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Taiwanese Journal of Obstetrics &... Jan 2019To observe the pregnancy and perinatal outcomes of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies with or without multifetal pregnancy reduction... (Observational Study)
Observational Study
OBJECTIVE
To observe the pregnancy and perinatal outcomes of trichorionic triplet (TCT) and dichorionic triplet (DCT) pregnancies with or without multifetal pregnancy reduction (MFPR).
MATERIALS AND METHODS
This was a retrospective study of 732 TCT and 118 DCT pregnancies after IVF/ICSI cycles between October 1999 and May 2014 at the Reproductive & Genetic Hospital of CITIC-Xiangya. The TCT and DCT groups were subdivided into three subgroups: MFPR to single fetus group, MFPR to twins group and expectant group. Pregnancy and perinatal outcomes were compared between different subgroups.
RESULTS
The resulting subgroups were TCT-Expectant (n = 40), TCT to twin (n = 610), TCT to single (n = 22), DCT-Expectant (n = 17), DCT to twin (n = 50), and DCT to single (n = 22). The groups with MFPR had the better pregnancy and perinatal outcomes. Meanwhile, the significantly higher abortion rates but lower live birth and take home baby rates were found in TCT-Expectant group and DCT-Expectant group (all P < 0.05). Besides, the abortion rate of DCT-Expectant group was much higher than TCT-Expectant group (41% verse 15%, P = 0.032). As for the perinatal outcomes, retaining single fetus group showed the advantage of higher birth weight, and elder gestational age in both DCT and TCT pregnancies (all P < 0.05).
CONCLUSION
For DCT and TCT pregnancies, MFPR application could reduce the miscarriage rate, while improving live birth and take home baby rates compared to the expectant groups. Especially, when reduced to a single fetus, MFPR could provide the better perinatal outcomes.
Topics: Abortion, Spontaneous; Adult; Cesarean Section; Female; Humans; Live Birth; Pregnancy; Pregnancy Outcome; Pregnancy Reduction, Multifetal; Pregnancy, Triplet; Premature Birth; Reproductive Techniques, Assisted; Retrospective Studies
PubMed: 30638467
DOI: 10.1016/j.tjog.2018.11.025 -
The American Journal of Psychiatry Mar 2018
Topics: Female; Humans; Pregnancy; Pregnancy Complications; Spouses; Substance-Related Disorders
PubMed: 29490492
DOI: 10.1176/appi.ajp.2017.17101099 -
Hypertension in Pregnancy 2005We compared second pregnancy outcomes among women with and without preeclampsia in their first pregnancies who all had second pregnancies without preeclampsia. (Comparative Study)
Comparative Study
OBJECTIVES
We compared second pregnancy outcomes among women with and without preeclampsia in their first pregnancies who all had second pregnancies without preeclampsia.
METHODS
One hundred thirty women with and 6148 without preeclampsia in their first pregnancies, who all had nonpreeclamptic second pregnancies, were included. Outcomes, including delivery gestational age, birthweight, small-for-gestational-age (SGA), and preterm delivery were compared.
RESULTS
Overall, second pregnancy outcomes were not different between women with and without preeclampsia in their first pregnancy. However, when women were stratified by gestational timing of preeclampsia, women with preeclampsia at < 34 weeks (N = 22) had smaller infants and delivered earlier in their second nonpreeclamptic pregnancy compared to women with later preeclampsia (N = 108) or no preeclampsia in the first pregnancy. Women with early preeclampsia also had an increased risk of prematurity (< 37 weeks) in second pregnancies that persisted after controlling for confounding factors [Odds ratio (OR = 3.2)].
DISCUSSION
Second, nonpreeclamptic pregnancy outcomes are different between women with previous early preeclampsia and controls but not between late preeclampsia and controls. These findings support other epidemiological data indicating differences between early and late onset preeclampsia as well as a potential relationship of preeclampsia and spontaneous preterm birth.
Topics: Adult; Female; Gravidity; Humans; Infant, Newborn; Logistic Models; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Premature Birth
PubMed: 16036400
DOI: 10.1081/PRG-200059869 -
BMC Pregnancy and Childbirth Mar 2020Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. However, data on...
Pregnancy outcomes of dichorionic triamniotic triplet pregnancies after in vitro fertilization-embryo transfer: multifoetal pregnancy reduction versus expectant management.
BACKGROUND
Trichorionic triplet pregnancy reduction to twin pregnancy is associated with a lower risk of preterm delivery but not with a lower risk of miscarriage. However, data on dichorionic triamniotic (DCTA) triplet pregnancy outcomes are lacking. This study aimed to compare the pregnancy outcomes of DCTA triplets conceived via in vitro fertilization-embryo transfer (IVF-ET) managed expectantly or reduced to a monochorionic (MC) singleton or monochorionic diamniotic (MCDA) twins at 11-13 gestational weeks.
METHODS
Two hundred ninety-eight patients with DCTA triplets conceived via IVF-ET between 2012 and 2016 were retrospectively analysed. DCTA triplets with three live foetuses were reduced to a MC singleton (group A) or MCDA twins (group B) or underwent expectant management (group C). Each multifoetal pregnancy reduction (MFPR) was performed at 11-13 gestational weeks. Pregnancy outcomes in the 3 groups were compared.
RESULTS
Eighty-four DCTA pregnancies were reduced to MC singleton pregnancies, 149 were reduced to MCDA pregnancies, and 65 were managed expectantly. There were no significant differences among groups A, B, and C in miscarriage rate (8.3 vs. 7.4 vs. 10.8%, respectively) and live birth rate (90.5 vs. 85.2 vs. 83.1%, respectively) (P > 0.05). Group A had significantly lower rates of preterm birth (8.3 vs. 84.6%; odds ratio (OR) 0.017, 95% confidence interval (CI) 0.006-0.046) and low birth weight (LBW; 9.2 vs. 93.2%; OR 0.007, 95% CI 0.003-0.020) than group C (P < 0.001). Group B had significantly lower preterm birth (47.0 vs. 84.6%; OR 0.161, 95% CI 0.076-0.340) and LBW rates (58.7 vs. 93.2%; OR 0.103, 95% CI 0.053-0.200) than group C (P < 0.001). Group A had significantly lower preterm birth (8.3 vs. 47.0%; OR 0.103, 95% CI 0.044-0.237; P < 0.001), LBW (9.2 vs. 58.7%; OR 0.071, 95% CI 0.032-0.162; P < 0.001) and perinatal death rates (1.3 vs. 9.1%; OR 0.132, 95% CI 0.018-0.991; P = 0.021) than group B.
CONCLUSION
The MFPR of DCTA triplets to singleton or MCDA pregnancies was associated with better pregnancy outcomes compared to expectant management. DCTA triplets reduced to singleton pregnancies had better perinatal outcomes than DCTA triplets reduced to MCDA pregnancies.
Topics: Adult; Embryo Transfer; Female; Fertilization in Vitro; Gestational Age; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Pregnancy Reduction, Multifetal; Pregnancy, Triplet; Pregnancy, Twin; Retrospective Studies
PubMed: 32178634
DOI: 10.1186/s12884-020-2815-4 -
Romanian Journal of Ophthalmology 2021Due to the increasing rate of couples suffering from infertility, recently, the use of assisted reproductive technology (ART) has increased by 5%-10% per year. Some ART... (Review)
Review
Due to the increasing rate of couples suffering from infertility, recently, the use of assisted reproductive technology (ART) has increased by 5%-10% per year. Some ART pregnancies are at risk of obstetric and neonatal complications, but it is unknown whether the procedures used or the etiology of infertility influences this risk. Multiple ART pregnancies are responsible for the increased rate of prematurity and its associated complications. Also, it has been demonstrated that ART pregnancies have a higher risk of congenital anomalies. The rate of ART-associated ocular abnormalities is incompletely known due to a small number of studies conducted regarding this pathology. In this paper, we presented a review of literature on ocular anomalies associated with ART in order to raise awareness of the need to implement ophthalmological screening in children from pregnancies obtained by ART. ART = assisted reproductive techniques, IVF = in vitro fertilization, ICSI = intracytoplasmic sperm injection, LBW = low birth weight, ROP = retinopathy of prematurity.
Topics: Child; Female; Fertilization in Vitro; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Reproductive Techniques, Assisted; Sperm Injections, Intracytoplasmic
PubMed: 35087971
DOI: 10.22336/rjo.2021.65 -
American Journal of Public Health Oct 1997This study assessed the effect of unintended pregnancy on breast-feeding behavior.
OBJECTIVES
This study assessed the effect of unintended pregnancy on breast-feeding behavior.
METHODS
All women delivering a live birth between January 1, 1995, and July 31, 1996 (n = 33,735), in the 15-county central New York region were asked whether they had intended to become pregnant and their breast-feeding plans.
RESULTS
Women with mistimed pregnancies, and pregnancies that were not wanted were significantly less likely to breast-feed than were women whose pregnancies were planned. After adjustment for confounding variables and contraindications for breast-feeding, the odds ratios of not breast-feeding remained significant.
CONCLUSIONS
Promoting breast-feeding among women with unintended pregnancies is important to improve health status.
Topics: Breast Feeding; Female; Humans; New York; Pregnancy; Pregnancy, Unwanted
PubMed: 9357361
DOI: 10.2105/ajph.87.10.1709 -
Obstetrics and Gynecology Jun 1990During an 8-year period, we managed 42 women with 101 pregnancies with previously diagnosed but uncorrected uterine malformations referred to our institution for...
During an 8-year period, we managed 42 women with 101 pregnancies with previously diagnosed but uncorrected uterine malformations referred to our institution for high-risk obstetric care. All patients were managed under the same standardized protocol requiring weekly visits and decreased physical activity. The population studied consisted of four groups of pregnancies with the following uterine anomalies: unicornuate (five), bicornuate (61), septate (25), and didelphys (ten). Sixty percent of the pregnancies in the unicornuate and didelphys group reached term, 39% in the bicornuate group, and 48% in the septate group. Preterm labor requiring tocolysis occurred in 21% of the pregnancies in the bicornuate group and 15% of the pregnancies in the septate group. Cerclage was placed in 5% of the pregnancies in the bicornuate group. Before our care, the fetal survival rate for pregnancies in the bicornuate and septate groups was 52 and 53%, respectively; with our management protocol, it was 58 and 65%, differences that were not statistically significant. Our experience suggests that high-risk obstetric intervention does not obviate the potential benefit of metroplasty, especially for patients with a bicornuate or septate uterus. We believe that traditional indications for metroplasty should continue to be used.
Topics: Abortion, Spontaneous; Delivery, Obstetric; Female; Fetal Death; Humans; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Uterus
PubMed: 2342734
DOI: No ID Found -
Reproductive Sciences (Thousand Oaks,... Jan 2023The most common systemic connective tissue diseases (CTD), such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS),... (Review)
Review
The most common systemic connective tissue diseases (CTD), such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), systemic sclerosis (SSc), and Sjögren's syndrome (SjS), affect many women of reproductive age. These diseases may strongly impact the course of pregnancy and increase the risk factors of incompatibility. A literature search was done on MEDLINE, PubMed, and Google Scholar in 2011-2021. The analysis included meta-analysis, randomized control trials, prospective and retrospective studies, and systematic reviews. The literature search allowed us to form conclusions and underline recommendations regarding pregnancy's risk and treatment possibilities in the course of rheumatic disease. Optimal control of CTD activity should be reached at least 6 months before conception. High-risk pregnancies are often accompanied by maternal-placental syndrome, which manifests as preeclampsia, eclampsia, fetal growth restriction, and prematurity. The flare of rheumatic disease can coexist with obstetrical complications, and differential diagnosis can be difficult. Medications that do not influence the risk of fetus complications should be applied before and during pregnancy. Teratogenic drugs (e.g., methotrexate, leflunomide, cyclophosphamide) must be withdrawn before pregnancy. Conventional medications such as hydroxychloroquine, sulfasalazine, colchicine, and the TNFα inhibitor certolizumab can be used safely at any stage of pregnancy. Corticosteroids should be tapered, and other biologics should be avoided due to teratogenicity or carefully administered due to the impact on the fetal immune system. Distinguishing between disease flare and obstetrical complications can be difficult in clinical practice; however, some clinical symptoms and serological markers can be helpful in the differential diagnosis.
Topics: Female; Humans; Pregnancy; Lupus Erythematosus, Systemic; Placenta; Pregnancy Complications; Pregnancy Outcome; Prospective Studies; Retrospective Studies; Rheumatic Diseases; Meta-Analysis as Topic; Randomized Controlled Trials as Topic
PubMed: 35359225
DOI: 10.1007/s43032-022-00901-6 -
BMC Pregnancy and Childbirth May 2023A barrier to achieving first trimester antenatal care (ANC) attendance in many countries has been the widespread cultural practice of not discussing pregnancies in the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A barrier to achieving first trimester antenatal care (ANC) attendance in many countries has been the widespread cultural practice of not discussing pregnancies in the early stages. Motivations for concealing pregnancy bear further study, as the interventions necessary to encourage early ANC attendance may be more complicated than targeting infrastructural barriers to ANC attendance such as transportation, time, and cost.
METHODS
Five focus groups with a total of 30 married, pregnant women were conducted to assess the feasibility of conducting a randomised controlled trial to evaluate the effectiveness of early initiation of physical activity and/or yoghurt consumption in reducing Gestational Diabetes Mellitus in pregnant women in The Gambia. Focus group transcripts were coded through a thematic analysis approach, assessing themes as they arose in relation to failure to attend early ANC.
RESULTS
Two reasons for the concealment of pregnancies in the first trimester or ahead of a pregnancy's obvious visibility to others were given by focus group participants. These were 'pregnancy outside of marriage' and 'evil spirits and miscarriage.' Concealment on both grounds was motivated through specific worries and fears. In the case of a pregnancy outside of marriage, this was worry over social stigma and shame. Evil spirits were widely considered to be a cause of early miscarriage, and as such, women may choose to conceal their pregnancies in the early stages as a form of protection.
CONCLUSION
Women's lived experiences of evil spirits have been under-explored in qualitative health research as they relate specifically to women's access to early antenatal care. Better understanding of how such sprits are experienced and why some women perceive themselves as vulnerable to related spiritual attacks may help healthcare workers or community health workers to identify in a timely manner the women most likely to fear such situations and spirits and subsequently conceal their pregnancies.
Topics: Female; Humans; Pregnancy; Motivation; Gambia; Abortion, Spontaneous; Cognition; Community Health Workers
PubMed: 37226126
DOI: 10.1186/s12884-023-05710-6 -
The Journal of the Royal College of... Feb 1976Among 1,041 women fitted with intra-uterine contraceptive devices during a period of 21,445 months there were 51 pregnancies: a rate of 2.9 per hundred women years....
Among 1,041 women fitted with intra-uterine contraceptive devices during a period of 21,445 months there were 51 pregnancies: a rate of 2.9 per hundred women years. Pregnancy occurred most commonly in the young and nulliparous. The importance of the patient checking her device is stressed. Pregnancy occurs most commonly soon after fitting, but may occur at any time. In more than half the cases pregnancy occurred with the device in the uterus. Though most pregnancies were uterine there was a high incidence of ectopic pregnancies. Many pregnancies ended in vaginal delivery, but since the Abortion Act 1967 fewer probably now go to term.
Topics: Age Factors; Family Practice; Female; Humans; Intrauterine Devices; Parity; Pregnancy
PubMed: 1255551
DOI: No ID Found