High-risk obstetrics, hypertension,malformations

Obesity negatively impacts the health of women in many ways. Being overweight or obese increases the relative risk of diabetes and coronary artery disease in women. Women who are obese have a higher risk of low back pain and knee osteoarthritis. Obesity negatively affects both contraception and fertility as well. Maternal obesity is linked with higher rates of cesarean section as well as higher rates of high-risk obstetrical conditions such as diabetes and hypertension. Pregnancy outcomes are negatively affected by maternal obesity (increased risk of neonatal mortality and malformations)...

OBJECTIVE: To determine the perinatal outcome of high risk pregnancies, in terms of perinatal mortality, Apgar score, birth weight and neonatal complications in first week after birth. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Obstetric Department of Sir Syed Trust Hospital, Karachi, from January to December 2007. METHODOLOGY: All antenatal patients attending the Outpatient Department were interviewed, after informed consent...

OBJECTIVE: To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN: Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING: Obstetric department and neonatal department of a university hospital in Denmark. PARTICIPANTS: All liveborn babies without malformations, with gestational ages between 37 and 41 weeks, and delivered between 1 January 1998 and 31 December 2006 (34 458 babies)...

BACKGROUND AND AIM: To determine pregnancy outcome in women with type 1 and type 2 diabetes. METHODS AND RESULTS: A prospective study was conducted in 33 centers in Italy between 1999 and 2003, mainly recording preterm delivery, stillbirths, neonatal mortality, congenital malformations and birthweight. Of the 668 women examined, 504 had type 1 diabetes and 164 had type 2. Pre-pregnancy counseling had been provided to 43.9% of the women who had type 1 diabetes and 29...

OBJECTIVE: Preeclampsia, gestational hypertension, and unexplained intrauterine growth restriction may have similar determinants and consequences. In this study, we compared determinants and perinatal outcomes associated with these obstetric conditions. STUDY DESIGN: We analyzed 39,615 pregnancies (data from the WHO Antenatal Care Trial), of which 2.2% were complicated by preeclampsia, 7.0% by gestational hypertension, and 8.1% by unexplained intrauterine growth restriction (ie, not associated with maternal smoking, maternal undernutrition, preeclampsia, gestational hypertension, or congenital malformations)...

OBJECTIVE: To compare the complications, delivery mode and fetal outcome between elderly primigravidae and young primigravidae. DESIGN: A comparative study. PLACE AND DURATION OF STUDY: Department of Obstetrics and Gynaecology, POFs Hospital, Wah Cantt, from January 2001 to December 2002. SUBJECTS AND METHODS: One hundred and fifty six elderly primigravidae were compared with a matched pair group of younger primigravidae regarding antenatal, intrapartum and postpartum complications...

OBJECTIVE: The purpose of this study was to investigate the pregnancy outcome of patients after bariatric surgery. STUDY DESIGN: A population-based study was performed that compared all pregnancies of patients with and without previous obesity operations between the years 1988 and 2002. Stratified analyses with the Mantel-Haenszel technique and a multiple logistic regression model were performed to control for confounders. RESULTS: Of the 159210 deliveries that were performed during the study period, 298 deliveries were to patients after bariatric operations...

Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is becoming an increasing health problem worldwide and one of the most common complications of pregnancy. The prevalence of GDM in Central Europe is 5-7%. GDM is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. The key symptom of GDM is the development of diabetic fetopathy. Fetal hyperinsulinism is associated with macrosomia and a higher rate of birth injuries and caesarean sections, neonatal hypoglycemia, respiratory distress and due to fetal programming the development of the sequelae of the metabolic syndrome in childhood or adolescence...

UNLABELLED: Pre-gestational diabetes is a serious risk factor in pregnancy and delivery. Complications during pregnancy in this group of women depend on the glycemic control and on the clinical course of diabetes. MATERIAL AND METHOD: On the period of 1991-2001, 186 pregnant women with diabetes diagnosed before pregnancy were hospitalized in Ob/Gyn Department, Medical University of Bydgoszcz. In this study, 178 deliveries and 8 abortions were analyzed. The selected glycemic control indices-GCI (General Control Index) were analyzed in diabetic women with non-complicated pregnancies and in women with complications during pregnancy...

OBJECTIVE: To determine the incidence, obstetric risk factors and pregnancy outcome of placental abruption at term. METHODS: A comparison of all singleton term deliveries (> or = 37 weeks' gestation) complicated with placental abruption to singleton term deliveries without placental abruption. Multivariate analysis was performed to investigate independent risk factors for placental abruption. RESULTS: Placental abruption complicated 0.3% of all term deliveries (n = 72,995)...

BACKGROUND: We evaluated interactions between perinatal outcome after oocyte donation and various maternal factors. METHODS: The study included 134 parturients after oocyte donation. Data were collected from medical files and personal interviews. Stepwise logistic regression analyses were used to evaluate associations between perinatal outcomes and selected maternal variables. RESULTS: Fifty percent of the women were >43 years old, 30.6% were >45 years and 67...

OBJECTIVE: To evaluate the maternal morbidity in < or = 16 year old pregnant teenagers. MATERIAL AND METHODS: A prospective study of the reviewed cases was carried out from June 1998 to May 1999. All pregnant teenagers which attended the Coordination for the Attention of the Teenage Patient and whose pregnancy came to term during the study period were included. The following variables were analyzed: maternal age, preexisting related diseases, number of pregnancies, number of prenatal control medical visits and the time at which these were started, and maternal morbidity secondary to pregnancy...

BACKGROUND: Advances in surgical techniques and immunosuppression have improved the results in organ transplantation. The quality of life in these patients is good in the most of cases and pregnancy, which means for them to resume a normal life, isn't an exceptional event, specially for kidney transplant recipients. METHODS: Retrospective data regarding pregnancies observed at the Dept. of Nephrology and Dialysis of the S. Giovanni Battista Hospital in Turin, have been collected to value the pregnancy frequency and outcome (complications, miscarriage, therapeutic abortion), the mother follow-up as a function of transplant rejection risk, the newborn conditions, their hematological and immunological situation, and the children follow-up...

Gestational diabetes complicates 3-5% of pregnancies. Of diabetes seen during pregnancy, 10% is pregestational and the remaining 90% represents gestational diabetes. (1,2) Pregnancy in women with pregestational diabetes is especially high risk. Spontaneous abortion, preterm labor, congenital malformations, preeclampsia, macrosomia, birth injury, and cesarean section are all increased in these pregnancies. Deterioration of maternal health during pregnancy, especially in the setting of diabetes-induced end-organ disease, is a real concern...

The aim of this study was to analyze the outcome of pregnancy and delivery in epileptic women. A retrospective review of the 41 pregnant women with epilepsy who delivered in the Department of Obstetrics and Perinatology of the University School of Medicine in Lublin over 7 years (1993-1999) was carried out. Women with epilepsy had more pregnancy complications including premature labor, anemia, hypertension, vaginal bleeding, urinary tract infection, nausea and vomiting. An increased risk of congenital malformations and intrauterine fetal growth retardation was observed...

OBJECTIVE: To determine whether congenital anomalies are associated with a high rate of neonatal morbidity in preterm birth. STUDY DESIGN: 312 singletons (22-36 wk) with congenital anomalies that were delivered preterm were compared with a random sample of 936 preterm singleton without congenital anomalies. Data was obtained using the computerized birth discharge records. Statistical analysis included univariate and multivariate logistic regression analyses. RESULTS: Three thousand five hundred and seventy-eight (3578) women with preterm births met the inclusion criteria (singleton with prenatal care)...

All gravid women attending the antenatal clinic of the department of Gynaecology Unit-II, Civil Hospital Karachi and unbooked cases presenting in labour from October, 1986 to December, 1993, were included in the study. On the basis of risk factors for diabetes mellitus (DM), they were divided into 3 groups. Women in Group-I had family history of DM, bad obstetric history, congenitally malformed babies, polyhydramnios, obesity and macrosomia. Group-II included women with pregnancy induced hypertension (PIH) abruptio placentae, age > 30 years and multiple pregnancy...

We report 2 cases of aortic coarctation in women aged 18.5 and 24 years, respectively. In 1 the malformation was found during gestation, while the other became pregnant after the diagnosis was made. Both had uneventful pregnancies and delivered healthy babies. Coarctation of the aorta is found in approximately 7% of those with congenital heart disease. The clinical diagnosis is made from the absence of femoral artery pulsations and low arterial pressure in arteries originating distal to the coarctation and hypertension in those proximal to it...

OBJECTIVE: We sought to determine the effect of clinical chorioamnionitis on cord blood gas values in term pregnancies not complicated by any other disease. STUDY DESIGN: 2200 consecutive deliveries were studied. Following exclusion of twins, non-viable malformations and stillbirths, as well as mothers with high-risk pregnancy diseases--i.e. hypertension, diabetes, preterm labor, third-trimester bleeding, IUGR, postdates, oligohydramnios, i.v. drug abused, decreased fetal movement, maternal viral infection, UTI or pneumonia (n = 897)--two groups of patients remained: term pregnancies complicated only by clinical chorioamnionitis (n = 81) and uncomplicated term pregnancies (n = 1246)...

OBJECTIVE: To determine the risk of adverse neonatal outcome associated with meconium-stained amniotic fluid independent of that related to antepartum or intrapartum abnormalities. METHODS: A cohort of 2200 consecutive deliveries was examined and the fetal heart rate (FHR) tracings analyzed independently. Singleton term pregnancies without fatal malformations were stratified by the consistency of meconium and compared. RESULTS: Moderate or thick meconium increased the risk for adverse outcome more than threefold (relative risk 3...