Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
22,935
result(s) for
"Obstetric outcome"
Sort by:
Eight-Year Trends in the Effect of the Great East Japan Earthquake on Obstetrics Outcomes: A Study from the Fukushima Health Management Survey
Information regarding the longitudinal effects of natural/environmental disasters on obstetrics outcomes is limited. This study aimed to analyze the longitudinal changes in obstetrics outcomes over 8 years after the Great East Japan Earthquake and the Fukushima power plant accident. We used data from the first 8 years of the Pregnancy and Birth Survey by the Fukushima prefectural government, launched in 2011. We compared data on obstetrics outcomes by year and divided Fukushima Prefecture into six districts based on administrative districts. Longitudinal changes in the occurrence of preterm birth before 37 gestational weeks, low birth weight, and anomalies in newborns were accessed using the Mantel–Haenszel test for trends in all six districts. Overall, 57,537 participants were included. In 8 years, maternal age, conception rate after sterility treatment, and cesarean section delivery incidence increased. Although significant differences were observed in preterm birth and low birth weight occurrence among districts, there was no significant trend in the occurrence of preterm birth, low birth weight, and anomalies in newborns in all six districts of Fukushima Prefecture. The Great East Japan Earthquake and Fukushima power plant accident were associated with increased cesarean section delivery incidence but had no significant adverse effects on obstetrics outcomes.
Journal Article
Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis
Congenital uterine anomalies (CUA) may influence reproductive performance, resulting in adverse pregnancy associated complications. This study aimed to assess the association of CUA subtypes with reproductive, obstetric, and perinatal outcomes. We performed a systematic search of the MEDLINE, EMBASE, and Cochrane libraries for studies comparing pregnancy outcomes between women with CUA and those with a normal uterus. The random effects model was used to estimate the odds ratios (ORs) with a 95% confidence interval (CI). Women with CUA had a lower rate of live births (OR 0.47; 95% CI 0.33–0.69), and a higher rate of first trimester miscarriage (OR, 1.79; 95% CI, 1.34–2.4), second trimester miscarriage (OR 2.92; 95% CI 1.35–6.32), preterm birth (OR 2.98; 95% CI 2.43–3.65), malpresentation (OR 9.1; 95% CI 5.88–14.08), cesarean section (OR 2.87; 95% CI 1.56–5.26), and placental abruption (OR 3.12; 95% CI 1.58–6.18). Women with canalization defects appear to have the poorest reproductive performance during early pregnancy. However, unification defects were associated with obstetric and neonatal outcomes throughout the course of pregnancy. It may be beneficial for clinicians to advise on potential complications that may be increased depending on the type and severity of CUA.
Journal Article
The effects of PTSD treatment during pregnancy: systematic review and case study
PTSD in pregnant women is associated with adverse outcomes for mothers and their children. It is unknown whether pregnant women with PTSD, or symptoms of PTSD, can receive targeted treatment that is safe and effective.
The purpose of the present paper was to assess the effectiveness and safety of treatment for (symptoms of) PTSD in pregnant women.
A systematic review was conducted in accordance with the PRISMA guidelines in Pubmed, Embase, PsychINFO, and Cochrane. In addition, a case is presented of a pregnant woman with PTSD who received eye-movement desensitization and reprocessing (EMDR) therapy aimed at processing the memories of a previous distressing childbirth.
In total, 13 studies were included, involving eight types of interventions (i.e. trauma-focused cognitive behavioural therapy, exposure therapy, EMDR therapy, interpersonal psychotherapy, explorative therapy, self-hypnosis and relaxation, Survivor Moms Companion, and Seeking Safety Intervention). In three studies, the traumatic event pertained to a previous childbirth. Five studies reported obstetrical outcomes. After requesting additional information, authors of five studies indicated an absence of serious adverse events. PTSD symptoms improved in 10 studies. However, most studies carried a high risk of bias. In our case study, a pregnant woman with a PTSD diagnosis based on DSM-5 no longer fulfilled the criteria of PTSD after three sessions of EMDR therapy. She had an uncomplicated pregnancy and delivery.
Despite the fact that case studies as the one presented here report no adverse events, and treatment is likely safe, due to the poor methodological quality of most studies it is impossible to allow inferences on the effects of any particular treatment of PTSD (symptoms) during pregnancy. Yet, given the elevated maternal stress and cortisol levels in pregnant women with PTSD, and the fact that so far no adverse effects on the unborn child have been reported associated with the application of trauma-focused therapy, treatment of PTSD during pregnancy is most likely safe.
Journal Article
Maternal indicators and obstetric outcome in the north Indian population: A hospital-based study
Background: Understanding the effect of maternal parameters on
obstetric outcome has public health importance because these indicators
are associated with infant health and survival and influence
development and health in later life. Aim: To determine the effects of
various maternal indicators on pregnancy outcome in north-Indian women.
Settings and Design: A prospective study of all consecutive women with
singleton pregnancy, who were registered in the first two months of
pregnancy and delivered in the hospital. Materials and Methods:
Maternal indicators such as age, height, prepregnancy weight, body mass
index (BMI), hemoglobin and parity were correlated with pregnancy
outcome. The women with a medical disorder or complication that
developed during the course of pregnancy were excluded. Results: A
total of 2027 women were analyzed. Maternal height, weight, BMI and
parity had a positive significant correlation with birth weight of the
newborn (r=0.081, P value < 0.001, r=0.148, P value <0.001, r =
0.121, P value < 0.001 and r = 0.099, P value < 0.001,
respectively). Maternal height, weight and period of gestation were
significant indicators for low birth weight on multivariate logistic
regression. The rate of preterm delivery was significantly higher in
women with hemoglobin < 7 g% and women with parity >3. The
chances of caesarian section increased significantly with increase in
maternal height, weight and BMI. Conclusions: A prepregnancy weight of
more than 40 kg, BMI of more than 19.8 and hemoglobin of at least 7g%
or more favor good obstetric outcome.
Journal Article
The effect of intrapartum deinfibulation on obstetric outcomes and postpartum sexual function in pregnant women with Type 3 Female Genital Mutilation/Cutting
Purpose
Female Genital Mutilation/Cutting (FGM/C) is a surgical intervention that is still performed in large numbers worldwide and has severe effects in terms of both obstetric and sexual consequences. Due to the increase in immigration, it has become more frequent in many countries. This study aims to compare the labor performance, complications, and postpartum sexual function of Type 3 Female Genital Mutilation/Cutting (FGM/C) pregnant women undergoing deinfibulation with Type 3 FGM/C patients without deinfibulation.
Methods
This is a prospective study of pregnant women with Type 3 FGM/C and puerperium patients at Nyala Turkish Training and Research Hospital in Sudan over 4 years, from September 2018 to September 2022. Type 3 FGM/C patients who underwent deinfibulation were compared with those who did not, considering age, parity, and obstetric and neonatal outcomes and the Female Sexual Function Index (FSFI) scores at 3 months.
Results
In our homogeneous Type 3 FGM/C group mainly consisting of primiparous women, it was found that more episiotomy procedures were performed. The second stage of labor was significantly prolonged, and perineal damage was greater in the group without deinfibulation. In addition, postpartum hemorrhage and hospitalization of mother and baby were longer in the group without deinfibulation. In the second part of our study, we compared the FSFI scores between the deinfibulation group and the episiotomy subgroup. The results indicated that the deinfibulation group exhibited higher scores across all FSFI domains.
Conclusion
Type 3 FGM/C is definitely associated with poor obstetric and sexual outcomes. It is essential to include partners in family discussions and to protect the perineum by performing deinfibulation and episiotomy at appropriate times and in the correct manner during labor.
What does this study adds to the clinical work
The contribution of the deinfibulation procedure, which is recognized for its obstetric benefits, should also be communicated to families and spouses in terms of its long-term impact on sexual performance. By sharing this information, the devastating effects of Female Genital Mutilation/Cutting (FGM/C) can be mitigated, both obstetrically and sexually.
Journal Article
The influence of uterine fibroids on adverse outcomes in pregnant women: a meta-analysis
Objective
The objective of the meta-analysis was to determine the influence of uterine fibroids on adverse outcomes, with specific emphasis on multiple or large (≥ 5 cm in diameter) fibroids.
Materials and methods
We searched PubMed, Embase, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), and SinoMed databases for eligible studies that investigated the influence of uterine fibroids on adverse outcomes in pregnancy. The pooled risk ratio (RR) of the variables was estimated with fixed effect or random effect models.
Results
Twenty-four studies with 237 509 participants were included. The pooled results showed that fibroids elevated the risk of adverse outcomes, including preterm birth, cesarean delivery, placenta previa, miscarriage, preterm premature rupture of membranes (PPROM), placental abruption, postpartum hemorrhage (PPH), fetal distress, malposition, intrauterine fetal death, low birth weight, breech presentation, and preeclampsia. However, after adjusting for the potential factors, negative effects were only seen for preterm birth, cesarean delivery, placenta previa, placental abruption, PPH, intrauterine fetal death, breech presentation, and preeclampsia. Subgroup analysis showed an association between larger fibroids and significantly elevated risks of breech presentation, PPH, and placenta previa in comparison with small fibroids. Multiple fibroids did not increase the risk of breech presentation, placental abruption, cesarean delivery, PPH, placenta previa, PPROM, preterm birth, and intrauterine growth restriction. Meta-regression analyses indicated that maternal age only affected the relationship between uterine fibroids and preterm birth, and BMI influenced the relationship between uterine fibroids and intrauterine fetal death. Other potential confounding factors had no impact on malposition, fetal distress, PPROM, miscarriage, placenta previa, placental abruption, and PPH.
Conclusion
The presence of uterine fibroids poses increased risks of adverse pregnancy and obstetric outcomes. Fibroid size influenced the risk of breech presentation, PPH, and placenta previa, while fibroid numbers had no impact on the risk of these outcomes.
Journal Article
Rates of live birth after mosaic embryo transfer compared with euploid embryo transfer
PurposeMosaicism is a prevalent characteristic of human preimplantation embryos. This retrospective cohort study aimed to investigate pregnancy outcomes after transfer of mosaic or euploid embryos.MethodsThe embryos, which had been transferred as “euploidy,” were processed using array-based comparative genomic hybridization (aCGH). The original aCGH charts of the transferred embryos were reanalyzed. Mosaic and control euploid embryos were defined according to log2 ratio calls.ResultsOverall, 102 embryos were determined to be mosaic, of which 101 were estimated to harbor no more than 50% aneuploid mosaicism. Additionally, 268 euploid embryos were matched as controls. The rates of live birth (46.6% vs. 59.1%, odds ratio (OR) 0.60, 95% confidence interval (CI) 0.38–0.95), and biochemical pregnancy (65.7% vs. 76.1%, OR 0.60, 95% CI 0.37–0.99) per transfer cycle were significantly lower after mosaic embryo transfer than after euploid embryo transfer. The rates of clinical pregnancy and pregnancy loss and the risks of obstetric outcomes did not differ significantly between the two groups.ConclusionsCompared with euploid embryo transfer, mosaic embryo transfer is associated with a lower rate of live birth, which is mainly attributed to a decreased rate of conception. However, as mosaic embryo transfer yielded a live birth rate of 46.6%, patients without euploid embryos could be counseled regarding this alternative option.
Journal Article
Do variations in insulin sensitivity and insulin secretion in pregnancy predict differences in obstetric and neonatal outcomes?
Aims/hypothesisGestational diabetes mellitus (GDM) is generally defined based on glycaemia during an OGTT, but aetiologically includes women with defects in insulin secretion, insulin sensitivity or a combination of both. In this observational study, we aimed to determine if underlying pathophysiological defects evaluated as continuous variables predict the risk of important obstetric and neonatal outcomes better than the previously used dichotomised or categorical approaches.MethodsUsing data from blinded OGTTs at mean gestational week 28 from five Hyperglycemia and Adverse Pregnancy Outcome study centres, we estimated insulin secretion (Stumvoll first phase) and sensitivity (Matsuda index) and their product (oral disposition index [DI]) in 6337 untreated women (1090 [17.2%] with GDM as defined by the International Association of Diabetes and Pregnancy Study Groups). Rather than dichotomising these variables (i.e. GDM yes/no) or subtyping by insulin impairment, we related insulin secretion and sensitivity as continuous variables, along with other maternal characteristics, to obstetric and neonatal outcomes using multiple regression and receiver operating characteristic curve analysis.ResultsStratifying by GDM subtype offered superior prediction to GDM yes/no only for neonatal hyperinsulinaemia and pregnancy-related hypertension. Including the DI and the Matsuda score significantly increased the area under the receiver operating characteristic curve (AUROC) and improved prediction for multiple outcomes (large for gestational age [AUROC 0.632], neonatal adiposity [AUROC 0.630], pregnancy-related hypertension [AUROC 0.669] and neonatal hyperinsulinaemia [AUROC 0.688]). Neonatal hypoglycaemia was poorly predicted by all models. Combining the DI and the Matsuda score with maternal characteristics substantially improved the predictive power of the model for large for gestational age, neonatal adiposity and pregnancy-related hypertension.Conclusion/interpretationContinuous measurement of insulin secretion and insulin sensitivity combined with basic clinical variables appeared to be superior to GDM (yes/no) or subtyping by insulin secretion and/or sensitivity impairment in predicting obstetric and neonatal outcomes in a multi-ethnic cohort.
Journal Article
Placental histopathological abnormalities in adverse obstetric outcomes: a retrospective cross-sectional study at Sultan Qaboos University Hospital
Introduction
Placenta is a vital organ with highly specialized functions. According to the Perinatal Section of the Pediatric Pathology Society, placental histopathological abnormalities are typically categorized into maternal vascular hypoperfusion, fetal thrombotic vasculopathy, and inflammatory lesions. This study aims to assess the placental histopathological abnormality results in relation to adverse obstetric outcomes and to investigate whether specific placental abnormalities are associated with particular adverse outcomes.
Methods
A retrospective cross-sectional study was conducted between January 2017 and January 2020 including all women who were admitted to Sultan Qaboos University Hospital with an adverse obstetric outcome who met the inclusion criteria, and whose placentas were sent for histopathological examination.
Results
A total of 191 women were included in the study. The most common adverse obstetric outcomes included preterm labor (25.1%), fetal growth restriction (FGR) (19.4%), preeclampsia and related complications (15%), placental abruption (14.1%), and chorioamnionitis (14%). 74% of women had abnormal placental findings. Among women with preterm labor, inflammatory lesions were present in 56.3% of cases (
p
= 0.006). Fetal thrombotic vasculopathy lesions were present in 13.5% of FGR cases (
p
= 0.037). In preeclampsia cases, maternal under perfusion lesions were present in 79% of cases (
p
= 0.013).
Conclusion
Placental histopathological examination is an important tool for assessing perinatal outcomes. Correlating placental findings with specific obstetrical conditions and adverse outcomes provides valuable information that can assist obstetricians in developing appropriate management plans for future pregnancies.
Journal Article