2nd Trimester Of Pregnancy Research Articles

Possibilities of the correction of placental dysfunction in women with preeclampsia

Objective. To study the possibilities of diagnosing placental dysfunction and its correction in women with preeclampsia.
 Materials and methods. 72 women with preeclampsia in the 2nd and 3rd trimesters of pregnancy were examined at the multidisciplinary clinic of the Tashkent Medical Academy from 2017 to 2019. All women underwent: clinical, laboratory, echography, color Doppler mapping of the vessels of the uteroplacental-fetal system with Doppler analysis of blood flow velocity.
 Results and discussion. Diagnostic criteria for placental dysfunction: the placenta acquires its echographic picture at the beginning of the 2nd trimester of pregnancy. During the 2nd and 3rd trimesters of pregnancy, the thickness of the placenta corresponds to 2-3.6 cm. A decrease of <2 cm is regarded as hypoplasia, an increase >4 cm as hyperplasia. Premature aging of the placenta was detected in 77.3 % of cases, the presence of cysts of the placental tissue – in 4.5 %, turbid amniotic fluid – 59.09 %, oligohydramnios – in 27.3 %. At 24th week, the fetal thigh length lag was less by 9.04 % (p<0.05). Doppler criteria for placental dysfunction: in almost equal proportions there are circulatory disorders in the uteroplacental and fetal-placental blood flow (28.2 and 27.7 %). Treatment of placental dysfunction in compensated form: was carried out according to the generally accepted method according to the national guidelines; 4.2 g of L-arginine (Tivortin, “Yuria-Pharm”, Ukraine) was added to the complex therapy in the hospital in dosage 100 ml per day for 7 days. Then Tivortin aspartate was continued on an outpatient basis, orally, 20 ml (1 table spoon 4 times per day, 20 days). The effectiveness of therapy was monitored again after 2 weeks.
 Conclusions. Timely initiation of therapy for uterine-fetal-placental blood flow disorders in the 2nd trimester was more effective than in the 3rd.

4D Sonography in Prenatal Diagnosis of Fetal Anomalies in First &Second Trimester of Pregnancy.

Background: One of the most consistently used justifications for the use of obstetric ultrasound is that, accurate diagnosis of fetal malformations before delivery can provide health care providers and parents a number of management options. Aim: evaluate the role of 4D ultrasound in assessment and detection of fetal congenital anomalies, in 1st & 2nd trimester of pregnancy. Subjects & Methods: Fifty women were examined by 2D followed by 4D US, and 52 detected anomalies. Results: Our results demonstrate an advantage of 4D US over 2DUS in 13 % of cases, equal findings in 30%, and less information in 17 % of anomalies detected. Four dimensional US is advantageous in some anomalies of the face and extremities only. Conclusion: 2D US remains the gold standard in assessment of fetal anomalies, and 4D US, therefore, is not a screening technique but an adjunct to 2D US for those fetuses in whom malformations are already determined or suspected on the basis of standard sonography.

Investigation of the PD-1 and PD-L1 Immune Checkpoint Molecules Throughout Healthy Human Pregnancy and in Nonpregnant Women

Background: A growing body of evidence supports the importance of PD-1 and PD-L1, especially in the materno-fetal interface, although limited information is available about the peripheral expression of these molecules during the trimesters of pregnancy. Methods: 13 healthy women were enrolled from the 1st, 10 from the 2nd and 12 from the 3rd trimester of pregnancy at the same time, 10 healthy, age-matched nonpregnant women formed the control group. From peripheral blood, mononuclear cells were separated and stored at –80 °C. From freshly thawed samples, surface and intracellular staining were performed for flow cytometric analyses. CD107a degranulation assay was used to evaluate the cytotoxicity. Results: significant alternation was detected in PD-1 expression by CD8+T cells and in PD-L1 expression by CD8+T, CD4+T and Treg cells. An interesting relationship was revealed between the PD-1 and PD-L1 expression by the investigated subpopulations in 2nd trimester of pregnancy. Different expression patterns of an activation receptor NKG2D by the PD-1+ CD8+T cells was observed during pregnancy. The notable relationship was further determined in cytotoxicity between PD-1+ and NKG2D+ CD8+T cells throughout pregnancy. Conclusions: the different PD-1 presence and the relationship with NKG2D could contribute to the dynamic changes of the Th1 and Th2 predominance throughout the three trimesters of a healthy pregnancy.

Evaluation of maternal inflammation as a marker of future offspring ADHD symptoms: A prospective investigation

Early life predictors of attention-deficit/hyperactivity disorder (ADHD) are critically needed; they could inform etiological theory and may help identify new prevention targets. The current study examined prospectively whether maternal cytokine levels during pregnancy predict offspring ADHD symptoms at age 4–6 years. Secondarily, we evaluated maternal cytokine levels as a possible common pathway through which prenatal risks exert influence on child ADHD. Data came from a sample of women recruited during the 2nd trimester of pregnancy (N = 62) and followed postnatally until children were 4–6 years old. Maternal inflammation was assessed using 3rd trimester plasma concentrations of three indicators of nuclear factor kappa B signaling: interleukin-6, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1 which were combined into a latent variable. Mothers and teachers reported on child ADHD symptoms, negative affect, and externalizing behaviors at 48–72 months of age. Maternal inflammation in the 3rd trimester predicted ADHD symptoms when children were 4–6 years old (β = 0.53, 95% CI = 0.154, 0.905, p = 0.006). Further, maternal inflammation mediated the effect of prenatal distress on child ADHD (β = 0.21, 95% CI = 0.007, 0.419, p = 0.04). The inflammation effect on ADHD was not explained by concurrent child negative affect, externalizing behavior, or familial ADHD status. This is the first human study to prospectively link maternal pregnancy cytokine levels and offspring ADHD symptoms, suggesting that cytokine levels are a possible marker of ADHD risk. Results also provide new evidence that maternal prenatal inflammation may be one common pathway by which prenatal risk factors influence offspring mental health outcomes.

Which role for trait-anxiety in paternal perinatal depression? Preliminary results on healthy subjects

Objectives Paternal Perinatal Depression (PPND) is a clinical condition, referred to emergence of depressive mood, i.e. sadness, hopelessness, despair and melancholy, but also loss of interest, and impairment in concentration and work performance, in fathers during the pregnancy in first postpartum year. Recently, the overlap with anxiety disorders is frequently observed. The study was aimed at evaluating a relationship between trait-anxiety and symptoms of PPND, in order to highlight trait-anxiety in onset of depressive syndrome. Study design A total number 79 participants have been recruited by convenience sampling method. Partners of pregnant women at the second trimester of pregnancy (17 ÷ 21 weeks of gestation) were consecutively recruited. At baseline, in 2nd trimester of pregnancy, and at 2nd months after childbirth, the psychiatric interview and socio-demographic data collection, were carried out and all subjects completed a self-administered STAI questionnaire. In postpartum period, the subjects completed the screening for postpartum depressive symptoms with PDSS scale. Results Severity of “Anxiety proneness,” assessed by STAI-Y, was “moderate in total sample (mean 58.7 ± 4.2). All fathers reported scores in clinical range, with one subject (1.3%) described as “mild,” 56 “moderate” (70.9%), and 22 “severe” (27.8%). For symptoms of PPND, considering total sample, severity of depressive symptoms, was at the upper normal limit (mean score ± S.D. = 59.2 ± 33.1) and according to cutoff, in 35 subjects “normal adjustment” (44.3%), “significant symptoms” (13.9%) and “positive” in 33 (41.8%). We find a positive correlation among total score of STAI-Y and PDSS subscales, in particular section of Anxiety/Insecurity (p = .011), Emotional Liability (p = .007), Cognitive Impairment (p = .023), and Loss of Self (p = .012). Conclusions Trait-anxiety, as a personality dimension, is included in neuroticism, that is one of the risk factors of the clinical condition of prenatal depression. In our study, we found a level of pathological trait anxiety, assessed in the post-partum phase. This confirms the stability of the trait anxiety construct, as a dimensional component of the personality and the findings, may be useful for promote early intervention programs for psychological support of parents, focused on individual differences in anxiety vulnerability.

Fine particular matter and its constituents in air pollution and gestational diabetes mellitus

BackgroundAmbient air pollution has been linked to the development of gestational diabetes mellitus (GDM). However, previous studies provided inconsistent findings and no study has examined the effects of complex chemical constituents of the particular matter on GDM, especially in developing countries. Therefore, we aim to investigate the associations of exposure to PM2.5 (particular matter ≤ 2.5 μm) and its constituents with GDM, and to identify susceptible exposure window in a large survey in China. MethodsThe China Labor and Delivery Survey was a cross-sectional investigation conducted in 24 provinces in China between 2015 and 2016. A random sample of all deliveries in each participating hospital was selected and detailed obstetric and newborn information was extracted from medical records. Average concentrations of PM2.5 and six constituents (organic matter, black carbon, sulfate, nitrate, ammonium and soil dust) were estimated (1 km × 1 km) using a combined geoscience-statistical model. GDM was diagnosed based on an oral glucose tolerance test (OGTT) between 24 to 28 weeks of gestation and according to IADPSG criteria. Generalized linear mixed models were used to adjust for potential confounders. ResultsA total of 54,517 subjects from 55 hospitals were included. The incidence of GDM was 10.8%. An interquartile range (IQR) increase in PM2.5 exposure in the 2nd trimester of pregnancy was associated with an increased GDM risk in the single pollutant model, [adjusted odds ratio (aOR) = 1.11 and 95% confidence interval (CI): 1.01–1.22]. Exposure to organic matter (aOR = 1.14; 95%CI: 1.05–1.23), black carbon (aOR = 1.15; 95%CI: 1.07–1.25) and nitrate (aOR = 1.13; 95%CI: 1.02–1.24) during 2nd trimester were associated with increased risks of GDM. Associations between constituents and GDM were robust after controlling for total PM2.5 mass and accounting for multi-collinearity. ConclusionsExposure to PM2.5 in 2nd trimester of pregnancy was associated with an increased risk of GDM. Organic matter, black carbon and nitrate may be the main culprits for the association.

Associations of Maternal Non-Nutritive Sweetener Intake During Pregnancy with Childhood BMI Trajectory

Abstract Objectives To examine the extent to which non-nutritive sweetener (NNS; e.g., aspartame) intake during pregnancy is associated with offspring BMI z-score trajectory from birth to 15 years. Methods We included 1683 mother-child pairs from Project Viva, a prospective pre-birth-cohort recruited in 1999–2002 in Massachusetts. The main exposure was maternal NNS intake assessed in the 1st and 2nd trimesters of pregnancy using a food frequency questionnaire. We defined NNS as servings/day of diet soda + NutraSweet (aspartame packets) averaged across 1st and 2nd trimesters. We used linear regression models to examine associations of maternal NSS intake with offspring BMI z-score at each in-person research visit (birth, 6 months, 3 years, 7 years, and 12 years). We also used mixed-effects models to examine associations with BMI z-score trajectory from birth to 15 years, including both research and clinical measures of BMI for 1570 participants with ≥3 BMI z-score values. We adjusted all models for maternal pre-pregnancy BMI, age, race/ethnicity, education, parity, and pregnancy smoking status. Results 70% of mothers were white and mean (SD) pre-pregnancy BMI was 24.6 (5.2) kg/m2. Mean (SD; IQR) intake of NNS was 0.23 (0.55; 0.22) servings/day. While maternal NNS intake (per servings/day) was not associated with BMI z-score at birth (β −0.03 units; 95% CI −0.14, 0.08), NNS was associated with higher BMI z-score at 6 months (β 0.17; 0.06, 0.28), 3 years (β 0.13; 0.03, 0.24), 7 years (β 0.16; 0.04, 0.29) and 12 years (β 0.16; 0.01, 0.31). Based on the BMI z-score trajectory, the associations of NNS intake (Q4 vs. Q1) with BMI z-score became stronger with increasing age from 3–14 years (pinteraction with age: <0.01); e.g., 3 years (β 0.13; 0.02, 0.23), 7 years (β 0.24; 0.11, 0.37) and 12 years (β 0.38; 0.20, 0.57). Conclusions Our findings showed higher maternal NNS intake during pregnancy was associated with higher BMI z-score from childhood to early adolescence, and the associations strengthened with increasing age. Funding Sources US National Institutes of Health (R01 HD034568, UH3 OD023286).

0859 Types Of Childhood Maltreatment And Sleep Regulation During Pregnancy

Abstract Introduction Pregnant women with history of childhood maltreatment would have around 2-fold increased odds of poor subjective sleep in comparison to pregnant women without history of trauma (Gelaye et al., 2015). Our aim was to evaluate whether different types of childhood maltreatment were associated with poorer subjective and objective sleep regulation during the second trimester of pregnancy. Methods Sleep regulation between 18-20 weeks of gestation was assessed in a sample of 55 expectant mothers, including 31 women exposed to childhood maltreatment. Three measures of sleep were administered: 7-day actigraph measures (Mini-Mitter/Respironics), 7-day sleep diary and the completion of Pittsburgh Sleep Quality Index. Childhood maltreatment was assessed using the Chilhood Trauma Questionnaire. Generalized linear regression models were used to examine the associations between sleep measures and types of childhood maltreatment after adjusting for confounding variables (e.g., maternal age, maternal wellbeing, education attainment and family income). Results Among the 31 participants with history of childhood maltreatment, 71% (n=22) reported emotional abuse, 26% (n=8) physical abuse, 39% (n=12) sexual abuse, 42% (n=13) emotional neglect and 65% (n=20) physical neglect. Pregnant women with childhood emotional abuse had around 2.8 higher score on PSQI in comparison to pregnant women without childhood emotional abuse (P<0.003). For objective sleep measures, pregnant women with childhood sexual abuse had around 1 hour less of nocturnal sleep (P<0.004), 30 minutes more nocturnal awakenings (P<0.03) and 6% less of sleep efficiency (P<0.01) compared with pregnant women without childhood sexual abuse. Conclusion Emotional abuse during childhood was associated with poorer perceived sleep quality during the 2nd trimester of pregnancy while childhood sexual abuse was particularly associated with objective measures of sleep regulation. Future larger studies are needed to confirm the impact of the different types of childhood maltreatment on maternal sleep quality during pregnancy. Support Social Sciences and Humanities Research Council (SSHRC, 2018-2020, Canada)

Multilevel Analysis of the Influence of Maternal Smoking and Alcohol Consumption on the Facial Shape of English Adolescents.

This cross-sectional study aims to assess the influence of maternal smoking and alcohol consumption during pregnancy on the facial shape of non-syndromic English adolescents and demonstrate the potential benefits of using multilevel principal component analysis (mPCA). A cohort of 3755 non-syndromic 15-year-olds from the Avon Longitudinal Study of Parents and Children (ALSPAC), England, were included. Maternal smoking and alcohol consumption during the 1st and 2nd trimesters of pregnancy were determined via questionnaire at 18 weeks gestation. 21 facial landmarks, used as a proxy for the main facial features, were manually plotted onto 3D facial scans of the participants. The effect of maternal smoking and maternal alcohol consumption (average 1–2 glasses per week) was minimal, with 0.66% and 0.48% of the variation in the 21 landmarks of non-syndromic offspring explained, respectively. This study provides a further example of mPCA being used effectively as a descriptive analysis in facial shape research. This is the first example of mPCA being extended to four levels to assess the influence of environmental factors. Further work on the influence of high/low levels of smoking and alcohol and providing inferential evidence is required.

Breast Symptoms After Pregnancy Loss and Abortion: An Observational Study [03J

INTRODUCTION: We aimed to determine the prevalence, duration and bother of breast symptoms (engorgement, tenderness and leakage) after 1st and 2nd trimester pregnancy loss and abortion; an under-studied area in obstetrics and gynecology. METHODS: We enrolled a convenience sample of 86 patients seen for pregnancy loss and abortion services at the Duke Family Planning Clinic. Participants were surveyed using the Bristol Breast Symptoms Inventory on the day of medical or surgical abortion, after three to four days, and at two weeks. RESULTS: Of the patients enrolled, 59 were in their 1st trimester and 27 were in their 2nd trimester. The average age was 32; the majority of patients had a prior pregnancy and were white or African American. At time of presentation, 42% reported engorgement, 61% reported tenderness, and 6% reported leakage. The majority of patients with tenderness or engorgement reported the symptoms as bothersome and this proportion increased as time progressed. First trimester patients’ symptoms decreased over time, while symptoms persisted for 2nd trimester patients. At two weeks, 40% of 2nd trimester patients reported engorgement, 50% reported tenderness, and 20% reported leakage. There were no differences in symptoms by route of or reason for abortion. CONCLUSION: Breast engorgement and tenderness are common and bothersome following pregnancy loss and abortion. Breast symptoms can persist for many patients with pregnancy loss or abortion in the 2nd trimester. Determining those at higher risk for breast symptoms and adapting procedural counseling to address these symptoms may improve patient-centered care.

A Seromolecular Study on the Prevalence of Cytomegalovirus in Pregnant Women Living in Golestan Province, Iran

Background: Infection with cytomegalovirus (CMV) is highly frequent during pregnancy in human beings, which mostly results in preterm birth. Objectives: The current study aimed at comparing serological and molecular methods to determine the frequency of CMV infection in pregnant women admitted to hospitals in Golestan Province, Northern Iran. Methods: The study was conducted on 315 blood samples collected from pregnant women. After completion of the screening test questionnaire, CMV-IgG, CMV-IgM, and CMV-IgG avidity tests were performed to determine the seropositivity prevalence of CMV. Finally, after DNA extraction, the PCR technique was employed to detect the CMV genome in the samples. Results: Out of the studied women, 81.2% were positive for CMV-IgG and CMV-IgM, but only 8.2% had positive results in the molecular detection of CMV, out of which 61.9% had a history of abortion. In terms of the correlation between ethnicity and infection with CMV, 66.7% of positive samples belonged to Fars ethnic group. The relationship between ethnicity and occupational status in terms of CMV infection revealed that 85% of Fars and 29% of Turkmen housewives were positive for CMV. In terms of the relationship between ethnicity and age, 35% of pregnant women from Fars and 42% from Turkmen ethnic groups were over 30 years. Furthermore, the results showed that 71% of Fars and 42% of Turkmen pregnant women were infected with CMV during the 2nd trimester of pregnancy. Among all these variables, a significant relationship was observed only between the age of pregnant women and infection with CMV (P = 0.045). Conclusions: The current study results showed that despite the increasing frequency of CMV infection in pregnant women, seropositivity, and even higher titers of CMV-IgG have no predictive value for active CMV infection. Concerning the importance of rapid and definitive diagnosis of the disease before the emergence of manifestations, molecular techniques could be of great help as they are effective in the diagnosis of infection with smaller amounts of the pathogenic genome.

What Accounts for Physical Activity during Pregnancy? A Study on the Sociodemographic Predictors of Self-Reported and Objectively Assessed Physical Activity during the 1st and 2nd Trimesters of Pregnancy.

Physical activity (PA) during pregnancy has positive health implications for both mother and child. However, current literature indicates that not all pregnant women meet the international recommendations for PA (at least 150 min/week of moderate-to-vigorous PA). The main objective of this study was to assess PA levels among pregnant women in the city of Donostia-San Sebastian and identify their main sociodemographic predictors. We recruited 441 women in the 12th week of pregnancy from the local public obstetric health services. Women wore an accelerometer for one week during two separate time points (1st and 2nd trimesters of pregnancy) and completed a questionnaire assessing several sociodemographic variables as well as self-reported PA. With this information, we estimated women’s overall PA levels during both time points. The fulfillment of PA recommendations raised up to 77% and 85% during the first and second trimesters, respectively. We found that a higher number of children and a greater preference for exercise positively predicted light-to-moderate PA, being the most consistent predictors. The availability of a greater number of cars negatively predicted moderate-to-vigorous PA.

Effectiveness of Oral Health Promotion by Community Health Workers in Reducing Periodontal Diseases among Pregnant Women

Background: Poor periodontal conditions among pregnant women might be a risk factor for adverse pregnancy outcomes which include preeclampsia, preterm delivery, intrauterine growth restriction, and fetal demise (stillbirth). Aim: To assess the effectiveness of oral health promotion by community health workers in diminishing periodontal diseases among pregnant women in rural areas of Jammu District. Methodology: In this community-based cluster randomized controlled study, Jammu district was divided into 5 administrative provinces with a total of 16 PHCs. In our study baseline assessment of Oral Health-related Knowledge, Attitude and Practices, and Oral health status using Oral Hygiene Index was done among pregnant women. Trained ASHA workers served as a medium to impart oral health education to pregnant females on a regular basis. After 3 months of follow up in the 2nd trimester, again oral health-related knowledge, attitude and practices, and oral health status using Oral Hygiene Index were assessed and oral prophylaxis was done for all pregnant women. After 4-5 months birth outcomes were collected at PHC's. Results: The knowledge about oral health was poor in pregnant women, and it improved after providing health education in pregnant women. Scaling alone as an independent variable did not influence the reduction in the preterm birth week (p= 1.000) and birth weight (p=0.113) at 2ndtrimester of pregnancy. Conclusion: Sociocultural factors, illiteracy, misconception, and the extra burden of work on ASHA workers are the main reasons for the ineffective transfer of knowledge and very little change in oral health behavior in pregnant women.

Giant uterine leiomyoma in a pregnant woman – case study and review of literature

AbstractThe case of successful pregnancy outcome in a 39-year-old nulligravida with an enormous leiomyoma is presented. At 16th week of gestation patient began to complain of dyspnoea and abdominal pain. Due to rapid growth, high vascularization, worsening pain, respiratory symptoms and limited conditions for foetal development, surgery was taken. Repeat sonography was performed at the 20th week and normal fetal development consistent with a 2nd trimester pregnancy was observed. Singular fibroids 1–5 cm in diameter were visualized and no tumor growth was noted when compared with subsequent ultrasound studies. At the 39th week, the patient was referred to the hospital for preparations towards elective cesarean section due to a breech presentation. During the planned cesarean section, numerous subscapular fibroids were observed which were left without intervention. The patient delivered a live female neonate, in a good condition, weighting 3280 g. There were no complications during the surgery and the postpartum period.

Associations of acetaminophen use during pregnancy and the first year of life with neurodevelopment in early childhood.

Over-the-counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children. Estimate associations of prenatal and early-life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts. The American Project Viva cohort (1217 mother-child pairs enrolled 1999-2002) assessed cognition at approximately 3years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother-child pairs) assessed cognition at 2years using the INTERGROWTH-21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre-pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex. In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (β -1.51, 95% CI -2.92, -0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER-NDA motor scores (β 0.02; 95% CI -0.05, 0.09) and was associated with higher INTER-NDA total scores (β 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations. Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.

Ultrasound assessment of maternal adipose tissue during 1st trimester screening for aneuploidies and risk of developing gestational diabetes.

The objective of the present study is to compare the sonographic measurement of subcutaneous adipose thickness and visceral adipose thickness during 1st trimester screening for aneuploidies between non-diabetic pregnant women and patients who develop 1st trimester or 2nd trimester gestational diabetes mellitus (GDM). Adipose thickness was measured by transabdominal ultrasound imaging in pregnant women attending our clinic for screening for fetal aneuploidies between 11 and 13weeks of gestation. During the 1st trimester all patients were evaluated for fasting glycemia in accordance with the International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommendations. Patients with confirmed fasting glycemia (FPG) ≥92mg/dL were diagnosed as 1st trimester GDM. Patients with FPG<92mg/dL underwent a 75-g oral glucose tolerance test between 24 and 28weeks. The study population included 238 non-diabetic women, 29 women with 1st trimester GDM and 28 women with 2nd trimester GDM. Mean subcutaneous adipose thickness and visceral adipose thickness values in non-diabetic women were 9.8mm (standard deviation [SD=4.9) and 7.2mm (SD=3.5), respectively. Values in women with 1st trimester GDM were 12.8mm (SD=6.5) and 9.9mm (SD=4.4). In the 2nd trimester GDM group, the mean subcutaneous adipose thickness was 11.1mm (SD=4.6) and the mean visceral adipose thickness 10.5mm (SD=5.3). Multiple logistic regression analysis showed that visceral adipose thickness, but not subcutaneous adipose thickness, was significantly and independently associated with both 1st trimester GDM (OR 1.15, 95% CI 1.02-1.29) and 2nd trimester GDM (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.05-1.34). Sonographic thickness of maternal visceral adipose tissue was greater in women with GDM than in non-diabetic patients, independently of other known risk factors associated with GDM in the 1st and in the 2nd trimester of pregnancy. Thus, this measurement may be considered of clinical use in 1st trimester screening.

КЛИНИКО-ЛАБОРАТОРНАЯ ХАРАКТЕРИСТИКА НОВОРОЖДЕННЫХ ОТ МАТЕРЕЙ, ПЕРЕБОЛЕВШИХ ОСТРЫМ ВИРУСНЫМ ГЕПАТИТОМ В И ОСОБЕННОСТИ РЕАБИЛИТАЦИИ

Relevance. Viral hepatitis in women during pregnancy is characterized by etiological diversity and has the entire spectrum of manifestations characteristic of HB infections. In the structure of viral hepatitis in pregnant women, viral hepatitis B accounts for up to 70 %. In case of a woman's illness, infection of newborns during pregnancy is a leading factor for the development of HB and HC - a viral infection in children. At the same time, the nature of specific immunological markers in the blood of the mother and child is of particular importance for the development of neonatal NV or HC-viral infection. Objective: assessment of the rehabilitation of children from mothers with acute viral hepatitis B at various stages of pregnancy based on the study of the clinical and laboratory characteristics of this infection. Materials and methods.The study included 45 children whose mothers suffered from acute viral hepatitis during pregnancy. The diagnosis was verified in all children according to the data of clinical and laboratory studies with the determination of HBsAg, HBeAg, DNA, RNA of viral hepatitis. Results. The first group consisted of 16 (35.5%) children whose mothers had HBsAg in their blood. HB viral infection developed in the third trimester of pregnancy, childbirth took place in the acute period of the disease at the end of the third week of the icteric period. The second group – 19 (42.3 %) newborns, whose mothers also fell ill in the third trimester of pregnancy, but childbirth took place later on the third week of the icteric period 15 (33.3 %) or in the period of early convalescence 4 (8.8 %). At the same time, HBsAg in the blood of all mothers continued to be determined during the early and late period of convalescence. Unlike the newborns of the first group, only 2 (4.4 %) children in the second group had HBsantigenemia at the 2nd week of life. In 2/3 of the examined newborns, antibodies to HBsAg were detected in cord blood or in serum taken in the first days of life. At the same time, the mothers had no antibodies, despite the presence of HBsAg. It is necessary to pay special attention to the fact that in the presence of antibodies to HBsAg in the umbilical cord blood in these children of HBsAg, there was no antigenemia during the follow-up during the year. Antibodies to HBsAg were re-detected at the age of 5-6 months and only in 3 (6.6 %) children at the age of 12 months. Mothers of 10 (22.2 %) newborns of the 3rd group were ill with HBV infection in the 2nd trimester of pregnancy and childbirth took place during the period of convalescence, after 6-7 months after clinical recovery and release from HBsantigenemia. However, these infants had anti-HBs in the absence of HBsAg, which persisted for 3-6 months after birth. Conclusion: the above requires rehabilitation measures in newborns from mothers who have had acute viral hepatitis B during pregnancy in order to prevent the development of complications and chronicity of the process.

Perinatal outcomes of second trimester antenatal genital bleeding

Objective: To evaluate the prognosis of singleton pregnancies complicated by genital bleeding during the 2nd trimester and to identify the factors associated with poor perinatal outcome. Materials and Methods: We conducted a retrospective study (January 2009 to December 2012), which included all women presenting with midtrimester bleeding (15 to 27 weeks of gestation). The cases were compared with women without bleeding, who delivered in our center during the same period. Results: Ninety-seven women were included (0.57% of the overall singleton births). An underlying placental cause was discovered by ultrasound in 56% of the cases (low-lying placenta, partially detached placenta or a combination of both of these pathologies). We report a significantly increased rate of preterm birth (47.4% vs. 12.2%; RR=3.9), perinatal mortality (11.3% vs. 1.3%; RR=8.8), PPROM (16.5% vs. 3.7%; RR=4.5; CI 95% [2.8-7.1]), and cesarean section (42.3% vs. 21%; RR=2; CI 95% [1.6-2.5]) in the bleeding group. The factors associated with preterm birth were recurrent bleeding (OR=4.7), gestational age &gt; 22 WG at the first bleeding (OR=3.7), and low-lying placenta. Conclusion: Despite a low incidence, the occurrence of bleeding in the 2nd trimester of pregnancy should alert the physician because of increased perinatal morbimortality. These patients may thus require increased monitoring.

73 Within and between animal variation in supplement intake with the use of a novel precision feeding system for beef cattle

Abstract Survey data suggests that in Western Canada, approximately 62% of forage samples may not meet energy requirements for gestating beef cows in 2nd trimester of pregnancy. Individual supplementation via a precision feeder would improve animal productivity and welfare. A CV of 30% was selected as a threshold for acceptable variation based on previous studies, which reported a CV of 41% for supplements hand-fed to grazing animals. Over three, 14-d experimental periods, precision feeders were used to deliver and monitor consumption of the following supplements to 24 steers (375 kg; n = 8 per pen): 1) supplementation of low protein forage (5.5% CP) with commercial pellets (1 kg hd-1d-1 with and without flavoring); 2) supplementation of low protein forage (5.5% CP) with processed pea screening powder (PPSP), sunflower screenings, and flax screenings provided at 0.57, 1.04, and 1.34 kg hd-1d-1, respectively; and 3) supplementation of low energy forage (41.4% TDN) with wheat screenings, wheat bran, and quinoa dockage all provided at 2.61 kg hd-1d-1. Feeding commercial pellets without flavoring resulted in within animal CVs (15.12% and 13.15%) and between animal CVs (14.78% and 12.68%) similar to pellets with flavoring (13.98% within and 12.85% between animal CV). Steers offered PPSP had significantly higher within and between animal CV (31.05% and 31.41%, respectively) than was observed for animals offered sunflower screenings (14.98% within and 18.30% between animal) and flax screenings (11.19% within and 16.03% between animal). Within and between animal CV was 6.99% and 7.14% for wheat screenings, 10.47% and 11.77% for wheat bran, and 10.07% and 10.42% for quinoa dockage. Intake CV for all supplements was below 30% except for PPSP which may have resulted from the powdery texture or low amount offered relative to other feedstuffs, indicating that the precision feeders are an effective system to deliver supplements on an individual animal basis.

Profile of oral manifestations, oral hygiene, and nutritional status in pregnant women

Introduction: The pregnancy condition leads to few changes in women’s bodies, such as hormonal, physiological, and diet. These changes also manifest in dental and oral health. Hormonal changes affect the susceptibility of oral mucosal tissue, whereas emotional and dietary changes alter the pattern of dietary intake, dental cleaning, oral hygiene, and nutritional status. The purpose of this study was to discover the profile of oral manifestations, oral hygiene, and nutritional status in pregnant women. Methods: The population of the study was the pregnant women who visited the Garuda Community Health Centre in Bandung. Subjects were pregnant women aged 17-43 years old. The samples must meet the inclusion criteria of good health status, and the exclusion criteria were no systemic abnormalities, and not currently under long-term antibiotic therapy. The research design was a cross-sectional observation. Indicators measured in this survey were the profiles of oral manifestations, oral hygiene status which assessed using OHI-S, and nutritional status of pregnant women using haemoglobin (Hb) and Body Mass Index (BMI) level. Results: Oral manifestations found in pregnant women were tongue disorders and ulceration, with the coated tongue as the most frequently detected manifestation, and the least found was recurrent aphthous stomatitis, whereas the oral hygiene of pregnant women was categorised as good in the 1st and 2nd-trimester of pregnancy. However, it was found to be moderate in the 3rd trimester. In respect of the Hb level, the nutritional status of the pregnant women was averagely good. By contrast, the BMI score revealed that pregnant women was found of having overweight during the 2nd and 3rd trimester. Conclusion: The most frequently found oral manifestation in pregnant women is coated tongue, while the oral hygiene is categorised as good on the first two trimesters, and the nutritional status in the last two trimesters is considered as overweight.Keywords: Oral manifestation, oral hygiene, nutritional status.