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Last Menstrual Period (last + menstrual_period)
Selected AbstractsGestational age estimation on United States livebirth certificates: a historical overviewPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2007Megan L. Wier Summary Gestational age on the birth certificate is the most common source of population-based gestational age data that informs public health policy and practice in the US. Last menstrual period is one of the oldest methods of gestational age estimation and has been on the US Standard Certificate of Live Birth since 1968. The ,clinical estimate of gestation', added to the standard certificate in 1989 to address missing or erroneous last menstrual period data, was replaced by the ,obstetric estimate of gestation' on the 2003 revision, which specifically precludes neonatal assessments. We discuss the strengths and weaknesses of these measures, potential research implications and challenges accompanying the transition to the obstetric estimate. [source] Heart Rate and its Variability Change After the MenopauseEXPERIMENTAL PHYSIOLOGY, Issue 3 2000C. L. Brockbank Resting heart rate and heart rate variability of 33 postmenopausal women were compared with those of 50 premenopausal women of comparable activity level, none of whom had used hormone replacement therapy. Heart rate was measured as the mean of at least 600 consecutive R-R intervals obtained from electrocardiograph (ECG) records, and its variability as the standard deviation of these intervals. Activity levels were assessed by a scale modified from the Allied Dunbar National Fitness Survey (1992). There was a significant reduction in both mean R-R interval and the standard deviation in the postmenopausal women who had experienced their last menstrual period (LMP) 1 year or more prior to the observations being made, but no observable changes during the first year post menopause. [source] Menopausal symptom perception and severity: results from a screening questionnaireJOURNAL OF CLINICAL NURSING, Issue 7 2008FAANP, Judith A Berg PhD Background., Although it is widely acknowledged women experience symptoms during their transition from reproductive to postreproductive stage, there is inconsistency as to the prevalence of symptoms as well as their severity ratings. Aim and objectives., The purpose of this study was to describe symptom perception and severity in mid-life women volunteering for an intervention study for menopause symptom management. Design., A cross-sectional descriptive design was used to provide data on presenting symptoms in a sample of women negotiating the menopausal transition. Methods., A community-based sample of Caucasian women aged 43,55 years was recruited from national nursing media, local media and a variety of local community sources. A screening questionnaire was administered to determine qualification for study entry based upon symptom severity scores from the questionnaire. This report includes results from the screening questionnaire. Results., One hundred and sixty-five women were screened to obtain 110 qualified participants with mean age of 49·3 SD 3·04 years who were 4·7 SD 7 months past their last menstrual period. Sleep difficulties, forgetfulness and irritability were perceived by the highest number of women while sleep difficulties, night sweats, irritability and forgetfulness were rated the most severe. Conclusions., Findings from this study expand understanding of the menopause symptom experience, because few reports include symptom severity reports. All aspects of the symptom experience are necessary to develop appropriate interventions and to evaluate them. Relevance to clinical practice., Providing education about menopause symptoms is central to nursing practice of mid-life women. Therefore, nurses must keep abreast of current knowledge to prepare women for their transition to postreproductive phase or to reassure women who are surprised to find hot flashes are not the only symptoms encountered. [source] Sonographic appearance of the uterine cavity following administration of mifepristone and misoprostol for termination of pregnancyJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2006Ofer Markovitch MD Abstract Purpose. To describe the sonographic appearance of the uterine cavity in women after administration of mifepristone and misoprostol for termination of pregnancy. Methods. Thirty-six women treated with mifepristone 600 mg followed by misoprostol 400 ,g 2 days later for termination of pregnancy were the subjects of the study. Gestational age as calculated from the last menstrual period was ,49 days. Pretreatment sonographic parameters, including gestational sac size and crown,rump length, were measured. The sonographic appearance of the uterine cavity was recorded and documented 6 hours (T-1) and 14 days (T-2) after administration of misoprostol. Results. The mean menstrual age of the patients was 42 days (range 31,49 days). The mean gestational age according to crown,rump length was 43 days (range 40,48 days). Sonographic examination performed atT-1 revealed 23 patients (62.9%) with a well-defined echogenic mass located in the uterine cavity, 2 patients (5.5%) with an intrauterine sac containing a nonviable embryo, and 11 patients (30.5%) with an endometrium thickness of 7,14 mm with no evidence of intrauterine contents. Doppler flow signals were detected in 15 of the 23 patients (65.2%) with an echogenic intrauterine mass. Sonographic examination performed at T-2 revealed 19 patients (52.8%) with a persistent echogenic intrauterine mass; Doppler flow could be detected in 15 of these patients (78.9%). Dilatation and curettage was required in 2 patients (5.6%) due to failure of treatment; all others regained normal menses. Conclusions. An intrauterine echogenic mass with well-defined borders, with or without Doppler flow signals, can be detected 2 weeks after administration of mifepristone and misoprostol for termination of pregnancy. Because most of the women in our study regained normal menses without further surgical intervention, this finding could indicate remnants of trophoblastic tissue evacuated spontaneously from the uterine cavity. Therefore, dilatation and curettage should be avoided in these cases, unless clinical symptoms or signs necessitate surgical intervention. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:278,282, 2006 [source] Cardiothoracic ratio in the first half of pregnancyJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2004Theera Tongsong MD Abstract Purpose The present study was conducted to establish the nomogram of fetal cardiothoracic (C/T) ratio in the first half of normal pregnancies (eg, 11,20 weeks of gestation), using conventional sonographic techniques. Methods Two hundred thirty-eight normal pregnant women enrolled in our prenatal care were recruited into this study. All the patients had singleton fetuses whose gestational age could be accurately determined by the patient's last menstrual period and sonographic measurements. All the newborns were proven to be normal at birth. The sonographic measurements used to calculate the C/T ratio were obtained from axial scans at the level of the four-chamber view. All measurements were made by the same examiner using a single high-resolution machine. Results A total of 238 C/T ratio measurements were made. The mean C/T ratio values increased slightly with gestational age, rising from 0.38 at 11 weeks to 0.45 at 20 weeks. The mean C/T value at each gestational week was never greater than 0.50, and no fetus had a C/T ratio greater than 0.50 at 11,15 weeks of gestation. The means and 5th, 50th, and 95th percentiles of the C/T ratio were calculated for each week of gestation and the nomogram was established. Conclusions Calculation of the C/T ratio is a simple, reliable, reproducible, and time-efficient means of assessing the size of the fetal heart. By comparing the C/T ratio with the normal values presented here, physicians should be able to more easily identify cases of cardiomegaly early in their patients' pregnancies. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:186,189, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.20014 [source] Relationships between air pollution and preterm birth in CaliforniaPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2006Mary Huynh Summary Air pollution from vehicular emissions and other combustion sources is related to cardiovascular and respiratory outcomes. However, few studies have investigated the relationship between air pollution and preterm birth, a primary cause of infant mortality and morbidity. This analysis examined the effect of fine particulate matter (PM2.5) and carbon monoxide (CO) on preterm birth in a matched case,control study. PM2.5 and CO monitoring data from the California Air Resources Board were linked to California birth certificate data for singletons born in 1999,2000. Each birth was mapped to the closest PM monitor within 5 miles of the home address. County-level CO measures were utilised to increase sample size and maintain a representative population. After exclusion of implausible birthweight,gestation combinations, preterm birth was defined as birth occurring between 24 and 36 weeks' gestation. Each of the 10 673 preterm cases was matched to three controls of term (39,44 weeks) gestation with a similar date of last menstrual period. Based on the case's gestational age, CO and PM2.5 exposures were calculated for total pregnancy, first month of pregnancy, and last 2 weeks of pregnancy. Exposures were divided into quartiles; the lowest quartile was the reference. Because of the matched design, conditional logistic regression was used to adjust for maternal race/ethnicity, age, parity, marital status and education. High total pregnancy PM2.5 exposure was associated with a small effect on preterm birth, after adjustment for maternal factors (adjusted odds ratio [AOR] = 1.15, [95% CI 1.07, 1.24]). The odds ratio did not change after adjustment for CO. Results were similar for PM2.5 exposure during the first month of pregnancy (AOR = 1.21, 95% CI [1.12, 1.30]) and the last 2 weeks of pregnancy (AOR = 1.17, 95% CI [1.09, 1.27]). Conversely, CO exposure at any time during pregnancy was not associated with preterm birth (AORs from 0.95 to 1.00). Maternal exposure to PM2.5, but not CO, is associated with preterm birth. This analysis did not show differences by timing of exposure, although more detailed examination may be needed. [source] Assessing number-specific error in the recall of onset of last menstrual periodPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2000D.K. Waller The goal of this investigation was to determine whether women who did not report preferred numbers for their last menstrual period (LMP) may be a group of women who are particularly careful in keeping track of their menstrual cycles and therefore have more accurate LMP dating , based on a comparison with ultrasound examinations. We also sought to estimate the frequency with which preferred numbers are reported in different sources of data and for different subgroups of women. First, we examined the 1987 California birth certificates in which LMP was collected at the time of birth (n = 504 853). We also examined the records of 43 880 women participating in the California Alpha-fetoprotein (AFP) Screening Program between 1986 and 1987, for whom gestational ages based on both early ultrasound examination and LMP were collected before 20 weeks of gestation. In the 1987 California birth certificates, seven numbers,1, 5, 10, 15, 20, 25 and 28,were recorded more frequently than expected. An estimated 12.9% of these records had preferred numbers. The most frequently recorded number was 15, occurring 2.5 times more often than expected (P < 0.01). In the data of the AFP Screening Program, the same seven numbers were preferred, and approximately 7.9% of records were affected by number preference. Comparisons with measurements of gestational age based on ultrasound demonstrated that LMP-based gestational ages in which non-preferred numbers are reported for the LMP are slightly more accurate than those in which preferred numbers are reported (P < 0.01). In most cases, number preference appears to introduce small errors into measurements of gestational age, probably as a result of rounding. Thus, the effect of number preference may be primarily of interest to research studies in which small errors in the measurement of gestational age will have a significant impact on findings. [source] A discrepancy between gestational age estimated by last menstrual period and biparietal diameter may indicate an increased risk of fetal death and adverse pregnancy outcomeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2000Tri huu Nguyen Research Fellow Objective To determine if the discrepancy between gestational age estimated by last menstrual period and by biparietal diameter (GALMP, GABPD) is associated with adverse pregnancy outcome. Design Population-based follow up study. Population Singleton pregnancies were studied when a reliable date of last menstrual period and biparietal diameter measured between 12 and 22 weeks of gestation was available (n= 16,469). Methods Logistic regression analysis and Kaplan-Meier survival analysis were used to analyse the association between GALMP, GABPD and adverse pregnancy outcome. Main outcome measures Adverse outcome was defined as abortion after 12 weeks of gestation, stillbirth or postnatal death within one year of birth, delivery < 37 weeks of gestation, a birthweight < 2500 g or a sex-specific birthweight lower than 22% below the expected. Results The risk of death was more than doubled if GALMP, GABPD of , 8 days was compared with GALMP, GABPD of < 8 days (OR 2.2; 95% CI 1.6,3.1). The risk of death was a factor of 6.1 higher if GALMP, GABPD of , 8 days was combined with increased (> 2 × multiple of median) maternal alphafetoprotein measured in the 2nd trimester. Conclusions A discrepancy between GALMP and GABPD generally reflects the precision of the two methods used to predict term pregnancy. However, a positive discrepancy of more than seven days, particularly with high maternal alpha-fetoprotein, might indicate intrauterine growth retardation and an increased risk of adverse perinatal outcome. [source] Agrichemicals in surface water and birth defects in the United StatesACTA PAEDIATRICA, Issue 4 2009Paul D Winchester Abstract Objectives: To investigate if live births conceived in months when surface water agrichemicals are highest are at greater risk for birth defects. Methods: Monthly concentrations during 1996,2002 of nitrates, atrazine and other pesticides were calculated using United States Geological Survey's National Water Quality Assessment data. Monthly United States birth defect rates were calculated for live births from 1996 to 2002 using United States Centers for Disease Control and Prevention natality data sets. Birth defect rates by month of last menstrual period (LMP) were then compared to pesticide/nitrate means using logistical regression models. Results: Mean concentrations of agrichemicals were highest in April,July. Total birth defects, and eleven of 22 birth defect subcategories, were more likely to occur in live births with LMPs between April and July. A significant association was found between the season of elevated agrichemicals and birth defects. Conclusion: Elevated concentrations of agrichemicals in surface water in April,July coincided with higher risk of birth defects in live births with LMPs April,July. While a causal link between agrichemicals and birth defects cannot be proven from this study an association might provide clues to common factors shared by both variables. [source] Exposure to low outdoor temperature in the midtrimester is associated with low birth weightAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2004Koray ELTER Abstract Background: Although seasonal variation of birth weight has been reported previously, contributing factors such as the meteorological factor and its specific period of exposure remain unclear. Aim: To investigate the effect of season on birth weight and to determine the meteorological factor and its specific period of exposure which can contribute to any seasonal variation in birth weight. Methods: Retrospective analysis of 3333 singleton live births after 36 completed weeks of pregnancy. Maternal age, parity, route of delivery, sex and individual meteorological variables for the first, second, and third trimesters of each pregnancy were analysed using multiple regression analysis with the birth weight as the dependent variable. Results: A seasonal pattern was observed with lowest birth weights in women who had their last menstrual periods in summer and autumn. Upon multiple regression analysis, sex, parity, mode of delivery, and the temperature which the mother was exposed to in the second trimester were the independent determinants of birth weight. Conclusion: Exposure to low outdoor ambient temperature in the midtrimester can be associated with low birth weight. 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