Is there an association between maternal thrombophilia and oligohydramnios during the gestational age of 18-23 weeks? a case-control study

Objective: to study the prevalence of genetically related thrombophilic Factor V Leiden, Factor V Cambridge, prothrombin gene mutation G20210A, factor XIII, methylenetetrahydrofolate reductase [MTHFR] C677T and A1298C mutations in pregnant women with oligohydramnios at the gestational age of 18-23 weeks

Methods: a case-control study was conducted in Jordan, at Jordan University Hospital and Farah Hospital between 2007 and 2011. Sixty three pregnant women with oligohydramnios were compared with 85 pregnant women with normal amniotic fluid volume at the gestational age of 18-23 weeks. All the fetuses have satisfactory fetal anomaly scan and there was no history suggestive of preterm premature rupture of the membranes. All subjects were investigated for 6 genetically related thrombophilic factors

Results: the presence of MTHFR C677T was found to be significantly higher in the oligohydramnios group compared to the control group, 61.9% vs. 37.6% [p value 0.01], and The presence of heterozygosity for pregnant women with oligohydramnios [49.2%] was also significant [p value 0.005] compared to the control [29.4%]. Factor XIII, Factor II G20210A, MTHFR A1298C, Factor V Leiden were not found to have a statistically significant difference between the two groups. Factor V Cambridge was found in none of the cases, but was found in 3% of the control group [p value 0.32]

Conclusions: this study suggests that the presence of MTHFR C677T in women with oligohydramnios at the time of fetal morphology scan may indicate a placental mal-function; however, larger studies are needed to validate this association

Acute transient puerperal psychosis: a case report

Postpartum psychosis occurs in 1 to 2 cases per 1000 post-partum women. This includes psychotic and bipolar disease. The impact of puerperal psychosis on the relationship between mother and infant could have long-termadverse effects on both mother and child. Former mental illness is a major risk factor for puerperal psychosis, but the effect of other independent factors, such as birth complications and side effects of drugs and their interactions, it is not clear. Some independent risks can be elucidated as causative factors of puerperal psychosis through the study of mothers that are affected by it, for the first time, in the puerperium. Few reports have addressed this problem. We report, for the first time, a case of acute transient puerperal psychosis.

Impact of maternal overweight and obesity on perinatal outcomes

Maternal obesity adversely affects perinatal outcome through increasing rates of hypertensive disease during pregnancy, diabetes, cesarean section and fetal macrosomia. To investigate the prevalence of prepregnancy over weight and obesity and their impact on pregnancy and perinatal outcomes in Jordan. A prospective study comparing prepregnancy BMI categories with pregnancy and perinatal outcomes. University teaching hospital. Singleton term babies [>37 weeks] born in the year 2009. A total of 2129 newborns were categorized according to their mothers self reported body mass index [BMI] into three groups [normal, over weight and obese]. Multivariate regression analysis was performed. The main outcomes were pregnancy induced hypertension, gestational diabetes, mode of delivery, birthweight, neonatal admission and death. A total 2129 newborns were identified. The incidence of overweight and obese mothers was 33.6% and 12.5%, respectively. In comparison to mothers with normal BMI, overweight and obese mothers were older and more likely to be multiparious. Their pregnancy was at a significantly higher risk for pregnancy-induced hypertension, gestational diabetes, Cesarean delivery, induction of labor, giving birth to a macrocosmic baby and neonatal admission. Obese women were less likely to have instrumental delivery. Babies born to overweight and obese mothers were not at a higher risk of having other short adverse perinatal outcomes. Increasing prepregnancy BMI was associated with increased risk of adverse outcomes. Effective Interventional programs are important implications for health policy for counseling mothers during antenatal, postnatal and primary health care visit

Perceptions and expectations among pregnant women receiving second-trimester ultrasound scans at Jordan University Hospita

To evaluate women's information about the purpose of the second-trimester ultrasound scan, their expectations before the scan, the extent to which these expectations are fulfilled after the scan, and their perceptions of the foetus. A sample of pregnant women [540] attending a second-trimester ultrasound scan at Jordan University Hospital were asked to complete two parts of a questionnaire during a 3-month period in 2011. The first part included patients' characteristics, the purpose of the scan, and expectations before the scan. The second part included patients' perceptions of the foetus and how the expectations of the scan were fulfilled. Both parts of the questionnaires were completed by 503 [93%] of the women. Three fourths of the participants were accompanied by their husband or a family member. Sixty [12%] women were referred specifically to rule out congenital anomalies. Comparison between patients' expectations before and after the scan using the chi-square test showed significant improvement in all expectations variables [P-value< 0.001]. A routine second-trimester ultrasound scan is an important event for most participating women. Improvements are required in the provision of pre-ultrasound information

prevalence of thrombophilic factors in pregnant women with subjectively oligohydraminos during the gestational age of 18- 27 weeks

To study the prevalence of Factor V Leiden [FVL], prothrombin gene mutation G20210A [F II] and methylenetetrahydrofolate reductase C677T [MTHFR] in pregnant women with subjectively diagnosed oligohydraminos during the gestational age from 18-27 weeks. A case-control study was conducted at the Jordan University Hospital and Farah Hospital Amman, Jordan during the period of 2006-2009. 100 pregnant women with oligohydraminos have been compared to 96 normal healthy childbearing age women. All subjects were investigated for the 3 genetically related thrombophilic factors. Prothrombin gene mutation G20210A [F II] in pregnant women with oligohydraminos was higher 7.0% Vs 0% in the control group with a P-value of 0.008. Factor V Leiden [FVL] was also higher among pregnant women with subjectively oligohydraminos, 23.0% Vs 13.5% among the control group, but it did not reach statistical significance, P-value was 0.087. Methylenetetrahydrofolate Reductase C677T [MTHFR] was 52% among the pregnant women with subjectively oligohydraminos versus 55.2% in the control group: P-value was 0.653 as shown in Table [2]. As compared to the control group, Factor II G20210A was significantly higher among the pregnant women with subjectively oligohydraminos while FVL was also higher among this group, but it did not reach statistical significance. MTHFR was not higher among this group of pregnant women