Pub Date : 2024-08-09DOI: 10.1177/1753495x241269121
N. Keating, Grainne Rooney, S. McGuinness, F. McAuliffe
The Valsalva manoeuvre (VM) is a normal physiological event that occurs during the second active phase of labour. In women with medical conditions that may be exacerbated by the Valsalva, caesarean birth may be recommended. This carries with it its own potential for maternal morbidity, and thus it is important that women are appropriately counselled about the mode of delivery most suited to their individual situation. It is possible to avoid VM with spontaneous pushing rather than reverting to caesarean birth. Neuraxial analgesia and instrumental delivery may also be used to avoid prolonged VM. We outline the effect of VM on the various organ systems in pregnancy and summarise the available evidence on its implication.
{"title":"A review of the effects of Valsalva manoeuvre in labour and birth","authors":"N. Keating, Grainne Rooney, S. McGuinness, F. McAuliffe","doi":"10.1177/1753495x241269121","DOIUrl":"https://doi.org/10.1177/1753495x241269121","url":null,"abstract":"The Valsalva manoeuvre (VM) is a normal physiological event that occurs during the second active phase of labour. In women with medical conditions that may be exacerbated by the Valsalva, caesarean birth may be recommended. This carries with it its own potential for maternal morbidity, and thus it is important that women are appropriately counselled about the mode of delivery most suited to their individual situation. It is possible to avoid VM with spontaneous pushing rather than reverting to caesarean birth. Neuraxial analgesia and instrumental delivery may also be used to avoid prolonged VM. We outline the effect of VM on the various organ systems in pregnancy and summarise the available evidence on its implication.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922748","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 : 2024-07-26DOI: 10.1177/1753495x241263441
Julia Zöllner, Catherine Williamson, Peter H. Dixon
Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disorder with variable global incidence. Genetic susceptibility, combined with hormonal and environmental influences, contributes to ICP aetiology. Adverse pregnancy outcomes linked to elevated serum bile acids highlight the importance of comprehensive risk assessment. ABCB4 and ABCB11 gene variants play a significant role in about 20% of severe ICP cases. Several other genes including ATP8B1, NR1H4, ABCC2, TJP2, SERPINA1, GCKR and HNF4A have also been implicated with ICP. Additionally , ABCB4 variants elevate the risk of drug-induced intrahepatic cholestasis, gallstone disease, gallbladder and bile duct carcinoma, liver cirrhosis and abnormal liver function tests. Genetic variations, both rare and common, intricately contribute to ICP susceptibility. Leveraging genetic insights holds promise for personalised management and intervention strategies. Further research is needed to elucidate variant-specific phenotypic expressions and therapeutic implications, advancing precision medicine in ICP management.
{"title":"ICP miniseries: Genetic issues in ICP","authors":"Julia Zöllner, Catherine Williamson, Peter H. Dixon","doi":"10.1177/1753495x241263441","DOIUrl":"https://doi.org/10.1177/1753495x241263441","url":null,"abstract":"Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disorder with variable global incidence. Genetic susceptibility, combined with hormonal and environmental influences, contributes to ICP aetiology. Adverse pregnancy outcomes linked to elevated serum bile acids highlight the importance of comprehensive risk assessment. ABCB4 and ABCB11 gene variants play a significant role in about 20% of severe ICP cases. Several other genes including ATP8B1, NR1H4, ABCC2, TJP2, SERPINA1, GCKR and HNF4A have also been implicated with ICP. Additionally , ABCB4 variants elevate the risk of drug-induced intrahepatic cholestasis, gallstone disease, gallbladder and bile duct carcinoma, liver cirrhosis and abnormal liver function tests. Genetic variations, both rare and common, intricately contribute to ICP susceptibility. Leveraging genetic insights holds promise for personalised management and intervention strategies. Further research is needed to elucidate variant-specific phenotypic expressions and therapeutic implications, advancing precision medicine in ICP management.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800551","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 : 2024-07-26DOI: 10.1177/1753495x241265528
Gabriela McMahon, CM McCarthy, Rebecca Weedle, Colm Magee, Donna Eaton, Jennifer C. Donnelly
Bullous lung disease presenting as a pneumothorax in pregnancy has not been reported in the literature to date. We present the case of a woman in her third pregnancy presenting to routine antenatal clinic with a secondary spontaneous pneumothorax in the third trimester. We describe the multidisciplinary approach to her management with obstetrics, obstetric anaesthesiology, cardiothoracic surgery and midwifery. This included decision making around conservative management in the initial disease course, preparation for delivery and a plan for definitive surgery postnatally. Caesarean section was performed at 36 weeks’ gestation owing to worsening chest pain. The underlying pathological process was deemed to be bullous lung disease which was confirmed on histology obtained from a video-assisted thoracoscopic surgery procedure done postnatally. We demonstrate the importance of the multidisciplinary team approach in the care of complex and rare medical conditions in pregnancy.
{"title":"Bullous lung disease in pregnancy: a case report","authors":"Gabriela McMahon, CM McCarthy, Rebecca Weedle, Colm Magee, Donna Eaton, Jennifer C. Donnelly","doi":"10.1177/1753495x241265528","DOIUrl":"https://doi.org/10.1177/1753495x241265528","url":null,"abstract":"Bullous lung disease presenting as a pneumothorax in pregnancy has not been reported in the literature to date. We present the case of a woman in her third pregnancy presenting to routine antenatal clinic with a secondary spontaneous pneumothorax in the third trimester. We describe the multidisciplinary approach to her management with obstetrics, obstetric anaesthesiology, cardiothoracic surgery and midwifery. This included decision making around conservative management in the initial disease course, preparation for delivery and a plan for definitive surgery postnatally. Caesarean section was performed at 36 weeks’ gestation owing to worsening chest pain. The underlying pathological process was deemed to be bullous lung disease which was confirmed on histology obtained from a video-assisted thoracoscopic surgery procedure done postnatally. We demonstrate the importance of the multidisciplinary team approach in the care of complex and rare medical conditions in pregnancy.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801462","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 : 2024-07-25DOI: 10.1177/1753495x241260792
Allison Pihelgas, Laura Sevick, Gabriela Pelinska, Winnie Sia
We aimed to evaluate the effectiveness of our vascular risk reduction clinic for women who had preeclampsia, in improving patients’ cardiovascular outcomes, self-reported healthy behaviors, and knowledge about their long-term cardiovascular health. Retrospective case-control study where 470 surveys were mailed: half were patients seen in Postpartum Preeclampsia Clinic 2010–2019, and controls were patients who did not attend a scheduled clinic appointment or were seen in Obstetric Medicine clinic postpartum for preeclampsia. Primary outcome was a lack of postpartum weight gain. Secondary outcomes included new vascular diseases, smoking, exercise, and physician follow-up. Ninety-four (43.3%) of clinic attendees returned survey and 30.3% of controls. Fewer clinic attendees gained weight postpartum, and attendees had fewer hypertension and followed up more with family physicians. Most attendees found the clinic helpful. Postpartum Preeclampsia Clinic was effective in affecting some vascular outcomes and in improving knowledge and follow-up behaviors.
{"title":"Effectiveness of a postpartum vascular risk reduction clinic on behavioral change and long-term cardiovascular outcomes in women who had preeclampsia: a case-control study","authors":"Allison Pihelgas, Laura Sevick, Gabriela Pelinska, Winnie Sia","doi":"10.1177/1753495x241260792","DOIUrl":"https://doi.org/10.1177/1753495x241260792","url":null,"abstract":"We aimed to evaluate the effectiveness of our vascular risk reduction clinic for women who had preeclampsia, in improving patients’ cardiovascular outcomes, self-reported healthy behaviors, and knowledge about their long-term cardiovascular health. Retrospective case-control study where 470 surveys were mailed: half were patients seen in Postpartum Preeclampsia Clinic 2010–2019, and controls were patients who did not attend a scheduled clinic appointment or were seen in Obstetric Medicine clinic postpartum for preeclampsia. Primary outcome was a lack of postpartum weight gain. Secondary outcomes included new vascular diseases, smoking, exercise, and physician follow-up. Ninety-four (43.3%) of clinic attendees returned survey and 30.3% of controls. Fewer clinic attendees gained weight postpartum, and attendees had fewer hypertension and followed up more with family physicians. Most attendees found the clinic helpful. Postpartum Preeclampsia Clinic was effective in affecting some vascular outcomes and in improving knowledge and follow-up behaviors.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803641","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 : 2024-07-25DOI: 10.1177/1753495x241263135
Audrey Lacasse, Vincent Williams, Pallavi Ganguli, S. Grand’Maison, Bilan Wo, Veronique Cyr, Marie-Lou Tardif, Nadia Caron, Julien Viau-Lapointe, Veronique Naessens, M. Mahone
Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence. In this multicenter retrospective cohort study across five tertiary centers, we aimed to validate TRV as a determinant of increased maternal and fetal risk. Data was collected on 93 women and included 21 patients with TRV of at least 2.5 m/s. The maternal primary composite outcome included occurrence of vaso-occlusive crisis, acute chest syndrome, gestational hypertension, preeclampsia, and mortality. The fetal primary composite outcome comprised perinatal mortality, premature delivery, reduced birth weight, and fetal distress. Adverse maternal and fetal events arose in both groups with no statistical difference. This study cannot support TRV of 2.5 m/s or more as an independent predictor of adverse obstetric outcomes among women with SCD.
{"title":"Prediction of obstetric outcomes in sickle cell patients based on tricuspid regurgitant velocity","authors":"Audrey Lacasse, Vincent Williams, Pallavi Ganguli, S. Grand’Maison, Bilan Wo, Veronique Cyr, Marie-Lou Tardif, Nadia Caron, Julien Viau-Lapointe, Veronique Naessens, M. Mahone","doi":"10.1177/1753495x241263135","DOIUrl":"https://doi.org/10.1177/1753495x241263135","url":null,"abstract":"Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence. In this multicenter retrospective cohort study across five tertiary centers, we aimed to validate TRV as a determinant of increased maternal and fetal risk. Data was collected on 93 women and included 21 patients with TRV of at least 2.5 m/s. The maternal primary composite outcome included occurrence of vaso-occlusive crisis, acute chest syndrome, gestational hypertension, preeclampsia, and mortality. The fetal primary composite outcome comprised perinatal mortality, premature delivery, reduced birth weight, and fetal distress. Adverse maternal and fetal events arose in both groups with no statistical difference. This study cannot support TRV of 2.5 m/s or more as an independent predictor of adverse obstetric outcomes among women with SCD.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804114","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 : 2024-06-06DOI: 10.1177/1753495x241258385
Sarah K. Giles, W. M. Hague, Rob A. Edwards
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver-specific disorder affecting pregnant women, with an Australian incidence of 0.6% pa and recurring in 70% of those affected. ICP causes mild to severe pruritus, often resulting in considerable skin excoriations, profound sleep disturbances, and severe anxiety, and yet the aetiology and optimal treatment or management of this condition remains unknown. In this review, we consider the role of viruses in causing or exacerbating ICP and discuss viruses that have been most closely implicated in the disease, including the role of Hepatitis B and Hepatitis C viruses in ICP.
{"title":"ICP miniseries: ICP – could there be a virus in the works?","authors":"Sarah K. Giles, W. M. Hague, Rob A. Edwards","doi":"10.1177/1753495x241258385","DOIUrl":"https://doi.org/10.1177/1753495x241258385","url":null,"abstract":"Intrahepatic cholestasis of pregnancy (ICP) is the most common liver-specific disorder affecting pregnant women, with an Australian incidence of 0.6% pa and recurring in 70% of those affected. ICP causes mild to severe pruritus, often resulting in considerable skin excoriations, profound sleep disturbances, and severe anxiety, and yet the aetiology and optimal treatment or management of this condition remains unknown. In this review, we consider the role of viruses in causing or exacerbating ICP and discuss viruses that have been most closely implicated in the disease, including the role of Hepatitis B and Hepatitis C viruses in ICP.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141380378","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 : 2024-06-05DOI: 10.1177/1753495x241258668
S. Ye, Ibrahim Shahid, Christopher J Yates, Dev Kevat, I. Lee
Background: Type 2 diabetes (T2DM) in pregnancy is associated with poor perinatal outcomes; however, there are limited data on outcomes of continuous glucose monitoring (CGM) use in this population. Objective: We reviewed the literature on studies reporting CGM outcomes in pregnant women with T2DM. We aimed to synthesise in a narrative review, the effects of CGM on glycaemic and perinatal outcomes as well as current research gaps. Results: Of 34 articles screened, three reported CGM outcomes in T2DM pregnancies compared to self-monitoring of blood glucose (SMBG). Other feasibility and mixed population studies were also reviewed. CGM in T2DM has good feasibility, acceptability, and improved glycaemic control beyond SMBG. There were limited data to draw conclusions on its effect on maternal and fetal outcomes. Conclusion: Further studies of perinatal outcomes in pregnant women with T2DM are required to determine the impact of improved glycaemia with CGM.
{"title":"Continuous glucose monitoring in pregnant women with pregestational type 2 diabetes: a narrative review","authors":"S. Ye, Ibrahim Shahid, Christopher J Yates, Dev Kevat, I. Lee","doi":"10.1177/1753495x241258668","DOIUrl":"https://doi.org/10.1177/1753495x241258668","url":null,"abstract":"Background: Type 2 diabetes (T2DM) in pregnancy is associated with poor perinatal outcomes; however, there are limited data on outcomes of continuous glucose monitoring (CGM) use in this population. Objective: We reviewed the literature on studies reporting CGM outcomes in pregnant women with T2DM. We aimed to synthesise in a narrative review, the effects of CGM on glycaemic and perinatal outcomes as well as current research gaps. Results: Of 34 articles screened, three reported CGM outcomes in T2DM pregnancies compared to self-monitoring of blood glucose (SMBG). Other feasibility and mixed population studies were also reviewed. CGM in T2DM has good feasibility, acceptability, and improved glycaemic control beyond SMBG. There were limited data to draw conclusions on its effect on maternal and fetal outcomes. Conclusion: Further studies of perinatal outcomes in pregnant women with T2DM are required to determine the impact of improved glycaemia with CGM.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141382872","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 : 2024-06-05DOI: 10.1177/1753495x241258383
M. Dekker Nitert, C. Ovadia
Bile acid metabolism is partially regulated through the activity of the gut microbiota. Primary bile acids can be deconjugated and modified by bacteria expressing bile salt hydrolase and other enzymes, changing bile acid recycling by changing the interactions between enterocytes and hepatocytes. The modified bile acids can also activate signalling in cells regulating metabolism including colonic L-cells, skeletal muscle cells and brown adipocytes. In pregnancy, both bile acid metabolism and gut microbiota composition are altered. In women with intrahepatic cholestasis of pregnancy, the changes in bile acid metabolism are exacerbated and there is some evidence that the gut microbiota composition is also altered. Here we review the crosstalk between the liver and the gut especially in women with intrahepatic cholestasis of pregnancy, with a focus on the role of the gut microbiota in this crosstalk.
胆汁酸代谢部分受肠道微生物群活动的调节。表达胆盐水解酶和其他酶的细菌可以对初级胆汁酸进行解聚和修饰，通过改变肠细胞和肝细胞之间的相互作用来改变胆汁酸的循环。改性胆汁酸还能激活调节新陈代谢的细胞信号，包括结肠 L 细胞、骨骼肌细胞和棕色脂肪细胞。在怀孕期间，胆汁酸代谢和肠道微生物群的组成都会发生改变。在患有妊娠肝内胆汁淤积症的妇女中，胆汁酸代谢的变化会加剧，有证据表明肠道微生物群的组成也会发生改变。在此，我们回顾了肝脏和肠道之间的相互影响，尤其是妊娠肝内胆汁淤积症妇女的肝脏和肠道之间的相互影响，重点是肠道微生物群在这种相互影响中的作用。
{"title":"ICP miniseries: Microbial metabolites as a way to provide crosstalk between gut and liver","authors":"M. Dekker Nitert, C. Ovadia","doi":"10.1177/1753495x241258383","DOIUrl":"https://doi.org/10.1177/1753495x241258383","url":null,"abstract":"Bile acid metabolism is partially regulated through the activity of the gut microbiota. Primary bile acids can be deconjugated and modified by bacteria expressing bile salt hydrolase and other enzymes, changing bile acid recycling by changing the interactions between enterocytes and hepatocytes. The modified bile acids can also activate signalling in cells regulating metabolism including colonic L-cells, skeletal muscle cells and brown adipocytes. In pregnancy, both bile acid metabolism and gut microbiota composition are altered. In women with intrahepatic cholestasis of pregnancy, the changes in bile acid metabolism are exacerbated and there is some evidence that the gut microbiota composition is also altered. Here we review the crosstalk between the liver and the gut especially in women with intrahepatic cholestasis of pregnancy, with a focus on the role of the gut microbiota in this crosstalk.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386427","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 : 2024-06-05DOI: 10.1177/1753495x241254243
Laura De Souza, D. Pham, Ann-Maree Craven, Renuka Sekar, S. Jesudason, S. Ratanjee, Wallace Walker, D. Ranganathan
Pregnancies in women on dialysis remain rare but are increasing in numbers. Retrospective observational audit of seven cases from 1977 to 2022 of all women who conceived prior to dialysis or conceived whilst on dialysis. Of a total of seven women, three were referred from regional centres in Australia, between the 6 and 20 weeks of gestation, generally without any opportunity for pre-conception counselling. Five were managed with intensive haemodialysis aiming for six sessions per week; one patient continued peritoneal dialysis until birth by caesarean section. Five women out of seven had live births, two of which were conceived whilst on dialysis. Four were delivered prematurely between 27 and 31 weeks of gestation, and one at term via spontaneous vaginal delivery. Outcomes for women with pregnancies on dialysis benefit from intensive dialysis management however the practical implementation remains challenging. Our cases highlight the diversity of experience in our centre across two decades.
{"title":"Pregnancy in women on dialysis – A case series – Challenges in achieving evidence-based care","authors":"Laura De Souza, D. Pham, Ann-Maree Craven, Renuka Sekar, S. Jesudason, S. Ratanjee, Wallace Walker, D. Ranganathan","doi":"10.1177/1753495x241254243","DOIUrl":"https://doi.org/10.1177/1753495x241254243","url":null,"abstract":"Pregnancies in women on dialysis remain rare but are increasing in numbers. Retrospective observational audit of seven cases from 1977 to 2022 of all women who conceived prior to dialysis or conceived whilst on dialysis. Of a total of seven women, three were referred from regional centres in Australia, between the 6 and 20 weeks of gestation, generally without any opportunity for pre-conception counselling. Five were managed with intensive haemodialysis aiming for six sessions per week; one patient continued peritoneal dialysis until birth by caesarean section. Five women out of seven had live births, two of which were conceived whilst on dialysis. Four were delivered prematurely between 27 and 31 weeks of gestation, and one at term via spontaneous vaginal delivery. Outcomes for women with pregnancies on dialysis benefit from intensive dialysis management however the practical implementation remains challenging. Our cases highlight the diversity of experience in our centre across two decades.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386100","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 : 2024-06-02DOI: 10.1177/1753495x241258676
Zainab Ajoke Abdulkadir, M. Ijaiya, I. Adebara
Microvascular, placental, haematological and lipid studies suggest striking similarities between preeclampsia/eclampsia and atherosclerosis. To determine the lipid profile and atherogenic indices in preeclamptic/eclamptic patients and compare with normal pregnant women. Comparative cross-sectional study conducted in North Central Nigeria. The study population was preeclamptic/eclamptic patients and normal pregnant women. A total of 192 women, comprising 96 pregnant women with preeclampsia/eclampsia and an equal number of normotensive controls were recruited consecutively by purposive sampling. Lipid profiles were estimated and atherogenic indices were calculated. Coronary heart disease risk ratio (CRR) and atherogenic index of plasma (AIP) showed significantly increased atherogenic potentials in subjects compared to controls. Mean ± SD CRR of subjects was 0.28 ± 0.17, Mean ± SD CRR of controls was 0.44 ± 0.24 ( p = 0.001); Mean ± SD AIP of subjects was 0.32 ± 0.42 and mean ± SD AIP of controls was 0.16 ± 0.26 ( p = 0.003). Atherogenic indices show increased atherogenic potentials in preeclamptic/eclamptics.
{"title":"Atherogenic indices in preeclamptic and eclamptic patients in North-Central Nigeria","authors":"Zainab Ajoke Abdulkadir, M. Ijaiya, I. Adebara","doi":"10.1177/1753495x241258676","DOIUrl":"https://doi.org/10.1177/1753495x241258676","url":null,"abstract":"Microvascular, placental, haematological and lipid studies suggest striking similarities between preeclampsia/eclampsia and atherosclerosis. To determine the lipid profile and atherogenic indices in preeclamptic/eclamptic patients and compare with normal pregnant women. Comparative cross-sectional study conducted in North Central Nigeria. The study population was preeclamptic/eclamptic patients and normal pregnant women. A total of 192 women, comprising 96 pregnant women with preeclampsia/eclampsia and an equal number of normotensive controls were recruited consecutively by purposive sampling. Lipid profiles were estimated and atherogenic indices were calculated. Coronary heart disease risk ratio (CRR) and atherogenic index of plasma (AIP) showed significantly increased atherogenic potentials in subjects compared to controls. Mean ± SD CRR of subjects was 0.28 ± 0.17, Mean ± SD CRR of controls was 0.44 ± 0.24 ( p = 0.001); Mean ± SD AIP of subjects was 0.32 ± 0.42 and mean ± SD AIP of controls was 0.16 ± 0.26 ( p = 0.003). Atherogenic indices show increased atherogenic potentials in preeclamptic/eclamptics.","PeriodicalId":51717,"journal":{"name":"Obstetric Medicine","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141273594","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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