β-hCG levels in second trimester as a predictor of gestational hypertension and preeclampsia

Background: Hypertensive disorders of pregnancy complicate up to 10% of pregnancies worldwide, and remain amongst the most significant and intriguing unsolved problems in obstetrics. The goal of this study is to test the hypothesis that women with high serum β-hCG levels in early pregnancy are at higher risk of developing gestational hypertension and preeclampsia.Methods: This is a prospective study done in 200 women between 13 and 20 weeks of gestation, selected randomly for this study. Serum β-hCG estimation was done by Sandwich chemiluminescence immunoassay method and calculated in multiple of median (MOM). They were followed till delivery for development of gestational hypertension and preeclampsia. Results were analysed statistically.Results: Out of 200 cases, 43 (21.5%) cases developed PIH. β-hCG levels were considered raised if the levels were >2 MOM. Out of 39 cases with beta HCG levels >2 MOM, 32 (82.1%) developed PIH whereas 7 (17.9%) remain normotensives against. Also, higher levels of beta HCG are associated with increased severity of PIH (p<0.000). The sensitivity was 82%, specificity was 93.2% and positive predictive value was 74.3%.Conclusions: The study conclude that elevated serum β-hCG levels in women with second trimester pregnancy indicates increased risk of gestational hypertension and preeclampsia and raised β-hCG levels are associated with severity of disease

Clinical-sonographical and dopplerometric criteria of determining the obstetrician's tactics in cases of the umbilical cord entanglement of the fetal body

The complex method of antenatal diagnostics of the cord entanglement round the body of the fetus is elaborated. It includes echography, color Doppler mapping, dopplerometry and actocardiography. On the basis of the data received the system of prognosing and estimating the severity of feta l hypoxia in the end of the third trimester pregnancy is suggested, that allows to choose the correct tactics of pregnancy and delivery management in different rates ofcord entanglement. The use o f this method made it possible to rise the effectiveness of antenatal diagnostics of this gestational complication from 23,5% to 79,4%, to decrease the frequency of postnatal asphyxia to 46,1% and, therefore, to avoid intra- and postnatal loss.

Maternal Secondhand Smoke Exposure Enhances Macrosomia Risk Among Pregnant Women Exposed to PM2.5: A New Interaction of Two Air Pollutants in a Nationwide Cohort

Background: Fine particulate matter (PM2.5) is one of the most common outdoor air pollutants, and secondhand smoking (SHS) is an important source of inhalable indoor air pollution. Previous studies were controversial and inconsistent about PM2.5 and SHS air pollutants on neonatal birth weight outcomes, and no studies assessed the potential interactive effects between PM2.5 and SHS on birth weight outcomes.Purpose: To investigate the interaction between gestational PM2.5 and SHS air pollution exposure on the risk of macrosomia among pregnant women and examine the modifying effect of SHS exposure on the association of PM2.5 air pollution and birth weight outcomes during pregnancy.Methods: Research data were derived from the National Free Preconception Health Examination Project (NFPHEP), which lasted 3 years from January 1, 2010, to December 31, 2012. At least 240,000 Chinese women from 220 counties were enrolled in this project. PM2.5 exposure concentration was obtained using a hindcast model specific for historical PM2.5 estimation from satellite-retrieved aerosol optic depth. Different interaction models about air pollution exposure on birth weight outcomes were established, according to the adjustment of different confounding factors and different pregnancy stages. The establishment of interaction models was based on multivariable logistic regression, and the main confounding factors were maternal age at delivery and pre-pregnancy body mass index (BMI) of participants. SHS subgroups analysis was conducted to further confirm the results of interaction models.Results: In total, 197,877 participants were included in our study. In the full-adjusted interaction model, maternal exposure to PM2.5 was associated with an increased risk of macrosomia in whole, the first-, second-, and third trimesters of pregnancy (p &lt; 0.001). The interactive effect was statistically significant between maternal exposure to PM2.5 and SHS on the risk of macrosomia in the whole (interaction p &lt; 0.050) and the first-trimester pregnancy (interaction p &lt; 0.050), not in the second (interaction p &gt; 0.050) or third trimester (interaction p &gt; 0.050) of pregnancy. The higher frequency of SHS exposure prompted the stronger interaction between the two air pollutants in the whole pregnancy and the first-trimester pregnancy.Conclusions: In the whole and first-trimester pregnancy, maternal exposure to SHS during pregnancy enhanced the risk of macrosomia among pregnant women exposed to PM2.5 air pollutants, and the interaction became stronger with the higher frequency of SHS exposure.

Pengetahuan terhadap Sikap Ibu Hamil tentang Tanda Bahaya Kehamilan Trimester III

Indonesia is one of the developing countries in Southeast Asia with a high maternal mortality rate. One of the causes of the high maternal mortality rate is pregnancy complications that can appear through pregnancy danger signs. Danger signs of pregnancy are signs that indicate danger that can occur during pregnancy or the antenatal period, which if not detected can cause death. This study aims to determine the relationship between knowledge and attitudes of pregnant women about the danger signs of third-trimester pregnancy in one area of Central Indonesia. This study used an analytical survey method with approach cross-sectional. The sample in this study was 23 pregnant women. The sampling technique used was the consecutive sampling method. The consecutive sampling study was conducted in February - March 2020. The results showed a significant relationship between knowledge of the attitudes of pregnant women about the danger signs of third-trimester pregnancy. The conclusion in this study is that there is a significant relationship between knowledge of the attitudes of pregnant women about the danger signs of third-trimester pregnancy.