• Title/Summary/Keyword: Multiple pregnancy

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Prenatal and Perinatal Antibiotic Exposure and Long-Term Outcome

  • Thomas Gestels;Yvan Vandenplas
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.3
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    • pp.135-145
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    • 2023
  • Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.

Outcome of Twin Pregnancies after Selective Fetal Reduction (선택적 유산술에 의한 쌍태임신의 예후에 관한 연구)

  • Seo, Seong-Seog;Jo, Mi-Yeong;Kim, Mi-Ran;Hwang, Kyung-Joo;Kim, Young-Ah;Ryu, Hee-Sug
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.1
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    • pp.85-93
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    • 2003
  • Objective : To evaluate the safety and efficacy of selective fetal reduction (SFR) and compare the outcome of twin pregnancy after SFR in multiple pregnancy induced by assisted reproductive technology (ART) with that of natural twin pregnancy. Methods : From September 1995 to March 2002 in Ajou University Hospital, SFR was performed in 79 patients whose gestational sacs were more than 3. Of these 79 patients, 47 patents resulted in twin pregnancy after SFR. SFR was performed using transvaginal intracardiac KCl injection at gestational age of $6{\sim}9$ weeks. Control group was composed of 264 patients with natural twin pregnancy, who delivered after intrauterine pregnancy at 24 weeks, from June 1994 through December 2002. We compared Obstetric and perinatal outcomes between SFR group and natural twin group. Results: Among 47 patients with twin pregnancy after SFR, 2 spontaneous abortion were occurred at intrauterine pregnancy at 8 and 19 weeks. Obstetrical and perinatal outcomes were available in 43 patients. Single intrauterine fetal death was occurred in 1 of 43 (2.3%) patients in SFR group. Incidence of preterm labor, premature rupture of membrane, preeclampsia and placenta previa were similar, but gestational diabetes mellitus (GDM) was occurred more frequently in SFR group (3 (7.0%) vs 4 (1.5%), p=0.02). Mean gestational age, mean birth weight, incidence of discordancy, use of intubation and ventilation, incidence of fetal anomaly, low (<7) Apgar score and intrauterine growth restriction were similar in both groups. Conclusion: Twin pregnancy after SFR has the increased incidence for GDM but other obstetric and perinatal outcome was similar compared with natural twin pregnancy. So SFR is a safe and effective procedure, so we suggest SFR is needed in multifetal pregnancy more than triplet.

A case of congenital cloacal exstrophy/omphalocele-exstrophy-imperforate anus-spinal defects syndrome and a successful pregnancy

  • Seat, Mara;Boxwalla, Munira;Hough, Arielle;Goodwin, Glenn
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.3
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    • pp.215-218
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    • 2022
  • Herein, we report an exceptionally rare case of a 25-year-old woman with cloacal exstrophy/omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) syndrome achieving a viable pregnancy despite many gastrointestinal and genitourinary malformations and multiple respective corrective operations. The patient was born with two vaginas, two uteruses, four ovaries, an imperforate anus, a large omphalocele including bowel and bladder exstrophy, and diaphysis of the pubic rami. This patient is the only documented OEIS patient not to have tethered spinal cord as an anomaly, perhaps contributing to her successful pregnancy. After experiencing preeclampsia with severe features at 35 weeks, the baby was born via cesarean section.

Factors Influencing Self Confidence during Delivery in Laboring Women (산부의 분만 자신감 결정요인에 관한 연구)

  • Lee, Mi-Kyeong
    • Women's Health Nursing
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    • v.11 no.1
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    • pp.20-26
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    • 2005
  • Purpose: The purpose of this study was to understand self confidence during delivery in laboring women and to identify the factors influencing self confidence for delivery. Method: The participants of the study were 166 women who were admitted to a delivery room at C hospital in Seoul from July 1 to October 31, 2002. Data was collected using a structured questionnaire, self confidence scale, anxiety scale, knowledge of childbirth scale and graphic rating scale. The data was analyzed by the SPSS PC+ program. For the analysis of collected data, frequency analysis, Pearson's correlation, multiple linear regression analysis and stepwise selection method was used. Result: Self confidence during delivery had negative correlation coefficients with anxiety, and positive correlation coefficients with endurance of pain, husband support during pregnancy, age and parity. Anxiety was the highest factor influencing self confidence for delivery(40.0%). Endurance of pain, husband support during pregnancy and age accounted for 49.0% of self confidence in laboring women. Conclusion: The factors influencing self confidence during delivery were anxiety, endurance to pain, husband support during pregnancy and age. Further studies need to be done to identify interventions for overcoming on anxiety, promoting endurance of pain, and increasing husband support during pregnancy.

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Clinical Experiences of Gamete Intrafallopian Transfer (GIFT) Procedure (Gamete Intrafallopian Transfer(GIFT)방법의 임상체험에 관한 고찰)

  • Song, J.S.;Park, Y.S.;Kye, Y.S.;Kim, E.I.;Hur, K.O.;Han, C.W.;Mok, Y.J.
    • Clinical and Experimental Reproductive Medicine
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    • v.17 no.2
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    • pp.145-151
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    • 1990
  • This study was carried out to elevating the pregnancy rate in infertile patient by Gamete intrafallopian transfer (GIFT). The GIFT program was performed from July 1988 to June 1990. Of the 131 cycles, the mean age of patient was 31.6 years and the mean duration of infertility was 5.3 years. 41 patients became pregnant, for a pregnancy rate of 31.3%. 5 preclinical abortions and 6 clinincal abortion was occured. 2 ectopic pregnanices and 1 combined pregnancy were occured. 7 twin pregnancies and 1 triplet were occured (multiple pregnancy rate;22.2%). 11 pregnancies were term delivered, 17 are ongoing pregnancies. GIFT may be considered as an alternative to in vitro fertilazation in infertility cases in which at least one fallopian tube is patent.

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Factors of Prenatal Depression by Stress-vulnerability and Stress-coping Models (스트레스 취약성 및 스트레스 대처 모델을 적용한 임신 중 우울 관련요인)

  • Kim, Younglan;Chung, Chae Weon
    • Women's Health Nursing
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    • v.20 no.1
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    • pp.38-47
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    • 2014
  • Purpose: This study aimed to identify related factors of prenatal depression by stress-vulnerability and stress-coping models for pregnant women. Methods: A cross-sectional survey design with a convenience sampling was used. A total of 107 pregnant women who visited a general hospital in a metropolitan city were recruited from August to October, 2013. A structured questionnaire included the Korean version of Beck Depression Inventory II, and the instruments measuring Self-Esteem, Marital Satisfaction, Pregnancy Stress, Stressful Life Events, and Coping. The data were analyzed using descriptive statistics, t-test, Parson's correlation analysis, and stepwise multiple regression. Results: The mean score of prenatal depression was $11.95{\pm}6.2$, then showing 19.6% with mild depression, 15.0% with moderate depression, and 0.9% with severe depression on BDI II scale. Prenatal depression had positive correlation with pregnancy stress (r=.55, p<.01), stressful life events (r=.26, p<.01) and negative correlation with self- esteem (r=-.38, p<.01), marital satisfaction (r=-.40, p<.01), and coping (r=-.21, p<.05). Factors of pregnancy stress, self-esteem, stressful life events, and planned pregnancy explained 38% of the total variance of prenatal depression. Conclusion: These findings show that health providers need to assess prenatal depression and to control the influencing factors.

An Overview about Treatment of Gestational Diabetes Mellitus: A Short Communication

  • Maqbool, Mudasir;Zehravi, Mehrukh;Maqbool, Rubeena;Ara, Irfat
    • CELLMED
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    • v.11 no.3
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    • pp.12.1-12.5
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    • 2021
  • Gestational diabetes mellitus (GDM) has become one of the major public health problems for both mothers and children globally. Internationally, the frequency of excess weight and obesity has risen dramatically in women of childbearing age. There seems to be a greater risk of having GDM in overweight or obese women, resulting in problems during pregnancy, birth and neonatal development. Hospital management is a problem for obese pregnant females with GDM and places extra burdens on the healthcare sector. GDM can result in possible risks to the wellbeing of the mother, fetus, and infant, as well as clinically significant negative effects on the mental health of the mother. For females and their developing babies, diabetes may cause problems during pregnancy. Unsatisfactory diabetes control enhances the risk of complications and other birth related issues during pregnancy. It may also cause a woman to suffer severe complications. Numerous maternal and fetal effects are associated with GDM and multiple detection and management methods are also pursued globally in order to reduce the burden of health. An overview of gestational diabetes treatment is given in this review.

The Effects of the Attitude toward Terminating Pregnancy among Women College Students in Nursing (여자 간호대학생의 낙태태도 영향요인)

  • Kim, Jong-Gun;Han, Nam-Kyung
    • The Journal of the Korea Contents Association
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    • v.19 no.9
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    • pp.357-365
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    • 2019
  • This study aimed to identify the effects of the attitude toward terminating pregnancy among women college students in nursing. Data were collected by 181 nursing students using a self-questionnaire from April 17 to 30, 2017. The data were analyzed using an independent t-test, ANOVA, pearson correlation coefficients, and hierarchical multiple regression. There were significant positive correlations among attitude toward terminating pregnancy and the other variables. The significant predictors of the attitude toward terminating pregnancy were catholic among religion (${\beta}=0.22$, p=.029), the most of family income(${\beta}=0.48$, p=.005) and sexual attitude (${\beta}=-0.17$, p=.014). This study showed that religion, family income and sexual attitude were factors women college students in nursing' attitude toward terminating pregnancy.

Factors affecting the ongoing pregnancy rate in women with repeated implantation failure undergoing an endometrial receptivity array

  • Hyun Kyoung Lee;Kyoung Yong Moon;Haerin Paik;Byung Chul Jee
    • Clinical and Experimental Reproductive Medicine
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    • v.50 no.4
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    • pp.277-284
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    • 2023
  • Objective: In this retrospective study, we analyzed factors influencing the ongoing pregnancy rate (PR) in women with repeated implantation failure (RIF) undergoing embryo transfer with endometrial receptivity array (ERA). Methods: Eighty-three consecutive personalized embryo transfers (pETs) with ERA, from 54 women with RIF, were selected from June 2020 to April 2022. Vitrified blastocyst transfer was timed based on ERA results. Results: The ongoing PR per pET was 33.7%. Using ERA, the endometrium was identified as pre-receptive in 26 cycles, early receptive in 25 cycles, receptive in 31 cycles, and late receptive in one cycle. With cycles categorized into three receptivity phases (pre-receptive, early receptive, or receptive), no significant differences were found in the clinical PR (27.3%, 55.6%, and 40%, respectively) or ongoing PR (9.1%, 55.6%, and 40%, respectively) after a single blastocyst transfer. Similarly, no significant differences were observed in the clinical PR or ongoing PR after the transfer of two or more blastocysts. Among women with ongoing pregnancy relative to those without, age at first pET was significantly lower (35 years vs. 39 years, p=0.001), while blastocyst score (23 vs. 18, p=0.012) and the proportion of blastocyst scores >18 (71.4% vs. 38.9%, p=0.005) were significantly higher. In multiple logistic regression analysis, the woman's age (odds ratio [OR], 0.814; 95% confidence interval [CI], 0.706 to 0.940; p=0.005) and blastocyst score >18 (OR, 3.052; 95% CI, 1.075 to 8.665; p=0.036) were identified as significant factors influencing ongoing pregnancy. Conclusion: In pET with ERA, ongoing pregnancy was closely associated with woman's age and blastocyst quality.

Improvement of Pregnancy Rate by the Selection of Early Cleavage Embryos to 2-cell Stage in Human IVF (2세포기로의 조기난할 배아 선발을 이용한 체외수정술의 임신율 증가)

  • Park, Sea Hee;Joo, Bo Sun;Lee, Su Kyung;Kim, Kyung Sue;Moon, Hwa Sook
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.1
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    • pp.47-54
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    • 2005
  • Objective: Evaluation of embryos using early cleavage to 2-cell stage has been proposed, but a critical time-point for selecting embryos is unclear. The aim of the present study is to provide a guideline including critical time-point in the selection of early cleaving embryo for the reduction of multiple pregnancies as well as the increase of pregnancy rate in human IVF. Methods: This prospective study was performed in 116 cycles from 85 patients who underwent conventional IVF or ICSI at the infertility clinic of Good Moonhwa Hospital from January 2002 to December 2003. Early cleavage (EC) of embryos to 2-cell stage was assessed at 25 h and 27 h postinsemination/microinjection. Embryos that had early cleaved at each time point were designated as EC-1 and EC-2, respectively, while others were designated as non-early cleavage (NEC). Results: At least one early cleavage embryo was observed in 54 (46.6%) for the EC-1 and 84 (72.4%) for the EC-2 of the 116 cycles assessed. Clinical pregnancy rates (PR) were significantly higher in the EC-1 group (66.7%) compared to the EC-2 group (53.6%) or the NEC group (31.2%) (p<0.05). Significant improvement of the pregnancy rate was found when at least two or more embryos were early cleaved at 25 h postinsemination or when the proportion of early cleavage embryo at 25 h postinsemination was higher than 20% (p<0.05). Conclusion: The critical time-point for the selection of early cleavage embryos with high implantation potential is more effective in 25 h postinsemination/microinjection compared to 27 h. The proportion as well as number of early cleavage embryos is also an important factor for the prediction of pregnancy outcome and the chance of multiple pregnancies. These results demonstrated that the evaluation of early cleavage embryos to 2-cell stage is an easy, simple, and objective method for the selection of good quality embryos suitable for embryo transfer.