Effect of Gravidity on Biochemical Parameters in Normotensive and Hypertensive 3rd Trimester Pregnant Women

Background: Pregnancy is a period in which a woman carries one or more foetus in her uterus. It is typically divided into three trimesters based on gestational age which is measured in weeks and months. Gravidity is referred to the number of times a woman has been pregnant. Pregnancy comes with several changes in metabolism, resulting to changes biochemical markers in pregnant women, some of which to certain extent may pose health risks in those with existing health conditions such as high blood pressure. The study of these changes becomes necessary to determine and arrest the risks should they exist during pregnancy. Aim: The study was aimed at evaluating the effects of gravidity on biochemical markers in normotensive and hypertensive 3rd trimester pregnant women. Materials and Methods: At Rivers State University Teaching Hospital, a cross-sectional study was conducted on 100 women. The consenting patients who met the inclusion criteria were randomly assigned to one of two groups: normotensive (50 normotensive pregnant women at their third trimester) or hypertensive (50 hypertensive pregnant women at their third trimester) (HPW2T). The subjects in each group were subsequently split into three categories depending on gravidity: primigravida (one pregnancy), multigravida (two or more), and grand multigravida (five or more). For the assessment of TC, TG, HDL, and LDL, fasting blood samples were taken using the venepuncture technique. AIP, CR-I, CR-II, AC, and APoB/APoA1) biochemical indices were computed quantitatively. At a p<0.05, the data were examined using ANOVA and the Tukey comparison test. Result: There was no significant difference in the mean levels of the biochemical parameters among the gravidity groups in the normotensive group except for LDL and APoB levels that was significantly higher, p<0.05. The hypertensive group had no significant difference in the mean levels of all studied parameters among the gravidity group, p>0.05.. Conclusion: In this study conducted at Rivers State University Teaching Hospital, gravidity had no impact on most biochemical markers in normotensive and hypertensive pregnant women at their third trimester.

Effect of Gravidity on Cardiovascular Markers in Normotensive Pregnant Women

Gravidity, or the number of pregnancies a woman has had, is linked to a number of biochemical alterations, including changes in cardiovascular parameters. These modifications may increase the likelihood of cardiovascular disease in this population. The aim of this research was to evaluate the effect gravidity has on some cardiovascular markers among normotensive pregnant women. A cross-sectional study of 100 women of reproductive age was carried out at Rivers State University and Rivers State University Teaching Hospital, the subjects were chosen at random for the study. Blood samples were taken and tested for total cholesterol, triglycerides, high density lipoprotein, uric acid, and Apolipoprotein A1 and B. Apolipoprotein A1 and B were all measured in blood samples for biochemical analysis. The levels of low density lipoprotein and very low density lipoprotein were determined. Graph Pad Prism Version 8.0.2.263 was used to analyze the data from the study. Result gotten from the study showed that Gravidity had no significant effect on biochemical parameters (TC, TG, UA, LDL, Apo A1, Apo B, CRP, and VLDL) in pregnant women (P>0.05), but there was a significant increase (P<0.05) in HDL levels among the group; 0.87 ± 0.21 (1-2), 0.93 ± 0.21 (3-4), 0.86 ± 0.12(5-6) and 1.30 ± 0.00 for (7-8). The effect of gravidity (1-2, 3-4, 5-6, 7-8) on HDL was shown to be significant for ANOVA and Turkey post hoc multiple comparison test; (1-2 vs 7-8) (P= 0.0204) and (5-6 vs 7-8) (P= 0.0250).. This study demonstrated that gravidity had little or no effect on the biochemical parameters but increases the HDL cholesterol level in normotensive pregnant women.

The real impact of the coronavirus disease 2019 (covid-19) on the pregnancy outcome / O impacto real da doença do coronavirus 2019 (covid-19) no desfecho da gestação

Abstract The COVID-19 outbreak is increasing around the world in the number of cases, deaths, and affected countries. Currently, the knowledge regarding the clinical impact of COVID-19 on maternal, fetal, and placental aspects of pregnancy is minimal. Although the elderly and men were the most affected population, in previous situations, such as the 2009 H1N1 influenza pandemic and the Ebola epidemic, pregnant women were more likely to develop complications than nonpregnant women. There are unanswered questions specific to pregnant women, such as whether pregnant women are more severely affected and whether intrauterine transmission occurs. Additional information is needed to inform key decisions, such as whether pregnant health care workers should receive special consideration, whether to separate infected mothers and their new borns, and whether it is safe for infected women to breastfeed.

Resumo A COVID-19 está se disseminando em todo o mundo, expandindo o número de casos, mortes e países afetados. Atualmente, o conhecimento sobre o impacto da COVID-19 nos desfechos materno, fetal e placentário da gravidez é mínimo. A despeito de serem os homens e idosos a população mais afetada em situações anteriores, como a pandemia de influenza H1N1 de 2009 e a epidemia de Ebola, as gestantes foram mais propensas a desenvolver complicações do que as mulheres não grávidas. Em relação à gravidez, existem questões específicas a serem respondidas, tais como se as mulheres grávidas são mais gravemente afetadas e se ocorre transmissão intrauterina. São necessárias informações adicionais para embasar a tomada de decisões, tais como; se as profissionais de saúde grávidas devem receber atenção especial, se é necessário separar as mães infectadas dos seus recém-nascidos e se é seguro que as puérperas infectadas amamentem.

A healthy neonate born at the third pregnancy of a woman with ornithine carbamoyltransferase deficiency under multidisciplinary management / 中华围产医学杂志

We reported a women with omithine carbamoyltransferase deficiency who delivered a healthy boy after two pregnancies with adverse outcome with the help of a multidiscipline team.The woman was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine with an acute prenatal hyperammonemic episode at 28 gestational weeks of her first pregnancy in 2013 and was diagnosed with ornithine transcarbamylase deficiency.Her hyperammonemic complications were controlled under a well-planned multidisciplinary management including a low-protein diet and appropriate medications assisting nitrogen removal.A boy was delivered by cesarean section at 32 weeks of gestation but died three days later.Mutation analysis revealed a hemizygous c.583G＞A (G195R) mutation in the neonatal omithine carbamyltransferase gene and his mother was a heterozygous carrier with the same mutation.Two years later in 2015,the patient was pregnant spontaneously.However,she received an induced abortion at 21 weeks of gestation because amniocentesis and DNA analysis showed that the male fetus had the same omithine transcarbamylase gene mutation.The index pregnancy was assisted by in vitro fertilization-embryo transfer and preimplantation genetic diagnosis in 2017 and the woman delivered a healthy boy with the management ofa multidisciplinary team.

Determinants of anemia among pregnant women: A hospital based cross sectional study

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.

Comparison on gravidity of post-operative patients between uterine fibroid ablation of high intensity focused ultrasound and laparoscopic myomectomy / 中国医学装备

Objective: To compare the effects between uterine fibroid ablation of high intensity focused ultrasound (HIFU) and laparoscopic myomectomy for gravidity of postoperative patients. Methods: 120 patients with uterine fibroid were divided into ultrasound ablation group (60 cases) and laparoscopy group (60 cases) as random number table. And the patients of ultrasound ablation group were treated by using HIFU and the patients of laparoscopy group received the treatment of laparoscopic myomectomy. The operative situation, curative effect and post-operative situation of gravidity of the two groups were compared and researched. Results: The effective rate of laparoscopy group was significantly higher than that of ultrasound ablation group (x2=3.56, P<0.05), while operation time, bleeding volume and postoperative recovery time of laparoscopy group were significantly higher than that of ultrasound ablation group, respectively (t=1.560, t=1.975, t=1.896, P<0.05). On the other hand, the postoperative gravidity rate of ultrasound ablation group was significantly higher than that of laparoscopy group (x2=3.65, P<0.05). Conclusion:Although the effective rate of HIFU for ablation of uterine fibroids is lower than that of laparoscopic myomectomy, its recovery time is shorter and its postoperative gravidity rate is higher than that of laparoscopic myomectomy. Therefore, it has popularized worthy in clinical practice.

Continued Compliance and Degree of Satisfaction in Nulligravida and Parous Women with Intrauterine Contraceptive Devices / Adesão e grau de satisfação em nuligestas e mulheres com parto anterior usuárias de dispositivo intrauterino

Purpose To evaluate the compliance and degree of satisfaction of nulligravida (has not given birth) and parous (had already given birth) women who are using intrauterine devices (IUDs). Methods A cross-sectional cohort study was conducted comparing nulligravida and parous women who had had an IUD inserted between July 2009 and November 2011. A total of 84 nulligravida women and 73 parous women were included. Interviews were conducted with women who agreed to participate through telephone contact. Statistical analysis was performed with Student s t-test and Mann-Whitney test for numeric variables; Pearson s chi-square test to test associations; and, whenever pertinent, Fisher s exact test for categorical variables. A survival curve was constructed to estimate the likelihood of each woman continuing the use of the IUD. A significance level of 5% was established. Results When compared with parous women, nulligravida women had a higher education level (median: 12 vs. 10 years). No statistically significant differences were found between the nulligravida and parous women with respect to information on the use of the IUD, prior use of other contraceptive methods, the reason for having chosen the IUD as the current contraceptive method, reasons for discontinuing the use and adverse effects, compliance, and degree of satisfaction. The two groups did not show any difference in terms of continued use of the IUD (p = 0.4). Conclusion There was no difference in compliance or the degree of satisfaction or continued use of IUDs between nulligravida and parous women, suggesting that IUD use may be recommended for women who have never been pregnant.

Objetivo Avaliar a adesão e o grau de satisfação de nuligestas emulheres com partos anteriores usuárias do dispositivo intrauterino (DIU). Métodos Realizamos um estudo de corte transversal comparando-se um grupo de nuligestas commulheres com partos anteriores que tinham sido submetidas à inserção do DIU no período de julho de 2009 a novembro de 2011. Foram incluídas 84 nuligestas e 73mulheres compartos anteriores. Uma entrevista foi realizada comas mulheres que concordaram em participar por meio de contato telefônico. Para se verificar as diferenças entre os dois grupos foram utilizados os testes t de Student e Mann- Whitney para as variáveis numéricas, e os testes qui-quadrado de associação e exato de Fisher, quando pertinente, para as variáveis categóricas. Realizou-se análise de sobrevivência de Kaplan-Meyer para continuidade do uso do DIU. Adotou-se o nível de significância de 5%. Resultados As nuligestas apresentaram escolaridade (mediana: 12 anos) superior às mulheres com um ou mais partos anteriores (mediana: 10 anos). Não houve diferença entre as nuligestas e mulheres comparto anterior em relação à informação sobre o uso do dispositivo intrauterino (DIU), uso prévio de outrosmétodos contraceptivos,motivo da escolha do DIU como método contraceptivo atual, motivos para descontinuidade, efeitos colaterais, adesão e grau de satisfação. A continuidade do uso do dispositivo intrauterino foi diminuída como passar do tempo emambos os grupos e sem diferença significativa (p = 0,4). Conclusão A adesão, o grau de satisfação e a continuidade do uso do DIU entre as nuligestas e mulheres com parto anterior são semelhantes, sugerindo que o DIU pode ser recomendado para mulheres que nunca engravidaram.

Analysis of pregnancy outcome in patients with cervical cancer after cervical cold knife conization / 中国基层医药

Objective To explore the effect of pregnancy outcome with cervical cold knife conization in pa -tients with early stage cervical cancer .Methods 23 patients with cold knife conization and 21 patients with radical trachelectomy were collected .The pregnancy outcome and perinatal infants between the two groups were compared . Results The pregnancy rate was 82.6%in the observation group,71.4%in the control group,there was statistically significant difference(χ2 =8.654,P=0.002);the section rate was 37.5% in the observation group,30.8% in the control group,there was statistically significant difference (χ2 =9.645, P =0.000 );10 cases of term delivery (62.5%)and birth weight was(3.27 ±1.15)in the observation group,term delivery(69.2%)and birth weight was (2.81 ±0.96)in the control group,proportion and birth weight were statistically significant differences (χ2 =11.671, P=0.000)(t =9.683,P=0.000);there were statistical significance in the outcome of pregnancy (Fisher P=0.036)and perinatal infants(Fisher P=0.034)among patients with different cervical conization height;the relapse rate was 4.4% in observation group,9.5% in the control group,the relapse rate of the two groups had significant difference(Fisher P =0.039).Conclusion Compared with radical trachelectomy ,patients treated by cold knife conization has high pregnancy rate and high cesarean section rate ,which can influence the outcome of pregnancy and perinatal infants .

Relationship between the antigenic titer of anti-A(B) IgG in pregnant women and the incidence of hyperbilirubinemia in newborns / 中国小儿急救医学

Objective To study the relationship between the antigenic titer of anti-A(B) IgG in pregnant women with blood-type O and the incidence of hyperbilirubinemia in newborns with blood-type A or B.Methods The antigenic titer of anti-A(B) IgG were determined in pregnant women with blood-type O whose blood type were incompatible with their mates'.Serological tests for the umbilical blood were analyzed in the neonates with blood-type A or B.The incidence and the pathogenic time of hyperbilirubinemia in newborns were studied by gravidity and test results.Results (1) There was no significant difference in the antigenic titer of anti-A(B) IgG,test results of umbilical blood and the incidence of hyperbilirubinemia between the first and the second pregnancy (P>0.05).(2) With the antigenic titer of anti-A(B) IgG increased,there was significant difference in the positive rate of antibody releasing test to newborns,positive rate of free antibody and the incidence of hyperbilirubinemia (P<0.01).(3) The incidence of hyperbilirubinemia in neonates whose results of antibody releasing test were positive and the antigenic titer of anti-A(B) IgG≤1∶64 were much higher than control group(P<0.01).(4)There was no significant difference in the incidence of hyperbilirubinemia in 3 days after birth (P>0.05).Conclusion The gravidity is not correlative with the antigenic titer of anti-A(B) IgG and the incidence of hyperbilirubinemia in neonates.The risk of hyperbilirubinemia in neonates increases as the antigenic titer of anti-A(B) IgG in gravida ≥1∶32.The incidence of hyperbilirubinemia in neonates become higher as the antigenic titer of anti-A(B) IgG in their mother increasing,however,it has no influence on the onset time of hyperbilirubinemia in newborns.