RESUMO
OBJECTIVE: A successful assisted reproductive technique (ART) cycle is not flawless, and several studies have reported high incidences of maternal complications, but the association is inconclusive. In addition, the racial and ethnic effects of the Asian population undergoing ART on maternal outcomes is not well studied. This study attempts to compare various maternal outcome parameters ART and spontaneously conceived singleton pregnancies from a single high volume tertiary care centre. METHODS: A retrospective cohort study from a single tertiary infertility center was conducted from January 2011 to September 2020. The study included 1125 IVF conceived singletons (AP group) and 7193 spontaneous conceived singletons (SP group). The groups were compared using the Pearson Chi-square test and the adjusted odds ratio calculated using multivariate analysis. RESULTS: Maternal outcomes like gestational hypertension, pre-eclampsia, gestational diabetes (GDM), oligohydramnios, chorioamnionitis, operative, and instrumental delivery were significantly different in the two groups (p<0.05). The AP group had a significantly increased risk of GDM (aOR 1.093; 95% CI 1.076-1.110) and pregnancy-induced hypertension (PIH) (aOR 1.577; 95% CI 1.288-1.930) as compared to the SP group. IVF significantly increases the risk of abruption by 2 times (p=0.028), and independently increases the risk of caesarean section by 3.1-fold (p<0.001). But overall the IVF is the protective factor for oligohydramnios (p=0.024). CONCLUSIONS: ART increases the likelihood of pregnancy-related maternal complications, such as PIH, GDM, abruption, chorioamnionitis, and an increased rate of caesarean delivery. Thus, all patients undergoing ART procedures should receive pre-conceptional counselling regarding the associated obstetric risks and consider ART pregnancy as a high-risk pregnancy.
Assuntos
Corioamnionite , Diabetes Gestacional , Oligo-Hidrâmnio , Complicações na Gravidez , Gravidez , Humanos , Feminino , Resultado da Gravidez/epidemiologia , Estudos de Coortes , Cesárea/efeitos adversos , Estudos Retrospectivos , Oligo-Hidrâmnio/etiologia , Corioamnionite/etiologia , Fertilização in vitro/efeitos adversos , Fertilização in vitro/métodos , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etiologia , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/etiologiaAssuntos
Humanos , Feminino , Gravidez , Oligo-Hidrâmnio/etiologia , Oligo-Hidrâmnio/tratamento farmacológico , Oligo-Hidrâmnio/diagnóstico por imagem , Poli-Hidrâmnios/etiologia , Poli-Hidrâmnios/tratamento farmacológico , Poli-Hidrâmnios/diagnóstico por imagem , Líquido Amniótico/diagnóstico por imagem , Drenagem , Ultrassonografia/métodosRESUMO
Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia.
Assuntos
Eclampsia , Pré-Eclâmpsia , Resultado da Gravidez , Adulto , Cesárea/estatística & dados numéricos , Equador/epidemiologia , Feminino , Sofrimento Fetal/epidemiologia , Sofrimento Fetal/etiologia , Idade Gestacional , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Oligo-Hidrâmnio/epidemiologia , Oligo-Hidrâmnio/etiologia , Mortalidade Perinatal , Pobreza/estatística & dados numéricos , Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologiaRESUMO
Se realizó un estudio prospectivo, de corte transversal en todas aquellas pacientes embarazadas a las que les realizó diagnóstico mediante ultrasonido de oligoamnios, y que fueron ingresadas a las salas del Hospital Berta Calderón Roque durante el periodo de 01 de junio- 31 de diciembre del 2007, el universo y la muestra fue constituido por 49 pacientes embarazadas con diagnóstico por ultrasonido de oligohidramnios. Los principales resultados obtenidos fueron: Las pacientes estudiadas en su mayoría estaban comprendida en el grupo etáreo de 20- 35 años, eran solteras, amas de casa, de procedencia urbana, con bajo nivel de escolaridad y multigestas. Los antecedentes patológicos no fueron signifativos en la aparición o presencia de malformaciones fetales, tenían controles prenatales deficientes y aproximadamente un 70 por ciento de las pacientes tenían un embarazo mayor de 37 semanas de gestación. Se encontraron patologías asociadas durante el embarazo como: Síndrome hipertensivo del embarazo, cervicovaginitis, infección de vías urinarias y anemias entre otras...
Assuntos
Anormalidades Urogenitais/diagnóstico , Anormalidades Urogenitais , Líquido Amniótico , Oligo-Hidrâmnio/diagnóstico , Oligo-Hidrâmnio/etiologia , Oligo-Hidrâmnio/mortalidade , Oligo-Hidrâmnio/patologia , Retardo do Crescimento Fetal/classificação , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/patologiaRESUMO
We present the case of a 1 day-old newborn with extensive squamous cell peritonitis resulting from vaginal atresia with hydrometrocolpos and squamous cell reflux through the genital system, a combination rarely recognized in the literature. Delivery was preceded by ultrasound diagnosis of oligohydramnios and "large bladder," the latter representing the dilated proximal vagina. Additional findings included paraesophageal hiatus hernia containing squames, urethral atresia, absence of vulva, lung hypoplasia, mild hypoplasia of the corpus callosum, and short umbilical cord with single umbilical artery (SUA). The possible relationship of the SUA with the constellation of infradiaphragmatic malformations is discussed.