Pub Date : 2021-06-01DOI: 10.1080/14767058.2019.1645111
E. Avşar
In the 2019 edition (issue: 9) of the “Journal of MaternalFetal & Neonatal Medicine,” Mannaerts et al. reported that mean platelet volume (MPV) is significantly elevated in the first half of pregnancy in women who later develop preeclampsia (PE) and might, therefore, be implemented in combination with other parameters in a PE prediction model [1]. However, there is a major limitation about MPV levels in this study. When we look at the Methods section, there is no information regarding MPV measurement technique. Some variable factors, such as the anticoagulant used, and the time between blood collection and measurement are known to significantly affect MPV measurements. Although ethylenediaminetetraacetic acid (EDTA) is traditionally used and recommended for samples destined for blood counting, it is well known that platelets collected into EDTA anticoagulants undergo time-dependent platelet swelling and activation [2–4]. The retrospective nature of the study leads to a significant problem because the MPV results could not be standardized. Disclosure statement
Mannaerts等人在2019年版(第9期)《母胎与新生儿医学杂志》(Journal of MaternalFetal & Neonatal Medicine)上报道，后来发生子痫前期(PE)的妇女在妊娠前半期平均血小板体积(MPV)显著升高，因此可能与PE预测模型中的其他参数结合使用[1]。然而，在这项研究中，MPV水平有一个主要的限制。当我们查看方法部分时，没有关于MPV测量技术的信息。一些可变因素，如抗凝剂的使用，以及采血和测量之间的时间，已知会显著影响MPV的测量。虽然乙二胺四乙酸(EDTA)传统上被推荐用于血液计数，但众所周知，收集到EDTA抗凝剂中的血小板会经历时间依赖性的血小板肿胀和活化[2-4]。该研究的回顾性性质导致了一个重大问题，因为MPV结果无法标准化。公开声明
{"title":"Comment on “Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia?”","authors":"E. Avşar","doi":"10.1080/14767058.2019.1645111","DOIUrl":"https://doi.org/10.1080/14767058.2019.1645111","url":null,"abstract":"In the 2019 edition (issue: 9) of the “Journal of MaternalFetal & Neonatal Medicine,” Mannaerts et al. reported that mean platelet volume (MPV) is significantly elevated in the first half of pregnancy in women who later develop preeclampsia (PE) and might, therefore, be implemented in combination with other parameters in a PE prediction model [1]. However, there is a major limitation about MPV levels in this study. When we look at the Methods section, there is no information regarding MPV measurement technique. Some variable factors, such as the anticoagulant used, and the time between blood collection and measurement are known to significantly affect MPV measurements. Although ethylenediaminetetraacetic acid (EDTA) is traditionally used and recommended for samples destined for blood counting, it is well known that platelets collected into EDTA anticoagulants undergo time-dependent platelet swelling and activation [2–4]. The retrospective nature of the study leads to a significant problem because the MPV results could not be standardized. Disclosure statement","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"9 1","pages":"1843 - 1843"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84249197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1080/14767058.2019.1649388
Ebru Alıcı Davutoğlu, Asuman Akkaya Fırat, A. Ozel, I. Uzun, Nida Özer, R. Madazlı
Abstract Objective The aim of the current study was to determine serum endocan levels in patients with threatened preterm labor and to assign whether endocan levels in patients with true preterm labor who give birth within 7 days differ from those of false preterm labor and uncomplicated pregnancy. Materials and methods This cross-sectional study was conducted on 58 patients diagnosed with threatened preterm labor and 31 healthy pregnant women matched for gestational age. Patients with threatened preterm labor were divided into two groups; preterm delivery (28) and term delivery (30) groups. Maternal serum endocan levels were measured with the use of an enzyme-linked immunosorbent assay kit. Results The median serum endocan level (pg/mL) in patients with threatened preterm labor was significantly higher than that of women with uncomplicated pregnancies (725, IQR 619–823 versus 310, IQR 218–423; p < .001 Figure 1). Subgroup analysis performed among threatened preterm labor group revealed that median serum endocan level (pg/mL) in preterm delivery group was higher compared with the other two groups (preterm 823, IQR 718–905 versus term 637, IQR 590–729 p < .001 and preterm 823, IQR 718–905 versus control 310, IQR 218–423 p < .001). The threshold value of maternal serum endocan level for predicting delivery within 7 days after admission was calculated 655 pg/mL, (the area under curve was 0.934, 95% CI 0.88–0.98, p < .001) with 85.7% sensitivity and 78.7% specificity. The mean cervical length measurement was significantly higher in the control group (p < .001); there was no significant difference in cervical length between the term and preterm delivery groups. Maternal characteristics including age, BMI, gravidity, gestational age at blood sampling, CRP and Hb levels were not significantly different between groups (p > .05). Conclusions The maternal serum endocan level may be a useful marker to define high risk group for preterm delivery in patients with threatened preterm labor and similar cervical length measures.
摘要目的本研究旨在测定先兆早产患者血清内啡肽水平，并确定7天内分娩的真早产患者血清内啡肽水平与假早产和无并发症妊娠患者血清内啡肽水平是否存在差异。材料与方法对58例先兆早产患者和31例胎龄匹配的健康孕妇进行横断面研究。先兆早产患者分为两组;早产组28例，足月组30例。使用酶联免疫吸附测定试剂盒测定母体血清内啡肽水平。结果先兆早产患者血清中位内啡肽水平(pg/mL)显著高于无并发症妊娠妇女(725,IQR 619-823 vs 310, IQR 218-423;p . 05)。结论对宫颈长度相近的先兆早产患者，血清内啡肽水平可作为判定早产高危人群的有效指标。
{"title":"The utility of maternal serum endocan level to predict preterm delivery within seven days in patients with threatened preterm labor","authors":"Ebru Alıcı Davutoğlu, Asuman Akkaya Fırat, A. Ozel, I. Uzun, Nida Özer, R. Madazlı","doi":"10.1080/14767058.2019.1649388","DOIUrl":"https://doi.org/10.1080/14767058.2019.1649388","url":null,"abstract":"Abstract Objective The aim of the current study was to determine serum endocan levels in patients with threatened preterm labor and to assign whether endocan levels in patients with true preterm labor who give birth within 7 days differ from those of false preterm labor and uncomplicated pregnancy. Materials and methods This cross-sectional study was conducted on 58 patients diagnosed with threatened preterm labor and 31 healthy pregnant women matched for gestational age. Patients with threatened preterm labor were divided into two groups; preterm delivery (28) and term delivery (30) groups. Maternal serum endocan levels were measured with the use of an enzyme-linked immunosorbent assay kit. Results The median serum endocan level (pg/mL) in patients with threatened preterm labor was significantly higher than that of women with uncomplicated pregnancies (725, IQR 619–823 versus 310, IQR 218–423; p < .001 Figure 1). Subgroup analysis performed among threatened preterm labor group revealed that median serum endocan level (pg/mL) in preterm delivery group was higher compared with the other two groups (preterm 823, IQR 718–905 versus term 637, IQR 590–729 p < .001 and preterm 823, IQR 718–905 versus control 310, IQR 218–423 p < .001). The threshold value of maternal serum endocan level for predicting delivery within 7 days after admission was calculated 655 pg/mL, (the area under curve was 0.934, 95% CI 0.88–0.98, p < .001) with 85.7% sensitivity and 78.7% specificity. The mean cervical length measurement was significantly higher in the control group (p < .001); there was no significant difference in cervical length between the term and preterm delivery groups. Maternal characteristics including age, BMI, gravidity, gestational age at blood sampling, CRP and Hb levels were not significantly different between groups (p > .05). Conclusions The maternal serum endocan level may be a useful marker to define high risk group for preterm delivery in patients with threatened preterm labor and similar cervical length measures.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"73 1","pages":"1786 - 1791"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80599516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-27DOI: 10.1080/14767058.2020.1826134
A. Malamitsi‐Puchner
Maria Delivoria-Papadopoulos was born in Athens, Greece. The hard times before, during and after World War 2, followed by the Greek civil war, severely affected her leftist family. However, hards...
Maria Delivoria-Papadopoulos出生于希腊雅典。第二次世界大战之前、期间和之后的艰难时期，以及随后的希腊内战，严重影响了她的左派家庭。然而,毛屑……
{"title":"Maria Delivoria-Papadopoulos: the legendary pioneer in perinatology and mother of neonatology","authors":"A. Malamitsi‐Puchner","doi":"10.1080/14767058.2020.1826134","DOIUrl":"https://doi.org/10.1080/14767058.2020.1826134","url":null,"abstract":"Maria Delivoria-Papadopoulos was born in Athens, Greece. The hard times before, during and after World War 2, followed by the Greek civil war, severely affected her leftist family. However, hards...","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"48 1","pages":"3631 - 3632"},"PeriodicalIF":0.0,"publicationDate":"2020-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87773386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.1080/14767058.2019.1676414
B. Astepe, H. Aytuluk, A. Yavuz, Ünal Türkay, H. Terzi, A. Kale
Abstract Background: With increasing cesarean section rates all around the world, postoperative pain management is an important issue for all women. Good postoperative pain management helps to shorten the recovery period of the mother, improve the mother’s feeling of well-being, enable good breastfeeding, and provide optimum maternal–neonatal bonding. Objective: To evaluate the efficacy of intraoperative superior hypogastric plexus block (SHPB) during cesarean section and describe the technique. Study design: This was a prospective quasi-experimental study that was conducted with 69 pregnant women at HSU. Kocaeli Derince Training and Research Hospital Obstetrics and Gynecology Clinics between 15 March 2018 and 15 August 2018. The case group included 34 healthy pregnant women who received SHPB (SHPB+) for postoperative pain relief during cesarean section under general anesthesia, and the control group included 35 healthy pregnant women who did not receive SHPB during cesarean section with general anesthesia (SHPB−). Postoperative 1st hour, 6th hour, 12th hour, 24th hour, and 48th hour visual analog scale (VAS) scores, the amount of analgesics used for pain relief, and the time of the postoperative first gas extraction were assessed. Results: The SHPB (+) group had lower 1st hour VAS scores than the SHPB (−) group (p < .001). The mean postoperative 1st hour VAS score of the SHPB (+) group was 4.74 ± 1.44, and was 6.80 ± 2.08 for the SHPB (−) group. There were no differences in postoperative 6th hour, 12th hour, 24th hour, and 48th hour VAS scores between the groups. When the SHPB (+) and SHPB (−) groups were compared for postoperative analgesic use and for the first postoperative gas extraction time, the SHPB (+) group had lower analgesic use (p < .001), and the SHPB (−) group had earlier gas extraction. The mean analgesic use in the SHPB (+) group was 2.29 ± 1.11 and it was 4 ± 0.84 in SHPB (−) group. The mean gas extraction time for the SHPB (−) group was 18.03 ± 7.2 h, and was 24.56 ± 8.56 h for the SHPB (+) group (p = .001). Conclusion: SHPB performed intraoperatively in cesarean section procedures with general anesthesia is a simple, easy approach to perform during open surgery with direct vision. SHPB helps postoperative pain management extensively with low postoperative VAS scores and low analgesic requirement.
{"title":"Intraoperative superior hypogastric plexus block during cesarean section: a new technique for pain relief","authors":"B. Astepe, H. Aytuluk, A. Yavuz, Ünal Türkay, H. Terzi, A. Kale","doi":"10.1080/14767058.2019.1676414","DOIUrl":"https://doi.org/10.1080/14767058.2019.1676414","url":null,"abstract":"Abstract Background: With increasing cesarean section rates all around the world, postoperative pain management is an important issue for all women. Good postoperative pain management helps to shorten the recovery period of the mother, improve the mother’s feeling of well-being, enable good breastfeeding, and provide optimum maternal–neonatal bonding. Objective: To evaluate the efficacy of intraoperative superior hypogastric plexus block (SHPB) during cesarean section and describe the technique. Study design: This was a prospective quasi-experimental study that was conducted with 69 pregnant women at HSU. Kocaeli Derince Training and Research Hospital Obstetrics and Gynecology Clinics between 15 March 2018 and 15 August 2018. The case group included 34 healthy pregnant women who received SHPB (SHPB+) for postoperative pain relief during cesarean section under general anesthesia, and the control group included 35 healthy pregnant women who did not receive SHPB during cesarean section with general anesthesia (SHPB−). Postoperative 1st hour, 6th hour, 12th hour, 24th hour, and 48th hour visual analog scale (VAS) scores, the amount of analgesics used for pain relief, and the time of the postoperative first gas extraction were assessed. Results: The SHPB (+) group had lower 1st hour VAS scores than the SHPB (−) group (p < .001). The mean postoperative 1st hour VAS score of the SHPB (+) group was 4.74 ± 1.44, and was 6.80 ± 2.08 for the SHPB (−) group. There were no differences in postoperative 6th hour, 12th hour, 24th hour, and 48th hour VAS scores between the groups. When the SHPB (+) and SHPB (−) groups were compared for postoperative analgesic use and for the first postoperative gas extraction time, the SHPB (+) group had lower analgesic use (p < .001), and the SHPB (−) group had earlier gas extraction. The mean analgesic use in the SHPB (+) group was 2.29 ± 1.11 and it was 4 ± 0.84 in SHPB (−) group. The mean gas extraction time for the SHPB (−) group was 18.03 ± 7.2 h, and was 24.56 ± 8.56 h for the SHPB (+) group (p = .001). Conclusion: SHPB performed intraoperatively in cesarean section procedures with general anesthesia is a simple, easy approach to perform during open surgery with direct vision. SHPB helps postoperative pain management extensively with low postoperative VAS scores and low analgesic requirement.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"12 1","pages":"2657 - 2663"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75935858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.1080/14767058.2019.1671348
Cihan Karadağ, B. Akar, G. Gönenç, R. Aslancan, Nagihan Yılmaz, E. Çalışkan
Abstract Objective: The aim of this study was to compare the effects of low molecular weight heparin (LMWH), LMWH plus low dose aspirin, or low dose aspirin only on pregnancy outcomes in recurrent pregnancy loss (RPL) patients with factor V Leiden mutation (FVLM). Materials and methods: A total of 2764 RPL patients were evaluated in for the etiology of RPL. Mutations in factor V Leiden homozygous and heterozygous were determined. Subsequently, 196 of these patients were diagnosed with FVLM and included in the study; of these 174 completed the study. At the sixth week of gestation of subsequent pregnancy participants were randomly distributed into three groups. Group A (n = 61) was composed of patients with an oral dose of 100 mg aspirin daily, Group B (n = 59) consisted of patients using 40 mg enoxaparin and 100 mg orally aspirin daily, and Group C (n = 54) included patients using 40 mg enoxaparin daily during pregnancy. Results: Among the 174 patients who completed the study, the live birth and miscarriage rates were similar for the three groups (p = .843 and p = .694, respectively). There was no significant difference among the groups in rates of eclampsia, placental abruption, intrauterine fetal growth restriction and gestational diabetes mellitus. The number of preeclamptic patients was significantly higher in Group A than Groups B and C. The levels of preterm birth was significantly higher in Group A than Groups B and C. Conclusion: Using low dose aspirin, LMWH plus aspirin, or LMWH alone yielded comparable live birth rates in RPL patients with FVLM. However, LMWH decreased the risk of preeclampsia in this group of patients. LMWH might therefore have a preventive role regarding preeclampsia.
{"title":"Aspirin, low molecular weight heparin, or both in preventing pregnancy complications in women with recurrent pregnancy loss and factor V Leiden mutation","authors":"Cihan Karadağ, B. Akar, G. Gönenç, R. Aslancan, Nagihan Yılmaz, E. Çalışkan","doi":"10.1080/14767058.2019.1671348","DOIUrl":"https://doi.org/10.1080/14767058.2019.1671348","url":null,"abstract":"Abstract Objective: The aim of this study was to compare the effects of low molecular weight heparin (LMWH), LMWH plus low dose aspirin, or low dose aspirin only on pregnancy outcomes in recurrent pregnancy loss (RPL) patients with factor V Leiden mutation (FVLM). Materials and methods: A total of 2764 RPL patients were evaluated in for the etiology of RPL. Mutations in factor V Leiden homozygous and heterozygous were determined. Subsequently, 196 of these patients were diagnosed with FVLM and included in the study; of these 174 completed the study. At the sixth week of gestation of subsequent pregnancy participants were randomly distributed into three groups. Group A (n = 61) was composed of patients with an oral dose of 100 mg aspirin daily, Group B (n = 59) consisted of patients using 40 mg enoxaparin and 100 mg orally aspirin daily, and Group C (n = 54) included patients using 40 mg enoxaparin daily during pregnancy. Results: Among the 174 patients who completed the study, the live birth and miscarriage rates were similar for the three groups (p = .843 and p = .694, respectively). There was no significant difference among the groups in rates of eclampsia, placental abruption, intrauterine fetal growth restriction and gestational diabetes mellitus. The number of preeclamptic patients was significantly higher in Group A than Groups B and C. The levels of preterm birth was significantly higher in Group A than Groups B and C. Conclusion: Using low dose aspirin, LMWH plus aspirin, or LMWH alone yielded comparable live birth rates in RPL patients with FVLM. However, LMWH decreased the risk of preeclampsia in this group of patients. LMWH might therefore have a preventive role regarding preeclampsia.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"116 1","pages":"1934 - 1939"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87961855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-25DOI: 10.1080/14767058.2020.1767060
G. Rizzo, M. Pietrolucci, I. Mappa, V. Bitsadze, J. Khizroeva, A. Makatsariya, F. D’Antonio
Abstract Objective Recent evidences highlight a considerable heterogeneity in the methodology of previously published studies reporting reference ranges for maternal and fetal Dopplers, which may have relevant implications in clinical practice. In view of these limitations, a standardized methodology to construct Doppler charts has been proposed. The aim of this study was to develop charts for pulsatility index (PI) of maternal and fetal Dopplers based upon the recently proposed standardized methodology and using quantile regression. Methods Prospective cross-sectional study including 2516 low-risk singleton pregnancies between 24 and 40 weeks of gestation. The mean uterine, umbilical (UA), middle cerebral (MCA) and their ratio (cerebroplacental ratio, CPR) centile values were established by quantile regression in the considered gestational interval. Interclass correlation coefficient (ICC) of each maternal and fetal vessel was also computed to assess the intra- and inter-observer agreement of the results. Results There was a good intra- and inter-observer agreement for each of the explored vessels (ICC >0.92 and >0.91 for a single and two observers, respectively). The 5th, 10th, 50th, 90th and 95th centiles of the reference range for gestation were constructed by quantile regression and compared to previously established reference charts. All the Doppler indices significantly changed with gestation. Second-degree polynomial regression models better described the changes with gestation in PCR and MCA PI values while a linear model better predicted the changes of other Doppler indices with advancing gestation. When compared to other studies reporting reference ranges for maternal and fetal Dopplers, the present charts showed similar median values but different distribution from the median. Conclusions We provided prospective charts of maternal and fetal Dopplers based upon a previously proposed standardized methodology and using quantile regression. When compared to previously published studies, these new charts showed similar median values but different deviations from the median which may help in better differentiating cases at higher risk of placental insufficiency and adverse perinatal outcome.
{"title":"Modeling Pulsatility Index nomograms from different maternal and fetal vessels by quantile regression at 24–40 weeks of gestation: a prospective cross-sectional study","authors":"G. Rizzo, M. Pietrolucci, I. Mappa, V. Bitsadze, J. Khizroeva, A. Makatsariya, F. D’Antonio","doi":"10.1080/14767058.2020.1767060","DOIUrl":"https://doi.org/10.1080/14767058.2020.1767060","url":null,"abstract":"Abstract Objective Recent evidences highlight a considerable heterogeneity in the methodology of previously published studies reporting reference ranges for maternal and fetal Dopplers, which may have relevant implications in clinical practice. In view of these limitations, a standardized methodology to construct Doppler charts has been proposed. The aim of this study was to develop charts for pulsatility index (PI) of maternal and fetal Dopplers based upon the recently proposed standardized methodology and using quantile regression. Methods Prospective cross-sectional study including 2516 low-risk singleton pregnancies between 24 and 40 weeks of gestation. The mean uterine, umbilical (UA), middle cerebral (MCA) and their ratio (cerebroplacental ratio, CPR) centile values were established by quantile regression in the considered gestational interval. Interclass correlation coefficient (ICC) of each maternal and fetal vessel was also computed to assess the intra- and inter-observer agreement of the results. Results There was a good intra- and inter-observer agreement for each of the explored vessels (ICC >0.92 and >0.91 for a single and two observers, respectively). The 5th, 10th, 50th, 90th and 95th centiles of the reference range for gestation were constructed by quantile regression and compared to previously established reference charts. All the Doppler indices significantly changed with gestation. Second-degree polynomial regression models better described the changes with gestation in PCR and MCA PI values while a linear model better predicted the changes of other Doppler indices with advancing gestation. When compared to other studies reporting reference ranges for maternal and fetal Dopplers, the present charts showed similar median values but different distribution from the median. Conclusions We provided prospective charts of maternal and fetal Dopplers based upon a previously proposed standardized methodology and using quantile regression. When compared to previously published studies, these new charts showed similar median values but different deviations from the median which may help in better differentiating cases at higher risk of placental insufficiency and adverse perinatal outcome.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"43 1","pages":"1668 - 1676"},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77111343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1080/14767058.2019.1674806
B. Kaya, A. Tayyar, Salim Sezer, S. Kaya
Abstract Introduction: This study aimed to evaluate the cardiac function of fetuses with congenital diaphragmatic hernia by conventional echocardiography and spectral tissue Doppler imaging (s-TDI) and to evaluate the relationship between cardiac function and the severity of pulmonary hypoplasia. We also aimed to investigate the effect of diaphragmatic hernia side on fetal cardiac function. Methods: Fetal cardiac function were evaluated in 28 fetuses (20 with left-sided and 8 with right-sided) complicated with isolated congenital diaphragmatic hernia (CDH) and 56 gestational age matched control in this single center prospective study. s-TDI measurements were obtained at the right atrioventricular valve annulus. The annular peak velocities and their ratios, the time periods of cardiac cycle and myocardial performance index were calculated. Results: In comparison to controls, significantly prolonged isovolumetric contraction time (ICT′) and isovolumetric relaxation time (IRT′) and, significantly shortened ejection time (ET′) were observed in fetuses with CDH by s-TDI. Fetuses with CDH also had higher myocardial performance index (MPI′) z-scores compared to controls. There were no significant differences in terms of s-TDI cardiac function parameters between fetuses with right- and left-sided CDH. In correlation analysis, a significant positive correlation was found between ET′ value and o/e LHR. Conclusion: The signs of both systolic and diastolic altered function were observed in fetuses with CDH with s-TDI independent of the side of the hernia, and a significant positive correlation was observed between fetal cardiac systolic function and the severity of pulmonary hypoplasia.
{"title":"The assessment of cardiac function with tissue Doppler imaging in fetuses with congenital diaphragmatic hernia","authors":"B. Kaya, A. Tayyar, Salim Sezer, S. Kaya","doi":"10.1080/14767058.2019.1674806","DOIUrl":"https://doi.org/10.1080/14767058.2019.1674806","url":null,"abstract":"Abstract Introduction: This study aimed to evaluate the cardiac function of fetuses with congenital diaphragmatic hernia by conventional echocardiography and spectral tissue Doppler imaging (s-TDI) and to evaluate the relationship between cardiac function and the severity of pulmonary hypoplasia. We also aimed to investigate the effect of diaphragmatic hernia side on fetal cardiac function. Methods: Fetal cardiac function were evaluated in 28 fetuses (20 with left-sided and 8 with right-sided) complicated with isolated congenital diaphragmatic hernia (CDH) and 56 gestational age matched control in this single center prospective study. s-TDI measurements were obtained at the right atrioventricular valve annulus. The annular peak velocities and their ratios, the time periods of cardiac cycle and myocardial performance index were calculated. Results: In comparison to controls, significantly prolonged isovolumetric contraction time (ICT′) and isovolumetric relaxation time (IRT′) and, significantly shortened ejection time (ET′) were observed in fetuses with CDH by s-TDI. Fetuses with CDH also had higher myocardial performance index (MPI′) z-scores compared to controls. There were no significant differences in terms of s-TDI cardiac function parameters between fetuses with right- and left-sided CDH. In correlation analysis, a significant positive correlation was found between ET′ value and o/e LHR. Conclusion: The signs of both systolic and diastolic altered function were observed in fetuses with CDH with s-TDI independent of the side of the hernia, and a significant positive correlation was observed between fetal cardiac systolic function and the severity of pulmonary hypoplasia.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"13 1","pages":"1233 - 1238"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81931546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1080/14767058.2019.1639661
Didem Arman, S. Sancak, T. Gürsoy, S. Topçuoğlu, G. Karatekin, F. Ovalı
Abstract Objective: To determine if near-infrared spectroscopy (NIRS), which is easier to obtain than Doppler ultrasonography (USG), may be used in accordance with Doppler USG to provide additional data for assessment of organ blood flow velocities in preterm infants with hemodynamically significant PDA. Study design: Thirty-one infants who were treated with ibuprofen for closure of PDA were monitored continuously with NIRS. Cerebral, mesenteric, and renal arterial blood flow velocities were measured with Doppler USG before and after the treatment. Results: While cerebral, mesenteric, and renal fractional oxygen extraction (FTOE) measurements decreased significantly (p = .042, p < .001, p < .001, respectively), NIRS measurements (p = .016, p < .001, p < .001, respectively) and mean blood flow velocities (p = .003, p = .011, p = .002, respectively) increased significantly after the treatment. There was a significant correlation between pretreatment cerebral and mesenteric FTOE and resistive index (RI) values (r = 0.45, p = .01, and r = 0.46, p = .01, respectively). However, no correlation was observed between renal FTOE values and renal RI (r = 0.33, p = .06). Posttreatment cerebral, renal, and mesenteric FTOE values correlated positively with corresponding RI (r = 0.41, p = .02; r = 0.39, p = .02; r = 0.65, p < 01; respectively). Pretreatment and posttreatment cerebral, mesenteric, and renal FTOE values and arterial mean velocities were inversely correlated (pretreatment: r = 0.69, p < .01; r = 0.72, p < .01; r = 0.77, p < .01; posttreatment: r = 0.54, p = .01; r = 0.69, p < .01; r = 0.38, p = .01; respectively). Conclusion: As Doppler and NIRS measurements correlated significantly, we concluded that NIRS might be used in monitoring organ blood flow in preterm infants with PDA, which may provide additional data for management of this condition.
摘要目的:探讨近红外光谱(NIRS)技术是否可与多普勒超声(USG)技术相结合，为血流动力学显著性PDA早产儿器官血流速度评估提供额外数据。研究设计:31名接受布洛芬治疗的婴儿用近红外光谱仪连续监测PDA。治疗前后分别用多普勒USG测量脑、肠系膜、肾动脉血流速度。结果:脑、肠系膜和肾的分数氧提取(FTOE)测量值显著降低(p =。042, p <。001, p <。001)，近红外光谱测量(p =。[16]， p <。001, p <。0.001)和平均血流速度(p = 0.001)。003, p =。011, p =。002，分别)治疗后显著增高。预处理脑及肠系膜FTOE与阻力指数(RI)值有显著相关性(r = 0.45, p = 0.45)。0.01, r = 0.46, p =。分别为01)。然而，肾脏FTOE值与肾脏RI之间没有相关性(r = 0.33, p = 0.06)。治疗后脑、肾、肠系膜FTOE值与相应的RI呈正相关(r = 0.41, p = 0.02;R = 0.39, p = 0.02;R = 0.65, p < 01;分别)。治疗前后脑、肠系膜、肾FTOE值与动脉平均流速呈负相关(治疗前:r = 0.69, p < 0.01;R = 0.72, p < 0.01;R = 0.77, p < 0.01;后处理:r = 0.54, p = 0.01;R = 0.69, p < 0.01;R = 0.38, p = 0.01;分别)。结论:由于多普勒和近红外光谱测量结果显著相关，我们得出结论，近红外光谱可能用于监测PDA早产儿的器官血流，这可能为该疾病的治疗提供额外的数据。
{"title":"The association between NIRS and Doppler ultrasonography in preterm infants with patent ductus arteriosus","authors":"Didem Arman, S. Sancak, T. Gürsoy, S. Topçuoğlu, G. Karatekin, F. Ovalı","doi":"10.1080/14767058.2019.1639661","DOIUrl":"https://doi.org/10.1080/14767058.2019.1639661","url":null,"abstract":"Abstract Objective: To determine if near-infrared spectroscopy (NIRS), which is easier to obtain than Doppler ultrasonography (USG), may be used in accordance with Doppler USG to provide additional data for assessment of organ blood flow velocities in preterm infants with hemodynamically significant PDA. Study design: Thirty-one infants who were treated with ibuprofen for closure of PDA were monitored continuously with NIRS. Cerebral, mesenteric, and renal arterial blood flow velocities were measured with Doppler USG before and after the treatment. Results: While cerebral, mesenteric, and renal fractional oxygen extraction (FTOE) measurements decreased significantly (p = .042, p < .001, p < .001, respectively), NIRS measurements (p = .016, p < .001, p < .001, respectively) and mean blood flow velocities (p = .003, p = .011, p = .002, respectively) increased significantly after the treatment. There was a significant correlation between pretreatment cerebral and mesenteric FTOE and resistive index (RI) values (r = 0.45, p = .01, and r = 0.46, p = .01, respectively). However, no correlation was observed between renal FTOE values and renal RI (r = 0.33, p = .06). Posttreatment cerebral, renal, and mesenteric FTOE values correlated positively with corresponding RI (r = 0.41, p = .02; r = 0.39, p = .02; r = 0.65, p < 01; respectively). Pretreatment and posttreatment cerebral, mesenteric, and renal FTOE values and arterial mean velocities were inversely correlated (pretreatment: r = 0.69, p < .01; r = 0.72, p < .01; r = 0.77, p < .01; posttreatment: r = 0.54, p = .01; r = 0.69, p < .01; r = 0.38, p = .01; respectively). Conclusion: As Doppler and NIRS measurements correlated significantly, we concluded that NIRS might be used in monitoring organ blood flow in preterm infants with PDA, which may provide additional data for management of this condition.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"6 1","pages":"1245 - 1252"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91172370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1080/14767058.2019.1677599
Nurullah Peker, M. Yavuz, Edip Aydın, Serhat Ege, Muhammed Hanifi Bademkıran, T. Karaçor
Abstract Aim: This study aimed to examine the risk factors for relaparotomy after cesarean section (RLACS) due to bleeding. Material and methods: In this retrospective descriptive case-control study, women who underwent RLACS only for bleeding between 2008 and 2019 at a single tertiary center were examined (the center oversees approximately 25,000 deliveries per year). Maternal characteristics, postoperative findings, and surgical features were compared with a control group that included non-complicated cesarean sections (CS). Multivariable logistic regression analysis was used to identify the risk factors for relaparotomy. Results: Relaparotomy complicated 0.07% (n = 40) of CS during the study period (n = 58,095). When compared with the control group, age, parity, estimated blood loss (EBL), postoperative pulse, blood replacement, and length of hospital stay were statistically higher in patients undergoing relaparotomy, whereas their postoperative systolic and diastolic blood pressure were found to be low. A history of pelvic surgery, the need for intensive care, and complications were more frequent in patients undergoing relaparotomy. When CSs were grouped according to 8-h periods of the day, it emerged that relaparotomies were mostly performed on the patients who underwent CS after working hours. Time interval during the day of the CS [OR: 2.59 (1.10–6.12)] and high postoperative pulse rate [OR: 1.58 (1.28–1.96)] were found to be independent risk indicators for RLACS (AUC: 0.97). Conclusions: Monitoring vital signs in the postoperative period and increasing the number of physicians and nurses during off-hours in hospitals working with on-call duty procedures as determined by the Ministry of Health will reduce the incidence rate of relaparotomy, maternal morbidity, and mortality due to hemorrhage.
{"title":"Risk factors for relaparotomy after cesarean section due to hemorrhage: a tertiary center experience","authors":"Nurullah Peker, M. Yavuz, Edip Aydın, Serhat Ege, Muhammed Hanifi Bademkıran, T. Karaçor","doi":"10.1080/14767058.2019.1677599","DOIUrl":"https://doi.org/10.1080/14767058.2019.1677599","url":null,"abstract":"Abstract Aim: This study aimed to examine the risk factors for relaparotomy after cesarean section (RLACS) due to bleeding. Material and methods: In this retrospective descriptive case-control study, women who underwent RLACS only for bleeding between 2008 and 2019 at a single tertiary center were examined (the center oversees approximately 25,000 deliveries per year). Maternal characteristics, postoperative findings, and surgical features were compared with a control group that included non-complicated cesarean sections (CS). Multivariable logistic regression analysis was used to identify the risk factors for relaparotomy. Results: Relaparotomy complicated 0.07% (n = 40) of CS during the study period (n = 58,095). When compared with the control group, age, parity, estimated blood loss (EBL), postoperative pulse, blood replacement, and length of hospital stay were statistically higher in patients undergoing relaparotomy, whereas their postoperative systolic and diastolic blood pressure were found to be low. A history of pelvic surgery, the need for intensive care, and complications were more frequent in patients undergoing relaparotomy. When CSs were grouped according to 8-h periods of the day, it emerged that relaparotomies were mostly performed on the patients who underwent CS after working hours. Time interval during the day of the CS [OR: 2.59 (1.10–6.12)] and high postoperative pulse rate [OR: 1.58 (1.28–1.96)] were found to be independent risk indicators for RLACS (AUC: 0.97). Conclusions: Monitoring vital signs in the postoperative period and increasing the number of physicians and nurses during off-hours in hospitals working with on-call duty procedures as determined by the Ministry of Health will reduce the incidence rate of relaparotomy, maternal morbidity, and mortality due to hemorrhage.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"55 1","pages":"464 - 470"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74890175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/14767058.2022.2044775
Jacquelyn H Adams, J. Poehlmann, Jenna L Racine, J. Iruretagoyena, April Eddy, K. Hoppe, Katharina S. Stewart, Janine S. Rhoades, K. Antony
Abstract Objective Metformin has been associated with modest weight reduction in the non-pregnant population. Our hypothesis is that metformin exposure will lead to a higher incidence of appropriate weight gain during pregnancy. Study Design This was a retrospective cohort study in a single center between 2009 and 2019. We included all pregnant women with type 2 diabetes or prediabetes. We compared women exposed to metformin in any trimester. The primary outcome was appropriate weight gain defined by the Institute of Medicine guidelines. Secondary outcomes included excessive weight gain, weight loss, suspected fetal growth restriction (FGR), and mean birth weight. Adjusted odds ratios or group differences were calculated using logistic or linear regression, controlling for confounders. Results Of 41,472 deliveries during the study period, 511 pregnancies met inclusion criteria. 284 pregnancies had no metformin exposure; 227 did have metformin exposure, of which 169 (72.2%) were initiated on metformin in the first trimester. Women exposed to metformin in any trimester were statistically not more likely to have appropriate weight gain (aOR 1.53 (95% CI 1.00–2.34, p = .048), but did have less excess weight gain (aOR 0.45, 95% CI 0.30–0.66, p < .001), and more maternal weight loss (aOR 2.17, 95% CI 1.18–3.98, p = .012) than the unexposed group. Women exposed to metformin in the first trimester of pregnancy were less likely to have excess weight gain (aOR 0.39, 95% CI 0.25–0.61, p < .001) and more likely to have maternal weight loss (aOR 2.56, 95% CI 1.30–5.07, p = .007) than the unexposed cohort. There was no difference in FGR (5.3% vs 2.5% p = .094) or mean birth weight (3235.6 vs 3352.4 gm p = .122) in the metformin exposed group vs non-exposed groups, respectively. Conclusions Metformin exposure in pregnancy was associated with less excess weight gain and a higher rate of weight loss. There was no difference in FGR or mean birth weight in metformin exposed neonates. This suggests that metformin may help avoid excess weight gain and its associated comorbidities.
【摘要】目的二甲双胍与非怀孕人群适度体重减轻有关。我们的假设是，二甲双胍暴露将导致怀孕期间适当体重增加的发生率更高。这是一项2009年至2019年在单中心进行的回顾性队列研究。我们纳入了所有患有2型糖尿病或前驱糖尿病的孕妇。我们比较了在任何孕期暴露于二甲双胍的女性。主要结果是医学研究所指南规定的适当体重增加。次要结局包括体重过度增加、体重减轻、疑似胎儿生长受限(FGR)和平均出生体重。校正后的优势比或组间差异使用逻辑或线性回归计算，控制混杂因素。结果在研究期间的41472例分娩中，511例妊娠符合纳入标准。284例妊娠未接触二甲双胍;227人确实有二甲双胍暴露，其中169人(72.2%)在妊娠早期开始使用二甲双胍。在任何三个月暴露于二甲双胍的妇女在统计上都不太可能有适当的体重增加(aOR 1.53 (95% CI 1.00-2.34, p = 0.048)，但与未暴露组相比，确实有更少的额外体重增加(aOR 0.45, 95% CI 0.30-0.66, p < 0.001)，并且更多的产妇体重减轻(aOR 2.17, 95% CI 1.18-3.98, p = 0.012)。与未接触二甲双胍的孕妇相比，妊娠前三个月接触二甲双胍的孕妇体重增加的可能性更小(aOR 0.39, 95% CI 0.25-0.61, p < 0.001)，而孕妇体重减轻的可能性更大(aOR 2.56, 95% CI 1.30-5.07, p = .007)。二甲双胍暴露组与未暴露组的FGR (5.3% vs 2.5% p = 0.094)或平均出生体重(3235.6 vs 3352.4 gm p = 0.122)分别无差异。结论妊娠期二甲双胍暴露与体重增加较少和体重减轻率较高有关。二甲双胍暴露的新生儿FGR和平均出生体重没有差异。这表明二甲双胍可能有助于避免体重过度增加及其相关的合并症。
{"title":"Weight gain in pregnancy: can metformin steady the scales?","authors":"Jacquelyn H Adams, J. Poehlmann, Jenna L Racine, J. Iruretagoyena, April Eddy, K. Hoppe, Katharina S. Stewart, Janine S. Rhoades, K. Antony","doi":"10.1080/14767058.2022.2044775","DOIUrl":"https://doi.org/10.1080/14767058.2022.2044775","url":null,"abstract":"Abstract Objective Metformin has been associated with modest weight reduction in the non-pregnant population. Our hypothesis is that metformin exposure will lead to a higher incidence of appropriate weight gain during pregnancy. Study Design This was a retrospective cohort study in a single center between 2009 and 2019. We included all pregnant women with type 2 diabetes or prediabetes. We compared women exposed to metformin in any trimester. The primary outcome was appropriate weight gain defined by the Institute of Medicine guidelines. Secondary outcomes included excessive weight gain, weight loss, suspected fetal growth restriction (FGR), and mean birth weight. Adjusted odds ratios or group differences were calculated using logistic or linear regression, controlling for confounders. Results Of 41,472 deliveries during the study period, 511 pregnancies met inclusion criteria. 284 pregnancies had no metformin exposure; 227 did have metformin exposure, of which 169 (72.2%) were initiated on metformin in the first trimester. Women exposed to metformin in any trimester were statistically not more likely to have appropriate weight gain (aOR 1.53 (95% CI 1.00–2.34, p = .048), but did have less excess weight gain (aOR 0.45, 95% CI 0.30–0.66, p < .001), and more maternal weight loss (aOR 2.17, 95% CI 1.18–3.98, p = .012) than the unexposed group. Women exposed to metformin in the first trimester of pregnancy were less likely to have excess weight gain (aOR 0.39, 95% CI 0.25–0.61, p < .001) and more likely to have maternal weight loss (aOR 2.56, 95% CI 1.30–5.07, p = .007) than the unexposed cohort. There was no difference in FGR (5.3% vs 2.5% p = .094) or mean birth weight (3235.6 vs 3352.4 gm p = .122) in the metformin exposed group vs non-exposed groups, respectively. Conclusions Metformin exposure in pregnancy was associated with less excess weight gain and a higher rate of weight loss. There was no difference in FGR or mean birth weight in metformin exposed neonates. This suggests that metformin may help avoid excess weight gain and its associated comorbidities.","PeriodicalId":22921,"journal":{"name":"The Journal of Maternal-Fetal & Neonatal Medicine","volume":"11 1","pages":"9504 - 9510"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87124332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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