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Low-Dose Prophylactic Oral Iron Supplementation (Ferrous Fumarate, Ferrous Bisglycinate, and Ferrous Sulphate) in Pregnancy Is Not Associated With Clinically Significant Gastrointestinal Complaints: Results From Two Randomized Studies. 妊娠期小剂量预防性口服铁补充剂(富马酸亚铁、甘氨酸亚铁和硫酸亚铁)与临床上明显的胃肠道不适无关:两项随机研究的结果。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-15 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1716798
Nils Thorm Milman, Thomas Bergholt

Background: Many pregnant women are reluctant to follow the recommendation concerning oral iron prophylaxis due to concerns about gastrointestinal (GI) side effects. Objective: To assess the frequency of GI complaints during low-dose oral iron prophylaxis and compare three iron formulas in equipotent doses: ferrous fumarate versus ferrous bisglycinate versus ferrous sulphate, in healthy women with an uncomplicated single pregnancy. Methods: Results from two randomized, double-blind studies are reported: the Gentofte study comprising 404 women allocated into four groups taking 20, 40, 60, and 80 mg of elemental iron as ferrous fumarate/day and the Naestved study comprising 78 women allocated into two groups: 25 mg of elemental iron as ferrous bisglycinate/day and 50 mg of elemental iron as ferrous sulphate/day between meals from 15 to 19 weeks of gestation to delivery. GI complaints (nausea, vomiting, epigastric pain/pyrosis, belching, meteorism, borborygmi, intestinal colic, flatulence, loose stools, constipation, and use of laxatives), as well as black stools, were recorded by interview at the time of inclusion and at regular intervals during gestation. Results: At inclusion, the frequency of total combined GI complaints in all women (n = 482) was 21%. The Gentofte study showed that in the groups taking 20-60 mg iron/day as fumarate, there was no association between the iron dose and the frequency of GI side effects. An iron dose of 80 mg as fumarate was associated with significantly higher frequencies of constipation and the use of laxatives. Comparing the three equipotent doses of iron formulas, which can prevent iron deficiency, ferrous bisglycinate 25 mg iron had the most favourable GI side effect profile, while ferrous fumarate 40 mg iron and ferrous sulphate 50 mg iron had higher but similar GI side effect profiles. The frequency of black stools increased with the iron dose. Ferrous bisglycinate 25 mg iron had a lower frequency of black stools (8%) than ferrous fumarate 40 mg iron (22%) and ferrous sulphate 50 mg iron (31%). Conclusion: Low-dose iron supplementation appears to have no clinically significant GI side effects, as none of the included women presented with GI complaints of such severity that it necessitated either reduction of iron dose, change to an alternative iron formula, or discontinuation of iron supplement. However, ferrous bisglycinate 25 mg iron/day is associated with significantly fewer GI complaints than ferrous fumarate 40 mg iron/day and ferrous sulphate 50 mg iron/day. Ferrous bisglycinate may be preferred for iron prophylaxis, especially in women experiencing GI side effects when taking other conventional iron formulas.

背景:由于担心胃肠道(GI)副作用,许多孕妇不愿意听从有关口服铁剂预防的建议。目的在无并发症的单胎妊娠健康妇女中,评估低剂量口服铁剂预防期间出现胃肠道不适的频率,并比较三种同等剂量的铁剂配方:富马酸亚铁、甘氨酸亚铁和硫酸亚铁。方法:报告了两项随机双盲研究的结果:Gentofte 研究由 404 名妇女组成,分为四组,每天服用 20、40、60 和 80 毫克元素铁(富马酸亚铁);Naestved 研究由 78 名妇女组成,分为两组:每天服用 25 毫克元素铁(双甘氨酸亚铁)和每天服用 50 毫克元素铁(硫酸亚铁),从妊娠 15 到 19 周直至分娩。在入组时和妊娠期间定期进行访谈,记录消化道主诉(恶心、呕吐、上腹痛/胃痉挛、嗳气、陨石症、肠绞痛、胀气、大便稀、便秘和使用泻药)以及黑便情况。结果所有妇女(n = 482)在纳入研究时,合并消化道症状的总频率为 21%。Gentofte 研究显示,在每天服用 20-60 毫克富马酸铁的组别中,铁剂量与胃肠道副作用的发生频率之间没有关联。铁剂量为 80 毫克富马酸盐时,便秘和使用泻药的频率明显较高。比较可预防缺铁的三种等剂量铁剂,25 毫克富马酸亚铁的胃肠道副作用最大,而 40 毫克富马酸亚铁和 50 毫克硫酸亚铁的胃肠道副作用较高但相似。黑便的频率随铁剂量的增加而增加。与富马酸亚铁 40 毫克铁剂(22%)和硫酸亚铁 50 毫克铁剂(31%)相比,25 毫克富马酸亚铁的黑便频率(8%)较低。结论:小剂量铁质补充剂似乎没有明显的胃肠道副作用,因为所纳入的妇女中没有人出现严重的胃肠道不适,以致需要减少铁质剂量、改用其他铁质配方或停止铁质补充剂。不过,与富马酸亚铁 40 毫克铁/天和硫酸亚铁 50 毫克铁/天相比,25 毫克铁/天的甘氨酸亚铁引起的胃肠道不适明显较少。在预防性服用铁剂时,特别是在服用其他常规铁剂时出现胃肠道副作用的妇女中,可首选双甘氨酸亚铁。
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引用次数: 0
Magnitude and Associated Factors of Herbal Medicine Use During Pregnancy Among Women Attending Antenatal Care in Public Health Institutions of Central Tigray, Northern Ethiopia (2020): Facility-Based Cross-Sectional Study. 埃塞俄比亚北部提格雷中部公共卫生机构产前护理妇女孕期使用草药的程度及相关因素(2020 年):基于医疗机构的横断面研究。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9932851
Hailemikael Gebrekidan, Gebregziabher Kidanemariam

Introduction: Herbal medicine is described by the World Health Organization (WHO) as plant-derived compounds, either raw or processed, that are thought to have therapeutic advantages. Herbal medication is becoming more and more popular worldwide, particularly during pregnancy. The WHO estimates that 80% of people utilize herbal remedies. In Ethiopia, grandmothers and grandfathers frequently use herbal medicine at home to treat common health issues. Instead of using medically proven treatments during their pregnancy, the majority of expectant mothers trust herbal remedies. Objective: The aim of this study was to assess the magnitude and associated factors of herbal medicine use during pregnancy among women attending antenatal care in public health institutions of central Tigray, northern Ethiopia. Methods: Facility-based cross-sectional study was conducted from March 01 to May 15, 2020. Data were collected using a structured and pretested questionnaire. Data were entered into Epi-data manager version 7.2.5 and analyzed using SPSS version 23. Both binary and multivariate logistic regression analyses were carried out to assess the associated factors. Variables with p value less the 0.2 in bivariate analysis were transferred to multivariate analysis, and variables with p value ≤ 0.05 were considered as significant. Result: Out of the total 333 respondents, making a response rate of 100%, 176 (52.9%) used herbal medicine during current pregnancy. The most common medicines used during pregnancy were garlic (59.4%) and ginger (51.7%). Occupation that is housewife had educational status (AOR = 11.816, 95% CI 1.848-35.535), illiterate (AOR = 1.886, 95% CI 1.586-2.241), residency/rural (AOR = 2.905, 95% CI 1.173-7.197), and average monthly income less than 500 Ethiopian birrs (AOR = 7.621, 95% CI 2.691-21.585) were factors that are significantly associated with the use of herbal medicine during pregnancy. Conclusion and Recommendation: Based on our results, herbal medicine use during pregnancy is highly practiced in this study, and occupation, residency, educational status, and average monthly income were the significantly associated factors of herbal medicine use during pregnancy. There is a need to educate and counsel pregnant women on the harmful effects of herbal medicine use during pregnancy by the health care personnel and health extension worker.

导言:世界卫生组织(WHO)将草药描述为植物提取的化合物,无论是未加工的还是加工过的,都被认为具有治疗优势。草药在全世界越来越受欢迎,尤其是在怀孕期间。世卫组织估计,80% 的人使用草药疗法。在埃塞俄比亚,祖母和祖父经常在家里使用草药来治疗常见的健康问题。大多数准妈妈在怀孕期间不使用经过医学验证的治疗方法,而是相信草药疗法。研究目的本研究旨在评估埃塞俄比亚北部提格雷中部公共医疗机构中接受产前检查的妇女在怀孕期间使用草药的程度和相关因素。研究方法于 2020 年 3 月 1 日至 5 月 15 日开展了基于医疗机构的横断面研究。采用结构化的预试问卷收集数据。数据输入 Epi-data 管理器 7.2.5 版,并使用 SPSS 23 版进行分析。对相关因素进行了二元和多元逻辑回归分析。二元分析中 P 值小于 0.2 的变量转入多元分析,P 值小于 0.05 的变量被视为显著变量。结果在 333 名受访者中,有 176 人(52.9%)在怀孕期间使用过中草药,回复率为 100%。孕期最常用的药物是大蒜(59.4%)和生姜(51.7%)。家庭主妇职业、受教育程度(AOR = 11.816,95% CI 1.848-35.535)、文盲(AOR = 1.886,95% CI 1.586-2.241)、居住地/农村(AOR = 2.905,95% CI 1.173-7.197)和平均月收入低于 500 埃塞俄比亚比尔(AOR = 7.621,95% CI 2.691-21.585)是与孕期使用草药显著相关的因素。结论与建议:根据我们的研究结果,在本研究中,孕期使用中草药的比例很高,而职业、居住地、教育状况和平均月收入是与孕期使用中草药显著相关的因素。医护人员和卫生推广人员有必要就孕期使用中草药的有害影响对孕妇进行教育和咨询。
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引用次数: 0
Prevalence and Factors Associated With Abnormal Cerebroplacental Ratio Among Women With Hypertensive Disorders of Pregnancy at a Tertiary Referral Hospital in Southwestern Uganda. 乌干达西南部一家三级转诊医院中患有妊娠高血压疾病的妇女脑-胎盘比例异常的患病率及其相关因素。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-17 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8895971
Suada Suleiman Ibrahim, Yarine Fajardo Tornes, Musa Kayondo, Fidel Kasereka Tsongo, Godfrey Rwambuka Mugyenyi, Joseph Ngonzi, Henry Mark Lugobe, Julius Sebikali Mugisha, Leevan Tibaijuka

Background: Hypertensive disorders of pregnancy (HDP) are associated with placental insufficiency and adverse perinatal outcomes-over half (58.9%) of women with HDP at Mbarara Regional Referral Hospital (MRRH) have adverse perinatal outcomes. The cerebroplacental ratio (CPR) is an important predictor and prevents approximately 30% of these adverse perinatal outcomes. We determined the prevalence and factors associated with abnormal CPR among women with HDP at MRRH. Methods: We conducted a cross-sectional study from December 2022 to May 2023 at the high-risk obstetrics unit of MRRH. We consecutively enrolled all women with hypertensive disorders and gestational ages ≥ 26 weeks and performed obstetric Doppler studies to document the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and then calculated the CPR as a ratio of the MCA-PI and UA-PI. The prevalence of women with an abnormal CPR ≤ 1.0 was expressed as a percentage. We used robust modified Poisson regression analysis to determine the factors associated with abnormal CPR. Results: We enrolled 128 women with hypertensive disorders in pregnancy, with a mean age of 28.8 ± 6.3 years. Of these, 67 (52.3%) had abnormal CPR. The factors associated with abnormal CPR were severe pre-eclampsia (adjusted prevalence ratio (aPR): 5.0, 95% CI: 1.28, 29.14) and eclampsia (aPR: 5.27, 95% CI: 1.11, 34.27). Conclusion: On average, half of the women with hypertensive disorders have abnormal CPR. Women with severe pre-eclampsia or eclampsia are more likely to have abnormal CPR. Obstetric Doppler studies with CPR may be warranted for all pregnant women with severe pre-eclampsia and eclampsia. We recommend further research to assess perinatal outcomes among those with and without abnormal CPR to profile women with HDP at increased risk of adverse perinatal outcomes.

背景:妊娠期高血压疾病(HDP)与胎盘功能不全和不良围产期结局有关--在姆巴拉拉地区转诊医院(MRRH),一半以上(58.9%)的妊娠期高血压疾病妇女会出现不良围产期结局。脑-胎盘比率(CPR)是一个重要的预测指标,可避免约 30% 的围产期不良结局。我们确定了 MRRH 的 HDP 妇女中 CPR 异常的发生率和相关因素。方法:我们于 2022 年 12 月至 2023 年 5 月在瑞金医院高风险产科进行了一项横断面研究。我们连续登记了所有患有高血压疾病且孕龄≥26周的产妇,并对其进行了产科多普勒检查,以记录脐动脉(UA)和大脑中动脉(MCA)的搏动指数(PI),然后将MCA-PI和UA-PI的比值计算为CPR。CPR 异常≤1.0 的女性患病率以百分比表示。我们使用稳健的修正泊松回归分析来确定与 CPR 异常相关的因素。结果我们共招募了 128 名患有妊娠期高血压疾病的妇女,平均年龄为 28.8 ± 6.3 岁。其中 67 人(52.3%)心肺复苏异常。与 CPR 异常相关的因素是严重先兆子痫(调整后患病率比值(aPR):5.0,95% CI:1.0):5.0,95% CI:1.28,29.14)和子痫(aPR:5.27,95% CI:1.11,34.27)。结论平均而言,半数患有高血压疾病的妇女心肺复苏出现异常。患有严重先兆子痫或子痫的妇女更有可能出现心肺复苏术异常。所有患有重度子痫前期和子痫的孕妇都可能需要进行心肺复苏的产科多普勒检查。我们建议开展进一步研究,评估心肺复苏异常和心肺复苏未见异常孕妇的围产期预后,以确定 HDP 孕妇围产期不良预后的风险。
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引用次数: 0
Development, Validation, and Diagnostic Accuracy of the Fetal Lack of Responsiveness Scale for Diagnosis of Severe Perinatal Hypoxia. 用于诊断围产期严重缺氧的胎儿无反应量表的开发、验证和诊断准确性。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-16 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9779831
Luis Carlos Franco, Sandra M Buitrago, Isabel Arbelaez, Laura F Pinto, Daniela Blanco, María C Pizarro, Laura Santamaria, Catalina Trillos

Background: There are limitations to predicting perinatal asphyxia, as current tools rely almost entirely on fetal cardiotocography (CTG). The fetal lack of responsiveness scale (FLORS) is a new diagnostic alternative based on the physiological phenomena associated with fetal hypoxia. Objectives: The objective of this study was to develop, validate, and assess the diagnostic accuracy of the FLORS for predicting severe perinatal hypoxia (SPH). Study Design: A two-phase retrospective observational cross-sectional analytical study was conducted. Phase 1 involved the formulation and retrospective validation of the FLORS. A total of 366 fetal CTG records were evaluated twice by seven readers. Phase 2 was a collaborative, retrospective, multicenter diagnostic test study that included 37 SPH and 366 non-SPH cases. Results: Phase 1: A numeric, physiology-based scale was developed and refined based on expert opinions. The median time to apply the scale per reading was 38 s. Cronbach's alpha, which is a reliability measure, was significant (p = 0.784). The kappa index for test-retest agreement was moderate to reasonable, with a median value of 0.642. For interobserver agreement, the kappa index per variable was as follows: baseline, 0.669; accelerations, 0.658; variability, 0.467; late/variable decelerations, 0.638; slow response decelerations, 0.617; and trend to change, 0.423. Phase 2, including 37 SPH and 366 non-SPH cases, showed a sensitivity of 62.2% and specificity of 75.4% for the 2-point score, whereas the 3-point score had a sensitivity of 35.1% and specificity of 89.9%. The area under the curve (AUC) was significant at 0.73 (CI 0.645-0.818). Conclusions: FLORS demonstrated significant internal consistency and observer agreement, with a promising sensitivity-specificity balance and significant AUC. Further research is needed to assess its impact on perinatal hypoxia and cesarean delivery.

背景:由于目前的工具几乎完全依赖于胎儿心动图(CTG),因此预测围产期窒息存在局限性。胎儿缺氧反应量表(FLORS)是一种基于胎儿缺氧相关生理现象的新诊断方法。研究目的本研究旨在开发、验证和评估 FLORS 预测围产期严重缺氧(SPH)的诊断准确性。研究设计:分两个阶段进行回顾性观察横断面分析研究。第一阶段包括制定和回顾性验证 FLORS。共有 7 位读者对 366 份胎儿 CTG 记录进行了两次评估。第二阶段是一项合作性、回顾性、多中心诊断测试研究,包括 37 例 SPH 和 366 例非 SPH 病例。结果:第 1 阶段:根据专家意见制定并完善了基于生理学的数字量表。每次读数应用量表的中位时间为 38 秒。信度指标 Cronbach's alpha 具有显著性(p = 0.784)。测试-重复测试一致性的卡帕指数为中等至合理水平,中值为 0.642。在观察者之间的一致性方面,每个变量的卡帕指数如下:基线,0.669;加速度,0.658;可变性,0.467;晚期/可变减速,0.638;慢反应减速,0.617;变化趋势,0.423。第二阶段包括 37 例 SPH 和 366 例非 SPH 病例,结果显示 2 点评分的灵敏度为 62.2%,特异性为 75.4%,而 3 点评分的灵敏度为 35.1%,特异性为 89.9%。曲线下面积(AUC)为 0.73(CI 0.645-0.818),差异显著。结论:FLORSFLORS显示出明显的内部一致性和观察者一致性,具有良好的敏感性-特异性平衡和显著的AUC。需要进一步研究以评估其对围产期缺氧和剖宫产的影响。
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引用次数: 0
Navigating Pregnancy: Information Sources and Lifestyle Behavior Choices-A Narrative Review. 孕期导航:信息来源和生活方式行为选择--叙述性评论。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-21 eCollection Date: 2024-01-01 DOI: 10.1155/2024/4040825
Christina Gjestvang, Lene Annette Hagen Haakstad

Background: Accessible health information during pregnancy is important to positively affect maternal and fetal health. However, the quality and accuracy of health information can greatly vary across numerous sources. This narrative review is aimed at summarizing the literature on pregnant individuals' information sources and how these sources influence their habits toward GWG, PA, and nutrition. Such data will highlight preferences and needs, reveal challenges, and identify opportunities for improvement. Methods: We searched PubMed for studies published in the last decade. Out of 299 studies initially identified, 20 (16 quantitative and four qualitative) met the eligibility criteria (investigating information sources and their influence on health habits toward GWG, PA, nutrition, pregnant participants, adequate data reporting, and being available in full text). Results: Primary sources of health information varied. The Internet (26%-97%) and healthcare providers (HCPs) (14%-74%) predominated, followed by family/friends (12%71%), books/magazines (49%-65%), and guidelines/brochures (25%-53%). Despite the widespread use of the Internet, HCPs were considered the most reliable source. The use of the Internet to retrieve health information was reported to be 2-4 h a week, and < 50% discussed the online information with their HCP. The Internet was also used as a supplementary resource on topics raised by HCPs. Regarding the influence on health habits, the Internet, HCPs, media, and family positively influenced GWG and promoted adherence to recommended guidelines (OR = 0.55-15.5). Only one study showed a positive association between Internet use and PA level. The Internet, media, HCPs, and information brochures were associated with better adherence to nutritional recommendations. Conclusions: Pregnant individuals relied on the Internet and HCP, with a preference for the Internet despite trust in midwives. Several sources of health information were positively associated with adherence to GWG and nutrition recommendations. Improving the quality of online information should be a priority for policymakers and health authorities.

背景:孕期健康信息的可获取性对孕产妇和胎儿的健康有着重要的积极影响。然而,在众多信息来源中,健康信息的质量和准确性可能存在很大差异。本叙事性综述旨在总结有关孕妇信息来源的文献,以及这些来源如何影响她们对 GWG、PA 和营养的习惯。这些数据将凸显人们的偏好和需求,揭示所面临的挑战,并确定改进的机会。研究方法我们在 PubMed 上搜索了过去十年间发表的研究。在初步确定的 299 项研究中,有 20 项(16 项定量研究和 4 项定性研究)符合资格标准(调查信息来源及其对 GWG、PA、营养健康习惯的影响、怀孕参与者、充分的数据报告以及全文可用)。研究结果健康信息的主要来源各不相同。互联网(26%-97%)和医疗保健提供者(HCPs)(14%-74%)占主导地位,其次是家人/朋友(12%-71%)、书籍/杂志(49%-65%)和指南/手册(25%-53%)。尽管互联网被广泛使用,但保健医生被认为是最可靠的来源。据报告,每周使用互联网检索健康信息的时间为 2-4 小时,小于 50%的人与他们的保健医生讨论过网上信息。对于保健医生提出的问题,互联网也被用作补充资源。关于对健康习惯的影响,互联网、保健医生、媒体和家庭对 GWG 有积极影响,并促进了对推荐指南的遵守(OR = 0.55-15.5)。只有一项研究显示互联网的使用与 PA 水平之间存在正相关。互联网、媒体、保健医生和信息手册与更好地遵守营养建议有关。结论:孕妇依赖互联网和保健医生,尽管信任助产士,但更倾向于互联网。几种健康信息来源都与孕妇是否遵守 GWG 和营养建议呈正相关。提高在线信息的质量应成为政策制定者和卫生当局的优先考虑事项。
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引用次数: 0
The Impact of Fetal Growth Restriction on Prenatal 2D Ultrasound and Doppler Study of the Fetal Adrenal Gland. 胎儿生长受限对产前二维超声和胎儿肾上腺多普勒研究的影响。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-29 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9968509
Suphawan Pattamathamakul, Chatuporn Duangkum, Sukanya Chaiyarach, Kiattisak Kongwattanakul, Piyamas Saksiriwuttho, Ratana Komwilaisak, Sathida Chantanavilai, Manasicha Pongsamakthai, Prapassara Sirikarn

Background: Uteroplacental insufficiency in fetuses with growth restriction (FGR) leads to chronic hypoxia and stress, predominantly affecting the adrenal glands. However, the mechanisms of impact remain unclear. Objectives: This study is aimed at comparing the Doppler indices of the adrenal artery and the adrenal gland sizes between FGR and those with normal growth. Materials and Methods: A multicenter, cross-sectional study was conducted from February to December 2023. We compared 34 FGR to 34 with normal growth in terms of inferior adrenal artery (IAA) Doppler indices and adrenal gland volumes. Results: The IAA peak systolic velocity (PSV) in the FGR group was 14.9 ± 2.9 cm/s compared to 13.5 ± 2.0 cm/s in the normal group, with a mean difference of 1.4 cm/s (95% confidence interval [CI]: 0.27-2.65; p value = 0.017). There were no significant differences between groups in terms of IAA pulsatility index (PI), resistance index (RI), or systolic/diastolic (S/D), with p values of 0.438, 0.441, and 0.658, respectively. The volumes of the corrected whole adrenal gland and the corrected neocortex were significantly larger in the FGR group, with p values of 0.031 and 0.020, respectively. Conclusion: Both increased IAA PSV and enlarged volumes of the corrected whole adrenal gland and neocortex were found in fetuses with FGR, suggesting significant adrenal gland adaptation in response to chronic intrauterine stress.

背景:生长受限(FGR)胎儿的子宫胎盘功能不全导致长期缺氧和应激,主要影响肾上腺。然而,其影响机制仍不清楚。研究目的本研究旨在比较 FGR 胎儿和发育正常胎儿的肾上腺动脉多普勒指数和肾上腺大小。材料和方法:于 2023 年 2 月至 12 月进行了一项多中心横断面研究。我们比较了 34 例 FGR 和 34 例发育正常婴儿的肾上腺下动脉(IAA)多普勒指数和肾上腺体积。结果显示FGR组的IAA峰值收缩速度(PSV)为14.9 ± 2.9 cm/s,而正常组为13.5 ± 2.0 cm/s,平均相差1.4 cm/s(95%置信区间[CI]:0.27-2.65;P值=0.017)。各组间的 IAA 脉动指数 (PI)、阻力指数 (RI) 或收缩/舒张 (S/D) 均无明显差异,P 值分别为 0.438、0.441 和 0.658。FGR组校正后的整个肾上腺体积和校正后的新皮质体积明显更大,P值分别为0.031和0.020。结论FGR胎儿的IAA PSV增加,校正后的整个肾上腺和新皮质体积增大,表明肾上腺对宫内慢性应激有明显的适应性。
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引用次数: 0
Retrospective Analysis of the Impact of SARS-CoV-2 (COVID-19) on Pregnancy and Neonatal Outcomes. SARS-CoV-2(COVID-19)对妊娠和新生儿结局影响的回顾性分析。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1177119
Leyla Sero, Nilufer Okur, Duygu Tunçel, Mehmet Nur Talay, Mustafa Fırat Aydın, Suleyman Cemil Oglak

Background: The novel coronavirus disease 2019 (COVID-19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID-19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre-eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR-proven COVID-19 infection during pregnancy on fetus and newborn. Methods: Between December 2019 and October 2021, data from pregnant women with COVID-19 symptoms or a history of contact with people with COVID-19, infected with PCR-proven COVID-19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID-19 were evaluated. Clinical and laboratory findings of newborns related to COVID-19 and mortality data related to COVID-19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853). Results: We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty-five (56.6%) of the pregnant women had at least one COVID-19-related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID-19 infection. A total of 23 live-born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < -12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive (p = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive. Conclusion: While COVID-19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.

背景:新型冠状病毒病 2019(COVID-19)对高龄和免疫缺陷等合并症患者的破坏性更大。受 COVID-19 影响的另一个群体是孕妇。妊娠期间的免疫变化以及妊娠期间出现的妊娠糖尿病和先兆子痫等情况也会对胎儿产生影响。本研究旨在分析妊娠期经 PCR 证实的 COVID-19 感染对胎儿和新生儿的影响。研究方法在2019年12月至2021年10月期间,对感染了PCR证实的COVID-19病毒、有COVID-19症状或与COVID-19患者有接触史的孕妇数据进行回顾性分析。分析了孕妇的临床和实验室数据。评估了与 COVID-19 相关的死亡数据。记录了与 COVID-19 相关的新生儿临床和实验室检查结果,以及与 COVID-19 相关的死亡数据。该研究获得了 Gazi Yasargil 培训与研究医院伦理委员会的批准(09.07.2021/853)。研究结果我们对在本医院接受随访的 327 名孕妇进行了评估,这些孕妇的分娩结局为活产、死产、流产或刮宫。其中 185 名(56.6%)孕妇至少有一种 COVID-19 相关症状。我们评估了 306 例活产、21 例胎儿宫内死亡和 13 例产后死亡的数据。在产后死亡病例中,有 5 名婴儿直接死于 COVID-19 感染。共有 23 名活产婴儿(7.5%)被归类为小于胎龄(SGA),80 名婴儿(26.1%)在妊娠 37 周前出生,32 名婴儿(10.4%)在妊娠 32 周前出生。脐带血气体分析显示,19 名婴儿(6.3%)有 pH 值(p=0.027)。119名婴儿(40.3%)被送进了新生儿重症监护室(NICU)。在新生儿重症监护室收治的 PCR 结果呈阳性的 7 名婴儿中,有 5 名(4.2%)未能存活。结论妊娠期感染 COVID-19 会严重影响孕妇的死亡率和发病率,同时也会导致胎儿的死亡率和发病率。
{"title":"Retrospective Analysis of the Impact of SARS-CoV-2 (COVID-19) on Pregnancy and Neonatal Outcomes.","authors":"Leyla Sero, Nilufer Okur, Duygu Tunçel, Mehmet Nur Talay, Mustafa Fırat Aydın, Suleyman Cemil Oglak","doi":"10.1155/2024/1177119","DOIUrl":"10.1155/2024/1177119","url":null,"abstract":"<p><p><b>Background:</b> The novel coronavirus disease 2019 (COVID-19) was more devastating in people with comorbidities such as advanced age and immunodeficiency. Another group affected by COVID-19 was pregnant women. Immunological changes during pregnancy and conditions such as gestational diabetes and pre-eclampsia that occur during pregnancy also have effects on the fetus. The aim of this study was to analyze the effects of PCR-proven COVID-19 infection during pregnancy on fetus and newborn. <b>Methods:</b> Between December 2019 and October 2021, data from pregnant women with COVID-19 symptoms or a history of contact with people with COVID-19, infected with PCR-proven COVID-19 virus, were analyzed retrospectively. Clinical and laboratory data of pregnant women were analyzed. Death data associated with COVID-19 were evaluated. Clinical and laboratory findings of newborns related to COVID-19 and mortality data related to COVID-19 were recorded. The study received approval from the Gazi Yasargil Training and Research Hospital ethics committee (09.07.2021/853). <b>Results:</b> We evaluated 327 pregnant women who were followed up in our hospital and whose deliveries ended in live birth, stillbirth, miscarriage, or curettage. One hundred eighty-five (56.6%) of the pregnant women had at least one COVID-19-related symptom. We evaluated the data of 306 live births, 21 intrauterine fetal deaths, and 13 postnatal deaths. Among the postnatal deaths, five infants succumbed directly due to COVID-19 infection. A total of 23 live-born babies (7.5%) were classified as small for gestational age (SGA), while 80 babies (26.1%) were born before 37 weeks of gestation, and 32 babies (10.4%) were born before 32 weeks. Cord blood gas analysis revealed that 19 infants (6.3%) had pH < 7 and base excess (BE) < -12. The rate of perinatal asphyxia was significantly higher in babies born to mothers who did not survive (<i>p</i> = 0.027). A considerable number of infants, 119 (40.3%), were admitted to the neonatal intensive care unit (NICU). Among the seven infants with positive PCR results admitted to the NICU, five (4.2%) did not survive. <b>Conclusion:</b> While COVID-19 infection in pregnancy seriously affects mortality and morbidity in pregnant women, it also causes mortality and morbidity on the fetus.</p>","PeriodicalId":47062,"journal":{"name":"Journal of Pregnancy","volume":"2024 ","pages":"1177119"},"PeriodicalIF":3.2,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Connecting the Dots: Exploring the Interplay Between Preeclampsia and Peripartum Cardiomyopathy. 连接点:探索先兆子痫与围产期心肌病之间的相互作用。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7713590
Khanisyah Erza Gumilar, Khairunnisa Binti Abd Rauf, Muhammad Ilham Aldika Akbar, Nareswari Cininta Imanadha, Susetyo Atmojo, Alisia Yuana Putri, Erry Gumilar Dachlan, Gus Dekker

Preeclampsia and peripartum cardiomyopathy (PPCM) are significant obstetric problems that can arise during or after pregnancy. Both are known to be causes of maternal mortality and morbidity. Several recent studies have suggested a link between preeclampsia and the pathophysiology of PPCM. However, the common thread that connects the two has yet to be thoroughly and fully articulated. Here, we investigate the complex dynamics of preeclampsia and PPCM in this review. Our analysis focuses mainly on inflammatory and immunological responses, endothelial dysfunction as a shared pathway, and potential genetic predisposition to both diseases. To begin, we will look at how excessive inflammatory and immunological responses can lead to clinical symptoms of both illnesses, emphasizing the role of proinflammatory cytokines and immune cells in modifying vascular and tissue responses. Second, we consider endothelial dysfunction to be a crucial point at which endothelial damage and activation contribute to pathogenesis through increased vascular permeability, vascular dysfunction, and thrombus formation. Finally, we examine recent information suggesting genetic predispositions to preeclampsia and PPCM, such as genetic variants in genes involved in the management of blood pressure, the inflammatory response, and heart structural integrity. With this synergistic study, we seek to encourage more research and creative therapy solutions by emphasizing the need for an interdisciplinary approach to understanding and managing the connection between preeclampsia and PPCM.

子痫前期(Preeclampsia)和围产期心肌病(PPCM)是妊娠期间或之后可能出现的重要产科问题。众所周知,这两种疾病都是导致孕产妇死亡和发病的原因。最近的一些研究表明,子痫前期与 PPCM 的病理生理学之间存在联系。然而,将两者联系起来的共同点尚未得到彻底和全面的阐明。在本综述中,我们探讨了子痫前期和 PPCM 的复杂动态关系。我们的分析主要集中在炎症和免疫反应、作为共同途径的内皮功能障碍以及这两种疾病的潜在遗传易感性。首先,我们将探讨过度的炎症和免疫反应如何导致这两种疾病的临床症状,强调促炎症细胞因子和免疫细胞在改变血管和组织反应中的作用。其次,我们认为内皮功能障碍是一个关键点,内皮损伤和活化通过增加血管通透性、血管功能障碍和血栓形成而导致发病。最后,我们研究了提示子痫前期和 PPCM 遗传易感性的最新信息,如参与血压管理、炎症反应和心脏结构完整性的基因的遗传变异。通过这项协同研究,我们强调需要采用跨学科的方法来理解和管理子痫前期和 PPCM 之间的联系,从而鼓励开展更多的研究和创造性的治疗方案。
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引用次数: 0
Serious Concern of Congenital Zika Syndrome (CZS) in India: A Narrative Review. 印度对先天性寨卡综合征(CZS)的严重关切:叙述性综述。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-13 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1758662
Maneesh Kumar, Suman Kumar, Ratnesh Kumar, Mithilesh Kumar Jha, Shashank Nand Tiwari, Pratima Gupta

Congenital Zika syndrome (CZS) is a major concern in India and highlights the multifaceted challenges posed by the Zika virus (ZIKV). The alarming increase in CZS cases in India, a condition that has serious effects on both public health and newborns, has raised concerns. This review highlights the importance of raising concern and awareness and taking preventive measures by studying the epidemiology, clinical symptoms, and potential long-term consequences of CZS. The review also contributes to worldwide research and information sharing to improve the understanding and prevention of CZS. As India deals with the changing nature of CZS, this thorough review is an important tool for policymakers, health workers, and researchers to understand what is happening now, plan for what to do in the future, and work together as a team, using medical knowledge, community involvement, and study projects to protect newborns' health and reduce the public health impact of these syndromes.

先天性寨卡综合征(CZS)是印度的一个重大问题,凸显了寨卡病毒(ZIKV)带来的多方面挑战。印度先天性寨卡综合征病例的惊人增长引起了人们的关注,这种疾病对公众健康和新生儿都有严重影响。本综述强调了通过研究 CZS 的流行病学、临床症状和潜在的长期后果来提高人们的关注和意识并采取预防措施的重要性。本综述还有助于世界范围内的研究和信息共享,以增进对 CZS 的了解和预防。随着印度应对 CZS 性质的不断变化,这篇详尽的综述是决策者、卫生工作者和研究人员了解当前情况、规划未来工作的重要工具,也是利用医学知识、社区参与和研究项目,保护新生儿健康和减少这些综合征对公共卫生影响的团队合作的重要工具。
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引用次数: 0
A Novel Approach for Conservative Management of Placenta Accreta Spectrum Disorder Cases: Experience of a Single Surgeon: PAS Disorders and Conservative Management. 保守治疗胎盘早剥谱系障碍病例的新方法:一位外科医生的经验:PAS紊乱和保守治疗。
IF 3.2 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-12 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9910316
Ahmet Yalınkaya, Süleyman Cemil Oğlak

Background: This study is aimed at evaluating the conservative surgical treatment of patients with placenta accreta spectrum (PAS) disorder and at presenting the experience of a single surgeon. Materials and Methods: This retrospective study included 245 patients with placenta previa accompanied by PAS disorders operated at a university hospital between June 2013 and December 2023. The diagnosis of PAS was made by a single perinatologist using a combination of transvaginal and transabdominal ultrasonography. All patients were operated with conservative surgical technique by the same surgeon. The demographic and clinical characteristics of the patients, the anesthesia and incision types used, and the details of the surgical technique were evaluated. Results: Of the patients, 165 were operated on at the scheduled time, 80 were operated on under emergency conditions, and 232 (94.69%) of them were operated on under spinal anesthesia. All patients were operated on with a Pfannenstiel incision followed by a transverse incision to the upper border of the placenta to enter into the uterus. An average of 0.52 units of red blood cells per patient was transfused to all patients. Spontaneous intra-abdominal bleeding developed in five patients, and surgical complications occurred in eight patients. No cesarean hysterectomy was performed, and no maternal mortality was detected in any of the cases. The mean time duration of surgery was 54.44 ± 11.37 (30-90) min, and the mean length of hospital stay was 1.71 ± 1.30 (1-9) days. Conclusions: We recommend this procedure as a novel technique and a robust and safe alternative to peripartum hysterectomy and other conservative surgical management procedures for cases with complete PP accompanied with PAS. This technique preserves the uterus as well as reduces blood loss, and transfusion requirement, and thus maternal morbidity and mortality in PAS cases.

背景:本研究旨在评估胎盘早剥谱系(PAS)紊乱患者的保守手术治疗,并介绍一位外科医生的经验。材料与方法:这项回顾性研究纳入了 2013 年 6 月至 2023 年 12 月期间在一家大学医院接受手术的 245 例前置胎盘伴有 PAS 疾病的患者。PAS的诊断由一名围产期医师通过经阴道和经腹部超声波联合做出。所有患者均由同一位外科医生采用保守手术技术进行手术。对患者的人口统计学和临床特征、使用的麻醉和切口类型以及手术技术的细节进行了评估。结果:患者中有 165 人在预定时间接受了手术,80 人在紧急情况下接受了手术,其中 232 人(94.69%)在脊髓麻醉下接受了手术。所有患者的手术均采用 Pfannenstiel 切口,然后在胎盘上缘做横切口进入子宫。所有患者平均每人输注了 0.52 个单位的红细胞。五名患者出现自发性腹腔内出血,八名患者出现手术并发症。没有进行剖腹产子宫切除术,也没有发现产妇死亡病例。平均手术时间为(54.44 ± 11.37)分钟(30-90),平均住院时间为(1.71 ± 1.30)天(1-9)天。结论:对于完全性 PP 伴有 PAS 的病例,我们推荐该手术作为一种新技术,是围产期子宫切除术和其他保守手术治疗方法的可靠、安全的替代方案。这项技术既能保留子宫,又能减少失血和输血需求,从而降低 PAS 病例中产妇的发病率和死亡率。
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引用次数: 0
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Journal of Pregnancy
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