Дисертації з теми "Pregnancy disease"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Pregnancy disease.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 дисертацій для дослідження на тему "Pregnancy disease".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте дисертації для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Shub, Alexis. "Periodontal disease and adverse pregnancy outcomes." University of Western Australia. School of Women's and Infants' Health, 2007. http://theses.library.uwa.edu.au/adt-WU2007.0184.
Анотація:
[Truncated abstract] Periodontal disease is a common and underdiagnosed disease in humans that may have adverse effects on pregnancy outcomes. The aim of this thesis was to investigate the effects of periodontal disease in pregnancy by means of two observational human studies and the development of animal models of fetal and uterine exposure to periodontopathic bacteria and lipopolysaccharide. I performed a prospective study examining the rates of preterm birth, small for gestational age neonates and neonatal inflammation in 277 women who had undergone a detailed antenatal periodontal examination and oral health questionnaire. Periodontal disease was associated with small for gestational age neonates, and increased CRP levels in umbilical cord blood, but no effect was seen on the rate of preterm birth. Maternal oral health symptoms predicted both periodontal disease and newborn biometry. In a retrospective case control study, I examined the role of periodontal disease in perinatal mortality. Participants included 53 women who had experienced a perinatal loss for which no cause could be found after thorough investigation, and 111 control women. Women who had experienced a perinatal loss were more than twice as likely as controls to have periodontal disease. The incidence of periodontal disease was even higher in women in whom the perinatal loss was due to extreme prematurity. In contrast to my prospective study, risks to the pregnancy could not be predicted by maternal oral health behaviours or oral health symptoms. In order to better understand the mechanisms regulating the associations described in the human studies, two animal models were developed; one to investigate acute exposure and the second to investigate long-term exposure to periodontal pathogens. The first study examined the effects of administration of a bolus of periodontopathic bacteria and lipopolysaccharide to the pregnant sheep. Injection of bacteria and lipopolysaccharide in the amniotic fluid of the pregnant preterm sheep caused a high rate of fetal lethality, disturbance of fetal acid base status and inflammation of the fetus and membranes. Given the circumstances of exposure to periodontopathic pathogens in human periodontal disease, a model investigating long-term exposure to periodontopathic lipopolysaccharide on pregnancy outcomes was developed. ... Overall, I have demonstrated that maternal periodontal disease is associated with adverse pregnancy outcomes including fetal growth restriction and possibly perinatal loss. Mechanisms regulating these effects are likely to be mediated by fetal adaptations to intrauterine inflammation resulting in altered fetal development, growth or survival. Randomised controlled trials that are currently in progress will provide further information on the effects of periodontal disease in human pregnancy, and the efficacy of treatment to reduce these adverse outcomes.
2
Price, Tabitha. "Periodontal Disease and Adverse Pregnancy Outcomes: Treatment Recommendations for the Pregnant Patient." Digital Commons @ East Tennessee State University, 2010. https://dc.etsu.edu/etsu-works/2530.
3
Rodie, Vanessa Angela. "Metabolic complications of pregnancy and cardiovascular disease risk." Thesis, University of Glasgow, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.421118.
4
Curry, Ruth. "Studies in pre-existing heart disease and pregnancy." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/44495.
Анотація:
Aims: To study the effect of pre-existing maternal cardiac disease on cardiovascular function during pregnancy, and on obstetric and fetal/neonatal outcomes, and to investigate maternal risk factors for adverse events. Methods: Retrospective case note review. Results: Four hundred and eighty-nine pregnancies in 326 women were studied. Most pregnancies (50%) occurred in women with congenital heart disease. There were 4 maternal deaths, 6 stillbirths and 5 neonatal deaths. Cardiovascular events occurred in 7.4% of pregnancies, while obstetric and perinatal complications occurred in 34% and 30% of pregnancies respectively. Conclusions: Pregnancy in women with pre-existing heart disease continues to be associated with high rates of maternal and neonatal mortality and morbidity. This work highlights the importance of effective prepregnancy counselling and meticulous surveillance during pregnancy, delivery and the puerperium by an experienced multidisciplinary team. Additionally there is an urgent need for well-designed randomisedcontrolled trials to determine best practice.
5
Sturgiss, S. N. "Renal haemodynamic reserve during pregnancy in health and disease." Thesis, University of Newcastle Upon Tyne, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321301.
6
Moore, Suzanne. "The relationship between maternal periodontal disease and adverse pregnancy outcome." Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399114.
7
Sotiriadis, Georgios. "Innate immune molecules in preterm birth and disease." Thesis, Brunel University, 2016. http://bura.brunel.ac.uk/handle/2438/12777.
Анотація:
Preterm labour is one of the leading causes of perinatal mortality and morbidity. Most premature babies die before the age of five, and if they survive they face a high risk of disabilities and impairments. SP-A and SP-D are pattern recognition, innate immune molecules that are responsible for the maintenance of pulmonary immunity and surfactant homeostasis. They have been localised in the human reproductive tract and implicated in pregnancy and the initiation of labour. We hypothesised that SP-A and SP-D could play an active role in the activation of the myometrium and the timing of parturition. In this study we investigated the effects of the recombinant forms of SP-A and SP-D (rhSP-A and rhSP-D) on contractile events in the myometrium. We validated the expression of surfactant proteins A and D in the in vitro model of myometrium cell line, ULTR, using qPCR, immunofluorescence and ImageStream technology. We demonstrate that rhSP-A and rhSP-D treatments led to an increase in cell motility and had an effect on the contractile response of ULTR cells when grown on collagen matrices showing reduced surface area. We studied this effect further by measuring the expression of contraction-associated protein genes. rhSP-A and rhSP-D led to an increase in the expression of oxytocin receptor and connexin 43. We reported that both rhSP-A and rhSP-D induce the secretion of pro-inflammatory cytokines, such as IL-6 and IL-8. We also propose a new model for functional progesterone withdrawal showing a cross-talk between progesterone (including non-genomic effects) and SP-A. Emerging evidence has linked shredding of the uterine wall with ovarian cancer cases, suggestive of an interaction between myometrium and ovaries. We investigated the effects of rhSP-D in ovarian cancer in vitro using SKOV3 cells as a model. Conditioned media from ULTRs treated with rhSP-D resulted in growth arrest of SKOV3. We also demonstrated that rhSP-D led to a decrease in cell motility and cell proliferation in these cells. This was followed by an inhibition of the mTOR pathway activity. We expanded on our observations by measuring expression of SP-A and SP-D in human myometrial samples as well as the expression of SP-D in human ovaries. Collectively, this study presents novel interactions of SP-A and SP-D at both myometrial and ovarian level, rendering them key molecules for conditions such as preterm labour as well as implicating them as therapeutic targets for ovarian cancer.
8
Lawley, Claire Margaret. "Outcomes in structural heart disease in New South Wales, Australia: From paediatrics to pregnancy." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20465.
Анотація:
Aim To characterise and explore the contemporary outcomes at key points in the life of individuals in New South Wales (NSW), Australia, who have undergone a procedure for structural heart disease. Methods The population with structural heart disease was identified and outcomes at key points in life were evaluated using different methodologies; record linkage, retrospective cohort study and systematic review. Health and education outcomes of children with structural heart disease were evaluated via population-based record-linkage cohort studies. The role of advanced imaging methods in managing structural heart disease in paediatrics was evaluated via literature review. A retrospective cohort study was used to evaluate individuals who had undergone a percutaneous pulmonary valve implantation for structural heart disease. Health outcomes of women (and their offspring) who had undergone a prosthetic heart valve placement prior to pregnancy were evaluated using population-based record-linkage studies, systematic review and meta-analysis Results The main findings of this thesis include: -Structural heart disease in NSW requiring procedural management in the first year of life affects 2.5 per 1 000 births. Immediate health outcomes such as length of stay and mortality are similar to other centers. -Children who have had a cardiac procedure demonstrate a greater incidence of poor education outcome. Sociodemographic risk factors and ongoing health status are the major predictors of educational outcomes. -Novel imaging strategies can aid diagnosis, monitoring and management in complex structural heart disease. -Percutaneous pulmonary valve implantation, for rehabilitation of the right ventricular outflow tract in structural heart disease, has a low risk of a serious adverse event and shorter length of stay than historical surgical options. -The risk of severe maternal morbidity, a cardiovascular event, preterm birth and small-for-gestation age infants remains higher for women with a heart valve prosthesis than a pregnancy in the general population. Conclusions From early childhood to adult life, including child bearing years, individuals who have undergone a cardiac procedure for structural heart disease remain at risk of altered health status. This includes additional hospitalisations, maternal morbidity as well as adverse developmental and educational outcomes compared to the general population. Contemporary data demonstrates improvements in some domains. Evolution in multi-disciplinary, life-long care provides hope for further ameliorating outcomes.
9
Cauldwell, Matthew. "The management of pregnancy and labour in women with cardiac disease." Thesis, Imperial College London, 2016. http://hdl.handle.net/10044/1/53283.
Анотація:
Within my thesis I have shown that women with congenital heart disease are amenable to preconception counselling, but that many women are not referred to see a specialist cardiologist or obstetrician prior to pregnancy. Women with more severe forms of heart disease such as a Fontan repair have worse obstetric outcomes with high rates of miscarriage, preterm delivery and postpartum haemorrhage (PPH), hence the importance of comprehensive counselling prior to pregnancy. When women are counselled prior to pregnancy regarding the potential risks that they face, I have shown that the quoted risk of an adverse event assessed by an experienced clinician has a better correlation with actual outcome than other validated scoring systems such as the modified WHO score. Women with congenital heart disease are at much greater than average risk of postpartum haemorrhage (PPH). My analysis has shown that after correcting for known risk factors for PPH, women with a Fontan repair are at the highest risk of increased blood loss, and that low molecular weight heparin at both a prophylactic and therapeutic dose is associated with higher rates of PPH even when stopped at an appropriate time prior to delivery. I have focussed on the management of labour in women with heart disease, in particular of the second and third stages. Having shown that a restricted second stage for women with heart disease recommended by the multidisciplinary team (MDT) is often not adhered to in our actual clinical practice, my pilot study showed that there was only a modest measured haemodynamic effect of pushing (bearing down), with a small but significant increase in maternal heart rate in the active second stage of labour. I have found from a literature review and from our own historical dataset that the practice of a restricted oxytocin regimen for the management of the third stage (designed to minimise cardiovascular side-effects) is associated with greater rates of PPH, mainly due to uterine atony. In a prospective cohort study, women with heart disease were allocated to either a low dose infusion or a combination of the low dose infusion with an initial bolus of 2IU of oxytocin over ten minutes; those receiving the additional oxytocin had a significantly lower volume of blood loss and rate of PPH. Importantly, the women receiving the higher dose of oxytocin had no measured deleterious cardiovascular side effects.
10
Westbrook, Rachel Helen. "Liver disease and pregnancy : early identification of those at greatest risk." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/liver-disease-and-pregnancy(1d7530ab-dc29-464b-bcea-bcca8b08ba1e).html.
Анотація:
Historically, women with pre-existing liver disease were advised against pregnancy due to concerns regarding the potential for worsening of liver function, hepatic decompensation and death. The available literature detailing outcomes of pregnancy in women with liver disease is sparse, combining this with the fact that the term “liver disease” incorporates a spectrum of severity from a variety of underlying aetiologies means that generic advice regarding pregnancy risk is clearly not appropriate for all women. In addition, women with previously normal hepatic function may develop acute liver failure in pregnancy which is associated with high morbidity and mortality. Data regarding early identification of women at high risk of death from liver failure is lacking. This body of work addresses the paucity of information regarding pregnancy risk in women with liver disease. The potential risks related to pregnancy for the mother, baby and graft in the context of different diseases and underlying severity are explored and detailed. Pre-conception parameters are identified which can predict poor pregnancy outcomes in women with different aetiologies of liver disease and severity. The King’s College Hospital poor prognostic criteria in patients with pregnancy associated acute liver failure (ALF) are shown not to be applicable to this unique cohort of patients and alternative early poor prognostic indicators are suggested. This work should enable individualised advice regarding pregnancy risk to be given to women with liver disease who are considering pregnancy, increase our understanding of specific complications a women may encounter and aid identification of women they may benefit from liver transplantation.
11
Zhao, Jieyu, and Yanling Zhang. "Experience of pregnancy in women with heart disease: A descriptive review." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-36617.
12
Stainer, Karen Louise. "The peripheral venous system in health and disease." Thesis, University of Nottingham, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.252946.
13
Tam, Hoi-lam Elizabeth, and 譚凱琳. "FBI-1 amplification in gestational trophoblastic disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206493.
Анотація:
Gestational Trophoblastic Disease (GTD) encompasses a spectrum of disease that involves abnormal trophoblastic proliferation. It includes hydatidiform mole (HM), placental site trophoblastic tumor (PSTT), epithelioid trophoblastic tumor (ETT) and choriocarcinoma (CCA). While HMs are abnormal pregnancies with limited invasive potential, CCAs are true malignancies requiring chemotherapy. Although the majority of HM is resolved by surgical intervention, approximately 8-30% of them would develop into persistent GTD. In addition to that, being the most aggressive neoplasm in GTD, choriocarcinoma is a frankly malignant gestational trophoblastic neoplasm (GTN) that could be arisen from HM and could be fetal when widespread metastasis is developed. However, the underlying mechanisms of this disease progression are still unclear.
FBI-1 (Factor that Binds to Inducer of Short Transcripts (IST) protein 1) is a transcription factor that has been observed to be overexpressed in various types of human cancers. Recently, overexpression of FBI-1 is also reported in GTD and also in association with GTN development. However, the causes of FBI-1 overexpression in GTD are still unclear. This study aims to investigate gene amplification as a possible cause of FBI-1 overexpression in GTD. A quantitative real time PCR (qPCR) assay was established and was used to investigate ZBTB7A (the gene encoding FBI-1) amplification in GTD cell lines and clinical samples.
Using our qPCR assay, we demonstrated that ZBTB7A is not amplified in the CCA cell lines JEG-3 and JAR, in comparison with an immortalized trophoblast cell line HTR-8/SVneo. Testing ZBTB7A amplification in clinical samples also obtained similar findings although overexpression of FBI-1 was demonstrated in our previous studies. This is the first report illustrating absence of ZBTB7A amplification in cells with FBI-1 overexpression. There are other techniques that can detect gene amplification and/or other genetic and epigenetic mechanisms that may govern FBI-1 expression in GTD. Further studies will be worthwhile to pursue as FBI-1 is a potential target for cancer therapy.published_or_final_version
Pathology
Master
Master of Medical Sciences
14
Turton, Mervyn Sydney. "The effect of maternal oral health on pregnancy outcomes." University of the Western Cape, 2014. http://hdl.handle.net/11394/4360.
Анотація:
Philosophiae Doctor - PhDAdverse pregnancy outcomes such as preterm birth and low birth weight are major causes of maternal and neonatal morbidity and mortality. Increasing evidence points to an association between periodontal disease and adverse pregnancy outcomes and thus a better understanding of the nature of this association will assist in treatment planning to reduce adverse pregnancy outcomes. Among the Gram-negative anaerobic bacteria frequently associated with periodontal disease are Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis which may be detected in plaque using the BANA test (N-benzoyl-DL-arginine-2-naphthylamide). The aim of this study was to investigate the effect of periodontal disease on pregnancy outcomes and evaluate the use of BANA as a screening test for the risk of adverse pregnancy outcomes. This study complied with the Declaration of Helsinki (2013) and included 443 pregnant women attending ante-natal clinics in KwaZulu Natal. At first visit, maternal oral health status was assessed by the measurement of periodontal indices and BANA testing of dental plaque from the same teeth. Patient demography and medical history were obtained by means of a questionnaire and all data compared with pregnancy outcomes. While controlling for other factors, significant differences were found between the distributions of periodontal disease at BANA-negative and BANA-positive sites and between infant birth weight and maternal periodontal index scores such as plaque index and gingival index. The birth weight and gestational age at delivery of infants born of BANA-positive periodontally diseased mothers were significantly lower than those born of BANA-negative mothers with no periodontal disease. We may conclude that the presence of periodontal disease during pregnancy has a significant association with negative pregnancy outcomes and suggest that the risk for adverse pregnancy outcomes may be reduced by monitoring the oral health status of women during pregnancy.
15
Hang, Thi Thu Le Sutthi Jareinpituk. "Maternal periodontal disease and preterm birth /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd401/4737317.pdf.
16
Kernell, Kristina. "Cardiac disease in pregnancy and consequences for reproductive outcomes, comorbidity and survival." Doctoral thesis, Linköpings universitet, Avdelningen för kliniska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-134854.
Анотація:
Background Advances in medical treatment during the last 50 years have resulted in more individuals with congenital heart disease (CHD) and Marfan syndrome reaching childbearing age. The substantial physiological changes during pregnancy result in a high-risk situation, and pregnancy is a major concern in women with these conditions. Aims To describe the socio-demographic characteristics, birth characteristics and reproductive patterns of individuals with CHD and women with Marfan syndrome. To investigate obstetric and neonatal outcomes in the firstborn children of individuals with CHD and women with Marfan syndrome. To study long-term cardiovascular outcomes after childbirth in women with Marfan´syndrome. Methods The studies are population-based register studies. The study population in the first paper included all women born between 1973 and 1983 who were alive and resident in Sweden at the age of 13 (494 692 women, of whom 2 216 were women with CHD). In the second paper, the same definition of the study population was chosen, except that it involved all men born between 1973 and 1983 (522 216 men, of whom 2 689 men with CHD). The third and fourth papers involved a study population of all Swedish women born between 1973 and 1993 who were still living in Sweden at age 13. This population consisted of 1 017 538 women, 273 of whom had been diagnosed with Marfan syndrome. Results and conclusions The individuals studied were more often born preterm, and were small-for-gestational age babies. They were more likely to have been born by cesarean section. In women with CHD, these characteristics were repeated in their firstborn children. No increased risks were found in children of men with CHD or in children of women with Marfan syndrome. There was no increased risk of aortic dissection in women with Marfan syndrome during pregnancy compared to women with Marfan syndrome who did not give birth. Higher frequencies of cardiac arrhythmia and valvular heart disease were found after childbirth in women with Marfan syndrome. Pregnancy in women with CHD is a high-risk situation associated with increased risk of adverse neonatal outcomes for the expected child. Pregnancy in women without CHD, but where the father has CHD is not so associated with increased risk of adverse obstetric or neonatal outcomes. Pregnancy in women with Marfan syndrome is not associated with adverse outcomes for the expected child.
17
Lindoff, Claes. "Haemostasis during pregnancy and perimenopausal age studies of fibrinolytic components and coagulation factors involved in vascular disease /." Lund : Dept. of Obstetrics and Gynaecology, Lund University, 1994. http://catalog.hathitrust.org/api/volumes/oclc/39750405.html.
18
Nkomo, Faith Dineo. "HIV testing barriers pregnant women - a case study /." Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-09232008-150105.
19
Mahdy, Z. A. "Human hand vein endothelial cells : isolation, culture and calcium signalling characteristics in pregnancy and preeclampsia." Thesis, University of Newcastle Upon Tyne, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246095.
20
Cordier, Anne-Gaël. "Impact de la drépanocytose sur les fonctions et le développement placentaires Sickle cell disease pregnancy paradox: Impaired placental structure with maintained fetal growth Sickle cell disease profoundly impacts TRP metabolism pregnancy." Thesis, Sorbonne Paris Cité, 2019. http://www.theses.fr/2019USPCB052.
Анотація:
La drépanocytose est la maladie héréditaire autosomique récessive la plus fréquente. Elle affecte la synthèse de l'hémoglobine suite à des mutations du gène de la chaîne de la ß-globine. La falciformation des globules rouges en situation d'hypoxie se manifeste par une anémie hémolytique chronique et une vaso-occlusion microvasculaire conduisant à des lésions d'ischémie-reperfusion et à des thromboses. Les taux sériques d'IL1ß, IL6, IL8, TNF-alpha et MCP1 sont significativement plus élevés chez ces patientes et participent à l'expression de molécules d'adhésion sur les cellules endothéliales. L'hémolyse chronique est responsable de la libération de l'hème et contribue à un état proinflammatoire et procoagulant qui provoque l'activation de l'endothélium. La grossesse est une situation à risque pour les femmes drépanocytaires en raison de la consommation accrue d'oxygène par la croissance fœtale et du contexte pro-inflammatoire qui augmente le risque de vaso-occlusion et d'hémolyse. La littérature a rapporté de nombreuses complications : prééclampsie, prématurité, retard de croissance intra-utérin et mort fœtale in utero. Très peu d'études sur la structure et les fonctions du placenta sont décrites dans la littérature. Le but de ce travail était de caractériser le développement et la fonction du placenta drépanocytaire et de rechercher une explication aux complications décrites. Dans notre cohorte de patientes drépanocytaires, nous avons constaté une dysmorphie placentaire majeure, malgré une croissance fœtale conservée. Notamment, nous avons observé un défaut d'arborisation des villosités choriales associé à une augmentation significative du ratio sFlt1 / PlGF à terme. L'analyse longitudinale des taux sériques de PlGF et de sFlt1 pendant la grossesse a confirmé cette altération de l'équilibre angiogénique. De plus, en réalisant des cultures cellulaires, nous avons constaté que les cytotrophoblastes des placentas drépanocytaires s'agrégeaient mais ne fusionnaient pas de manière efficace pour former le syncytiotrophoblaste et que la synthèse d'hCG associée était anormale. Cette morphologie anormale des placentas associée à une croissance fœtale conservée nous a amené à émettre l'hypothèse que des mécanismes compensatoires pourraient exister. L'environnement inflammatoire a été confirmé dans les sérums maternels par une augmentation significative de nombreuses cytokines. De plus, comme l'indolamine-2,3-dioxygénase (IDO1) est induite par les cytokines pro-inflammatoires et est impliquée dans la tolérance materno-fœtale, nous avons exploré la voie métabolique du tryptophane dans les placentas drépanocytaires. Comme attendu, le rapport kynurénine / tryptophane (activité IDO1) était significativement augmenté dans les sérums maternels et fœtaux. Par perfusion placentaire de tryptophane, nous avons mis en évidence une baisse du taux d'acide quinolinique dans le compartiment fœtal, expliquée par une forte diminution de l'activité placentaire de la Kynurénine 3-mono-oxygénase. L'impact sur la concentration en NAD, impliqué dans l'équilibre redox et dans de nombreuses voies métaboliques doit être évalué. L'analyse transcriptomique bioinformatique des gènes exprimés dans les cytotrophoblastes extraits des placentas drépanocytaires, a retrouvé des modifications du métabolisme lipidique : diminution de la Fatty acid transport protein 2, augmentation de la périlipine 2, associées à une diminution de la protéine MLN64 (transporteur du cholestérol mitochondrial). Ces résultats peuvent contribuer à expliquer la diminution des concentrations d'estradiol et de progestérone observées dans les sérums des patientes drépanocytaires à terme. Toutes ces données nous permettent d'avoir une meilleure connaissance de l'adaptation placentaire dans les grossesses drépanocytaires. Il est nécessaire de poursuivre les recherches pour établir un lien entre altération morphologique, dysfonctionnement placentaire et préservation de la croissance fœtaleSickle cell disease (SCD) is the most common inherited autosomal recessive disease that affects hemoglobin synthesis, because of mutations in the ß-globin chain gene inherited from each parent. Signs and symptoms of SCD usually begin in early childhood. The sickling of red blood cells in deoxygenated conditions manifest in chronic hemolytic anemia and microvascular vaso-occlusion leading to ischemia-reperfusion injury and infarction. Serum levels of IL1ß, Il6, TNF-alpha, IL8, MCP1 have been shown to be significantly elevated in SCD patients and activate the expression of adhesion molecules on endothelial cells. Chronic hemolysis is responsible for heme release, that contributes to a proinflammatory and procoagulant state and activates endothelium. Pregnancy is a significant concern for women with SCD because of the increased consumption of oxygen by fetal growth and the proinflammatory context that raise the risk of vaso-occlusion and hemolysis. Literature reported numerous complications including preeclampsia, premature birth, intrauterine growth retardation, and intrauterine fetal death. Very few studies on placental structure and functions are described in the literature. The aim of this work was to characterize SCD placental development and function and to search explanation of described pregnancies impairment. We first reported in a large cohort of SCD pregnancies, that major placental dysmorphias were observed, although growth retardation was not frequent. Notably, we observed a relative lack of arborization in chorial villosities with a significant increase of the ratio sFlt1 / PlGF leading at term. Longitudinal PlGF and sFlt1 levels during pregnancy confirmed this impairment in the angiogenic balance of SCD pregnancies. Furthermore, using cultured cells from SCD placentas, we found that cytotrophoblast cells aggregate normally but fuse inefficiently to form syncytiotrophoblast with an abnormal hCG synthesis. This abnormal placenta morphology with normal fetal growth led us to hypothesize that some compensatory mechanisms could counterpart those abnormal placentas. The inflammatory environment was confirmed by a significant increase of IL1 ß, IL6, IL8, IL10, TNF-alpha, MCP1 in maternal sera. Moreover, because Indoleamine-2,3-dioxygenase (IDO1) is induced by pro-inflammatory cytokines and is involved in feto-maternal tolerance, we explored tryptophan metabolic pathway in the placentas of pregnant women with SCD. As expected, Kynurenine/Tryptophan ratio (IDO1 activity) was significantly increased in maternal and fetal sera at term. By placental perfusion of tryptophan, we highlighted a drop in quinolinic acid fetal compartment concentration, explained by a strong decrease in Kynurenine 3-mono-oxygenase (KMO) activity. The impact on the NAD concentration, involved in redox balance and in numerous metabolic pathways have to be assessed. Finally, by bioinformatic transcriptomic analysis of cytotrophoblast gene expression, we have found modifications in lipid metabolism: a decrease in FATP2 (Fatty acid transport protein 2) and an increase in PLIN2 (perilipine 2) m RNA, associated to a decrease of MLN64 protein expression (mitochondrial cholesterol transporter). These results can contribute to explain the decrease in estradiol and progesterone concentrations observed in SCD maternal sera. All these datas allow us to have a better knowledge of placental adaptation to SCD pregnancies. Further investigation should be continued to link morphological impairment, placental dysfunction and fetal growth preservation
21
Liu, Song. "Hemaglobinopathy and Pregnancy Outcomes: A Historical Cohort Study." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20621.
Анотація:
Pregnancy in women with hemoglobinopathy has been associated with an increased risk of adverse pregnancy outcomes. We conducted a historical cohort study using Discharge Abstract Database for the fiscal year 1991-1992 through 2007-2008. We estimated the frequency of pregnant women with hemoglobinopathy and examined their associations with adverse pregnancy outcomes. Women with sickle cell disease are more likely to develop pre-eclampsia and preterm labor, and to undergo cesarean delivery than women with nutritional deficiency anemia, suggesting that there are other mechanisms beyond anemia that may be responsible for an increased risk of adverse pregnancy outcomes. The data suggested a synergistic effect of hemoglobinopathy and pre-eclampsia on preterm labor and cesarean delivery. Prediction models for pre-eclampsia, preterm labor and cesarean delivery were created and internally validated for women with hemoglobinopathy, with satisfactory discrimination and calibration.
22
Toivo, Aini-Kaarin. "Perceptions and experiences of pregnant women towards HIV voluntary antenatal counselling and testing in Oshakati Hospital, Namibia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Анотація:
This study focused on perceptions and experiences of pregnant women who opted in against those who opted out of voluntary antenatal HIV counseling and testing. The pregnant women's perceptions and experiences were assessed in order to gain insight into their views towards voluntary antenatal counseling and testing.
23
Ludvigsson, Jonas F. "Some epidemiological aspects of perinatal gastrointestinal disease /." Linköping : Univ, 2001. http://www.bibl.liu.se/liupubl/disp/disp2001/med707s.pdf.
24
Wongweragiat, Sutatip. "Trophoblast proliferation and invasion in gestational trophoblastic disease : a study of decidual leucocytes and cytokines." Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366572.
25
Caimari, Palou Francisca. "Pituitary disease in the context of unusual situations." Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/669456.
Анотація:
El síndrome de Cushing (SC) y los adenomas hipofisarios aislados familiares (FIPA, del inglés familial isolated pituitary adenomas), son enfermedades raras que afectan a menos de 1-9 casos/100.000 habitantes. El embarazo en mujeres que han sido diagnosticadas con SC es extremadamente infrecuente y, tanto su diagnóstico como el tratamiento, suponen un verdadero reto médico. La dificultad del diagnóstico recae principalmente en la similitud de los síntomas del SC y del embarazo y en la complejidad de la interpretación de las pruebas diagnósticas en este contexto. La etiología del SC en estas pacientes difiere de aquellos pacientes con SC en la población general, pues en el primer grupo el orígen suprarrenal es la causa más frecuente que se da en hasta el 60% de los casos. No existe un consenso en cuanto al tratamiento más efectivo para mejorar el pronóstico materno y fetal, ya que hasta el momento no existen estudios que comparen las diferentes modalidades de tratamiento del SC durante el embarazo.
Por otro lado, los tumores hipofisarios clínicamente relevantes, diagnosticados en la infancia, son también una condición médica infrecuente. Estos casos a menudo se dan junto con mutaciones germinales que predisponen al desarrollo de tumores hipofisarios, habitualmente en un marco familiar, como, por ejemplo, ocurre en los síndromes clásicos como la neoplasia endocrina múltiple tipo 1 o 4, así como FIPA, una condición heterogénea de pacientes que incluye a aquellos sin causa genética conocida, a pacientes con mutaciones en AIP y al acrogigantismo ligado al cromosoma X, todas ellas siendo una causa frecuente de gigantismo de origen hipofisario.
Esta tesis comprende dos estudios. El primero tiene el objetivo de investigar si la etiología del SC durante el embarazo constituye un impacto diferente en el pronóstico fetal y materno. Para ello se realizó una revisión sistemática de los casos publicados en la literatura entre enero de 1952 y abril de 2015, incluyendo las palabras “Cushing AND pregnancy”. Se incluyeron doscientos sesenta y tres embarazos de pacientes con SC activo durante el embarazo y pacientes con historia de SC curadas en el momento de la gestación. La causa principal de SC activo durante el embarazo fue el adenoma suprarrenal (44.1%). Aquellas mujeres con SC activo presentaron más complicaciones durante el embarazo en comparación con aquellas con SC curado, tales como diabetes gestacional, hipertensión y preeclampsia. El porcentaje de pérdida fetal fue mayor en aquellas pacientes con SC activo, en comparación con las curadas (23.7 vs 8.5%, p=0.021), así como la morbilidad global fetal (33.6 vs 4.9%, p<0.001). En comparación con otras causas de SC, las pacientes con diagnóstico de SC inducido por el embarazo presentaron más probemas durante la gestación y tuvieron peor pronóstico fetal. El diagnóstico de SC durante el embarazo también se asoció con mayor morbi-mortalidad fetal. Finalmente, tanto el tratamiento médico como el quirúrgico, demostraron ser efectivos frente a la mortalidad fetal.
El segundo estudio tiene como objetivo desarrollar y validar una escala de riesgo para detectar pacientes con tumores hipofisarios portadores de mutaciones en el gen AIP. Se incluyeron de forma consecutiva una cohorte internacional de 2227 sujetos entre el año 2007 y 2016, incluyendo pacientes con tumores hipofisarios (familiares y esporádicos) y sus familiares. 1405 pacientes tenían un tumor hipofisario, de los cuales un 43% con historia familiar, 55.5% eran somatotropinomas y 81.5% macroadenomas. Se detectaron mutaciones en AIP en 134 pacientes (9.5%). Se identificaron cuatro predictores independientes para la presencia de mutaciones en AIP, los cuales se utilizaron para el desarrollo de la escala de riesgo: la edad de aparición de síntomas, la historia familiar, los tumores hipofisarios secretores de hormona de crecimiento y la presencia de macroadenoma. Esta escala de riesgo clasifica a los pacientes en bajo riesgo (<5% riesgo de mutación en AIP), moderado- (5-19%) y alto riesgo (>20%). El estadístico ‘c’ obtenido (0.87) indica una excelente discriminación del modelo, el cual se evaluó mediante el método de validación interna, indicando la fiabilidad de la estimación del riesgo individual de portar una mutación en AIP.Cushing’s syndrome (CS) and familial isolated pituitary adenomas (FIPA) are rare diseases, present in less than 1-9 cases/100.000 of the general population. Pregnancy in women with a diagnosis of CS is an extremely rare event and its diagnosis and treatment are a real medical challenge. The difficulties in diagnosis are related to the resemblance of symptoms of CS and those of pregnancy, and to the complex interpretation of the screening tests. Importantly, the etiology of CS in pregnancy differs from non-pregnant status as the adrenal origin is the most frequent in up to 60% of the cases. There is no consensus as to the most effective treatment in these circumstances in terms of improving maternal and fetal outcomes, as there are no studies comparing the different modalities of treatment for CS in pregnancy. On the other hand, clinically relevant pituitary tumors during childhood are also a rare medical condition. These cases can be related to germline mutations predisposing to pituitary tumorigenesis, often in a familial setting, including classical tumor predisposition syndromes such as multiple endocrine neoplasia type 1 or 4 syndromes, as well as FIPA, a heterogeneous condition of patients with unknown genetic cause, patients with mutation in AIP and X-linked acrogigantism, often leading to pituitary gigantism. This thesis is composed of two studies. The first study aimed to investigate whether the etiology of CS in pregnancy determined a different impact on the fetal/newborn and maternal outcomes. A systematic review of cases published in the literature was performed from January 1952 to April 2015 including the words “Cushing AND pregnancy”. Two-hundred and sixty-three pregnancies with active CS during pregnancy and with a history of CS, but treated and cured hypercortisolism at the time of gestation, were included in the study. Adrenal adenoma was the main cause of active CS during pregnancy (44.1%). Women with active CS had more pregnancy-related complications like gestational diabetes mellitus, gestational hypertension and preeclampsia, than those with cured disease. The proportion of fetal loss in active CS was higher than in cured CS (23.7 vs 8.5%, p=0.021), as well as global fetal morbidity (33.6 vs 4.9%, p<0.001). Patients with active CS, especially in pregnancy-induced CS, experienced more problems in pregnancy and had the worst fetal prognosis in comparison to other causes. Diagnosis of CS during pregnancy was also associated with worse overall fetal morbimortality. Finally, both medical treatment and surgery during pregnancy appeared to be protective in avoiding fetal loss. The second study aimed to develop and validate a reliable risk category system for AIP mutations in patients with pituitary adenomas (PA). An international cohort of 2227 subjects were consecutively recruited between 2007 and 2016, including patients with PAs (familial and sporadic) and their relatives. 1405 patients had a pituitary tumor, of which 43% had a positive family history, 55.5% had somatotropinomas and 81.5% presented with macroadenoma. Overall, 134 patients had an AIP mutation (9.5%). Four independent predictors for the presence of an AIP mutation were identified and used to develop the risk category system: age of onset, family history, growth hormone excess tumor type and large tumor size. The risk category system classified patients into low-risk (<5% risk of AIP mutation), moderate- (5-19%) and high-risk (>20% risk). Excellent discrimination (c-statistic=0.87) and internal validation were achieved, indicating it can reliably estimate the individual risk of carrying an AIP mutation for a given patient.
26
Merrell, Karen. "A Top-Down Proteomic Approach for the Discovery of Novel Serum Biomarkers of Pregnancy-Related Disease." Diss., CLICK HERE for online access, 2009. http://contentdm.lib.byu.edu/ETD/image/etd3117.pdf.
27
Harkness, Mairi. "Policy and practice concerning women with an RhD negative blood type : a midwifery perspective." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/9625.
Анотація:
In May 2002 the National Institute for Clinical Excellence (NICE) made the recommendation that all pregnant women with an RhD negative blood type should be offered routine antenatal anti-D immunoglobulin (Ig) prophylaxis (RAADP). Midwives were the key professional group who would be involved in administration of anti-D Ig and yet they had little input to formation of policy and contributed little to the evidence base that informs policy and practice. A midwifery perspective is however important and relevant, and forms the basis of this work. The thesis comprises three distinct, but related, pieces of research: a survey conducted in 2005 to determine implementation of RAADP at UK maternity units; secondary analysis of anti-D Ig errors involving midwives that were reported to the Serious Hazards of Transfusion (SHOT) scheme in 2007/8; and focus group interviews conducted in 2010 to explore midwives’ views on issues that impact the care provided for women with an RhD negative blood type. The aim of the RAADP survey was to establish current {2005} policy in the United Kingdom in relation to the NICE recommendation for RAADP (NICE, 2002). The survey formed the foundation on which to build the thesis by determining that by 2005 RAADP had become an integral aspect of maternity care within the UK. However it also found that there were significant variations within local policies and among the information that was provided to pregnant women and healthcare professionals. The aim of the survey was to determine implementation of policy and not to explain findings, raising important questions which were used to inform the subsequent research. The second piece of research was secondary analysis of existing anti-D Ig error reports collated by SHOT. The analysis was unique in that it included only those errors involving midwives. The findings highlight both individual and organisational impact on errors, building on the findings of the RAADP survey. The research identified proximal errors, trigger events and fallible practices providing a framework within which the common pathways to error involving anti-D Ig can be understood. This will allow midwives to better understand and improve the care they provide. This piece of research also raised further questions about midwifery practice and those questions informed the focus group research. The focus group research aimed to consolidate the findings of the previous research by gaining direct input from midwives. Two focus group interviews were held, with clinical midwives as participants. The research found that the midwives and the organisations within which they worked provided care in line with policy and procedure at the apparent expense of a woman centred approach. This appeared to be linked to the midwives’ understanding of their responsibility, accountability and the education and information that underpinned the care they provided. The other important finding from the focus group research was that the midwives regarded RAADP as a less important intervention than they did anti-D Ig given following a potentially sensitising event (PSE) during pregnancy or given following delivery. When considered as a whole body of work, this research provides unique and valuable insight to midwifery involvement in the care of women with an RhD negative blood type. The research highlights the challenge of achieving government objectives for individualised, woman centred care within the present framework of clinical governance and evidence based care. In doing so it also raises questions about how individual midwives and the midwifery profession have engaged with medical colleagues and policy makers to maintain a midwifery context to the care they provide. Although the research findings relate to care provided for women with an RhD negative blood type the findings are pertinent to other aspects midwifery practice, particularly those originating within the medical profession that are now a routine part of midwifery care.
28
Alwan, Nisreen Ala-Din A. S. "The effect of maternal iron status and intake during pregnancy on cardiovascular disease risk in the offspring." Thesis, University of Leeds, 2014. http://etheses.whiterose.ac.uk/7177/.
Анотація:
Iron is an important micronutrient essential in carrying oxygen and maintaining the function of many body enzymes. It is of particular importance during gestation as body demands increase leading to iron deficiency in women with inadequate iron stores at the start of pregnancy. Animal studies have shown that iron deficiency in pregnancy leads to offspring with adverse cardiovascular risk profiles compared to offspring of iron replete mothers. This thesis aimed to examine the association of maternal iron intake and status in pregnancy with short and long term birth outcomes that are considered cardiovascular risk indicators later in life. Analysis of data from three cohorts and one Mendelian randomisation study was included in this thesis. Total maternal iron intake in early, but not late, pregnancy was positively associated with birth size. There was no evidence of association between taking iron-containing supplements in pregnancy and size at birth. However, taking multivitamin-mineral supplements, which contain iron, in late pregnancy was associated with an increased risk of preterm birth. Also taking iron supplements up to 32 weeks gestation was associated with lower offspring systolic blood pressure at 10 years. Maternal iron deficiency and anaemia in early pregnancy were associated with an increased risk of giving birth to a SGA baby. Infant brachio-femoral PWV measured at 2-6 weeks of age was found to be higher in women who were anaemic in early pregnancy, but not in those who were only iron deficient. Finally, using a Mendelian randomisation design, maternal iron status measured by serum ferritin with C282Y mutation as an instrumental variable, was not found to be associated with adult offspring BP and adiposity. In conclusion, maternal iron intake and status in early pregnancy seem to be associated with short term birth outcomes like size at birth, while associations with long term offspring cardiovascular indicators were not detected in this thesis.
29
Agbeniyi, Olusola Charles. "Periodontal disease during pregnancy and low birth weight of newborns at Chris Hani district of Eastern Cape." Diss., University of Pretoria, 2012. http://hdl.handle.net/2263/28774.
Анотація:
Objective: This study sought to determine the association between periodontal disease in pregnancy and the delivery of low birth weight newborns in a rural population of South African women. Methods: This case-control study involved 348 new mothers. All subjects were recruited post-delivery from three public hospitals in the rural Eastern Cape of South Africa. The cases (n=119) were mothers who delivered through normal delivery and whose babies at the time of delivery weighed <2.5 kg. Age-matched controls (n=229) were mothers who delivered ≥2.5 kg babies. Potential risk factors for periodontal disease and low birth weight were collected by means of a structured questionnaire and maternity record review. Using the WHO's community periodontal index, a trained dental clinician blinded to participants' birth-outcomes recorded the periodontal health status of each participant (intraexaminer reliability; kappa = 0.95). Mothers who presented with a probing depth ≥4 mm on more than four index teeth without the presence of gingival overgrowth were deemed to present with periodontal disease. Data analysis included conditional logistic regression analysis. Results: Periodontal disease was diagnosed in 37.9%> (n=45) of the case group and 9.2°/o (n=21) of the control group. Low birth weight was also significantly more common among those who were unemployed, those who reported fewer than three antenatal visits and drinking on five or more days per week during pregnancy. After controlling for potential confounders, mothers presenting with a probing depth ≥ 4 mm on four teeth (OR = 4.12; 95°/o Cl = 1. 78 - 9.50) or more than four teeth (OR = 4.95; 95%> Cl: 1.52 - 15.81) were found to be significantly more likely to have low birth weight babies. Conclusions: The study findings suggest that there is a significant dose-dependent positive association between periodontal disease and low birth weight, independent of other risk factors measured in this study.Dissertation (MSc)--University of Pretoria, 2013.
Community Dentistry
unrestricted
30
Wallenius, Marianne. "Pregnancy related aspects of chronic inflammatory arthritides: disease onset postpartum, pregnancy outcomes and fertility : Data from a Norwegian patient registry linked to the Medical Birth Registry of Norway." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for nevromedisin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-16168.
31
Sihavong, Amphoy. "Management of reproductive tract infections among health providers and in the community in Lao People's Democratic Republic /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-383-2/.
32
Kinra, Sanjay. "The effect of supplemental nutrition in pregnancy and early childhood on future risk of cardiovascular disease : long term follow up of a community trial." Thesis, University of Bristol, 2007. http://hdl.handle.net/1983/33bed0b3-769c-461f-830d-04896f8cd6c5.
33
Valimont, Amanda Story. "The Effectiveness of Sex Education Programs in Virginia Schools: Teenage Pregnancy and Sexually Transmitted Disease Rates: A Comparison of Counties." Thesis, Virginia Tech, 2005. http://hdl.handle.net/10919/35896.
Анотація:
There has been little scientific evidence to suggest that abstinence-only-until-marriage education programs are effective in preventing or reducing teenage pregnancy and sexually transmitted disease. There is also little scientific evidence to suggest that comprehensive sex education programs are as or more effective in preventing or reducing teenage pregnancy and sexually transmitted disease than their abstinence-only counterpart. The following study compares the teenage pregnancy and sexually transmitted disease rates among minors in Virginia that participate in abstinence-only programs with rates among minors participating in comprehensive sex education programs. I hypothesize that counties implementing comprehensive sex education programs in schools will typically have lower pregnancy and sexually transmitted disease rates among minors than counties implementing abstinence-only education programs. I test these hypotheses with data on the 16 Virginia counties and county equivalents which could be verified as having either comprehensive or abstinence-only sex education programs in public schools during 1998-2003. The data confirm the hypotheses. On average, comprehensive program counties showed greater declines in pregnancy rates among females aged 15-17 than abstinence-only program counties. Comprehensive counties experienced declines in Chlamydia and Gonorrhea rates among males and females aged 15-17, whereas abstinence-only counties' Gonorrhea and Chlamydia rates increased. These findings underscore the need for statewide -- indeed, nationwide -- public reporting of school systems' sex education program types to permit a more thorough comparison and evaluation of program outcomes. In the meantime, these results challenge Virginia advocates of abstinence-only education programs to empirically defend their claims.Master of Science
34
D'Aronco, Sara. "DHA synthesis during pregnancy and markers of lung injury in infants with acute lung diseases." Doctoral thesis, Università degli studi di Padova, 2016. http://hdl.handle.net/11577/3424515.
Анотація:
Docosahexaenoic acid (DHA) is an essential constituent of membrane cell phospholipids and a precursor of eicosanoid’s synthesis. During pregnancy, DHA is taken up from the maternal bloodstream and supplied to the fetus by placenta transfer. Maternal DHA intake, metabolism, and transfer are therefore crucial for fetal growth and development. In the first part of this thesis we aimed to evaluate the feasibility of measuring DHA endogenous synthesis in pregnant women using the stable isotope natural abundance approach. Alveolar surfactant is a key player in sustaining lung physiology. It’s well established that lack of surfactant, surfactant inhibition as well as changes in surfactant composition, can seriously compromise gas exchange and may lead to mechanical ventilation support. Thus, in the second part of this thesis we studied surfactant composition during acute lung disease in newborn infants. First we compared term newborns affected by neonatal pneumonia and without lung disease to clarify if surfactant proteins’ changes could have a role in the reduced pulmonary compliance observed in these patients. Finally, we studied if and how histological chorioamnionitis and gestational age affect surfactant composition in pre-term infants affected by RDS.L’acido docoesaenoico è un componente essenziale dei fosfolipidi delle membrane cellulari ed un precursore per la sintesi degli eicosanoidi. Durante la gravidanza il passaggio di DHA dalla circolazione materna al feto è mediata dal passaggio trans-placentare. Assunzione, metabolismo materno e transfer placentare del DHA sono quindi fondamentali per la crescita e lo sviluppo del feto. L’obiettivo della prima parte di questa tesi è stato quello di valutare la fattibilità nel misurare la sintesi endogena di DHA durante la gravidanza utilizzando l’approccio dell’abbondanza naturale degli isotopi stabili. Il surfattante alveolare è di fondamentale importanza nella fisiologia polmonare. E' noto che una carenza di surfattante, una sua inibizione così come dei cambiamenti nella sua composizione, possono compromettere l’efficienza dello scambio gassoso al punto da rendere necessario il supporto della ventilazione meccanica. Nella seconda parte di questa tesi abbiamo quindi studiato la composizione del surfattante nei neonati affetti da malattia polmonare acuta. Prima abbiamo confrontato neonati con polmonite neonatale con neonati privi di patologia polmonare per chiarire il ruolo delle proteine specifiche del surfattante nella ridotta compliance polmonare che si osserva nella fase acuta della polmonite. Infine abbiamo studiato come e se età gestazionale ed esposizione alla corioamniosite istologica influenzano la composizione del surfattante in neonati pretermine affetti da RDS.
35
Stamatopoulos, Nicole. "The use of ultrasound in the prediction of miscarriage, gestational trophoblastic disease and first trimester embryonic growth." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/28828.
Анотація:
Miscarriage occurs in approximately 25% of all clinical pregnancies. Little is known as to the causes. It is commonly due to aneuploidy including gestational trophoblastic disease.
Ultrasound parameters as well as serum human chorionic gonadotrophin ratios have been incorporated into algorithms.
Pregnant women with any bleeding become anxious and fear they have miscarried. A mathematical model was previously developed to assess the likelihood of miscarriage in women who had had previous ultrasound demonstrating a viable intra-uterine pregnancy. Five objective variables were identified. The aim of this thesis was to internally and externally validate this model. This allows further insight into the role of ultrasound in miscarriage prediction.
If a woman has had a diagnosis of gestational trophoblastic disease, this will impact when she can next conceive, follow up after every pregnancy and may progress to gestational trophoblastic neoplasia. There are features on ultrasound suggestive of gestational trophoblastic disease. Histopathology of the products of conception is the gold standard for diagnosis. Given that this is a complication of early pregnancy and at times can be mistaken for miscarriage, a secondary aim of this thesis was to assess if transvaginal ultrasound could be used as a diagnostic tool to predict gestational trophoblastic disease.
There are modifiable risk factors that may lead to miscarriage or complications. Cigarette smoking is one of those; associated with pre-term birth, placental abruption, and fetal growth restriction in the second and third trimesters of pregnancy. It is not known whether the effects cigarette smoking on fetal growth can be detected as early as the first trimester. The final aim of this thesis was to evaluate the impact of cigarette smoking on first trimester embryonic growth.
36
Breckler, Liza Anne. "The role of maternal-fetal interactions on the aetiology of allergic disease." University of Western Australia. School of Paediatrics and Child Health, 2009. http://theses.library.uwa.edu.au/adt-WU2010.0042.
Анотація:
[Truncated abstract] The dramatic increase in the expression of allergic diseases such as asthma and allergy over the last 20-30 years has highlighted the urgent need to identify causative factors. It was hypothesised that direct immune interactions between mother and fetus contribute to the cytokine milieu of pregnancy, thus influencing immune maturation after birth. Further it was speculated that the cytokine responses produced as a result of maternalfetal interactions are Th-2 skewed in women allergic disease, which programmes their offspring towards developing an allergic phenotype after birth. To test this hypothesis a cohort of 169 pregnant women were recruited at 20 weeks gestation and defined as allergic or non-allergic based on both clinical history and skin prick test sensitisation. These women and their infants were followed up throughout pregnancy (20 weeks, 30 weeks, 36 weeks gestation and 6 weeks post-partum) and up to 2.5 years of age. Mixed lymphocyte reactions (MLR) were used to measure maternal cytokine (IL-6, IL-10, IL-13 and IFN-) and lymphoproliferative responses to fetal alloantigens at each pregnancy time-point. Human leukocyte antigen (HLA) typing of mothers and infants were performed to assess the effect of HLA mismatch on maternal MLR responses to their fetus. After delivery, mononuclear cells (MNC) were isolated from cord blood (CB) and stimulated with allergens, mitogen and toll-like receptor (TLR) ligands. .... As IL-6 also participates in adaptive immunity by promoting Th-2 differentiation it is proposed that the production of IL-6 as a results of maternal encounters with paternal antigens during pregnancy, contribute to the Th-2 skewed responses observed universally in most infants at birth. Associations between maternal-fetal interaction and clinical outcomes in infancy: Although clinical signs of allergy in infancy were not the main outcome measure of this thesis, there were interesting, yet complex relationships between the production of these maternal cytokines towards the fetus and allergic disease at infant follow-ups. Increased maternal IFN-¿ to fetal alloantigen was associated with asthma at 2.5 years and a trend towards recurrent wheeze at 12 months. In contrast decreased maternal IL-13 production was associated with IgE mediated food allergy at 12 months. Adjusting for maternal allergy and other potential confounders including infant gender, method of delivery, HLA mismatch, and paternal allergy did not account for these relationships. Further follow-ups of these infants are required to determine if these relationship last in to early childhood. In conclusion, the findings of this thesis provides further support for the hypothesis that immune responses at birth are programmed prenatally, and that this programming has implications later in life. Importantly, the placenta is the immunologically active interface between mother and fetus during pregnancy. Therefore it is emphasised that there is a crucial need for future research to focus on early immune programming at the placental level before the aetiological pathways of immune mediated diseases can be fully elucidated.
37
Stemp, Melissa. "Biomarkers of disease : concentrations in the serum of women during natural and stimulated ovarian cycles and during early pregnancy." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/865.
Анотація:
Molecular biomarkers are chemical signatures that all cell types possess. They are used in medicine to evaluate both normal biological events and pathogenic processes. A series of biomarkers associated with cancer of the breast, ovaries and other parts of the female reproductive tract and the monitoring of pregnancy were measured in disease‐free women. The biomarkers measured were prostate specific antigen (PSA), CA125, CA15‐3, CA72‐4, and pregnancy associated plasma protein‐a (PAPP‐A). The patterns of change during natural and stimulated ovarian cycles and early pregnancy were investigated to determine if these biomarkers could reflect normal events relating to ovulation and implantation/placentation. In addition, the study was able to investigate the possible erroneous crossing of clinical cut‐off values associated with disease due to other biological processes rather than the disease itself.
total of 73 blood samples (10 women) taken throughout the natural menstrual cycle, 64 blood samples (11 women) during stimulated ovarian cycles and 86 blood samples (14 women) during early pregnancy monitoring were collected and all samples were analysed by batch analysis on the Roche Cobas e411. Concentrations of CA125, tPSA, CA15‐3 and CA72‐4 showed no significant difference between the natural and stimulated ovarian cycle groups (p≥0.5989). On average the mean PAPP‐A of the natural group was 2.41±0.58 mIU/L higher than the stimulated group (t = 4.10, p < 0.001). CA125 and CA15‐3 results were both significantly influenced by the stage of the cycle (p=
In conclusion, batch analysis of all samples from each of the participants was conducted to maximise the possibility that any changes seen in biomarker concentrations were due to biological fluctuations and not because of assay variability. Ovarian stimulation reduced serum PAPP‐A levels, whilst CA125 and CA15‐3 were unaffected by ovarian stimulation per se but showed cyclical changes throughout both natural and stimulated cycles. PAPP‐A, CA125, tPSA and CA15‐3 all showed consistent changes in early pregnancy, and their combined benefits as markers of different aspects of implantation, embryogenesis and placentation warrants further investigation. Only CA125 in early pregnancy crossed the cut‐off associated with disease, ie ovarian cancer, and other gynaecological and inflammatory conditions. Care must therefore be taken when using CA125 determinations to detect disease if the woman is less than 7 weeks pregnant as transient elevations during this time appear normal.
38
RODRIGUES, Paula Adriana Borba. "Avaliação do Estado Mental e validação do Perception of Pregnancy Risk Questionnaire em gestantes de alto risco." Universidade Federal de Pernambuco, 2015. https://repositorio.ufpe.br/handle/123456789/19989.
Анотація:
Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-24T11:56:49Z
No. of bitstreams: 2
license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5)
TESE PARA DEPÓSITO.pdf: 1020977 bytes, checksum: 8eff6af757005586cdc17a12637c3302 (MD5)Made available in DSpace on 2017-07-24T11:56:49Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) TESE PARA DEPÓSITO.pdf: 1020977 bytes, checksum: 8eff6af757005586cdc17a12637c3302 (MD5) Previous issue date: 2015-10-29
Introdução: Cerca de 20% das gestantes apresentam fatores de morbidade e mortalidade que podem tornar a evolução da gestação desfavorável, constituindo o chamado grupo de alto risco. Esta é uma condição de maior probabilidade de comprometimento à saúde ou de significante risco materno ou fetal. A expectativa de risco de vida para si ou para o bebê pode predispor a gestante a apresentar um maior comprometimento em seu estado de saúde mental. Além de que a percepção do risco da mulher grávida pode influenciar os comportamentos de saúde durante a gravidez. Ser de alto risco, portanto, pode ser fator contribuinte para um estado de sofrimento mental e com isso necessitar de intervenções mais específicas. Objetivo: avaliar o estado de saúde mental de gestantes que preenchem critério para gestação de alto risco reprodutivo e validar um instrumento que medisse a percepção de risco destas gestantes. Método: realizado um estudo transversal conduzido em uma amostra de 456 gestantes, composta por 241 gestantes de alto risco e 215 gestantes de baixo risco como grupo comparativo, atendidas em serviços públicos de pré-natal, na cidade de Natal, RN. Avaliou-se o estado de saúde mental destas gestantes através da verificação da presença de Transtorno mental comum (TMC) e aplicou-se o instrumento Perception of Pregnancy Risk Questionnaire (PPRQ), como avaliação da percepção de risco, com a finalidade de validação à população brasileira. Resultados: A prevalência encontrada de TMC foi de 63,5% nas gestantes de alto risco, enquanto presente em 41,9% das gestantes de baixo risco (p<0,001). Na análise multivariada, o transtorno mental comum esteve associado a fatores como ser do grupo de risco, renda pessoal, planejamento da gravidez e história de transtorno mental anterior. O PPRQ demonstrou ser concordante entre suas variáveis e o seu total, além de boa confiabilidade extraída de uma alfa de Cronbach de 0,87 e adequado teste-resteste, semelhante ao instrumento original. Conclusão: De acordo com os dados disponíveis na literatura, consideramos que a prevalência de TMC em gestantes de alto risco encontrada neste estudo pode ser considerada alta, alertando para a importância da investigação sobre o estado de saúde mental nestas mulheres em serviços de pré-natal. A versão em português do PPRQ demonstrou resultados satisfatórios na tradução, adaptação e consistência interna, sugerindo esta versão para ser utilizado na população brasileira.
Introduction: About 20% of pregnant women have morbidity and mortality factors that can make the evolution of unfavorable pregnancy, constituting the so-called high-risk group. This is a condition likely to compromise the health or significant maternal or fetal risk. The expectation of life threatening for you or the baby may predispose pregnant women to have a greater commitment to their mental health. In addition to that the perception of the pregnant woman's risk may influence health behaviors during pregnancy. The fact to be at high risk can therefore be a contributing factor to a state of mental distress and thus require interventions that are more specific. Objective: To assess the mental health status of pregnant women who meet criteria for high-risk pregnancy and reproductive validate an instrument to measure the perception of risk of these pregnant women. Method: a cross-sectional study conducted in a sample of 456 pregnant women, consisting of 241 high-risk pregnant women and 215 low-risk pregnant women as a control group treated at public services prenatal, in the city of Natal, RN. We evaluated the mental health status of these pregnant women by checking the presence of common mental disorder (CMD) and applied the Perception instrument of Pregnancy Risk Questionnaire (PPRQ) as assessment of risk perception, in order to validate the Brazilian population. Results: The prevalence of CMD was 63.5% in high-risk pregnant women, while present in 41.9% of low-risk pregnant women (p <0.001). In multivariate analysis, the common mental disorder was associated with factors such as being risk group, personal income, pregnancy planning and history of previous mental disorder. The PPRQ proved concordant between your variables and their total, and good reliability extracted a Cronbach's alpha of 0.87 and adequate test-retest, similar to the original instrument. Conclusion: According to the data available in the literature, we believe that the prevalence of CMD in high-risk pregnant women in this study can be considered high, stressing the importance of research on the state of mental health in these women in prenatal services . The Portuguese version of Perception of Pregnancy Risk Questionnaire demonstrated satisfactory results in the translation, adaptation and internal consistency, suggesting that version to be used in the Brazilian Population.
39
Rodrigues, Leonardo Correa de Oliveira. "Interação da gestação na atividade da doença inflamatória intestinal e sua influência sobre o prognóstico gestacional e na fecundidade." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-08122009-173713/.
Анотація:
INTRODUÇÃO: A maioria das mulheres que desenvolvem doença inflamatória intestinal (DII) encontra-se em idade fértil, despertando preocupação dos médicos e mulheres no entendimento desta interação. Avaliamos a influência da DII sobre a fecundidade e gestação e vice- versa. MÉTODOS: Os protocolos de pacientes com doença de Crohn (DC) e retocolite ulcerativa (RC), de 1984 a 2006, em idade fértil, cadastrados no ambulatório de DII, foram revisados. Pacientes foram entrevistados para preenchimento de dados não encontrados nos protocolos. Outros tipos de colites, investigação incompleta, pacientes que não estavam em idade fértil ou sem capacidade cognitiva foram excluídos. Prematuridade, baixo peso ao nascer, anomalias congênitas, natimortalidade, abortamentos, tipos de partos, localização da doença na gestante e uso de medicamentos durante a gestação foram investigados. O método estatístico adotado foi o teste de qui- quadrado e Fisher, com nível de significância de 5%. Nenhum paciente se recusou a participar desta pesquisa. RESULTADOS: 140 gestações em 104 pacientes com DII foram avaliados (RC em 63 gestações e DC em 77). Houve redução da fecundidade após o início dos sintomas relacionados à DII em 41,6%, com influência da doença sobre a opção de não ter filhos em 20,6% (10,3% dos pacientes por medo da doença; 6,5% por orientação médica e 2,2% por más condições clínicas), sem diferenças entre DC e RC. A grande maioria não quis engravidar por já ter filhos, por ser solteira ou estar ter baixa idade (53,3%). A atividade da RC não foi alterada durante a gestação na maioria das pacientes (77,8%; p>0,003). A atividade da doença melhorou durante a gestação mais nas gestantes com DC do que nas com RC (p>0.0007). A incidência de prematuros, baixo peso ao nascer e natimortos foi maior quando todo o cólon estava acometido na RC (p < 0.037). A proporção estimada de prematuros e baixos pesos ao nascer foi de 83,3% [IC 95%: 10,3%; 100,0%]. Não houve diferença estatística quanto à localização da doença e alterações do feto na DC (p > 0,6513). Em 21 gestantes foram administrados aminossalicilatos e em 15, corticosteróides. Em 106 gestações, nenhum medicamento foi administrado. Não houve maior taxa de alterações do concepto quando aminossalicilatos ou corticosteróides foram administrados às gestantes com DII (p > 0,17 and p > 0,1585, respectivamente). CONCLUSÃO: A DII não influenciou diretamente na fecundidade na grande maioria das pacientes. A gestação influenciou positivamente a evolução da DC, independente do uso de medicamentos. A taxa de prematuridade foi maior nas proles de mães com DC. Houve maior taxa de proles com alterações quando todo o cólon estava comprometido na mãe com RC. A DC influenciou o tipo de parto, apenas nos casos de doença perianal extensa associada à doença colônica.INTRODUCTION: Most of women that develops inflammatory bowel disease (IBD) are in fertile age, concerning doctors and patients to understand this interaction. We evaluated the influence of IBD on fecundity and pregnancy and vice- versa. METHODS: the protocols of patients with Crohns disease (CD) and ulcerative colitis (UC), from 1984 and 2006, in fertile age, followed at the outpatient clinic were reviewed. Patients were interviewed by the research medical doctor, to complete missing data not found in their protocols. Patients with others colitis, incomplete investigation, not in fertile age or without cognitive capacity were excluded from this study. Preterm delivery, low birth weight, congenital anomalies, stillbirth, miscarriages, types of delivery, disease topography in pregnant patients and drug administration during pregnancy were investigated. The statistic method adopted was the chi-square and Fisher test, with significance level of 5%. No patient refused to participate in this study. RESULTS: 140 pregnancies in 104 patients with IBD were evaluated (UC in 63 and CD in 77 pregnancies). : a reduction of 41.6% in fecundity was observed after beginning of symptoms related to IBD, with influence of the disease in 20.6% (10.3% of patients didnt want to have children because of fear related to disease; 6.5% because of medical orientation and 2.2% for poor medical conditions). There was no difference between CD and UC. Most of patients didnt want to become pregnant because they already had children, were underage or alone (53.3%) Most of pregnancies didnt altered clinic conditions in UC patients (77.8% / p=0.003). Clinical conditions improved during pregnancies more in CD patients than UC patients (p=0.0007). The incidence of preterm delivery, low birth weight and stillbirth was higher when the whole colon was affected in UC (p < 0.037). The estimated rate of preterm delivery low birth weight was 83.3%[IC 95%: 10.29%; 100.00%]. There was no statistic difference between the disease topography and the fetus alteration in CD (p > 0.6513). In twentyone and fifteen pregnant women, aminosalicilates and corticosteroids were administered, respectively. In 106 pregnancies, no drugs were administered. There were no higher rates of fetus alteration when aminosalicilates or corticosteroids were administered to mothers with IBD (p > 0.17 and p > 0.1585, respectively). Conclusions: IBD didn´t have any direct influence on fecundity in most of the patients. Pregnancy influenced positively on CD evolution, independently of drug use. The preterm birth rate was higher in children of mothers with CD. There were higher rates of fetus alteration when the whole colon was affected in mothers with UC. CD influenced the type of delivery only when perianal disease was associated to colonic disease.
40
Focesi, Eris. "Impressos em programa para gestante cardíaca." Universidade de São Paulo, 1987. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-03082016-145444/.
Анотація:
Este estudo teve por objetivo avaliar a eficácia de determinado impresso na fixação dec conhecimentos e adoção de práticas de saúde. Para se atingir esse objetivo foi elaborado o Manual \"Gestante Cardíaca\" para educação de pacientes do Programa \"Cardiopatia e Gravidez\" do Instituto \"Dante Pazzanese\"de Cardiologia. As gestantes cardíacas inscritas no Programa foram divididas em dois grupos. Após consulta médica onde receberam orientação, um dos grupos recebeu o Manual. Conhecimentos e práticas das gestantes foram testados quando ingressaram no Programa e retestados na última consulta. As gestantes do grupo que recebeu o impresso tiveram maior ganho em conhecimentos (82,4 por cento ) e adotaram mais priticas (94,4 por cento ) que as do outro grupo (2,0 por cento e 40,5 por cento ). Os resultados obtidos parecem sugerir a eficácia do Manual para fixar conhecimentos e estimular a gestante cárdiaca na adoção das práticas recomendadas. O processo de elaboraçio do Manual é descrito no trabalho.The purpose of this study was to evaluate the efficacy of a printed material to reinforce knowledge and in the adoption of health practices. A manual designed to cardiac pregnant women of the Program \"Cardiopathy and Pregnancy\" of the Institute of Cardiology \"Dante Pazzanese\" of São Paulo was prepared. The women were divided into two groups, one of which received the Manual after medical consultation. Both groups were subjected to orientation. Womens\' knowledge and practices were tested at the first consultation and retested at the last one. The group of women who had rcceived the material gained more in knowledge (82,4 per cent ) and adopted more practices (94,4 per cent ) than the group who did not receive the Manual (2,0 per cent and 40,5 per cent ). The results obtained suggest the efficacy of the printed material to reinforce knowledge and stimulate recommended practices. The Manual elaboration process is described in this paper.
41
Сюсюка, В. Г., В. І. Бальченко та А. В. Жарких. "Оцінка параметрів біофізичного профілю плода у вагітних з варикозною хворобою". Thesis, Видавництво СумДУ, 2005. http://essuir.sumdu.edu.ua/handle/123456789/12537.
42
Temba, Vuyo Noluthando. "A phenomenological study of the experiences of pregnant, black adolescent girls living with HIV/AIDS." Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-09302008-093355.
43
Milne, Jane E. C. "Renal reserve in human pregnancy in health and disease : elucidation of mechanisms using neutral dextran sieving coefficients and biomathematical modelling." Thesis, University of Newcastle upon Tyne, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405071.
44
Thomas, Hugh. "Maternal metformin treatment in obese pregnancy alters priming of offspring metabolic dysfunction and non-alcoholic fatty liver disease in mice." Thesis, University of Southampton, 2017. https://eprints.soton.ac.uk/415500/.
Анотація:
Background: Interventions to protect offspring from the deleterious long-term effects of maternal obesity during pregnancy have been sought but have proven largely ineffective in humans. Metformin, an antidiabetic drug used to control gestational diabetes, failed to reduce obesity-associated fetal overgrowth in two human trials, yet long-term follow-up of these children will take many years. Thus, this thesis aims to characterize the effect of metformin on offspring in a mouse model of maternal obesity. Methods: Female mice were fed normal chow (C; 7% kcal fat) or obesogenic high-fat diet (HF; 45% kcal fat) for 6 weeks prior to mating. Metformin (m) was given in drinking water (250mg/kg) to half of dams during pregnancy and lactation. Dam and fetal parameters were assessed in a subgroup at gestation day 16.5. At weaning, offspring received C or HF diet. Offspring metabolic parameters were assessed at 28 weeks, and offspring were killed and tissue collected at 30 weeks. Plasma metabolic and inflammatory markers and hepatic gene expression, lipid levels and pathology were evaluated. Results: In fetuses, metformin treatment altered fetal hepatic gene expression and reduced fetal weight. Metformin had no effect on obese dam glucose homeostasis. In adult female offspring of obese dams, maternal metformin reduced adiposity, improved glucose homeostasis and reduced nonalcoholic fatty liver disease (NAFLD) severity. In adult male offspring of obese dams, metformin had no beneficial effects. In adult offspring of either sex born to lean dams, maternal metformin increased offspring adiposity, impaired glucose homeostasis and worsened NAFLD severity. Conclusions: Metformin treatment in obese dams partially protects female offspring from the effects of maternal obesity, yet male offspring do not benefit. Offspring of metformin-treated lean dams, of either sex, have more severe metabolic disease. These data urge investigation of mechanisms priming adverse offspring responses to maternal metformin.
45
Beeson, Jessica Holly. "An investigation into whether an exercise intervention during pregnancy can prevent the programming of cardiovascular disease in the offspring of obese mothers." Thesis, University of Cambridge, 2019. https://www.repository.cam.ac.uk/handle/1810/289772.
Анотація:
A strong body of evidence suggests that environmental insults from the point of fertilisation to birth and neonatal life can shape the health of the individual for many years to come. Adverse exposures, such as maternal overnutrition, in the early life environment increase the risk of traditionally adult-onset diseases such as cardiovascular disease and type 2 diabetes adding greatly to the next generation's burden of disease. Studies in animal models provide strong evidence that these effects are mediated by non-genetic programmed mechanisms. This is of particular concern, as recent studies in the UK suggest that over half of women are now overweight or obese during pregnancy. Current preventative strategies for adult cardiovascular disease have, thus far, focused on reducing an individual's modifiable risk factors. However, given growing evidence that risk of cardiovascular disease is determined in utero, there is strong rationale that disease risk from mother to child could be reduced prior to birth, through targeted interventions in the mother before and during pregnancy. Using an established murine model of maternal diet-induced obesity during pregnancy, the first aim of this thesis was to characterise potential programming factors in the obese mother and identify those that were targeted by a treadmill exercise intervention. Through feeding of an obesogenic diet, dams became heavier, with increased fat mass, and showed insulin resistance at weaning. Previous work has shown the intervention improved maternal insulin sensitivity during pregnancy (E19) and data from this thesis revealed that this was not accompanied by any changes to body composition. Previous data using this model showed that male offspring born to obese dams have pathological cardiac hypertrophy and ex vivo cardiac dysfunction. A second aim of this thesis was to establish if exercise intervention in obese dams was protective to the cardiovascular health of the offspring. These studies revealed that maternal exercise intervention during obese pregnancy had a positive impact by preventing pathological left ventricular cardiac hypertrophy and in vivo dysfunction, but did not prevent programmed hypertension in the male offspring. This demonstrates that offspring cardiac hypertrophy and dysfunction can be programmed independently of hypertension by maternal diet-induced obesity. The third aim of this thesis was to establish how female offspring were impacted by maternal obesity. The results demonstrated that female offspring born to obese dams were hypertensive and displayed right ventricular cardiac hypertrophy. However, there was no observable effect of maternal obesity on cardiac function in female offspring at this age. This highlights the potential sexually dimorphic effects of developmental programming by maternal obesity. A final aim of this thesis was to assess the immediate consequences of maternal obesity on the fetal heart and whether maternal exercise had any impact. This showed that in late gestation (E19), cardiac remodelling were already present in the male fetuses of obese dams, and the exercise intervention did not fully prevent this adverse finding. In conclusion, this thesis highlights that the cardiovascular health legacy of an individual is determined by maternal nutrition before birth and by the intrauterine environment. Just a small improvement in offspring risk could have important implications for the future prevalence of cardiovascular disease worldwide. Importantly this thesis highlights a potential need for combination intervention strategies to tackle the epidemic of obesity in pregnancy, as maternal exercise alone was not sufficient to reduce all aspects of the future burden of cardiovascular disease.
46
Orbea, Therese B. "Adolescent Sexual Behavior and Sexual Education in the United States." Scholarship @ Claremont, 2010. http://scholarship.claremont.edu/cmc_theses/5.
Анотація:
This review of sexual education in the United States broadly defines the two most common approaches in sexual education seen in this country today. I cover the status of certain sexual behaviors and risks amongst the teenage population in the U.S. and specifically cover reported sexual activity in high school students and overall data on teen pregnancies and sexually transmitted infections (STIs). This work specifically looks at Maine, California, Texas, Maryland, North Carolina, and New Mexico to highlight the variety of state policies concerning sexual education and the differences in teenage sexual behaviors that exist within each of those six states. A description of how cultural influences can affect a young person’s sexual behavior is also given. In the final discussion section of this paper I have emphasized the need for more comprehensive sexual education programs in the United States and the importance of providing culturally sensitive programs in order to continue the fight against teenage pregnancy and STI rates in adolescents.
47
Cândido, Elaine Cristina 1976. "Transmissão vertical de hepatite em gestantes no CAISM Campinas = HBV mother to child transmission at CAISM UNICAMP." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312690.
Анотація:
Orientador: Helaine Maria Besteti Pires Mayer MilanezDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-24T05:11:32Z (GMT). No. of bitstreams: 1 Candido_ElaineCristina_M.pdf: 1043425 bytes, checksum: 4797b5103af38ecbe53b5dd29b496856 (MD5) Previous issue date: 2013
Resumo: Objetivos: avaliar a transmissão vertical (TV) em gestantes portadoras de hepatite B crônica, em um serviço universitário. Sujeitos e Método: foram analisadas as sorologias para hepatite B de todas as gestantes atendidas no serviço entre 2000 e 2005, identificando-se as HbsAg +; nessas foi realizado levantamento de prontuários, avaliando a presença do marcador de replicação viral (HbeAg positivo), imunoprofilaxia neonatal e taxa de TV. Análise de dados: foi avaliada a proporção de casos com HbsAg+ e nessas a presença do HbeAg. Para as portadoras de hepatite B, analisaram-se características clínicas e epidemiológicas através de frequências simples e a presença de TV. Resultados: entre 2000 e 2005 foram rastreadas para hepatite B no CAISM 5638 mulheres; dessas 28 (0,5%) apresentavam HbsAg+, definindo-se como portadoras crônicas. Não se encontrou nenhuma com replicação viral (HbeAg+). A idade média foi de 25 anos, com escolaridade média de sete anos, sendo 57% de brancas. O número de gestações médio foi de dois, sendo 52% de nulíparas. A categoria de exposição foi ignorada em 20; em quatro a via foi a sexual, em duas por TV e em duas por uso de drogas. A média de Idade gestacional ao parto foi de 38 semanas, com uma taxa de cesárea de 42%. O peso médio ao nascimento foi de 3094g e todos os recém-nascidos apresentaram boas condições de vitalidade e receberam imunoprofilaxia neonatal (vacina e imunoglobulina específica) nas primeiras horas de vida. Não houve TV. Conclusões: Nas gestantes atendidas no período, a prevalência de hepatite B crônica foi de 0,5%. Todas as crianças receberam imunoprofilaxia neonatal nas primeiras horas de vida e não ocorreu nenhum caso de TV, reforçando que para as gestantes sem replicação viral, as medidas de imunoprofilaxia neonatal protegeram a totalidade de seus recém-nascidos
Abstract: The purpose of this paper is to evaluate mother-to-child transmission of chronic hepatitis B in a university hospital. Subjects and methods: Hepatitis B serologic studies were pooled from all pregnant women referred to this prenatal service from 2000 to 2005. HBsAg positive patients were selected and, for those, clinical, laboratory and epidemiologic data were analyzed, including presence of HBeAg marker, immunoprophylactic procedures for the newborn and mother-to-child transmission rates. Data analysis: HBsAg carriers were characterized for clinical and epidemiologic factors associated with mother-to-child transmission. Results: Between 2000 and 2005, 5638 pregnant women were referred to high-risk prenatal care at our facility; of these, 28 women (0,5%) were HbsAg+ ¿ defined as chronic Hepatitis B virus (HBV) carriers. None of these were seropositive for HBeAg. Mean age was 25 years with a mean of 7 years of formal education and 57% were white; 52% were nulliparous. Exposure to hepatitis B virus was ignored in 20 women, sexual in 4, from mother-to-child transmission in 2 and associated with drug use in 2. Mean gestational age at delivery was 38 weeks with cesarean delivery in 42% of women. Mean weight at birth was 3094g and all newborns presented with good vitality and received immunoprophylactic procedures. There were no cases of mother-to-child transmission. Conclusion: Among all pregnant women seen at this tertiary high risk prenatal care facility between 2000 and 2005, chronic HBV infection was detected in 0,5% of patients. All newborns received immunoprophylaxis during the first hours after delivery and no case of mother-to-child transmission was detected. Our findings support that, among pregnant chronic HBV carriers without serologic evidence of active viral replication, immunoprophylactic measures are effective in preventing mother-to-child transmission in all instances
Mestrado
Saúde Materna e Perinatal
Mestra em Ciências da Saúde
48
Chaves, Vanessa Rodrigues. "Custo, efetividade e custo-efetividade do tratamento periodontal em gestantes." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/52699.
Анотація:
Análises econômicas em saúde bucal são escassas na literatura e, portanto, muitas das práticas, especialmente aquelas propostas e realizadas nos sistemas públicos de saúde em diferentes países, são realizadas sem o conhecimento de seus aspectos econômicos. Na maioria dos países, os recursos destinados à saúde são limitados e, portanto, carecem de análises econômicas para que se tenha base científica para a proposição e implementação de diretrizes de atenção à saúde. O presente estudo trata de uma análise econômica em saúde bucal que teve por objetivo avaliar o custo, a efetividade e o custo-efetividade do tratamento periodontal sistemático, comparando-o com o tratamento convencional realizado em gestantes no Hospital Materno Infantil Presidente Vargas, na perspectiva do Sistema Único de Saúde, partindo de dados já coletados nos prontuários de 213 pacientes. O custo do tratamento periodontal sistemático e o ofertado pelo HMIPV foram estimados a partir do somatório dos custos de todas as consultas de exames periodontais, instruções de higiene bucal. raspagens alisamentos e polimentos supragengivais e raspagem e alisamento radiculares subgengivais por gestante. O tratamento periodontal sistemático custou R$ 442,80, levando em média 8,23 consultas por gestante, e o tempo médio gasto para a realização do tratamento foi de 6 horas e 35 minutos. O tratamento periodontal ofertado pelo HMIPV teve um custo médio de R$ 144,05 e uma média de 2,96 consulta por paciente; o tempo total médio para a realização desse tratamento foi de 2 horas e 15 minutos. A razão de custo-efetividade para se controlar a doença periodontal por gestante mediante o tratamento periodontal sistemático é de R$ 6,91 e de R$ 9,50 pelo tratamento ofertado pelo HMIPV. Os resultados do presente estudo permitem concluir que o tratamento periodontal sistemático é custo-efetivo em reduzir processo inflamatório periodontal, não sendo influenciado diretamente por tabagismo, renda e escolaridade.Economic analyses of oral health are scarce in the literature and therefore many of the practices, especially those proposed and implemented in public health systems in different countries, are performed without the knowledge of its economic aspects. In most countries, resources for health are limited and therefore lack economic analyses in order to have a scientific basis for proposing and implementing policies for health care. This study deals with an economic analysis of oral health that aims to assess the cost, effectiveness and cost-effectiveness of systematic periodontal treatment, compared with conventional treatment performed on pregnant women in the Maternal and Child Hospital Presidente Vargas, the prospect of health system, based on data already collected from medical records of 213 patients. The cost of periodontal treatment were estimated from the sum of the costs of all queries including periodontal examinations, oral hygiene instructions, supragingival and subgingival scaling per pregnant women. The systematic periodontal treatment cost was R$ 442.80, taking an average of 8.23 consultations per pregnant woman, and the average time taken for completion of treatment was 6 hours and 35 minutes. Periodontal treatment offered by HMIPV had an average cost of R$ 144.05 and an average of 2.96 consultations per patient, the average total time to perform this treatment was 2 hours and 15 minutes. The cost-effectiveness ratio to control periodontal disease in pregnant women through systematic periodontal treatment is R$ 6.91 and R$ 9.50 for the treatment offered by HMIPV. The results of this study allow us to conclude that the systematic periodontal treatment is cost-effective in reducing periodontal inflammation and is not directly influenced by smoking, income and education.
49
Macfarlane, Trisha Victoria. "The effect of maternal atopy on chemokine production during pregnancy and at birth, and the production of and response to thymic stromal lymphopoietin in the adult and cord circulation." Thesis, Swansea University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678506.
50
Allerkamp, Hanna Verfasser], Christiane [Akademischer Betreuer] [Pfarrer, Prondzinski Mario von [Akademischer Betreuer] Depka, and Reinhard [Akademischer Betreuer] Mischke. "Characterization of von Willebrand disease during pregnancy in a porcine model / Hanna Allerkamp ; Christiane Pfarrer, Mario von Depka Prondzinski, Reinhard Mischke." Gießen : DVG, 2019. http://nbn-resolving.de/urn:nbn:de:gbv:95-112493.