Trimester Group Research Articles

Effects of multiple micronutrients (MMN) on ovulation inductionin subfertile women with PCOS

Introduction: PCOS is a very common disorder of reproductive women characterized by hyperandrogenism and chronic auovulation. The beneficial effects on micronutrients supplements may have been mediated not only through the presence of multiple vitamin & minerals and multiple antioxidant such as vitamin C and vitamin E. It also mediated insulin sensitization with inositol and improvement of the blood flow in the pelvic organ with the presence of L-arginine. Multiple micronutrients supplementation is a cost effective remedy that is well tolerated with no adverse effects. Its use as an adjuvant in fertility treatment may benefit women pre conceptionaly.Objective: The aims of this study was to investigate the effects of MMN in subfertile women with PCOS.And also to demonstrate that MMN is act as adjuvant therapy to a standard ovulation induction regimen. And to identify ovulation rate and pregnancy rate.Materials and methods: This is a prospective randomized control trial. In this study total 100 patients between the age of 20-40 years were taken from infertility OPD, BSMMU and in private sector, Baridhara, Dhaka, during the period from July 2011 to June 2012.Among 100 patients 50 infertile patients undergoing ovulation induction for 3 months were allocated to receive adjuvant MMN treated as group A. 50 infertile patient undergoing ovulation induction were not allocated to receive adjuvant treated as group B.Results: Clinical pregnancy rate are assessed after third cycle or as soon as the women achieved pregnancy. There was no significant differences in age, menstrual history, BMI (kg/m2) in both groups. This difference was statistically significant p<0.04. And also shows the endometrial thickness with TVS >9mm in 31 patients and less than 9mm in 11 patients with case group compared with the control group >9mm 11 patient and <9mm in 17 patients which is statistically significant p value <0.05. There was no significant difference in progesterone in both groups. There were 22 of 50 patient conceived during the study 2 miscarriage in first trimester in group A and 6 of 50 are conceived in group B and 2 miscarriage in 1st trimester. There was significant difference pregnancy rate p <0.001.Discussion: Our study is to demonstrate that multiple micronutrients supplementation is adjuvant therapy to a standard ovulation induction regimen in women undergoing treatment for anovulatory PCOS patients. The effect of this adjuvant therapy is improved the ovulation and pregnancy rate. Women who take adjuvant micronutrients supplementation during ovulation induction have a higher chance of pregnancy compared with women without micronutrients supplementation.Conclusions: Women who take adjuvant micronutrients supplementation during ovulation induction have a higher chance of pregnancy compared with women without micronutrients supplementation.J. Paediatr. Surg. Bangladesh 4(2): 50-53, 2013 (July)

Prevalence of oral lesions and measurement of salivary pH in the different trimesters of pregnancy.

Oral changes observed during pregnancy have been studied for many years, but their magnitude and frequency have not been stressed upon. This study was undertaken to assess the prevalence of oral lesions during different trimesters of pregnancy and their correlation with salivary pH change. The gingival, simplified oral hygiene, community periodontal and decayed-missing-filled teeth indices were used to assess a total of 120 pregnant women (40 in each trimester group) and 40 nonpregnant women (control group). Salivary pH was measured using a digital pH meter. Presence of any oral lesions was determined via oral examination. Scores for all indices increased while salivary pH decreased from the control group to the first trimester group, through to the third. Oral lesions were seen in 44.2% of pregnant women. Lesions were seen in 27.5%, 52.5% and 52.5% of women in the first, second and third trimesters, respectively. The percentage of pregnant women with one oral lesion was highest in the second trimester (47.5%), whereas the third trimester had the highest prevalence (17.5%) of two concurrent oral lesions. The incidence of fissured tongue was highest in the first trimester group, and that of gingival enlargement was highest in the third trimester group. In the second trimester group, there was an almost equal incidence of fissured tongue and gingival/mucosal enlargement. Most changes in oral tissues during pregnancy can be avoided with good oral hygiene. Salivary pH could be used to assess the prevalence of oral lesions in the different trimesters of pregnancy.

Placental Oxidative Status throughout Normal Gestation in Women with Uncomplicated Pregnancies.

The effects of gestational age on placental oxidative balance throughout gestation were investigated in women with uncomplicated pregnancies. Placental tissues were obtained from normal pregnant women who delivered at term or underwent elective pregnancy termination at 6 to 23 + 6 weeks of pregnancy. Placental tissues were analyzed for total antioxidant capacity (TAC) and lipid peroxide (malondialdehyde, MDA) levels using commercially available kits. Two hundred and one placental tissues were analyzed and the mean ± SD MDA (pmol/mg tissue) and TAC (µmol Trolox equivalent/mg tissue) levels for first, second, and third trimester groups were 277.01 ± 204.66, 202.66 ± 185.05, and 176.97 ± 141.61, P < 0.004 and 498.62 ± 400.74, 454.90 ± 374.44, and 912.19 ± 586.21, P < 0.0001 by ANOVA, respectively. Our data reflects an increased oxidative stress in the placenta in the early phase of normal pregnancy. As pregnancy progressed, placental antioxidant protective mechanisms increased and lipid peroxidation markers decreased resulting in diminution in oxidative stress. Our findings provide a biochemical support to the concept of a hypoxic environment in early pregnancy. A decrease in placental oxidative stress in the second and third trimesters appears to be a physiological phenomenon of normal pregnancy. Deviations from this physiological phenomenon may result in placental-mediated disorders.

Accuracy of sonographic fetal gender determination: predictions made by sonographers during routine obstetric ultrasound scans.

Objectives: The purpose of this study was to determine the accuracy of sonographer predictions of fetal gender during routine ultrasounds. Primarily, the study sought to investigate the accuracy of predictions made in the first trimester, as requests from parents wanting to know the gender of their fetus at this early scan are becoming increasingly common. Second and third trimester fetuses were included in the study to confirm the accuracy of later predictions. In addition, the mother's decision to know the gender was recorded to determine the prevalence of women wanting prenatal predictions. Methods: A prospective, cross sectional study was conducted in a specialist private obstetric practice in the Illawarra, NSW. A total of 640 fetuses across three trimesters were examined collectively by seven sonographers. Fetal gender was predicted using the sagittal plane only in the first trimester and either the sagittal or transverse plane in later trimesters. Phenotypic gender confirmation was obtained from hospital records or direct telephone contact with women postnatally. Results: Results confirmed 100% accuracy in predictions made after 14 weeks gestation. The overall success rate in the first trimester group (11–14 weeks) was 75%. When excluding those scans where a prediction could not be made, success rates increased to 91%. Results were less accurate for fetuses younger than 12 weeks, with an overall success rate of 54%. Male fetuses under 13 weeks were more likely to have gender incorrectly or unable to be assigned. After 13 weeks, success rates for correctly predicting males exceeded that of female fetuses. Statistical differences were noted in the success rates of individual sonographers. Sixty seven percent of women were in favour of knowing fetal gender from ultrasound. Publicly insured women were more likely to request gender disclosure than privately insured women. Conclusions: Sonographic gender determination provides high success rates in the first trimester. Results vary depending on sonographer experience, fetal age and fetal gender. Practice guidelines regarding gender disclosure should be developed. Predictions prior to 12 weeks should be discouraged.

PMM.31 Pregnant women’s knowledge and consumption on long chain omega-3 polyunsaturated fatty acid supplements

ObjectivesTo study the percentage of pregnant women who consumed omega-3 fatty acids in the course of pregnancy, and to assess their knowledge on the source and potential health benefits of...

Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study

BackgroundThe aims were to evaluate the effect of pregnancy on carotid artery elasticity and determine the associations between maternal lipids, endothelial function and arterial elasticity during pregnancy.MethodsWe examined 99 pregnant and 99 matched non-pregnant control women as part of a population-based prospective cohort study. Carotid artery elasticity indexes; carotid artery distensibility (CAD), Young’s elastic modulus (YEM) and stiffness index (SI) as well as brachial artery flow-mediated dilation (FMD) were assessed using ultrasound; serum lipid levels were also determined.ResultsSI was 57% and YEM 75% higher and CAD 36% lower in the third trimester group than the corresponding values in the first trimester group. Serum cholesterol and triglyceride levels were significantly higher in women at the end of the pregnancy than at the beginning of pregnancy (P < 0.001) and in controls (P < 0.001). In multivariate analysis, gestational age was the only independent correlate of arterial elasticity in pregnant women. In controls, age (P ≤ 0.001) and common carotid diameter (P = 0.001-0.029) were associated with SI, YEM and CAD.ConclusionsThe present study revealed that carotid artery elasticity declined towards the end of the pregnancy; this neither is straight correlating with maternal hyperlipidemia or the diameter of the carotid artery nor is it associated with changes in endothelial function.

Detection efficiency of fetal epigenetic marker in maternal plasma

Objective To analyze the detection efficiency of non-sex dependent Ras association domain family 1A (RASSF1A) sequences in maternal plasma as a fetal epigenetic marker,and to explore the feasibility of replacing SRY gene in quantitative detection of fetal free DNA.Methods Maternal peripheral blood samples were collected in the first,second and third trimester from 50 normal pregnant women who had their prenatal care in the First and Fifth People's Hospital in Datong,Shanxi Province,between May 1,2011 and April 30,2012.Among them,pregnant women with single male fetus (n=28) were selected as study group,and another 20 normal healthy non-pregnant women in the same period were selected as control.The methylationsensitive restriction enzymes were used specifically to cut the maternal hypomethylated RASSF1A gene,the fetal hypermethylated sequences were determined by fluorescence quantitative polymerase chain reaction,and SRY sequences in maternal plasma were determined as a reference.Shapiro-wilk,Pearson or Spearman correlation analysis and Chi-square test were applied for statistical analysis.Results Among the 28 pregnant women with male fetus,the hypermethylated RASSF1A sequences in maternal plasma was tested 84 times and identified as early as at 8+2 weeks of gestation,giving the detection rate of 97.62％ (82/84).However,no RASSF1A or SRY gene was identified in control group.The mean concentrations of hypermethylated RASSF1A and SRY gene in the first,second and third trimester group were (60.19± 14.16) copies/ml vs (58.22± 15.13) copies/ml (r=0.933,P＜0.01),(99.18±28.44) copies/ml vs (95.43±32.33) copies/ml (r=0.931,P＜0.01)and (144.93±33.51) copies/ml vs (132.96±28.24) copies/ml (r=0.654,P＜0.01),respectively.The mean concentrations of hypermethylated RASSF1A and SRY gene showed positive correlation with gestational weeks (r=0.933 and 0.896,P＜0.01,respectively).Conclusions By using hypermethylated RASSF1A gene as an epigenetic marker,the detected free fetal DNA results is highly consistent with SRY gene without gender influence.Thus,it is helpful to expand its clinical application of noninvasive prenatal diagnosis. Key words: Tumor suppressor proteins; Methylation; Epigenomics; Genes, SRY; Prenatal diagnosis; Polymerase chain reaction

The Effect of Maternity Support Belts on Postural Balance in Pregnancy

The purpose of this study was to evaluate the effect of maternity support belts (MSB) on postural balance during pregnancy. Prospective, observational cohort study. Outpatient visits at a university hospital, obstetrics and gynecology clinic. A total of 90 pregnant women in first, second, and third trimesters of pregnancy; 30 pregnant women for each trimester. Dynamic and postural stability by using a Biodex Stability System and comparing pregnant women with and without an MSB in each cohort group. Overall, anterior-posterior stability index, medial-lateral stability index, and fall risk test (FRT) scores were obtained with 1 stance at platform stability of level 8. Four measurements from the Biodex Stability System were compared between pregnant women with and without an MSB in each group. The scores of anterior-posterior stability index and FRT were significantly lower in the first-trimester group with an MSB than without an MSB (P < .05). Medial-lateral stability index and FRT scores were significantly lower in the second-trimester group with an MSB than without an MSB (P < .05). In the third-trimester group, overall, medial-lateral stability index, and FRT scores were lower for participants with an MSB compared with participants without an MSB (P < .05). In all trimester groups, FRT scores were detected to be lower in pregnant women with an MSB than in those without an MSB (P < .05). MSB use improves impaired balance and FRT scores during all periods of pregnancy, especially in the third trimester. MSB is useful for fall prevention during pregnancy, especially during the third trimester.

Variations in electrical activity of the heart as the pregnancy progresses

Background: Pregnancy is a physiological condition that brings a considerable alteration in hemodynamic activity of the maternal heart. It is very important to understand the cardiac functioning of maternal heart during normal pregnancy because apart from obstetric causes, cardiac disorders are the main cause of mortality in females .Study of electrical activity of the heart is a simple noninvasive and cost effective method which can also raise alarm about the pathological changes in the cardiac function. Aims & Objective: To study the intervals of Electrocardiogram (ECG) in pregnant women and to compare the same with healthy non pregnant women. Materials and Methods: A total of 223 females fulfilling the inclusion criteria were recruited for the study. They were divided into four groups - nonpregnant/control group (n=30), 1st trimester (n=36), 2nd trimester (n=64) and 3rd trimester (n= 93). ECG was recorded in lead II. Heart rate, PR, QT interval and QTc were also calculated. These parameters were compared between the groups using one way ANOVA test. A p value of less than 0.05 was considered as significant. Results: An increase in heart rate and QTc interval and decrease in PR interval was observed in pregnant women when compared with the heart rate of nonpregnant females. This was statistically insignificant when compared between controls and 1st trimester. However a significant change was observed between control group and 2nd/3rd trimester groups. This change was also observed significantly within the pregnant groups when compared with each other. Conclusion: The cardiovascular hemodynamic adaptation to pregnancy is a well-established physiological fact which was also apparent in this study. Further we noticed a significant change in electrical activity in pregnancy in terms of PR, QT and QTc intervals. These changes became more significant after 1st trimester and peaking during the 3rd trimester.

Analysis of intrauterine fetal demise—A hospital-based study in Taiwan over a decade

ObjectiveTo identify timing-specified risk factors for stillbirth, in order to help physicians to reduce preventable factors and stillbirths, and improve general outcomes of pregnancy. Materials and MethodsA retrospective analysis was performed of births registered in our hospital, a medical center in Taiwan, between September 1, 1999 and December 31, 2011. We collected basic characteristics from the medical records, including maternal and fetal conditions. All stillbirths were divided into two groups according to gestational age: the second trimester group and the third trimester group. Comparisons were made between these groups. ResultsThere were a total of 12,290 births and 121 stillbirths during our study period. The 121 stillbirths were divided into two groups: 67/121 (55.4%) were in the second trimester group and 54/121 (44.6%) were in the third trimester group. The overall incidence for intrauterine fetal demise was 0.98% (121/12,290). The increased risks in the third trimester stillbirths, as compared with the second trimester group, were significantly associated with males born, increased maternal body mass index (BMI) at delivery, habitual cigarette smoking, previous history of intrauterine fetal demise, and diabetic or hypertensive pregnancies. Unexplained causes (29.85%) were the most common causes of second trimester intrauterine fetal demise and the most common cause of third trimester intrauterine fetal demise was umbilical cord pathology (33.33%). ConclusionManagement of any pregnant patient remains a challenge. Identifying upstream and cost-effective solutions will improve these pregnancy outcomes.

Iodine Supplementation throughout Pregnancy Does Not Prevent the Drop in FT4 in the Second and Third Trimesters in Women with Normal Initial Thyroid Function

Objectives: The aim of the study was to determine the evolution of thyroid tests throughout pregnancy and postpartum in healthy women with and without iodine supplementation. Methods: This was a prospective, randomized, interventional study of iodine supplementation (150 μg/day) from the first trimester until 3 months postpartum versus controls. 111 pregnant women with normal initial thyroid tests were enrolled, undergoing comprehensive thyroid assessment at each trimester. We present results of longitudinal and cross-sectional analyses. Results: Initial ioduria suggested mild iodine deficiency in both groups, while third-trimester ioduria rose to levels of iodine sufficiency in the iodine-supplemented group. In the longitudinal study, free T4 (FT4) levels decreased in the second and third trimesters compared to the first trimester in both groups, with no change in TSH, and rose postpartum, though lower than the first trimester. FT3 levels and the total T4 (TT4)/thyroxine-binding globulin (TBG) ratio followed the same evolution as FT4. TT4 levels rose due to TBG increase. Thyroglobulin (Tg) of iodine group remained stable, contrasting with the rise in the control group. In the cross-sectional study, there was no difference between the two groups in thyroid tests at any time-point, except for lower Tg in the second trimester and postpartum visits in the iodine group. Conclusions: In healthy, mildly iodine-deficient pregnant women, a ‘drop' of FT4 and TT4/TBG without TSH increase occurs between the first and second trimesters, and is not prevented by iodine supplementation, suggesting physiology. Therefore, FT4 is valuable to assess thyroid function in pregnancy in clinical practice with appropriate trimester-specific reference range. It brings up reflection on threshold for diagnosis and treatment of hypothyroxinemia.

DETERMINATION OF BIOLOGICAL AGE IN PREGNANT AND RECENTLY CONFINED WOMEN USING ANTHROPOMETRIC INDICES

Aim. To determine the biological age and ageing rate in pregnant women of I, II, III trimesters of pregnancy, in the puerperal period on the days 3–10 and 1 year after the first investigation. Materials and methods. Thirty five women in I, II, III trimesters of physiological pregnancy, puerperal period on the days 3–10 and 1 year after the first investigation were examined. Patients were divided into 2 age groups. Group I (20–29 years old) included 24 pregnant women with a mean age of 25,4±0,49 years, group II (30–39 years old) included 11 women with a mean age of 34,02±0,71 years. Biological age (BA) was determined with anthropometry method using L. M. Belozerova method. Results. Analysis of the obtained data showed that only in group I biological age reliably exceeded the proper biological age in I, III trimesters and in the puerperal period (3–10 days after the delivery), in II trimester no reliable difference between biological and proper biological age was observed. In group II, biological age also prevailed over the proper biological age throughout the investigation without reliable difference. In age group I, there is a reliable difference between trimester I biological age and puerperal period. In group II, no reliable difference between biological ages throughout the investigation was noted. Thus, the accelerated rate of age changes is typical for group I in I, III trimesters of pregnancy and in the puerperal period. The second trimester of group I is characterized by a mean rate of age changes. In group II, a mean rate of age changes throughout the investigation was registered. Conclusion. Biological age by anthropometric indices investigated reliably exceeds the proper biological age in group I during I, III trimesters of pregnancy and in the puerperal period. The rate of age changes has an accelerated character in I, III trimesters and in the puerperal period among women of group I. In group II, a mean rate of age changes throughout the investigation was observed.

Total Macular Volume and Foveal Retinal Thickness Alterations in Healthy Pregnant Women

ABSTRACTPurpose: To evaluate whether there are alterations in total macular volume (TMV) and foveal retinal thickness (FT) values during pregnancy. Methods: This study included 60 healthy pregnant women in their first, second, and third trimester (groups 1, 2, and 3) and 20 nonpregnant women (group 4). TMV and FT values were measured by optical coherence tomography (OCT) in each group. Results: Mean TMV was 1.43 ± 0.56 mm3, 1.88 ± 0.54 mm3, 2.04 ± 0.66 mm3 and 1.35 ± 0.41 mm3 in groups 1, 2, 3, and 4, respectively. Mean FT was 199.20 ± 64.35 µ, 274.35 ± 67.45 µ, 287.95 ± 95.50 µ and 192.100 ± 58.61 µ in groups 1, 2, 3, and 4, respectively. There was statistical significance among group 1–2 (p1 = 0.014, p2 = 0.001), group 1–3 (p1 = 0.003, p2 = 0.002), group 2–4 (p1 = 0.001, p2 = 0.001), and group 3–4 (p1 = 0.001, p2 = 0.001) for both TMV and FT, respectively. Conclusion: The increase of fluid in the body, in particular in the second and last trimester, may cause an increase of TMV and FT.

Comparison of spread of subarachnoid sensory block and incidence of hypotension in early and late second trimester of pregnancy

BackgroundObstetric or non-obstetric surgery can be performed in pregnant women during the second trimester. We evaluated maximal sensory block level (MSBL), and other sensory block characteristics after spinal anesthesia in early and late second trimester pregnant women.MethodsForty-four pregnant women scheduled for cervical cerclage under spinal anesthesia in the early second trimester (Group E) or in the late second trimester (Group L) were enrolled in this study. Spinal anesthesia was performed at the L3/4 and 7 mg of 0.5% hyperbaric bupivacaine was injected into the subarachnoid space. Hemodynamic variables, incidence of nausea/vomiting, ephedrine dose, and sensory block were recorded every 2.5 min during the first 15 min and 20 min after the injection. The MSBL, the time at which MSBL was achieved, and the time to the two-segment regression of the sensory level were also recorded.ResultsThe maximum number of segments blocked was significantly greater in the Group L than in the Group E. The incidence of nausea/vomiting and hypotension, and dose of administrated ephedrine were significantly higher in the Group L than in the Group E. The mean arterial pressure during the 15 min after subarachnoid injection was significantly lower compared to the baseline value in the Group L.ConclusionsThe MSBL of spinal anesthesia with hyperbaric bupivacaine 7 mg were T9 in the early and T5 in the late second trimester groups. Pregnant women in the late second trimester exhibited increased incidence of hypotension and need for ephedrine than women in the early second trimester.

Glycemic and Lipedimic Status in Different Trimester of Pregnancy

The study has been undertaken to assess the lipid profile in different trimester of pregnancy. Under a cross-sectional design, 30 healthy nonpregnant as well as 130 pregnant women, at 3 different trimesters of pregnancy (43 in 1st trimester, 44 in 2nd trimester and 43 in 3rd trimester) were sampled for plasma levels of glucose and lipids profile. All the study groups were age matched [mean ± SD; years: 26.02 ± 2.90 in nonpregnant group; 24.95 ± 4.77 in 1st trimester group; 24.36 ± 4.95 in 2nd trimester and 25.49 ± 5.24 in 3rd trimester group respectively]. Plasma total cholesterol, triglyceride, LDL cholesterol and HDL cholesterol level increased throughout the pregnancy. In present study dyslipidemia was found to develop in group with advancing trimester of pregnancy that is the risk of cardio vascular disease. DOI: http://dx.doi.org/10.3329/bjnut.v22i0.12831 Bangladesh Journal of Nutrition Vol.22-23 2009-2010 pp.53-60

Plasma Homocysteine, Folate and Vitamin B&lt;sub&gt;12&lt;/sub&gt; in Different Trimester of Pregnancy

The present study has been undertaken to investigate plasma creatinine, folate and vitamin B12 as underlying factors in the reduction of plasma homocysteine concentration in different trimesters of pregnancy. Under a cross-sectional design, 30 healthy nonpregnant as well as 130 pregnant women, at 3 different trimesters of pregnancy (43 in 1st trimester, 44 in 2nd trimester and 43 in 3rd trimester) were sampled for plasma levels of folate, vitamin B12, homocysteine and creatinine. Plasma homocysteine and creatinine level were significantly (p&lt;0.014) lower in pregnant women at different trimester (1st, 2nd and 3rd trimester) compared to nonpregnant women. Plasma folate was significantly higher in different groups of pregnant women compared to nonpregnant women. Significant negative correlation was found between plasma homocysteine and folate in nonpregnant (r=-0.453, p&lt;0.012) and pregnant women at 2nd trimester (r=-0.681, p&lt;0.001). There was found significant negative correlation between plasma homocysteine and vitamin B12 at 1st trimester group (r=-0.322, p&lt;0.035) and 2nd trimester group (r=-0.394, p&lt;0.008) but not in 3rd trimester. In present study, reduction of plasma total homocysteine appears to be a physiological response in pregnancy, and the level of plasma folate and vitamin B12, but can not be explained by renal homodynamic changes. DOI: http://dx.doi.org/10.3329/bjnut.v22i0.12833 Bangladesh Journal of Nutrition Vol.22-23 2009-2010 pp.69-79

Clinical application of noninvasive prenatal diagnosis using cell free fetal DNA in maternal plasma

To investigate the clinical value of non-invasive prenatal diagnosis using cell free fetal DNA (cff-DNA) in maternal blood. From Sep. 2010 to Mar. 2012, 103 pregnant women who came to Henan Province People's Hospital in the first trimester for prenatal diagnosis of sex-linked inherited diseases were included in the first trimester group. From Oct. 2010 to Jan. 2012, 205 pregnant women undergoing amniotic fluid sampling for fetal karyotype analysis in the same hospital were included in the second trimester group. Real time quantitative PCR and fluorescent PCR were used to detect sex determining region of Y chromosome gene (SRY) and amelogenin gene (AML) on cff-DNA of the first trimester group. Moreover, 12 Y chromosome STR loci analysis were performed for 33 male fetuses and their fathers. Massively Parallel Signature Sequencing (MPSS) was used for aneuploidy analysis in cff-DNA of the second trimester group. (1) In the first trimester group, there were 53 SRY positive and 50 SRY negative. Compared with the results of cff-DNA of chorionic villus samples, there was one SRY false positive and one false negative results, with a sensitivity of 98% and specificity of 98%. For the AML gene test, there were two PCR products of male fetuses:102 bp fragment originating from X chromosome (AML X) and 108 bp fragment from Y chromosome (AML Y); but only AML X was found in products from female fetuses. In the first trimester group, 102 bp and 108 bp fragments were detected in 52 cases, and only 102 bp fragment was found in the other cases. Compared to AML results from chorionic villus samples, there were 2 false negative results, with a sensitivity of 96% and specificity of 100%. (2) For cff-DNA with plasma SRY over 30 copy/ml, Y STR loci were analyzed on cff-DNA of 33 fetuses and their fathers. The Y STR loci less then 200 bp were successfully detected, while Y STR loci with PCR products between 200-300 bp showed low signal or could not be amplicated; and no PCR products more than 300 bp were detected from cff-DNA. Comparing the detected Y STR loci of cff-DNA to the fathers, 32 fetuses were concordant with their fathers'. Exogenous contamination was found in the rest one sample. (3) In the second trimester group, 6 fetuses with abnormal karyotype (two trisomy 21, three trisomy 18 and one 45, XO) were detected by cff-DNA and were proved by karyotype analysis. Moreover, the MPSS results of cff-DNA revealed one 45, Y and one trisomy 16 whose karyotype analysis showed normal results. And in one case, MPSS suggested less chrX or chrY, that was proved to be 47, XYY by karyotype analysis. (1) Cff-DNA in maternal blood can be used to determine fetal gender in early prenancy with considerable sensitivity and specificity. But the trace cff-DNA and the high maternal DNA background might have impact on the result. (2) Analysis of cff-DNA in maternal blood of the second trimester women showed that MPSS could be used for prenatal screening of trisomy 21 and trisomy 18. However, further research should be done for other chromosomes aneuploidy detection.

Anthropometric and body composition characteristics during pregnancy: A study from West Bengal, India

The present cross-sectional study was aimed at investigating changes in anthropometric, body composition and blood pressure characteristics during pregnancy. A total of 406 healthy, pregnant women aged between 16 and 33 years participated in the study. Pregnant women were recruited from the outpatient department of the two-referral hospital in Bolpur subdivision of Birbhum district, West Bengal, India. Anthropometric measures such as height, weight, three circumferences and skinfold thickness at four sites (biceps, triceps, subscapular and suprailaic) were obtained using standard techniques. Percentages of body fat (%BF), intra abdominal visceral fat (IVF), basal metabolic rate (BMR) and body mass index (BMI) were measured using an Omron body fat analyser. Two forenoon blood pressure measurements were also taken and averaged for analysis. Subjects were categorized into three trimester groups: Group I, n=30; Group II, n=163; and Group III, n=213. ANOVA with Scheffe's post-hoc test revealed that Group I had significantly lower mean than both Group II and Group III for systolic blood pressure and IVF, whereas Group I had significantly lower mean than Group III for BMI, BMR, %BF, diastolic blood pressure and skinfolds. The mean change in maternal weight from the first to the third trimester was merely 3kg. Mean waist circumference varied from the first to the third trimester but not from the first to the second trimester. Furthermore, significantly increased systolic and diastolic blood pressure was observed across the trimesters. However, longitudinal studies involving interaction of body fat topography and pregnancy-induced hormones are required to further our understanding of gestation mechanism.

Nutrition awareness before and throughout different trimesters in pregnancy: a quantitative study among Dutch women

To examine the nutrition awareness of women before and during pregnancy in order to provide a greater understanding of the life course perspective (LCP) in relation to nutrition behaviours and pregnancy. Data were collected in a cross-sectional study with the aid of a face-to-face interview, based on our conceptualization of nutrition awareness and the 'rules of thumb' designed by the Dutch Nutrition Centre. The sample consisted of five groups each of ~100 Dutch nulliparous women: women not trying to conceive a child, women trying to conceive a child and women in their first, second or third trimesters of pregnancy. The measurement tool based on our conceptualization of nutrition awareness resulted in a Cronbach's alpha of 0.84. Pregnant women are significantly more aware of their nutrition than women who are not trying to conceive. The scores on nutrition awareness do not differ significantly between the three trimester groups of pregnant women. Women who are trying to conceive do not have a significantly higher nutrition awareness than women who are not trying to conceive. Our conceptualization of nutrition awareness has shown to be fruitful in obtaining a better understanding of behavioural changes in health. The study provided indications in favour of the LCP; pregnancy could indeed be an event in a woman's life that causes increased nutrition awareness. This should be kept in mind when healthy nutrition promotion activities are being developed.

The Prevalence of Malaria among Pregnant Women in Maradi, Niger Republic

Astudy was conducted to determine the prevalence of malaria among pregnant women in Maradi, Niger Republic. Questionnaires were administered to a total of four hundred and eight (408) pregnant women to obtain information about their trimester group, gravid status, duration of the pregnancy, educational level and age group. Blood samples were collected from the interviewed subjects and analysed for the presence of Plasmodium infection using thin and thick smear techniques.Atotal of one hundred and forty-nine (149) samples were found to be infected, representing 36.52%. The distribution of the infection by trimester groups showed that, women in their first trimester had the highest&nbsp; prevalence of 43.47%. The age-group distribution of the infection showed that, persons aged 10-19 had the highest prevalence of 45.58%, while the distribution of the infection by level of education showed that persons with non-formal education had the highest prevalence of 75.0%. All the infections were found to be due to Plasmodium falciparum. The survey found ignorance to be a contributing factor in the epidemiology of malaria in the area and suggested mass public enlightenment programme as a control measure.