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European Journal of Obstetrics,... Oct 2023This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of...
INTRODUCTION
This retrospective single centre study considers the predictive value of specific ultrasound features of sub-chorionic haemorrhage (SCH) as potential indicators of adverse pregnancy outcome.
METHODS
Ultrasound reports and images were reviewed for 160 participants presenting to an early pregnancy assessment unit from January 2018 to January 2019. Participants were selected based upon the presence of SCH within the first trimester. The outcome of each pregnancy and the features of SCH, including the size, location and echogenicity were recorded and multinominal logistic regression was used to establish predictive value.
RESULTS
The majority of participants were asymptomatic and delivered healthy babies. 24% miscarried prior to delivery or had stillborn babies; the features of bleed within this group revealed an increased prevalence of adverse outcome in the presence of moderate sized haemorrhage (p = 0.02). 61% of miscarried pregnancies presented with "wrapping" SCH, in which haemorrhage encased the gestation sac, suggesting wrapping posed a probable risk (p = 0.01). 71% of miscarriages occurred within 5 + 0-10 + 0 weeks gestation. Persistent SCH was of greater incidence within those participants with adverse outcome (57%). There was no association between fetal abnormality and miscarriage. Jaundice babies and premature delivery occurred more frequently (p = 0.001) and may be a secondary finding following SCH.
CONCLUSION
There was a strong correlation between presence of SCH in early pregnancy and rate of miscarriage. Specific ultrasound features of SCH, most notably a wrapping location with moderate size, may be indicative of increased risk of miscarriage or post-natal complications. Jaundice and premature births may have an association with placental compromise.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Retrospective Studies; Placenta; Pregnancy Outcome; Pregnancy Trimester, First; Hemorrhage; Premature Birth; Ultrasonography
PubMed: 37619520
DOI: 10.1016/j.ejogrb.2023.08.009 -
Future Oncology (London, England) Jul 2022To review pregnancy and perinatal outcomes associated with exposure to antineoplastic drugs around pregnancy as reported within the US FDA Adverse Event Reporting...
To review pregnancy and perinatal outcomes associated with exposure to antineoplastic drugs around pregnancy as reported within the US FDA Adverse Event Reporting System (FAERS). The FAERS database was accessed and reports of exposure to antineoplastic drugs before/during pregnancy 2000-2020 were reviewed. An analysis of the frequency of different adverse pregnancy outcomes and perinatal outcomes was conducted for all agents as well as for specific categories of antineoplastic agents. A total of 5312 reports of pregnancy exposure to antineoplastic drugs within the FAERS database were found to be eligible and were included in the current study. The most frequent adverse pregnancy outcomes included premature delivery (21.8%) and abortion (11.9%). The most frequent adverse perinatal outcomes included congenital malformations (15.9%) and fetal/neonatal death (12.9%). Within the limitations of the study (especially the lack of an accurate denominator), premature delivery, abortion, fetal/neonatal death and congenital malformations seemed to be the main risks associated with pregnancy exposure to antineoplastic drugs.
Topics: Abortion, Spontaneous; Antineoplastic Agents; Databases, Factual; Female; Humans; Infant, Newborn; Perinatal Death; Pregnancy; Pregnancy Outcome
PubMed: 35611663
DOI: 10.2217/fon-2021-1255 -
Frontiers in Public Health 2023Exposure to high ambient temperature is reported to cause adverse pregnancy outcomes. However, considering myriad temperature and climatic conditions as well as...
BACKGROUND
Exposure to high ambient temperature is reported to cause adverse pregnancy outcomes. However, considering myriad temperature and climatic conditions as well as different contextual factors, the paucity of studies from the developing regions impedes the development of a clear understanding of the heat-pregnancy outcome relationship.
MATERIALS AND METHODS
This study was conducted in Chakaria, a coastal region of Bangladesh, where International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) administers a health and demographic surveillance system (HDSS). The surveillance workers visit the households every three months as a part of the routine surveillance activity. Between 2012 and 2020, the surveillance workers documented histories of 23,482 pregnancies among 13,376 women and the women were followed up for their pregnancy outcomes. The temperature records were obtained from the Bangladesh Meteorological Department's weather station at Cox's Bazar. The dates of pregnancy outcome were linked with the daily average temperature on the day of pregnancy outcome. A logistic regression model was employed to examine the relationship between temperature and the incidence of miscarriage.
RESULTS
Out of 23,482 pregnancy outcomes, 3.7% were induced abortions. Among the remaining 22,624 pregnancy outcomes, 86.2% were live births, 10.7% were miscarriages and 3.1% were stillbirths. Miscarriages peaked between 8-14 weeks of gestation and varied according to temperature. For women exposed to temperatures between 28°C and 32°C, the risk of miscarriage was 25% greater (adjusted OR 1.25, 95% CI 1.07-1.47) compared to those exposed to temperatures from 16°C to 21°C.
CONCLUSION
The study establishes a connection between miscarriage and high ambient temperatures in a coastal region of Bangladesh. Implementing timely and appropriate adaptation strategies to prevent miscarriages is of paramount importance for a densely populated country like Bangladesh.
Topics: Pregnancy; Female; Humans; Abortion, Spontaneous; Temperature; Bangladesh; Pregnancy Outcome; Live Birth
PubMed: 38026421
DOI: 10.3389/fpubh.2023.1238275 -
Archives of Gynecology and Obstetrics Sep 2020To explore whether the adverse pregnancy outcomes in first frozen embryo transfer (FET) cycles affect live birth and neonatal outcomes in the subsequent pregnancy?
PURPOSE
To explore whether the adverse pregnancy outcomes in first frozen embryo transfer (FET) cycles affect live birth and neonatal outcomes in the subsequent pregnancy?
METHODS
This was a retrospective study. Women with a history of adverse pregnancy outcomes in first FET cycles started their subsequent embryo transfer cycles. The adverse pregnancy outcomes included biochemical pregnancy, ectopic pregnancy, and first-trimester pregnancy loss. The main outcomes of present study were live birth rate and neonatal outcomes.
RESULTS
Results showed patients with first-trimester pregnancy loss in first FET cycles had a 95 percent greater chance of live birth in subsequent FET cycles (OR 1.95, 95% CI 1.33-2.88). However, the biochemical pregnancy/ectopic pregnancy in initial FET cycles did not affect the chance of live birth in second cycles (biochemical pregnancy: OR 1.21, 95% CI 0.82-1.77; ectopic pregnancy: OR 1.06, 95% CI 0.55-2.05). The neonatal outcomes of singletons were not affected by the number of embryo transfer cycles.
CONCLUSIONS
Patients with first-trimester pregnancy loss in first FET cycle had a greater chance of live birth in second FET cycles, but the biochemical pregnancy/ectopic pregnancy in first FET cycles did not significantly affect the live birth in second FET cycles. The three types of adverse pregnancy outcomes in first FET cycles did not affect neonatal outcomes in the second cycles.
Topics: Adult; Embryo Transfer; Female; Humans; Live Birth; Pregnancy; Pregnancy Outcome; Retrospective Studies
PubMed: 32468163
DOI: 10.1007/s00404-020-05608-0 -
Journal of Obstetrics and Gynaecology :... Feb 2010Advice given to women regarding optimum interpregnancy interval (IPI) following spontaneous miscarriage remains controversial. There is robust evidence from many studies... (Review)
Review
Advice given to women regarding optimum interpregnancy interval (IPI) following spontaneous miscarriage remains controversial. There is robust evidence from many studies including a meta-analysis that after full term or pre-term delivery, IPIs of <18 months and >5 years are associated with increased risk of poor perinatal and maternal outcome. However, there is paucity of good studies to infer the effect of IPI after a spontaneous miscarriage, which is a relatively common event. The results have been variable and inconsistent but a recent good quality study (DaVanzo et al. 2007 ) showed similar pregnancy outcome with IPIs of <6, 6-14, 15-26 and 27-50 months following spontaneous miscarriage. Hence, it seems reasonable to attempt conception soon after an uncomplicated miscarriage in otherwise healthy women depending on their desire. More good quality, preferably prospective studies regarding effect IPI after miscarriage are required for better evidence-based advice.
Topics: Abortion, Spontaneous; Birth Intervals; Female; Humans; Live Birth; Pregnancy; Stillbirth
PubMed: 20143964
DOI: 10.3109/01443610903470288 -
American Journal of Epidemiology Apr 2016An estimated 11%-20% of clinically recognized pregnancies result in spontaneous abortion. The literature finds elevated risk of spontaneous abortion among women who...
An estimated 11%-20% of clinically recognized pregnancies result in spontaneous abortion. The literature finds elevated risk of spontaneous abortion among women who report adverse financial life events. This work suggests that, at the population level, national economic decline-an ambient and plausibly unexpected stressor-will precede an increase in spontaneous abortion. We tested this hypothesis using high-quality information on pregnancy and spontaneous loss for all women in Denmark. We applied time-series methods to monthly counts of clinically detected spontaneous abortions (n = 157,449) and the unemployment rate in Denmark beginning in January 1995 and ending in December 2009. Our statistical methods controlled for temporal patterns in spontaneous abortion (e.g., seasonality, trend) and changes in the population of pregnancies at risk of loss. Unexpected increases in the unemployment rate preceded by 1 month a rise in the number of spontaneous abortions (β = 33.19 losses/month, 95% confidence interval: 8.71, 57.67). An attendant analysis that used consumption of durable household goods as an indicator of financial insecurity supported the inference from our main test. Changes over time in elective abortions and in the cohort composition of high-risk pregnancies did not account for results. It appears that in Denmark, ambient stressors as common as increasing unemployment may precede a population-level increase in spontaneous abortion.
Topics: Abortion, Spontaneous; Denmark; Economic Recession; Female; Humans; Pregnancy; Pregnancy Outcome; Registries; Stress, Psychological; Unemployment
PubMed: 27009344
DOI: 10.1093/aje/kww003 -
American Journal of Epidemiology Jul 2023The inherent correlation between the total amount of weight gained in pregnancy and the duration of pregnancy creates major methodological challenges in the study of...
The inherent correlation between the total amount of weight gained in pregnancy and the duration of pregnancy creates major methodological challenges in the study of pregnancy weight gain. In this issue (Am J Epidemiol. 2022;191(10):1687-1699), Richards et al. examine the extent to which different measures of pregnancy weight gain (including covariate adjustment for gestational age and standardizing weight gain for gestational duration using a pregnancy weight gain chart) are able to disentangle the effects of low weight gain on perinatal health from the role of younger gestational age at delivery for 3 outcomes: small-for-gestational-age birth, cesarean delivery, and low birth weight. While methodological research to understand how to best disentangle the effects of gestational weight gain from pregnancy duration is valuable, we argue that the practical utility of this type of research would be increased by aligning the specific research questions more closely with health outcomes on which evidence is most needed-those not considered in current weight gain guidelines due to lack of high-quality evidence (such as pre-eclampsia and stillbirth). Further, evaluations of weight gain charts should separate out the potential for bias introduced by the use of a normative chart per se from the use of a chart unsuitable for the study population.
Topics: Pregnancy; Female; Humans; Pregnancy Outcome; Gestational Weight Gain; Public Health; Weight Gain; Stillbirth; Pregnancy Complications
PubMed: 36899293
DOI: 10.1093/aje/kwad047 -
Thrombosis Research Feb 2015The brain and the placenta synthesize identical peptides and proteins, such as brain-derived neurotrophic factor, oxytocin, vascular endothelial growth factor, cortisol,... (Review)
Review
The brain and the placenta synthesize identical peptides and proteins, such as brain-derived neurotrophic factor, oxytocin, vascular endothelial growth factor, cortisol, and matrix metalloproteinases. Given the promiscuity between neurochemistry and the mechanism of placentation, it would be expected that mental disorders occurring during pregnancy would increase the risk of adverse obstetric and neonatal outcomes. Indeed, expectant mothers with anxiety disorders, post-traumatic stress disorder, schizophrenia, or depressive disorders are at higher risk of preterm birth, low-birth-weight and small-for-gestational-age infants than controls. These mental illnesses are accompanied by a procoagulant phenotype and low activity of tissue plasminogen activator, which may contribute to placental insufficiency. Another risk factor for pregnancy complications is hyperemesis gravidarum, more common among women with eating disorders or anxiety disorders than in controls. Severe hyperemesis gravidarum is associated with dehydration, electrolyte imbalance and malnutrition, all of which may increase the risk of miscarriages, of low-birth-weight babies and preterm birth. This paper reviews some aspects of mental disorders that may influence pregnancy and neonatal outcomes.
Topics: Abortion, Spontaneous; Causality; Female; Humans; Hyperemesis Gravidarum; Mental Disorders; Placental Insufficiency; Pregnancy; Pregnancy Outcome; Prevalence; Risk Factors
PubMed: 25903540
DOI: 10.1016/S0049-3848(15)50446-5 -
Journal of Obstetrics and Gynaecology :... 2010
Topics: Abortion, Spontaneous; Adult; Female; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Red-Cell Aplasia, Pure; Stillbirth
PubMed: 20925624
DOI: 10.3109/01443615.2010.501919 -
Medicine Apr 2024This study aimed to assess the impact of continuous precision nursing on neurobehavioral function and pregnancy outcomes in patients experiencing threatened abortion. A...
This study aimed to assess the impact of continuous precision nursing on neurobehavioral function and pregnancy outcomes in patients experiencing threatened abortion. A total of 130 patients with early threatened abortion admitted to our hospital between October 2020 and January 2023 were selected and categorized into 2 groups based on intervention methods. The control group received routine nursing intervention, whereas the observation group received continuous precision nursing intervention. Changes in affective status scores, SF-36 scores, knowledge mastery scores, and satisfaction scores in the neurobehavioral function test before and after intervention were recorded in both groups. Additionally, pregnancy outcomes, obstetric adverse reaction rates, and neonatal conditions were documented. Following intervention, scores for tension-anxiety, depression-dejection, anger-hostility, vigor-activity, fatigue-inertia, and confusion-bewilderment gradually decreased in both groups, with significantly lower scores observed in the observation group compared to the control group (P < .05). SF-36 scores in 8 dimensions, including physical functioning, role-physical, bodily pain, and overall health rating, showed a gradual increase in both groups, with the observation group scoring higher than the control group (P < .05). Knowledge mastery and satisfaction scores also increased significantly after intervention, with the observation group surpassing the control group (P < .05). The observation group exhibited lower rates of abortion and premature birth, along with a higher rate of full-term pregnancy compared to the control group, with statistically significant differences (P < .05). Furthermore, the observation group displayed lower rates of adverse reactions and low birth weight infants, with significant differences compared to the control group (P < .05). No significant differences were observed in neonatal mortality and neonatal intensive care unit transfer rates between the observation and control groups (P > .05). Continuous precision nursing contributes to improved pregnancy outcomes for patients with threatened miscarriage within the first 12 weeks of pregnancy. This comprehensive care approach is associated with enhanced knowledge retention, protection of neurological function, and an overall improvement in quality of life.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Pregnancy Outcome; Abortion, Threatened; Quality of Life; Abortion, Spontaneous; Pregnancy Complications
PubMed: 38579069
DOI: 10.1097/MD.0000000000037133