Polyamines and Female Reproduction: An Overview | Chapter 13 | Achievements and Challenges of Medicine and Medical Science Vol. 4

Polyamine metabolism has been studied in female reproduction in humans and experimental models. Changes in the ovary, uterus, endometrium and myometrium, in maternal blood, urine, placenta, and embryo development as pregnancy progresses have been documented, as well as in women with spontaneous abortion and preeclampsia. Polyamines play an essential role in cell proliferation, growth, and differentiation. These molecules exert significant effects on embryonic development, implantation, placentation, and fetal development. Inhibition of the polyamine synthesis in immature female mice inhibits ovarian development and delays puberty. In the uterus, polyamine synthesis is regulated by hormones such as 17-β estradiol. In young female rats, this hormone increases rapidly uterine ornithine decarboxylase activity; an enzyme involved in polyamine synthesis. The concentration of polyamines increases in the plasma and urine of pregnant women as the pregnancy progresses. They exert significant effects on embryonic development, implantation, placentation, and fetal development. In rats, specific and irreversible inhibition of polyamine synthesis causes inhibition of embryonic development and embryo resorption. Polyamines are oxidized by polyamine oxidase. It has been hypothesized that this enzyme has a protective role in the physiology of pregnancy and that polyamine oxidase at high levels protects the mother and fetus from high concentrations of biogenic amines. On the other hand, acrolein, a highly reactive aldehyde, is formed by oxidation of polyamines. Since acrolein is highly reactive to molecules containing amine groups such as proteins, nucleic acids, and aminophospholipids forming advanced glycation end products, it can be speculated the participation of this metabolite in toxemia development, but this remains to be demonstrated. In conclusion, polyamines are involved in all stages of the reproductive process in women. From the maturation of the ovary, the menstrual cycle, the implantation process, embryonic development, growth, and lactation are regulated by polyamines, in turn, the activity of enzymes that biosynthesize polyamines is regulated by hormones, as is the case of ornithine decarboxylase. If the synthesis of polyamines stops, embryonic development is blocked, which clearly demonstrates its participation in this process.

 

Author (s) Details

 

José D. Méndez
Medical Research Unit in Metabolic Diseases, Cardiology Hospital. National Medical Center, Mexican nstitute of Social Security, Mexico.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v4/1943

Examining the Perinatal Results in Patients Suffering from Acute Fatty Liver of Pregnancy | Chapter 1 | Achievements and Challenges of Medicine and Medical Science Vol. 13

Introduction: Acute fatty liver of pregnancy (AFLP) is a rare obstetric emergency requiring immediate attention and intensive care to avoid adverse outcomes for the mother and fetus. High morbidity and mortality are seen among women with AFLP. As this condition poses many complications and is varied in its clinical presentation, the perinatal outcomes in women diagnosed with AFLP were studied.

Materials and Methods: This was a retrospective study that involved all patients over the past 6 years who presented with AFLP. Clinical signs and other altered biochemical parameters were included.

Results: In the study, 19 women were diagnosed to have AFLP. The mean age of the study population was 25.74±3.7 years. 14 ( 73.68% ) women were below the age of 30 years. A gestational age of more than 37 weeks was seen in 13 ( 68.42% ) women. Ten primigravidae ( 52.63% ) and nine multiparous (47.3%) women were found to present with AFLP. The mean blood loss at the time of delivery for a lower-section cesarian section and vaginal delivery was 787.5±494.07 mL and 280±44.72 mL, respectively. The preferred treatment at the time of admission was transfusion of fresh frozen plasma (FFP) (Mean: 7.00±9 pints), followed by transfusion of platelet (Mean: 2.37±3.515 pints), transfusion of packed red blood cells (Mean: 2.21±3.691 pints) and cryoprecipitate (Mean: 0.0±2 pints). Nine ( 47.37% ) women were delivered through emergency lower segment cesarean section (LSCS) and all 4 (21.05%) pregnant women who succumbed to AFLP underwent an LSCS. Among the newborns, 13 (65%) of them were low birth weight and 2 (10.53%) had fetal distress.

Conclusion: This study showed a higher maternal mortality rate of 21% in comparison to other studies. Health professionals should be sensitized about this condition and the use of the existing scoring system available to help in detecting AFLP at an early stage to reduce maternal mortality and adverse fetal outcomes. Blood loss at the time of delivery makes it imminent to arrange for appropriate treatment and supportive care in the management of the patient, which includes fresh frozen plasma transfusion which was found beneficial in the patients.

 

Author (s) Details

 

Christy Vijay
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Annamma Thomas
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Angeline Yvette Mascarenhas
Department of Emergency Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Naveen Ramesh
Department of Community Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v13/4088

Spectrum of Serum Sodium, Chloride and Potassium and Its Role in the Prediction of Preeclampsia | Chapter 4 | Achievements and Challenges of Medicine and Medical Science Vol. 9

Background and Objective: Preeclampsia is a common complication of pregnancy that leads to maternal and neonatal morbidity and mortality. It may result in lifelong sequelae in pregnant women like reduced life expectancy, increased risks of stroke, cardiovascular disease and diabetes while babies from such mothers have increased risks of preterm birth, perinatal death and neurodevelopmental disability and cardiovascular and metabolic disease later in life. Pre-eclampsia is an intricate multisystem disease, diagnosed by sudden-onset hypertension (>20 weeks of gestation). In spite of decades of research, the aetiology of pre-eclampsia remains poorly defined. To investigate the pathogenesis of pre-eclampsia research is needed to evaluate new prognostic tests and treatments in adequately powered clinical trials. The role of different serum electrolytes in its pathogenesis is in this direction a step as they are considered important for blood pressure regulation.

Materials and Methods: A hospital-based cross-sectional study of 100 diagnosed cases of preeclampsia divided into mild and severe according to latest International Society for the Study of Hypertension in Pregnancy ( ISSHP ) guidelines and equal number of age, parity and gestational age-matched women (n=100), that acted as control group, with singleton normal pregnancies, admitted in obstetrics wards from January to March 2022 of our tertiary care hospital associated with GMC Srinagar were included in the study. Clinical examination and laboratory investigations to estimate biochemical parameters were conducted. Data was analyzed with SPSS V:26. Statistical tests to find out the mean standard deviation among the groups and the One-way ANOVA test was applied to find the significance of associations.

Results: In the severe preeclampsia group, the mean values of Na⁺, K⁺ and Cl^- were 134.50±4.24, 4.28±0.74, 106.48±3.41 mEq/L respectively in comparison to the control group 135.57±3.29, 4.12±0.53, 108.20±3.19 mEq/L respectively. Results from one-way ANOVA showed that there was a statistically significant difference between the means of the three groups for systolic blood pressure (SBP), diastolic blood pressure (DBP), Potassium and Chloride levels with p<0.05. A post hoc analysis was used to distinguish the differences in means of these parameters among the groups with p-value <0.05 considered statistically significant.

Conclusion: Estimation of readily available serum sodium, chloride and potassium during the course of pregnancy can help to identify preeclampsia and thus reduce the burden of morbidity and mortality in pregnant women and fetal outcome.

 

Author (s) Details

Javid Ahmed Khan

Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India.

Aadil Ashraf
Department of Gastroenterology, AIG Hospital, Hyderabad, Telangana, India.

Waseem A. Qureshi
Government Medical College Srinagar, Jammu and Kashmir, India.

Faizana Fayaz
Delhi Institute of Pharmaceutical Sciences and Research, New Delhi, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v9/3517

Study about Young Women to Specifics of Human Sexuality/Reproduction | Chapter 11 | Advancement and New Understanding in Medical Science Vol. 5

This paper explains first, concerning physiological vaginal first birth (primiparity) why young women should consider delivering her first baby before the age of 26 (there is a linear association between maternal ages and healthy deliveries). Second, because of the comparatively large human fetal brain, nutritional maternal-foetal exchanges are twice those of other mammals (per body-mass ratios). There is a lack of awareness among young of the very specific reproductive and sexual strategies of humans as compared to other mammals. Homo sapiens appeared some 300,000 years ago and our female ancestors delivered obligatorily vaginally prior to the development of medical interventions (such as caesarean sections, a safe procedure only since the 1960’s). Furthermore, women are unique among the 4,300 mammal species suffer from a harmful complication of pregnancy, preeclampsia (especially during a first pregnancy). But, as the human species has retained the hemochorial placenta, that first appeared in mammalian evolution, women face the great challenge of immunological tolerance towards the male partner’s tissues during the nine months of gestation. This major challenge occurs during the first pregnancy and tolerance is related to semen exposure prior to conception.  In subsequent additional pregnancies, immunological recognition is largely achieved through the initial pregnancy. This is why for a first pregnancy (nulliparous woman or multiparous woman with a new male partner), it is preferable to conceive after a delay of 6 months of non-barrier contraception before planning conception. Short-term sexual cohabitation after the couple's constitution (partially recognized male tissue) may result in incomplete embryo implantation, which can cause problems including early-onset preeclampsia and/or fetal growth restriction. Third, to have a baby neither too small, nor too big, women overweight or obese at the beginning of any pregnancy must gain less weight during the 9 months of gestation as compared to their leaner counterparts. The optimal gestational weight gain may be acknowledged during the first prenatal visit, with, a goal to achieve during the next 7- 8 months of pregnancy.

Author(s) Details:

Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France and Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre cedex, La Réunion, France.

Please see the link here: https://stm.bookpi.org/ANUMS-V5/article/view/13340

Women and Pregnancies as an Immediate Target against the Obesity Epidemic | Chapter 14 | Advancement and New Understanding in Medical Science Vol. 1

People with obesity worldwide have become a major challenge in this 21st century with an apparent irresistible rise of this epidemic since the 1970’s. Nowadays, it is evaluated that obese people (≥ 30 kg/m²) represent some one billion inhabitants (out of seven) on this planet. The author wishes to enlarge an important current debate among obstetricians trying to sensitize specialists of obesity/endocrinology/ nutrition, and make them aware of a possible very important debate: having a “normal shaped” baby (neither too small, nor too big, 10% of SGA, small for gestational age and 10% of LGA, large for gestational age), is possible by an optimal gestational weight gain (optGWG) during pregnancy. This is a simple- mathematical linear equation, y= ax+b (y being optimal gestational weight gain, optGWG, x being pre-pregnancy body mass index, ppBMI). Beginning with severe obesity (36 kg/m²), women should not gain weight during their pregnancy, while they should lose weight in higher BMIs (e.g., losing 6 kg for a 40 kg/m² morbid obese). This is predictable since the first trimester of pregnancy. This chapter concluded that besides actively counter balancing morbid effects of high BMIs in pregnancies (and, importantly for the future of mankind, by avoiding a lot of macrosomic and LGA newborns), should imply new habits in women’s future lives afterwards.

Author(s) Details:

Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France and Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/13031

A Retrospective Analysis on the Urgent Need to Optimize Gestation Weight in Overweight/Obese Women to Lower Maternal-Fetal Morbidities: 59000 Singleton Term Pregnancies | Chapter 1 | Advancement and New Understanding in Medical Science Vol. 1

Objective: This study primarily focuses on examining the criticalities of optimizing gestational weight for obese women to reduce fatal morbidities. We retrospectively did a simulation applying the optimal gestational weight gain (optGWG) equation (that we proposed in 2018) on our population, and observed if its effect on maternal/fetal morbidities in singleton term pregnancies (≥37 weeks).

Design: This is a Retrospective observational study.

Setting: The setting for this study was in a single large tertiary maternity unit in Reunion Island, Indian Ocean, overseas French department.

Population or Sample: All consecutive singleton births delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion's maternity was the chosen population for this study. A standardized epidemiological perinatal database was used here.

Methods: This study employed mathematical simulation on a 19-year historical cohort (2001-2019)'. Data was presented as numbers and proportions for categorical variables and as mean and Standard Deviation (SD) for continuous ones.

Main Outcome Measures: Five Maternal/fetal morbidities were measured for this study.

Results: Beginning with overweight women, and enlarging the effect with the rise of different obesities (class I to III) and considering maternal pre- pregnancy BMI (ppBMI), individualized counselling women on their GWG (optimal gestational weight gain, optGWG) lowers significantly maternal/ fetal morbidities: in a logistic regression model among overweight/obese women, with the outcome optGWG, several morbidities have a negative coefficient as independent factors: cesarean-section, birthweight ≥ 4000 g, term preeclampsia, lowering the effect of rising maternal ppBMI per increment of 5 kg/m² (coefficient -0.13), all p < 0.001. Dietary and lifestyle interventional studies have reduced GWG by 0.7kg or 3.7kg and had no effect on other pregnancy and birth outcomes including GDM, PE, PIH, LGA and macrosomic infants.

We propose as a prediction to be verified in future prospective studies that a follow-up and counselling since the first prenatal visit should also lower gestational diabetes mellitus rates.

Conclusion: We may have significant health (and cost) benefits by lowering c-section rates, term preeclampsia, macrosomic babies and LGA babies in overweight/obese women and low-birthweight babies in lean women. We may have much to win from reducing weight gain during pregnancy in overweight/obese women. It is urgent to verify and establish in all continents the specific linear curve of optGWG for each geographic/ethnic area.

Author(s) Details:

Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Centre d'Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France.

Gustaaf Dekker,
Department of Obstetrics & Gynaecology, University of Adelaide, Robinson Institute, Lyell McEwin Hospital, Australia.

Malik Boukerrou,
Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France.

Brahim Boumahni,
Service de Neonatologie, Centre Hospitalier Universitaire Sud Reunion, Saint-Pierre Cedex, La Reunion, France.

Thomas C Hulsey,
Department of Epidemiology, School of Public Health, West Virginia University, Morgantown WV, USA.

Marco Scioscia,
Department of Obstetrics and Gynaecology, Policlinico of Abano Terme, Abano Terme (PD), Italy.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/12998

Detection of Proteins in Urine by Using Sulfosalicylic Acid in Pregnant Women | Chapter 12 | Novel Research Aspects in Medicine and Medical Science Vol. 5

 The objective search out verify the efficiency of 3% sulfosalicylic acid, its sensitivity, particularity, positive and negative predicting value of pregnant wives in 24-hour excretion. The first level of care in pregnant daughters is decisive for a timely disease of complications that happen in pregnancy, individual of them is preeclampsia since changeable and non-modifiable multicausal determinants can lead the woman towards fatal eventualities accompanying reserved prognoses, particularly in high Andean regions with more than 3800 meters above ocean's surface. This being an extremely troublesome condition that puts at stake the health of the mother and her produce. The sulfosalicylic acid test would help us early to take the appropriate measures in this place clinical condition that create it more difficult to manage gestation in a pregnant she.

Author(s) Details:

Sandra A. Fernández Macedo,
Nestor Caceres Velasquez Andean University, Puno-Peru, Peru.

Esperanza Cueva Rossel,
Manuel Nuñez Butron Hospital, Puno-Peru, Peru.

Sonia Benita Fernández Tapia,
Nestor Caceres Velasquez Andean University, Puno-Peru, Peru.

Julio Jimenez Agüero,
Hospital Santa Rosa, Lima-Peru, Peru.

Please see the link here: https://stm.bookpi.org/NRAMMS-V5/article/view/12172

Determining the Association of Mean Platelet Volume in the Late First Trimester of Pregnancy and Development of Preeclampsia| Chapter 3 | Current Innovations in Medicine and Medical Science Vol. 10

 The present study proposed to find out the correlation betwixt the mean platelet volume in the late 1st trimester of gestation and development of a Preeclampsia later on. Preeclampsia (PE) is a gestation-specific healing disorder that is characterized by incitement of the coagulation plan, and endothelial cell dysfunction. This disorder is a major cause of motherly and fetal depression and mortality.It was a prospective companion study in which 500 significant women (11–14 weeks of gestation) were registered and their mean platelet volume (MPV) was calculated. They were followed till delivery. MPV of pre-eclamptic and normotensive wives was compared.MPV of pre-eclamptic daughters was significantly higher than that of the normotensive wives (p = 0.001).MPV > 10.55 fL was found to be 68.7% delicate and 55.9% specific for the prophecy of Preeclampsia with a negative predictive profit of 87.6%. Thestudy suggest attending future research with a large sample amount to investigate the blend of mean platelet volume with added cost-effective indicators in order to increase the sensitivity and particularity of preeclampsia prediction outside adding additional fiscal burden to expectant inventors, particularly in low-means settings.

Author(s) Details:

Shailja S. Bhamri,
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India.

Urmila Singh,
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India.

Seema Mehrotra,
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India.

Vandana Solanki,
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, Uttar Pradesh, India.

Please see the link here: https://stm.bookpi.org/CIMMS-V10/article/view/8863

Preeclampsia and Oxidative Stress: A Review | Chapter 10 | Current Innovations in Medicine and Medical Science Vol. 5

 This chapter is aimed to review the mechanisms and biomarkers for oxidative stress development in preeclampsia. Hypertensive diseases of gestation and their complications are one of the leading causes of motherly and fetal morbidity and mortality. In normal gestation, optimum irruption of trophoblast in uterine helical arterioles is achieved leading to vasodilation of these arterioles. This process is necessary for placental and fetal growth and well- being. bloodied trophoblastic irruption is noted in maters with preeclampsia( PE) which causes placental hypoxia and hypoperfusion. Placental hypoperfusion and hypoxia lead to the development of inflammation, endothelial dysfunction, and oxidate stress in maters with PE. Experimenters have linked colorful labels to estimate the position of oxidative stress and antioxidant capacity. farther studies are demanded to establish the mileage of these labels in the opinion, prognostic, and monitoring of PE.

Author(s) Details:

Amit D. Sonagra,
Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.

Ragini Singh,
Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.

Sagar Dholariya,
Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.

Anita Motiani,
Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.

Deepak Parchwani,
Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.

Please see the link here: https://stm.bookpi.org/CIMMS-V5/article/view/8468

Isthmin 2 is Decreased in Preeclampsia and Highly Expressed in Choriocarcinoma: A Prospective Cross-sectional Study | Chapter 17 | Emerging Trends in Disease and Health Research Vol. 9

The human placenta nearly exclusively expresses the protein isthmin 2 (ISM2). No prior research has examined this protein in preeclampsia or choriocarcinoma. Women with preeclampsia, gestational hypertension, and normotensive pregnancy were the subjects of a prospective, cross-sectional research. We carried out immunohistochemistry on placenta samples and assessed ISM2 protein serum concentrations. Additionally, we contrasted the ISM2 immunohistochemistry of choriocarcinoma samples with tissues from lung, prostate, colon, stomach, and breast cancers. The study included 81 participants, including 30 preeclamptic patients, 21 pregnant hypertensive patients, and 30 healthy controls. The ISM2 protein was shown to be decreased in preeclampsia patients when compared to the control group (P 14 0.036). These results were confirmed by immunohistochemistry. Additionally demonstrated to be overexpressed in choriocarcinoma is the ISM2 protein. Our results suggest that ISM2 has an angiogenic role. While its high expression in choriocarcinoma shows that ISM2 may be engaged in the angiogenesis of this and other cancers, its lower blood level in our preeclampsia patients raises the possibility that it is implicated in the pathogenesis of the condition.

Author (s) Details:

Cynthia Martinez,
Department of Obstetrics and Gynecology, Maternity and Children Hospital, Mexicali, B.C., 21376, Mexico.

Javier González-Ramírez,
Faculty of Nursing, University Autonomous of Baja California, Mexicali, B.C., 21100. Mexico.

María E. Marín,
School of Medicine, University Autonomous of Baja California, Mexicali, B.C., 21000, Mexico.

Gustavo Martínez-Coronilla,
Faculty of Nursing, University Autonomous of Baja California, Mexicali, B.C., 21100. Mexico.

Vanessa I. Meza-Reyna,
Laboratory of Surgical Pathology and Cytodiagnosis, Mexicali, B.C., 21389, Mexico.

Rafael Mora,
School of Medicine, University Autonomous of Baja California, Mexicali, B.C., 21000, Mexico.

Raul Díaz-Molina,
School of Medicine, University Autonomous of Baja California, Mexicali, B.C., 21000, Mexico.

Please see the link here: https://stm.bookpi.org/ETDHR-V9/article/view/7455

Hypertension in Pregnancy | Chapter 8 | Current Practice in Medical Science Vol. 1

Pregnancy-related hypertensive disorders are one of the main causes of maternal morbidity and death. Pregnancy complications caused by hypertension disorders are frequent and constitute one of the lethal triad—along with bleeding and infection—that significantly increases maternal morbidity and death.

The mother's risk of heart attack, cardiac failure, cerebral vascular accidents, and renal failure increases with severe hypertension [3]. The risk of issues such as inadequate oxygen transport through the placenta, foetal growth restriction, premature delivery, placental abruption, stillbirth, and neonatal mortality is also higher for the foetus and neonate.

Significant improvements in the treatment of the illnesses have resulted in advice and suggestions that are supported by research. The decrease of maternal morbidity and death depends on early identification and fast and effective care because the aetiology is poorly understood and there are no effective prediction techniques.

Increased understanding of hypertensive disorders in pregnancy among medical professionals and greater public awareness of the illnesses, particularly among women of reproductive age, are crucial for lowering the related morbidity and death.

Author(s) Details:

Omotayo Ramon Sunday,

Department of Obstetrics and Gynaecology, University of Medical Sciences Teaching Hospital, Akure, Ondo State, Nigeria and Department of Obstetrics & Gynaecology, University of Medical Sciences, Ondo City, Ondo State, Nigeria.

Please see the link here: https://stm.bookpi.org/CPMS-V1/article/view/7327

A Case Report of Pregnancy in Porphyria and It’s Complications | Chapter 12 | Emerging Trends in Disease and Health Research Vol. 8

Like many rare illnesses, porphyrias and reproduction are poorly understood. There is a lack of knowledge on pregnancy problems in porphyria patients. The information we gather comes from handling certain instances. The case study that follows describes a rare instance of porphyria cutanea tarda in a 30-year-old female patient who arrived to the emergency room of the Government Medical College in Nagpur with severe anaemia after giving birth to a stillborn child elsewhere that same day. Known pregnancy complications in people with porphyria include stillbirths, spontaneous abortions, hypertension, and low birth weights.

Author(s) Details:

Tuhina K. Mital,

Department of Obstetrics and Gynaecology, Govt. Medical College, Nagpur, India.

Rujuta Fuke,

Department of Obstetrics and Gynaecology, Govt. Medical College, Nagpur, India.

Please see the link here: https://stm.bookpi.org/ETDHR-V8/article/view/7238

Determining the Prevalence of Asymptomatic Bacteriuria among Antenatal Women and its Effects on Maternal and Perinatal Outcome | Chapter 03 | New Horizons in Medicine and Medical Research Vol. 5

 The goal of this study was to find out how common asymptomatic bacteriuria is in pregnant women and how it affects perinatal and maternal outcomes. In this prospective study, 300 pregnant women at Anil Neerukonda Hospital were examined for ASB. The standardised Kirby-Bauer disc diffusion method was used to culture urine on blood agar and Mac Conkey's agar for antibiotic sensitivity testing. The presence of ASB was discovered in 11.33 percent of the population. Eight (23.5%) of the 34 ASB positive cases were delivered with a birth weight of less than 2500 grammes, compared to 11 (4.1%) of the unexposed cases (RR 5.68, 95 percent CI; 2.46-13.15; p0.05). Preterm low birth was seen in 5 (14.7 percent) cases of ASB positive pregnant women when compared to unexposed cases (RR 1.5, 95 percent CI; 0.61-3.65, p=0.36). Preterm labour occurred in 8 (23.5%) of ASB exposed women and 22 (8.3%) of non-exposed women (RR 2.84, 95 percent CI; 1.37-5.88, p=0.004). When ASB positive and ASB negative cases were compared, a significant number of women (17.6%) developed hypertension and preeclampsia (8.8 percent ). (Respectively, 4.9 percent and 2.3 percent). ASB was reported to be present in 11.33 percent of the subjects in this study. For an integrated approach to safe motherhood and newborn health, regular and repeated trimester-wise screening should be adopted as part of standard antenatal care.

Author(S) Details

Prabhavathi V
Department of Obstetrics and Gynaecology, NRI Institute of Medical Sciences, Sangivalasa, Andhra Pradesh, India

Prasad DKV
Department of Biochemistry, NRI Institute of Medical Sciences, Sangivalasa, Andhra Pradesh, India.

View Book:- https://stm.bookpi.org/NHMMR-V5/article/view/6477

Determining the Role of Pregnancy-associated Plasma Protein-A Level in the First Trimester of Pregnancy and Clinical Outcome in an Urban Referral Centre, South India | Chapter 13 | Highlights on Medicine and Medical Science Vol. 13

 Introduction: Screening for aneuploidy in the first trimester, which includes nuchal translucency (NT), pregnancy-associated plasma protein-A (PAPP-A), and free-beta subunit human chorionicgonadotrophin (fhCG), has become a standard element of prenatal care. Estimating serum PAPP-A levels has also been extensively researched in terms of other prediction factors for unfavourable neonatal outcomes. This case-control study also aims to determine if there is a link between low PAPP-A levels in pregnant women and a poor maternal foetal outcome.

Objectives:

The primary goal of this study was to see if a low PAPP-A level in the first trimester of pregnancy was linked to poor mother and foetal outcomes.

Secondary goal: Determine the predictive significance of a low PAPP-A level in predicting negative perinatal outcomes.

Methods: This is a case-control study of women delivered at Mehta Multispecialty Hospitals India Pvt. Ltd.'s Department of OBG between August 2017 and May 2018. Women who underwent a PAPP-A level screening in the first trimester gave birth in the labour room. After receiving informed consent (Annexure II & III), the study was explained to the participants, and a questionnaire with full prenatal history, birth mode, and infant data was input into Annexure II. The subjects are divided into case and control groups depending on the outcome. Out of the 264 people in the study, 88 patients with complications were designated as cases, while 176 patients with no issues were designated as controls, and both the case and control group studies were conducted.

The study found no statistically significant link between the case and control groups for characteristics such as maternal age, parity, marital history, family history, and previous obstetric difficulty.

Mode of conception (ART, IUI, Ovulation induction) represented substantially larger number in the case group compared to the control group, which was statistically shown (p 0.05).

In the case group, 78 percent of the babies were born at 37 weeks, whereas only 18 percent were born at term, a statistically significant difference from the control group.

In our study, the most common complications were PIH and Pre-Eclampsia (17%), Preterm (9.1%), and IUGR (6.8%), with normal outcomes in 66.7 percent.

In our study, the LSCS rate was higher than the normal delivery rate out of 264 deliveries. Normal deliveries account for 28% of all deliveries, while LSCS deliveries account for more than 72%.

In our research, low PAPP-A levels (0.5MoM) are associated with a higher risk of PIH and Preeclampsia, followed by IUGR and Preterm birth. When PAPP-A levels are greater than 0.5MoM, the normal outcome outweighs the unfavourable outcome. PAPP-A levels varied by a statistically significant amount.

Low birth weight was observed to be statistically significant in women with a low PAPP A level as compared to those with a 0.5 PAPP A level. The relationship between NICU admission and APGAR was not found to be statistically significant. LBW newborns have a significant prevalence of low PAPP A levels.

PAPP A levels had a sensitivity of 17.04 percent and a specificity of 98.85 percent in identifying difficult outcomes in the current investigation. Predicting complications had a positive predictive value of 88.23 percent and a negative predictive value of 70.44 percent.

Conclusion: Based on the findings of the above study, low PAPP-A levels detected during the first trimester of pregnancy are linked to unfavourable maternal and foetal outcomes such as PIH, preeclampsia, preterm birth, IUGR, and LBW. As a result, anytime an obstetrician encounters a patient with low PAPP-A levels, he or she should be cautious and vigilant, which can also assist with self-preparation.

Author (S) Details

T. Lavanya
Pranav Speciality Clinic & SLP Scan Center, Urapakkam, Chennai, India.

Nandita A. Thakkar
Dept. of OBG Dr. Mehtas Multi Speciality Hospitals, Chetpet. Chennai, India.

R. Premalatha
Dept. of OBG Dr. Mehtas Multi Speciality Hospitals, Chetpet. Chennai, India.

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A Concise Clinicopathological Handbook of Diabetes Mellitis | Book Publisher International

 Diabetes mellitus (DM) is one of the most common chronic illnesses worldwide. According to the World Health Organization, about By 2025, Asian developing countries would account for 60% of diabetic patients. Insulin, as well as other hormones, are produced by pancreatic beta cells. Increased blood sugar levels are required for insulin release above basal levels, and insulin, as an anabolic hormone, will aid in the process of glycogenesis, protein synthesis, and glucose uptake in muscles and adipose tissue. Type I Diabetes Mellitus is caused by a complex interaction of inherited, environmental, and immunological variables that lead to immune system dysfunction, pancreatic cell damage, and insulin deficiency. There is strong evidence of lymphocytic insulinitis and cell-mediated autoimmunity, with helper/inducer and cytotoxic/suppressor T lymphocyte subsets, as well as natural killer cells, present. Because of compensatory over-secretion of insulin by pancreatic islets, glucose tolerance remains normal in the early stages despite insulin resistance. The pathophysiology of long-term diabetic consequences such microvascular disease (microangiopathy), retinal disease (retinopathy), kidney disease (nephropathy), and nerve dysfunction (neuropathy) is currently being studied extensively. Pioglitazone and rosiglitazone are rapidly absorbed and mainly bound by serum albumin after oral dosing. Both of these medicines go through CYP450 metabolism, which is mediated by several isozymes. Increased frequency of infections, sepsis, preeclampsia, postpartum haemorrhage, foetal malformations, large newborns, labour irregularities, and unexpected foetal deaths are all maternal problems related with diabetes during pregnancy.

Author(s) Details

Sourya Acharya
Department of Internal Medicine, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College Sawangi (Meghe), Wardha, Maharashtra, India.

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