
Forty women formed four groups: non-pregnant women (NP) and women at their first, second, and third trimester of pregnancy (P1, P2, and P3, respectively). All participants performed (1) postural evaluation of the pelvic inclination using a digital system of postural analysis and (2) instrumented posturography using a force platform to collect the coordinates of the body's center of pressure (COP) during quiet bipedal stance for 120 s. Kruskal-Wallis H test and post-hoc Mann-Whitney U tests were used to investigate the effects of pregnancy (NP, P1, P2, and P3) on pelvic inclination angle and postural indices computed from the COP signals.
RESULTS
Results revealed significant larger body sway accompanied by a more regular medial-lateral pattern of oscillation and a more synchronized anterior-posterior and medial-lateral sway already at the first trimester of pregnancy. The averaged COP migrated posteriorly at third trimester of pregnancy and the anterior pelvic tilt increased at second and third trimesters.
CONCLUSIONS
Our results indicate the existence of changes in posture and balance metrics even at early stages of pregnancy. We suggest the use of posturography as one of screening tools for postural instability and fall risk during pregnancy.
Topics: Adult; Anthropometry; Cross-Sectional Studies; Female; Humans; Pelvis; Postural Balance; Posture; Pregnancy; Pregnancy Trimesters
PubMed: 30134216
DOI: 10.1016/j.gaitpost.2018.08.004 -
International Journal of Gynaecology... Sep 2021Hypertensive disorder of pregnancy is a major cause of fetal and maternal morbidity and mortality. The current approach for pregnancy-induced hypertension (PIH)...
OBJECTIVE
Hypertensive disorder of pregnancy is a major cause of fetal and maternal morbidity and mortality. The current approach for pregnancy-induced hypertension (PIH) screening is complex and expensive. The present prospective cohort study assesses the advantage of combining first- and second-trimester uterine artery pulsatility index (UAPI) for predictive diagnosis of PIH.
METHODS
A total of 151 prenatal cases in their first trimester were studied and followed up till delivery. The mean UAPI was calculated for the first and second trimesters during the nuchal translucency and anomaly scans. Receiver operating characteristic analysis was used to calculate the cut-off of UAPI for first-trimester, second-trimester, and both trimesters combined.
RESULTS
Twenty-seven (17.9%) pregnant women developed PIH. Mean ± SD UAPI values for first and second trimesters were 1.92 ± 0.60 and 1.23 ± 0.36, respectively. The cut-offs for abnormal UAPI were ≥2.51, ≥1.32, and ≥1.91 for first trimester, second trimester, and both trimesters combined, respectively. The sensitivity and specificity of UAPI in predictive diagnosis of PIH were 82% and 95% for first trimester, 93% and 85% for the second trimester, and 93% and 98% for both trimesters combined.
CONCLUSION
Combining UAPI of first and second trimesters improves the predictive diagnosis of PIH, which can be carried out during the nuchal translucency and anomaly scans without imparting extra cost to the patient.
Topics: Female; Humans; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Prospective Studies; Ultrasonography, Prenatal; Uterine Artery
PubMed: 33326607
DOI: 10.1002/ijgo.13545