Successful Pregnancy Outcome In Woman Research Articles

Evaluating Successful Pregnancy Outcome in Women Undergoing Trial of Labour after Caesarean Section (TOLAC)

Objective: To determine the successful pregnancy outcome in women who opted for trial of labour after one lower segment transverse caesarean section (TOLAC). Study Design and Setting: Descriptive cross-sectional study. Department of Obstetrics and Gynaecology, Combined Military Hospital Abbottabad, from Nov 2022 to April 2023. Methodology: 54 pregnant women were included in our study who had previously undergone one lower segment caesarean section more than 18 months back. They were booked at their first visit, briefed and counselled for trial of labour after caesarean section (TOLAC ), and were advised to await spontaneous labour till 40 completed weeks of gestation and in case of failure of onset of labour then for induction of labour. Data was collected in terms of successful vaginal birth/repeat caesarean section and fetomaternal outcome. Results: In our study, 54 women agreed for trial of labour who had one caesarean section more than 18 months back. Vaginal birth was successful in 39 women (72.22%). Gestational age, BMI, and age of the woman did not show any significant effect on trial of labour. Factors leading to successful outcome include previous vaginal delivery, spontaneous onset of labour, favourable bishop score, women who are keen for vaginal delivery. Conclusion: The study concluded that most pregnant women prefer labour trial after one CS. Adequate counselling and briefing of women reduce their anxiety, and help them to make decisions about their preferred mode of delivery.

A Case Report of Successful Pregnancy Outcome in Women with Recurrent Miscarriage with Systemic Lupus Erythematosus

A Case Report of Successful Pregnancy Outcome in Women with Recurrent Miscarriage with Systemic Lupus Erythematosus

Successful Pregnancy Outcome in a Woman with Prior Temporal Lobe Surgery for Intractable Epilepsy

Temporal lobectomy as a treatment of intractable epilepsy is well established though rare. There is lack of literature on detailed management of pregnancy after temporal lobe surgery for epilepsy. We report one such woman who had undergone right temporal lobectomy and unco-amygdalo-hippocampectomy ten years back. The woman presented even before conception. The management during pregnancy is detailed. The course during labour is detailed. Mono therapy with newer anti-epileptics, strict surveillance during pregnancy and labour as per the guidelines can result in successful pregnancy outcome in woman with epilepsy who have undergone temporal lobe operation.

Successful Pregnancy Outcome in Women with Recurrent IVF Failure and Anti-hCG Autoimmunity: A Report of Three Cases.

We report three cases of effective management of infertility in women with a history of repeated unsuccessful IVF attempts, who have developed antibodies to hCG. A novel approach to conservative treatment of immunologic reproductive failure, suggested for selected patients, included membrane plasmapheresis, combined prednisolone, and intravenous immunoglobulin therapy. No adverse side effects were observed; all cases resulted in pregnancy and subsequent life births. In order to be given an adequate efficient treatment, women with recurrent implantation failure should be suspected for autoimmune factor of infertility and its possible association with anti-hCG autoimmunity.

Successful Pregnancy Outcome in Women With Bad Obstetric History and Recurrent Fetal Loss Due to Thrombophilia: Effect of Unfractionated Heparin and Low—Molecular Weight Heparin

Acquired and inherited thrombophilias are known to be associated with unfavorable pregnancy outcome including recurrent fetal loss. There are differences of opinion whether these patients need to be treated with aspirin, unfractionated heparin, low-molecular weight heparin, corticosteroids, or intravenous immunoglobulins. In all, 25 consecutive patients with a history of fetal loss and 7 patients who presented in early pregnancy with deep-vein thrombosis were treated, and their pregnancy outcome was noted. All the women were positive either for a solitary or for a combination of acquired and heritable thrombophilia markers. In all, 23 patients were treated with unfractionated heparin and 9 with low-molecular weight heparin. In all, 16 out of 23 patients (69.6%) treated with unfractionated heparin and 9 out of 9 (100%) treated with low-molecular weight heparin had successful pregnancy outcome. There was a complete resolution of thrombus in all the cases. None of the patients had any adverse reactions such as heparin-induced thrombocytopenia, thrombosis, or fracture. Both unfractionated heparin and low-molecular weight heparin were effective in cases of bad obstetric history and recurrent pregnancy loss due to thrombophilia. However, low-molecular weight heparin was found to be more effective than unfractionated heparin along with other advantages of not requiring laboratory monitoring and easy administration. None of the patients in either group had to interrupt the therapy for any adverse treatment-related complications.

Individual patient data meta-analysis : Cervical stitch (cerclage) for preventing pregnancy loss in women.

BackgroundCervical cerclage is a surgical procedure involving suturing the cervix with a purse type stitch to keep it closed during pregnancy. This procedure has been used widely in the management of pregnancies considered at high risk of preterm delivery. Several observational studies into the efficacy of cervical cerclage have claimed high rates of successful pregnancy outcome in women with a poor obstetric history attributed to cervical incompetence. However, a recent aggregate data Cochrane review found no such conclusive evidence from seven included randomised studies. Current data suggests that cervical cerclage is likely to benefit women considered to be 'at very high risk' of a second trimester miscarriage due to a cervical factor, however identifying such women remains elusive and many women may be treated unnecessarily. Undertaking an individual patient data (IPD) meta-analysis of the studies will allow us to investigate whether treatment is more effective in particular subgroups. Such an analysis will also provide a more powerful analysis of the predictors of preterm delivery and pregnancy loss, including ultrasound measurement of cervical length, and will allow a more complete analysis of 'time to event' outcomes.Methods/DesignThe analysis will include data from randomised trials comparing the intervention of elective cerclage versus no cerclage or bedrest to prevent miscarriage or pre-term labour. A specific list of data will be requested for each trial, including demographic and obstetric history data. The primary outcomes of interest will be neonatal mortality/morbidity. Attention will also be given to secondary outcomes such as time from randomisation to delivery, preterm delivery before 32 weeks and maternal morbidity. An intention to treat analysis will be performed, with attention paid to assessing clinical and statistical heterogeneity. Multilevel models with patients and trials as the two levels will be explored to investigate treatment effect on various outcomes. Patient-level covariates will be incorporated into the models in an attempt to account for statistical heterogeneity as well as to investigate interactions with treatment effect.DiscussionPredictive models generated from our analysis should lead to more effective counselling of women at risk and a more cost effective use of cerclage.

Maternal and perinatal outcome in pregnancy with hypothyroidism

Several maternal and foetal complications have been described in patients with overt hypothyroidism. The complications are less in patients with sub clinical hypothyroidism and successful pregnancy outcome in women with hypothyroidism are also known. We analysed the records of 30 patients with the diagnosis of pregnancy with hypothyroidism from July 1998 to June 2004. According to thyroid function test results 12 patients had sub clinical hypothyroidism (Only elevated TSH) ten were euthyroid on replacement therapy (before pregnancy) and eight had overt hypothyroidism diagnosed in current pregnancy and were started on replacement therapy. Pregnancy complications in the form of pregnancy induced hypertension (PIH) abruption gestational diabetes (GDM) anemia post-partum hemorrhage (PPH) low birth weight foetal distress and congenital malformation were studied. Duration and control of hypothyroidism during pregnancy change in dosage during pregnancy were also studied. (excerpt)

Extracellular Matrix Protein-dependent Apoptosis of T Cells in Women with a History of Recurrent Spontaneous Abortion.

The purpose of the study was to determine the role of T-cell apoptosis in extracellular matrix (ECM) environment in pregnancy maintenance in women with a history of recurrent spontaneous abortion (RSA). Thirty-nine non-pregnant women with the history of RSA (anatomic, genetic, endocrine and microbiologic causes were excluded) and 22 healthy women with the previous successful pregnancy outcome were studied. In addition, 21 women with the history of RSA were also studied at the beginning of their next pregnancy. We studied apoptosis of peripheral blood T cells after culture with monoclonal antibody (mAb) OKT-3 alone or with mAb OKT-3 following ECM proteins: collagen IV (C-IV) or fibronectin (Fn). We used Cell Death Detection ELISA for studying cell death in cell population. In addition, apoptotic peripheral blood T cells were identified by annexin V-PE staining protocol using flow cytometry. CD29+ and CD95+ T-cell surface receptors were also analyzed by flow cytometry. The significantly higher values of enrichment factor: mU of the sample (dying/dead cells) per mU of the corresponding control (viable cells) were observed after peripheral blood T-cell culture with C-IV (P = 0.0002) or Fn (P = 0.004) in samples of non-pregnant women with the history of RSA when compared with control women. The significantly higher values of enrichment factor were observed after peripheral blood T-cell culture with C-IV in samples of pregnant women with the history of RSA with successful pregnancy outcome when compared with pregnant women with the history of RSA with failed pregnancy outcome (P = 0.01). However, the percentage of apoptotic T cells stained by annexin V was significantly lower in non-pregnant RSA women compared with control (P = 0.0001). CD95 expression was significantly lower in non-pregnant RSA women compared with control (P = 0.01). Apoptosis of T cells might be an interesting possible explanation of successful pregnancy outcome in women with the history of RSA.

Extracellular matrix proteins dependent apoptosis of T Cells in women with a history of recurrent spontaneous abortion

INTRODUCTION: The purpose of the study was to determine the role of T cell apoptosis in ECM environment in pregnancy maintenance in women with a history of recurrent spontaneous abortion (RSA).MATERIALS AND METHODS: Thirty nonpreg‐ nant women with the history of RSA and 10 normal healthy women with the previous successful pregnancy outcome were studied. In addition, 15 pregnant women with the history of RSA were studied. We studied apoptosis of peripheral blood T cells after culture with mAb OKT‐3 alone and with mAb OKT‐3 and the following ECM: fibronectin and collagen IV. We used Cell Death Detection ELISA. In addition, apoptotic peripheral blood T cells were identified by annexin V‐PE staining protocol using flow cytometry. CD29, CD95 T cells' surface receptors were studied.RESULTS: The highest values of enrichment factor: mU of the sample (dying/dead cells) per mU of the corresponding control (viable cells) were observed after peripheral T cells' culture with fibronectin or collagen IV in samples of women with the history of RSA. However, percentage of apoptotic T cells stained by annexin V was significantly lower in RSA women compared to control (P < 0.05). CD95 expression was significantly lower in RSA women compared to control (P < 0.05).CONCLUSIONS: Apoptosis of activated cytotoxic T cells might be an interesting possible explanation of successful pregnancy outcome in women with the history of RSA.

The number of embryos available for transfer predicts successful pregnancy outcome in women over 39 years with normal ovarian hormonal reserve testing.

The purpose was to determine whether the number of embryos available for transfer following IVF in women over age 39 predicted a successful pregnancy outcome. Retrospective analysis of 455 consecutive IVF cycles in women > or = 40 years of age. Few cycles were canceled (29/455, 6.4%) or produced no embryos (5/455, 1.1%). Women 40-43 years of age with normal ovarian reserve had a significantly greater delivery rate when > or = 4 embryos were available for transfer than when < 4 embryos were available (17.8% versus 2.4%, P = 0.002). Subsequent IVF cycles, from women with normal FSH whose first cycle produced < 4 embryos, produced delivery rates of 13.0% when > or = 4 embryos were available. Women with abnormal ovarian reserve or age > or = 44 years had very low delivery rates (1.2% and 1.4% respectively). The number of embryos available for transfer significantly predicts delivery from IVF-ET among reproductively older women. Many women age 40-43 with normal ovarian reserve can achieve pregnancy through IVF.

Providing for women following miscarriage.

It is apparent that an increased awareness amongst health care workers of the need for parents to grieve the loss of their baby, regardless of the gestation, is essential. It should also be noted that this time of coming to terms with the loss can be quite lengthy. This healing may be aided by support groups such as the Miscarriage Association, and also through pre-pregnancy counselling clinics. Support in the next pregnancy appears to improve the chance of a successful pregnancy outcome in women with a history of recurrent miscarriages. It is important that the current interest in bereavement counselling does not lead to every miscarriage being 'magnified into a catastrophe'. For some women the event will pass with little trauma. In seeking to improve the management of this distressing condition we must be careful to take into consideration the individual's requirements. In a recent publication by SANDS, guidelines for the management of patients who have experienced the loss of a baby are given. This book can be commended for all involved in the care of women at the time of pregnancy loss.