L Khambule, C Chikomba, Y Adam, L Khan, C Haldane, B Vetter, J George
Objective: Lack of accessibility to oral glucose tolerance tests (OGTTs) in South Africa means many pregnant women go without testing for gestational diabetes mellitus (GDM). This study evaluated point-of-care (POC) glucometers against the laboratory-based glucose method in pregnant women.
Methods: This was a cross-sectional study on pregnant women attending the prenatal clinic in Johannesburg who were recommended for the OGTT. OGTTs were conducted as per International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines. Women who consented to the study donated both venous and capillary blood for laboratory-based and POC glucose measurements using seven POC glucometers: I-STAT, Xpress, LDX, VivaChek-Ino, Accu-Chek Active, StatStrip, and Codefree. By assessing sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) and comparing Bland-Altman plots, the diagnostic accuracy of each glucose meter was compared with the reference method, the laboratory-based glucose method.
Results: Data were analyzed for 1076 pregnant women. Based on OGTT testing, 83 women had GDM (7.7%). Overall, the POC glucometers performed poorly, with sensitivity ranging from 17.6% to 87.18% and specificity ranging between 62.7% and 99.8%. The AUC ranged from 0.59 to 0.79. All POC glucometers showed moderate to poor reliability. Laboratory-based fasting plasma glucose (FPG) surpassed the POC glucometers in sensitivity, specificity, and AUC, with values of 94.0%, 100%, and 0.98, respectively.
Conclusion: We demonstrated that laboratory-based FPG has the potential to be used as a diagnostic test for GDM and that the POC glucometers cannot replace OGTT laboratory-based measurements.
{"title":"Performance of point-of-care glucose testing for the diagnosis of gestational diabetes in South Africa.","authors":"L Khambule, C Chikomba, Y Adam, L Khan, C Haldane, B Vetter, J George","doi":"10.1002/ijgo.15914","DOIUrl":"https://doi.org/10.1002/ijgo.15914","url":null,"abstract":"<p><strong>Objective: </strong>Lack of accessibility to oral glucose tolerance tests (OGTTs) in South Africa means many pregnant women go without testing for gestational diabetes mellitus (GDM). This study evaluated point-of-care (POC) glucometers against the laboratory-based glucose method in pregnant women.</p><p><strong>Methods: </strong>This was a cross-sectional study on pregnant women attending the prenatal clinic in Johannesburg who were recommended for the OGTT. OGTTs were conducted as per International Association of Diabetes and Pregnancy Study Groups (IADPSG) guidelines. Women who consented to the study donated both venous and capillary blood for laboratory-based and POC glucose measurements using seven POC glucometers: I-STAT, Xpress, LDX, VivaChek-Ino, Accu-Chek Active, StatStrip, and Codefree. By assessing sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) and comparing Bland-Altman plots, the diagnostic accuracy of each glucose meter was compared with the reference method, the laboratory-based glucose method.</p><p><strong>Results: </strong>Data were analyzed for 1076 pregnant women. Based on OGTT testing, 83 women had GDM (7.7%). Overall, the POC glucometers performed poorly, with sensitivity ranging from 17.6% to 87.18% and specificity ranging between 62.7% and 99.8%. The AUC ranged from 0.59 to 0.79. All POC glucometers showed moderate to poor reliability. Laboratory-based fasting plasma glucose (FPG) surpassed the POC glucometers in sensitivity, specificity, and AUC, with values of 94.0%, 100%, and 0.98, respectively.</p><p><strong>Conclusion: </strong>We demonstrated that laboratory-based FPG has the potential to be used as a diagnostic test for GDM and that the POC glucometers cannot replace OGTT laboratory-based measurements.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aaron D. Masjedi, Zachary S. Anderson, Fay F. Pon, Shinya Matsuzaki, Rachel S. Mandelbaum, Joseph G. Ouzounian, Koji Matsuo
SynopsisRe‐defining advanced maternal age based on the risk of severe maternal morbidity at delivery may be of value in obstetric medicine.
简要说明根据分娩时产妇严重发病的风险重新定义高龄产妇可能在产科医学中具有价值。
{"title":"Introduction of advanced maternal age based on mortality‐specific severe morbidity","authors":"Aaron D. Masjedi, Zachary S. Anderson, Fay F. Pon, Shinya Matsuzaki, Rachel S. Mandelbaum, Joseph G. Ouzounian, Koji Matsuo","doi":"10.1002/ijgo.15923","DOIUrl":"https://doi.org/10.1002/ijgo.15923","url":null,"abstract":"SynopsisRe‐defining advanced maternal age based on the risk of severe maternal morbidity at delivery may be of value in obstetric medicine.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVETo assess the impact of an educational video on immediate postpartum contraceptive implant utilization.METHODSThis was a randomized controlled study conducted in a university hospital. Postpartum women aged over 18 years were recruited and divided into two groups: the intervention group, which viewed a 7-min educational video about contraceptive implants; and the control group, which did not. We evaluated the uptake of contraceptive implants immediately and during a 12-week period postpartum, in addition to the reasons for not selecting this method.RESULTSA total of 202 participants were included in the study, 101 in each group. Viewing the educational video was associated with higher immediate postpartum contraceptive implant usage (22.77% vs 10.89%; relative risk [RR] 2.09, 95% confidence interval [CI] 1.08-4.06). However, no significant difference was observed at the postpartum follow-up visit (29.9% vs 25.74%; RR 1.61, 95% CI 0.74-1.82). The primary reasons for not selecting contraceptive implants were concerns about potential side effects and discomfort associated with the insertion procedure.CONCLUSIONThe inclusion of an animated educational video significantly improved immediate postpartum contraceptive implant uptake, making it a potentially viable strategy in settings with high rates of loss to follow-up. However, further research into how to address patients' fears regarding the implant is required.
目的：评估教育视频对产后立即使用避孕皮下埋植剂的影响。方法：这是一项在大学医院进行的随机对照研究。我们招募了 18 岁以上的产后妇女，并将她们分为两组：干预组和对照组，前者观看了 7 分钟的避孕皮下埋植剂教育视频，后者则没有观看。我们评估了产后即刻和 12 周内采取皮下埋植避孕法的情况，以及不选择这种方法的原因。结果共有 202 人参加了研究，每组 101 人。观看教育视频与更高的产后立即使用避孕植入物率相关（22.77% vs 10.89%；相对风险 [RR] 2.09，95% 置信区间 [CI]1.08-4.06）。然而，在产后随访中未观察到明显差异（29.9% vs 25.74%；RR 1.61，95% CI 0.74-1.82）。不选择植入避孕药具的主要原因是担心潜在的副作用和植入过程中的不适。然而，如何消除患者对植入手术的恐惧还需要进一步研究。
{"title":"The effect of an educational video on the immediate insertion of postpartum contraceptive implants: A randomized controlled trial.","authors":"Nutruja Boontor,Srinaree Kaewrudee,Jen Sothornwit","doi":"10.1002/ijgo.15921","DOIUrl":"https://doi.org/10.1002/ijgo.15921","url":null,"abstract":"OBJECTIVETo assess the impact of an educational video on immediate postpartum contraceptive implant utilization.METHODSThis was a randomized controlled study conducted in a university hospital. Postpartum women aged over 18 years were recruited and divided into two groups: the intervention group, which viewed a 7-min educational video about contraceptive implants; and the control group, which did not. We evaluated the uptake of contraceptive implants immediately and during a 12-week period postpartum, in addition to the reasons for not selecting this method.RESULTSA total of 202 participants were included in the study, 101 in each group. Viewing the educational video was associated with higher immediate postpartum contraceptive implant usage (22.77% vs 10.89%; relative risk [RR] 2.09, 95% confidence interval [CI] 1.08-4.06). However, no significant difference was observed at the postpartum follow-up visit (29.9% vs 25.74%; RR 1.61, 95% CI 0.74-1.82). The primary reasons for not selecting contraceptive implants were concerns about potential side effects and discomfort associated with the insertion procedure.CONCLUSIONThe inclusion of an animated educational video significantly improved immediate postpartum contraceptive implant uptake, making it a potentially viable strategy in settings with high rates of loss to follow-up. However, further research into how to address patients' fears regarding the implant is required.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jia Kang, Dongyan Mei, Xiaoyan Xing, Yang Cao, Dandan Liang, Honghui Shi
ObjectiveThe aim of the study was to investigate the clinical characteristics, therapy strategies and prognosis of Sertoli‐Leydig cell tumors (SLCTs).MethodsA total of 50 cases of ovarian SLCTs were retrospectively analyzed. We performed descriptive statistics to describe baseline characteristics.ResultsA total of 70% of SLCT patients were below the age of 45 years. The dominant pathologic types were poor (40%) and moderate (40%) differentiation. Retiform variant tumor is more aggressive and tends to appear in children. According to the 2014 FIGO (the International Federation of Gynecology and Obstetrics) classification, tumors were classified as Stage I (n = 46: well differentiated, n = 4; moderately differentiated, n = 19; poorly differentiated, n = 18; and retiform, n = 5), Stage II (n = 1, moderately differentiated), Stage III (n = 1, poorly differentiated), and Stage IV (n = 2: poorly differentiated, n = 1; and retiform, n = 1). Median follow‐up was 58.1 months (2–132 months). A total of 45 patients (90%) achieved clinical remission. Four patients experienced a relapse (34.5 months, range: 7–58) and one patient died of the tumor at 10 months after initial treatment. All patients in grossly Stage IA achieved complete response, irrespective of the presence or absence of staging surgery or chemotherapy. After treatment, five patients successfully gave birth to healthy babies.ConclusionThe prognosis for women diagnosed with early stage (I–II) SLCT is generally favorable, especially Stage IA. while those with advanced stages, poorly differentiated, retiform variant, or tumors containing heterologous components exhibit a more aggressive clinical course. Fertility sparing surgery appears to represent a feasible treatment approach for early stage SLCTs.
{"title":"Characteristics and prognostic implications of a cohort of 50 Sertoli‐Leydig cell tumors at a single center","authors":"Jia Kang, Dongyan Mei, Xiaoyan Xing, Yang Cao, Dandan Liang, Honghui Shi","doi":"10.1002/ijgo.15908","DOIUrl":"https://doi.org/10.1002/ijgo.15908","url":null,"abstract":"ObjectiveThe aim of the study was to investigate the clinical characteristics, therapy strategies and prognosis of Sertoli‐Leydig cell tumors (SLCTs).MethodsA total of 50 cases of ovarian SLCTs were retrospectively analyzed. We performed descriptive statistics to describe baseline characteristics.ResultsA total of 70% of SLCT patients were below the age of 45 years. The dominant pathologic types were poor (40%) and moderate (40%) differentiation. Retiform variant tumor is more aggressive and tends to appear in children. According to the 2014 FIGO (the International Federation of Gynecology and Obstetrics) classification, tumors were classified as Stage I (<jats:italic>n</jats:italic> = 46: well differentiated, <jats:italic>n</jats:italic> = 4; moderately differentiated, <jats:italic>n</jats:italic> = 19; poorly differentiated, <jats:italic>n</jats:italic> = 18; and retiform, <jats:italic>n</jats:italic> = 5), Stage II (<jats:italic>n</jats:italic> = 1, moderately differentiated), Stage III (<jats:italic>n</jats:italic> = 1, poorly differentiated), and Stage IV (<jats:italic>n</jats:italic> = 2: poorly differentiated, <jats:italic>n</jats:italic> = 1; and retiform, <jats:italic>n</jats:italic> = 1). Median follow‐up was 58.1 months (2–132 months). A total of 45 patients (90%) achieved clinical remission. Four patients experienced a relapse (34.5 months, range: 7–58) and one patient died of the tumor at 10 months after initial treatment. All patients in grossly Stage IA achieved complete response, irrespective of the presence or absence of staging surgery or chemotherapy. After treatment, five patients successfully gave birth to healthy babies.ConclusionThe prognosis for women diagnosed with early stage (I–II) SLCT is generally favorable, especially Stage IA. while those with advanced stages, poorly differentiated, retiform variant, or tumors containing heterologous components exhibit a more aggressive clinical course. Fertility sparing surgery appears to represent a feasible treatment approach for early stage SLCTs.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveTo identify the associations between gestational cholesterol levels and the risk of postpartum hypercholesterolemia, and to establish trimester‐specific reference values.MethodsSerum lipids at gestational weeks 6–8, 16, 24, and 36, and 42 days postpartum were derived from 905 pregnant women of a prospective cohort. The major outcome was postpartum hypercholesterolemia. Logistic regression and restricted cubic splines were conducted to estimate the associations between cholesterol levels at specific gestational ages and postpartum hypercholesterolemia. Associations of the trend of changes in cholesterol levels during pregnancy with postpartum hypercholesterolemia were evaluated by linear mixed‐effect model and linear or logistic regression. Reference values were computed by the receiver operating characteristic curves.ResultsSerum concentrations of total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and the ratios of TC/HDL‐C and LDL‐C/HDL‐C all increased during pregnancy and decreased at 42 days postpartum. The elevated levels of TC and LDL‐C, decreased levels of HDL‐C in pregnancy, and their rapid change rates were positively associated with higher risks of postpartum hypercholesterolemia. The established reference values from the first to the third trimester were below 5.47, 6.35, and 7.22 mmol/L for TC; below 2.83, 3.82, and 4.21 mmol/L for LDL‐C; and more than 1.50, 1.55, and 1.50 mmol/L for HDL‐C, respectively.ConclusionMaternal cholesterol levels and their trend of change during pregnancy were predictors of postpartum hypercholesterolemia. Trimester‐specific reference values were established in a Chinese population.
{"title":"Elevated serum cholesterol levels during pregnancy as predictors for postpartum hypercholesterolemia: A prospective cohort study","authors":"Yandi Zhu, Haiyan Zhu, Qinyu Dang, Qian Yang, Xiaoyan Zhao, Yadi Zhang, Xiaxia Cai, Zhuo Hu, Yuchen Wei, Zhaoyang Chen, Huanling Yu","doi":"10.1002/ijgo.15922","DOIUrl":"https://doi.org/10.1002/ijgo.15922","url":null,"abstract":"ObjectiveTo identify the associations between gestational cholesterol levels and the risk of postpartum hypercholesterolemia, and to establish trimester‐specific reference values.MethodsSerum lipids at gestational weeks 6–8, 16, 24, and 36, and 42 days postpartum were derived from 905 pregnant women of a prospective cohort. The major outcome was postpartum hypercholesterolemia. Logistic regression and restricted cubic splines were conducted to estimate the associations between cholesterol levels at specific gestational ages and postpartum hypercholesterolemia. Associations of the trend of changes in cholesterol levels during pregnancy with postpartum hypercholesterolemia were evaluated by linear mixed‐effect model and linear or logistic regression. Reference values were computed by the receiver operating characteristic curves.ResultsSerum concentrations of total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and the ratios of TC/HDL‐C and LDL‐C/HDL‐C all increased during pregnancy and decreased at 42 days postpartum. The elevated levels of TC and LDL‐C, decreased levels of HDL‐C in pregnancy, and their rapid change rates were positively associated with higher risks of postpartum hypercholesterolemia. The established reference values from the first to the third trimester were below 5.47, 6.35, and 7.22 mmol/L for TC; below 2.83, 3.82, and 4.21 mmol/L for LDL‐C; and more than 1.50, 1.55, and 1.50 mmol/L for HDL‐C, respectively.ConclusionMaternal cholesterol levels and their trend of change during pregnancy were predictors of postpartum hypercholesterolemia. Trimester‐specific reference values were established in a Chinese population.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdominal wall scar endometriosis (AWE) is a rare endometriosis that usually occurs after gynecological or obstetric surgery and for which surgical resection is the standard treatment. For large tissue defects after resection, abdominal wall reconstruction is needed. Here, we describe a mesh bridging technique using biological and polypropylene meshes for abdominal wall reconstruction. A 34‐year‐old woman visited the center with complaints of low abdominal wall pain during menstruation for more than 5 years. Her surgical history included undergoing a cesarean section delivery twice. A mass measuring 6 cm × 5 cm × 3 cm was found above the symphysis pubis in the lower part of the abdominal incision. Endometriosis lesion was considered based on abdominal ultrasound and magnetic resonance imaging findings. After a multidisciplinary discussion that included surgical experts and gynecologists, the decision was made to perform abdominal endometrial focus excision plus abdominal wall reconstruction. Two kinds of mesh were skillfully used in the operation of this patient. Biological mesh was used close to the peritoneal side and covered with polypropylene mesh to reduce the stimulation by the polypropylene mesh of the peritoneum, enhance the strength of the biological mesh, and reduce the incidence of abdominal wall hernia. Our case demonstrates that accurate diagnosis of AWE followed by complete resection and reconstruction of the abdominal wall using a combination of biological and polypropylene mesh bridging can achieve good therapeutic results and patient satisfaction.
{"title":"Application of the mesh bridging technique in the excision of abdominal endometriosis lesions: Case report and literature review","authors":"Yingying Chen, Lifang Wu, Cheng Qian, Wenting Wu, Boliang Chu, Jie Dong","doi":"10.1002/ijgo.15913","DOIUrl":"https://doi.org/10.1002/ijgo.15913","url":null,"abstract":"Abdominal wall scar endometriosis (AWE) is a rare endometriosis that usually occurs after gynecological or obstetric surgery and for which surgical resection is the standard treatment. For large tissue defects after resection, abdominal wall reconstruction is needed. Here, we describe a mesh bridging technique using biological and polypropylene meshes for abdominal wall reconstruction. A 34‐year‐old woman visited the center with complaints of low abdominal wall pain during menstruation for more than 5 years. Her surgical history included undergoing a cesarean section delivery twice. A mass measuring 6 cm × 5 cm × 3 cm was found above the symphysis pubis in the lower part of the abdominal incision. Endometriosis lesion was considered based on abdominal ultrasound and magnetic resonance imaging findings. After a multidisciplinary discussion that included surgical experts and gynecologists, the decision was made to perform abdominal endometrial focus excision plus abdominal wall reconstruction. Two kinds of mesh were skillfully used in the operation of this patient. Biological mesh was used close to the peritoneal side and covered with polypropylene mesh to reduce the stimulation by the polypropylene mesh of the peritoneum, enhance the strength of the biological mesh, and reduce the incidence of abdominal wall hernia. Our case demonstrates that accurate diagnosis of AWE followed by complete resection and reconstruction of the abdominal wall using a combination of biological and polypropylene mesh bridging can achieve good therapeutic results and patient satisfaction.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor: Re “the future of patient education: A study on AI‐driven responses to urinary incontinence inquiries”","authors":"Amnuay Kleebayoon, Viroj Wiwanitkit","doi":"10.1002/ijgo.15920","DOIUrl":"https://doi.org/10.1002/ijgo.15920","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor: Relationship between menopausal hormone therapy and breast cancer: A nationwide population-based cohort study.","authors":"Lifang Jin","doi":"10.1002/ijgo.15918","DOIUrl":"https://doi.org/10.1002/ijgo.15918","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of the present study was to evaluate the obstetric complications associated with isolated fetal congenital heart disease (CHD) by comparing pregnancies with and without this condition.
Methods: In this retrospective matched comparative study at Siriraj Hospital, Thailand, we included 233 postnatally confirmed fetal CHD cases and 466 unaffected fetuses. Controls were selected at a 2:1 ratio, ensuring that they matched the cases in terms of maternal age, parity, and history of preterm deliveries.
Results: Fetal CHD was significantly associated with an increased risk of spontaneous preterm labor (30% vs 9.7%; adjusted odds ratio [aOR] 2.42; 95% confidence interval [CI]: 1.35-4.36; P = 0.003), delivery before 34 gestational weeks (11.6% vs 0.6%; aOR 12.33; 95% CI: 3.32-45.78; P < 0.001), and pre-eclampsia (11.6% vs 2.8%; aOR 2.19; 95% CI: 1.01-4.76; P = 0.047). Newborns with CHD were significantly more likely to be small for gestational age (10.7% vs 5.2%; aOR 2.09; 95% CI: 1.11-3.94; P = 0.022). Intriguingly, a prenatal diagnosis of CHD was associated with a reduced risk of preterm delivery in affected pregnancies (P = 0.002).
Conclusion: Pregnancies affected by isolated fetal CHD demonstrated a higher propensity for several adverse outcomes. These findings underscore the importance of prenatal CHD detection and tailored perinatal care to potentially improve both pregnancy outcomes and neonatal health.
{"title":"Impact of isolated fetal congenital heart disease on pregnancy and perinatal outcomes.","authors":"Yossawadee Kittiratanapinan, Sanitra Anuwutnavin, Supaluck Kanjanauthai, Punnanee Wutthigate, Dittakarn Boriboonhirunsarn, Saifon Chawanpaiboon","doi":"10.1002/ijgo.15912","DOIUrl":"https://doi.org/10.1002/ijgo.15912","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to evaluate the obstetric complications associated with isolated fetal congenital heart disease (CHD) by comparing pregnancies with and without this condition.</p><p><strong>Methods: </strong>In this retrospective matched comparative study at Siriraj Hospital, Thailand, we included 233 postnatally confirmed fetal CHD cases and 466 unaffected fetuses. Controls were selected at a 2:1 ratio, ensuring that they matched the cases in terms of maternal age, parity, and history of preterm deliveries.</p><p><strong>Results: </strong>Fetal CHD was significantly associated with an increased risk of spontaneous preterm labor (30% vs 9.7%; adjusted odds ratio [aOR] 2.42; 95% confidence interval [CI]: 1.35-4.36; P = 0.003), delivery before 34 gestational weeks (11.6% vs 0.6%; aOR 12.33; 95% CI: 3.32-45.78; P < 0.001), and pre-eclampsia (11.6% vs 2.8%; aOR 2.19; 95% CI: 1.01-4.76; P = 0.047). Newborns with CHD were significantly more likely to be small for gestational age (10.7% vs 5.2%; aOR 2.09; 95% CI: 1.11-3.94; P = 0.022). Intriguingly, a prenatal diagnosis of CHD was associated with a reduced risk of preterm delivery in affected pregnancies (P = 0.002).</p><p><strong>Conclusion: </strong>Pregnancies affected by isolated fetal CHD demonstrated a higher propensity for several adverse outcomes. These findings underscore the importance of prenatal CHD detection and tailored perinatal care to potentially improve both pregnancy outcomes and neonatal health.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号