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1.
Medicine (Baltimore) ; 100(3): e24048, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33546004

RESUMEN

INTRODUCTION: Uterine rupture during pregnancy is a serious obstetric complication accompanied by a high incidence of maternal morbidity and mortality, and the presence of uterine scars is the main risk factor. In the present case, uterine rupture occurred in an unscarred uterus in a nonlaboring primigravida woman with adenomyosis and twin pregnancy in the third trimester. PATIENT CONCERNS: In this case, the patient suspected to have a history of endometriosis have got twin pregnancies following intracytoplasmic sperm injection, and complained of recurrent lower abdominal pain from 16 weeks to 29 weeks of gestation. DIAGNOSIS: After exploratory laparotomy, the patient was diagnosed with uterine rupture and adenomyosis. INTERVENTIONS: The patient was first administered expectant treatment such as antibiotics, tocolytics, and fluid replacement therapy. Symptoms then appeared repeatedly and worsened, followed by eventual peritoneal irritation, and exploratory laparotomy was performed. OUTCOMES: Two live female fetuses were extracted by cesarean section, and the uterine laceration was repaired. The mother recovered without any postoperative complications, and the babies were discharged after receiving one month of prematurity care without any postnatal complications. CONCLUSION: Adenomyosis and the conception of twins may lead to uterine rupture. For pregnant women with a history of adenomyosis with multiple gestations, close monitoring for signs of uterine rupture is necessary. Single-embryo transfer and multifetal pregnancy reduction should be recommended for infertile patients with adenomyosis.


Asunto(s)
Adenomiosis/complicaciones , Complicaciones del Embarazo/etiología , Embarazo Gemelar , Nacimiento Prematuro/etiología , Rotura Uterina/etiología , Adulto , Cesárea , Femenino , Humanos , Nacimiento Vivo , Embarazo , Tercer Trimestre del Embarazo , Rotura Espontánea
2.
Cell ; 184(3): 628-642.e10, 2021 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-33476549

RESUMEN

SARS-CoV-2 infection causes more severe disease in pregnant women compared to age-matched non-pregnant women. Whether maternal infection causes changes in the transfer of immunity to infants remains unclear. Maternal infections have previously been associated with compromised placental antibody transfer, but the mechanism underlying this compromised transfer is not established. Here, we used systems serology to characterize the Fc profile of influenza-, pertussis-, and SARS-CoV-2-specific antibodies transferred across the placenta. Influenza- and pertussis-specific antibodies were actively transferred. However, SARS-CoV-2-specific antibody transfer was significantly reduced compared to influenza- and pertussis-specific antibodies, and cord titers and functional activity were lower than in maternal plasma. This effect was only observed in third-trimester infection. SARS-CoV-2-specific transfer was linked to altered SARS-CoV-2-antibody glycosylation profiles and was partially rescued by infection-induced increases in IgG and increased FCGR3A placental expression. These results point to unexpected compensatory mechanisms to boost immunity in neonates, providing insights for maternal vaccine design.


Asunto(s)
Anticuerpos Antivirales/inmunología , Inmunoglobulina G/inmunología , Intercambio Materno-Fetal/inmunología , Placenta/inmunología , Complicaciones Infecciosas del Embarazo/inmunología , /inmunología , Adulto , Femenino , Humanos , Recién Nacido , Embarazo , Tercer Trimestre del Embarazo/inmunología , Receptores de IgG/inmunología , Células THP-1
3.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431442

RESUMEN

Fibroepithelial polyps are benign lesions that may appear in the vulvovaginal region. They usually occur in women of reproductive age and tend to grow up to 5 cm, but there are some rare cases in which they grow up to 20 cm. We report a case of a 22-year-old woman in the third trimester of her first pregnancy with spontaneous bleeding from a pedunculated mass measuring 15 cm in the widest diameter on the right side of the vulva. Features of this case are discussed as well as its implications, especially regarding the decision of labour. Due to the big size of the mass and its propensity to bleed, we decided to perform an elective caesarean section as well as its excision.


Asunto(s)
Neoplasias Fibroepiteliales/diagnóstico , Pólipos/diagnóstico , Complicaciones Neoplásicas del Embarazo/diagnóstico , Hemorragia Uterina/etiología , Neoplasias de la Vulva/diagnóstico , Cesárea , Femenino , Humanos , Recién Nacido , Neoplasias Fibroepiteliales/complicaciones , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/cirugía , Pólipos/complicaciones , Pólipos/patología , Pólipos/cirugía , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Complicaciones Neoplásicas del Embarazo/cirugía , Tercer Trimestre del Embarazo , Resultado del Tratamiento , Hemorragia Uterina/cirugía , Vulva/patología , Vulva/cirugía , Neoplasias de la Vulva/complicaciones , Neoplasias de la Vulva/patología , Neoplasias de la Vulva/cirugía , Adulto Joven
4.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-33462017

RESUMEN

Lymphangioleiomyomatosis (LAM) is a progressive cystic lung disease which mostly affects premenopausal women and could be exacerbated by pregnancy. Therefore, it is thought that oestrogen plays an important role in LAM pathogenesis. Here, a case of LAM is described in which the first presentation of symptoms occurred during the third trimester of pregnancy. Symptoms included acute onset dyspnoea and chest pain at gestational age of 39 weeks and 2 days. A CT was performed which showed multiple thin-walled cysts and a small pneumothorax. Serum levels of vascular endothelial growth factor-D (VEGF-D) was 1200 pg/mL. The typical cystic lung changes on chest CT in combination with elevated VEGF-D is diagnostic for LAM. Given the risk of respiratory complications, the decision was made to deliver the baby at a gestational age of 39 weeks and 6 days by a planned caesarean section. Both mother and child were discharged home in good condition.


Asunto(s)
Neoplasias Pulmonares/diagnóstico , Linfangioleiomiomatosis/diagnóstico , Complicaciones Neoplásicas del Embarazo/diagnóstico , Adulto , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo
5.
Mymensingh Med J ; 30(1): 69-72, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33397853

RESUMEN

Pregnancy is a natural physiological state with hormonal and metabolic changes that helps the growth and survival of the fetus. Adequate body mass index (BMI) in pregnancy is important for securing, protecting and promoting the health of women and newborns. High or low maternal body mass index is associated with adverse outcome. Thyroid physiology plays a major role in pregnancy and thyroid disorders constitute one of the most common endocrine disorders in pregnancy. To assess the levels of body mass index and serum thyroid stimulating hormone (TSH) in third trimester of pregnancy in order to compare these parameters with non-pregnant women of same age range. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Bangladesh from January 2019 to December 2019. A total number of 140 subjects, age range between 20-35 years were included in this study. Among them, 70 healthy subjects were taken as control group (Group I) and 70 pregnant women of third trimester were taken as study group (Group II). The results were calculated and analyzed by using SPSS. Quantitative data were expressed as mean (±SE) and statistical significance of difference among the group was calculated by unpaired student's 't' test. In this study we found that BMI was 27.87±1.9kg/m² and serum TSH level was 2.27±1.18µIU/ml in study group. Both (BMI & TSH) are significantly increased in study groups in comparison with control group. Therefore, by this study we recommended that routine estimation of these parameters is important for prevention of complication related to pregnancy.


Asunto(s)
Tirotropina , Adulto , Bangladesh , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Recién Nacido , Embarazo , Tercer Trimestre del Embarazo , Adulto Joven
6.
BMJ Case Rep ; 14(1)2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33472804

RESUMEN

Six days after a normal delivery, a 24-year-old woman with atraumatic lumbosacral pain radiating to the left groin was referred to the orthopaedic surgeon due to worsening pain and impossible load bearing on the left lower limb. Standard pelvic radiographs revealed an unstable displaced left neck of femur (NOF) fracture. A CT scanner and MRI showed diffuse osteopaenia of the left proximal femur and the corresponding acetabulum. A diagnosis of transient osteoporosis of the hip (TOH) complicated by a pathological displaced subcapital NOF fracture was established. The patient underwent total hip arthroplasty without complication and recovered excellent function after rehabilitation. Awareness of the differential diagnosis of TOH in pregnancy, a high index of suspicion and early MRI to make an early diagnosis and to prevent devastating fracture complications are mandatory.


Asunto(s)
Fracturas del Cuello Femoral/diagnóstico por imagen , Fracturas Espontáneas/diagnóstico por imagen , Dolor de la Región Lumbar/diagnóstico , Osteoporosis/diagnóstico por imagen , Complicaciones del Embarazo/diagnóstico por imagen , Artroplastia de Reemplazo de Cadera , Femenino , Fracturas del Cuello Femoral/etiología , Fracturas del Cuello Femoral/cirugía , Fracturas Espontáneas/etiología , Fracturas Espontáneas/cirugía , Humanos , Dolor de la Región Lumbar/etiología , Imagen por Resonancia Magnética , Osteoporosis/complicaciones , Embarazo , Tercer Trimestre del Embarazo , Tomografía Computarizada por Rayos X , Adulto Joven
7.
Diagn Pathol ; 16(1): 8, 2021 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-33441152

RESUMEN

AIMS: To explore the clinical characteristics and placental pathological changes of pregnant women with 2019 novel coronavirus (CoV) disease (COVID-19) in the third trimester, and to assess the possibility of vertical transmission. METHODS AND RESULTS: The placenta tissues were evaluated by using immunohistochemistry for inflammatory cells and Hofbauer cells, and using severe acute respiratory syndrome (SARS) CoV-2 RNA Fluorescence In-Situ Hybridization (FISH) and SARS-CoV-2 spike protein immunofluorescence (IF) double staining. All eight placentas from the third trimester pregnancy women were studied. All patients were cured, no clinical or serological evidence pointed to vertical transmission of SARS-CoV-2. Features of maternal vascular malperfusion (MVM) such as increased syncytial knots were present in all 8 cases (8/8), and increased focal perivillous fibrin depositions were presented in 7 cases (7/8). No significate chronic histiocytic intervillositis was noted in the placenta. The number of macrophages and inflammatory cells such as T cells, B cells and plasma cells in the placental villous was not significantly increased in all cases. Moreover, all of eight cases demonstrated negative results by FISH using a SARS-CoV-2 virus RNA probe and by IF using a monoclonal antibody against SARS-CoV-2 spike protein. CONCLUSIONS: We found no evidence of vertical transmission and adverse maternal-fetal outcomes in the placentas of third trimester COVID-19 pregnancy women, which provided further information for the clinical management of those women in the third trimester. However, further studies are still needed for patients with infections in different stage of gestation, especially in first and second trimester.


Asunto(s)
/virología , Placenta/virología , Complicaciones Infecciosas del Embarazo/virología , /patogenicidad , Adulto , Femenino , Humanos , Embarazo , Tercer Trimestre del Embarazo/inmunología , Mujeres Embarazadas , Glicoproteína de la Espiga del Coronavirus/metabolismo
8.
Rev Med Liege ; 76(1): 18-22, 2021 Jan.
Artículo en Francés | MEDLINE | ID: mdl-33443324

RESUMEN

We report the case of a 24-year-old female patient with spontaneous rupture of a splenic artery aneurysm in the third trimester of pregnancy. Pregnancy, throughout the physiological and hormonal changes it imposes, promotes the occurrence of aneurysm of the splenic artery and its rupture. Although this is a rare complication, its prognosis is severe and its typical clinical picture associating abdominal pain, hypotension and anemia is misleading for the clinician who likelier evokes a retroplacental hematoma or an uterine rupture. The maternal and foetal survival depends on rapid diagnosis and multidisciplinary management. Thus, it's important for the clinician to consider this differential diagnosis when abdominal pain or hemoperitoneum occurs in pregnant woman, particularly during the third trimester of pregnancy.


Asunto(s)
Aneurisma Roto , Complicaciones Cardiovasculares del Embarazo , Adulto , Aneurisma Roto/complicaciones , Aneurisma Roto/diagnóstico , Femenino , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Tercer Trimestre del Embarazo , Rotura Espontánea , Arteria Esplénica/diagnóstico por imagen , Adulto Joven
9.
Isr Med Assoc J ; 23(1): 43-47, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33443342

RESUMEN

BACKGROUND: The sonographic assessment of estimated fetal weight (EFW) is essential for identification of fetuses in weight extremes and aids in peripartum management. However, there are inconsistent reports regarding EFW accuracy. OBJECTIVES: To examine maternal and fetal determinants associated with unreliable EFW. METHODS: A retrospective case-control study was conducted at a single, tertiary medical center between 2011 and 2019. All term, singleton deliveries with a sonographic EFW within 2 weeks of delivery were included. Unreliable EFW was defined as > 500 grams discordance between it and the actual birth weight. We allocated the study cohort into two groups: unreliable EFW (cases) and accurate EFW (controls). RESULTS: Overall, 41,261 deliveries met inclusion criteria. Of these, 1721 (4.17%) had unreliable EFW. The factors positively associated with unreliable EFW included body mass index > 30 kg/m2, weight gain > 20 kg, higher amniotic fluid index, pregestational diabetes, gestational age > 410/7, and birth weight ≥ 4000 grams. On multiple regression analysis, pregestational diabetes (odds ratio [OR] 2.22, 95% confidence interval [95%CI] 1.56-3.17, P < 0.001) and a higher birth weight (OR 1.91, 95%CI 1.79-2.04, P < 0.001) were independently associated with unreliable EFW. On analysis of different weight categories, pregestational diabetes was associated with unreliable EFW only among birth weights ≥ 3500 grams (OR 3.28, 95%CI 1.98-5.44, P< 0.001) and ≥ 4000 grams (OR 4.27, 95%CI 2.31-7.90, P < 0.001). CONCLUSIONS: Pregestational diabetes and increased birth weight are independent risk factors for unreliable EFW and should be considered when planning delivery management.


Asunto(s)
Peso al Nacer , Peso Fetal , Atención Prenatal/métodos , Ultrasonografía Prenatal , Adulto , Diabetes Mellitus/epidemiología , Precisión de la Medición Dimensional , Femenino , Edad Gestacional , Humanos , Valor Predictivo de las Pruebas , Embarazo , Tercer Trimestre del Embarazo , Pronóstico , Factores de Riesgo , Ultrasonografía Prenatal/métodos , Ultrasonografía Prenatal/normas
10.
Medicine (Baltimore) ; 100(1): e24239, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33429826

RESUMEN

RATIONALE: Subarachnoid hemorrhages (SAHs) from ruptured intracranial aneurysms are very rare during pregnancy. Management of ruptured intracranial aneurysms with SAH in pregnancy is often challenging because of the risks to the fetus and the mother. We present the first successful awake endovascular coiling of a dissected intracranial aneurysm in a third trimester twin pregnancy. PATIENT CONCERNS: A 28 years' old pregnant woman was admitted at the obstetric department of our hospital on account of very severe headaches associated with nausea and vomiting. DIAGNOSIS: Emergency obstetric ultrasound scan done confirmed 32 weeks' twin gestation, whereas magnetic resonance imaging established hemorrhage in the suprasellar cistern and the subarachnoid space. Magnetic resonance angiography revealed a dissected aneurysm in the ophthalmic segment of the left internal carotid artery. INTERVENTIONS: Awake cerebral angiography as well as embolization of the aneurysm with coils was done via the transarterial route and the twins were delivered via caesarean section at 37 weeks' gestation. OUTCOMES: Two years' follow-up indicated no complications and children as well as their mother are healthy. LESIONS: Awake endovascular coiling was very beneficial in our case because we avoided general anesthesia and the use of osmotic diuretics which are potentially hazardous during pregnancy.


Asunto(s)
Aneurisma Intracraneal/diagnóstico , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Embarazo Gemelar , Hemorragia Subaracnoidea/diagnóstico , Ultrasonografía Prenatal , Adulto , Angiografía por Tomografía Computarizada , Diagnóstico Diferencial , Embolización Terapéutica , Procedimientos Endovasculares , Femenino , Cefalea/etiología , Humanos , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/terapia , Angiografía por Resonancia Magnética , Embarazo , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Complicaciones Cardiovasculares del Embarazo/terapia , Tercer Trimestre del Embarazo , Hemorragia Subaracnoidea/complicaciones , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Subaracnoidea/terapia
11.
BMJ Case Rep ; 14(1)2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33514616

RESUMEN

A 31-year-old G3P2002 with history of two prior caesarean sections presented with influenza-like illness, requiring intubation secondary to acute respiratory distress syndrome. Investigations revealed intrauterine fetal demise at 30-week gestation.She soon deteriorated with sepsis and multiple organs impacted. Risks of the gravid uterus impairing cardiopulmonary function appeared greater than risks of delivery, including that of uterine rupture. Vaginal birth after caesarean was achieved with misoprostol and critical care status rapidly improved.Current guidelines for management of fetal demise in patients with prior hysterotomies are mixed: although the American College of Obstetricians and Gynecologists recommends standard obstetric protocols rather than misoprostol administration for labour augmentation, there is limited published data citing severe maternal morbidity associated with misoprostol use. This case report argues misoprostol-augmented induction of labour can be a reasonable option in a medically complex patient with fetal demise and prior hysterotomies.


Asunto(s)
Muerte Fetal/etiología , Trabajo de Parto Inducido/métodos , Trabajo de Parto/efectos de los fármacos , Misoprostol/administración & dosificación , Oxitócicos/administración & dosificación , Administración Intravaginal , Adulto , Parto Obstétrico/normas , Femenino , Humanos , Histerotomía/efectos adversos , Intubación Intratraqueal/métodos , Misoprostol/farmacología , Insuficiencia Multiorgánica/etiología , Oxitócicos/farmacología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Tercer Trimestre del Embarazo , /terapia , Resultado del Tratamiento , Rotura Uterina/prevención & control
12.
Midwifery ; 92: 102876, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33220602

RESUMEN

OBJECTIVE: The rapid pace of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) presents significant challenges to midwives and nurses. This study aimed to explore midwifery and nursing interventions to limit the transmission of COVID-19 among women in their third trimester of pregnancy, to reduce the incidence of nosocomial infection and promote safety of care for women and their infants. METHOD: We completed a retrospective review of medical records from 35 women in their third trimester of pregnancy with SARS-CoV-2, admitted to one hospital in Wuhan, China in January and February 2020. We investigated the clinical characteristics of the COVID-19 infection in pregnancy, and the individualized midwifery and nursing care offered, including environmental protection, prevention of nosocomial infection, maternal observations, monitoring of signs and symptoms of COVID-19, and psychological care. RESULT: Thirty-one women had a caesarean section, and four had vaginal births. Retrospective analysis of midwifery and nursing strategies implemented to care for these women showed no maternal complications or nosocomial infections. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The care strategies we implemented could prevent complications and nosocomial infection in the third trimester of pregnancy, thus ensuring the safety of women and their infants. Further research needs to determine treatment priorities for women infected with COVID-19 during pregnancy and the postnatal period.


Asunto(s)
/prevención & control , Parto Obstétrico/enfermería , Partería/métodos , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo/epidemiología , Adulto , China , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Pandemias/estadística & datos numéricos , Embarazo , Complicaciones Infecciosas del Embarazo/enfermería , Tercer Trimestre del Embarazo , Estudios Retrospectivos
13.
Chemosphere ; 262: 128404, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33182127

RESUMEN

BACKGROUND: Reduced growth velocity before birth increases the risk of adverse health outcomes in adult life. However, until recently, there has been a lack of studies demonstrating the impact of prenatal PM2.5 exposure on fetal growth velocity. METHODS: The current study was embedded in a previous cohort built between January 1, 2014, and April 30, 2015, in Shanghai First Maternity and Infant Hospital, China, in 6129 eligible singleton pregnancies. The PM2.5 concentration was estimated by an inverse distance weighted method according to the residential addresses of the participants. Repeated fetal biometry measurements, including head circumference (HC), abdominal circumference (AC), femur length (FL), and biparietal diameter (BPD), were measured through ultrasound between 14 and 41 gestational weeks. A principal component analysis through conditional expectation for sparse longitudinal data was used to estimate the corresponding velocities. RESULTS: A total of 22782 ultrasound measurements were conducted among 6129 participants with a median of 2 and a maximum of 9 measurements. With each 10 µg/m3 increase in cumulative PM2.5 exposure, the velocity of HC, AC FL and BPD decreased by 0.12 mm/week, 0.17 mm/week, 0.02 mm/week and 0.02 mm/week, respectively, on average. The results of the Generalized Functional Concurrent Model showed that the velocity decreased significantly with PM2.5 exposure between 22 and 32 gestational weeks, which might be the potential sensitive exposure window. CONCLUSIONS: There are negative associations between prenatal exposure to PM2.5 and fetal growth velocity, and the late second trimester and early third trimester might be the potential sensitive window.


Asunto(s)
Contaminantes Atmosféricos/toxicidad , Exposición Materna , Material Particulado/toxicidad , Efectos Tardíos de la Exposición Prenatal , Adulto , China , Estudios de Cohortes , Femenino , Desarrollo Fetal , Edad Gestacional , Humanos , Masculino , Material Particulado/análisis , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Ultrasonografía Prenatal/métodos
14.
Int J Antimicrob Agents ; 57(2): 106260, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33309765

RESUMEN

OBJECTIVES: Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. However, the hazard to newborns in pregnancy remains controversial. The aim of this study was to investigate the vertical transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from mother to child and developmental toxicity in the fetus. METHODS: All clinical information was recorded on 22 neonates born to mothers with confirmed COVID-19 pneumonia in Tongji Hospital. RESULTS: The average birth weight of the 22 newborns (16 males and 6 females) was 2980 g, and the mean gestational week was 37W+3. The birth weight of three babies was <2500 g, and the gestational week of all three low-birth-weight neonates was less than 36W. Three newborns had minor lesions of infection in the lungs as shown by computed tomography (CT) scans. Furthermore, three newborns had elevated SARS-CoV-2-related immunoglobin M (IgM) antibodies, and 11 newborns (52.4%) had positive immunoglobin G (IgG) antibodies. Notably, both cystatin C and ß2-microglobulin were increased in all newborns. Five of the 21 tested newborns had leukocytosis, and 11 had increased neutrophil levels. In addition, the aspartate aminotransferase of 18 newborns and the γ-glutamyl transpeptidase of 19 newborns were increased. Total bilirubin was elevated in all newborns and serum albumin was reduced in 20 of 22 newborns. CONCLUSIONS: This study was the first to discover that COVID-19 infection in the third trimester of pregnancy could cause fetal kidney developmental injury, as indicated by increased cystatin C and ß2-microglobulin in all neonates. Furthermore, there is the possibility of maternal-fetal transmission of SARS-CoV-2.


Asunto(s)
/transmisión , Enfermedades Renales/virología , Complicaciones Infecciosas del Embarazo/virología , Aspartato Aminotransferasas/sangre , Bilirrubina/sangre , /inmunología , Femenino , Humanos , Inmunoglobulina M/sangre , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Enfermedades Renales/embriología , Masculino , Neutrófilos , Embarazo , Complicaciones Infecciosas del Embarazo/etiología , Tercer Trimestre del Embarazo , Estudios Retrospectivos , gamma-Glutamiltransferasa/sangre
15.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(4): 143-148, oct.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-197641

RESUMEN

ANTECEDENTES Y OBJETIVO: La compleja fisiología de la función tiroidea durante el embarazo requiere la evaluación hormonal según valores de referencia para cada trimestre, cada zona y con las técnicas de cada laboratorio. Los objetivos de este estudio fueron analizar la función tiroidea en los tres trimestres de gestación y establecer los valores de referencia de las hormonas en las mujeres gestantes de nuestra área sanitaria (Lugo). MÉTODOS: Un total de 831 gestantes fueron incluidas en el estudio (mediana de edad: 33años; rango: 16-47años). Una vez aplicados los criterios de exclusión, nuestra muestra estuvo compuesta por 641 gestantes, tamaño que puede considerarse representativo de la población de referencia. RESULTADOS: Los intervalos de referencia fueron los siguientes: TSH primer trimestre, 0,10-3,74mUI/l; segundo trimestre, 0,45-3,77mUI/l; y tercer trimestre, 0,36-4,15mUI/l. Para T4L en el primer trimestre, 0,87-1,34ng/dl; segundo trimestre, 0,78-1,20ng/dl; y tercer trimestre, 0,78-1,23ng/dl. Para la T3L en el primer trimestre, 2,52-3,78pg/ml; segundo trimestre, 2,22-3,21pg/ml; y tercer trimestre, 2,17-3,14pg/ml. Se confirmó presencia de autoinmunidad tiroidea en 109 mujeres (13,1%), que presentaron valores de TSH superiores a las gestantes sin autoinmunidad tiroidea. CONCLUSIÓN: Los intervalos de referencia para la TSH, T4L y T3L obtenidos en este trabajo están por debajo de los utilizados en la población adulta no gestante en nuestro laboratorio, por lo que permitirán identificar de manera más precisa una posible disfunción tiroidea en las gestantes de nuestra área evitando un infradiagnóstico de hipotiroidismo subclínico y reduciendo las posibles complicaciones perinatales asociadas


BACKGROUND AND OBJECTIVE: The complex physiology of thyroid function during pregnancy requires a hormonal evaluation according to reference values for each trimester, each area, and with the techniques of each laboratory. The objectives of this study were to analyse thyroid function in the three trimesters of pregnancy and to establish the reference values of hormones in pregnant women in this health area (Lugo). METHODS: A total of 831 pregnant women were included in the study (median age: 33years, age range: 16-47years). Once the exclusion criteria were applied, the sample consisted of 641 pregnant women, a size that can be considered representative of the reference population. RESULTS: The reference intervals were as follows: TSH first trimester, 0.10-3.74mIU/L; second trimester, 0.45-3.77mIU/L; and third trimester, 0.36-4.15mIU/L. For Free T4 in the first trimester, 0.87-1.34ng/dL; second trimester, 0.78-1.20ng/dL; and third trimester, 0.78-1.23ng/dL. For Free T3 in the first trimester, 2.52-3.78pg/mL; second trimester, 2.22-3.21pg/mL; and third trimester, 2.17-3.14pg/mL. The presence of thyroid autoimmunity was confirmed in 109 women (13.1%), who presented with higher TSH values than pregnant women without thyroid autoimmunity. CONCLUSION: The reference intervals for TSH, Free T4, and Free T3 obtained in this study are below those used in the non-pregnant adult population in this laboratory. This should help to identify more accurately a possible thyroid dysfunction in pregnant women in the study area, avoiding an underdiagnosis of subclinical hypothyroidism and reducing the possible associated perinatal complications


Asunto(s)
Humanos , Femenino , Embarazo , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Hormonas Tiroideas/sangre , Valores de Referencia , Autoinmunidad/fisiología , Tirotropina/sangre , Triyodotironina/sangre , Tiroxina/sangre , Primer Trimestre del Embarazo/sangre , Segundo Trimestre del Embarazo/sangre , Tercer Trimestre del Embarazo/sangre , España/epidemiología , Estudios Prospectivos
16.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-33318250

RESUMEN

This case report describes a right-sided borderline ovarian tumour diagnosed unexpectedly following suspected torsion in the third trimester of pregnancy. The patient had had a right mucinous cystadenoma and left serous cystadenoma in her previous pregnancy and underwent bilateral ovarian cystectomy at the time of her first elective caesarean section. The management of borderline ovarian tumours is generally difficult in younger women of reproductive age and is made more complex by pregnancy. The authors share the challenges of managing this condition in pregnancy together with a review of the literature.


Asunto(s)
Cesárea , Cistoadenoma Mucinoso/cirugía , Cistadenoma Seroso/cirugía , Neoplasias Ováricas/cirugía , Adulto , Apendicectomía , Biomarcadores de Tumor/análisis , Cistoadenoma Mucinoso/patología , Cistadenoma Seroso/patología , Cistectomía , Femenino , Humanos , Estadificación de Neoplasias , Neoplasias Ováricas/patología , Ovariectomía , Embarazo , Tercer Trimestre del Embarazo , Resultado del Tratamiento , Ultrasonografía Doppler
17.
Klin Lab Diagn ; 65(12): 733-737, 2020 Dec 29.
Artículo en Inglés | MEDLINE | ID: mdl-33373503

RESUMEN

We examined 66 women who were 22-40 weeks pregnant and their newborns. Of these, 15 women with moderate PE were in group 1, 22 women with severe PE were in group 2, and 55 women with uncomplicated pregnancy without hypertensive disorders were in the control group. Blood was taken from women when they were admitted to the clinic, and newborns ' blood was taken for 3-5 days of life. Free radical oxidation and antioxidant activity were evaluated by induced chemiluminescence. It was found that in patients with severe and moderate preeclampsia, the development of oxidative stress is accompanied by a weakening of antioxidant activity. In newborns born to mothers with preeclampsia, oxidative stress is accompanied by a compensatory increase in antioxidant activity.


Asunto(s)
Antioxidantes/fisiología , Estrés Oxidativo , Preeclampsia/fisiopatología , Femenino , Humanos , Recién Nacido , Embarazo , Tercer Trimestre del Embarazo
18.
PLoS One ; 15(12): e0243761, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315949

RESUMEN

BACKGROUND: Because there are no published biochemical reference intervals (RI) for pregnant Taiwanese women, we used an established islandwide birth cohort, the Taiwan Maternal and Infant Cohort Study, to establish RIs for important biochemical parameters in women during their 3rd trimester in Taiwan. Additionally, we compared the differences in these biochemical parameters between early third trimester (weeks 28 to 31) and late third trimester (weeks 37 to 40) of pregnant women as well as the differences in them between the third trimester and after delivery. METHODS: Between 2012 and 2015, we recruited a total of 2,136 pregnant women from nine hospitals located in northern (n = 3), central (n = 3), southern (n = 2), and eastern Taiwan (n = 1) to receive regular prenatal health examinations during their third trimester (weeks 28 to 40). After exclusion, samples obtained from 993 eligible pregnant women were analyzed. RESULTS: There were increases in both lower and upper normal limits for blood neutrophil, thyroid profile (triiodothyronine (T3) and thyroxine (T4)), testosterone, estradiol, and progesterone and decreases for RBC, hemoglobin (Hb), alanine aminotransferase (ALT) and creatinine (Cr) during their third trimesters. Women in their late third trimester (n = 378) had higher median RBC, Hb, aspartate aminotransferase (AST), Cr, thyroid-stimulating hormone (TSH), testosterone, estradiol, and progesterone and lower median platelet and insulin, compared with those in their early third trimester (n = 490). Twenty-three of the women had both third trimester and post-pregnancy data. After delivery, the women had lower median AST, ALT, insulin, T3, T4, testosterone, estradiol, and progesterone and higher median Cr, free T4, FSH, and luteinizing hormone (LH), compared to their third trimesters. CONCLUSIONS: Gestation-related changes in important biochemical parameters should be considered when evaluating clinical laboratory values in pregnant women.


Asunto(s)
Pruebas de Química Clínica/normas , Pruebas Hematológicas/normas , Primer Trimestre del Embarazo/sangre , Tercer Trimestre del Embarazo/sangre , Adulto , Alanina Transaminasa/sangre , Alanina Transaminasa/normas , Aspartato Aminotransferasas/sangre , Aspartato Aminotransferasas/normas , Índice de Masa Corporal , Estudios de Cohortes , Estradiol/sangre , Estradiol/normas , Femenino , Humanos , Recuento de Leucocitos , Neutrófilos/citología , Periodo Posparto , Embarazo , Mujeres Embarazadas , Valores de Referencia , Hormonas Tiroideas/sangre , Hormonas Tiroideas/normas
20.
Harefuah ; 159(11): 789-792, 2020 Nov.
Artículo en Hebreo | MEDLINE | ID: mdl-33210847

RESUMEN

INTRODUCTION: General pustular pruritus psoriasis (GPPP), also known by the name impetigo herpetiformis, is a rare type of pustular dermatosis which typically occurs in pregnant women during the 3rd trimester and usually regresses after birth. The disease is characterized by acute abruption of erythematous plaque with a disseminated spread of sterile pustule, and may progress to sepsis and even death. Notably, it also carries obstetric complications and is associated with an increase in neonatal morbidity and stillbirth. We present a case report of a patient, and discuss the importance of proper management in this rare condition.


Asunto(s)
Dermatitis Herpetiforme , Impétigo , Complicaciones Infecciosas del Embarazo , Complicaciones del Embarazo , Psoriasis , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/diagnóstico , Tercer Trimestre del Embarazo , Psoriasis/complicaciones , Psoriasis/diagnóstico
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