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Sample records for 12th gestational week

  1. Gas chromatography-mass spectrometry assay for the simultaneous quantification of drugs of abuse in human placenta at 12th week of gestation.

    PubMed

    Joya, Xavier; Pujadas, Mitona; Falcón, María; Civit, Ester; Garcia-Algar, Oscar; Vall, Oriol; Pichini, Simona; Luna, Aurelio; de la Torre, Rafael

    2010-03-20

    We describe the development and validation of a method for the quantification of drugs of abuse, using gas chromatography-mass spectrometry (GC/MS), in human placenta. Concentration ranges covered were 5-500 ng/g for amphetamine, methamphetamine, MDMA, methadone, cocaine, benzoylecgonine, cocaethylene, morphine, 11-nor-9-carboxy-delta-9-tetrahydrocannabinol, nicotine, and cotinine. Intra-assay and inter-assay imprecisions were less than 15.7% for lower quality control samples and less than 14.9% for medium and high quality control samples. Recovery range was 36.2-83.7%. Placenta samples were kept at -80 degrees C until analysis; analytes were stable after three freeze-thaw cycles (samples stored at -20 degrees C). This accurate and precise assay has sufficient sensitivity and specificity for the analysis of specimens collected from women who voluntarily terminated their pregnancy at 12th week of gestation. The method has proven to be robust and accurate for the quantification of the principal recreational drugs of abuse in this period of the prenatal life. This is the first report that highlights the presence of drugs of abuse during the first trimester of gestation.

  2. [The effect of maternal dexamethasone treatment after the 12th week of pregnancy on fetal genital development in adrenogenital syndrome with 21-hydroxylase deficiency].

    PubMed

    Schwab, K O; Kruse, K; Dörr, H G; Horwitz, A E; Spingler, H

    1989-05-01

    Prenatal treatment with dexamethasone starting with gestation week 5 has been proposed to prevent virilization of female fetuses with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We report dexamethasone treatment in a mother during her third pregnancy; this treatment could not be started before the 12th week of gestation. The second child (index case) had a simple virilizing 21-hydroxylase deficiency CAH and Prader IV genitalia. Because after amniocentesis a normal female karyotype and HLA identity with the index case were found, the dexamethasone treatment (3 x 0.5 mg/die) was continued until delivery.-In contrast to patients with salt-wasting CAH, the 17-alpha-hydroxyprogesterone level in the amniotic fluid was within the normal range. Decreased maternal plasma and urine estriol concentrations, as well as the plasma cortisol values, demonstrated adequate suppression of the fetal and maternal adrenal gland. No side effects were found in the mother as a result of the dexamethasone treatment. The newborn had virilization of the external genitalia according to Prader III but without hypertrophy of the clitoris. The degree of rugated scrotum was less marked in relation to the index case and the sinus urogenitalis was more distally shifted. Thus, surgery on the clitoris could be avoided. The conditions for further surgery (vaginoplasty) could probably be improved. Therefore, dexamethasone treatment of a mother with a female CAH fetus due to 21-hydroxylase deficiency seems to be justified starting at the 12th week of gestation. However, the optimal beginning of therapy is in early pregnancy.

  3. [Induced abortion after the 12th week of pregnancy in the county of Arhus 1993-1994. Psychological consequences].

    PubMed

    Meyer, L; Petersson, B H

    1996-07-29

    The records of all women applying for permission to have an abortion performed after the 12th week of pregnancy during a one-year period in the County of Aarhus were continuously reviewed, and the women who had the abortion performed due to psychosocial reasons were interviewed with a questionnaire at the time of the abortion and again four months later. Of the 76 women who applied for permission for a late abortion the following were excluded from the study: 31 who had the abortion because a malformed child was suspected, six women who did not have the abortion although permission had been given, five women who did not receive permission, four who were under 18 years of age, one who had a miscarriage, 10 who were from another country of origin and did not understand Danish and finally four women who were allowed an abortion on a medical indication and who were either in hospital or in jail. Fifteen women were questioned concerning their age, length of pregnancy and psychological and social histories and were asked to fill out a depression scale. The data showed that none of them had planned their pregnancy and they had had no symptoms of pregnancy until the time at which they applied for the abortion. None of them regretted the abortion afterwards; half of the women were under psychological strain at the time of application, and a few of them had even more psychological symptoms four months after the abortion. Although they had many social problems, physical complications and psychological problems only a few of the women had seen a doctor in the four month period between the abortion and the follow-up.

  4. [Anencephaly at 20 weeks gestation. What is the optimal gestational age for early diagnosis?].

    PubMed

    Porath, M; Henrich, W; Schmider, A; Dudenhausen, J W

    2002-01-01

    Anencephaly is a lethal defect resulting from a disturbed closure of the neural tube. Prenatal diagnosis during first-trimester-scan is essential but implies pitfalls. Three findings of anencephaly at 20 weeks gestation are reported. Fetuses with anencephaly are correctly identified at 12 to 13 weeks gestation. Anencephaly occurs in absence of the cranial vault. Ultrasound findings can be normal until onset of ossification has definitely failed. A first trimester scan at 12 to 13 weeks allows reliable diagnosis and active management of anencephaly. At this gestational age fetal anatomy can be screened in detail by transvaginal ultrasound and nuchal translucency can be measured.

  5. Development of the Human Biceps Brachii Tendon and Coracoglenoid Ligament (7th-12th Week of Development).

    PubMed

    de la Cuadra-Blanco, Crótida; Arráez-Aybar, Luis A; Murillo-González, Jorge A; Herrera-Lara, Manuel E; Mérida-Velasco, Juan A; Mérida-Velasco, José R

    2017-02-10

    The goal of this study is to clarify the development of the long head of the biceps brachii tendon (LHBT) and to verify the existence and development of the coracoglenoid ligament. Histological preparations of 22 human embryos (7-8 weeks of development) and 43 human fetuses (9-12 weeks of development) were studied bilaterally using a conventional optical microscope. The articular interzone gives rise to the LHBT, glenoid labrum, and articular capsule. During the fetal period, it was observed that in 50 cases (58%), the LHBT originated from both the glenoid labrum and the scapula, while in 36 cases (42%), it originated only from the glenoid labrum. The coracoglenoid ligament, first described by Sappey in 1867, is a constant structure that originates at the base of the coracoid process and projects toward the glenoid labrum zone, which is related to the origin of the LHBT. The coracoglenoid ligament was more easily identifiable in the 36 cases in which the LHBT originated only from the glenoid labrum. We suggest that the coracoglenoid ligament is a constant anatomical structure, is not derived from the articular interzone unlike the LHBT, and contributes to the fixation of the glenoid labrum in the scapula in cases in which the LHBT originated only from the glenoid labrum. We postulate that, when the LHBT is fixed only at the glenoid labrum, alterations in the coracoglenoid ligament could lead to a less sufficient attachment of the glenoid labrum to the scapula which could predispose to a superior labral lesion.

  6. Pregnancy outcome at 24-31 weeks' gestation: mortality.

    PubMed Central

    Wariyar, U; Richmond, S; Hey, E

    1989-01-01

    A study of all the mothers in the Northern region in 1983 whose pregnancies ended at between 24 and 31 weeks' gestation was undertaken. These pregnancies accounted for 1.3% of all the births and 44% of all the fetal and neonatal deaths in pregnancies that lasted more than 23 weeks. Most of the 389 singleton deliveries without malformations between 24 and 31 weeks were caused by spontaneous premature labour (n = 119, 31%), placental abruption (n = 79, 20%), pre-eclampsia (n = 56, 14%), and premature rupture of membranes (n = 48, 12%). The percentages of babies alive at the onset of delivery who survived the neonatal period were 66, 84, 78, and 73, respectively and the percentages of neonatal survivors with severe disabilities were 19, 13, 3, and 6, respectively. A further 65 (17%) of these babies died before the onset of labour for no obvious reason. The mode of delivery did not correlate with the outcome once the period of gestation at delivery was taken into account. The results highlight the inadequacy of the perinatal mortality index currently used in the United Kingdom, which identified 10.7 deaths/1000 registered births in 1983; 20% of the babies delivered at 24-31 weeks were excluded by this index because the birth went unregistered, as were 21% of all the babies born alive who died before discharge. An index that accounted for all babies weighing 500 g or more at birth irrespective of the period of gestation, and all neonatal (0-27 days) deaths, would be more appropriate and would bring reporting more into line with recommended international practice. PMID:2730121

  7. Conservative management of preterm premature rupture of membranes beyond 32 weeks' gestation: is it worthwhile?

    PubMed

    Tsafrir, Z; Margolis, G; Cohen, Y; Cohen, A; Laskov, I; Levin, I; Mandel, D; Many, A

    2015-01-01

    We aimed to investigate whether conservative management of preterm premature rupture of membranes (PPROM) at 32-34 weeks' gestation improves outcome. In this retrospective analysis of singleton pregnancies, the study group included patients with PPROM at 28-34 weeks' gestation and the control group included patients presented with spontaneous preterm delivery at 28-34 weeks' gestation. Both groups were subdivided according to gestational age - early (28-31 weeks' gestation) versus late (32-34 weeks' gestation). Adverse neonatal outcome included neonatal death, intraventricular haemorrhage grade 3/4, respiratory distress syndrome, periventricular leucomalacia and neonatal sepsis. The study and control groups included 94 and 86 women, respectively. The study group had a lower incidence of adverse neonatal outcome at the earlier weeks (28-31), compared with the control group at the same gestational age. In contrast, at 32-34 weeks' gestation no difference in the risk for adverse neonatal outcome was noticed. Additionally, within the study group, chorioamnionitis rate was significantly higher among those who delivered at 32-34 weeks' gestation (p < 0.01). No advantage for conservative management of PPROM was demonstrated beyond 31 weeks' gestation. Moreover, conservative management of PPROM at 32-34 weeks' gestation may expose both mother and neonate to infectious morbidity.

  8. Anthropometry of Malawian live births between 35 and 41 weeks of gestation.

    PubMed

    Kalanda, B F; van Buuren, S; Verhoeff, F H; Brabin, B J

    2005-01-01

    The aim of this analysis was to construct cross-sectional gestational age specific percentile curves for birthweight, length, head and mid-arm circumference for Malawian babies, and to compare these percentiles with reference values for babies born to women with normal pregnancies, from a developed country. A cross-sectional study which enrolled pregnant women attending two study hospitals between March 1993 and July 1994 was undertaken. Data on maternal socio-economic status, newborn anthropometry, previous obstetric history and current pregnancy were collected. Smoothed percentile values were derived using the LMS method. Malawian reference percentiles were constructed for fetal growth from 35 weeks' gestation for singleton births. Mean birthweight, length and head circumference were lower at all gestational ages for Malawian compared with Swedish newborns. Fetal growth per completed gestational week was higher by 60 g in weight, 0.5 cm in length and 0.2 cm in head circumference in Swedish compared with Malawian babies. Growth restriction was present from 35 to 41 weeks' gestation. The pattern for the 10th percentile suggested that this was occurring from well before 35 weeks' gestation in a proportion of babies.

  9. Pregnancy rhinitis in Turkish women: Do gestational week, BMI and parity affect nasal congestion?

    PubMed Central

    Ulkumen, Burak; Ulkumen, Burcu Artunc; Pala, Halil Gursoy; Celik, Onur; Sahin, Nevin; Karaca, Gizem; Demirdag, Meltem

    2016-01-01

    Objective: To determine the cumulative incidence of pregnancy rhinitis along with prevalence in different trimesters and to find out whether gestational age, BMI and parity have any effect on pregnancy related nasal congestion. Methods: In the prospective protocol at the obstetrics outpatient clinic, 167 pregnant women were enrolled consecutively. According to exclusion criteria, 67 of them were excluded. Visual-Analogue-Scale (VAS), Nasal-Obstructive-Symptom-Evaluation (NOSE) scale and Discharge-Inflammation-Polyps/Oedema (DIP) scoring were utilized for diagnosis of pregnancy rhinitis. Besides, weight, length, age, parity and week of pregnancy were recorded. Results: Total prevalence of pregnancy rhinitis was 17.17% and cumulative incidence was 38.89%. Our study revealed significant relation of NOSE score with both gestational week (r=0.474, p=0.001) and BMI (r=0.301, p=0.003). VAS score was significantly related with gestational week (r=0.409, p=0.001) and BMI (r=0.270, p=0.007). DIP score was found to be correlated only with gestational week (r=0.375, p=0.001). Conclusion: Cumulative incidence of pregnancy rhinitis was 38.89%. Nasal congestion was significantly associated with BMI and gestational week. Patients should be informed about unfavorable fetal and maternal outcomes of pregnancy related nasal congestion which is triggered by obesity and excessive weight gain in pregnancy. PMID:27648046

  10. Developmental characteristics in sustained fetal tachycardia in 30 to 41 weeks of gestation.

    PubMed

    Shono, H; Muro, M; Shono, M; Ito, Y; Uchiyama, A; Sugimori, H

    1998-05-29

    The aim of the present study is to reveal gestational age-related changes in sustained foetal tachycardia (SFT). 24 h fetal heart rate (FHR) recordings were made on 102 normal pregnant women in 30-41 weeks of gestation. SFT was defined as an increase for 20 or more beats per minute from the FHR-baseline persisting for more than 20 min. In the results, SFTs in 38-39 weeks started during night-time (1900-0700) more frequently than during day-time (0700-1900) (P < 0.01, by chi-square test). The rate and duration were 0% and 0 min in 30-31 weeks of gestation, and increased to 85% and 114 min in 40-41 weeks, respectively. Two critical points were detected by a piecewise linear regression analysis: in the rate between 34-35 weeks and 36-37 weeks, and in the duration between 38-39 to 40-41 weeks. We conclude that gestational age-related changes in SFT depend on the developmental stages.

  11. Fetal, Infant and Maternal Outcomes among Women with Prolapsed Membranes Admitted before 29 Weeks Gestation

    PubMed Central

    Robertson, Julie E.; Lisonkova, Sarka; Lee, Tang; De Silva, Dane A.; von Dadelszen, Peter; Synnes, Anne R.; Joseph, K. S.; Liston, Robert M.; Magee, Laura A.

    2016-01-01

    Background Few studies have examined fetal, infant and maternal mortality and morbidity among pregnant women at very early gestation with an open cervix and prolapsed membranes. We carried out a study describing the outcomes of women hospitalized with prolapsed membranes at 22–28 weeks’ gestation. Methods We prospectively recruited women with singleton pregnancies admitted at 22–28 weeks’ gestation to tertiary hospitals of the Canadian Perinatal Network between 2005 and 2009. Time-to-delivery, perinatal death, neonatal intensive care unit (NICU) admission, severe neonatal morbidity and severe maternal morbidity were compared between women admitted at 22–25 vs. 26–28 weeks gestation. Logistic regression was used to estimate adjusted odds ratios (AOR) and 95% confidence intervals. Results 129 women at 22–25 weeks gestation and 65 women at 26–28 weeks gestation were admitted to hospital and the median time-to-delivery was 4 days in both groups. Stillbirth rates were 12.4% vs 4.6% among women admitted at earlier vs later gestation (AOR 2.8, 95% CI 0.5–14.8), while perinatal death rates were 38.0% vs 6.1% (AOR 14.1, 95% CI 3.5–59.0), respectively. There were no significant differences in NICU admission and severe morbidity among live-born infants; 89.4% and 82.3% died or were admitted to NICU, (P value 0.18), and 53.9% vs 44.0% of NICU infants had severe neonatal morbidity (P value 0.28). Antibiotics, tocolysis and cerclage did not have a significant effect on perinatal death. Maternal death or severe maternal morbidity occurred in 8.5% and 6.2% of women admitted at 22–25 vs 26–28 weeks (AOR 1.2, 95% CI 0.4–4.2). Conclusion Perinatal mortality among women with prolapsed membranes at very early gestation is high, although significantly lower among those admitted at a relatively later gestational age. Rates of adverse maternal outcomes are also high. This information can be used to counsel women with prolapsed membranes at 22 to 28 weeks

  12. Achondrogenesis type 2 diagnosed by transvaginal ultrasound at 12 weeks' gestation.

    PubMed

    Soothill, P W; Vuthiwong, C; Rees, H

    1993-06-01

    Ultrasound examination at 12 weeks' gestation revealed severe generalised subcutaneous oedema in a pregnancy at risk for achondrogenesis type II. Transvaginal scanning confirmed the oedema and suggested abnormal limb development. The prenatal diagnosis was confirmed by X-ray examination after transvaginal termination.

  13. Factors Affecting Vocabulary Acquisition at Age 2 in Children Born between 23 and 28 Weeks' Gestation

    ERIC Educational Resources Information Center

    Marston, Louise; Peacock, Janet L.; Calvert, Sandra A.; Greenough, Anne; Marlow, Neil

    2007-01-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the…

  14. The human chorion contains definitive hematopoietic stem cells from the fifteenth week of gestation.

    PubMed

    Muench, Marcus O; Kapidzic, Mirhan; Gormley, Matthew; Gutierrez, Alan G; Ponder, Kathryn L; Fomin, Marina E; Beyer, Ashley I; Stolp, Haley; Qi, Zhongxia; Fisher, Susan J; Bárcena, Alicia

    2017-04-15

    We examined the contribution of the fetal membranes, amnion and chorion, to human embryonic and fetal hematopoiesis. A population of cells displaying a hematopoietic progenitor phenotype (CD34(++) CD45(low)) of fetal origin was present in the chorion at all gestational ages, associated with stromal cells or near blood vessels, but was absent in the amnion. Prior to 15 weeks of gestation, these cells lacked hematopoietic in vivo engraftment potential. Differences in the chemokine receptor and β1 integrin expression profiles of progenitors between the first and second trimesters suggest that these cells had gestationally regulated responses to homing signals and/or adhesion mechanisms that influenced their ability to colonize the stem cell niche. Definitive hematopoietic stem cells, capable of multilineage and long-term reconstitution when transplanted in immunodeficient mice, were present in the chorion from 15-24 weeks gestation, but were absent at term. The second trimester cells also engrafted secondary recipients in serial transplantation experiments. Thus, the human chorion contains functionally mature hematopoietic stem cells at mid-gestation.

  15. Maternal Prepregnancy BMI and Glucose Level at 24-28 Gestational Weeks on Offspring's Overweight Status within 3 Years of Age.

    PubMed

    Li, Weiqin; Wang, Leishen; Li, Nan; Li, Wei; Liu, Huikun; Zhang, Shuang; Hu, Gang; Leng, Junhong

    2017-01-01

    Objective. To examine the relative impact of maternal prepregnancy body mass index (BMI) and glucose level at 24-28 gestational weeks on offspring's overweight status from birth to 3 years of age in China. Methods. Health care records of 21,354 mother-child pairs were collected. The single and joint associations of maternal prepregnancy BMI and glucose level at 24-28 gestational weeks with 0-3-year-old offspring's overweight status were assessed. Results. The odds ratios (95% confidence intervals) of offspring's macrosomia at birth and overweight/obesity at the 12th month, 24th month, and 36th month were 1.12 (1.11-1.13), 1.05 (1.04-1.06), 1.07 (1.06-1.08), and 1.11 (1.10-1.12) for each 1-unit increase (km/m(2)) in maternal prepregnancy BMI and 1.13 (1.10-1.17), 1.01 (0.99-1.03), 0.99 (0.96-1.01), and 1.00 (0.97-1.02) for each 1-unit increase (mmol/L) in maternal glucose level at 24-28 gestational weeks, respectively. The positive association of maternal glucose level with macrosomia at birth was similar between prepregnancy normal weight (BMI < 24 kg/m(2)) and overweight (BMI ≥ 24 kg/m(2)); however, the positive association of high maternal glucose level with childhood overweight was only seen among prepregnancy normal weight mothers but not among overweight mothers. Conclusions. The impact of maternal gestational hyperglycemia on offspring's overweight before 3 years of age can be modified by prepregnancy BMI.

  16. Maternal Prepregnancy BMI and Glucose Level at 24–28 Gestational Weeks on Offspring's Overweight Status within 3 Years of Age

    PubMed Central

    Li, Weiqin; Wang, Leishen; Li, Nan; Li, Wei; Liu, Huikun; Zhang, Shuang

    2017-01-01

    Objective. To examine the relative impact of maternal prepregnancy body mass index (BMI) and glucose level at 24–28 gestational weeks on offspring's overweight status from birth to 3 years of age in China. Methods. Health care records of 21,354 mother-child pairs were collected. The single and joint associations of maternal prepregnancy BMI and glucose level at 24–28 gestational weeks with 0–3-year-old offspring's overweight status were assessed. Results. The odds ratios (95% confidence intervals) of offspring's macrosomia at birth and overweight/obesity at the 12th month, 24th month, and 36th month were 1.12 (1.11–1.13), 1.05 (1.04–1.06), 1.07 (1.06–1.08), and 1.11 (1.10–1.12) for each 1-unit increase (km/m2) in maternal prepregnancy BMI and 1.13 (1.10–1.17), 1.01 (0.99–1.03), 0.99 (0.96–1.01), and 1.00 (0.97–1.02) for each 1-unit increase (mmol/L) in maternal glucose level at 24–28 gestational weeks, respectively. The positive association of maternal glucose level with macrosomia at birth was similar between prepregnancy normal weight (BMI < 24 kg/m2) and overweight (BMI ≥ 24 kg/m2); however, the positive association of high maternal glucose level with childhood overweight was only seen among prepregnancy normal weight mothers but not among overweight mothers. Conclusions. The impact of maternal gestational hyperglycemia on offspring's overweight before 3 years of age can be modified by prepregnancy BMI. PMID:28251156

  17. Acardiac twin pregnancy: successful intrauterine ablative treatment with alcohol at 14 weeks of gestation.

    PubMed

    Guven, M A; Koc, O; Bodur, H; Erkanli, S; Bagis, T; Usal, D

    2016-01-01

    Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation. Postnatal outcome of the pump twin was excellent at 30 months after birth. Early second trimester elective ablation by alcohol injection can be an inexpensive, alternative, and reasonable minimal invasive treatment option to prevent fetal loss of pump twin before mid and late second trimester in perinatology centers where intrafetal cord occlusive methods are not available.

  18. "Hugging sisters": thoracoomphalopagus with anencephaly confirmed by three-dimensional ultrasonography at 9 weeks of gestation.

    PubMed

    Shim, Jae-Yoon; Joo, Da-Hye; Won, Hye-Sung; Lee, Pil Ryang; Kim, Ahm

    2011-06-01

    We describe a rare conjoined twinning at 9 weeks of gestation. We compared the results of two- and three-dimensional sonography with autopsy findings after the termination of pregnancy. These results showed a thoracoomphalopagus with a shared heart and visceral organs. Three-dimensional sonography showed anencephaly in one of the embryos. Early and accurate prenatal diagnosis of this type of conjoined twins using three-dimensional sonography is critical for both parental counseling and minimizing maternal morbidity.

  19. Successful caspofungin treatment of persistent candidemia in extreme prematurity at 23 and 24 weeks' gestation.

    PubMed

    Jeon, Ga Won; Sin, Jong Beom

    2014-03-01

    Systemic fungal infection continues to be a major cause of mortality in extremely low-birth-weight premature infants. Amphotericin B has been recommended as the primary treatment; however, its use is limited due to drug-induced nephrotoxicity and amphotericin B-resistant candidemia. Caspofungin therapy was initiated in seven extremely premature infants at 23 and 24 weeks' gestation with persistent systemic candidiasis despite liposomal amphotericin B treatment. The gestational age was 23(+1)-24(+6) weeks, and birth weight was 530-825 g. Of the seven patients, the peripheral blood cultures of six patients were positive for Candida parapsilosis and one had positive culture for Candida albicans. The dosage of caspofungin was 2 mg/kg/day, and the mean treatment duration was 14 days. All of the persistent candidemia resolved on caspofungin therapy. There was no recurrent candidemia after discontinuing caspofungin. There were no adverse effects, hepatotoxicity, nephrotoxicity, anemia, or thrombocytopenia. Caspofungin successfully treated persistent candidemia in extremely premature infants at 23 and 24 weeks' gestational age.

  20. HELLP Syndrome at 17 Weeks Gestation: A Rare and Catastrophic Phenomenon

    PubMed Central

    Berry, Erica L.; Iqbal, Sara N.

    2015-01-01

    HELLP syndrome is a collection of symptoms described as hemolysis, elevated liver enzymes and low platelets. HELLP syndrome complicates 0.01–0.6% of pregnancies and can be considered a severe variant of preeclampsia. The occurrence of HELLP syndrome diagnosed before the 20th week of gestation has been most commonly reported in association with antiphospholipid antibody syndrome (APS) or triploid chromosomal anomalies. A 41-year-old primigravida was admitted at 17 weeks and 6 days gestation with hypertension, proteinuria, hemolytic anemia and acute renal injury. She was diagnosed with HELLP syndrome, and subsequently suffered from an intrauterine fetal demise. After delivery, the clinical manifestations of HELLP syndrome resolved within 7 days with the exception of her acute renal failure. Interdisciplinary teams of physicians were able to exclude other imitators of preeclampsia, such as hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), APS, lupus and acute fatty liver of pregnancy. This case is difficult to diagnose, given the similar presentation of several microangiopathic hemolytic anemias. The clinical manifestations and laboratory findings of HELLP and its mimicking conditions seem as if they are mirror images of each other. However, the discrete differences in our patient presentation, clinical findings, laboratory results and overall postpartum course leave HELLP syndrome as the most consistent diagnosis. It is imperative to investigate for all possible etiologies as HELLP syndrome at 17 weeks gestation is extremely rare and mimicking conditions may require alternative management strategies. PMID:25806101

  1. Neurological and physical maturation in normal growth singletons from 37 to 41 weeks' gestation.

    PubMed

    Amiel-Tison, C; Maillard, F; Lebrun, F; Bréart, G; Papiernik, E

    1999-03-01

    An evaluator blinded to gestational age (GA) assessed a cohort of 397 singletons born at between 37 and 41 week's gestation, by looking at 11 criteria exploring neurological maturity and 12 criteria exploring physical maturity. The analysis of correlation coefficients shows various degrees of association between GA and each of the criteria examined. A highly significant correlation (p < 0.001) was found for 4 neurological criteria defining passive tone in limbs and sucking reflex. The activity of flexor muscles of the neck and crossed extension reflex were also associated with maturity but weakly (p < 0.01). A highly significant correlation (p < 0.001) was found for 8 of the physical criteria, skin colour and texture, lanugo, ear firmness, genitalia, breast size, nipple formation and plantar skin creases. Oedema, skull firmness and ear form were also associated but weakly. With multivariate analysis combining the neurological and physical criteria, predictive values ranked in the following order: 1) plantar skin, 2) breast size, 3) sucking reflex, 4) scarf sign, 5) skin colour, 6) genitalia, 7) popliteal angle, 8) return to flexion of forearms, 9) dorsiflexion angle. In conclusion, a score based on physical and neurological criteria is associated with duration of pregnancy (r2 = 0.32) between 37 and 41 weeks' gestation. Such an instrument allows us to study fetal maturity as a variable independent of GA, and therefore makes it possible to identify various influences that may modify maturational rate during the last weeks of pregnancy.

  2. Monoamniotic twins with one fetal anencephaly and cord entanglement diagnosed with three dimensional ultrasound at 14 weeks of gestation.

    PubMed

    Jo, Yun Sung; Son, Hyun Joo; Jang, Dong Gyu; Kim, Narinay; Lee, Guisera

    2011-01-01

    A 29-year-old pregnant woman with parity 0-0-0-0 was diagnosed with monoamniotic twin pregnancy discordant for anencephaly at 14 weeks gestation. Umbilical cord entanglement, which is an important cause of fetal death in monoamniotic twins, was confirmed by three-dimensional ultrasound. Cesarean section was performed at 34 weeks of gestation, and the normal newborn infant was discharged without any complications. We report a case of monoamniotic twin pregnancy discordant for anencephaly and diagnosed with cord entanglement by three-dimensional ultrasound at 14 weeks of gestation, and now report it along with a literature review.

  3. Antenatal corticosteroids beyond 34 weeks gestation: What do we do now?

    PubMed

    Kamath-Rayne, Beena D; Rozance, Paul J; Goldenberg, Robert L; Jobe, Alan H

    2016-10-01

    The practice of antenatal corticosteroid administration in pregnancies of 24-34 weeks of gestation that are at risk of preterm delivery was adopted over 20 years after the first randomized clinical trial in humans. It is biologically plausible that antenatal corticosteroid in pregnancies beyond 34 weeks of gestation would reduce rates of respiratory morbidity and neonatal intensive care admission. Mostly guided by the results of a large multicenter randomized trial of antenatal corticosteroid in late preterm infants, the Antenatal Late Preterm Steroids Trial, the American Congress of Obstetricians and Gynecologists has released a practice advisory that the "administration of betamethasone may be considered in women with a singleton pregnancy between 34 0/7 and 36 6/7 weeks of gestation at imminent risk of preterm birth within 7 days." However, many unanswered questions about the risks and benefits of antenatal corticosteroids in this population remain and should be considered with the adoption of this treatment recommendation. This review of the literature indicates that the greatest effect is in the reduction of transient tachypnea of the newborn infant, which is a mostly self-limited condition. This benefit must be weighed against unanticipated outcomes, such as neonatal hypoglycemia, and unknowns about long-term neurodevelopmental follow up and metabolic risks. Amelioration of respiratory morbidity in late preterm infants does not preclude these infants from having other complications that are related to prematurity that require intensive care. Other possible morbidities of prematurity may be magnified if these babies no longer have respiratory symptoms. Conversely, if these late preterm babies no longer exhibit respiratory symptoms and "look good," they may be discharged before other morbidities of prematurity have resolved and be at risk for readmission. Furthermore, it is also important to ensure that unintended consequences are avoided to achieve a minor

  4. A Case of Vaginal Stillbirth in the Presence of Placenta Previa at 33 Weeks of Gestation

    PubMed Central

    Chinen, Yukiko; Kinjo, Tadatsugu; Nitta, Hayase; Kinjo, Yui; Masamoto, Hitoshi

    2016-01-01

    It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery. Finally, intrauterine fetal death (IUFD) was confirmed at 33 weeks of gestation. Two days after IUFD, the patient experienced labor pain. The placenta and dead fetus weighing 961 g were vaginally delivered, and total bleeding was 270 mL. Although further studies to confirm the dynamic change of the uteroplacental blood flow are necessary to avoid the risk of maternal hemorrhage, vaginal TOP with placenta previa after feticide or IUFD would be feasible. PMID:27579202

  5. Elective delivery before 39 weeks' gestation: reconciling maternal, fetal, and family interests in challenging circumstances.

    PubMed

    Van McCrary, S; Shah, Shetal I; Combs, Adriann; Quirk, J Gerald

    2012-01-01

    We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order to alleviate the couple's anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist.

  6. Gastric Cancer Presenting as a Krukenberg Tumor at 22 Weeks' Gestation

    PubMed Central

    Gupta, Ashutosh; Attar, Bashar M; Demetria, Melchor

    2014-01-01

    Gastric cancer is rare during pregnancy, and often advanced upon presentation. A Krukenberg tumor presents a diagnostic and therapeutic challenge in the pregnant patient. We present a case of a 38-year-old woman at 22 weeks' gestation who presented with worsening epigastric pain, and was found to have a left pelvic mass on ultrasound, which was confirmed by magnetic resonance imaging. She went into active labor and delivered a viable infant via vaginal delivery. An exploratory laparotomy revealed a large mass originating from her left ovary and diffuse thickening of the lesser curvature of the stomach. Frozen section investigation revealed the presence of signet cell adenocarcinoma. Subsequent upper endoscopy showed linitis plastica, while biopsy confirmed the presence of adenocarcinoma. In conclusion, the occurrence of gastric cancer in pregnancy is rare despite extremely common symptoms. The management poses a challenge because of the need for early treatment, and the continuation of the pregnancy. PMID:25580361

  7. Readmission of Preterm Infants Less Than 32 Weeks Gestation Into Early Childhood

    PubMed Central

    Elke, Griesmaier; Vera, Neubauer; Maria, Gnigler; Michaela, Höck; Ursula, Kiechl-Kohlendorfer

    2014-01-01

    The aim of the study was to investigate the frequency of and the predictors for rehospitalization in preterm infants into early childhood, focusing on gender differences. All preterm infants born at <32 weeks of gestation in North Tyrol between January 2003 and December 2005 were enrolled in this survey. About one fifth of all children were readmitted, showing an inverse downward trend with increasing age. The most common reason for readmission in the third (36.5%) and fourth (42.9%) years of life was respiratory infection, but changed to miscellaneous surgeries in the fifth (52.1%). Male sex showed significantly higher readmission rates and more miscellaneous surgeries. Additionally, male sex and chronic lung disease were risk conditions for rehospitalization in the multivariate analysis. Readmission rates and respiratory infections in preterm-born children showed an inverse downward trend with increasing age. In early childhood, gender difference still plays a role with regard to rehospitalization. PMID:27335903

  8. Perinatal Outcomes of Monochorionic-Diamniotic Twin Pregnancies Uncomplicated at 28 Weeks of Gestation.

    PubMed

    Suzuki, Shunji

    2016-01-01

    We examined the prevalence of specific perinatal complications of monochorionic-diamniotic twin pregnancies in cases without any abnormal findings until the second trimester of pregnancy. This was a retrospective cohort study performed at a tertiary perinatal center in Tokyo, Japan. There were 88 cases of uncomplicated monochorionic-diamniotic twin pregnancies at 28 weeks of gestation. In five of them (5.7%), there were serious complications associated with placental circulatory imbalance between the twins during the third trimester of pregnancy. Two cases were complicated by twin-twin transfusion syndrome, two cases were complicated by twin anemia-polycythemia sequence, and one case was complicated by acute twin-twin transfusion syndrome. In the five cases, no abnormal ultrasonographic findings or symptoms were recognized one or two weeks prior to the diagnosis. Fifty-eight cases (65.9%) were delivered at term uneventfully. Serious complications due to placental circulatory imbalance between twins occurred in about 6% of cases during the third trimester of pregnancy.

  9. Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestation.

    PubMed

    Marston, Louise; Peacock, Janet L; Calvert, Sandra A; Greenough, Anne; Marlow, Neil

    2007-08-01

    Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1-9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm.

  10. Serum levels of endothelial glycocalyx constituents in women at 20 weeks' gestation who later develop gestational diabetes mellitus compared to matched controls: a pilot study

    PubMed Central

    Hou, Weilin; Taylor, Rennae S; McCowan, Lesley M E

    2016-01-01

    Objectives The aim of this pilot study was to determine the serum concentration of heparan sulfate, hyaluronan, chondroitin sulfate and syndecan-1 and if these serum concentrations can be used to identify women at 20 weeks' gestation who later develop gestational diabetes mellitus (GDM). Design Nested case–control study from Auckland, New Zealand participants in the prospective cohort Screening for Pregnancy Endpoints study. Setting Auckland, New Zealand. Participants 20 pregnant women (70% European, 15% Indian, 10% Asian, 5% Pacific Islander) at 20 weeks' gestation without any hypertensive complications who developed GDM by existing New Zealand criteria defined as a fasting glucose ≥5.5 mmol/L and/or 2 hours ≥9.0 mmol/L after a 75 g Oral Glucose Tolerance Test. Women not meeting these criteria were excluded from this study. The patients with GDM were matched with 20 women who had uncomplicated pregnancies and negative screening for GDM and matched for ethnicity, maternal age and BMI. Primary and secondary outcome measures The primary measures were the serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate determined by quantitative ELISA. There were no secondary outcome measures. Results Binary logistic regression was performed to determine if serum concentrations of endothelial glycocalyx layer constituents in women at 20 weeks' gestation would be useful in predicting the subsequent diagnosis of GDM. The model was not statistically significant χ2=12.5, df=8, p=0.13, which indicates that the model was unable to distinguish between pregnant women at 20 weeks' gestation who later developed GDM and those who did not. Conclusions Serum concentrations of syndecan-1, heparan sulfate, hyaluronan and chondroitin sulfate in pregnant women at 20 weeks' gestation were not associated with later development of GDM. To further explore whether there is any relationship between endothelial glycocalyx constituents and GDM

  11. Tracking embryo implantation using cell-free fetal DNA enriched from maternal circulation at 9 weeks gestation.

    PubMed

    Treff, Nathan R; Tao, Xin; Su, Jing; Lonczak, Agnieszka; Northrop, Lesley E; Ruiz, Andrew A; Scott, Richard T

    2011-07-01

    Embryo DNA fingerprinting represents an important tool for tracking embryo-specific outcomes after multiple embryo transfer during IVF. The situation in which two embryos are transferred and only one implants represents a unique opportunity for the most well-controlled validation of markers capable of identifying competent and incompetent embryos. Specifically, this design eliminates all patient-related variables from the comparison of embryos with or without reproductive potential. However, in order to determine which embryo implanted, the investigator must wait until newborn DNA is available upon delivery. This study validates a non-invasive cell-free fetal DNA fingerprinting method that reduces the time to identify which embryo implanted by ∼31 weeks. Thirty-four patients were studied to determine if fingerprinting of fetal DNA extracted from maternal plasma at nine gestational weeks concurred with the buccal DNA results obtained from the newborn after delivery. This validation required single nucleotide polymorphism profiles on each couples' preimplantation embryos, cell-free fetal DNA from maternal plasma at 9 weeks gestation, and newborn DNA obtained from buccal swabs after delivery. The predictions from fetal DNA-based embryo tracking and gender assignments made at 9 weeks gestation were 100% consistent with standardized methods of assessment performed after term delivery. This study demonstrates the first validated fetal DNA fingerprinting method which predicts both gender and which embryo implanted at 9 weeks gestation following multiple embryo transfer.

  12. Early-Childhood Neurodevelopmental Outcomes Are Not Improving for Infants Born at <25 Weeks' Gestational Age

    PubMed Central

    Kendrick, Douglas E.; Wilson-Costello, Deanne E.; Das, Abhik; Bell, Edward F.; Vohr, Betty R.; Higgins, Rosemary D.

    2011-01-01

    OBJECTIVE: We compared neurodevelopmental outcomes at 18 to 22 months' corrected age of infants born with extremely low birth weight at an estimated gestational age of <25 weeks during 2 periods: 1999–2001 (epoch 1) and 2002–2004 (epoch 2). PATIENTS AND METHODS: We conducted a multicenter, retrospective analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Perinatal and neonatal variables and outcomes were compared between epochs. Neurodevelopmental outcomes at 18 to 22 months' corrected age were evaluated with neurologic exams and Bayley Scales of Infant Development II. Logistic regression analyses determined the independent risk of epoch for adverse outcomes. RESULTS: Infant survival was similar between epochs (epoch 1, 35.4%, vs epoch 2, 32.3%; P = .09). A total of 411 of 452 surviving infants in epoch 1 and 405 of 438 surviving infants in epoch 2 were evaluated at 18 to 22 months' corrected age. Cesarean delivery (P = .03), surgery for patent ductus arteriosus (P = .004), and late sepsis (P = .01) were more common in epoch 2, but postnatal steroid use was dramatically reduced (63.5% vs 32.8%; P < .0001). Adverse outcomes at 18 to 22 months' corrected age were common in both epochs. Moderate-to-severe cerebral palsy was diagnosed in 11.1% of surviving infants in epoch 1 and 14.9% in epoch 2 (adjusted odds ratio [OR]: 1.52 [95% confidence interval (CI): 0.86–2.71]; P = .15), the Mental Developmental Index was <70 in 44.9% in epoch 1 and 51% in epoch 2 (OR: 1.30 [95% CI: 0.91–1.87]; P = .15), and neurodevelopmental impairment was diagnosed in 50.1% of surviving infants in epoch 1 and 58.7% in epoch 2 (OR: 1.4 [95% CI: 0.98–2.04]; P = .07). CONCLUSIONS: Early-childhood outcomes for infants born at <25 weeks' estimated gestational age were unchanged between the 2 periods. PMID:21187312

  13. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

    PubMed

    2004-07-01

    Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy while minimizing the risks of unintended harm such as maternal anxiety, decreased breastfeeding, and unnecessary costs or treatment. Although kernicterus should almost always be preventable, cases continue to occur. These guidelines provide a framework for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. In every infant, we recommend that clinicians 1) promote and support successful breastfeeding; 2) perform a systematic assessment before discharge for the risk of severe hyperbilirubinemia; 3) provide early and focused follow-up based on the risk assessment; and 4) when indicated, treat newborns with phototherapy or exchange transfusion to prevent the development of severe hyperbilirubinemia and, possibly, bilirubin encephalopathy (kernicterus).

  14. [Mid and long-term neurological prognosis of preterm infants less than 28 weeks gestational age].

    PubMed

    Valleur, D; Magny, J-F; Rigourd, V; Kieffer, F

    2004-02-01

    The study of the long-term outcome of extremely premature babies is specially difficult because data in the literature is very heterogeneous. Recruitment (inborn, outborn), type of obstetrical management, and criteria and means used for interrupting curative treatment have varied greatly. We present the outcome of 204 infants born before 28 weeks of gestation between 1992 and 1997. The minimal follow up is 6 years. 82 infants (40.2%) died during the neonatal period. Significantly associated with neonatal death were absence of prenatal steroid course, male gender, elevated lactic acid at birth, and occurrence of pulmonary complications. When major neurological lesions (ventricular hemorrage stage III or IV and kryptic leucomalacia) developed, most infants died following a decision to stop active treatment. Out of the 114 survivors, 17 (14.9%) developed cerebral palsy (CP) or a low IQ. 31 (27.2%) had minor disorders, 66 (57.9%) were completely normal. The predictive factors of CP were major brain lesions, elevated lactic acid at the time of birth and multiple pregnancy. We also detail the minor neurological sequelae, cognitive behavioral, and psychological disorders observed in this population of extremely premature children and discuss the need for early and continuous care for these high risk babies.

  15. Expectant management of severe preeclampsia at 27(0/7) to 33(6/7) weeks' gestation: maternal and perinatal outcomes according to gestational age by weeks at onset of expectant management.

    PubMed

    Bombrys, Annette E; Barton, John R; Habli, Mounira; Sibai, Baha M

    2009-06-01

    We sought to determine perinatal outcome and maternal morbidities based on gestational age (GA) at onset of expectant management in severe preeclampsia (PE) between 27(0/7) and 33 (6/7) weeks. In this retrospective analysis of outcome in patients with severe preeclampsia, we studied 66 patients (71 fetuses) with severe PE at 27 (0)/ (7) to 33(6/ 7). All patients received corticosteroids. Perinatal and maternal complications were analyzed. Five patients had twin gestations. Median for days of prolongation was 5 days (range, 3 to 35). Birth weights of 19 (27%) were < 10% for gestational age, and 6 (8%) were < 5%. All fetuses survived except for one neonatal death at 27 weeks, and three infants had chronic lung disease-two at 27 and one at 28 weeks-but there were no cases of intraventricular hemorrhage (>or= grade ?). Rate of abruption was significantly higher at 27 to 28 weeks as compared with > 28 weeks (25% vs 6%, p = 0.05). There was no eclampsia, and two had transient renal insufficiency at 27 weeks. Four of 11 (36%) patients with expectant management at >or= 32 weeks had pulmonary edema or hemolytic anemia, elevated liver enzymes, and low platelet count. During expectant management, rate of respiratory distress syndrome and other serious neonatal complications decrease with increasing GA, supporting a role for such management in early severe preeclampsia. Because there is significant maternal morbidity at >or= 32 weeks with minimal neonatal benefit, consideration should be given for delivery of these pregnancies following corticosteroid administration.

  16. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22–25 weeks gestation

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Fanaroff, Avroy A.; Vohr, Betty R.; Stoll, Barbara J.; Ehrenkranz, Richard A.; Andrews, William W.; Wallace, Dennis; Das, Abhik; Bell, Edward F.; Walsh, Michele C.; Laptook, Abbot R.; Shankaran, Seetha; Poindexter, Brenda B.; Hale, Ellen C.; Newman, Nancy S.; Davis, Alexis S.; Schibler, Kurt; Kennedy, Kathleen A.; Sanchez, Pablo J.; Van Meurs, Krisa P.; Goldberg, Ronald N.; Watterberg, Kristi L.; Faix, Roger G.; Frantz, Ivan D.; Higgins, Rosemary D.

    2013-01-01

    Context Current guidelines, initially published in 1995, recommend antenatal corticosteroids for mothers with preterm labor from 24–34 weeks gestational age, but not before 24 weeks because of lack of data. However, many infants born before 24 weeks are provided intensive care now. Objective To determine if antenatal corticosteroids are associated with improvement in major outcomes in infants born at 22 and 23 weeks. Design, Setting, Participants Data for this cohort study were collected prospectively on 401–1000 gram inborn infants (N=10,541) of 22–25 weeks gestation born between 1993–2009 at 23 academic perinatal centers in the United States. Certified examiners unaware of exposure to antenatal corticosteroids performed follow-up examinations on 4,924 (86.5%) of the infants born in 1993–2008 who survived to 18–22 months. Logistic regression models generated adjusted odds ratios, controlling for maternal and neonatal variables. Main Outcome Measures Mortality and neurodevelopmental impairment at 18–22 months corrected age RESULTS Death or neurodevelopmental impairment at 18–22 months was lower for infants whose mothers received antenatal corticosteroids born at 23 weeks (antenatal corticosteroids, 83.4% vs no antenatal corticosteroids, 90.5%; adjusted odds ratio 0.58; 95% CI, 0.42–0.80), at 24 weeks (antenatal corticosteroids, 68.4% vs no antenatal corticosteroids, 80.3%; adjusted odds ratio 0.62; 95% CI, 0.49–0.78), and at 25 weeks (antenatal corticosteroids, 52.7% vs no antenatal corticosteroids, 67.9%; adjusted odds ratio 0.61; 95% CI, 0.50–0.74) but not at 22 weeks (antenatal corticosteroids, 90.2% vs no antenatal corticosteroids, 93.1%; adjusted odds ratio 0.80; 95% CI, 0.29–12.21). Death by 18–22 months, hospital death, death/intraventricular hemorrhage/periventricular leukomalacia, and death/necrotizing enterocolitis were significantly lower for infants born at 23, 24, and 25 weeks gestational age if the mothers had received

  17. A Case of Life-threatening Obstetrical Hemorrhage Secondary to Placental Abruption at 17 Weeks of Gestation

    PubMed Central

    Kinoshita, Toshihiko; Takeshita, Naoki; Takashima, Akiko; Yasuda, Yutaka; Ishida, Hiroaki; Manrai, Megumi

    2014-01-01

    A 40-year old woman, gravida 4, para 4, presented with sudden lower abdominal pain and severe vaginal bleeding at 17 weeks of gestation. Clinical symptoms and ultrasonographic finding revealed placental abruption. The volume of bleeding was heavy and led to disseminated intravascular coagulation and hypovolemic shock. We performed blood transfusion and therapy to treat the critical condition. However, the mother’s condition continued to worsen. Therefore, we performed a hysterotomy and aborted the pregnancy to save the mother. Since heavy bleeding caused by placental abruption leading to a life-threatening condition for a mother before the 20 weeks of gestation is very rare, the present case is an important case study. PMID:24847429

  18. Executive Functioning and Learning Skills of Adolescent Children Born at Fewer than 26 Weeks of Gestation

    PubMed Central

    Farooqi, A.; Adamsson, M.; Serenius, F.; Hägglöf, B.

    2016-01-01

    Aims To assess the cognitive and behavioral aspects of executive functioning (EF) and learning skills in extremely preterm (EPT) children compared with term control children aged 10 to 15 years. Methods A total of 132 of 134 (98% of all eligible survivors) EPT children born at the 2 Swedish regional tertiary care centers from 1992 to 1998 (mean age = 12 years, mean birth weight = 718 g, and mean gestational age = 24.4 weeks) and 103 matched term controls were assessed. General intelligence was assessed using the Wechsler Intelligence Scale for Children (WISC-III-R), and cognitive aspects of EF were analyzed using EF-sensitive subscales of the WISC-III-R and Tower test of the Delis-Kaplan Executive Function Scale (D-KEFS). Behaviors related to EF and learning skills were assessed using the Five to Fifteen questionnaire, which is a validated parent and teacher instrument. Academic performance in school was assessed by teachers’ responses on Achenbach’s Teachers Report Form. Analyses performed included multivariate analyses of covariance (ANCOVA and MANCOVA) and logistic regression analyses. Results The EPT children displayed significant deficits in cognitive aspects of EF compared with the controls, exhibiting decreases on the order of 0.9 SD to 1.2 SD for tasks of verbal conceptual reasoning, verbal and non-verbal working memory, processing speed and planning ability (P <0.001 for all). After excluding the children with major neurosensory impairment (NSI) or a Full Scale intelligence quotient (FSIQ) of < 70, significant differences were observed on all tests. Compared with controls, parents and teachers of EPT children reported significantly more EF-related behavioral problems. MANCOVA of teacher-reported learning skills in children with FSIQ >70 and without major NSI revealed no interactions, but significant main effects were observed for the behavioral composite executive function score, group status (EPT vs control) and FSIQ, for which all effect sizes were

  19. Clinical patterns in extremely preterm (22 to 24 weeks of gestation) infants in relation to survival time and prognosis.

    PubMed

    Iijima, Shigeo; Arai, Hiroko; Ozawa, Yuri; Kawase, Yasuhiro; Uga, Naoki

    2009-06-01

    We investigated time-related predictors of death or neurological sequelae in extremely preterm infants (EPI) born at 22 to 24 weeks' gestation by categorizing clinical patterns according to their survival time and morbidity. Data on 113 infants born at 22 to 24 weeks' gestation from January 1991 through April 2006 were analyzed by a case-control approach. Cesarean section, Apgar score or= 24 hours, pulmonary hemorrhage and intraventricular hemorrhage (IVH) were significantly associated with death by day 6. Among those surviving >or= 7 days, sepsis and severe IVH were significantly associated with death. Assessment of survivors at a minimum follow-up period of 2 years revealed that protracted mechanical ventilation was significantly associated with a poor neurological outcome. There are various characteristic key events in relation to the outcome at different ages of life in EPI born at 22 to 24 weeks' gestation. Clinicians and parents should discuss management options for the infant on the basis of these findings.

  20. [EEG of the very premature infant born at 24 to 30 weeks gestational age. Definitions and normal area].

    PubMed

    Vecchierini, M-F; André, M; d'Allest, A-M

    2007-01-01

    This article aims at summarizing normal EEG criteria and their maturational pattern in premature infants of 24 to 30 weeks gestational age. Although very premature infants with a normal outcome are not numerous, their normal EEG patterns must be known, as EEG constitutes a basis for neurological prognosis. Background activity is first discontinuous. Discontinuity decreases thereafter with increasing age, so that some long periods of continuous activity may be observed in active sleep, around 30 weeks of age. Conversely, interburst intervals become shorter and the proportion of time without EEG activity is decreasing. Based on EEG activity and eye movements, a rough sleep-state differentiation was described as soon as 25 weeks of gestational age and is completely achieved at 30 weeks. The main EEG figures are high-voltage delta waves of higher amplitude and slower frequency in younger infants. Temporal delta waves occur in sequences, these are very characteristic of the very premature infant; thereafter, they become smaller, less numerous and eventually disappear around 27-28 weeks. In contrast, occipital delta waves remain numerous and of high voltage, are usually bilateral and superimposed with fast rhythms. The two types of frontal delta waves that are observed in 24-27 weeks prematures disappear with maturation. Bursts of synchronized delta waves are less numerous than localized delta waves and also disappear before 28 weeks of age. Finally, diffuse theta bursts are mainly recorded at 26-27 weeks GA and become more localized in temporal areas with maturation. At 30 weeks, they are observed on temporal areas, mainly during slow-wave sleep.

  1. Technetium-99m-methylene diphosphonate uptake in the fetal skeleton at 30 weeks gestation

    SciTech Connect

    McKenzie, A.F.; Budd, R.S.; Yang, C.

    1994-08-01

    Retention of {sup 99m}Tc-MDP in the fetal skeleton and placenta at 30 and 32 wk gestation was observed during bone scan examination of the maternal skeleton for staging of malignant tumors. The implications and significance of these observations are discussed. 8 refs., 2 figs., 1 tab.

  2. Intrauterine growth retardation in preterm infants ≤32 weeks of gestation is associated with low white blood cell counts.

    PubMed

    Wirbelauer, Johannes; Thomas, Wolfgang; Rieger, Lorenz; Speer, Christian P

    2010-11-01

    It is unclear if very immature preterm infants who are born small for gestational age (SGA) have similar leukocyte counts as infants who are born appropriate for gestational age (AGA). Our study included 49 preterm infants with a gestational age ≤32 weeks and without exposure to chorioamnionitis and funisitis. Blood cells were counted in the first 2 hours of life. Eighteen SGA preterm infants were compared with 31 AGA preterm infants. Gestational age, sex, rate of caesarean section, and prenatal administration of corticosteroids did not differ between the groups. Median birth weight was 583 g in the SGA group versus 1100 g in the AGA group. Infants in the SGA group had significantly lower counts of leukocytes, total neutrophils, immature neutrophils, lymphocytes, and monocytes. These findings were not affected by maternal preeclampsia. No significant difference for nucleated red blood cell counts was found. Prenatal growth retardation is an independent factor for lower counts of different leukocytes in very immature preterm infants. It is not clear if these low leukocyte counts are associated with a higher risk of neonatal infections or if lower numbers of inflammatory cells protect the lung and brain of very immature SGA infants by reducing inflammatory events postnatally.

  3. Transvaginal 3-d power Doppler ultrasound evaluation of the fetal brain at 10-13 weeks' gestation.

    PubMed

    Hata, Toshiyuki; Tanaka, Hirokazu; Noguchi, Junko

    2012-03-01

    The objective of this study was to measure the fetal brain volume (FBV) and vascularization and blood flow using transvaginal 3-D power Doppler (3DPD) ultrasound late in the first trimester of pregnancy. 3DPD ultrasound examinations with the VOCAL imaging analysis program were performed on 36 normal fetuses from 10-13 weeks' gestation. FBV and 3DPD indices related to the fetal brain vascularization (vascularization index [VI], flow index [FI] and vascularization flow index [VFI]) were calculated in each fetus. Intra- and interclass correlation coefficients and intra- and interobserver agreements of measurements were assessed. FBV was curvilinearly correlated well with the gestational age (R2 = 0.861, p < 0.0001). All 3-D power Doppler indices (VI, FI and VFI) showed no change at 10-13 weeks' gestation. FBV and all 3-D power Doppler indices (VI, FI and VFI) showed a correlation > 0.82, with good intra- and interobserver agreement. Our findings suggest that 3-D ultrasound is a superior means of evaluating the FBV in utero, and that 3-D power Doppler ultrasound histogram analysis may provide new information on the assessment of fetal brain perfusion.

  4. Prenatal diagnosis of ectopia cordis at 10 weeks of gestation using two-dimensional and three-dimensional ultrasonography.

    PubMed

    Liang, R I; Huang, S E; Chang, F M

    1997-08-01

    We report here the earliest prenatal diagnosis to date of a case of ectopia cordis using both two-dimensional and three-dimensional ultrasound at 10 weeks of gestation. Both two-dimensional and three-dimensional ultrasound clearly revealed a thoracoabdominal ectopia cordis and an omphalocele. Histopathological examination confirmed the prenatal ultrasonic findings. In addition to an ectopia cordis, a supraumbilical hepato-omphalocele, absence of a pericardium and an anterior diaphragmatic defect were seen, although there was a normal sternum. These pathological findings, suggested that our case was a variant of pentalogy of Cantrell.

  5. Background electroencephalographic (EEG) activities of very preterm infants born at less than 27 weeks gestation: a study on the degree of continuity

    PubMed Central

    Hayakawa, M; Okumura, A; Hayakawa, F; Watanabe, K; Ohshiro, M; Kato, Y; Takahashi, R; Tauchi, N

    2001-01-01

    AIMS—To clarify the features of the background electroencephalographic (EEG) activities in clinically well preterm infants born at less than 27 weeks gestation and to outline their chronological changes with increasing postconceptional age (PCA).
METHODS—EEGs of clinically well premature infants born at less than 27 weeks gestation were recorded during the early postnatal period. The infants were separated into three groups according to their PCA at the time of EEG recording (21-22 weeks PCA, 23-24 weeks PCA, and 25-26 weeks PCA). The mean and maximum duration of interburst intervals (IBIs), the mean duration of bursts, and the percentage of continuous and discontinuous patterns in each PCA group were evaluated.
RESULTS—There were three infants at 21-22 weeks PCA, seven at 23-24 weeks PCA, and five at 25-26 weeks PCA. Eighteen EEG recordings were obtained. The mean and maximum IBI duration decreased with increasing PCA. The percentage of continuous patterns increased with increasing PCA. Conversely, the percentage of discontinuous patterns decreased with increasing PCA.
CONCLUSIONS—In premature infants born at less than 27 weeks gestation, the characteristics of the background EEG activities were similar to those of older premature infants. These changes reflect the development of the central nervous system in this period.
 At less than 27 weeks gestational age, the characteristics of background EEG activities were found to be as follows: PMID:11320041

  6. Maternal and perinatal outcomes of pregnancies delivered at 23 weeks' gestation.

    PubMed

    Crane, Joan M G; Magee, Laura A; Lee, Tang; Synnes, Anne; von Dadelszen, Peter; Dahlgren, Leanne; De Silva, Dane A; Liston, Robert

    2015-03-01

    Objectif : Évaluer les issues maternelles et périnatales des grossesses donnant lieu à un accouchement entre 23+0 et 23+6 semaines de gestation. Méthodes : Cette étude de cohorte prospective portait sur des femmes du Réseau périnatal canadien qui ont été admises à l’une des 16 unités périnatales tertiaires canadiennes participantes entre le 1er août 2005 et le 31 mars 2011, et qui ont accouché entre 23+0 et 23+6 semaines de gestation. Les femmes ont été admises dans le réseau si elles avaient été hospitalisées en raison d’un travail préterme spontané (s’accompagnant de contractions), d’un col court (sans contractions), d’un prolapsus des membranes (s’accompagnant d’une dilatation du col ou dans le cadre duquel les membranes se situaient au niveau de l’orifice externe ou faisaient saillie au-delà de ce dernier), d’une rupture prématurée des membranes préterme, d’un retard de croissance intra-utérin, d’une hypertension gestationnelle ou d’une hémorragie antepartum. Parmi les issues maternelles, on trouvait la césarienne, le décollement placentaire et la manifestation d’une complication grave. La morbidité grave et la mortalité constituaient les issues périnatales. Résultats : En tout, 248 femmes et 287 nouveau-nés ont été inclus dans l’étude. Le taux de césarienne était de 10,5 % (26/248) et 40,3 % des femmes (100/248) ont connu une complication grave (la plus courante étant la chorioamnionite [38,6 %], suivie de la transfusion sanguine [4,5 %]). Parmi les nouveau-nés pour lesquels les issues étaient connues, le taux de mortalité périnatale était de 89,9 % (223/248) (taux de mortinaissance : 23,3 % [67/287] et taux de décès néonatal : 62,9 % [156/248]). Une admission à l’UNSI a été requise pour 38,1 % (69/181) des enfants nés vivants pour lesquels les issues étaient connues (n = 181). Parmi ces enfants ayant dû être admis à l’UNSI, un décès néonatal a

  7. Development of the mandibular condylar cartilage in human specimens of 10-15 weeks' gestation.

    PubMed

    Mérida Velasco, J R; Rodríguez Vázquez, J F; De la Cuadra Blanco, C; Campos López, R; Sánchez, Montesinos; Mérida Velasco, J A

    2009-01-01

    This study analyses some morphological and histological aspects that could have a role in the development of the condylar cartilage (CC). The specimens used were serial sections from 49 human fetuses aged 10-15 weeks. In addition, 3D reconstructions of the mandibular ramus and the CC were made from four specimens. During weeks 10-11 of development, the vascular canals (VC) appear in the CC and the intramembranous ossification process begins. At the same time, in the medial region of the CC, chondroclasts appear adjacent to the vascular invasion and to the cartilage destruction. During weeks 12-13 of development, the deepest portion of the posterolateral vascular canal is completely surrounded by the hypertrophic chondrocytes. The latter emerge with an irregular layout. During week 15 of development, the endochondral ossification of the CC begins. Our results suggest that the situation of the chondroclasts, the posterolateral vascular canal and the irregular arrangement of the hypertrophic chondrocytes may play a notable role in the development of the CC.

  8. Changing prognosis for babies of less than 28 weeks' gestation in the north of England between 1983 and 1994. Northern Neonatal Network.

    PubMed Central

    Tin, W.; Wariyar, U.; Hey, E.

    1997-01-01

    OBJECTIVE: To investigate the changing prognosis for babies of less than 28 weeks' gestation. DESIGN: A prospective, collaborative, population based survey. SETTING: The former Northern Regional Health Authority. SUBJECTS: All the births between 1983 and 1994 at 22 to 27 completed weeks' gestation to women normally resident in the region. MAIN OUTCOME MEASURES: Miscarriage, stillbirth, death in the first year of life, and disability in survivors. RESULTS: There were 479070 registered births in the study period. No baby of 22 weeks' gestation survived; only eight (4%) of the 197 babies of 23 weeks who were alive at the onset of labour survived for a year-a proportion that did not change during the study period. Survival among other babies of less than 28 weeks improved progressively between 1983-6 and 1991-4, but administration of artificial surfactant to babies requiring ventilation from mid-1990 was associated with further improvement in survival only in those over 25 weeks' gestation. Babies of 24 weeks required three times as much high dependency care per survivor as babies of 27 weeks (76 v 26 days). The rate of severe disability in the one year survivors of less than 26 weeks' gestation (30/123; 24%) was similar to that seen in the sampled survivors of 26 and 27 weeks (29/108; 27%); the proportion disabled did not change significantly during the study period. All the children born in 1983, 1987, and 1991 were later reassessed in greater detail: 10% (13/136) seemed destined for a continuing life of total dependency. CONCLUSIONS: Gestation, if accurately assessed, can give a woman facing very preterm delivery a clear indication of the prognosis for her baby and help her judge the appropriateness of accepting obstetric intervention and sustained perinatal support. PMID:9006468

  9. Neurosensory Differentiation and Innervation Patterning in the Human Fetal Vestibular End Organs between the Gestational Weeks 8-12.

    PubMed

    Johnson Chacko, Lejo; Pechriggl, Elisabeth J; Fritsch, Helga; Rask-Andersen, Helge; Blumer, Michael J F; Schrott-Fischer, Anneliese; Glueckert, Rudolf

    2016-01-01

    Balance orientation depends on the precise operation of the vestibular end organs and the vestibular ganglion neurons. Previous research on the assemblage of the neuronal network in the developing fetal vestibular organ has been limited to data from animal models. Insights into the molecular expression profiles and signaling moieties involved in embryological development of the human fetal inner ear have been limited. We present an investigation of the cells of the vestibular end organs with specific focus on the hair cell differentiation and innervation pattern using an uninterrupted series of unique specimens from gestational weeks 8-12. Nerve fibers positive for peripherin innervate the entire fetal crista and utricle. While in rodents only the peripheral regions of the cristae and the extra-striolar region of the statolithic organs are stained. At week 9, transcription factors PAX2 and PAX8 were observed in the hair cells whereas PAX6 was observed for the first time among the supporting cells of the cristae and the satellite glial cells of the vestibular ganglia. Glutamine synthetase, a regulator of the neurotransmitter glutamate, is strongly expressed among satellite glia cells, transitional zones of the utricle and supporting cells in the sensory epithelium. At gestational week 11, electron microscopic examination reveals bouton contacts at hair cells and first signs of the formation of a protocalyx at type I hair cells. Our study provides first-hand insight into the fetal development of the vestibular end organs as well as their pattern of innervation by means of immunohistochemical and EM techniques, with the aim of contributing toward our understanding of balance development.

  10. Neurosensory Differentiation and Innervation Patterning in the Human Fetal Vestibular End Organs between the Gestational Weeks 8–12

    PubMed Central

    Johnson Chacko, Lejo; Pechriggl, Elisabeth J.; Fritsch, Helga; Rask-Andersen, Helge; Blumer, Michael J. F.; Schrott-Fischer, Anneliese; Glueckert, Rudolf

    2016-01-01

    Balance orientation depends on the precise operation of the vestibular end organs and the vestibular ganglion neurons. Previous research on the assemblage of the neuronal network in the developing fetal vestibular organ has been limited to data from animal models. Insights into the molecular expression profiles and signaling moieties involved in embryological development of the human fetal inner ear have been limited. We present an investigation of the cells of the vestibular end organs with specific focus on the hair cell differentiation and innervation pattern using an uninterrupted series of unique specimens from gestational weeks 8–12. Nerve fibers positive for peripherin innervate the entire fetal crista and utricle. While in rodents only the peripheral regions of the cristae and the extra-striolar region of the statolithic organs are stained. At week 9, transcription factors PAX2 and PAX8 were observed in the hair cells whereas PAX6 was observed for the first time among the supporting cells of the cristae and the satellite glial cells of the vestibular ganglia. Glutamine synthetase, a regulator of the neurotransmitter glutamate, is strongly expressed among satellite glia cells, transitional zones of the utricle and supporting cells in the sensory epithelium. At gestational week 11, electron microscopic examination reveals bouton contacts at hair cells and first signs of the formation of a protocalyx at type I hair cells. Our study provides first-hand insight into the fetal development of the vestibular end organs as well as their pattern of innervation by means of immunohistochemical and EM techniques, with the aim of contributing toward our understanding of balance development. PMID:27895556

  11. Acute liver failure at 26 weeks' gestation in a patient with sickle cell disease.

    PubMed

    Greenberg, Mara; Daugherty, Tami J; Elihu, Arvand; Sharaf, Ravi; Concepcion, Waldo; Druzin, Maurice; Esquivel, Carlos O

    2009-10-01

    Orthotopic liver transplantation (OLT) for acute liver failure (ALF) during pregnancy is an uncommon occurrence with variable outcomes. In pregnancy-related liver failure, prompt diagnosis and immediate delivery are essential for a reversal of the underlying process and for maternal and fetal survival. In rare cases, the reason for ALF during pregnancy is either unknown or irreversible, and thus OLT may be necessary. This case demonstrates the development of cryptogenic ALF during the 26th week of pregnancy in a woman with sickle cell disease. She underwent successful cesarean delivery of a healthy male fetus at 27 weeks with concurrent OLT. This report provides a literature review of OLT in pregnancy and examines the common causes of ALF in the pregnant patient. On the basis of the management and outcome of our case and the literature review, we present an algorithm for the suggested management of ALF in pregnancy.

  12. The OPTIMIST-A trial: evaluation of minimally-invasive surfactant therapy in preterm infants 25–28 weeks gestation

    PubMed Central

    2014-01-01

    Background It is now recognized that preterm infants ≤28 weeks gestation can be effectively supported from the outset with nasal continuous positive airway pressure. However, this form of respiratory therapy may fail to adequately support those infants with significant surfactant deficiency, with the result that intubation and delayed surfactant therapy are then required. Infants following this path are known to have a higher risk of adverse outcomes, including death, bronchopulmonary dysplasia and other morbidities. In an effort to circumvent this problem, techniques of minimally-invasive surfactant therapy have been developed, in which exogenous surfactant is administered to a spontaneously breathing infant who can then remain on continuous positive airway pressure. A method of surfactant delivery using a semi-rigid surfactant instillation catheter briefly passed into the trachea (the “Hobart method”) has been shown to be feasible and potentially effective, and now requires evaluation in a randomised controlled trial. Methods/design This is a multicentre, randomised, masked, controlled trial in preterm infants 25–28 weeks gestation. Infants are eligible if managed on continuous positive airway pressure without prior intubation, and requiring FiO2 ≥ 0.30 at an age ≤6 hours. Randomisation will be to receive exogenous surfactant (200 mg/kg poractant alfa) via the Hobart method, or sham treatment. Infants in both groups will thereafter remain on continuous positive airway pressure unless intubation criteria are reached (FiO2 ≥ 0.45, unremitting apnoea or persistent acidosis). Primary outcome is the composite of death or physiological bronchopulmonary dysplasia, with secondary outcomes including incidence of death; major neonatal morbidities; durations of all modes of respiratory support and hospitalisation; safety of the Hobart method; and outcome at 2 years. A total of 606 infants will be enrolled. The trial will be conducted in >30 centres

  13. Use of magnesium sulfate before 32 weeks of gestation: a European population-based cohort study

    PubMed Central

    Wolf, H T; Huusom, L; Weber, T; Piedvache, A; Schmidt, S; Norman, M; Zeitlin, J

    2017-01-01

    Objectives The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. Methods We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires. The study population comprised 720 women with severe pre-eclampsia, eclampsia or HELLP and 3658 without pre-eclampsia delivering from 24 to 31 weeks of gestation in 119 maternity units with 20 or more very preterm deliveries per year. Results Among women with severe pre-eclampsia, eclampsia or HELLP, 255 (35.4%) received MgSO4 before delivery. 41% of units reported use of MgSO4 whenever possible for pre-eclampsia and administered MgSO4 more often than units reporting use sometimes. In women without pre-eclampsia, 95 (2.6%) received MgSO4. 9 units (7.6%) reported using MgSO4 for fetal neuroprotection whenever possible. In these units, the median rate of MgSO4 use for deliveries without severe pre-eclampsia, eclampsia and HELLP was 14.3%. Only 1 unit reported using MgSO4 as a first-line tocolytic. Among women without pre-eclampsia, MgSO4 use was not higher in women hospitalised before delivery for preterm labour. Conclusions Severe pre-eclampsia, eclampsia or HELLP are not treated with MgSO4 as frequently as evidence-based medicine recommends. MgSO4 is seldom used for fetal neuroprotection, and is no longer used for tocolysis. To continuously lower morbidity, greater attention to use of MgSO4 is needed. PMID:28132012

  14. Readmission of Preterm Infants Less Than 32 Weeks Gestation Into Early Childhood: Does Gender Difference Still Play a Role?

    PubMed

    Elisabeth, Ralser; Elke, Griesmaier; Vera, Neubauer; Maria, Gnigler; Michaela, Höck; Ursula, Kiechl-Kohlendorfer

    2014-01-01

    The aim of the study was to investigate the frequency of and the predictors for rehospitalization in preterm infants into early childhood, focusing on gender differences. All preterm infants born at <32 weeks of gestation in North Tyrol between January 2003 and December 2005 were enrolled in this survey. About one fifth of all children were readmitted, showing an inverse downward trend with increasing age. The most common reason for readmission in the third (36.5%) and fourth (42.9%) years of life was respiratory infection, but changed to miscellaneous surgeries in the fifth (52.1%). Male sex showed significantly higher readmission rates and more miscellaneous surgeries. Additionally, male sex and chronic lung disease were risk conditions for rehospitalization in the multivariate analysis. Readmission rates and respiratory infections in preterm-born children showed an inverse downward trend with increasing age. In early childhood, gender difference still plays a role with regard to rehospitalization.

  15. Molecular investigation of a dicentric 13;17 chromosome found in a 21-week gestation fetus with multiple congenital abnormalities.

    PubMed

    Cockwell, A E; Maloney, V K; Thomas, N S; Smith, E L; Gonda, P; Bass, P; Crolla, J A

    2006-01-01

    We report a 21-week gestation fetus terminated because of multiple congenital abnormalities seen on ultrasound scan, including ventriculomegaly, possible clefting of the hard palate, cervical hemivertebrae, micrognathia, abnormal heart, horseshoe kidney and a 2-vessel umbilical cord. On cytogenetic examination, the fetus was found to have a male karyotype with 45 chromosomes with a dicentric chromosome, which appeared to consist of the long arms of chromosomes 13 and 17. Molecular genetic investigations and fluorescence in situ hybridization (FISH) unexpectedly showed that the derivative chromosome contained two interstitial blocks of chromosome 17 short arm sequences, totalling approximately 7 Mb, between the two centromeres. This effectively made the fetus monosomic for approximately 15 Mb of 17p without the concurrent trisomy for another chromosome normally seen following malsegregation of reciprocal translocations. It also illustrates the complexity involved in the formation of some structurally abnormal chromosomes, which can only be resolved by detailed molecular investigations.

  16. Thyroxine values from newborn screening of 919 infants born before 29 weeks' gestation.

    PubMed Central

    Reuss, M L; Leviton, A; Paneth, N; Susser, M

    1997-01-01

    OBJECTIVES: Severe transient hypothyroxinemia in premature infants is associated with cerebral palsy and mental retardation: this study assessed its prevalence in very premature infants. METHODS: Congenital hypothyroidism screening programs in three states provided thyroxine values for 919 newborn infants younger than 29 weeks who were enrolled in a multicenter study. RESULTS: Thyroxine values were lower than 4.0 micrograms/dL in 21% of survivors and increased each week by 0.6 microgram/dL (95% confidence interval [CI] = 0.4, 0.7). At tests done 1 to 2 days after birth, levels were 2.5 micrograms/dL higher (95% CI = 1.8, 3.3) than at tests done at 8 to 14 days. In New York, levels were 1.0 microgram/dL higher (95% CI = 0.3, 1.6) than elsewhere. The levels of infants who died were 1.3 micrograms/dL lower (95% CI = 0.6, 2.0) than those of survivors. CONCLUSIONS: Severe transient hypothyroxinemia is common in very premature infants and deserves further study. PMID:9357357

  17. Randomised controlled trial of postnatal sodium supplementation on body composition in 25 to 30 week gestational age infants

    PubMed Central

    Hartnoll, G.; Betremieux, P.; Modi, N.

    2000-01-01

    AIMS—To compare the effects of early and delayed sodium supplementation on body composition and body water compartments during the first two weeks of postnatal life.
METHODS—Preterm infants of 25-30 weeks' gestation were stratified and randomly assigned according to gender and gestational age, to receive a sodium intake of 4 mmol/kg/day beginning either on the second day after birth or when weight loss of 6% of birthweight had been achieved. Daily sodium intake, total fluid intake, energy intake, urine volume, and urinary sodium excretion were recorded. Total body water was measured by H218O dilution on days 1, 7, and 14, and extracellular fluid volume by sodium bromide dilution on days 1 and 14.
RESULTS—Twenty four infants received early, and 22 delayed, sodium supplementation. There were no significant differences between the groups in body water compartments on day 1. In the delayed group, but not the early group, there was a significant loss of total body water during the first week (delayed −44 ml/kg, p=0.048; early 6 ml/kg, p=0.970). By day 14 the delayed, but not the early group, also had a significant reduction in extracellular fluid volume (delayed −53 ml/kg, p=0.01; early −37 ml/kg, p=0.2). These changes resulted in a significant alteration in body composition at the end of the first week (total body weight: delayed 791 ml/kg; early 849 ml/kg, p=0.013). By day 14 there were once again no significant differences in body composition between the two groups.
CONCLUSIONS—Body composition after preterm birth is influenced by the timing of introduction of routine sodium supplements. Early sodium supplementation can delay the physiological loss of body water that is part of normal postnatal adaptation. This is likely to be of particular relevance to babies with respiratory distress syndrome. A tailored approach to clinical management, delaying the introduction of routine sodium supplements until there has been postnatal loss of body water, is

  18. Predictors of RSV LRTI Hospitalization in Infants Born at 33 to 35 Weeks Gestational Age: A Large Multinational Study (PONI)

    PubMed Central

    Saliba, Elie; Kosma, Paraskevi; Posfay-Barbe, Klara; Yunis, Khalid; Farstad, Teresa; Unnebrink, Kristina; van Wyk, Jean; Wegzyn, Colleen; Notario, Gerard; Kalus, Stefanie; Campbell, Fiona J.

    2016-01-01

    Background Preterm infants are at high risk of developing respiratory syncytial virus (RSV)-associated lower respiratory tract infection (LRTI). This observational epidemiologic study evaluated RSV disease burden and risk factors for RSV-associated LRTI hospitalization in preterm infants 33 weeks+0 days to 35 weeks+6 days gestational age not receiving RSV prophylaxis. Methods Preterm infants ≤6 months of age during RSV season (1 October 2013–30 April 2014) were followed at 72 sites across 23 countries from September 2013–July 2014 (study period). RSV testing was performed according to local clinical practice. Factors related to RSV-associated hospitalization for LRTI were identified using multivariable logistic regression with backward selection. Results Of the 2390 evaluable infants, 204 and 127 were hospitalized for LRTI during the study period and RSV season, respectively. Among these subjects, 64/204 and 46/127, respectively, were hospitalized for confirmed RSV LRTI. Study period and RSV season normalized RSV hospitalization rates (per 100 infant years) were 4.1 and 6.1, respectively. Factors associated with an increased risk of RSV-related LRTI hospitalization in multivariable analyses were smoking of family members (P<0.0001), non-hemodynamically significant congenital heart disease diagnosis (P = 0.0077), maternal age of ≤25 years at delivery (P = 0.0009), low maternal educational level (P = 0.0426), household presence of children aged 4 to 5 years (P = 0.0038), age on 1 October ≤3 months (P = 0.0422), and presence of paternal atopy (P<0.0001). Conclusions During the 2013–2014 RSV season across 23 countries, for preterm infants 33–35 weeks gestation ≤6 months old on 1 October not receiving RSV prophylaxis, confirmed RSV LRTI hospitalization incidence was 4.1 per 100 infant years during the study period and 6.1 per 100 infant years during the RSV season. This study enhances the findings of single-country studies of common risk factors for

  19. A Comparison Between the Effect of Fluorescent Lamps and Quartz Halogen Incandescent Filament Lamps on the Treatment of Hyperbilirobinemia in Newborns with the Gestational Age of 35 Weeks or More

    PubMed Central

    Sadeghnia, Alireza; Ganji, Masoud; Armanian, Amir Mohammad

    2014-01-01

    Background: Icter is the most prevalent disease in newborns. Although most of the newborns affiliated with this seem healthy in other aspects, there is always a fear for toxic complication of indirect hyperbilirobinemia in the central nervous system. Nowadays phototherapy is the method of decreasing (or avoidance of increase) of total serum bilirobin (TSB) and it is also used widely in neonatal health care centers according to the availably of equipment, but without any defined standard. In this study, two light sources, quarts halogen incandescent filament lamp (QHIFL) and fluorescent lamp (FL) are compared with each other to find out which method is more useful and efficient. Methods: This study is a randomized controlled trial done on 25 newborns with gestational age of 35 weeks or more, with newborn's icter in the 1st week after birth, at Isfahan Behesti Hospital, February 2012 to March 2013. A group of these newborns was treated with FL and the other with QHIFL and they all were controlled and tested according to their level of TSB at the beginning of phototherapy, at 8th, 12th, and 24th h of treatment and at discharge. The data from the study was analyzed by IBM SPSS Statistics Version 21. Results: According to the findings, the level of TSB before and 8 h after the intervention had no significant difference among the groups. However, at 16th and 24th h of treatment, the TSB level was lower in the FL group and this difference was meaningful (P = 0.002 and P = 0.013 respectively). Furthermore the duration of the treatment was significantly shorter in FL group meaningfully (P = 0.047). Conclusions: According to the findings of this study, the technology used in QHIFL cannot show the capabilities of the FLs. However, more studies are needed to confirm the findings of this study are universal. PMID:25317303

  20. Neonatal mortality due to preterm birth at 28-36 weeks' gestation in China, 2003-2008.

    PubMed

    Liang, Juan; Mao, Meng; Dai, Li; Li, Xiaohong; Miao, Lei; Li, Qi; He, Chunhua; Li, Mingrong; Wang, He; Zhu, Jun; Wang, Yanping

    2011-11-01

    Almost all (99%) neonatal deaths occur in developing countries, where the progress in reducing neonatal mortality rates (NMR) has been small; the Millennium Development Goal for child survival cannot be met if this situation continues. China is among the 10 countries that have the largest numbers of neonatal deaths. In order to provide effective interventions to reduce the national NMR for government policy makers, we analyse the trends, causes and characteristics of the neonatal deaths of preterm babies in different regions of China during the period 2003-2008. The data for this retrospective study were retrieved from the population-based Maternal and Child Health Surveillance System of China. The Cochran-Armitage trend test was used to analyse the trend of NMRs due to immaturity. The national NMR due to immaturity has decreased by 38.7% in 6 years. However, the proportion of preterm births among the causes of neonatal death has increased significantly from 33.6% in 2003 to 40.9% in 2008. The relative risk of neonatal death among preterm babies has shown significant regional disparity. In 2008, the adjusted relative risk was 1.30 [95% confidence interval (CI) 0.95, 1.78] in the inland regions and 2.37 [95% CI 1.56, 3.60] in the remote regions, both compared with the coastal regions. The proportion of neonatal deaths with a gestational age <32 weeks or a birthweight <1500 g was highest among the coastal regions. Most neonatal deaths of preterm babies in remote areas were born at home and were not treated before death. Our study suggests that preterm birth is the leading cause of neonatal death in China and neonatal mortality due to immaturity displayed regional differences. The Chinese government should implement major effective strategies for reducing the mortality of preterm infants to further decrease the total NMR. Priority interventions should be region-specific, depending on the availability of economic and health care resources.

  1. Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

    PubMed Central

    2009-01-01

    Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome. PMID:19946536

  2. Maternal Vitamin D Status at Week 30 of Gestation and Offspring Cardio-Metabolic Health at 20 Years: A Prospective Cohort Study over Two Decades

    PubMed Central

    Rytter, Dorte; Bech, Bodil Hammer; Halldorsson, Thorhallur Ingi; Henriksen, Tine Brink; Grandström, Charlotta; Cohen, Arieh; Olsen, Sjurdur Frodi

    2016-01-01

    Background/Objectives Vitamin D deficiency is common among pregnant women and since the fetus relies exclusively on maternal supply, deficiency could potentially interfere with fetal development. Vitamin D blood concentrations during pregnancy have been associated with offspring cardio-metabolic health in a few previous studies but the evidence is still inconsistent and only one previous study has followed the offspring into adulthood. The aim of the present study was to investigate the association between maternal serum concentration of vitamin D (25(OH)D) in week 30 of gestation and offspring cardio-metabolic risk factors at 20 years. Subjects/Methods A follow up study of a Danish birth cohort from 1988–89 (n = 965) was conducted. A blood sample was drawn from the women in week 30 of gestation. In 2008–2009, 95% of the original mother and child dyads could be identified in the central registration registry and were alive and living in Denmark. The offspring were followed up with self-reported anthropometrics (N = 629, 69%) and a clinical examination (N = 410, 45%). Multiple linear regression was used to estimate the association between maternal 25(OH)D and offspring cardio-metabolic risk factors adjusting for potential confounders. Results No overall association was observed between maternal 25(OH)D in week 30 of gestation and offspring cardio-metabolic risk factors. However, the analyses did suggest a possible inverse association with blood pressure in females. Conclusions No clear association between maternal 25(OH)D concentration in week 30 of gestation and cardio-metabolic risk factors in the 20 year old offspring was found. PMID:27764169

  3. Screening for Fetal Spina Bifida Aperta by the Ultrasound and Intracranial Translucency Examinations at 11-13(+6) Weeks of Gestation.

    PubMed

    Liu, Min; Liu, Ying; Li, Zhi-Hong; Yu, Ding

    2015-06-01

    The objective of the study is to evaluate the clinical significance of screening for fetal spina bifida aperta by ultrasound examination and intracranial translucency (IT) measurement at 11-13(+6) weeks of gestation. About 1,479 women at 11-13(+6) weeks of gestation in our hospital in 2012 were included as observation group, and 1,608 women at 11-13(+6) weeks of gestation without IT measurement in 2011 was included as controls. Detection rates of fetal spina bifida aperta in two groups were compared. The translucency thickness between the brain stem and choroid plexus and crown-rump length (CRL) in mid-sagittal view of the fetal face was measured, and translucency thickness and CRL in fetuses with spina bifida and healthy ones were compared. Detection rate of fetal spina bifida aperta in observation group was significantly higher than that in control group (six cases in observation group and one case in control group, p = 0.046). IT thickness was significantly lower in fetuses with spina bifida aperta (0.01 ± 1.25 mm) than that in healthy ones (1.73 ± 0.32 mm) (p < 0.001). There was positive correlation in healthy fetuses between IT thickness and CRL (r = 0.702, p < 0.001), but not in fetuses with spina bifida aperta (r = 0.001, p = 0.081). Ultrasound examination with IT measurement at 11-13(+6) weeks of gestation can be used to screen for fetal spina bifida aperta, and the reduction of IT thickness is an indicator of spina bifida aperta.

  4. IMPORTANCE OF BIRTH WEIGHT AS A RISK FACTOR FOR SEVERE RETINOPATHY OF PREMATURITY WHEN GESTATIONAL AGE IS 30 OR MORE WEEKS

    PubMed Central

    Holzman, Ian R.; Ginsburg, Robin N.; Brodie, Scott E.; Stroustrup, Annemarie

    2015-01-01

    Purpose To determine whether birth weight less than1,500 grams is a relevant guideline indicating the need for examination for retinopathy of prematurity (ROP) when gestational age at birth is 30 or more completed weeks. Design A retrospective observational cohort study. Methods 266 infants in a single institutional neonatal intensive care unit (NICU), whose gestational age at birth was 30 or more weeks but whose birth weight was less than 1,500 grams, were examined according to published guidelines. Infants with lethal congenital anomalies or major ocular abnormalities were excluded. Outcomes were vascularization in retinal zone III without a prior need for treatment, or ROP warranting treatment. Results A study outcome was reached by 212 infants. Two hundred and eleven (99.5%) became vascularized through zone III without needing treatment. Only 1 (0.5%) required treatment for ROP. The 95% confidence interval for the occurrence rate of ROP requiring treatment in this cohort was 0.01 to 2.60%. Conclusion Our results suggest that the occurrence rates of ROP requiring treatment in infants with gestational age 30 or more weeks and birth weight less than 1,500 grams is very low, and could indicate the need to revise examination guidelines for this subgroup of infants. PMID:24582994

  5. [In case of fetal macrosomia, the best strategy is the induction of labor at 38 weeks of gestation].

    PubMed

    Rozenberg, P

    2016-11-01

    Macrosomic fetuses are at increased risk of obstetric complications, and notably shoulder dystocia, responsible for a severe neonatal morbidity. In case of fetal macrosomia, three options are: (i) the elective cesarean delivery, but this is recommended only when the estimated fetal weight is≥4500g for diabetic women and 5000g for non-diabetic women; (ii) the expectative management, but children with birth weight≥4500 had significantly increased risk of perinatal mortality, neonatal asphyxia, trauma, and cesarean delivery; (iii) the induction of labor which, reducing the possibility of fetal growth, reduce the risk of cesarean delivery for cephalopelvic disproportion and shoulder dystocia. As 2 former trials did not show maternal or neonatal benefit with induction of labor for fetal macrosomia, it was therefore not recommended. However, these 2 studies had small sample size (273 and 40 women) and a methodology limiting their ability to show a difference, justifying to achieve a large multicentre randomized controlled trial. This trial was performed by Boulvain et al. and the results published in 2015 in the Lancet. Inclusion criteria were: a singleton pregnancy in cephalic presentation and a suspected fetal macrosomia defined by an ultrasound estimated weight>95th percentile between 36 and 38 weeks. Women were randomly assigned to receive induction of labor within 3 days between 37(+0) and 38(+6) weeks of gestation, or expectant management. Expectant management continued until either spontaneous labour or diagnosis of a condition necessitating induction. The primary outcome was a composite of clinically significant shoulder dystocia, fracture of the clavicle, brachial plexus injury, intracranial haemorrhage, or death. Baseline characteristics were similar between groups. The mean birth weight (±SD) was 3831 (±324) g in the induction group 4118 (±392) g in the expectant group. Induction of labor significantly reduced the risk of shoulder dystocia or

  6. Cesarean scar pregnancy: uterine artery embolization combined with a hysterectomy at 13 weeks' gestation--a case report and review of the literature.

    PubMed

    Kwaśniewska, Anna; Stupak, Aleksandra; Krzyzanowski, Arkadiusz; Pietura, Radoslaw; Kotarski, Jan

    2014-12-01

    A cesarean scar pregnancy is a pregnancy located within the uterine muscle after previous cesarean sections. Recent years have shown a significant increase in the rate of CS and an improvement in the ultrasound diagnosis, and therefore a trend towards an increase in the rate of CSP cases has been reported in many countries. We report on a case of CSP diagnosed using ultrasound at 5/6 weeks'gestation and confirmedbymagnetic resonance imaging. The patient underwent surgical management at 13 weeks, combined with the chemioembolization of the uterine arteries. The current review aims to update the knowledge of the available treatment modalities.

  7. Randomised controlled trial of postnatal sodium supplementation on oxygen dependency and body weight in 25-30 week gestational age infants

    PubMed Central

    Hartnoll, G.; Betremieux, P.; Modi, N.

    2000-01-01

    AIM—To compare the effects of early against delayed sodium supplementation on oxygen dependency and body weight, in preterm infants of 25-30 weeks of gestational age.
METHODS—Infants were stratified by gender and gestation and randomly assigned to receive a sodium intake of 4 mmol/kg/day starting on either the second day after birth or when weight loss of 6% of birthweight was achieved. Daily sodium intake, serum sodium concentration, total fluid intake, energy intake, clinical risk index for babies (CRIB) score and duration of ventilatory support and additional oxygen therapy were recorded. Infants were weighed daily. Weights at 36 weeks and six months of postmenstrual age were also recorded.
RESULTS—Twenty four infants received early, and 22 delayed, sodium supplementation. There were no significant differences in total fluid and energy intake between the two groups. There was a significant difference in oxygen requirement at the end of the first week, with 9% of the early group in air in contrast to 35% of the delayed group (difference 26%, 95% confidence interval 2, 50). At 28 days after birth the proportions were 18% of the early group and 40% of the delayed group (difference 22%, 95% CI −5, 49). Proportional hazards modelling showed early sodium supplementation and lower birthweight to be significantly associated with increased risk of continuing oxygen requirement. The delayed sodium group had a greater maximum weight loss (delayed 16.1%; early 11.4%, p=0.02), but there were no significant differences in time to maximum weight loss, time to regain birthweight, and weight at 36 weeks and 6months of postmenstrual age.
CONCLUSION—In infants below 30 weeks of gestation, delaying sodium supplementation until at least 6% of birthweight is lost has a beneficial effect on the risk of continuing oxygen requirement and does not compromise growth.

 PMID:10634836

  8. Three-dimensional reconstruction and morphologic measurements of human embryonic hearts: a new diagnostic and quantitative method applicable to fetuses younger than 13 weeks of gestation

    PubMed Central

    Schleich, Jean-Marc; Dillenseger, Jean-Louis; Loeuillet, Laurence; Moulinoux, Jacques-Philippe; Almange, Claude

    2005-01-01

    Improvements in the diagnosis of congenital malformations explain the increasing early termination of pregnancies. Before 13 weeks of gestation, an accurate in vivo anatomical diagnosis cannot currently be made in all fetuses with the imaging instrumentation available. Anatomo-pathological examinations remain the gold standard to make accurate diagnoses, although they reach limits between 9 and 13 weeks of gestation. We present the first results of a methodology that can be applied routinely, using standard histological section, enabling the reconstruction, visual estimate and quantitative analysis of 13 weeks of age human embryonic cardiac structures. The cardiac blocks were fixed, included in paraffin and entirely sliced by a microtome. One slice out of 10 was topographically colored and digitized on an optical microscope. The cardiac volume was recovered by a semi-automatic realignment of the sections. Another semi-automatic procedure allowed extracting and labeling of the cardiac structures from the volume. The structures were studied with display tools, disclosing the internal and external cardiac components, and enabling the determination of size, thickness and precise position of the ventricles, atria and large vessels. This pilot study confirmed that a new 3-D reconstruction and visualization method enabled to make accurate diagnoses, including in embryos <13 weeks old. Its implementation at earlier stages of embryogenesis will provide a clearer view of cardiac development. PMID:16211458

  9. Amniotic Fluid Infection, Cytokine Levels, and Mortality and Adverse Pulmonary, Intestinal, and Neurologic Outcomes in Infants at 32 Weeks' Gestation or Less

    PubMed Central

    2017-01-01

    To what extent the risks of neonatal morbidities are directly related to premature birth or to biological mechanisms of preterm birth remains uncertain. We aimed to examine the effect of exposure to amniotic fluid (AF) infection and elevated cytokine levels on the mortality and pulmonary, intestinal, and neurologic outcomes of preterm infants, and whether these associations persist after adjustment for gestational age at birth. This retrospective cohort study included 152 premature singleton infants who were born at ≤ 32 weeks. AF obtained by amniocentesis was cultured; and interleukin-6 (IL-6) and IL-8 levels in AF were determined. The primary outcome was adverse perinatal outcome defined as the presence of one or more of the followings: stillbirth, neonatal death, bronchopulmonary dysplasia, necrotizing enterocolitis, intraventricular hemorrhage, and periventricular leukomalacia. Logistic regression analysis was adjusted for gestational age at birth and other potential confounders. In bivariate analyses, elevated AF IL-6 and IL-8 levels were significantly associated with adverse perinatal outcome. These results were not changed after adjusting for potential confounders, such as low Apgar scores, mechanical ventilation, and surfactant application. However, the independent effect of elevated cytokine levels in AF disappeared when additionally adjusted for low gestational age at birth; consequently, low gestational age remained strongly associated with the risk of adverse perinatal outcome. In conclusion, elevated levels of pro-inflammatory cytokines in AF are associated with increased risk of adverse perinatal outcomes, but this risk is not independent of low gestational age at birth. Culture-proven AF infection is not associated with this risk. PMID:28145652

  10. [Recommendations for the use of palivizumab in the prevention of respiratory syncytial virus infection in late preterm infants (32(1) to 35(0) weeks of gestation)].

    PubMed

    Figueras Aloy, J; Carbonell Estrany, X

    2010-08-01

    Late preterm infants (32(1) to 35(0) weeks gestation) aged less than 6 months at start of RSV station or discharged during this time may benefit from RSV monoclonal antibodies (palivizumab) administration to decrease the rates of RSV hospitalization. The Spanish Society of Neonatology considers, based on FLIP2 results in Spain, that palivizumab prophylaxis is strongly recommended if the "2 major risk factors" are present (chronological age less than 10 weeks at start of RSV season or being born during its first 10 weeks; sibling of school age or attending day-care assistance). Palivizumab is also recommended when "1 major risk factor and the 2 minor risk factors" are present. Minor risk factors are: mother smoking during pregnancy and being a male.

  11. Panel Recommends State-Level NAEP for 12th Graders

    ERIC Educational Resources Information Center

    Olson, Lynn

    2004-01-01

    A national commission formed to review the future of the 12th grade National Assessment of Educational Progress (NAEP) has recommended that the nation's primary barometer of student performance should expand dramatically to provide mandatory state results on the achievement of 12th graders and to measure their readiness for college, employment,…

  12. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report

    PubMed Central

    Pakniat, Hamideh; Soofizadeh, Nasrin; Khezri, Marzieh Beigom

    2016-01-01

    Background: Uterine rupture in pregnancy is rare and often could be life threatening and catastrophic. Myomectomy is one of very common surgeries in gynecology, performed as the vaginal, abdominal and laparoscopic surgeries. Pregnancies occured after abdominal and laparoscopic myomectomy are high risk for uterine rapture. Case: Patient was a 28 Years old female, pregnant woman at the 20 wks of gestational age with abdominal pain and a history of abdominal myomectomy 6 yrs ago. Uterus was ruptured and fetus in amniotic sac was found in abdominal cavity. Conclusion: Early diagnosis of uterine rupture after myomectomy can save patients from death. PMID:27525334

  13. A case of a surviving co-twin diagnosed with porencephaly and renal hypoplasia after a single intrauterine fetal death at 21 weeks of gestation in a monochorionic monoamniotic twin pregnancy.

    PubMed

    Machino, Hidenori; Iriyama, Takayuki; Nakayama, Toshio; Komatsu, Atsushi; Nagamatsu, Takeshi; Osuga, Yutaka; Fujii, Tomoyuki

    2017-01-01

    Monochorionic monoamniotic (MM) twin pregnancy carries a high risk of intrauterine fetal death (IUFD). Single IUFD in an MM twin pregnancy prior to 22 weeks of gestation has been reported to be strongly correlated with double twin demise. To our knowledge, there are no case reports on the natural course of a surviving co-twin in an MM twin pregnancy resulting in live birth after a single IUFD prior to 22 weeks of gestation. Here, we report a case of a surviving co-twin, after a single IUFD at 21 weeks of gestation in a MM twin pregnancy, with an antenatal diagnosis of renal hypoplasia and severe neurological damage leading to porencephaly, and live birth at 36 weeks of gestation.

  14. A case of a surviving co-twin diagnosed with porencephaly and renal hypoplasia after a single intrauterine fetal death at 21 weeks of gestation in a monochorionic monoamniotic twin pregnancy

    PubMed Central

    Machino, Hidenori; Iriyama, Takayuki; Nakayama, Toshio; Komatsu, Atsushi; Nagamatsu, Takeshi; Osuga, Yutaka; Fujii, Tomoyuki

    2017-01-01

    Monochorionic monoamniotic (MM) twin pregnancy carries a high risk of intrauterine fetal death (IUFD). Single IUFD in an MM twin pregnancy prior to 22 weeks of gestation has been reported to be strongly correlated with double twin demise. To our knowledge, there are no case reports on the natural course of a surviving co-twin in an MM twin pregnancy resulting in live birth after a single IUFD prior to 22 weeks of gestation. Here, we report a case of a surviving co-twin, after a single IUFD at 21 weeks of gestation in a MM twin pregnancy, with an antenatal diagnosis of renal hypoplasia and severe neurological damage leading to porencephaly, and live birth at 36 weeks of gestation. PMID:28116109

  15. Gestational Gigantomastia

    PubMed Central

    Türkan, Halil; Gökgöz, M. Şehsuvar; Taşdelen, İsmet; Dündar, Halit Ziya

    2016-01-01

    Gestational gigantomastia is a rare condition characterized by fast, disproportionate and excessive breast growth, decreased quality of life in pregnancy, and presence of psychologic as well as physical complications. The etiology is not fully understood, although hormonal changes in pregnancy are considered responsible. Prolactin is the most important hormone. To date, 125 cases of gigantomastia have been reported in the literature. In this case presentation, we report a pregnant woman aged 26 years with a 22-week gestational age with gestational gigantomastia and review the diagnosis and treatment of this rare disease in relation with the literature.

  16. The posterior part of the human cerebral arterial circle (CAC): arterial caliber from gestational weeks 13 to 24

    PubMed Central

    Vasović, Ljiljana P; Jovanović, Ivan D; Ugrenović, Sladjana Z; Anđelković, Zlatibor P

    2007-01-01

    Numerous studies have reported that all components of the cerebral arterial circle in the 4-month-old human fetus are more slender than adult vessels, and of equal caliber. After that period, a degree of caliber differentiation is present, especially at the level of the posterior communicating arteries. The aim of this study was to determine arterial diameters in the posterior part of the fetal cerebral arterial circle from the 4th month (IV) to the 6th (VI). One hundred and seventy-two fetal cerebral arterial circles were examined by means of a surgical microscope. It was determined that average diameters of the left (right) pre-communicating parts of the posterior cerebral artery ranged from 0.30 ± 0.03 (0.29 ± 0.02) mm in month IV, to 0.36 ± 0.04 (0.36 ± 0.03) mm during month V and up to 0.55 ± 0.22 (0.50 ± 0.18) mm in month VI. The average diameters of the left (right) posterior communicating artery ranged from 0.24 ± 0.02 mm (0.25 ± 0.02) in month IV, to 0.30 ± 0.03 mm (0.29 ± 0.05) during month V and up to 0.38 ± 0.08 (0.44 ± 0.10) in month VI. Gender differences between posterior cerebral artery and posterior communicating artery diameters were not significant. Average posterior cerebral artery diameters were significantly larger than posterior communicating artery diameters in months IV and V, but not in month VI. It was established that caliber differentiation in the posterior part of the cerebral arterial circle began from gestational month IV, and that gender differences in arterial diameters were not significant until month VI of gestation. PMID:17784935

  17. Newly diagnosed hyperthyroidism in the 25th gestational week of pregnancy presenting with systolic arterial hypertension only.

    PubMed

    Zaveljcina, Janez; Legan, Mateja; Gaberšček, Simona

    2016-05-01

    We present a case of a 30-year-old woman diagnosed with arterial hypertension in the 25th week of pregnancy. Our search for secondary causes of arterial hypertension revealed hyperthyroid Hashimoto's thyroiditis (HT), which was treated with propilthiouracil. Three weeks after delivery, she was normotensive without medication. In the next four months, she developed hypothyroidism and treatment with L-thyroxine was started. In conclusion, in the second half of pregnancy, a hyperthyroid HT can occur - in spite of the well-known amelioration of autoimmune thyroid disorders in that period, and can be the only cause of arterial hypertension.

  18. Effect of creatine supplementation during the last week of gestation on birth intervals, stillbirth, and preweaning mortality in pigs.

    PubMed

    Vallet, J L; Miles, J R; Rempel, L A

    2013-05-01

    We hypothesized that creatine supplementation would reduce birth intervals, stillbirth rate, and preweaning survival in pigs because of its reported improvement of athletic performance in humans. In Exp. 1, gilts (n = 42) and first parity sows (n = 75) were mated at estrus. Beginning on d 110 of gestation, dams received either no treatment or 20 g creatine daily until farrowing. At farrowing in November 2008, pigs were monitored by video camera to determine individual piglet birth intervals. On d 1, piglets were weighed, euthanized, and the cerebellum, brain stem, and spinal cord were collected from the largest and smallest piglets in each litter to measure myelin basic proteins, myelin cholesterol, glucocerebrosides, phosphatidylethanolamine, phosphatidylcholine, and sphingomyelin. Preweaning mortality of the remaining piglets was recorded, including whether a piglet had been overlayed by the dam. A second experiment was performed using gilts (n = 90), farrowing in July 2010, to test differential effects of creatine supplementation during hot, humid weather when dams typically have more difficulty farrowing. Once again, gilts were provided either no supplementation or 20 g creatine daily from d 110 to the day of farrowing. Gilts were video recorded during farrowing, piglets were weighed on d 1, and preweaning mortality (including overlays) was recorded. In Exp. 1, creatine supplementation had no effect on birth intervals or stillbirth rate. Creatine supplementation improved the amount of myelin lipids in brain regions of piglets, particularly the brain stem. Creatine supplementation also reduced overlays of low birth weight piglets from gilts but not second parity sows. Data from Exp. 2 were combined with gilt data from Exp. 1 to examine the effect of creatine, season, and their interaction. There were no effects of treatment or season on birth intervals, stillbirth rates, or overall preweaning mortality. Creatine treatment reduced the incidence of overlays in low

  19. Prenatal MRI Diagnosis of Hirschsprung's Disease at 29 Weeks' Gestational Age in a Fetus with Heterotaxy and Polysplenia Syndrome.

    PubMed

    Meyers, Mariana L; Crombleholme, Timothy

    2016-01-01

    Prenatal diagnosis of Hirschsprung's disease is extremely rare and has only been suggested by ultrasound. This report presents a 29-week fetus with heterotaxy and polysplenia syndrome and prenatal diagnosis of nonrotation of the bowel and Hirschsprung's disease by fetal MRI. None of the previously reported findings in the literature suggestive of distal bowel obstruction were noted in this case. Rather, there was a diminutive size of the rectosigmoid compared to the rest of the colon. Fetal MRI has become an important tool in the fetal diagnosis of multiple anomalies and can aid in perinatal and immediate postnatal care of patients, such as those with Hirschsprung's disease.

  20. Surface rendering of external genitalia of a fetus at the 32nd week of gestation affected by partial androgen insensitivity syndrome.

    PubMed

    Mazza, Vincenzo; Bertucci, Emma; Latella, Silvia; Cani, Carlotta; Ceccarelli, Pierluca; Iughetti, Lorenzo; Baldinotti, Fulvia; Percesepe, Antonio

    2013-01-01

    Objectives. To demonstrate the feasibility of the prenatal diagnosis of partial androgen insensitivity syndrome by 3D-4D ultrasound. Methods. To report prenatal diagnosis of partial androgen insensitivity syndrome at 32nd week of gestation by 3D-4D ultrasound in a fetus with a 46XY karyotype, testing negative to the mutation analysis of SRY gene and the 5 α -reductase 2 gene (SRD5A2). Results. 3D-4D surface rendering allows the detection of external and internal genital malformations and can address the prenatal diagnosis of PAIS and can exclude associated complications. Conclusions. Prenatal diagnosis of PAIS allows an adequate parental counseling and an early optimal management of the condition, not only for the psychological and social reflections but also for the avoidance of complications and postnatal morbidity due to misdiagnosis or delays in the treatment of the genital ambiguity.

  1. Case with a Nonreassuring Fetal Status Induced by Massive Hematemesis due to Mallory-Weiss Tear That Required Emergency Cesarean Section at 38 Weeks' Gestation

    PubMed Central

    Suzuki, Takashi; Wagata, Maiko; Konno, Hiroko; Ito, Takahiro; Torii, Yuichi; Murakoshi, Takeshi

    2015-01-01

    We describe a rare case of Mallory-Weiss tear with massive hematemesis at 38 weeks' gestation. A 35-year-old woman presented with epigastralgia followed by massive hematemesis. An emergency endoscopy indicated active pulsatile bleeding at the esophagocardial junction. Although an emergency endoscopic hemostasis was successful, late decelerations without acceleration on cardiotocogram were observed. Therefore, the patient underwent emergency cesarean section, along with blood transfusion, following the endoscopic hemostasis. The hemoglobin level just before the operation was 5.1 g/dL. We suspected that massive hematemesis induced maternal acute anemia and hypovolemia, which resulted in a nonreassuring fetal status. Hence, urgent endoscopic hemostasis, adequate blood transfusion, and emergency cesarean section were needed. Mallory-Weiss tear during the third trimester may have a possibility of massive hematemesis and urgent blood transfusion, emergency endoscopic hemostasis, and emergency cesarean section may be needed. PMID:26881157

  2. Relations of plasma polyunsaturated Fatty acids with blood pressures during the 26th and 28th week of gestation in women of Chinese, Malay, and Indian ethnicity.

    PubMed

    Lim, Wai-Yee; Chong, Mary; Calder, Philip C; Kwek, Kenneth; Chong, Yap-Seng; Gluckman, Peter D; Godfrey, Keith M; Saw, Seang-Mei; Pan, An

    2015-03-01

    Observational and intervention studies have reported inconsistent results of the relationship between polyunsaturated fatty acids (PUFAs) and hypertension during pregnancy. Here, we examined maternal plasma concentrations of n-3 and n-6 PUFAs between the 26th and the 28th week of gestation in relation to blood pressures and pregnancy-associated hypertension.We used data from a birth cohort study of 751 Chinese, Malay, and Indian women. Maternal peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken from the brachial arm, and central SBP and pulse pressures (PPs) were derived from radial artery pressure waveforms between the 26th and the 28th week of gestation. Pregnancy-associated hypertension (including gestational hypertension and preeclampsia) was ascertained from medical records. Plasma phosphatidylcholine n-3 and n-6 PUFAs were measured by gas chromatography and expressed as percentage of total fatty acids.Peripheral SBP was inversely associated with total n-3 PUFAs [-0.51 (95% confidence interval, CI, -0.89 to -0.13) mm Hg] and long-chain n-3 PUFAs [-0.52 (CI -0.92 to -0.13) mmHg]. Similar but weaker associations were observed for central SBP and PP. Dihomo-γ-linolenic acid was marginally positively associated with peripheral SBP, central SBP, and PP, whereas linoleic acid and total n-6 PUFAs showed no significant associations with blood pressures. We identified 28 pregnancy-associated hypertension cases, and 1% increase in total n-3 PUFAs was associated with a 24% lower odds of pregnancy-associated hypertension (odds ratio 0.76; 95% CI 0.60 to 0.97). Maternal ethnicity modified the PUFAs-blood pressure relations, with stronger inverse associations with n-3 PUFAs in Chinese women, and stronger positive associations with n-6 PUFAs in Indian women (P values for interaction ranged from 0.02 to 0.07).Higher n-3 PUFAs at midgestation are related to lower maternal blood pressures and pregnancy-associated hypertension in Asian women

  3. Relations of Plasma Polyunsaturated Fatty Acids With Blood Pressures During the 26th and 28th Week of Gestation in Women of Chinese, Malay, and Indian Ethnicity

    PubMed Central

    Lim, Wai-Yee; Chong, Mary; Calder, Philip C.; Kwek, Kenneth; Chong, Yap-Seng; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang-Mei; Pan, An

    2015-01-01

    Abstract Observational and intervention studies have reported inconsistent results of the relationship between polyunsaturated fatty acids (PUFAs) and hypertension during pregnancy. Here, we examined maternal plasma concentrations of n-3 and n-6 PUFAs between the 26th and the 28th week of gestation in relation to blood pressures and pregnancy-associated hypertension. We used data from a birth cohort study of 751 Chinese, Malay, and Indian women. Maternal peripheral systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken from the brachial arm, and central SBP and pulse pressures (PPs) were derived from radial artery pressure waveforms between the 26th and the 28th week of gestation. Pregnancy-associated hypertension (including gestational hypertension and preeclampsia) was ascertained from medical records. Plasma phosphatidylcholine n-3 and n-6 PUFAs were measured by gas chromatography and expressed as percentage of total fatty acids. Peripheral SBP was inversely associated with total n-3 PUFAs [−0.51 (95% confidence interval, CI, −0.89 to −0.13) mm Hg] and long-chain n-3 PUFAs [−0.52 (CI −0.92 to −0.13) mmHg]. Similar but weaker associations were observed for central SBP and PP. Dihomo-γ-linolenic acid was marginally positively associated with peripheral SBP, central SBP, and PP, whereas linoleic acid and total n-6 PUFAs showed no significant associations with blood pressures. We identified 28 pregnancy-associated hypertension cases, and 1% increase in total n-3 PUFAs was associated with a 24% lower odds of pregnancy-associated hypertension (odds ratio 0.76; 95% CI 0.60 to 0.97). Maternal ethnicity modified the PUFAs–blood pressure relations, with stronger inverse associations with n-3 PUFAs in Chinese women, and stronger positive associations with n-6 PUFAs in Indian women (P values for interaction ranged from 0.02 to 0.07). Higher n-3 PUFAs at midgestation are related to lower maternal blood pressures and pregnancy

  4. Fetal outcome of trisomy 18 diagnosed after 22 weeks of gestation: Experience of 123 cases at a single perinatal center.

    PubMed

    Nagase, Hiromi; Ishikawa, Hiroshi; Toyoshima, Katsuaki; Itani, Yasufumi; Furuya, Noritaka; Kurosawa, Kenji; Hirahara, Fumiki; Yamanaka, Michiko

    2016-01-01

    To investigate the pregnancy outcome of the fetuses with trisomy 18, we studied 123 cases of trisomy 18 who were born at our hospital from 1993 to 2009. Among them, 95.9% were diagnosed with trisomy 18 prenatally. Prenatal ultrasound findings showed fetal growth restriction in 77.2%, polyhydramnios in 63.4% and congenital heart defects in 95.1%. For 18 cases, cesarean section (C-section) was chosen, and for 75 cases, transvaginal delivery was chosen. Premature delivery occurred in 35.5%. Stillbirths occurred in 50 cases (40.7%). Fetal demise before onset of labor occurred in 30 cases and fetal demise during labor occurred in 20 cases which was 26.7% of vaginal deliveries. Among the 73 live-born infants, the survival rate for 24 h, 1 week, 1 month and 1 year were 63%, 43%, 33% and 3%. The median survival time was 3.5 days. There was no significant difference between the survival time of C-section and that of vaginal delivery. However, for the births involving breech presentation, the survival time of C-section was significantly longer than that of vaginal delivery. When the fetus is diagnosed with trisomy 18, the parents have to make many choices. These findings constitute critical information in prenatal counseling to the couples whose fetuses have been found to have trisomy 18, especially when they choose palliative approaches in the perinatal management.

  5. Spontaneous uterine rupture at 14 weeks gestation during a pregnancy consecutive to an oocyte donation in a woman with Turner's syndrome.

    PubMed

    Masia, Florent; Zoric, Lana; Ripart-Neveu, Sylvie; Marès, Pierre; Ripart, Jacques

    2015-04-01

    We describe a spontaneous uterine rupture at 14 weeks gestation in a Turner patient. A 39 year-old patient was admitted for abdominal pain and hypotension at 14 weeks of pregnancy. The pregnancy had been obtained by oocyte donation and in vitro fertilization (IVF) because of Turner's syndrome. The abdominal ultrasound scan showed a normal pregnancy and a conserved foetal cardiac activity. It also showed a large amount of free fluid in the perihepatic space. Haemoglobin was 11.2 g/dL. After hemodynamic degradation, urgent laparoscopy showed an unrepairable uterine rupture with partial exteriorisation of the pregnancy, and placenta percreta. Urgent conversion to laparotomy allowed haemostatic hysterectomy. Uterine rupture during pregnancy obtained by oocyte donation in Turner's syndrome may be life threatening. The possibility of such a complication should be considered before oocyte donation for IVF in Turner's patients. Early spontaneous uterine rupture (second trimester) is a challenging diagnostic that should be evoked in case of non-specific abdominal pain in the presence of risk factors.

  6. High concentration of vitamin E supplementation in sow diet during the last week of gestation and lactation affects the immunological variables and antioxidative parameters in piglets.

    PubMed

    Wang, Lin; Xu, Xiaodong; Su, Ge; Shi, Baoming; Shan, Anshan

    2017-02-01

    An experiment was conducted to investigate the effects of a high concentration of vitamin E supplementation in sow diet during the last week of gestation and lactation on the performance, milk composition, and vital immunological variables and antioxidative parameters in sows and piglets. The experiment started on day 107 of gestation and lasted until the piglets were weaned on day 21 of lactation. 48 sows were divided into two groups and fed either a basal diet with 44 IU/kg of vitamin E or a basal diet supplemented with additional vitamin E, total content of 250 IU/kg. Sow milk and blood samples were obtained on day 0 (farrowing) and on day 21 of lactation. One 21-day-old piglet per litter was selected to collect plasma. Results showed that supplementation of the maternal diet with 250 IU/kg vitamin E improved the average daily gain (ADG) and weaning weight of piglets (P < 0·05), and the concentrations of immunoglobulin G (IgG) and immunoglobulin A (IgA) in sow plasma, colostrum and milk. The concentrations of fat in the colostrum and milk were significantly increased by supplementation with 250 IU/kg of vitamin E (P < 0·05). The level of plasma IgG, IgA, total antioxidant capacity (T-AOC) and catalase (CAT) were all higher (P < 0·05) in piglets from sows that were fed 250 IU/kg of vitamin E than in those from the control group. The high concentration of vitamin E supplementation to the sows enhanced the concentrations of α-tocopherol in the sow milk and plasma as well as piglet plasma (P < 0·05). In conclusion, the addition to the maternal diet of vitamin E at high concentration improved the weight of piglets at weaning, and enhanced humoral immune function and antioxidant activity in sows and piglets.

  7. The 12th Annual Pharmacogenetics in Psychiatry meeting report.

    PubMed

    Zhang, Jian-Ping; Aitchison, Katherine J; Malhotra, Anil K

    2014-10-01

    The 12th Annual Pharmacogenetics in Psychiatry meeting was held in Hollywood, Florida, from 31 May to 1 June 2013, in conjunction with the NCDEU meeting. It included a series of oral presentations as well as a poster session. This report summarizes the presentations at the conference.

  8. Reflections on the 12th International Transformative Learning Conference

    ERIC Educational Resources Information Center

    Schapiro, Steven A.; Gallegos, Placida V.; Stashower, Keren; Clark, Donna F.

    2017-01-01

    This article is a reflective essay that explores the question: What can the content and experience of the conference tell us about the state of theory and practice in the field of TL; where is it today and where it may be going in the future? The 12th International Transformative Learning Conference (ITLC) held October 19-23 at Pacific Lutheran…

  9. Gestational age

    MedlinePlus

    Fetal age - gestational age; Gestation; Neonatal gestational age; Newborn gestational age ... Gestational age can be determined before or after birth. Before birth, your health care provider will use ultrasound to ...

  10. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks׳ gestation in nulliparous women who subsequently develop preeclampsia.

    PubMed

    Mistry, Hiten D; Gill, Carolyn A; Kurlak, Lesia O; Seed, Paul T; Hesketh, John E; Méplan, Catherine; Schomburg, Lutz; Chappell, Lucy C; Morgan, Linda; Poston, Lucilla

    2015-01-01

    Preeclampsia is a pregnancy-specific condition affecting 2-7% of women and a leading cause of perinatal and maternal morbidity and mortality. Deficiencies of specific micronutrient antioxidant activities associated with copper, selenium, zinc, and manganese have previously been linked to preeclampsia at the time of disease. Our aims were to investigate whether maternal plasma micronutrient concentrations and related antioxidant enzyme activities are altered before preeclampsia onset and to examine the dependence on genetic variations in these antioxidant enzymes. Predisease plasma samples (15±1 weeks׳ gestation) were obtained from women enrolled in the international Screening for Pregnancy Endpoints (SCOPE) study who subsequently developed preeclampsia (n=244) and from age- and BMI-matched normotensive controls (n=472). Micronutrient concentrations were measured by inductively coupled plasma mass spectrometry; associated antioxidant enzyme activities, selenoprotein-P, ceruloplasmin concentration and activity, antioxidant capacity, and markers of oxidative stress were measured by colorimetric assays. Sixty-four tag-single-nucleotide polymorphisms (SNPs) within genes encoding the antioxidant enzymes and selenoprotein-P were genotyped using allele-specific competitive PCR. Plasma copper and ceruloplasmin concentrations were modestly but significantly elevated in women who subsequently developed preeclampsia (both P<0.001) compared to controls (median (IQR), copper, 1957.4 (1787, 2177.5) vs 1850.0 (1663.5, 2051.5) µg/L; ceruloplasmin, 2.5 (1.4, 3.2) vs 2.2 (1.2, 3.0) µg/ml). There were no differences in other micronutrients or enzymes between groups. No relationship was observed between genotype for SNPs and antioxidant enzyme activity. This analysis of a prospective cohort study reports maternal micronutrient concentrations in combination with associated antioxidant enzymes and SNPs in their encoding genes in women at 15 weeks׳ gestation that subsequently

  11. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks׳ gestation in nulliparous women who subsequently develop preeclampsia

    PubMed Central

    Mistry, Hiten D.; Gill, Carolyn A.; Kurlak, Lesia O.; Seed, Paul T.; Hesketh, John E.; Méplan, Catherine; Schomburg, Lutz; Chappell, Lucy C.; Morgan, Linda; Poston, Lucilla

    2015-01-01

    Preeclampsia is a pregnancy-specific condition affecting 2–7% of women and a leading cause of perinatal and maternal morbidity and mortality. Deficiencies of specific micronutrient antioxidant activities associated with copper, selenium, zinc, and manganese have previously been linked to preeclampsia at the time of disease. Our aims were to investigate whether maternal plasma micronutrient concentrations and related antioxidant enzyme activities are altered before preeclampsia onset and to examine the dependence on genetic variations in these antioxidant enzymes. Predisease plasma samples (15±1 weeks׳ gestation) were obtained from women enrolled in the international Screening for Pregnancy Endpoints (SCOPE) study who subsequently developed preeclampsia (n=244) and from age- and BMI-matched normotensive controls (n=472). Micronutrient concentrations were measured by inductively coupled plasma mass spectrometry; associated antioxidant enzyme activities, selenoprotein-P, ceruloplasmin concentration and activity, antioxidant capacity, and markers of oxidative stress were measured by colorimetric assays. Sixty-four tag–single-nucleotide polymorphisms (SNPs) within genes encoding the antioxidant enzymes and selenoprotein-P were genotyped using allele-specific competitive PCR. Plasma copper and ceruloplasmin concentrations were modestly but significantly elevated in women who subsequently developed preeclampsia (both P<0.001) compared to controls (median (IQR), copper, 1957.4 (1787, 2177.5) vs 1850.0 (1663.5, 2051.5) µg/L; ceruloplasmin, 2.5 (1.4, 3.2) vs 2.2 (1.2, 3.0) µg/ml). There were no differences in other micronutrients or enzymes between groups. No relationship was observed between genotype for SNPs and antioxidant enzyme activity. This analysis of a prospective cohort study reports maternal micronutrient concentrations in combination with associated antioxidant enzymes and SNPs in their encoding genes in women at 15 weeks׳ gestation that subsequently

  12. Cord pilot trial - immediate versus deferred cord clamping for very preterm birth (before 32 weeks gestation): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Preterm birth is the most important single determinant of adverse outcome in the United Kingdom; one in every 70 babies (1.4%) is born before 32 weeks (very preterm), yet these births account for over half of infant deaths. Deferring cord clamping allows blood flow between baby and placenta to continue for a short time. This often leads to increased neonatal blood volume at birth and may allow longer for transition to the neonatal circulation. Optimal timing for clamping the cord remains uncertain, however. The Cochrane Review suggests that deferring umbilical cord clamping for preterm births may improve outcome, but larger studies reporting substantive outcomes and with long-term follow-up are needed. Studies of the physiology of placental transfusion suggest that flow in the umbilical cord at very preterm birth may continue for several minutes. This pilot trial aims to assess the feasibility of conducting a large randomised trial comparing immediate and deferred cord clamping in the UK. Methods/Design Women are eligible for the trial if they are expected to have a live birth before 32 weeks gestation. Exclusion criteria are known monochorionic twins or clinical evidence of twin-twin transfusion syndrome, triplet or higher order multiple pregnancy, and known major congenital malformation. The interventions will be cord clamping within 20 seconds compared with cord clamping after at least two minutes. For births with cord clamping after at least two minutes, initial neonatal care is at the bedside. For the pilot trial, outcomes include measures of recruitment, compliance with the intervention, retention of participants and data quality for the clinical outcomes. Information about the trial is available to women during their antenatal care. Women considered likely to have a very preterm birth are approached for informed consent. Randomisation is close to the time of birth. Follow-up for the women is for one year, and for the children to two years of

  13. PREFACE 12th International Workshop on Slow Positron Beam Techniques

    NASA Astrophysics Data System (ADS)

    Buckman, Stephen; Sullivan, James; White, Ronald

    2011-01-01

    Preface These proceedings arose from the 12th International Workshop on Slow Positron Beam Techniques (SLOPOS12), which was held on Magnetic Island, North Queensland, Australia, between 1-6th August 2010. Meetings in the SLOPOS series are held (roughly) every three years and have now been held on (almost) all continents, indicating the truly international nature of the field. SLOPOS12 marked the second time that the Workshop had been held in the southern hemisphere, and the first time in Australia. SLOPOS12 attracted 122 delegates from 16 countries. Most encouraging was the attendance of 28 student delegates, and that about half of the overall delegates were early career researchers - a good sign for the future of our field. We also enjoyed the company of more than a dozen partners and families of delegates. In a slight departure from previous SLOPOS meetings, the International Advisory Committee approved a broader scope of scientific topics for inclusion in the program for the 2010 Workshop. This broader scope was intended to capture the applications of positrons in atomic, molecular and biomedical areas and was encapsulated in the byeline for SLOPOS-12: The 12th International Workshop on Slow Positron Beam Techniques for Solids, Surfaces, Atoms and Molecules. The scientific and social program for the meeting ran over 6 days with delegates gathering on Sunday August 1st and departing on August 6th. The scientific program included plenary, invited, contributed and student lectures, the latter being the subject of a student prize. In all there were 53 oral presentations during the week. There were also two poster sessions, with 63 posters exhibited, and a prize was awarded for the best poster by a student delegate. The standard of the student presentations, both oral and posters, was outstanding, so much so that the judging panel recommended an additional number of prizes be awarded. Topics that were the focus of invited presentations and contributed papers at

  14. Is there a trans-abdominal testicular descent during the second gestational trimester? Study in human fetuses between 13 and 23 weeks post conception

    PubMed Central

    Favorito, Luciano A.; Bernardo, Fabio O.; Costa, Suelen F.; Sampaio, Francisco J. B.

    2016-01-01

    ABSTRACT Objectives To confirm if a real inner descend of testis occurs, correlating the testicular position with fetal parameters and analyzing the position of the testes relative to the internal ring. Material and Methods Twenty nine human fetuses between 13 and 23 weeks post conception (WPC) were studied. The fetuses were carefully dissected with the aid of a stereoscopic lens with 16/25X magnification and testicular position observed. With the aid of a digital pachymeter the distance between the lower pole of the kidney and the upper extremity of the testis (DK-T) was measured to show the position of the testis. During the dissection we also indicated the position of the testes relative to the internal ring. Means were statistically compared using simple linear regression and the paired T-test. Results The 58 testes had abdominal position. The DK-T in the right side measured between 0.17 and 1.82cm (mean=0.79cm) and in the left side it was between 0.12 and 1.84cm (mean=0.87cm), without statistically differences (p=0.0557). The linear regression analysis indicated that DK-T in both sides correlated significantly and positively with fetal age. All fetuses with more than 20 WPC, heavier than 350g and with CRL over 22cm had a greater distance than the average DK-T. We xobserved that the 58 testis remains adjacent to the internal ring throughout the period studied. Conclusions The testes remains adjacent to the internal ring throughout the period studied, indicating that there is no real trans-abdominal testicular descent during the second gestational trimester. PMID:27286121

  15. The effect of head covering in prevention of phototherapy-induced hypocalcemia in icterus newborns with gestational age less than 35 weeks

    PubMed Central

    Barekatain, Behzad; Badiea, Zohrea; Hoseini, Neda

    2016-01-01

    Background: Hypocalcemia is one of the complications of phototherapy resulted from influence of phototherapy in melatonin secretion reducing corticosterone and ultimately increasing bone uptake. In this study, effect of head covering in prevention of this common and serious complication is studied. Materials and Methods: This prospective, randomized clinical trial study conducted on premature infants with gestational age <35 weeks with jaundice. Infants were divided into two groups (n = 43). The first group (intervention group) and the second group (control group) while on the cut, underwent phototherapy using four blue fluorescent lamps in distance of 35 cm. Eyes and genitalia were protected using appropriate clothing. In the first group, head was covered using cloth helmet with a suitable size. For both groups, serum calcium was measured before and 36 h after starting phototherapy. Results: Mean serum calcium before phototherapy in both intervention and control groups was 8.72 ± 1.12 and 8.79 ± 0.87 mg/dL, respectively, and the difference between groups was not significant (P = 0.76). After treatment, calcium level in both intervention and control groups was 8.9 ± 0.82 and 8.43 ± 0.91, respectively, and the difference between the two groups was significant (P = 0.015). Mean serum calcium levels after phototherapy in the intervention group was −0.17 ± 1.46 (increase) and it was 0.35 ± 0.71 (decrease) in the control group. According to t-test, the difference between the two groups was significant (P = 0.036). Conclusion: Head covering during phototherapy probably prevents from hypocalcemia. PMID:28028516

  16. Early fetal gender determination using real-time PCR analysis of cell-free fetal DNA during 6th-10th weeks of gestation.

    PubMed

    Khorram Khorshid, Hamid Reza; Zargari, Maryam; Sadeghi, Mohammad Reza; Edallatkhah, Haleh; Shahhosseiny, Mohammad Hassan; Kamali, Koorosh

    2013-05-07

    Nowadays, new advances in the use of cell free fetal DNA (cffDNA) in maternal plasma of pregnant women has provided the possibility of applying cffDNA in prenatal diagnosis as a non-invasive method. In contrary to the risks of invasive methods that affect both mother and fetus, applying cffDNA is proven to be highly effective with lower risk. One of the applications of prenatal diagnosis is fetal gender determination, which is important in fetuses at risk of sex-linked genetic diseases. In such cases by obtaining the basic information of the gender, necessary time management can be taken in therapeutic to significantly reduce the necessity of applying the invasive methods. Therefore in this study, the probability of detecting sequences on the human Y-chromosome in pregnant women has been evaluated to identify the gender of fetuses. Peripheral blood samples were obtained from 80 pregnant women with gestational age between 6th to 10th weeks and the fetal DNA was extracted from the plasma. Identification of SRY, DYS14 & DAZ sequences, which are not presentin the maternal genome, was performed using Real-Time PCR. All the obtained results were compared with the actual gender of the newborns to calculate the test accuracy. Considerable 97.3% sensitivity and 97.3% specificity were obtained in fetal gender determination which is significant in the first trimester of pregnancy. Only in one case, false positive result was obtained. Using non-invasive method of cffDNAs in the shortest time possible, as well as avoiding invasive tests for early determination of fetal gender, provides the opportunity of deciding and employing early treatment for fetuses at risk of genetic diseases.

  17. Energy education resources: Kindergarten through 12th grade

    SciTech Connect

    1998-09-01

    Energy Education Resources: Kindergarten Through 12th Grade is published by the National Energy Information Center (NEIC) a service of the Energy Information Administration (EIA), to provide students, educators, and other information users, a list of generally available free or low-cost energy-related educational materials. Each entry includes the address, telephone number, and description of the organization and the energy-related materials available. Most of the entries also include Internet (Web) and electronic mail (E-Mail) addresses. Each entry is followed by a number, which is referenced in the subject index in the back of this book.

  18. Effects of Chronologic Age and Young Child Exposure on Respiratory Syncytial Virus Disease among US Preterm Infants Born at 32 to 35 Weeks Gestation

    PubMed Central

    Simões, Eric A. F.; Anderson, Evan J.; Wu, Xionghua; Ambrose, Christopher S.

    2016-01-01

    Objective To estimate the incidence of respiratory syncytial virus (RSV) disease as a function of chronologic age and exposure to young children in US preterm infants. Methods In the RSV Respiratory Events among Preterm Infants Outcomes and Risk Tracking (REPORT) study, preterm infants born at 32–35 weeks gestational age (wGA) were enrolled from 188 US clinics and followed September-May of 2009–2010 or 2010–2011. Infants with medically-attended acute respiratory illness had nasal/pharyngeal swabs collected for viral testing. Results of RSV tests conducted during routine clinical care were also collected. Event rates during November-March were modeled as a function of chronologic age and birth month using Poisson regression and adjusting for other covariates. Rates were calculated overall and for infants with and without exposure to young siblings or daycare attendance. Of 3317 infants screened, 1646 were enrolled as a consecutive sample. Infants with chronic lung disease of prematurity, hemodynamically significant congenital heart disease, life expectancy <6 months, or receiving or being considered for RSV immunoprophylaxis were excluded. 84% of patients completed the study. Demographics of the enrolled cohort were generally similar to those of US infants born at 32–35 wGA; infants 32–34 wGA, Hispanic infants, and infants of less-educated mothers were under-represented. Results Among 1642 evaluable infants, outpatient RSV lower respiratory illness incidence was highest at older ages, whereas RSV hospitalization and intensive care unit (ICU) admission were highest at younger ages. In all instances, young child exposure was associated with higher RSV incidence. The highest RSV hospitalization and ICU rates occurred among February-born infants with young child exposure, at 19.0 (95% CI, 13.5–27.0) and 6.5 (95% CI, 5.6–7.6) per 100 infant-seasons, respectively. Conclusions Preterm infants have a substantially elevated risk of RSV disease. Young age and

  19. International Geomagnetic Reference Field: the 12th generation

    NASA Astrophysics Data System (ADS)

    Thébault, Erwan; Finlay, Christopher C.; Beggan, Ciarán D.; Alken, Patrick; Aubert, Julien; Barrois, Olivier; Bertrand, Francois; Bondar, Tatiana; Boness, Axel; Brocco, Laura; Canet, Elisabeth; Chambodut, Aude; Chulliat, Arnaud; Coïsson, Pierdavide; Civet, François; Du, Aimin; Fournier, Alexandre; Fratter, Isabelle; Gillet, Nicolas; Hamilton, Brian; Hamoudi, Mohamed; Hulot, Gauthier; Jager, Thomas; Korte, Monika; Kuang, Weijia; Lalanne, Xavier; Langlais, Benoit; Léger, Jean-Michel; Lesur, Vincent; Lowes, Frank J.; Macmillan, Susan; Mandea, Mioara; Manoj, Chandrasekharan; Maus, Stefan; Olsen, Nils; Petrov, Valeriy; Ridley, Victoria; Rother, Martin; Sabaka, Terence J.; Saturnino, Diana; Schachtschneider, Reyko; Sirol, Olivier; Tangborn, Andrew; Thomson, Alan; Tøffner-Clausen, Lars; Vigneron, Pierre; Wardinski, Ingo; Zvereva, Tatiana

    2015-05-01

    The 12th generation of the International Geomagnetic Reference Field (IGRF) was adopted in December 2014 by the Working Group V-MOD appointed by the International Association of Geomagnetism and Aeronomy (IAGA). It updates the previous IGRF generation with a definitive main field model for epoch 2010.0, a main field model for epoch 2015.0, and a linear annual predictive secular variation model for 2015.0-2020.0. Here, we present the equations defining the IGRF model, provide the spherical harmonic coefficients, and provide maps of the magnetic declination, inclination, and total intensity for epoch 2015.0 and their predicted rates of change for 2015.0-2020.0. We also update the magnetic pole positions and discuss briefly the latest changes and possible future trends of the Earth's magnetic field.

  20. 12th Anglo-French Physical Acoustics Conference (AFPAC2013)

    NASA Astrophysics Data System (ADS)

    2014-04-01

    The Anglo-French Physical Acoustics Conference (AFPAC) had its 12th annual meeting in Villa Clythia, Fréjus, France, from 16th to 18th January 2013. This series of meetings is a collaboration between the Physical Acoustics Group (PAG) of the Institute of Physics and the Groupe d'Acoustique Physique, Sous-marine et UltraSonore (GAPSUS) of the Société Française d'Acoustique. This year, attendees got the opportunity to see the French Riviera with its Mediterranean vegetation covered by a nice thick snow layer. The participants heard 34 excellent oral presentations and saw 3 posters covering an exciting and diverse range of subjects and of frequencies, from ultrasonic wave propagation in chocolate to metamaterials applied to seismic waves for protecting buildings. Among them, invited talks were given by Pr F A Duck ( Enhanced healing by ultrasound: clinical effects and mechanisms), Pr. J-C Valiére, who actually gave two invited talks ( 1. Measurement of audible acoustic particle velocity using laser: Principles, signal processing and applications, 2. Acoustic pots in ancient and medieval buildings: Literary analysis of ancient texts and comparison with recent observations in French churches), Dr P Huthwaite ( Ultrasonic imaging through the resolution of inverse problems), Dr X Lurton ( Underwater acoustic systems on oceanographic research vessels: principles and applications), Dr S Guenneau ( From platonics to seismic metamaterials). For the fifth consecutive year AFPAC is followed by the publication of its proceedings with 12 peer-reviewed papers which cover the most recent research developments in the field of Physical Acoustics in the UK and France. Alain Lhémery (CEA, France) and Nader Saffari (UCL, United Kingdom) French Riviera 12th AFPAC — Villa Clythia, Fréjus (French Riviera), the 17th of January 2013

  1. Pregnancy week by week

    MedlinePlus

    ... Pregnancy > Prenatal care > Pregnancy week by week Pregnancy week by week Week by week Videos Swipe to advance Learn ... grows each week during pregnancy. Pick your week. Weeks 1-2 Conception (also called fertilization) usually happens ...

  2. 12th European VLBI Network Symposium and Users Meeting

    NASA Astrophysics Data System (ADS)

    Tarchi, Andrea; Giroletti, Marcello; Feretti, Luigina

    The Istituto di Radioastronomia (IRA) di Bologna and the Osservatorio Astronomico di Cagliari (OAC), on behalf of the European VLBI Consortium, hosted the 12th European VLBI Network (EVN) Symposium and Users Meeting. The Conference was held from 7th to 10th of October at the Hotel Regina Margherita, in the center of Cagliari. The latest scientific results and technical developments from VLBI, and, in particular, e-VLBI and space-VLBI (RadioAstron) outcomes were reported. The timing of this meeting coincided with the first successful observational tests of the Sardinia Radio Telescopes within the EVN, and with a number of results from new and upgraded radio facilities around the globe, such as e-MERLIN, ALMA, and the SKA pathfinders. The symposium was attended by 133 participants from all over the world, with the Asian community represented by more than 20 colleagues. The program of the meeting consisted of 70 oral contributions (including 8 invited speakers) and 50 poster that covered a very wide range of VLBI topics both in galactic and extragalactic astrophysics (e.g., AGN, stellar evolution from birth to death, astrometry, and planetary science) as well as technological developments and future international collaborations. The scientific program also included a visit to the 64-m Sardinia Radio Telescope (SRT) and the EVN Users Meeting, where astronomers have provided useful feedback on various matters regarding EVN operations. The research leading to these results has received funding from the European Commission Seventh Framework Programme (FP/2007-2013) under grant agreement No 283393 (RadioNet3). EDITORIAL BOARD: Andrea Tarchi, Marcello Giroletti, Luigina Feretti

  3. The 12th International Workshops on Opportunistic Protists (IWOP-12)

    PubMed Central

    Weiss, Louis M.; Cushion, Melanie T.; Didier, Elizabeth; Xiao, Lihua; Marciano-Cabral, Francine; Sinai, Anthony P.; Matos, Olga; Calderon, Enrique J.; Kaneshiro, Edna S.

    2013-01-01

    The 12th International Workshops on Opportunistic Protists (IWOP-12) was held in August 2012 in Tarrytown, New York. The objectives of the IWOP meetings are to: (1) serve as a forum for exchange of new information among active researchers concerning the basic biology, molecular genetics, immunology, biochemistry, pathogenesis, drug development, therapy, and epidemiology of these immunodeficiency-associated pathogenic eukaryotic microorganisms that are seen in patients with AIDS and (2) foster the entry of new and young investigators into these underserved research areas. The IWOP meeting focuses on opportunistic protists, e.g. the free-living amoebae, Pneumocystis, Cryptosporidium, Toxoplasma, the Microsporidia, and kinetoplastid flagellates. This conference represents the major conference that brings together research groups working on these opportunistic pathogens. Slow but steady progress is being achieved on understanding the biology of these pathogenic organisms, their involvement in disease causation in both immune-deficient and immune-competent hosts, and is providing critical insights into these emerging and reemerging pathogens. This IWOP meeting demonstrated the importance of newly developed genomic level information for many of these pathogens and how analysis of such large data sets is providing key insights into the basic biology of these organisms. A great concern is the loss of scientific expertise and diversity in the research community due to the ongoing decline in research funding. This loss of researchers is due to the small size of many of these research communities and a lack of appreciation by the larger scientific community concerning the state of art and challenges faced by researchers working on these organisms. PMID:23560871

  4. Increased levels of cell-free human placental lactogen mRNA at 28-32 gestational weeks in plasma of pregnant women with placenta previa and invasive placenta.

    PubMed

    Kawashima, Akihiro; Sekizawa, Akihiko; Ventura, Walter; Koide, Keiko; Hori, Kyouko; Okai, Takashi; Masashi, Yoshida; Furuya, Kenichi; Mizumoto, Yoshifumi

    2014-02-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive placenta (n = 5), and normal pregnancies (n = 92). Median (range) hPL mRNA was significantly higher in women with placenta previa, 782 (10-2301) copies/mL of plasma, and in those with invasive placenta, 615 (522-2102) copies/mL of plasma, when compared to normal pregnancies, 90 (4-4407) copies/mL of plasma, P < .01 and P < .05, respectively. We found a sensitivity of 100% and a specificity of 61.5% for the prediction of invasive placenta among women with placenta previa. In conclusion, expression of hPL mRNA is increased in plasma of women with placenta previa and invasive placenta at 28 to 32 weeks of gestation.

  5. PREFACE: 12th Conference on ''Theoretical Nuclear Physics in Italy''

    NASA Astrophysics Data System (ADS)

    Bombaci, I.; Covello, A.; Marcucci, L. E.; Rosati, S.

    2009-07-01

    These Proceedings contain the invited and contributed papers presented at the 12th Conference on Theoretical Nuclear Physics in Italy held in Cortona, Italy, from 8-10 October 2008. As usual, the meeting was held at il Palazzone, a 16th century castle owned by the Scuola Normale Superiore di Pisa. The aim of this biennal conference is to bring together Italian theorists working in various fields of Nuclear Physics to discuss their latest results and confront their points of view in a lively and informal way. This offers the opportunity to promote collaborations between different groups. There were about 50 participants at the conference, coming from 14 Italian Universities (Cagliari, Catania, Ferrara, Firenze, Genova, Lecce, Milano, Napoli, Padova, Pavia, Pisa, Roma, Trento, Trieste). The program of the conference, prepared by the Organizing Committee (Ignazio Bombaci, Aldo Covello, Laura Elisa Marcucci and Sergio Rosati) focused on six main topics: Few-Nucleon Systems, Nuclear Matter and Nuclear Dynamics, Nuclear Astrophysics, Structure of Hadrons and Hadronic Matter, Nuclear Structure, Nuclear Physics with Electroweak Probes. Winfried Leidemann, Maria Colonna, Marcello Lissia, Elena Santopinto, Silvia Lenzi and Omar Benhar took the burden of giving general talks on these topics and reviewing the research activities of the various Italian groups. In addition, 19 contributed papers were presented, most of them by young participants. In the last session of the Conference there were two invited talks related to experimental activities of great current interest. Gianfranco Prete from the Laboratori Nazionali di Legnaro spoke about the Italian radioactive ion beam facility SPES and the status of the European project EURISOL, while Nicola Colonna from the INFN, Bari, gave an overview of the perspectives of development of fourth-generation nuclear reactors. We would like to thank the authors of the general reports for their hard work in reviewing the main achievements in

  6. The use of a quality indicator to reduce elective repeat Caesarean section for low-risk women before 39 weeks' gestation: the Eastern Ontario experience.

    PubMed

    Dunn, Sandra; Sprague, Ann E; Fell, Deshayne B; Dy, Jessica; Harrold, Joann; Lamontagne, Bernard; Walker, Mark

    2013-04-01

    Objectif : La césarienne itérative planifiée (CIP) menée chez des femmes exposées à de faibles risques à < 39 semaines de gestation a régulièrement été associée à plus de risques pour le nouveau-né (dont une morbidité respiratoire, une admission à l’UNSI et une hospitalisation prolongée) que la CIP menée entre 39 et 40 semaines de gestation. Ce projet d’amélioration de la qualité avait pour objectif d’atténuer les taux élevés de CIP menée à < 39 semaines dans la région de l’est de l’Ontario. Méthodes : La participation de tous les hôpitaux de la région offrant des soins au cours du travail et de l’accouchement (n = 10) a été sollicitée. Des représentants de chacun de ces hôpitaux ont reçu des ressources d’application des connaissances pour les aider à mettre en œuvre le projet, ainsi que des renseignements au sujet des taux associés à leurs établissements respectifs. Un taux de référence de 30 % a été établi pour ce qui est de la CIP à < 39 semaines. Les taux de CIP à < 39 semaines ont été calculés pour deux périodes différentes (les exercices financiers 2009–2010 et 2010–2011); la différence relative et les intervalles de confiance à 95 % ont été calculés pour quantifier l’ampleur et l’importance statistique de tout changement. Des entrevues qualitatives ont été menées auprès d’intervenants clés de chacun des hôpitaux. Résultats : La proportion de CIP à < 39 semaines de gestation au sein de la région au cours de l’exercice financier 2010–2011 (n = 197/497; 39,6 %) a connu une baisse significative (différence relative : −21 %; IC à 95 %, −31 % - −8 %, P = 0,002) par comparaison avec l’exercice financier précédent 2009–2010 (n = 229/459; 49,9 %). Un certain nombre d’obstacles et de facteurs facilitants en matière de modification de la pratique ont été identifiés. Conclusion : Une baisse du taux de CIP à < 39 semaines chez les femmes exposées à de

  7. Seven Destructive Seismic Crises in 12th Century Syria

    NASA Astrophysics Data System (ADS)

    Guidoboni, E.; Bernardini, F.

    2002-12-01

    the region bridging the present-day Syro-Turkish border. The long and devastating series of shakes in 1156-59 and the great earthquake of June 1170, affected a huge area within the current territories of north-western Syria, northern Lebanon and the region of inter Antioch (modern Antakya, in southern Turkey). The effects of the earthquakes in August 1110 and June 1117 have been attested to in southern Lebanon and Palestine. On the grounds of the detailed seismic scenarios of the 5 most documented earthquakes we have also been able to advance some hypotheses as to the seismogenic structures involved. In the first half of the 12th century the most intense seismicity seems to be concentrated in the zones bordering south-eastern Turkey and north-western Syria, suggesting a likely involvement both of the northernmost portion of the Dead Sea Fault System (DSFS), and the south-western segment of the East-Anatolian Fault System (EAFS), as well as, perhaps, also the convergence structures present in south-eastern Turkey (Bitlis suture zone?). Beginning from around mid-1150 the greatest seismic activity seems to migrate more southwards, along the structures of the DSFS that cross western Syria (Ghab and Missyaf faults) and northern Lebanon (Akkar fault?). Lastly, for the great event of 1170, the sources we have retrieved and analysed contain information concerning damage or felt effects in slightly fewer than 30 Crusader and Arab locations, 15 of which new and never before identified. The detailed macroseismic picture that has been reconstructed has thus also allowed us to propose an estimate of the main shock parameters for this earthquake.

  8. Highlights of the 12th International Conference on Nuclear Cardiology and Cardiac CT.

    PubMed

    Kitsiou, Anastasia; Dorbala, Sharmila; Scholte, Arthur J H A

    2015-09-01

    The 12th International Conference on Nuclear Cardiology and Cardiac CT was held from 3 to 5 May 2015 in Madrid, Spain. In this article, the three Congress Program Committee Chairs summarize selected highlights of the presented abstracts.

  9. 75 FR 10483 - Filing Dates for the Pennsylvania Special Election in the 12th Congressional District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... From the Federal Register Online via the Government Publishing Office FEDERAL ELECTION COMMISSION Filing Dates for the Pennsylvania Special Election in the 12th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: Pennsylvania...

  10. [Gestational disorders].

    PubMed

    Ortigosa Corona, E; Carrasco Resendiz, I; González Flores, A; Dámaso Ortiz, M

    1993-09-01

    We present the results of an interview of 375 pregnant women which explores their gestational risk diagnoses, the types and frequencies of complaints. Five groups of 75 patients each were formed from this random sample corresponding to 30, 32, 34, 36 and 38 weeks of pregnancy respectively. We too analyze the patients' opinions about their own morbidity, the repercussion on activities of daily life and self-medication. The interview included the actions taken on their own account to deal with complaints during pregnancy, as well as to establish the relationships between these actions and medical attention they received. A total of 1534 complaints were recorded from the entire group, the mean per patient were four with a range from one to six. The reported from the entire group, the mean per patient were four with a range from one to six. The reported complaints did not caused medical consultation and were totally different with the respective risk diagnoses. Our results show that patients almost always accept their symptoms as a normal part of pregnancy, even when arise from pathology. Almost 70% of the patients view their symptoms as normal despite the fact that they produce difficulties of daily life in 41%, and that they temporarily block these activities in 19%. Around 10% of the patients admit self-medication. Over 50 types of actions were self-initiated, 1371 for the entire group as a whole. Around 95% of the complaints considered abnormal received no medical attention. We presented a series of thoughts on the effectiveness of popular practices and the possibility of integrating some of them into medical practice.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Gestational diabetes

    MedlinePlus

    ... you are pregnant and you have symptoms of diabetes . Prevention Getting prenatal care early and having regular checkups helps improve your health and the health of your baby. Having prenatal ... gestational diabetes early. If you are overweight, getting your weight ...

  12. The effect of trade books on the environmental literacy of 11th and 12th graders in aquatic science

    NASA Astrophysics Data System (ADS)

    Lewis, Ann S.

    The purpose of this study was to compare the environmental literacy of 11th and 12th graders who participated in an eighteen-week environmental education program using trade books versus 11 th- and 12th-graders who participated in an eighteen-week, traditional environmental education program without the use of trade books. This study was conducted using a quasi-experimental research technique. Four high school aquatic science classes at two suburban high schools were used in the research. One teacher at each high school taught one control class and one experimental class of aquatic science. In the experimental classes, four trade books were read to the classes during the eighteen-week semester. These four books were selected by the participating teachers before the semester began. The books used were A Home by the Sea, Sea Otter Rescue, There's a Hair in My Dirt, and The Missing Gator of Gumbo Limbo. The instrument used to measure environmental literacy was the Children's Environmental Attitude and Knowledge Scale. This test was given at the beginning of the semester and at the end of the semester. The scores at the end of the semester were analyzed by 2 x 2 mixed model ANOVA with the teacher as the random effect and the condition (trade books) as the fixed effect. The statistical analysis of this study showed that the students in the experimental classes did not score higher than the control classes on the Children's Environmental Attitude and Knowledge Scale or on a subset of "water" questions. Several limitations were placed on this research. These limitations included the following: (1) a small number of classes and a small number of teachers, (2) change from the original plan of using environmental science classes to aquatic science classes, (3) possible indifference of the students, and (4) restrictive teaching strategies of the teachers.

  13. Gestational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin disrupts B-cell lymphopoiesis and exacerbates autoimmune disease in 24-week-old SNF1 mice.

    PubMed

    Mustafa, Amjad; Holladay, Steven D; Witonsky, Sharon; Zimmerman, Kurt; Reilly, Christopher M; Sponenberg, D Phillip; Weinstein, Danielle A; Karpuzoglu, Ebru; Gogal, Robert M

    2009-11-01

    Female SNF(1) hybrid mice spontaneously develop an immune complex-mediated glomerulonephritis as early as 24 weeks of age, whereas the disease onset in males is much slower. Further, a rise in concentration of glomerulus-specific autoantibodies via autoreactive B cells is critical to progression of the disease in this strain. Environmental factors contributing to the onset or degree of such autoimmunity are of interest yet poorly understood. In the present study, time-pregnant SWR x NZB dams (10/treatment) were gavaged on gestational 12 with 40 or 80 mg/kg 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), and the SNF(1) offspring were evaluated at 24 weeks of age. Bone marrow B220(low)CD24(-)AA4.1(+) committed B lineage progenitors were increased in female offspring by TCDD, however, committed progenitors and pro-B cells were decreased in males. Splenic marginal zone B cells (CD21(hi)CD24(low-int)) were decreased and follicular B cells (CD21(int)CD24(low)) were increased across sex by prenatal TCDD, whereas transitional-2 B cells (CD21(int)CD24(hi)) and (CD23(low-int) CD1(low-int)) were decreased in males only. Antibodies to double-stranded DNA were significantly increased across sex by TCDD. Anti-IgG and anti-C3 immune complex renal deposition was visibly worsened in females, and present in TCDD-treated males. These data suggest that developmental exposure to TCDD permanently and differentially alters humoral immune function by sex, and exacerbates a type III hypersensitivity lupus-like autoimmune disease in genetically predisposed mice.

  14. Engaging the Learner. Annual Instructional Technology Conference (12th, Murfreesboro, Tennessee, April 1-3, 2007)

    ERIC Educational Resources Information Center

    Smith, Carter F.; Schneider, Gary F.; Kontos, George; Kuzat, Hanan; Janossy, James; Thurmond, Karen; Moore, Beth; Whitledge, Lynn; Speer, Priscilla; Harber, Annette; Bailey, Kathrine; Penney, Samantha

    2007-01-01

    The following is a collection of papers presented at the 12th annual Instructional Technology Conference at Middle Tennessee State University in Murfreesboro, Tennessee. This conference is an opportunity for higher-education professionals from across the country to discuss opportunities and challenges presented by instructional technology. The…

  15. Asian Studies: Experimental Course of Study, 11th or 12th Year Elective.

    ERIC Educational Resources Information Center

    Fryberg, Carl

    This experimental course of study has a twofold purpose. Primarily, it is intended to serve as basis for an elective for the 11th or 12th year student. Openended in organization, it encourages teachers and students to add new dimensions. It provides a comprehensive bibliography and detailed information with which to develop an elective in the area…

  16. Why 12th Grade Must Be Redesigned Now--and How

    ERIC Educational Resources Information Center

    Vargas, Joel

    2015-01-01

    This first report in a new series by Jobs For the Future (JFF) provides the rationale for restructuring 12th grade and tying it more tightly to the first year of college through new high school and college partnerships. The paper proposes a new common benchmark of readiness that high schools and colleges can work together to meet to ensure…

  17. Within-District Effects of Catholic Schooling on 12th-Grade Math Achievement

    ERIC Educational Resources Information Center

    Chen, Vivien W.; Pong, Suet-Ling

    2014-01-01

    Using a propensity score matching method, and regression modeling based on the 2002 Education Longitudinal Study, this study found a significant Catholic school, mathematics achievement effect among those 12th graders who were least likely to attend Catholic school. This result is evident within districts after we used the School District…

  18. Crime and the Law: A 12th Grade Social Studies Course.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Education, Madison.

    The document outlines a semester-long 12th grade study of criminal law which is accomplished through an examination of Wisconsin and constitutional law. Six sections comprise the teaching outline. Section I, The Legislative Process, considers the legislature, various statutes and terminologies, revision of legislation, and penalties. Section II,…

  19. Gestational surrogacy.

    PubMed

    Brinsden, Peter R

    2003-01-01

    Gestational surrogacy is a treatment option available to women with certain clearly defined medical problems, usually an absent uterus, to help them have their own genetic children. IVF allows the creation of embryos from the gametes of the commissioning couple and subsequent transfer of these embryos to the uterus of a surrogate host. The indications for treatment include absent uterus, recurrent miscarriage, repeated failure of IVF and certain medical conditions. Treatment by gestational surrogacy is straightforward and follows routine IVF procedures for the commissioning mother, with the transfer of fresh or frozen-thawed embryos to the surrogate host. The results of treatment are good, as would be expected from the transfer of embryos derived from young women and transferred to fit, fertile women who are also young. Clinical pregnancy rates achieved in large series are up to 40% per transfer and series have reported 60% of hosts achieving live births. The majority of ethical or legal problems that have arisen out of surrogacy have been from natural or partial surrogacy arrangements. The experience of gestational surrogacy has been largely complication-free and early results of the follow-up of children, commissioning couples and surrogates are reassuring. In conclusion, gestational surrogacy arrangements are carried out in a few European countries and in the USA. The results of treatment are satisfactory and the incidence of major ethical or legal complications has been limited. IVF surrogacy is therefore a successful treatment for a small group of women who would otherwise not be able to have their own genetic children.

  20. Gestational anemia.

    PubMed

    Wahed, F; Latif, S A; Nessa, A; Bhuiyan, M R; Hossain, M B; Akther, A; Mahmud, M M

    2010-07-01

    Gestational anemia is a common public health problem in our country. Most anemia during pregnancy results from an increased need for iron as her body is making more blood. Often dietary supplementation does not provide enough iron to meet the extra needs. Also the growing baby takes all the iron it needs from mother, regardless of how much iron is stored in mother's blood. Gestational Anemia contributed significantly to maternal morbidity and mortality, IUGR, preterm delivery and perinatal morbidity and mortality. A high proportion of women in both industrialized and developing countries become anemic during pregnancy. The most important cause of gestational anemia due to iron deficiency, because high iron requirements during pregnancy are not easily fulfilled by dietary intake. Adequate iron stores can help a pregnant women replace lost red blood cells. So, iron supplementation is strongly recommended for all pregnant women in developing countries. Oral iron intake is the treatment of choice and almost all pregnant women can be treated effectively with oral iron preparation during their pregnancy period.

  1. An Optimal Allocation of Recruiter and Facilities in the 12th Marine Corps District

    DTIC Science & Technology

    1992-03-01

    county level In the 12th Marine Corps District. A production function is presented to model Marine Corps (POMA) and the number of recruiters. the...Each recruiting facility’s value Is determined by its number of recruiters and the PQMA in the county . A 10% recruiting facility reduction plan is...the location of aptitude category I-IlA individuals by using the county recruited allocation model, use the facility reduction model which maximizes

  2. Target Allocation Methodology for China's Provinces: Energy Intensity in the 12th FIve-Year Plan

    SciTech Connect

    Ohshita, Stephanie; Price, Lynn

    2011-03-21

    Experience with China's 20% energy intensity improvement target during the 11th Five-Year Plan (FYP) (2006-2010) has shown the challenges of rapidly setting targets and implementing measures to meet them. For the 12th FYP (2011-2015), there is an urgent need for a more scientific methodology to allocate targets among the provinces and to track physical and economic indicators of energy and carbon saving progress. This report provides a sectoral methodology for allocating a national energy intensity target - expressed as percent change in energy per unit gross domestic product (GDP) - among China's provinces in the 12th FYP. Drawing on international experience - especially the European Union (EU) Triptych approach for allocating Kyoto carbon targets among EU member states - the methodology here makes important modifications to the EU approach to address an energy intensity rather than a CO{sub 2} emissions target, and for the wider variation in provincial energy and economic structure in China. The methodology combines top-down national target projections and bottom-up provincial and sectoral projections of energy and GDP to determine target allocation of energy intensity targets. Total primary energy consumption is separated into three end-use sectors - industrial, residential, and other energy. Sectoral indicators are used to differentiate the potential for energy saving among the provinces. This sectoral methodology is utilized to allocate provincial-level targets for a national target of 20% energy intensity improvement during the 12th FYP; the official target is determined by the National Development and Reform Commission. Energy and GDP projections used in the allocations were compared with other models, and several allocation scenarios were run to test sensitivity. The resulting allocations for the 12th FYP offer insight on past performance and offer somewhat different distributions of provincial targets compared to the 11th FYP. Recommendations for reporting

  3. The Impact of Gerontology Inclusion on 12th Grade Student Perceptions of Aging, Older Adults and Working with Elders

    ERIC Educational Resources Information Center

    Krout, John A.; McKernan, Peggy

    2007-01-01

    The present study examines the impact of including lessons on aging in a 12th grade social studies course on student perceptions of aging and older adults, working with older persons, and knowledge of "facts" on aging. Pre/post-test data were collected from approximately 650 upstate New York 12th grade students enrolled in a government…

  4. Conference report: 12th Annual University of Wisconsin Land O'Lakes Bioanalytical Conference.

    PubMed

    DeMuth, James E; Briscoe, Chad; Amaravadi, Lakshmi; Arnold, Mark E; Clement, Robert P; Fluhler, Eric N; Ji, Qin C; Stubbs, R John

    2011-10-01

    This University of Wisconsin School of Pharmacy bioanalytical conference is presented each year by the Extension Services in Pharmacy, the professional development department within the school. The purpose of this 4-day conference is to provide an educational forum to discuss issues and applications associated with the analysis of xenobiotics, metabolites, biologics and biomarkers in biological matrices. The conference is designed to include and encourage an open exchange of scientific and methodological applications for bioanalysis. To increase the interactive nature of the conference, the program was a mixture of lectures, poster sessions, round table discussions and workshops. This article summarizes the presentations at the 12th Annual Conference.

  5. Within-District Effects of Catholic Schooling on 12th Grad Math Achievement

    PubMed Central

    Chen, Vivien W.; Pong, Suet-Ling

    2015-01-01

    Using a propensity score matching method and regression modeling based on the 2002 Education Longitudinal Study, this study found a significant Catholic school effect on mathematics achievement among those 12th graders who were least likely to attend Catholic school. This result is evident within-districts after we used the School District Demographics System map data to locate Catholic schools within school district boundaries. Furthermore, the Catholic school effects were statistically significant for students in districts that allowed publicly funded private education. PMID:25606028

  6. 12th international conference on human retrovirology: HTLV and related retroviruses

    PubMed Central

    Lairmore, Michael D; Fujii, Masahiro

    2005-01-01

    The 12th International Conference on Human Retrovirology: HTLV and Related Retroviruses, was held at the Half Moon Hotel in Montego Bay, Jamaica, from June 22nd to June 25th 2005. The scientific conference, sponsored by the International Retrovirology Association, is held biennially at rotating international venues around the world. The meeting brings together basic scientists, epidemiologists and clinical researchers to discuss findings to prevent HTLV infection or develop new therapies against HTLV-mediated diseases. The Association fosters the education and training of young scientists to bring new approaches to the complex problems of HTLV research, such as translational research to bring findings from the laboratory into clinical trials that benefit HTLV-infected patients. The breadth and quality of research presentations and workshops at the 12th International Conference indicate that these goals are being accomplished. As HTLV research enters its third decade a new generation of scientists face many challenges. However, HTLV scientists and clinicians displayed exciting new approaches and discoveries during plenary talks and poster sessions. The conference encouraged research in HTLV infections and disease, fostered collaborations, and stimulated new partnerships between clinicians and scientists to encourage clinical trials and novel therapeutic interventions. PMID:16202161

  7. 12th Man in Space Symposium: The Future of Humans in Space. Abstract Volume

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The National Aeronautics and Space Administration (NASA) is pleased to host the 12th IAA Man in Space Symposium. A truly international forum, this symposium brings together scientists, engineers, and managers interested in all aspects of human space flight to share the most recent research results and space agency planning related to the future of humans in space. As we look out at the universe from our own uniquely human perspective, we see a world that we affect at the same time that it affects us. Our tomorrows are highlighted by the possibilities generated by our knowledge, our drive, and our dreams. This symposium will examine our future in space from the springboard of our achievements.

  8. The Manchester Microlensing Conference: The 12th International Conference and ANGLES Microlensing Workshop

    NASA Astrophysics Data System (ADS)

    Kerins, E.; Mao, S.; Rattenbury, N.; Wyrzykowski, L.

    The Manchester Microlensing Conference (M2C) was held at the Jodrell Bank Centre for Astrophysics at Manchester University in the UK from 21st-25th January 2008. M2C comprised two elements: the ANGLES Microlensing Workshop and the 12th International Conference on gravitational microlensing. M2C began with the two-day Workshop, providing interactive Master Classes to around 60 researchers on selected hot topics in microlensing. The Master Classes were delivered by world-leading experts on each of the topics. The topics reflected the diverse techniques and applications of microlensing, such as crowded-field photometry, modelling of extra-solar planetary systems, and the use of microlensing in cosmology. The 12th International Conference on microlensing followed immediately after the Workshop and was attended by around 90 researchers. The Conference covered all aspects of current research in microlensing, including: Microlensing towards the Magellanic Clouds; Cosmological Microlensing; Stellar and Galactic Microlensing; Galactic Microlensing Surveys; Follow-up Programmes and Planetary Microlensing; M31 Microlensing; and Future Directions. The M2C Proceedings serve three functions. Through the expert master classes the M2C Proceedings provide a great starting point for those who wish to enter the field or who just wish to learn more about microlensing at a depth beyond that usually covered by a single review article. The M2C proceedings also provide a snapshot of the state-of-the art in microlensing observations and theory as of January 2008, in what is a rapidly developing field. Lastly, the M2C meeting and its Proceedings are dedicated to the memory of the late Bohdan Paczynski, a towering figure and founding father of modern day microlensing research.

  9. Gestational weight gain trajectories in primary care

    PubMed Central

    Piccinini-Vallis, Helena; Lee-Baggley, Dayna; Stewart, Moira; Ryan, Bridget

    2016-01-01

    Objective To identify gestational weight gain trajectories, stratified by prepregnancy body mass index (BMI), of women with singleton pregnancies who received prenatal care in a primary care setting, and to compare these trajectories with the 2009 Institute of Medicine gestational weight gain recommendations. Design Retrospective cohort study. Setting Halifax, NS. Participants Women who received prenatal care at the Dalhousie Family Medicine clinics in Halifax from 2009 to 2013. Main outcome measures For each prenatal visit, gestational age and weight measurements were obtained. Multilevel modeling was used to analyze the gestational weight gain trajectories. The upper limit of the guideline-recommended weekly gestational weight gain was compared with the 95% CI of the observed mean weekly gestational weight gain for each prepregnancy BMI category. Results A total of 280 women were included in the analyses. There was a significant interaction between prepregnancy BMI category and gestational weight gain over time (P < .001), with gestational weight gain being significantly lower among women with prepregnancy BMI of 30.0 kg/m2 or greater compared with those with BMI of 18.5 to less than 25.0 kg/m2 and 25.0 to less than 30.0 kg/m2. When comparing women’s weight gain with the recommendations, women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 had the most guideline discordance, deviating from the weight gain recommendations at 20 weeks’ gestation. Conclusion These results are relevant and of benefit to women and clinicians wishing to address excess gestational weight gain, and to researchers and policy makers developing interventions aimed at curbing gestational weight gain in primary care. Although our results showed women with prepregnancy BMI of 25.0 to less than 30.0 kg/m2 gained the most excess, guideline-discordant weight, interventions should target all women planning or experiencing a pregnancy.

  10. Gestational diabetes - self-care

    MedlinePlus

    Pregnancy - gestational diabetes; Prenatal care - gestational diabetes ... Gestational diabetes is high blood sugar (glucose) that happens during pregnancy. There are no symptoms in most cases. But ...

  11. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Bancher-Todesca, Dagmar; Pollak, Arnold; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2012-12-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes. GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birthweight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e.g. glucosuria). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin therapy should be initiated. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery all women with GDM have to be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria) 6

  12. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Harreiter, Jürgen; Bancher-Todesca, Dagmar; Berger, Angelika; Repa, Andreas; Lechleitner, Monika; Weitgasser, Raimund

    2016-04-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl). Screening for undiagnosed type 2 diabetes at the first prenatal visit (Evidence level B) is recommended in women at increased risk using standard diagnostic criteria (high risk: history of GDM or pre-diabetes (impaired fasting glucose or impaired glucose tolerance); malformation, stillbirth, successive abortions or birth weight > 4,500 g in previous pregnancies; obesity, metabolic syndrome, age > 45 years, vascular disease; clinical symptoms of diabetes (e. g. glucosuria)). Performance of the OGTT (120 min; 75 g glucose) may already be indicated in the first trimester in some women but is mandatory between 24 and 28 gestational weeks in all pregnant women with previous non-pathological glucose metabolism (Evidence level B). Based on the results of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study GDM is defined, if fasting venous plasma glucose exceeds 92 mg/dl or 1 h 180 mg/dl or 2 h 153 mg/dl after glucose loading (OGTT; international consensus criteria). In case of one pathological value a strict metabolic control is mandatory. This diagnostic approach was recently also recommended by the WHO. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring and to increase physical activity to moderate intensity levels- if not contraindicated. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 140 mg/dl) insulin

  13. Gestational Diabetes and Pregnancy

    MedlinePlus

    ... Arrives Trouble Getting Pregnant Avoiding Pregnancy Articles Gestational Diabetes and Pregnancy Language: English Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  14. Proceedings of the 12th Biennial Conference of research on the Colorado Plateau

    USGS Publications Warehouse

    Ralston, Barbara E.

    2016-05-20

    The 12th Biennial Conference held in Flagstaff, Arizona, from September 16 to 19, 2013, covered a range of topics in the physical, biological, and socio-cultural sciences. The conference was organized and hosted by Northern Arizona University’s (NAU) Merriam-Powell Center for Environmental Research, the Colorado Plateau Cooperative Ecosystem Studies Unit, and the U.S. Geological Survey Southwest Biological Science Center. Financial and in-kind support was provided by a wide range of organizations including the U.S. Forest Service, National Park Service, Bureau of Land Management, Grand Canyon Trust, Colorado Plateau Research Station, and various NAU entities. NAU sponsors include the Landscape Conservation Initiative, School of Forestry, School of Earth Science and Environmental Sustainability, Office of the Provost, and Office of the Vice President of Research. Contributors to these proceedings include researchers and managers from Federal, State, and Tribal governments, universities, private entities, and non-profit organizations. In this regard, this conference has wide-ranging support and participation among private and public entities involved in the science and management of natural resources on the Colorado Plateau.

  15. PREFACE: 12th Europhysical Conference on Defects in Insulating Materials (EURODIM 2014)

    NASA Astrophysics Data System (ADS)

    Alfredsson, M. L.; Chadwick, A. V.; Jackson, R. A.; McCabe, E. E.

    2015-04-01

    The 12th Europhysical Conference on Defects in Insulating Materials (EURODIM14) was held at the University of Kent, UK, from 13-18 July 2014. It was attended by about 120 delegates from around the world, and featured 56 oral presentations and 77 posters. EURODIM14 followed other conferences in the series, held in Pecs (2010), Milan (2006) and Wroclaw (2002), as well as the related ICDIM conferences held in Santa Fe (2012), Aracaju (2008) and Riga (2004). These conferences all have the aim of bringing together scientists to discuss the chemistry and physics of defects in solids, and their role in determining material properties. We would like to thank the International Advisory Committee for suggesting invited speakers, and the Local and Programme Committee for their hard work in planning and running the conference. Finally we would like to thank the authors and referees for their contributions to the proceedings. M L Alfredsson (Conference Chair) A V Chadwick R A Jackson E E McCabe

  16. [Recent history: 12th International Conference on Cancer, Buenos Aires, Argentina, 1978].

    PubMed

    Spinelli, Hugo

    2014-04-01

    Using the approaches of history of the present, this article recovers the discussions surrounding the 12th International Conference on Cancer carried out in Buenos Aires in 1978, in reaction to which Georges Périès organized a "counter-conference" in Paris. In order to understand this discussion, the political situation of the time is described, as is the state of human rights at the time in Argentina, the role of the media - in particular the newspapers La Nación and Clarín and the magazine Gente - and the institutional position adopted by the National Academy of Medicine, as expressed in a letter sent to the presidents of the primary scientific societies of the world. The letter is reprinted in this text as a documentary source, taken from Memoria: Año 1978 (Presidencia de Dr. José E. Rivarola) [Acta: Year 1978 (Presidency of Dr. José E. Rivarola)]. The framework of the discussion makes reference to science's social policy versus science's supposed neutrality and the role of scientific societies.

  17. The BGS magnetic field candidate models for the 12th generation IGRF

    NASA Astrophysics Data System (ADS)

    Hamilton, Brian; Ridley, Victoria A.; Beggan, Ciarán D.; Macmillan, Susan

    2015-05-01

    We describe the candidate models submitted by the British Geological Survey for the 12th generation International Geomagnetic Reference Field. These models are extracted from a spherical harmonic `parent model' derived from vector and scalar magnetic field data from satellite and observatory sources. These data cover the period 2009.0 to 2014.7 and include measurements from the recently launched European Space Agency (ESA) Swarm satellite constellation. The parent model's internal field time dependence for degrees 1 to 13 is represented by order 6 B-splines with knots at yearly intervals. The parent model's degree 1 external field time dependence is described by periodic functions for the annual and semi-annual signals and by dependence on the 20-min Vector Magnetic Disturbance index. Signals induced by these external fields are also parameterized. Satellite data are weighted by spatial density and by two different noise estimators: (a) by standard deviation along segments of the satellite track and (b) a larger-scale noise estimator defined in terms of a measure of vector activity at the geographically closest magnetic observatories to the sample point. Forecasting of the magnetic field secular variation beyond the span of data is by advection of the main field using core surface flows.

  18. Design Document for 12th Grade NAEP Preparedness Research Judgmental Standard Setting Studies: Setting Standards on the National Assessment of Educational Progress in Reading and Mathematics for 12th Grade Preparedness

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2010

    2010-01-01

    The National Assessment Governing Board adopted a Program of Preparedness Research in March 2009. Several categories of research studies were recommended to produce results for reporting 12th grade preparedness for the 2009 grade 12 National Assessment of Educational Progress (NAEP) in reading and mathematics. The categories included content…

  19. The 12th I. E. Melhus Graduate Student Symposium: host plant resistance and disease management, current status and future outlook

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The 12th I. E. Melhus Graduate Student Symposium was held on 6 August 2012 during the Annual meeting of the American Phytopathological Society (APS) in Providence, RI. The theme for this symposium was “Host Plant Resistance and Disease Management: Current Status and Future Outlook”. The APS Host R...

  20. A Content Analysis of Kindergarten-12th Grade School-Based Nutrition Interventions: Taking Advantage of Past Learning

    ERIC Educational Resources Information Center

    Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.

    2011-01-01

    Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…

  1. Proceedings of the International Academy for Information Management Annual Conference (12th, Atlanta, Georgia, December 12-14, 1997).

    ERIC Educational Resources Information Center

    Rogers, Camille, Ed.

    This proceedings includes 62 papers presented at the 12th annual International Academy for Information Management (IAIM) conference. Topics of papers include: electronic undergraduate courses; software for teaching change management; cooperative projects; experiential learning; World Wide Web applications; internationalization of the information…

  2. Adventuring with Books: A Booklist for Pre-K--Grade 6. 12th Edition. NCTE Bibliography Series.

    ERIC Educational Resources Information Center

    Pierce, Kathryn Mitchell, Ed.

    Books that expand children's horizons and stimulate their imaginations are the focus of this 12th edition, an annotated bibliography of selected children's books published between 1996 and 1998. The 20 chapters in the book contain traditional and nontraditional categories of literature: Stories of the Universe: From Questions and Observations to…

  3. Project Based Learning for Life Skill Building in 12th Grade Social Studies Classrooms: A Case Study

    ERIC Educational Resources Information Center

    Zimmerman, Daniele C.

    2010-01-01

    Based on the assumption that project based learning (PBL) in 12th grade social studies classrooms contributes to the development of life skills for high school seniors in this advanced and globalized time, this research will investigate student experiences with PBL methods for helping them acquire skills along with a case study of a successful PBL…

  4. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  5. [Gestational diabetes mellitus].

    PubMed

    Kautzky-Willer, Alexandra; Bancher-Todesca, Dagmar; Birnbacher, Robert

    2004-01-01

    Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations in the diabetic range. In case of a high risk for GDM/type 2 diabetes (history of GDM or prediabetes [impaired fasting glucose or impaired glucose tolerance]; malformation, stillbirth, successive abortions or birth-weight > 4500 g in previous pregnancies) performance of the OGTT (120 min; 75 g glucose) is recommended already in the first trimester and--if normal--the OGTT should be repeated in the second/third trimester. In case of clinical symptoms of diabetes (glucosuria, macrosomia) the test has to be performed immediately. All other women should undergo a diagnostic test between 24 and 28 gestational weeks. If fasting plasma glucose exceeds 95 mg/dl, 1 h 180 mg/dl and 2 hrs 155 mg/dl after glucose loading (OGTT) the woman is classified as GDM (one pathological value is sufficient). In this case a strict metabolic control is mandatory. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 130 mg/dl) insulin therapy should be initiated. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery all women with GDM have to be reevaluated as to their glucose tolerance by a 75 g OGTT (WHO criteria).

  6. PREFACE: 12th European Workshop on Advanced Control and Diagnosis (ACD 2015)

    NASA Astrophysics Data System (ADS)

    Straka, Ondřej; Punčochář, Ivo; Duník, Jindřich

    2015-11-01

    The 12th European Workshop on Advanced Control and Diagnosis (ACD 2015) took place at the Research Centre NTIS - New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic, on November 19 - 20, 2015. The annual European Workshop on Advanced Control and Diagnosis has been organized since 2003 by Control Engineering departments of several European universities in Germany, France, the UK, Poland, Italy, Hungary, and Denmark to bring together senior and junior academics and engineers from diverse fields of automatic control, fault detection, and signal processing. The workshop provides an opportunity for researchers and developers to present their recent theoretical developments, practical applications, or even open problems. It also offers a great opportunity for industrial partners to express their needs and priorities and to review the current activities in the fields. A total of 74 papers have been submitted for ACD 2015. Based on the peer reviews 48 papers were accepted for the oral presentation and 10 papers for the poster presentation. The accepted papers covered areas of control theory and applications, identification, estimation, signal processing, and fault detection. In addition, four excellent plenary lectures were delivered by Prof. Fredrik Gustafsson (Automotive Sensor Mining for Tire Pressure Monitoring), Prof. Vladimír Havlena (Advanced Process Control for Energy Efficiency), Prof. Silvio Simani (Advanced Issues on Wind Turbine Modelling and Control), and Prof. Robert Babuška (Learning Control in Robotics). The ACD 2015 was for the first time in the workshop history co-sponsored by the International Federation of Automatic Control (IFAC). On behalf of the ACD 2015 organising committee, we would like to thank all those who prepared and submitted papers, participated in the peer review process, supported, and attended the workshop.

  7. [Gestational diabetes management: a multidisciplinary treatment algorithm].

    PubMed

    Weinert, Letícia Schwerz; Silveiro, Sandra Pinho; Oppermann, Maria Lúcia; Salazar, Cristiano Caetano; Simionato, Bárbara Marina; Siebeneichler, Aline; Reichelt, Angela Jacob

    2011-10-01

    Effective treatment of gestational diabetes is important as an attempt to avoid unfavorable maternal and fetal outcomes. The objective of this paper is to describe the available therapies to optimize gestational diabetes treatment and to suggest a multidisciplinary approach algorithm. Nutrition therapy is the first option for the majority of these pregnancies; light to moderate physical activity is recommended in the absence of obstetrical contraindications. Medical treatment is recommended if glycemic control is not achieved or if excessive fetal growth is detected by ultrasound. Insulin is the standard treatment although oral antidiabetic drugs have recently been considered an effective and safe option. The monitoring of gestational diabetes treatment includes capillary glucose measurements and evaluation of fetal abdominal circumference by ultrasound performed around the 28th gestational week.

  8. PREFACE: 12th Conference on Recent Developments in Gravity (NEB XII)

    NASA Astrophysics Data System (ADS)

    Christodoulakis, Theodosios; Vagenas, Elias C.

    2007-06-01

    Continuing the 24 year old tradition, one of the Greek relativistic groups, this time the Relativity Group of the Physics Department of the University of Athens, organized the 12th Conference of the series "Recent Developments in Gravity" (NEB XII). This time NEB took place at Nafplio, Greece, from Thursday 29 June to Sunday 2 July, 2006. The Conference was attended by more than 100 participants, more than 50% of whom were relativists from abroad (both Greek and other nationalities). This signifies a tendency of the last few Conferences to open up the Greek Relativity Conference to the international scientific community. Actually, many notable members of the relativistic community all over the globe showed particular interest in coming to Nafplio, and spend four relaxed days in a nice sunny and historical place, presenting the results of their more recent work and discussing it with colleagues and students from Greece. The NEB XII Conference covered various aspects of gravitational physics: Relativistic Astrophysics, Mathematical Relativity, Quantum Gravity, and Cosmology. Although the program was rather heavy and for the first time we had parallel sessions running in the afternoons, the wonderful weather (apart from the last afternoon when it rained heavily) and the beauty of Nafplio helped the organizers offer the participants a warm, pleasant, and creative time. According to most attendees, their impression was more than good, not only with respect to the hospitable environment, but with respect to the high level of talks as well. We hope the next Conference, which will be organized by the Relativity Group of the Aristotle University of Thessaloniki in the summer of 2008, will raise the standards of the Conference even higher, thus further establishing our Conference as a notable Conference in the Relativistic community all over the world. Finally, we would like to thank the Gravitational Physics Section of the European Physical Society (GPS/EPS), ILIAS

  9. "Loops and Legs in Quantum Field Theory", 12th DESY Workshop on Elementary Particle Physics

    NASA Astrophysics Data System (ADS)

    The bi-annual international conference "Loops and Legs in Quantum Field Theory" has been held at Weimar, Germany, from April 27 to May 02, 2014. It has been the 12th conference of this series, started in 1992. The main focus of the conference are precision calculations of multi- loop and multi-leg processes in elementary particle physics for processes at present and future high-energy facilities within and beyond the Standard Model. At present many physics questions studied deal with processes at the LHC and future facilities like the ILC. A growing number of contributions deals with important developments in the field of computational technologies and algorithmic methods, including large-scale computer algebra, efficient methods to compute large numbers of Feynman diagrams, analytic summation and integration methods of various kinds, new related function spaces, precise numerical methods and Monte Carlo simulations. The present conference has been attended by more than 110 participants from all over the world, presenting more than 75 contributions, most of which have been written up for these pro- ceedings. The present volume demonstrates in an impressive way the enormous development of the field during the last few years, reaching the level of 5-loop calculations in QCD and a like- wise impressive development in massive next-to-leading order and next-to-next-to-leading order processes. Computer algebraic and numerical calculations require terabyte storage and many CPU years, even after intense parallelization, to obtain state-of-the-art theoretical predictions. The city of Weimar gave a suitable frame to the conference, with its rich history, especially in literature, music, arts, and architecture. Goethe, Schiller, Wieland, Herder, Bach and Liszt lived there and created many of their masterpieces. The many young participants signal that our field is prosperous and faces an exciting future. The conference hotel "Kaiserin Augusta" offered a warm hospitality and

  10. PREFACE: 12th High-Tech Plasma Processes Conference (HTPP-12)

    NASA Astrophysics Data System (ADS)

    Gleizes, Alain; Ghedini, Emanuele; Gherardi, Matteo; Sanibondi, Paolo; Dilecce, Giorgio

    2012-12-01

    The High-Tech Plasma Processes - 12th European Plasma Conference (HTPP-12) was held in Bologna (Italy) on 24-29 June 2012. The conference series started in 1990 as a thermal plasma conference and gradually expanded to include other topic fields as well. Now the High-Tech Plasma Processes - European Plasma Conference (HTPP) is a bi-annual international conference based in Europe with topics encompassing the whole area of plasma processing science. The aim of the conference is to bring different scientific communities together, facilitate the contacts between science, technology and industry and provide a platform for the exploration of both fundamental topics and new applications of plasmas. Thanks to the efforts of the conference chairman, Professor Vittorio Colombo and of the co-chair, Professor Piero Favia, a well balanced participation from both the communities of thermal and nonthermal plasma researchers was achieved; this resulted in just about 196 attendees from 39 countries, with 8 plenary and 15 invited talks, plus 50 oral and 140 poster contributions. This volume of Journal of Physics: Conference Series gathers papers from regular contributions of HTPP-12; each contribution submitted for publication has been peer reviewed and the Editors are very grateful to the referees for their careful support in improving the original manuscripts. In the end, 39 manuscripts were accepted for publication, covering different topics of plasma processing science: from plasma fundamentals and modelling to source design and process diagnostics, from nanomaterial synthesis to surface modification, from waste treatment to plasma applications in a liquid environment. It is an honour to present this volume of Journal of Physics: Conference Series and we deeply thank the authors for their enthusiastic and high-grade contribution. Finally, we would like to thank the conference chairmen, the members of the steering committee, the international scientific committee, the local

  11. Placenta changes in pregnancy with gestational diabetes.

    PubMed

    Edu, Antoine; Teodorescu, Cristina; Dobjanschi, Carmen Gabriela; Socol, ZiŢa Zsuzsana; Teodorescu, Valeriu; Matei, Alexandru; Albu, Dinu Florin; Radulian, Gabriela

    2016-01-01

    Placental damage may be responsible for the fetal complications in pregnancies complicated by diabetes. We have analyzed the prevalence of gestational diabetes (GD) in a population of 109 pregnant women, the risk factors and the placental changes associated with gestational diabetes. Tests carried out were oral glucose tolerance test at 24-28 weeks of gestation, using the IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria for gestational diabetes, glycated hemoglobin, fasting insulin, total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, triglycerides, two-dimensional (2D) ultrasound and, also, there were analyzed macro and microscopic placental fragments from pregnant women with÷without GD. It has been recorded the weight of placenta at birth and there were analyzed the possible pathological changes. The prevalence of GD was 11.9%. We have applied the direct logistic regression to determine the impact of some factors over the probability of association with gestational diabetes. The most powerful predictor was the placental maturity grade, the patients with decreased maturity grade having chances 52.6 times higher than those with an increased placental maturity grade to associate gestational diabetes. Sizes of placentas in patients with gestational diabetes mellitus were significantly increased than in patients without this diagnosis (p=0.012) from week 24-28. Pathological changes were discovered in six of the 13 placentas of women with gestational diabetes mellitus, independent of the level of glycated hemoglobin (p=0.72). The level of hyperglycemia is only partially associated with the presence of placental changes, which may be caused by other maternal factors.

  12. Superbugs and Superdrugs-SMi's 12th annual conference--Overcoming resistance. 17-18 March 2010, London, UK.

    PubMed

    Oni, Adekemi

    2010-05-01

    The 12th Annual Superbugs and Superdrugs conference, held in London, included topics covering new therapeutic developments in the field of antimicrobial research. This conference report highlights selected presentations on antimicrobial peptides, addressing bacterial resistance, and new treatments for bacterial infections. Investigational drugs discussed include DPK-060 (DermaGen AB), DAV-132 (Da Volterra), PF-4287881, PNU-100480 and PF-02538084 (all Pfizer Inc), BAL-30072 (Basilea Pharmaceutica International Ltd) and lanbiotics from Novacta.

  13. Intraoperative blood loss and gestational age at pregnancy termination.

    PubMed

    Marchiano; Thomas; Lapinski; Balwan; Patel

    1998-07-01

    Objective: To establish the relationship of measured intraoperative blood loss to gestational age at pregnancy termination, and to determine which factors, if any, affect the risk of bleeding.Methods: A single-operator series of 363 consecutive women undergoing pregnancy termination between 5 and 24 weeks gestational age, as dated by ultrasound, was prospectively evaluated. All pregnancies under 13 weeks gestation were terminated by mechanical dilation and suction curettage without preoperative cervical ripening. All pregnancies between 13 and 24 weeks gestation were terminated by preoperative osmotic cervical dilation with laminaria tents and subsequent uterine evacuation by a combination of suction curettage, sharp curettage, and Bierer forceps extraction. All patients over 12 weeks gestation received a postoperative oxytocin infusion. Whenever possible, amniotic fluid and blood were collected and measured separately. Patients were excluded from the data analysis for pregnancy demise, PPROM, Potter's syndrome, or inability to separate blood establish their relationship. After adjustment for gestational age, the results were analyzed to determine if blood loss was related to maternal age, smoking history, body habitus, or operative indication.Results: A curvilinear relationship between blood loss and gestational age was observed. Mean blood loss at 24 weeks exceeded 800 mL. After adjustment for gestational age, no factors significantly affected blood loss at dilation and aspiration of first trimester pregnancies. In those patients undergoing dilation and evacuation in the second trimester, both simple and stepwise regression analyses showed obesity (BMI >/=32.3) to be significantly associated with increased blood loss (P <.05). Neither age, parity, previous cesarean section, nor smoking history were significantly associated with increased blood loss at dilation and evacuation.Conclusions: With advancing gestational age, intraoperative blood loss increases in

  14. A behavioral intervention to reduce excessive gestational weight gain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Excessive gestational weight gain (GWG) is a key modifiable risk factor for negative maternal and child health. We examined the efficacy of a behavioral intervention in preventing excessive GWG. 230 participants (87.8% Caucasian, mean age= 29.1 years; second parity) completed the 36 week gestational...

  15. PREFACE: 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM 2012)

    NASA Astrophysics Data System (ADS)

    Zhou, Zhangjian; Li, Jingfeng; Zhang, Lianmeng; Ge, Changchun

    2013-03-01

    The 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM-2012) was held in Beijing, China, from 22-36 October 2012. This was part of a series of conferences organized every two years endorsed by International Advisory Committee for FGM's, which serves as a forum for scientists, educators, engineers and young students interested in the development of functionally graded materials (FGM). The series continues from the previous international symposium on FGM held in Sendai, Japan (1990), San Francisco, USA (1992), Lausanne, Switzerland (1994), Tsukuba, Japan (1996), Dresden, Germany (1998), Estes Park, USA (2000), Beijing, China (2002), Leuven, Belgium (2004), Hawaii, USA (2006), Sendai, Japan (2008) and Guimaraes, Portugal (2010). Functionally graded materials are non-uniform materials which are designed with embodied continuous spatial variations in composition and microstructure for the specific purpose of adjusting their thermal, structural, mechanical, biological or functional response to specific application conditions. Such multi-phase materials cover a range of space and time scales, and are best understood by means of a comprehensive multiscale, multiphysics approach. These kinds of materials are presently in the forefront of materials research, receiving worldwide attention. They have a broad range of applications including for example, biomedical, biomechanical, automotive, aerospace, mechanical, civil, nuclear, and naval engineering. New applications are continuously being discovered and developed. The objective of the FGM-2012 intends to provide opportunities for exchanging ideas and discussing state-of-the-art theories, techniques and applications in the fields of multiscale, multifunctional and FGM, through invited lectures, oral and poster presentations. FGM-2012 was organized and hosted by University of Science and Technology Beijing, China, together with Tsing-hua University and Wuhan University of

  16. PREFACE: EMAS 2011: 12th European Workshop on Modern Developments in Microbeam Analysis

    NASA Astrophysics Data System (ADS)

    Brisset, François; Dugne, Olivier; Robaut, Florence; Lábár, János L.; Walker, Clive T.

    2012-03-01

    This volume of IOP Conference Series: Materials Science and Engineering contains papers from the 12th Workshop of the European Microbeam Analysis Society (EMAS) on Modern Developments and Applications in Microbeam Analysis, which took place from the 15-19 May 2011 in the Angers Congress Centre, Angers, France. The primary aim of this series of workshops is to assess the state-of-the-art and reliability of microbeam analysis techniques. The workshops also provide a forum where students and young scientists starting out on a career in microbeam analysis can meet and discuss with the established experts. The workshops have a very specific format comprising invited plenary lectures by internationally recognized experts, poster presentations by the participants and round table discussions on the key topics led by specialists in the field. This workshop was organized in collaboration with GN-MEBA - Groupement National de Microscopie Electronique à Balayage et de microAnalysis, France. The technical programme included the following topics: the limits of EPMA, new techniques, developments and concepts in microanalysis, microanalysis in the SEM, and new and less common applications of micro- and nanoanalysis. As at previous workshops there was also a special oral session for young scientists. The best presentation by a young scientist was awarded with an invitation to attend the 2012 Microscopy and Microanalysis meeting at Phoenix, Arizona. The prize went to Pierre Burdet, of the Federal Institute of Technology of Lausanne (EPFL), for his talk entitled '3D EDS microanalysis by FIB-SEM: enhancement of elemental quantification'. The continuing relevance of the EMAS workshops and the high regard in which they are held internationally can be seen from the fact that 74 posters from 18 countries were on display at the meeting, and that the participants came from as far away as Japan, Canada and the USA. A selection of participants with posters were invited to give a short oral

  17. 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems

    SciTech Connect

    Berk, Herbert L.; Breizman, Boris N.

    2014-02-21

    The 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems took place in Austin, Texas (7–11 September 2011). This meeting was organized jointly with the 5th IAEA Technical Meeting on Theory of Plasma Instabilities (5–7 September 2011). The two meetings shared one day (7 September 2011) with presentations relevant to both groups. Some of the work reported at these meetings was then published in a special issue of Nuclear Fusion [Nucl. Fusion 52 (2012)]. Summaries of the Energetic Particle Conference presentations were given by Kazuo Toi and Boris Breizman. They respectively discussed the experimental and theoretical progress presented at the meeting. Highlights of this meeting include the tremendous progress that has been achieved in the development of diagnostics that enables the ‘viewing’ of internal fluctuations and allows comparison with theoretical predictions, as demonstrated, for example, in the talks of P. Lauber and M. Osakabe. The need and development of hardened diagnostics in the severe radiation environment, such as those that will exist in ITER, was discussed in the talks of V. Kiptily and V.A. Kazakhov. In theoretical studies, much of the effort is focused on nonlinear phenomena. For example, detailed comparison of theory and experiment on D-III-D on the n = 0 geodesic mode was reported in separate papers by R. Nazikian and G. Fu. A large number of theoretical papers were presented on wave chirping including a paper by B.N. Breizman, which notes that wave chirping from a single frequency may emanate continuously once marginal stability conditions have been established. Another area of wide interest was the detailed study of alpha orbits in a burning plasma, where losses can come from symmetry breaking due to finite coil number or magnetic field imperfections introduced by diagnostic or test modules. An important area of development, covered by M.A. Hole and D.A. Spong, is concerned with the self

  18. Am I at Risk for Gestational Diabetes?

    MedlinePlus

    ... level is: High 1 Average 0 Low Your health care provider: Will test you as soon as you know you are ... their lifetime. If you had gestational diabetes, your health care provider will test you for diabetes 6 weeks after you give ...

  19. Large for Gestational Age (LGA)

    MedlinePlus

    ... 5 Additional Content Medical News Large for Gestational Age (LGA) By Arthur E. Kopelman, MD, The Brody ... Newborns Birth Injury Prematurity Postmaturity Small for Gestational Age (SGA) Large for Gestational Age (LGA) Respiratory Distress ...

  20. How to Treat Gestational Diabetes

    MedlinePlus

    ... A Listen En Español How to Treat Gestational Diabetes Be sure to see the latest Diabetes Forecast ... and a healthy start for your baby. Gestational Diabetes – Looking Ahead Gestational diabetes usually goes away after ...

  1. Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

    PubMed Central

    Odubamowo, K. H.; Akinpelu, O. M.; Lawal, O. O.; Okolo, C. A.; Odukogbe, A. A.; Adekunle, A. O.

    2014-01-01

    Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days' duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide). Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation. PMID:25580321

  2. Ultrasonographic measurement of thoracic diameters of the early gestating fetus.

    PubMed

    Hata, T; Hata, K; Yamane, Y; Osamu, T; Kitao, M

    1989-08-01

    Eighty-two ultrasonographic examinations were performed on 60 of our pregnant patients with regular menstrual cycles and no complications. The pregnancies ranged from 7 to 13 weeks of gestation. Thoracic anteroposterior diameter (ETAPD), transverse diameter (ETTD), cross-sectional area (ETA) and crown-rump length (CRL) were measured on each ultrasonogram. A high correlation between CRL and gestational age was firstly confirmed in this study. ETAPD, ETTD and ETA correlated well with the gestational age and CRL, respectively. Correlations between ETAPD/CRL and ETTD/CRL ratios with the gestational age were negative. A positive correlation of ETA/CRL ratio with the gestational age was evident. Ultrasonographic measurement of the thoracic diameters of the fetus in utero should be a useful parameter to evaluate the gestational age and for early detection of growth retardation in utero.

  3. STEM development: A study of 6th--12th grade girls' interest and confidence in mathematics and science

    NASA Astrophysics Data System (ADS)

    Heaverlo, Carol Ann

    Researchers, policymakers, business, and industry have indicated that the United States will experience a shortage of professionals in the Science, Technology, Engineering, and Mathematics (STEM) fields. Several strategies have been suggested to address this shortage, one of which includes increasing the representation of girls and women in the STEM fields. In order to increase the representation of women in the STEM fields, it is important to understand the developmental factors that impact girls' interest and confidence in STEM academics and extracurricular programs. Research indicates that greater confidence leads to greater interest and vice versa (Denissen et al., 2007). This study identifies factors that impact girls' interest and confidence in mathematics and science, defined as girls' STEM development. Using Bronfenbrenner's (2005) bioecological model of human development, several factors were hypothesized as having an impact on girls' STEM development; specifically, the macrosystems of region of residence and race/ethnicity, and the microsystems of extracurricular STEM activities, family STEM influence, and math/science teacher influence. Hierarchical regression analysis results indicated that extracurricular STEM involvement and math teacher influence were statistically significant predictors for 6--12th grade girls' interest and confidence in mathematics. Furthermore, hierarchical regression analysis results indicated that the only significant predictor for 6--12th grade girls' interest and confidence in science was science teacher influence. This study provides new knowledge about the factors that impact girls' STEM development. Results can be used to inform and guide educators, administrators, and policy makers in developing programs and policy that support and encourage the STEM development of 6--12th grade girls.

  4. [Diagnosis of siamese twins at 12 weeks gestation (author's transl)].

    PubMed

    Schmidt, W; Kubli, F; Heberling, D

    1981-03-01

    Double monsters are a rare obstetric event. The mean incidence is approximately 1:50,000 deliveries. The early diagnosis of siamese twins with the aid of routine ultra-sound investigation is described. Typical ultrasound findings and procedures to verify the diagnosis are described in detail.

  5. The Role of a Relative Age Effect in the 12th Winter European Youth Olympic Festival in 2015.

    PubMed

    Müller, Lisa; Hildebrandt, Carolin; Schnitzer, Martin; Raschner, Christian

    2016-04-01

    The aim of this study was to define the role of the relative age effect in the 12th Winter European Youth Olympic Festival 2015. The birth dates of all 899 participants and anthropometric data of 655 participants were analyzed. A significant relative age effect was present in the total sample and among the male athletes but not in the female athletes. Additionally, a significant relative age effect was present in strength- and endurance-related sports but not in technique-related sports. Statistically significantly more older athletes won medals. Relative age had a strong influence on participation in strength- and endurance-related sports as well as on performance.

  6. The impact of home computers on 12th grade students' achievement in the computer science curriculum in Riyadh, Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Aljuwaiber, Mohammed A.

    Technology has improved many educational issues. This is a very exciting time for technology and education. The primary purpose of this study was aimed at understanding the impact of home computer use on academic achievement in the computer curriculum of the 12th grade students in Riyadh, Kingdom of Saudi Arabia. In particular, the study attempted to determine if the use of home computers would be an effective manner for increasing students' academic achievement. The participants of the study were 240 male and female students as a random sample from 12th grade from eight random high schools in Riyadh, Saudi Arabia. An achievement exam and survey were developed by the researcher based on the computer science curriculum topics, the quantitative data was collected in both a single achievement exam and a single survey from a sample of 240 Saudi high school students. Both the survey and an achievement exam were split equally between male and female students. The study sought the answer to 10 questions. Analysis of variance (ANOVA), followed by tests of simple main effects and post hoc comparisons using Scheffe, as well as Pearson Correlation were conducted to answer the research questions. The study results pointed out that home computers were important to support the students in their academic achievement in the computer science curriculum. Therefore, more attention must be given to the use of home computers for all students. Moreover, we should attempt to treat the difficulties which students face for getting computers in their homes.

  7. Gestational age in twins.

    PubMed Central

    James, W H

    1980-01-01

    Dubowitz et al. have offered a scoring system for estimating the gestational age of newborn babies. If the system is applied to twin pairs, the heavier twin is generally estimated to have a greater gestational age than the lighter one. Previously this has been interpreted as a flaw in the scoring system. However, it may well be that in some twin pairs the gestational ages are slightly different and that therefore, the heavier twin would be expected to have a greater gestational age. Such cases would arise through superfecundation (the formation of two zygotes from different coitions). Superfecundation can be proved only in rare case (those with two fathers). It can be argued that the rarity of such cases is accounted for by the rarity with which women expose themselves to the risk of bearing such twins (and by the improbability of detection), rather than by the rarity of superfecundation. It is inferred that superfecundation by the same man is relatively common and that therefore dizygotic twins quite often have different gestational ages. The scoring system of Dubowitz can be tested for bias by submitting monozygotic pairs to it: the association between weight and estimated gestational age should be absent in such pairs. If the system proves free of such bias, then a finding first reported here will assume some interest: it is that in opposite-sexed twin pairs, the male is significantly more often assessed as having the greater gestational age. It is suggested that this finding should be provisionally accepted as evidence for the hyopthesis that male zygotes are formed earlier than females. PMID:7191240

  8. Comparison of gestational dating methods and implications ...

    EPA Pesticide Factsheets

    OBJECTIVES: Estimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassificat ion and inconsistencies in risk estimates, particularly if exposure assignment is also gestation-dependent. This paper examines a'what-if' scenario in which alternative methods are used and attempts to elucidate how method choice affects observed results.METHODS: We constructed two 20-week gestational age cohorts of pregnancies between 2000 and 2005 (New Jersey, Pennsylvania, Ohio, USA) using live birth certificates : one defined preterm birth (PTB) status using CE and one using LMP. Within these, we estimated risk for 4 categories of preterm birth (PTBs per 106 pregnancies) and risk differences (RD (95% Cl s)) associated with exposure to particulate matter (PM2. 5).RESULTS: More births were classified preterm using LMP (16%) compared with CE (8%). RD divergences increased between cohorts as exposure period approached delivery. Among births between 28 and 31 weeks, week 7 PM2.5 exposure conveyed RDs of 44 (21 to 67) for CE and 50 (18 to 82) for LMP populations, while week 24 exposure conveyed RDs of 33 (11 to 56) and -20 (-50 to 10), respectively.CONCLUSIONS: Different results from analyses restricted to births with both CE and LMP are most likely due to differences in dating methods rather than selection issues. Results are sensitive t

  9. [Gestational diabetes in the light of current literature].

    PubMed

    Hawryluk, Jarosław; Grafka, Agnieszka; Gęca, Tomasz; Łopucki, Maciej

    2015-06-01

    This paper presents current data on the pathophysiology of gestational diabetes mellitus, classification and new diagnostic methods. Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance first detected during pregnancy. It is the most common metabolic disorder of pregnant women. The frequency of its occurrence depends on inter alia body weight, belonging to a particular ethnic group and diagnostic methods. GDM reveals usually between 24 and 28 weeks of gestation. The development of diabetes in pregnancy poses a threat to both the mother and the fetus. It is associated with an increased incidence of birth defects in newborns, impaired intrauterine fetal growth, higher incidence of premature births and greater percentage of the intrauterine fetus death. Amongst women complicated by gestational diabetes arterial hypertension more often unfolds. In the development of gestational diabetes mellitus important role apart from maternal and fetal hyperinsulinemia play: antagonistic to insulin placental hormones, TNFα, placental pro-inflammatory cytokines, resistin, leptin ghrelin.

  10. Family support for physical activity in girls from 8th to 12th grade in South Carolina

    PubMed Central

    Dowda, Marsha; Dishman, Rod K.; Pfeiffer, Karin A.; Pate, Russell R.

    2007-01-01

    Objective To examine the relationship between perceived family support and other selected correlates of physical activity (PA) with changes in PA over time. Methods A total of 421 girls in South Carolina completed questionnaires at 8th, 9th and 12th grades (1998–2003). Family support for PA, PA self-efficacy, perceived behavioral control, attitudes, availability of equipment, and PA were measured. Results Growth curve analysis showed that family support, perceived behavioral control, and self-efficacy were independently related to age-related changes in PA as reflected by total METs. Girls who reported lower family support at the 8th grade measure had more rapid declines in PA, and a unit change in family support was related to approximately 1/3 of a standard deviation change in total METs. Conclusions Maintenance of support from family members may reduce the decline in PA independent of girl’s self-efficacy and perceived behavioral control. PMID:17157371

  11. 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals: susceptibility to environmental hazards.

    PubMed Central

    Barrett, J C; Vainio, H; Peakall, D; Goldstein, B D

    1997-01-01

    The 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC) considered the topic of methodologies for determining human and ecosystem susceptibility to environmental hazards. The report prepared at the meeting describes measurement of susceptibility through the use of biological markers of exposure, biological markers of effect, and biomarkers directly indicative of susceptibility of humans or of ecosystems. The utility and validity of these biological markers for the study of susceptibility are evaluated, as are opportunities for developing newer approaches for the study of humans or of ecosystems. For the first time a SGOMSEC workshop also formally considered the issue of ethics in relation to methodology, an issue of particular concern for studies of susceptibility. PMID:9255554

  12. Aplastic articular facets in a dog with intervertebral disk rupture of the 12th to 13th thoracic vertebral space.

    PubMed

    Werner, Thorsten; McNicholas, W Thomas; Kim, Jongmin; Baird, Debra K; Breur, Gert J

    2004-01-01

    A 6-year-old, female spayed Pomeranian was presented with acute hind-limb paraplegia with the presence of deep pain perception and urinary incontinence. Myelography showed a Hansen type I herniation of the12th to 13th thoracic intervertebral space (T(12-13)). Articular facets of the T(12-13) and T(13) to first lumbar vertebra (L(1)) were absent. The spinal cord was decompressed using a bilateral T(12-13) modified lateral hemilaminectomy (pediculectomy). The aplastic sites were associated with minimal instability of the vertebral column, and stabilization of the vertebral column was not required. Familiarity with this condition is important, because articular facet aplasia may cause vertebral instability and may require an adjusted surgical approach or vertebral reduction and fusion following decompression.

  13. Assessing the risk of gestational diabetes in twin gestation.

    PubMed Central

    Henderson, C. E.; Scarpelli, S.; LaRosa, D.; Divon, M. Y.

    1995-01-01

    This study examines the hypothesis that twin gestation is a risk factor for gestational diabetes. In a retrospective analysis, the incidence of gestational diabetes in twin and singleton pregnancies was determined in groups matched for maternal age, weight, and parity. One-hour oral glucose challenge tests (50 g) were used to screen 9185 pregnant women. Gestational diabetes was diagnosed when abnormal screens (> or = 130 mg/dL) were followed by two or more abnormal values on a 3-hour (100 g) glucose tolerance test using National Diabetes Data Group (NDDG) criteria. A twin gestation was identified in 1.5% (138/9185) of the pregnancies. Gestational diabetes was diagnosed in 5.8% (8/138) and 5.4% (439/9047) of the twin and singleton pregnancies, respectively. The incidence of gestational diabetes is similar for singleton and twin gestations. PMID:7473851

  14. Appropriate for gestational age (AGA)

    MedlinePlus

    Fetal age; Gestation; Development - AGA; Growth - AGA; Neonatal care - AGA; Newborn care - AGA ... Gestational age is the common term used during pregnancy to describe how far along the pregnancy is. It is ...

  15. Large for gestational age (LGA)

    MedlinePlus

    ... gov/ency/article/002248.htm Large for gestational age (LGA) To use the sharing features on this page, please enable JavaScript. Large for gestational age means that a fetus or infant is larger ...

  16. The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation

    PubMed Central

    Verd, Sergio; de Sotto, Diego; Fernández, Consuelo; Gutiérrez, Antonio

    2016-01-01

    Gestational diabetes increases the risk of a range of adverse perinatal outcomes, including breastfeeding failure, but the best cut-off point for gestational diabetes is unknown. The purpose of this study was to evaluate the association between mild gestational glucose tolerance impairment and the early cessation of exclusive breastfeeding (EBF). This is an observational study of 768 women with full term pregnancies that were screened for gestational diabetes at 24–28 weeks gestation. Subjects were divided into two groups: those with a normal 1-h glucose challenge test and those with an elevated 1-h glucose challenge test but still did not qualify for gestational diabetes. We constructed multivariable logistic regression models using data from 616 women with normal gestational glucose tolerance and 152 women with an isolated positive 1-h glucose challenge test. The risk of early exclusive breastfeeding cessation was found to increase in women with mildly impaired glucose tolerance during pregnancy (adjusted OR, 1.65; 95% CI: 1.11, 2.45). Risks of early EBF cessation were also independently associated with the amount of neonatal weight loss and admission to the neonatal ward. Instead, parity was associated with a decreased risk for shorter EBF duration. Insulin resistance—even in the absence of gestational diabetes mellitus—may be an impeding factor for EBF. PMID:27869777

  17. The Vietnam War: A Four Week Instructional Unit. Grades 11-12.

    ERIC Educational Resources Information Center

    Meadows, Darrell

    This 4-week curriculum is designed to help 11th and 12th grade students reach an understanding of the history and culture of Vietnam and the roots of U.S. military involvement there, and also to draw lessons from U.S. actions during the war in Vietnam. Students are encouraged to engage in critical thinking, evaluation, drawing conclusions, taking…

  18. Spontaneous triplet, tubal ectopic gestation.

    PubMed Central

    Nwanodi, Oroma; Berry, Robert

    2006-01-01

    Only six cases of spontaneous, unilateral, triplet ectopic gestations have previously been reported. We now present a seventh case. The patient's prior obstetrical history was significant for a term stillbirth and a term cesarean section for breech. Quantitative betahCG was normal for gestational age; however, the increased trophoblastic mass of an inappropriately implanted multiple gestation may produce sufficient betahCG to mimic an intrauterine singleton gestation. Resolution was achieved via salpingostomy. This case is significant for being spontaneously conceived and not the result of assisted reproductive technologies. Furthermore, this case supports an association between prior cesarean section and ectopic gestation. Images Figure 1 PMID:16775922

  19. Exposure to any antenatal corticosteroids and outcomes in preterm infants by gestational age: prospective cohort study

    PubMed Central

    Travers, Colm P; Clark, Reese H; Spitzer, Alan R; Das, Abhik; Garite, Thomas J

    2017-01-01

    Objective To determine whether exposure to any antenatal corticosteroids is associated with a lower rate of death at each gestational age at which administration is currently recommended. Design Prospective cohort study. Settings 300 participating neonatal intensive care units of the Pediatrix Medical Group in the United States. Participants 117 941 infants 23 0/7 to 34 6/7 weeks’ gestational age born between 1 January 2009 and 31 December 2013. Exposure Any antenatal corticosteroids. Main outcomes measures Death or major hospital morbidities analyzed by gestational age and exposure to antenatal corticosteroids with models adjusted for birth weight, sex, mode of delivery, and multiple births. Results Infants exposed to antenatal corticosteroids (n=81 832) had a significantly lower rate of death before discharge at each gestation 29 weeks or less, 31 weeks, and 33-34 weeks compared with infants without exposure (range of adjusted odds ratios 0.32 to 0.55). The number needed to treat with antenatal corticosteroids to prevent one death before discharge increased from six at 23 and 24 weeks’ gestation to 798 at 34 weeks’ gestation. The rate of survival without major hospital morbidity was higher among infants exposed to antenatal corticosteroids at the lowest gestations. Infants exposed to antenatal corticosteroids had lower rates of severe intracranial hemorrhage or death, necrotizing enterocolitis stage 2 or above or death, and severe retinopathy of prematurity or death compared with infants without exposure at all gestations less than 30 weeks and most gestations for infants born at 30 weeks’ gestation or later. Conclusion Among infants born from 23 to 34 weeks’ gestation, antenatal exposure to corticosteroids compared with no exposure was associated with lower mortality and morbidity at most gestations. The effect size of exposure to antenatal corticosteroids on mortality seems to be larger in infants born at the lowest gestations. PMID

  20. Longer Gestation among Children Born Full Term Influences Cognitive and Motor Development

    PubMed Central

    Espel, Emma V.; Glynn, Laura M.; Sandman, Curt A.; Davis, Elysia Poggi

    2014-01-01

    Children born preterm show persisting impairments in cognitive functioning, school achievement, and brain development. Most research has focused on implications of birth prior to 37 gestational weeks; however, the fetal central nervous system continues to make fundamental changes throughout gestation. Longer gestation is associated with reduced morbidity and mortality even among infants born during the period clinically defined as full term (37–41 gestational weeks). The implications of shortened gestation among term infants for neurodevelopment are poorly understood. The present study prospectively evaluates 232 mothers and their full term infants (50.4% male infants) at three time points across the first postnatal year. We evaluate the association between gestational length and cognitive and motor development. Infants included in the study were full term (born between 37 and 41 weeks gestation). The present study uses the combination of Last Menstrual Period (LMP) and early ultrasound for accurate gestational dating. Hierarchical Linear Regression analyses revealed that longer gestational length is associated with higher scores on the Bayley scales of mental and motor development at 3, 6 and 12 months of age after considering socio-demographic, pregnancy, and infant-level covariates. Findings were identical using revised categories of early, term, and late term proposed by the Working Group for Defining Term Pregnancy. Our findings indicate that longer gestation, even among term infants, benefits both cognitive and motor development. PMID:25423150

  1. Longer gestation among children born full term influences cognitive and motor development.

    PubMed

    Espel, Emma V; Glynn, Laura M; Sandman, Curt A; Davis, Elysia Poggi

    2014-01-01

    Children born preterm show persisting impairments in cognitive functioning, school achievement, and brain development. Most research has focused on implications of birth prior to 37 gestational weeks; however, the fetal central nervous system continues to make fundamental changes throughout gestation. Longer gestation is associated with reduced morbidity and mortality even among infants born during the period clinically defined as full term (37-41 gestational weeks). The implications of shortened gestation among term infants for neurodevelopment are poorly understood. The present study prospectively evaluates 232 mothers and their full term infants (50.4% male infants) at three time points across the first postnatal year. We evaluate the association between gestational length and cognitive and motor development. Infants included in the study were full term (born between 37 and 41 weeks gestation). The present study uses the combination of Last Menstrual Period (LMP) and early ultrasound for accurate gestational dating. Hierarchical Linear Regression analyses revealed that longer gestational length is associated with higher scores on the Bayley scales of mental and motor development at 3, 6 and 12 months of age after considering socio-demographic, pregnancy, and infant-level covariates. Findings were identical using revised categories of early, term, and late term proposed by the Working Group for Defining Term Pregnancy. Our findings indicate that longer gestation, even among term infants, benefits both cognitive and motor development.

  2. Gestational mutations in radiation carcinogenesis

    NASA Astrophysics Data System (ADS)

    Meza, R.; Luebeck, G.; Moolgavkar, S.

    Mutations in critical genes during gestation could increase substantially the risk of cancer. We examine the consequences of such mutations using the Luebeck-Moolgavkar model for colorectal cancer and the Lea-Coulson modification of the Luria-Delbruck model for the accumulation of mutations during gestation. When gestational mutation rates are high, such mutations make a significant contribution to cancer risk even for adult tumors. Furthermore, gestational mutations ocurring at distinct times during emryonic developmemt lead to substantially different numbers of mutated cells at birth, with early mutations leading to a large number (jackpots) of mutated cells at birth and mutation occurring late leading to only a few mutated cells. Thus gestational mutations could confer considerable heterogeneity of the risk of cancer. If the fetus is exposed to an environmental mutagen, such as ionizing radiation, the gestational mutation rate would be expected to increase. We examine the consequences of such exposures during gestation on the subsequent development of cancer.

  3. "Explosive volcanic activity at Mt. Yasur: A characterization of the acoustic events (9-12th July 2011)"

    NASA Astrophysics Data System (ADS)

    Spina, Laura; Taddeucci, Jacopo; Cannata, Andrea; Gresta, Stefano; Lodato, Luigi; Privitera, Eugenio; Scarlato, Piergiorgio; Gaeta, Mario; Gaudin, Damien; Palladino, Danilo Mauro

    2016-08-01

    Volcanic processes occur in a wide range of temporal and spatial scales. However, a key step of magma ascent is recognizable in the dynamics of gas and magma in the shallow plumbing system, where volatiles play a fundamental role in controlling the eruptive style. With the aim of investigating shallow degassing processes, an experimental setup was deployed at Mt. Yasur, an active volcano located in Tanna Island (Vanuatu arc), from 9th to 12th July 2011. The setup comprised high-speed and thermal cameras, as well as a microphone, capable of recording both in the infrasonic and audible range. The analysis of acoustic signals, validated by observing images from the high-speed and thermal cameras, has enabled characterizing the explosive activity during the investigated period. Two types of explosions, distinct for spectral features and waveforms, were observed: (i) minor events, corresponding to small overpressurized bursts, occurring almost continuously; (ii) major events, characterizing the Strombolian activity at Mt. Yasur. By investigating variation in the occurrence rate of the minor events, we found that, on a short timescale, the dynamics responsible for the two types of explosions are decoupled. These results, together with previous literature data, bring additional evidence of the existence of distinct sources of degassing. Finally, major events can be distinguished as emergent events, i.e. long-lasting signals, corresponding to ash-rich explosions, and impulsive events, featuring shorter duration and larger amplitude.

  4. The use of a multi-method approach to identify the pigments in the 12th century manuscript Liber Floridus.

    PubMed

    Deneckere, A; De Reu, M; Martens, M P J; De Coene, K; Vekemans, B; Vincze, L; De Maeyer, Ph; Vandenabeele, P; Moens, L

    2011-10-01

    A selection of illuminations of the 12th century manuscript Liber Floridus was analysed with Raman spectroscopy (in situ and laboratory measurements), X-ray fluorescence spectroscopy, UV-fluorescence photography and infrared reflectography (IRR). The aim of this study is to determine the pigments used, in order to search for anachronisms. Using a combination of Raman spectroscopy (molecular information) and X-ray fluorescence spectroscopy (elemental information) following pigments could be identified: ultramarine (Na(8-10)Al(6)Si(6)O(24)S(2-4)), azurite (2CuCO(3)·Cu(OH)(2)), caput mortuum (Fe(2)O(3)), vermilion (HgS), orpiment (As(2)S(3)) and lead white (2PbCO(3)·Pb(OH)(2)). Moreover, two synthetic red pigments, PR4 and PR176, and a degradation product, gypsum (CaSO(4)·2H(2)O), were present in the manuscript. To establish the origin of the modern materials UV-fluorescence photography was used. Infrared reflectography (IRR) was applied to visualise the underdrawing of the investigated folios.

  5. In Japanese, there is no word for abstinence. Report from the 12th World Congress of Sexology.

    PubMed

    Haffner, D W

    1995-01-01

    The 12th World Congress of Sexology took place in August 1995 in Japan under the sponsorship of the World Association for Sexology, a conglomerate of 60 member organizations representing 25 countries. The conference focused on sexuality education, and participants from around the world recounted how sexuality education and sexual rights are being politicalized in their countries. Sexuality professionals world-wide look to US professionals for information about effective programs, resources, and research, but the US has a great deal to learn from countries such as those in Scandinavia which have extremely low levels of unplanned pregnancy or sexually transmitted diseases as a result of their commitment to sexuality education and services for young people. During the Congress, debates centered around whether the nature of sexuality is a social construct or is innate and universal. The biological nature of sexuality was explored, and reports of sexuality surveys from around the world revealed surprisingly similar patterns of behavior. Homosexuality emerged as the issue most shaped by culture. In some countries, male same-sex behavior is recognized without being categorized into a separate identity. Terminology for sex behavior also differs across cultures. For example, there is no word for "abstinence" in Japanese or in Swedish. Conference participants were urged to exchange information, expand their work in sex education to "sexuality" education, evaluate their efforts, educate themselves and others, and encourage reforms to assure sexuality education and sexual rights.

  6. The use of a multi-method approach to identify the pigments in the 12th century manuscript Liber Floridus

    NASA Astrophysics Data System (ADS)

    Deneckere, A.; De Reu, M.; Martens, M. P. J.; De Coene, K.; Vekemans, B.; Vincze, L.; De Maeyer, Ph.; Vandenabeele, P.; Moens, L.

    2011-10-01

    A selection of illuminations of the 12th century manuscript Liber Floridus was analysed with Raman spectroscopy (in situ and laboratory measurements), X-ray fluorescence spectroscopy, UV-fluorescence photography and infrared reflectography (IRR). The aim of this study is to determine the pigments used, in order to search for anachronisms. Using a combination of Raman spectroscopy (molecular information) and X-ray fluorescence spectroscopy (elemental information) following pigments could be identified: ultramarine (Na 8-10Al 6Si 6O 24S 2-4), azurite (2CuCO 3·Cu(OH) 2), caput mortuum (Fe 2O 3), vermilion (HgS), orpiment (As 2S 3) and lead white (2PbCO 3·Pb(OH) 2). Moreover, two synthetic red pigments, PR4 and PR176, and a degradation product, gypsum (CaSO 4·2H 2O), were present in the manuscript. To establish the origin of the modern materials UV-fluorescence photography was used. Infrared reflectography (IRR) was applied to visualise the underdrawing of the investigated folios.

  7. Three centuries of geomagnetic field intensity changes in Spain (from the 9th to the 12th centuries)

    NASA Astrophysics Data System (ADS)

    Gomez-Paccard, M.; Osete, M. L.; Chauvin, A.; Jimenez-Castillo, P.; Perez-Asensio, M.

    2013-12-01

    Available European data indicate that during the past 2500 years there have been periods of rapid intensity geomagnetic fluctuations (at least of ~20 μT/century) interspersed with periods of little change. The challenge now is to precisely describe these rapid changes by the acquisition of well-dated high-quality archeomagnetic data. In this study we report the archeomagnetic study of Spanish ceramic fragments. The collected fragments belong to 14 superposed stratigraphic levels corresponding to a surface no bigger than 3 m by 7 m. The pottery fragments dates back to the 9th and 11th centuries. The dating was established by 4 radiocarbon dates and by archeological/historical constraints including typological comparisons and well-controlled stratigraphic constrains between the different stratigraphic units. From classical Thellier experiments including TRM anisotropy and cooling rate corrections upon archeointensity estimates and conducted on 79 fragments, twelve new high-quality mean intensities have been obtained. Together with previously published high-quality data from Western Europe, the new data provide an improved description of the intensity changes that took place in Spain between the 9th and the 12th centuries. The results confirm that rapid intensity changes took place in Western Europe during the recent history of the Earth.

  8. Human mid-gestation amniotic fluid contains interleukin-16 bioactivity.

    PubMed

    Thornton, Catherine A; Holloway, Judith A; Shute, Janis K; Holloway, John W; Diaper, Norma D; Warner, John O

    2009-04-01

    CD4-positive cells are detectable in the human fetal gastrointestinal tract from 11 weeks of gestation. Interleukin-16 (IL-16) is a chemoattractant for CD4(+) cells and, via fetal swallowing of amniotic fluid, could mediate the influx of CD4(+) cells into the fetal gut. We have shown that IL-16 was detectable in human amniotic fluid at 16-18 weeks of gestation (mid-pregnancy) but was not detectable at term (late pregnancy; > 37 weeks of gestation). Similarly, mid-pregnancy, but not late pregnancy, amniotic fluid contained chemotactic activity for CD4(+) T cells, this activity was reduced by 58% in the presence of a neutralizing anti-IL-16 antibody. The levels of IL-16 in fetal plasma at 16-24 weeks of gestation were very high, and decreased significantly by 25-36 weeks but at > 37 weeks remained significantly higher than adult levels. IL-16 transcripts were detectable in whole tissue extracts of fetal gut, skin and placenta but not in amniocytes, and IL-16 immunoreactivity was detectable in cells within the lamina propria of the fetal gut and within the skin, where it was associated with the basement membrane. Neither IL-16 levels nor chemotactic activity for CD4(+) T cells in mid-pregnancy amniotic fluid was related to atopic outcomes at 1 year of age. IL-16 might have an important role in the early development of the human immune system and/or in regulating fetal and maternal immunological responsiveness during pregnancy.

  9. Fetal fornix transection and gestation length in sheep.

    PubMed

    McDonald, T J; Li, C; Vincent, S E; Nijland, M J

    2006-08-01

    Experiments in several species indicate that the hippocampus influences hypothalamo-pituitary-adrenal (HPA) axis function. In fetal sheep, simultaneous ACTH and cortisol rises over the last 30 days of gestation peak at term and are necessary for birth. We hypothesized that if the fetal hippocampal formation is functional in late gestation, loss of hippocampal input to the HPA axis following fetal fornix transection would change gestation length in comparison to controls. At 118-121 days of gestation (dG), stereotaxic technique was used in fetal sheep to sham transect (SHAM; n = 8) or transect (FXTX; n = 6) the dorsal fornix at the level of the hippocampal commissure. No differences were found between SHAM and FXTX fetuses in daily hormone profiles over the last week of gestation or in gestation length (148.0 +/- 1.2 vs. 149.0 +/- 0.4 dG, respectively). We conclude that the fetal hippocampus is immature in late gestation and we speculate that an immature hippocampus is necessary for the loss of negative feedback control that gives rise to the long term, simultaneous increases in ACTH and cortisol that are indispensable for labor and delivery at term in sheep.

  10. Outcomes of children of extremely low birthweight and gestational age in the 1990's.

    PubMed

    Hack, M; Fanaroff, A A

    1999-01-01

    Advances in perinatal care have improved the chances for survival of extremely low birthweight (< 800 g) and gestational age (< 26 weeks) infants. A review of the world literature and our own experience reveals that at 23 weeks gestation survival ranges from 2% to 35%. At 24 weeks gestation the range is 17% to 58%, and at 25 weeks gestation 35% to 85%. Differences in population descriptors, in the initiation and withdrawal of treatment and the duration of survival considered may account for the wide variations in the reported ranges of survival. Major neonatal morbidity increases with decreasing gestational age and birthweight. The rates of severe cerebral ultrasound abnormality range at 23 weeks gestation from 10% to 83%, at 24 weeks from 17% to 64% and at 25 weeks gestation from 10% to 22%. At 23 weeks gestation, chronic lung disease occurs in 57% to 70% of survivors, at 24 weeks in 33% to 89%, and at 25 weeks gestation in 16% to 71% of survivors. When compared to children born prior to the 1990's, the rates of neurodevelopmental disability have, in general, remained unchanged. Of 30 survivors reported at 23 weeks gestation nine (30%) are severely disabled. At 24 weeks gestation the rates of severe neurodevelopmental disability (including subnormal cognitive function, cerebral palsy, blindness and deafness) range from 17% to 45%, and at 25 weeks gestation 12% to 35% are similarly affected. In Cleveland, Ohio, we compared the outcomes of 114 children with birthweight 500-749 g born 1990-1992 to 112 infants born 1993-1995. Twenty month survival was similar (43% vs 38%). The use of antenatal and postnatal steroids increased (10% vs 54% and 43% vs 84%, respectively, P< 0.001), however the rates of chronic lung disease increased from 41% to 63% (P = 0.06). There was a significant increase in the rate of subnormal cognitive function at 20 months corrected age (20% vs 48%, P < 0.02) and a trend to an increase in the rate of cerebral palsy (10% vs 16%) and

  11. The Advanced Program of Vocational Agriculture in Louisiana. Ag III and Ag IV (11th and 12th Grades). Volume II. Bulletin No. 1725.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This curriculum guide consists of materials for use in teaching an advanced course in agricultural mechanics designed for 11th and 12th grade students. Addressed in the individual units of the guide are arc welding; oxy-acetylene welding; soldering; electricity; tractor maintenance, operation, and safety; small engines; farm structures; and cold…

  12. Legal Implications of Personnel Management. Proceedings of the Annual Summer Workshop, Southeastern Community College Leadership Program (12th, Tallahassee, Florida, July 18-20, 1973).

    ERIC Educational Resources Information Center

    Clampitt, Joyce, Ed.

    The 12th Annual Summer Workshop, Southeastern Community College Leadership Program, focused on "first-level managers" and on the increasing role of the courts in the day-to-day operation of the college. The first session of the workshop was a video-tape presentation entitled "Legal Implications of Personnel Management." These proceedings provide…

  13. The Advanced Program of Vocational Agriculture in Louisiana. Ag III and Ag IV (11th and 12th Grades). Volume I. Bulletin No. 1725.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This curriculum guide consists of materials for use in teaching an advanced course in vocational agriculture designed for 11th and 12th grade students. Addressed in the individual units of the guide are the following topics: farm and agribusiness planning, employment-seeking skills, agricultural chemicals, and conservation. Each unit includes a…

  14. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (12th, Vilamoura, Algarve, Portugal, April 9-11, 2016)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2016-01-01

    These proceedings contain the papers of the 12th International Conference on Mobile Learning 2016, which was organized by the International Association for Development of the Information Society, in Vilamoura, Algarve, Portugal, April 9-11, 2016. The Mobile Learning 2016 Conference seeks to provide a forum for the presentation and discussion of…

  15. Cooperative Learning, Motivational Effects, and Student Characteristics: An Experimental Study Comparing Cooperative Learning and Direct Instruction in 12th Grade Physics Classes

    ERIC Educational Resources Information Center

    Hanze, Martin; Berger, Roland

    2007-01-01

    One hundred thirty-seven students in 12th grade physics classes participated in a quasi-experimental study comparing the jigsaw classroom method of cooperative instruction with traditional direct instruction. While no differences were found between the two conditions for physics achievement gains, the results revealed differences in students'…

  16. Alcohol, Tobacco, & Other Drug Use by 9th-12th Grade Students: Results from the 1993 North Carolina Youth Risk Behavior Survey.

    ERIC Educational Resources Information Center

    Mikow, Victoria A.

    This survey examined the behaviors associated with the six leading causes of death or disability in one state's high school youth. Participants were 2,439 9th-12th grade students. Results identified alcohol as the drug most frequently used by high school students, with over half of students having used alcohol by their senior year and almost half…

  17. Influence of Skip Patterns on Item Non-Response in a Substance Use Survey of 7th to 12th Grade Students

    ERIC Educational Resources Information Center

    Ding, Kele; Olds, R. Scott; Thombs, Dennis L.

    2009-01-01

    This retrospective case study assessed the influence of item non-response error on subsequent response to questionnaire items assessing adolescent alcohol and marijuana use. Post-hoc analyses were conducted on survey results obtained from 4,371 7th to 12th grade students in Ohio in 2005. A skip pattern design in a conventional questionnaire…

  18. Fixitup Faucet Company's Overseas Move. 12th Grade Lesson. Schools of California Online Resources for Education (SCORE): Connecting California's Classrooms to the World.

    ERIC Educational Resources Information Center

    Harris, Judy; Jacobson, Edy

    This lesson asks 12th grade students to imagine that they are special assistants to the Undersecretary of Commerce for a foreign country who must answer a letter from a U.S. company planning to move its manufacturing operations overseas. The lesson also asks them to design a business brochure that will convince the company to come to their…

  19. Making the Grade: Do Nebraska Teachers and Administrators Working in Public Schools in 7th-12th Grade Settings Agree about What Constitutes Sound Grading Practice?

    ERIC Educational Resources Information Center

    Olson, Mark E.

    2013-01-01

    In this study, the researcher sought to determine whether Nebraska teachers and administrators agreed about what constitutes sound grading practice. The results of this study indicated that Nebraska teachers and administrators working in public schools in 7th-12th grade settings did not always agree about what constituted sound grading practice.…

  20. [Gestational Diabetes Mellitus].

    PubMed

    Krejčí, Hana

    2016-01-01

    The present generation of women of childbearing age more frequently suffer from overweight, obesity, initial as well as fully established metabolic syndrome, which together with postponing motherhood until the third decade in life plays an important role in the increasing incidence of gestational diabetes (GDM) that currently affects about 1/5 of pregnant women. However the causal link between diabetes during pregnancy and metabolic diseases in the whole population is mutual. By way of epigenetic changes, maternal diabetes unfavourably programmes metabolism of the offspring, who tend to transfer the disorder to the next generations. Gestational diabetes is therefore an important link fitting into the accumulation curve of the incidence of overweight, obesity, metabolic syndrome and consequently also T2DM among the whole population. Genetic as well as epigenetic factors play a great role in the GDM pathogenesis, which is shown by the fact that this complication also affects women with normal BMI. When it comes to diagnosing GDM, we will need to manage also in future with establishing fasting glycemia and glycemia following glucose challenge (OGTT) that may include a considerable degree of measurement inaccuracy. It is therefore necessary to observe pre-analytical and analytical conditions of measurements in order to obtain a reliable result. It is a positive sign that the Czech professional associations have adopted new international criteria for diagnosing GDM which, as opposed to those valid earlier, better reflect the risk of pregnancy-related and perinatal complications.The care for gestational patients with diabetes at a low risk (due to satisfactory glycemic control through a diet or small pharmacotherapeutic doses, with an eutrophic fetus and without associated complications) is provided by an outpatient gynecologist and a diabetes specialist, they can give birth in standard maternity hospitals. The care for gestational patients with diabetes at a higher risk

  1. Foreword: The 12th International Conference on Vibrations at Surfaces (VAS 12) (Erice, 20 26 July 2007)

    NASA Astrophysics Data System (ADS)

    Benedek, Giorgio; Vattuone, Luca

    2008-06-01

    The 12th International Conference on Vibrations at Surfaces (VAS 12) took place from 20 26 July 2007 as an event of the International School of Solid State Physics at the Ettore Majorana Foundation and Centre for Scientific Culture, Erice (Italy). The format and special environment of the conference have contributed to its transition from a traditional, medium-size conference into a more effective workshop, with a series of lectures reporting the most recent developments in the field, two poster sessions presenting recent results and even works in progress being discussed. The papers collected in this issue cover the highlights of the conference very thoroughly. Quite a few novel aspects concerning vibrations at surfaces are represented here, for example: new aspects in surface phonon spectroscopy, such as the very recent progress in inelastic x-ray scattering, the first observation of the boson peak in disordered surfaces, progress in the theory of atom scattering inelastic resonances, the action spectroscopy, the study of polycrystalline surfaces with electron energy-loss spectroscopy etc; parallel developments in experimental vibrational studies of adsorbed phases, either inorganic or organic, with those in ab initio theoretical simulations; the theory of enhanced electron--phonon interaction in low dimensions (2D and 1D); the extension from the traditional realm of surface vibrations and spectroscopy to other aspects of surface dynamics, like friction and various nonlinear effects, and to relevant dynamical phenomena occurring at interfaces. Other novelties presented at the conference, but already published in recent issues of the Journal of Physics: Condensed Matter, are also worth mentioning: the spin-echo spectroscopy with 3He allowing for slow-dynamics spectroscopy at very high, unprecedented resolutions (2007 J. Phys.: Cond. Matter 19 300301 and 305010; the first demonstration of dissociative surface trapping of molecules (2007 J. Phys.: Cond. Matter 19

  2. EDITORIAL: Proceedings of the 12th Gravitational Wave Data Analysis Workshop (GWDAW 12), Cambridge, MA, USA, 13 16 December 2007

    NASA Astrophysics Data System (ADS)

    Hughes, S.; Katsavounidis, E.

    2008-09-01

    It was a great pleasure and an honor for us to host the 12th Gravitational Wave Data Analysis Workshop (GWDAW) at MIT and the LIGO Laboratory in Cambridge, Massachusetts, the place where this workshop series started in 1996. This time the conference was held at the conference facilities of the Royal Sonesta Hotel in Cambridge from 13 16 December, 2007. This 12th GWDAW found us with the ground interferometers having just completed their most sensitive search for gravitational waves and as they were starting their preparation to bring online and/or propose more sensitive instruments. Resonant mass detectors continued to observe the gravitational wave sky with instruments that have been operating now for many years. LISA, the Laser Interferometer Space Antenna, was recently reviewed by NASA's Beyond Einstein Program Assessment Committee (BEPAC) convened by the National Research Council (NRC) and found that 'on purely scientific grounds LISA is the mission that is the most promising and least scientifically risky…thus, the committee gave LISA its highest scientific ranking'. Even so, JDEM, the Joint Dark Energy Mission, was identified to go first, with LISA following a few years after. New methods, analysis ideas, results from the analysis of data collected by the instruments, as well as Mock Data Challenges for LISA were reported in this conference. While data from the most recent runs of the instruments are still being analyzed, the first upper limit results show how even non-detection statements can be interesting astrophysics. Beyond these traditional aspects of GWDAW though, for the first time in this workshop we tried to bring the non-gravitational wave physics and astronomy community on board in order to present, discuss and propose ways to work together as we pursue the first detection of gravitational waves and as we hope to transition to gravitational wave astronomy in the near future. Overview talks by colleagues leading observations in the electromagnetic

  3. Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009.

    PubMed

    Demissie, Zewditu; Lowry, Richard; Eaton, Danice K; Nihiser, Allison J

    2015-01-01

    To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods.

  4. [The 12th amendment to the German Drug Law. Chances and obstacles for investigator-initiated clinical trials].

    PubMed

    Dreier, G; Marx, C; Schmoor, C; Maier-Lenz, H

    2005-04-01

    The European Union's so called Clinical Trials Directive 2001/20/EC was implemented in national law in Germany in August 2004, leading to the 12th amendment of the German Drug Law (Arzneimittelgesetz). The directive is intended to harmonize the clinical trial's regulatory environment across the European Union and to improve protection of human subjects. It lays down the principles and guidelines of Good Clinical Practice (GCP). As the regulation applies to all clinical trials on medicinal products for human use, and as only non-interventional studies are excluded, academic, investigator-initiated clinical trials will also have to comply with the EU clinical trials directive implemented in the German Drug Law. In an investigator-initiated trial in which the investigator takes the responsibility of a sponsor, the investigator-sponsor must take total legal and financial responsibility for the clinical trial. Since publicly funded clinical trials make a large contribution to improved care, concern has been expressed that non-commercial research projects will be reduced and the vital medical research conducted at academic institutions curtailed. Nonetheless GCP ensures a valid study design, qualified data management, analysis and monitoring of the trial and thereby promotes more valid data and protection of study participants. The trials are more likely to lead to reliable results leading to new therapies, strategies or a better understanding of diseases. What is needed, therefore, is an increase in public funding and the establishment of clinical trial units/organizations associated with the universities or hospitals where independent researchers have the possibility to obtain theoretical advice and practical help, professional training and support. In the end, the directive may serve as a stimulus to build a better national research environment and to promote public funding, and may lead to fewer but more valid clinical trials.

  5. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study

    PubMed Central

    Wang, Sufang; Ge, Xing; Zhu, Beibei; Xuan, Yujie; Huang, Kun; Rutayisire, Erigene; Mao, Leijing; Huang, Sanhuan; Yan, Shuangqin; Tao, Fangbiao

    2016-01-01

    Supplementation with folic acid (FA) was proven to prevent neural tube defects (NTDs) and was recommended worldwide before and during early pregnancy. However, much less is known regarding the role of FA after the 12th gestational week (GW). This study aimed to investigate the related effects of continued FA supplementation after the first trimester of pregnancy on fetal growth. The study subjects came from the Ma’anshan-Anhui Birth Cohort Study (MABC) that recruited 3474 pregnant women from the city of Ma’anshan in Anhui Province in China during the period of May 2013 to September 2014. The information on use of vitamin and mineral supplements was recorded in different periods (the first/second/third trimester of pregnancy). Small-for-gestational-age (SGA) births were live-born infants that were <10th percentile of birth weight, and large-for-gestational-age (LGA) births were live-born infants that were ≥90th percentile of birth weight according to nomograms based on gender and gestational age from the latest standards. We used multivariable logistic regression to evaluate the effects of FA supplement consumption in the second/third trimester of pregnancy on the risk of LGA and SGA. In addition, propensity score analysis was also performed to examine the effects. In this prospective birth cohort study conducted in Chinese women who had taken FA in the first trimester of pregnancy, we found that continued FA supplementation with 400 micrograms/day in the second and third trimesters of pregnancy significantly increased the risk of LGA (RR = 1.98 (1.29, 3.04)). This relation was strong or monotonic after adjusting for maternal age, newborn’s gender, maternal pre-pregnancy BMI, maternal education level, smoking, alcohol consumption and calcium supplementation. We did not observe that continuing FA supplementation after the first trimester of pregnancy remarkably decreased the risk of SGA. The propensity score analysis showed similar results. To confirm these

  6. Increased visfatin concentrations in women with gestational diabetes mellitus.

    PubMed

    Krzyzanowska, Katarzyna; Krugluger, Walter; Mittermayer, Friedrich; Rahman, Rupa; Haider, Dominik; Shnawa, Nadja; Schernthaner, Guntram

    2006-05-01

    The recently discovered adipocytokine visfatin has insulin-like properties. It lowers blood glucose and improves insulin sensitivity; however, clinical data on visfatin are limited. To evaluate the role of visfatin in GDM (gestational diabetes mellitus), we determined visfatin levels in women with GDM and in healthy pregnant controls. Furthermore, visfatin concentrations were investigated longitudinally during pregnancy and after delivery in a subgroup of women with GDM. Blood for measurement of visfatin and metabolic parameters was obtained from 64 women with GDM [median week of gestation, 34 (interquartile range, 27-36) weeks] and 30 healthy pregnant controls [median week of gestation, 34 (interquartile range, 28-36) weeks]. In a subgroup of 24 women with GDM, visfatin, leptin and metabolic parameters were investigated twice during pregnancy (28-30 and 38-40 weeks of gestation) and 2 weeks after delivery. In the cross-sectional analysis, median visfatin levels were significantly elevated in women with GDM [64.0 (interquartile range, 50.9-74.8) ng/ml] compared with controls [46.0 (interquartile range, 36.9-54.6) ng/ml; P<0.0001]. In women with GDM, visfatin correlated with week of gestation at the time of blood draw (R=0.35, P=0.005). No association with fasting glucose, insulin, homoeostasis model assessment-insulin resistance or body mass index was observed. According to the longitudinal analysis, visfatin increased during pregnancy (P=0.002) and rose further after delivery (P=0.014), whereas leptin and insulin levels decreased after parturition (both P<0.001). In conclusion, visfatin is elevated in women with GDM and increases during the course of pregnancy as well as after delivery. Furthermore, visfatin shows no association with insulin and leptin in women with GDM.

  7. EDITORIAL: Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers

    NASA Astrophysics Data System (ADS)

    Hahm, T. S.

    2010-06-01

    The 12th International Workshop on H-mode Physics and Transport Barriers was held at the Princeton Plasma Physics Laboratory, Princeton, New Jersey, USA between September 30 and October 2, 2009. This meeting was the continuation of a series of previous meetings which was initiated in 1987 and has been held bi-annually since then. Following the recent tradition at the last few meetings, the program was sub- divided into six sessions. At each session, an overview talk was presented, followed by two or three shorter oral presentations which supplemented the coverage of important issues. These talks were followed by discussion periods and poster sessions of contributed papers. The sessions were: Physics of Transition to/from Enhanced Confinement Regimes, Pedestal and Edge Localized Mode Dynamics, Plasma Rotation and Momentum Transport, Role of 3D Physics in Transport Barriers, Transport Barriers: Theory and Simulations and High Priority ITER Issues on Transport Barriers. The diversity of the 90 registered participants was remarkable, with 22 different nationalities. US participants were in the majority (36), followed by Japan (14), South Korea (7), and China (6). This special issue of Nuclear Fusion consists of a cluster of 18 accepted papers from submitted manuscripts based on overview talks and poster presentations. The paper selection procedure followed the guidelines of Nuclear Fusion which are essentially the same as for regular articles with an additional requirement on timeliness of submission, review and revision. One overview paper and five contributed papers report on the H-mode pedestal related results which reflect the importance of this issue concerning the successful operation of ITER. Four papers address the rotation and momentum transport which play a crucial role in transport barrier physics. The transport barrier transition condition is the main focus of other four papers. Finally, four additional papers are devoted to the behaviour and control of

  8. Asymmetric dimethylarginine level in hyperglycemic gestation.

    PubMed

    Sertkaya, Ayse Cikim; Kafkasli, Ayse; Turkcuoglu, Ilgin; Karabulut, Aysun Bay

    2011-10-01

    We aimed to evaluate plasma asymmetric dimethylarginine (ADMA) concentrations and its relation with insulin sensitivity/resistance indices in pregnant women with different degrees of carbohydrate intolerance. This study included a two step approach; 50 g glucose challenge test (GCT) followed by 100 g oral glucose tolerance test (OGTT) was used for diagnosis of carbohydrate intolerance within 24-28th weeks of gestation. Pregnant women with positive GCT but negative OGTT (AGCT group, n=30) and gestational diabetics (GDM group, n=58) were compared to healthy pregnant controls (n=50). Plasma ADMA concentration and its relationship with glucose and insulin levels and insulin sensitivity/resistance indices (HOMA-IR, QUICKI, ISIOGTT) were evaluated. Both AGCT and GDM groups were found to have similarly higher plasma ADMA levels than control subjects (3.60±1.21; 4.00±1.70; 2.65±0.82 μmol/l, respectively, P=0.001). ADMA was significantly but slightly correlated with insulin sensitivity/resistance indices and moderately correlated with 2-h insulin level. The 2-h insulin value of the OGTT was the independent influencing constant for ADMA (R=0.57, P=0.0001). In conclusion, plasma asymmetric dimethylarginine level was higher in cases with abnormal glucose challenge test but normal OGTT as well as in gestational diabetics, compared to pregnant women with normal glucose tolerance. The elevated ADMA level in pregnant women with carbohydrate intolerance may possibly be due to elevated insulin level.

  9. The shifting trajectory of growth in femur length during gestation.

    PubMed

    Bjørnerem, Ashild; Johnsen, Synnøve L; Nguyen, Tuan V; Kiserud, Torvid; Seeman, Ego

    2010-05-01

    Bone size is a determinant of bone strength and tracks in its percentile of origin during childhood and adolescence. We hypothesized that the ranking of an individual's femur length (FL) is established in early gestation and tracks thereafter. Fetal FL was measured serially using 2D ultrasound in 625 Norwegian fetuses. Tracking was assessed using Pearson correlation, a generalized estimating equation model, and by calculating the proportion of fetuses whose FL remained within the same quartile. Baseline FL Z-score (weeks 10 to 19) and later measurements correlated, but more weakly as gestation advanced: r = 0.59 (weeks 20 to 26); r = 0.45 (weeks 27 to 33); and r = 0.32 (weeks 34 to 39) (p < 0.001). Tracking within the same quartile throughout gestation occurred in 13% of fetuses. Of the 87% deviating, 21% returned to the quartile of origin, so 34% began and ended in the same quartile, 38% deviated by one quartile, and 28% deviated by two or more quartiles by the end of gestation. A standard deviation higher baseline FL Z-score, placental weight (150 g), maternal height (5 cm), and weight (10 kg), was associated with a 0.25, 0.15, 0.10, and 0.05 SD higher FL Z-score at the end of gestation, respectively (p ranging from <0.001 to 0.02). Tracking within the same percentile throughout the whole of gestation, as suggest by growth charts, is uncommon. Deviation from tracking is more common and is the result of changes in growth velocity within and between fetuses and is partly influenced by maternal, fetal, and placental factors.

  10. Gestational diabetes mellitus

    PubMed Central

    Alfadhli, Eman M.

    2015-01-01

    Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. It is associated with maternal and neonatal adverse outcomes. Maintaining adequate blood glucose levels in GDM reduces morbidity for both mother and baby. There is a lack of uniform strategies for screening and diagnosing GDM globally. This review covers the latest update in the diagnosis and management of GDM. The initial treatment of GDM consists of diet and exercise. If these measures fail to achieve glycemic goals, insulin should be initiated. Insulin analogs are more physiological than human insulin, and are associated with less risk of hypoglycemia, and may provide better glycemic control. Insulin lispro, aspart, and detemir are approved to be used in pregnancy. Insulin glargine is not approved in pregnancy, but the existing studies did not show any contraindications. The use of oral hypoglycemic agents; glyburide and metformin seems to be safe and effective in pregnancy. PMID:25828275

  11. Gestation length in farmed reindeer.

    PubMed

    Shipka, M P; Rowell, J E

    2010-01-01

    Reindeer (Rangifer tarandus tarundus) are the only cervids indigenous to the arctic environment. In Alaska, reindeer are a recognized agricultural species and an economic mainstay for many native populations. Traditionally raised in extensive free-ranging systems, a recent trend toward intensive farming requires a more in-depth knowledge of reproductive management. Reported gestation length in reindeer varies, ranging from 198 to 229 d in studies performed at the University of Alaska Fairbanks. A switchback study that manipulated only breeding date demonstrated a mean increase in gestation length of 8.5 d among females bred early in the season. The negative correlation between conception date and gestation length is consistent with reindeer research at other locations and reports of variable gestation length in a growing number of domestic and non-domestic species. This paper reviews the phenomenon in reindeer and discusses some of the factors known to affect gestation length as well as possible areas for future research.

  12. Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.

    PubMed

    Liu, Chaoqun; Zhong, Chunrong; Zhou, Xuezhen; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

    2017-01-01

    Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.

  13. Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports

    PubMed Central

    Miyauchi, Azumi; Yamada, Mitsutoshi; Furuya, Masataka; Matsumura, Satoko; Murayama, Shinji; Yoshimura, Yasunori; Tanaka, Mamoru

    2015-01-01

    Key Clinical Message Peritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative. PMID:26185643

  14. Human cortex development: estimates of neuronal numbers indicate major loss late during gestation.

    PubMed

    Rabinowicz, T; de Courten-Myers, G M; Petetot, J M; Xi, G; de los Reyes, E

    1996-03-01

    This morphometric study explores temporal and topographic changes in the estimated neuronal number in human neocortex during the latter half of gestation and early infancy. Neuronal estimates are calculated from standardized measurements of cortical layer thickness and neuronal density in 6 neocortical regions in 9 human brains ranging from 17 weeks of gestation to 13 weeks postnatally. Layer thickness increases linearly with age while the average neuronal density first increases, then reaches a maximum at 20 weeks of gestation, and progressively declines. The sum of layer thickness times layer density estimates the number of neurons in a cortical column with a fixed surface area and a length that is equal to the cortical thickness. To derive an estimate of potentially overproduced neurons, the number of neurons in each cortical column was corrected for surface growth and for cortex gyration. These data show that a large percent of cortical neurons present at 20 weeks of gestation are used to populate the expanding cortex. Nevertheless, the growth-corrected data suggest that a substantial overproduction and secondary reduction of cortical neurons takes place mainly during the last quarter of gestation. The corrected mean number of neurons reaches a maximum at 28 weeks of gestation and then declines by approximately 70% to achieve a stable number of neurons around birth. This estimated number of neurons is significantly higher at 28 to 32 weeks of gestation than at 17 to 20 gestational weeks and at 0 to 13 postnatal weeks. These data imply that physiologic neuronal death (apoptosis) may play a major role in early human cortex development.

  15. Earthquake relocations and InSAR analysis following the June 12th 2011 eruption of Nabro volcano, Afar

    NASA Astrophysics Data System (ADS)

    Hamlyn, Joanna; Wright, Tim; Keir, Derek; Neuberg, Jurgen; Grandin, Raphael; Goitom, Berhe; Hammond, James; Kibreab, Alem; Ogubazghi, Ghebrebrhan; Pagli, Carolina; Sansosti, Eugenio

    2014-05-01

    Nabro volcano sits on the southern part of Danakil block to the east of the Afar depression, on the Arabian plate. On the 12th June 2011, Nabro volcano suddenly erupted after being inactive for 10,000 years. The eruption caused a 17-km-long lava flow, a 15-km-high ash cloud, and ranks as one of the largest emissions of SO2 since the Mt. Pinatubo (1991) event. This eruption creates an important opportunity to use seismicity and surface deformation measurements to understand the subsurface magmatic system and deformation of a hazardous, off axis caldera during continental rupture. We installed a network of 8 seismometers around Nabro caldera which began recording on the 31st August and tasked SAR acquisitions from TerraSAR-X (TSX) and Cosmo-SkyMed (CSK) satellites. The SAR images used for this study post date the eruption. We used TSX stripmap mode images from ascending and descending orbits. Using a small baseline approach, we used 25 images acquired between the 1st July 2011 to the 5th October 2012 on descending orbit 046, to create 34 interferograms. We complemented these with 19 images from ascending orbit 130 spanning the 6th July 2011 to the 10th October 2012 from ascending orbit 130, which we used to create 21 interferograms. We produced a velocity ratemap and timeseries using π-RATE showing subsidence of up to 25cm/yr centred on Nabro. We used a Monte-Carlo hybrid downhill simplex technique to invert the dataset and found the best fitting solution as a mogi source at 6.9 ±1.1 km depth, and located at a 13.35 (lat) and 41.69 (long). The time dependence observed is consistent with a viscoelastic relaxation around the magma chamber, following depletion. Concurrent with the TSX acquisitions, CSK imaged the volcano on a descending track between 26th June 2011 and 18th July 2012 within the ASI project SAR4Volcanoes, and 64 images were used to produce 171 interferograms which were inverted to form a timeseries using a SBAS approach. This dataset has an overall

  16. Screening for gestational diabetes mellitus. A perspective in 1998.

    PubMed

    Carr, S R

    1998-08-01

    Gestational diabetes mellitus (GDM) was originally defined using statistics. It is appropriate to examine the current state of screening for gestational diabetes using a similar approach. This article reviews data supporting current recommendations for universal screening of pregnant women for GDM at 24-28 weeks using the 50-g 1-h oral glucose challenge. The advantages and disadvantages of several thresholds for abnormality are discussed, as are possible alternatives to the 50-g 1-h oral glucose challenge. Finally, recent improvements in the precision of portable blood glucose meters are reviewed, and recommendations for their use are advanced.

  17. Gestational diabetes: A clinical update

    PubMed Central

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  18. Trying to understand gestational diabetes

    PubMed Central

    Catalano, P. M.

    2014-01-01

    Women with normal glucose tolerance pre-gravid and developing gestational diabetes in late gestation have subclinical metabolic dysfunction prior to conception compared with women with normal glucose tolerance. Because of the 60 % decrease in insulin sensitivity with normal pregnancy, these women develop clinical hyperglycaemia/gestational diabetes in late gestation. The metabolic dysfunction includes impaired insulin response, decreased hepatic suppression of glucose production during insulin infusion and decreased insulin-stimulated glucose uptake in skeletal muscle, i.e. peripheral insulin resistance. The insulin resistance in normal glucose tolerance pregnancy is related to a decrease in the post-receptor insulin signalling cascade, specifically decreased insulin receptor substrate 1 tyrosine phosphorylation. In women with normal glucose tolerance this is reversed post-partum. In contrast, in gestational diabetes, in addition to the decrease in insulin receptor substrate 1 tyrosine phosphorylation, there is an additional decrease in tyrosine phosphorylation of the intracellular portion of the insulin receptor that is not related to the insulin receptor protein content. Post-partum women with gestational diabetes, who had retention of gestational weight gain, had no significant improvement in insulin sensitivity and increased inflammation expressed as increased plasma and skeletal muscle tumour necrosis factor alpha. The increased inflammation or meta-inflammation is a hallmark of obesity and during pregnancy develops in both white adipose tissue and placenta. Last gene array studies of placenta were associated with alterations in gene expression relating primarily to lipid in contrast to glucose metabolic pathways in gestational diabetes compared with Type 1 diabetes. Future studies are directed at decreasing inflammation prior to and during pregnancy using various lifestyle and nutritional interventions. PMID:24341419

  19. FOREWORD: 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications

    NASA Astrophysics Data System (ADS)

    Kreter, Arkadi; Linke, Jochen; Rubel, Marek

    2009-12-01

    The 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications (PFMC-12) was held in Forschungszentrum Jülich (FZJ) in Germany in May 2009. This symposium is the successor to the International Workshop on Carbon Materials for Fusion Applications series. Between 1985 and 2003, 10 'Carbon Workshops' were organized in Jülich, Stockholm and Hohenkammer. After this time, the scope of the symposium was redefined to reflect the new requirements of ITER and the ongoing evolution of the field. The workshop was first organized under its new name in 2006 in Greifswald, Germany. The main objective of this conference series is to provide a discussion forum for experts from research institutions and industry dealing with materials for plasma-facing components in present and future controlled fusion devices. The operation of ASDEX-Upgrade with tungsten-coated wall, the fast progress of the ITER-Like Wall Project at JET, the plans for the EAST tokamak to install tungsten, the start of ITER construction and a discussion about the wall material for DEMO all emphasize the importance of plasma-wall interactions and component behaviour, and give much momentum to the field. In this context, the properties and behaviour of beryllium, carbon and tungsten under plasma impact are research topics of foremost relevance and importance. Our community realizes both the enormous advantages and serious drawbacks of all the candidate materials. As a result, discussion is in progress as to whether to use carbon in ITER during the initial phase of operation or to abandon this element and use only metal components from the start. There is broad knowledge about carbon, both in terms of its excellent power-handling capabilities and the drawbacks related to chemical reactivity with fuel species and, as a consequence, about problems arising from fuel inventory and dust formation. We are learning continuously about beryllium and tungsten under fusion conditions, but our

  20. Assisted Gestation and Transgender Women.

    PubMed

    Murphy, Timothy F

    2015-07-01

    Developments in uterus transplant put assisted gestation within meaningful range of clinical success for women with uterine infertility who want to gestate children. Should this kind of transplantation prove routine and effective for those women, would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation? Getting to the point of safe and effective uterus transplantation for those parties would require a focused line of research, over and above the study of uterus transplantation for non-transgender women. Some commentators object to the idea that the state has any duty to sponsor research of this kind. They would limit all publicly-funded fertility research to sex-typical ways of having children, which they construe as the basis of reproductive rights. This objection has no force against privately-funded research, of course, and in any case not all social expenditures are responses to 'rights' properly speaking. Another possible objection raised against gestation by transgender women is that it could alter the social meaning of sexed bodies. This line of argument fails, however, to substantiate a meaningful objection to gestation by transgender women because social meanings of sexed bodies do not remain constant and because the change in this case would not elicit social effects significant enough to justify closing off gestation to transgender women as a class.

  1. Discordant twins with the smaller baby appropriate for gestational age – unusual manifestation of superfoetation: A case report

    PubMed Central

    Baijal, Noopur; Sahni, Mohit; Verma, Neeraj; Kumar, Amit; Parkhe, Nittin; Puliyel, Jacob M

    2007-01-01

    Background Documentation of superfoetation is extremely rare in humans., The younger foetus has invariably been small for gestational age (estimated from the date of the last menstrual bleed) in all the cases reported in the literature. We report a case where the younger twin was of appropriate size for gestation. Case Presentation The first of twins was of 32 weeks gestation and the baby was of appropriate size and development for the gestational age. The second twin was of 36 weeks gestation. Gestational age was estimated with the New Ballard score, x-ray of the lower limbs, dental age on x-ray, and ophthalmic examination. Conclusion Bleeding on implantation of the first foetus probably helped demarcate the two pregnancies. Dental age and the New Ballard score can be used to diagnose superfoetation in discordant twins, when detailed first trimester ultra-sound data is not available. PMID:17239246

  2. Should Bilateral Uterine Artery Notching be used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?

    PubMed Central

    Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado-Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki-Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.

    2010-01-01

    Objective To determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational age (SGA) without preeclampsia. Methods This prospective cohort study included 4,190 singleton pregnancies that underwent ultrasound examination between 23-25 weeks of gestation. The 95th percentile of the mean pulsatility index (PI) and resistance index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (≤34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension and delivery of an SGA without preeclampsia, while controlling for confounding factors. Results 1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; 2) 7.2% of the study population had bilateral uterine artery notching; 3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia [odds ratio (OR) 2.1; 95% confidence interval (CI):1.28-3.36], early-onset preeclampsia (OR: 4.47; 95%CI: 1.50-13.35), and gestational hypertension (OR: 1.50; 95%CI: 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions Bilateral uterine notching between 23-25 weeks of gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications. PMID:20587434

  3. Discrimination of DPRK M5.1 February 12th, 2013 Earthquake as Nuclear Test Using Analysis of Magnitude, Rupture Duration and Ratio of Seismic Energy and Moment

    NASA Astrophysics Data System (ADS)

    Salomo Sianipar, Dimas; Subakti, Hendri; Pribadi, Sugeng

    2015-04-01

    On February 12th, 2013 morning at 02:57 UTC, there had been an earthquake with its epicenter in the region of North Korea precisely around Sungjibaegam Mountains. Monitoring stations of the Preparatory Commission for the Comprehensive Nuclear Test-Ban Treaty Organization (CTBTO) and some other seismic network detected this shallow seismic event. Analyzing seismograms recorded after this event can discriminate between a natural earthquake or an explosion. Zhao et. al. (2014) have been successfully discriminate this seismic event of North Korea nuclear test 2013 from ordinary earthquakes based on network P/S spectral ratios using broadband regional seismic data recorded in China, South Korea and Japan. The P/S-type spectral ratios were powerful discriminants to separate explosions from earthquake (Zhao et. al., 2014). Pribadi et. al. (2014) have characterized 27 earthquake-generated tsunamis (tsunamigenic earthquake or tsunami earthquake) from 1991 to 2012 in Indonesia using W-phase inversion analysis, the ratio between the seismic energy (E) and the seismic moment (Mo), the moment magnitude (Mw), the rupture duration (To) and the distance of the hypocenter to the trench. Some of this method was also used by us to characterize the nuclear test earthquake. We discriminate this DPRK M5.1 February 12th, 2013 earthquake from a natural earthquake using analysis magnitude mb, ms and mw, ratio of seismic energy and moment and rupture duration. We used the waveform data of the seismicity on the scope region in radius 5 degrees from the DPRK M5.1 February 12th, 2013 epicenter 41.29, 129.07 (Zhang and Wen, 2013) from 2006 to 2014 with magnitude M ≥ 4.0. We conclude that this earthquake was a shallow seismic event with explosion characteristics and can be discriminate from a natural or tectonic earthquake. Keywords: North Korean nuclear test, magnitude mb, ms, mw, ratio between seismic energy and moment, ruptures duration

  4. An estimation of the primary proton spectrum between 10 to the 12th and 10 to the 14th eV

    NASA Technical Reports Server (NTRS)

    Gaisser, T. K.; Siohan, F.; Yodh, G. B.

    1978-01-01

    Based on measurements of unaccompanied charged hadron flux from 10 to the 11th to 10 to the 14th eV at mountain altitudes, the primary proton flux is estimated using recently determined proton-proton total cross sections from new measurements of the real part of the forward scattering amplitude at ISR, and Glauber theory to calculate proton-air inelastic cross section. The derived spectrum agrees well with extrapolation of the direct measurements below 2 times 10 to the 12th eV without change of slope.

  5. Primary proton and helium spectra in the energy range 10 to the 12th to 10 to the 14th eV

    NASA Technical Reports Server (NTRS)

    Gregory, J. C.; Ogata, T.; Saito, T.; Holynski, R.; Jurak, A.; Wolter, W.; Wosiek, B.; Dake, S.; Fuki, M.; Parnell, T. A.; Jones, W. V.

    1982-01-01

    Measurements of proton and helium spectra have been made in the energy range 10 to the 12th to 10 to the 14th eV. Large area thin emulsion calorimeters were used in the Japanese American Cooperative Emulsion Experiment balloon flight series. Power indices of the integral spectra for both nuclei are consistent with published data at lower energies. Absolute intensities are also consistent for helium and proton fluxes with extrapolations of previous data. No steepening of the proton spectrum is indicated.

  6. The effect of level of feeding in early gestation on reproductive success in young rabbit does.

    PubMed

    Rommers, J M; Meijerhof, R; Noordhuizen, J P T M; Kemp, B

    2004-03-01

    An experiment examined the effect of restricted feeding during early gestation on later feed intake and on kindling performance in young rabbit does. Nulliparous rabbit does (n=94) were inseminated at 14.5 weeks of age. During the first 10 days of gestation, does were fed individually either to appetite (AL) or 1.35 times maintenance requirement (R). After 10 days of gestation, all animals were fed to appetite. Does were weighed at insemination and after kindling. Feed intake was recorded during the first 10 days of gestation and weekly, thereafter. The number of does that kindled, number of live and stillborn kits and litter weight was recorded. The experiment ended after kindling. During feed restriction, AL does consumed 70 g/day more on an average than R does (209 and 139+/-4 g for AL and R, respectively; P<0.001). In the first and second week after feed restriction, compensatory feed intake occurred. Restrictive fed does ate more than AL does (+34+/-5 g/day from days 11 to 17 of gestation; P<0.001; +17+/-6g/day from days 18 to 24 of gestation; P<0.05). In the last week of gestation, feed intake of AL and R was comparable (89 and 100+/-5 g, respectively). At kindling, AL does had consumed 8+/-3g/day more feed over the total gestation period than R does (P<0.04). Feeding level during early gestation neither affected the kindling rate (83%), total litter size (7.9+/-0.4) nor the number of does with stillborn kits (10 versus 9 for AL and R, respectively). Regardless of treatment, in the last week of gestation (days 25-32) the number of does with stillbirth was lower and average birth weight was higher (P<0.01) in does eating more than the average daily feed intake compared to does eating below average. Based on the results of this study it was concluded that feed restriction for 10 days in early gestation does not affect kindling performance of young does, but feed intake in the last week of gestation affects kit survival and birth weight.

  7. Effects of available surface on gaseous emissions from group-housed gestating sows kept on deep litter.

    PubMed

    Philippe, F X; Canart, B; Laitat, M; Wavreille, J; Bartiaux-Thill, N; Nicks, B; Cabaraux, J F

    2010-10-01

    In the European Union, the group-housed pregnant sows have to have a minimal legal available area of 2.25 m2/sow. However, it has been observed that an increased space allowance reduces agonistic behaviour and consecutive wounds and thus induces better welfare conditions. But, what about the environmental impacts of this greater available area? Therefore, the aim of this study was to quantify pollutant gases emissions (nitrous oxide, N2O, methane, CH4, carbon dioxide, CO2 and ammonia, NH3), according to the space allowance in the raising of gestating sows group-housed on a straw-based deep litter. Four successive batches of 10 gestating sows were each divided into two homogeneous groups and randomly allocated to a treatment: 2.5 v. 3.0 m2/sow. The groups were separately kept in two identical rooms. A restricted conventional cereals based diet was provided once a day in individual feeding stalls available only during the feeding time. Rooms were automatically ventilated. The gas emissions were measured by infra red photoacoustic detection during six consecutive days at the 6th, 9th and 12th weeks of gestation. Sows performance (body weight gain, backfat thickness, number and weight of piglets) was not significantly different according to the space allowance. In the room with 3.0 m2/sow and compared with the room with 2.5 m2/sow, gaseous emissions were significantly greater for NH3 (6.29 v. 5.37 g NH3-N/day per sow; P < 0.01) and significantly lower for N2O (1.78 v. 2.48 g N2O-N/day per sow; P < 0.01), CH4 (10.15 v. 15.21 g/day per sow; P < 0.001), CO2 equivalents (1.11 v. 1.55 kg/day per sow; P < 0.001), CO2 (2.12 v. 2.41 kg/day per sow; P < 0.001) and H2O (3.10 v. 3.68 kg/day per sow; P < 0.001). In conclusion, an increase of the available area for group-housed gestating sow kept on straw-based deep litter seems to be ambiguous on an environmental impacts point of view. Compared with a conventional and legal available area, it favoured NH3 emissions, probably due

  8. Multiple gestation: side effects of antepartum bed rest.

    PubMed

    Maloni, Judith A; Margevicius, Seunghee Park; Damato, Elizabeth G

    2006-10-01

    The birth rate for higher order multiples has dramatically increased in recent decades. Multiple gestation pregnancies are considered to be at high obstetric risk. Antepartum bed rest is often prescribed to offset complications despite the lack of evidence for its effectiveness in preventing complications. This longitudinal repeated-measures study identified side effects of antepartum bed rest treatment for 31 hospitalized women with twin or triplet gestation. Maternal weight gain and infant birth weight were recorded. Antepartum stressors were measured by the Antepartum Stressors Hospital Inventory, and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Antepartum and post-partum side effects of bed rest were also assessed by the Antepartum and Postpartum Symptom Checklists. The weekly rate of maternal weight gain during hospitalization was significantly less than recent recommendations for multiple gestation weight gain (t = - 2.14, p = .04). Infant birth weights were appropriate for gestational age. There were fewer than expected small-for-gestational-age infants. Concerns regarding family status and separation from family were the major antepartum stressors. Women reported a high number of symptoms during bed rest (M = 22), which did not significantly change across 2 weeks. CES-D scores for depressive symptoms were high on antepartum hospital admission. Postpartum symptoms were initially high but had significantly declined by 6 weeks: F(1, 27) = 15.68, p = .00. These findings suggest that interventions are needed to reduce antepartum maternal weight loss, stress, physiologic and psychosocial symptoms, and depressive symptoms, as well as reduce postpartum symptoms of maternal morbidity.

  9. The Clinical Significance of Early (<20 Weeks) Versus Late (20–24 Weeks) Detection of a Sonographic Short Cervix in Asymptomatic Women in the Mid-Trimester

    PubMed Central

    Vaisbuch, Edi; Romero, Roberto; Erez, Offer; Kusanovic, Juan Pedro; Mazaki-Tovi, Shali; Gotsch, Francesca; Romero, Vivian; Ward, Clara; Chaiworapongsa, Tinnakorn; Mittal, Pooja; Sorokin, Yoram; Hassan, Sonia S.

    2010-01-01

    Objective The aim of this study was to determine whether the risk of early spontaneous preterm delivery (sPTD) in asymptomatic women with a sonographic cervical length ≤15 mm in the mid-trimester changes as a function of gestational age at diagnos Methods This cohort study included 109 asymptomatic patients with a sonographic sonographic cervical length ≤15 mm diagnosed at 14–24 weeks of gestation. Women with a multifetal gestation, cerclage, and those with a cervical dilatation >2 cm were excluded. The study population was stratified by gestational age at diagnosis (<20 weeks vs. 20–24 weeks) and by cervical length (≤10 mm vs. 11–15 mm). The primary outcome variables were PTD <28 and <32 weeks’ gestation and the diagnosis-to-delivery interval. Results 1) The median gestational age at diagnosis of a short cervix before 20 weeks and at 20–24 weeks was 18.9 and 22.7 weeks, respectively; 2) women diagnosed before 20 weeks had a higher rate of sPTD at <28 weeks (76.9% vs. 30.9%; p<0.001) and at <32 weeks (80.8% vs. 48.1%; p=0.004), and a shorter median diagnosis-to-delivery interval (21 vs. 61.5 days, p=0.003) than those diagnosed at 20–24 weeks; 3) The rate of amniotic fluid “sludge” was higher among patients diagnosed at <20 weeks of gestation than those diagnosed between 20 and 24 weeks (92.3% vs. 48.2%;p<0.001). Conclusions Asymptomatic women with a sonographic cervical length ≤15 mm diagnosed before 20 weeks have a dramatic and significantly higher risk of early preterm delivery than women diagnosed at 20–24 weeks. These findings can be helpful to physicians in counseling these patients, and may suggest different mechanisms of disease leading to a sonographic short cervix before or after 20 weeks of gestation. PMID:20503224

  10. Relation of rate of urine production to oxygen tension in small-for-gestational-age fetuses.

    PubMed

    Nicolaides, K H; Peters, M T; Vyas, S; Rabinowitz, R; Rosen, D J; Campbell, S

    1990-02-01

    Hourly fetal urine production rate was determined by real-time ultrasonography immediately before cordocentesis for blood gas analysis in 27 small-for-gestational-age fetuses at 20 to 37 weeks' gestation; in 14 cases there was associated oligohydramnios. The values were compared with those of 101 appropriate-for-gestational-age fetuses. The hourly fetal urine production rate was significantly lower in the small-for-gestational-age fetuses than in the appropriate-for-gestational-age fetuses. Furthermore, there was a significant correlation between the degree of decrease in urine production and both the degree of fetal hypoxemia and the degree of fetal smallness. There was no significant difference between the oligohydramnios and nonoligohydramnios groups in either the degree of decrease in urine production or the degree of fetal hypoxemia.

  11. Detecting and managing gestational diabetes.

    PubMed Central

    Blair, M. M.; Noc, A. M.

    1993-01-01

    Gestational diabetes is an asymptomatic metabolic disorder of pregnancy associated with increased morbidity in mother and fetus. Early detection and intervention improve pregnancy outcome. This article reviews the current approach to diagnosis and management. Specific guidelines for nutritional management and insulin use are included. PMID:8495138

  12. Gestational diabetes insipidus. Case Report.

    PubMed

    Ejmocka-Ambroziak, Anna; Grzechocińska, Barbara; Jastrzebska, Helena; Kochman, Magdalena; Cyganek, Anna; Wielgoś, Mirosław; Zgliczyński, Wojciech

    2015-01-01

    Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor.

  13. Exercise during pregnancy and its association with gestational weight gain.

    PubMed

    Harris, Shericka T; Liu, Jihong; Wilcox, Sara; Moran, Robert; Gallagher, Alexa

    2015-03-01

    We examined the association between exercise during pregnancy and meeting gestational weight gain recommendations. Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (n = 856). Women reported their participation in exercise/sports activities before and during pregnancy, including the number of months and types of exercise. We developed an exercise index (EI), the product of the number of months spent in exercise and average metabolic equivalents for specific exercise. The 2009 Institute of Medicine's guideline was used to categorize gestational weight gain into three classes: inadequate, adequate, and excessive. Multinomial logistic regression models were used to adjust for confounders. Over 46 % of women exceeded the recommended weight gain during pregnancy. Nearly one third (31.9 %) of women reported exercising ≥3 times a week at any time during pregnancy. Compared to women who did not report this level of exercise during pregnancy, exercising women were more likely to meet gestational weight gain recommendations (32.7 vs. 18.7 %) and had a lower odds of excessive gestational weight gain [adjusted odds ratio (AOR) 0.43, 95 % confidence interval 0.24-0.78]. Women with an EI above the median value of those women who exercised or women who exercised ≥3 times a week for 6-9 months during pregnancy had lower odds of excessive gestational weight gain (AOR for EI 0.20, 0.08-0.49; AOR for months 0.26, 0.12-0.56, respectively). Our findings support the need to promote or increase exercise during pregnancy to reduce the high proportion of women who are gaining excessive weight.

  14. Labour induction with gestational hypertension: A great obstetric challenge

    PubMed Central

    Khaskheli, Meharun-Nissa; Baloch, Shahla; Sheeba, Aneela; Baloch, Sarmad; Khan, Fahad

    2017-01-01

    Objective: To observe the fetomaternal morbidity and mortality with induction of labour in pregnant women with gestational hypertension. Methods: The subjected study population included was 138 pregnant women with gestational hypertension. These pregnant women were between 34-40 weeks of gestational period in whom labour was induced, while the pregnant women who had labour induction for other reasons were excluded. These women were registered on the predesigned proforma. The data was collected and analyzed on SPSS version 21. Result: Out of the 138 cases, mean age of the women was 25.93±5.037, prim gravid women were 78(56.5%), gestational period in majority of these women 71(51.4%) varied between 35-38 weeks. The common presenting symptoms were oedema 119(86.23%), headache 90(65.21%). Labour induction in majority of the cases 81(58.7%) was carried with prosten pessary. The Caesarean section was needed in 39(28.3%) women in emergency due to maternal and fetal reasons or due to failed induction. Maternal complications were uncontrolled hypertension 23(16.7%), intensive care unit admission 21(15.2%), fits 15(10.9%), post partum haemorrhage 13(9.4%). Fetal complications were birth asphyxia 49(35.5%), neonatal intensive care unit admission 17(12.3%), neonatal death 14(10.1%). Conclusion: The emergency Caesarean section rate was quite high with induction of labour in pregnant women with gestational diabetes. The maternal morbidity as well as fetal morbidity and mortality rate was also high.

  15. Perinatal Outcome in Assisted Reproductive Pregnancies: Comparative Analysis of Reduced versus Unreduced Gestation

    PubMed Central

    Agrawal, Pallavi; Ganguly, Ishita; Gupta, Nitika

    2016-01-01

    Objectives. This study aims to evaluate perinatal outcomes such as gestational age at delivery and live birth rate in singleton and twin gestation with or without fetal reduction. Method. A retrospective analysis was done on patients which were divided into reduced and unreduced groups on the basis of order of reduction of one or more fetuses between 6 and 13 weeks of gestation. Patients records were studied to note gestational age at delivery/abortion, birth weight, and neonatal outcome. Result. The cohort included a total of 292 patients: 102 singletons and 190 twins. 52 pregnancies were reduced in singleton cohort and 68 were reduced in twin cohort. No statistical difference was observed in live birth rate, gestational age at delivery, and birth weight and significant higher incidence of IUGR was observed in reduced and unreduced twin gestation. In singleton pregnancies however preterm delivery rate increased with fetal reduction. Conclusion. Although reduction does not reduce the live birth rate, it does reduce gestation age of delivery and birth weight of newborn. This effect is more apparent when multiple gestation is reduced to singleton. PMID:27999824

  16. Improving gestational weight gain counseling through meaningful use of an electronic medical record.

    PubMed

    Lindberg, Sara M; Anderson, Cynthie K

    2014-11-01

    The purpose of this study was to test the effectiveness of an intervention to improve the consistency and accuracy of antenatal gestational weight gain counseling through introduction of a "best practice alert" into an electronic medical record (EMR) system. A best practice alert was designed and implemented in the EMR. Based on each patient's pre-gravid body mass index (BMI), fetal number, and 2009 Institute of Medicine (IOM) guidelines, the alert provides an individualized total gestational weight gain goal, the weight gain goal per week of gestation, a template for scripted provider counseling and documentation, and a patient handout containing personalized gestational weight gain information. Retrospective chart reviews of 388 pre-intervention patients and 345 post-intervention patients were used to evaluate effectiveness. Introduction of a gestational weight gain best practice alert into the EMR improved the rate of antenatal gestational weight gain counseling that was consistent with current IOM guidelines (p < 0.001). Improvement in IOM-consistent gestational weight gain counseling was seen across all provider types, including obstetricians, family practice physicians, and certified nurse midwives. The intervention also resulted in significant improvement in documentation of pre-gravid weights and BMIs within the EMR. The EMR is an effective tool for improving the consistency and accuracy of antenatal gestational weight gain counseling in accord with 2009 IOM guidelines.

  17. N-terminal-pro-brain natriuretic peptide is decreased in insulin dependent gestational diabetes mellitus: a prospective cohort trial

    PubMed Central

    2011-01-01

    Background N-terminal-pro-brain natriuretic peptide (NT-proBNP) is elevated in gestational hypertension and preeclampsia. This trial aimed to generate data for gestational diabetes mellitus patients, who are at risk to develop these complications. Methods We have measured NT-proBNP in 223 otherwise healthy women between gestational week 24 and 32 referred to the outpatient diabetes unit in a cross-sectional study. Results 88 control subjects, 45 patients with indication for medical nutrition therapy (MNT) alone and 90 patients who required insulin therapy were included. Groups of women were comparable regarding gestational week. Body mass index before pregnancy and at blood draw was significantly higher in subjects with insulin dependent gestational diabetes mellitus compared to MNT controlled gestational diabetes mellitus. NT-proBNP was significantly lower in patients with insulin dependent gestational diabetes mellitus (35 ± 25 pg/ml) compared to controls (53 ± 43 pg/ml, p = 0.012). Conclusions NT-proBNP is within the reference range of normal subjects in women with gestational diabetes mellitus. Differences in body mass index, changes in glomerular filtration rate and haemodynamics may explain lower NT-proBNP concentrations in insulin dependent gestational diabetes mellitus. A false negative interpretation needs to be considered in these women. PMID:21489265

  18. Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe.

    PubMed

    Friis, Henrik; Gomo, Exnevia; Nyazema, Norman; Ndhlovu, Patricia; Krarup, Henrik; Kaestel, Pernille; Michaelsen, Kim Fleischer

    2004-11-01

    The role of maternal infections, nutritional status and obstetric history in low birth weight is not clear. Thus, the objective of the present study was to assess the effects of maternal HIV infection, nutritional status and obstetric history, and season of birth on gestation length and birth size. The study population was 1669 antenatal care attendees in Harare, Zimbabwe. A prospective cohort study was conducted as part of a randomised, controlled trial. Maternal anthropometry, age, gravidity, and HIV status and load were assessed in 22nd-35th weeks gestation. Outcomes were gestation length and birth size. Birth data were available from 1106 (66.3%) women, of which 360 (32.5%) had HIV infection. Mean gestation length was 39.1 weeks with 16.6% <37 weeks, mean birth weight was 3030 g with 10.5% <2500 g. Gestation length increased with age in primigravidae, but not multigravidae (interaction, P=0.005), and birth in the early dry season, low arm fat area, multiple pregnancies and maternal HIV load were negative predictors. Birth weight increased with maternal height, and birth in the late rainy and early dry season; primi-secundigravidity, low arm fat area, HIV load, multiple pregnancies and female sex were negative predictors. In conclusion, gestation length and birth weight decline with increasing maternal HIV load. In addition, season of birth, gravidity, maternal height and body fat mass, and infant sex are predictors of birth weight.

  19. Alcohol mixed with energy drink use among U.S. 12th-grade students: Prevalence, correlates, and associations with unsafe driving

    PubMed Central

    Martz, Meghan E.; Patrick, Megan E.; Schulenberg, John E.

    2015-01-01

    Purpose The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. Methods Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) following alcohol consumption. Results Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and White students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors, and other substance use. Conclusions AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern. PMID:25907654

  20. Climate Change and the Water Cycle: A New Southwest Regional Climate Hub Curriculum Unit for 6th-12th Grade Students

    NASA Astrophysics Data System (ADS)

    Elias, E.; Steele, C. M.; Bestelmeyer, S.; Haan-Amato, S.; Deswood, H.; Rango, A.; Havstad, K.

    2015-12-01

    As climate change intensifies, increased temperatures and altered precipitation will make water, a limited resource in the arid southwestern United States, even scarcer in many locations. The USDA Southwest Regional Climate Hub (SWRCH) developed Climate Change and the Water Cycle, an engaging and scientifically rigorous education unit for 6th -12th grade students. The unit is aligned with Common Core State Standards and Next Generation Science Standards. Nine activities can be conducted over 10 instruction hours. Each activity can also stand alone. In partnership with SWRCH, the Asombro Institute for Science Education developed the unit. Each activity was reviewed by an educator for educational practices and by a scientist for scientific accuracy. The unit was pilot tested with 524 students in 2014, and pre- and post-tests were administered. Ninety-one percent of students were able to name a greenhouse gas on the post-test, compared to only 48% on the pre-test. On the post-test, 86% of students identified the relationship between average global temperature and carbon dioxide levels in the atmosphere, compared to only 52% on the pre-test. A student commented: "I loved all of the activities! They are fun and help us understand about what goes on in the world." Educators who participated in pilot testing said: "the entire curriculum is great, but I was particularly impressed with the progression of ideas and the variety of lessons," and "students could see the relevance and importance of these real life issues." Anyone interested in using the unit to host workshops for teachers in southwestern states should contact Asombro for more information (information@asombro.org). The Climate Change and the Water Cycle 6th-12th grade curriculum unit is available online: www.swclimatehub.info/education/climate-change-and-water-cycle

  1. Impact of gestational risk factors on maternal cardiovascular system

    PubMed Central

    Perales, María; Santos-Lozano, Alejandro; Luaces, María; Pareja-Galeano, Helios; Garatachea, Nuria; Barakat, Rubén; Lucia, Alejandro

    2016-01-01

    Background Scarce evidence is available on the potential cardiovascular abnormalities associated with some common gestational complications. We aimed to analyze the potential maternal cardiac alterations related to gestational complications, including body mass index (BMI) >25 kg/m2, gaining excessive weight, or developing antenatal depression. Methods The design of this study was a secondary analysis of a randomized controlled trial. Echocardiography was performed to assess cardiovascular indicators of maternal hemodynamic, cardiac remodeling and left ventricular (LV) function in 59 sedentary pregnant women at 20 and 34 weeks of gestation. Results Starting pregnancy with a BMI >25 kg/m2, gaining excessive weight, and developing antenatal depression had no cardiovascular impact on maternal health (P value >0.002). Depressed women were more likely to exceed weight gain recommendations than non-depressed women (P value <0.002). Conclusions The evaluated gestational complications seem not to induce cardiovascular alterations in hemodynamic, remodeling and LV function indicators. However, developing antenatal depression increases the risk of an excessive weight gain. This finding is potentially important because excessive weight gain during pregnancy associates with a higher risk of cardiovascular diseases (CVD) later in life. PMID:27500154

  2. Perceived needs in women with gestational diabetes: A qualitative study

    PubMed Central

    Khooshehchin, Taraneh Emamgoli; Keshavarz, Zohre; Afrakhteh, Maryam; Shakibazadeh, Elham; Faghihzadeh, Soghrat

    2016-01-01

    Introduction Diabetes is the most common medical complication of pregnancy. It can be associated with many complications for mother and fetus. Gestational diabetes is also one of the main health issues in Iran. Therefore, the present study is aimed at a deeper understanding of women’s experiences of gestational diabetes and their perceived needs to inform future lifestyle interventions. Methods This qualitative content analysis study was carried out in 2015. Participants were pregnant women diagnosed with gestational diabetes in the 24th to 36th week of pregnancy, who were referred to the clinics affiliated with Shahid Beheshti Medical Science University in Tehran, Iran. In-depth interviews were conducted with participants, using semi-structured questions. Interviews were audio taped and transcribed verbatim. Conventional content analysis was carried out for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). Results Content analysis highlighted two themes; educational needs and need to support. The former was featured with five main categories: information sources, education process, unknown and known, weaknesses of public information system, and eagerness to learn. The latter was featured with two main categories: family support and social support. Conclusion Clarifying the needs of the mothers with gestational diabetes, leads to better and proper education planning and a program toward the improvement of health, self-care, and prevention of diabetes. PMID:28163857

  3. Temporal changes in pregnancy-associated glycoproteins across different stages of gestation in the Barbari goat.

    PubMed

    Tandiya, Ujjawala; Nagar, V; Yadav, V P; Ali, I; Gupta, M; Dangi, S S; Hyder, I; Yadav, Brijesh; Bhakat, M; Chouhan, V S; Khan, F A; Maurya, V P; Sarkar, M

    2013-11-30

    The objective of this study was to characterize the temporal profile of pregnancy-associated glycoproteins (PAGs; isoforms 1-11) across different stages of gestation in the Barbari goat. Placentae were collected from local abattoir, classified according to crown rump length of the corresponding foetus into five groups (0-30, 31-60, 61-90, 91-120, and 121-150 days of gestation), and used for relative quantification of mRNA expression by Pfaffl method. In addition, adult female goats (pregnant, n = 7; non-pregnant, n = 5) were used to estimate weekly plasma PAG and progesterone (P4) concentrations. The relative mRNA expression of PAGs was greater (p<0.05) during 31-60 days of gestation, which correlated well with the temporal changes in plasma PAG concentrations. Relative expression of PAGs decreased steadily as gestation advanced with minimum expression observed just before parturition, except for PAG-4 and PAG-8 that showed constantly higher expression throughout pregnancy. Plasma PAG and P4 concentrations showed a distinct temporal pattern with a significant increase beginning at 2 weeks and return to basal levels by 20 weeks of gestation. However, PAG concentrations reached a peak earlier in gestation (8 weeks) than P4 (10-14 weeks). Correlation analysis indicated a strong positive association (r = 0.748, p<0.01) between plasma PAG and P4 concentrations. In conclusion, results of this study indicate a distinct temporal pattern of PAG expression and secretion during gestation in the Barbari goat. The temporal changes in PAGs and the positive association with P4 are suggestive of their role in maintenance of pregnancy and progressive foetal development.

  4. My week: Marc Armour.

    PubMed

    2017-03-11

    Marc Armour, is a fourth-year vet student at the Royal Veterinary College. Now on rotations, he chose to spend a week doing EMS with the BVA's journals, which are published by BMJ. Here's how he got on.

  5. My week: Sara Robson.

    PubMed

    Robson, Sara

    2017-01-28

    Having an interest in government veterinary work, Cambridge fifth-year vet student Sara Robson jumped at the chance of spending a week with Defra to learn what it does and the job opportunities it offers.

  6. MotorWeek

    ScienceCinema

    None

    2016-07-12

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  7. MotorWeek

    SciTech Connect

    2009-01-01

    In 2008, PBS's MotorWeek, television's original automotive magazine, visited Argonne's Transportation Technology R&D Center "to learn what it really takes to make clean power sources a viable reality."

  8. Estimating conception statistics using gestational age information from NHS Numbers for Babies data.

    PubMed

    Chow, Yuan Huang; Dattani, Nirupa

    2009-01-01

    Conception statistics routinely published for England and Wales include pregnancies that result in one or more live- or stillbirths (a maternity) or an abortion. All live births are assumed to be 38 weeks gestation as information on gestation is not collected at birth registration. For the first time, gestational age information from the National Health Service (NHS) Numbers for Babies (NN4B) data has been used to re-estimate conception statistics for 2005. This shows that 72 per cent of conceptions leading to a maternity in fact have a gestati on period that differs from 38 weeks and most of these fall at either 37 or 39 weeks. The age-specific conception rates using this revised method are not significantly different to those produced using the current method.

  9. Earth Science Week evolves

    NASA Astrophysics Data System (ADS)

    Earth Science Week, October 7-13, is an annual grassroots effort sponsored by the American Geological Institute (AGI) and its member societies, of which AGU is the largest. This year, for the first time, Earth Science Week has a general theme, evolution in Earth history. The Earth Science Week information kit for 2001, available from AGI, includes a variety of posters, bookmarks, and other materials that illustrate this concept. The kit contains a new 32-page “Ideas and Activities” booklet that emphasizes evolution in Earth history through an array of activities about rocks, fossils, and geologic time. It also has information on the upcoming Public Broadcasting Service series, “Evolution,” which is to be aired in late September.

  10. A two-component Bayesian mixture model to identify implausible gestational age

    PubMed Central

    Mohammadian-Khoshnoud, Maryam; Moghimbeigi, Abbas; Faradmal, Javad; Yavangi, Mahnaz

    2016-01-01

    Background: Birth weight and gestational age are two important variables in obstetric research. The primary measure of gestational age is based on a mother’s recall of her last menstrual period. This recall may cause random or systematic errors. Therefore, the objective of this study is to utilize Bayesian mixture model in order to identify implausible gestational age. Methods: In this cross-sectional study, medical documents of 502 preterm infants born and hospitalized in Hamadan Fatemieh Hospital from 2009 to 2013 were gathered. Preterm infants were classified to less than 28 weeks and 28 to 31 weeks. A two-component Bayesian mixture model was utilized to identify implausible gestational age; the first component shows the probability of correct and the second one shows the probability of incorrect classification of gestational ages. The data were analyzed through OpenBUGS 3.2.2 and 'coda' package of R 3.1.1. Results: The mean (SD) of the second component of less than 28 weeks and 28 to 31 weeks were 1179 (0.0123) and 1620 (0.0074), respectively. These values were larger than the mean of the first component for both groups which were 815.9 (0.0123) and 1061 (0.0074), respectively. Conclusion: Errors occurred in recording the gestational ages of these two groups of preterm infants included recording the gestational age less than the actual value at birth. Therefore, developing scientific methods to correct these errors is essential to providing desirable health services and adjusting accurate health indicators. PMID:28210605

  11. A resolution congratulating the students, parents, teachers, and administrators of charter schools across the United States for ongoing contributions to education, and supporting the ideals and goals of the 12th annual National Charter Schools Week.

    THOMAS, 112th Congress

    Sen. Landrieu, Mary L. [D-LA

    2011-05-02

    05/05/2011 Resolution agreed to in Senate without amendment and an amended preamble by Unanimous Consent. (text: CR S2752) (All Actions) Tracker: This bill has the status Passed SenateHere are the steps for Status of Legislation:

  12. Agreement between maternal interview- and medical record-based gestational age.

    PubMed

    Hakim, R B; Tielsch, J M; See, L C

    1992-09-01

    Agreement between maternal interview- and medical record-based gestational age was assessed by using data from a case-control study of childhood strabismus. The sample consisted of 383 cases of strabismus and their age-matched controls, diagnosed between 1985 and 1986 in Baltimore, Maryland, who were under age 7 years when diagnosed. Medical record-based gestational age was derived, in order of priority, from early ultrasound examination, time from the last menstrual period, pediatric examination, and obstetric examination. The intraclass correlation coefficient, kappa, and mean difference were used to compare agreement between maternal interview- and medical record-based gestational age by maternal and pregnancy characteristics and characteristics related to study design. Overall, 86 percent of mothers were within 2 weeks of the gestational age reported in the medical record. The intraclass correlation coefficient comparing maternal and medical record-based gestational age was 0.83 (95% confidence interval 0.80-0.86). Agreement was positively associated with shorter length of recall, low birth order, and having a neonatal illness related to prematurity. Agreement was poor among mothers of healthy preterm infants. There was a weak positive association between recall and some sociodemographic covariates. There was greater misclassification of prematurity in the controls than in the cases. The results suggest that, in general, women recall gestational age well, which supports the use of gestational age derived from maternal interviews.

  13. Evaluating Earth and Space Sciences STEM Research Communication in 7th-12th Grade Rural Mississippi Classrooms and Resulting Student Attitudinal Impacts

    NASA Astrophysics Data System (ADS)

    Radencic, S.; McNeal, K. S.

    2013-05-01

    Observation and evaluation of STEM graduate students from Mississippi State University communicating their research of the Earth and Space Sciences in rural 7th-12th grade classrooms participating in the Initiating New Science Partnerships in Rural Education (INSPIRE) NSF GK-12 project. The methods they utilize to communicate their STEM research includes introducing new technologies and inquiry based learning experiences. These communication experiences have been observed and evaluated using two observational systems, the Mathematics Science Classroom Observational Profile System (M-SCOPS) and the Presentation Skills Protocol (PSP). M-SCOPS has been used over the first three years of the project to evaluate what Earth and Space research the STEM graduate students communicate in classroom activities along with how they are introducing STEM research through a variety of communication methods and levels of understanding. PSP, which INSPIRE began using this year, evaluates and provides feedback to the STEM graduate students on their communication during these classroom experiences using a rubric covering a range of skills for successful communication. PSP also allows the participating INSPIRE teacher partners to provide feedback to the STEM graduate students about development of their communication skills over the course of the year. In addition to feedback from the INSPIRE project and participating teachers, the STEM graduate students have the opportunity to evaluate their personal communication skills through video documentation to determine specific skills they would like to improve. Another area of research to be discussed is how the STEM graduate students communicating Earth and Space sciences research in the participating classrooms is impacting student attitudes about science and mathematics over the last three years. Student Attitudinal Surveys (SAS) are administered as a pre-evaluation tool in the fall when the STEM graduate students first enter into their

  14. One Week Every Year.

    ERIC Educational Resources Information Center

    LeBuffe, James R.

    1991-01-01

    Guidelines are offered to schools and communities for developing activities of a yearly Deaf Awareness Week. Topics covered should include general information about deafness; common myths and misunderstandings; information about sign languages; technologies available to deaf people; interpreting; and interaction among deaf and hearing students.…

  15. A Week of Observations

    ERIC Educational Resources Information Center

    Colasacco, Jenne

    2011-01-01

    Even the most effective teachers have room to grow, but it's not always easy for principals to give adequate guidance through short observations. High school principal Jenne Colasacco decided to bring more depth to her observations by observing each of her teachers during one class for an entire week. The new observation structure, which included…

  16. Swahili 12 Weeks Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This 12-weeks course in basic Swahili comprises 55 lesson units in five volumes. The general course format consists of (1) perception drills for comprehension, oral production, and association using "situational picture" illustrations; (2) dialogs in English and Swahili, with cartoon guides; (3) sequenced pattern and recombination drills, and (4)…

  17. Phun Week: Understanding Physiology

    ERIC Educational Resources Information Center

    Limson, Mel; Matyas, Marsha Lakes

    2009-01-01

    Topics such as sports, exercise, health, and nutrition can make the science of physiology relevant and engaging for students. In addition, many lessons on these topics, such as those on the cardiovascular, respiratory, and digestive systems, align with national and state life science education standards. Physiology Understanding Week (PhUn…

  18. Arabic 12 Weeks Course.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    Volumes 1 and 2 (Lesson Units 1-55) of this beginning course in Arabic follow the Defense Language Institute format for intensive 12-week language courses, designed for native-speaker instructors using audiolingual methodology in the classroom. The third (and final) volume in this series constitutes a reference guide to pronunciation and grammar…

  19. A Week for Space

    ERIC Educational Resources Information Center

    Comstock, Diane

    2008-01-01

    Space Week focuses on concepts that enable students to make concrete observations in the early grades (K-2) and move to concepts that help students develop their internet research and writing skills in middle and upper grades (Grades 3-5), and culminates with the development of science investigation design skills (Grade 6). To help launch your…

  20. Trends in the Distribution of Gestational Age and Contribution of Planned Births in New South Wales, Australia

    PubMed Central

    Nassar, Natasha; Schiff, Michal; Roberts, Christine L.

    2013-01-01

    Background There is concern that the rate of planned births (by pre-labour caesarean section or induction of labour) is increasing and that the gestation at which they are being conducted is decreasing. The aim of this study was to describe trends in the distribution of gestational age, and assess the contribution of planned birth to any such changes. Methods We utilised the New South Wales (NSW) Perinatal Data Collection to undertake a population-based study of all births in NSW, Australia 1994–2009. Trends in gestational age were determined by year, labour onset and plurality of birth. Results From 1994–2009, there was a gradual and steady left-shift in overall distribution of gestational age at birth, with a decline in the modal gestational age from 40 to 39 weeks. For singletons, there was a steady but significant reduction in the proportion of spontaneous births. Labour inductions increased in the proportion performed, with a gradual and changing shift in the distribution from a majority at 40 weeks to an increase at both 37–39 weeks and 41 weeks gestation. The proportion of pre-labour caesareans also increased steadily at each gestational age and doubled since 1994, with most performed at 39 weeks in 2009 compared with 38 weeks up to 2001. Conclusions Findings suggest a changing pattern towards births at earlier gestations, fewer births commencing spontaneously and increasing planned births. Factors associated with changing clinical practice and long-term implications on the health and well-being of mothers and babies should be assessed. PMID:23437101

  1. Zinc-Associated Variant in SLC30A8 Gene Interacts With Gestational Weight Gain on Postpartum Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes Mellitus.

    PubMed

    Wang, Tiange; Liu, Huikun; Wang, Leishen; Huang, Tao; Li, Weiqin; Zheng, Yan; Heianza, Yoriko; Sun, Dianjianyi; Leng, Junhong; Zhang, Shuang; Li, Nan; Hu, Gang; Qi, Lu

    2016-12-01

    Zinc transporter 8 genetic variant SLC30A8 has been associated with postpartum risk of type 2 diabetes among women with gestational diabetes mellitus (GDM). Gestational weight gain is one of the strongest risk factors for postpartum hyperglycemia. We assessed the interaction between type 2 diabetes-associated SLC30A8 rs13266634 and gestational weight gain on 1-5 years of postpartum glycemic changes in 1,071 women with prior GDM in a longitudinal study. Compared with gestation of 26-30 weeks, postpartum levels of fasting glucose, oral glucose tolerance test 2-h glucose, and hemoglobin A1c (HbA1c) increased across rs13266634 TT, CT, and CC genotypes in women with excessive gestational weight gain, whereas opposite genetic associations were found in women with inadequate or adequate gestational weight gain. Postpartum changes in fasting glucose per additional copy of the C allele were -0.18, -0.04, and 0.12 mmol/L in women with inadequate, adequate, and excessive gestational weight gain, respectively (P for interaction = 0.002). We also found similar interactions for changes in 2-h glucose and HbA1c (P for interaction = 0.003 and 0.005, respectively). Our data indicate that gestational weight gain may modify SLC30A8 variant on long-term glycemic changes, highlighting the importance of gestational weight control in the prevention of postpartum hyperglycemia in women with GDM.

  2. Conservative Management of an Advanced Abdominal Pregnancy at 22 Weeks

    PubMed Central

    Marcellin, Louis; Ménard, Sophie; Lamau, Marie-Charlotte; Mignon, Alexandre; Aubelle, Marie Stephanie; Grangé, Gilles; Goffinet, François

    2014-01-01

    Objective We report an uneventful conservative approach of an advanced abdominal pregnancy discovered at 22 weeks of gestation. Study Design This study is a case report. Results Attempting to extend gestation of an advanced abdominal pregnancy is not a common strategy and is widely questioned. According to the couple's request, the management consisted in continuous hospitalization, regular ultrasound scan, and antenatal corticosteroids. While the woman remained asymptomatic, surgery was planned at 32 weeks, leading to the birth of a preterm child without any long-term complications. Placenta was left in situ with a prophylactic embolization, and its resorption was monitored. Conclusion Depending on multidisciplinary cares and agreement of the parents, when late discovered, prolonging advanced abdominal pregnancy appears to be a reasonable option. PMID:25032062

  3. Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age

    PubMed Central

    Sridhar, Sneha B.; Xu, Fei; Hedderson, Monique M.

    2016-01-01

    Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90th percentile or <10th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2nd and 3rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1st: 1.17 [0.94, 1.44], 2nd: 1.47 [1.13, 1.92], 3rd: 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2nd and 3rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth. PMID:27442137

  4. Detection of subsequent episodes of gestational diabetes mellitus: a need for specific guidelines.

    PubMed

    Maser, Raelene E; Lenhard, M James; Henderson, Bernardine C; Cobb, Rosemary S; Hands, Kathleen E

    2004-01-01

    Guidelines for detection of individuals with gestational diabetes mellitus (GDM) indicate that glucose testing for women with a history of GDM should occur as soon as feasible with retesting of an initially negative screen to occur between the 24th and 28th week of gestation. The aim of this study was to evaluate medical records for individuals enrolled in a GDM management program that presented with two subsequent pregnancies with GDM and to determine if more specific guidelines for detection are needed. Records (n=60) from both pregnancies were reviewed for gestational age at enrollment, delivery, and when insulin was started, infant birth weights and complications (e.g., hypoglycemia), and maternal complications (e.g., emergency cesarean section). Over half [33/60 (55%)] of the women required insulin during both pregnancies, while 16.7% (10/60) required insulin during the second enrollment for GDM but not the first. For those requiring insulin during both pregnancies, 88% (29/33) required it earlier during the subsequent pregnancy (31.5+/-2.7 vs. 21.6+/-8.4 weeks of gestation, P<.001). During the subsequent pregnancy, approximately 1/2 of the women requiring insulin needed it before the 24th week of gestation while 1/3 required it by the 15th week. Also during the subsequent pregnancy, neonate birth weights declined (3494+/-521 vs. 3356+/-515 g, P<.05) and there were fewer complications. Given that approximately 70% of the women required insulin therapy during a subsequent GDM pregnancy and that this therapy was on average necessary by the 22nd week of gestation, we recommend that specific guidelines be established with a definitive time frame determined for the detection of repeat episodes of GDM.

  5. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    USGS Publications Warehouse

    Benson, L.V.; Berry, M.S.; Jolie, E.A.; Spangler, J.D.; Stahle, D.W.; Hattori, E.M.

    2007-01-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  6. Longitudinal Study of Career Cluster Persistence from 8th Grade to 12th Grade with a Focus on the Science, Technology, Engineering, & Math Career Cluster

    NASA Astrophysics Data System (ADS)

    Wagner, Judson

    Today's technology driven global economy has put pressure on the American education system to produce more students who are prepared for careers in Science, Technology, Engineering, and Math (STEM). Adding to this pressure is the demand for a more diverse workforce that can stimulate the development of new ideas and innovation. This in turn requires more female and under represented minority groups to pursue future careers in STEM. Though STEM careers include many of the highest paid professionals, school systems are dealing with exceptionally high numbers of students, especially female and under represented minorities, who begin but do not persist to STEM degree completion. Using the Expectancy-Value Theory (EVT) framework that attributes student motivation to a combination of intrinsic, utility, and attainment values, this study analyzed readily available survey data to gauge students' career related values. These values were indirectly investigated through a longitudinal approach, spanning five years, on the predictive nature of 8 th grade survey-derived recommendations for students to pursue a future in a particular career cluster. Using logistic regression analysis, it was determined that this 8 th grade data, particularly in STEM, provides significantly high probabilities of a 12th grader's average grade, SAT-Math score, the math and science elective courses they take, and most importantly, interest in the same career cluster.

  7. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    NASA Astrophysics Data System (ADS)

    Benson, Larry V.; Berry, Michael S.; Jolie, Edward A.; Spangler, Jerry D.; Stahle, David W.; Hattori, Eugene M.

    2007-02-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  8. Absence of point mutation in the 12th codon of transformed c-Ha-rasl genes of human cancer of the breast, stomach, melanoma, and neuroblastoma

    SciTech Connect

    Knyazev, P.G.; Schafer, R.; Willecke, K.V.; Seitz, I.F.

    1985-11-01

    In the authors' previous investigations, they established that the tumorous cell lines SK-BR-3 (breast cancer), LAN-1 (neuroblastoma), and a heterotransplant of malignant melanoma Jal contain transforming genes of Ha-ras type. Now, the authors report their results using restriction endonucleases of MspI and HpaII restriction to study nucleotide sequences 5'-CCGGC-3' and 3'GGCCG-5', which contain the 12th codon of GGC for the amino acid glycine in the normal allele of c-Ha-rasl in the three tumors listed above, in addition to human adenocarcinoma of the stomach (CaVSt) and normal cells corresponding to them. For hybridization of MspI/HpaII, fragments of chromosomal DNA isolated from cell lines SK-BR-3, and LAN-1, Ja-1 heterotransplant, and stomach adenocarcinoma CaVSt, the XmaI section of EJ oncogene, c-Ha-rasl (plasmid pEJ 6.6), labeled with /sup 32/P was used in down-translation reaction. Hybridization was performed in 3 x SSC buffer containing 5x Deinhardt's reagent and 10% dextran sulfate at 68/sup 0/C for 16-18 h. Washing of filters was conducted under rigid conditions. For autoradiography, Kodak XR-5 x-ray film in cartridges with reinforcing shields was used at -70/sup 0/C, exposure time of four to six days.

  9. Slow-release carbohydrates: growing evidence on metabolic responses and public health interest. Summary of the symposium held at the 12th European Nutrition Conference (FENS 2015)

    PubMed Central

    Vinoy, Sophie; Laville, Martine; Feskens, Edith J M

    2016-01-01

    To draw attention to the necessity of considering differences in the digestibility of carbohydrates, and more specifically of starch, a symposium was held at the 12th European Nutrition Conference (FENS), which took place in Berlin from October 20 to 23, 2015. The purpose of this session was to present the consolidated knowledge and recent advances regarding the relationship between slow-release carbohydrates, metabolic responses, and public health issues. Three main topics were presented: 1) the definition of, sources of, and recognised interest in the glycaemic response to slowly digestible starch (SDS); 2) clinical evidence regarding the physiological effects of slow-release carbohydrates from cereal foods; and 3) interest in reducing the postprandial glycaemic response to help prevent metabolic diseases. Foods with the highest SDS content induce the lowest glycaemic responses, as the starch is protected from gelatinisation during processing. In humans, high-SDS food consumption induces slower glucose release, lower postprandial insulinaemia, and stimulation of gut hormones. Moreover, postprandial hyperglycaemia is an independent risk factor for type two diabetes mellitus (T2DM) and cardiovascular disease (CVD). Therefore, given the plausible aetiologic mechanisms, we argue that postprandial glucose levels are relevant for health and disease and represent a meaningful target for intervention, for example, through dietary factors. This symposium was organised by Mondelez International R&D. PMID:27388153

  10. Once weekly alendronate.

    PubMed

    Sambrook, Philip

    2003-05-01

    Alendronate, a bisphosphonate that potently inhibits bone resorption, has been shown in long-term clinical trials to be an effective treatment for osteoporosis, increasing bone mineral density and substantially reducing the incidence of both vertebral and nonvertebral fractures, including hip fractures, mostly using a daily dosage regimen. Although daily administration has generally been well tolerated in these trials, some patients develop upper gastrointestinal symptoms. Current safety and efficacy data suggest that once-weekly dosing of alendronate appears to be as efficacious as daily administration in the treatment of osteoporosis, providing greater convenience to patients, improved compliance and a lower risk of upper gastrointestinal symptoms compared with daily administration. This review examines published data addressing the safety and efficacy of once-weekly alendronate administration.

  11. Pregnancy Calendar: A Week-by-Week Guide

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old A Week-by-Week Pregnancy Calendar KidsHealth > For Parents > A Week-by-Week Pregnancy Calendar Print A A A en español ... place in your baby — and in you. Each week of pregnancy includes a description of your baby's ...

  12. Pregnancy Calendar: A Week-by-Week Guide

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old A Week-by-Week Pregnancy Calendar KidsHealth > For Parents > A Week-by-Week Pregnancy Calendar A A A en español Calendario ... place in your baby — and in you. Each week of pregnancy includes a description of your baby's ...

  13. An unusual presentation of gestational thrombocytopenia.

    PubMed

    Lim, Calvin C Y; Patel, D K; Bakhtiari, Azam; Subrayan, Visvaraja

    2013-01-01

    Thrombocytopenia is classically defined as a platelet count of less than 150 000/µl. Counts from 100 000 to 150 000/µl are considered mildly depressed, 50 000 to 100 000/µl moderately depressed, and less than 50 000/µl severely depressed. Thrombocytopenia occurs in about 10% of pregnant women. Gestational thrombocytopenia (GT) is a diagnosis of exclusion and considered the most prevalent cause of thrombocytopenia in pregnancy. GT accounts for almost 75% of cases of thrombocytopenia in pregnancy. The cause of GT is unclear, although existing studies denote the possibility of accelerated platelet consumption and the increased plasma volume during pregnancy. The presence of antiplatelet antibodies is not specific to GT. The degree of thrombocytopenia in GT is usually mild to moderate, usually remaining greater than 70 000/µl. Patients are asymptomatic with no evidence of bleeding and rarely preconception history of thrombocytopenia. The platelet count returns to normal within 2-12 weeks post partum. We wish to report a unique case of GT presenting as blurred vision due to retinal hemorrhages.

  14. Exercise guidelines for gestational diabetes mellitus

    PubMed Central

    Padayachee, Cliantha; Coombes, Jeff S

    2015-01-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. This disease has many detrimental consequences for the woman, the unborn foetus and child. The management of GDM aims to mediate the effects of hyperglycaemia by controlling blood glucose levels. Along with pharmacology and dietary interventions, exercise has a powerful potential to assist with blood glucose control. Due to the uncertainty of risks and benefits of exercise during pregnancy, women tend to avoid exercise. However, under adequate supervision exercise is both safe and beneficial in the treatment of GDM. Therefore it is vital that exercise is incorporated into the continuum of care for women with GDM. Medical doctors should be able to refer to competently informed exercise professionals to aid in GDM treatment. It is important that exercise treatment is informed by research. Hence, the development of evidence-based guidelines is important to inform practice. Currently there are no guidelines for exercise in GDM. This review aims to assess the efficacy of exercise for the management of GDM in order to establish an exercise prescription guideline specific to the condition. It is recommended that women with GDM should do both aerobic and resistance exercise at a moderate intensity, a minimum of three times a week for 30-60 min each time. PMID:26240700

  15. Fetal pituitary negative feedback at early gestational age.

    PubMed

    Rakover, Y; Weiner, E; Mosh, N; Shalev, E

    1999-06-01

    We describe an early prenatal diagnosis and the successful treatment of fetal Graves' disease from transplacental transfer of maternal thyroid stimulating autoantibodies (TSAb). The diagnosis of fetal thyrotoxicosis was made by umbilical cord sampling (UBS) at 20 weeks gestation, based on suppressed TSH with elevated FT4 levels. Therapy with propylthiouracil (PTU) improved fetal thyroid function tests as well as the clinical signs of fetal Graves' disease. Three more UBS were conducted before delivery indicating persisting mild fetal hyperthyroidism. Undetectable concentrations of thyrotrophin in fetal serum in the presence of markedly elevated FT4, suggests pituitary negative feedback at as early as 20 weeks gestation. Amniotic fluid thyrotrophin levels were measured at 20,24 and 26 weeks and were shown to correlate better with (elevated) maternal rather than (suppressed) fetal TSH values; therefore, we believe that amniotic fluid thyrotrophin measurement is unreliable for prediction of fetal thyroid status. Our observation is the first documentation of an intact feedback mechanism so early in fetal development and it suggests that pituitary maturation occurs earlier than previously believed.

  16. Report of the Two-Day National Seminar on New Directions in Higher Education, Organized by the Kerala State Higher Education Council on 12th and 13th July 2010

    ERIC Educational Resources Information Center

    Praveen, C.

    2010-01-01

    This is a report of the Two-Day National Seminar on New Directions in Higher Education, organized by the Kerala State Higher Education Council on 12th and 13th July 2010. The objective of the seminar was to deliberate upon the reforms being undertaken by the Government of India in Higher Education. Reputed scholars from within and outside the…

  17. Building on Family Strengths: Research and Services in Support of Children and Their Families. Proceedings of the Building on Family Strengths Annual Conference (12th, Portland, Oregon, June 23-25, 2005)

    ERIC Educational Resources Information Center

    Gordon, Lyn, Ed.; Bradley, Jennifer, Ed.; Aue, Nicole, Ed.; Holman, Ariel, Ed.

    2006-01-01

    The 12th Annual Building on Family Strengths Conference was held from June 23rd through June 25th 2005 in Portland, Oregon. Highlights included: (1) An information-packed keynote address by Dr. Richard M. Lerner on promoting positive youth development through enhancing the assets of communities; (2) An exciting research plenary panel session that…

  18. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA) (12th, Maynooth, Greater Dublin, Ireland, October 24-26, 2015)

    ERIC Educational Resources Information Center

    Sampson, Demetrios G., Ed.; Spector, J. Michael, Ed.; Ifenthaler, Dirk, Ed.; Isaias, Pedro, Ed.

    2015-01-01

    These proceedings contain the papers of the 12th International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA 2015), October 24-26, 2015, which has been organized by the International Association for Development of the Information Society (IADIS), co-organized by Maynooth University, Ireland, and endorsed by the…

  19. Dynamics of lipoprotein level in blood plasma of pregnant women as a function of gestational age according to FTIR spectroscopy

    NASA Astrophysics Data System (ADS)

    Korolik, E. V.; Korolenko, E. A.; Tretinnikov, O. N.; Kozlyakova, O. V.; Korolik, A. K.; Kirkovskiy, V. V.

    2013-01-01

    Results of an IR spectroscopic investigation of films of blood plasma taken from women of reproductive age, pregnant women with positive and negative Rh factors, and Rh-immunized women were presented as a function of gestational age. It was found that the lipoprotein content in blood plasma of all groups of pregnant women increased during the early stages of pregnancy (17-23 weeks) irrespective of the Rh factor and attained its peak value by weeks 30-35. It was shown that the lipoprotein level in blood plasma as a function of gestational age was quantitatively the same for pregnant women with positive and negative Rh factors. It was established for the first time that this dependence for Rh-immunized women featured a considerable increase of lipoprotein content at gestational age 30-32 weeks and declined acutely by week 36.

  20. a week in space

    NASA Astrophysics Data System (ADS)

    collette, christian

    2016-04-01

    COLLETTE Christian Institut Saint Laurent Liège Belgium. I am a science teacher at a technical high school. Generally, my students don't come from a privileged social background and are not particularly motivated for studies. For 10 years, I organize, for one of my sections, a spatial (and special) school year that ends in a spatial week. Throughout this year, with the help of my colleagues, I will introduce into all themes a lot of concepts relating to space. French, history, geography, English, mathematics, technical courses, sciences, and even gymnastics will be training actors in space culture. In spring, I will accompany my class in the Euro Space Center (Redu- Belgium) where we will live one week 24 hours on "like astronauts" One third of the time is dedicated to astronaut training (moonwalk, remote manipulator system, mission simulation, weightless wall, building rockets, satellites, etc.), One third to more intellectual activities on space (lectures, research, discovery of the outside run) the last one third of time in outside visits (museums, site of ESA-Redu) or in movies about space (October sky, Apollo 13, etc.) During this year, the profits, so educational as human, are considerable!

  1. Relation of arterial stiffness with gestational age and birth weight

    PubMed Central

    Cheung, Y; Wong, K; Lam, B.; Tsoi, N

    2004-01-01

    Background: The cardiovascular risk of individuals who are born small as a result of prematurity remains controversial. Given the previous findings of stiffer peripheral conduit arteries in growth restricted donor twins in twin–twin transfusion syndrome regardless of gestational age, we hypothesised that among children born preterm, only those with intrauterine growth retardation are predisposed to an increase in cardiovascular risks. Aim: To compare brachioradial arterial stiffness and systemic blood pressure (BP) among children born preterm and small for gestational age (group 1, n = 15), those born preterm but having birth weight appropriate for gestational age (group 2, n = 36), and those born at term with birth weight appropriate for gestational age (group 3, n = 35). Methods: Systemic BP was measured by an automated device (Dinamap), while stiffness of the brachioradial arterial segment was assessed by measuring pulse wave velocity (PWV). The birth weight was adjusted for gestational age and expressed as a z score for analysis. Results: The 86 children were studied at a mean (SD) age of 8.2 (1.7) years. Subjects from group 1, who were born at 32.3 (2.0) weeks' gestation had a significantly lower z score of birth weight (-2.29 (0.63), p<0.001), compared with those from groups 2 and 3. They had a significantly higher mean blood pressure (p<0.001) and their diastolic blood pressure also tended to be higher (p = 0.07). Likewise, their brachioradial PWV, and hence arterial stiffness, was the highest of the three groups (p<0.001). While subjects from group 2 were similarly born preterm, their PWV was not significantly different from that of group 3 subjects (p = 1.00) and likewise their z score of birth weight did not differ (-0.01 (0.71) v -0.04 (1.1), p = 1.00). Brachioradial PWV correlated significantly with systolic (r = 0.31, p = 0.004), diastolic (r = 0.38, p<0.001), and mean (0.47, p<0.001) BP, and with z score of birth weight (r = -0.43, p<0

  2. Exercise: An Alternative Therapy for Gestational Diabetes.

    ERIC Educational Resources Information Center

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  3. Acute Pancreatitis Secondary to Gestational Hypertriglyceridaemia

    PubMed Central

    Cahalane, Alexis M.; Smith, Myles J.; Ryan, James; Maguire, Donal

    2012-01-01

    Gestational hypertriglyceridaemia is a rare cause of acute pancreatitis. Its pathophysiology is incompletely understood. Severity scoring and effective management remain challenging. We report a case of acute pancreatitis secondary to gestational hypertriglyceridaemia. We describe the use of computed tomography to provide an alternative determination of severity, as well as plasmapheresis as a means of treating the condition. PMID:22844296

  4. The effects of gestational age and gender on grief after pregnancy loss.

    PubMed

    Goldbach, K R; Dunn, D S; Toedter, L J; Lasker, J N

    1991-07-01

    The roles of gestational age and gender in grief reactions following loss of pregnancy were explored. Parents with losses later in pregnancy reported more intense grief than did those whose losses were earlier. Women expressed higher levels of grief than did men six to eight weeks after the loss; however, this difference had decreased by one and two years after the loss.

  5. First-trimester prenatal sonographic diagnosis of ectopia cordis in a twin gestation.

    PubMed

    Barbee, Kristen; Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2009-01-01

    The 11-14-week ultrasound examination allows early pregnancy dating, detection of major anomalies and multiple gestations, and accurate chorionicity determination. We describe a rare case of first-trimester sonographic diagnosis of ectopia cordis in a dichorionic twin pregnancy, illustrating the benefits of early ultrasound in patient counseling and management.

  6. [Appendiceal abscess in the third gestational trimester of pregnancy, complications pre and postoperatively].

    PubMed

    Cyrkowicz, A; Cibor, Z; Słowińska-Zabówka, M; Kisiel, W; Oleksy, P; Orczyk, K; Bajorek, M; Kwiek, G

    1996-01-01

    Delayed surgical intervention connected with misdiagnosis of preterm labour and urinary tract infection caused in gravida 3 in 34th gestational week appendiceal abscess, septic shock, stillbirth by cesarean section, necessity of hysterectomy, recidivism of multi peritoneal and pleural abscesses. Although the patient was rescued the retrospective pro memoria considerations of our procedure are regarded.

  7. Moderate and Vigorous Intensity Exercise during Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

    PubMed Central

    Ehrlich, Samantha F.; Sternfeld, Barbara; Krefman, Amy E.; Hedderson, Monique M.; Brown, Susan D.; Mevi, Ashley; Chasan-Taber, Lisa; Quesenberry, Charles P.; Ferrara, Assiamira

    2016-01-01

    Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic medical records (n= 1,055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine’s (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [Odds Ratio (95% Confidence Interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m2: any vigorous intensity exercise, as compared to none, was associated with 54% decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM’s recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG. PMID:26955997

  8. Capillary blood glucose screening for gestational diabetes: a preliminary investigation.

    PubMed

    Landon, M B; Cembrowski, G S; Gabbe, S G

    1986-10-01

    Home glucose monitoring with the use of reflectance meters is an important adjunct in the care of pregnant women with insulin-dependent diabetes. The accuracy of reflectance meters for the assay of capillary glucose specimens has been well documented. The present preliminary study was undertaken to determine the utility of outpatient screening for gestational diabetes mellitus with the use of a reflectance meter (Accu-Chek, Boehringer Mannheim Co.). One hundred twenty-five patients in our high-risk practice had a standard 50 gm glucose load at 26 to 28 weeks' gestation. Capillary glucose values were measured on site with the Accu-Chek. Venous plasma glucose levels were measured by the central laboratory chemistry analyzer. While the laboratory (x) and meter (y) glucose determinations between the two sets of values were highly correlated (R = 0.89, p less than 0.001), there was a significant difference in their average values (x = 111.74, y = 136.35, p less than 0.0001). With the use of a receiver operator characteristic curve, a meter value of 160 mg/dl was determined as the optimal threshold for performing a 3-hour glucose tolerance test. The sensitivity and specificity with the use of a meter value of 160 mg/dl were 93% and 96%, respectively, for detecting an abnormal screening test in venous plasma (greater than or equal to 135 mg/dl). A total of 32 glucose tolerance tests were performed, with four patients included who had venous values less than 135 mg/dl. All eight patients with gestational diabetes mellitus were correctly identified. These data suggest that a glucose reflectance meter can be used for accurate outpatient screening of gestational diabetes mellitus. The potential advantages of capillary blood glucose screening include both cost and efficiency. Patients with abnormal screening values can be promptly identified and scheduled for a follow-up 3-hour glucose tolerance test.

  9. Foetal growth and duration of gestation relative to water chlorination

    PubMed Central

    Jaakkola, J; Magnus, P; Skrondal, A; Hwang, B; Becher, G; Dybing, E

    2001-01-01

    OBJECTIVE—To assess the effect of exposure to chlorination byproducts during pregnancy on foetal growth and duration of pregnancy.
METHODS—A population based study was conducted of 137 145 Norwegian children born alive in 1993-5. Information was obtained from the Norwegian medical birth registry, waterwork registry, and social science data service. The outcomes of interest were birth weight, low birth weight (<2500 g), small for gestational age, and preterm delivery (gestational age <37 weeks). The exposure assessment was based on quality of drinking water in the municipality where the mother lived during pregnancy. Municipal exposure was calculated with information on chlorination and the amount of natural organic matter in raw water measured as colour in mg precipitate/l. The main exposure category was high colour and chlorination, which was contrasted with the reference category of low colour and no chlorination.
RESULTS—In logistic regression analysis adjusting for confounding, the risks of low birth weight (odds ratio (OR) 0.97, 95% confidence interval (95% CI) 0.89 to 1.06) and small for gestational age (OR 1.00, 95% CI 0.91 to 1.10) were not related to exposure. Contrary to the hypothesis, the risk of preterm delivery was slightly lower among the exposed than the reference category (OR 0.91, 95% CI 0.84 to 0.99). The risks of the studied outcomes were similar in newborn infants exposed to high colour drinking water without chlorination and chlorinated drinking water with low colour compared with the reference category.
CONCLUSIONS—The present study did not provide evidence that prenatal exposure to chlorination byproducts at the relatively low concentrations encountered in Norwegian drinking water increases the risk of the studied outcomes.


Keywords: water chlorination; foetal growth; gestational age PMID:11404447

  10. References of birth weights for gestational age and sex from a large cohort of singleton births in cameroon.

    PubMed

    Kemfang Ngowa, Jean Dupont; Domkam, Irénée; Ngassam, Anny; Nguefack-Tsague, Georges; Dobgima Pisoh, Walter; Noa, Cyrille; Kasia, Jean Marie

    2014-01-01

    Objective. To establish the percentile charts of birth weights for gestational age and sex within the Cameroonian population. Methods. A review of medical records of infants born between January 2007 and December 2011 at the maternities of two hospitals in Cameroon, Central Africa. Multiple pregnancies, births of HIV infected women, stillbirths, and births with major fetal malformations were excluded. The smooth curves of birth weight for gestational age and sex were created using the Gamlss package under R.3.0.1 software. Results. The birth weights of 12837 live birth singleton infants born to HIV negative women between 28 and 42 weeks of gestation were analyzed to construct the birth weight curves for gestational age and sex. The smoothed percentile curves of birth weights for gestational age and sex of Cameroonian infants have demonstrated an increasing slope until 40 weeks and then a plateau. There was a varied difference of distribution in birth weights for gestational age between Cameroonian, Botswanan, American, and French infants. Conclusion. We established the reference curves of birth weights for gestational age and sex for Cameroonians. The difference in birth weight curves noted between Cameroonian, Botswanan, American, and French infants suggests the importance of establishing the regional birth weight norms.

  11. Variations in stride length and running economy in male novice runners subsequent to a seven-week training program.

    PubMed

    Bailey, S P; Messier, S P

    1991-06-01

    The purposes of this investigation were to document the changes in stride length of college-age male novice runners (n = 13) who were allowed of freely choose their stride length throughout a 7-week training period (FCSL), and to compare subsequent changes in running economy to those observed in a similar group of runners (n = 13) that ran for 7 weeks with constant stride lengths equivalent to their initially chosen stride lengths (CSL). Subjects trained 3 days per week for approximately 7 weeks (22 training bouts). Each training bout consisted of a minute warmup (60% VO2max) and a 15-minute run at a speed equivalent to 80% of the subjects' initial VO2max. Absolute stride length (ASL), heart rate (HR), and ratings of perceived exertion (RPE) were measured during the 12th and 20th minute of exercise. Relative and absolute submaximal VO2 were measured during the 4th and 22nd training bout. No significant differences in percent change in ASL were found between the groups or across the weeks of training at the 12th or 20th minute of exercise; however, there was a significant difference (p less than or equal to .05) between the groups during the 4th week of training. No significant differences were found between the groups in relative or absolute submaximal VO2. Relative submaximal VO2 at the 12th minute of exercise decreased significantly following the training period in both the FCSL (-3.38%) and CSL (-4.32%) groups. Absolute submaximal VO2 did not change significantly following the training period.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Gestational Age and Neonatal Brain Microstructure in Term Born Infants: A Birth Cohort Study

    PubMed Central

    Broekman, Birit F. P.; Wang, Changqing; Li, Yue; Rifkin-Graboi, Anne; Saw, Seang Mei; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter D.; Fortier, Marielle V.; Meaney, Michael J.; Qiu, Anqi

    2014-01-01

    Objective Understanding healthy brain development in utero is crucial in order to detect abnormal developmental trajectories due to developmental disorders. However, in most studies neuroimaging was done after a significant postnatal period, and in those studies that performed neuroimaging on fetuses, the quality of data has been affected due to complications of scanning during pregnancy. To understand healthy brain development between 37–41 weeks of gestational age, our study assessed the in utero growth of the brain in healthy term born babies with DTI scanning soon after birth. Methods A cohort of 93 infants recruited from maternity hospitals in Singapore underwent diffusion tensor imaging between 5 to 17 days after birth. We did a cross-sectional examination of white matter microstructure of the brain among healthy term infants as a function of gestational age via voxel-based analysis on fractional anisotropy. Results Greater gestational age at birth in term infants was associated with larger fractional anisotropy values in early developing brain regions, when corrected for age at scan. Specifically, it was associated with a cluster located at the corpus callosum (corrected p<0.001), as well as another cluster spanning areas of the anterior corona radiata, anterior limb of internal capsule, and external capsule (corrected p<0.001). Conclusions Our findings show variation in brain maturation associated with gestational age amongst ‘term’ infants, with increased brain maturation when born with a relatively higher gestational age in comparison to those infants born with a relatively younger gestational age. Future studies should explore if these differences in brain maturation between 37 and 41 weeks of gestational age will persist over time due to development outside the womb. PMID:25535959

  13. Spontaneous Rupture of Uterine Artery in a 14-Week Pregnant Woman

    PubMed Central

    de Carvalho, João Paulo Mancusi; Severo, Luciano Augusto de Carvalho; de Carvalho, Maria Helena Mancusi; Gomes, Mariano Tamura Vieira; Podgaec, Sergio

    2016-01-01

    We report a case of uterine artery rupture in a woman at 14 weeks' gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation. PMID:27891272

  14. Mitral valve endocarditis due to Abiotrophia defectiva in a 14th week pregnant woman.

    PubMed

    Botta, Luca; Merati, Roberto; Vignati, Gabriele; Orcese, Carlo Andrea; De Chiara, Benedetta; Cannata, Aldo; Bruschi, Giuseppe; Fratto, Pasquale

    2016-01-01

    Infective endocarditis during pregnancy carries a high mortality risk, both for the mother and for the foetus and requires a multidisciplinary team in the management of complicated cases. We report our experience with a 39-year old patient, affected by an acute active mitral endocarditis due to Abiotrophia defectiva at the 14th gestational week, strongly motivated to continue the pregnancy. Our patient successfully underwent mitral valve replacement with a normothermic high-flow cardiopulmonary bypass under continuous intraoperative foetal monitoring. Caesarean section occurred at the 38th gestational week. The delivery was uneventful and both the mother and child are doing well at the 16-month follow-up.

  15. Folic acid supplementation during early pregnancy and the risk of gestational hypertension and preeclampsia.

    PubMed

    Li, Zhiwen; Ye, Rongwei; Zhang, Le; Li, Hongtian; Liu, Jianmeng; Ren, Aiguo

    2013-04-01

    Emerging evidence has suggested that folic acid-containing multivitamins may markedly reduce the risk of gestational hypertension or preeclampsia. We examined whether maternal supplementation with folic acid alone during early pregnancy can prevent the occurrence of gestational hypertension and preeclampsia. The data are from a large population-based cohort study established to evaluate the effectiveness of the campaign to prevent neural tube defects with folic acid supplementation in China. We selected participants who were registered in 2 southern provinces, had exact information on folic acid use, and were not affected by chronic hypertension or diabetes mellitus before 20 weeks gestation. A logistic regression model was used to adjust for the effects of the main potential confounders, including age, body mass index, education, occupation, parity, and multiple births. The study size had 99.9% power (α=0.05) to detect a decrease of 10% over the unexposed rate of 9.4% for gestational hypertension. Among the 193 554 women (47.9% took folic acid, 52.1% did not), the overall incidence of gestational hypertension and preeclampsia was 9.5% and 2.5%, respectively. The incidence of gestational hypertension and preeclampsia was 9.7% and 2.5% for women who took folic acid, and 9.4% and 2.4% for women who did not use it. The adjusted risk ratio associated with folic acid use was 1.08 (95% confidence interval, 1.04-1.11) for gestational hypertension and 1.11 (95% confidence interval, 1.04-1.18) for preeclampsia. Our findings suggest that daily consumption of 400 μg folic acid alone during early pregnancy cannot prevent the occurrence of gestational hypertension and preeclampsia.

  16. [Management of arterial hypertension before 20weeks gestation in pregnant women].

    PubMed

    Seguro, Florent; Duly Bouhanick, Béatrice; Chamontin, Bernard; Amar, Jacques

    2016-01-01

    In the first 6 months of pregnancy, the primary goal of antihypertensive treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension (blood pressure>160/110mmHg). Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk (diabetes, chronic kidney disease, personal history of cardiovascular disease) with moderate hypertension (blood pressure between 140-159/90-109mmHg). A systolic blood pressure goal<160 and a diastolic blood pressure goal between 85 and 100mmHg is recommended in pregnancy. Labetalol, nifedipine, nicardipine and alphamethyldopa should be considered preferential antihypertensive drugs in pregnancy. Salt restriction, physical exercise and weight loss have not demonstrated any effect in the prevention of preeclampsia and serious maternal complications of hypertension.

  17. The Distribution and Predictive Value of Bishop Scores in Nulliparas between 37 and 42 Weeks Gestation

    DTIC Science & Technology

    2011-01-01

    the course of labor. Obstet Gynecol 1966;28:495 501. 2. American College of Obstetricians and Gynecologists: induction of labor, ACOG Practice Bulletin...relationship to cesarean delivery: a review of 7001 consecutive inductions. Am J Obstet Gynecol 1999;180:628 633. 4. Maslow AS, Sweeny AL. Elective induction...of labor as a risk factor for cesarean delivery among low risk women at term. Obstet Gynecol 2000;95:917 922. 5. Seyb ST, Berka RJ, Socol ML, Dooley

  18. Thrombolysis for stroke in pregnancy at 39 weeks gestation with a subsequent normal delivery.

    PubMed

    Ritchie, Joanne; Lokman, Mariam; Panikkar, Jane

    2015-08-11

    Stroke during pregnancy is fortunately a rare event, however, it can have severe consequences, with 9.5% of all maternal deaths being related to stroke. The most common presentation is an ischaemic stroke. There has been much debate as to the correct treatment for such cases' and whether thrombolysis can be used safely in pregnancy. Our case describes a 28-year-old woman with a previous normal vaginal delivery presenting in her third trimester with a sudden onset of dense left hemiparesis. She was successfully treated with alteplase, an intravenous recombinant tissue-type plasminogen activator, and made a full recovery after normal delivery of a healthy infant. This case report highlights one of the first documented successful outcomes from thrombolysis for this condition in the UK and may help inform future management of these women.

  19. Achondrogenesis type I diagnosed by transvaginal ultrasonography at 13 weeks' gestation.

    PubMed

    Meizner, I; Barnhard, Y

    1995-11-01

    We present the first transvaginal first-trimester diagnosis of achondrogenesis type I confirmed by radiographic and histologic studies. The ultrasonographic signs included severe short limb mesomelic dwarfism, large head with decreased ossification, and lack of vertebral ossification.

  20. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes

    PubMed Central

    Kubo, Ai; Ferrara, Assiamira; Brown, Susan D.; Ehrlich, Samantha F.; Tsai, Ai-Lin; Quesenberry, Charles P.; Crites, Yvonne; Hedderson, Monique M.

    2017-01-01

    Growing evidence links perceived stress—a potentially modifiable psychosocial risk factor—with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis to examine associations between psychosocial stress during pregnancy and gestational weight gain among women with gestational diabetes. We used baseline data from the Gestational Diabetes’s Effects on Moms (GEM) study: 1,353 women with gestational diabetes who delivered a term singleton within Kaiser Permanente Northern California were included. Perceived stress near the time of gestational diabetes diagnosis was measured using the validated Perceived Stress Scale (PSS10). Gestational weight gain was categorized according to the 2009 Institute of Medicine recommendations. Binomial regression analyses adjusted for gestational age and maternal age at the time of gestational diabetes diagnosis, and race/ethnicity and estimated rate ratios (RR) and their 95% confidence interval (CI). Among women with a normal pregravid Body Mass Index (BMI 18.5–24.9 kg/m2), there was a significant association between high (Q4) PSS score and risk of both exceeding and gaining below the Institute of Medicine recommendations compared to those with lower stress (Q1) [adjusted RR = 2.16 95% CI 1.45–3.21; RR = 1.39 95% CI 1.01–1.91, respectively.] Among women with pregravid overweight/obesity (BMI≥25 kg/m2), there was no association. Although the temporal relationship could not be established from this study, there may be a complex interplay between psychosocial stress and gestational weight gain among women with gestational diabetes. Further studies examining stress earlier in pregnancy, risk of developing gestational diabetes and excess/inadequate gestational weight gain are warranted to clarify these complex relationships. PMID:28350836

  1. Early Diagnosis of Gestational Diabetes Mellitus (EDoGDM) study: a protocol for a prospective, longitudinal cohort study

    PubMed Central

    Liu, Bin; Xu, Yun; Zhang, Ying; Cai, Jian; Deng, Langhui; Yang, Jianbo; Zhou, Yi; Long, Yuhang; Zhang, Jinxin; Wang, Zilian

    2016-01-01

    Introduction A diagnosis of gestational diabetes mellitus (GDM) in low-risk pregnant women is based on an oral glucose tolerance test (OGTT) between 24 and 28 gestational weeks. However, there is insufficient evidence for why the test is performed in this time period. Moreover, the fetus may be exposed to hyperglycaemia prior to the current testing time frame, making earlier administration potentially advantageous. The main purpose of the present study is to investigate the GDM diagnostic value of an OGTT performed at 18–20 gestational weeks. The results of the study may provide scientific insight into the most beneficial time of OGTT for pregnant women. Methods and analysis As a prospective, longitudinal cohort study, the Early Diagnosis of Gestational Diabetes Mellitus (EDoGDM) study will recruit 570 pregnant women who meet the inclusion and exclusion criteria outlined below. OGTTs will be performed between 18 and 20 gestational weeks (early OGTT) and 24–28 gestational weeks (regular OGTT). Clinical and laboratory information of the mother and their offspring will be collected for analysis. The prevalence of GDM at 18–20 gestational weeks will be described, and the sensitivity, specificity, positive predictive value and negative predictive value of early OGTT on diagnosis of GDM will be studied. Clinical outcomes associated with hyperglycaemia will be compared between groups diagnosed by early or regular OGTT. Ethics and dissemination The study was approved by The Ethical Committees of The First Affiliated Hospital of Sun Yat-sen University (number 2016-042). Signed informed consent will be obtained from all participants. The results of this study will be disseminated in peer-reviewed journals. Trial registration number NCT02740283. PMID:27872115

  2. Initiating New Science Partnerships in Rural Education: STEM Graduate Students Bring Current Research into 7th-12th Grade Science Classrooms

    NASA Astrophysics Data System (ADS)

    Radencic, S.; Dawkins, K. S.; Jackson, B. S.; Walker, R. M.; Schmitz, D.; Pierce, D.; Funderburk, W. K.; McNeal, K.

    2014-12-01

    Initiating New Science Partnerships in Rural Education (INSPIRE), a NSF Graduate K-12 (GK-12) program at Mississippi State University, pairs STEM graduate students with local K-12 teachers to bring new inquiry and technology experiences to the classroom (www.gk12.msstate.edu). The graduate fellows prepare lessons for the students incorporating different facets of their research. The lessons vary in degree of difficulty according to the content covered in the classroom and the grade level of the students. The focus of each lesson is directed toward the individual research of the STEM graduate student using inquiry based designed activities. Scientific instruments that are used in STEM research (e.g. SkyMaster weather stations, GPS, portable SEM, Inclinometer, Soil Moisture Probe, Google Earth, ArcGIS Explorer) are also utilized by K-12 students in the activities developed by the graduate students. Creativity and problem solving skills are sparked by curiosity which leads to the discovery of new information. The graduate students work to enhance their ability to effectively communicate their research to members of society through the creation of research linked classroom activities, enabling the 7-12th grade students to connect basic processes used in STEM research with the required state and national science standards. The graduate students become respected role models for the high school students because of their STEM knowledge base and their passion for their research. Sharing enthusiasm for their chosen STEM field, as well as the application techniques to discover new ideas, the graduate students stimulate the interests of the classroom students and model authentic science process skills while highlighting the relevance of STEM research to K-12 student lives. The measurement of the student attitudes about science is gathered from pre and post interest surveys for the past four years. This partnership allows students, teachers, graduate students, and the public to

  3. Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor with RENAL nephrometry score ≥10: an innovation of traditional open surgery.

    PubMed

    Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin

    2015-04-01

    The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score ≥10). Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score ≥10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded. MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5-8.1). Mean warm ischemia time was 28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150) and mean estimated blood loss was 68 mL (range: 10-400). Mean postoperative hospital stay was 6.5 days (range: 5-12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47-132) and 87.1 μmol/L (range: 61-189) with significant difference (P = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5), respectively with significant difference (P = 0.024). In an average follow-up of 19.9 months (range: 8-50), no local recurrence or systemic progression occurred. In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open

  4. Zipingpu Concrete Face Rockfill Dam Failures caused by the 8.0R Earthquake on the 12th May 2008 (Chengdu, China)

    NASA Astrophysics Data System (ADS)

    Lekkas, E.

    2009-04-01

    The 8.0R earthquake that struck Sichuan on the 12th of May 2008, in the district of Chengdu of Southern China resulted in tenths of thousands casualties, the complete destruction of many towns and extended damages to public works. The earthquake was triggered by a reverse fault of NE-SW trend, more than 100 km long, that divides morphologically the affected area in two sections, the eastern one with mild low topography and the western one with intense relief representing the boundary of Tibet Mountains. This mountainous section is characterized by a rich drainage network that drains the greater region of the Tibet plateau. Along the trace of this high-stand for thousands of years numerous hydraulic works have been attempted in order to manage the water supply. Especially during the past decades, 400 small and large dams have been constructed. The main dam is the Zipingpu dam. It is a Concrete Face Rockfill Dam (CFRD) that has a height of 150m, a capacity of 1.2 billion m3 and includes a hydroelectric plant of 3.4 billion Kwh power. The Zipingpu dam is located 10km east of the earthquake epicenter and after the earthquake of 8.0R, the following failures were recorded: (i) Subsidence of the crown in the central part of the dam, of the order of 50cm in relation to the side survey control points, (ii) Deformation of the lower face of the dam, an area of approximately 1000 m2, (iii) Deviations and deformations of the construction elements throughout the face of the dam, (iv) Widening of construction joints (approximately 15 cm on the upper face), (v) Extended massive landslides throughout the reservoir, and (vi) Landslides on both left and right abutments of the dam causing further damages to secondary constructions. After the evaluation of the dam damages, the discharge of the reservoir was ordered through the emergency spillway in order to minimize the risk of a potential disaster for the nearby towns and especially Dujiangyan. Finally, the causes of the failures are

  5. PREFACE: 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity and 9th International Conference on Functional Materials and Nanotechnologies (RCBJSF-2014-FM&NT)

    NASA Astrophysics Data System (ADS)

    Sternberg, Andris; Grinberga, Liga; Sarakovskis, Anatolijs; Rutkis, Martins

    2015-03-01

    The joint International Symposium RCBJSF-2014-FM&NT successfully has united two international events - 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity (RCBJSF-12) and 9th International Conference Functional Materials and Nanotechnologies (FM&NT-2014). The RCBJSF symposium is a continuation of series of meetings on ferroelectricity, the first of which took place in Novosibirsk (USSR) in 1976. FM&NT conferences started in 2006 and have been organized by Institute of Solid State Physics, University of Latvia in Riga. In 2012 the International program committee decided to transform this conference into a traveling Baltic State conference and the FM&NT-2013 was organized by the Institute of Physics, University of Tartu, Estonia. In 2014 the joint international symposium RCBJSF-2014-FM&NT was organized by the Institute of Solid State Physics, University of Latvia and was part of Riga - 2014, the European Capital of Culture event. The purpose of the joint Symposium was to bring together scientists, students and high-level experts in solid state physics, materials science, engineering and related disciplines. The number of the registered participants from 26 countries was over 350. During the Symposium 128 high quality scientific talks (5 plenary, 42 invited, 81 oral) and over 215 posters were presented. All presentations were divided into 4 parallel sessions according to 4 main topics of the Symposium: Ferroelectricity, including ferroelectrics and multiferroics, pyroelectrics, piezoelectrics and actuators, integrated ferroelectrics, relaxors, phase transitions and critical phenomena. Multifunctional Materials, including theory, multiscale and multiphenomenal material modeling and simulation, advanced inorganic, organic and hybrid materials. Nanotechnologies, including progressive methods, technologies and design for production, investigation of nano- particles, composites, structures, thin films and coatings. Energy, including perspective materials and

  6. Effects of twin gestation on maternal morbidity.

    PubMed

    Young, Brett C; Wylie, Blair J

    2012-06-01

    As the incidence of twin gestation increases, it is important to consider the maternal risks associated with carrying multiples. Compared with singleton gestation, there are increased risks to the mother during the antepartum, intrapartum, and postpartum periods. Certain pregnancy complications are more likely to occur during a twin gestation, including preeclampsia and other hypertensive disorders, antepartum hospitalization for preterm labor or abnormal bleeding, nutritional deficiencies, cesarean delivery, and postpartum hemorrhage. Women carrying twins may benefit from early education regarding these issues, close maternal monitoring as well as physical therapy sessions, and nutrition counseling during their pregnancies.

  7. [Gestational diabetes insipidus during a twin pregnancy].

    PubMed

    De Mesmay, M; Rigouzzo, A; Bui, T; Louvet, N; Constant, I

    2013-02-01

    Gestational diabetes insipidus is an uncommon clinical disease whose prevalence is approximately two to three pregnancies per 100,000. It may be isolated or associated with preeclampsia. We report a case of gestational diabetes insipidus in a twin pregnancy, originally isolated during two months, and secondarily complicated by HELLP-syndrome. We recall the specific pathophysiology of polyuric-polydipsic syndrome during pregnancy and summarize its various causes. Finally, we discuss the indications, in case of isolated gestational diabetes insipidus, of treatment by dDAVP.

  8. Why is there a modifying effect of gestational age on risk factors for cerebral palsy?

    PubMed Central

    Greenwood, C; Yudkin, P; Sellers, S; Impey, L; Doyle, P

    2005-01-01

    Objective: To investigate risk factors for cerebral palsy in relation to gestational age. Design: Three case-control studies within a geographically defined cohort. Setting: The former Oxfordshire Health Authority. Participants: A total of 235 singleton children with cerebral palsy not of postnatal origin, born between 1984 and 1993, identified from the Oxford Register of Early Childhood Impairment; 646 controls matched for gestation in three bands: ⩽32 weeks; 33–36 weeks; ⩾37 weeks. Results: Markers of intrapartum hypoxia and infection were associated with an increased risk of cerebral palsy in term and preterm infants. The odds ratio (OR) for hypoxia was 12.2 (95% confidence interval 1.2 to 119) at ⩽32 weeks and 146 (7.4 to 3651) at ⩾37 weeks. Corresponding ORs for neonatal sepsis were 3.1 (1.8 to 5.4) and 10.6 (2.1 to 51.9). In contrast, pre-eclampsia carried an increased risk of cerebral palsy at ⩾37 weeks (OR 5.1 (2.2 to 12.0)) but a decreased risk at ⩽32 weeks (OR 0.4 (0.2 to 1.0)). However, all infants ⩽32 weeks with maternal pre-eclampsia were delivered electively, and their risk of cerebral palsy was no lower than that of other electively delivered ⩽32 week infants (OR 0.9 (0.3 to 2.7)). Nearly 60% of ⩽32 week controls were delivered after spontaneous preterm labour, itself an abnormal event. Conclusion: Inflammatory processes, including pre-eclampsia, are important in the aetiology of cerebral palsy. The apparent reduced risk of cerebral palsy associated with pre-eclampsia in very preterm infants is driven by the characteristics of the gestation matched control group. Use of the term "protective" in this context should be abandoned. PMID:15724038

  9. Estimation of gestational age, using neonatal anthropometry: a cross-sectional study in India.

    PubMed

    Thawani, Rajat; Dewan, Pooja; Faridi, M M A; Arora, Shilpa Khanna; Kumar, Rajeev

    2013-12-01

    Prematurity is a significant contributor to neonatal mortality in India. Conventionally, assessment of gestational age of newborns is based on New Ballard Technique, for which a paediatric specialist is needed. Anthropometry of the newborn, especially birthweight, has been used in the past to predict the gestational age of the neonate in peripheral health facilities where a trained paediatrician is often not available. We aimed to determine if neonatal anthropometric parameters, viz. birthweight, crown heel-length, head-circumference, mid-upper arm-circumference, lower segment-length, foot-length, umbilical nipple distance, calf-circumference, intermammary distance, and hand-length, can reliably predict the gestational age. The study also aimed to derive an equation for the same. We also assessed if these neonatal anthropometric parameters had a better prediction of gestational age when used in combination compared to individual parameters. We evaluated 1,000 newborns in a cross-sectional study conducted in Guru Teg Bahadur Hospital in Delhi. Detailed anthropometric estimation of the neonates was done within 48 hours after birth, using standard techniques. Gestational age was estimated using New Ballard Scoring. Out of 1,250 consecutive neonates, 1,000 were included in the study. Of them, 800 randomly-selected newborns were used in devising the model, and the remaining 200 newborns were used in validating the final model. Quadratic regression analysis using stepwise selection was used in building the predictive model. Birthweight (R=0.72), head-circumference (R = 0.60), and mid-upper arm-circumference (R = 0.67) were found highly correlated with gestation. The final equation to assess gestational age was as follows: Gestational age (weeks) = 5.437 x W-0.781 x W(2) + 2.815 x HC-0.041 x HC(2) + 0.285 x MUAC-22.745 where W=Weight, HC=Head-circumference and MUAC=Mid-upper arm-circumference; Adjusted R = 0.76. On validation, the predictability of this equation is 46

  10. FOREWORD: The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009) The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009)

    NASA Astrophysics Data System (ADS)

    Orlando, Thomas M.; Diebold, Ulrike

    2010-03-01

    The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) took place from 19-23 April 2009 in Pine Mountain, Georgia, USA. This was the 12th conference in a strong and vibrant series, which dates back to the early 1980s. DIET XII continued the tradition of exceptional interdisciplinary science and focused on the study of desorption and dynamics induced by electronic excitations of surfaces and interfaces. The format involved invited lectures, contributed talks and a poster session on the most recent developments and advances in this area of surface physics. The Workshop International Steering Committee and attendees wish to dedicate DIET XII to the memory of the late Professor Theodore (Ted) Madey. Ted was one of the main pioneers of this field and was one of the primary individuals working to keep this area of science exciting and adventurous. His overall contributions to surface science were countless and his contributions to the DIET field and community were enormous. He is missed and remembered by many friends and colleagues throughout the world. The papers collected in this issue cover many of the highlights of DIET XII. Topics include ultrafast electron transfer at surfaces and interfaces, quantum and spatially resolved mapping of surface dynamics and desorption, photon-, electron- and ion-beam induced processes at complex interfaces, the role of non-thermal desorption in astrochemistry and astrophysics and laser-/ion-based methods of examining soft matter and biological media. Although the workshop attracted many scientists active in the general area of non-thermal surface processes, DIET XII also attracted many younger scientists (i.e., postdoctoral fellows, advanced graduate students, and a select number of advanced undergraduate students). This field has had an impact in a number of areas including nanoscience, device physics, astrophysics, and now biophysics. We believe that this special issue of Journal of Physics

  11. Drugs Approved for Gestational Trophoblastic Disease

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gestational trophoblastic disease. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  12. National Society of Black Physicists XXV Annual Day of Scientific Lectures and 21st Annual Meeting - NSBP '98: The Next Generation/12th Annual National Conference of Black Physics Students - NCPBS '98: Physics/Life in Motion

    SciTech Connect

    MacKellar, Alan

    1999-02-28

    The 12th Annual National Conference of Black Physics Students (NCBPS) was held jointly with the Annual Meeting of the National Society of Black Physicists (NSBP) March 4-8, 1998 in Lexington, Ky. The Proceedings consists of scientific talks and abstracts given by NSBP members and students attending the NCBPS meeting. One joint session of general scientific interest was held, with NCBPS students, NSBP members, and about 75 high school students from the state of Kentucky present. NCBPS session included ''How to get into Graduate School'', ''How to Survive in Graduate School'', and a Panel on ''Opportunities for Physics Graduates.'' The report by AIP: ''Survey of Participants of the 12th Annual NCBPS'' is included in the Proceedings.

  13. Adaptive responses of cardiac function to fetal postural change as gestational age increases

    PubMed Central

    Kim, Woo Jin; Choi, Hye Jin; Yang, Sun Young; Koo, Boo Hae; Ahn, Ki Hoon; Hong, Soon Cheol; Oh, Min-Jeong; Kim, Hai-Joong

    2016-01-01

    Objective The cardiovascular system maintains homeostasis through a series of adaptive responses to physiological requirements. However, little is known about the adaptation of fetal cardiac function to gravity, according to gestational age. In the present study, we aimed to evaluate the adaptive responses of cardiac function to postural changes, using Tei index measurements. Methods Fetal echocardiography and Doppler examination were performed on 114 women with vertex singleton pregnancies at 19 to 40 weeks' gestation. Participants were placed in an upright seated position, and the Tei index for fetal left ventricular cardiac function was measured. The women were then moved into a supine position and the Tei index was re-measured. Results The mean Tei index when measured in an upright seated position was significantly lower than that measured in a supine positioning for all fetuses (0.528±0.103 vs. 0.555±0.106, P=0.014, respectively). This difference was also noted in fetuses with a gestational age of 28–40 weeks (0.539±0.107 vs. 0.574±0.102, P=0.011, respectively). However, there was no difference in the Tei index between an upright seated and a supine position among fetuses with a gestational age of <28 weeks (0.505±0.091 vs. 0.516±0.103, P=0.571, respectively). Conclusion Postural changes from an upright seated to a supine position result in an increased Tei index after a gestational age of 28 weeks. This appears to reflect maturation in the adaptive responses of the fetal cardiovascular system to postural changes. PMID:27896244

  14. Plasma Markers of Oxidative Stress in Patients with Gestational Diabetes Mellitus in the Second and Third Trimester

    PubMed Central

    Ouyang, Zhenbo

    2016-01-01

    Objective. To determine plasma markers of oxidative stress during the second and third trimester of pregnancy in patients with gestational diabetes mellitus (GDM). Study Design. We conducted a prospective nested case-control study involving 400 pregnant women, 22 of whom developed GDM. As control group, 30 normal pregnant women were chosen randomly. Plasma samples were analyzed for 8-iso-prostaglandin F2α (8-iso-PGF2α), advanced oxidative protein products (AOPPs), protein carbonyl (PCO), glutathione peroxidase-3 (GPX-3), and paraoxonase-1 (PON1) at 16–20 weeks, 24–28 weeks, and 32–36 weeks of gestation. Results. Compared to control subjects, the plasma levels of PCO, AOPPs, and 8-iso-PGF2α were elevated at 16–20 weeks' and 32–36 weeks' gestation in GDM. There was no significant difference in PCO and 8-iso-PGF2α at 24–28 weeks in GDM. GPX-3 was statistically significantly increased at 16–20 weeks and 32–36 weeks in GDM. PON1 reduced in patients with GDM. No significant differences were found at 24–28 and 32–36 weeks between the GDM and control groups. In GDM, PCO, AOPPs, and 8-iso-PGF2α levels were higher and GPX-3 and PON1 levels were lower in the second than the third trimester. Conclusion. Oxidation status increased in GDM, especially protein oxidation, which may contribute to the pathogenesis of GDM. PMID:27803713

  15. Gestational age-dependency of height and body mass index trajectories during the first 3 years in Japanese small-for-gestational age children

    PubMed Central

    Maeyama, Kaori; Morioka, Ichiro; Iwatani, Sota; Fukushima, Sachiyo; Kurokawa, Daisuke; Yamana, Keiji; Nishida, Kosuke; Ohyama, Shohei; Fujioka, Kazumichi; Awano, Hiroyuki; Taniguchi-Ikeda, Mariko; Nozu, Kandai; Nagase, Hiroaki; Nishimura, Noriyuki; Shirai, Chika; Iijima, Kazumoto

    2016-01-01

    Gestational age (GA) is thought to affect height growth in small-for-gestational age (SGA) children. However, the GA-specific trajectories in body mass index (BMI) and early appearances of adiposity rebound (AR) have not been fully investigated in a cohort of Japanese SGA children. A longitudinal cohort study was conducted with 1063 SGA children born in Kobe, Japan, with sufficient records from birth to 3 years of age. Subjects were divided into subgroups based on GA: 39–41 weeks GA (n = 723), 37–38 weeks GA (n = 256), 34–36 weeks GA (n = 62), and <34 weeks GA (n = 22). Height and BMI were assessed at 4 months, 9 months, 1.5 years, and 3 years of age. The catch-up rate for height was GA-dependent. Most children with 39–41 weeks GA (91%) caught up by 4 months of age; however, lower GA was associated with a slower elevation in the catch-up rate. The BMI trajectory during the first 3 years was also GA-dependent, with a change in GA dependency at a boundary of 37 weeks GA. Approximately 7% of SGA children had already developed AR before 3 years of age. In conclusion, growth patterns during infancy and early childhood in SGA children differ depending on GA. PMID:27934914

  16. Understanding Gestational Diabetes: A Practical Guide to a Healthy Pregnancy.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This brochure addresses the problem of gestational diabetes and answers the most frequently asked questions about the disease. It begins by defining gestational diabetes and discussing its cause, then addresses such topics as: (1) how gestational diabetes differs from other types of diabetes; (2) who is at risk for developing gestational diabetes…

  17. Born just a few weeks early: does it matter?

    PubMed

    Boyle, Jennifer D; Boyle, Elaine M

    2013-01-01

    Until recently, infants born at moderate preterm (32-33 weeks) and late preterm (34-36 weeks) gestations have gone largely unstudied. Since their outcomes were thought to be similar to those of infants born at 37 weeks and above, they have historically been managed in much the same way as infants born at term. However, accumulating data indicate that risks of morbidity and mortality are significantly greater in this group than previously believed. Since moderate and late preterm infants account for around 6% of all births, very large numbers of babies are potentially affected. Although their problems may be less obvious than those of extremely preterm infants, the population impact of long-term health and neurodevelopmental problems in this group will be substantial. This review summarises the current available literature, highlights gaps in knowledge and discusses the implications of late preterm birth for both clinical practice and research in the perinatal period and beyond.

  18. Elective Delivery Before 39 Weeks

    MedlinePlus

    ... Delivery, and Postpartum Care Elective Delivery Before 39 Weeks • What is a “medically indicated” delivery? • What is ... the baby grow and develop during the last weeks of pregnancy? • What are the risks for babies ...

  19. [The meanings that postpartum women assign to gestational hypertension and premature birth].

    PubMed

    de Souza, Nilba Lima; Araujo, Ana Cristina Pinheiro Fernandes; Costa, Iris do Céu Clara

    2011-12-01

    The objective of this study was to understand the meanings that postpartum women assign to gestational hypertension that resulted in premature birth. Participants were 70 women, with a mean age of 28 years, 85.7% of whom delivered between the 32nd and 36th gestational week. A questionnaire with subjective questions was applied to identify the meanings of gestational hypertension and premature delivery for postpartum women. Results were analyzed based on the Theory of Social Representations. We observed the construction of a negative social representation, with death as the central nucleus and negative aspects as the peripheral nuclei. The latter derive from the risks the mother and fetus were exposed to during pregnancy and later in the postpartum period with the hospitalization of the child in the neonatal intensive care unit.

  20. Associations of lipid levels during gestation with hypertensive disorders of pregnancy and gestational diabetes mellitus: a prospective longitudinal cohort study

    PubMed Central

    Shen, Hong; Liu, Xiaohua; Chen, Yan; HE, Biwei; Cheng, Weiwei

    2016-01-01

    Objective To assess associations of elevated lipid levels during gestation with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM). Methods This prospective cohort study was conducted in a tertiary maternal hospital in Shanghai, China from February to November 2014. Lipid constituents, including triglycerides (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) of 1310 eligible women were assessed in the first (10–13+ weeks), second (22–28 weeks) and third (30–35 weeks) trimesters consecutively. Associations of lipid profiles with HDP and/or GDM outcomes were assessed. Results Compared with the normal group, maternal TG concentrations were higher in the HDP/GDM groups across the three trimesters (p<0.001); TC and LDL-c amounts were only higher in the first trimester for the HDP and GDM groups (p<0.05). HDL-c levels were similar in the three groups. Compared with intermediate TG levels (25–75th centile), higher TG amounts (>75th centile) were associated with increased risk of HDP/GDM in each trimester with aORs (95% CI) of 2.04 (1.41 to 2.95), 1.81 (1.25 to 2.63) and 1.78 (1.24 to 2.54), respectively. High TG elevation from the first to third trimesters (>75th centile) was associated with increased risk of HDP, with an aOR of 2.09 (1.16 to 3.78). High TG elevation before 28 weeks was associated with increased risk of GDM, with an aOR of 1.67 (1.10 to 2.54). TG elevation was positively correlated with weight gain during gestation (R=0.089, p=0.005). Conclusions Controlling weight gain during pregnancy could decrease TG elevation and reduce the risk of HDP/GDM. TGs could be used as follow-up parameters during complicated pregnancy, while other lipids are meaningful only in the first trimester. PMID:28011814

  1. Associations of Prenatal Exposure to Organophosphate Pesticide Metabolites with Gestational Age and Birth Weight

    PubMed Central

    Rauch, Stephen A.; Braun, Joe M.; Barr, Dana Boyd; Calafat, Antonia M.; Khoury, Jane; Montesano, M. Angela; Yolton, Kimberly

    2012-01-01

    Background: Prenatal exposure to organophosphate (OP) insecticides, a widely used class of pesticides, may be associated with decreased gestational age and lower birth weight. Single nucleotide polymorphisms in paroxanase (PON1) enzyme genotypes may modify the relationships between OP exposure and perinatal outcomes. Objective: We examined the relationship of prenatal OP insecticide exposure, measured using urinary dialkyl phosphate (DAP) metabolite concentrations, with gestational age and birth weight. Methods: We measured the concentrations of six nonspecific DAP metabolites of OP insecticides in two maternal spot urine samples collected in a prospective birth cohort. We performed multivariable regression to examine associations between the sum of six DAP concentrations (ΣDAP) with gestational age and birth weight. We also examined whether these associations differed according to infant PON1192 and PON1–108 genotypes. Results: Among 306 mother–infant dyads, a 10-fold increase in ΣDAP concentrations was associated with a decrease in covariate-adjusted gestational age [–0.5 weeks; 95% confidence interval (CI): –0.8, –0.1] and birth weight (–151 g; CI: –287, –16); the decrements in birth weight were attenuated after adjusting for gestational age. The relationship between ΣDAP concentrations and gestational age was stronger for white (–0.7 weeks; CI: –1.1, –0.3) than for black (–0.1 weeks; 95% CI: –0.9, 0.6) newborns. In contrast, there was a greater decrease in birth weight with increasing urinary ΣDAP concentrations for black (–188 g; CI: –395, 19) than for white (–118 g; CI: –296, 60) newborns. Decrements in birth weight and gestational age associated with ΣDAP concentrations were greatest among infants with PON1192QR and PON–108CT genotypes. Conclusions: Prenatal urinary ΣDAP concentrations were associated with shortened gestation and reduced birth weight in this cohort, but the effects differed by race/ethnicity and PON

  2. Effects of late gestation distillers grains supplementation on fall-calving beef cow performance and steer calf growth and carcass characteristics.

    PubMed

    Wilson, T B; Schroeder, A R; Ireland, F A; Faulkner, D B; Shike, D W

    2015-10-01

    Fall-calving, mature Angus and Simmental × Angus cows ( = 251 total) and their progeny were used to evaluate the effects of late gestation dried distillers grains plus solubles (DDGS) supplementation on cow performance and progeny growth and carcass characteristics. Cows were blocked by breed and allotted to 12 tall fescue pastures (6.8 ha average). Pastures were randomly assigned to 1 of 2 treatments: cows were offered 2.1 kg DM DDGS·cow·d (SUP; CP = 23%, fat = 7%; = 6 pastures) or were not offered a supplement (CON; = 6 pastures) 69 ± 9 d before expected calving date. Cows remained on treatments until calving. Once weekly, cows that had calved were removed from treatment pastures and were moved to new tall fescue pastures (21.6 ha average) where cows from both treatments were comingled without further supplementation. Cows ( = 74) were removed from study for calving more than 30 d after expected calving date, calf loss and injury, or euthanasia. Cow BW and BCS were recorded at the beginning of the supplementation period, after calving, and at breeding. Calf BW was taken at birth and early weaning (82 ± 14 d of age). After weaning, 71 steer progeny (representative of dam breed and treatment pastures) were transitioned to a common feedlot diet with individual feed intake monitored using the GrowSafe feeding system. Steers were slaughtered at 47 ± 4 d after a minimum 12th rib fat thickness (back fat) estimation of 0.6 cm, with cattle being shipped in 3 groups. Forage availability was not different between treatments ( = 0.69). Cows offered SUP gained more BW and BCS ( ≤ 0.02) during the supplementation period. There were no differences ( ≥ 0.12) in calving date, calf birth or weaning BW, or preweaning ADG. Cow BW at breeding was not different ( = 0.19); however, BCS at breeding was greater ( < 0.01) for cows offered supplement. No differences ( ≥ 0.11) in milk production, AI conception, or overall pregnancy rate were detected. For steer progeny, initial

  3. Early-weaning and postweaning nutritional management affect feedlot performance, carcass merit, and the relationship of 12th-rib fat, marbling score, and feed efficiency among Angus and Wagyu heifers.

    PubMed

    Wertz, A E; Berger, L L; Walker, P M; Faulkner, D B; McKeith, F K; Rodriguez-Zas, S L

    2002-01-01

    Twelve 3/4 Angus (Angus) and 12 Wagyu-cross (1/2 Wagyu x 1/2 Angus) (Wagyu) heifers were weaned at 180 d of age and grazed on endophyte-infected tall fescue for 16 mo before entering the feedlot as 2-yr-olds. Twelve 3/4 Angus heifer calves and 12 Wagyu-cross heifer calves from the following year's calf crop were weaned at 142 +/- 4.1 d of age, immediately adjusted to an 80% concentrate diet, and finished as calves. All heifers were fed a common finishing diet until an estimated 50% of their respective group would grade USDA low Prime or better based on ultrasound predictions. Ultrasound measurements of s.c. and i.m. fat depots were recorded at 60-d intervals throughout the finishing period. Heifers finished as calves had higher (P = 0.02) marbling scores at any given fat thickness and gained more efficiently (P < or = 0.01) at any given marbling score than heifers finished as 2-yr-olds. Gain:feed decreased quadratically (P < or = 0.05) as 12th-rib fat thickness increased for Angus and Wagyu heifers. Gain:feed decreased linearly (P < or = 0.01) for Wagyu calves and quadratically (P < or = 0.01) for Angus calves as 12th-rib fat thickness increased. However, these differences in slope were not different (P = 0.34) as a result of breed among heifers finished as calves. Marbling score increased linearly (P < or = 0.01) as 12th-rib fat thickness increased for Angus and Wagyu heifers finished as 2-yrolds or as calves. However, Wagyu heifers, regardless of age at feedlot entry, had a higher marbling score (P < or = 0.05) at any given 12th-rib fat thickness than Angus heifers. Finishing early-weaned heifers as calves as opposed to 2-yr-olds results in i.m. fat deposition during a period of more efficient growth. Additionally, including Wagyu genetics into the breeding of early-weaned heifers finished as calves or as 2-yr-olds results in higher marbling scores at any 12th-rib fat thickness.

  4. Intermanual Transfer of Shapes in Preterm Human Infants from 33 to 34 + 6 Weeks Postconceptional Age

    ERIC Educational Resources Information Center

    Lejeune, Fleur; Marcus, Leila; Berne-Audeoud, Frederique; Streri, Arlette; Debillon, Thierry; Gentaz, Edouard

    2012-01-01

    This study investigated the ability of preterm infants to learn an object shape with one hand and discriminate a new shape in the opposite hand (without visual control). Twenty-four preterm infants between 33 and 34 + 6 gestational weeks received a tactile habituation task with either their right or left hand followed by a tactile discrimination…

  5. Fetal kidney length as a useful adjunct parameter for better determination of gestational age

    PubMed Central

    Ugur, Mete G.; Mustafa, Aynur; Ozcan, Huseyin C.; Tepe, Neslihan B.; Kurt, Huseyin; Akcil, Emre; Gunduz, Reyhan

    2016-01-01

    Objectives: To determine the validity of fetal kidney length and amniotic fluid index (AFI) in labor dating. Methods: This prospective study included 180 pregnant women followed up in the outpatient clinic at the Department of Obstetrics and Gynecology, Gaziantep University, Turkey, between January 2014 and January 2015. The gestational age (GA) was estimated by early fetal ultrasound measures and last menstrual period. Routine fetal biometric parameters, fetal kidney length, and amniotic fluid index were measured. We studied the correlation between fetal kidney length, amniotic fluid index, and gestational age. Result: The mean gestational age depending on last menstrual period and early ultrasound was 31.98±4.29 (24-39 weeks). The mean kidney length was 35.66±6.61 (19-49 mm). There was a significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001). However, there was a moderate negative correlation between GA and AFI. Adding fetal kidney length to the routine biometrics improved the effectiveness of the model used to estimate GA (R2=0.965 to R2=0.987). Conclusion: Gestational age can be better predicted by adding fetal kidney length to other routine parameters. PMID:27146616

  6. Effects of cannabinoid drugs on the reinforcing properties of food in gestationally undernourished rats.

    PubMed

    Wakley, Alexa A; Rasmussen, Erin B

    2009-11-01

    Involvement of the endocannabinoids in hyperphagia has been demonstrated, however, behavioral characterization of its role in food reinforcement is limited. The present study investigated whether 2-arachidonoyl glycerol, an endocannabinoid ligand, and rimonabant, a CB1 antagonist, change the reinforcing properties of food in gestationally undernourished rats (a putative model of obesity) vs controls. Albino dams were food deprived by 0 to 45% of their free-feeding weights up to day 18 of their gestational period. Their offspring were allowed to free-feed until postnatal day 75. Then, behavior of the offspring was placed under progressive ratio schedules of sucrose reinforcement. After baseline data were established, intraperitoneal injections of 2-AG (0.03-3.75 mg/kg), and rimonabant (SR141716, 0.3-3.0 mg/kg) were administered and compared across group. Results show gestationally undernourished (GU) rats as adults weighed less than controls at the time of testing and female offspring allowed to free-feed for over 35 weeks exhibited lower body weights than controls. Under baseline, GU rats had lower breakpoints than controls. 2-AG and rimonabant significantly increased and decreased, respectively, breakpoint and responses made per session, suggesting involvement of the cannabinoid system in food reinforcement. When comparing peak doses of 2-AG on breakpoint, gestationally undernourished rats exhibited lower peak doses than controls. These data suggest that under the gestation deprivation method employed, GU rats were thinner and had lower food reinforcer efficacy than controls, and may have heightened sensitivity to 2-AG.

  7. Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks

    PubMed Central

    Sabih, D; Ahmad, E; Sabih, A; Sabih, Q

    2010-01-01

    The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face, fused thoraces, common umbilicus but had two pelvises and two sets of genitalia. The fetus had four normally formed legs and arms. Antenatal ultrasound images are supplemented by post natal photographs. A review of literature, clues to ultrasound diagnosis and possible causes of missing this significant abnormality until the 3rd trimester are discussed. PMID:21611074

  8. Assessment of gestational age in the Cameroonian newborn infant: a comparison of four scoring methods.

    PubMed

    Sunjoh, F; Njamnshi, A K; Tietche, F; Kago, I

    2004-10-01

    A clinical assessment of gestational age using four different methods was performed in the same population of 358 Cameroonian newborn infants with the aim of determining the most applicable in the local context. Method applicability was compared in terms of validity, accuracy, reliability, and ease of administration. The gestational age ranged from 25 to 44 weeks. The infants were evaluated within 72 h from birth, using the scoring methods of Farr (FSM), Dubowitz (DSM), Ballard (New Ballard Score--NBS) and Eregie (ESM). The DSM was the most valid with a 93 per cent agreement within +/-2 weeks of gestational age by dates followed by the ESM with 92.4 per cent. The NBS and the FSM showed lower validity of 85.6 per cent and 78.3 per cent respectively. The ESM was the most accurate with a mean difference (MD) in weeks (+/-1 SD) between gestational age by method and gestational age by dates of 0.259+/-1.376, followed by the NBS with 0.355+/-1.51. The DSM was fairly accurate with a MD of 0.500+/-1.31, and the FSM the least accurate with a MD of 1.228+/-1.495. The DSM was the most reliable with a high correlation coefficient (r) of 0.94. The NBS and the ESM had comparable reliability with correlation coefficient of 0.93 each. The easiest to administer was the ESM, completed in an average of 41 s, followed by the FSM in 1 min 22 s. The NBS was completed in 2 min 48 s and the DSM in 4 min 28 s. We concluded that the Eregie model has comparable validity and reliability to the Dubowitz score but is more accurate, simple, and very easy to administer. It is therefore recommended where the workload is heavy and health personnel limited, as is the case in developing countries.

  9. Cognitive outcome varies in adolescents born preterm, depending on gestational age, intrauterine growth and neonatal complications

    PubMed Central

    Lundequist, Aiko; Böhm, Birgitta; Lagercrantz, Hugo; Forssberg, Hans; Smedler, Ann-Charlotte

    2015-01-01

    Aim The aim of this study was to investigate long-term cognitive outcome in a cohort of 18-year-olds born preterm and previously assessed at the age of 5.5. Methods We tested 134 adolescents born preterm with a very low birthweight of <1500 g and 94 term-born controls with a comprehensive cognitive battery at 18 years of age. The cohort was subdivided into 73 extremely preterm, 42 very preterm and 19 moderately preterm infants with gestational ages of 23–27, 28–31 and 32–36 weeks, respectively. The moderately preterm group was dominated by adolescents born small for gestational age. Results Very preterm adolescents performed on a par with term-born controls. In contrast, extremely preterm adolescents displayed inferior results on all cognitive tests, more so if they had suffered neonatal complications. Moderately preterm adolescents scored lower than very preterm and full-term born adolescents, particularly on complex cognitive tasks. Conclusion Adolescents born at 28 weeks of gestation or later, with appropriate birthweight and no perinatal complications, functioned like term-born peers at 18 years of age. Extremely preterm birth per se posed a risk for long-term cognitive deficits, particularly executive deficits. Adolescents born moderately preterm but small for gestational age were at risk of general cognitive deficits. PMID:25394225

  10. Maternal TSH level and TPOAb status in early pregnancy and their relationship to the risk of gestational diabetes mellitus.

    PubMed

    Ying, Hao; Tang, Yu-Ping; Bao, Yi-Rong; Su, Xiu-Juan; Cai, XueYa; Li, Yu-Hong; Wang, De-Fen

    2016-12-01

    Subclinical hypothyroidism is common in pregnant women and often related to adverse pregnancy outcomes, but its relationship with gestational diabetes remains controversial. In particular, the impact of thyroperoxidase antibodies status on the relationship between subclinical hypothyroidism and gestational diabetes is not clear. We investigated the association between combined thyroid stimulating hormone (TSH) level and thyroperoxidase antibodies status in early pregnancy (<20 weeks of gestation) and gestational diabetes mellitus. A total of 7084 pregnant women met the inclusion criteria, which included thyroperoxidase antibodies-positive subclinical hypothyroidism [TSH(H)TPOAb(+)] (n = 78), thyroperoxidase antibodies-negative subclinical hypothyroidism [TSH(H)TPOAb(-)] (n = 281), thyroperoxidase antibodies-positive euthyroidism [TSH(N)TPOAb(+)] (n = 648), and thyroperoxidase antibodies-negative euthyroidism [TSH(N)TPOAb(-)] (n = 6077). Of the 7084 cases included in our study, 1141 cases were diagnosed with gestational diabetes mellitus at 24-28 weeks of pregnancy. The prevalence of gestational diabetes mellitus in TSH(N)TPOAb(-), TSH(H)TPOAb(-), TSH(N)TPOAb(+), and TSH(H)TPOAb(+) was 14.65, 19.57, 24.85, and 46.15 %, respectively. Compared with TSH(N)TPOAb(-) women, the risk of gestational diabetes mellitus was increased in all other groups of women in early pregnancy. After dividing early pregnancy into first and second trimesters, we found that TSH(H)TPOAb(-) women in the first trimester do not show this increase. Our study suggests that subclinical hypothyroidism and thyroperoxidase antibodies-positive euthyroidism in early pregnancy are associated with an increased risk of gestational diabetes mellitus.

  11. Marijuana impairs growth in mid-gestation fetuses.

    PubMed

    Hurd, Y L; Wang, X; Anderson, V; Beck, O; Minkoff, H; Dow-Edwards, D

    2005-01-01

    Marijuana (Cannabis sativa) is the most commonly used illicit drug by pregnant women, but information is limited about the effects of prenatal cannabis exposure on fetal development. The present study evaluated the influence of early maternal marijuana use on fetal growth. Women electing voluntary saline-induced abortions were recruited at a mid-gestational stage of pregnancy (weeks 17-22), and detailed drug use and medical histories were obtained. Toxicological assays (maternal urine and fetal meconium) were used in conjunction with the maternal report to assign groups. Subjects with documented cocaine and opiate use were excluded. Main developmental outcome variables were fetal weight, foot length, body length, and head circumference; ponderal index was also examined. Analyses were adjusted for maternal alcohol and cigarette use. Marijuana (n=44)- and nonmarijuana (n=95)-exposed fetuses had similar rates of growth with increased age. However, there was a 0.08-cm (95% CI -0.15 to -0.01) and 14.53-g (95% CI -28.21 to 0.86) significant reduction of foot length and body weight, respectively, for marijuana-exposed fetuses. Moreover, fetal foot length development was negatively correlated with the amount and frequency of marijuana use reported by the mothers. These findings provide evidence of a negative impact of prenatal marijuana exposure on the mid-gestational fetal growth even when adjusting for maternal use of other substances well known to impair fetal development.

  12. Retinoic acid exposure on gestational days 11 to 13 impairs swallowing in rat offspring.

    PubMed

    Holson, R R; Adams, J; Ferguson, S A; Scalzo, F M

    2000-01-01

    We have previously reported that exposure to 10 mg/kg of all-trans-retinoic acid (RA) daily on the 11th, 12th, and 13th days of rat gestation is lethal to all fetuses so exposed, due to an inability to suckle [R.R. Holson et al., Neurotoxicol Teratol 19 (1997) 347-353]. Because this lethal RA effect could be due to any of a variety of causes, from olfactory problems in locating the nipple to a motor problem in sucking or swallowing, we performed the following experiment. Albino dams were exposed to 10-mg/kg RA or vehicle daily over gestational days (GDs) 11 to 13. On the afternoon of GD 21 all pups were delivered by c-section. Tongue cannulae were inserted into the oral cavity of these offspring, and used to infuse a solution of condensed milk directly into the mouth. During and after each of four infusions, the behavioral response to the infusion (typically rolling and curling) was recorded. Controls responded well to this procedure, typically swallowing all milk so infused. In contrast, almost no RA-exposed neonates were able to swallow milk infused into the oral cavity. In such cases the milk simply dribbled out of the mouth, while the stomach was found to be empty at autopsy. However, the RA-treated animals did seem aware that milk was entering their mouths, because they showed a normal behavioral response to milk infusion. We conclude that GD 11-13 retinoid lethality is due to motor not sensory problems in the control of swallowing.

  13. An Evaluation of Gestational Exposure to Perfluorooctanoic ...

    EPA Pesticide Factsheets

    Exposure to environmental pollutants can be a factor for induction of metabolic disorders. This study examined if exposure to PFOA during development could alter body composition and other physiological outcomes. Study 1: Pregnant CD-1 mice were gavaged with PFOA at 0,0.001,0.01, 0.1, or 0.3 mg/kg body weight (bw) from gestation day (GD) 1 — 17. At weaning, pups were fed a high fat (HFD) or control (CD) diet. Body composition, blood pressure (bp), and gene expression in tissues of offspring were examined. Male- BW increased, in 0 mg PFOA+HFD vs 0 m PFOA+CD and 0.01 mg PFOA+HFD vs 0.01 mg PFOA+CD. In HFD, bw decreased in 0.3 vs 0 mg PFOA. There were no effects on percent of body fat. At postnatal day (PND) 90, diastolic bp was decreased in 0.1 and 0.3 mg PFOA+HFD vs 0 mg PFOA+HFD and increased in 0.3 mg PFOA+HFD vs 0.3 mg PFOA+CD. The bp effects of 0.1 mg PFOA+HFD persisted to PND 180. Female- At 0 and 0.001 mg PFOA+HFD had increased weight gain vs CD. The %fat increased in 0.001 vs 0 mg PFOA+HFD. At PND 180, diastolic bp decreased in 0.01 and 0.3 mg PFOA+CD vs 0 mg PFOA+CD. Differential gene regulation was produced by HFD and PFOA in white fat and liver at 52 weeks of age. At 0.001 mg PFOA+HFD vs 0.001 mg PFOA+CD, 3 genes in white fat and liver were under-expressed while 14 genes in white fat and 19 in liver were over expressed. At 0.01 mg PFOA+HFD vs 0.01 mg PFOA+CD, 3 genes in white fat and 4 genes in liver were under-expressed while 14 genes in white fat an

  14. Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011) Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011)

    NASA Astrophysics Data System (ADS)

    Berk, H. L.

    2012-09-01

    The topic of the behaviour of energetic alpha particles in magnetic fusion confined plasmas is perhaps the ultimate frontier plasma physics issue that needs to be understood in the quest to achieve controlled power from the fusion reaction in magnetically confined plasmas. The partial pressure of alpha particles in a burning plasma will be ~5-10% of the total pressure and under these conditions the alpha particles may be prone to develop instability through Alfvénic interaction. This may lead, even with moderate alpha particle loss, to a burn quench or severe wall damage. Alternatively, benign Alfvénic signals may allow the vital information to control a fusion burn. The significance of this issue has led to extensive international investigations and a biannual meeting that began in Kyiv in 1989, followed by subsequent meetings in Aspenäs (1991), Trieste (1993), Princeton (1995), JET/Abingdon (1997), Naka (1999), Gothenburg (2001), San Diego (2003), Takayama (2005), Kloster Seeon (2007) and Kyiv (2009). The meeting was initially entitled 'Alpha Particles in Fusion Research' and then was changed during the 1997 meeting to 'Energetic Particles in Magnetic Confinement Systems' in appreciation of the need to study the significance of the electron runaway, which can lead to the production of energetic electrons with energies that can even exceed the energy produced by fusion products. This special issue presents some of the mature interesting work that was reported at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems, which was held in Austin, Texas, USA (7-11 September 2011). This meeting immediately followed a related meeting, the 5th IAEA Technical Meeting on Theory of Plasma Wave Instabilities (5-7 September 2011). The meetings shared one day (7 September 2011) with presentations relevant to both groups. The presentations from most of the participants, as well as some preliminary versions of papers, are available at the

  15. Amplitude-integrated electroencephalographic activity and middle cerebral artery Doppler flow measurements in preterm small for gestational age infants.

    PubMed

    Kolsuz, Leyla Daban; Topcuoglu, Sevilay; Gursoy, Tugba; Karatekin, Güner; Ovali, H Fahri

    2015-03-01

    Amplitude-integrated encephalography (EEG) is frequently used in neonatal intensive care units to monitor brain functions. Its bedside application and easy interpretation are the most important features. Brain development of small for gestational age infants can be affected by intrauterine chronic hypoxia. The current study aimed to evaluate cerebral functions of small for gestational age infants by means of amplitude-integrated EEG. Thirty- to 34-week-old 22 small for gestational age and 27 appropriate for gestational age preterm infants were included in the study. The mode of delivery, gender, birth weight, and Apgar scores of the patients were recorded. Following middle cerebral artery mean velocity measurement with cranial Doppler at the 24th hour of birth, an amplitude-integrated EEG recording was performed on all infants, for a period of 4 to 24 hours. Small for gestational age infants had significantly higher middle cerebral artery mean velocity than appropriate for gestational age infants (21.09 ± 4.25 vs 17.8 ± 4.07; P = .029). The amplitude-integrated EEG recordings showed lower "lower border of quiet sleep" and total Burdjalov score in small for gestational age infants when compared with appropriate for gestational age infants (2.5 [1-3.25] µV vs 3 [2.75-4] µV; P = .04, 8 [6-10], 9 [9-11]; P = .04, respectively). Increased middle cerebral artery blood flow observed in small for gestational age infants might be a marker of chronic intrauterine hypoxia to which these infants were exposed. These infants demonstrated a more immature pattern of amplitude-integrated EEG.

  16. Cohort study of growth patterns by gestational age in preterm infants developing morbidity

    PubMed Central

    Klevebro, S; Lundgren, P; Hammar, U; Smith, L E; Bottai, M; Domellöf, M; Löfqvist, C; Hallberg, B; Hellström, A

    2016-01-01

    Objectives To examine differences in growth patterns in preterm infants developing major morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC) and intraventricular haemorrhage (IVH). Study design Cohort study of 2521 infants born at a gestational age (GA) of 23–30 weeks from 11 level III neonatal intensive care units in USA and Canada, and 3 Swedish population-based cohorts. Outcomes Birth weight and postnatal weight gain were examined relative to birth GA and ROP, BPD, NEC and IVH development. Results Among infants with a birth GA of 25–30 weeks, birth weight SD score and postnatal weight were lower in those developing ROP and BPD. Infants developing ROP showed lower growth rates during postnatal weeks 7–9 in the 23–24 weeks GA group, during weeks 4–6 in the 25–26 weeks GA group and during weeks 1–5 in the 27–30 weeks GA group. Infants with BPD born at 27–30 weeks GA showed lower growth rates during postnatal weeks 3–5. Infants with NEC had lower growth rates after postnatal week 6 in all GA groups, with no significant differences in birth weight SD score. IVH was not associated with prenatal or postnatal growth. Conclusions In this cohort study of extremely preterm infants, we found that the postnatal growth pattern was associated with morbidities such as ROP, BPD and NEC as well as with gestational age at birth. PMID:27856479

  17. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam

    PubMed Central

    Young, Melissa F.; Hong Nguyen, Phuong; Addo, O. Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-01

    Objective To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21–29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Methods Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Results Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21–29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46–0.70). Conclusion There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. Trial Registration ClinicalTrials.gov, NCT01665378 PMID:28114316

  18. Management of high-order multiple gestation.

    PubMed

    Elliott, John P

    2005-06-01

    High-order multiple gestation presents unique challenges to the clinician to obtain the best possible outcome. An aggressive proactive approach works best compared with a wait-and-treat strategy when complications occur. Frequent ultrasound evaluations, fetal fibronectin testing, and contraction monitoring are important diagnostic tools. Aggressive weight gain, bed rest, and relaxation techniques are important interventions. Tocolytic drugs are used to prevent preterm labor, and aggressive dosing of MgSO4, terbutaline pumps, and oral agents are advocated to treat preterm labor. Outcome is generally good with high-order multiple gestation with this management protocol.

  19. Modifiable predictors associated with having a gestational weight gain goal.

    PubMed

    Tovar, Alison; Guthrie, Lauren B; Platek, Deborah; Stuebe, Alison; Herring, Sharon J; Oken, Emily

    2011-10-01

    The goal of this paper was to determine predictors of having a weight gain goal in early pregnancy. In 2008, we administered a 48-item survey to 249 pregnant women attending obstetric visits. We examined predictors of women having a goal concordant or discordant with 1990 Institute of Medicine (IOM) guidelines, vs. no goal, using binary and multinomial logistic regression. Of the 292 respondents, 116 (40%) had no gestational weight gain goal, 112 (39%) had a concordant goal and 61 (21%) had a goal discordant with IOM guidelines. Predictors of a guideline-concordant goal, vs. no goal, included sugar sweetened beverage consumption < vs. ≥ 1 serving per week (OR = 2.4, 95%CI: 1.1, 5.7), physical activity ≥ vs. <2.5 h per week (OR = 3.6, 95%CI: 1.7, 7.5), agreeing that 'I tried to keep weight down not to look pregnant' (OR = 14.3, 95%CI: 1.4, 140.5). Other predictors only of having a discordant goal (vs. no goal) included agreeing that 'as long as I am eating well, I don't care how much I gain' (OR = 0.3, 95%CI: 0.2, 0.8) and agreeing that 'if I gain too much weight one month, I try to keep from gaining the next' (OR = 4.1, 95%CI: 1.6, 10.4). Women whose doctors recommended weight gains consistent with IOM guidelines were more likely to have a concordant goal (vs. no goal) (OR = 5.3, 95%CI: 1.5, 18.6). Engaging in healthy behaviors and having health providers offer IOM weight gain recommendations may increase the likelihood of having a concordant gestational weight gain goal, which, in turn, is predictive of actual weight gains that fall within IOM guidelines.

  20. The effect of conception date on gestation length of red deer (Cervus elaphus).

    PubMed

    Scott, I C; Asher, G W; Archer, J A; Littlejohn, R P

    2008-12-01

    Recent studies have demonstrated that gestation length of red deer (Cervus elaphus) is highly variable and influenced by various environmental factors, and this may confer survival advantages for neonates. The current study investigated the relationship between conception date and gestation length to test the hypothesis that within-herd synchrony of red deer births is facilitated by a 'push/pull' control over gestation length, such that hinds conceiving early and late in the breeding season have longer and shorter gestation periods, respectively. In Study 1, data on conception and calving dates were obtained for 393 naturally cycling hinds across two herds. In Study 2, conception and calving dates were obtained from 91 hinds in which oestrus/conception were artificially synchronised across a 4-week range of dates spanning the natural rut. Gestation length for each population was analysed by linear regression, fitting conception day followed by terms for the fixed effect which included hind age (pubertal vs. adult), hind genotype (Cervus elaphus scoticus vs. Cervus elaphus hippelaphus and their crossbreds), calf sex, sire genotype (Study 1 only), birth weight and year. In Study 1, both populations of naturally cycling hinds exhibited highly significant (P<0.001) negative slopes (-0.36, -0.49) for the regression of gestation length against conception date, with indications of a significant hind genotype effect favouring shorter overall gestation lengths for crossbred hinds. Other effects for hind age, calf sex, birth weight, sire genotype and year were not significant. In Study 2, in which conception dates were artificially induced, there was a highly significant negative slope (-0.19), with a notable but non-significant effect of hind age favouring shorter overall gestation length for primiparous (pubertal) hinds (P>0.05). Other effects for hind live weight, calf sex and calf birth weight were not significant. All data sets support the hypothesis, and indicate that

  1. Birth weight and longitudinal growth in infants born below 32 weeks’ gestation: a UK population study

    PubMed Central

    Cole, Tim J; Statnikov, Yevgeniy; Santhakumaran, Shalini; Pan, Huiqi; Modi, Neena

    2014-01-01

    Objective To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks’ gestation, using routinely captured electronic clinical data. Design Anonymised longitudinal weight data from 2006 to 2011. Setting National Health Service neonatal units in England. Methods Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis. Results Data on 103 194 weights of 5009 babies born from 22–31 weeks’ gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks’ gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks’ gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks. Conclusions In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management. PMID:23934365

  2. The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study

    PubMed Central

    Nasiri-Amiri, Fatemeh; Bakhtiari, Afsaneh; Faramarzi, Mahbobeh; Adib Rad, Hajar; Pasha, Hajar

    2016-01-01

    Background Gestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus. Objectives The present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy. Patients and Methods In the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders. Results Females who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in

  3. Influence of Gestational Age and Postnatal Age on Speech Sound Processing in NICU infants

    PubMed Central

    Key, Alexandra P.F.; Lambert, E. Warren; Aschner, Judy L.; Maitre, Nathalie L.

    2012-01-01

    The study examined the effect of gestational (GA) and postnatal (PNA) age on speech sound perception in infants. Auditory ERPs were recorded in response to speech sounds (CV syllables) in 50 infant NICU patients (born at 24–40 weeks gestation) prior to discharge. Efficiency of speech perception was quantified as absolute difference in mean amplitudes of ERPs in response to vowel (/a/–/u/) and consonant (/b/–/g/, /d/–/g/) contrasts within 150–250, 250–400, 400–700 ms after stimulus onset. Results indicated that both GA and PNA affected speech sound processing. These effects were more pronounced for consonant than vowel contrasts. Increasing PNA was associated with greater sound discrimination in infants born at or after 30 weeks GA, while minimal PNA-related changes were observed for infants with GA less than 30 weeks. Our findings suggest that a certain level of brain maturity at birth is necessary to benefit from postnatal experience in the first 4 months of life, and both gestational and postnatal ages need to be considered when evaluating infant brain responses. PMID:22332725

  4. Maternal and neonatal outcomes by labor onset type and gestational age

    PubMed Central

    Bailit, Jennifer L.; Gregory, Kimberly D.; Reddy, Uma M.; Gonzalez-Quintero, Victor H.; Hibbard, Judith U.; Ramirez, Mildred M.; Branch, D. Ware; Burkman, Ronald; Haberman, Shoshana; Hatjis, Christos G.; Hoffman, Matthew K.; Kominiarek, Michelle; Landy, Helain J.; Learman, Lee A.; Troendle, James; Van Veldhuisen, Paul; Wilkins, Isabelle; Sun, Liping; Zhang, Jun

    2010-01-01

    OBJECTIVE We sought to determine maternal and neonatal outcomes by labor onset type and gestational age. STUDY DESIGN We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age. RESULTS Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28 – 0.53), sepsis (OR, 0.36; 95% CI, 0.26 – 0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48 – 0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08 – 9.54) with elective induction, 1.16 (95% CI, 0.24 – 5.58) with indicated induction, and 6.57 (95% CI, 1.78 – 24.30) with cesarean without labor compared to spontaneous labor. CONCLUSION Some neonatal outcomes improved until 39 weeks. Babies born with elective induction are associated with better neonatal outcomes compared to spontaneous labor. Elective induction may be associated with an increased hysterectomy risk. PMID:20207242

  5. Gestation length and birth weight in relation to intake of marine n-3 fatty acids.

    PubMed

    Olsen, S F; Hansen, H S; Secher, N J; Jensen, B; Sandström, B

    1995-03-01

    It has been hypothesized that marine n-3 fatty acids ingested during pregnancy prolong duration of pregnancy and increase fetal growth rate in humans. By a combined self-administered questionnaire and interview applied in the 30th week of gestation we assessed dietary intake of marine n-3 fatty acids and energy in a population-based sample of 965 pregnant Danish women; in a random 14% subsample we also measured marine n-3 fatty acids relative to arachidonic acid (FA-ratio) in erythrocytes. Mean intake of marine n-3 fatty acids was 0.25 (95% range 0-0.75) g/d. We could detect no association between n-3 fatty acid intake and FA-ratio on the one hand, and gestation length, birth weight and birth length on the other. The analyses were adjusted for maternal height, prepregnant weight, parity and smoking. The conclusion from the study was that within the intake range of this population, marine n-3 fatty acids ingested in the weeks prior to the 30th week of pregnancy seem not to be a predictor of gestation length or fetal growth rate.

  6. Gestational dating by metabolic profile at birth: a California cohort study

    PubMed Central

    Jelliffe-Pawlowski, Laura L.; Norton, Mary E.; Baer, Rebecca J.; Santos, Nicole; Rutherford, George W.

    2016-01-01

    Background Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. Objective We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (<37 weeks) from term births and to assign a specific gestational age in the PTB group. Study Design We evaluated a cohort of 729,503 singleton newborns with a California birth in 2005 through 2011 who had routine newborn metabolic screening and fetal ultrasound dating at 11–20 weeks’ gestation. Using training and testing subsets (divided in a ratio of 3:1) we evaluated the association among PTB, target newborn characteristics, acylcarnitines, amino acids, thyroid-stimulating hormone, 17-hydroxyprogesterone, and galactose-1-phosphate-uridyl-transferase. We used multivariate backward stepwise regression to test for associations and linear discriminate analyses to create a linear function for PTB and to assign a specific week of gestation. We used sensitivity, specificity, and positive predictive value to evaluate the performance of linear functions. Results Along with birthweight and infant age at test, we included 35 of the 51 metabolic markers measured in the final multivariate model comparing PTBs and

  7. Effects of Gestational Maternal Undernutrition on Growth, Carcass Composition and Meat Quality of Rabbit Offspring

    PubMed Central

    Symeon, George K.; Goliomytis, Michael; Bizelis, Iosif; Papadomichelakis, George; Pagonopoulou, Olga; Abas, Zafeiris; Deligeorgis, Stelios G.; Chadio, Stella E.

    2015-01-01

    An experiment was conducted in order to evaluate the effects of gestational undernutrition of rabbit does on growth, carcass composition and meat quality of the offsprings. Thirty primiparous non lactating rabbit does were artificially inseminated and randomly divided in three treatment groups: Control (C; fed to 100% of maintenance requirements throughout gestation, n = 10), early undernourished (EU; fed to 50% of maintenance requirements during days 7–19 of gestation, n = 10) and late undernourished (LU; fed to 50% of maintenance requirements during days 20-27 of gestation, n = 10). During the 4th week of the gestation period, LU does significantly lost weight compared to C and EU groups (P<0.05). At kindling, C does produced litters with higher proportions of stillborn kits (P<0.05) while the total litter size (alive and stillborn kits) was not different among groups (10.7, 12.8 and 12.7 kits in C, EU and LU groups, respectively). Kit birth weight tended to be lower in the LU group. During fattening, body weight and feed intake were not different among offsprings of the three experimental groups. Moreover, the maternal undernutrition did not have any impact on carcass composition of the offsprings in terms of carcass parts and internal organs weights as well as meat quality of L. lumborum muscle (pH24, colour, water holding capacity and shear values) at slaughter (70 days of age). Therefore, it can be concluded that the gestational undernutrition of the mother does not have detrimental effects on the productive and quality traits of the offsprings. PMID:25671602

  8. FFA2 Contribution to Gestational Glucose Tolerance Is Not Disrupted by Antibiotics

    PubMed Central

    Li, Xiaoran; Fisch, Robert; Bughara, Moneb; Wicksteed, Barton; Kovatcheva-Datchary, Petia; Layden, Brian T.

    2016-01-01

    During the insulin resistant phase of pregnancy, the mRNA expression of free fatty acid 2 receptor (Ffar2) is upregulated and as we recently reported, this receptor contributes to insulin secretion and pancreatic beta cell mass expansion in order to maintain normal glucose homeostasis during pregnancy. As impaired gestational glucose levels can affect metabolic health of offspring, we aimed to explore the role of maternal Ffar2 expression during pregnancy on the metabolic health of offspring and also the effects of antibiotics, which have been shown to disrupt gut microbiota fermentative activity (the source of the FFA2 ligands) on gestational glucose homeostasis. We found that maternal Ffar2 expression and impaired glucose tolerance during pregnancy had no effect on the growth rates, ad lib glucose and glucose tolerance in the offspring between 3 and 6 weeks of age. To disrupt short chain fatty acid production, we chronically treated WT mice and Ffar2-/- mice with broad range antibiotics and further compared their glucose tolerance prior to pregnancy and at gestational day 15, and also quantified cecum and plasma SCFAs. We found that during pregnancy antibiotic treatment reduced the levels of SCFAs in the cecum of the mice, but resulted in elevated levels of plasma SCFAs and altered concentrations of individual SCFAs. Along with these changes, gestational glucose tolerance in WT mice, but not Ffar2-/- mice improved while on antibiotics. Additional data showed that gestational glucose tolerance worsened in Ffar2-/- mice during a second pregnancy. Together, these results indicate that antibiotic treatment alone is inadequate to deplete plasma SCFA concentrations, and that modulation of gut microbiota by antibiotics does not disrupt the contribution of FFA2 to gestational glucose tolerance. PMID:27959892

  9. Effects of gestational maternal undernutrition on growth, carcass composition and meat quality of rabbit offspring.

    PubMed

    Symeon, George K; Goliomytis, Michael; Bizelis, Iosif; Papadomichelakis, George; Pagonopoulou, Olga; Abas, Zafeiris; Deligeorgis, Stelios G; Chadio, Stella E

    2015-01-01

    An experiment was conducted in order to evaluate the effects of gestational undernutrition of rabbit does on growth, carcass composition and meat quality of the offsprings. Thirty primiparous non lactating rabbit does were artificially inseminated and randomly divided in three treatment groups: Control (C; fed to 100% of maintenance requirements throughout gestation, n = 10), early undernourished (EU; fed to 50% of maintenance requirements during days 7-19 of gestation, n = 10) and late undernourished (LU; fed to 50% of maintenance requirements during days 20-27 of gestation, n = 10). During the 4th week of the gestation period, LU does significantly lost weight compared to C and EU groups (P<0.05). At kindling, C does produced litters with higher proportions of stillborn kits (P<0.05) while the total litter size (alive and stillborn kits) was not different among groups (10.7, 12.8 and 12.7 kits in C, EU and LU groups, respectively). Kit birth weight tended to be lower in the LU group. During fattening, body weight and feed intake were not different among offsprings of the three experimental groups. Moreover, the maternal undernutrition did not have any impact on carcass composition of the offsprings in terms of carcass parts and internal organs weights as well as meat quality of L. lumborum muscle (pH24, colour, water holding capacity and shear values) at slaughter (70 days of age). Therefore, it can be concluded that the gestational undernutrition of the mother does not have detrimental effects on the productive and quality traits of the offsprings.

  10. Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study

    PubMed Central

    Bishop, Deborah C; Pang, Ruyan; Ohuma, Eric O; Kac, Gilberto; Abrams, Barbara; Rasmussen, Kathleen; Barros, Fernando C; Hirst, Jane E; Lambert, Ann; Papageorghiou, Aris T; Stones, William; Jaffer, Yasmin A; Altman, Douglas G; Noble, J Alison; Giolito, Maria Rosa; Gravett, Michael G; Purwar, Manorama; Kennedy, Stephen H; Bhutta, Zulfiqar A; Villar, José

    2016-01-01

    Objective To describe patterns in maternal gestational weight gain (GWG) in healthy pregnancies with good maternal and perinatal outcomes. Design Prospective longitudinal observational study. Setting Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States, April 2009 to March 2014. Participants Healthy, well nourished, and educated women enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of 18.50-24.99 in the first trimester of pregnancy. Main outcome measures Maternal weight measured with standardised methods and identical equipment every five weeks (plus/minus one week) from the first antenatal visit (<14 weeks’ gestation) to delivery. After confirmation that data from the study sites could be pooled, a multilevel, linear regression analysis accounting for repeated measures, adjusted for gestational age, was applied to produce the GWG values. Results 13 108 pregnant women at <14 weeks’ gestation were screened, and 4607 met the eligibility criteria, provided consent, and were enrolled. The variance within sites (59.6%) was six times higher than the variance between sites (9.6%). The mean GWGs were 1.64 kg, 2.86 kg, 2.86 kg, 2.59 kg, and 2.56 kg for the gestational age windows 14-18+6 weeks, 19-23+6 weeks, 24-28+6 weeks, 29-33+6 weeks, and 34-40+0 weeks, respectively. Total mean weight gain at 40 weeks’ gestation was 13.7 (SD 4.5) kg for 3097 eligible women with a normal BMI in the first trimester. Of all the weight measurements, 71.7% (10 639/14 846) and 94.9% (14 085/14 846) fell within the expected 1 SD and 2 SD thresholds, respectively. Data were used to determine fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation, with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. Conclusions

  11. Gestational diabetes mellitus with diabetic ketoacidosis in a Yorkshire terrier bitch.

    PubMed

    Armenise, Andrea; Pastorelli, Gianfranco; Palmisano, Angela; Sontas, Hasan B; Romagnoli, Stefano

    2011-01-01

    A 6 yr old pregnant Yorkshire terrier bitch presented 62 days after mating with an acute history of vomiting and coughing. The owners also reported that the dog was polyuric and polydypsic for the last 2 weeks. Complete blood count, serum biochemistry, and urinalysis revealed hyperglycemia, ketonemia, ketonuria, and metabolic acidosis. Diabetic ketoacidosis was diagnosed and after emergency treatment, including fluid therapy, prophylactic antibiotics, and regular insulin, the bitch whelped six healthy normal puppies. Two weeks after treatment, the bitch was clinically normal with normal fructosamine levels. To the authors' knowledge, this is the first reported case of gestational diabetes mellitus in a small breed dog.

  12. Adult Learners' Week in Australia.

    ERIC Educational Resources Information Center

    Cross, John

    2002-01-01

    Promotional materials and activities for Australia's Adult Learners Week, which are shaped by a variety of stakeholders , include media strategies and a website. Activities are evaluated using a market research company and website and telephone hotline statistics. (SK)

  13. Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

    PubMed Central

    Rezai, Shadi; Nakagawa, Jenna T.; Tedesco, John; Chadee, Annika; Gottimukkala, Sri; Mercado, Ray; Henderson, Cassandra E.

    2015-01-01

    Background. Gestational gigantomastia is a rare disorder without clear etiology or well-established risk factors. Several pathogenic mechanisms contributing to the disease process have been proposed, all of which can lead to a similar phenotype of breast hypertrophy. Case. A 28-year-old Guinean woman presented at 37 weeks of gestation with bilateral gigantomastia, mastalgia, peau d'orange, and back pain. Prolactin levels were 103.3 μg/L (with a normal reference value for prolactin in pregnancy being 36–372 μg/L). The patient was treated with bromocriptine (2.5 mg twice daily), scheduled for a repeat cesarean, and referred to surgery for bilateral mammoplasty. Conclusion. Gestational gigantomastia is a rare disorder, characterized by enlargement and hypertrophy of breast tissue. Our patient presented with no endocrine or hematological abnormalities, adding to a review of the literature for differential diagnoses, workup, and management of cases of gestational gigantomastia with normal hormone levels. PMID:26713166

  14. Early Onset Intrauterine Growth Restriction in a Mouse Model of Gestational Hypercholesterolemia and Atherosclerosis

    PubMed Central

    Busso, Dolores; Mascareño, Lilian; Salas, Francisca; Berkowitz, Loni; Santander, Nicolás; Quiroz, Alonso; Amigo, Ludwig; Valdés, Gloria; Rigotti, Attilio

    2014-01-01

    The susceptibility to develop atherosclerosis is increased by intrauterine growth restriction and prenatal exposure to maternal hypercholesterolemia. Here, we studied whether mouse gestational hypercholesterolemia and atherosclerosis affected fetal development and growth at different stages of gestation. Female LDLR KO mice fed a proatherogenic, high cholesterol (HC) diet for 3 weeks before conception and during pregnancy exhibited a significant increase in non-HDL cholesterol and developed atherosclerosis. At embryonic days 12.5 (E12.5), E15.5, and E18.5, maternal gestational hypercholesterolemia and atherosclerosis were associated to a 22–24% reduction in male and female fetal weight without alterations in fetal number/litter or morphology nor placental weight or structure. Feeding the HC diet exclusively at the periconceptional period did not alter fetal growth, suggesting that maternal hypercholesterolemia affected fetal weight only after implantation. Vitamin E supplementation (1,000 UI of α-tocopherol/kg) of HC-fed females did not change the mean weight of E18.5 fetuses but reduced the percentage of fetuses exhibiting body weights below the 10th percentile of weight (HC: 90% vs. HC/VitE: 68%). In conclusion, our results showed that maternal gestational hypercholesterolemia and atherosclerosis in mice were associated to early onset fetal growth restriction and that dietary vitamin E supplementation had a beneficial impact on this condition. PMID:25295255

  15. Gestational Age and Autism Spectrum Disorder: Trends in Risk Over Time.

    PubMed

    Atladóttir, H Ó; Schendel, D E; Henriksen, T B; Hjort, L; Parner, E T

    2016-02-01

    Autism Spectrum Disorder (ASD) is a serious neurodevelopmental disorder. Several previous studies have identified preterm birth as a risk factor for ASD but none has studied whether the association between gestational age and ASD has changed over time. This is a Danish population-based follow-up study including live-born singletons born in Denmark between 1980 and 2009, identified in the Danish Medical Birth Registry, a study population of 1,775,397 children. We used a Cox regression model combined with spline to study the risk for ASD by gestational age across three decades of birth cohorts. We included 19,020 children diagnosed with ASD. Across all birth year cohorts, we found that the risk of being diagnosed with ASD increased with lower gestational age (P-value: <0.01). Across all gestational weeks, we found a statistically significant higher risk estimates in birth cohort 1980 to 1989, compared to birth cohorts 1990 to 1999 and 2000 to 2009, respectively. No statistically significant difference in risk estimates was observed between birth cohort 1990 to 1999 and 2000 to 2009. The observed time trend in risk of ASD after preterm birth may reflect: (1) a change in the risk profile of persons with ASD due to the broadening of ASD diagnostic criteria over time; or (2) improved neonatal care for low GA infants, which has reduced risk of adverse outcomes like ASD in preterm children.

  16. Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management

    PubMed Central

    2012-01-01

    Background Gestational diabetes rates have increased dramatically in the past two decades and this pattern of increase appears to relate primarily to the obesity epidemic, older maternal age and migration from world areas of high GDM risk. Women from disadvantaged and migrant backgrounds are most at risk of developing and of mismanaging this condition. The aim of the study was to explore the factors that facilitated or inhibited gestational diabetes self-management among women in a socially deprived area. Methods Fifteen pregnant women, with a diagnosis of gestational diabetes, were purposively recruited for this study. Qualitative semi structured interviews and 1 focus group were conducted when participants were approximately 28–38 weeks gestation. The study’s theoretical framework was based on interpretative phenomenology and data was analysed using a thematic analysis approach. Results Women in this study identified a number of factors that complicated their task of GDM self-management. Barriers included: (1) time pressures; (2) physical constraints; (3) social constraints; (4) limited comprehension of requirements, and (5) insulin as an easier option. Factors facilitating GDM self-management included: thinking about the baby and psychological support from partners and families. Conclusion Women from low socio economic and migrant backgrounds often struggle to comprehend GDM self-management requirements. To improve adherence to management plans, these women require educational and supportive services that are culturally appropriate and aimed at a low level of literacy. PMID:22988897

  17. The pattern of antenatal visits with emphasis on gestational age at booking in Riyadh Health Centres.

    PubMed

    al-Shammari, S A; Khoja, T; Jarallah, J S

    1994-04-01

    1344 expectant mothers were selected by random sampling from the catchment population of 15 health centres in Riyadh. The health centres were taken to represent all areas of urban Riyadh. These mothers were asked to complete a pre-designed questionnaire in Arabic and undergo a structured interview by trained midwives to explore their knowledge, attitude and practice toward antenatal visits. It was found that the average gestational age at booking was 13 weeks. The number of antenatal visits achieved during the current pregnancy was 6. 97% of expectant mothers were aware of the importance of antenatal visits. Various demographic characteristics were studied in relation to the number of antenatal visits achieved and the gestational age at booking. It was found that the level of education of both husband and wife and poor obstetric history significantly affected gestational age at booking, (P-values) were less than 0.03 and 0.002 respectively). However the family income and gestational age at booking affected the number of antenatal visits (P-values were less than 0.0003 and 0.0001 respectively). The respondents' most striking reason for non-compliance was related to accessibility to health centre. 23.3% thought that the health centres were far away from their residence and they needed to involve the husbands in driving them to health centres. Recommendations were given to improve aspects of accessibility and inviting more antenatal visits in addition to improving quality of such service.

  18. Gestational diabetes mellitus is associated with increased leukocyte peroxisome proliferator-activated receptor γ expression

    PubMed Central

    Mac-Marcjanek, Katarzyna; Nadel, Iwona; Woźniak, Lucyna; Cypryk, Katarzyna

    2015-01-01

    Introduction Peroxisome proliferator-activated receptor γ (PPARγ) is a ligand-activated transcription factor of the nuclear receptor superfamily that is involved in lipid and carbohydrate metabolism as well as inflammation; thereby it participates in metabolic diseases including diabetes. Although PPARγ expression has been observed in different tissues of diabetic patients, its level in leukocytes from subjects affected by gestational diabetes mellitus (GDM) has not yet been reported. This study aimed to investigate leukocyte PPARG expression in GDM patients at 24–33 weeks of gestation and, in turn, to correlate these alterations with anthropometric and metabolic parameters of patients. Material and methods Leukocytes were isolated from the blood of normal glucose tolerant (NGT; n = 34) and GDM (n = 77) pregnant women between 24 and 33 weeks of gestation. Leukocyte PPARG mRNA expression was determined by semi-quantitative polymerase chain reaction. Univariate correlation analysis was performed to investigate associations between PPARG expression and clinical characteristics of patients. Results Leukocyte PPARG mRNA level was significantly higher in GDM than NGT women (p < 0.05). In the whole study group, PPARG expression positively correlated with plasma glucose concentrations at 1 h (r = 0.222, p = 0.049) and 2 h (r = 0.315, p = 0.020) of 75 g oral glucose tolerance test (OGTT), and negatively correlated with plasma HDL cholesterol concentration (r = -0.351, p = 0.010). Conclusions The correlation between leukocyte PPARG overexpression and hyperglycaemia suggests that PPARG mRNA expression in these cells might be up-regulated in high-glucose conditions in GDM patients at 24–33 weeks of gestation. PMID:26322090

  19. Winter-feeding systems for gestating sheep II. Effects on feedlot performance, glucose tolerance, and carcass composition of lamb progeny.

    PubMed

    Radunz, A E; Fluharty, F L; Susin, I; Felix, T L; Zerby, H N; Loerch, S C

    2011-02-01

    Mature pregnant crossbred ewes (n = 90) were used in a randomized complete block design experiment and were assigned to 1 of 3 winter-feeding systems differing in primary feed source: haylage (HL), limit-fed corn (CN), or limit-fed dried distillers grains (DDGS). Effects of these winter-feeding strategies on postweaning progeny performance were determined. Lamb progeny (n = 96) were weaned at 61 ± 4 d of age and fed a common high-concentrate diet. Lambs were assigned to feedlot pen (n = 18) based on dam mid-gestation pen. Growth rate, DMI, and ADG were determined for the first 40 d of the finishing period. At 96 ± 4 d of age, 1 wether lamb was randomly selected from each pen (n = 18) for a glucose tolerance test. The experiment was terminated, and lambs were slaughtered individually when they were determined to have achieved 0.6-cm 12th-rib fat thickness. After a 24-h chill, carcass data were collected and a 2.54-cm chop was removed from each lamb from the LM posterior to the 12th rib for ether extract analysis. Additional carcass measurements of bone, muscle, and fat from the shoulder, rack, loin, and leg were collected on 35 carcasses. At weaning, lamb BW was not different among treatments, whereas final BW tended to be greater (P = 0.09) for lambs from ewes fed DDGS and CN during gestation than from those fed HL. Overall lamb growth rate from birth to slaughter was not different among treatments. Lambs from ewes fed DDGS vs. CN or HL tended to have a greater initial insulin response (P = 0.09). Dressing percent was less (P = 0.04) in lambs from ewes fed DDGS, but no difference (P = 0.16) was detected in HCW among treatments. As expected, 12th rib fat thickness was similar among treatments, whereas LM area was largest to smallest (P = 0.05) in lambs from ewes fed CN, HL, and DDGS, respectively. Proportion of internal fat tended to be greatest to smallest (P = 0.06) in lambs from ewes fed DDGS, CN, and HL, respectively. Calculated boneless trimmed retail cuts

  20. [Gestational pyelonephritis: modern aspects of diagnosis and treatment].

    PubMed

    Aliaev, Iu G; Gazimiev, M A; Enikeev, D V

    2008-01-01

    Acute gestational pyelonephritis (AGP) is considered to be a complicated urinary tract infection with altered urodynamics on the affected side. We analyzed minimally invasive treatment results achieved in 57 females with AGP. Pyelonephritis has been diagnosed basing on the results of physical examination, urinalysis and urine culturing. Conventional, Doppler ultrasound and MR tomography provided early diagnosis and AGP staging. A timely upper urinary tract drainage with an ureteral stent and adequate antibacterial and antiinflammatory treatment made it possible to avoid open surgical treatment and effectively treat 56 of 57 patients (98.2%). Out of 55 patients with 39-40 week pregnancy, 43 women had normal vaginal delivery and 12 delivered by the cesarian section. In two cases delivery by cesarian section at weeks 36-37 was performed because of individual intolerance of an ureteral stent. All the neonates were born healthy (7-9 points by Apgar score). Recently gained experience in early diagnosis and treatment of AGP and good follow-up results demonstrate a clear benefit from the use of minimally invasive diagnostic and treatment methods.

  1. The importance of gestational diabetes beyond pregnancy.

    PubMed

    Ramírez-Torres, María Aurora

    2013-10-01

    Diabetes mellitus is the main health problem affecting Mexico's population. The mechanisms by which susceptibility to it is acquired and diabetes develops are topics of ongoing research. In order to prevent type 2 diabetes, one of the challenges is to fully understand gestational diabetes and the hormonal changes and altered carbohydrate metabolism that are associated with it during fetal development. A recent study by the Instituto Nacional de Perinatología found a 12.9% prevalence of gestational diabetes; if the current criteria suggested by the American Diabetes Association were applied, this figure would rise to almost 30%. Identifying mothers and children at high risk of developing diabetes mellitus and its comorbid conditions will help facilitate the timely implementation of preventive measures. This will be a rational use of economic resources in Mexico that will vitally benefit public health.

  2. Termination of second trimester, complicated gestation.

    PubMed

    Al-Taani, M I

    2005-07-01

    To assess the effectiveness of intravaginal misoprostol for second trimester uterine evacuation, we studied 70 women with singleton pregnancies complicated by fetal malformation or dead fetuses. Participants received 200 microg misoprostol administered at 4-hour intervals. Gestations with dead fetuses had a shorter induction-abortion interval [14.2 hours, standard deviation (SD) 4.3] than those with live, malformed fetuses (20.2 hours, SD 7.3) (P< 0.001). The abortion rate was significantly higher for gestations with dead fetuses (92.1%) than those with live, malformed fetuses (68.8%) (P< 0.05). There were no major complications and no significant difference in the incidence of side-effects. All women aborted within 38 hours. Administration of misoprostol is an effective clinical method to terminate second trimester, complicated pregnancy.

  3. Dad’s Last Week

    PubMed Central

    DeVoe, Jennifer E.

    2016-01-01

    I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relationships in life. I am a better person and a better physician because my dad trusted me to be there while he was dying. During his last week, I was grateful to have spent years studying medicine and years getting to know my dad. This combination of professional and personal knowledge enabled me to help him choose his own end-of-life path. As someone who does not like hospitals, I have always wondered why I became a doctor; now I know. PMID:27185000

  4. Gestational weight gain among Hispanic women.

    PubMed

    Sangi-Haghpeykar, Haleh; Lam, Kim; Raine, Susan P

    2014-01-01

    To describe gestational weight gain among Hispanic women and to examine psychological, social, and cultural contexts affecting weight gain. A total of 282 Hispanic women were surveyed post-partum before leaving the hospital. Women were queried about their prepregnancy weight and weight gained during pregnancy. Adequacy of gestational weight gain was based on guidelines set by the Institute of Medicine in 2009. Independent risk factors for excessive or insufficient weight gain were examined by logistic regression. Most women were unmarried (59 %), with a mean age of 28.4 ± 6.6 years and an average weight gain of 27.9 ± 13.3 lbs. Approximately 45 % of women had gained too much, 32 % too little, and only 24 % had an adequate amount of weight gain. The mean birth weight was 7.3, 7.9, and 6.8 lbs among the adequate, excessive, and insufficient weight gain groups. Among women who exercised before pregnancy, two-thirds continued to do so during pregnancy; the mean gestational weight gain of those who continued was lower than those who stopped (26.8 vs. 31.4 lbs, p = 0.04). Independent risk factors for excessive weight gain were being unmarried, U.S. born, higher prepregnancy body mass index, and having indifferent or negative views about weight gain. Independent risk factors for insufficient weight gain were low levels of support and late initiation of prenatal care. Depression, stress, and a woman's or her partner's happiness regarding pregnancy were unrelated to weight gain. The results of this study can be used by prenatal programs to identify Hispanic women at risk for excessive or insufficient gestational weight gain.

  5. Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women

    PubMed Central

    Lamyian, Minoor; Hosseinpour-Niazi, Somayeh; Mirmiran, Parvin; Moghaddam Banaem, Lida; Goshtasebi, Azita; Azizi, Fereidoun

    2017-01-01

    The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM) among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women (n = 1026), aged 18–45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and reliable food frequency questionnaire. Consumption of total fast foods including hamburgers, sausages, bologna (beef), pizza and French fries was calculated. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3 h oral glucose tolerance test. GDM was defined according to the American Diabetes Association definition. The mean age and pre-pregnancy body mass index BMI of participants were 26.7 ± 4.3 years and 25.4 ± 4.5 Kg/m2, respectively. A total of 71 women developed GDM. After adjustment for confounders, the OR (95% CI) for GDM for total fast food consumption was 2.12 (1.12–5.43) and for French fries it was 2.18 (1.05–4.70). No significant association was found between hamburgers, sausages, bologna (beef), pizza and GDM. Fast food consumption in women of reproductive age was found to have undesirable effects in the prevalence of GDM. PMID:28257029

  6. The Effect of Gestational and Lactational Age on the Human Milk Metabolome.

    PubMed

    Sundekilde, Ulrik K; Downey, Eimear; O'Mahony, James A; O'Shea, Carol-Anne; Ryan, C Anthony; Kelly, Alan L; Bertram, Hanne C

    2016-05-19

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5-7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery.

  7. Elevated First-Trimester Total Bile Acid is Associated with the Risk of Subsequent Gestational Diabetes

    PubMed Central

    Hou, Wolin; Meng, Xiyan; Zhao, Weijing; Pan, Jiemin; Tang, Junling; Huang, Yajuan; Tao, Minfang; Liu, Fang; Jia, Weiping

    2016-01-01

    The aim of the current study is to assess whether total bile acid (TBA) level in first trimester pregnancy is associated with gestational diabetes mellitus (GDM). Biochemical parameters including serum TBA of 742 pregnant women were collected within 12 weeks of gestation and compared. At 24–28th weeks of gestation, 75 g oral glucose tolerance test (OGTT) was performed. The perinatal data of 330 women were collected. The results demonstrated women with GDM (n = 268) had higher first-trimester serum levels of TBA compared with healthy subjects (n = 474) (2.3 ± 1.4 μmol/L vs. 1.9 ± 1.0 μmol/L, P < 0.001). TBA was independently associated with GDM [adjusted odds ratio (AOR), 1.38; 95% confidence interval (CI), 1.18–1.61, P < 0.001]. Compared to the first category of TBA, women in the highest category had a marked increase in risk for GDM (AOR, 7.72; 95% CI, 3.22–18.50, P < 0.001). In conclusion, higher first-trimester TBA levels, even within normal range, may help indicate increased risk of GDM. PMID:27667090

  8. Pre-Pregnancy Fast Food Consumption Is Associated with Gestational Diabetes Mellitus among Tehranian Women.

    PubMed

    Lamyian, Minoor; Hosseinpour-Niazi, Somayeh; Mirmiran, Parvin; Moghaddam Banaem, Lida; Goshtasebi, Azita; Azizi, Fereidoun

    2017-03-01

    The aim of this study was to evaluate the association between fast food consumption and gestational diabetes mellitus (GDM) among Tehranian women. This study was conducted over a 17-month period, on a random sample of pregnant women (n = 1026), aged 18-45 years, attending prenatal clinics in five hospitals affiliated with universities of medical sciences, located in different districts of Tehran, Iran. Dietary data were collected during gestational age ≤6 weeks, using a 168-item valid and reliable food frequency questionnaire. Consumption of total fast foods including hamburgers, sausages, bologna (beef), pizza and French fries was calculated. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3 h oral glucose tolerance test. GDM was defined according to the American Diabetes Association definition. The mean age and pre-pregnancy body mass index BMI of participants were 26.7 ± 4.3 years and 25.4 ± 4.5 Kg/m², respectively. A total of 71 women developed GDM. After adjustment for confounders, the OR (95% CI) for GDM for total fast food consumption was 2.12 (1.12-5.43) and for French fries it was 2.18 (1.05-4.70). No significant association was found between hamburgers, sausages, bologna (beef), pizza and GDM. Fast food consumption in women of reproductive age was found to have undesirable effects in the prevalence of GDM.

  9. The Effect of Gestational and Lactational Age on the Human Milk Metabolome

    PubMed Central

    Sundekilde, Ulrik K.; Downey, Eimear; O’Mahony, James A.; O’Shea, Carol-Anne; Ryan, C. Anthony; Kelly, Alan L.; Bertram, Hanne C.

    2016-01-01

    Human milk is the ideal nutrition source for healthy infants during the first six months of life and a detailed characterisation of the composition of milk from mothers that deliver prematurely (<37 weeks gestation), and of how human milk changes during lactation, would benefit our understanding of the nutritional requirements of premature infants. Individual milk samples from mothers delivering prematurely and at term were collected. The human milk metabolome, established by nuclear magnetic resonance (NMR) spectroscopy, was influenced by gestational and lactation age. Metabolite profiling identified that levels of valine, leucine, betaine, and creatinine were increased in colostrum from term mothers compared with mature milk, while those of glutamate, caprylate, and caprate were increased in mature term milk compared with colostrum. Levels of oligosaccharides, citrate, and creatinine were increased in pre-term colostrum, while those of caprylate, caprate, valine, leucine, glutamate, and pantothenate increased with time postpartum. There were differences between pre-term and full-term milk in the levels of carnitine, caprylate, caprate, pantothenate, urea, lactose, oligosaccharides, citrate, phosphocholine, choline, and formate. These findings suggest that the metabolome of pre-term milk changes within 5–7 weeks postpartum to resemble that of term milk, independent of time of gestation at pre-mature delivery. PMID:27213440

  10. Secondary Measures of Access to Abortion Services in the United States, 2011 and 2012: Gestational Age Limits, Cost, and Harassment

    PubMed Central

    Jerman, Jenna; Jones, Rachel K.

    2016-01-01

    Background Aspects of U.S. clinical abortion service provision such as gestational age limits, charges for abortion services, and anti-abortion harassment can impact the accessibility of abortion; this study documents changes in these measures between 2008 and 2012. Methods In 2012 and 2013, we surveyed all known abortion-providing facilities in the United States (n = 1,720). This study summarizes information obtained about gestational age limits, charges, and exposure to anti-abortion harassment among clinics; response rates for relevant items ranged from 54% (gestational limits) to 80% (exposure to harassment). Weights were constructed to compensate for nonresponding facilities. We also examine the distribution of abortions and abortion facilities by region. Findings Almost all abortion facilities (95%) offered abortions at 8 weeks’ gestation; 72% did so at 12 weeks, 34% at 20 weeks, and 16% at 24 weeks in 2012. In 2011 and 2012, the median charge for a surgical abortion at 10 weeks gestation was $495, and $500 for an early medication abortion, compared with $503 and $524 (adjusted for inflation) in 2009. In 2011, 84% of clinics experienced at least one form of harassment, only slightly higher than found in 2009. Hospitals and physicians’ offices accounted for a substantially smaller proportion of facilities in the Midwest and South. Clinics in the Midwest and South were exposed to more harassment than their counterparts in the Northeast and West. Conclusions Although there was a substantial decline in abortion incidence between 2008 and 2011, the secondary measures of abortion access examined in this study changed little during this time period. PMID:24981401

  11. [Rescheduling genetic amniocentesis from the 16th to the 13th/14th week of pregnancy--report of experience].

    PubMed

    Huter, O; Brezinka, C; Fessler, S; Kraft, H G; Duba, H C

    1993-11-01

    At the ob/gy department of the Innsbruck University routine, genetic amniocentesis has been offered from the 13/14 week of gestation since 1991. In 1991 44.5% of all amniocenteses were performed as early amniocentesis, it rose in 1992 to 61.5%, the rest being performed in the 16th week of gestation. In a total of 346 genetic amniocenteses, 8 pathological karyotypes were obtained (six trisomies, one 47 XXY, one marker chromosome), six from samples obtained at early amniocentesis and two obtained at the 16th week. Three weeks following the procedure, a spontaneous abortion rate of 0.87% occurred. Cultivation took 1-2 days longer with samples from early amniocentesis than with samples collected at the 16th week. In two cases the cultures failed and a repeat procedure had to be performed at the 16th week. With early amniocentesis performed at week 13/14 results are known of gestation. The long period of anxiety, which many women see as a serious disadvantage of amniocentesis is thus significantly reduced.

  12. Portuguese Special Course: 12 Weeks.

    ERIC Educational Resources Information Center

    Defense Language Inst., Washington, DC.

    This 12-week course in beginning Portuguese comprises four volumes of student text (Lessons 1-55) and a fifth volume of Portuguese-English/English-Portuguese vocabulary. Lesson materials consist of basic dialogs with English translation, recombination dialogs, readings and comprehension questions, oral exercises, and in later units, additional…

  13. Dietary energy density but not glycemic load is associated with gestational weight gain

    PubMed Central

    Deierlein, Andrea L.; Siega-Riz, Anna Maria; Herring, Amy

    2009-01-01

    Background The majority of pregnant women are gaining outside of the recommended weight gain ranges. Excessive weight gains have been linked to pregnancy complications and long term maternal and child health outcomes. Objective To examine the impact of dietary glycemic load and energy density on total gestational weight gain and weight gain ratio (observed weight gain/expected weight gain). Design Data are from 1231 women with singleton pregnancies who participated in the Pregnancy, Infection, and Nutrition Cohort Study. Dietary information was collected at 26–29 weeks gestation using a semi-quantified food frequency questionnaire. Linear regression models were used to estimate the associations between glycemic load (in quartiles) and energy density (in quartiles) with total gestational weight gain and weight gain ratio. Results Dietary patterns of pregnant women significantly differed across many sociodemographic and behavioral characteristics, with the greatest contrasts seen for glycemic load. After adjustment for covariates, in comparison to women in the first quartile, consuming a mean dietary energy density of 0.77 kcal/g (reference), women in the second quartile, consuming a mean energy density of 0.95 kcal/g, gained an excess of 0.91 kg (95% CI: 0.02–1.79) and women in the third quartile, consuming a mean energy density of 1.09 kcal/g, gained an excess of 1.47 kg (95% CI: 0.58–2.36). All other comparisons of energy intakes were not statistically significant. Glycemic load was not associated with total gestational weight gain or weight gain ratio. Conclusions Dietary energy density is a modifiable factor that may assist pregnant women in managing gestational weight gains. PMID:18779285

  14. Clinical Values of Studying Kidney Elasticity with Virtual Touch Quantification in Gestational Hypertension Patients.

    PubMed

    Wang, Yi; Feng, Yujin; Yang, Xiaoyun; Zhang, Liyan; Zhang, Tongdi; Wang, Wengang

    2016-02-07

    BACKGROUND The aim of this study was to investigate the differences in shear wave velocity (SWV) in renal cortex, renal medulla, and renal sinuses between gestational hypertension and normal pregnant women. MATERIAL AND METHODS Ninety patients with gestational hypertension and 30 women with normal pregnancy were enrolled in this study. Kidney biopsy was performed within 6 weeks to 3 months postpartum to determine the pathological nature of renal injury. According to the classification criteria for gestational hypertension, the patients were divided into 3 groups. Gestational hypertension only patients were classified as Group A; patients with mild preeclampsia as group B; patients with severe preeclampsia as group C; normal pregnant women as a control group. Virtual Touch Quantification technique was used to measure renal shear wave velocity; blood pressure, urine analysis, and renal function were also tested. RESULTS There was no difference in renal function between patients in group A and the control group (p>0.05), but there was a significant difference in renal function among patients in group A, B, and C, and there was a significant difference in renal function between patients in group B and C versus control (p<0.05 for all comparisons). There was also a significant difference in SWV values of the renal cortex, renal medulla, and renal sinus between patients in group A, B, and C versus control group (p<0.05). CONCLUSIONS The SWV values of the renal cortex, renal medulla, and renal sinus in patients with gestational hypertension were smaller than those of normal pregnant women, and the more severe the kidney injury, the smaller the SWV value.

  15. Roles of Perinatal Problems on Adolescent Antisocial Behaviors among Children Born after 33 Completed Weeks: A Prospective Investigation

    ERIC Educational Resources Information Center

    Nomura, Yoko; Rajendran, Khushmand; Brooks-Gunn, Jeanne; Newcorn, Jeffrey H.

    2008-01-01

    Background: There is uncertainty about the extent to which mildly sub-optimal perinatal characteristics among individuals born near-term (greater than 33 weeks of gestation) are associated with various subsequent childhood problems, including antisocial behavior. There is even more uncertainty about whether the pathway to antisocial behavior…

  16. Maternal ambient air pollution exposure preconception and during early gestation and offspring congenital orofacial defects

    PubMed Central

    Zhu, Yeyi; Zhang, Cuilin; Liu, Danping; Grantz, Katherine L.; Wallace, Maeve; Mendola, Pauline

    2015-01-01

    Background Maternal air pollution exposure has been related to orofacial clefts but the literature is equivocal. Potential chronic preconception effects have not been studied. Objectives Criteria air pollutant exposure during three months preconception and gestational weeks 3–8 was studied in relation to orofacial defects. Methods Among 188,102 live births and fetal deaths from the Consortium on Safe Labor (2002–2008), 63 had isolated cleft palate (CP) and 159 had isolated cleft lip with or without cleft palate (CL ± CP). Exposures were estimated using a modified Community Multiscale Air Quality model. Logistic regression with generalized estimating equations adjusted for site/region and maternal demographic, lifestyle and clinical factors calculated the odds ratio (OR) and 95% CI per interquartile increase in each pollutant. Results Preconception, carbon monoxide (CO; OR = 2.24; CI: 1.21, 4.16) and particulate matter (PM) ≤10 μm (OR = 1.72; CI: 1.12, 2.66) were significantly associated with CP, while sulfur dioxide (SO2) was associated with CL ± CP (OR = 1.93; CI: 1.16, 3.21). During gestational weeks 3–8, CO remained a significant risk for CP (OR = 2.74; CI: 1.62, 4.62) and nitrogen oxides (NOx; OR = 3.64; CI: 1.73, 7.66) and PM ≤2.5 μm (PM2.5; OR = 1.74; CI: 1.15, 2.64) were also related to the risk. Analyses by individual week revealed that positive associations of NOx and PM2.5 with CP were most prominent from weeks 3–6 and 3–5, respectively. Conclusions Exposure to several criteria air pollutants preconception and during early gestation was associated with elevated odds for CP, while CL ± CP was only associated with preconception SO2 exposure. PMID:26099933

  17. Maternal Glycemia and Risk of Large-for-Gestational-Age Babies in a Population-Based Screening

    PubMed Central

    Kerényi, Zsuzsa; Tamás, Gyula; Kivimäki, Mika; Péterfalvi, Andrea; Madarász, Eszter; Bosnyák, Zsolt; Tabák, Adam G.

    2009-01-01

    OBJECTIVE Gestational diabetes is a risk factor for large-for-gestational-age (LGA) newborns, but many LGA babies are born to mothers with normal glucose tolerance. We aimed to clarify the association of maternal glycemia across the whole distribution with birth weight and risk of LGA births in mothers with normal glucose tolerance. RESEARCH DESIGN AND METHODS We undertook a population-based gestational diabetes screening in an urban area of Hungary in 2002–2005. All singleton pregnancies of mothers ≥18 years of age, without known diabetes or gestational diabetes (World Health Organization criteria) and data on a 75-g oral glucose tolerance test at 22–30 weeks of gestation, were included (n = 3,787, 78.9% of the target population). LGA was determined as birth weight greater than the 90th percentile using national sex- and gestational age–specific charts. RESULTS Mean ± SD maternal age was 30 ± 4 years, BMI was 22.6 ± 4.0 kg/m2, fasting blood glucose was 4.5 ± 0.5 mmol/l, and postload glucose was 5.5 ± 1.0 mmol/l. The mean birth weight was 3,450 ± 476 g at 39.2 ± 1.2 weeks of gestation. There was a U-shaped association of maternal fasting glucose with birth weight (Pcurve = 0.004) and risk of having an LGA baby (lowest values between 4 and 4.5 mmol/l, Pcurve = 0.0004) with little change after adjustments for clinical characteristics. The association of postload glucose with birth weight (P = 0.03) and the risk of an LGA baby (P = 0.09) was weaker and linear. CONCLUSIONS Both low and high fasting glucose values at 22–30 weeks of gestation are associated with increased risk of an LGA newborn. We suggest that the excess risk related to low glucose reflects the increased use of nutrients by LGA fetuses that also affects the mothers' fasting glucose. PMID:19729526

  18. Increased Maternal and Cord Blood Betatrophin in Gestational Diabetes

    PubMed Central

    Wawrusiewicz-Kurylonek, Natalia; Telejko, Beata; Kuzmicki, Mariusz; Sobota, Angelika; Lipinska, Danuta; Pliszka, Justyna; Raczkowska, Beata; Kuc, Pawel; Urban, Remigiusz; Szamatowicz, Jacek; Kretowski, Adam; Laudanski, Piotr; Gorska, Maria

    2015-01-01

    Aim The aim of the study was to compare maternal and cord blood levels of betatrophin – a new peptide potentially controlling beta cell growth - as well as in its mRNA expression in subcutaneous adipose tissue, visceral adipose tissue and placental tissue obtained from pregnant women with normal glucose tolerance (NGT) and gestational diabetes (GDM). Methods Serum betatrophin and irisin concentrations were measured by ELISA in 93 patients with GDM and 97 women with NGT between 24 and 28 week of gestation. Additionally, maternal and cord blood betatrophin and irisin, as well as their genes (C19orf80 and Fndc5) expression were evaluated in 20 patients with GDM and 20 women with NGT at term. Results In both groups, serum betatrophin concentrations were significantly higher in the patients with GDM than in the controls (1.91 [1.40-2.60] ng/ml vs 1.63 [1.21-2.22] ng/ml, p=0.03 and 3.45 [2.77-6.53] ng/ml vs 2.78 [2.16-3.65] ng/ml, p=0.03, respectively). Cord blood betatrophin levels were also higher in the GDM than in the NGT group (20.43 [12.97-28.80] ng/ml vs 15.06 [10.11-21.36] ng/ml, p=0.03). In both groups betatrophin concentrations in arterial cord blood were significantly higher than in maternal serum (p=0.0001). Serum irisin levels were significantly lower in the patients with GDM (1679 [1308-2171] ng/ml) than in the healthy women between 24 and 28 week of pregnancy (1880 [1519-2312] ng/ml, p=0.03). Both C19orf80 and Fndc5 mRNA expression in fat and placental tissue did not differ significantly between the groups studied. Conclusions Our results suggest that an increase in maternal and cord blood betatrophin might be a compensatory mechanism for enhanced insulin demand in GDM. PMID:26115519

  19. Feed allowance and maternal backfat levels during gestation influence maternal cortisol levels, milk fat composition and offspring growth.

    PubMed

    Amdi, Charlotte; Giblin, Linda; Hennessy, Alan A; Ryan, Tomás; Stanton, Catherine; Stickland, Neil C; Lawlor, Peadar G

    2013-01-01

    The fetal and early postnatal environment can have a long-term influence on offspring growth. Using a pig model, we investigated the effects of maternal body condition (thin or fat) and maternal gestation feeding level (restricted, control or high) on maternal stress, milk composition, litter size, piglet birth weight and pre-weaning growth. A total of sixty-eight thin (backfat depth about 8 mm) and seventy-two fat (backfat depth about 12 mm) gilts were selected at about 22 weeks. This backfat difference was then accentuated nutritionally up to service at about 32 weeks. During gestation, individual gilts from within each group were randomly allocated to a gestation diet at the following feed allowances: 1·8 kg/d (restricted); 2·5 kg/d (control) and 3·5 kg/d (high) until day 90 of gestation. During gestation restricted gilts had higher levels of cortisol than high and control fed animals. Piglets born to fat gilts had higher average daily gain during the lactation period and higher weaning weights at day 28 than piglets born to thin gilts. Gilts on a high feed level had heavier piglets than those provided with restricted and control allocations. Fat gilts had less saturated fat in their milk at day 21 of lactation and higher unsaturated fat levels. No differences were found in the n-6:n-3 PUFA ratio in the milk between thin and fat gilts. In conclusion, maternal body condition influenced the daily weight gain of offspring up to weaning (day 28) and milk fat composition. Furthermore, maternal feed level during gestation alters maternal cortisol levels and milk fat composition.

  20. Astronomy Week in Madeira, Portugal

    NASA Astrophysics Data System (ADS)

    Augusto, P.; Sobrinho, J. L.

    2012-05-01

    The outreach programme Semanas da Astronomia (Astronomy Weeks) is held in late spring or summer on the island of Madeira, Portugal. This programme has been attracting enough interest to be mentioned in the regional press/TV/radio every year and is now, without doubt, the astronomical highlight of the year on Madeira. We believe that this programme is a good case study for showing how to attract the general public to astronomy in a small (population 250 000, area 900 km2) and fairly isolated place such as Madeira. Our Astronomy Weeks have been different each year and have so far included exhibitions, courses, talks, a forum, documentaries, observing sessions (some with blackouts), music and an astro party. These efforts may contribute towards putting Madeira on the map with respect to observational astronomy, and have also contributed to the planned installation of two observatories in the island.

  1. The Influence of Gestational Diabetes on Neurodevelopment of Children in the First Two Years of Life: A Prospective Study

    PubMed Central

    Qiu, Anqi; Broekman, Birit F. P.; Wong, Eric Qinlong; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang Mei; Soh, Shu-E; Kwek, Kenneth; Chong, Yap-Seng; Meaney, Michael J.; Kramer, Michael S.; Rifkin-Graboi, Anne

    2016-01-01

    Objective Analyze the relation of gestational diabetes and maternal blood glucose levels to early cognitive functions in the first two years of life. Methods In a prospective Singaporean birth cohort study, pregnant women were screened for gestational diabetes at 26–28 weeks gestation using a 75-g oral glucose tolerance test. Four hundred and seventy three children (n = 74 and n = 399 born to mothers with and without gestational diabetes respectively) underwent neurocognitive assessments at 6, 18, and/or 24 month, including electrophysiology during an attentional task and behavioral measures of attention, memory and cognition. Results Gestational diabetes is related to left hemisphere EPmax amplitude differences (oddball versus standard) at both six (P = 0.039) and eighteen months (P = 0.039), with mean amplitudes suggesting offspring of mothers with gestational diabetes exhibit greater neuronal activity to standard stimuli and less to oddball stimuli. Associations between 2-hour maternal glucose levels and the difference in EPmax amplitude were marginal at 6 months [adjusted β = -0.19 (95% CI: -0.42 to +0.04) μV, P = 0.100] and significant at 18 months [adjusted β = -0.27 (95% CI: -0.49 to -0.06) μV, P = 0.014], and the EPmax amplitude difference (oddball-standard) associated with the Bayley Scales of Infant and toddler Development-III cognitive score at 24 months [β = 0.598 (95% CI: 0.158 to 1.038), P = 0.008]. Conclusion Gestational diabetes and maternal blood glucose levels are associated with offspring neuronal activity during an attentional task at both six and eighteen months. Such electrophysiological differences are likely functionally important, having been previously linked to attention problems later in life. PMID:27603522

  2. Six Week Slavery Novel Unit.

    ERIC Educational Resources Information Center

    Jones, Darolyn Lyn

    Developed in conjunction with a graduate course and used in classrooms with all types of learners, this paper presents a 6-week unit of study on slavery based on two adolescent novels--"NIGHTJOHN" by Gary Paulson and "My Name Is not Angelica" by Scott O'Dell. After a brief introduction to the unit, the paper presents the 14 activities of the unit:…

  3. Gestational diabetes mellitus: an updated overview.

    PubMed

    Chiefari, E; Arcidiacono, B; Foti, D; Brunetti, A

    2017-03-10

    The clinical and public health relevance of gestational diabetes mellitus (GDM) is widely debated due to its increasing incidence, the resulting negative economic impact, and the potential for severe GDM-related pregnancy complications. Also, effective prevention strategies in this area are still lacking, and controversies exist regarding diagnosis and management of this form of diabetes. Different diagnostic criteria are currently adopted worldwide, while recommendations for diet, physical activity, healthy weight, and use of oral hypoglycemic drugs are not always uniform. In the present review, we provide an update of current insights on clinical aspects of GDM, by discussing the more controversial issues.

  4. Rate of gestational weight gain, pre-pregnancy body mass index and preterm birth subtypes: a retrospective cohort study from Peru

    PubMed Central

    Carnero, AM; Mejía, CR; García, PJ

    2014-01-01

    Objective To examine the shape (functional form) of the association between the rate of gestational weight gain, pre-pregnancy body mass index (BMI), and preterm birth and its subtypes. Design Retrospective cohort study. Setting National reference obstetric centre in Lima, Peru. Population Pregnant women who delivered singleton babies during the period 2006–2009, resident in Lima, and beginning prenatal care at ≤12 weeks of gestation (n = 8964). Methods Data were collected from the centre database. The main analyses consisted of logistic regression with fractional polynomial modelling. Main outcome measures Preterm birth and its subtypes. Results Preterm birth occurred in 12.2% of women, being mostly idiopathic (85.7%). The rate of gestational weight gain was independently associated with preterm birth, and the shape of this association varied by pre-pregnancy BMI. In women who were underweight, the association was linear (per 0.1 kg/week increase) and protective (OR 0.88; 95% CI 0.82–1.00). In women of normal weight or who were overweight, the association was U-shaped: the odds of delivering preterm increased exponentially with rates <0.10 or >0.66 kg/week, and <0.04 or >0.50 kg/week, respectively. In women who were obese, the association was linear, but nonsignificant (OR 1.01; 95% CI 0.95–1.06). The association described for preterm birth closely resembled that of idiopathic preterm birth, although the latter was stronger. The rate of gestational weight gain was not associated with indicated preterm birth or preterm prelabour rupture of membranes. Conclusions In Peruvian pregnant women starting prenatal care at ≤12 weeks of gestation, the rate of gestational weight gain is independently associated with preterm birth, mainly because of its association with idiopathic preterm birth, and the shape of both associations varies by pre-pregnancy BMI. PMID:22607522

  5. Nutrition during mid to late gestation affects growth, adipose tissue deposition, and tenderness in cross-bred beef steers.

    PubMed

    Underwood, K R; Tong, J F; Price, P L; Roberts, A J; Grings, E E; Hess, B W; Means, W J; Du, M

    2010-11-01

    The objective of this study was to examine whether the plane of nutrition of cows at a critical time for fetal skeletal muscle and adipose tissue development would affect meat quality and carcass composition of offspring. To alter maternal nutrition, beef cows were placed on improved pasture (IP) or native range (NR) pasture from 120 to 150 through 180 to 210days of gestation. Esophageal extrusa samples collected from cows grazing IP varied from 11.1% crude protein of organic matter early in the test period to 6.0% crude protein of organic matter at the end of the grazing period; whereas, extrusa samples of cows grazing NR ranged from 6.5% crude protein of organic matter during early grazing to 5.4% crude protein of organic matter at the end of the grazing period. Steers were slaughtered and carcass characteristics were collected. Warner-Bratzler shear force was performed on longissumus steaks, western blotting was used to measure proteolysis, and myosin isoform typing was performed. Improved pasture steers had heavier live and hot carcass weights. Tenderness was greater in IP compared to NR steers. No difference in calpastatin content and troponin-T degradation was observed between treatments. The 12th rib fat thickness was greater for IP than for NR steers. Subcutaneous adipose tissue of IP steers tended to have a greater number of cells per field of view than NR steers. Data show improving nutritional status of cows during mid to late gestation affects tenderness, adipose tissue deposition and growth in steers.

  6. Uterine rupture due to invasive metastatic gestational trophoblastic neoplasm.

    PubMed

    Bruner, David I; Pritchard, Amy M; Clarke, Jonathan

    2013-09-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia.

  7. Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

    PubMed Central

    Bruner, David I.; Pritchard, Amy M.; Clarke, Jonathan

    2013-01-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. PMID:24106538

  8. Insulin aspart in patients with gestational diabetes mellitus and pregestational diabetes mellitus

    PubMed Central

    Deepaklal, M. C.; Joseph, Kurian; Rekha, Kurian; Nandita, Thakkar

    2015-01-01

    Aims: This study was undertaken to assess the effectiveness and safety of insulin aspart in patients with gestational and pregestational diabetes. Settings and Design: An open-label, prospective, nonrandomized, comparative, and observational study conducted at single center in India. Subjects and Methods: A total of 276 patients were in gestational diabetes mellitus (GDM) group, 79 were in the pre-GDM group. Patients were started on insulin therapy (insulin aspart ± neutral protamine hagedorn) once medical nutrition therapy for 2 weeks failed to achieve control, that is., fasting plasma glucose ≥90 mg/dL and/or 1.0 h postprandial plasma glucose ≥130 mg/dL. Insulin dose was titrated to keep the blood glucose values between 90 and 130 mg/dL. Patients were followed once every 4 weeks until the 28th week, then once every 2 weeks until 32nd week, then once every week until delivery, and the final visit was on 60 ± 7 days. The final outcome was assessed in terms of incidence of macrosomia (>3.5 kg body weight) between the two groups and episodes of confirmed (blood glucose <56 mg/dL) minor or major maternal hypoglycemia. Results: There was no statistically significant difference among the two groups in terms of incidence of macrosomia that is., it was 5.1%, 8.9% in GDM, pre-GDM group, respectively. Conclusions: Insulin aspart was found safe in pregnancy, however, more studies with double-blind, standard controlled studies are required to confirm the findings of this study. PMID:26425478

  9. Gestational carcinoma of the female breast

    SciTech Connect

    Wallack, M.K.; Wolf, J.A. Jr.; Bedwinek, J.; Denes, A.E.; Glasgow, G.; Kumar, B.; Meyer, J.S.; Rigg, L.A.; Wilson-Krechel, S.

    1983-03-01

    Few neoplastic diseases can equal the amazing complexity and sheer perversity of carcinoma of the breast. No doubt as many decades of research lie ahead in its study as already have passed. Clinicians have long appreciated the special relationship of the disease to gestation. Diagnosis and treatment of breast cancer during pregnancy represent only a small part of this fascinating relationship. Although indispensable as research tools, animal models pertain to the human disease only in limited, ill-defined ways. The etiology of human breast cancer remains unclear; chemical, viral, hormonal, genetic, and immunologic theories have all been put forward as possibilities. Although gestation clearly alters both the initiation and growth of mammary tumors, its exact role in the various theoretical considerations remains a mystery. The obstetrician-gynecologist holds an important front-line position in the war against breast cancer, as does any provider of primary care to women, and, indeed, as do women themselves. Rather than decrease vigilance during pregnancy, the physician should pursue with extra vigor any breast mass discovered in the gravid patient, when the clinical examination is even less reliable than usual. The finding of a breast mass usually necessitates biopsy. Except for the inclusion of specific pregnancy-related problems, such as galactocele, the diagnostic spectrum of breast masses removed during pregnancy does not differ from that in nonpregnant women.

  10. Climate Extremes and the Length of Gestation

    PubMed Central

    Basagaña, Xavier; Sartini, Claudio; Figueras, Francesc; Vrijheid, Martine; de Nazelle, Audrey; Sunyer, Jordi; Nieuwenhuijsen, Mark J.

    2011-01-01

    Background: Although future climate is predicted to have more extreme heat conditions, the available evidence on the impact of these conditions on pregnancy length is very scarce and inconclusive. Objectives: We investigated the impact of maternal short-term exposure to extreme ambient heat on the length of pregnancy. Methods: This study was based on a cohort of births that occurred in a major university hospital in Barcelona during 2001–2005. Three indicators of extreme heat conditions based on 1-day exposure to an unusually high heat–humidity index were applied. Each mother was assigned the measures made by the meteorological station closest to maternal residential postcodes. A two-stage analysis was developed to quantify the change in pregnancy length after maternal exposure to extreme heat conditions adjusted for a range of covariates. The second step was repeated for lags 0 (delivery date) to 6 days. Results: We included data from 7,585 pregnant women in our analysis. We estimated a 5-day reduction in average gestational age at delivery after an unusually high heat–humidity index on the day before delivery. Conclusion: Extreme heat was associated with a reduction in the average gestational age of children delivered the next day, suggesting an immediate effect of this exposure on pregnant women. Further studies are required to confirm our findings in different settings. PMID:21659038

  11. Gestational Trophoblastic Disorders: An Update in 2015

    PubMed Central

    Stevens, F. T.; Katzorke, N.; Tempfer, C.; Kreimer, U.; Bizjak, G. I.; Fleisch, M. C.; Fehm, T. N.

    2015-01-01

    Gestational trophoblastic diseases (GTD) are a group of pregnancy-related disorders representing rare human tumours. They encompass premalignant disorders including complete (CHM), partial hydatidiform mole (PHM), exaggerated placental site (EPS), and placental-site nodule (PSN) as well as malignant disorders (also known as “gestational trophoblastic neoplasia [GTN]”) including invasive mole, choriocarcinoma (CC), placenta-site trophoblastic tumour (PSTT), and epitheloid trophoblastic tumours (ETT) (Fig. 1). Originally, GTD develop from abnormal proliferation of trophoblastic tissue and form botryoid arranged vesicles. Premalignant moles are usually treated by suction curettage while persistent and recurrent moles and malignant forms require systemic therapy with methotrexate or combination chemotherapy consisting of etoposide, actimomycin D, methotrexate, vincristine, and cyclophosphamide (EMA-CO). β-human chorion gonadotropin (β-hCG) plays a crucial role in diagnosis and monitoring therapeutic effects. Since the definitive diagnosis cannot be obtained by histology in most cases, persistent or recurrent disease is diagnosed by elevated or persistent serum levels of β-hCG. While curing rates are described to be as high as 98 %, GTD may initially present, recur, or end up as a metastasising systemic disease. This underlines the importance of a regular and consistent follow-up after treatment. PMID:26556906

  12. Potential Mechanisms of Exercise in Gestational Diabetes

    PubMed Central

    Golbidi, Saeid; Laher, Ismail

    2013-01-01

    Gestational diabetes mellitus (GDM) is defined as glucose intolerance first diagnosed during pregnancy. This condition shares same array of underlying abnormalities as occurs in diabetes outside of pregnancy, for example, genetic and environmental causes. However, the role of a sedentary lifestyle and/or excess energy intake is more prominent in GDM. Physically active women are less likely to develop GDM and other pregnancy-related diseases. Weight gain in pregnancy causes increased release of adipokines from adipose tissue; many adipokines increase oxidative stress and insulin resistance. Increased intramyocellular lipids also increase cellular oxidative stress with subsequent generation of reactive oxygen species. A well-planned program of exercise is an important component of a healthy lifestyle and, in spite of old myths, is also recommended during pregnancy. This paper briefly reviews the role of adipokines in gestational diabetes and attempts to shed some light on the mechanisms by which exercise can be beneficial as an adjuvant therapy in GDM. In this regard, we discuss the mechanisms by which exercise increases insulin sensitivity, changes adipokine profile levels, and boosts antioxidant mechanisms. PMID:23691290

  13. Gestational diabetes mellitus: Where are we now?

    PubMed

    Ashwal, Eran; Hod, Moshe

    2015-12-07

    Gestational diabetes mellitus (GDM) is defined as any carbohydrate intolerance first diagnosed during pregnancy. The prevalence of GDM is about 2-5% of normal pregnancies and depends of the prevalence of same population to type 2 diabetes mellitus. It is associated with adverse outcome for the mother, the fetus, neonate, child and adult offspring of the diabetic mother. Detection of GDM lies on screening, followed as necessary by diagnostic measures. Screening can either be selective, based upon risk stratification or universal. Timely testing enables the obstetrician to assess glucose tolerance in the presence of the insulin-resistant state of pregnancy and permits treatment to begin before excessive fetal growth has occurred. Once a diagnosis of GDM was made close perinatal surveillance is warranted. The goal of treatment is reducing fetal-maternal morbidity and mortality related with GDM. The exact glucose values needed are still not absolutely proved. The decision whether and when to induce delivery depends on gestational age, estimated fetal weight, maternal glycemic control and bishop score. Future research is needed regarding prevention of GDM, treatment goals and effectiveness of interventions, guidelines for pregnancy care and prevention of long term metabolic sequel for both the infant and the mother.

  14. [Intensive therapy in complicated forms of purulent gestational pyelonephritis].

    PubMed

    Dovlatian, A A

    2008-01-01

    The experience with 65 cases of purulent gestational pyelonephritis (PGP) is reviewed. The efficacy of PGP intensive therapy depends on early surgical elimination of the source of bacteriemia and sepsis. Choice of the surgical technique should be based both on extension of destructive changes in the kidney and severity of the complications. In some cases it is necessary to perform nephrostomy with sanation of the pyonecrotic foci in the kidney, in the other--it is necessary to perform urgent nephrectomy. Three basic components of pre- and postoperative intensive care should be considered: antibacterial treatment, infusion-transfusion therapy and efferent detoxication. Etiotropic therapy is conducted with three antibiotics injected intravenously and intramuscularly to provide effective concentrations of the drugs in the blood, urine and affected organs. PGP medication is based on inhibitor-defended penicillines and cephalosporines of the third-forth generation. Combined use of these antibiotics is effective in 95% cases. If the condition is life-threatening, carbapenems, fluoroguinolones, aminoglycosides and metronidasol can be applied. Detoxication is provided by 24-h infusion of crystalloids, concentrated glucose solutions (10-20%) with insulin, transfusion of fresh frozen plasm, albumin, protein. Plasmapheresis accelerates recovery, diminished nephrectomy rate by 14% and obstetric complications 1.8 fold, enables physiological term of delivery (37-39 weeks) in significant reduction of postnatal complications. Lethal outcomes were absent.

  15. Preventive letter: doubling the return rate after gestational diabetes mellitus.

    PubMed

    Olmos, Pablo R; Borzone, Gisella R; Berkowitz, Loni; Mertens, Nicolás; Busso, Dolores; Santos, José L; Poblete, José A; Vera, Claudio; Belmar, Cristián; Goldenberg, Denisse; Samith, Bárbara; Acosta, Ana M; Escalona, Manuel

    2015-05-01

    To measure the impact of a "Preventive Letter" designed to encourage the return of gestational diabetes mellitus (GDM) mothers to follow up visit after delivery, in the context of a worldwide concern about low return rates after delivery of these patients. Mothers with GDM require medical evaluation and an oral glucose tolerance test (OGTT) 6 weeks after delivery, in order to: [a] confirm remission of GDM and [b] provide advice on the prevention of type 2 diabetes. In the year 2003 we developed a "Preventive Letter", containing three aspects: [a] current treatment, [b] suggested management during labor, and [c] a stapled laboratory order for OGTT to be performed 6 weeks after delivery. The return rate after delivery was assessed in two groups of GDM mothers: [a] "Without Preventive Letter" (n = 253), and "With Preventive Letter" (n = 215). Both groups, similar with respect to age (33.0 ± 5.4 and 32.3 ± 4.9 years respectively, p = 0.166) and education time (14.9 ± 1.8 and 15.0 ± 1.8 years respectively, p = 0.494), showed a significant difference in the 1-year return rate after delivery, as assessed by the Kaplan-Meier test: 32.0 % for the group "Without Preventive Letter", and 76.0 % for the group "With Preventive Letter" (p < 0.001). The 1-year return rate after delivery of GDM mothers was 2.4 times higher in the group "With Preventive Letter" than in the group without it. We believe that this low-cost approach could be useful in other institutions caring for pregnant women with diabetes.

  16. Does Chocolate Intake During Pregnancy Reduce the Risks of Preeclampsia and Gestational Hypertension?

    PubMed Central

    Saftlas, Audrey F.; Triche, Elizabeth W.; Beydoun, Hind; Bracken, Michael B.

    2010-01-01

    Purpose Chocolate consumption is associated with favorable levels of blood pressure and other cardiovascular disease risk markers. We analyzed a prospective cohort study to determine if regular chocolate intake during pregnancy is associated with reduced risks of preeclampsia and gestational hypertension (GH). Methods Subjects were recruited from 13 prenatal care practices in Connecticut (1988-1991). In-person interviews were administered at <16 weeks gestation to ascertain risk factors for adverse pregnancy outcomes. Hospital delivery and prenatal records were abstracted to classify preeclampsia (n=58), GH (n=158), and normotensive pregnancies (n=2351). Chocolate consumption (servings/week) during the 1st and 3rd trimesters was ascertained at initial interview and immediately postpartum, respectively. Consumers of <1 serving/week comprised the referent group. Adjusted odds ratios (aOR) were estimated using logistic regression. Results Chocolate intake was more frequent among normotensives (80.7%) than preeclamptics (62.5%) or GH women (75.8%), and associated with reduced odds of preeclampsia (1st trimester: aOR=0.55, 95% CI: 0.32-0.95; 3rd trimester: aOR=0.56, 95% CI: 0.32-0.97). Only 1st trimester intake was associated with reduced odds of GH (aOR=0.65, 95% CI: 0.45-0.87). Conclusions These findings provide additional evidence of the benefits of chocolate. Prospective studies are needed to confirm and delineate protective effects of chocolate intake on risk of preeclampsia. PMID:20609337

  17. A Rare Case of Gestational Gigantomastia with Hypercalcemia: The Challenges of Management and Follow up

    PubMed Central

    Moazzami, Bahram; Chaichian, Shahla; Farahvash, Mohammad Reza; Taheri, Saeedeh; Ahmadi, Seyed Ali; Mokhtari, Majid; Sheibani, Kourosh

    2016-01-01

    Background: Gigantomastia is a breast disorder marked by exaggerated rapid growth of the breasts, generally bilaterally. Since this disorder is very rare and has been reported only in sparse case reports its etiology has yet to be fully established. Treatment is aimed at improving the clinical and psychological symptoms and reducing the treatment side effects; however, the best therapeutic option varies from case to case. Case Presentation: The present report described a case of gestational gigantomastia in a 30-year-old woman, gravida 2, parity 1, 17 week pregnant admitted to Pars Hospital, Tehran, Iran, on May 2014. The patient was admitted to hospital at week 17 of pregnancy, although her breasts initially had begun to enlarge from the first trimester. The patient developed hypercalcemia in her 32nd week of pregnancy. The present report followed this patient from diagnosis until the completion of treatment. Conclusion: Although gestational gigantomastia is a rare condition, its timely prognosis and careful examination of some conditions like hyperprolactinemia and hypercalcemia is essential in successful management of this condition. PMID:27921004

  18. 12th Annual ALS Users' Association Meeting

    SciTech Connect

    Robinson, Arthur L.

    1999-12-17

    Science took the front seat as 219 Advanced Light Source (ALS) users and staff gathered on Monday and Tuesday, October 18 and 19 for the twelfth annual users' meeting. The bulk of the meeting was dedicated to reports on science at the ALS. Packed into two busy days were 31 invited oral presentations and 80 submitted poster presentations, as well as time to visit 24 vendor booths. The oral sessions were dedicated to environmental science, chemical dynamics, biosciences, magnetic materials, and atomic and molecular science. In addition, there was an ALS highlights session that emphasized new results and a session comprising highlights from the young scientists who will carry the ALS into the future.

  19. 12th Annual School Construction Report, 2007

    ERIC Educational Resources Information Center

    Abramson, Paul

    2007-01-01

    School construction completed in 2006 totaled just more than $20 billion, a drop of seven percent from the record $21.6 billion put in place in 2005. Even so, it was the sixth year in the last seven that annual construction exceeded $20 billion. During the seven years of the present century, school districts have completed construction projects…

  20. The 12th Aerospace Mechanisms Symposium

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Mechanisms developed for various aerospace applications are discussed. Specific topics covered include: boom release mechanisms, separation on space shuttle orbiter/Boeing 747 aircraft, payload handling, spaceborne platform support, and deployment of spaceborne antennas and telescopes.

  1. Small for gestational age and exposure to particulate air pollution in the early-life environment of twins.

    PubMed

    Bijnens, Esmée M; Derom, Catherine; Gielen, Marij; Winckelmans, Ellen; Fierens, Frans; Vlietinck, Robert; Zeegers, Maurice P; Nawrot, Tim S

    2016-07-01

    Several studies in singletons have shown that maternal exposure to ambient air pollutants is associated with restricted fetal growth. About half of twins have low birth weight compared with six percent in singletons. So far, no studies have investigated maternal air pollution exposure in association with birth weight and small for gestational age in twins. We examined 4760 twins of the East Flanders Prospective Twins Survey (2002-2013), to study the association between in utero exposure to air pollution with birth weight and small for gestational age. Maternal particulate air pollution (PM10) and nitric dioxide (NO2) exposure was estimated using a spatial temporal interpolation method over various time windows during pregnancy. In the total group of twins, we observed that higher PM10 and NO2 exposure during the third trimester was significantly associated with a lower birth weight and higher risk of small for gestational age. However, the association was driven by moderate to late preterm twins (32-36 weeks of gestation). In these twins born between 32 and 36 weeks of gestation, birth weight decreased by 40.2g (95% CI: -69.0 to -11.3; p=0.006) and by 27.3g (95% CI: -52.9 to -1.7; p=0.04) in association for each 10µg/m³ increment in PM10 and NO2 concentration during the third trimester. The corresponding odds ratio for small for gestational age were 1.68 (95% CI: 1.27-2.33; p=0.0003) and 1.51 (95% CI: 1.18-1.95; p=0.001) for PM10 or NO2, respectively. No associations between air pollution and birth weight or small for gestational age were observed among term born twins. Finally, in all twins, we found that for each 10µg/m³ increase in PM10 during the last month of pregnancy the within-pair birth weight difference increased by 19.6g (95% CI: 3.7-35.4; p=0.02). Assuming causality, an achievement of a 10µg/m³ decrease of particulate air pollution may account for a reduction by 40% in small for gestational age, in twins born moderate to late preterm.

  2. Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus

    SciTech Connect

    Robledo, Candace A.; Mendola, Pauline; Yeung, Edwina; Männistö, Tuija; Sundaram, Rajeshwari; Liu, Danping; Ying, Qi; Sherman, Seth; Grantz, Katherine L.

    2015-02-15

    Background: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk. Methods: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5 μm (PM{sub 2.5}) and PM{sub 2.5} constituents, PM ≤ 10 μm (PM{sub 10}), nitrogen oxides (NO{sub x}), carbon monoxide, sulfur dioxide (SO{sub 2}) and ozone (O{sub 3}) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1–24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity. Results: Preconception maternal exposure to NO{sub X} (RR=1.09, 95% CI: 1.04, 1.13) and SO{sub 2} (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O{sub 3} was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy. Conclusion: Maternal exposures to NO{sub x} and SO{sub 2} preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O{sub 3} appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation. - Highlights: • Air pollution may be related to gestational diabetes (GDM). • No prior studies have examined preconception exposure. • Maternal exposure to NO{sub x} and SO{sub 2} before conception increased subsequent GDM risk. • NO{sub x} and SO{sub 2} exposure in the first seven weeks of pregnancy also increased

  3. ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects.

    PubMed

    Baz, Baz; Riveline, Jean-Pierre; Gautier, Jean-François

    2016-02-01

    Gestational diabetes (GDM) is defined as a glucose intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy. This review aims to revisit the pathogenesis and aetiology of GDM in order to better understand its clinical presentation and outcomes. During normal pregnancy, insulin sensitivity declines with advancing gestation. These modifications are due to placental factors, progesterone and estrogen. In a physiological situation, a compensatory increase in insulin secretion maintains a normal glucose homeostasis. GDM occurs if pancreatic β-cells are unable to face the increased insulin demand during pregnancy. GDM is most commonly a forerunner of type 2 diabetes (T2D) - the most prevalent form of diabetes. These women share similar characteristics with predisposed subjects to T2D: insulin resistance before and after pregnancy, and carry more T2D risk alleles. Auto-immune and monogenic diabetes are more rare aetiologies of GDM. Adverse pregnancy outcomes of GDM are mainly related to macrosomia caused by fetal hyperinsulinism in response to high glucose levels coming from maternal hyperglycaemia. Screening recommendations and diagnosis criteria of GDM have been recently updated. High risk patients should be screened as early as possible using fasting plasma glucose, and if normal, at 24-28 weeks of gestation using 75 g oral glucose tolerance test. The treatment of GDM is based on education with trained nurses and dieticians, and if necessary insulin therapy.

  4. Glycosylated haemoglobin for screening and diagnosis of gestational diabetes mellitus

    PubMed Central

    Phuah, Eileen; Al-Barazan, Abdul Majeed; Nikakis, Irena; Radford, Andrea; Clarkson, Wade; Trevett, Clinton; Brain, Terry; Gebski, Val; Corbould, Anne

    2016-01-01

    Objectives The oral glucose tolerance test (OGTT) is a cumbersome test that is time consuming, labour intensive and often poorly tolerated by pregnant women. To date, glycosylated haemoglobin (HbA1c) is the most accepted measure of chronic glycaemia outside of pregnancy. HbA1c is an uncomplicated test, less time consuming, does not require any specific patient preparation and is considered straightforward compared with the OGTT. Therefore, we prospectively tested the utility of the HbA1c when used as a screening tool in pregnancy for gestational diabetes mellitus (GDM). Settings Primary health care. Single tertiary referral centre, Tasmania, Australia. Participants A direct comparison between HbA1c levels and the OGTT results in pregnant women, tested concurrently at the 24–28 gestational week, was undertaken. A full profile of 480 pregnant women during the period from September 2012 to July 2014 was completed. Median and mean age of participants was 29 years (range 18–47 years). Interventions A simultaneous prospective assessment of HbA1c versus standard OGTT in a cohort of consecutive pregnant women presenting to our institute was performed. Results The number of women who had GDM according to OGTT criteria was 57, representing 11.9% of the evaluated 480 pregnant women. Using a cut-off value for HbA1c at 5.1% (32 mmol/mol) for detecting GDM showed sensitivity of 61% and specificity of 68% with negative predictive value (NPV) of 93%, versus sensitivity of 27% and specificity of 95% with NPV of 91% when using HbA1c cut-off value of 5.4% (36 mmol/mol). Conclusions Our results suggest that pregnant women with an HbA1c of≥5.4% (36 mmol/mol) should proceed with an OGTT. This may result in a significant reduction in the burden of testing on both patients and testing facility staff and resources. Further investigations are required to integrate and optimise the HbA1c as a single, non-fasting, screening tool for GDM. Trial registration number ACTRN

  5. Effects of a12-week endurance exercise program on adiposity and flexibility of Nigerian perimenopausal and postmenopausal women.

    PubMed

    Ogwumike, O O; Arowojolu, A O; Sanya, A O

    2011-12-20

    Menopause is a sign of aging in the woman. Loss of ovarian function induces a reduction in resting metabolic rate, physical energy expenditure, fat-free mass and abdominal adipose tissue accumulation. Location of adipose tissue deposit in abdominal region plays an important role in occurrence of hyperlipidemia, diabetes, hypertension and atherosclerosis. Although regular participation in physical exercise have been suggested to improve adiposity and body flexibility which are important health related components of physical fitness, few published studies are available on the effect of exercise on Nigerian menopausal women. This study investigated effects of a twelve-week endurance exercise program (EEP) on central and abdominal obesity as well as flexibility of perimenopausal and postmenopausal Nigerian women. The study employed a pretest- posttest control group design comprising a sample of 175 apparently healthy, literate, sedentary women within age range 40-59 years. They were workers in state and federal establishments in Ibadan North Local Government Area of Oyo State, Nigeria. Based on history of their last menstrual period, women with regular or irregular menstrual cycle status were allocated into perimenopausal group and those who no longer menstruated into postmenopausal group. A table of random numbers was used for further allocation into perimenopausal exercise group (PEMEG, 45), postmenopausal exercise group (POMEG, 45) perimenopausal control group (PEMCG, 42) and postmenopausal control group (POMCG, 43). Waist Hip Ratio (WHR), Body Mass Index (BMI) as well as Hip and Trunk Flexibility (HTF) were evaluated at baseline and 4weekly intervals until end of 12th week. EEP consisted of a 10-station circuit of cardiovascular endurance, flexibility, coordination, abdominal and pelvic floor muscle exercises. Data were analyzed using descriptive and inferential statistics. Mean age of participants was 52.3±4.1 years, 95% C.I (51.64-52.88) years. Significant

  6. Variation in gestation length among captive reindeer (Rangifer tarandus tarandus).

    PubMed

    Rowell, J E; Shipka, M P

    2009-07-15

    An estimated 90% of reindeer females are mated in a 10- to 21-d interval and give birth in an equally synchronized manner. Reported gestation length in reindeer is highly variable (range, 203 to 240 d), almost twice the reindeer estrous cycle length. Previously, we identified a significant, negative relationship between gestation length and conception date in a small group of reindeer. In the current study, the negative relationship was investigated in a switchback design, where reindeer were divided into two groups synchronized for early and late mating over a 2-yr trial. Regression analysis of 11 paired observations produced a negative (P<0.001) association between gestation length and conception date (slope= -0.31). Dam weight at breeding and prior to parturition, calf birth weight, and calf sex were not significant variables in the regression. Regression analysis of a larger data set from two University of Alaska Fairbanks reindeer herds, where conception date (verified by systemic progesterone) and gestation length were recorded (historical data set), supported previous conclusions (n=70; slope= -0.37; P<0.001). Although the calf sex ratio did not differ with gestation length, there was a positive relationship (r(2)=0.19; P=0.014) between male birth weight and gestation length in the larger data set. The negative relationship between conception date and gestation length enhanced calving synchrony, though the limits of gestation plasticity and underlying mechanisms are not clear. The potential role of photoperiod on early embryonic development is discussed.

  7. ABM Clinical Protocol #10: Breastfeeding the Late Preterm (34-36 6/7 Weeks of Gestation) and Early Term Infants (37-38 6/7 Weeks of Gestation), Second Revision 2016.

    PubMed

    Boies, Eyla G; Vaucher, Yvonne E

    2016-12-01

    A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

  8. Gestational diabetes mellitus: Non-insulin management

    PubMed Central

    Magon, Navneet; Seshiah, V.

    2011-01-01

    Gestational diabetes mellitus (GDM) complicates a substantial number of pregnancies. There is consensus that in patients of GDM, excellent blood glucose control, with diet and, when necessary, oral hypoglycemics and insulin results in improved perinatal outcomes, and appreciably reduces the probability of serious neonatal morbidity compared with routine prenatal care. Goals of metabolic management of a pregnancy complicated with GDM have to balance the needs of a healthy pregnancy with the requirements to control glucose level. Medical nutrition therapy is the cornerstone of therapy for women with GDM. Surveillance with daily self-monitoring of blood glucose has been found to help guide management in a much better way than blood glucose checking in labs and clinics, which tends to be less frequent. Historically, insulin has been the therapeutic agent of choice for controlling hyperglycemia in pregnant women. However, difficulty in medication administration with multiple daily injections, potential for hypoglycemia, and increase in appetite and weight make this therapeutic option cumbersome for many pregnant patients. Use of oral hypogycemic agents (OHAs) in pregnancy has opened new vistas for GDM management. At present, there is a growing acceptance of glyburide (glibenclamide) use as the primary therapy for GDM. Glyburide and metformin have been found to be safe, effective and economical for the treatment of gestational diabetes. Insulin, however, still has an important role to play in GDM. GDM is a window of opportunity, which needs to be seized, for prevention of diabetes in future life. Goal of our educational programs should be not only to improve pregnancy outcomes but also to promote healthy lifestyle changes for the mother that will last long after delivery. Team effort on part of obstetricians and endocrinologists is required to make “the diabetes capital of the world” into “the diabetes care capital of the world”. PMID:22028999

  9. Gestational thrombocytopenia and immune thrombocytopenias in pregnancy.

    PubMed

    Schwartz, K A

    2000-10-01

    Appropriate management of thrombocytopenia in the pregnant patient is important for the well-being of both mother and fetus. The healthy-appearing mother with mild thrombocytopenia may have either gestational benign thrombocytopenia, which does not produce fetal thrombocytopenia, or immune-mediated thrombocytopenia, which can produce fetal thrombocytopenia. These two types of pregnancy-associated thrombocytopenias can be differentiated. Gestational benign thrombocytopenia is initially discovered during pregnancy, and in these patients a reliable test for antiplatelet antibody is usually negative. Conversely, patients with immune-mediated thrombocytopenia may have a history of thrombocytopenia before the pregnancy, and these patients usually have a detectable antiplatelet antibody. The pregnancy patient who presents with a normal platelet count and a history of neonatal alloimmune thrombocytopenia in a prior pregnancy or with a history of an infant of a close relative with NAT must be carefully monitored. Antiplatelet antibody assays performed on mother's and baby's blood will help determine if an antiplatelet antibody is present in maternal plasma, if the antibody reacts with the baby's platelets, and (with appropriate typing plasma) the antigenic specificity of the maternal and fetal platelets. In addition, antigenic typing of the father's platelets will help determine the risk of NAT in the current pregnancy. If a fetus is at risk for severe immune-mediated thrombocytopenia from either an autoantibody or an alloantibody, the fetal platelet count should be measured, if possible, from blood obtained by umbilical cord puncture. If the fetal platelet count is less than 50,000/microL or cannot be measured but is thought to have a high probability of being less than 50,000/microL, strong consideration should be given to a cesarean delivery.

  10. Analysis of gestation length in American Simmental cattle.

    PubMed

    Wray, N R; Quaas, R L; Pollak, E J

    1987-10-01

    Records of gestation length (71,461) for Simmental cattle were distributed with mean 284.3 d and standard deviation 5.52 d. Gestation length was found to increase with percent Simmental and was 1.9 d longer for calves born to mature dams than for those born to heifer dams. Bull calves experienced gestation lengths 1.5 d longer than heifer calves. Sire, maternal grandsire, residual and total variances were estimated to be 2.42, .58, 22.78 and 25.78 d2, respectively, by Henderson's Method III. Heritability of gestation length was calculated to be .374 from the sire variance and .09 from the maternal grandsire variance. Direct additive genetic variance was considered to be of greater importance than maternal additive genetic variance. Correlations between the evaluations of sires for gestation length and heifer calving ease, birth weight and weaning weight were .26, .26 and .13, respectively.

  11. Coat color and gestation length in thoroughbred mares.

    PubMed

    Dring, L A; Hintz, H F; Van Vleck, L D

    1981-01-01

    Average gestation periods for bay, chestnut, dark bay, gray, and black Thoroughbred mares were compared. A total of 1359 gestation periods were used. A linear model including factors for age of mare, sex of foal, month and year of breeding, and sire effects was used in the analysis. Dam and sire coat-color combinations were also investigated in a similar manner. No significant differences in gestation length could be attributed to coat color of the mare of to dam and sire coat-color combinations. Heritability of gestation length was estimated to be 0.38. The results of this study strongly suggest that coat color is not associated with gestation length in Thoroughbred mares.

  12. Gestational diabetes: Linking epidemiology, excessive gestational weight gain, adverse pregnancy outcomes, and future metabolic syndrome.

    PubMed

    Durnwald, Celeste

    2015-06-01

    Gestational diabetes (GDM) affects up to 200,000 deliveries in the United States each year. With the growing obesity epidemic, delayed childbearing, and multiple gestations, the diagnosis of GDM is expected to continue to rise. GDM unmasks a beta-cell defect that persists after pregnancy and typically worsens over time imparting the increased risk of type 2 diabetes mellitus after the index pregnancy. In addition, coexisting obesity and progressive weight gain are additive factors for progression to type 2 DM. Obstetricians play an integral role in informing GDM women about their lifelong risk of type 2 diabetes (T2DM) and can help bridge the care to primary care physicians, as it relates to recommended screening and long-term follow-up.

  13. Polyunsaturated Fatty Acid (PUFA) Status in Pregnant Women: Associations with Sleep Quality, Inflammation, and Length of Gestation

    PubMed Central

    Christian, Lisa M.; Blair, Lisa M.; Porter, Kyle; Lower, Mary; Cole, Rachel M.; Belury, Martha A.

    2016-01-01

    Mechanistic pathways linking maternal polyunsaturated fatty acid (PUFA) status with gestational length are poorly delineated. This study examined whether inflammation and sleep quality serve as mediators, focusing on the antiinflammatory ω-3 docosahexaenoic acid (DHA; 22:6n3) and proinflammatory ω-6 arachidonic acid (AA; 20:4n6). Pregnant women (n = 135) provided a blood sample and completed the Pittsburgh Sleep Quality Index (PSQI) at 20–27 weeks gestation. Red blood cell (RBC) fatty acid levels were determined by gas chromatography and serum inflammatory markers [interleukin (IL)-6, IL-8, tumor necrosis factor-α, IL-1β, and C-reactive protein] by electrochemiluminescence using high sensitivity kits. Both higher serum IL-8 (95% CI = 0.10,3.84) and poor sleep (95% CI = 0.03,0.28) served as significant mediators linking lower DHA:AA ratios with shorter gestation. Further, a serial mediation model moving from the DHA:AA ratio → sleep → IL-8 → length of gestation was statistically significant (95% CI = 0.02, 0.79). These relationships remained after adjusting for depressive symptoms, age, BMI, income, race, and smoking. No interactions with race were observed in relation to length of gestation as a continuous variable. However, a significant interaction between race and the DHA:AA ratio in predicting preterm birth was observed (p = 0.049); among African Americans only, odds of preterm birth decreased as DHA:AA increased (p = 0.048). These data support a role for both inflammatory pathways and sleep quality in linking less optimal RBC PUFA status with shorter gestation in African American and European American women and suggest that African-Americans have greater risk for preterm birth in the context of a low DHA:AA ratio. PMID:26859301

  14. Perinatal outcome of twins compared to singletons of the same gestational age: a case-control study.

    PubMed

    Petit, Nathalie; Cammu, Hendrik; Martens, Guy; Papiernik, Emile

    2011-02-01

    Our objective was to determine the perinatal outcome of first- and second-born twins compared to singletons, born at the same gestational age. To that end we conducted a case-control study in Flanders (Northern Belgium). During a 10-year period (01.01.1999-31.12.2008), the entire twin population - 11,154 first- and 11,118 second-born twins (cases) - was compared to 22,228 singletons (controls) with respect to fetal and neonatal (0-27 days) mortality. Only case and control infants of ≥ 500 grams were included, which explained the unequal number of first- and second-born twins. Mothers and their infants of cases and of controls were derived from the Flemish perinatal database and were matched for maternal age and parity, gestational age and gender of the offspring. The main outcome measures were fetal and neonatal mortality according to gestational age. The frequency of fetal death was statistically significantly less frequent in preterm born twins than in singletons, except at term where the reverse was seen in second-born twins compared to controls. After adjustment for congenital malformations, the results stayed unchanged. Below 28 weeks gestation, singletons had a significantly lower neonatal mortality rate than twins that persisted after adjustment for congenital malformations: the first-born twin versus singleton OR 1.71 (1.17-2.51) and second-born versus singleton OR 2.09 (1.43-3.05). Between 28 and 32 weeks, the second-born twin showed a survival advantage over the control singleton. Between 32 and 36 6/7 weeks both twins had a significantly higher survival rate than the corresponding singleton controls. However, after adjustment for congenital malformations, the aforementioned differences between 28 and 36 6/7 weeks disappeared. When at term, twins and singletons had a comparable, though very low, neonatal death rate. These results confirm previous published data. In conclusion, we demonstrated that the neonatal death rate was lower for twins between 32

  15. Factors associated with the differential in actual gestational age and gestational age predicted from transrectal ultrasonography in pregnant dairy cows.

    PubMed

    Fitzgerald, A M; Ryan, D P; Berry, D P

    2015-08-01

    The objective of the study was to determine (1) how gestational age predicted using transrectal ultrasonography related to actual gestational age derived as the number of days from the most recent artificial insemination date, (2) what factors, if any, were associated with the differential between the two measures, and (3) the association between this differential in gestational age and the likelihood of subsequent pregnancy loss, stillbirth, or calving dystocia. The data set contained 7340 ultrasound records from 6805 Holstein Friesian dairy cows in 175 herds. Ultrasonography assessment underestimated gestational age relative to days since last service by 0.51 days (standard error [SE]: 0.040), although the differential was less during embryonic development phase (i.e., ≤42 days of gestation; mean overestimation of 0.31 days) versus fetal development phase (i.e., >42 days of gestation; mean underestimation of 0.81 days). Predicted calving date calculated from ultrasonography was 1.41 days (SE: 0.040) later than the actual subsequent calving date and was, on average, 0.52 days later than predicted calving date, assuming a gestation length of 282 days. Parity of the dam (P < 0.05), stage of pregnancy (P < 0.001), and sex of the calf born (P < 0.001) were all associated with the differential in gestational age based on ultrasonography versus days since last service. No obvious trend among parities was evident in the difference between the methods in predicting gestational age. Ultrasonography underestimated gestational age by 0.83 (SE: 0.15) days in parity 5+ cows and underestimated gestational age by 0.41 (SE: 0.14) days in the first-parity cows. Relative to gestational age predicted from the most recent service, ultrasonography underestimated gestational age by 0.75 (SE: 0.13) days for heifer fetuses and underestimated gestational age by 0.36 (SE: 0.13) days for bull fetuses. The heritability of the differential in gestational age between the methods of

  16. Body mass index, gestational weight gain and fatty acid concentrations during pregnancy: the Generation R Study.

    PubMed

    Vidakovic, Aleksandra Jelena; Jaddoe, Vincent W V; Gishti, Olta; Felix, Janine F; Williams, Michelle A; Hofman, Albert; Demmelmair, Hans; Koletzko, Berthold; Tiemeier, Henning; Gaillard, Romy

    2015-11-01

    Obesity during pregnancy may be correlated with an adverse nutritional status affecting pregnancy and offspring outcomes. We examined the associations of prepregnancy body mass index and gestational weight gain with plasma fatty acid concentrations in mid-pregnancy. This study was embedded in a population-based prospective cohort study among 5636 women. We obtained prepregnancy body mass index and maximum weight gain during pregnancy by questionnaires. We measured concentrations of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), n-3 polyunsaturated fatty acid (n-3 PUFA) and n-6 polyunsaturated fatty acid (n-6 PUFA) at a median gestational age of 20.5 (95% range 17.1-24.9) weeks. We used multivariate linear regression models. As compared to normal weight women, obese women had higher total SFA concentrations [difference: 0.10 standard deviation (SD) (95% Confidence Interval (CI) 0, 0.19)] and lower total n-3 PUFA concentrations [difference: - 0.11 SD (95% CI - 0.20, - 0.02)]. As compared to women with sufficient gestational weight gain, those with excessive gestational weight gain had higher SFA concentrations [difference: 0.16 SD (95% CI 0.08, 0.25)], MUFA concentrations [difference: 0.16 SD (95% CI 0.08, 0.24)] and n-6 PUFA concentrations [difference: 0.12 SD (95% CI 0.04, 0.21)]. These results were not materially affected by adjustment for maternal characteristics. Our results suggest that obesity and excessive weight gain during pregnancy are associated with an adverse fatty acids profile. Further studies are needed to assess causality and direction of the observed associations.

  17. A rare case of gestational thyrotoxicosis as a cause of acute myocardial infarction

    PubMed Central

    Lvovsky, Dmitry

    2016-01-01

    Summary Angina pectoris in pregnancy is unusual and Prinzmetal’s angina is much rarer. It accounts for 2% of all cases of angina. It is caused by vasospasm, but the mechanism of spasm is unknown but has been linked with hyperthyroidism in some studies. Patients with thyrotoxicosis-induced acute myocardial infarction are unusual and almost all reported cases have been associated with Graves’ disease. Human chorionic gonadotropin hormone-induced hyperthyroidism occurs in about 1.4% of pregnant women, mostly when hCG levels are above 70–80 000 IU/L. Gestational transient thyrotoxicosis is transient and generally resolves spontaneously in the latter half of pregnancy, and specific antithyroid treatment is not required. Treatment with calcium channel blockers or nitrates reduces spasm in most of these patients. Overall, the prognosis for hyperthyroidism-associated coronary vasospasm is good. We describe a very rare case of an acute myocardial infarction in a 27-year-old female, at 9 weeks of gestation due to right coronary artery spasm secondary to gestational hyperthyroidism with free thyroxine of 7.7 ng/dL and TSH <0.07 IU/L. Learning points: AMI and cardiac arrest due to GTT despite optimal medical therapy is extremely rare. Gestational hyperthyroidism should be considered in pregnant patients presenting with ACS-like symptoms especially in the setting of hyperemesis gravidarum. Our case highlights the need for increased awareness of general medical community that GTT can lead to significant cardiac events. Novel methods of controlling GTT as well as medical interventions like ICD need further study. PMID:27933173

  18. 77 FR 31151 - World Trade Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-24

    ... 8827 of May 21, 2012 World Trade Week, 2012 By the President of the United States of America A... services designed and produced by Americans. During World Trade Week, we reaffirm the essential role... Week. I encourage all Americans to observe this week with events, trade shows, and educational...

  19. 75 FR 20885 - National Park Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... Proclamation 8498--National Park Week, 2010 Proclamation 8499--National Crime Victims' Rights Week, 2010 Proclamation 8500--National Volunteer Week, 2010 Proclamation 8501--National Day of Service and Remembrance for... President ] Proclamation 8498 of April 16, 2010 National Park Week, 2010 By the President of the...

  20. Lean body mass in small for gestational age and appropriate for gestational age infants

    SciTech Connect

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-11-01

    Dual photon absorptiometry using /sup 153/Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation.

  1. The Four Day School Week. Research Brief

    ERIC Educational Resources Information Center

    Muir, Mike

    2013-01-01

    Can four-day school weeks help districts save money? How do districts overcome the barriers of moving to a four-day week? What is the effect of a four-day week on students, staff and the community? This paper enumerates the benefits for students and teachers of four-day school weeks. Recommendations for implementation of a four-day week are also…

  2. Effect of protein or energy restriction during late gestation on hormonal and metabolic status in pregnant goats and postnatal male offspring.

    PubMed

    He, Z X; Sun, Z H; Beauchemin, K A; Yang, W Z; Tang, S X; Zhou, C S; Han, X F; Wang, M; Kang, J H; Tan, Z L

    2015-11-01

    The objective of this study was to investigate the effects of maternal protein or energy restriction on hormonal and metabolic status of pregnant goats during late gestation and their postnatal male kids. Forty-five pregnant goats were fed a control (CON), 40% protein-restricted (PR) or 40% energy-restricted (ER) diet from 90 days of gestation until parturition. Plasma of mothers (90, 125 and 145 days of gestation) and kids (6 weeks of age) were sampled to determine metabolites and hormones. Glucose concentration for pregnant goats subjected to PR or ER was less (P < 0.001) than that of CON goats at 125 and 145 days of gestation. However, plasma nonesterified fatty acids concentration was greater (P < 0.01) at 125 and 145 days for PR and ER than CON. Protein restriction increased (P < 0.01) maternal cortisol concentration by 145 days of gestation, and ER decreased (P < 0.01) maternal insulin concentration at 125 days of gestation. Moreover, maternal amino acid (AA) concentrations were affected by nutritional restriction, with greater (P < 0.05) total AA (TAA) and nonessential AA (NEAA) for PR goats but less (P < 0.05) TAA and NEAA for ER goats at 125 days of gestation. After 6 weeks of nutritional recovery, plasma concentrations of most metabolic and hormonal parameters in restricted kids were similar to CON kids, except for reduced (P < 0.05) insulin concentration in ER, and reduced (P < 0.05) Asp concentration in PR and ER kids. These results provide information on potential metabolic mechanisms responsible for fetal programming.

  3. Emotional Reactions of Mothers Facing Premature Births: Study of 100 Mother-Infant Dyads 32 Gestational Weeks

    PubMed Central

    Eutrope, Julien; Thierry, Aurore; Lempp, Franziska; Aupetit, Laurence; Saad, Stéphanie; Dodane, Catherine; Bednarek, Nathalie; De Mare, Laurence; Sibertin-Blanc, Daniel; Nezelof, Sylvie; Rolland, Anne-Catherine

    2014-01-01

    Objectives This current study has been conducted to clarify the relationship between the mother's post-traumatic reaction triggered by premature birth and the mother-infant interactions. In this article, the precocious maternal feelings are described. Methods A multicenter prospective study was performed in three French hospitals. 100 dyads with 100 very premature infants and their mothers were recruited. Mothers completed, at two different times self-questionnaires of depression/anxiety, trauma and social support. The quality of interactions in the dyads was evaluated. Results Thirty-nine percent of the mothers obtained a score at HADS suggesting a high risk of depression at the first visit and approximately one-third at visit two. Seventy-five percent of the mothers were at risk of suffering from an anxiety disorder at visit one and half remained so at visit two. A “depressed” score at visits one and two correlated with a hospitalization for a threatened premature labor. We noted a high risk of trauma for 35% of the mothers and high interactional synchrony was observed for approximately two-thirds of the dyads. The mothers' psychological reactions such as depression and anxiety or postnatal depression correlate strongly with the presence of an initial trauma. At visit one and visit two, a high score of satisfaction concerning social support correlates negatively with presence of a trauma. A maternal risk of trauma is more frequent with a C-section delivery. Conclusions Mothers' psychological reactions such as depression and anxiety correlate greatly with the presence of an initial trauma. The maternal traumatic reaction linked to premature birth does not correlate with the term at birth, but rather with the weight of the baby. Social support perceived by the mother is correlated with the absence of maternal trauma before returning home, and also seems to inhibit from depressive symptoms from the time of the infant's premature birth. PMID:25153825

  4. Effect of creatine supplementation during the last week of gestation on birth intervals, stillbirth, and preweaning mortality in pigs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We hypothesized that creatine supplementation would reduce birth intervals, stillbirth rate, and preweaning survival in pigs because of its reported improvement of athletic performance in humans. In Exp. 1, gilts (n = 42) and first parity sows (n = 75) were mated at estrus. Beginning on d 110 of ges...

  5. Changes in Sweet Taste Across Pregnancy in Mild Gestational Diabetes Mellitus: Relationship to Endocrine Factors

    PubMed Central

    Belzer, Lisa M.; Smulian, John C.; Lu, Shou-En

    2009-01-01

    Gestational diabetes mellitus (GDM) is glucose intolerance diagnosed during pregnancy. Previous work suggested that women with GDM showed exaggerated preferences for sweet taste, but data were limited to a single time point during pregnancy. This study longitudinally assessed sweet taste changes across pregnancy in women who developed GDM (n = 15) as compared with women with normal glucose tolerance (NGT; n = 93) and nonpregnant controls (n = 19). A second objective was to relate sweet taste changes in GDM to fasting leptin and insulin profiles. Following an overnight fast, subjects evaluated strawberry-flavored milks varying in sucrose and fat content, as well as glucose solutions. Evaluations were made at 3 time points during pregnancy and during early postpartum. At 34–38 weeks gestation, women with GDM gave higher liking ratings to moderately sweetened (5% and 10% sucrose) strawberry milks than women with NGT. These differences were not related to alterations in the perception of the samples. At 24–28 weeks gestation, and in women with GDM only, fasting insulin was correlated with liking of the glucose solutions (R2 = 0.63, P = 0.004) and fasting leptin was correlated with sweetness liking of the 10% sucrose milk (R2 = 0.42, P = 0.017). These data suggest that women with GDM exhibit higher liking ratings for a sweet fat milk drink late in pregnancy. Also, higher hedonic ratings for sweet taste in GDM may be related to elevated leptin and insulin concentrations at midpregnancy. GDM may increase the desire for sweet taste that could influence dietary management of this disease. PMID:19587026

  6. Maternal Body Weight and Gestational Diabetes Differentially Influence Placental and Pregnancy Outcomes

    PubMed Central

    Martino, J.; Sebert, S.; Segura, M. T.; García-Valdés, L.; Florido, J.; Padilla, M. C.; Marcos, A.; Rueda, R.; McArdle, H. J.; Budge, H.; Campoy, C.

    2016-01-01

    Context: Maternal obesity and gestational diabetes mellitus (GDM) can both contribute to adverse neonatal outcomes. The extent to which this may be mediated by differences in placental metabolism and nutrient transport remains to be determined. Objective: Our objective was to examine whether raised maternal body mass index (BMI) and/or GDM contributed to a resetting of the expression of genes within the placenta that are involved in energy sensing, oxidative stress, inflammation, and metabolic pathways. Methods: Pregnant women from Spain were recruited as part of the “Study of Maternal Nutrition and Genetics on the Foetal Adiposity Programming” survey at the first antenatal visit (12–20 weeks of gestation) and stratified according to prepregnancy BMI and the incidence of GDM. At delivery, placenta and cord blood were sampled and newborn anthropometry measured. Results: Obese women with GDM had higher estimated fetal weight at 34 gestational weeks and a greater risk of preterm deliveries and cesarean section. Birth weight was unaffected by BMI or GDM; however, women who were obese with normal glucose tolerance had increased placental weight and higher plasma glucose and leptin at term. Gene expression for markers of placental energy sensing and oxidative stress, were primarily affected by maternal obesity as mTOR was reduced, whereas SIRT-1 and UCP2 were both upregulated. In placenta from obese women with GDM, gene expression for AMPK was also reduced, whereas the downstream regulator of mTOR, p70S6KB1 was raised. Conclusions: Placental gene expression is sensitive to both maternal obesity and GDM which both impact on energy sensing and could modulate the effect of either raised maternal BMI or GDM on birth weight. PMID:26513002

  7. Oxytocin receptor binding in the hypothalamus during gestation in rats.

    PubMed

    Bealer, Steven L; Lipschitz, David L; Ramoz, Gina; Crowley, William R

    2006-07-01

    Central oxytocin receptors (OTR) may be involved in adaptations of the brain oxytocin (OT) system during gestation, which are critical for systemic release of OT during parturition and lactation. We used quantitative autoradiography to determine changes in OTR binding in numerous brain sites during the course of gestation in the rat. Furthermore, to evaluate the importance of ovarian steroids in mediating pregnancy-related changes in OTR binding, we measured binding in ovariectomized animals treated with progesterone and/or estrogen, and in pregnant animals treated with exogenous progesterone during late gestation. We found that OTR binding was significantly increased in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) by midgestation (day 15) compared with control. In addition, there was a further significant increase in OTR binding in these nuclei by late gestation (day 20). The bed nucleus of the stria terminalis (BNST) and the medial preoptic area (MPOA) also showed significant gestation-associated increases in OTR binding, which were similar during mid- and late pregnancy. Treatment with exogenous progesterone throughout pregnancy did not alter the increase in OTR binding characteristic of late gestation in any of these brain sites. Finally, estrogen treatment in ovariectomized animals resulted in increased OTR binding in the SON, BNST, and MPOA, but not the PVN. These data demonstrate that OTR binding in the hypothalamus is increased during mid- and late-gestation, compared with ovariectomized control animals, which may be mediated by increased estradiol.

  8. Fetal growth, gestation length and phosphoglucomutase-1 phenotype.

    PubMed

    Johnstone, F D; West, J D; Prescott, R J; Steel, J M; Flockhart, J A; Greer, I A; Drago, G A; Whitehouse, D B

    1993-12-01

    This study investigates reports that phosphoglucomutase-1 (PGM1) phenotype is associated with fetal growth and gestation length. A total of 350 women were studied, 234 having uncomplicated pregnancies and 114 with a baby weighing greater than 90th centile, corrected for parity, gestation and fetal sex. All women had gestation confirmed by early ultrasound. Conventional cellulose acetate electrophoresis was used to distinguish the three common PGM1 phenotypes and polyacrylamide gel isoelectric focusing to distinguish the ten PGM1 subtypes. Neither PGM1 phenotype nor subtype were found to be associated with gestation length or standardised birth weight. Logistic regression, where maternal age, parity, fetal sex, maternal weight, gestation and smoking were introduced as explanatory variables in addition to PGM1 phenotype testing against the dependent variables birth weight, standardised birth weight and gestation length, did not show differences related to PGM1 phenotype. Two possible reasons for the discrepancy with previously published data are discussed. We conclude that the study provides no support for the belief that PGM1 phenotype is related to fetal growth or gestation length and that the original observations could have arisen as a result of statistical artefact due to multiple testing.

  9. Factors affecting gestation length in the Thoroughbred mare.

    PubMed

    Davies Morel, M C G; Newcombe, J R; Holland, S J

    2002-12-16

    In order to assist in the accurate prediction of the timing of parturition in the mare true gestation length, along with the potential effect of a number of factors, was investigated. Data from 433 Thoroughbred foal pregnancies were used. Sequential ultrasonic scanning allowed the true gestation length (fertilisation-parturition) to be ascertained, as apposed to previous work, which used the mating-parturition interval. An average gestation length of 344.1 +/- 0.49 days was evident. Colt foal pregnancies were significantly (P < 0.001) longer (346.2 +/- 0.72) than fillies (342.4 +/- 0.65). Month of birth had a significant effect on gestation length in all foals (P < 0.001). With foals born in January having the shortest gestation lengths and those born in April the longest. Mare age, year of birth, stallion age, stud farm and the interval between ovulation and mating had no significant effect. It is concluded that (i) the gestation length range (315-388 days), all resulting in viable foals is noteworthy and of clinical importance when considering the classification of dysmaturity in foals, (ii) mares carrying colt foals due to be born in the middle of the breeding season (April) are likely to have the longer gestation lengths.

  10. Early Onset of Metastatic Gestational Trophoblastic Disease after Full-Term Pregnancy

    PubMed Central

    Ghaemmaghami, Fatemeh; Zarchi, Mojgan Karimi

    2008-01-01

    Choriocarcinoma is a curable malignancy that occurred approximately 50% after term pregnancies, and prognosis in this form of gestational trophoblastic Disease (GTD) is Poor. The earliest onset choriocarcinoma after term pregnancy in one study was reported 3 weeks after delivery, but in current study, choriocarcinoma was diagnosed 2 weeks after delivery. 28 years-old women gravidity 2, parity 2 delivered a healthy infant at term. Frequent episodes of vaginal bleeding occurred after 10 days of delivery. On admission to hospital, she had lesions in the lungs. The pretreatment human chorionic gonadotropin (HCG) level was 84,000 mIU/ml and her FIGO risk factor score was 8 (high risk group). The EMA/CO regimen was administered as first line chemotherapy and the patient achieved complete remission after 7 courses. Although early onset postpartum hemorrhage is due to complication of delivery, but gestational trophoblastic disease (GTD) may be occurred and assessment of human chorionic gonadotropin could be help to early diagnose of GTD. PMID:23675070

  11. Association of In Utero Organochlorine Pesticide Exposure and Fetal Growth and Length of Gestation in an Agricultural Population

    PubMed Central

    Fenster, Laura; Eskenazi, Brenda; Anderson, Meredith; Bradman, Asa; Harley, Kim; Hernandez, Hedy; Hubbard, Alan; Barr, Dana B.

    2006-01-01

    From 1940 through the 1970s, organochlorine compounds were widely used as insecticides in the United States. Thereafter, their use was severely restricted after recognition of their persistence in the environment, their toxicity in animals, and their potential for endocrine disruption. Although substantial evidence exists for the fetal toxicity of organochlorines in animals, information on human reproductive effects is conflicting. We investigated whether infants’ length of gestation, birth weight, and crown–heel length were associated with maternal serum levels of 11 different organochlorine pesticides: p,p′-dichlorodiphenyltrichloroethane (p,p′-DDT), p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE), o,p′-dichlorodiphenyltrichloroethane (o,p′-DDT), hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCCH), γ-hexachlorocyclohexane (γ-HCCH), dieldrin, heptachlor epoxide, oxychlordane, trans-nonachlor, and mirex. Our subjects were a birth cohort of 385 low-income Latinas living in the Salinas Valley, an agricultural community in California. We observed no adverse associations between maternal serum organochlorine levels and birth weight or crown–heel length. We found decreased length of gestation with increasing levels of lipid-adjusted HCB (adjusted β= −0.47 weeks; p = 0.05). We did not find reductions in gestational duration associated with any of the other organochlorine pesticides. Our finding of decreased length of gestation related to HCB does not seem to have had clinical implications for this population, given its relatively low rate of preterm delivery (6.5%). PMID:16581552

  12. AN ALGORITHM FOR THE ESTIMATION OF GESTATIONAL AGE AT THE TIME OF FETAL DEATH

    PubMed Central

    Conway, Deborah L.; Hansen, Nellie I.; Dudley, Donald J.; Parker, Corette B.; Reddy, Uma M.; Silver, Robert M.; Bukowski, Radek; Pinar, Halit; Stoll, Barbara J.; Varner, Michael W.; Saade, George R.; Hogue, Carol; Willinger, Marian; Coustan, Donald; Koch, Matthew A.; Goldenberg, Robert L.

    2013-01-01

    Background Accurate assignment of gestational age at time of fetal death is important for research and clinical practice. An algorithm to estimate gestational age (GA) at fetal death was developed and evaluated. Methods The algorithm developed by the Stillbirth Collaborative Research Network (SCRN) incorporated clinical and postmortem data. The SCRN conducted a population-based case-control study of women with stillbirths and live births from 2006 to 2008 in five geographic catchment areas. Rules were developed to estimate a due date, identify an interval during which death likely occurred, and estimate GA at the time of fetal death. Reliability of using fetal foot length to estimate GA at death was assessed. Results The due date estimated for 620 singleton stillbirths studied was considered clinically reliable for 87%. Only 25.2% of stillbirths were documented alive within two days before diagnosis and 47.6% within one week of diagnosis. The algorithm-derived estimate of GA at time of fetal death was 1 or more weeks earlier than the GA at delivery for 43.5% of stillbirths. GA estimated from fetal foot length agreed with GA by algorithm within two weeks for 75% within a subset of well-dated stillbirths. Conclusions Precise assignment of GA at death, defined as reliable dating criteria and a short interval (≤1 week) during which fetal death was known to have occurred, was possible in 46.6% of cases. Fetal foot length is a relatively accurate measure of GA at death and should be collected in all stillbirth cases. PMID:23374059

  13. Nucleotide supplementation and the growth of term small for gestational age infants.

    PubMed

    Cosgrove, M; Davies, D P; Jenkins, H R

    1996-03-01

    A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula.

  14. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    PubMed Central

    Burlina, S.; Dalfrà, M. G.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected. PMID:27956897

  15. Gestational Diabetes Insipidus Associated with HELLP Syndrome: A Case Report.

    PubMed

    Gambito, Renela; Chan, Michael; Sheta, Mohamed; Ramirez-Arao, Precious; Gurm, Harmeet; Tunkel, Allan; Nivera, Noel

    2012-01-01

    Gestational diabetes insipidus is a rare, but well recognized, complication of pregnancy. It is related to excess vasopressinase enzyme activity which is metabolized in the liver. A high index of suspicion of gestational diabetes insipidus is required in a correct clinical setting especially in the presence of other risk factors such as preeclampsia, HELLP syndrome, and twin pregnancies. We are presenting a case of gestational diabetes insipidus in a patient with HELLP syndrome. The newborn in this case also had hypernatremia thereby raising possibilities of vasopressinase crossing the placenta.

  16. Genetic study of gestation length in Andalusian and Arabian mares.

    PubMed

    Valera, M; Blesa, F; Dos Santos, R; Molina, A

    2006-09-01

    The length of gestation in Andalusian, or Spanish Purebred (SPB) and Arabian (AB) mares reared in Spain was analysed, based on 766 spontaneous full-term deliveries appertaining to 141 mares of SPB breed and 72 mares of AB breed in 31 breeding seasons. The data were obtained from the Yeguada Militar de Jerez de la Frontera stud farm in Cádiz, Spain. The mean length of gestation was of 336.8+/-0.48 days in the SPB mares and 340.3+/-0.63 days in AB mares. To assess the accurate prediction of time of birth the potential effect of a number of factors was investigated. The influences of the breed, mare, month and year of mating, age of the mother, number of births and sex of the foal were statistically significant. The factor have the greatest influence over the gestation length was the mare itself, with a correlation among consecutive births of around 0.4. The effect of inbreeding, both of the mare and foal, was negligible. Gestation length shortened as the breeding season progressed: in both breeds, a delay of 1 month in mating corresponded to a decrease of 3 days in the gestation length. According to our results, gestation length decrease as the mare gets older, with the shortest gestation periods when the mare is 10-12 years old, and from this point on, it slowly increases. The gestation period shortens as the 4th or 5th birth approaches, and then gets progressively longer. The range of variation in gestation length due to the number of births to the mare is of 2.9 days for the AB mares, and 2.2 days for SPB mares. The heritability for the gestation length for AB and the SPB breeds was 0.2, with a repeatability of 0.36 and 0.37, for SPB and AB breeds, respectively. With the data from both breeds, and using a classical approach, the response to selection was estimated if mares with extreme gestation lengths were culled, i.e. lengths which are under 310 days, or over 360 days. According to our results, in the case of SPB, a decrease of 14-45% would occur in the number

  17. Impact of spiramycin treatment and gestational age on maturation of Toxoplasma gondii immunoglobulin G avidity in pregnant women.

    PubMed

    Lefevre-Pettazzoni, M; Bissery, A; Wallon, M; Cozon, G; Peyron, F; Rabilloud, M

    2007-03-01

    The objective of the present study was to investigate the maturation of immunoglobulin G (IgG) avidity after Toxoplasma gondii seroconversion during pregnancy and the factors that affect IgG avidity over time. The study used 309 serum samples from 117 women and a multiple linear mixed regression analysis to show the patterns of variation of IgG avidity throughout gestation. The IgG avidity ratios and the patterns of their evolution with time were quite diverse among the women and were statistically heterogeneous (P = 0.011); however, the trend was toward a statistically significant increase (P < 0.0001). On average, a 1.0167-fold increase was observed for each additional gestational week after the putative date of infection. At 12 weeks after putative infection (the expected IgG avidity maturation time), the mean avidity ratio was 16.6% (95% confidence interval, 15.4 to 17.9%). At all times, the avidity ratio remained significantly heterogeneous among the women (P < 0.05); for 95% of them, that ratio ranged from 7.8 to 35.3% at 12 weeks after putative infection. Maternal age at the putative time of infection did not influence the maturation of IgG avidity. However, on average, a 1.009-fold decrease (P = 0.03) in that avidity was observed for each additional week of gestational age before infection and a 1.03-fold increase (P = 0.0003) was observed for each additional week of delay to the onset of spiramycin treatment. The rate of increase in the avidity ratio was lower if infection occurred late in pregnancy and higher if the delay to treatment was long. This information cannot allow accurate determination of the delay since the time of infection. The present results provide support for interpretation of the assay and caution against overinterpretation.

  18. Preconceptional Iron Intake and Gestational Diabetes Mellitus

    PubMed Central

    Darling, Anne Marie; Mitchell, Allen A.; Werler, Martha M.

    2016-01-01

    Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. PMID:27231921

  19. Gestational Diabetes Testing, Narrative, and Medical Distrust.

    PubMed

    Edwell, Jennifer; Jack, Jordynn

    2017-03-01

    In this article, we investigate the role of scientific and patient narratives on perceptions of the medical debate around gestational diabetes (GDM) testing. Among medical scientists, we show that the narrative surrounding GDM testing affirms that future research and data will lead to medical consensus. We call this narrative trajectory the "deferred quest." For patients, however, diagnosis and their subsequent discovery that biomedicine does not speak in one voice ruptures their trust in medical authority. This new distrust creates space for patients to develop a Frankian quest narrative where they become the protagonist in their story. Additionally, across these different narratives, we observe how character is constructed and employed to negotiate trust. We conclude that healthcare providers should assess the narrative trajectory adopted by patients after diagnosis. Also, we suggest that providers acknowledge the lack of medical consensus to their patients. This veracity would foster women's sense of trust in their provider as well as allow women to be active interlocutors in a debate that ultimately plays out in their deliberation about their body, pregnancy, and risk.

  20. Gestational dexamethasone alters fetal neuroendocrine axis.

    PubMed

    Ahmed, R G

    2016-09-06

    This study tested whether the maternal transport of dexamethasone (DEXA) may affect the development of the neuroendocrine system. DEXA (0.2mg/kg b.w., subcutaneous injection) was administered to pregnant rats from gestation day (GD) 1-20. In the DEXA-treated group, a decrease in maternal serum thyroxine (T4), triiodothyronine (T3), and increase in thyrotropin (TSH) levels (hypothyroid status) were observed at GDs 15 & 20 with respect to control group. The reverse pattern (hyperthyroid status) was observed in their fetuses at embryonic days (EDs) 15 & 20. Although the maternal body weight was diminished, the weight of the thyroid gland was increased at studied GDs as compared to the control group. The fetal growth retardation, hyperleptinemia, hyperinsulinism, and cytokines distortions (transforming growth factor-beta; TGF-β, tumor necrosis factor-alpha; TNF-α, and interferon-γ; IFN-γ) were noticed at examined EDs if compared to the control group. Alternatively, the maternofetal thyroid dysfunctions due to the maternal DEXA administration attenuated the levels of fetal cerebral norepinephrine (NE) and epinephrine (E), and elevated the levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) at considered days. These alterations were age-dependent and might damage the nerve transmission. Finally, maternal DEXA might act as neuroendocrine disruptor causing dyshormonogenesis and fetal cerebral dysfunction.

  1. Pharmacological Management of Gestational Diabetes Mellitus.

    PubMed

    Bergel, Riki; Hadar, Eran; Toledano, Yoel; Hod, Moshe

    2016-11-01

    Gestational diabetes mellitus (GDM) is one of the most common morbidities complicating pregnancy, with short- and long-term consequences to the mothers, fetuses, and newborns. Management and treatment are aimed to achieve best possible glycemic control, while avoiding hypoglycemia and ensuring maternal and fetal safety. It involves behavioral modifications, nutrition and medications, if needed; concurrent with maternal and fetal surveillance for possible adverse outcomes. This review aims to elaborate on the pharmacological options for GDM therapy. We performed an extensive literature review of different available studies, published during the last 50 years, concerning pharmacological therapy for GDM, dealing with safety and efficacy, for both fetal and maternal morbidity consequences; as well as failure and success in establishing appropriate metabolic and glucose control. Oral medication therapy is a safe and effective treatment modality for GDM and in some circumstances may serve as first-line therapy when nutritional modifications fail. When oral agents fail to establish glucose control then insulin injections should be added. Determining the best oral therapy in inconclusive, although it seems that metformin is slightly superior to glyburide, in some aspects. As for parenteral therapy, all insulins listed in this article are considered both safe and effective for treatment of hyperglycemia during pregnancy. Importantly, a better safety profile, with similar efficacy is documented for most analogues. As GDM prevalence rises, there is a need for successful monitoring and treatment for patients. Caregivers should know the possible and available therapeutic options.

  2. 76 FR 63801 - Fire Prevention Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-13

    ... Part IV The President Proclamation 8732--Fire Prevention Week, 2011 Proclamation 8733--National School Lunch Week, 2011 Proclamation 8734--Leif Erikson Day, 2011 Proclamation 8735--Columbus Day, 2011...;Title 3-- #0;The President [[Page 63803

  3. 76 FR 72601 - National Family Week, 2011

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    ... Part IV The President Proclamation 8756--National Family Week, 2011 Proclamation 8757--National Farm-City Week, 2011 Proclamation 8758--National Child's Day, 2011 Executive Order 13590--Authorizing the...-- #0;The President [[Page 72603

  4. 78 FR 44867 - Captive Nations Week, 2013

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    2013-07-24

    ... July 24, 2013 Part VI The President Proclamation 8998--Captive Nations Week, 2013 #0; #0; #0... Nations Week, 2013 By the President of the United States of America A Proclamation As citizens of the... privileged few. Captive Nations Week is an opportunity to reaffirm America's role in advancing human...

  5. 76 FR 28623 - Small Business Week, 2011

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    2011-05-18

    ... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8673 of May 12, 2011 Small Business Week... to work hard enough, you can succeed in our country. This week, we honor and celebrate the... of the United States, do hereby proclaim May 15 through May 21, 2011, as Small Business Week. I...

  6. Understanding Infidelity: An Interview with Gerald Weeks

    ERIC Educational Resources Information Center

    Smith, Travis

    2011-01-01

    In this interview, Gerald Weeks shares his expertise on the topic of infidelity and couples counseling. Dr. Weeks defines infidelity, presents assessment strategies for treating the issue of infidelity, and discusses an intersystemic model for infidelity treatment when counseling couples. Dr. Weeks also provides insight into common mistakes made…

  7. 75 FR 29393 - Small Business Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-26

    ... 8525 of May 20, 2010 Small Business Week, 2010 By the President of the United States of America A.... During Small Business Week, we reaffirm our support for America's small businesses and celebrate the... that have helped small business owners acquire loans and hire workers. This week, we celebrate the...

  8. 77 FR 22177 - National Volunteer Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-12

    ... April 12, 2012 Part III The President Proclamation 8797--National Volunteer Week, 2012 Proclamation 8798--Pan American Day and Pan American Week, 2012 Proclamation 8799--National Former Prisoner of War... 8797 of April 9, 2012 National Volunteer Week, 2012 By the President of the United States of America...

  9. 76 FR 43107 - Captive Nations Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-19

    ... July 19, 2011 Part IV The President Proclamation 8692--Captive Nations Week, 2011 #0; #0; #0... Nations Week, 2011 By the President of the United States of America A Proclamation There are times in the... other achievements that have shaped our world. During Captive Nations Week, we remember the men...

  10. 77 FR 68045 - American Education Week, 2012

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    2012-11-15

    ... Documents#0;#0; ] Proclamation 8904 of November 9, 2012 American Education Week, 2012 By the President of... Nation's economic prosperity and civic life. This week, we reaffirm our national mission of educating our... will take you. During American Education Week, we recommit to keeping the promise of education...

  11. 78 FR 71431 - National Family Week, 2013

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    2013-11-27

    ... November 27, 2013 Part V The President Proclamation 9061--National Family Week, 2013 #0; #0; #0... National Family Week, 2013 By the President of the United States of America A Proclamation Whether united... guardian--families are the building blocks of American society. During National Family Week, we...

  12. 78 FR 69749 - American Education Week, 2013

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    2013-11-20

    ... November 20, 2013 Part II The President Proclamation 9058--American Education Week, 2013 #0; #0; #0... American Education Week, 2013 By the President of the United States of America A Proclamation Education is... Education Week, we reaffirm our commitment to the next generation, and we celebrate everyone who is...

  13. 78 FR 24321 - National Volunteer Week, 2013

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    2013-04-24

    ... Documents#0;#0; ] Proclamation 8960 of April 19, 2013 National Volunteer Week, 2013 By the President of the... accept certain obligations to one another. National Volunteer Week is a time to renew that fundamentally... one. During National Volunteer Week, let us tap into that spirit once more. To find a...

  14. 75 FR 71519 - National Family Week, 2010

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    2010-11-24

    ... Week, 2010 By the President of the United States of America A Proclamation Like generations before them... Family Week, we celebrate the resilient spirit of America's families and their role in building vibrant... loved ones safe here at home and abroad. This National Family Week, we recognize the importance of...

  15. 76 FR 22001 - National Park Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-20

    ... Documents#0;#0; ] Proclamation 8656 of April 15, 2011 National Park Week, 2011 By the President of the.... ``Healthy Parks, Healthy People,'' the focus for this year's National Park Week, highlights the role of... waived during National Park Week. All Americans can visit www.NPS.gov to find nearby parks where...

  16. 78 FR 24323 - National Park Week, 2013

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    2013-04-24

    ... Documents#0;#0; ] Proclamation 8961 of April 19, 2013 National Park Week, 2013 By the President of the... be passed on. During National Park Week, we celebrate the wonders entrusted to us by our forebears..., and they summon us to experience it firsthand. This week, the National Park Service will make...

  17. 77 FR 69733 - National Family Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... Week, 2012 By the President of the United States of America A Proclamation The bonds that tie us to our... strength of character in their children. This week, we celebrate the unity and compassion that keep our... opportunity for all who are working hard to get ahead. During National Family Week, let us recommit to...

  18. 78 FR 30729 - World Trade Week, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... Documents#0;#0; ] Proclamation 8983 of May 17, 2013 World Trade Week, 2013 By the President of the United... Week, we recognize workers, growers, and entrepreneurs nationwide who share that ambition, and we... United States, do hereby proclaim May 19 through May 25, 2013, as World Trade Week. I encourage...

  19. 76 FR 20215 - National Volunteer Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Week, 2011 By the President of the United States of America A Proclamation America's story has been... they see a need. During National Volunteer Week, we celebrate the profound impact of volunteers and... April 10 through April 16, 2011, as National Volunteer Week. I call upon all Americans to observe...

  20. 76 FR 29139 - World Trade Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-19

    ...#0;#0; ] Proclamation 8677 of May 13, 2011 World Trade Week, 2011 By the President of the United... interdependent. World Trade Week is a time to highlight the vital connection between the global economy and the... hereby proclaim May 15 through May 21, 2011, as World Trade Week. I encourage all Americans to...

  1. 75 FR 71005 - American Education Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... Education Week, 2010 By the President of the United States of America A Proclamation Education is essential to our success as both a people and a Nation. During American Education Week, we rededicate ourselves..., career, and life. This week, let us reaffirm the importance of education and recognize that we all...

  2. 75 FR 42279 - Captive Nations Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8541 of July 16, 2010 Captive Nations Week... and requested the President to issue a proclamation designating the third week of July of each year as ``Captive Nations Week.'' NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America,...

  3. 75 FR 28183 - World Trade Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ...#0;#0; ] Proclamation 8521 of May 12, 2010 World Trade Week, 2010 By the President of the United.... World Trade Week is an opportunity for us to reaffirm the importance of trade to our Nation's continued... been forged through decades of hard work, ingenuity, optimism, and common purpose. This week, let...

  4. 77 FR 24575 - National Park Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-25

    ... Documents#0;#0; #0; #0;Title 3-- #0;The President ] Proclamation 8801 of April 20, 2012 National Park Week... National Park Week, all 397 National Parks will offer free admission from April 21 through April 29, 2012... as our National Parks.'' This week, we honor the uniquely American idea behind them: that each of...

  5. 76 FR 71445 - American Education Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... November 17, 2011 Part II The President Proclamation 8753--American Education Week, 2011 #0; #0; #0... American Education Week, 2011 By the President of the United States of America A Proclamation Ensuring our... economic prosperity and our role as a thriving democracy. During American Education Week, we...

  6. 77 FR 42941 - Captive Nations Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... July 20, 2012 Part VI The President Proclamation 8841--Captive Nations Week, 2012 Memorandum of July 11... President ] Proclamation 8841 of July 16, 2012 Captive Nations Week, 2012 By the President of the United... Week amidst an escalating Cold War, he affirmed that ``the citizens of the United States are linked...

  7. 2-weekly docetaxel: issues for clinical practice

    PubMed Central

    Massari, F; Maines, F; Bria, E; Galligioni, E; Caffo, O; Tortora, G

    2015-01-01

    In the phase III trial comparing 2 docetaxel schedules (3-weekly versus 2-weekly) as first-line chemotherapy for CRPC, recently published in The Lancet Oncology, fewer serious adverse events, particularly hematologic toxicities, and longer times on treatment, in favor of the 2-weekly regimen are reported.1,2,3 PMID:25456569

  8. Advanced tubal pregnancy at 30 weeks.

    PubMed

    Koçak, Idris; Dagdemir, Aynur; Yilmaz, Mustafa Sadi; Ustün, Cazip

    2005-08-01

    A case of advanced tubal pregnancy at 30 weeks is described. The placenta was implanted on the salpinx. Most tubal pregnancies become symptomatic within the first 12 weeks. A small number of tubal pregnancies have progressed beyond this. We present this unusual case of a 30-week tubal pregnancy situated in the proximal half of the tube that created a diagnostic dilemma.

  9. Physicians' refusal to resuscitate at borderline gestational age.

    PubMed

    Mercurio, Mark R

    2005-11-01

    Most neonatologists believe there is a minimal gestational age, below which it is appropriate to refuse to provide resuscitation or intensive care. Determination of this threshold should involve knowledge of the outcome data, but also an understanding of the potential for misuse of these data. In particular, there is a risk of deception, of the parents and of ourselves, due to the uncertainty of the true gestational age, and the "self-fulfilling prophecy" that may occur when a center refuses to try below a certain gestational age because they have had no survivors below that age. Finally, any refusal to treat requires ethical justification. Concepts such as futility and patient's best interest should play a role in the determination of the gestational age threshold, applied in light of the data's inherent weaknesses.

  10. Consideration of the gestational carrier: a committee opinion.

    PubMed

    2013-06-01

    Gestational carriers have a right to be fully informed of the risks of the surrogacy process and of pregnancy, should receive psychological evaluation and counseling, and should have independent legal counsel.

  11. Gestational Diabetes a Risk Factor for Postpartum Depression

    MedlinePlus

    ... html Gestational Diabetes a Risk Factor for Postpartum Depression: Study It found chances increased even more if woman had suffered an earlier bout of depression To use the sharing features on this page, ...

  12. Trends in gestational age and birth weight in Chile, 1991–2008. A descriptive epidemiological study

    PubMed Central

    2012-01-01

    Background Gestational age and birth weight are the principal determinants of newborn’s health status. Chile, a middle income country traditionally has public policies that promote maternal and child health. The availability of an exhaustive database of live births has allows us to monitor over time indicators of newborns health. Methods This descriptive epidemiological study included all live births in Chile, both singleton and multiple, from 1991 through 2008. Trends in gestational age affected the rate of prevalence (%) of preterm births (<37 weeks, including the categories < 32 and 32–36 weeks), term births (37–41) and postterm births (42 weeks or more). Trends in birth weight affected the prevalence of births < 1500 g, 1500–2499 g, 2500–3999 g, and 4000 g or more. Results Data from an exhaustive register of live births showed that the number of term and postterm births decreased and the number of multiple births increased significantly. Birth weights exceeding 4000 g did not vary. Total preterm births rose from 5.0% to 6.6%, with increases of 28% for the singletons and 31% for multiple births (p for trend < 0.0001). Some categories increased even more: specifically preterm birth < 32 weeks increased 32.3% for singletons and 50.6% for multiple births (p for trend 0.0001). The overall rate of low birth weight infants (<2500 g) increased from 4.6% to 5.3%. This variation was not statistically significant for singletons (p for trend = 0.06), but specific analyses exhibited an important increase in the category weighing <1500 g (42%) similar to that observed in multiple births (43%). Conclusions The gestational age and birth weight of live born child have significantly changed over the past two decades in Chile. Monitoring only overall rates of preterm births and low-birth-weight could provide restricted information of this important problem to public health. Monitoring them by specific categories provides a solid

  13. Gestational urinary bisphenol A and maternal and newborn thyroid hormone concentrations: The HOME Study

    SciTech Connect

    Romano, Megan E.; Webster, Glenys M.; Vuong, Ann M.; Thomas Zoeller, R.; Chen, Aimin; Hoofnagle, Andrew N.; Calafat, Antonia M.; Karagas, Margaret R.; Yolton, Kimberly; Lanphear, Bruce P.; Braun, Joseph M.

    2015-04-15

    Bisphenol A (BPA), an endocrine disruptor used in consumer products, may perturb thyroid function. Prenatal BPA exposure may have sex-specific effects on thyroid hormones (THs). Our objectives were to investigate whether maternal urinary BPA concentrations during pregnancy were associated with THs in maternal or cord serum, and whether these associations differed by newborn sex or maternal iodine status. We measured urinary BPA concentrations at 16 and 26 weeks gestation among pregnant women in the HOME Study (2003–2006, Cincinnati, Ohio). Thyroid stimulating hormone (TSH) and free and total thyroxine (T{sub 4}) and triiodothyronine (T{sub 3}) were measured in maternal serum at 16 weeks (n=181) and cord serum at delivery (n=249). Associations between BPA concentrations and maternal or cord serum TH levels were estimated by multivariable linear regression. Mean maternal urinary BPA was not associated with cord THs in all newborns, but a 10-fold increase in mean BPA was associated with lower cord TSH in girls (percent change=−36.0%; 95% confidence interval (CI): −58.4, −1.7%), but not boys (7.8%; 95% CI: −28.5, 62.7%; p-for-effect modification=0.09). We observed no significant associations between 16-week BPA and THs in maternal or cord serum, but 26-week maternal BPA was inversely associated with TSH in girls (−42.9%; 95% CI: −59.9, −18.5%), but not boys (7.6%; 95% CI: −17.3, 40.2%; p-for-effect modification=0.005) at birth. The inverse BPA–TSH relation among girls was stronger, but less precise, among iodine deficient versus sufficient mothers. Prenatal BPA exposure may reduce TSH among newborn girls, particularly when exposure occurs later in gestation. - Highlights: • Examined associations of BPA with thyroid hormones in pregnant women and newborns. • Assessed effect modification of BPA–thyroid hormone associations by newborn sex. • Greater BPA related to decreased thyroid stimulating hormone in girls' cord serum. • Results may

  14. Anembryonic Gestation in Wild South American Sea Lion, Otaria flavescens.

    PubMed

    Grandi, M F; Crespo, E A; Dans, S L

    2016-10-01

    We present the first record and description of an anembryonic gestation in a wild South America sea lion, Otaria flavescens (Carnivora, Pinniped). This is the first report of an anembryonic gestation in a wild marine mammal species. This description furthers the knowledge of general aspects of the reproduction of an otariid species, which presents the particularities of delayed implantation and polygynic breeding system, and adds information on a reproductive abnormality in marine mammals.

  15. Is Doppler ultrasound useful for evaluating gestational trophoblastic disease?

    PubMed Central

    Lin, Lawrence H; Bernardes, Lisandra S; Hase, Eliane A; Fushida, Koji; Francisco, Rossana P V

    2015-01-01

    Doppler ultrasound is a non-invasive method for evaluating vascularization and is widely used in clinical practice. Gestational trophoblastic neoplasia includes a group of highly vascularized malignancies derived from placental cells. This review summarizes data found in the literature regarding the applications of Doppler ultrasound in managing patients with gestational trophoblastic neoplasia. The PubMed/Medline, Web of Science, Cochrane and LILACS databases were searched for articles published in English until 2014 using the following keywords: “Gestational trophoblastic disease AND Ultrasonography, Doppler.” Twenty-eight articles met the inclusion criteria and were separated into the 4 following groups according to the aim of the study. 1 Doppler ultrasound does not seem to be capable of differentiating partial from complete moles, but it might be useful when evaluating pregnancies in which a complete mole coexists with a normal fetus. 2 There is controversy in the role of uterine artery Doppler velocimetry in the prediction of development of gestational trophoblastic neoplasia. 3 Doppler ultrasound is a useful tool in the diagnosis of gestational trophoblastic neoplasia because abnormal myometrial vascularization and lower uterine artery Doppler indices seem to be correlated with invasive disease. 4 Lower uterine artery Doppler indices in the diagnosis of gestational trophoblastic neoplasia are associated with methotrexate resistance and might play a role in prognosis. CONCLUSION: Several studies support the importance of Doppler ultrasound in the management of patients with gestational trophoblastic neoplasia, particularly the role of Doppler velocimetry in the prediction of trophoblastic neoplasia and the chemoresistance of trophoblastic tumors. Doppler findings should be used as ancillary tools, along with human chorionic gonadotropin assessment, in the diagnosis of gestational trophoblastic neoplasia. PMID:26735221

  16. Duration of gestation in pregnant dogs carrying cloned fetuses.

    PubMed

    Kim, Min Jung; Oh, Hyun Ju; Park, Jung Eun; Kim, Geon A; Park, Eun Jung; Jo, Young Kwang; Lee, Byeong Chun

    2013-01-15

    The aim of this study was to investigate gestation duration and the physiologic characteristics of pregnant dogs bearing cloned fetuses, especially in the prepartum period. A retrospective study was performed to compare gestation duration in females pregnant with cloned (somatic cell nuclear transfer) fetuses (cloned group) with those bearing noncloned fetuses (control group), and effects of litter size, birth weight, and breed of somatic cell donors on gestation duration in the cloned group were evaluated. Clinical delivery onset signs associated with serum progesterone concentration and rectal temperature were also compared in both groups. The gestation duration calculated from day of ovulation was significantly longer in the cloned (62.8 ± 0.3 days) versus the control group (60.9 ± 0.5 days; P < 0.001). There was a negative correlation between litter size and gestation duration including both groups (r = -0.59; P < 0.01), but there were no differences between birth weights or breed of cell donors and gestation duration in the cloned group. Even though the basal rectal temperature in the prepartum period was not different between control and cloned groups (36.9 ± 0.1 °C and 37.2 ± 0.1 °C, respectively), serum progesterone concentration on delivery day was significantly higher in the cloned group (2.2 ± 0.4 ng/ml) compared with the control group (0.5 ± 0.1 ng/ml; P < 0.05). The longer gestation duration of pregnant dogs bearing cloned fetuses might be because of the smaller litter size in this group. Also, the weaker drop in serum progesterone levels in the prepartum period in cloned dog pregnancies indicates that the parturition signaling process might be altered resulting in longer gestation periods.

  17. Is incidental gestational thrombocytopaenia really always safe for the neonate?

    PubMed

    Pourrat, O; Valère, G; Pierre, F

    2014-08-01

    It is widely admitted that neonates' platelet counts (PCs) are always normal in babies born to mothers with incidental gestational thrombocytopaenia. However, results of PC determinations at delivery have led us to wonder whether incidental gestational thrombocytopaenia is actually safe for the neonate under all circumstances, and to recommend that for every baby born to a mother with a pregnancy-associated thrombocytopaenia, even in the case of confirmed IGT, platelet counts on umbilical cord blood be closely monitored.

  18. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial – study protocol

    PubMed Central

    2013-01-01

    Background Gestational diabetes mellitus (GDM) is an increasing problem world-wide. Lifestyle interventions and/or vitamin D supplementation might help prevent GDM in some women. Methods/design Pregnant women at risk of GDM (BMI≥29 (kg/m2)) from 9 European countries will be invited to participate and consent obtained before 19+6 weeks of gestation. After giving informed consent, women without GDM will be included (based on IADPSG criteria: fasting glucose<5.1mmol; 1 hour glucose <10.0 mmol; 2 hour glucose <8.5 mmol) and randomized to one of the 8 intervention arms using a 2×(2×2) factorial design: (1) healthy eating (HE), 2) physical activity (PA), 3) HE+PA, 4) control, 5) HE+PA+vitamin D, 6) HE+PA+placebo, 7) vitamin D alone, 8) placebo alone), pre-stratified for each site. In total, 880 women will be included with 110 women allocated to each arm. Between entry and 35 weeks of gestation, women allocated to a lifestyle intervention will receive 5 face-to-face, and 4 telephone coaching sessions, based on the principles of motivational interviewing. The lifestyle intervention includes a discussion about the risks of GDM, a weight gain target <5kg and either 7 healthy eating ‘messages’ and/or 5 physical activity ‘messages’ depending on randomization. Fidelity is monitored by the use of a personal digital assistance (PDA) system. Participants randomized to the vitamin D intervention receive either 1600 IU vitamin D or placebo for daily intake until delivery. Data is collected at baseline measurement, at 24–28 weeks, 35–37 weeks of gestation and after delivery. Primary outcome measures are gestational weight gain, fasting glucose and insulin sensitivity, with a range of obstetric secondary outcome measures including birth weight. Discussion DALI is a unique Europe-wide randomised controlled trial, which will gain insight into preventive measures against the development of GDM in overweight and obese women. Trial registration ISRCTN70595832 PMID:23829946

  19. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    PubMed Central

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  20. Histopathological placental lesions in mild gestational hyperglycemic and diabetic women

    PubMed Central

    2011-01-01

    Objective To investigate and compare the incidence of histopathological placental lesions in mild gestational hyperglycemia, gestational diabetes and overt diabetes at term and preterm gestation. Research design and methods One-hundred-and-thirty-one placental samples were collected from Diabetes mellitus (DM) positive screened patients. Two diagnostic tests, glycemic profile and 100 g oral glucose tolerance test (OGTT) in parallel identified 4 groups normoglycemic, mild gestational hyperglycemia (MGH), gestational DM (GDM) or overt DM (DM). Placental tissue specimens and sections from 4 groups were obtained by uniform random sampling and stained with hematoxylin-eosin. Results Placentas from MGH group presented 17 types of histopathological change and higher rates of syncytial nodes and endarteritis. GDM placentas presented only nine types of histopathological change, high rates of dysmaturity, low rates of calcification and no syncytial nodes. Overt DM placentas showed 22 types of histopathological change, 21 of which were present in the preterm period. There were histopathological similarities between MGH and DM placentas, but the former exhibited a higher incidence of endarteritis, which has been described as a "post-mortem" phenomenon. Conclusion Our results confirmed that the distinct placental changes associated with DM and MGH depend on gestational period during which the diabetic insult occurs. It may reasonably be inferred that subclinical maternal hyperglycemia during pregnancy, as showed in MGH group, is responsible for increased placental endarteritis, a postmortem lesion in the live fetus. PMID:21831283

  1. Seasonal effects on gestation length and birth weight in alpacas.

    PubMed

    Davis, G H; Dodds, K G; Moore, G H; Bruce, G D

    1997-04-01

    Gestation lengths and birth weights were measured in 162 pregnancies in alpacas (Lama pacos) farmed in the high country of the South Island of New Zealand. A comparison of pregnancies from spring (mid-October to mid-December) and autumn (mid-February to late April) matings showed that gestation lengths were 12.5 days longer in spring (348.9 +/- 1.4 days vs. 336.4 +/- 1.2 days; P < 0.0001). For each day later in spring that a female was mated there was an increase in gestation length of 0.11 days (P < 0.05), whereas for each day later in autumn the gestation was reduced by 0.24 days. There were no significant effects of sex of cria or age of dam on gestation length. After adjustment for gestation length, crias born in autumn weighed 1.0 kg more than those born in spring (8.8 +/- 0.15 kg vs. 7.8 +/- 0.18 kg: P < 0.001). Female crias weighed 0.4 kg less than males at birth (P < 0.05). The results suggest that in this environment it will be difficult to maintain spring-mated females in a 12 month breeding cycle.

  2. Perinatal and Neonatal Outcomes of Triplet Gestations Based on Chorionicity

    PubMed Central

    Downing, Maureen; Sulo, Suela; Parilla, Barbara V.

    2017-01-01

    Objective To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations. Methods A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC, n = 26; DC + MC, n = 16). Maternal demographics and pregnancy data were compared. Neonatal outcomes were assessed using composite morbidity and mortality. Results Maternal baseline characteristics including age, mode of conception, race, parity, body mass index, and previous preterm delivery were statistically comparable. Comparison of prenatal management and complications yielded no significant differences in terms of presence of shortened cervix, cerclage placement, use of tocolytics, intrauterine growth restriction, premature rupture of membranes, pregnancy-induced hypertension, or gestational diabetes. However, evaluation of composite morbidity and mortality (RDS, IVH, NEC, IUGR, and death) illustrated that all infants born from DC + MC triplet gestations suffered some morbidity or mortality compared with TC pregnancies (p < 0.01). Conclusion DC + MC triplet gestations are at an increased risk of neonatal morbidity and mortality compared with TC triplet gestations. PMID:28367358

  3. The Bertarelli Foundation's actions in the field of multiple gestations.

    PubMed

    Germond, Marc

    2007-01-01

    The Bertarelli Foundation aims to promote understanding of infertility. Two international conferences in 1999 and 2002 have highlighted the importance of multiple gestations, which have been recognized as a major problem associated with assisted reproductive technologies and ovulation induction therapies. For this reason, the Bertarelli Foundation has, since 2002, decided to focus its efforts on multiple gestations: the final aim of this programme is to make the medical population more aware of this public health problem, its psychosocial implications, and the high costs of any attitude that leads to an unacceptably high rate of multiple gestations. Conclusions and consensus statements have been widely published from the first expert meeting 2003 and used as the basis for the following actions: (i) organization of national conferences and consensus meetings with the aim of establishing gold standards in managing the ongoing epidemic of multiple gestations; (ii) funding research projects focused on different aspects of multiple gestations; (iii) supporting the European Society of Human Reproduction and Embryology's multiple gestations working group's (European IVF Monitoring) registry; and (iv) promoting understanding of the human face of infertility by promoting publications, development of websites, exhibitions in the field of infertility.

  4. Postnatal Foot Length to Determine Gestational Age: A Pilot Study.

    PubMed

    Wyk, Lizelle Van; Smith, Johan

    2016-04-01

    Gestational age is a critical factor in the management, decision-making, prognostication and follow-up of newborn infants. It is also essential for research and epidemiology. In the absence of an early assessment of fetal gestation by abdominal ultrasound, many neonatal units in developing countries determine gestational age by neonatal scores and last menstrual period-both of which are highly inaccurate. The aim of this pilot study was to determine whether postnatal foot length measurement could accurately determine gestational age in a specified South African hospitalized neonatal population. Foot length was measured with a plastic Verniere's caliper. Foot length was shown to correlate well with gestational age (r = 0.919,p < 0.001). Intra-observer and inter-observer variability of foot length measurements was low. Foot length can therefore be used with high accuracy to determine the gestational age in a population where there is poor access to or utilization of antenatal sonar.

  5. Gestational changes in iodine status in a cohort study of pregnant women from the United Kingdom: season as an effect modifier123

    PubMed Central

    Bath, Sarah C; Furmidge-Owen, Victoria L; Redman, Christopher WG

    2015-01-01

    Background: Iodine is required throughout pregnancy for thyroid hormone production, which is essential for fetal brain development. Studies of iodine status in pregnant women from the United Kingdom (UK) have focused on early gestation (<16 wk). Data on the effect of advancing gestation on urinary iodine excretion are conflicting, with suggestions of both an increase and a decrease. Objectives: The aims were to evaluate iodine status in a cohort of UK pregnant women and to explore how it changes throughout gestation. Design: We used samples and data from 230 UK pregnant women who were recruited to the Selenium in PRegnancy INTervention study. Iodine concentration was measured in spot-urine samples that were collected at ∼12, 20, and 35 wk of gestation; creatinine concentration was also measured to correct for urine dilution. A linear mixed model was used to explore the effect of gestational week on iodine-to-creatinine ratio, with change in season, body mass index, daily milk intake, and maternal age controlled for. Results: The median urinary iodine concentration from urine samples collected at all time points (n = 662) was 56.8 μg/L, and the iodine-to-creatinine ratio was 116 μg/g, thus classifying this cohort as mildly-to-moderately iodine deficient. The median iodine-to-creatinine ratios at 12, 20, and 35 wk were 102.5, 120.0, and 126.0 μg/g, respectively. Only 3% of women were taking iodine-containing prenatal supplements. The iodine-to-creatinine ratio increased with advancing gestation, and there was a significant interaction between gestational week and season (P = 0.026). For a 1-wk increase in gestation, the iodine-to-creatinine ratio increased by a factor of 1.05 (95% CI: 1.02, 1.08) in winter and by a factor of 1.04 (95% CI: 1.00, 1.08) in summer. Conclusions: This group of UK pregnant women was mildly-to-moderately iodine deficient at all trimesters, which is of public health concern. The finding that the iodine-to-creatinine ratio increased over

  6. A Gestational Profile of Placental Exosomes in Maternal Plasma and Their Effects on Endothelial Cell Migration

    PubMed Central

    Salomon, Carlos; Torres, Maria Jose; Kobayashi, Miharu; Scholz-Romero, Katherin; Sobrevia, Luis; Dobierzewska, Aneta; Illanes, Sebastian E.; Mitchell, Murray D.; Rice, Gregory E.

    2014-01-01

    Studies completed to date provide persuasive evidence that placental cell-derived exosomes play a significant role in intercellular communication pathways that potentially contribute to placentation and development of materno-fetal vascular circulation. The aim of this study was to establish the gestational-age release profile and bioactivity of placental cell-derived exosome in maternal plasma. Plasma samples (n = 20 per pregnant group) were obtained from non-pregnant and pregnant women in the first (FT, 6–12 weeks), second (ST, 22–24 weeks) and third (TT, 32–38 weeks) trimester. The number of exosomes and placental exosome contribution were determined by quantifying immunoreactive exosomal CD63 and placenta-specific marker (PLAP), respectively. The effect of exosomes isolated from FT, ST and TT on endothelial cell migration were established using a real-time, live-cell imaging system (Incucyte). Exosome plasma concentration was more than 50-fold greater in pregnant women than in non-pregnant women (p<0.001). During normal healthy pregnancy, the number of exosomes present in maternal plasma increased significantly with gestational age by more that two-fold (p<0.001). Exosomes isolated from FT, ST and TT increased endothelial cell migration by 1.9±0.1, 1.6±0.2 and 1.3±0.1-fold, respectively compared to the control. Pregnancy is associated with a dramatic increase in the number of exosomes present in plasma and maternal plasma exosomes are bioactive. While the role of placental cell-derived exosome in regulating maternal and/or fetal vascular responses remains to be elucidated, changes in exosome profile may be of clinical utility in the diagnosis of placental dysfunction. PMID:24905832

  7. A gestational profile of placental exosomes in maternal plasma and their effects on endothelial cell migration.

    PubMed

    Salomon, Carlos; Torres, Maria Jose; Kobayashi, Miharu; Scholz-Romero, Katherin; Sobrevia, Luis; Dobierzewska, Aneta; Illanes, Sebastian E; Mitchell, Murray D; Rice, Gregory E

    2014-01-01

    Studies completed to date provide persuasive evidence that placental cell-derived exosomes play a significant role in intercellular communication pathways that potentially contribute to placentation and development of materno-fetal vascular circulation. The aim of this study was to establish the gestational-age release profile and bioactivity of placental cell-derived exosome in maternal plasma. Plasma samples (n = 20 per pregnant group) were obtained from non-pregnant and pregnant women in the first (FT, 6-12 weeks), second (ST, 22-24 weeks) and third (TT, 32-38 weeks) trimester. The number of exosomes and placental exosome contribution were determined by quantifying immunoreactive exosomal CD63 and placenta-specific marker (PLAP), respectively. The effect of exosomes isolated from FT, ST and TT on endothelial cell migration were established using a real-time, live-cell imaging system (Incucyte). Exosome plasma concentration was more than 50-fold greater in pregnant women than in non-pregnant women (p<0.001). During normal healthy pregnancy, the number of exosomes present in maternal plasma increased significantly with gestational age by more that two-fold (p<0.001). Exosomes isolated from FT, ST and TT increased endothelial cell migration by 1.9±0.1, 1.6±0.2 and 1.3±0.1-fold, respectively compared to the control. Pregnancy is associated with a dramatic increase in the number of exosomes present in plasma and maternal plasma exosomes are bioactive. While the role of placental cell-derived exosome in regulating maternal and/or fetal vascular responses remains to be elucidated, changes in exosome profile may be of clinical utility in the diagnosis of placental dysfunction.

  8. Maternal folic acid supplementation modulates DNA methylation and gene expression in the rat offspring in a gestation period-dependent and organ-specific manner.

    PubMed

    Ly, Anna; Ishiguro, Lisa; Kim, Denise; Im, David; Kim, Sung-Eun; Sohn, Kyoung-Jin; Croxford, Ruth; Kim, Young-In

    2016-07-01

    Maternal folic acid supplementation can alter DNA methylation and gene expression in the developing fetus, which may confer disease susceptibility later in life. We determined which gestation period and organ were most sensitive to the modifying effect of folic acid supplementation during pregnancy on DNA methylation and gene expression in the offspring. Pregnant rats were randomized to a control diet throughout pregnancy; folic acid supplementation at 2.5× the control during the 1st, 2nd or 3rd week of gestation only; or folic acid supplementation throughout pregnancy. The brain, liver, kidney and colon from newborn pups were analyzed for folate concentrations, global DNA methylation and gene expression of the Igf2, Er-α, Gr, Ppar-α and Ppar-γ genes. Folic acid supplementation during the 2nd or 3rd week gestation or throughout pregnancy significantly increased brain folate concentrations (P<.001), while only folic acid supplementation throughout pregnancy significantly increased liver folate concentrations (P=.005), in newborn pups. Brain global DNA methylation incrementally decreased from early to late gestational folic acid supplementation and was the lowest with folic acid supplementation throughout pregnancy (P=.026). Folic acid supplementation in late gestation or throughout pregnancy significantly decreased Er-α, Gr and Ppar-α gene expression in the liver (P<.05). The kidney and colon were resistant to the effect of folic acid supplementation. Maternal folic acid supplementation affects tissue folate concentrations, DNA methylation and gene expression in the offspring in a gestation-period-dependent and organ-specific manner.

  9. Experimental ovine toxoplasmosis: influence of the gestational stage on the clinical course, lesion development and parasite distribution.

    PubMed

    Castaño, Pablo; Fuertes, Miguel; Regidor-Cerrillo, Javier; Ferre, Ignacio; Fernández, Miguel; Ferreras, M Carmen; Moreno-Gonzalo, Javier; González-Lanza, Camino; Pereira-Bueno, Juana; Katzer, Frank; Ortega-Mora, Luis Miguel; Pérez, Valentín; Benavides, Julio

    2016-03-16

    The relation between gestational age and foetal death risk in ovine toxoplasmosis is already known, but the mechanisms involved are not yet clear. In order to study how the stage of gestation influences these mechanisms, pregnant sheep of the same age and genetic background were orally dosed with 50 oocysts of Toxoplasma gondii (M4 isolate) at days 40 (G1), 90 (G2) and 120 (G3) of gestation. In each group, four animals were culled on the second, third and fourth week post infection (pi) in order to evaluate parasite load and distribution, and lesions in target organs. Ewes from G1 showed a longer period of hyperthermia than the other groups. Abortions occurred in all groups. While in G2 they were more frequent during the acute phase of the disease, in G3 they mainly occurred after day 20 pi. After challenge, parasite and lesions in the placentas and foetuses were detected from day 19 pi in G3 while in G2 or G1 they were only detected at day 26 pi. However, after initial detection at day 19 pi, parasite burden, measured through RT-PCR, in placenta or foetus of G3 did not increase significantly and, at in the third week pi it was lower than that measured in foetal liver or placenta from G1 to G3 respectively. These results show that the period of gestation clearly influences the parasite multiplication and development of lesions in the placenta and foetus and, as a consequence, the clinical course in ovine toxoplasmosis.

  10. Association of in utero organophosphate pesticide exposure and fetal growth and length of gestation in an agricultural population.

    PubMed

    Eskenazi, Brenda; Harley, Kim; Bradman, Asa; Weltzien, Erin; Jewell, Nicholas P; Barr, Dana B; Furlong, Clement E; Holland, Nina T

    2004-07-01

    Although pesticide use is widespread, little is known about potential adverse health effects of in utero exposure. We investigated the effects of organophosphate pesticide exposure during pregnancy on fetal growth and gestational duration in a cohort of low-income, Latina women living in an agricultural community in the Salinas Valley, California. We measured nonspecific metabolites of organophosphate pesticides (dimethyl and diethyl phosphates) and metabolites specific to malathion (malathion dicarboxylic acid), chlorpyrifos [O,O-diethyl O-(3,5,6-trichloro-2-pyridinyl) phosphoro-thioate], and parathion (4-nitrophenol) in maternal urine collected twice during pregnancy. We also measured levels of cholinesterase in whole blood and butyryl cholinesterase in plasma in maternal and umbilical cord blood. We failed to demonstrate an adverse relationship between fetal growth and any measure of in utero organophosphate pesticide exposure. In fact, we found increases in body length and head circumference associated with some exposure measures. However, we did find decreases in gestational duration associated with two measures of in utero pesticide exposure: urinary dimethyl phosphate metabolites [beta(adjusted) = -0.41 weeks per log10 unit increase; 95% confidence interval (CI), -0.75 -- -0.02; p = 0.02], which reflect exposure to dimethyl organophosphate compounds such as malathion, and umbilical cord cholinesterase (beta(adjusted) = 0.34 weeks per unit increase; 95% CI, 0.13-0.55; p = 0.001). Shortened gestational duration was most clearly related to increasing exposure levels in the latter part of pregnancy. These associations with gestational age may be biologically plausible given that organophosphate pesticides depress cholinesterase and acetylcholine stimulates contraction of the uterus. However, despite these observed associations, the rate of preterm delivery in this population (6.4%) was lower than in a U.S. reference population.

  11. Acute brief heat stress in late gestation alters neonatal calf innate immune functions.

    PubMed

    Strong, R A; Silva, E B; Cheng, H W; Eicher, S D

    2015-11-01

    Heat stress, as one of the environmental stressors affecting the dairy industry, compromises the cow milk production, immune function, and reproductive system. However, few studies have looked at how prenatal heat stress (HS) affects the offspring. The objective of this study was to evaluate the effect of HS during late gestation on calf immunity. Calves were born to cows exposed to evaporative cooling (CT) or HS (cyclic 23-35°C) for 1 wk at 3 wk before calving. Both bull and heifer calves (CT, n=10; HS, n=10) were housed in similar environmental temperatures after birth. Both CT and HS calves received 3.78 L of pooled colostrum within 12 h after birth and were fed the same diet throughout the study. In addition to tumor necrosis factor α, IL-1β, IL-1 receptor antagonist (IL-1RA), and toll-like receptor (TLR)2, and TLR4 mRNA expression, the expression of CD14(+) and CD18(+) cells, and DEC205(+) dendritic cells were determined in whole blood samples at d 0, 3, 7, 14, 21, and 28. The neutrophil to lymphocyte ratio, differential cell counts, and the hematocrit were also determined. During late gestation, the HS cows had greater respiration rates, rectal temperatures, and tended to spend more time standing compared with the CT cows. The HS calves had less expression of tumor necrosis factor-α and TLR2 and greater levels of IL-1β, IL-1RA, and TLR4 compared with CT calves. The HS calves also had a greater percentage of CD18(+) cells compared with the CT calves. Additionally, a greater percentage of neutrophils and lesser percentage of lymphocytes were in the HS calves compared with the CT calves. The results indicate that biomarkers of calves' immunity are affected in the first several weeks after birth by HS in the dam during late gestation.

  12. Gestation length in red deer: genetically determined or environmentally controlled?

    PubMed

    Asher, G W

    2007-01-01

    The red deer (Cervus elaphus) of European origin (e.g. subspecies scoticus, hispanicus, hippelaphus) is a medium sized (100-150kg mature hind weight) ruminant that exhibits highly seasonally patterns of autumn conceptions and summer births. Historic data indicate average (+/- s.d.) gestation length of 233-234 (+/- 2-4) days. Recently, however, there has been growing awareness that there is considerably greater variation in gestation length than earlier indicated and that there is a significant element of environmental, and possibly even social, control over the duration of pregnancy in this species. Imposition of variable levels of nutrition over late pregnancy of red deer hinds has been observed to influence fetal growth trajectory and gestation length, with no apparent effect on birth weight. This supports a hypothesis that under conditions of modest feed imbalance, variation in gestation length compensates for variation in fetal growth trajectory to ensure optimisation of birth weight. More recent studies on primiparous (24 month old) red deer hinds have identified surprisingly large variation in gestation length (193-263 days) compared with adult hinds (228-243 days), with earlier conceiving individuals within the primiparous cohort expressing significantly longer gestation than the later conceiving hinds, resulting in a higher level of calving synchrony than expected from known conception dates. This introduces an intriguing hypothesis of social indicative effects on parturition timing to promote within-cohort birth synchrony. Collectively, these data debunk the commonly held notion that gestation length of red deer is genetically fixed within strict limits. A review of the literature points to this as possibly a common phenomenon across a range of non-domesticated ruminant species but this conclusion is not supported by numerous conflicting studies on domestic sheep and cattle.

  13. The risk of prematurity and small-for-gestational-age birth in Mexico City: the effects of working conditions and antenatal leave.

    PubMed Central

    Cerón-Mireles, P; Harlow, S D; Sánchez-Carrillo, C I

    1996-01-01

    OBJECTIVES: This study examined the effect of working conditions, occupational stress, and antenatal leave on risk of small-for-gestational age and premature births in Mexico City. METHODS: Over a 3-month period, 2663 (96.2%) of 2767 women who gave birth at three major hospitals and worked at least 3 months during pregnancy were interviewed shortly after delivery. After the exclusion of multiple gestations and birth defects, 261 (10.0%) small-for-gestational-age and 288 (11.0%) preterm births were identified. RESULTS: For small-for-gestational-age births, working more than 50 hours a week (odds ratio [OR] = 1.59), standing more than 7 hours a day (OR = 1.40), and no antenatal leave (OR = 1.55) were associated with an increased risk. Women with no antenatal leave were also much more likely to give birth prematurely (OR = 3.04). CONCLUSIONS: In this study, arduous working conditions and lack of antenatal leave benefits were found to increase the risk of poor birth outcome in Mexican women. Enforcement of existing antenatal leave laws and provision of comparable benefits for the uninsured may reduce the incidence of small-for-gestational-age births and prematurity. PMID:8659657

  14. Maternal caffeine intake during pregnancy is associated with birth weight but not with gestational length: results from a large prospective observational cohort study

    PubMed Central

    2013-01-01

    Background Pregnant women consume caffeine daily. The aim of this study was to examine the association between maternal caffeine intake from different sources and (a) gestational length, particularly the risk for spontaneous preterm delivery (PTD), and (b) birth weight (BW) and the baby being small for gestational age (SGA). Methods This study is based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. A total of 59,123 women with uncomplicated pregnancies giving birth to a live singleton were identified. Caffeine intake from different sources was self-reported at gestational weeks 17, 22 and 30. Spontaneous PTD was defined as spontaneous onset of delivery between 22+0 and 36+6 weeks (n = 1,451). As there is no consensus, SGA was defined according to ultrasound-based (Marsal, n = 856), population-based (Skjaerven, n = 4,503) and customized (Gardosi, n = 4,733) growth curves. Results The main caffeine source was coffee, but tea and chocolate w