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Wieringa-de, Waard Margrethe. "Bleeding in the first trimester of pregnancy." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2002. http://dare.uva.nl/document/61606.
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Niemimaa, M. (Marko). "First trimester screening for Down syndrome." Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:9514270290.
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Abstract
The aim of the present study was to evaluate the efficacy of the first trimester screening for Down syndrome (DS) in an unselected low-risk Finnish population. The study involved 4,617 women who attended screening between the 8th and 14th weeks of pregnancy in 1998-2000. They gave a blood sample for the measurement of pregnancy associated plasma protein A (PAPP-A) and free beta human chorionic gonadotrophin (β-hCG). Of these women, 3,178 also had an ultrasound examination for the measurement of fetal nuchal translucency (NT). The risk figure for every screened woman was calculated using a computerized risk figure program. The risk 1 in 250 was used as a cut-off. The subgroup of screen positives comprised 5.8% of the study group.
There were 16 DS cases. The combined method (maternal age, NT and the biochemical markers) detected 77% of the affected pregnancies. NT combined with maternal age gave a detection rate of 69%. Serum markers without NT combined with maternal age found 75% of the Down's.
In 49 consecutive singleton in-vitro-fertilization pregnancies, the β-hCG value was more often elevated compared to spontaneous pregnancies, increasing the false positive rate. In 67 twin pregnancies, the serum marker levels were approximately double those in singletons. Smoking reduced PAPP-A by 20% making the smokers more likely to get a positive screening result.
To determine the impact of the screening on the live born incidence of DS, two historical populations were compared. The first group was screened by second trimester serum samples (β-hCG and AFP) and the second group by first trimester ultrasound examination. When detection rates were at the same level, the second trimester screening reduced the number of live born Down's children more effectively.
In conclusion, the first trimester combined method (maternal age, NT, β-hCG and PAPP-A) for Down syndrome screening is efficient in an unselected low risk population. The biochemical screening is not recommended in IVF-pregnancies.
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Marttala, J. (Jaana). "First trimester screening and Down syndrome." Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514294815.
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Abstract The purpose of this study was to evaluate extended first trimester screening for severe chromosomal disorders and adverse pregnancy outcomes in singleton pregnancies among the general population in Finland. Maternal serum biochemical markers, pregnancy associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (fβ-hCG), and fetal nuchal translucency (NT) thickness were measured during the gestational weeks 8+0–13+6. A computerized risk figure program was used to calculate an individual risk figure for chromosomal disorders. It was investigated whether the screening parameter, PAPP-A, is associated with adverse pregnancy outcomes. The prevalence of Down syndrome (DS) cases in Finland during the years 2002–2006 was 1:364 (N=795). The proportion of women aged 35 years or older increased from 5–10% in the years 1980–1990 to 19.1% during the study period. Most DS cases (61.1%) presented in that age group. The first trimester combined screening for Down syndrome yielded a detection rate (DR) of 81.9% for a 4.3% false positive rate (FPR). The performance was evaluated among 76949 voluntary women during the study period of 01.05.2002–31.12.2008. There were 188 cases of DS. The screening worked better among the older women. The number of invasive procedures needed to detect one case of DS was higher among the younger women. Adding specific algorithms for screening of other chromosomal abnormalities yielded DR of 74.0% for trisomy 18 (T18) and 54.5% for trisomy 13 (T13) with an additional increase of 0.3% FPR. For chromosomal abnormalities other than T18 and T13, the specific algorithms did not improve the screening performance. Low first trimester maternal serum levels of PAPP-A (≤0.30 MoM) were significantly associated with small for gestational age (SGA) newborns and stillbirths (SBs). The combined screening method for DS works well in practice and has been standardized in Finland. In screening for trisomies 18 and 13 a specific algorithm is reasonable. Low first trimester levels of PAPP-A could be used as an independent marker for pregnancies at high risk for SGA babies and SBsTiivistelmä Tutkimuksen tarkoituksena oli arvioida laajennetun ensimmäisen raskauskolmanneksen kromosomipoikkeavuuksien seulonnan toimivuutta yksisikiöisissä raskauksissa suomalaisessa normaaliväestössä. Äidin seerumin biokemialliset merkkiaineet, raskauteen liittyvä valkuaisaine A (PAPP-A) ja raskaushormoni (fβ-hCG) sekä sikiön niskaturvotus mitattiin raskausviikoilla 8+0–13+6. Yksilöllinen riskiluku kromosomipoikkeavuuksille laskettiin käyttäen tietokoneen riskinlaskentaohjelmaa. Seulonnan merkkiaineen, PAPP-A:n, matalien pitoisuuksien yhteyttä epäsuotuisiin raskauden lopputuloksiin tutkittiin. Downin oireyhtymän esiintyvyys Suomessa oli 1:364 (N=795) vuosina 2002–2006. 35-vuotiaiden tai sitä vanhempien naisten osuus oli tutkimusaikana 19.1 %, mikä on huomattavasti suurempi kuin vuosien 1980–1990: 5–10 %. Näiden naisten sikiöiden joukosta löytyi suurin osa Down oireyhtymistä (61.1 %). Ensimmäisen raskauskolmanneksen yhdistelmäseulonnan toimivuutta tutkittiin aikana 01.05.2002–31.12.2008. Tutkimukseen osallistui 76 949 vapaaehtoista naista. Joukossa oli 188 Downin oireyhtymätapausta. Seulonnan herkkyys Downin oireyhtymälle oli 81.9 % ja tarkkuus 4.3 %. Seulonta toimi parhaiten vanhempien naisten joukossa. Niiden kajoavien toimenpiteiden määrä, jotka tarvittiin yhden Down-sikiön löytämiseksi, oli suurempi nuorten naisten joukossa. Tutkimuksessa Downin oireyhtymän algoritmiin lisättiin spesifiset algoritmit trisomioille 18 ja 13, jolloin saavutettiin 74.0 %:n herkkyys trisomialle 18 ja 54.5 %:n herkkyys trisomialle 13. Väärien positiivisten seulontatulosten määrä kasvoi 0.3 %:n verran. Seulonnan toimivuus muiden kromosomipoikkeavuuksien joukossa ei parantunut spesifisten algoritmien avulla. Lisäksi matalan PAPP-A-pitoisuuden yhteys pienipainoisuuten ja kuolleena syntyneisyyteen oli tilastollisesti merkittävä. Tutkimus osoitti, että esimmäisen raskauskolmanneksen yhdistelmäseulonta toimii hyvin käytännössä. Trisomioiden 18 ja 13 seulonnassa spesifisten algoritmien käyttö on järkevää. Matalaa ensimmäisen raskauskolmanneksen PAPP-A-arvoa voitaisiin käyttää itsenäisenä riskimerkkiaineena raskauksille, joissa pienipainoisuuden ja kuolleena syntymisen riski on kohonnut
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Tong, Stephen. "Investigation of novel endocrine markers of early pregnancy and later pregnancy health." Monash University, Dept. of Obstetrics and Gynaecology, 2004. http://arrow.monash.edu.au/hdl/1959.1/9689.
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Bottomley, Cecilia. "Prediction of first trimester pregnancy outcome using prior risk factors and ultrasound findings." Thesis, St George's, University of London, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.676895.
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The aim of this thesis was to examine a large cohort of women undergoing pregnancy assessment before 12 weeks gestation, collecting demographic, symptom and ultrasound data. I aimed to examine the role of prior risk factors and initial ultrasound findings in the prediction of first trimester viability of these pregnancies. Further, I aimed to develop and validate models to counsel women in future about the likely chance of viability for any individual pregnancy. The hypotheses were: (1) There are prior risk and ultrasound factors that can predict likely pregnancy viability, (2) These factors can be used to predict pregnancy loss or ongoing viability in any particular pregnancy and (3) In predicting outcome, both mathematical models } and 'simple rules' (for everyday clinical use) can perform well. ) The prospective study included 1881 women, with median age 32 years and median gestational age at presentation of 50 days. 46% presented with bleeding and 36% with pain. The final outcome was an ongoing pregnancy in 885 (61.7%) and early pregnancy loss in 550 (38.3%) women. Both 'prior risks' (maternal age and bleeding score) and ultrasound factors (gestation and yolk sac size and fetal heart beat) predicted viability. Mathematical models developed showed that these factors used separately and when combined together predicted viability with accuracy. The final scoring system using both demographic and ultrasound variables together was proven to be highly accurate in prediction of pregnancy viability, performing with a sensitivity of 0.92, specificity of 0.73, positive predictive value of 84.7% and negative predictive value of 85.4%. All 3 study hypotheses were proven. The conclusion of this study is that using routinely collected demographic and ultrasound data an accurate individualised likelihood of ongoing viability can be offered to women in early pregnancy with and without symptoms of pain or bleeding.
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Chen, Min, and 陳敏. "Application of ultrasonography in early pregnancy." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B36603314.
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Ramos-Orosco, Elizabeth J. "Comment on first trimester maternal serum analytes and second trimester uterine artery doppler in the prediction of preeclampsia and fetal growth restriction." Taiwan Association of Obstetrics and Gynecology, 2018. http://hdl.handle.net/10757/622873.
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Buckley, Rebecca J. "The role of decidual macrophages in the first trimester of pregnancy and in the pregnancy complication pre-eclampsia." Thesis, St George's, University of London, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.719150.
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Uterine decidual macrophages are present throughout pregnancy however, little is known of their phenotype or functional relevance. This study aimed to further the understanding of decidual macrophage phenotype and function across the first and early second trimester. In addition, this study aimed to compare decidual macrophages derived from normal pregnancies and those at increased risk of developing complications (pre-eclampsia, FGR and stillbirth). Macrophage phenotype was shown to differentially affect trophoblast behaviour, with pro-inflammatory (M1 -like) macrophages inducing trophoblast apoptosis and impairing trophoblast motility, proliferation and network formation, when compared with an anti-inflammatory (M2-like) phenotype. Decidual macrophages were found to become increasingly anti-inflammatory with gestation; with upregulation of CD206 expression and downregulation of CD86, TLR4 and CD11c expression between the 4th and 14th week of pregnancy. The relative risk of a pregnancy developing complications was calculated by uterine artery resistance indices (Rl) measured by Doppler Ultrasound scanning, enabling phenotypic and functional comparisons to be made between decidual macrophages from normal and higher risk pregnancies. Decidual macrophages from normal pregnancies and those with a higher risk were found to differ in their cytokine secretion profiles, with those from higher risk pregnancies having reduced TNF-a, IL-8, VEGF, IL-1 ra and M-CSF secretion. Decidual macrophages from pregnancies with a higher risk of developing complications were also found to increase trophoblast apoptosis, reduce trophoblast proliferation, and impair trophoblast chemotaxis and network formation, when compared to decidual macrophages from normal pregnancies. Vascular smooth muscle apoptosis, proliferation and motility was not found to be affected by decidual macrophages. When decidual NK cells were cultured with secreted factors from decidual macrophages no effect on decidual NK phenotype was observed. Conversely, decidual macrophages cultured with decidual NK cell secreted factors were found to have elevated expression of CD11c and TLR4. The shift in decidual macrophage phenotype with advancing gestation likely reflects the requirement for tolerance of the semi-allogeneic fetus to support a successful pregnancy. The differential regulatory effect of decidual macrophages from normal and higher risk pregnancies on trophoblast phenotype and function are particularly interesting given that aberrant trophoblast invasion and spiral artery remodelling is related to the pathology of pre-eclampsia. These observations suggest that preeclampsia is preceded by impaired decidual macrophage-trophoblast interactions.
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Vukas, Radulovic Nina. "Clinical, biochemical and morphological aspects of cervical ripening in the first trimester /." Göteborg : Department of Obstetrics and Gynecology, Institute of Clinical Sciences, The Sahlgrenska Academy, 2009. http://hdl.handle.net/2077/20456.
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Alyahyaei, Zahraa. "The role of IL-33 and ST2 in early pregnancy." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:a6fd7c02-feeb-4fe5-b8e1-5713a65653b9.
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Regulation of the growth and differentiation of trophoblast cells is critical for successful embryo implantation and placentation. Cytokines are key players in these processes, as well as modulating the maternal immune response to prevent rejection of the conceptus. This thesis focused on the investigation of the cytokine interleukin (IL) - 33 and its receptor, ST2. ST2 has two isoforms, a functional cell surface receptor (ST2L) and a soluble decoy receptor (sST2). Previous work in this laboratory had shown that the human placenta expresses both IL-33 and sST2 at term. The aim of this thesis was to investigate IL-33 and ST2 in early pregnancy, the time when trophoblast is at its most active, with a view to better understanding their role. IL-33 and ST2 mRNA and protein were examined in 14 first trimester placentas from 6-12 weeks of gestation. IL-33 was localized to cells in the villous stroma, whereas ST2 was present in the syncytiotrophoblast, villous cytotrophoblast and the invasive extravillous cytotrophoblast of the cell columns. Secretion of sST2, but not IL-33, by the placenta was found. Investigation of pre-implantation embryos showed the presence of ST2, but not IL-33 protein. Decidualized endometrium was investigated as a potential source of IL-33 and sST2 at the maternal-fetal interface and, although mRNA for both was present, no protein could be found. The key finding was that sST2, rather than ST2L, was the predominant isoform in the placenta. This led us to reconsider the hypothesis that IL-33/ST2 interactions in the placenta are important for successful pregnancy and raised the possibility that they may have independent roles. Using trophoblast cell lines as a model, it was shown that sST2 binds to trophoblast cells, significantly inhibits their proliferation and stimulates their invasion in vitro. This is the first report of this novel role for sST2 in pregnancy. Thus these studies have shown that sST2 may play an important role in implantation and placentation through controlling trophoblast invasion.
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Kulin, Nathalie A. "Pregnancy outcome following first trimester maternal exposure to the newer selective serotonin reuptake inhibitors." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29322.pdf.
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Morgan, Chelsea, Judy G. McCook, and Beth Bailey. "First Trimester Depression Scores Predict Development of Gestational Diabetes Mellitus in Pregnant Rural Appalachian Women." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7170.
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Gestational diabetes (GDM) occurs in up to 9% of pregnancies. Perinatal depression affects up to 20% of women during pregnancy, and can extend into the postpartum period. A number of studies have linked depression and diabetes, however, whether this applies to GDM or which might come first is less understood. The purpose of this study was to examine the potential relationship between depression identified in the first trimester of pregnancy and the subsequent development of GDM. Women without pre-existing Type I/II diabetes (n = 1021) were evaluated for depression during the first trimester of pregnancy, and medical records were reviewed to identify a positive history of diabetes. Women identified as depressed during the first trimester were more likely to have GDM compared to those not depressed. After controlling for demographic factors and weight-related variables level of depression in the first trimester still predicted later GDM development. Depression identified in early pregnancy may predict increased risk of subsequent GDM development. Due to the numerous maternal, fetal and neonatal complications associated with GDM, early recognition is essential to promote the best possible outcomes for mother and infant. Recognizing depression as a possible risk factor for GDM development could lead to earlier screening and preventative measures.
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Deason, Brandon. "Perception of Access to Prenatal Care of Women Presenting to the Emergency Department During the First Trimester of Pregnancy." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/603592.
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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Background: Despite the large amount of research regarding prenatal care (PNC) in physicians’ offices, hospital outpatient clinics, and community health centers, there is a great paucity of information regarding the role the Emergency Department plays in PNC. Objective: To understand the factors associated with pregnant women’s choice to seek prenatal care in the Emergency Department. Methods: This study is an investigative examination of the attitudes towards and perceived barriers to PNC of women in the first trimester of pregnancy presenting to the Emergency Department at an urban level 1 trauma center. Survey questions examined demographic information and patient factors, such as how they found out about the pregnancy, if they had seen a doctor for this pregnancy, use of PNC in prior pregnancies, and whether they would utilize first trimester PNC in the future. Additionally, the survey contained a series of statements about the importance of PNC and factors affecting their utilization as rated on a 5 point Likert scale. All data was abstracted and coded into Excel. Descriptive statistics and 95% confidence intervals were calculated. Logistic regression was used to predict future PNC use. Results: A total of 74 patients who met the inclusion criteria were surveyed. Ninety‐three percent (CI 84‐97%) knew they were pregnant prior to presenting to the ED. Thirty‐seven percent (CI 27‐50%) had a prenatal visit prior to the index ED visit. Twelve percent (CI 6‐22%) reported they were at the ED for PNC, 70% (CI 59‐80%) for another OB/GYN issue, and 18% (CI 10‐28%) for a reason unrelated to pregnancy. However, 22% strongly agreed and 8% agreed that if they had PNC they would not have come to the ED that day. Predictors of future PNC use included knowledge of pregnancy prior to ED visit, number of pregnancies, belief that PNC is important for the mother’s health, knowledge of where to receive PNC, and belief that taking prenatal vitamins during pregnancy can help the baby. Conclusions: For the population of pregnant females presenting to an urban level 1 trauma emergency department during the first trimester of pregnancy, a large proportion (30%) reported they would not have come to the ED if they received PNC. This would represent a significant reduction in ED visits per year if these women received appropriate services. Future research would need to further delineate the perceived barriers to PNC in this population.
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McGowan, Clare. "Are women making informed choices with regard to Combined Ultrasound & Biochemical (CUB) screening in the first trimester of pregnancy?" Thesis, University of Glasgow, 2007. http://theses.gla.ac.uk/10/.
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Summary Background: Previous studies report that women are failing to make informed choices with regard to antenatal screening, due to significant deficits in knowledge. However, current definitions dictate that informed choice occurs not merely as a result of sufficient knowledge, but by acting in line with one’s attitudes despite perceived social pressure (Dormandy et al., 2002). Objective: To investigate whether women are making informed choices with regard to Combined Ultrasound & Biochemical (CUB) screening, using more substantial criteria. Design: Prospective non-experimental. Setting: The Queen Mother’s Maternity Hospital in Glasgow. Sample: 63 women due attend their first antenatal appointment. Outcome measures: responses to a questionnaire constructed for the purposes of the study. Methods: A multidimensional questionnaire measure encompassing demographic factors, areas of knowledge recommended by The Royal College of Obstetricians and Gynaecologists (RCOG, 1993) and all aspects of the Theory of Planned Behaviour (TPB; Ajzen, 1985). Results: Women appeared to be well informed, though there were some worrying misconceptions. Women appeared to intend to act in line with their attitudes, although small numbers of women planning to refuse screening limited findings. Attitude was the strongest predictor of behavioural intention. Conclusions: There appears to be moderate support for the hypothesis that women would make ‘informed choices’, though this is limited by a number of factors which require further investigation.
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Mohammednur, Mohammedmekin Mohammedseid. "Adverse pregnancy outcomes among HIV-positive pregnant women treated with efavirenz-containing antiretroviral drugs: a retrospective cohort study in the Cape Flats." Thesis, University of the Western Cape, 2017. http://hdl.handle.net/11394/6185.
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Doctor Pharmaceuticae - DpharmThe use of efavirenz (EFV) in the first trimester of pregnancy remains controversial. In South Africa, the use of EFV-containing antiretroviral therapy (ART) as part of a Fixed Dose Combination (FDC) during the first trimester of pregnancy started in April, 2013. Literature to date has reported conflicting outcomes following the use of EFV-containing ART during the first trimester of pregnancy. The objectives of the study were to determine the prevalence of adverse pregnancy outcomes among HIV-positive pregnant women treated with EFV-containing ART and compare these results with those of pregnant women treated with NVP-containing ART and HIV-negative pregnant women in resource-limited settings. In addition, the study also aimed to determine the effect of the time of initiation of ART on the prevalence of adverse pregnancy outcomes.
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Lamberty, Clarissa Oliveira. "Avaliação da eficácia da ultrassonografia no primeiro trimestre gestacional para detecção de artéria umbilical única." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-21122010-121420/.
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Objetivo: Calcular os valores preditivos da ultrassonografia de primeiro trimestre gestacional para a detecção da artéria umbilical única. Avaliar a relação dos marcadores ultrassonográficos de cromossomopatias do primeiro trimestre (translucência nucal, osso nasal e ducto venoso), além da idade gestacional do exame, CCN, sexo fetal, medida da bexiga fetal, alterações de morfologia e IMC da gestante, com a acurácia do diagnóstico no primeiro trimestre. Métodos: Estudo longitudinal prospectivo envolvendo 1.564 gestantes, que foram submetidas à ultrassonografia com avaliação do cordão umbilical entre 11 e 13 semanas e 6 dias, no período de novembro de 2007 a setembro de 2009. Posteriormente, realizaram a avaliação do cordão umbilical em ultrassonografia realizada no segundo ou terceiro trimestres. Foi verificada a concordância do diagnóstico de AUU no primeiro trimestre com o diagnóstico no segundo trimestre, calculando-se o coeficiente Kappa. Os testes qui-quadrado e exato de Fisher foram utilizados para verificar a existência de associação entre a acurácia da ultrassonografia de primeiro trimestre e as variáveis da ultrassonografia e da gestante (translucência nucal, osso nasal, ducto venoso, idade gestacional do exame, CCN, sexo fetal, medida da bexiga fetal, alterações de morfologia e IMC da gestante). Resultados: A concordância dos diagnósticos de AUU no primeiro e segundo trimestres foi moderada (Kappa = 0,609), sendo que a sensibilidade da ultrassonografia de primeiro trimestre em relação à ultrassonografia de segundo trimestre foi de 76%, a especificidade foi de 99%, o valor preditivo positivo foi de 51,6% e o valor preditivo negativo foi de 99,6%. A acurácia foi de 98,7%. Dentre as variáveis analisadas, que poderiam ter influenciado na acurácia da ultrassonografia de primeiro trimestre na detecção de AUU, a única que se mostrou estatisticamente significante foi o sexo fetal. Conclusão: A sensibilidade da ultrassonografia de primeiro trimestre na detecção da AUU é de 76%, o que é menor do que a observada no segundo ou terceiro trimestres.Objective: To calculate the predictive values of first gestational trimester ultrasonography for detection of single umbilical artery. Assess the relation of ultrasound markers of chromosomal disease in the first trimester (nuchal translucency, nasal bone and ductus venosus) in addition to gestational age at exam, CRL, fetal gender, measurement of fetal bladder, morphological alterations and BMI of a pregnant woman, with accuracy of diagnosis in the first trimester. Methods: A prospective longitudinal study was conducted from November 2007 to September 2009 encompassing 1564 pregnant women submitted to ultrasound imaging for umbilical cord assessment between the 11 and 13 weeks and six days. Later they underwent evaluation of the umbilical cord by ultrasound performed in the second or third trimesters. Consistency of SUA diagnosis in the first trimester was verified with that of the second trimester by calculating the Kaplan coefficient. The Chi-square and Fisher\'s exact tests were used to verify if there was an association between accuracy of ultrasonography of the first trimester and the variables of ultrasonography and those of the pregnant woman (nuchal translucency, nasal bone, ductus venosus, gestational age at exam, CRL, fetal gender, measurement of fetal bladder and morphological alterations as well as pregnant woman\'s BMI). Results: SUA diagnoses in the first and second trimester disclosed moderate consistency (Kaplan=0.609) while sensitivity of first trimester ultrasound in relation to that of the second trimester was of 76% and specificity was of 99%, positive predictive value was of 51.6% and negative predictive value was of 99.6%. Accuracy was of 98.7%. Among the analyzed variables, fetal gender was the only one with a statistical significance that might bear influence on first trimester ultrasound accuracy for detection of SUA. Conclusion: Sensitivity of the first trimester ultrasound for detection of SUA is of 76%, that is to say, lower than that observed in the second or third trimesters
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Huang, Pinchia. "Implications of False-Positive Trisomy 18 or 21 Screening Test Results in Predicting Adverse Pregnancy Outcomes." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1247627814.
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Morrison, Chelsea, Judy G. McCook, and Beth Bailey. "First Trimester Depression Scores Predict Development of Gestational Diabetes Mellitus in Pregnant Rural Appalachian Women." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7180.
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Dufresne, Alexandra. "Facteurs descriptifs de la susceptibilité hypnotique : une sous-analyse de l'essai clinique "Hypnotic analgesia intervention during first-trimester pregnancy termination : an open randomized trial"." Thesis, Université Laval, 2008. http://www.theses.ulaval.ca/2008/25783/25783.pdf.
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Meade, Eliza. "Hypoxic Regulation of VEGF and PAI-1 Expression by HIF-1[alpha] and HIF-2[alpha] in First Trimester Trophoblasts." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-115727/.
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Preeclampsia results from incomplete trophoblast invasion of the spiral arteries during early pregnancy. Vascular endothelial growth factor (VEGF) and plasminogen activator inhibitor-1 (PAI-1) are critical factors involved in angiogenesis, invasion and hemostasis at the maternal-fetal interface. Both factors are transcriptionally regulated by hypoxia inducible factor (HIF), a heterodimeric complex consisting of HIF-1[beta] and either HIF-1[alpha] or -2[alpha] whose specificity or redundancy in gene regulation is cell-type specific. This study uses siRNA technology to dissect the mechanisms of hypoxia-mediated regulation of PAI-1 and VEGF expression in first trimester trophoblasts. Immortalized first trimester human extravillous trophoblasts (HTR8/SVneo cells) were maintained in serum-free and serum-containing media for 4h (n=3-4), 8h (n=6), 24h (n=5) and 48h (n=5) under normoxic (21% O2) and hypoxic (1-2% O2) conditions to determine a time of maximum induction of both VEGF and PAI-1. Subsequently, cells were maintained for 48h in the presence or absence of siRNA for HIF-1[alpha], HIF-2[alpha], HIF-1[alpha] + -2[alpha], a non-targeting (NT) sequence or Cyclophilin B (CB). Media were then removed, cells lysed, and Western blotting used to assess HIF-[alpha] knockdown. VEGF and PAI-1 levels in the media were quantified by ELISA and results expressed as pg or ng/[micro]g protein. Results from 3 to 8 independent experiments were analyzed using unpaired t-tests. Under hypoxic conditions treatment of cells with HIF-1[alpha], HIF-2[alpha] or HIF -1[alpha] + -2[alpha] siRNA resulted in >90% HIF-Ñ protein knockdown as determined by Western blotting. 48h of hypoxic treatment caused a statistically significant increase in PAI-1 levels (p<0.01) and VEGF levels (p<0.001) compared to normoxic controls. Under hypoxic conditions, PAI-1 levels were 4.75 [plus-minus] 0.46 ng/[micro]g protein and VEGF levels were 7.27 [plus-minus] 1.08 pg/[micro]g protein. Treatment with siRNA to HIF-1[alpha], HIF-2[alpha] and HIF-1[alpha] + -2[alpha] significantly reduced PAI-1 levels to 3.3 [plus-minus] 0.35 (p<0.02), 3.1 [plus-minus] 0.38 (p<0.03) and 2.4 [plus-minus] 0.19 (p<0.003), respectively. No significant difference in PAI-1 reduction was noted between the three HIF siRNA conditions. Under hypoxic conditions, levels of VEGF in cells treated with siRNA to HIF-1[alpha] (5.79 [plus-minus] 0.55), HIF-2[alpha] (5.50 [plus-minus] 1.24) and HIF-1[alpha] + -2[alpha] (4.24 [plus-minus] 0.93) were reduced compared to the hypoxic control (7.27 [plus-minus] 1.08), yet these effects did not reach statistical significance. However, when compared with the levels observed in cells treated with NT siRNA (9.90 [plus-minus] .98), all HIF siRNA treatments promoted a significant reduction in VEGF expression (p<0.003, p<0.02 and p<0.003 for HIF-1[alpha], HIF-2[alpha] and HIF-1[alpha]+ -2[alpha], respectively). In conclusion, these results indicate that hypoxia-mediated changes in PAI-1 and VEGF expression in trophoblasts are regulated similarly by both HIF-1[alpha] and HIF-2[alpha]. This provides important insight into the molecular mechanisms regulating hemostasis and trophoblast invasion as well as their potential dysfunction in pregnancies complicated by preeclampsia
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Kao, Chien-Huei. "First time Taiwanese fathers' lived experiences during the third trimester of their wives' pregnancy, labour and delivery and the initial postnatal period : a phenomenological study." Thesis, University of Ulster, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273047.
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Hernandez, Isabelle. "Étude de l’expression, de l’activité et du rôle de la NADPH oxydase dans la villosité choriale au premier trimestre de la grossesse : implication dans la physiopathologie de la prééclampsie NADPH oxidase is the major source of placental superoxide in early pregnancy: association with MAPK pathway activation sFlt-1 secretion in early first trimester chorionic villi is associated with p38 MAPK pathway activation NADPH oxydase : enzyme potentiellement impliquée dans la physiopathologie de la prééclampsie." Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCB051.
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Le placenta est un organe transitoire permettant les échanges nutritionnel et gazeux entre la mère et le fœtus. Son unité structurale et fonctionnelle est la villosité choriale (VC), constituée en son centre d'un axe mésenchymateux bordé par une couche cellulaire de cytotrophoblastes villeux (CTV) fusionnant pour former la couche la plus externe : le syncytiotrophoblaste (ST), sécréteur d'hormones indispensables au maintien de la grossesse, notamment l'hCG. Au premier trimestre de la grossesse (T1), le placenta se développe dans un environnement pauvre en O2 dû à l'obstruction des artères utérines spiralées par des bouchons cytotrophoblastiques empêchant le sang maternel oxygéné de pénétrer dans la chambre intervilleuse (CIV). Dès 10 semaines d'aménorrhée (SA), ces bouchons se délitent, laissant entrer le flux sanguin dans la CIV au contact direct du placenta. La pO2 passe alors de 20 mmHg à 60 mmHg. En présence d'O2, la cellule produit des espèces réactives de l'oxygène (ERO) jouant le rôle de seconds messagers dans de multiples processus physiologiques (prolifération, différenciation, apoptose). Ils peuvent être cytotoxiques dans le cas du stress oxydant : la cellule possède un système de défense antioxydant permettant de maintenir le taux d'ERO intracellulaire à un niveau physiologique faible. L'équilibre des espèce pro- et anti-oxydantes est appelé homéostasie redox. Au T1, le placenta est soumis à une transition environnementale requérant l'adaptation de sa balance redox pour assurer le bon développement du placenta. Les objectifs de ce travail sont : (i) Déterminer la source principale d'anion superoxyde O2.- avant et après l'augmentation de la pO2 dans la CIV et étudier les défenses antioxydantes associées. (ii) Etudier l'impact de l'oxygéno-transition sur les voies redox-sensibles, notamment les MAPKs impliquées dans la prolifération et la différentiation trophoblastique. (iii) De déterminer au T1 l'influence de l'activité de la NADPH oxydase (Nox) placentaire sur la sécrétion du sFlt-1, facteur anti-angiogénique impliqué dans la physiopathologie de la prééclampsie (PE) afin de proposer de nouvelles réflexions concernant l'implication de la Nox dans la genèse de cette pathologie d'origine placentaire. Dans la VC (7-9 SA et 12-14 SA), la mesure de la production d'O2.- alliée à l'utilisation d'inhibiteurs spécifiques des différentes sources d'ERO montre que la Nox est la source principale d'O2.- au T1. Cette production est plus importante avant 10 SA et est associée à une modification de la localisation de la sous-unité organisatrice de Nox2, p47phox. Cette activation de la Nox placentaire est associée à une activation de la voie p38MAPK. p38 est localisée essentiellement dans le CTV au T1. L'expression génique et protéique des différentes isoformes de Nox révèle la présence de Nox2, Nox4 et Nox5 dans le trophoblaste au T1. Nox1 est cependant indétectable. L'activité des enzymes antioxydantes (SOD1, catalase, Gpx1) est augmentée à 12-14 SA, témoin de l'adaptation du système antioxydant à l'oxygéno-transition. L'exposition de VC à 7-9 SA au TGF-B1, activateur de Nox4 et de p38MAPK, associée à un inhibiteur de la voie p38 (SB203580), montre que l'activation de la voie p38 par le TGF-B1 entraine une augmentation de la sécrétion de sFlt-1. Cet effet est aboli par l'utilisation de SB203580. Dans notre modèle, l'exposition au TGF-B1 n'influence pas l'activation de la Nox. Cependant, l'utilisation d'un inhibiteur de Nox (DPI) permet de diminuer la sécrétion de sFlt-1. Ce travail a permis de montrer que la Nox est la source principale d'O2.- dans le placenta au premier trimestre en association avec l'activation de la voie p38MAPK. Nos résultats montrent que la sécrétion du sFlt-1 par la VC au premier trimestre est dépendante de la voie p38MAPK. Ce travail permettra une meilleure compréhension de l'implication des sources d'ERO dans le développement placentaire précoce et leur(s) rôle(s) dans la pathogenèse de la PEThe placenta is a transitory organ allowing gas and nutrients exchanges between mother and fetus. The structural and functional unit of the human placenta is the chorionic villi (CV). It is composed by a mesenchymal axis covered with a cellular layer called villous cytotrophoblast (VCT), which merges to form the syncytiotrophoblast (ST). The ST secretes hormones essential to maintain pregnancy, especially hCG. During the first trimester of pregnancy (T1), placenta develops itself in a poor oxygenated environment because of the obstruction of uterine spiraled arteries by cytotrophoblastic plugs which restrain the entry of the oxygenated maternal blood into the intervillous space (IVS). Between 10-12 gestational weeks (GW), the plugs will gradually disappear allowing blood to enter IVS in direct contact with CV. The pO2 will increase from 20 mmHg to 60 mmHg. Exposed to O2, the cell produces reactive oxygen species (ROS). ROS play a role as second messenger in redox-sensitive signaling pathways involved in physiological processes (proliferation, differentiation, apoptosis). They may become cytotoxic when oxidative stress occurs: the cell has an antioxidant defense system responsible for keeping low physiological levels of intracellular ROS, enough to ensure signal transduction. The balance between pro- and antioxidant systems is called redox homeostasis. The first trimester placenta is submitted to an environmental transition requiring redox balance adaptation to allow correct placental development in early pregnancy. The aim of this works are: (i) to determine the principal source of superoxide anion O2.- before and after the increase of pO2 in the intervillous space and the associated antioxidant defenses. (ii) To study the impact of the O2 transition on the activity of redox-sensitive pathways, specifically MAPKs involved in trophoblastic proliferation, differentiation. (iii) To determine, during T1, the placental NADPH oxidase (Nox) activity influence on the secretion of the antiangiogenic factor sFlt-1, which is involved in the pathophysiology of preeclampsia (PE), to offer new insight about Nox involvement in genesis of this pathology with placental origin. We measured the O2.- production in CV (7-9 GW vs. 12-14 GW). The O2.- assay was performed with specific inhibitors of ROS sources. The results show that NADPH oxidase (Nox) is the major source of O2.- in first trimester CV. Nox activity is significantly higher before 10 GW. This is confirmed by the modification of the Nox2 organizer subunit location, p47phox. This Nox activation in early stage of pregnancy is associated with p38 MAPK activation. p38 protein is mainly located within the villous cytotrophoblast in first trimester CV. Genic and protein expression study reveals the expression of Nox2, Nox4 and Nox5 isoforms in T1 trophoblast. Nox1 expression remains undetectable. The antioxidant enzymes (SOD1, catalase, and Gpx1) activities are increased at 12-14 GW, revealing an antioxidant system adaptation to the oxygen transition. We exposed CV from 7 to 9 GW to TGF-B1, described as an activator of Nox4 and p38MAPK, and to p38 inhibitor (SB203580). The results showed that the activation of p38MAPK pathway in first trimester CV by TGF-B1 increases the level of secreted sFlt-1. This effect is abolished using SB203580. TGF-B1 exposure does not influence the activation of placental Nox in our model, but the use of a Nox inhibitor (DPI) decreases the secretion of sFlt-1. To conclude, our work shows that Nox is the main source of O2.- in first trimester placenta and is associated with the activation of the p38MAPK pathway. Our results also demonstrate that first trimester CV sFlt-1 secretion relies on the p38MAPK activation. This work allows a better understanding of the cellular sources of ROS involvement in early placental development and their role in pathogenesis of preeclampsia
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Ninno, Milena Almeida Prado. "Dopplervelocimetria do fluxo normal da valva tricúspide fetal entre 11 e 13 semanas e 6 dias de gestação." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-27052010-164819/.
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Objetivo: Determinar os valores dopplervelocimétricos normais do fluxo através da valva tricúspide em gestações únicas, entre 11 e 13 semanas e seis dias. Examinar a reprodutibilidade dos parâmetros avaliados e sua correlação com variáveis clínicas maternas e obstétricas. Métodos: Estudo prospectivo envolvendo 166 gestações únicas, com desfecho normal, examinadas entre 11 e 13 semanas e seis dias, no período de fevereiro de 2006 a agosto de 2008. Foram aferidas as velocidades máximas das ondas E e A, duração do ciclo cardíaco completo e sua fase diastólica e calculadas as relações onda E/onda A e diástole/ciclo. Os valores normais foram descritos pelas respectivas médias e desvio-padrão. Para análise da reprodutibilidade desses parâmetros foi calculado o coeficiente de correlação intra-classes em 12 casos examinados por dois examinadores. Regressão linear simples e multivariada foram empregadas para examinar a correlação dos parâmetros dopplervelocimétricos entre si e com a idade gestacional, a medida da translucência nucal e variáveis maternas. Resultados: Neste intervalo gestacional, os valores normais encontrados foram: onda E, 25 (± 4,6) cm/s; onda A, 42,9 (± 5,9) cm/s; relação E/A, 0,58 (± 0,07); ciclo cardíaco, 390 (± 21,1) ms; diástole, 147 (± 18) ms; relação diástole/ciclo, 0,38 (± 0,04). Entre as variáveis dopplervelocimétricas, foi observada correlação significativa entre o ciclo cardíaco e diástole (r=0,53; p<0,0001), diástole e onda A (r=-0,15; p=0,05), ondas E e A (r=0,77; p<0,0001), onda E e relação D/C (r=0,16; p=0,04), onda A e relação diástole/ciclo (r=-0,17; p=0,03). Todas as variáveis, exceto a velocidade da onda A, correlacionaram-se positivamente com a idade gestacional. Não foi observada correlação significativa das variáveis com a medida da translucência nucal, e, na comparação com as variáveis maternas, apenas a onda E e a idade materna apresentaram correlação significativa (r=-0,18, p=0,04). Os coeficientes de correlação intra-classes para a avaliação interobservador e intra-observador (examinadores um e dois) foram: onda E = 0,53 (0,53 e 0,64); onda A = 0,45 (0,46 e 0,49); ciclo cardíaco = 0,70 (0,79 e 0,84) e diástole = 0,63 (0,85 e 0,82). Conclusão: O presente estudo estabeleceu os valores normais dos parâmetros dopplervelocimétricos do fluxo através da valva tricúspide e demonstrou que tais parâmetros, com exceção da onda A, correlacionaram-se de forma positiva com a idade gestacional, e apresentaram reprodutibilidade boa/moderada.Objective: To establish the measurements of normal tricuspid valve flow velocities at 11 to 13 weeks and 6 days to determine E-wave, A-wave, E/A ratio, cardiac cycle length, diastole length, diastole/cardiac cycle ratio, and their relationship with gestational age, nuchal translucency thickness, the characteristics of the study population, and to assess the reproducibility of flow measurements. Methods: Between February, 2006, and August, 2008, a total of 166 women with a singleton normal pregnancy between 11 and 13 + 6 weeks of gestation consented to participate in the study. Analysis of the waveforms consisted of calculation of peak velocity (cm/s) of the E-wave and A-wave, E-wave/A-wave ratio, cardiac cycle length (ms), diastole length (ms) and diastole/cardiac cycle ratio. To evaluate the intraobserver and interobserver agreement, a subgroup of 12 patients, chosen randomly, was examined twice by each examiner. For descriptive analysis of the results were calculated average and standard deviation. Simple and multivariate linear regression was used to establish the correlation between dopplervelocimetry among parameters and with gestational age, nuchal translucency thickness and the characteristics of the study population. Results: The average (± standard deviation) for transtricuspid flow-velocities waveforms parameters were: E-wave 25 (± 4.6) cm/s; A-wave 42.9 (± 5.9) cm/s; E/A ratio 0.58 (± 0.07); cardiac cycle length 390 (± 21.1) ms; diastole length 147 (± 18) ms; diastole/cardiac cycle length 0,38 (± 0.04). A statistically significant linear increase relative to gestational age was established for all parameters, except A-wave. Nuchal translucency thickness was not correlated with any parameter. A statistically significant negative regression coefficient was established for E-wave to maternal age (r=-0,18, p=0,04). A statistically significant relationship was established between: cardiac cycle length and diastole length (r=0.53; p<0.0001); diastole length and A-wave velocity (r=-0.15; p=0.05); E-wave and A-wave velocities (r=0.77; p<0.0001); E-wave velocity and D/C ratio (r=0.16; p=0.04); A-wave velocity and D/C ratio (r=-0.17; p=0.03). The intraclass correlation coeficients of interobserver and intraobsever evaluations (examiners 1 and 2) were: Ewave = 0.53 (0.53 and 0.64); A-wave = 0.45 (0.46 and 0.49); cardiac cycle = 0.70 (0.79 and 0.84) and diastole= 0.63 (0.85 and 0.82). Conclusions: These data determine normal parameters for tricuspid valve dopplervelocimetry and shows that these parameters, except A-wave, have positive correlation with gestational age, and good/moderate reproducibility.
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Wigins, Rebecca Clare. "An investigation of the enzyme activities in normal and bacterial vaginosis related microflora in the vagina, and their possible effects on human cervical mucus in the first trimester of pregnancy." Thesis, University of Bristol, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364891.
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Accrombessi, Manfred Mario Kokou. "Survenue du paludisme pendant la grossesse et retard de croissance intra-utérin en Afrique." Thesis, Sorbonne université, 2018. http://www.theses.fr/2018SORUS238.
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En Afrique sub-Saharienne, les mesures préventives contre le paludisme pendant la grossesse ne sont mises en place qu'à partir du 2ème trimestre de la grossesse, laissant les femmes insuffisamment voire non protégées lors du 1er trimestre. Pourtant certaines études ont montré que les infections palustres survenant avant la 20ème semaine pourraient être délétères pour la santé de la mère et du fœtus. L'objectif de cette thèse était de décrire la prévalence des infections palustres au cours de la grossesse, notamment au 1er trimestre, et d'en évaluer les effets sur la morbidité de l'enfant à la naissance et sur la santé maternelle. Une cohorte de 411 femmes enceintes a été suivie depuis la période pré-conceptionnelle jusqu'à l'accouchement dans le sud du Bénin. L'infection palustre était dépistée mensuellement en utilisant une goutte épaisse. Nous avons montré que les infections palustres étaient plus fréquentes au 1er trimestre que pendant la période pré-conceptionnelle et aux 2ème et 3ème trimestres de grossesse. Les infections du 1er trimestre avaient un effet direct significatif sur le risque d'anémie en fin de grossesse. En revanche, aucune association directe n'a été mise en évidence entre la survenue d'une infection au 1er trimestre et le faible poids de naissance, la prématurité et le retard de croissance intra-utérin. Toutefois, les infectées de façon répétée au cours de la grossesse, avec une première infection au 1er trimestre, étaient significativement plus à risque de faibles poids de naissance. Les stratégies de prévention de paludisme devraient débuter dès le début de la grossesse, en complément aux mesures préventives existantesIn sub-Saharan Africa, preventive strategies against malaria during pregnancy are usually provided from the 2nd trimester of pregnancy. Consequently, pregnant women remain insufficiently or not protected during the first trimester. However, recentes studies have showed that malaria before 20 weeks of gestation would be deleterious for the mother and her fetus. The goal of this thesis was to describe the prevalence of malaria infections during pregnancy, particularly those occuring in the first trimester. For that purpose, we set up a cohort of 411 pregnant women followed from the preconception period to delivery in Southern Benin. Microscopic malaria infections were detected monthly using thick blood smear. We showed that microscopic malaria was more prevalent in early pregnancy than before conception and in comprarison to 2nd and 3rd trimester. We observed a significant direct effect of malaria infection in the first trimester on the maternal anaemia at the end of pregnancy whereas no direct effect was found on low birthweight, premature birth, and intrauterine growth restriction. However, women with repetead malaria infections starting in the frist trimester had highest risk to deliver lowbirthweight newborns. Preventives stratégies against malaria should clearly start from the first trimester of pregnancy and they should complement currently implemented measures by combining the administration of efficacious and safe drugs in the first trimester, associated to vector control interventions
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Hettfleisch, Karen. "Avaliação da relação entre os índices vasculares placentários e a exposição individual à poluição atmosférica no primeiro trimestre." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-02052016-142155/.
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OBJETIVO: Avaliar a influência dos efeitos da poluição atmosférica sobre o volume e a vascularização placentários no primeiro trimestre. MÉTODOS: O presente estudo é uma coorte prospectiva realizada de outubro de 2011 a março de 2014, em São Paulo, Brasil. Os critérios de inclusão foram: feto único, idade gestacional entre 11 semanas e 13 semanas e 6 dias, ausência de doença materna, ausência de malformações e utilização correta do amostrador passivo individual de poluentes. Os critérios de exclusão foram: gestação gemelar, malformações e abortamento diagnosticados à ultrassonografia, mudança de endereço para fora da área de recrutamento, desistência da paciente, doença materna diagnosticada durante o acompanhamento. A exposição à poluição foi avaliada por 7 a 18 dias, antes da avaliação ultrassonográfica, utilizando-se amostrador passivo individual dos poluentes NO2 e de O3. Após uso do filtro, as gestantes eram avaliadas na Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina de São Paulo (FMUSP). Nesse local, elas foram submetidas à ultrassonografia morfológica entre 11 semanas e 13 semanas e 6 dias e à avaliação placentária pela técnica tridimensional associada ao power Doppler. Por meio desse exame foram avaliados quantitativamente o volume da placenta e seus índices vasculares placentários (com o software VOCAL), os quais compreendem: índice de vascularização (IV), índice de fluxo (IF) e índice de vascularização e fluxo (IVF). A influência dos níveis de poluentes na vascularização e volume placentários log-transformada foi analisada utilizando modelos de regressão linear múltipla que controlavam a idade gestacional, índice de massa corpórea, tabagismo, localização da placenta e paridade. RESULTADOS: Foram avaliadas 229 gestantes no primeiro. O aumento dos níveis de NO2 no primeiro trimestre teve um efeito negativo significativo sobre o IV (p = 0,012 e beta = 0,160) e IVF (p = 0,015 e beta = -0,159). Não houve influência de NO2 e O3 no volume placentário ou IF. CONCLUSÃO: A exposição materna ao NO2 foi significativamente associada com diminuição do índice de vascularização e do índice de vascularização e fluxo no primeiro trimestre da gravidez, o que sugere que esse poluente e outros poluentes primários e secundários, os quais estão associados ao NO2, influenciam na placentação, reduzindo sua vascularizaçãoOBJECTIVE: To evaluate the influence of air pollution on the volume and placental vascularization in the first trimester. METHODS: This study is a prospective cohort conducted from October 2011 to March 2014 in São Paulo, Brazil. The inclusion criteria were single fetus, gestational age between 11 weeks and 13 weeks and 6 days, the absence of maternal disease, fetal defects and correct use of passive personal monitors pollutants. The exclusion criteria were twin pregnancy, abortion and malformations diagnosed on ultrasound, change of address out of the area of recruitment, patient abandonment, and maternal disease diagnosed during follow-up. The pollution exposure was evaluated by 7 to 18 days, before the ultrasound evaluation, using passive personal monitors pollutants of NO2 and O3. After using the filter, the pregnant women were evaluated at Obstetrics Department from Hospital das Clinicas of Faculdade de Medicina de São Paulo (FMUSP). In this place, they were subjected to morphological ultrasound between 11 weeks and 13 weeks and 6 days and placental evaluation by the three dimensional ultrasound power Doppler. Through the ultrasound examination were quantitatively evaluated the volume of the placenta and their placental vascular indices (with VOCAL software), which comprise the vascularization index (VI), flow index (FI) and vascularization flow index (VFI). The influence of pollutant levels on logtransformed placental vascularization and volume was analyzed using multiple linear regression models that controlled for gestational age, body mass index, smoking status, placental location and parity. RESULTS: In the first trimester 229 pregnant women were evaluation. NO2 levels increased in the first trimester had a significant negative effect on the VI (p=0.012 and beta= -0.160) and the VFI (p = 0.015 and beta= -0.159). No effect of NO2 and O3 on the log of placental volume or FI was observed. CONCLUSION: NO2 exposure was significantly associated with a diminished Vascularization Index and Vascularization and Flow Index in the first trimester of pregnancy, which suggests that this pollutant and other primary and secondary pollutants that are associated with NO2 influence placentation and decrease vascularization
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黃康素 and Hong-soo Wong. "First trimester fetal echocardiographic normogram." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970813.
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Di, Giovanni Jessica Louise. "Early second trimester amniotic fluid erythropoietin and pregnancy outcomes." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112615.
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The study objective was to determine whether early 2 nd trimester amniotic fluid (AF) erythropoietin (EPO) was associated with and predictive of (a) development of maternal gestational diabetes (GDM) and (b) the infant outcome parameters of (i) gestational age at birth (GAAB) assessed exclusively among spontaneous vaginal deliveries or (ii) birth weight (measured in grams and percentiles). Enzyme-linked-immunosorbent assay was used to determine the EPO concentration of 170 biobanked AF samples. Student's t-test revealed no difference between GDM and non-GDM subjects. AF EPO was not predictive of GAAB despite being significantly greater among preterm infants compared to post-term infants. In contrast, AF EPO was significantly higher among the smallest infants using both birth weight classification schemes. However, following inclusion of known covariates AF EPO was predictive of gram birth weight only. Early 2nd trimester AF EPO may emerge as a useful biomarker of fetal nutritional status and/or growth.
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Rodger, Mary Wallace. "Studies with an antiprogesterone in early and mid trimester pregnancy." Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/22598.
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In this thesis safety, efficacy and acceptability of early medical abortion with mifepristone and the prostaglandin analogue gemeprost are investigated in Chapters 2,3 and 5. In Chapter 4 the mechanism of abortion with these agents is explored. The use of a single dose of 400 mg, 500 mg or 600 mg of mifepristone followed 48 hours later by a half or a whole 1 mg gemeprost pessary was shown to induce complete abortion in 95% of women of £ 56 days amenorrhoea. No significant differences were demonstrated between the three treatment regimes. When 600 mg of mifepristone was given with either a half or a whole gemeprost pessary, women receiving the smaller dose of prostaglandin experienced significantly less severe pain. Abortion rates were not compromised by a reduction in the dose of prostaglandin with 98% of women receiving a half pessary aborting, compared with 100% of women receiving a whole pessary. Pretreatment with mifepristone or gemeprost 48 hours prior to the administration of 1 mg gemeprost was also studied. Measurement of uterine tone with an intrauterine pressure catheter showed that while pretreatment with gemeprost had no effect on uterine tone following a further dose of gemeprost, pretreatment with mifepristone exerted a significant effect. In addition, the pattern of uterine activity following gemeprost or mifepristone pretreatment was shown to differ. Blood loss was measured during and after the induction of abortion with mifepristone and gemeprost in 222 consecutively treated women of <63 days of amenorrhoea. The median loss <56 days amenorrhoea was 72 mls. Blood loss was found to increase with increasing gestation and was significantly greater in women treated between 56 and 63 days of amenorrhoea. Although the introduction of prostaglandins to gynaecological practice has improved midtrimester abortion techniques, it remains a long, unpleasant and relatively high risk procedure.
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Goode, Natasha Diane, and Natasha Diane Goode. "Assessment of Tdap Administration in the Third Trimester of Pregnancy." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625597.
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Introduction: In 2012, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention expanded their recommendation for the Tdap vaccination to include the antepartum period. Regardless of immunization history, the recommendation states that medical practitioners should administer the Tdap vaccination to every pregnant woman in each occurring pregnancy (Munoz, et al., 2014; Shakib, et al., 2013; Goldfarb, Little, Brown, Riley, 2014).
Methods: To describe treatment practices and uptake of Tdap vaccine, a cross-sectional descriptive survey design was utilized. The purpose of survey is to gather information regarding prevalence, distribution, and interrelations of variables within a population (Polit & Beck). In this study, the survey questionnaire was conducted in an online format.
Results: Of the six HBM questions included in the study, except for question four, the results of the chi-squared analysis suggest that any single measured dimension of the HBM cannot predict a health behavior, in this case receipt of the Tdap vaccination. The population is split regarding infants' perceived susceptibility to pertussis infection. Strong agreement to the benefit of vaccination was revealed. Question six regarded available information, although the majority were satisfied a significant percentage indicated a desire for more information.
Discussion: This Doctorate of Nursing Practice project developed a survey based on the Health Belief Model with the intention of assessing perceived susceptibility, perceived severity, perceived benefits and perceived barriers to the health care preventative action of receiving the Tdap vaccination in the third trimester of pregnancy. Through in-depth literature review, consideration of the updated ACIP guidelines, and support of a developed theoretical framework, an eight-question survey was developed. The data examined in this project may serve to illustrate limitations in provider care that can be immediately improved upon, such as information sharing. The primary limitation of the study is in the sample size of 44 eligible survey responses and the uniform demographics of the population. Despite these limitations, the survey design may be extended to other populations of interest, with greater demographic variation for further study.
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Mukherjee, Soma. "The actions and metabolism of glucocorticoids in first trimester trophoblast." Thesis, St George's, University of London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.558350.
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The local actions of glucocorticoids are modulated by 11βhydroxysteroid dehydrogenase (ll~HSD) enzymes which catalyse interconversion of cortisol with its inert metabolite, cortisone. Expression and activity of 11βHSD enzymes has not been well characterised in the first trimester placenta. The aims of this study were to determine the effects of glucocorticoids on trophoblast, and to establish whether glucocorticoid metabolism differs in first trimester placentae from pregnancies at a higher risk of developing pre-eclampsia compared to low risk pregnancies (as determined by uterine artery Doppler ultrasound scanning). Cortisol treatment led to a small increase in extravillous trophoblast (EVT: SGHPL-4 cell line) motility as determined by time-lapse microscopy. Neither cortisol nor cortisone altered trophoblast invasion. ) 11βHSD2 expression was detected in first trimester placental tissue, and was localised to syncytiotrophoblast. Immunocytochemistry confirmed 11βHSD2 expression in EVT explant outgrowths and SGHPL-4 cells. No 11βHSD1 expression was detected. Glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) expression were both detected in EVT. MR was detected in placental tissue by western blot analysis, but not immunohistochemistry. Enzyme assays confirmed that the 11βHSD2 enzyme inactivates cortisol in first trimester placental tissue. Net cortisol oxidation was significantly greater in placental tissue from pregnancies at higher risk of pre-eclampsia than in lower risk pregnancies; however there was no difference In 11βHSD2 expression. The 11βHSD2 enzyme is thought to protect the fetus from exposure to maternal cortisol. While other studies have suggested that 11βHSD2 is decreased in term pre- eclamptic placentae (relative to normotensive pregnancies), this study suggests that there is increased 11βHSD2 activity in first trimester placentae from pregnancies at higher risk of developing pre-eclampsia. This increase in enzyme activity is not accompanied by an increase in expression of 11βHSD2 consistent with post- translational regulation of enzyme activity. It remains to be determined if this difference is related to the pathophysiology of pre-eclampsia or is a compensatory response to poor trophoblast development.
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Karagiannis, Georgios. "First trimester prediction of the 'small for gestational age' fetus." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/first-trimester-prediction-of-the-small-for-gestational-age-fetus(bc6f0017-55bf-4d26-b1fe-f2e6cd0a87f5).html.
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Objective: In this thesis, we investigate the association between maternal factors, biophysical and biochemical markers and the delivery of small-for-gestational-age (SGA) neonates in the absence of preeclampsia (PE) at 11–13 weeks’ gestation. We evaluate their performance as predictors of SGA, both in isolation and combined, in an effort to develop a model for the prediction of SGA in the first trimester of pregnancy. Methods: Screening study in 1,536 SGA and 31,314 non-SGA pregnancies based on maternal characteristics, fetal nuchal translucency (NT) thickness, serum pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotrophin (β-hCG). We also measured mean arterial pressure (MAP), uterine artery pulsatility index (PI) and performed case-control studies for measurement of maternal serum concentration of placental growth factor (PLGF), placental protein 13 (PP13), A Disintegrin And Metalloprotease (ADAM12), Soluble endoglin (sENG) and thyroid hormones (thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)). Regression analysis was used to develop a model for the prediction of SGA. Results: In the SGA group, uterine artery PI and MAP were increased, serum PAPP-A, free β-hCG, PLGF, PP13, and ADAM12 and fetal NT were decreased while sENg and thyroid hormones were not significantly altered. At a false positive rate of 10%, the estimated detection rate by a combination of maternal factors and biophysical and biochemical markers at 11–13 weeks was 73% for SGA requiring delivery before 37 weeks and 46% for those delivering at term. Conclusions: Half of the pregnancies with SGA neonates in the absence of PE could potentially be identified at 11–13 weeks.
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Holding, Stephen. "Aspects of biochemical screening for Down's syndrome in the second trimester of pregnancy." Thesis, University of Hull, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301635.
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Howe, Esther Colburn 1940. "Exploring uncertainty in first pregnancy." Thesis, The University of Arizona, 1993. http://hdl.handle.net/10150/291361.
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A qualitative study was conducted to explore the phenomenon of uncertainty in women experiencing a first uncomplicated pregnancy. Ten subjects, three from each of the first two pregnancy trimesters and four from the third pregnancy trimester, comprised the sample. Subjects ranged in age from 19 years to 30 years and lived in a southwestern city. Interviews were conducted in the subjects' homes or in the researcher's office over a four month period. Constant comparative analysis of data permitted the researcher to elicit specific uncertainties by trimester and the meaning of uncertainty to women involved in a normal change process. Implications for nursing highlight the need to provide continuity of care from office to hospital and within the hospital environment itself. Providing support by functioning as a mediator between the physician and the patient, nurses could contribute to the pregnant woman's positive perception of her experience. In addition to traditional third trimester childbirth education, classes for first and second trimester women are recommended.
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Hera, Raluca. "Isolation and characterization of human cytotrophoblast cells from first trimester placenta." [S.l.] : [s.n.], 2000. http://deposit.ddb.de/cgi-bin/dokserv?idn=962075892.
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McGee, Jennifer. "Women's perceptions of nursing care and management after first trimester miscarriage." Honors in the Major Thesis, University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/876.
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Spontaneous abortion, or miscarriage, is an event that affects approximately one in four women during their reproductive years. Despite the psychological and physiological trauma associated with the loss of pregnancy, few evidence-based practice recommendations exist to guide nursing care of women experiencing first trimester miscarriage. The purpose of this integrative review of literature was to examine research related to women's health care experiences of first trimester miscarriage and discuss common themes relating to nursing care. Inclusion criteria consisted of peer review research articles published after 2001 and available in the English language and women that experienced miscarriage during the first 12 weeks of pregnancy. Current literature was collected from Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE- EBSCOhost and PsycINFO databases using combinations of various key words. Six qualitative studies and one quasi-experimental study met the inclusion criteria and were reviewed. The results indicated that nursing care of women experiencing miscarriage should include therapeutic communication, psychological support, and provision of information and follow-up care. While there is little research reviewing nursing interventions related to first trimester miscarriage, these themes may help guide the development of further research reviewing the efficacy and effectiveness of specific nursing interventions.B.S.N.
Bachelors
Nursing
Nursing
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Liu, David T. Y. "Development of transcervical chorion villus sampling for first trimester prenatal diagnosis." Thesis, University of Nottingham, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.293186.
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Tisi, Daniel Kevin. "Association of second trimester amniotic fluid constitutents with emergence of gestational diabetes mellitus." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=100213.
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Our objectives were to measure concentrations of glucose, insulin, insulin-like-growth-factor-binding-protein-1 (IGF BP1) and beta-hydroxybutyrate (BOHB) in amniotic fluid (AF), and establish if these concentrations were associated with emergence of maternal gestational diabetes mellitus (GDM). AF samples (n=408) were collected following routine amniocentesis (12-22 weeks gestation). Glucose and insulin concentrations were elevated in our GDM mother-infant pairs, where GDM was associated with a 176g increase in birth weight. Logistic regression showed that AF glucose but not insulin was associated with developing GDM. Non-linear Bayesian probability plots showed that when 2nd trimester glucose was plotted against insulin increases in both were predictive of the subsequent emergence of GDM. In conclusion, our findings show that: (1) AF glucose but not insulin predicts subsequent emergence of GDM and (2) these observed elevations provide evidence that the fetus of GDM mothers is being exposed early in-utero to metabolic perturbations (i.e. elevated glucose) that may have important long-term metabolic consequences for their future development.
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Chen, Yang, Liang Wang, Maosun Fu, Jie Wang, Arsham Alamian, and Marc Jr Stevens. "Risk Factors of Mental Health Disorder among Chinese Women in Third Trimester of Pregnancy." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1401.
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Mental health disorder is the leading cause of disease burden in women worldwide. Pregnant women with mental disorder are especially at risk of having offspring with adverse outcomes. This study aimed to investigate risk factors of mental health disorder among Chinese pregnant women in the third trimester. A total of 462 pregnant women in their third trimester completed interviews at three hospitals in Shandong Province, China from July to December, 2010. The Symptom Checklist-90-R (SCL-90-R) was used to evaluate mental health disorder, and was defined as total score ≥160, or scores of any symptom dimensions ≥3, or total of positive symptoms ≥43. Multiple logistic regression was used to examine the risk factors of mental health disorder, and to adjust for covariates. The total score and scores of somatization, obsessive-compulsive, anxiety, and phobic anxiety were higher than corresponding national norm by SCL-90-R assessment (all p<0.05). Multiple logistic regression showed family income, relationship with parents-in-law, concerns about child's health, fear of delivery, and pregnancy complications were negatively associated with mental health disorder (all p<0.05). More specifically, relationship with parents-in-law, fear of delivery, preference on mode of delivery (Caesarean section), and body image concerns were positively associated with anxiety (all p<0.05); Fear of delivery was positively associated with depression (p=0.023). Family income, relationship with parents-in-law, concern about child's health, fear of delivery, and pregnancy complications were identified as potential risk factors of mental health disorder in this Chinese pregnant women population. Strategies to reduce mental health disorder are needed among Chinese pregnant women.
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Cheong, Kah-bik, and 張嘉碧. "The use of volumetry by three-dimensional ultrasound in the first trimester." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43572339.
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Cheong, Kah-bik. "The use of volumetry by three-dimensional ultrasound in the first trimester." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43572339.
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Lee, Qin En Cheryl. "Characterisation of the possible trophoblast progenitor niches in first trimester human placentas." Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648730.
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Veyhe, Anna Sofía. "Færøske kvinders kostvaner i tredje trimester." Thesis, Nordic School of Public Health NHV, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3246.
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Formålet med undersøgelsen var at finde ud af, hvorvidt gravide kvinder på Færøerne fik en kost, som er i overensstemmelse med rekommandationer der foreligger gravide. 148 kvinder deltog i undersøgelsen, hvor der blev gennemført tre 24 h recall og seks selvregistreringer, samt et food frequency qeistionnaire omhandlende de sidste 12 måneder. Resultatet af den samlede energi, energifordeling, A-, C-, D- og E-vitaminer, og folsyre, jern og calcium er sammenlignet med de rekommandationer der foreligger for gravide i de nordiske lande, specielt Danmark, idet Færøerne følger de danske anbefalinger. Det gennemsnitlige energiindtag var 10,0 MJ, som i gennemsnit fordelte sig i henhold til kostanbefalingerne med 15% proteiner, 52% kulhydrater og 33% fedt. Kostfiberindtaget var lavere end anbefalet, 17,4 gram per dag. Mættede og monoumættede fedtsyrer fulgte anbefalingerne, men indtaget af polyumættede fedtsyrer var lavt, 3,6%. Indtaget af n-3 fedtsyrer var 0,6%, som er lavere end anbefalet. Indtaget at C-vitaminer og calcium var tilstrækkeligt gennem kosten. Indtaget af de andre vitaminer og mineraler var mindre end anbefalingerne. 85% tager vitamintilskud og 64% tager jerntilskud. Indtaget af fisk var 280 gram per uge, kornprodukter 323 gram per dag, kød 193 gram per dag, sødesager 128 gram per dag, frugt og grønt 193 gram per dag, frugt juice 98 gram per dag. Resultatet fra denne opgave kan sætte større fokus på kost og graviditet, samt at der er et behov for en større og mere indgående kostundersøgelse blandt den generelle befolkning, hvis resultater kan bruges i sundhedsfremmende arbejde.The purpose of this project was to find out whether pregnant women in the Faroe Islands had a dietary intake, which were in accordance with recommendations for pregnant women. 148 women participated in the survey, which involved three 24 hour recall and six days diary, and a food frequency questionnaire for the last 12 months. The results of total energy, the energy distribution of protein, carbohydrate and fat and the micronutrients vitamin-A, -C, -D, -E, folic acid, iron and calcium are compared with recommendations for pregnant women in the Nordic countries, especially from Denmark because the Faroe Islands follow the Danish recommendations. In average the total energy consumption per day was 10,0 MJ, and the distribution was 15% protein, 52% carbohydrates and 33% fat. Dietary fibre intake was 17,4 gram per day, which is lower than recommended. The intake of saturated and monounsaturated fatty acids followed the recommendations whereas the intake of polyunsaturated fatty acids and n-3 fatty acids was lower then recommended, 3,6% and 0,6%. Supply of vitamin-C and calcium through the food was sufficient, whereas the supply of the other micronutrients was too low compare to recommendations. 85% of the women took vitamin supplements and 64% took iron supplements. Intake of fish was 280 gram per week, cereal products 323 gram per day, meat 139 gram per day, sweets 128 gram per day, fruit and vegetables 193 gram per day, fruit juice 98 gram per day. The results from this project can put a focus on the connection between diet and pregnancy as well as there is a need for a detailed dietary survey among the general population, where the results can used in further health promotion
ISBN 91-7997-141-5
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Bailey, Beth, Judy G. McCook, Andrea Clements, and Lana McGrady. "Quitting Smoking During Pregnancy and Birth Outcomes: Evidence of Gains Following Cessation by Third Trimester." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7189.
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Bailey, Beth A., Judy G. McCook, A. L. Hodge, Andrea D. Clements, and Lana McGrady. "Quitting Smoking During Pregnancy and Birth Outcomes: Evidence of Gains Following Cessation by Third Trimester." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7278.
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Nodine, Janet Lynn. "THE EFFECT OF THERAPEUTIC TOUCH ON ANXIETY AND WELL-BEING IN THIRD TRIMESTER PREGNANT WOMEN." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276506.
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This study was conducted to determine whether or not a significant difference exists in pregnant women among those receiving therapeutic touch, mock therapeutic touch, or no touch on measurements of anxiety and well-being. Thirty third trimester primigravida subjects were tested pre- and postintervention using the State-Anxiety Inventory and a Well-Being Visual Analog; heart and respiratory rates were monitored before, during, and after the treatment. No significant differences were found using analysis of covariance with the pre-test scores as the covariate. The findings indicate that therapeutic touch may not be useful in reducing state anxiety or enhancing subjective well-being in pregnancy. Study limitations include a small sample size, use of an instrument without established reliability and validity, and a study environment that may have increased anxiety.
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Franklyn, Lindsey, Hemendra Mhadgut, Alok Sinha, and Sakshi Singal. "A Rare Case of Acute Promyelocytic Leukemia in Pregnancy." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/21.
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Acute promyelocytic leukemia (APL) is a clinically distinct and rare type of acute myeloid leukemia and represents an oncologic emergency. Even rarer is the incidence of APL in pregnancy with less than 60 cases described in the literature. A 33-year-old pregnant female at 34 week gestation presented to hospital with reports of abdominal pain. On admission she was found to have acute onset pancytopenia with a WBC count of 1.2, Hemoglobin of 9.7g/dl, and platelet count of 26000. Initial history, exam, and investigations including a peripheral smear, coagulation panel, liver function, vitamin b12 and folate levels did not reveal possible etiology of pancytopenia. Given worsening pancytopenia, bone marrow biopsy was done which showed 58% promyelocytes and 11% blasts with numerous Auer rods present. Cytogenetics showed abnormal female karyotype with t(15:17) and FISH analysis revealed PML/RARA fusion in 76.5% of analyzed cells. The above findings were diagnostic of APL. After multidisciplinary discussion with high risk obstetrics physician, it was decided to immediately induce labor for immediate initiation of treatment of APL. She had a prolonged labor requiring aggressive blood product support and initiation of All trans retinoic acid (ATRA) before delivery given concerns of coagulopathy. Induction treatment with Arsenic trioxide (ATO) was started the day after her delivery. Repeat bone marrow biopsy on day 24 showed complete morphologic remission. Shortly thereafter, she started cycle 1 of consolidation with ATRA and arsenic trioxide. APL is characterized by a translocation between chromosome 15 and 17. Coagulopathy is a pathognomonic feature of this leukemia and often the reason for high mortality in early course of disease. APL when treated with ATRA and ATO, has excellent remission rate and 99% overall survival at 2 years. APL in pregnancy is associated with increased risk of preterm delivery, perinatal mortality, and miscarriage. Following pregnancy, there is an increased risk of bleeding, infection, or placental abruption. ATRA, one of the pillars around which treatment of APL revolves, is highly teratogenic during the first trimester and has low risk later in pregnancy. Treatment is directed by the trimester of pregnancy. Termination of pregnancy or treatment with single agent conventional chemotherapy is preferred in the first trimester whereas treatment with ATRA prior to delivery and use of chemotherapy after delivery is the preferred approach in the 2nd and 3rd trimester. This case is an example of individualized approach with a multidisciplinary team need in the setting of scarce data.
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Kirkman, S. R. "A phenomenological study of planned first pregnancy." Thesis, Cardiff University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267905.
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De, La Torre Mary McCarter. "Maternal anthropometric measures and nutrient intake during the second trimester of pregnancy of normal weight and overweight gravidas." Thesis, Virginia Tech, 1985. http://hdl.handle.net/10919/45644.
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Height, skinfold, and circumference measurements were obtained from
29 normal weight and 17 overweight (>110% of desirable weight for
height) healthy pregnant women every four weeks during their second
trimester of pregnancy. The mean weight gain and food intake values
were not significantly different for both groups. Measurements
increased at a greater rate for the normal weight gravidas than for the
overweight gravidas in almost every case. For both groups, increases in
fat stores were greater in the central sites than in the peripheral
sites. No clear relationship between age, prepregnant weight, and weight
gain during the second trimester with the birthweight of the baby was
found. The infant birthweights of both groups were at an optimal level
( >2500 grams) except for one (born to the mother 151% of her desirable
weight for height). The similarity in results for the two groups is
greatly due to there not being a large enough difference in prepregnant
weights between the two groups. Nevertheless, the results do lend
support to a 20 to 30 pound weight gain for an optimal outcome of
pregnancy for healthy pregnant women with a wide range of prepregnancy
weights. Those women 150% or more of their desirable weight for height
may need to gain on the lower end of the spectrum due to their excess
endogenous reserves and to possible harm to the fetus with large gains.Master of Science
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Lynn, F. A. "The value of a third trimester ultrasound scan in low-risk pregnancy; a discrete choice approach." Thesis, Queen's University Belfast, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517102.
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