Analysis of Perinatal Outcomes of Twin Pregnancy in a Referral Hospital for High Risk

Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.

Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

Effects of High Risk Pregnancy Factors on Pelvic Floor Muscle Weakness and Changes of PG, ACTH and CRP

Objective: To investigate the effects of different delivery modes on perinatal pelvic floor muscle strength, PG, ACTH and CRP of high-risk pregnant women. Methods: 380 high-risk pregnant women who gave birth in our hospital from March 2021 to February 2022 were selected as subjects, including 100 vaginal natural delivery, 156 forceps assisted delivery and 124 cesarean section. Pelvic floor pressure, PG, ACTH, CRP, IL-6, TNF-α and IL-4, IL-10 levels were evaluated and compared. The perinatal occurrence of pelvic floor functional disease (PFD) in high-risk pregnant women in each group was analyzed and evaluated. Results: There were statistical differences in the amount of postpartum blood loss (P 0.0001, F = 99.01), postpartum blood loss 24 h (P = 0.0004, F = 19.54) and hospital stay (P 0.0001, F = 70.81) among the three groups of high-risk women in natural vaginal delivery, forceps delivery and cesarean section. In addition, there were 72, 134 and 70 cases of abnormal pelvic floor fatigue in natural vaginal delivery, forceps assisted delivery and cesarean section (P 0.0001, χ2 = 30.16). There were 36, 79 and 21 cases of muscle injury, respectively (P 0.0001, χ2 = 34.16). There were 49, 98 and 43 cases of dysmuscular contraction, respectively (P 0.0001, χ2 = 21.94). There were 65, 120 and 41 cases with vaginal dynamic pressure 80 cm H2O (P 0.0001, χ2 = 56.86), respectively. The.

Risk Factors and Pregnancy Outcomes： Complete versus Incomplete Placenta Previa in Mid-pregnancy

This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy. The study was carried out from April 2014 to December 2015, during which 70 patients with complete previa and 113 with incomplete previa between 20＋0 weeks and 25＋6 weeks of gestation were included. Maternal demographics and pregnancy outcomes were compared between the two groups. Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test. Resolution ofprevia occurred in 87.43% of the studied women. The mean gestational age at resolution was 32.1＋4.4 weeks. Incidence of maternal age ≥35 years and incidence of prior uterine operation 〉3 were high in women with complete previa （28.6% vs. 8.8%, P=0.003; 28.6% vs. 8.8%, P=0.003）. Resolution ofprevia occurred less often in complete previa group （74.3% vs. 95.6%, P=0.001）. Women with complete previa admitted earlier （37.3±2.0 weeks vs. 38.1±1.4 weeks, P=0.011） and delivered earlier （37.7±1.2 weeks vs. 38.3±1.4 weeks, P=0.025）. Maternal age ≥35 years and prior uterine operation 〉3 increase the risk of complete previa in mid-pregnancy. Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in mid- pregnancy. What is more, women with complete previa in mid-pregnancy delivers earlier.

Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

AIM： To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS： A total of 2 147 persons （1 111 females, age 42.8 ＋ 12.7 years; 1 036 males, age 42.3 ＋ 13.1 years） participating in an investigation on the prevalence of Echinococcus rnultilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index （BMI）. A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS： Gallbladder stones were detected in 171 study participants （8.0%, n = 2 147）. Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy （yes/no） and number of pregnancies did not exert any influence. CONCLUSION： Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations.

Prediction of Gestational Diabetes Mellitus in Early Pregnancy: Is Abdominal Skin Fold Thickness 20 mm or More an Independent Risk Predictor?

Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.

Pregnancy risk markers in Tourette syndrome: A systematic review

The published literature on the prevalence of pregnancy risk markers in patients with Tourette Syndrome (TS) was reviewed. PubMed was searched for papers describing studies of pregnancy risk markers in TS. All years and languages were searched, and the reference sections of each paper were also reviewed for additional citations. We identified 20 studies reporting on pregnancy risk markers in 1588 subjects with TS. Six studies used comparison populations and two utilized twins for comparisons. Three risk markers (decreased birth weight, father’s age, and number of prior terminations of pregnancy) were identified as possible risk markers for TS. To date, no pregnancy risk marker has been demonstrated to increase risk for development of TS, to increase syndromal severity, rates of comorbidity, or to increase duration of TS.

Cervical Pregnancy in a Primigravida Patient without Risk Factors: A Case Report

Cervical pregnancy is defined as the implantation of the egg below of the internal cervical orifice, and remains a rare clinical entity which affects on average 1 out of 20,000 pregnancies worldwide. Its hemorrhagic complications are life-threatening in case of late diagnosis. It occurs mainly on a history of curettage or caesarian which are the most recognized risk factors. The objective pursued here is to discuss the possibility of the occurrence of this rare clinical entity in a primigravida without risk factors and the different therapeutic possibilities according to the technical platforms. Authors report a case of cervical pregnancy at 6 weeks’ gestation occurring in a primigravida without risk factors who consulted at University clinics of Kinshasa (UCK) for a genital hemorrhage chart. The diagnosis was made using ultrasound and treatment provided by curettage followed by the placement of an intra-cervical foley tube for hemostatic purposes. Given its high mortality, the diagnosis must be early even in pregnant women without obvious risk factors. The diversity of therapeutic means gives practitioners a choice depending on the technical platform.

Comprehension of Risk Factors of Malaria during Pregnancy among Pregnant Women Attending Antenatal Care in Malawi

A study was conducted to determine the comprehension of pregnant women on malaria risk factors during pregnancy. Comprehension of Malaria risks is important to ensure compliance to prevention methods and treatment by the pregnant women and hence optimizes the pregnancy outcomes. The study was conducted in 2012 at three health facilities, Queen Elizabeth Central Hospital, Ndirande health Centre and St. Joseph Mission Hospital in Malawi. The study design was descriptive and utilized quantitative data collection and analysis methods on a random sample of 316 antenatal mothers. The study targeted antenatal mothers who were aged between 15 and 49 years, in the gestation period of 28 to 36 weeks and able to converse in English or vernacular language. A structured questionnaire was used to collect data which were analyzed using SPSS version 16.0. Most of the participants (79.4%, n = 251) knew the risk factors of malaria during pregnancy but very few (18.4%, n = 58) knew about intermittent prevention treatment despite taking SP as prescribed. The motivation factors for taking SP were husband support and the desire to protect their babies and themselves from Malaria. Although the comprehension of the intermittent prevention treatment among the women was low, the women were motivated to adhere to the treatment when instructed by the healthcare workers due to the desire for good health for themselves and their unborn babies. Husbands were the most significant other that motivated the pregnant women to adhere to treatment. Results show that there is a need for healthcare workers to facilitate comprehension of intermittent prevention treatment among pregnant mothers.

The effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet and prenatal care quality:A cross‑sectional multivariate analysis

Background:Risk perception and COVID‑19 anxiety in pregnant women restrict access to health services,cause pregnant women to resort to alternative channels such as the Internet,and affect prenatal care quality(PCQ)negatively.Purpose:The purpose of this study was to examine the effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet(DMI)and PCQ with multivariate analysis.Materials and Methods:This cross‑sectional study was conducted with 406 pregnant women selected using the convenience sampling method in a training and research hospital,in Turkey.The data were collected using the information form,the perception of pregnancy risk questionnaire,the Coronavirus Anxiety Scale,the DMI Scale,and the PCQ Scale.The data obtained were subject to descriptive analysis and the multivariate analysis of variance.Results:Approximately 24.9%of the pregnant women were found to have a high perception of risk and 18%had symptoms of COVID‑19 anxiety.Pregnant women with high COVID‑19 anxiety and a higher perception of risk perceived the Internet as less influential for decision‑making(P<0.05).Pregnant women with a high‑risk perception had lower PCQ(P<0.05).Conclusion:The findings can be used to enhance mental health and resilience in pregnant women and to formulate appropriate intervention strategies.

Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

ESTABLISHMENT OF HIGH RISK POPULATION AND PRECANCEROUS LESION OF NASOPHARYNGEAL CARCINOMA(NPC)

A prospective study was done by the examination of nasopharyngoscope, reaction of EB virus's antigens and antibodies, nasopharyngofibroscope, pathological and EB virus's DNA, EBERs, etc. of about 100000 persons in high risk area of NPC in Guangdong Province, China from 1986 to 1995. If any one of the following four conditions is present in some persons, i.e., (1) EBV VCA/IgA titer>1:80, (2) EBV EDAb>60%, (3) Dual or triple positiveness in VCA/IgA, EA/IgA and EDAb, (4) Any one of VCA/IgA, EA/IgA and EDAb keeps high titer or going up, they should be regarded as in precancerosis of NPC. The moderate or severe heteroplasia and heterometaplasia of nasopharyngeal mucosa are the precancerous lesions of NPC. Some individual who is in precancerosis or with precancerous lesion should be regarded as the high risk population of NPC. The results are of important scientific basis for screening and second degree prevention of NPC.

Liver stiffness in pregnant women with intrahepatic cholestasis of pregnancy:A case control study

BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn child.The diagnosis is primarily based on elevated serum levels of bile acids.In a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within minutes.AIM To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated pregnancy.METHODS LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and 2020.In 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control group.Routine laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also measured.RESULTS Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(P<0.0001).Postpartum LS decreased significantly in both groups but was still higher in ICP(5.8±1.7 kPa vs 4.2±0.9 kPa,P<0.0001),respectively.In ICP,LS was highly significantly correlated with levels of bile acids and M30 but not transaminases.No correlation was seen with GGT that even increased significantly after delivery in the ICP group.Bile acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and bilirubin.In multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile acids.CONCLUSION In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte apoptosis.In association with conventional laboratory markers,LS provides additional non-invasive information to rapidly identify women at risk for ICP.

Management and Results of Ectopic Pregnancy Adapted by Clinical Guidelines: Two Years Experience of University Hospital in Turkey

Ectopic pregnancy is defined as the fertilized ovum implants in a location outside the endometrial cavity, remains to be an important cause of maternal morbidity and mortality worldwide and is a health problem with incidence ranges between 0.25% and 2% of all pregnancies. In our study, in Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetrics and Gynecology from 2011 to 2013, 96 cases with diagnosis of ectopic pregnancy managed by the adapted RCOG’s Guide were analyzed retrospectively. The data were analyzed as follows: age, the history of operation, smoking, the presence of intrauterine device, blood groups, hemoglobin, platelets, values of B-hCG, the diagnostic interval, intra-abdominal free fluid and/or acute abdomen, the method of treatment and the success of treatment.

THE ANALYSIS OF HUMAN CYTOMEGALOVIRUS INFECTION DURING PREGNANCY IN QINBA MOUNTAINOUS AREA

Objective To study the epidemiology of cytomegalovirus (CMV) infection in Qinba mountainous area Shaanxi Province China, where there was high prevalence of mental retardation(MR) in children. Methods 367 pregnant women in Qinba mountainous area were monitored with ELISA and PCR and presented with questionnaire. We detected the following: CMV DNA in urine of 63 neonates born within two weeks whose mother infected CMV during pregnancy and CMV DNA in breast milk post delivery within two weeks of 61 women infected and 84 women non infected. Results Infection rate of CMV in mental retardation prevalent area was 19.62% , the incidence of transmission in uterus was 33.33%, the incidence of excretion by breast milk was 39.34%, CMV infection during pregnancy relates to age, education, economic states, pregnant frequency and pathological delivery. It has no relation with gestational age. Conclusion The study points out that attention should also be paid to detecting CMV infection during pregnancy in mental retardation prevalence. Less education, worse financial condition, more frequent or pathological delivery should be regarded as high risk factors of CMV infection during pregnancy.

Prevalence and Factors Associated with Anemia Pregnancy in a Group of Moroccan Pregnant Women

Background: Pregnancy is typically accompanied by an increase of micronutrient requirements in general and especially iron. This increased need may be an additional risk factor for developing anemia. Purpose of the study: The aim of this study is to provide data on the prevalence of anemia of pregnancy in the maternity ward of the regional hospital in the city of Temara, and examine risk factors that may expose women to anemia during pregnancy. Materiel and Methods: A prospective cross-sectional study of a year was conducted to the hospital Sidi Lahcen in the city of Temara. Sociodemographic and nutritional data were collected through a questionnaire, obstetric and medical histories of women in labor and the results of biological tests were recorded from the patient obstetric file. Results: Among the 849 women surveyed, 690 (82%) had performed a blood count, and among these 117 (16.8%) were found anemic, with the following proportions: 57.6% had mild anemia, 41.5% had moderate anemia and a minority (0.8%) had severe anemia. The pregnant women aged over 35 years were the most exposed to anemia during pregnancy (47%) compared with younger women (p < 0.001). Women who had a history of anemia aside from pregnancy and those who had anemia in earlier pregnancies were more prone to developing anemia in the current pregnancy with a statistically significant difference (p < 0.001). The number of pregnancies, number of previous abortions and place of residence had no influence on the occurrence of anemia of pregnancy. The consumption of fortified flour with iron and vitamins as well as consuming iron rich foods was not a protective factor against the development of anemia of pregnancy. Tea consumption near the meal was not a factor exposing to anemia during pregnancy. Conclusion: Anemia is a public health problem in Morocco. Evidence from our study emphasizes the need to implement educational programs to improve the nutritional knowledge and sensitization of women.

The Association between <i>Chlamydia Trachomatis</i>and Ectopic Pregnancy in Lagos, Nigeria—A Case Control Study

Objectives: To determine the seropositivity of Chlamydia antibody in patients with ruptured ectopic pregnancy compared to normal pregnant women and the risk factors for ectopic pregnancy. Study Design: This was a prospective case-control study of 85 cases of ruptured ectopic pregnancy and 100 cases of second trimester on-going intrauterine pregnant controls presenting in Lagos State University Teaching Hospital (LASUTH) between September 2009 and March 2010. Study Site: This was at the gynaecological emergency room and antenatal clinic in the Department of Obstetrics and Gynaecology. Ethical approval was sought and granted by the ethics review committee of LASUTH. Study Participants: Patients presenting with ruptured ectopic pregnancy were recruited as cases while the controls were made up of those with uncomplicated second trimester intrauterine pregnancy. A semi-structured questionnaire containing socio-demographic and clinical characteristics was administered following informed consent. Five milliliters of venous blood was taken from each participant and tested for?Lymphogranuloma Venerum?(LGV) type 2 broadly reacting antigen of?Chlamydia trachomatis.?Data Analysis: Data gathered from the case notes and laboratories were imputed into the computer and analyzed using the statistical package?Epi-Info 3.51, Atlanta, USA. Frequency tables were generated for continuous variables and?chi-square analysis used to determine association between variables, with p values <0.05 considered statistically significant. Results: There were 91 cases of ectopic pregnancy among a total of 2468 deliveries giving an incidence of 3.68% or 1 in 27 deliveries. Factors which significantly contributed to increased incidence of ectopic pregnancy in this study were: level of education (p = 0.001), socio-economic status (p = 0.001), parity (p = 0.005), early age of sexual debut (p = 0.001), multiple sexual partners (p = 0.001), previous pelvic inflammatory disease (p = 0.003), previous induced abortion (p = 0.013) and previous?postabortal/puerperal sepsis (p = 0.013). The seropositivity of?Chlamydia IgG (62.4%) in the cases was significantly higher than that of 29% in the control (p < 0.0001). Conclusion: There was a high incidence of ectopic during the period of study and the seropositivity of Chlamydia IgG antibody was significantly higher amongst the cases. Risk factors identified were low level of education, low socio-economic status, low parity, early age of sexual debut, multiple sexual partners, previous history of pelvic inflammatory disease, previous induced abortion and previous postabortal/puerperal sepsis.

Health behavior after intrahepatic cholestasis of pregnancy

Background: Pregnancy is an opportunity to adopt favorable health behaviors. We studied whether intrahepatic cholestasis of pregnancy (ICP) promotes favorable health behavior in later life. Design: A prospective controlled cohort study. The method was a questionnaire survey in 2010 among 575 women with ICP and 1374 controls, all having delivered between the years 1969 and 1988 in Tampere University Hospital in Finland. Questionnaires were sent to 544 ICP patients and 1235 controls. Responses were received from 1178 (response rate 66.2%). The main outcome measures concerning recent or current health behavior were smoking, alcohol consumption, physical activity, body mass index (BMI) and special diet. Results: Current smoking was less common in the ICP group than among controls (10.5% vs 15.7%, p = 0.017). Assessed by smoking pack years there was a similar difference: in the ICP group 11.7% of women had at least 10 smoking pack years compared to 18.0% of the controls (p = 0.006). Recent alcohol consumption did not separate the two groups. The groups did not differ as to reported physical activity assessed in MET units. Fewer ICP women had had BMIs of 30 or more during pregnancy compared with controls (18.8% vs 25.1%, p = 0.023). In other points of life the BMI differences were not statistically significant. Weight-loss diet and gallbladder diet were more common in the ICP group (6.3% vs 3.6%, p = 0.044, and 3.0% vs 1.3%, p = 0.038). Conclusions: Having developed ICP two to four decades earlier seemed to constitute an effective intervention for smoking habits but not for other aspects of health behavior.

“Eli-P-Complex” Diagnostic Test for Preconception Care in Women with History of Adverse Pregnancy Outcome: A Randomized Multicenter Trial

Background: ELI-P-Complex is the most advanced diagnostic test designed to assess whether the female body is ready (or unready) for the normal pregnancy course and for giving birth to a healthy child. ELI-P-Complex enables the perceived abnormalities to be individually treated even prior to the pregnancy planning, thus minimizing the risk of gestational and delivery-related complications. This prospective study shows the effectiveness of ELI-P-Complex testing during preconception care in women with a history of adverse pregnancy outcomes (APO). Methods: The data were reviewed from 4519 women with a history of APO and who planned to get pregnant. Following randomization, subjects of Group A were tested with ELI-P-Complex and treated before the pregnancy based on the results obtained. Group B subjects were not examined using the ELI- P-Complex test and were prepared for pregnancy in accordance with the standard strategy of pre- conception care [1]. Results: In Group A, gestational complications (GC) were revealed in 20% of women compared to 88.7% of Group B subjects;the relative risk (RR) of GC was 11.67 (95% CI: 9.9851 to 13.6392;P < 0.0001). APO was reported in 12% of Group A subjects vs. 38.1% of Group B ones;RR of APO was 5.8908 (95% CI: 4.9365 to 7.0296;P < 0.0001). Absolutely healthy children were born from 88.1% of Group A subjects compared to 50.3% of Group B ones;RR was 7.9601 (95% CI: 6.6110 to 9.5845;P < 0.0001). The positive predictive value, sensitivity, and specificity of the test for GC were 93.82% (95% CI: 92.72% to 94.80%), 93.17% (95% CI: 92.03% to 94.20%), and 92.62% (95% CI: 91.31% to 93.78%), respectively. Conclusions: The use of ELI-P-Complex for examination and further preconception care in women with a history of APO considerably reduces GC, improves pregnancy outcomes, and increases chances of giving birth to a healthy child.