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Mean Gestation (mean + gestation)
Selected AbstractsPeri-conceptual folic acid supplementation in type 1 diabetesPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2001C.J. Wills Specialist Registrar in Diabetes, Endocrinology Abstract Aim To document peri-conceptual folic acid supplementation in women with type 1 diabetes mellitus (DM) attending the diabetic ante-natal clinic of a university teaching hospital. Methods Women with pre-existing type 1 DM who booked at the diabetes antenatal clinic at University Hospital, Nottingham over 3 years (1996,98) took part in a telephone survey about folic acid supplements. Results Data was available on 50 women, 65 pregnancies. Folic acid supplements were used before 50.7% (33) pregnancies, all planned, and started on confirmation of pregnancy in 34% (22), at a mean gestation of 5.8 weeks. No folic acid was used before or during 10 (15.4%) pregnancies. 75.4% (49) pregnancies were planned. 24 planned pregnancies were in women who had never had pre-pregnancy counselling. 70.8%(17) of these were in multiparous women, and folic acid was taken before 41.1% (seven) of such pregnancies. Lack of awareness was the predominant reason for failure to take folic acid supplements in all groups. Conclusions Folic acid was taken before conception in only half of the pregnancies in the survey, due to lack of awareness of its importance. Three-quarters of pregnancies were planned but a disappointing number of women had pre-pregnancy counselling, probably due to poor advertising and the assumption that women who had been pregnant before did not need such a session. Women with DM should be informed about folic acid and offered pre-pregnancy counselling. It should not be assumed that women who have had a pregnancy know about folic acid. Copyright © 2001 John Wiley & Sons, Ltd. Key Points Folic acid supplementation prior to conception and in the first trimester helps to prevent neural tube defects. Almost half of the women in this survey failed to take folic acid prior to conception. Women who did not take folic acid were unaware of its importance. We need to ensure that women with diabetes understand the importance of folic acid. [source] Maternal anxiety at amniocentesis and plasma cortisolPRENATAL DIAGNOSIS, Issue 6 2006P. Sarkar Abstract Objectives To assess whether anticipation of amniocentesis is linked with maternal anxiety, and whether this anxiety is associated with increased maternal plasma cortisol. Methods Two hundred and fifty-four women awaiting a morning amniocentesis for karyotyping (gestation range 15,37 weeks, median 17 weeks) completed Spielberger state and trait anxiety inventory (STAI) questionnaires, and provided blood samples immediately before the procedure for cortisol assay. Six hundred and five women at mean gestation of 20 weeks, attending the same hospital for routine ultrasound but not for amniocentesis, also completed Spielberger STAI questionnaires and served as a comparison group for the anxiety ratings. Results Mean state and trait anxiety scores (± SD) in the comparison group of 605 women at mean gestation of 20 weeks were 36.1 ± 10.2 (range 20,70) and 35.6 ± 8.9 (range 20,73), respectively. The mean state anxiety score (±SD) of 49.8 ± 14.0 (range 20,77) of the amniocentesis group was considerably higher than the comparison group (p < 0.001), although the mean trait anxiety score in the amniocentesis group was similar at 36.4 ± 8.6 (range 21,60). The state, but not trait, anxiety correlated with plasma cortisol (r = 0.176, p = 0.005). Maternal cortisol in the amniocentesis group increased with gestational age (r = 0.310, p < 0.001), whereas state anxiety scores showed no significant change with increase in gestational age (r = , 0.042, ns). Multivariate analysis demonstrated that maternal state anxiety was positively correlated with plasma cortisol independent of gestation and time of collection. Conclusion Women awaiting amniocentesis experience a high state anxiety associated with modestly increased plasma cortisol. Copyright © 2006 John Wiley & Sons, Ltd. [source] Population-based carrier screening for cystic fibrosis in Victoria: The first three years experienceAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009John MASSIE Background: Cystic fibrosis (CF) is the most common inherited, life-shortening condition affecting Australian children. The carrier frequency is one per 25 and most babies with CF are born to parents with no family history. Carrier testing is possible before a couple has an affected infant. Aims:, To report the outcomes of a carrier screening program for CF. Method: Carrier screening was offered to women and couples planning a pregnancy, or in early pregnancy, through obstetricians and general practitioners in Victoria, Australia. Samples were collected by cheek swab and posted to the laboratory. Twelve CFTR gene mutations were tested. Carriers were offered genetic counselling and partner testing. Carrier couples were offered prenatal testing by chorionic villous sampling (CVS) if pregnant. The number of people tested, carriers detected and pregnancy outcomes were recorded from January 2006 to December 2008. Results: A total of 3200 individuals were screened (3000 females). One hundred and six carriers were identified (one per 30, 95% confidence interval one per 25, one per 36). All carrier partners were screened, and nine carrier couples identified (total carriers 115). Ninety-six individuals (83%) were carriers of the p.508del mutation. Of the nine carrier couples, six were pregnant at the time of screening (five natural conception and one in vitro fertilisation) and all had CVS (mean gestation 12.5 weeks). Two fetuses were affected, three were carriers and one was not a carrier. Termination of pregnancy was undertaken for the affected fetuses. Conclusion: Carrier screening for CF by obstetricians and general practitioners by cheek swab sample can be successfully undertaken prior to pregnancy or in the early stages of pregnancy. [source] Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, ChinaBIRTH DEFECTS RESEARCH, Issue 6 2006Le Zhang Abstract BACKGROUND: Although an information campaign concerning periconceptional folic acid supplementation was launched in 1998 in Shanxi Province, China, the prevalence of neural tube defects in rural areas was reported as high as 140 per 10,000 births in 2002. The blood folate concentrations and the practice of folic acid supplementation among pregnant women in rural areas of the province are described. METHODS: A total of 483 pregnant women (mean gestation, 8.1 weeks) in a rural area of Shanxi were interviewed. Nonfasting blood samples and information on folic acid supplementation were collected. Folate concentrations in plasma and erythrocytes were determined by a microbiological assay. RESULTS: The mean concentrations of plasma and erythrocyte folate for pregnant women was 10.4 nmol/liter and 375.8 nmol/liter, respectively. Deficiencies of plasma and erythrocyte folate were observed in 20.9% and 47.6% of women, respectively. Seasonal variations were noted in the prevalence of folate deficiency, with significantly lower plasma folate concentrations in spring and summer and lower erythrocyte folate concentrations in seasons other than summer. Among pregnant women, <10% reported having taken or currently taking folic acid, and virtually no women (0.6%) took folic acid as recommended. CONCLUSIONS: Women in rural areas had low plasma and erythrocyte folate levels, and folate deficiency was highly prevalent in the area. Few women followed the recommendations regarding folic acid supplementation, and the information campaign in Shanxi was unsuccessful. These findings suggest the urgent need for combined strategies in rural areas to fortify grain with folic acid and promote folic acid supplements for childbearing-age women. Birth Defects Research (Part A) 76:461,466, 2006. © 2006 Wiley-Liss, Inc. [source] Early N-terminal pro-brain natriuretic peptide measurements predict clinically significant ductus arteriosus in preterm infantsACTA PAEDIATRICA, Issue 8 2009S Ramakrishnan Abstract We report a blinded, prospective study of the diagnostic utility of N-terminal pro-brain natriuretic peptide (NTproBNP) measurements for predicting clinically significant patent ductus arteriosus (PDA) and assessing closure. Methods:, Plasma NTproBNP was measured during the first week in 100 preterm babies (mean gestation 28.8 ± 2.9 weeks; mean birth weight 1224 ± 512 g). Echocardiography was performed between days 5 and 7 by operators, blinded to NTproBNP concentration. Results: NTproBNP peaked on days 2 and 3, declined by day 7. Twenty babies, later treated for PDA, had significantly higher NTproBNP levels throughout. Areas under receiver operating characteristic (ROC) curves were 0.896, 0.897 and 0.931 on days 2, 3 and 7, respectively (p < 0.0001). A concentration > 2850 pmol/L had diagnostic sensitivity of 90% and specificity of 89% (95% CI: 68, 99; likelihood ratio 8.10). Ductal closure was associated with a fall in mean NTproBNP from 3003 to 839 pmol/L (p < 0.001). Conclusion:, N-terminal pro B-type brain natriuretic peptide (NTproBNP) concentrations peaked and then declined in the first week but remained higher in preterm babies whose PDA required treatment. NTproBNP on day 3 predicted whether a neonatal physician blinded to results would treat a PDA. Fall in plasma NTproBNP indicated closure. [source] | |||||||||||||