Results In Pregnant Women Research Articles

Maternal and Perinatal Outcomes in Pregnant Women with Heart Disease: A Case-Control Study.

Objective: We analyzed the obstetric and cardiac characteristics and results of pregnant women with heart disease (HD) and compared their results with those of healthy controls. Methods: In this retrospective single-center case-control study, women with HD attended between 2010 and 2018 were matched at a 1:2 ratio (according to date of delivery, parity, and singleton or twin pregnancy) with controls without heart disease treated in the same referral center. Results: We identified 141 pregnant women with HD, of whom 132 reached 22 weeks of gestation and were paired with 264 healthy controls, for a total of 396 participants and 408 newborns. Most common HDs were congenital HD (53 women), arrhythmia (46), valvular HD (35), and cardiomyopathy (16), having women with more than one coexisting HD. During pregnancy or the puerperium, 19.9% of mothers experienced a major adverse cardiac event (MACE), with 5% requiring intensive care unit (ICU) admission. The rates of cesarean section were 37.1% in the case group and 18.2% in the control group, with an odds ratio (OR) of 2.66 (95% CI = 1.66-4.26, p < 0.001). We also found a higher use of general anesthesia, with an OR of 10.73 (95% CI = 2.32-49.75, p = 0.002); more prolonged hospitalizations, with an OR of 2.91 (95% CI 1.02-8.35, p = 0.023); and a higher incidence of low neonatal weight, with an OR of 1.96 (95% CI 1.09-3.52, p = 0.012). There were no differences between groups in terms of gestational age at delivery; however, we observed greater prematurity in women with HD, without reaching statistical significance. The rate of congenital heart disease among the newborns of mothers with HD was 13.2%. Conclusions: HD increases maternal morbidity during pregnancy and it is associated with higher rates of cesarean section and low birth weight.

Proteinuria en rango nefrótico en gestantes.

Introduction: Physiological changes in pregnant women can be altered by the appearance of pathological phenomena such as proteinuria in the nephrotic range, relevant in the diagnosis of preeclampsia and glomerular disease. The objective of the present study was to describe the clinical characteristics and results of pregnant women with nephrotic proteinuria in a reference center in Cuba. Methods: The present observational, prospective, longitudinal follow-up study, which lasted 12 weeks, was conducted at the Vladimir Ilich Lenin General Hospital in Holguín, Cuba, between October 2020 and September 2022. All pregnant women with proteinuria in the nephrotic range were registered. The variables were age, body mass index at pregnancy detection, gestational age, African descent, number of pregnancies, serum creatinine, proteinuria in 24 hours at the onset of symptoms, and clinical history. Descriptive statistics are presented. Results: 48 patients entered the study. White, primigravida pregnant women predominated; the average age was 24.8 years. The average gestational time was 31.8 weeks, and serum creatinine was 94.8 µmol/L. The main personal medical history was arterial hypertension and systemic lupus erythematosus. There was no statistical association between the age groups and the persistence of proteinuria. Pregnant women with proteinuria before 20 weeks maintained it after 12 weeks postpartum, defining it as kidney disease. Pregnant women with previous high blood pressure had a 2.2 times higher risk of preeclampsia. Conclusion: In both causal groups (preeclampsia and kidney disease), there were maternal-fetal complications, highlighting induced abortion, preterm birth, intrauterine growth retardation, and low birth weight.

Pregnancy-associated changes in urinary uromodulin excretion in chronic hypertension

BackgroundPregnancy involves major adaptations in renal haemodynamics, tubular, and endocrine functions. Hypertensive disorders of pregnancy are a leading cause of maternal mortality and morbidity. Uromodulin is a nephron-derived protein that is associated with hypertension and kidney diseases. Here we study the role of urinary uromodulin excretion in hypertensive pregnancy.MethodsUrinary uromodulin was measured by ELISA in 146 pregnant women with treated chronic hypertension (n = 118) and controls (n = 28). We studied non-pregnant and pregnant Wistar Kyoto and Stroke Prone Spontaneously Hypertensive rats (n = 8/strain), among which a group of pregnant Stroke–Prone Spontaneously Hypertensive rats was treated with either nifedipine (n = 7) or propranolol (n = 8).ResultsIn pregnant women, diagnosis of chronic hypertension, increased maternal body mass index, Black maternal ethnicity and elevated systolic blood pressure at the first antenatal visit were significantly associated with a lower urinary uromodulin-to-creatinine ratio. In rodents, pre-pregnancy urinary uromodulin excretion was twofold lower in Stroke-Prone Spontaneously Hypertensive rats than in Wistar Kyoto rats. During pregnancy, the urinary uromodulin excretion rate gradually decreased in Wistar Kyoto rats (a twofold decrease), whereas a 1.5-fold increase was observed in Stroke-Prone Spontaneously Hypertensive rats compared to pre-pregnancy levels. Changes in uromodulin were attributed by kidney injury in pregnant rats. Neither antihypertensive changed urinary uromodulin excretion rate in pregnant Stroke-Prone Spontaneously Hypertensive rats.ConclusionsIn summary, we demonstrate pregnancy-associated differences in urinary uromodulin: creatinine ratio and uromodulin excretion rate between chronic hypertensive and normotensive pregnancies. Further research is needed to fully understand uromodulin physiology in human pregnancy and establish uromodulin’s potential as a biomarker for renal adaptation and renal function in pregnancy.Graphical abstract

Toxoplasmosis Test Requests and Test Results in Pregnant Women: A Research on Prenatal Screening Practices

Toxoplasmosis Test Requests and Test Results in Pregnant Women: A Research on Prenatal Screening Practices

ANTIBODY RESPONSE TO THE COVID-19 VACCINE AMONG PREGNANT WOMEN: A PROSPECTIVE STUDY

The study's objective was to investigate the antibody responses and fetal and maternal adverse effects of the Sinopharm vaccine. A prospective study was conducted in The Gynaecology Department of LUMHS Hospital Jamshoro, Hyderabad, Multan and DG Khan from January 2021 to January 2022. A total of 90 women were included in the study who were administered Sinopharm. 3/90 (3.3%) women received shots in 1st trimester, 56/90 (62%) in 2nd trimester and 31/90 (34%) in 3rd trimester. ELISA measured SARS-CoV-2 receptor binding domain (RBD) specific total antibodies and ACE2 blocking antibodies. The adverse effects on the mother and fetus were evaluated after the delivery. The vaccine administration showed no harmful effects or pregnancy-related complications like congenital anomalies, miscarriage, preterm delivery, thrombotic events, fetal death, or hypertensive disorders. SARS-CoV-2 specific total antibodies were found in 57/90 (63%) women at the time of recruitment (when receiving 1st dose); thus, they were considered to be previously infected. The whole sample was seroconverted after 2nd dose. Significantly high levels of RBD binding antibodies and ACE2 blocking antibodies were observed in previously infected women after administration of the second dose compared to uninfected individuals. The Sinopharm vaccine showed positive results in pregnant women and induced high seroconversion rates and ACE2-blocking antibodies in 2nd and 3rd trimester.

Prediction of the development of fetal growth retardation in pregnant women with chronic arterial hypertension

During intrauterine life a fetus with growth restriction does hemodynamic, metabolic and hormonal adjustments to cope with the adverse uterine environment, and these changes can become permanent and irreversible. Despite the progress in the knowledge of delayed fetal development, the biomarkers are able to identify this pathology at an early stage and stratify its severity, both before and after childbirth, are still not determined. The objective: to evaluate the prognostic value of the angiogenesis marker level, hormonal profile and Doppler examination for fetal growth restriction (FGR) in pregnant women with chronic arterial hypertension (CAH).Materials and methods. A prospective examination of 61 pregnant women with CAH 1-2 degrees was conducted, which included an analysis of the clinical and anamnestic characteristics and the study of the pregnancy course in the first trimester (11-12 weeks). To determine the level of risk factors for the FGR development the examined pregnant women were divided into groups: women with CAH with FGR (n=10), and pregnant women with CAH without FGR (n=51).Human chorionic gonadotropin (CHG), progesterone (PG) and estradiol (E) were determined in blood serum. Angiogenesis markers – placental growth factor (P1GF) as a pro-angiogenic factor and soluble fms-like tyrosine kinase (sFlt-1) as an anti-angiogenic factor were studied, the ratio of sFlt-1/PLGF (coefficient K) was calculated. All patients had Doppler examination of vascular blood flow in the left and right uterine arteries (pulsation index – PI, resistance index – RI and systolic-diastolic ratio – SDR). The ultrasound examination was done with the ultrasound machine “Mylab Six System”. Statistical analysis was performed using program Statistica® for Windows 13.0. A single-factor logistic regression analysis and a method of building logistics regression, which was evaluated by means of receive operating characteristic curve (ROC-curve) according to the area under the curve (AUC) were used to determine the prognostic level of markers, the 95 % confidence interval was calculated. Results. In the first trimester of pregnancy in women with CAH the PLGF level was &lt; 8.2 pg/ml (sensitivity – 80.0 %, specificity – 60.78 %), area under the ROC curve (AUC) – 0.697 (95 % CI: 0.566–0.808; p =0.0128), which indicate an increased risk of FGR development. The growth of sFl-1 &gt; 1802.59 ng/ml (sensitivity – 70.0 %, specificity – 64.71 %), area under the ROC-curve (AUC) 0.678 (95 % CI: 0.547–0.792; p=0.05) increase the risk of FGR development. The coefficient K in 11-12 weeks of pregnancy was ≥ 95.36 units (sensitivity – 100.0 %, specificity – 43.14 %), area under ROC-curve (AUC) – 0.735 (95 % CI: 0.607–0.840; p=0.0128), which indicate an increase the risk of FGR development. PG/PlGF ratio is 7.21 (sensitivity – 70.0 %, specificity – 70.59 %) and area under the ROC-curve (AUC) 0.702 (95 % CI: 0.571–0.812; p = 0.0118) also indicate the increase the risk of FGR development, as well as the value of the ratio of E/PLGF &gt; 138.53 (sensitivity – 100.0 %, specificity – 35.29 %) and area under the ROC-curve (AUC) 0.640 (95 % CI: 0.507– 0,759). Doppler results in pregnant women with CAH, in the presence of risk factors for FGR development, demonstrate that the CDR was not likely to differ in all groups of patients: 3.62±0.09 units in the persons with CAH and FGR (n=10) and 3.71±0.05 units in the pregnant women with CAG without FGR (n=51) in the right uterine artery; 3.63 ± 0.09 units and 3.71 ± 0.05 units in the left uterine artery, respectively (p&lt;0.05 for all values). However, if PI in the right uterine artery is more than 1.84 units and more than 1.82 units in the left uterine artery, the FGR will further develop. Conclusions. According to the results of the study, it was found that pregnant women with CAH 1-2th degrees with FGR development in the future, in the first trimester of gestation (11-12 weeks) have a decrease PlGF level, sFlt-1and the coefficient K increase. These indicators in the 11–12 weeks of pregnancy were: PlGF ≤ 8.2 pg/ml, sFlt-1 &gt; 1802.59 ng/ml, coefficient K ≥ 95.36 units, and PG/PlGF &gt; 7.21 units, E/PlGF &gt; 138.53 units and CHG/PlGF ≥ 30.14 units.In the pregnant women with CAG, in whom FGR risk will subsequently determine, the significant changes in the CDR and RI at 11-12 weeks of pregnancy are not established, but with an increase of PI more than 1.84 units in the right uterine artery and more than 1.82 units in the left uterine artery FGR will further develop.

Performance of glycated albumin as a biomarker of hyperglycemia in pregnancy: Results from the National Health and Nutrition Examination Survey 1999–2004

AimWe sought to evaluate the performance of glycated albumin (GA) as a measure of hyperglycemia in pregnant women. MethodsWe used data from 555 pregnant women aged 20–40 years who participated in NHANES 1999–2004 and did not report a pre-pregnancy diagnosis of diabetes. We used Pearson’s correlations and evaluated the area under the curve (AUC) for GA to detect elevated concentrations of random glucose, HbA1c, or fasting glucose (subset). We compared results to 1607 nonpregnant women aged 20–40 without diabetes. ResultsIn pregnant women, 1.9 % had HbA1c ≥ 39 mmol/mol (≥5.7 %), 9.1 % had random glucose ≥ 5.3 mmol/L (≥95 mg/dL), and 10.7 % had fasting glucose ≥ 5.3 mmol/L. In pregnancy, GA was poorly correlated with HbA1c (r = 0.08) and random glucose (r = 0.17). BMI was positively associated with HbA1c (r = 0.33) and random glucose (r = 0.25) but was inversely associated with GA (r = -0.27). GA had poor discrimination for detecting hyperglycemia in pregnant women, defined as HbA1c ≥ 39 mmol/mol (AUC = 0.634) or random glucose ≥ 5.3 mmol/L (AUC = 0.628). Similar patterns were observed among nonpregnant women. ConclusionsGA is not a sensitive test to screen for hyperglycemia in pregnancy. GA was inversely associated with adiposity in pregnant women without diabetes. Pregnancy-related weight gain may complicate interpretation of repeated GA measurements.

Antibody Responses Following Covid-19 Vaccine in Pregnant Women- A Prospective Study

Objective: To assess the antibody responses and adverse effects of sinopharm vaccine in pregnant women.Study Design: A prospective cohort study.Place and Duration of Study: The study was conducted in the Gynaecology Department of Ibn-e-Siena HospitalMultan, Independent Hospital Faisalabad and Mayo Hospital Lahore from January 2021 to January 2022.Materials and Methods: A total of 90 women were included in the study who were administered Sinopharm.Three out of ninety (3.3%) women received shots in 1st trimester, 56/90 (62%) in 2nd trimester and 31/90 (34%) in third trimester. Enzyme-linked immunosorbent assay (ELISA) was used to measure SARS-CoV-2 receptorbinding domain (RBD) specific total antibodies and angiotensin-converting enzyme 2 (ACE2) blockingantibodies. The adverse effects on the mother and fetus were evaluated after the delivery.Results: The administration of the sinopharm vaccine showed no adverse effects or pregnancy complicationssuch as congenital anomalies, miscarriage, preterm delivery, thrombotic events, fetal death or hypertensivedisorders. SARS-CoV-2 specific total antibodies were found in 57/90 (63%) women at the time recruitment(when receiving 1st dose); thus they were considered to be previously infected. After the second dose, allwomen were seroconverted. Significantly high levels of RBD binding antibodies and ACE2 blocking antibodieswere observed in previously infected women after administration of the second dose compared to uninfectedindividuals.Conclusion: The Sinopharm vaccine showed positive results in pregnant women and induced highseroconversion rates and ACE2 blocking antibodies in second and third trimesters.&#x0D; How to cite this: Hamayun Z, Javaid U, Ahmed R, Shehzad K, Gul PI. Antibody Responses Following Covid-19 Vaccine in Pregnant Women- A Prospective Study. Life and Science. 2022; 3(4): 196-199. doi: http://doi.org/10.37185/LnS.1.1.273

Association between perceived partner support and lifestyle in mother-father dyads expecting a first child.

BackgroundA healthy lifestyle during pregnancy is important for the health of mother and child. However, unfavorable physical activity (PA) and dietary changes are observed in pregnant women and their partner. Partner's influence on lifestyle has been reported by expectant women and men. The first aim was to analyze associations between perceived partner support on expectant parents own as well as their partner's moderate-to-vigorous intensity PA (MVPA) levels and dietary intake. Secondly, this study aimed to investigate intra-couple associations of MVPA, dietary intake and perceived support.MethodsA total of 152 heterosexual couples were recruited between week 8 and 10 of gestation by means of convenience sampling. Objective anthropometric and 7-day MVPA measurements were performed at 12 weeks of gestation. An online questionnaire was used to assess dietary intake, perceived partner support and socio-demographic characteristics. An Actor-Partner Interdependence Model for distinguishable dyads was constructed to examine the relationship between perceived partner support and both own's (i.e., actor-effect) and the partner's (i.e., partner-effect) MVPA levels, intake of fruits and vegetables, and an “avoidance food group.”ResultsFor pregnant women, perceived support from their partner was significantly associated with women's own MVPA levels (i.e., actor-effect; estimate = 0.344, SE = 0.168, p = 0.040) as well as the MVPA levels of the men (i.e., partner-effect; estimate = 0.717, SE = 0.255, p = 0.005). No significant actor- nor partner-effects were found for the expectant fathers. For none of the sexes significant actor-effects were found for fruit/vegetables and “avoidance food group” intake. For pregnant women, there was a positive partner-effect for fruit and vegetable intake (estimate = 7.822, SE = 1.842, p < 0.001) and a negative partner-effect for the “avoidance food group” intake (estimate = −16.115, SE = 3.629, p < 0.001). Positive correlations were found for perceived MVPA support (r = 0.40, p < 0.001), MVPA levels (r = 0.24, p = 0.007) and food intake from the “avoidance food group” (r = 0.28, p = 0.005) between partners.ConclusionThis study shows that male partners can act as significant facilitators for women. Partners may be an important target when promoting MVPA during pregnancy. Additionally, supportive couples seem to strengthen each other in keeping a healthy lifestyle in early pregnancy. These results justify couple-based interventions in the promotion of a healthy lifestyle during the transition to parenthood.Clinical trial registrationClinicaltrials.gov, identifier: NCT03454958.

The Evaluation of Risk Factors and Results in Pregnant Women with Intrauterine Fetal Hydrocephalus: A Single Center Experience

The Evaluation of Risk Factors and Results in Pregnant Women with Intrauterine Fetal Hydrocephalus: A Single Center Experience

Pregnancy Outcomes in Patients with Heart Valve Replacement: Sohag Perspective

Background: Management of a pregnant woman with a prosthetic heart valve requires significant contemplations, particularly concerning looking after anticoagulation. Objective: We directed this observational study to notice maternal and fetal results in pregnant women with heart valve replacement in Sohag University Hospital. Patients and methods: An observational study was done in Sohag University Hospital, 20 cases recruited in Department of Obstetrics and Gynecology during the period from April 2019 to October 2019. All cases were exposed to finish history taking, total physical assessment (general and obstetrical), obstetric US and investigations as echocardiography, PT, PC and INR. Results: The mean age of the study group was around 28 years, with a range from 18 to 38 years. The vast majority of the cases had mitral valve replaced. CS was done for 40% of the cases, followed by vaginal delivery in 35% of them, evacuation in 20% and hysterotomy in one case (5%). Hemorrhagic complications were seen in 25% of the cases, followed by thrombosis and rapid AF (10% each), then heart failure and supraventricular arrhythmias (5% each). Miscarriage before the 24th week occurred in 30% of the cases and IUFD in one case (5%). Before 14 weeks of gestation, most of the cases used heparin either UFH or LMWH, with only 35% used vitamin K antagonists. Hemorrhage was more common with MVR. Conclusion: Patients with mechanical valves have more rate of fetal misfortunes and maternal complexities. Mitral valve replacement is related with more maternal hemorrhagic complications than aortic valve alone or double valve substitution.

Evaluation of Urine and Rectovaginal Culture Results in Pregnant Women with Threatened Preterm Labor

Amaç: Doğum eyleminin 20 0/7 ile 36 6/7 gebelik haftaları arasında başlamasına erken doğum tehdidi denir. En önemli sebeplerinden biri ürogenital enfeksiyonlardır. Bu çalışmada erken doğum tehdidi ile ürogenital enfeksiyonlar arasındaki ilişkinin araştırılması amaçlanmıştır. Araçlar ve Yöntem: Ekim 2018-Ekim 2019 tarihleri arasında erken doğum tehdidi sebebiyle Kadın Hastalıkları ve Doğum servisine yatırılan 49 adet gebe çalışmaya dahil edildi. Her hastaya jinekolojik muayene yapıldı ve mikrobiyolojik inceleme için idrar ve rektovajinal sürüntü örnekleri alındı. Elde edilen veriler bir veri tabanında toplandı ve analiz edildi. Bulgular: Hastaların %24.5’inde vajinal kültürde (n=12), %16.3’ünde idrar kültüründe (n=8), %6.1’inde rektal kültürde (n=3) üreme oldu. Vajen kültürü sonuçları; 5 adet vajinal kandidiyazis (Candida albicans), 3 adet Grup B streptokok, 2 adet bakteriyel vajinozis (Gardnerella vaginalis), 2 adet Trichomanas vaginalis, idrar kültürü sonuçları; 5 adet Escherichia coli, 2 adet Staphylococcus aureus, 1 adet Proteus mirabilis, rektal kültür sonuçları; 3 adet rektovajinal grup B streptokok idi. Kültürde üremesi olan ve uygun antibiyoterapi ile tedavi edilen 20 hastanın 1’inde erken doğum gözlendi. Sonuç: Erken doğum tehdidi olan hastalarda idrar ve rektovajinal kültür yapılıp belirlenen patojene göre uygun tedavi verilmesi doğum eyleminin ilerlemesini engellemek için atılacak en önemli adımdır.

General Features and Laboratory Diagnosis of Toxoplasma gondii Infection.

Toxoplasmosis is a common infection worldwide caused by Toxoplasma gondii, an intracellular parasite. The prevalence of Toxoplasmosis ranges from 17.5% to 69.5% in Turkey. Toxoplasmosis is mostly asymptomatic. It may cause fetal mortality in case of vertical passage. The most common clinical findings in congenital toxoplasmosis are chorioretinitis, hydrocephalus and cerebral calcification. Another group of susceptible patients for Toxoplasma gondii are immunesuppressive patients. Reactivation of a latent infection in the case of immunodeficiency can lead to fatal toxoplasmic encephalitis. Serological diagnostic methods based on the detection of specific antibodies for Toxoplasma gondii are the most commonly used diagnostic methods. However, it may be difficult to interpret the results in pregnant women, neonates, and the patients receiving treatment. It is stated that using more than one method together to improve the reliability of the diagnosis is a more accurate approach. In the prenatal diagnosis of congenital toxoplasmosis, in patients with immunodeficiency, in ocular toxoplasmosis, the polymerase chain reaction is seen as having a higher sensitivity. The aim of this review is to present the general features, diagnostic methods and current approaches in toxoplasma infection, an important public health problem.

Performance of a Toxo IgM prototype assay for the diagnosis of maternal and congenital Toxoplasma infections.

Background Testing for anti-Toxoplasma immunoglobulin (Ig)M is of main importance in the context of pregnancy to promptly alert to an acute maternal infection prior to the detection of IgG and to identify infected newborns. Their absence helps exclude a recent maternal infection in the presence of IgG. Methods The performance of a Toxo IgM immunocapture prototype assay (bioMérieux, France) was compared with that of the VIDAS® Toxo IgM and the ARCHITECT® Toxo IgM (Abbott, Germany) assays at Grenoble and Lyon (France). A total of 1446 sera were sampled from (i) 1054 pregnant women found by routine workup to have no infection (n = 843), an acute infection (<4 months) (n = 28) or a chronic infection (>4 months) with residual (n = 120) or no IgM (n = 62); (ii) 50 three-serum panels sampled immediately after a maternal seroconversion; (iii) 242 samples taken in 41 children with a congenital toxoplasmosis (n = 122) and in 40 uninfected children (n = 120). Results In pregnant women, the overall agreement with the VIDAS® assay was 99.23% (CI: 99.16-99.27) and that with the ARCHITECT® assay was 99.14% (CI: 99.07-99.17). Sensitivity of the Toxo IgM prototype assay was 100% (CI: 87.66-100.00) and specificity was 99.64% (98.96-99.93). In acute maternal infections, IgM assays were detected as early with the prototype as with the other two. In the congenitally infected children, IgM were detected on their first sample in 25/40 with the prototype vs. 23/40 with the VIDAS® test. No uninfected child had positive IgM. Conclusion The prototype performed comparably to the ARCHITECT® and VIDAS® Toxo IgM assays for the diagnosis of maternal and congenital toxoplasmosis.

Evaluation of glycaemic profile variability as a basis for insulin therapy strategy in pregnant women with type 1 diabetes

BACKGROUND: Patients with any form of diabetes during pregnancy should achieve the target (close to physiological) values of glycaemia, the main condition for a safe course and outcomes of pregnancy. To accomplish this task, effective and safe methods of insulin therapy should be selected.&#x0D; AIM: To determine the glycaemic profile and pregnancy outcomes in women with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) and multiple insulin injections (MII).&#x0D; METHODS: A continuous glucose monitoring (CGM) of 100 pregnant women with type 1 diabetes treated with CSII and 100 women treated with MII was conducted to assess the effectiveness of these insulin therapy regimens in achieving target blood glucose values.&#x0D; RESULTS: HbA1c levels were significantly lower during the first, second, and third trimesters in patients treated with CSII than those treated with MII. Glucose variability has already improved since the second trimester of pregnancy in women treated with CSII, which was not observed in those treated with MII. The period of hyperglycaemia according to the results in pregnant women treated with CSII was 25 [13; 38] %, which was lower than those treated with MII, 41 [18; 54] %. No risk of obstetric and perinatal complications was observed with the duration of the hyperglycaemic state of 25% of the CGM time, whereas the risk of neonatal hypoglycaemia appeared with the duration of the hypoglycaemic state of a mother with type 1 diabetes of 0.2%. The relationship between glucose variability in terms of MAGE and MODD and the risk of developing macrosomia has been observed, and the dependence of glucose variability (MODD and CONGA) and the risk of neonatal hypoglycaemia and preeclampsia have also been confirmed.&#x0D; CONCLUSION: Comprehensive assessment of the glycaemic profile when using CSII, confirmed the advantages of using CSII in pregnant women with type 1 diabetes to achieve the target glycaemia values, to reduce glucose variability and duration of hypoglycaemic episodes, which led to decreased frequency of obstetric and perinatal complications.

Retrospective Evaluation of the Seropositivity Rate of Toxoplasmosis and Clinical Results in Pregnant Women That were Admitted to a Tertiary Health Institution Between 2012 and 2017 in Turkey

The aim of this study was to determine the frequency of toxoplasmosis in pregnant women who were admitted to our hospital in their first trimester and to contribute to screening and management strategies by evaluating clinical outcomes. In this retrospective study, women in their first trimester of pregnancy who were aged between 15-49 years, admitted to the Mersin University Medical Faculty Gynecology and Obstetrics outpatient clinic between 2012-2017, and screened for Toxoplasma gondii immunoglobulin M (IgM) antibodies were included. The data was obtained from the hospital’s digital records. First, the high-risk patients were identified who had anti-T. gondii IgM seropositivity and subsequently underwent anti-T. gondii immunoglobulin G (IgG) and anti-T. gondii IgG avidity tests. Next, the invasive procedures and medical treatments performed for diagnosis and treatment, as well as the clinical course and results for each patient were evaluated. Cases were then analyzed according to the admittance year and patient’s age. Anti-T. gondii IgM positivity was found in 266 (7.66%) of 3474 pregnant women meeting the study’s criteria. The frequency of the Toxoplasma IgM seropositivity was the highest in the 15-25 age group and this frequency decreased gradually as the age of the patients increased. Congenital toxoplasmosis was detected in 1 of 61 patients who had a positive polymerase chain reaction for T. gondii performed in the amniotic fluid. In our province, the prevalence of anti-T. gondii IgM was found to be 7.66% in pregnant women who were admitted to a tertiary health institution in their first trimester of pregnancy. This rate is much higher than the average in Turkey; therefore, we suggest that routine screening of pregnant women for T. gondii may be recommended in this region.

Plasma metanephrine concentrations in pregnant hypertensive women

Phaeochromocytoma is a rare cause of hypertension during pregnancy but should be considered in pregnant women presenting with extremely elevated blood pressure. Plasma free metanephrines (PFM) can be readily measured using liquid chromatography-MS/MS and have been shown to have good diagnostic performance for the diagnosis of phaeochromocytoma.1 Interpretation of PFM Results in pregnant women is hindered by the lack of population specific reference intervals. The objective of this study was to establish PFM reference intervals for pregnant women without phaeochromocytoma.

Persepsi Ibu Hamil pada Pelayanan Antenatal Care di Desa Bolorejo Kecamatan Kauman Kabupaten Tulungagung

The high maternal mortality rate or MMR in Indonesia is an important issue that needs to be handled seriously. AKI is a measure of maternal health success and is a barometer of health services in a country, if the rate is still high, it means that health services in the country are categorized not good (Adriansz, 2007). So one of the efforts that need to get attention in reducing AKI is through improvement of health service quality of pregnant and maternity mother especially through antenatal care. The purpose of this study to determine the perception of pregnant women on antenatal care (ANC) in the Bolorejo village, Kauman District, Tulungagung Regency. This research is a qualitative research with cross sectional research design. Variable in this research is pregnant woman's perception on antenatal care service with population counted 11 responden, using technique of non probability sampling saturated (census), where research tool used is structured interview guidance, research location in Bolorejo village, Kauman district, Tulungagung regency. Time of study in July 2017. Presentation of data in the form of pie chart. From the results of the study obtained the results of pregnant women's perception on antenatal care service in the village of Bolorejo District Kauman Tulungagung district based on the care of ANC 10T that has been given to pregnant women has not been fully achieved. This is indicated from the data of the majority of pregnant women have received antenatal care 8T (80%) While a small proportion of pregnant women have not received antenatal care 2T (20%) which includes TT immunization and laboratory examination related to pregnancy (PP test, Hb, Protein urine, Urine reduction). Pregnant women who do not get TT immunization that there is 1 pregnant women due to pregnant women check into the village midwife in late third trimester of pregnancy and approaching delivery. As for pregnant women who do not get laboratory tests related to pregnancy (PP test, Hb, urine protein, urine reduction) that is as many as 3 pregnant women because the pregnant women did not want to be examined for fear of injections and no signs of danger pregnancy accompanying pregnant women during pregnancy (seen from the characteristics of respondents based on maternal reproductive age in low risk categories, based on parity also low risk). For pregnant women who are afraid of injections have actually been motivated by health cadres and village midwives but pregnant women are still not pleased to do laboratory examination (Based on the perception of pregnant women to public services and services ANC indicates that the services provided by health personnel are in conformity with standards) So that an unacceptable ANC examination of the standard (10T) was caused by a low awareness of pregnant women themselves. Keywords: Perception, Pregnant Women, Antenatal Care

Ispitivanje markera krvlju prenosivih bolesti, algoritama testiranja i preventivnih mera

Introduction/Aim The most common blood borne diseases or transfusion transmitted infections (TTI) are hepatitis B, hepatitis C and human immunodeficiency virus (HIV). Numerous tests are used to prove the presence of these viruses indirectly (by detecting antibody presence - ELISA and CLIA) or directly (by detecting the presence of viral genome - NAT-PCR and LCR).To present a two-year analysis of testing for blood borne disease markers in pregnant women, patients preparing for surgery procedures and people with high-risk behavior (HBs Ag, anti-HCV and anti-HIV) at the Belgrade City Institute for Public Health and adopting measures for their prevention. Methodology During the two-year period, 11,983 pregnant women and 934 people with high-risk behavior were tested. Preliminary testing for HBs antigen, anti-HCV antibodies and anti-HIV antibodies was performed with 3rd generation ELISA tests ("Hepanostika HBsAg Uni-Form II", "Vironostika HIV Uni-Form II Ag / Ab" ; "The bioMérieux Clinical Diagnostics," manufactured in France; "Hepanostika HCV Ultra" is manufactured by "Beijing United Biomedical Co.Ltd.", China and the other two are manufactured in France). Primarily positive blood samples were tested again with the same test (in a duplicate procedure) on a new sample which was placed in a "dry" tube with no anticoagulant 10-14 days after being primarily positive for TTI markers. Those samples were also tested with a WB "Western Blot" confirmatory test - WB ("INNO-LIA HCV Ab III"; INNO-LIPA HBV Genotyping "and" INNO-LIA HIV I / II"). "Innogenetics NV ", Belgium is the manufacturer of all three confirmatory tests. Blood samples with positive results on the confirmatory tests for TTI were accepted as positive for HBs Ag, anti-HCV or anti-HIV. Results From 11,983 tested pregnant women, 152 (1.27%) were preliminarily reactive to HBsAg, 38 (0.32%) were confirmed positive for HBsAg and 114 (0.95%) were false reactive to HBsAg; 123 (1.03%) were preliminarily reactive to anti-HCV, 35 (0.29%) pregnant women were confirmed positive for antiHCV and 88 (0.74%) were false reactive for anti-HCV; and 15 (0.13%) pregnant women were preliminarily reactive to anti-HIV, 5 (0.04%) pregnant women were confirmed positive for anti-HIV and 10 (0.09%) were false reactive to anti-HIV. From 934 tested individuals with high-risk behavior 36 (3.85%) were preliminarily reactive to HBs Ag, 28 (2.99%) were confirmed positive for HBsAg and 8 (0.86%) were false reactive to HBsAg; 38 (4.07 %) were preliminarily reactive to anti-HCV, 33 (3.53%) were confirmed positive for anti-HCV and 5 (0.54%) false reactive to anti-HCV and 10 (1.07%) were preliminarily reactive to anti-HIV, 9 (0.96%) were confirmed anti-HIV positive and 1(0.11%) was false reactive to anti-HIV. Conclusion The results of our study showed a higher prevalence of HBsAg, anti-HCV and anti-HIV in people with high-risk behavior than in pregnant women. There are more false reactive results in pregnant women than in people with high-risk behavior. Preventive measures would include broader education on ways blood borne diseases are transmitted, testing blood and blood products with the latest generation of tests and correct execution of medical interventions with special attention on principles of asepsis and antisepsis.

2 Angiogenic markers (sflt-1, plgf) in patients with suspected und confirmed placental dysfunction (preeclampsia, IUGR, placental abruption) – continuous values according to biochemical, clinical symptoms and particular perinatal results

Aims To assess value of the serum level of soluble Fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF) and sFlt-1/PlGF ratio according to clinical, ultrasound, biochemical symptoms and particular perinatal results in pregnant women with suspected/confirmed placental dysfunction (preeclampsja, IUGR, HELLP, placental abruption). Material and methods 927 pregnant women between 18 and 41 weeks of pregnancy with suspected/confirmed placental dysfunction. Everyone woman included to cohort had introduced monolithe clinical, biochemical, ultrasound management and sFlt-1, PLGF, sFlt-1/PlGF ratio was assessed. Results In patients with confirmed placental dysfunction sFlt-1/PlGF ratio was higher independent from clinical symptoms compare to patients who didn’t develop clinical placental dysfunction. Trial occurs statistical correlation angiogenic markers with parameters doppler ultrasound (i.e umbilical artery, uterine artery) traditional biochemical predictors (i.e. uric acid, AST,ALT, LDH, prothrombin time), clinical symptoms (systolic and diastolic pressure) and perinatal results (prematurity, days to delivery, birth weight, pH umbilical blood). Conclusions Angiogenic markers sFlt-1 i PlGF and sFlt-1/PlGF ratio increase in placental dysfunction independent from clinical presentation. The values angiogenic markers correlate with traditional clinical, ultrasound, biochemical parameters and there are independent predictors perinatal results. sFlt-1/PlGF is helpful in diagnosis and monitoring women with suspected/confirmed placental dysfunction and can be useful in making therapeutic decisions in the future.