“Intermediate hyperglycemia in early pregnancy(IHEP)”refers to mild hyperglycemia detected before 24 gestational weeks(GW),satisfying the criteria for the diagnosis of gestational diabetes mellitus.Many professional...“Intermediate hyperglycemia in early pregnancy(IHEP)”refers to mild hyperglycemia detected before 24 gestational weeks(GW),satisfying the criteria for the diagnosis of gestational diabetes mellitus.Many professional bodies recommend routine screening for“overt diabetes”in early pregnancy,which identifies a significant number of women with mild hyperglycemia of undetermined significance.A literature search revealed that one-third of GDM women in South Asian countries are diagnosed before the conventional screening period of 24 GW to 28 GW;hence,they belong in the IHEP category.Most hospitals in this region diagnose IHEP by oral glucose tolerance test(OGTT)using the same criteria used for GDM diagnosis after 24 GW.There is some evidence to suggest that South Asian women with IHEP are more prone to adverse pregnancy events than women with a diagnosis of GDM after 24 GW,but this observation needs to be proven by randomized control trials.Fasting plasma glucose is a reliable screening test for GDM that can obviate the need for OGTT for GDM diagnosis among 50%of South Asian pregnant women.HbA1c in the first trimester predicts GDM in later pregnancy,but it is not a reliable test for IHEP diagnosis.There is evidence to suggest that HbA1c in the first trimester is an independent risk factor for several adverse pregnancy events.Further research to identify the pathogenetic mechanisms behind the fetal and maternal effects of IHEP is strongly recommended.展开更多
Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients ...Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients who requested termination of pregnancy due to early pregnancy from August 2022 to April 2023, and analyze the data. 40 patients who underwent ultrasound-guided induced abortion to terminate pregnancy were included in the control group, and 40 patients who underwent uterine cavity observation surgery to terminate pregnancy were included in the observation group. Compare the surgical time, number of times the straw enters the uterine cavity, incidence of complications, and menstrual recovery time between the two groups. Results: There was no statistically significant difference in the surgical time between the observation group and the control group, but the number of times negative pressure straws entered the uterine cavity and the incidence of surgical complications in the observation group were significantly lower than those in the control group (P Conclusion: Applying the uterine cavity observation and suction surgical system to terminate pregnancy in very early pregnancy has the advantages of minimal damage to the uterus and low incidence of surgical complications, greatly protecting the patient’s fertility.展开更多
Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to ide...Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to identify the factors associated with early pregnancies in the municipality of Bohicon in 2022. Materials and Methods: This is a case-control study conducted in Bohicon, involving 47 cases and 94 controls from 16 secondary and technical schools. Cases were selected exhaustively, while controls were randomly drawn from girls aged 10 to 19 in the same class who had never been pregnant. Matching was based on the type of institution and class. Data were collected through a questionnaire and analyzed using Epi info 7.2.1.0 and STATA 15 software, employing multiple conditional logistic regression (5% significance threshold) to identify factors related to early pregnancies. Results: The average age of adolescents was 17.63 years ± 0.09 for cases and 17.12 years ± 0.13 for controls. Associated factors included age over 16 years (p = 0.049), the marital status of the adolescent (single) (p = 0.001), and the monthly pocket money of the adolescent less than 10,000 FCFA (p = 0.031). Conclusion: Three factors related to early pregnancies were identified. To counteract this phenomenon and promote responsible sexuality among adolescents, it is essential to strengthen communication efforts aimed at modifying behaviors.展开更多
<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of...<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). <strong>Methods: </strong>This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). <strong>Results: </strong>The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. <strong>Conclusions:</strong> Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.展开更多
Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who...Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who continued pregnancy after a diagnostic hysteroscopy was performed in early pregnancy and delivered a healthy baby. The patient had a history of infertility and oligomenorrhea, probably due to a previous induced abortion. A hysteroscopy was performed after the end of her "menstruation" for assessment of her uterine cavity. Early pregnancy, instead of the expected intrauterine adhesions, was suspected, and the procedure was immediately ceased. Subsequent tests confirmed the diagnosis of pregnancy. She had a fullterm delivery by elective caesarean section. The success of this case was attributed to the use of vaginoscopic techniques in hysteroscopy and correct judgment and decision-making during the procedure. This case report provides some useful methods and experience that might be helpful when a similar situation occurs in clinical practice.展开更多
Background: The aim of the present study was to evaluate CCL8 and CXCL10 expression and its regulatory mechanism in peripheral blood leukocytes(PBLs) at the time of maternal recognition in cows. Blood samples were col...Background: The aim of the present study was to evaluate CCL8 and CXCL10 expression and its regulatory mechanism in peripheral blood leukocytes(PBLs) at the time of maternal recognition in cows. Blood samples were collected on 14, 15, 16, 17 and 18 d after artificial insemination(AI). Based on the day of return of estrus, cows were divided into three groups, pregnant(n = 5), early embryonic mortality(EEM; n = 5) and late embryonic mortality(LEM; n = 5). The gene expression levels in PBLs were assessed with quantitative real-time reverse transcription PCR.Results: The expression of CCL8 and CXCL10 mRNA in PBLs gradually increased from 14 to 18 d of pregnant cows and significant differences were observed on 18 d(P < 0.05), whereas no significant changes were observed both in EEM and LEM cows. Interferon-stimulated protein 15 k Da(ISG15), myxovirus-resistance gene(MX) 1 and MX2 mRNA expression in PBLs increased from 14 to 18 d which was significant on 18 d of pregnant cows as well as in LEM cows(P < 0.05), but no changes were observed in EEM cows. To determine whether the expression of CCL8 and CXCL10 in PBLs was regulated by pregnancy-related substances or not, expression level was assessed after exposure to interferon-τ(IFNT) and CCL16. Monocytes, granulocytes and lymphocytes were obtained using density-gradient centrifugation and flow cytometry. The addition of IFNT(100 ng/mL) and CCL16(100 ng/mL) to cultured PBLs increased the expression of CCL8 and CXCL10 mRNA(P < 0.05). The expression of ISG15, MX1 and MX2 mRNA in PBLs was also stimulated by IFNT and CCL16(P < 0.05).Conclusions: The expression of CCL8 and CXCL10 genes increased in PBLs during early pregnancy. Since IFNT stimulated CCL8 and CXCL10 expression in cultured PBLs, the increase of CCL8 and CXCL10 might be pregnancy-dependent events.The expression of both CCL8 and CXCL10 in PBLs was stimulated by CCL16 as wel as IFNT, suggesting a chemokine interaction that at least includes CCL8, CXCL10 and CCL16, and may play a role in regulating maternal recognition in cows.展开更多
Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, r...Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.展开更多
Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total...Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.展开更多
Platelet-activating factor (PAF) exhibits a variety of biological activities and it be thought to involved in various pathophysiological process. In this paper, some studies were summarized about those roles of PAF in...Platelet-activating factor (PAF) exhibits a variety of biological activities and it be thought to involved in various pathophysiological process. In this paper, some studies were summarized about those roles of PAF in a variety productive processes of female of mammalian that include fertilization, implantation and parturition, and that was involved ic the concentration, degradation and some assay methods of PAF. The relationship between PAF and early pregnancy factor(EPF was reviewed.展开更多
Objective To explore the effects on macaques’ menstrual recovery after terminating early pregnancy by focused ultrasound beams (FUB) Methods FUB was used to terminate early pregnancy in 5 macaques with gestation dura...Objective To explore the effects on macaques’ menstrual recovery after terminating early pregnancy by focused ultrasound beams (FUB) Methods FUB was used to terminate early pregnancy in 5 macaques with gestation duration ranging from 37-66 d. Two circles after the recovery of menstruation, color Doppler flow imaging (CDFI) and magnetic resonance imaging (MRI) were used to estimate the shape, size and blood flow of uterus, and pathological examinations were performed to check against any lesions to uterine endometrium and ovary. Results Forty days after FUB abortion, menstruation recovered and the volume and duration of each macaque’s menstruation were not changed compared with those be- fore gestation. CDFI and MRI suggested that the size and shape of uterus were normal. The endometrial line was clear and no lesions were found in adjacent organs. Conclusion FUB termination of early pregnancy in macaques did not damage their ovarian tissue and had no influence on subsequent menstrual recovery.Key words: focused ultrasound beams (FUB); macaque; early pregnancy; menstrual展开更多
A cross sectional transvaginal color Doppler study of the uteroplacental circulation was performed on 105 pregnant women with normal intrauterine pregnancy. Gestational age was ranged from 4 to 12 weeks. The blood flo...A cross sectional transvaginal color Doppler study of the uteroplacental circulation was performed on 105 pregnant women with normal intrauterine pregnancy. Gestational age was ranged from 4 to 12 weeks. The blood flow velocity waveforms were obtained from four separate parts of the uteroplacental circulation: uterine, arcuate, radial, and spiral arteries. The resistance index (RI) and peak systolic velocity (PSV) were analyzed. The RI significantly decreased and PSV increased with advancing gestation in uterine artery and its branches (P<0 05). The RI gradully decreased from uterine artery through arcuate, radial to spiral arteries (P<0 05). At the same time, the PSV decreased from uterine artery then arcuate to radial artery, but PSV in spiral arteries were higher than that in radial artery (P<0 05). The results showed that transvaginal color Dopper ultrasonography was a simple, reliable method to assess the uteroplacental circulation in the early pregnancy; the detection of PSV was useful parameter for better understanding of physiological and pathophysiological hemodynamic changes as well as RI.展开更多
Objective:To study the application of a machine learning algorithm for predicting gestational diabetes mellitus(GDM)in early pregnancy.Methods:This study identified indicators related to GDM through a literature revie...Objective:To study the application of a machine learning algorithm for predicting gestational diabetes mellitus(GDM)in early pregnancy.Methods:This study identified indicators related to GDM through a literature review and expert discussion.Pregnant women who had attended medical institutions for an antenatal examination from November 2017 to August 2018 were selected for analysis,and the collected indicators were retrospectively analyzed.Based on Python,the indicators were classified and modeled using a random forest regression algorithm,and the performance of the prediction model was analyzed.Results:We obtained 4806 analyzable data from 1625 pregnant women.Among these,3265 samples with all 67 indicators were used to establish data set F1;4806 samples with 38 identical indicators were used to establish data set F2.Each of F1 and F2 was used for training the random forest algorithm.The overall predictive accuracy of the F1 model was 93.10%,area under the receiver operating characteristic curve(AUC)was 0.66,and the predictive accuracy of GDM-positive cases was 37.10%.The corresponding values for the F2 model were 88.70%,0.87,and 79.44%.The results thus showed that the F2 prediction model performed better than the F1 model.To explore the impact of sacrificial indicators on GDM prediction,the F3 data set was established using 3265 samples(F1)with 38 indicators(F2).After training,the overall predictive accuracy of the F3 model was 91.60%,AUC was 0.58,and the predictive accuracy of positive cases was 15.85%.Conclusions:In this study,a model for predicting GDM with several input variables(e.g.,physical examination,past history,personal history,family history,and laboratory indicators)was established using a random forest regression algorithm.The trained prediction model exhibited a good performance and is valuable as a reference for predicting GDM in women at an early stage of pregnancy.In addition,there are cer tain requirements for the propor tions of negative and positive cases in sample data sets when the random forest algorithm is applied to the early prediction of GDM.展开更多
Early pregnancy loss,defined as a nonviable intrauterine pregnancy occurring before 12 weeks of gestation,is estimated to affect 25%of clinically diagnosed pregnancies[1].Several demographic,lifestyle,and environmenta...Early pregnancy loss,defined as a nonviable intrauterine pregnancy occurring before 12 weeks of gestation,is estimated to affect 25%of clinically diagnosed pregnancies[1].Several demographic,lifestyle,and environmental risk factors have been reported to associate with the risk of early pregnancy loss,yet the causes of most early pregnancy losses remain elusive;thus,further studies are needed.Perfluorinated compounds(PFCs)are a class of widespread environmental pollutants that can adversely affect human reproductive health.Humans are inevitably exposed to PFCs through diet,water,air and dust.A wealth of epidemiological and toxicological research using a variety of animal models has warned of the persistence,bioaccumulation,and toxicity of PFCs[2].展开更多
To investigate the characteristic food intake during early pregnancy in women with gestational diabetes mellitus (GDM) in a rural city in Aomori Prefecture, Japan, one hundred and twenty-one women were recruited and q...To investigate the characteristic food intake during early pregnancy in women with gestational diabetes mellitus (GDM) in a rural city in Aomori Prefecture, Japan, one hundred and twenty-one women were recruited and queried about their habitual dietary intake. Food intake of patients was assessed using the model nutritional balance chart at 12 - 16, 24 - 28, and 34 - 36 weeks of gestation. Of the 121 pregnant women examined, 19 were obese. During early pregnancy, food intake ratios of the obese women were significantly lower than those of the non-obese women for the categories of milk (p < 0.001) and sugar (p < 0.05). GDM group was 7 women among 19 women in obesity group during mid-pregnancy. During early pregnancy, women with GDM had significantly higher sugar intake ratios than women without GDM (p < 0.05). These results suggested that obese pregnant women are able to prevent GDM by limiting their sugar intake during early pregnancy.展开更多
Objective:To accurately detect pregnancy in local Aardi goats of Saudi Arabia before day 30 of pregnancy by using serum caprine pregnancy associated glycoproteins (caPAG) concentrations and to evaluate the effects of ...Objective:To accurately detect pregnancy in local Aardi goats of Saudi Arabia before day 30 of pregnancy by using serum caprine pregnancy associated glycoproteins (caPAG) concentrations and to evaluate the effects of heat stress on early pregnancy and on caPAG concentrations in pregnant and non-pregnant goats.Methods:This study was to confirm the reliability of our methods in different seasons of the year. A new protocol to evaluate and improve Aardi goats' reproductive performance was implemented during summer and winter months. A total of 60 healthy mature Aardi goats were used (30 and 30 in the summer and winter, respectively). All were synchronized using an ovsynch protocol and then naturally mated (NM) to mature tested bucks. Conception rates and caPAG were measured and pregnancy was verified by ultrasonography.Results:Regardless of season, however, on day 23 and 35 post-NM, caPAGs were higher in sera of pregnant (P<0.05) than in non-pregnant goats, while there was no difference in caPAG concentrations on day 15. On day 23 and 35 post-NM, serum caPAG concentrations were higher (P<0.001) in the pregnant winter group than in the pregnant summer group, while no differences were found in non-pregnant goats. Measuring serum caPAG concentrations proved to be easy and accurate in assessing early stages of pregnancy (as early as 23 days post-NM) during both summer and winter seasons.Conclusions: It can be concluded that pregnancy rates were not affected by seasonal differences. The modified ovsynch program can be advantageous and worthwhile for its ease of use. When we add the accuracy of caPAG tests, such a program will help in detecting pregnancies in Aardi goats as early as 23 days post-NM, regardless of the season.展开更多
During human and mammalian pregnancy,endogenous progesterone is the dominant hormone since it is not only essential for conception and implantation,but also needed throughout pregnancy.Progesterone provided the effect...During human and mammalian pregnancy,endogenous progesterone is the dominant hormone since it is not only essential for conception and implantation,but also needed throughout pregnancy.Progesterone provided the effects of prevention and treatment in human pregnancy by certain mechanisms.If one considers prevention or treatment with progestogens in human pregnancy,that all progestogens are progestogenic,if one condsiders the progestogens for prevention and therapeutic approaches,nowadays,only two progenstogens can be considered fully suitable for prevention and treatment in human pregnancy:progesterone and dydrogesteone.This review introduced the mechanism of progesterone and dydrogesterone in pregnancy and treatment in human.展开更多
Objectives: To calculate the incidence of ectopic pregnancy in cases with recurrent early pregnancy loss and cases of recurrent implantation failure. Methods and materials: This is a retrospective cohort study. 200 wo...Objectives: To calculate the incidence of ectopic pregnancy in cases with recurrent early pregnancy loss and cases of recurrent implantation failure. Methods and materials: This is a retrospective cohort study. 200 women were recruited from the infertility clinic at shat by maternity university hospital seeking fertility. 100 of them were with history of recurrent implantation failure (RIF) and 100 with history of recurrent pregnancy loss (RPL). Revisiting their hospital files for the history of ectopic pregnancy was done. Results: 8% of cases of RPL had history of ectopic pregnancy while only 6% of cases of RIF had the history. There was no significant difference between the two groups (p = 0.579). There was significantly higher incidence of ectopic pregnancy in both groups if compared with the general population (p = 0.0001 and 0.043) in RPL and RIF consecutively. Conclusions: RPL and RIF may be considered as a risk factor for ectopic pregnancy.展开更多
AIM:To evaluate the safety of lamivudine(LAM) treatment for chronic hepatitis B in early pregnancy.METHODS:A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enr...AIM:To evaluate the safety of lamivudine(LAM) treatment for chronic hepatitis B in early pregnancy.METHODS:A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enrolled in this study.All of the pregnant women volunteered to take lamivudine during pregnancy and were not co-infected with hepatitis C virus,human immunodeficiency virus,cytomegalovirus,or other viruses.All infants received passiveactive immunoprophylaxis with 200 IU hepatitis B immunoglobulin and three doses of 10 μg hepatitis B vaccines(0-1-6 mo) according to the guidelines for the prevention and treatment of chronic hepatitis B.Adverse events were observed throughout the entire pregnancy and perinatal period,and the effectiveness of lamivudine treatment for blocking mother-to-infant transmission of hepatitis B virus(HBV) was evaluated.All adverse events in mothers and infants during pregnancy and the perinatal period and the HBV motherto-infant transmission blocking rate were compared with the literature.RESULTS:Among the 92 pregnant women,spontaneous abortions occurred in 11 cases,while 3 mothers had a second pregnancy after the initial abortion;72 mothers delivered 73 live infants,of whom 68 infants were followed up for no less than 6 mo,and 12 mothers were still pregnant.During pregnancy,the main maternal adverse events were vaginitis(12/72,16.7%),spontaneous abortion(11/95,11.6%),and gestational diabetes(6/72,8.3%);only one case had 1-2 degree elevation of the creatine kinase level(195 U/L).During the perinatal period,the main maternal adverse events were premature rupture of the membranes(8/72,11.1%),preterm delivery(5/72,6.9%),and meconium staining of the amniotic fluid(4/72,5.6%).In addition,2 infants were found to have congenital abnormalities;1 had a scalp hemangioma that did not change in size until 7 mo,and the other had early cerebral palsy,but with rehabilitation training,the infant's motor functions became totally normal at 2 years of age.The incidence of adverse events among the mothers or abnormalities in the infants was not higher than that of normal mothers or HBV-infected mothers who did not receive lamivudine treatment.In only 2 cases,mother-to-infant transmission blocking failed;the blocking rate was 97.1%(66/68),which was higher than has been previously reported.CONCLUSION:Lamivudine treatment is safe for chronic HBV-infected pregnant mothers and their fetuses with a gestational age of less than 12 wk or throughout the entire pregnancy.展开更多
文摘“Intermediate hyperglycemia in early pregnancy(IHEP)”refers to mild hyperglycemia detected before 24 gestational weeks(GW),satisfying the criteria for the diagnosis of gestational diabetes mellitus.Many professional bodies recommend routine screening for“overt diabetes”in early pregnancy,which identifies a significant number of women with mild hyperglycemia of undetermined significance.A literature search revealed that one-third of GDM women in South Asian countries are diagnosed before the conventional screening period of 24 GW to 28 GW;hence,they belong in the IHEP category.Most hospitals in this region diagnose IHEP by oral glucose tolerance test(OGTT)using the same criteria used for GDM diagnosis after 24 GW.There is some evidence to suggest that South Asian women with IHEP are more prone to adverse pregnancy events than women with a diagnosis of GDM after 24 GW,but this observation needs to be proven by randomized control trials.Fasting plasma glucose is a reliable screening test for GDM that can obviate the need for OGTT for GDM diagnosis among 50%of South Asian pregnant women.HbA1c in the first trimester predicts GDM in later pregnancy,but it is not a reliable test for IHEP diagnosis.There is evidence to suggest that HbA1c in the first trimester is an independent risk factor for several adverse pregnancy events.Further research to identify the pathogenetic mechanisms behind the fetal and maternal effects of IHEP is strongly recommended.
文摘Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients who requested termination of pregnancy due to early pregnancy from August 2022 to April 2023, and analyze the data. 40 patients who underwent ultrasound-guided induced abortion to terminate pregnancy were included in the control group, and 40 patients who underwent uterine cavity observation surgery to terminate pregnancy were included in the observation group. Compare the surgical time, number of times the straw enters the uterine cavity, incidence of complications, and menstrual recovery time between the two groups. Results: There was no statistically significant difference in the surgical time between the observation group and the control group, but the number of times negative pressure straws entered the uterine cavity and the incidence of surgical complications in the observation group were significantly lower than those in the control group (P Conclusion: Applying the uterine cavity observation and suction surgical system to terminate pregnancy in very early pregnancy has the advantages of minimal damage to the uterus and low incidence of surgical complications, greatly protecting the patient’s fertility.
文摘Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to identify the factors associated with early pregnancies in the municipality of Bohicon in 2022. Materials and Methods: This is a case-control study conducted in Bohicon, involving 47 cases and 94 controls from 16 secondary and technical schools. Cases were selected exhaustively, while controls were randomly drawn from girls aged 10 to 19 in the same class who had never been pregnant. Matching was based on the type of institution and class. Data were collected through a questionnaire and analyzed using Epi info 7.2.1.0 and STATA 15 software, employing multiple conditional logistic regression (5% significance threshold) to identify factors related to early pregnancies. Results: The average age of adolescents was 17.63 years ± 0.09 for cases and 17.12 years ± 0.13 for controls. Associated factors included age over 16 years (p = 0.049), the marital status of the adolescent (single) (p = 0.001), and the monthly pocket money of the adolescent less than 10,000 FCFA (p = 0.031). Conclusion: Three factors related to early pregnancies were identified. To counteract this phenomenon and promote responsible sexuality among adolescents, it is essential to strengthen communication efforts aimed at modifying behaviors.
文摘<strong>Background: </strong>This study aims to evaluate the infertility reflection in early pregnancy after assistive reproductive therapy (ART), including 1) process evaluation (the use and evaluation of infertility reflection) and 2) outcome evaluation (satisfaction of care needs, anticipatory anxiety towards the loss of a pregnancy or fetus, cognition of infertility experience, and depression and anxiety). <strong>Methods: </strong>This program evaluation study used a one-group pre-post-test design. The participants were 50 primiparas who had undergone ART at two fertility treatment facilities in a metropolitan area in Japan. For the infertility reflection, they conducted an online reflection. Data were collected three times: at the 5th week of pregnancy (Time 1), the 8th week of pregnancy as the final consultation at the clinic (Time 2), and the 16th week of pregnancy as the final point of early pregnancy (Time 3). <strong>Results: </strong>The data from 40 participants were analyzed. More than 80% of the users of the online reflection positively evaluated the appropriateness and usefulness of the methods and contents. Organized thoughts and feelings by reflection were shown as the reasons for the usefulness. The evaluation of the online reflection showed a relatively strong correlation with the Care Need Satisfaction Scale (CNSS) for both Time 2 and Time 3, but the online reflection did not show a significant correlation with the other outcome variables. There were no significant differences in outcome variables between users and non-users of online reflection between Time 2 and Time 3. <strong>Conclusions:</strong> Attempts at the reflection in early pregnancy require modified methods that do not have a negative impact and lead to the fulfillment of needs.
文摘Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who continued pregnancy after a diagnostic hysteroscopy was performed in early pregnancy and delivered a healthy baby. The patient had a history of infertility and oligomenorrhea, probably due to a previous induced abortion. A hysteroscopy was performed after the end of her "menstruation" for assessment of her uterine cavity. Early pregnancy, instead of the expected intrauterine adhesions, was suspected, and the procedure was immediately ceased. Subsequent tests confirmed the diagnosis of pregnancy. She had a fullterm delivery by elective caesarean section. The success of this case was attributed to the use of vaginoscopic techniques in hysteroscopy and correct judgment and decision-making during the procedure. This case report provides some useful methods and experience that might be helpful when a similar situation occurs in clinical practice.
基金supported by Grants-in-Aid for the Research Program on Innovative Technologies for Animal Breeding,Reproduction,and Vaccine Development (REP1001) from the Ministry of Agriculture,Forestry and Fisheries of Japansupported by JSPS KAKENHI Grant Number 17 K08056
文摘Background: The aim of the present study was to evaluate CCL8 and CXCL10 expression and its regulatory mechanism in peripheral blood leukocytes(PBLs) at the time of maternal recognition in cows. Blood samples were collected on 14, 15, 16, 17 and 18 d after artificial insemination(AI). Based on the day of return of estrus, cows were divided into three groups, pregnant(n = 5), early embryonic mortality(EEM; n = 5) and late embryonic mortality(LEM; n = 5). The gene expression levels in PBLs were assessed with quantitative real-time reverse transcription PCR.Results: The expression of CCL8 and CXCL10 mRNA in PBLs gradually increased from 14 to 18 d of pregnant cows and significant differences were observed on 18 d(P < 0.05), whereas no significant changes were observed both in EEM and LEM cows. Interferon-stimulated protein 15 k Da(ISG15), myxovirus-resistance gene(MX) 1 and MX2 mRNA expression in PBLs increased from 14 to 18 d which was significant on 18 d of pregnant cows as well as in LEM cows(P < 0.05), but no changes were observed in EEM cows. To determine whether the expression of CCL8 and CXCL10 in PBLs was regulated by pregnancy-related substances or not, expression level was assessed after exposure to interferon-τ(IFNT) and CCL16. Monocytes, granulocytes and lymphocytes were obtained using density-gradient centrifugation and flow cytometry. The addition of IFNT(100 ng/mL) and CCL16(100 ng/mL) to cultured PBLs increased the expression of CCL8 and CXCL10 mRNA(P < 0.05). The expression of ISG15, MX1 and MX2 mRNA in PBLs was also stimulated by IFNT and CCL16(P < 0.05).Conclusions: The expression of CCL8 and CXCL10 genes increased in PBLs during early pregnancy. Since IFNT stimulated CCL8 and CXCL10 expression in cultured PBLs, the increase of CCL8 and CXCL10 might be pregnancy-dependent events.The expression of both CCL8 and CXCL10 in PBLs was stimulated by CCL16 as wel as IFNT, suggesting a chemokine interaction that at least includes CCL8, CXCL10 and CCL16, and may play a role in regulating maternal recognition in cows.
文摘Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.
文摘Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostot.Subjects and Methods A total of 213 pregnant women with amenorrhea of 34-69d after caesarian section who asked for medical abortion were recruited,including 63 cases undergoing their second medical abortion.A total amount of mi feprisstone of 150 mg given in separate doses(25 mg×4 and 50 mg at the first time)was administered orally within 3d, followed by misoprostot of 0.6 mg orally in the morning of d 3.Results The complete abortion rate was 92.5%,incomplete abortion was 4.7% and failure was 2.8%.Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section histo-ry.Its efficacy was similar to that for ordinary population.Its safety and effec-tiveness were satisfactory.
文摘Platelet-activating factor (PAF) exhibits a variety of biological activities and it be thought to involved in various pathophysiological process. In this paper, some studies were summarized about those roles of PAF in a variety productive processes of female of mammalian that include fertilization, implantation and parturition, and that was involved ic the concentration, degradation and some assay methods of PAF. The relationship between PAF and early pregnancy factor(EPF was reviewed.
基金This study was supported by the Natural Science Foundation of China (NSFC) grantNo. 39630340
文摘Objective To explore the effects on macaques’ menstrual recovery after terminating early pregnancy by focused ultrasound beams (FUB) Methods FUB was used to terminate early pregnancy in 5 macaques with gestation duration ranging from 37-66 d. Two circles after the recovery of menstruation, color Doppler flow imaging (CDFI) and magnetic resonance imaging (MRI) were used to estimate the shape, size and blood flow of uterus, and pathological examinations were performed to check against any lesions to uterine endometrium and ovary. Results Forty days after FUB abortion, menstruation recovered and the volume and duration of each macaque’s menstruation were not changed compared with those be- fore gestation. CDFI and MRI suggested that the size and shape of uterus were normal. The endometrial line was clear and no lesions were found in adjacent organs. Conclusion FUB termination of early pregnancy in macaques did not damage their ovarian tissue and had no influence on subsequent menstrual recovery.Key words: focused ultrasound beams (FUB); macaque; early pregnancy; menstrual
文摘A cross sectional transvaginal color Doppler study of the uteroplacental circulation was performed on 105 pregnant women with normal intrauterine pregnancy. Gestational age was ranged from 4 to 12 weeks. The blood flow velocity waveforms were obtained from four separate parts of the uteroplacental circulation: uterine, arcuate, radial, and spiral arteries. The resistance index (RI) and peak systolic velocity (PSV) were analyzed. The RI significantly decreased and PSV increased with advancing gestation in uterine artery and its branches (P<0 05). The RI gradully decreased from uterine artery through arcuate, radial to spiral arteries (P<0 05). At the same time, the PSV decreased from uterine artery then arcuate to radial artery, but PSV in spiral arteries were higher than that in radial artery (P<0 05). The results showed that transvaginal color Dopper ultrasonography was a simple, reliable method to assess the uteroplacental circulation in the early pregnancy; the detection of PSV was useful parameter for better understanding of physiological and pathophysiological hemodynamic changes as well as RI.
基金supported by the Qingdao Municipal Bureau of Science and Technology(No.19-6-1-55-nsh)。
文摘Objective:To study the application of a machine learning algorithm for predicting gestational diabetes mellitus(GDM)in early pregnancy.Methods:This study identified indicators related to GDM through a literature review and expert discussion.Pregnant women who had attended medical institutions for an antenatal examination from November 2017 to August 2018 were selected for analysis,and the collected indicators were retrospectively analyzed.Based on Python,the indicators were classified and modeled using a random forest regression algorithm,and the performance of the prediction model was analyzed.Results:We obtained 4806 analyzable data from 1625 pregnant women.Among these,3265 samples with all 67 indicators were used to establish data set F1;4806 samples with 38 identical indicators were used to establish data set F2.Each of F1 and F2 was used for training the random forest algorithm.The overall predictive accuracy of the F1 model was 93.10%,area under the receiver operating characteristic curve(AUC)was 0.66,and the predictive accuracy of GDM-positive cases was 37.10%.The corresponding values for the F2 model were 88.70%,0.87,and 79.44%.The results thus showed that the F2 prediction model performed better than the F1 model.To explore the impact of sacrificial indicators on GDM prediction,the F3 data set was established using 3265 samples(F1)with 38 indicators(F2).After training,the overall predictive accuracy of the F3 model was 91.60%,AUC was 0.58,and the predictive accuracy of positive cases was 15.85%.Conclusions:In this study,a model for predicting GDM with several input variables(e.g.,physical examination,past history,personal history,family history,and laboratory indicators)was established using a random forest regression algorithm.The trained prediction model exhibited a good performance and is valuable as a reference for predicting GDM in women at an early stage of pregnancy.In addition,there are cer tain requirements for the propor tions of negative and positive cases in sample data sets when the random forest algorithm is applied to the early prediction of GDM.
基金This study was supported by National Natural Science Foundation of China （No. 81601280, No. 31371517）, Foundation of Nanfang Hospital, Southern Medical University, and Science and Technology Project of Guangdong Province （No. 2013B051000086）.
基金supported by the National Key Research and Development Program of China[nos.2018YFC1004303 and 2016YFC1000306]the National Natural Science Foundation of China[no.41871360]+1 种基金the Danone Institute China Diet Nutrition Research&Communication Grant[no.DIC2015-05]the National Health Commission Key Laboratory of Birth Defects and Prevention,Henan Province[no.ZD202002].
文摘Early pregnancy loss,defined as a nonviable intrauterine pregnancy occurring before 12 weeks of gestation,is estimated to affect 25%of clinically diagnosed pregnancies[1].Several demographic,lifestyle,and environmental risk factors have been reported to associate with the risk of early pregnancy loss,yet the causes of most early pregnancy losses remain elusive;thus,further studies are needed.Perfluorinated compounds(PFCs)are a class of widespread environmental pollutants that can adversely affect human reproductive health.Humans are inevitably exposed to PFCs through diet,water,air and dust.A wealth of epidemiological and toxicological research using a variety of animal models has warned of the persistence,bioaccumulation,and toxicity of PFCs[2].
文摘To investigate the characteristic food intake during early pregnancy in women with gestational diabetes mellitus (GDM) in a rural city in Aomori Prefecture, Japan, one hundred and twenty-one women were recruited and queried about their habitual dietary intake. Food intake of patients was assessed using the model nutritional balance chart at 12 - 16, 24 - 28, and 34 - 36 weeks of gestation. Of the 121 pregnant women examined, 19 were obese. During early pregnancy, food intake ratios of the obese women were significantly lower than those of the non-obese women for the categories of milk (p < 0.001) and sugar (p < 0.05). GDM group was 7 women among 19 women in obesity group during mid-pregnancy. During early pregnancy, women with GDM had significantly higher sugar intake ratios than women without GDM (p < 0.05). These results suggested that obese pregnant women are able to prevent GDM by limiting their sugar intake during early pregnancy.
文摘Objective:To accurately detect pregnancy in local Aardi goats of Saudi Arabia before day 30 of pregnancy by using serum caprine pregnancy associated glycoproteins (caPAG) concentrations and to evaluate the effects of heat stress on early pregnancy and on caPAG concentrations in pregnant and non-pregnant goats.Methods:This study was to confirm the reliability of our methods in different seasons of the year. A new protocol to evaluate and improve Aardi goats' reproductive performance was implemented during summer and winter months. A total of 60 healthy mature Aardi goats were used (30 and 30 in the summer and winter, respectively). All were synchronized using an ovsynch protocol and then naturally mated (NM) to mature tested bucks. Conception rates and caPAG were measured and pregnancy was verified by ultrasonography.Results:Regardless of season, however, on day 23 and 35 post-NM, caPAGs were higher in sera of pregnant (P<0.05) than in non-pregnant goats, while there was no difference in caPAG concentrations on day 15. On day 23 and 35 post-NM, serum caPAG concentrations were higher (P<0.001) in the pregnant winter group than in the pregnant summer group, while no differences were found in non-pregnant goats. Measuring serum caPAG concentrations proved to be easy and accurate in assessing early stages of pregnancy (as early as 23 days post-NM) during both summer and winter seasons.Conclusions: It can be concluded that pregnancy rates were not affected by seasonal differences. The modified ovsynch program can be advantageous and worthwhile for its ease of use. When we add the accuracy of caPAG tests, such a program will help in detecting pregnancies in Aardi goats as early as 23 days post-NM, regardless of the season.
文摘During human and mammalian pregnancy,endogenous progesterone is the dominant hormone since it is not only essential for conception and implantation,but also needed throughout pregnancy.Progesterone provided the effects of prevention and treatment in human pregnancy by certain mechanisms.If one considers prevention or treatment with progestogens in human pregnancy,that all progestogens are progestogenic,if one condsiders the progestogens for prevention and therapeutic approaches,nowadays,only two progenstogens can be considered fully suitable for prevention and treatment in human pregnancy:progesterone and dydrogesteone.This review introduced the mechanism of progesterone and dydrogesterone in pregnancy and treatment in human.
文摘Objectives: To calculate the incidence of ectopic pregnancy in cases with recurrent early pregnancy loss and cases of recurrent implantation failure. Methods and materials: This is a retrospective cohort study. 200 women were recruited from the infertility clinic at shat by maternity university hospital seeking fertility. 100 of them were with history of recurrent implantation failure (RIF) and 100 with history of recurrent pregnancy loss (RPL). Revisiting their hospital files for the history of ectopic pregnancy was done. Results: 8% of cases of RPL had history of ectopic pregnancy while only 6% of cases of RIF had the history. There was no significant difference between the two groups (p = 0.579). There was significantly higher incidence of ectopic pregnancy in both groups if compared with the general population (p = 0.0001 and 0.043) in RPL and RIF consecutively. Conclusions: RPL and RIF may be considered as a risk factor for ectopic pregnancy.
文摘AIM:To evaluate the safety of lamivudine(LAM) treatment for chronic hepatitis B in early pregnancy.METHODS:A total of 92 pregnant women who received LAM treatment either before pregnancy or in early pregnancy were enrolled in this study.All of the pregnant women volunteered to take lamivudine during pregnancy and were not co-infected with hepatitis C virus,human immunodeficiency virus,cytomegalovirus,or other viruses.All infants received passiveactive immunoprophylaxis with 200 IU hepatitis B immunoglobulin and three doses of 10 μg hepatitis B vaccines(0-1-6 mo) according to the guidelines for the prevention and treatment of chronic hepatitis B.Adverse events were observed throughout the entire pregnancy and perinatal period,and the effectiveness of lamivudine treatment for blocking mother-to-infant transmission of hepatitis B virus(HBV) was evaluated.All adverse events in mothers and infants during pregnancy and the perinatal period and the HBV motherto-infant transmission blocking rate were compared with the literature.RESULTS:Among the 92 pregnant women,spontaneous abortions occurred in 11 cases,while 3 mothers had a second pregnancy after the initial abortion;72 mothers delivered 73 live infants,of whom 68 infants were followed up for no less than 6 mo,and 12 mothers were still pregnant.During pregnancy,the main maternal adverse events were vaginitis(12/72,16.7%),spontaneous abortion(11/95,11.6%),and gestational diabetes(6/72,8.3%);only one case had 1-2 degree elevation of the creatine kinase level(195 U/L).During the perinatal period,the main maternal adverse events were premature rupture of the membranes(8/72,11.1%),preterm delivery(5/72,6.9%),and meconium staining of the amniotic fluid(4/72,5.6%).In addition,2 infants were found to have congenital abnormalities;1 had a scalp hemangioma that did not change in size until 7 mo,and the other had early cerebral palsy,but with rehabilitation training,the infant's motor functions became totally normal at 2 years of age.The incidence of adverse events among the mothers or abnormalities in the infants was not higher than that of normal mothers or HBV-infected mothers who did not receive lamivudine treatment.In only 2 cases,mother-to-infant transmission blocking failed;the blocking rate was 97.1%(66/68),which was higher than has been previously reported.CONCLUSION:Lamivudine treatment is safe for chronic HBV-infected pregnant mothers and their fetuses with a gestational age of less than 12 wk or throughout the entire pregnancy.
