Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Arch Gynecol Obstet ; 2023 Jul 12.
Article in English | MEDLINE | ID: mdl-37436461

ABSTRACT

PURPOSE: This study aimed to   investigate hematological and cardiac changes after early (ECC) versus delayed cord clamping (DCC) in preterm infants at 24-34 weeks of gestation. METHODS: Ninety-six healthy pregnant women were assigned randomly to the ECC (< 10 s postpartum, n = 49) or DCC (45-60 s postpartum, n = 47). Primary endpoint was evaluation of neonatal hemoglobin, hematocrit and bilirrubin levels within the first 7 days after birth. A postpartum blood test was performed in the mother and a neonatal echocardiography in the first week of life. RESULTS: We found differences in hematological parameters during the first week of life. On admission, the DCC group had higher hemoglobin levels than the ECC group (18.7 ± 3.0 vs. 16.8 ± 2.4, p < 0.0014) and higher hematocrit values (53.9 ± 8.0 vs. 48.8 ± 6.4, p < 0.0011). Around day 7 of life, hemoglobin levels were also higher in the DCC group compared with the ECC group (16.4 ± 3.8 vs 13.9 ± 2.5, p < 0.005), as was the hematocrit (49.3 ± 12.7 vs 41.2 ± 8.4, p < 0.0087). The need of transfusion was lower in the DCC compared to the ECC (8.5% vs 24.5%; OR: 0.29, 95% CI: 0.09-0.97, p < 0.036). The need for phototherapy was also higher in the DCC (80.9% vs 63.3%; OR: 0.23, 95% CI: 0.06-0.84, p < 0.026). No differences in cardiac parameters or maternal blood tests. CONCLUSION: DCC improved neonatal hematological parameters. No changes in cardiac function were found and maternal blood loss did not increase to require transfusion.

2.
Fetal Diagn Ther ; 47(8): 615-623, 2020.
Article in English | MEDLINE | ID: mdl-32069451

ABSTRACT

OBJECTIVE: To determine the contribution of short femur diaphysis length (FDL) at 19-22 weeks of gestation in the prediction of adverse pregnancy outcomes. METHODS: The study included singleton pregnant women who underwent a routine anomaly scan at 19-22 weeks of gestation at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between August 2011 and August 2012. Fetal biometry and Doppler ultrasound of uterine arteries were assessed as part of the anomaly scan, and the mean pulsatility index of both uterine arteries was recorded. Maternal obstetric characteristics, such as ethnicity, age, weight, parity, cigarette smoking, and medical history including hypertension and diabetes mellitus were collected from our database system. RESULTS: A total of 6,366 women were included in the study after excluding cases with abnormal karyotype, major fetal abnormalities, or termination of pregnancy. There were 88 cases of preeclampsia (PE) (1.4%). Logistic regression was performed including maternal and fetal characteristics. Short FDL at 19-22 weeks was significantly associated with subsequent development of PE (OR = 0.89, 95% CI: 0.80-0.99, p = 0.025). The best model to predict PE from our sample included gestational age at scan, parity, maternal weight, chronic hypertension, mean pulsatility index in the uterine arteries, and FDL (AUC = 0.78, 95% CI: 0.71-0.84). Regarding small for gestational age (SGA) neonates, there were also significant differences in FDL and FDL <5th centile between the control group and SGA newborns below the 3rd, 5th, and 10th centile. In the groups of preterm births (delivery before 32, 34, and 37 weeks), there were no differences in FDL compared with the control group (term births). DISCUSSION: Our results suggest that FDL at 19-22 weeks of gestation is an independent predictor of PE and SGA newborns.


Subject(s)
Femur/diagnostic imaging , Pre-Eclampsia/diagnostic imaging , Pregnancy Trimester, Second , Adult , Biometry/methods , Female , Gestational Age , Humans , Infant, Newborn , Infant, Small for Gestational Age , Pregnancy , Pregnancy Outcome , Ultrasonography, Prenatal , Young Adult
3.
J Matern Fetal Neonatal Med ; 31(24): 3314-3319, 2018 12.
Article in English | MEDLINE | ID: mdl-28835144

ABSTRACT

PURPOSE: The purpose of this study is to investigate the potential role of the mean external iliac artery pulsatility index (EIA-PI) as a predictor of adverse obstetric outcomes such as preeclampsia, gestational hypertension and small for gestational age (SGA). METHODS: In women attending for first trimester screening at 11 + 0-13 + 6 weeks of gestation, we recorded maternal characteristics and measured EIA mean PI and uterine artery mean PI. We compared EIA mean PI in those that developed preeclampsia (n = 84), gestational hypertension (n = 50) or small for gestational age (n = 444) with those unaffected (n = 3736). Regression analysis was used to first determine which of the factors among the maternal variables were significant predictors of EIA mean PI in the unaffected group and, second, to predict adverse pregnancy outcomes. RESULTS: In the unaffected group, EIA mean PI increased with maternal age and decreased with mean blood pressure. Additionally, EIA mean PI was lower in cigarette smokers. Compared with the unaffected group, EIA mean PI was significantly lower in women who develop gestational hypertension or SGA below third centile. CONCLUSION: EIA mean PI in the first trimester is decreased in women who develop gestational hypertension and in those complicated by SGA below third centile. More studies are needed to confirm these findings.


Subject(s)
Hypertension, Pregnancy-Induced/diagnostic imaging , Iliac Artery/diagnostic imaging , Pre-Eclampsia/diagnostic imaging , Adolescent , Adult , Case-Control Studies , Female , Humans , Infant, Newborn , Infant, Small for Gestational Age , Middle Aged , Pregnancy , Pregnancy Outcome , Ultrasonography, Prenatal , Young Adult
4.
Eur J Obstet Gynecol Reprod Biol ; 207: 153-156, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27863273

ABSTRACT

OBJECTIVE: To compare the time in the third stage of labour, differences in maternal hematologic parameters 48h after birth and acid-base status in the umbilical cord between the early cord clamping (ECC) and delayed cord clamping (DCC). STUDY DESIGN: 97 healthy pregnancies at term and a spontaneous vertex delivery at Clinic University Hospital "Virgen de la Arrixaca" (Murcia, Spain), were randomized to ECC group (<10s post-delivery) or to DCC group (2min post-delivery). Duration of the third stage of labour was measured. Samples for acid-base status were taken both from the umbilical artery and vein. Blood samples were taken from the mothers 48h after birth. RESULTS: No statistical differences were found in the time of the third stage of labour (p=0.35). No statiscally significant differences were found between the number of red cells (p=0.25), hemoglobin (p=0.08) or hematocrit (p=0.15) in mothers. Umbilical acid-base status or gas analysis did not show any differences between the two groups CONCLUSIONS: Delayed cord clamping does not affect significantly the time of the third stage of labour. It does not show either any effect on the hematological parameters in the mother 48h after birth.


Subject(s)
Acid-Base Imbalance/prevention & control , Fetal Distress/prevention & control , Labor Stage, Third , Umbilical Cord/surgery , Uterine Hemorrhage/prevention & control , Acid-Base Imbalance/blood , Acid-Base Imbalance/epidemiology , Acid-Base Imbalance/etiology , Adult , Erythrocyte Count , Female , Fetal Blood/chemistry , Fetal Distress/blood , Fetal Distress/epidemiology , Fetal Distress/etiology , Hematocrit , Hemoglobins/analysis , Hospitals, University , Humans , Infant, Newborn , Ligation , Male , Peripartum Period , Pregnancy , Risk , Spain/epidemiology , Term Birth , Time Factors , Uterine Hemorrhage/blood , Uterine Hemorrhage/epidemiology , Uterine Hemorrhage/etiology
5.
Fertil Steril ; 105(1): 134-43.e1-3, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26450530

ABSTRACT

OBJECTIVE: To evaluate the association between fetal and maternal catechol-O-methyltransferase (COMT) Val158Met and methyl tetrahydrofolate reductase (MTHFR) C677T functional polymorphisms and preeclampsia, examining its influence on placental COMT and in maternal 2-methoxyestradiol (2-ME) plasma levels. DESIGN: Prospective case-control study. SETTING: University hospital. PATIENT(S): A total of 53 preeclamptic and 72 normal pregnant women. INTERVENTION(S): Maternal and cord blood samples and placental tissue samples were obtained. MAIN OUTCOME MEASURE(S): Maternal and fetal COMT and MTHFR polymorphisms were genotyped. Maternal plasma 2-ME and homocysteine levels, and expression and activity of placental COMT were measured. RESULT(S): The odds ratio for the risk of preeclampsia for fetal COMT Met/Met was 3.22, and it increased to 8.65 when associated with fetal MTHFR TT. Placental COMT activity and expression were influenced by genotype, but COMT activity in preeclamptic placentas did not differ from control pregnancies. There was no association between any genotypes and maternal 2-ME. Homocysteine levels were higher in women with preeclampsia than in normal pregnancies, and were inversely correlated with 2-ME plasma levels, indicating that its altered metabolism may lower COMT activity in vivo. CONCLUSION(S): Fetal Met-Met COMT genotype reduces COMT placental expression and activity in vitro and increases preeclampsia, risk but it does not explain the difference in maternal 2-ME levels between preeclamptic and normal pregnancies. However, the preeclamptic patients had elevated homocysteine levels that correlated inversely with 2-ME, indicating that an altered methionine-homocysteine metabolism may contribute to reduce COMT activity in vivo and explain the decreased levels of 2-ME in preeclamptic women.


Subject(s)
Blood Pressure/genetics , Catechol O-Methyltransferase/genetics , Polymorphism, Single Nucleotide , Pre-Eclampsia/genetics , 2-Methoxyestradiol , Adult , Biomarkers/blood , Case-Control Studies , Catechol O-Methyltransferase/blood , Chi-Square Distribution , Estradiol/analogs & derivatives , Estradiol/blood , Female , Fetal Blood/enzymology , Gene Frequency , Genetic Association Studies , Genetic Predisposition to Disease , Haplotypes , Homocysteine/blood , Hospitals, University , Humans , Logistic Models , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Multivariate Analysis , Odds Ratio , Phenotype , Placenta/enzymology , Pre-Eclampsia/blood , Pre-Eclampsia/diagnosis , Pre-Eclampsia/enzymology , Pre-Eclampsia/physiopathology , Pregnancy , Prospective Studies , Risk Assessment , Risk Factors , Spain
6.
Prenat Diagn ; 35(3): 294-8, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25483940

ABSTRACT

OBJECTIVE: The objective of this study was to determine the contribution of uterine (UtA) and umbilical arteries (UA) Doppler examination at 28 weeks to predict adverse pregnancy outcomes in women who had increased resistance in UtA in the early second trimester. METHODS: Women with UtA mean pulsatility index (PI) above the 95th centile at 19-22 weeks of gestation were offered a growth scan including Doppler examination of UtA and UA at 28 weeks. Adverse pregnancy outcomes included small for gestational age (SGA), defined as birth weight below the tenth centile, preeclampsia (PE) and early-onset PE (PE before 34 weeks). RESULTS: We studied 266 pregnant women with elevated PI in the UtAs in the second trimester and ultrasound reassessment at 28 weeks. UtA PI >95th centile at 28 weeks was associated with subsequent PE [odds ratio (OR): 10.0, 95% CI: 2.3-43.5], early-onset PE (OR: 57.7, 95% CI: 3.8-87.6) and SGA less than the tenth centile (OR: 5.5, 2.2-13.9). UA PI >95th centile at 28 weeks was not significantly associated with any adverse outcome. CONCLUSIONS: In women with abnormal UtA Doppler in the early second trimester scan, persistence of elevated UtA PI, but not abnormal UA PI, is associated with adverse pregnancy outcomes including PE, early-onset PE and SGA. © 2014 John Wiley & Sons, Ltd.


Subject(s)
Pre-Eclampsia/epidemiology , Pregnancy Outcome/epidemiology , Umbilical Arteries/diagnostic imaging , Uterine Artery/diagnostic imaging , Vascular Resistance , Adult , Cohort Studies , Female , Humans , Infant, Newborn , Infant, Small for Gestational Age , Odds Ratio , Pregnancy , Pregnancy Trimester, Second , Pulsatile Flow , Retrospective Studies , Ultrasonography, Doppler , Ultrasonography, Prenatal , Uterine Artery/physiopathology
7.
Reprod Sci ; 22(2): 198-206, 2015 Feb.
Article in English | MEDLINE | ID: mdl-24899468

ABSTRACT

We investigated whether clinical severity indices and biomarkers for preeclampsia (PE) are associated with low plasmatic 2-methoxyestradiol (2ME) in the third trimester of gestation. Blood was collected from 53 women with PE and 73 control pregnant women before parturition. The concentration of 2ME was significantly higher in controls than in patients with PE (2906.43 ± 200.69 pg/mL vs 1818.41 ± 189.25 pg/mL). The risk of PE decreased as 2ME levels increased. The 2ME values were negatively correlated with systolic peak arterial pressure and proteinuria in PE. Additionally, those women with PE with lower 2ME had a more serious clinical situation and needed a more aggressive therapy. Finally, 2ME levels (in patients with PE and total population) were significantly correlated with concentrations of soluble fms-like tyrosine kinase 1 and placental growth factor . Summarizing, patients with PE had lower 2ME levels that were correlated with different clinical indices and biomarkers of severity, indicating that 2ME could be taken into account for the clinical management of this syndrome.


Subject(s)
Estradiol/analogs & derivatives , Pre-Eclampsia/blood , 2-Methoxyestradiol , Adult , Biomarkers/blood , Case-Control Studies , Down-Regulation , Estradiol/blood , Female , Humans , Placenta Growth Factor , Pre-Eclampsia/diagnosis , Pre-Eclampsia/therapy , Predictive Value of Tests , Pregnancy , Pregnancy Proteins/blood , Pregnancy Trimester, Third/blood , Prognosis , Prospective Studies , Severity of Illness Index , Vascular Endothelial Growth Factor Receptor-1/blood
SELECTION OF CITATIONS
SEARCH DETAIL
...