scholarly journals Pregnancy physiology pattern prediction study (4P study): protocol of an observational cohort study collecting vital sign information to inform the development of an accurate centile-based obstetric early warning score

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016034 ◽  
Author(s):  
Fiona Kumar ◽  
Jude Kemp ◽  
Clare Edwards ◽  
Rebecca M Pullon ◽  
Lise Loerup ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Early Warning ◽  
Vital Signs ◽  
Observational Cohort Study ◽  
Mobile Internet ◽  
Early Warning Score ◽  
Evidence Based ◽  
Reference Ranges ◽  
Observational Cohort

IntroductionSuccessive confidential enquiries into maternal deaths in the UK have identified an urgent need to develop a national early warning score (EWS) specifically for pregnant or recently pregnant women to aid more timely recognition, referral and treatment of women who are developing life-threatening complications in pregnancy or the puerperium. Although many local EWS are in use in obstetrics, most have been developed heuristically. No current obstetric EWS has defined the thresholds at which an alert should be triggered using evidence-based normal ranges, nor do they reflect the changing physiology that occurs with gestation during pregnancy.Methods and analysisAn observational cohort study involving 1000 participants across three UK sites in Oxford, London and Newcastle. Pregnant women will be recruited at approximately 14 weeks’ gestation and have their vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation and temperature) measured at 4 to 6-week intervals during pregnancy. Vital signs recorded during labour and delivery will be extracted from hospital records. After delivery, participants will measure and record their own vital signs daily for 2 weeks. During the antenatal and postnatal periods, vital signs will be recorded on an Android tablet computer through a custom software application and transferred via mobile internet connection to a secure database. The data collected will be used to define reference ranges of vital signs across normal pregnancy, labour and the immediate postnatal period. This will inform the design of an evidence-based obstetric EWS.Ethics and disseminationThe study has been approved by the NRES committee South East Coast–Brighton and Sussex (14/LO/1312) and is registered with the ISRCTN (10838017). All participants will provide written informed consent and can withdraw from the study at any point. All data collected will be managed anonymously. The findings will be disseminated in international peer-reviewed journals and through research conferences.

A single-centre observational cohort study of admission National Early Warning Score (NEWS)

Resuscitation ◽  
2015 ◽  
Vol 92 ◽  
pp. 89-93 ◽  
Author(s):  
Tom E.F. Abbott ◽  
Nidhi Vaid ◽  
Dorothy Ip ◽  
Nicholas Cron ◽  
Matt Wells ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Warning ◽  
Observational Cohort Study ◽  
Early Warning Score ◽  
Single Centre ◽  
Observational Cohort ◽  
National Early Warning Score

scholarly journals Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies

Diabetologia ◽  
2019 ◽  
Vol 62 (7) ◽  
pp. 1143-1153 ◽  
Author(s):  
Karl Kristensen ◽  
Linda E. Ögge ◽  
Verena Sengpiel ◽  
Karin Kjölhede ◽  
Annika Dotevall ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cohort Study ◽  
Pregnant Women ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Observational Cohort Study ◽  
Observational Cohort

scholarly journals Adherence to Treatment for Hypothyroidism in Pregnancy and Relationship With Thyrotropin Control: a Retrospective Observational Cohort Study

2021 ◽  
Author(s):  
Júlia Siscart ◽  
Miriam Orós ◽  
M. Catalina Serna ◽  
Daniel Perejon ◽  
Leonardo Galvan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Hormone Replacement ◽  
Good Control ◽  
Observational Cohort Study ◽  
Adherence To Treatment ◽  
Health Region ◽  
Observational Cohort ◽  
The Mean ◽  
Retrospective Observational Cohort Study

Abstract Background: Hypothyroidism is the second most common endocrinological disease during pregnancy, with percentages that can range between 3.2 and 5.5%. A good maternal and foetal health outcome depends on thyroid hormone replacement therapy. The goal of such therapy is to maintain thyrotropin (TSH) in a range that is specific for pregnant women and varies between the trimesters of pregnancy. In our study, we wanted to analyse the adherence to hypothyroidism treatment among pregnant women and to evaluate the degree of control of the disease.Methods: We performed a retrospective observational cohort study in pregnant women between 2012 and 2018 in the Lleida health region. Therapeutic adherence was analysed by the proportion of days covered (PDC). The relationship with other variables was assessed using the regression coefficients and their 95% confidence interval (CI).Results: We examined a sample of 17281 women, representing more than 92% of the pregnant women in the Lleida health region in the period analysed. Among this sample, the mean prevalence of hypothyroidism was 6.52% (0.07% clinical and 6.45% subclinical). 3.3% of the 17281 pregnant women were treated. Among them, the mean adherence score was 79.6 ± 22.2. Of these, 54% presented high adherence. The latter had a higher mean age and better TSH control, in comparison to the ones showing low adherence. Conclusions: Half of the treated patients had good adherence to treatment and a better TSH control, in comparison to the others. Most of them achieved a good control at the third trimester of pregnancy.

Maternal Outcomes in Women with Major Degree Placenta Previa: An Observational Cohort Study

2020 ◽  
Vol 17 ◽  
Author(s):  
Safinaz Reda Mahmoud Abdelwhab ◽  
Ali El-Shabrawy Ali ◽  
Mostafa Abdo Ahmed ◽  
Basem Mohamed Hamed
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Observational Cohort Study ◽  
Maternal Outcomes ◽  
Significant Difference ◽  
Before And After ◽  
Screening Protocol ◽  
Observational Cohort ◽  
Study Participants

Objective:: We aimed to evaluate the maternal outcomes among pregnant women with major degree placenta previa. Methods:: We conducted an observational cohort study on 80 pregnant women diagnosed with major placenta previa (grades III and IV where the placenta partially or completely cover the internal cervical os) after 20 weeks of pregnancy, within the period from January 2019 to June 2019. The diagnosis of placenta previa was made by ultrasound and confirmed at the time of delivery. The study participants were divided into three groups based on the placental location (Anterior, Central, and Posterior). All analyses were conducted using IBM SPSS software package version 20.0. Results:: Eighty pregnant women, with a mean age of 32.3 (5.01) years and a mean gestational age of 36.2 (2.03) weeks, were included in our study. Of them, 56.30% had a previous abortion, and previous Cs delivery was reported in 75%. Most of the placenta previa cases were central (52.5%), with a completely covered internal cervical os (70%). Thirty-nine patients (48.8%) had placenta accreta. Blood transfusion, postpartum hemorrhage, and anemia were noted with a percentage of 75%, 32.5%, and 32.5%, respectively. Around 28.8% of the included patients had a hysterectomy. Before and after delivery, nine patients (21.4%) and 15 patients (35.7%) of the placenta previa centralis group had anemia, respectively. Moreover, there was no statistically significant difference between the three studies groups in terms of anemia before and after delivery (P= 0.41 and P= 0.78. respectively). Placenta previa centralis showed a higher incidence of CS hysterectomy (45.2%) while wound infection was higher in anterior placenta previa (18.2%). Conclusion:: As a predictor of possible obstetric adverse events, placenta previa should be considered. A combination of proper clinical assessment and timely delivery to reduce the associated complications should be considered as well as developing a prenatal screening protocol.

scholarly journals Development and evaluation of a novel Vital Signs Alert device for use in pregnancy in low-resource settings

2018 ◽  
Vol 4 (4) ◽  
pp. 192-198 ◽  
Author(s):  
Hannah L Nathan ◽  
Nicola Vousden ◽  
Elodie Lawley ◽  
Annemarie de Greeff ◽  
Natasha L Hezelgrave ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Warning ◽  
Early Warning System ◽  
Healthcare Providers ◽  
Vital Signs ◽  
Warning System ◽  
Evidence Based ◽  
Traffic Light ◽  
Low Resource Settings ◽  
In Pregnancy

ObjectivesHaemorrhage, hypertension, sepsis and abortion complications (often from haemorrhage or sepsis) contribute to 60% of all maternal deaths. Each is associated with vital signs (blood pressure (BP) and pulse) abnormalities, and the majority of deaths are preventable through simple and timely intervention. This paper presents the development and evaluation of the CRADLE Vital Signs Alert (VSA), an accurate, low-cost and easy-to-use device measuring BP and pulse with an integrated traffic light early warning system. The VSA was designed to be used by all cadres of healthcare providers for pregnant women in low-resource settings with the aim to prevent avoidable maternal mortality and morbidity.MethodsThe development and the mixed-methods clinical evaluation of the VSA are described.ResultsPreliminary fieldwork identified that introduction of BP devices to rural clinics improved antenatal surveillance of BP in pregnant women. The aesthetics of the integrated traffic light system were developed through iterative qualitative evaluation. The traffic lights trigger according to evidence-based vital sign thresholds in hypertension and haemodynamic compromise from haemorrhage and sepsis. The VSA can be reliably used as an auscultatory device, as well as its primary semiautomated function, and is suitable as a self-monitor used by pregnant women.ConclusionThe VSA is an accurate device incorporating an evidence-based traffic light early warning system. It is designed to ensure suitability for healthcare providers with limited training and may improve care for women in pregnancy, childbirth and in the postnatal period.

Opiate Detoxification of Pregnant Women Using Clonidine: An Observational Cohort Study

1995 ◽  
Vol 4 (4) ◽  
pp. 381-386 ◽  
Author(s):  
FRANK J. LePREAU ◽  
BOBBI GARVEY ◽  
NANCY PAULL ◽  
MICHAEL D. STEIN
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Observational Cohort Study ◽  
Observational Cohort
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