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Tubal hydatidiform mole is an
uncommon condition with about 40 confirmed cases in the accessible literature.
The patient usually presents with symptoms and signs of a classical ectopic
pregnancy, and it is only after histological examination and DNA ploidy analysis
of the conceptus that a hydatidiform mole is diagnosed. We present an unusual
case of primi gravida at 6 weeks gestation that was diagnosed as having ectopic
Pica is an eating disorder
in which non-nutritional objects are frequently eaten, and may have serious
side effects for both the mother and neonate. The aim of this study was to
determine the pica and its association with biochemical profiles of pregnant
women and its relation to pregnancy outcome. A prospective cohort study was
conducted in five health care centers in Zahedan City, Iran, in 2011-2012.
Samples of pregnant women (n = 200) in the age groups 18 - 40 years were
selected for this study and interviewed using a questionnaire. Maternal
biochemical profiles (hemoglobin and ferritin) during pregnancy, mean gestational
age and pregnancy outcome namely height, weight, and head circumferences of
neonates were compared to pregnant women who reported pica (pica group) and
women who did not (without pica group). The results showed pica prevalence
categorized by substance as follows: clay (23.3%), ice (53.7%), ice and freezer
frost (11.5%) and other substances (11.5%). Women in pica group had lower
hemoglobin levels during the three trimesters of pregnancy than without pica
group. Head circumferences of neonates in pica groups were significantly lower
than those of without pica groups (31.0 ± 0.6 vs. 34.0 ± 0.2 respectively).
There were no differences in mean birth weight, length, gestational age of
infants born to pregnant women from the pica group and without pica group. The
findings suggest that the pica practices during pregnancy are associated with
lower maternal hemoglobin during the pregnancy
periods, and also significantly lower head circumferences of neonates.
Dietitians should ask pregnant women with anemia about pica and should counsel
pregnant women who report pica.
Background/Aims: Excessive gestational weight gain was known to be associated with adverse pregnancy outcomes. It increased the complications during pregnancy, delivery and postpartum period. Nevertheless, there are studies reporting the incompliance of pregnant women with recommendations of weight gain. The objectives of this study were to estimate the prevalence of high gestational weight gain and to identify the increased adverse pregnancy outcomes in these women. Methods: This was a cross sectional study. Data were collected retrospectively from hospital electronic database of Lampang Regional Hospital (LPH) along with manual retrieval from medical charts and labor records. Data of all pregnant women who delivered at labor room of LPH were collected from 1st February 2011 to 31st August 2012. After preterm and multifetal pregnancies were excluded, 4747 cases were brought to the study. This study used the new weight gain recommendation from the Institute of Medicine and National Research Council to classify pregnant women by pre-pregnancy body mass index. Data were analyzed by univariate and multivariate analysis. Results: The proportions of pregnant women with different level of weight gain were 28.4%, 38.5% and 33.1% for low, normal and high weight gain. After multivariate analysis was done to control the confounders, women with high weight gain were significantly correlated with having preeclampsia, higher birth weight group, cesarean section and long neonatal length with relative risk (RR) and 95% confidence interval (95% CI) of 4.84 (2.31 - 10.16), 3.94 (3.24 - 4.79), 2.12 (1.82 - 2.47) and 2.33 (1.90 - 2.86). Conclusions: There were more than half of pregnant women that were prone to have inappropriate weight gain. Many complications from high weight gain that have been reported from aboard also occurred in Thai pregnant women. This should alert corresponding health institute to establish a new guideline to avoid high gestational weight gain.
Anencephaly is a frequent and easily diagnosed condition affecting twin pregnancies with higher incidence than singletons. Discordance for anencephaly in twins raises management dilemmas about the best approach to the situation. The authors report a successful case of a 33 years old woman who had a dichorionic twin pregnancy resulting from ICSI, with discordance for anencephaly. Diagnosis was performed at 13 weeks during first trimester ultrasound screening. A selective feticide with intrathoracic injection of KCl at 13 + 2 weeks was performed with no complications. The normal fetus proceeded with an uneventful pregnancy with spontaneous vaginal delivery at 40 weeks, weighting 3110 g. Management of twin pregnancies discordant for fetal anencephaly is far from being consensual. Two options are considered: selective feticide or expectant management, with serial ultrasound surveillance. In the latter option, amniodrainage or selective feticide may become options if polyhydramnios develops later in pregnancy. Therapeutic strategy requires an individual approach considering chorionicity, gestational age and all the risks of miscarriage, preterm labor and fetal demise to which these pregnancies are particularly exposed.
There is a dearth of
literature regarding the pregnancy outcomes in antenatal women using smokeless
tobacco products (STP). Objective: To compare maternal and neonatal pregnancy
outcomes in antenatal women using smokeless tobacco products with those not
using tobacco products. Method:
Pregnant women attending antenatal clinic at Guru Teg Bahadur hospital, Delhi
received brief information about smokeless tobacco products. Antenatal women
using STP and matched controls, 92 in each group (total 184) were recruited for
the study. After obtaining consent, the urinary cotinine level was measured in
both groups at first contact. Antenatal, labour and postpartum events were
recorded in both groups. Urinary cotinine levels were again measured at 6
months in the user group. Results:
Average age of antenatal women under study was 24.8 yrs and 25.21 yrs in user
and non-user groups respectively. More women in the user group were illiterate
(P < 0.05). Mean urinary cotinine in user and non-users was 44.21 +/? 20.39 μg/ml and 24.37 +/? 20.14 μg/ml respectively (p <
0.0001). Women using STPs for more than 5 yrs recorded higher urinary cotinine
levels. There was no significant difference in urinary cotinine levels with the
type of tobacco product consumed. Pregnancy outcomes of 39 women are known.
There was no significant difference in antenatal, intra-natal and postpartum
complications in the two groups. Neonatal weight difference was 20 gms.Conclusion:
Smokeless tobacco products are the most