20th Week Of Gestation Research Articles

The Diagnostic Value of Hepatic and Renal Biochemical Tests for the Detection of Preeclampsia Among Pregnant Women Attending the Antenatal Care Clinic at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia.

BackgroundPreeclampsia has a deleterious effect on renal and liver function, which results in alterations of various biochemical tests. Therefore, the main aim of this study was to evaluate the role of some hepatic and renal biochemical tests in the diagnosis of preeclampsia.MethodsA comparative cross-sectional study was carried out on a total of 126 pregnant women after 20th week of gestation who attended at the University of Gondar Comprehensive Specialized Hospital. The participants were divided into two groups as cases and controls. The case group consisted of 63 preeclamptic women, whereas the control group had 63 age and gestational week matched normotensive pregnant women. From each participant, three milliliters of blood was collected, the serum part was separated, and selected biochemical tests were measured using Humastar 800 chemistry analyzer. An independent t-test and receiver operating characteristics were done using SPSS 20 for comparison and diagnostic value determination of different biochemical tests between the study groups.ResultsThe maternal serum aminotransferases, total bilirubin, Creatinine, and Urea levels were all significantly elevated in preeclamptic women compared to normotensive pregnant women. The receiver operating characteristics plots revealed that serum aspartate aminotransferase level had area under the curve of 0.89 (95% CI: 0.84–0.95) and can distinguish preeclampsia patients from normotensive pregnant women at cut-off value of ≥58.5 U/l with 74.6% sensitivity, 87.3% specificity, and 80.9% diagnostic accuracy. Serum Creatinine level had area under the curve of 0.91 (95% CI: 0.86–0.96), which enabled to indicate preeclampsia at a cut-off value ≥0.90 mg/dl with 77.8% sensitivity and 85.7% specificity.ConclusionAn increased serum aminotransferases, total bilirubin, creatinine, and Urea levels in pregnant women could indicate the development of preeclampsia, and needs to be investigated. Among biochemical tests, serum Creatinine level was the best diagnostic marker of preeclampsia, followed by serum aspartate aminotransferase level.

Cohort profile: the Swedish Maternal Microbiome project (SweMaMi) – assessing the dynamic associations between the microbiome and maternal and neonatal adverse events

PurposeThe Swedish Maternal Microbiome (SweMaMi) project was initiated to better understand the dynamics of the microbiome in pregnancy, with longitudinal microbiome sampling, shotgun metagenomics, extensive questionnaires and health registry linkage.ParticipantsPregnant...

Magnetic resonance imaging of the supra-cervical fetal membrane detects an increased risk of prelaborrupture of membranes.

ObjectiveIn 10% of term deliveries and 40% of preterm deliveries, the fetal membrane (FM) ruptures before labor. However, the ability to predict these cases of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) is very limited. In this paper, our objective was to determine whether a prediction method based on T2 weighted magnetic resonance imaging (MRI) of the supra-cervical FM could predict PROM and PPROM.MethodsThis prospective cohort study enrolled 77 women between the 28th and 37th weeks of gestation. Two indicators of fetal membrane defects, including prolapsed depth >5 mm and signal abnormalities, are investigated for our prediction. Fisher’s exact test was used to determine whether prolapsed depth >5 mm and/or signal abnormalities were associated with PROM and PPROM. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for prolapsed depth >5 mm, signal abnormalities, and the combination of prolapsed depth >5 mm and signal abnormalities.ResultAmong 12 women with PROM (5 preterm and 7 term, prior to labor onset), 9 had membrane prolapse >5 mm and 5 had FM signal abnormalities. Among 65 women with rupture of membranes at term, 2 had membrane prolapse >5 mm and 1 had signal abnormalities. By Fisher’s exact test both indicators, membrane prolapse >5 mm and signal abnormalities, were associated with PROM (P<0.001, P<0.001) and PPROM (P=0.001, P<0.001). Additionally, membrane prolapse >5 mm, signal abnormalities, and the combination of the two indicators all demonstrated high specificity for predicting PROM (96.9%, 98.5%, and 100%, respectively) and PPROM (90.3%, 97.2%, and 100%, respectively).ConclusionMRI can distinguish the supra-cervical fetal membrane in vivo and may be able to identify women at high risk of PPROM.

Do First-Trimester Subchorionic Hematomas Affect Pregnancy Outcomes?

The aim of this study is to investigate the relationship between first trimester subchorionic hematomas and pregnancy outcomes in women with singleton pregnancies. Between January 2018 and January 2019, patients who had a single pregnancy between the 6th and 14th weeks of their pregnancy and were hospitalized with the diagnosis of abortus imminens in the early pregnancy service were included in the study. According to the ultrasonographic examination, those with subchorionic hematoma and those with no hematoma were compared in terms of demographic data, pregnancy outcomes and pregnancy complications. 400 abortus immines cases with subchorionic hematoma and 400 abortus imminens cases without subchorionic hematoma were compared. Preterm delivery percentages were similar in both groups, however abortus percentage was significantly higher in the hematoma group (34.2 vs. 24.7%; p=0.007). In addition, it was revealed that the presence of subchorionic hematoma before the 20th gestational week increased the risk of miscarriage 1.58 times. However, no data could be found in the study that could correlate the size of the hematoma with pregnancy loss. The presence of subchorionic hematoma increases abortion rates in abortus imminens cases. And the presence of subchorionic hematoma in cases with ongoing pregnancy does not increase the complications of delivery.

Symptomatic preterm infants suffer from lung function deficits, regardless of bronchopulmonary dysplasia.

The long-term respiratory consequences for children with bronchopulmonary dysplasia (BPD) are well known. However, there is little emphasis on monitoring preterm infants without BPD. Few studies have explored the lung function status of infants with the symptoms of chronic lung disease of prematurity (CLD). To evaluate functional lung deficits in preterm infants with CLD, and to assess the perinatal determinants of diminished lung function. In our cross-sectional study, 132 preterm infants with symptomatic CLD underwent infant pulmonary function testing (iPFT) at a median post-term age of 0.9 years. The iPFT included bodypletysmography, compliance measurement, tidal breath analysis, and rapid thoracoabdominal compression. The relationships between the respective z scores of the iPFT parameters and perinatal characteristics, postnatal treatment, and BPD status were investigated. Seventy-threepatients (55.3%) were born before the 28th week of gestation, and 92 (69.7%) met the BPD criteria. Functional deficits were detected in 85.8%. The obstructive ventilatory pattern was more prevalent than restrictive (36.3 vs. 12.4%, p < 0.001). Infants with restriction had lower birth weight (BW) and required a longer duration of oxygenotherapy. In a univariate model, the lung function correlated with the duration of invasive mechanical ventilation, gestational week, and BW. In a general linear model, BPD status was not an additional determinant of the iPFT results. IPFT may reveal significant functional deficits in preterm infants with CLD even without BPD. The current symptoms and perinatal factors may be more important determinants of functional deficits than the BPD status itself.

Clinical characteristics and pregnancy outcomes of cases with an incarcerated gravid uterus

This study aimed to clarify the appropriate management of gravid uterus incarceration through a retrospective analysis of 10 women with an incarcerated gravid uterus who delivered at our hospital between 2000 and 2019. The incidence of an incarcerated gravid uterus was one in 2000 cases. Nine cases were diagnosed during pregnancy (15–30 gestational weeks) and one during caesarean section (performed at 37 gestational weeks on suspicion of placenta previa). Two women underwent manual reduction at 19 and 20 gestational weeks, respectively; the procedure failed in one case, and intrauterine foetal death occurred after the procedure. Among the remaining eight cases, spontaneous reduction was observed in three women at 31, 33 and 34 gestational weeks, respectively. The prevalence of incarcerated gravid uteri may be higher than that previously reported, cases may more likely recover spontaneously, and spontaneous reduction could occur in the third trimester. Impact Statement What is already known on this subject? Gravid uterine incarceration is a rare condition that occurs in one in 3000–10,000 cases. In addition, previous reports have suggested that manual reduction should not be attempted after the 20th week of gestation. What do the results of this study add? In the current study, the incidence of an incarcerated gravid uterus was one in 2000 cases, higher than that mentioned in previous reports. In addition, spontaneous reductions occurred in three of eight cases in which manual reductions were not performed at 31, 33 and 34 gestational weeks. What are the implications of these findings for clinical practice and/or further research? The prevalence of an incarcerated gravid uterus and the rate of spontaneous reduction might be higher than those reported in previous studies, and spontaneous reduction could occur in later gestational weeks than that previously reported. Further prospective multicentre studies are necessary to establish new evidence for the management of gravid uterine incarceration.

Factors affecting the response of the premature neonates with respiratory distress syndrome to the surfactant

BACKGROUND: Respiratory distress syndrome (RDS) is a common problem in premature babies who born before 37 weeks of gestation. It occurs due to the lack of pulmonary surfactant, which is a phospho-lipoprotein produced by alveolar cells at the last stage of lung development. There are many risk factors of RDS among premature neonates including; born before the 28th week of gestation and Low birth weight.&#x0D; OBJECTIVES: To assess the response of the premature neonates admitted in Benghazi pediatric hospital with respiratory distress syndrome (RDS) to the surfactant therapy and factors affecting it. METHODS: The records of all respiratory distress premature neonates who admitted to the hospital during the year 2013, received surfactant (Survanta) 4 ml/kg under a sterile condition through special endotracheal tube and kept on a ventilator either continuous positive airway pressure (CPAP) or intermittent positive pulmonary ventilation (IPPV)were reviewed.&#x0D; RESULTS: The total number of cases with RDS and received surfactant therapy were 38 cases. 63% of them were born before 34-week gestational age, 84% of the cases their birth weight were less than 2.0 kg. About 55% of the respiratory distress premature neonates respond to the surfactant therapy and cured. The most significant factors affected their response were gestational age, birth weight, complications during pregnancy and the type of assisted ventilator. CONCLUSION: The response of premature neonates with RDS to the surfactant therapy can be improved by treating the pregnancy complications and using a continuous positive airway pressure ventilator.

Physical fitness and maternal body composition indices during pregnancy and postpartum: the GESTAFIT project

ABSTRACT We explored the association of physical fitness (PF) during pregnancy with maternal body composition indices along pregnancy and postpartum period. The study comprised 159 pregnant women (32.9 ± 4.7 years old). Assessments were carried out at the 16th and 34th gestational weeks (g.w.) and six weeks postpartum. Cardiorespiratory fitness (CRF), muscular strength (absolute and relative values) and flexibility were measured. Body composition indices were obtained by using dual-energy X-ray absorptiometry at postpartum. The results, after adjusting for potential covariates at the 16th g.w., indicated that greater CRF was associated with lower postpartum indices total fat mass, android and gynoid fat mass (all, p < 0.05). Greater absolute upper-body muscular strength was associated with greater pre-pregnancy body mass index (BMI), gestational weight gain (GWG); and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, gynoid fat mass, T-score and Z-score bone mineral density (BMD) (all, p < 0.05). Greater upper-body flexibility was associated with lower pre-pregnancy BMI; and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, android fat mass and gynoid fat mass, and with greater GWG (all, p < 0.05). At the 34th g.w., greater CRF was additionally associated with greater postpartum T-score and Z-score BMD (both, p < 0.05). In conclusion, this study reveals that greater PF levels, especially during early pregnancy, may promote a better body composition in the postpartum period. Therefore, clinicians and health promoters should encourage women to maintain or improve PF levels from early pregnancy.

Exercise Training During Multiple Pregnancy Achieved By Assisted Reproductive Technology

HISTORY: A previously physically inactive 35-year-old woman (heigh: 170 cm, body mass: 60 kg, BMI: 20.76 kg/m2) visited the Hospital Department of Human Reproduction with her husband, reporting unsuccessful attempts for a sufficient period to become pregnant. PHYSICAL EXAMINATION: The couple underwent basic screening for detecting potential infertility factors. DIFFERENTIAL DIAGNOSIS: The male factor infertility, asthenospermia, was identified. TEST AND RESULTS: The woman underwent controlled ovarian stimulation. After the induction of final maturation and ovulation, intrauterine insemination was performed. FINAL WORKING DIAGNOSIS: Biochemical testing of circulating Beta-human Chorionic Gonadotropin (B-hCG) in the woman and later transvaginal ultrasound confirmed a twin pregnancy. TREATMENT AND OUTCOMES: At the 10th week of gestation, the pregnant woman joined an individualized exercise program, which was modified during pregnancy depending on her current physical condition, symptoms and trimester of pregnancy. Specifically, the exercise program consisted of 3 sessions/week, each session lasted 30-50 minutes and contained moderate-intensity aerobic, strength-training and flexibility exercises. The exercise intensity was continuously monitoring via heart rate responses using a smart watch. The pregnancy progressed normaly and after 23 weeks of exercise training, i.e., at the 33rd week of pregnancy, the medical examinations showed satisfactory respiratory maturity, physical development and weight of the fetuses, amount of amniotic fluid and maturity of the placenta. Analysis of blood flow to the fetus and placenta did not reveal any pathological conditions. Pregnant woman's HbA1c levels were within the normal values (16wk: 4.2%, 20wk: 4.3%, 22wk: 4.4%, 31wk: 4.5%), her body weight increased by 14 kg throughout the pregnancy, while her blood pressure did not exhibit any pathological changes remaining within the normal range. By scheduled cesarean section at the 37th week of pregnancy, the two female infants were born weighing 2,500 and 2,200 gr, with an Apgar Score 10 both at the 1st and 5th min.

HLA sharing and maternal HLA expression in couples with recurrent pregnancy loss in Taiwan

ObjectiveThe aim of this study is to investigate the frequency and distribution of human HLA sharing and maternal HLA allele expression in couples with recurrent pregnancy loss in Taiwan. Materials and methodsWe retrospectively reviewed couples experienced two or more pregnancy loss before 20th weeks of gestation from March 2014 to November 2020 having HLA determination. Fertile individuals with one or more live-birth offspring receiving HLA allele determination during the same period were included as the control group. The distribution and frequency of HLA sharing were analyzed and presented by descriptive statistics. Fisher Exact Test were used to analyze specific maternal and paternal HLA allele comparing individuals with RPL to fertile group. P-value < 0.05 was thought to be statistically significant. Results72 couples were enrolled from March 2014 to November 2020. Regarding the distribution of HLA sharing, HLA sharing between females and their male partners less and equal to 2 pairs were found in 40.3% of the couples. HLA sharing greater and equal to 3 pairs are found in 59.8% couples. HLA sharing was most frequently found in alleles HLA-A02, A11, DQ07, C07 and B60 in descending order. There was a significant lower expression of HLA-B13 in women with RPL compared to women who had successful pregnancy (p = 0.0234). Compared infertile men with fertile men cohort, the frequency of HLA-DR04 (p = 0.0438, OR 2.444, 95% CI 1.0251–5.8287), HLA-DR12 (p = 0.001, OR 30.85, 95% CI 4.0296–236.19) and HLA-15 (p = 0.0357, OR 9.354, 95% CI 1.1610–75.37) were found to be significantly higher in men with RPL. On the contrary, HLA-DR07 (p = 0.0085, OR 0.124, 95% CI 0.0264–0.587) and HLA-DR10 (p = 0.0395, OR 0.048, 95% CI 0.0027–0.8641) were found to be significantly lower in men with RPL. ConclusionWe found a tendency to recurrent pregnancy loss in couples with more than 2 pairs of HLA sharing. The similarity of HLA sharing, the expression of maternal HLA-B13 allele and paternal HLA-DR alleles in Taiwanese couples might play a role in recurrent pregnancy loss.

Cesarean scar pregnancy - a retrospective analysis of cases in the years 2012-2021.

With the increasing number of caesarean sections, the number of cesarean scar pregnancies (CSP) is also increasing. This is a relatively new entity of an ectopic pregnancy, which is risky mainly because of its possible association with placenta accreta spectrum. CSP is thought to represent about 6% of the total number of ectopic pregnancies in all women who have a history of at least one caesarean section. The estimated incidence of CSP is about 1/1,688 of all pregnancies and about 1/2,000 of all caesarean sections. Retrospective analysis of individual cases of cesarean scar pregnancies managed in our health care facility in the years 2012-2021. In total, we managed 16 cases of pregnancy in the caesarean scar in 15 women. In one woman, we recorded CSP twice. The mean age of the women was 36.6 years (27-41). The mean number of caesarean sections was 1.6 (1-3) and gestational week was 7 (4-10). The average time since the caesarean section was 3.6 years (2-11). The management was methotrexate administration once, hysteroscopic resection once and 11times primarily vacuum aspiration only, when in two cases we had to attach laparoscopic uterine artery ligation due to postoperative bleeding. We performed primary ligature of uterine arteries twice before performing vacuum aspiration. In pregnancies above 10 weeks of gestation, we observed more bleeding complications requiring surgical management. Bleeding complications were also related to the presence of fetal cardiac action. Early correct dia-gnosis is essential in the management of CSP. Pregnancies up to the 10th week of gestation are managed by simple vacuum aspirations under ultrasound guidance. If the pregnancy is over the 10th week of gestation and especially with cardiac activity, we add laparoscopic uterine artery ligation before vacuum aspiration. All patients are subsequently advised to undergo laparoscopic resuturing of the lower uterine segment.

The effect of dietary fiber supplement on prevention of gestational diabetes mellitus in women with pre-pregnancy overweight/obesity: A randomized controlled trial.

Objective: To investigate the effect of dietary fiber intake during pregnancy on the prevention of gestational diabetes mellitus (GDM) in women who are overweight/obese prior to pregnancy. Methods: This randomized controlled trial was conducted in Shanghai General Hospital from June 2021 to March 2022. A total of 98 women who reported BMI≥24 kg/m2 prior to pregnancy were recruited before their 20th gestational week, and randomly (simple random allocation) assigned to the fiber supplement group (12 g of dietary fiber power twice daily) and the control group (standard prenatal care) from 20 to 24+6 gestational weeks. Both groups received nutrition education and dietary advice during the study. GDM diagnosis was performed by an oral glucose tolerance test (OGTT) at 25–28 weeks’ gestation. Data are presented as means with SD, as medians with IQR, or as counts with percentages as appropriate. Comparisons were conducted using a t-test, Mann-Whitney U test, and χ2 test, respectively. Results: The incidence of GDM was significantly reduced in the fiber supplement group compared with the control group: 8.3 vs. 24.0% (χ2 = 4.40, p = 0.036). At OGTT, the mean fasting plasma glucose in the fiber supplement group was significantly lower than before the intervention (4.57 ± 0.38 mmol/L vs. 4.41 ± 0.29 mmol/L, p < 0.01) but not in the control group (4.48 ± 0.42 mmol/L vs. 4.37 ± 0.58 mmol/L, p = 0.150). Compared with the control group, the TG and TG/HDL-C ratio levels in the intervention group were significantly higher than those in the control group (2.19 ± 0.54 mmol/L vs. 2.70 ± 0.82 mmol/L and 1.19 ± 0.49 vs.1.63 ± 0.63, respectively, all P＜0.05). The body weight gain was significantly lower in the fiber supplement group than the control group (1.99 ± 1.09 kg vs. 2.53 ± 1.20kg, p = 0.022). None of the women randomized to the fiber supplement group experienced preterm birth (<37 weeks gestation) compared with 12.0% in the control group (p = 0.040). Excessive weight gain (total weight gain >11.5 kg for overweight, and >9.0 kg for obesity) occurred in 46.7% of women in the fiber supplement group compared with 68.0% in the control group (p = 0.035). There were no differences in other maternal and neonatal outcomes. Conclusion: Increased dietary fiber intake in pregnant women who were overweight/obese prior to pregnancy may reduce the risk of GDM, excessive weight gain, and preterm birth, but it did not improve blood lipids.

Cervical strain elastography: pattern analysis and cervical sliding sign in preterm and control pregnancies.

The aim of this study was to assess the value of cervical strain elastography and Cervical Sliding Sign (CSS) for predicting spontaneous preterm birth (sPTB). In our case-control study we performed an elastographic assessment of the cervix in 82 cases of preterm birth (preterm group) and 451 control pregnancies (control group) between the 20th and 37thweek of gestation. We divided the anterior cervical lip first into two ("Intern2", "Extern2") and into three sectors ("Intern3", "Middle3", "Extern3"). The tissue deformation pattern after local compression with an ultrasound probe was recorded. We distinguished between an irregularly distributed ("Spotting") and homogeneous pattern presentation. Additionally, the presence of a sliding of the anterior against the posterior cervical lip (positive CSS) during compression was evaluated. A logistic regression analysis and the Akaike Information Criterion (AIC) were used to estimate the probability of sPTB and to select a prediction model. Spotting and positive CSS occurred more frequently in the preterm group compared to control group (97.8 vs. 2.2%, p<0.001; 26.8 vs. 4.2%, p<0.001; respectively). The model with the parameters week of gestation at ultrasound examination, Intern3, Middle3 and CSS was calculated as the highest quality model for predicting sPTB. The AUC (Area Under the Curve) was higher for this parameter combination compared to cervical length (CL) (0.926 vs. 0.729). Cervical strain elastography pattern analysis may be useful for the prediction of sPTB, as the combination of Spotting analysis and CSS is superior to CL measurement alone.

Nutritional study among adolescent pregnant attending primary health care centers

It was the goal of this study to examine the relationship between pregnant women's consumption of fruits, vegetables, and ultra-processed foods and their nutritional status. Analysis of data from a cohort study of pregnant women enrolled in prenatal care at a primary health care center in the urban area of Al Qyarah, Saudi Arabia Socioeconomic, obstetric, and maternal anthropometric, biochemical, and dietary data will be collected from October 2021 to January 2022. (obtained in the 1st clinical evaluation, between the 16th and 20th week of gestation, performed at the health unit). Serum concentrations of vitamin E, folic acid and beta-carotene, as well as pre-pregnancy body mass (BMI, kg/m2), were used to assess nutritional status. Anemia and vitamin A deficiency were also examined. Only 183 of the 860 pregnant women screened were found to be ineligible for the study, and 171 had subsequently dropped out. As a result, 506 pregnant women were included in the study, with 26% of them being adolescents (under the age of 20) and 44% being primigravidae. 15.4% of pregnant women had anemia, and 10.9% had vitamin A deficiency, both of which were found in the study.

Fetal Outcomes in Preterm Cesarean Sections

IntroductionNeonatal mortality is a major challenge in low-middle-income countries. The current study was conducted to assess the association between preterm cesarean delivery and fetal outcomes.MethodsA prospective study was conducted at the Combined Military Hospital in Peshawar, Pakistan, from October 1, 2020, to March 31, 2021. All women reporting to the hospital with a cephalic presentation and singleton pregnancies between the 27th and 34th weeks of gestation were included in the study. Pregnancies with an abnormal presentation, those diagnosed with a congenital abnormality, and those with indications for growth restriction or preterm delivery were excluded from the study. We also excluded infants delivered via vacuum or forceps. The outcomes of interest in this study included neonatal death prior to discharge, neonatal respiratory distress, sepsis, intraventricular hemorrhage (IVH), seizure, subdural hemorrhage (SDH), or appearance, pulse, grimace, activity, and respiration (APGAR) test score of less than 7 at five minutes. Maternal features including diabetes, hypertension and gestational age of delivery, parity, previous cesarean sections (CS), and last pregnancy outcomes were documented in a predefined pro forma.ResultsOur sample size consisted of 288 women, who were classified into two groups. Group A comprised 144 women who gave birth vaginally and group B consisted of 144 women who underwent CS. It was observed that women who underwent cesareans had a higher likelihood of a history of hypertension and related pathologies. It was also observed that these women had a greater likelihood of being of higher age compared to women who underwent vaginal deliveries. Neonates of women who had CS were at a greater risk of presenting with respiratory distress than those who had spontaneous vaginal deliveries.ConclusionBased on our findings, respiratory distress was significantly more common in babies of women who delivered via CS. However, there was no difference in neonatal outcomes in terms of IVH, seizures, SDH, and APGAR score of <7.

Evaluation of platelet indices in cases of spontaneous abortion and recurrent pregnancy loss

Background: Spontaneous abortion is defined as a clinically recognized pregnancy loss before the 20th week of gestation, or an expulsion of an embryo weighing 500 g or less. .Pregnancy is a condition of hypercoagulation. study aimed to evaluate the change of platelet indices namely platelet count, platelet crit , platelet distribution width and mean platelet volume among patients . Methods: This study is observational case control study . participants were 135 and divided into three groups Group1: 45 women with spontaneous abortion. Group2: 45 women with recurrent pregnancy loss.Group3: 45 normally pregnant women Results At cut off 14.12, platelet distribution width diagnose abortion (P=0.008) with sensitivity, specificity, PPV, NPV and accuracy of 74.4%, 53.3%, 76.1%, 51.1%, 67.4% respectively.At cut off 6.98, Mean platelet volume diagnose abortion (P=0.002) with sensitivity, specificity, PPV, NPV and accuracy of 76.7%, 44.4%, 75.0%, 57.1%, 70.4% respectively. At cut off 0.31, Platelet crit diagnose abortion with sensitivity, specificity, PPV, NPV and accuracy of 31.1%, 97.8%, 96.6%, 41.5%, 53.3% respectively. There were univariate regression for value of platelet indices in prediction of abortion in the studied sample. Conclusions: Platelet indices are markers for the prediction of spontaneous abortion and recurrent pregnancy loss

Immature Platelet Fraction and Thrombin Generation: Preeclampsia Biomarkers.

Preeclampsia, a human pregnancy syndrome, is characterized by elevated blood pressure and proteinuria after the 20th week of gestation. Its etiology remains unknown, and its pathophysiological mechanisms are related to placental hypoperfusion, endothelial dysfunction, inflammation, and coagulation cascade activation. Recently, the role of the complement system has been considered. This syndrome is one of the main causes of maternal and fetal mortality and morbidity. This article discusses the hypothesis of preeclampsia being triggered by the occurrence of inadequate implantation of the syncytiotrophoblast, associated with bleeding during the first stage of pregnancy and with augmented thrombin generation. Thrombin activates platelets, increasing the release of antiangiogenic factors and activating the complement system, inducing the membrane attack complex (C5b9). Immature platelet fraction and thrombin generation may be possible blood biomarkers to help the early diagnosis of preeclampsia.

Fetal kidney length as a parameter for determination of gestational age after 20th week in healthy women with uncomplicated pregnancy

Aim: To check the accuracy of Fetal Kidney Length (FKL) in the estimation of Gestational Age (GA). Materials and Methods: The present prospective cross sectional study was conducted in Max Super Specialty Hospital, Mohali, Punjab, India. The subjects were selected from the patients visiting the department of Radio diagnosis on in-patient or out-patient basis. The study was carried out for the duration of 12 months after taking approval from the IEC. Healthy women with uncomplicated pregnancy after 20th week of gestation were included in the study. Results: Out of 203 patients included in the study, 3 (1.3%) were in the age group of &lt; 20 years, 76 (37.7%) were in the age group of 20-25 years, 100 (49%) were in the age group of 25-30 years and 24 (12%) were in the age group of &gt; 30 years. In the 203 pregnant patients, age group included in the study ranged from 18 to 36 years with the mean age of 26.46 years Age of second trimester patients (100 patients) ranged from 19 to 35 with the mean of 26.26 years. The age of third trimester (103 patients) patient ranged from 18 to 36 with mean of 26.67 years.

Diagnostic Value of Abdominal B-Ultrasound for Congenital Heart Disease Complicated with Extracardiac Malformation in the Second Trimester of Pregnancy.

Objective To explore the diagnostic value of abdominal B-ultrasound in the diagnosis of congenital heart disease complicated with extracardiac malformations in the second trimester of pregnancy. Methods 50 pregnant women with congenital cardiac malformations and extracardiac malformations diagnosed in our hospital from 2015 to 2019 were retrospectively analyzed. The diagnostic results and the types of congenital heart disease complicated with extracardiac malformations were compared to analyze the diagnostic value of abdominal B-ultrasound. Results In the diagnosis of 50 fetuses with congenital heart disease and extracardiac malformation, the tetralogy of Fallot syndrome accounts for the largest proportion. Abdominal B-ultrasound in the second trimester was associated with a higher detection rate of fetal heart malformation (72%) versus in the third trimester (40%) (P < 0.05). The single atrium and single ventricle had the highest diagnostic accuracy of fetal congenital heart malformation in the second trimester. The highest success rate of detection at different gestational weeks was observed at the 14th gestational week (P < 0.05). Four-chamber cardiac section (4CV) had the lowest diagnostic accuracy (62%) for cardiac malformations, and the 4CV + three-vessel-trachea plane (3VVT) had the highest diagnostic accuracy (90%) for cardiac malformations. Conclusion Abdominal B-ultrasound features a high diagnostic value for congenital heart disease complicated with extracardiac malformations in the second trimester of pregnancy, and the second trimester is the optimal detection timing with the highest detection accuracy.

Role of Calcium Supplementation on Pregnancy Induced Hypertension Outcomes

Background: Pregnancy induced hypertension (PIH), is an important cause of both maternal and perinatalmorbidity and mortality. Low dietary calcium (Ca) intake represents a factor associated with an increasedincidence of hypertensive disease in general and in pregnant population in most low and middle income countries.Ca supplementation has the potential to reduce adverse gestational outcomes of PIH.Aim: To assess the effects of low-dose Ca supplementation on PIH outcomes.Method: A single- blind, randomized controlled trial was conducted in January through March, 2021. A totalnumber of 66 pregnant women with PIH at their 20th week of gestation attended maternal care outpatient inBaghdad Medical City were assigned randomly in two groups those received Ca supplementation 500 mg/day vsnone and follow up both groups till delivery for outcomes.Results: A significant reduction in diastolic blood pressure mean (93.28 mmHg vs. 88.62 mmHg, P= 0.015) andalmost significant reduction in systolic blood pressure mean (149.65 mmHg vs. 142.58 mmHg, P= 0.051) in theparticipants after receiving Ca supplements. Pre eclampcia (10.3% vs. 45.9%, P = 0.002), Low birth weight (6.9%vs. 40.5%, P = 0.002), Pre term delivery (10.3% vs. 43.2%, P=0.003), and admissions to neonatal intensive care unit(10.3% vs. 45.9%, P = 0.002) were significantly lower in the intervention group.Conclusion: Ca supplementation of 500 mg daily started at 20th week of gestation associated with reduction ofmaternal blood pressure, pre-eclampcia, preterm delivery, low birth weight and admission to neonatal intensivecare unit especially in a low dietary Ca intake mothers.