ABSTRACT
Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal Intensive Care Unit (NICU), would be beneficial for appropriately stratifying pregnant women into a high-risk category. Our study evaluated whether biochemical and ultrasonographical markers universally used in first-trimester screenings for non-heritable chromosomal aberrations could serve this purpose. Methods: This study encompassed 1164 patients who underwent first-trimester screening, including patient history, ultrasound examinations, and biochemical tests for pregnancy-associated plasma protein-A (PAPP-A) and the free beta-HCG subunit (fbHCG), from January 2019 to December 2021. The research concentrated on the correlation between these prenatal test results and neonatal outcomes, particularly Apgar scores, umbilical blood pH levels, and the necessity for NICU admission. Results: In our cohort, neonates scoring lower than 8 on the Apgar scale at birth exhibited lower concentrations of PAPP-A in the first trimester, both in raw and normalized values (PAPP-A MoM 0.93 vs. 1.027, p = 0.032). We also observed a higher pulsatility index in the venous duct in the first trimester in full-term neonates born with <8 points on the Apgar scale. Additionally, newborns born with an umbilical blood pH < 7.2 had lower normalized first-trimester PAPP-A concentrations (0.69 vs. 1.01 MoM, p = 0.04). We also noted that neonates requiring NICU hospitalization post-delivery had lower first-trimester bHCG concentrations (0.93 MoM vs. 1.11 MoM, p = 0.03). However, none of the correlations in our study translated into a robust prognostic ability for predicting dichotomous outcomes. All areas under the curve achieved a value < 0.7. Conclusions: Low concentrations of PAPP-A and free bHCG subunit in the first trimester may be associated with poorer clinical and biochemical conditions in neonates post-delivery. However, the relationship is weak and has limited predictive capability. Further research evaluating these relationships is necessary for the appropriate stratification of pregnant women into high-risk categories for neonatological complications.
ABSTRACT
OBJECTIVES: Pregnancy loss is associated with distress which can have a significant emotional impact on women and their spouses including a lower sexual quality of life and sexual dysfunction. The present study aimed to assess sexual quality of life and sexual function in women after fetal death. MATERIAL AND METHODS: A total of 110 women with a history of pregnancy loss hospitalized in the Clinic of Obstetrics and Gynecology were included. In order to evaluate the sexual quality of life and sexual functions the standardized questionnaires - the Sexual Quality of Life (SQoL-F) and Female Sexual Function Index (FSFI), respectively were used. RESULTS: Women declared a lower sexual quality of life. Most of them (52.73%) were at a risk of sexual dysfunction in the areas of desire (4.15 ± 1.21) and orgasm (3.82 ± 1.48). The older the age and length of the relationship was (p = 0.002; r = -0.298) the worse the sexual quality of life (p < 0.001) and sexual function were (p < 0.05). The sexual quality of life (p < 0.001) and sexual function in the area of desire (p = 0.001), arousal (p = 0.001) and orgasm (p < 0.001) were significantly better in the women who have experienced one pregnancy loss than in those with more than one pregnancy loss. Sexual function was better in women who did not plan to have a pregnancy. The week in which the pregnancy was lost and the fact of having other children have not been statistically significant. CONCLUSIONS: The sexual quality of life and female sexual function in women after an experience of fetal death were less satisfying.
Subject(s)
Abortion, Spontaneous , Sexual Dysfunction, Physiological , Pregnancy , Child , Female , Humans , Quality of Life/psychology , Sexual Behavior/psychology , Orgasm , Sexual Dysfunction, Physiological/psychology , Surveys and Questionnaires , Fetal DeathABSTRACT
Group B Streptococcus (GBS) is a gram-negative bacteria, which is the most frequent cause of invasive neonatal infection. About 10-30% of pregnant woman are carriers of GBS. GBS infection is transmitted to neonates from colonized vagina. Children of those mothers have 25 times higher risk of early onset neonatal sepsis then of those not colonized. Colonization can be transient, intermittent or persistent that is why ano-vaginal swabs are taken between 35 to 37 gestation week. This is a primary way of defining a risk of neonatal GBS infection. Before the labor additional risk factors are determined. According to those two data a decision is made about intravenous administration of efficient antibiotic dose at least 4 hours before delivery. Selection ofintrapartum chemoprophylaxis depends on mothers drug allergies or given GBS strain resistance profile. GBS-positive mother's neonates should be under proper observation. When abnormal symptoms are present a full diagnostic evaluation should be made, including blood tests, lumbar puncture, chest X-Ray and cultures. Empirical antimicrobial treatment against E. coli and GBS should be administered. Current data concerning Group B Streptococcus infection epidemiology, standards of diagnosis, prophylaxis and treatment are quoted in the article.
