A Prediction Model for Short-Term Neonatal Outcomes in Severe Early-Onset Fetal Growth Restriction

Publication date: Available online 16 August 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Andrew Sharp, Richard Jackson, Christine Cornforth, Jane Harrold, Mark A. Turner, Louise Kenny, Philip N. Baker, Edward D. Johnstone, Asma Khalil, Peter von Dadelszen, Aris T. Papageorghiou, Zarko AlfirevicAbstractBackgroundSevere early-onset fetal growth restriction (FGR) predisposes to fetal death, neonatal death, neonatal morbidity and neurodisability. The use of placental biomarkers has been proposed for risk stratification in pre-eclampsia, but they could be equally useful in fetal growth restriction in aiding management.ObjectiveTo determine the efficacy of angiogenic biomarkers at predicting adverse pregnancy outcome in severe early-onset fetal growth restriction.Study DesignThis is a secondary analysis of the multicentre, placebo-controlled STRIDER UK randomised controlled trial of singleton pregnancies with severe early-onset fetal growth restriction.Women with FGR pregnancies between 22+0 and 29+6 weeks of gestation were randomly assigned to receive either sildenafil 25 mg three times daily or placebo until 32+0 weeks’ gestation or delivery. We developed prediction models based upon maternal demographics (age, parity, blood pressure, preeclampsia, gestational hypertension), fetal biometric (estimated fetal weight) and Doppler measurements (Middle Cerebral Artery (MCA), Umbilical Artery (UA)) and maternal angiogenic b...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research

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We examined the relationship between worry about pregnancy health and pre-eclampsia. General stress, mental health, and self-reported pregnancy health worry were measured in a study of 10,037 U.S. nulliparous women. Logistic regression found a dose-response relationship between first trimester pregnancy-health worry and subsequent pre-eclampsia onset, controlling for health history (Beta = 0.40, SE = 0.09, P 
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
Abstract BACKGROUND: The traditional definition of preeclampsia (PE) is based on the development of hypertension and proteinuria. This has recently been revised to include cases without proteinuria but with evidence of renal, hepatic or hematological dysfunction. OBJECTIVE: To examine the impact of the new definition of PE on first, the incidence and severity of the disease, and second, the performance of the competing risks model for first-trimester assessment of risk for PE. METHODS: This was a retrospective study of 66,964 singleton pregnancies that were classified as PE, gestational hypertension (GH)...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Abstract OBJECTIVE: The Hypertension and Preeclampsia Intervention Trial At near Term-I (HYPITAT-I) randomized controlled trial showed that, in women with gestational hypertension or mild pre-eclampsia at term, induction of labor, compared with expectant management, was associated with improved maternal outcome without compromising neonatal outcome. The aim of the current study was to evaluate the impact of these findings on obstetric management and maternal and perinatal outcomes in The Netherlands. METHODS: We retrieved data for the period 2000-2014 from the Dutch National Perinatal Registry, including 143&...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
CONCLUSIONS The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.RESUMO OBJETI...
Source: Revista de Saude Publica - Category: International Medicine & Public Health Source Type: research
Publication date: Available online 28 August 2019Source: The LancetAuthor(s): Lucy C Chappell, Peter Brocklehurst, Marcus E Green, Rachael Hunter, Pollyanna Hardy, Edmund Juszczak, Louise Linsell, Virginia Chiocchia, Melanie Greenland, Anna Placzek, John Townend, Neil Marlow, Jane Sandall, Andrew Shennan, Umber Agarwal, Irshad Ahmed, Bini Ajay, Zarko Alfirevic, Rita Arya, Gabrielle BambridgeSummaryBackgroundIn women with late preterm pre-eclampsia, the optimal time to initiate delivery is unclear because limitation of maternal disease progression needs to be balanced against infant complications. The aim of this trial was ...
Source: The Lancet - Category: General Medicine Source Type: research
ConclusionWe found that the PC, MPV, and PC/MPV may be changed in atypical PE patients who did not have significant PE symptoms. Our results indicated that it could be a diagnostic method to predict atypical PE during pregnancy. PC/MPV and the other platelet parameters can play a role in predicting the development of atypical PE, leading to better diagnosis and management of atypical PE.
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
Abstract Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder of premenopausal women worldwide and is characterized by reproductive, endocrine, and metabolic abnormalities. The clinical manifestations of PCOS include oligomenorrhea or amenorrhea, hyperandrogenism, ovarian polycystic changes, and infertility. Women with PCOS are at an increased risk of suffering from type 2 diabetes; me\tabolic syndrome; cardiovascular events, such as hypertension, dyslipidemia; gynecological diseases, including infertility, endometrial dysplasia, endometrial cancer, and ovarian malignant tumors; pregnancy complication...
Source: Reproductive Biology - Category: Reproduction Medicine Authors: Tags: Reprod Biol Endocrinol Source Type: research
Abstract Objective To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil. Methods Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, andmaternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum. Results A total of 22 women had at least 1 pregnancy during the considered timeinterval, and 3 of them had> 1 pregnancy, totalizing 25 pregn...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
ConclusionData obtained indicates that very low amounts of PlGF-3 is present in blood but significantly higher amounts of protein is present in placental tissue where it is prominently associated with cellular membranes.
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
AbstractBackgroundHypertension disorders in pregnancy (HDP) were common complications in women with systemic lupus erythematosus (SLE). However, the impact of HDP and the measures to prevent HDP-related fetal adverse pregnancy outcomes (APOs) remained to be explored.MethodsA multicenter retrospective study of 342 pregnant women with SLE was performed. Variables related to SLE and APOs were recorded. Fetal development was evaluated by umbilical artery Doppler ultrasonography.ResultsHDP was diagnosed in 45 (13.2%) patients, including pre-eclampsia in 42 and gestational hypertension in 3. Patients with HDP had higher incidenc...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
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