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Consecutive Pregnancies (consecutive + pregnancy)
Selected AbstractsA single institutional experience with 43 pregnancies in essential thrombocythemiaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2001Curtis A. Wright Abstract: Objectives: We describe the periconception circumstances and outcome of 43 consecutive pregnancies in an unselected group of young women with essential thrombocythemia (ET). Patients and methods: We retrospectively studied 74 consecutive cases of young women with ET seen at our institution, among whom 43 pregnancies occurred in 20 patients. Results: Of the 43 pregnancies, 22 (51%) were successful (21 term and 1 preterm live births) and 21 (49%) ended in miscarriages (1 ectopic pregnancy, 2 elective abortions, 16 first-trimester spontaneous abortions, 1 stillbirth at 22 wk, and 1 abruptio placentae at 33 wk). Management of ET at the time of conception included either no specific therapy (16 cases) or the use of aspirin alone (24 cases), a cytoreductive agent (2 cases), or heparin (1 case). There were no significant differences with respect to platelet count or the effect of treatment with aspirin, either at the time of conception or during the first trimester, among cases of successful pregnancies (22), all miscarriages (21), or first-trimester spontaneous abortions (16). The findings were similar when the analysis was restricted to only first-time pregnancies. In patients with multiple pregnancies, the outcome of a subsequent pregnancy was not predicted by the outcome of the first. In general, in successful cases the last two trimesters were mostly uneventful, with healthy offspring being reported in all cases. Conclusions: Pregnant patients with ET have an increased risk of first-trimester abortion which is not predictable by preconception platelet count or aspirin therapy. In addition, our experience does not support the use of prophylactic platelet apheresis during delivery. [source] Serial factitious disorder and Munchausen by proxy in pregnancyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2006M. D. FELDMAN Summary Factitious disorder, including Munchausen syndrome, is seldom documented among pregnant patients but can have powerful consequences. We report on a 44-year-old woman who, over a period of two decades, self-induced labour and delivery in five consecutive pregnancies. She precipitated labour by rupturing her own amniotic sac with a fingernail or cervical manipulation, or misappropriating and self-administering prostaglandin suppositories from the hospital unit on which she worked as a nurse. Preterm deliveries resulted in fetal demise in one case and in neonatal intensive care treatment for two of the offspring. One of the surviving children has cerebral palsy attributable to the mother's factitious illness behaviour, which raises the spectre of Munchausen by proxy maltreatment. The patient sought attention and care through the ruses, which have never been uncovered by her obstetric and gynaecologic caregivers. Indeed, she underwent an unnecessary hysterectomy because of the illusion of heavy menstrual bleeding. Most recently, the patient has been engaging in surreptitious autophlebotomy to force blood transfusions. [source] Determination of gestational age in medium and small size bitches using ultrasonographic fetal measurementsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 7 2000G. C. Luvoni A study was undertaken to estimate gestational age, in terms of days from parturition, in medium and small size dogs by ultrasonographic examination. Serial ultrasonographic examinations were performed in four medium size pregnant bitches throughout two consecutive pregnancies and three small size pregnant bitches throughout one pregnancy, in order to determine the range of variation in the size of selected fetal structures throughout gestation. Formulae were derived to estimate the expected delivery date for both groups of bitches by measuring anatomical fetal structures, so that this method could be applied to a large number of different breeds. The determination of gestational age could be achieved with reasonable precision by selecting fetal structures. Prediction of parturition date was accurate to within one day by ultrasonographic measurement of the diameter of the gestational sac in early pregnancy and the biparietal diameter in late pregnancy in both small size breeds and medium size breeds. [source] Prenatal diagnosis by rapid aneuploidy detection and karyotyping: a prospective study of the role of ultrasound in 1589 second-trimester amniocentesesPRENATAL DIAGNOSIS, Issue 10 2004Wing Cheong Leung Abstract Background Reliable methods are available for rapid aneuploidy detection (RAD) for the prenatal diagnosis of trisomies 21, 18 and 13. This study examines the potential advantages and limitations of using RAD as a replacement rather than as an adjunct to traditional karyotyping. Methods One thousand five hundred and eighty-nine consecutive pregnancies referred for cytogenetic assessment were offered RAD (FISH or QF-PCR) as an adjunct to traditional karyotyping. The results of these two processes were compared, and the effects of three policies for cytogenetic evaluation were determined: RAD alone, a combination of RAD for all and traditional karyotyping for cases with ultrasound anomalies or a policy of RAD and traditional karyotyping in all cases. Results RAD was uninformative because of maternal-cell contamination in 37 (2.3%) cases compared to 4 (0.3%) cases of culture failure in traditional karyotyping. RAD and traditional karyotyping results were concordant in 1526 of 1548 (98.6%) cases. All non-mosaic cases of trisomies 21, 18 and 13 and cases of triploidy were correctly identified by RAD, and there were no false-positive diagnoses. The gold standard of a traditional karyotype in each case would have detected all chromosomal abnormalities. A policy of RAD alone would have identified 60 of 73 (82%) clinically important chromosomal abnormalities. The addition of a full karyotype for cases with evidence of ultrasound abnormalities would have improved detection to 95%. Conclusion A policy offering RAD to all patients, but restricting traditional karyotyping to cases with ultrasound anomalies, would reduce the number of traditional karyotypes requested by 70%, but maintain a 95% detection rate for all clinically important chromosomal abnormalities. Further studies are required to determine whether similar results could be obtained in district general hospital units and to determine whether this approach would be acceptable to health professionals and patients. Copyright © 2004 John Wiley & Sons, Ltd. [source] Proteomic analysis of recurrent spontaneous abortion: Identification of an inadequately expressed set of proteins in human follicular fluidPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 11 2006Yong-Soo Kim Abstract Recurrent spontaneous abortion (RSA), defined as the loss of three or more consecutive pregnancies prior to the 20th,week of gestation, affects up to 5% of the child-bearing population. To investigate the proteins associated with RSA, the protein expression in human follicular fluid was analyzed using 2-DE. Follicular fluid contains a variety of biologically important proteins for oocyte fertilization and follicle maturation in the mammalian reproductive process. Therefore, it can be used as a provisional source for identifying proteins involved in RSA. In this study, we identified five aberrantly expressed proteins (complement component,C3c chain,E, fibrinogen,,, antithrombin, angiotensinogen, and hemopexin precursor) in follicular fluid from RSA patients with MALDI-TOF-MS and nano-LC MS/MS. Western blot analysis confirmed that the protein expression level of fibrinogen,, and antithrombin was less in follicular fluid from RSA patients than those from normal controls. Semiquantitative RT-PCR and real-time PCR analyses revealed that mRNA level of these coagulation factors was also decreased significantly in chorionic villi of RSA patients compared with normal samples. Taken all together, it is likely that coagulation factors (fibrinogen,, and antithrombin) play an important role in maintaining the normal pregnancy. [source] Oligozoospermia: recent prognosis and the outcome of 73 pregnancies in oligozoospermic couplesANDROLOGIA, Issue 3 2006J. A. Van Zyl Summary The minimum value for each of the five main semen parameters, below which conception rarely occurred or did not occur at all, was calculated in a group of 1884 couples complaining of primary and secondary infertility: 304 conceptions including first as well as consecutive conceptions, occurred. The parameters evaluated were (minimum value calculated in this study between brackets) volume (1.0 ml), sperm count ml,1 (2.0 million), total sperm count (4.0 million), motility (10%), forward progression (2.0 MacLeod units: scale 1,4) and normal sperm morphology (3%). The pregnancy rate in the group of 308 oligozoospermic men and the minimum value of semen parameters were the cornerstones in determining the prognosis for oligozoospermic patients. A sperm count of >2.0 million ml,1 was considered relatively adequate for eventual conception judged by the 68 of 308 (22.1%) pregnancies that occurred among oligozoospermic men in this study, provided that the other five semen parameters showed values above the minimum value. In cases where the average sperm count was <2 million ml,1, the chances for conception became rare, viz five of 308 (1.6%). The total number of pregnancies in the group classified as oligozoospermic was 73 (23.7%). With these pregnancies there was no increase in the rate of foetal wastage and congenital abnormalities. Abortion occurred in 15.09% and ectopic pregnancy in 0.9% among first and consecutive pregnancies. One infant among the 56% boys and 44% girls was born with congenital abnormalities. Most of these infants had a normal birth mass of >2500 g. [source] Selective fetoscopic laser ablation in 100 consecutive pregnancies with severe twin,twin transfusion syndromeAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Robert B. CINCOTTA Aims: To report the perinatal outcomes of a large series of twin pregnancies with severe twin,twin transfusion syndrome (TTTS) managed with laser ablation surgery in an Australian tertiary perinatal centre and to compare the outcome with other large cohorts. Methods: The outcomes of 100 consecutive pregnancies with severe TTTS managed with selective fetoscopic laser ablation from March 2002 to June 2007 were examined. Survival and neonatal morbidity were analysed. Comparisons were made with the results from other studies of laser surgery with at least 100 pregnancies. Results: There were 100 women with TTTS treated with laser ablation; 34 stage II, 44 stage III and 22 at stage IV. Median gestation at time of laser was 21 weeks (range 18,28) and median gestation at delivery was 31 weeks (range 20,39). Overall perinatal survival rate was 151 of 200 (75.5%). Eighty five per cent had one or more surviving twins. The survival rate for stage IV TTTS was 88.6%, significantly better than for stage II (69.1%) and stage III (73.9%) pregnancies. The perinatal mortality rate for donors (30%) was not significantly different from recipients (19%), but the fetal death rate for donors was significantly greater than that for recipients (P = 0.03). Severe cerebral abnormalities were present in only 2.8% of newborns. The overall survival rate was comparable to other large series. Conclusions: These results for the management of severe TTTS are comparable to the best reported international series. Long-term follow-up is required and more research needs to be undertaken to further improve these results. [source] Recurrence of breech presentation in consecutive pregnanciesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2010JB Ford Please cite this paper as: Ford J, Roberts C, Nassar N, Giles W, Morris J. Recurrence of breech presentation in consecutive pregnancies. BJOG 2010;117:830,836. Objective, To investigate the recurrence risk of breech presentation at term, and to assess the risk factors that contribute to its recurrence. Design, Cohort study. Setting, New South Wales, Australia. Population, Women with their first two (n = 113 854) and first three (n = 21 690) consecutive singleton term pregnancies, in the period 1994,2002. Methods, Descriptive statistics including rates, relative risks and adjusted relative risks, as determined from logistic regression and Poisson analyses. Main outcome measures, Rates and risks of occurrence and recurrence of breech presentation at birth in each pregnancy, and maternal and infant risk factors associated with breech recurrence. Results, First-time breech presentation at term occurred in 4.2% of first pregnancy deliveries, 2.2% of second pregnancies and 1.9% of third pregnancies. The rate of breech recurrence in a second consecutive pregnancy was 9.9%, and in a third consecutive pregnancy (after two prior breech deliveries) was 27.5%. The relative risk of breech recurrence in a second pregnancy was 3.2 (95% CI 2.8,3.6), and in a third consecutive breech pregnancy was 13.9 (95% CI 8.8,22.1). First pregnancy factors associated with recurrence included placenta praevia [adjusted relative risk (aRR) 2.2; 95% CI 1.3,3.7], maternal diabetes (aRR 1.4; 95% CI 1.0,2.1) and a maternal age of ,35 years (aRR 1.2; 95% CI 0.9,1.6). Second pregnancy factors included birth defects (aRR 2.5; 95% CI 1.4,4.2), placenta praevia (aRR 2.5; 95% CI 1.5,4.1) and a female infant (aRR 1.2; 95% CI 1.0,1.5). Conclusions, The increased recurrence risk of breech presentations suggests that women with a history of breech delivery should be closely monitored in the latter stages of pregnancy. [source] | ||||||||||