ABSTRACT
@#Objective To investigate the association between physical activity and glucose metabolism during the second trimester of pregnancy． Methods A cross－sectional study was conducted from March 2017 to November 2018． 1 083 pregnant women at 20－28 weeks of gestation in Guangzhou，China were recruited into this study． A standardized questionnaire was used to collect demographics and lifestyles． Physical activity was assessed by the international physical activity questionnaire． The participants underwent an oral glucose tolerance test． Multiple linear regression was used to analyze the association between physical activity and blood glucose． Logistic regression analysis model was used to analyze the association between physical activity and gestational diabetes mellitus(GDM) ． Results Only 36. 57% of pregnant women met the recommended level of total physical activity． There was a negative correlation ( β= －0. 104， P= 0. 017) between total physical activity and postprandial 2 h blood glucose． Results from different types of physical activities showed that the recreation，sport，and leisure－time physical activity were negatively associated with postprandial 1 h blood glucose ( β = －0. 114，P = 0. 042) ． No significant association was found between either various types of physical activities or sedentary time and GDM． Conclusions Physical activity during mid－pregnancy is inadequate in pregnant women in Guangzhou，China． Higher total physical activity and recreation，sport，and leisure－time physical activity in the second trimester of pregnancy are associated with lower postprandial blood glucose.
ABSTRACT
Introducción: la hemorragia obstétrica es la segunda causa más frecuente de mortalidad materna en el Ecuador, a pesar de ello, es un tema que se ha estudiado poco a nivel provincial y nacional. Objetivo: determinar la ocurrencia e identificar los factores de riesgo, manifestaciones clínicas y comorbilidades más frecuentes de la hemorragia de la segunda mital del embarazo. Métodos: estudio descriptivo, transversal, donde se analizaron las historias clínicas de las pacientes obstétricas con hemorragia de la segunda mitad del embarazo atendidas en el Hospital Provincial General Docente Riobamba (HPGDR) entre junio 2017 y junio 2018. Resultados: de un total de 3 460 pacientes obstétricas atendidas, 0.49% (n = 17) cumplieron los criterios de hemorragia en la segunda mital del embarazo, las cuales tuvieron una edad media de 29 años (desviación estándar = 7), una edad gestacional media de 36 semanas (desviación estándar = 5) y en su mayoría fueron multíparas. El desprendimiento de placenta normoinserta fue la principal patología causante de la hemorragia y el dolor abdominal el principal síntoma manifestado, en la mayoría no se observó otras comorbilidades obstétricas. Conclusión: se observó una baja ocurrencia de hemorragia de la segunda mitad del embarazo en el HGDR entre junio 2017 y junio 2018, siendo la causa más frecuente el desprendimiento de placenta normoinserta y el principal mitivo de consulta dolor abdominal.
Introduction: obstetric hemorrhage is the second most frequent cause of maternal mortality in Ecuador. Nevertheless, the topic has been little studied at a local and national level. Objective: to determine the ocurrence and identify the most frequent risk factors, clinical manifestations and comorbilities in antepartum hemorrhage. Methods: it is a descriptive, cross-sectional study, in which clinical histories of obstetric patients with hemorrhage of the second half of pregnancy were analyzed in the Hospital Provincial General Docente Riobamba (HGPDR) between June 2017 and June 2018. Results: from 3 460 obstetric patients attended, 0.49% (n = 17) met antepartum hemorrhage criteria. Women were in average 29 years old (standard deviation = 7), had an average gestational age of 36 weeks (standard deviation = 5) and were multiparous. Detachment of normoinserta placenta was the main cause of bleeding, abdominal pain was the most frequent symptom reported and in the majority of cases no obstetric comorbilities were observed. Conclusions: it was observed a low ocurrence of hemorrhage of the second half of pregnancy in the HGDR between June 2017 and June 2018. The mots common cause of the patology was detachment of normoinserta placenta and the most frequent complain reported was abdominal pain.
Subject(s)
Humans , Female , Pregnancy , Adult , Middle Aged , Pregnancy Trimester, Second , Uterine Hemorrhage , Risk Factors , Pregnancy Trimester, Third , Signs and Symptoms , Maternal Mortality , EcuadorABSTRACT
OBJECTIVE: To analyse the clinical value of uterine artery embolization(UAE)in the treatment of caesarean scar pregnancy(CSP)in the second trimester of pregnancy.METHODS: The clinical data of 29 cases treated from January2013 to June 2018 in Shengjing Hospital of China Medical University was retrospective analyzed.The patients were divided into group A(14 cases)and group B(15 cases)according to the first hospital. visitedPatients in group A first visited basic local hospitals and underwent drug-induced labor.Due to a large amount of vaginal bleeding or failure of induced labor,they were transferred to our hospital for further treatment. Patients in group B first visited our hospital and were treated by UAE before induced labor. The therapeutic effect was compared between the two groups.RESULTS: There was no statistical difference between the two groups in age,gestational weeks,number of caesarean section,period of time from previous caesarean section,or number of previous induced abortions(P>0.05).The average operation time of group B was shorter than that of group A[(54.00±31.19)min vs.(105.07±67.92)min,P<0.05]. The average intraoperative bleeding of group B was less than that of group A[(73.33±24.57)mL vs.(869.29±276.99)mL,P<0.05].Postoperative vaginal bleeding time of group B was shorter than that of group A[(4.46±1.06)d vs.(6.79±2.08)d,P<0.05].Average hospitalization time of group B was shorter than that of group A[(8.80±1.74)d vs.(14.57±4.54)d,P<0.05].The transfusion rate of group B was lower than that of group A[0 vs.78.6%,P<0.05].The uterine retention rate of group B was higher than group A[100% vs.71.4%,P<0.05].CONCLUSION: UAE has significant clinical value in the treatment of CSP in the second trimester of pregnancy.It can reduce operation time,intraoperative bleeding volume and increase uterine retention rate.
ABSTRACT
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.