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Analysis of Perinatal Outcomes of Twin Pregnancy in a Referral Hospital for High Risk
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作者 Eduarda Paim Pedro Lucas Carneiro Ferreira +3 位作者 Luciano Selistre Fernanda Grossi José Mauro Madi Gabriela Françoes Rostirolla 《Open Journal of Obstetrics and Gynecology》 2024年第7期983-995,共13页
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... 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. 展开更多
关键词 pregnancy Twin pregnancy High risk pregnancy MORBIDITY Perinatal Mortality Perinatal Results
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Liver stiffness in pregnant women with intrahepatic cholestasis of pregnancy:A case control study
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作者 Juliane Nees Franziska J Ammon +2 位作者 Johannes Mueller Herbert Fluhr Sebastian Mueller 《World Journal of Hepatology》 2023年第7期904-913,共10页
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 co... 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. 展开更多
关键词 Intrahepatic cholestasis of pregnancy Transient elastography Bile acids Liver stiffness High risk pregnancy
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Peripartum Cardiomyopathy Complicated by Ventricular Tachycardia during Labor: A Case Report and Literature Review
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作者 Nada Alayed 《Open Journal of Obstetrics and Gynecology》 2024年第3期365-380,共16页
Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventric... Background: Peripartum cardiomyopathy (PPCM) is a rare disease that typically affects young, healthy women. Because PPCM is associated with significant mortality, timely diagnosis and management are essential. Ventricular tachycardia (VT) is a major complication and contributor to sudden death. Available data on VT in patients with PPCM are limited. Aim: This case report demonstrates the clinical presentation, antenatal care, and management of labor and delivery in a patient with PPCM complicated by VT. Case report: 36-year old patient G4P3 presents at 27 weeks gestation to the emergency department complaining of chest tightness, palpitations, and profuse sweating. Peripartum cardiomyopathy was diagnosed after her last pregnancy a few years prior. Ventricular tachycardia was diagnosed at this visit and treated successfully. The remainder of the pregnancy was uneventful until she had another episode of ventricular tachycardia during labor. Treatment using antiarrhythmics (diltiazem, amiodarone, adenosine) highlights the importance of prompt intervention and the need for a range of therapeutic options. Results: This case demonstrated successful VT management during pregnancy and labor, emphasizing multidisciplinary collaboration, influencing maternal and fetal outcomes positively, providing insights into optimal care strategies. Conclusion: Peripartum cardiomyopathy complicated by ventricular tachycardia is a life-threatening combination. This case highlights the importance of timely diagnosis and management with combined care between cardiologists, maternal fetal medicine specialists and anesthesiologists to prevent morbidities and sudden maternal death. 展开更多
关键词 Peripartum Cardiomyopathy Ventricular Tachycardia High risk pregnancy Antenatal Care Delivery Planning
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The Utero-placental Circulation,Eugenics and the Prevention and treatment of High Risk Pregnancies 被引量:1
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作者 杨大森 吴熙瑞 +9 位作者 李郁 闻良珍 闪珍珍 韩八斤 司远征 马庭元 孙莹璞 鲁秋云 冯玲 黄引平 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 1994年第1期1-6,共6页
Through systematic experimental and clinical studies,the physiological regulation of utero-placental circulation and the relation of the disturbance in this acirculation to pathogenic mechanisms of high risk pregnanci... Through systematic experimental and clinical studies,the physiological regulation of utero-placental circulation and the relation of the disturbance in this acirculation to pathogenic mechanisms of high risk pregnancies-Intrauterine Growth Retardation (IUfGR)and Pregnancy-induced hypertension(PIH) were explored.The pharmacological effects and mechanism of a Chinese herbal medicine-Qingxintong in improving the uteroplacental circulation and the therapeutic efficacy in treatment of IUGR and PIH,both accompanied by disturbance of utero-placental circulation.were investigated as well. 展开更多
关键词 utero-placental circulation EUGENICS high risk pregnancy IUGR PIH
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Impact of Omega-3 Nutritional Protocol on the Occurrence of Preeclampsia among High Risk Pregnant Women
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作者 Abeer Mokhtar Abu Khatwa Shadia Hassan Abdel Kader 《Journal of Life Sciences》 2012年第12期1414-1419,共6页
Purpose: to examine the impact of omega-3 nutritional protocol for risky pregnant women on the occurrence of preeclampsia. Topic: Supplementation with omega-3 has been proposed to reduce the risk of preeclampsia, bu... Purpose: to examine the impact of omega-3 nutritional protocol for risky pregnant women on the occurrence of preeclampsia. Topic: Supplementation with omega-3 has been proposed to reduce the risk of preeclampsia, but the effects of this intervention are still uncertain. Method: A RCT (randomized controlled trial) had been conducted on 400 pregnant women between 12 and 16 weeks of gestation. Women were assigned randomly to either the control group or the study group. Achievements: Of the 400 women enrolled, 195 were randomly assigned to the study group and 205 to the control group. There was a significant difference between the study and the control groups in relation to the incidence ofpreeclampsia (0.5% and 5.5% respectively, P 〈 0.05). 展开更多
关键词 Omega-3 fatty acids high risk pregnancy PREECLAMPSIA supplementation.
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The role of drug utilization evaluation in medical sciences
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作者 Ruby Gangwar Arvind Kumar +2 位作者 Abrar Ahmed Zargar Amit Sharma Ranjeet Kumar 《Global Health Journal》 2023年第1期3-8,共6页
Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in ... Background:Drug utilization evaluation(DUE)is defined by the World Health Organization(WHO)and focuses on the medical,social,and economic consequences of pharmaceutical marketing,distribution,prescribing,and usage in society.The WHO recommends a physician to every 1000 people.According to the recent data from the Health Ministry in 2019,in which 1.16 million doctors are of active population with just 80%,or 0.9 million,practicing.As a result,a ratio of 0.68 doctors for every 1000 people,which is much below as per the WHO reports.This article describes history,types,WHO guidelines,need and purpose of DUE.Objective:The main aim of this paper is to provide information about the rational use of medication in outpa­tient and inpatient department with special emphasis of DUEs.It also provides awareness directly to healthcare professionals,researchers,academicians,pharmacist and nurses to reduce the irrationality of medicines.Methods:The method used to compile this review information gathered from websites,Google scholar,PubMed,Research gate,and studies published on DUE from July 20 to Oct 22 were included as source of information.Results:We studied more than 35 published study on DUE,that reveals most of the physicians prescribed branded drugs not generic drugs,but WHO prescribing indicator allows to prescribe generic drugs in the hospital pharmacy to maintain better inventory control.It may also help to prevent pharmacist misunderstanding during dispensing.Conclusion:The use of generic prescription names avoids the possibility of medication product duplication and lowers patient costs.It is important to remember that incorrect medication prescriptions have impact on both patients and their family members.WHO indicators identify irrational prescribing behaviours to make therapy more rational and cost-effective. 展开更多
关键词 Anatomical therapeutic chemical classification Drug utilization evaluation Prescribing indicators pregnancy risk classification Rational use of the drug
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Additional risk factors associated with thrombosis and pregnancy morbidity in a unique cohort of antiphospholipid antibody-positive patients 被引量:1
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作者 Chun Li Yu Zuo +3 位作者 Song Zhang Una E.Makris David R.Karp Zhanguo Li 《Chinese Medical Journal》 SCIE CAS CSCD 2022年第6期658-664,共7页
Background:Antiphospholipid syndrome(APS)is an autoimmune prothrombotic condition with significant morbidity.The objective of this study was to identify additional clinical and epidemiological risks of arterial thromb... Background:Antiphospholipid syndrome(APS)is an autoimmune prothrombotic condition with significant morbidity.The objective of this study was to identify additional clinical and epidemiological risks of arterial thrombosis,venous thrombosis,and pregnancy morbidities in a large cohort of persistent antiphospholipid antibodies(aPLs)-positive carriers.Methods:This was a cross-sectional cohort study of 453 consecutive patients with a documented positive aPL who attended Peking University People's Hospital.Among 453 patients screened,297 patients had persistent positive aPL.We compared asymptomatic aPL carriers with thrombotic and obstetric APS patients.And the univariate analysis and multivariable logistic regression were used to evaluate the association between different risk factors and APS clinical manifestations.The levels of circulating markers of neutrophil extracellular traps(NETs)(cell-free DNA and citrullinated histone H3[Cit-H3])were assessed and compared among aPL-positive carriers with or without autoimmune disease and APS patients.Results:Additional risk factors associated with arterial thrombosis among aPL-positive carriers included:smoking(odds ratio[OR]=6.137,95%confidence interval[CI]=2.408-15.637,P=0.0001),hypertension(OR=2.368,95%CI=1.249-4.491,P=0.008),and the presence of underlying autoimmune disease(OR=4.401,95%CI=2.387-8.113,P<0.001).Additional risks associated with venous thrombosis among aPL carriers included:smoking(OR=4.594,95%CI=1.681-12.553,P=0.029)and the presence of underlying autoimmune disease(OR=6.330,95%CI=3.355-11.940,P<0.001).The presence of underlying autoimmune disease(OR=3.301,95%CI=1.407-7.744,P=0.006)is the additional risk,which demonstrated a significant association with APS pregnancy morbidity.Higher circulating levels of cell-free DNA and Cit-H3 were observed among APS patients and aPL patients with autoimmune diseases compared with those aPL carriers without underlying autoimmune diseases.Furthermore,control neutrophils that are conditioned with APS patients'sera have more pronounced NET release compared with those treated with aPL carriers'sera without underlying autoimmune diseases.Conclusions:We identified several potential additional risk factors for APS clinical manifestations among a large cohort of Chinese aPL carriers.Our data may help physicians to risk stratify aPL-positive Asian patients. 展开更多
关键词 Antiphospholipid antibodies Antiphospholipid syndrome Arterial thrombosis pregnancy risk Venous thrombosis
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高危妊娠数据分析系统
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作者 李世存 张曦 +2 位作者 唐林 李志明 王世杰 《郑州大学学报(理学版)》 CAS 1987年第2期23-25,共3页
数据库管理是当代计算机技术所提供的最重要功能之一,并已深入到我国的各项领域之中。本文将高危妊娠病例,根据国际疾病分类(ICD—9)的方法,建立了适应于用户不同需要的dBASEⅡ和dBASEⅢ高危妊娠数据库,并编制了相应的应用程序。本系统... 数据库管理是当代计算机技术所提供的最重要功能之一,并已深入到我国的各项领域之中。本文将高危妊娠病例,根据国际疾病分类(ICD—9)的方法,建立了适应于用户不同需要的dBASEⅡ和dBASEⅢ高危妊娠数据库,并编制了相应的应用程序。本系统具有进行自动化快速检索、统计分析、输出报表、追加、修改和删除等各种功能,并可根据需要显示或打印有关信息资料。这一自动化管理的最新技术可成为围产医学工作者的得力工具。 展开更多
关键词 high risk pregnancy PERINATOLOGY MICROCOMPUTER date base.
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Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs
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作者 Yang Jianzhou Xie Rihua +4 位作者 Daniel Krewski Wang Yongjin Mark Walker Cao Wenjun Shi Wu Wen 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第4期702-706,共5页
Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health... Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C,D and X drugs.Methods A 50% random sample of women who gave a birth in Saskatchewan between January 1,1997 and December 31,2000 were chosen for this study.The association between the number of changes in health care providers and with pregnancy exposure to category C,D,and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression,with adjusted odds ratios (ORs) and its 95% confidence intervals (C/s) as the association measures.Results A total of 18 568 women were included in this study.Rates of FDA C,D,and X drug uses were 14.35%,17.07%,21.72%,and 31.14%,in women with no change of provider,1-2 changes,3-5 changes,and more than 5 changes of health care providers.An association between the number of changes of health care providers and pregnancy exposure to FDA C,D,and X drugs existed in women without chronic diseases but not in women with chronic disease.Conclusion Change of health care providers is associated with pregnancy exposure to FDA category C,D and X drugs in women without chronic diseases. 展开更多
关键词 change health care providers prescription drugs FDA pregnancy risk classification pregnancy
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