Third Term Of Pregnancy Research Articles

Effects of Intrahepatic Cholestasis on the Foetus During Pregnancy.

The most typical condition of the liver in pregnancy is intrahepatic cholestasisof pregnancy (ICP). There is the occurrence of itching/pruritus together with a decline in liver function tests (LFTs) and frequently higher blood levels of total bile acids, which are used to make the diagnosis. ICP often shows symptoms during the third term of pregnancy and sometimes in the second term. After delivery, the disease's symptoms disappear on their own. It is still unclear what causes this disorder. It constitutes a hazard for the infant and is exceedingly stressful for the mother. Although relatively harmless for the expectant mother, ICP poses a significant risk to the unborn child. Preterm birth, meconium excretedinthe amniotic fluid, respiratory distress syndrome, foetal distress and abrupt intrauterine foetal death are all risks seen in this disorder. It is still challenging to identify foetuses who are at risk for ICP issues. There needs to be a clear consensus on the best obstetrical care for ICPs. This reviewis done to brief theresearch on the foetal consequences of ICP and to discuss treatment strategies for its avoidance. Serum alanine transaminase, aspartate transaminase, total bilirubin, alkaline phosphatase, albumin, direct bilirubin, total protein, and total bile acids were among the biochemical predictors. Blood tests that confirm obstetric cholestasis should alter the course of treatment. Ursodeoxycholic acid may be prescribed to affected individuals to cure itching and prevent the build-up of biliary components of maternal origin in the baby, which may increase the danger of foetal discomfort and stillbirth.

The COVID-19 pandemic impact on prenatal anxiety

IntroductionAnxiety manifestations are one of the most described symptoms during pregnancy. Meanwhile, the effect of the coronavirus disease 2019 (COVID-19) pandemic on the mental health and anxiety distress in particular, of pregnant and postpartum women remains unclear.ObjectivesThe purpose of our study was to evaluate anxiety among prgnant women during covid19 and describe its associated factorsMethodsIt was a comparative cross-sectional case- control study in a Tunisian gynecologic department. All women were in the third term of pregnancy. Anxiety symptoms were evaluated using Beck Anxiety Inventory (BAI). The data were compared to a control group assessed in a similar study conducted before the pandemic in the same city. Eighty pregnant women was investigated during the covid pandemic and 100 pregnant women investigated before the COVID-19 outbreak in Tunisia was assigned to the control group.ResultsPregnant women during COVID-19 scored less on BAI than controls (15.49±9.223 vs 17.40±7.410). Less patients presented moderate to severe anxiety during pandemic (38.8% (n=31) than controls 51% (n=51)). The difference between groups in means and prevalence values was not significant. The negative results could be related to the low power of the test (P=0.36).ConclusionsDespite the expected psychological distress among vulnerable population , Covid-19 didn’t impact anxiety prevalence or scores among pregnant women in our current study .DisclosureNo significant relationships.

Dual-Session Tokophobia Intervention, a Novel Ultrashort Cognitive Behavioral Therapy Protocol for Women Suffering From Tokophobia in the Third Term of Pregnancy

Tokophobia is a debilitating, relatively prevalent, and undertreated anxiety disorder, which can lead to prenatal, natal, and postpartum adverse effects. This article provides an outline of the Dual-Session Tokophobia Intervention (DSTI), an ultrashort exposure-based cognitive behavioral therapy (CBT) protocol that can be delivered by non-mental-health professionals to women in the third term of pregnancy. The detailed description of the intervention is illustrated by a case study that is part of an ongoing clinical trial, targeting the specific needs of women suffering from Tokophobia near term. DSTI is carried out in two sessions (for a total of 4 hours) with a 1-week interval in between. The intervention protocol presented in this article, to the best of our knowledge, is the first to offer treatment specifically for women near term. It aims to decrease anxiety and provide women and their newborns with better obstetric and psychiatric outcomes. The patient presented was screened by the Fear of Birth Scale and a Structured Clinical Interview for DSM Disorders. She indicated her Subjective Units of Distress on a list of specific fears related to childbirth, before and after the intervention. Following treatment, the patient showed a 70% decrease in SUDS, a cessation of avoidance and information seeking behaviors, a short labor duration and a subjective experience of being able to calm herself during a difficult birth and concentrate on the delivery process. Six weeks postpartum there were no signs of depression or PTSD.

COVID-19 and pregnancy: A scoping review on pregnancy characteristics and outcomes.

AimThe study aim was to map clinical characteristics and the evolution of pregnancies in pregnant women with confirmed diagnosis of SARS‐CoV‐2 infection.MethodsSearching four databases, studies were investigated that described the evolution of pregnancies in women diagnosed with SARS‐CoV‐2 infection through laboratory tests. A scoping review was undertaken, including 35 articles published in English. Two pairs of independent researchers synthesized the data.ResultsMost studies were case studies or case series and had a low risk of bias. A predominance of cases was found in women over the age of 30 years who got infected in the third term of pregnancy and who had comorbidities. The prematurity index varied with the heterogeneity of the samples, and the cases of abortion occurred in combination with severe forms of infection. Caesarean section deliveries predominated, indicated mainly by respiratory decompensation caused by infection. Most women were discharged.ConclusionBased on the reviewed studies, the profile and evolution of pregnant women infected with COVID‐19 could be evaluated.

Apelin 13 Improves Anxiety and Cognition Via Hippocampal Increases BDNF Expression and Reduction Cell Death in Neonatal Alcohol Exposed Rats

Fetal alcohol Spectrum Disorder (FASD) describes the range of detrimental impacts which are likely to occur in children who are born to these women. Disorders related to anxiety are among the most commonly psychiatric reported problems in both children and adults with FASD. Additionally, Animals which are exposed to alcohol show anxiety like behavior and other impaired hippocampal-related brain functions such as memory and cognition. Apelin-13, a principal neuropeptide with inhibitory effects on cell death and stimulatory properties on production Brain—derived neurotrophic factor (BDNF), has beneficial effects on cognition impairment, anxiety related-behavior and neuronal injury. In this study, we examined the protective effects of apelin-13 on ethanol-related neurotoxicity in the hippocampus of rat pups. The intubation of total daily dose of ethanol (5/27 g/kg/day) was started from PD 2 up to PD 10 (equal to third term of pregnancy in humans). Immediately after intubation, 25 and 50 μg/kg of apelin-13 injected subcutaneously. To evaluate the levels of anxiety, the elevated plus maze test was carried out 39 days after pups’ birth. Also, by using novel object recognition task, the hippocampus-dependent cognition memory was evaluated 39–40 days after birth. Then, immunohistochemical staining was done to determine the levels of BDNF in 40 days after birth. Also, to measure necrotic cell death, Nissl staining was performed. The current study demonstrated that administration of apelin-13 significantly ameliorated cognitive impairment and anxiety-related behavior associated FASD (P < 0.001). Additionally, apelin-13 could significantly increase the BDNF level (P < 0.001), and attenuates necrotic cell death (P < 0.01) induced by alcohol neurotoxicity.

Immature sleep pattern in newborn rats when dams encountered sleep restriction during pregnancy

There is a growing realization that proper sleep during pregnancy is essential for the health of the mother and the offspring. However, there are no reports on the effects of maternal sleep restriction on the sleep-wake profiles of newborns. So, this study was conducted to evaluate the effects of sleep restriction during the third term of pregnancy on the sleep-wake profiles of neonates born to them. The female pregnant Wistar rats were sleep restricted for 5 h/day on gestational days 15–20 by gentle handling. Sleep-wake profiles of the pups born to them and to the control rats were recorded on postnatal days 1–21. Pups of sleep restricted dams had higher active sleep (AS) and lower quiet sleep (QS) as well as wakefulness. Higher ratio of AS to QS, longer duration of sleep cycles, lesser bout frequency and reduced EEG delta power were also observed in these pups, all of which indicated brain immaturity. All these signs of delayed maturation, usually found in premature babies, were observed in the pups of sleep restricted mothers, who had longer gestation period. This report not only shows the importance of sleep during pregnancy, but it also suggests that neonatal sleep monitoring can be used as a tool for early assessment of retarded brain development.

The effects of rapid eye movement sleep deprivation during late pregnancy on newborns' sleep.

Sleep deprivation during pregnancy is an emerging concern, as it can adversely affect the development of the offspring brain. This study was conducted to evaluate the effects of deprivation of rapid eye movement (REM) sleep during the third term of pregnancy on the sleep-wake profiles of neonates in the Wistar rat model. Sleep-wake patterns were assessed through electrophysiological measures and behavioural observations during postnatal days 1-21 on pups born to REM sleep-deprived dams and control rats. Pups of REM sleep-deprived dams had active sleep that was not only markedly higher in percentage during all the days studied, but also had reduced latency during later postnatal days 15-21. Quiet sleep and wake periods were lower. These factors, along with less frequent but longer sleep-wake cycles, indicated maturational delay in the sleep-wake neural networks. The disruption of time-bound growth of sleep-wake neural networks was substantiated further by the decreased slope of survival plots in the sleep bouts. Examination of altered sleep-wake patterns during early development may provide crucial information concerning deranged neural development in the offspring. This is the first report, to our knowledge, to show that maternal sleep deprivation during pregnancy can delay and impair the development of sleep-wake profile in the offspring.

Some Uterine and Ovarian Biometric Changes in Pregnant Maradi Female Goats (Capra aegagrus hircus L.)

This study aimed to determine the changes in the biometry of the ovaries, of the uteri and its contents in the Maradi doe-goat during the three terms of pregnancy. Pregnant uteri from 28 female goats and their corresponding ovaries were used to study the biometric changes in the ovaries, gravid uteri, amniotic and allantoic fluids volumes, fetuses and plancentomes during the three terms of pregnancy. The results revealed that there was no significant variation in the ovarian weight during the three terms of pregnancy. However, there were significant variations in the ovarian length (left ovary 2.15 ± 0.16 cm; right ovary 2.10 ± 0.10 cm) and width (left ovary 1.77 ± 0.19 cm; right ovary 1.60 ± 0.10 cm) in the third term of pregnancy compared to the ovarian length and width in the first term of pregnancy. The uterine weight showed significant variation in the first term, second term and in the third term of pregnancy. The uterine length of both horns also showed significant variations in the first term (left side 31.40 ± 1.79 cm; right side 28.22 ± 0.98 cm), second term (left side 51.58 ± 4.14 cm; right side 50.51 ± 3.62 cm) and in the third term (left side 70.67 ± 1.76 cm; right side 80.38 ± 2.75 cm) of pregnancy but only in the third term of pregnancy was a significant difference in the lengths of the left side uterine horn (70.67 ± 1.76 cm) compared to the right side (80.38 ± 2.75 cm). The number of plancentomes was constant in both uterine horns throughout gestation; however the mean caruncular diameter increased progressively from the first term of gestation through the third term of pregnancy. The smallest and largest caruncles were observed on the ventral surfaces of the uterine horns, and the plancentomes were observed to be aligned in a linear manner along the longitudinal axis of the uterine horns. This study shows that there are differences in the biometrics of the ovary and uterus in Maradi goats compared to some other breed.

Uterocutaneous Fistula Following Conservative Management of Placenta Increta: A Rare Case Report and Review of the Literature

Introduction: This was a report of uterocutaneous fistula as a rare complication of expectant management of placenta increta, and a review of the literature. Case Presentation: A 38- year- old pregnant woman in her third term of pregnancy was operated on in a secondary hospital in Arak (a city located in the center of Iran) in April 2015. As a result of placenta incereta, the attached placenta was left in the uterus. On the 38th day, she was referred to our tertiary care hospital due to intermittent fever and bleeding. More examinations by MRI and hystrosalpingography revealed uterocutaneous fistula. She was operated on again, and surgical findings indicated coexistent uterine necrosis and uterocutaneous fistula. Conclusions: This case was the first reported morbidity of fistula in the uterocutaneous pathway.

Intraplacental blood flow in third trimester of placental insufficiency pregnancy

Background. Serious perinatal, most of all, neurological consequences of placental insufficiency condition necessity further search it’s markers for optimal delivery time. Methods. At third term of pregnancy we examined 16 singleton physiological pregnant women (first group) and 27 placental insufficiency patients (second group). We standard obstetrical examined, ultrasound fetometry, basic arteries of functional system mother-placenta-fetus Doppler and three-dimensional power Doppler in central, two paracentral and two periphery placenta areas. We processing images by VOCAL and analyzed vascularisation (VI), flow (FI) and vascularisation-flow indexes (VFI). Results. In placentae correlated groups FI differ in size reliable in central (t=4,03; p&lt;0,001 и U=240,00; p&lt;0,001) and paracentral (t=2,61; p&lt;0,05 и U=348,00; p&lt;0,05) areas. Patients second group indexes were relative on 17% and 8% less than patients first group indexes. Patients second group VFI was on 35% less than patients first group VFI (t=2,08; p&lt;0,05 и U=337,00; p&lt;0,05). We described results of comparison three-dimensional power Doppler intraplacental blood flow indexes from patients second group with different degree hemodynamic disorder. Conclusion. In placental insufficiency presence reduction blood circulation, particular in central placenta area, conditioned by reduction blood flow in initial vessels number. Central placenta area FI may be regarded new additional criterion of placental insufficiency at third term of pregnancy.

Pregnancy gingivitis and causal inference

The PubMed and Embase databases were searched together with hand searching of the Journal of Periodontology, Journal of Periodontal Research and Journal of Clinical Periodontology. The reference lists of identified articles were also searched. Prospective cohort or cross-sectional studies assessing the effect of pregnancy on gingival inflammation evaluated by the gingival index and/or bleeding on probing were included. Study quality was assessed using the Newcastle-Ottawa scale (NOS). Study assessment and data extraction were carried out independently by two reviewers, with disputes resolved by a third reviewer. Mean values of primary and secondary outcomes were directly pooled and analysed with weighted mean differences (WMDs) and 95% confidence intervals (CIs), considering independently each study design (cohort and cross-sectional). Study specific estimates were pooled with both the fixed- and random-effect models. Forty-four articles representing 33 studies (14 cohort and 19 cross-sectional) were included. Meta-analyses revealed a significantly lower GI in pregnant women in the first term compared with those in their second or third term of pregnancy; a lower mean GI score in post-partum women compared with women in their second [WMD = 0.143; 95% CI (0.031; 0.255); p = 0.012] or third term [WMD = 0.256; 95% CI (0.151; 0.360); p < 0.001] of pregnancy, when considering cohort studies; non-pregnant women had lower mean GI values than women in their second or third term of pregnancy. Small changes in plaque levels were reported. The results of this systematic review confirm that gingival inflammation is significantly increased throughout pregnancy and when comparing pregnant versus post-partum or non-pregnant women, without a concomitant increase in plaque levels. However, this information should be considered with caution, due to the small number of studies included in the meta-analyses, the low quality of the included studies, differences in study design, absence of a periodontal diagnosis at baseline and performance of periodontal treatment in some cases. No conclusions could be drawn regarding secondary outcomes such as microbiological, immunological and patient-centred data, because no meta-analyses were possible for these factors. Future studies with higher quality should be designed to answer these questions.

Effect of pregnancy on gingival inflammation in systemically healthy women: a systematic review.

To obtain an overall quantitative estimate of the association between pregnancy and gingival inflammation. Medline and EMBASE databases were searched through August 2011. Prospective cohort or cross-sectional studies assessing the effect of pregnancy on gingival inflammation evaluated by the gingival index (GI) and/or bleeding on probing were included. Meta-analyses were performed if possible. Forty-four articles representing 33 studies (14 cohort and 19 cross-sectional) were included. Meta-analyses, performed whenever possible, revealed (1) a significantly lower GI in pregnant women in the first term compared with those in their second or third term of pregnancy; (2) a lower mean GI score in post-partum women compared with women in their second [WMD=0.143; 95% CI (0.031; 0.255); p=0.012] or third term [WMD=0.256; 95% CI (0.151; 0.360); p<0.001] of pregnancy, when considering cohort studies; (3) Non-pregnant women had lower mean GI values than women in their second or third term of pregnancy. Small changes in plaque levels were reported. Despite the limited number of studies included in the meta-analyses, the present systematic review confirms the existence of a significant increase in GI throughout pregnancy and between pregnant versus post-partum or non-pregnant women, without a concomitant increase in plaque levels.

Força muscular respiratória: comparação entre nuligestas e primigestas

A gestação influencia o sistema respiratório originando mudanças anatômicas e fisiológicas que podem repercutir nos índices da força muscular respiratória. O objetivo do presente trabalho foi comparar a pressão respiratória máxima entre nuligestas e primigestas no terceiro trimestre gestacional e associá-la ao predito por Neder et al.,1999. Foi realizado estudo do tipo corte transversal com 80 mulheres (40 nuligestas e 40 primigestas no terceiro trimestre gestacional) entre 20 e 29 anos, eutróficas e sem histórico de doença cardiorrespiratória. A média dos valores obtidos para pressão inspiratória máxima (Pimáx) foi: -93,95 cmH2O nas nuligestas e -87,78 cmH2O nas primigestas, mostrando haver diferença estatística (p=0,0182). Para pressão expiratória máxima (Pemáx) foram alcançados 98,28 cmH2O e 96,73 cmH2O, respectivamente, não sendo estatisticamente significante (p=0,710). Não obstante,as modificações anatômicas e fisiológicas ocorridas durante a gestação verificou-se que apenas a Pimáx estava diminuída quando comparada ao grupo das nuligestas, enquanto que a Pemáx não apresentou alteração significativa. No mais, não foi observada concordância entre valores encontrados e preditos por Neder et al., 1999.

P0384 THREE CASES OF CONGENITAL INTRAHEPATIC PORTOSYSTEMIC VENOUS SHUNT IN NEONATES.

Introduction: Congenital intrahepatic portosystemic venous shunt (CIHPSS) are very unusual abnormalities. Only 50 publications have been counted. They are defined as macroscopic communications between the portal and the systemic venous circulation. They are entirely or partially located within a heathy liver that functions without portal blood. When discovered early in life, they are in favour of a malformative origin of the shunt. HEREIN, we report three neonate observations with their icon-çography. For the case n°1, it was a color Doppler and ultrasound scanning for a fever checkup,, which diagnosed the CIHPSS. between the right portal vein and the right-sus hepatic vein. In the two other one, it was the antenatal color Doppler and ultrasound scanning which diagnosed shunts during the third term of pregnancy. Those three shunts were considered as type II, according to the PARK’s classification system for IHPSS anormalies, because they link up a portal branch to an hepatic vein in a same parenchymal segment. Methods: Case n°1 is now 6 years old and is still asymptomatic. A clinical, biological and ultrasonographic examination, once a year is sufficient. The vascular fistula resolved spontaneously when case n°2 was 28 months old and when case n°3 was 8,5 months old. Results: DISCUSSION: Normally, toxic metabolites of nutrients and residual activity of pancreatic enzymes are degraded by the liver. Here, due to the shunt, they bypass directly into the systemic circulation. Then, hyperammoniemia, trimethylaminuria, hyperinsulinemia, pulmonary hypertension or congestive heart failure can appear. THERAPY: Because of the rarity of this disorder, the choice of treatment is controversial. It depends on the natural course of the disease, but the majority of patients did not have symptoms until their 6th decade. Initially, the spontaneous resolution is expected. If hepatic encephalopathy or heart failure progress, some treatment may indicate: angiographic intervention with percutaneous coil embolisation, surgical intervention such as shunt ligation and hepatic resection or realisation of an alternative portosystemic shunt. Conclusion: CIHPSS have been thought to be uncommon, but improvement of imaging (US, CT, MRI) have shown even asymptomatic intrahepatic shunts in an increasing number of patients. Spontaneous resolution is frequent. Metabolic and hemodynamic repercussions will guide the management in other cases.

Characterization of one α2-macroglobulin with anticomplementary activity from pregnant women

In 15 pregnant women during the third term of pregnancy, the immunomodulatory property of alpha 2-macroglobulin (alpha 2M) was initially detected by measuring the inhibitory effect on immune complement-dependent haemolysis of serum alpha 2M fractions obtained by gel filtration. By a two-step chromatography procedure consisting of gel filtration followed by anion-exchange chromatography, different sub-forms of alpha 2M in serum were separated. Amongst them, it was shown that the inhibition of complement activity was almost exclusively linked to one particular subform. Additional studies revealed that the observed effect was not due to proteases bound to alpha 2M during clotting since, by using protease-specific inhibitors, no change was observed in complement inhibition. This subform, though present at very low levels in control sera, appeared in strikingly increased amounts during the third trimester of pregnancy (35 mg/l) and comprised between 3 and 5% of the total alpha 2M. Results show that the increase of alpha 2M anticomplementary activity is linked to the increase in alpha 2M levels in serum.