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Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy

Chinese Medical Journal 2009年第5期122卷 521-524页

作者： ZHANG Yan ZHAO Yang-yu QIAO Jie YE Rong-hua Department of Obstetrics and Gynecology Peking University Third Hospital Beijing 100191 China

Background Appendicitis is the most common surgical problem in pregnancy, however the particular dangers of appendicitis in pregnancy lie in the varied presentation of symptoms and the higher chance of delayed diagnosis. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis during second and third trimester pregnancies. Methods This was a retrospective single-center study that presented a descriptive analysis of the results. A total of 102 pregnant women who were diagnosed with acute appendicitis and operated upon in Peking University Third Hospital, China between January 1993 and December 2007 were presented. SPSS 12.0 for Windows was used for data analysis. Results Seventy-eight pregnant women who were diagnosed with acute appendicitis （sixteen patients had a perforated appendix, 62 patients had a non-perforated appendix） were operated upon during late pregnancy. The interval between symptom onset and surgery was the only predictive variable. A longer interval between symptom onset and surgery was associated with appendix perforation （（109.5±52.7） hours） than with no appendix perforation （（35.1±19.62） hours; P=-0.007）. There was a significant difference in the rate of preterm labor （5.1% vs 1.3%） and the rate of fetal mortality （25% vs 1.7%） between patients with and without a perforated appendix. Conclusions Delaying surgery correlates to more advanced disease with an increased risk of perforation. This contributes to an increased risk of further complications, including premature labor or abortion, and to higher maternal complication rates. Prompt diagnosis may improve the prenatal outcome.

关键词： pregnancy acute appendicitis perinatal outcome

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Prevalence of hypertensive disorders of pregnancy,associated factors and pregnancy complications in a primigravida population

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Gynecology and Obstetrics Clinical Medicine 2023年第2期3卷 119-123页

作者： Rachel Mathew Benita P.Devanesan Srijana N.S.Sreedevi Department of Obstetrics and Gynaecology Pushpagiri Institute of Medical Sciences&Research CentreThiruvalla689101KeralaIndia

Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved *** is one of the major causes of maternal and perinatal morbidity and *** study estimates the prevalence of hypertensive disorders of pregnancy,their associated risk factors and pregnancy complications in primiparous ***:All primigravida who gave birth in our hospital from December 2020 to December 2021 were included in the *** prevalence,risk factors,mode of delivery,and maternal and fetal outcomes of hypertensive disorders of pregnancy in primigravidae were collected from the patient's medical *** analysis was done using the SPSS 18.0 software *** Chi-square test was used to analyse the association between the risk factors and hypertensive disorders of pregnancy in ***:A total of 807 women were included in the study,and the mean age was 26.34±3.84 *** prevalence of hypertensive disorders of pregnancy in primigravidae was found to be 18.6%.Among the prevalent population,79.3%of women had gestational *** findings indicate that hypertension in pregnancy has a significant relationship with risk factors such as increased maternal age(p30 kg/m^(2)(pperinatal outcomes were placental abruption(p<0.001),postpartum haemorrhage(p<0.001),prematurity(p<0.001),and fetal growth restriction(p<0.001).Conclusion:The study emphasises the importance of knowledge and timely assessment of risk factors of *** also highlights the need for pre-conceptional counselling,which includes early detection,careful monitoring and treatment of HDP for preventing morbidity and mortality related to this disorder and it should be followed up even in the postpartum period.

关键词： Hypertensive disorders of pregnancy Maternal outcome perinatal outcome Primigravidae

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Advanced maternal age and adverse obstetrical and neonatal outcomes of singleton pregnancies

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Gynecology and Obstetrics Clinical Medicine 2022年第4期2卷 175-180页

作者： Mitra Shekari Malihe Shirzadfardjahromi Amene Ranjbar Vahid Mehrnoush Fatemeh Darsareh Nasibeh Roozbeh Mother and Child Welfare Research Center Hormozgan University of Medical SciencesBandar AbbasIran Fertility and Infertility Research Center Hormozgan University of Medical SciencesBandar AbbasIran Urology Department Northern Ontario School of MedicineThunder BayOntarioCanada

Objective:To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton *** design:We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital in Bandar Abbas,Iran,from January 2020 to January *** and obstetrical factors include educational level,medical insurance,residency place,access to prenatal care facilities,number of prenatal care visits,smoking status,gestational age,parity,infertility,maternal comorbidities,preeclampsia,eclampsia,preterm birth,low birth weight(LBW),intrauterine growth restriction(IUGR),macrosomia,placenta abnormalities(previa/acreta),placenta abruption,chorioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacerations,postpartum hemorrhage,childbirth injury,shoulder dystocia,congenital malformation,neonatal asphyxia,and unfavorable maternal and neonatal outcome were compared between two *** Chi-square test assessed the relationship between categorical factors and maternal age *** influence of advanced maternal age on the risk of unfavorable pregnancy outcomes was evaluated using bivariate and multivariate logistic ***:Of 8354 singleton deliveries,22.2%belonged to advanced-age ***-age mothers had less education than those aged 20–34 years *** hypertension,cardiovascular disease,overt diabetes,and thyroid dysfunction were more prevalent among advanced-age *** with mothers aged 20–34 years,mothers aged 35 years and higher had a significantly higher risk of gestational diabetes(aOR:3.18,95%CI:1.56–6.95),preeclampsia(aOR:2.91,95%CI:1.35–4.72),placenta abnormalities(aOR:1.09,95%CI:0.77–1.94),CS(aOR:3.16,95%CI:1.51–3.87),postpartum hemorrhage(aOR:1.94,95%CI:1.24–2.61),intensive care unit admission(aOR:1.36,95%CI:1.15–1.99),LBW(aOR:1.35,95%CI:0.97–2.96),preterm birth(aOR:2.36,95%CI:1.65–4.83),stillbirth(aOR:1.18,95%CI:1.01–3.16),and neonatal

关键词： Advanced maternal age Pregnancy Childbirth perinatal outcome Neonatal outcomes

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Pregnancy,childbirth and neonatal outcomes associated with adolescent pregnancy

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Gynecology and Obstetrics Clinical Medicine 2023年第2期3卷 100-105页

作者： Amene Ranjbar Maliheh Shirzadfard Jahromi Banafsheh Boujarzade Nasibeh Roozbeh Vahid Mehrnoush Fatemeh Darsareh Fertility and Infertility Research Center Hormozgan University of Medical SciencesBandar AbbasIran Mother and Child Welfare Research Center Hormozgan University of Medical SciencesBandar AbbasIran Urology Department Northern Ontario School of MedicineThunder BayOntarioCanada

Objective:To assess the obstetric and neonatal outcomes associated with adolescent pregnancy in ***:We retrospectively assessed women who gave birth between January 1st,2020,and January 1st,*** pregnant women were separated into two groups:(1)women aged 19 and younger;(2)women aged 20-34 *** outcome measures include preterm birth,maternal comorbidities,preeclampsia,eclampsia,low birth weight(LBW),intrauterine growth restriction(IUGR),placenta abnormalities,placenta abruption,cho-rioamnionitis,meconium fluid,fetal distress,methods of delivery,rate of cesarean section(CS),perineal lacer-ations,postpartum hemorrhage,childbirth trauma,shoulder dystocia,congenital malformation,and unfavorable maternal and neonatal *** regression models were used to determine the influence of teenage pregnancy on adverse pregnancy and childbirth ***:Of 7033 deliveries,92.4%of women were adults,and 7.6%were *** residing in rural districts were more common than adults(42.3%vs.33.7%).However,access to prenatal facility care was the same as the majority of women had 6-10 prenatal care visits during their *** was no difference in the risk of preeclampsia,placenta abruption,placenta previa,fetal distress,preterm labor,shoulder dystocia,perineal lacerations,childbirth trauma,congenital malformation,postpartum hemorrhage,intensive care unit admission,maternal death,and unfavorable neonatal outcome including stillbirth,neonatal intensive care unit admission,neonatal death in adolescent pregnancies compared to *** had a significantly higher risk of LBW(OR:1.47,95%CI:1.01-2.73),IUGR(OR:1.96,95%CI:1.31-2.45),and meconium fluid(OR:1.74,95%CI:1.41-2.32),however,there was no statistically significant difference after adjusting the confounding *** with adults,adolescents had a significantly lower risk of CS(aRR:0.67,95%CI:0.51-0.77)and a lower risk of gestational diabetes(aRR:0.78,95%CI:0.51-0.95)

关键词： Adolescents Pregnancy Childbirth perinatal outcome Neonatal outcomes

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Prevalence, Risk Factors and outcome of Preterm Premature Rupture of Membranes at the Bamenda Regional Hospital

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Open Journal of Obstetrics and Gynecology 2021年第3期11卷 233-251页

作者： Dobgima Walter Pisoh Claude Hector Mbia William Ako Takang Obelda Guiswe Beltus Djonsala Mbah Cypress Munje Ascensius Achuo Mforteh Dohbit Julius Sama Robert John Ivo Leke Department of Clinical Sciences Faculty of Health Sciences University of Bamenda Bambili Cameroon Bamenda Regional Hospital Bamenda Cameroon Department of Obstetrics and Gynaecology Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Catholic University of Cameroon Bamenda Cameroon

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is one of the leading identifiable cause of preterm deliveries, and an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine the prevalence of PPROM, to identify its associated factors and to evaluate the early outcome (within 72 hrs after delivery) following PPROM at the Bamenda Regional Hospital (BRH). Methods: A cross-sectional study was conducted in March and April 2020. Three hundred and eighty-seven women who delivered at the labour room of the BRH were included in this study. Interviewer-administered questionnaires were used to obtain data. The cases of PPROM were women who had lost amniotic fluid continuously before hospitalisation and whose gestational age was between 28 weeks + 0 days and 36 weeks + 6 days. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Among the 387 participants included in the study, 19 had PPROM giving a prevalence of 4.91%. Of 57 preterm deliveries, PPROM accounted for 33.33% (n = 19). The statistically significant independent factors associated with lower odds of PPROM were the age groups 20

关键词： Preterm PROM Maternal outcome perinatal outcome Associated Factors

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Nuchal Cord at Delivery and Neonatal outcomes: A Retrospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 285-291页

作者： Mbodji Aissatou Gueye Mamour Wade Mouhamadou Ndiaye Mame Diarra Dia Aliou Djiby Cisse Aliou Ibrahim Rahadat Ndiaye Mor Talla Mbaye Magatte Philippe Maguilen Senghor Health Center Dakar Sénégal Cheikh Anta Diop Univeristy Dakar Sénégal Gaston Berger University Saint-Louis Sénégal

Objective: The present study was aimed at evaluating the outcome of pregnancies with a nuchal cord. Methods: A retrospective population-based study of all deliveries during the years 2011-2020 in Philippe Maguilen SENGHOR Center was conducted. perinatal outcome of patients with and without nuchal cord was compared. Results: Among 44,958 deliveries during the study period, 1.8% had a nuchal cord, documented at birth (n = 807). Higher rates of labor induction (9.1% vs. 3.2%;p 0.001) and non-reassuring fetal heart rate patterns (RR = 2.366;CI: 1.631 - 3.432) were noted among pregnancies with nuchal cord as compared with the control group. The cesarean delivery rate was significantly higher among pregnancies with a nuchal cord (39.5% vs. 21.8%;RR = 2333;CI: 2.023 - 2.692). Although 5 min Apgar scores lower than 7 were more common in pregnancies with a nuchal cord (7.8% vs. 3.8%;RR = 2.117;CI: 1.629 - 3.363). There was no statistical significance between the two groups for the perinatal mortality. Conclusion: Nuchal cord is associated with prolonged labor and adverse perinatal outcome.

关键词： Nuchal Cord perinatal outcome Philippe Senghor Health Center Dakar

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Why more attentions to fetus in cases of intrahepatic cholestasis of pregnancy?

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World Journal of Obstetrics and Gynecology 2013年第4期2卷 62-64页

作者： Xiu-Quan Zhang Yi-Lin Ding Li-Juan Zhang Department of Obstetrics and Gynecology and Reproductive Genetics University of Utah School of Medicine Salt Lake City UT 84132 United States Department of Obstetrics and Gynecology the Second Xiangya Hospital Central South University

Intrahepatic cholestasis of pregnancy(ICP) is a peculiar disease in middle-late pregnancy with the pathological characteristics of hepatic capillary bile duct silts and is accompanied by clinical presentations of pruritus and bile acid(BA) elevation in serum. Maternal outcomes for patients diagnosed with ICP are usually good. However, fetal outcomes can be devastating with high frequencies of perinatal complications. Patients with ICP generally have an early delivery due to fetal complications. The current hypothesis is that ICP has higher frequencies of fetal complications due to high concentrations of BA which has toxic cellular effects to many organs. In lungs, it destroys the AT-II cells, decreasing phospholipids synthesis leading to the alveolar capillary permeability to increase and pulmonary surfactant to decrease. In heart, cholate can cross into the fetal compartment and causing fetal arrhythmias and decreased contractility. In the nervous system, high BAs can cause nerve cell denaturation and necrosis, mitochondria edema and membrane dissolve. In the placenta, high BA concentration can cause edema of the villous, decrease number of villous, intervillous thickening and balloon *** addition, high total BA can result in chorionic vein constriction and impaired fetal adrenal function.

关键词： Intrahepatic cholestasis of pregnancy Bile acid perinatal outcome Fetal lung Fetal heart

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