RESUMEN
AIM: To compare the outcome of intracytoplasmic sperm injection (ICSI) pregnancies complicated by spontaneous loss of a dichorionic co-twin with that of singleton ICSI pregnancies. METHODS: The study group included dichorionic ICSI pregnancies with co-twin loss (n = 33) and the control group included ICSI pregnancies with a singleton from the beginning (n = 327). Primary outcome measures were obstetric complications, including preterm delivery, newborn small for gestational age, gestational diabetes, gestational hypertensive disorders and abruptio placenta; admission to neonatal intensive care unit (NICU) and perinatal mortality observed in the study and control groups. Statistical analysis was performed using spss for Windows, version 22.0. RESULTS: In the study group, there were 26 cases of first trimester (early) and 7 cases of second or third trimester (late) co-twin losses. Mean gestational age at delivery and mean birth weight were significantly lower in the whole study group compared to control (P < 0.05). Preterm delivery and NICU admission rates were significantly higher in the whole study group, compared to control (39.3% vs 14.6% and 36.36% vs 11.69% respectively, P < 0.05), but did not show significant difference between early loss subgroup and control (P > 0.05). Preterm delivery rate was significantly higher in the late loss subgroup compared to the early loss subgroup (85.71% vs 26.92% P < 0.05). CONCLUSION: Loss of a co-twin in dichorionic ICSI pregnancies is associated with increased risk of preterm birth. This risk is significantly higher in cases with late loss compared to the early loss cases.
Asunto(s)
Aborto Espontáneo , Resultado del Embarazo , Embarazo Gemelar , Inyecciones de Esperma Intracitoplasmáticas , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Edad Materna , Persona de Mediana Edad , Mortalidad Perinatal , Embarazo , Adulto JovenRESUMEN
A 39-year-old woman who became pregnant with twins after an intracytoplasmic sperm injection was referred at the ninth gestational week to determine chorionicity. Ultrasonographic examination showed a monochorionic diamniotic twin pregnancy. First trimester nuchal translucency measurements of the fetuses were 1.6 and 2.7 mm. A non-invasive prenatal test was performed and revealed low risk. One fetus appeared to be female and the other male at the 14th gestational week. Second trimester anatomic scanning results were otherwise normal for both fetuses. The newborns delivered at term appeared to be normal female and male babies phenotypically. At the fourth month, buccal cell analysis showed chimeric karyotypes, 46,XX[98]/46,XY[2] and 46,XY[98]/46,XX[2] in the female and male infant, respectively. The recognition of sex discordance despite monochorionicity may be a clue for the diagnosis of such rare cases of chimerism in dizygotic twins, most of which occur in pregnancies obtained by assisted reproductive technology.
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Quimerismo , Corion/diagnóstico por imagen , Embarazo Gemelar , Inyecciones de Esperma Intracitoplasmáticas , Gemelos Dicigóticos , Adulto , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Gemelos Dicigóticos/genética , Ultrasonografía PrenatalRESUMEN
The aim of this study was to evaluate the relationship between neonatal mortality-morbidity and pregnancies with preterm premature rupture of membranes (PPROM), particularly those complicated by histologic chorioamnionitis (HCA), in preterm infants. A retrospective study was conducted on 58 preterm neonates born to 46 pregnant women with PPROM. Maternal characteristics, placental examination, and neonatal morbidity and mortality were analyzed. Of 1,392 deliveries, 46 (3.3%) pregnancies and 58 newborn infants were complicated with PPROM. HCA was present in 21 (1.5%) cases, and 15 of them were <28 weeks of gestational age. In the HCA (+) group, 8/21(38%) neonates had 5-minute Apgar scores of <5, 12/21 (57.1%) infants had patent ductus arteriosus (PDA), and 16/21 (76.1%) infants had respiratory distress syndrome (RDS). The latency period was significantly longer and the rate of chorioamnionitis and percentage of major neonatal morbidity and mortality were significantly higher in preterm infants with gestational age <28 weeks. Respiratory distress syndrome, perinatal hypoxia and PDA were significantly associated with HCA in preterm infants.
Asunto(s)
Corioamnionitis/etiología , Hipoxia Encefálica/etiología , Enfermedades del Prematuro/etiología , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , Femenino , Rotura Prematura de Membranas Fetales , Humanos , Recién Nacido , Embarazo , Estudios RetrospectivosRESUMEN
AIMS: To determine whether there is a relationship between Helicobacter pylori (H. pylori) infection, iron deficiency anemia and thrombocytopenia in pregnant women. METHODS: Hemoglobin and ferritin levels and platelet counts of pregnant women were measured during the third trimester. H. pylori infection was determined using a 14C-urea breath test (14C-UBT) after delivery. Statistical analyses were determined with a Mann-Whitney U-test and the chi(2) test. Statistical significance was determined with a P-value less than .05. RESULTS: Seventy-two of 117 women had positive results on the 14C-UBT. Overall, 27 of 117 pregnant women had anemia (23.1%), and all them were in the H. pylori-positive group; 18 of 27 (66.7%) had iron deficiency anemia. Median hemoglobin levels and neonatal body weights were 12.0 g/dL vs 12.0 g/dL and 3320.0 grams vs 3520.0 grams in the H. pylori-positive and negative groups, respectively. Serum hemoglobin and ferritin levels and neonatal body weight were found to be lower in the anemic group compared with the non-anemic group among H. pylori-infected women (P = 0.0001, P = 0.02, P = 0.008, respectively). There were no statistically significant differences with regard to gestational thrombocytopenia between the H. pylori-positive and H. pylori-negative groups (P = 0.532). CONCLUSIONS: Our study indicates that there is a strong relationship between H. pylori infection and iron deficiency anemia in women with uncomplicated pregnancy. However, an association between H. pylori infection and thrombocytopenia was not found.
Asunto(s)
Anemia Ferropénica/epidemiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori/aislamiento & purificación , Complicaciones Hematológicas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Adulto , Anemia Ferropénica/sangre , Anemia Ferropénica/microbiología , Pruebas Respiratorias , Radioisótopos de Carbono , Femenino , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/microbiología , Humanos , Recién Nacido , Embarazo , Complicaciones Hematológicas del Embarazo/sangre , Complicaciones Hematológicas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/microbiología , Turquía/epidemiología , Urea/análisis , Adulto JovenRESUMEN
OBJECTIVE: To establish an early, safe, and well-tolerated time to start oral hydration after cesarean delivery. METHODS: A prospective randomized trial of women delivered by cesarean under regional anesthesia at Alanya Research and Medical Center, Turkey, between 2005 and 2006. A clear liquid drink was given to 100 women in the early oral intake (EOI) group 2 hours after surgery, and to 100 women in the delayed oral intake (DOI) group 8 hours after surgery. If the drink was tolerated, solid foods were then given gradually. RESULT: In the EOI and DOI groups, respectively, the mean time for the return of bowel movements was 4.4+/-1.9 h vs 6.3+/-2.4 h; mean time elapsed until initial passage of flatus was 12.1+/-5.5 h vs 24.1+/-6.0 h; and mean duration of hospitalization was 29.6+/-5.5 h vs 44.6+/-6.8 h (P<0.05). CONCLUSION: Following cesarean delivery under regional anesthesia, oral hydration given as early as 2 hours after the operation is safe and well tolerated.
Asunto(s)
Anestesia de Conducción/efectos adversos , Cesárea , Fluidoterapia , Cuidados Posoperatorios , Adulto , Ingestión de Alimentos , Femenino , Flatulencia , Humanos , Tiempo de Internación , Náusea y Vómito Posoperatorios , Embarazo , Estudios Prospectivos , Factores de Tiempo , TurquíaRESUMEN
OBJECTIVE: The purpose of this study was to evaluate certain pulmonary function tests of the pre-eclamptic women in the early postpartum period. STUDY DESIGN: Forced vital capacity (FVC), forced expiratory volume in 1s (FEV(1)) and peak expiratory flow (PEF) were measured in 13 pre-eclamptic and 15 control subjects undergoing cesarean section (C/S); and 11 pre-eclamptic and 15 control subjects undergoing vaginal delivery (VD) on the postpartum third day. RESULTS: Pre-eclamptic women had significantly lower FVC, FEV(1) and PEF measurements than the control women (P<0.05). When the subjects were grouped according to the mode of delivery, FVC and FEV(1) values were observed to be significantly different between the pre-eclamptic and control groups undergoing C/S (P<0.05). None of these parameters were significantly different between the pre-eclamptic and control groups who had delivered vaginally (P>0.05). CONCLUSION: These data indicate that certain pulmonary functions might be impaired in the early postpartum period in pre-eclamptic women undergoing C/S.
Asunto(s)
Pulmón/fisiología , Preeclampsia/fisiopatología , Adulto , Estudios de Casos y Controles , Parto Obstétrico/métodos , Femenino , Humanos , Persona de Mediana Edad , Periodo Posparto , Embarazo , Valores de Referencia , Pruebas de Función RespiratoriaRESUMEN
It is now clear that estrogen intervention reduces bone loss in postmenopausal osteoporosis. The aim of this study was to investigate whether the route of estrogen administration or addition of progesterone changes this positive effect. Transdermal estrogen (T-E), oral estrogen (E), and oral estrogen plus progestogen (E-P) were administered to 15, 18, and 17 postmenopausal women, respectively, who all had normal bone mineral density (BMD) before hormone replacement therapy (HRT). Calcium (500 mg/day) was routinely added to all HRT regimens. The BMD of the lumbar spine (L2-L4) was measured initially and at the end of the first and second years of treatment. The paired-sample t test, independent-sample t test, and Pearson correlation analysis were used for the statistical evaluation. The initial BMD measurements and the values at the end of the first and second years of the therapy were not significantly different either within or among the groups (P > 0.05). These results indicate a similar therapeutic value of each HRT regimen in the prevention of bone loss in postmenopausal women.