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OBJECTIVE: To assess the maternal demographic characteristics and uterine artery (UA) Doppler parameters at first and second trimesters of pregnancy as predictors for hypertensive disorders (HDs) and adverse perinatal outcomes. METHODS: This prospective cohort study comprised 162 singleton low-risk women undergoing routine antenatal care. The left and right UA were assessed by color and pulsed Doppler and the mean pulsatility and resistance indices as well as the presence of a bilateral protodiastolic notch were recorded at 11 to 14 and 20 to 24 weeks' gestation. Multilevel regression analysis was used to determine the effects of maternal characteristics and abnormal UA Doppler parameters on the incidence of HD, small for gestational age newborn, cesarean section rate, Apgar score 95th percentile only at the first trimester showed an increased risk for HD (odds ratio, 23.25; 95% confidence interval, 3.47 to 155.73; P95th percentile (odds ratio, 9.84; 95% confidence interval, 1.05 to 92.10; P=0.05). The model including maternal age, maternal and paternal ethnicity, occupation, parity and UA mean RI increased the relative risk for HD (area under receiver operating characteristics, 0.81). CONCLUSION: A first-trimester screening combining maternal characteristics and UA Doppler parameters is useful to predict HD in a low-risk population.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Pregnancy , Apgar Score , Cesarean Section , Cohort Studies , Gestational Age , Hypertension, Pregnancy-Induced , Incidence , Intensive Care, Neonatal , Mass Screening , Maternal Age , Methods , Occupations , Parity , Pregnancy Trimester, First , Pregnancy Trimester, Second , Prospective Studies , ROC Curve , Ultrasonography, Doppler , Uterine ArteryABSTRACT
Objective To provide the theoretical basis for clinical diagnosis and treatment of the related diseases by the com-parative analysis of serum thyroid stimulating hormone (TSH)and thyroid hormone (TH)[three iodine thyroid glycine (T3),thyroxine (T4),three free iodine thyroid former glycine (FT3)and free thyroxine (FT4)]levels between early preg-nant women and non-pregnant healthy women of childbearing age.Method Examined in the outpatient department of Yan’ an University Affiliated Hospital during 2013 November~2014 March,171 healthy women in 4~13 weeks of pregnancy were regarded as the observation group.In addition,149 non pregnant healthy women of childbearing age were regarded as the control group,who got physical examination in the hospital.The inclusion criteria were:no thyroid diseases history;no living history in local thyroid tumorarea;excluding the abnormal functionof thyroid diseases after history investigation and relevant examination.The detection method of serum TSH,T3,T4,FT3 and FT4 was the direct chemiluminescence assay. With reference of serum TSH and TH levels of the non-pregnant healthy women of childbearing age,the change of serum TSH and TH levels of early pregnant women was observed.Results Comparing the two groups,the pregnant women’s TSH level [1.97(1.17~2.65)mU/L],the non-pregnant women’s TSH level [2.42(1.73~3.58)mU/L],the difference was statistically significant (P0.05).Conclusion Serum TSH and TH levels of women in the first trimester of pregnancy have different degrees of chan-ges.Therefore,thyroid function testing is necessary for pregnant women during childbirth examination.It can avoid the women and offspring from negative influence of pregnancy women with abnormal thyroid function and achieve the goal of eu-genics.
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OBJETIVO: Determinar valores de referência para o volume da placenta entre 7 e 10 semanas e 6 dias de gestação por meio da ultrassonografia tridimensional utilizando o método XI VOCAL (eXtended Imaging Virtual Organ Computer-aided Analysis). MATERIAIS E MÉTODOS: Realizou-se estudo de corte transversal com 70 gestantes normais entre 7 e 10 semanas e 6 dias. Para o cálculo de volume, utilizou-se o método XI VOCAL com delimitação de dez planos adjacentes. Foram determinadas médias, medianas, desvios-padrão, valores máximo e mínimo para o volume da placenta. Para avaliar a correlação do volume da placenta com a idade gestacional, foi criado gráfico de dispersão, sendo o ajuste realizado pelo coeficiente de determinação (R²). RESULTADOS: A média do volume da placenta variou de 4,6 cm³ (2,6-8,6 cm³) a 28,9 cm³ (11,4-66,9 cm³). O volume da placenta (VP) se mostrou altamente correlacionado com a idade gestacional (IG), sendo o melhor ajuste com a regressão exponencial [VP = exp(0,582 × IG + 0,063); R² = 0,82]. CONCLUSÃO: Valores de referência para o volume da placenta no primeiro trimestre de gestação utilizando o método XI VOCAL foram determinados.
OBJECTIVE: To determine reference values for placental volume at 7 to 10 + 6 weeks of gestation by means of three-dimensional ultrasonography with the XI VOCAL (eXtended Imaging Virtual Organ Computer-aided Analysis) method. MATERIALS AND METHODS: A cross-sectional study was developed with 70 pregnant women at 7 to 10 + 6 weeks of gestation. The XI VOCAL method with ten sequential adjacent planes was utilized in the volume calculations. Means, medians, standard deviation, minimum and maximum values for placental volume were calculated. A scatter plot adjusted by the determination coefficient (R²) was constructed to correlate placental volume and gestational age. RESULTS: Mean placental volume ranged from 4.6 cm³ (2.6-8.6 cm³) to 28.9 cm³ (11.4-66.9 cm³). The placental volume (PV) has shown to be highly correlated with the gestational age (GA) and the best fit equation was [PV = exp(0.582 × GA + 0.063); R² = 0.82]. CONCLUSION: Reference values for placental volume in the first gestational trimester were determined with the XI VOCAL method.
Subject(s)
Humans , Female , Pregnancy , Young Adult , Gestational Age , Pregnancy Trimester, First , Placenta/anatomy & histology , Organ Size , Ultrasonography/methodsABSTRACT
Objective To investigate the prevMenee depression in pregnant women during the first trimester in Chengdu.Methods Women in pregnancy for less than 12% weeks were enrolled in this study.They were investigated about depression condition by fulling out the EPDS and the self-compiled related factor forms.Results The pmvulence of depression was 39.1% at the pregnancy during the first trimester.The prevalence of depressive symptoms was significantly higher in women with induced abortion more than 2 times than those less than 2 times,also higher in women with unexpected pregnancy than those planned pregnancy. Conclusions The depression emotional disorder in the pregnancy women during the fast trimester is high.The doctorand nurse should pay close attention to those women to reduce depression.
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OBJETIVO: Avaliar a correlação do volume da vesícula vitelínica aferida por meio da ultrassonografia tridimensional com a idade gestacional entre a 7ª e a 10ª semanas. MATERIAIS E MÉTODOS: Realizou-se um estudo do tipo corte transversal envolvendo 72 gestantes normais entre a 7ª e a 10ª semanas de gestação. Para o cálculo do volume da vesícula vitelínica, utilizou-se o método multiplanar com intervalo de 1,0 mm entre os planos. Para o volume da vesícula vitelínica foram determinadas médias, medianas, desvios-padrão e valores máximo e mínimo. Para avaliar a correlação entre o volume da vesícula vitelínica e a idade gestacional, foram criados modelos de regressão, sendo os ajustes realizados pelo coeficiente de determinação (R²). RESULTADOS: O volume da vesícula vitelínica (VV) mostrou-se fracamente correlacionado com a idade gestacional (IG), melhor representado pela regressão quadrática, representada pela equação: volume VV = 0,9757 - 0,2499 × IG + 0,0172 × IG² (R² = 0,234). O volume médio da vesícula vitelínica variou de 0,07 cm³ (0,02-0,11) a 0,20 cm³ (0,02-0,74) entre a 7ª e a 10ª semanas de gestação, com média de 0,11 cm³ (± 0,10 cm³). CONCLUSÃO: O volume da vesícula vitelínica correlacionou-se fracamente com a idade gestacional.
OBJECTIVE: To evaluate the correlation between the yolk sac volume measured by three-dimensional ultrasonography with gestational age at 7-10 weeks. MATERIALS AND METHODS: A cross-sectional study involving 72 healthy pregnant women at 7th-10th gestational weeks. The multiplanar method with 1.0 mm intervals was utilized. Regression models were constructed to analyze the correlation between yolk sac volume and gestational age, adjusted by the determination coefficient (R²). Mean, median, standard deviation, maximum and minimum values for yolk sac volume were calculated for each gestational age. RESULTS: A poor correlation was observed between yolk sac volume (YSV) and gestational age (GA). The quadratic regression was the model that best expressed this correlation: YSV = 0.9757 - 0.2499 × GA + 0.0172 × GA² (R² = 0.234). Mean yolk sac volume ranged from 0.07 cm³ (0.02-0.11) to 0.20 cm³ (0.02-0.74) between the 7th and 10th weeks (mean, 0.11 cm³, ± 0.10 cm³). CONCLUSION: There was a poor correlation between yolk sac volume and gestational age.
Subject(s)
Humans , Female , Pregnancy , Gestational Age , Organ Size , Pregnancy Trimester, First , Pregnant Women , Gestational Sac , Imaging, Three-Dimensional , Ultrasonography, PrenatalABSTRACT
Objetivos: determinar la utilidad diagnóstica y el poder de detección del índice de pulsatilidad anormal de las arterias uterinas durante el primer trimestre del embarazo en relación con la aparición de preeclampsia en una población de bajo riesgo. Metodología: estudio de cohorte prospectivo, en el cual se midió el índice de pulsatilidad de las arterias uterinas en 444 pacientes que asistieron a control prenatal normal entre las semanas 11 y 14 de gestación. Se evaluó de manera prospectiva la aparición de preeclampsia o hipertensión gestacional y preeclampsia severa y se determinaron las características operativas de esta prueba a diferentes puntos de corte. Resultados: en total, 30 pacientes presentaron preeclampsia o hipertensión gestacional (7,8%) y 6 desarrollaron preeclampsia severa (1,5%). El índice de pulsatilidad de las arterias uterinas durante el primer trimestre fue significativamente más alto en las mujeres que luego desarrollaron preeclampsia que en aquellas que no la presentaron (1,9 - 1,45, p=0,0001). Asimismo, este índice mostró un mejor desempeño para la detección de preeclampsia severa. Conclusión: el presente estudio demuestra que un Doppler anormal durante el primer trimestre se asocia de manera significativa con el desarrollo de preeclampsia. De este modo, esta prueba puede ser una herramienta útil para seleccionar a las mujeres que se beneficiarían de una vigilancia más estrecha durante el control prenatal.
Objectives: this prospective study was aimed at determining the diagnostic usefulness and detection power of the abnormal pulsatility index in the uterine arteries during the first trimester of pregnancy related to the appearance of preeclampsia in a low-risk population. Methodology: this was a prospective cohort study of the uterine artery pulsatility rate in 444 patients who attended normal prenatal checkups between 11 to 14 weeks of pregnancy. It prospectively assessed the onset of preeclampsia or gestational hypertension and severe preeclampsia. This tests operative characteristics were determined at different cut-off points. Results: thirty patients suffered from gestational preeclampsia or gestational hypertension (7.8%) and six patients developed severe preeclampsia (1.5%). Uterine artery pulsatility rate during the first trimester was significantly higher in women who later developed preeclampsia than those who did not suffer (1.9 - 1.45, p=0.0001). Uterine artery pulsatility rate presented a better function for determining severe preeclampsia. Conclusions: the present study demonstrated that an abnormal Doppler result during the first trimester of pregnancy was significantly associated with developing preeclampsia. This test may be a useful tool for selecting women who could benefit from closer attention during prenatal checkups.