Disease In Pregnancy Research Articles

Effect of thyroid disease in pregnancy on fetal development and neonatal health

Thyroid disease is one of the most common diseases in pregnant women.Thyroid diseases during pregnancy mainly include hypothyroidism and hyperthyroidism.Thyroxine in mothers flows throughout the placenta throughout pregnancy.Thyroxine plays an important role in fetal development, especially in brain development.In the early stages of pregnancy, thyroid hormones required for fetal growth and development are entirely dependent on the mother.Untimely treatment or poor control of thyroid diseases during pregnancy will not only increase the risk of adverse pregnancy complications, but also adversely affect the intelligence development and thyroid function of fetuses and neonates.Therefore, attention should be paid to the diagnosis and treatment of thyroid diseases during pregnancy in order to reduce the harm to future generations.In addition, for neonates born to mothers with thyroid diseases during pregnancy, attention should be paid to physical examination, assessment of intellectual development and monitoring of thyroid function are required. Key words: Thyroid disease; Pregnancy; Fetus; Infant, newborn

Research progress on health education in patients with thyroid disease in pregnancy

Based on the latest research results at home and abroad, the article first describes the epidemiological status of thyroid diseases in pregnancy, and then points out the function and importance of health education. Then by analyzing the three health education modes of the disease, this paper brings forward the information technology platform model. Finally, it discusses the current problems in the health education of the disease. And on this basis, it gives some advice on the development of health education in patients with thyroid diseases during pregnancy in our country, in order to provide a reference for effective improvement of adverse pregnancy outcomes and the realization of prenatal and postnatal care. Key words: Pregnancy; Thyroiddisease; Health education; Solution-focusedapproach; Information education

The clinical characteristic and anesthesia management of cerebrovascular disease during pregnancy: a retrospective analysis

Objective To investigate the clinical characteristic and anesthesia management in patients with pregnancy complicated with cerebrovascular disease. Methods We reviewed the clinical data, anesthesia management and outcome of pregnant women with cerebrovascular disease retrospectively from June 2010 to December 2017 in Beijing Tiantan Capital Medical University. Results A total of 30 cases of pregnant women with cerebrovascular disease were collected, including 5 cases of ischemic cerebrovascular disease: 3 cases of cerebral infarction, 2 cases of cerebral venous sinus thrombosis, 25 cases of hemorrhagic cerebrovascular disease, 4 cases of moyamoya, 1 case of preeclampsia, 4 cases of aneurysms, 13 cases of arteriovenous malformations, 3 cases of arteriovenous vascular malformation. Five cases underwent neurosurgery before cesarean section. Four cases of caesarean section during the same period of emergency neurosurgy, 6 cases of caesarean section after neurosurgery, and 15 cases of non-neurosurgical treatment after caesarean section. Thirty cases of obstetric anesthesia, including 3 cases in the second trimester and 27 cases in the second trimester, 16 cases of spinal anesthesia, 11 cases of general anesthesia. Two cases resulted in maternal death, 1 case resulted in fetal death. Conclusions The management of cerebrovascular diseases in pregnancy should be closely coordinated and managed by obstetrician, anesthesiologist and neurosurgeon. The patient's neurological symptoms, intracranial lesions (hematoma size, site), gestational age and fetal maturity, as well as the desire of pregnancy should be fully evaluated to timely terminate pregnancy and neurosurgical intervention and improve maternal fetal outcome. Key words: Pregnancy; Cerebrovascular disease; Anesthesia

Acute respiratory distress syndrome due to Tsutsugamushi disease in pregnancy: a case report

Acute respiratory distress syndrome due to Tsutsugamushi disease in pregnancy: a case report

Perioperative management of obstetrical surgeries in women having coexisting cardiovascular disease: our experience

Background and aim: Coexisting cardiovascular disease in pregnancy is associated with high maternal morbidity and mortality. These patients pose a great challenge to both anesthesiologist and obstetrician. Present study was aimed at reviewing the perioperative management and outcome of obstetrical surgeries in women who had coexisting cardiovascular disease in a tertiary care teaching institute. Materials and Methods: Departmental database of all pregnant patients with coexisting cardiovascular diseases who underwent obstetrical surgeries during January 2011 to August 2016 were reviewed. Patients functional status, obstetrical history, stage of labor, type of anaesthesia, monitoring, hemodynamics, post operative care and baby outcome were noted. Data are expressed in absolute number and percentage scale and INSTAT software was used for measuring central tendencies and dispersion. Results: A total of 22 women (mean + Standard deviation: SD age 26.18 + 4.78 years) were found eligible and included for analysis. 21(95.45%) patients underwent cesarean section and one medical termination of pregnancy. 68.18% cases were done under subarachnoid block. Most of the patient needed post operative high dependant unit care, one patient developed mild pulmonary edema and no maternal and fetal deaths were noted. All the babies were born with APGAR > 7 at 1 min. No patient was managed using pulmonary artery catheter or continuous cardiac output monitoring. Conclusion: Pregnant patients with coexisting cardiovascular disease need multidisciplinary approach, timely delivery and intensive therapy in perioperative period. They can be safely delivered under subarachnoid blocks. Pulmonary artery catheterization is probably not an essential for hemodynamics management of such patients in perioperative management.

Gestation-specific reference intervals for thyroid function tests and the clinical significance for thyroid function monitoring through different periods of pregnancy

Objective To investigate the gestation-specific reference intervals (GRIs) and dynamic changes of thyroid function at different gestational ages in Chongqing. Methods Combining self-sequential longtitudinal with cross-sectional study, the serum samples from 640 pregnant women with different gestational age were collected from June 2014 to September 2015 in the Third Military Medical University. The free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (TG), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TGAb) were detected by the direct chemiluminescence method. According to China Guideline for the diagnosis and treatment of thyroid disease in pregnancy and postpartum in 2012, the reference interval of the thyroid function was calculated. The data were analyzed by Chi square test. Results Established GRIs of thyroid function during pregnancy in Chongqing: The GRIs was 3.68-5.59 pmol/L for FT3, 9.34-17.02 pmol/L for FT4, 0.18-5.26 mIU/L for TSH in 6-9+ 6 weeks of pregnancy; the GRIs was 3.69-6.03 pmol/L for FT3, 8.42-15.75 pmol/L for FT4、0.09-4.85 mIU/L for TSH in 10-13+ 6 weeks of pregnancy; the GRIs was 3.24-5.46 pmol/L for FT3, 6.50-14.24 pmol/L for FT4, 0.11-5.13 mIU/L for TSH in 14-27+ 6 weeks of pregnancy; the GRIs was 3.06-5.05 pmol/L for FT3, 6.12-11.69 pmol/L for FT4, 0.75-3.67 mIU/L for TSH in 30-34 weeks of pregnancy; the GRIs was 2.96-5.00 pmol/L for FT3, 6.26-11.36 pmol/L for FT4, 0.84-5.54 mIU/L for TSH in 36-40 weeks of pregnancy. Screening by GRIs, the prevalence of thyroid dysfunction was 8.75% (46), however, the prevalence was 37.07% (195) in according with the guidelines, χ2=120.5, P=0.000. The overdiagnosis rate was 28.32%(149/526). Using the guidelines of thyroid disease and our GRIs, the thyroid disease was found 116 (22.05%) and 30(5.70%) in the first screening. Moreover, the thyroid disease was found 79(19.27%) and 10(3.23%) during the repeat screening in the normal population. Conclusions Using the GRIs for thyroid function tests in normal singleton pregnant women could reduce the risk of over diagnosis. The detection rate of repeat screening of TPOAb negative patients was close to the first screening detection rate, and repeated screening could reduce the risk of missed diagnosis for thyroid dysfunction in pregnancy women.(Chin J Lab Med, 2016, 39: 511-515) Key words: Pregnancy; Reference values; Hypothyroidism; Thyroxine

Impaired placental thiamine transport in human pregnancy diseases

s / Placenta 36 (2015) A1eA60 A33 P1.65. IMPAIRED PLACENTAL THIAMINE TRANSPORT IN HUMAN PREGNANCY DISEASES Xiao Huang , Lu Hostettler , Michael Luthi , Marc Baumann , Daniel Surbek , Edgar Ontsouka , Christiane Albrecht . 1 Swiss National Center of Competence in Research, NCCR TransCure, University of Bern, Bern, Switzerland; 2 Institute of Biochemistry and Molecular Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland; Department of Obstetrics and Gynecology, University Hospital, University of Bern, Bern,

The use of ERCP during pregnancy: is it safe and effective?

Cholangitis and pancreatitis are the most gruesome complications that can be potentially fatal for the mother and fetus. The management of bile stone disease complicated with duct stones during pregnancy is challenging. Conservative treatment instead of surgery has always been advocated due to the increased risk for fetal compromise. Minimally invasive therapy with ERCP has been suggested as an effective therapeutic option for the management of pancreaticobiliary diseases during pregnancy. The main topics of discussion are the risks stemming from the endoscopic procedure itself, drugs used for sedation and the adverse effects of radiation exposure on the fetus. In this manuscript, we want to present the efficiency and feasibility of the ERCP for the management of hepatobiliary and pancreatic diseases in pregnancy.

Effects of mothers suffering from disease in pregnancy on preterm infants

Objective To investigate the effects of mothers suffering from disease on the preterm infants. Methods One hundred and eighty-seven premature neonates in accordance with inclusion criteria, who were admitted to the Department of Pediatrics, Peking University People's Hospital from January to December 2012, were chosen as study samples.The preterm infants were divided into 2 groups: mothers with pregnancy disease group(observation group) and mothers without pregnancy disease group(control group). Then the general condition, causes of preterm birth as well as complications of preterm infants in the 2 groups were compared.In addition, the main types of pregnancy diseases of mothers were also analyzed. Results The incidence of caesarean section delivery[71.8%(84/117 cases) vs 52.9%(37/70 cases)] and fetal distress[9.4%(11/117 cases) vs 1.4%(1/70 cases)] were higher in the observation group, the differences were statistically significant(χ2=6.878, P<0.01; χ2=5.246, P<0.05). However, the proportion of infants appropriate for gestational age in the observation group was less[76.0%(89/117 cases) vs 88.6%(62/70 cases), χ2=4.404, P<0.05]. Chronic hypertension, pregnancy-induced hypertension, gestational diabetes and diabetes were the main types of pregnancy diseases of the mothers with preterm infants, accounting for 49.6%(58/117 cases), 23.0%(27/17 cases), 38.5%(45/117 cases) and 14.5%(17/117 cases), respectively.The ratio of premature birth due to pregnancy diseases was 51.3%(60/117 cases) in the observation group, significantly higher than other causes.While compared with control group, the incidence of premature rupture of the fetal membrane was lower in the observation group[18.80%(22/117 cases) vs 47.10%(33/70 cases), χ2=16.94, P<0.01]. Compared with the control group, the incidence of neonatal asphyxia[13.70%(16/117 cases) vs 2.90%(2/70 cases), χ2=5.892, P<0.05] and hypoglycemia[17.10%(20/117 cases) vs 4.30%(3/70 cases), χ2=6.661, P<0.05] were higher in the observation group, but the neonatal hyperbilirubinemia was lower[6.80%(8/117 cases) vs 17.10%(12/70 cases), χ2=4.87, P<0.05]. Conclusions Hypertension and diabetes are the main types of pregnancy diseases of mothers with premature offsprings.Mothers suffering from pregnancy diseases can affect the fetus intrauterine growth.At the same time, it also increases the possibility of perinatal hypoxia, hypoglycemia and cesarean section. Key words: Caesarean section; Perinatal hypoxia; Pregnancy; Preterm infant

Clinical analysis of 56 gestational hypertension patients with heart disease

Objective To investigate the early diagnosis and preventive measures for gestational hypertensive patients with heart disease.Methods Clinical data of 56 gestational hypertensive patients with heart disease were retrospectively analyzed.Results Aggressive treatment of maternal deaths occured in 1 case,2 cases of stillbirth,and the other 55 cases had good maternal prognosis.Conclusion Treatment of hypertensive heart disease in pregnancy should be based on the strong heart vasodilator,diuretic,caution magnesium sulfate.In the control of heart failure after 6-8h,shall terminate the pregnancy.Active treatment of the primary disease,to correct anemia and hypoproteinemia,early diagnosis of heart failure and strictly control expansion of indications can help to improve the prognosis of hypertensive heart disease in pregnancy. Key words: Gestational hypertension; Heart disease; Heart failure

The prevention and treatment of venous thromboembolic disease in pregnancy

The prevention and treatment of venous thromboembolic disease in pregnancy

Arteriální hypertenze a gravidita. Zkušenosti z kardiologické poradny pro těhotné ve VFN

Arterialni hypertenze v těhotenstvi představuje různe typy onemocněni, mezi ktere řadime preexistujici hypertenzi, preeklampsii/eklampsii, preeklampsii nasedajici na preexistujici hypertenzi a gestacni hypertenzi. Arterialni hypertenze patři v graviditě mezi hlavni přiciny mateřske i fetalni morbidity a mortality. Cilem nasi studie bylo urcit typ, prevalenci a průběh arterialni hypertenze u souboru gravidnich kontrolovaných v poradně pro těhotne s kardiovaskularnimi chorobami. Slo o retrospektivni studii u gravidnich žen sledovaných v poradně od ledna 2006 do prosince 2009. Celkem 52 žen (13 %) s arterialni hypertenzi bylo vybrano ze souboru 408 pacientek se 413 graviditami. U 35 těhotných (67 %) slo o preexistujici hypertenzi, u sedmi (13,5 %) o gestacni hypertenzi, u dalsich sedmi (13,5 %) o hypertenzi při fenomenu bileho plastě. Preeklampsie byla diagnostikovana u tři těhotných (6 %). Až na jednu výjimku (cisařský řez ve 36. týdnu gravidity) byly vsechny gravidity ukonceny v terminu spontannim porodem. Při pravidelných kontrolach a terapii ma těhotenstvi u žen s lehkou až středně významnou arterialni hypertenzi ve větsině připadů přiznivý průběh.

Comparison of maternal interleukin-1β levels in gingival cervical fluid and Serum in women with preterm

Objective To investigate the association of periodontal diseases in pregnancy with preterm labor by comparing maternal interleukin-1β(IL-1β)levels in gingival cervical fluid(GCF)and serum in preterm labor and full-term pregnancies. Methods Twenty-eight women with preterm labor and 22 women with full-term birth were chosen.GCF samples were collected from all individuals and serum samples were collected from 12 of them,respectively.Interleukin-1β levels were measured by enzyme-linked immunoabsorbent assay(ELISA). Results IL-1β levels in GCF were significantly higher in preterm mothers than those in the full-term group[(66.66 4.50)pg/ml vs(38.77 8.14)pg/ml,P 0.05].Negative correlations were observed between IL-1β levels in GCF and the gcstational age at the onset of preterm labor (r=-0.555,P<0.05). Conclusions Periodontal infections may associated with preterm labor. Key words: Premature birth; Gingival cervicular fluid; Serum; Interleukin-1

Sexually Transmitted Diseases in Pregnancy

Sexually Transmitted Diseases in Pregnancy

Sexually transmitted diseases in pregnancy

Sexually transmitted diseases in pregnancy

Induction of Labour at Usmanu Danfodiyo University Teaching Hospital, Sokoto

Context: Induction of labour is always a therapeutic challenge in obstetrics. Objective: The aim of this study is to determine the incidence, indications and outcome of induction of labour in our obstetric unit. Study Design and Setting: Descriptive study involving 205 patients admitted for induction of labour between January 1995 and December 2000. Results: There were 6,931 deliveries within the period and 205 cases of induction of labour, giving an incidence of 3%. Hypertensive disease in pregnancy, prolonged pregnancy, and intra-uterine fetal deaths accounted for over 85% of cases of induction of labour in the unit. Induction of labour with successful vaginal delivery was achieved in 168 patients (82%). While 70 out of the 72 patients (97%) that had spontaneous uterine contractions following cervical ripening with Foley's catheter had successful vaginal delivery, only 96 of 133 patients (72%) that had uterine contractions initiated with Syntocinon drip after cervical ripening had vaginal delivery. Induction of labour was also more likely to be successful in cases of intra-uterine fetal death (95%). There was no maternal mortality in the series. Conclusion: Induction of labour accounted for only 3% of our deliveries. Hypertensive disease in pregnancy and post term pregnancy were the most common indications. Chances of vaginal delivery were higher in the group that had spontaneous uterine contractions following cervical ripening than those that had uterine contractions initiated with Syntocinon. Vaginal delivery was also more likely when the indication for induction of labour was intra-uterine fetal demise. Key Words: Labour Induction, Cervix Ripening, Delivery Outcome. [Trop J Obstet Gynaecol, 2002, 19: 74-77]

A Case of Behçet's Disease in Pregnancy

A Case of Behçet's Disease in Pregnancy

HIV DISEASE IN PREGNANCY: Ethics, Law, and Policy

Legal and ethical principles mandate that informed consent be an integral element of HIV-related education, counseling, testing, treatment, and intervention. Minimizing patient counseling and education (for economic reasons or otherwise) is likely to backfire. The presumption that a parent will act in her child's best interest, accepted in analogous contexts, should be foundational in the development of HIV policy in the obstetric and gynecologic setting. Most women, when provided with counseling, care, and confidentiality, consent to prenatal or perinatal testing and, most important, engage their families in HIV-related care and services. Because of the changing terrain of knowledge about and treatments of HIV disease, providers must thoroughly counsel women regarding the risks and benefits of available treatment and intervention.

Treating sexually transmitted diseases in pregnancy.

Treating sexually transmitted diseases in pregnancy.

Endoscopic retrograde cholangiopancreatography in pregnancy.

Pancreaticobiliary disease in pregnancy is relatively uncommon. The frequency of choledocholithiasis in pregnancy requiring intervention has been reported to be as low as one in 1200 deliveries. Traditionally, intervention in these patients has been surgical. Although surgery has an overall low morbidity and mortality for the expectant mother, it carries with it a 4- to 6-wk recovery period and a possibly increased risk of fetal wastage. Published information regarding the role and safety of ERCP in pregnancy is limited. This series of 23 pregnant patients undergoing ERCP was collected from six different medical centers. Twenty-three pregnant patients with symptomatic pancreaticobiliary disease underwent a total of 29 ERCPs (three patients had diagnostic ERCP, and 20 had therapeutic ERCP). Fifteen, eight, and six procedures were performed in the first, second, and third trimesters, respectively. The only ERCP complication was pancreatitis in one patient. There was one spontaneous abortion (3 months after ERCP) and one neonatal death; however, casual relationship to ERCP was not apparent. Diagnostic and therapeutic ERCP appears reasonably safe and effective in pregnancy. Cautious and selective use of this procedure offers a viable alternative to surgery or observation in patients with emergent pancreaticobiliary problems.