Assessment of the relationship between recurrent high-risk pregnancy and mothers' previous experience of having an infant admitted to a neonatal intensive care unit

High-risk pregnancies increase the risk of Intensive Care Unit [ICU] and Neonatal Intensive Care Unit [NICU] admission in mothers and their newborns. In this study, we aimed to identify the association between the recurrence of high-risk pregnancy and mothers' previous experience of having an infant admitted to NICU. We performed a cohort, retrospective study to compare subsequent pregnancy outcomes among 232 control subjects and 200 female cases with a previous experience of having a newborn requiring NICU admission due to intrauterine growth retardation, preeclampsia, preterm birth, premature rupture of membranes, and asphyxia. The information about the prevalence of subsequent high-risk pregnancies was gathered via phone calls. As the results indicated, heparin, progesterone, and aspirin were more frequently administered in the case group during subsequent pregnancies, compared to the control group [P<0.001]. Also, pregnancy-induced hypertension, preeclampsia, preterm labor, and gestational diabetes mellitus were more frequent in the case group, compared to the control group [P<0.05]. There was a positive correlation between recurrent high-risk pregnancy and previous experience of having a newborn requiring NICU admission. As the results indicated, mothers in the case group were at a higher risk for preeclampsia, preterm labor, and gestational diabetes mellitus, compared to the control group. Therefore, earlier diagnosis, prompt treatment, and prevention should be taken into account by physicians

Prediction of fetal anemia by different thresholds of MCA-PSV and delta-OD in first and second intrauterine transfusions

Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity [MCA-PSV] and amniotic fluid delta optical density [Delta-OD] with fetal hemoglobin [Hb] during first and second intrauterine transfusions [IUT]. We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin levels. From 27 fetuses, first time IUT MCA-PSV with a normal median value [MOM] cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was detected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5. Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT