Exposición a temperaturas extremas y su efecto en la gestación en un departamento de Colombia / Exposure to extreme temperatures and its effect on pregnancy in a department of Colombia

Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

Investigation of serum Metrnl levels in pregnant women with gestational diabetes mellitus: a prospective non-interventional cohort study

SUMMARY OBJECTIVE: The objective of this study was to investigate serum Metrnl levels in pregnant women with gestational diabetes mellitus and compare them with pregnant women without gestational diabetes mellitus. METHODS: The gestational diabetes mellitus group consisted of 87 pregnant women diagnosed with gestational diabetes mellitus, and the control group consisted of 93 healthy pregnant women without gestational diabetes mellitus. Serum Metrnl levels were determined by the enzyme-linked immunosorbent assay method. RESULTS: The two groups were similar in terms of demographic features. The median serum Metrnl level was found to be 1.16 ng/mL in the gestational diabetes mellitus group, while it was determined as 2.2 ng/mL in the control group (p=0.001). The two groups were divided into two subgroups based on participants' body mass index, normal weight and overweight. The lowest median Metrnl level was detected in the normal weight gestational diabetes mellitus group, followed by the overweight gestational diabetes mellitus group, normal weight control group, and overweight control group (1.1, 1.2, 2, and 2.4 ng/mL, respectively). Receiver operating curve analysis was performed to determine the value of the serum Metrnl level in terms of predicting gestational diabetes mellitus. The area under the curve analysis of serum Metrnl for gestational diabetes mellitus estimation was 0.768 (p=0.000, 95%CI 0.698-0.839). The optimal cutoff value for serum Metrnl level was determined as 1.53 ng/mL with 69% sensitivity and 70% specificity. CONCLUSION: Serum Metrnl levels in pregnant women with gestational diabetes mellitus were found to be significantly lower than in pregnant women without gestational diabetes mellitus. The mechanisms underlying the decrease in serum Metrnl levels in gestational diabetes mellitus remain unclear for now, and future studies will reveal the role of Metrnl in the pathophysiology of gestational diabetes mellitus.

Relationship of vitamin D deficiency and gestational diabetes mellitus in pregnant women

Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder among pregnant women. It is important to be diagnosed and treated early to minimize complications for both the mother and the foetus. Recent studies found that deficiency of vitamin D is a risk factor for GDM and its supplementation may be helpful in prevention of GDM. Objectives were to assess vitamin D status in pregnant women with or without GDM and to find out the association between vitamin D deficiency and GDM.Methods: A total of 400 patients were included in the study, 200 pregnant women diagnosed with GDM and 200 normoglycemic pregnant women. Serum 25 (OH) vitamin D concentration in these women were compared.Results: Only 6.75% of women were found to have normal vitamin D levels, all others having either insufficiency 18.5% or deficiency 74.75%. In case group around 79% of women had vitamin D deficiency, 70.5% in control group. In case group around 14.5% of women had vitamin D insufficiency, 22.5% in control group. In both case and control group around 6.5% and 7% of women were within the normal range respectively. Mean vitamin D is 14.3 ng/ml in case group and 15.4 ng/ml in control group.Conclusion: Prevalence of vitamin D deficiency is alarmingly high in pregnant women in India and has become a re-emerging public health issue and needs to be addressed.

Effect of obesity in pregnancy: implications for maternal and fetal health

Obesity during pregnancy poses noteworthy threats to maternal and fetal health. This investigation looks to probe maternal obesity抯 implications on pregnancy outcomes and neonatal health. This study employed a qualitative methodology utilizing secondary data analysis of recent literature to explore the associations between maternal obesity and pregnancy outcomes. Secondary data from 2017 to 2024 were gathered from peer-reviewed journals, databases, and reports published focusing on clinical characteristics and health parameters related to maternal obesity. Only studies providing detailed information on these factors were included. Clinical characteristics such as age distribution, gravidity, parity, and childhood obesity background significantly influenced pregnancy outcomes among obese women. A significant portion of the pregnant women with obesity, over half, were within the age range of 25-30 years, and a notable number had experienced obesity during their childhood. Additionally, obesity during pregnancy significantly impacted various health parameters compared to normal weight, including prepregnant BMI, maternal weight, and incidence of chronic conditions such as hypertension. Maternal obesity correlated strongly with adverse pregnancy outcomes, particularly preeclampsia and rectovaginal group B streptococcus infection. Similarly, adverse neonatal health outcomes were significantly associated with maternal obesity, including fetal macrosomia and neonatal intensive care unit (NICU) admission. Maternal obesity is linked with adverse pregnancy and neonatal outcomes, highlighting the prominence of managing maternal weight to boost maternal and fetal health. These discoveries underscore the necessity for targeted interventions and management strategies to mitigate the risks linked with obesity during pregnancy.

Association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from the 2010/2011 BRISA birth cohort

Abstract Objective: To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort. Method: This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data. Results: 723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05-7.57), stunting (OR 2.23; 95 % CI 1.07-4.65), and wasting (OR 8.22; 95 % CI 1.96-34.37). No relationship was found between LGA and placental efficiency. Conclusions: Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities.

A comparative study of cord blood lipid profile in term, pre term and small for gestational age - appropriate for gestational age neonates

Background: Cord blood lipid profile in neonates helps to screen for neonatal dyslipidaemia which is associated with long term morbidity mainly cardiovascular disease.Methods: The present study is a observational study done in government medical college, Chidambaram for a period of 2 years from October-2020 till September-2022 with 222 term and pre-term small or appropriate for gestational age (AGA) neonates using cord blood lipid profile.Results: In the present study of above mentioned 222 neonates, preterm accounts for 30.1% and term neonates accounts for 69.9%. AGA was 63.1% and SGA was 36.9%. Term AGA was 38.2%, term SGA 31.5%, preterm AGA was 24%, preterm SGA was 5.4%. Conclusions: Preterm AGA had higher cord lipid profile values compared to the term AGA neonates. Preterm SGA neonates had lower cord lipid profile of HDL, and LDL as compared to preterm AGA neonates. SGA neonates had higher total cholesterol, triglycerides and VLDL compared to AGA neonates. SGA neonates had lower LDL and HDL as compared to AGA neonates.

The impact of exercise on pregnancy: a comprehensive examination of benefits, risks, and considerations

Pregnancy represents a crucial developmental stage characterized by notable physiological transformations. The significance of maintaining an active lifestyle during this period is widely acknowledged as a crucial element of prenatal health, providing a multitude of advantages for the overall well-being of both the mother and the fetus. This article offers a comprehensive examination of the role of exercise during pregnancy, delving into the physiological adjustments, suggested recommendations, and the potential advantages and drawbacks. Physical activity during pregnancy has been shown to have positive effects on weight management, the prevention of gestational diabetes and hypertensive diseases, as well as the enhancement of mood, body image, and sleep quality. There is a positive impact on fetal health outcomes, including ideal birth weight and enhanced heart rate patterns. Nevertheless, some medical issues and complications during pregnancy may necessitate adjustments or contraindications to activity. Although the advantages of exercise are well recorded, numerous pregnant women encounter obstacles when it comes to engaging in physical activity. Healthcare practitioners assume a pivotal role in resolving these problems and facilitating the promotion of safe and effective exercise among expecting moms. Additional investigation is required to clarify the most beneficial exercise recommendations, ascertain efficacious intervention approaches, and advocate for exercise as an essential element of prenatal healthcare.

Presentación inusual de coriocarcinoma metastásico a hígado y pulmón: un reporte de caso / Unusual presentation of metastatic choriocarcinoma to liver and lung: a case report

La enfermedad trofoblástica gestacional (ETG) es un trastorno proliferativo del trofoblasto. Incluye la mola hidatidiforme, el coriocarcinoma, la mola invasiva, el tumor trofoblástico del lecho placentario y el tumor trofoblástico epitelioide. Las últimas cuatro hacen parte de la neoplasia trofoblástica gestacional, que agrupa menos del 1% de todos los tumores ginecológicos. La incidencia de la ETG puede variar, siendo aproximadamente de 1 a 3 de cada 1.000 embarazos en América del Norte y Europa. El coriocarcinoma es la forma más agresiva por su rápida invasión vascular y compromiso metastásico. Sin embargo, es un tumor muy quimiosensible con una alta tasa de respuestas y posibilidad de curación superior al 90%. Se presenta el caso de una paciente de 40 años quien ingresó al servicio de urgencias por disnea súbita secundaria a tromboembolia pulmonar y posteriormente tras el inicio de anticoagulación presentó hemoperitoneo debido a lesiones hepáticas metastásicas de un coriocarcinoma, además de compromiso metastásico pulmonar. Se presenta este caso por ser una patología poco frecuente, agresiva y con presentaciones inusuales, con el fin de mostrar la importancia de un diagnóstico y tratamiento oportuno.

Gestational trophoblastic disease (GTD) is a condition in which the trophoblast, a layer of cells surrounding the embryo, develops abnormally. GTD includes both pre-malignant and malignant pathologies, such as hydatidiform mole, choriocarcinoma, invasive mole, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Although GTD is rare, it affects about 1 to 3 out of every 1,000 pregnancies in North America and Europe. Choriocarcinoma is the most aggressive form of GTD, as it can quickly invade blood vessels and metastasize to other parts of the body. However, it is highly responsive to chemotherapy, with a cure rate of over 90%. In this case, a 40-year-old patient presented to the emergency department with sudden dyspnea due to pulmonary embolism. After starting anticoagulation therapy, she developed hemoperitoneum due to the spread of choriocarcinoma to her liver, as well as pulmonary metastases. This case is noteworthy because of its unusual presentation and aggressive nature, underscoring the importance of early diagnosis and treatment.

Caracterización de enfermedad trofoblástica gestacional en el Hospital de Talca, 2013-2022 / Characterization of gestational trophoblastic disease at Hospital de Talca, 2013-2022

Introducción: La enfermedad trofoblástica gestacional (ETG) corresponde al espectro de lesiones proliferativas del tejido trofoblástico placentario. Presenta una incidencia mundial variable; en Chile no existen estudios nacionales, por lo que las cifras se deben extrapolar de estudios extranjeros. Objetivo: Caracterizar clínica y epidemiológicamente a las pacientes diagnosticadas con embarazo molar en el periodo 2013-2022 en el Hospital Regional de Talca (HRT). Método: Estudio observacional transversal, se consideró el recuento total de pacientes de la base de datos del Servicio de Onco-Ginecología (n = 100) y la cantidad de embarazos ocurridos entre 2013-2022 en el HRT. Resultados: La edad promedio de presentación fue de 32 años, obteniéndose una incidencia de ETG de 2,1 casos por cada 1.000 embarazos. El 54% de los casos corresponde a mola parcial. Los principales síntomas fueron metrorragia (67%) y dolor abdominal (40%). El principal tratamiento efectuado fue aspiración uterina (92%). En el 48% de los casos se sospechó la ETG con la clínica previo al diagnóstico por biopsia y solo en un 13% únicamente con estudio ecográfico. Conclusiones: Es necesario realizar más investigaciones nacionales que permitan recopilar información actualizada sobre ETG, sobre todo por la variabilidad clínica de la enfermedad, que hace difícil su sospecha diagnóstica.

Introduction: Gestational trophoblastic disease (GTO) corresponds to the spectrum of proliferative lesions of placental trophoblastic tissue. It has a variable global incidence; in Chile there are no national studies so it must be extrapolated from foreign studies. Objective: To clinically and epidemiologically characterize patients diagnosed with molar pregnancy in the period 2013-2022, at the Talca Regional Hospital (HRT). Method: Cross-sectional observational study, the total count of patients from the Onco-Gynecology Service database (n = 100) and the number of pregnancies that occurred between 2013-2022 in the HRT were considered. Results: The average age of presentation was 32 years, obtaining an incidence of GTO of 2.1 cases per 1000 pregnancies; 54% of cases correspond to partial mole. The main symptoms were metrorrhagia (67%) and abdominal pain (40%). The main treatment performed was uterine aspiration (92%). In 48% of the cases, GTO was suspected with clinical symptoms prior to diagnosis by biopsy, and only 13% with an ultrasound study alone. Conclusions: It is necessary to carry out more national research to collect updated information on GTO, especially due to the clinical variability of the disease that makes its diagnostic suspicion difficult.

Factors associated with decreased respiratory pressures in high-risk pregnant women / Fatores associados à diminuição das pressões respiratória em gestantes de alto risco

Introduction: The gestational period brings anatomical and physiological changes to women in several systems, especially the respiratory system. Objective: To determine whether there is an association between gestational age (GA), Diabetes, uterine fundal height (UFH), Body Mass Index (BMI), level of dyspnea, and physical activity with maximum respiratory and nasal pressures. Methods: Cross-sectional study that included 55 high-risk pregnant women in the 2nd and 3rd trimester of pregnancy at the Obstetrics Outpatient Clinic of the Hospital das Clínicas in Recife ­ PE, Brazil, personal, sociodemographic, anthropometric, clinical and Maximal Inspiratory Pressure (MIP) data were described and nasal inspiratory pressure (NIP), that, using regression and multivariate analysis, analyzed the influence of risk factors for high-risk pregnancy with NIP considering a p<0.005. Results: Among the pregnant women, according to the clinical variables, it was observed that 56.4% (n=31) had a gestational age above 28 weeks, 27.3% (n=15) diabetes, 25.5% (n=14) asthma, 43.6% (n=24) Gestational Hypertension, 56.4% (n=31) obesity, 85.5% (n=47) complaints of dyspnea 38.1% (n=21) mild to severe dyspnea and 65.5% (n=36) vigorous physical activity. Low MIP (76.76 cmH2O) and NIP (68.62 cmH2O) values were found for age. An association was observed between an increase in UFH and a decrease of 0.8 cmH2O in NIP, regardless of gestational age. Conclusion: High-risk pregnant women in the second and third trimester of pregnancy have decreased NIP and MIP with a negative association of UFH with NIP regardless of gestational age.

Introdução: O período gestacional traz para a mulher alterações anatômicas e fisiológicas, em diversos sistemas, principalmente no sistema respiratório. Objetivo: Determinar se há associação da idade gestacional (IG), Diabetes, altura de fundo de útero (AFU), Índice de Massa Corpórea (IMC), nível de dispneia e atividade física com as pressões respiratória máxima e nasal. Método: Estudo transversal que incluiu 55 gestantes de alto risco no 2º e 3º trimestre de gestação do Ambulatório de Obstetrícia do Hospital das Clínicas de Recife ­ PE, foi descrito os dados pessoais, sociodemográficos, antropométricos, clínicos e das Pressão Inspiratória Máxima (PImáx) e pressão inspiratória nasal (PIN), que, por meio da regressão e da análise multivariada analisou a influência dos fatores de risco para gestação de alto risco com a PIN considerando um p<0,005. Resultados: Dentre as gestantes, segundo as variáveis clínicas, observou-se que 56,4% (n=31) apresentaram idade gestacional acima de 28 semanas, 27,3% (n=15) diabetes, 25,5% (n=14) asma, 43,6% (n=24) Hipertensão Arterial Sistêmica Gestacional (HASG), 56,4% (n=31) obesidade, 85,5% (n=47) queixas de dispneia 38,1% (n=21) dispneia de um pouco forte a forte e 65,5% (n=36) atividade física vigorosa. Foram encontrados valores baixos de PImáx (76,76 cmH2O) e PIN (68,62 cmH2O) para a idade. Foi observada uma associação do aumento da AFU com a diminuição de 0,8 cmH2O da PIN, independentemente da idade gestacional. Conclusão: As gestantes de alto risco no segundo e terceiro trimestre gestacional apresentam PIN e PImáx diminuídas com uma associação negativa da AFU com a PIN independentemente da idade gestacional.

Predicción de la valoración del recién nacido según el estado nutricional materno: modelo basado en árboles de decisión / Prediction of newborn assessment according to maternal nutritional status: a model based on decision trees

Objetivo: Determinar si es posible predecir la valoración del recién nacido según el estado nutricional materno a través de un modelo de árbol de decisión. Métodos: Estudio analítico transversal. Se revisaron 326 historias clínicas de gestantes de un hospital público peruano, 2021. Se valoró el recién nacido mediante el puntaje APGAR, edad gestacional al nacer, peso al nacer, peso y talla para la edad gestacional. El estado nutricional materno incluyó el índice de masa corporal pregestacional y la ganancia de peso gestacional. La predicción se realizó mediante un modelo de aprendizaje automático supervisado denominado "árbol de decisión". Resultados: No fue posible predecir mediante el estado nutricional materno, el puntaje APGAR al minuto y la talla para la edad gestacional. La probabilidad de tener edad gestacional a término al nacer es de 97,2 % cuando la ganancia de peso gestacional es > 5,4 Kg (p = 0,007). Las probabilidades más altas de peso adecuado al nacer fueron con ganancia de peso gestacional entre 4,5 Kg (p < 0,001) y 17 Kg (p < 0,001) y con índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,004). Finalmente, la mayor probabilidad de peso adecuado para la edad gestacional es cuando la ganancia de peso gestacional es ≤ 11,8 Kg (p < 0,001) y con un índice de masa corporal pregestacional ≤ 36,523 Kg/m2 (p = 0,005). Conclusiones: Es posible predecir la valoración del recién nacido a partir del estado nutricional materno mediante un aprendizaje automático(AU)

Objective: To determine whether it is possible to predict the assessment of the newborn according to maternal nutritional status through a decision tree model. Methods: Cross-sectional analytical study. A total of 326 medical records of pregnant women from a Peruvian public hospital were reviewed, in 2021. The newborn was assessed using the APGAR score, gestational age at birth, birth weight, weight and height for gestational age. Maternal nutritional status included pregestational body mass index and gestational weight gain. The prediction was made using a supervised machine learning model called a "decision tree." Results: The APGAR score at one minute and height for gestational age were not possible to predict by maternal nutritional status. The probability of having full-term gestational age at birth is 97.2% when gestational weight gain is > 5.4 kg (p = 0.007). The highest probabilities of adequate birth weight were with gestational weight gain between 4.5 kg (p < 0.001) and 17 kg (p < 0.001) and with pregestational body mass index ≤ 36.523 kg/m2 (p = 0.004). Finally, the highest probability of adequate weight for gestational age is when gestational weight gain is < 11.8 Kg (p < 0.001) and with a pregestational body mass index ≤ 36.523 Kg/m2 (p = 0.005). Conclusions: It is possible to predict the assessment of the newborn based on the mother's nutritional status using machine learning(AU)

Risk factor for premature rupture of membranes: a clinical study

Background: Premature rupture of membranes (PROM) is the rupture of the amniotic membrane before the onset of labour. Based on the time of occurrence, PROM can be divided into two, namely Premature Rupture of Membranes (PROM) and Preterm Premature Rupture of Membranes (PPROM). PROM occurs at or after 37 weeks gestation. PPROM, occurs before 37 weeks gestation. Methods: This study is a descriptive retrospective analytical observational study with cross sectional method. This research uses SPSS data processing. Data were taken from the medical records of inpatients in the maternity ward at Bima Hospital in the period January-December 2023. Results: The results of the analysis showed that there was a significant relationship in the maternal age factor of less than 20 years by 70.6%. Risk factors in the education sample were most prevalent in low education level at 62.7%. The risk factor of gestational age of the sample was mostly found in preterm gestation (less than 37 weeks) showing a significant relationship to the incidence of PROM by 66.6%. In the risk factor of parity most in primigravida is 66.6%. Conclusions: In this study there is a relationship of risk factors that affect the occurrence of premature rupture of membranes in the maternity ward of Bima Hospital, namely maternal age less than 20 years, low education level, with preterm gestational age or less than 37 weeks and primigravida parity.

Feto-maternal outcome of pregnancy with thrombocytopenia

Background: Thrombocytopenia is the second most haematological abnormality in pregnancy where the platelets count below 1,50,000/µl. Gestational thrombocytopenia is most common cause of thrombocytopenia, accounts for 70% of thrombocytopenia in pregnancy.Methods: It is retrospective study with 30 antenatal women at any gestational age having thrombocytopenia, platelet count less than 1,50,000/µl at SVP Hospital, Ahmedabad during duration of May 2023-November 2023. All the pregnant women who attend OPD and admitted in SVP Hospital, Ahmedabad were included in the study.Results: The present study found that gestational thrombocytopenia (53.34%) accounted for most common cause of thrombocytopenia, followed by hypertensive disorders (10.0%), HELLP syndrome (6.67%), dengue and malaria (6.67%), DIC (6.67%) and ITP (3.34%) in which 53.34% women has mild, 36.67% has moderate and 10% has severe thrombocytopenia. In this study vaginal delivery accounts for 33.34% and caesarean delivery accounts for 66.67%. In present study 50.0% patient of gestational thrombocytopenia didn’t required any treatment. About 6.67% patients required transfusion of PRC and 33.34% of neonates needed NICU admission. Neonatal mortality due to complications like prematurity, septicemia was seen in 10.0% of the cases.Conclusions: Outcome of pregnancy with moderate to severe thrombocytopenia depends mainly on the etiology of thrombocytopenia. Early interdisciplinary evaluation of thrombocytopenia during pregnancy can help in optimizing care as fetal outcomes and management depend on the etiology.

Efficacy of early versus late postpartum DIPSI test in gestational diabetes mellitus women for follow up

Background: The present study aimed to evaluate if postpartum gestational diabetes mellitus (GDM) screening can be performed during immediate post-delivery 72 hrs instead of six weeks postpartum for follow-up.Methods: Total 150 GDM patients were included. The sample size was calculated as 150 with Nimaster2.0 software. GDM patients are enrolled after meeting the exclusion criteria for the study. The GDM diagnosis was made by DIPSI test and treated as per guidelines. After delivery, the Dipsi test was done on PND-3 (PP1). Furthermore, all were kept on LSM irrespective of the glycaemic level DIPSI test was repeated in all Patients after 45 days (PP2).Results: All 150 patients had a DIPSI test on 3rd day post-partum (PP1) and repeat test at 45 days (PP2)., Of these, 60 patients (40%) showed negative DIPSI test on P1 and all remained in Group 1, with 63 patients having negative DIPSI test on PP2. 50 patients (33.3%) had blood glucose between 140-199 mg (Group 2) on PP1 and increased to 53 patients in PP2 in 45 days. 40 patients had diabetic (26.6%) value (Group 3) in PP1, and out of them 34 (22.6%) remained in group 3 in PP2 after 45 days post-partum.Conclusions: This pilot study shows that nearly 60% of the GDM patient have either IGT or diabetic value following delivery on 3rd day of PP1 and almost similar results in PP2. Hence, we can do the postpartum screening on the postpartum 3rd day and need not wait for 6 wks when more than 50% is lost for follow-up. This study shows among GDM 60% of them have underlying beta cell dysfunction.

Association of metabolic syndrome with gestational hypertension

Background: Metabolic syndrome is a group of clinical, metabolic and biochemical abnormalities with negative impact on global health. The aim of the study was to determine the association between metabolic syndrome and pregnancy induced hypertension, and incidence and effects of metabolic syndrome in pregnant patients.Methods: Prospective observational study, performed in the Department of Obstetrics and Gynecology, Holy Family Hospital, New Delhi. Antenatal women before 20 weeks of gestation were enrolled in the study. Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy to observe their progression into hypertensive disorders of pregnancy i.e. gestational hypertension, pre-eclampsia and eclampsia.Results: Out of 100 cases with metabolic syndrome 37% developed PIH, 21 developed pre-eclampsia and 14 developed gestational hypertension, 2 patients developed eclampsia as compared to controls in which only 10% developed PIH among which only 3% developed pre-eclampsia.Conclusions: Our study demonstrates a higher rate of complicated pregnancy with higher incidence of PIH in association with metabolic syndrome compared to control group. Each component of metabolic syndrome increases the probability of PIH. The addition of components of metabolic syndrome exacerbates this probability, especially the combination of increased BMI, increased blood sugar levels and increased triglycerides.

Incidencia de diabetes gestacional en Chile durante el periodo 2001-2022 / Incidence of gestational diabetes in Chile during the period 2001-2022

Introducción: La diabetes mellitus gestacional (DG) se define como una hiperglucemia que se diagnostica por primera vez durante la gestación. Objetivo: Describir la incidencia de diabetes gestacional (DG) durante el periodo 2001-2022 en Chile. Método: Estudio observacional, descriptivo, ecológico y longitudinal. Se incluyeron los egresos hospitalarios consignados como diabetes durante el embarazo y DG en el periodo 2001-2022, de la base de datos del Departamento de Estadística e Información en Salud. Se determinó la incidencia de DG por la cantidad de partos institucionalizados, para cada año. Se analizaron la tendencia en el periodo y las diferencias entre regiones. Resultados: Se determinó un aumento de 2,615 casos de DG por 1000 partos atendidos por año en el periodo 2001-2022. En particular, en el periodo 2016-2022 la incidencia aumentó hasta 6,746 casos de DG por 1000 partos por año. En el año 2022, la región de La Araucanía presentó una incidencia de 284,4 casos por 1000 partos, lo que representa un aumento del 503% en relación con la incidencia media nacional (56,5 casos por 1000 partos). Conclusiones: Se demuestra un aumento significativo de la DG, en especial desde 2016. La situación en La Araucanía podría relacionarse con los niveles de pobreza multidimensional.

Introduction: Gestational diabetes mellitus (GDM) is defined as hyperglycemia first diagnosed during pregnancy. Objetive: To describe the incidence of gestational diabetes (GD) during the period 2001-2022 in Chile. Method: Observational, descriptive, ecological, longitudinal study. Hospital records of diabetes during pregnancy and GD in the period 2001-2022 were included, from the database of the Department of Statistics and Health Information. The incidence of GD was determined by the number of births, for each year. Trends in the period and differences between regions were analysed. Results: The results show an increase of 2.615 GD cases per 1000 births per year in the period 2001-2022. Particularly, in the period 2016-2022 the incidence increased to 6.746 cases of GD per 1000 births per year. In 2022, La Araucanía region presented an incidence of 284.4 cases per 1000 births, which represents an increase of 503% in relation to the mean national incidence (56.5 cases per 1000 births). Conclusions: A significant increase in DG is demonstrated, especially since 2016. The situation in La Araucanía could be related to the levels of multidimensional poverty.

Intraventricular hemorrhage on mortality and neurological outcomes in premature infants

Background: Intraventricular hemorrhage (IVH) is the commonly encountered clinical event in preterm neonates which imposes significant morbidity and mortality. Although there is a rapid advancement in the neonatal care, IVH is the common cause of neonatal intensive care units admissions. The present study was carried out to evaluate the risk factors, mortality and neurological outcomes in preterm neonates with IVH.Methods: This was a prospective study conducted on 75 preterm neonates who were delivered before 37 weeks of gestation. The neonates were subjected to cranial ultrasound for the diagnosis of IVH and graded as per the severity. The neonatal and prenatal variables were recorded and analysed to find its association with IVH progression and mortality. Immediate neurological outcome was also assessed among the IVH preterm neonates. Results: In this study out of 75 preterm neonates, the prevalence of IVH was 18 (24%). The main neonatal factors for IVH are less gestational age at delivery, 28-31 weeks (p=0.001), birth weight <1500 gm (p=0.001), APGAR scores <5 at 1 and 5 minutes (p>0.05) and maternal factors associated with IVH is premature rupture of membranes (p=0.01). The mortality rate among the IVH preterm neonates was 7 (38.9%). The significant predictors of mortality were male gender (p=0.004), grade III and IV IVH (p=0.001) and birth weight (p=0.001). The main neurological outcomes observed were seizures and post-hemorrhagic ventricular dilatation.Conclusions: Increased severity of IVH, early gestational age and low birth weight were associated with mortality in preterm neonates with IVH.

Comparative study on the efficacy of mifepristone versus mifepristone and misoprostol in the induction of labor in cases of intrauterine fetal demise

Background: This study aimed to compare the efficacy of two labor induction methods, mifepristone alone and mifepristone followed by misoprostol, in cases of intrauterine fetal demise (IUFD) beyond 28 weeks of gestation.Methods: A prospective study was carried out at, BRD Medical College in Gorakhpur and aimed to investigate the efficacy of two different methods for labor induction in pregnancies with intrauterine fetal demise (IUFD) beyond 28 weeks of gestation during September 2019 to August 2020. Sixty participants were divided into two groups of 30 each, with mifepristone administered orally in both groups. Group 2 received additional vaginal misoprostol. Patient demographics, Bishop scores, induction to active labor intervals, and induction to delivery intervals were examined. Augmentation methods, side effects, complications, and time to full dilatation were analyzed.Results: The groups exhibited similar patient characteristics, including age, parity, socioeconomic status, and literacy rates. Gestational age at induction and Bishop scores were comparable. Both groups showed substantial improvements in Bishop scores. The induction to active labor interval was shorter in the mifepristone group, and the induction to delivery interval was similar. The mifepristone group required fewer mifepristone tablets, while the combination group used less misoprostol, reducing side effects. Complications were minimal, with a decreased need for augmentation methods in both groups.Conclusions: Mifepristone, whether used alone or followed by misoprostol, proved effective in labor induction for IUFD beyond 28 weeks. Mifepristone's ability to enhance cervical ripening and prostaglandin sensitivity makes it a promising option for reducing the risks associated with delayed birth in cases of IUFD. These findings suggest that mifepristone can be a valuable addition to obstetric practices, particularly in cases where traditional induction methods may pose greater risks.

Complicaciones del embarazo en pacientes con ganancia excesiva de peso gestacional en un hospital público peruano / Pregnancy complications in patients with excessive gestational weight gain in a Peruvian public hospital, 2022

Objetivo: Determinar las características demográficas y clínicas, de embarazadas con ganancia excesiva de peso gestacional y su relación con las complicaciones maternas. Métodos: Estudio analítico, retrospectivo. Se incluyeron gestantes a término, mayores de 18 años, con fetos únicos vivos, historia clínica legible y tarjeta de atención prenatal con primer y último control, atendidas en un hospital público del Perú, entre enero ­ junio 2022. Se excluyeron pacientes con problemas mentales, y/o con fetos con malformaciones. Las variables medidas fueron: características sociodemográficas, obstétricas, ganancia de peso gestacional y complicaciones maternas. El excedente de peso gestacional se definió con el índice de masa corporal pregestacional, diferencia de peso entre primer y último control prenatal, y las pautas del Instituto de Medicina. Se hizo un análisis descriptivo y para reconocer la relación entre la ganancia de peso gestacional y los resultados maternos, se utilizó X2. El Comité Institucional de Ética en Investigación de la Universidad Nacional de San Agustín otorgó la aprobación del estudio. Resultados: Se incluyeron 1021 gestantes en el estudio. De estas, el 49,0 % tuvo excesivo peso gestacional. 43,0 % de pacientes con peso excesivo tuvo complicaciones maternas. Se observó anemia en 7,9 % con ganancia de peso adecuada y en 4 % con excesiva ganancia de peso (p = 0,009), 0,2 % y 1,8 % de diabetes, respectivamente, (p = 0,009). Las otras complicaciones evaluadas no mostraron diferencias significativas entre los grupos. Conclusión: Las pacientes con excesiva ganancia de peso en la gestación tuvieron mayor probabilidad de padecer diabetes gestacional(AU)

Objective: TTo determine the demographic and clinical characteristics, of pregnant women with excessive gestational weight gain. And determine their relationship with maternal complications. Methods: Analytical, retrospective study. Full-term pregnant women, older than 18 years and with single live fetuses, with legible clinical history and prenatal care card with first and last check-up, treated at a public hospital in Peru between January - June 2022, were included. Patients with mental problems and those with fetuses with malformations, were excluded. The variables measured were: sociodemographic characteristics, obstetric, gestational weight gain, and maternal complications. Excess gestational weight was defined using pre-pregnancy body mass index, difference in weight between the first and last prenatal check-up, and Institute of Medicine guidelines. A descriptive analysis was made and to recognize the relationship between excessive gestational weight and maternal results, the X2 test was used. The National University of San Agustín Institutional Research Ethics Committee granted approval of the study. Results: We included 1021 pregnant women in the study. Of these, 49.0% had excessive gestational weight. 43.0% of overweight patients had maternal complications. A relationship was found between excessive weight gain in pregnancy and gestational diabetes. Conclusions: Patients with excessive weight gain in pregnancy were more likely to have gestational diabetes(AU)

Exploring the impact of early-term labor induction on cesarean section risk in gestational diabetes mellitus: insights from a tertiary care hospital study in Pakistan

Background: Gestational diabetes mellitus (GDM) is the most common endocrine disorder in pregnancy. It is associated with significant perinatal morbidity and mortality, therefore, an early-term delivery by routine induction of labor is proposed by some societies, to prevent/reduce these complications. Methods: This cross-sectional study was conducted between 1st January 2019 and 30th June 2020 at Aga Khan University Hospital, Pakistan to compare the pregnancy outcomes of patients with GDM when induced at 37, 38, and 39 weeks in comparison to women with GDM managed expectantly. The study included all women with singleton pregnancy and vertex presentation. Women induced after 41 weeks, previous cesarean delivery, placenta previa, major fetal anomalies, chronic maternal medical conditions that necessitate delivery, and those women presenting with spontaneous onset of labor were excluded. Data was analyzed in SPSS v.19. Results: A total of 293 women were included. The mean age of women was 27 years, and the mean BMI was 27.8 kg/m2. We found that women who were induced at earlier gestational weeks were managed with a combination of diet and pharmacological therapy in comparison to those induced at later gestational weeks and achieved glycemic control with diet and lifestyle modifications only. Around 77% of women required pharmacological therapy. The mode of delivery was not significantly different for women induced at different gestational weeks after 37 completed weeks. For neonatal outcomes, the birth weight was significantly greater for women induced at later gestational weeks. Conclusions: In women with gestational diabetes induced after 37 weeks at various gestational weeks, the mode of delivery is not significantly different.