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DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Post-maturity is associated with: A. Increased risk of perinatal mortality rate. B. Passage of meconium. C. 42/40 weeks' gestation and induction of labour is advisable. D. Meconium staining of the nails and cord. E. Placental insufficiency.
The Epidemiology and Etiology of Intrauterine Growth Retardation
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
Placental insufficiency is another phrase commonly used in association with poor growth of the fetus. This begs the question, for more commonly in the Western World, IUGR is associated with a placental bed problem and it is not of necessity the placenta that is insufficient. Unfortunately the obstetrical profession had got into a habit of measuring placental function through the estimation of various aspects of its metabolism, such as the oestriol production or human placental lactogen manufacture. These may have had some relationship to the transfer of nutrients or oxygen but these associations were loose and varying ones; the use of these estimates have mostly been abandoned. Further, all functions of transfer may not go at the same pace. The same baby for whom amino acids and calories have been reduced by poor transfer during pregnancy does not have to suffer from hypoxia in labor due to poor transfer of oxygen. Placental insufficiency as a phrase is therefore probably best avoided in this context for it is too loose a concept and it probably draws attention to the wrong place.
Omics and coagulation disorders in pregnancy
Published in Moshe Hod, Vincenzo Berghella, Mary E. D'Alton, Gian Carlo Di Renzo, Eduard Gratacós, Vassilios Fanos, New Technologies and Perinatal Medicine, 2019
Sara Ornaghi, Michael J. Paidas
A maternal predisposition to endothelial dysfunction and an impaired trophoblast invasion and maternal spiral arteries remodeling have been proposed as underlying pathogenic mechanisms for these obstetric diseases, by contributing to shallow placental implantation and eventually placental insufficiency (25–33). In turn, placental insufficiency leads to decreased uteroplacental blood perfusion and impaired materno-fetal exchange of nutrients, gases, and waste products (34). Hypoperfusion and endothelial dysfunction appear to be both a cause and a consequence of abnormal placental development, as suggested by the following examples: (1) successful animal models of preeclampsia have involved mechanically reducing uteroplacental blood flow (35,36), and (2) medical conditions associated with vascular insufficiency and endothelial dysfunction (e.g., chronic hypertension, diabetes mellitus) increase the risk of abnormal placentation and development of placentally related complications (20).
Cerebroplacental doppler ratio and perinatal outcome in late-onset foetal growth restriction
Published in Journal of Obstetrics and Gynaecology, 2022
Ozge Kahramanoglu, Oya Demirci, Mucize Eric Ozdemir, Agnese Maria Chiara Rapisarda, Munip Akalin, Ali Sahap Odacilar, Hayal Ismailov, Gizem Elif Dizdarogullari, Aydin Ocal
The CPR may predict earlier delivery in late-onset FGR. Among our patients, 49% of those with abnormal CPR gave birth before term. However, only less than one of five patients in the normal CPR group had a preterm birth. One possible explanation is that the abnormal CPR group had a significantly higher rate of oligohydramnios resulting in a lower biophysical profile score. Accordingly, foetuses with abnormal CPR had a lower birth weight. Both findings may be explained with the association of low CPR and placental insufficiency. Khalil (2017) studied the association between adverse perinatal outcomes and CPR. They evaluated 7944 pregnancies, retrospectively. They didn’t state whether they exclude pregnancies with congenital/chromosomal abnormality. Similar to our results, the mean birth weight of the foetuses with abnormal CPR was lower than those with normal CPR.
Diagnosis of preeclampsia in women with diabetic kidney disease
Published in Hypertension in Pregnancy, 2021
Jakub Kornacki, Daniel Boroń, Paweł Gutaj, Urszula Mantaj, Przemysław Wirstlein, Ewa Wender-Ozegowska
The results of the present study indicate a crucial role of primary chronic hypertension and the degree of primary kidney injury and dysfunction in the development of PE in women with DKD. Both these factors are strong determinants of PE in this group of patients. Proteinuria seems to be the best renal predictive factors of PE from the beginning of pregnancy whereas serum creatinine concentration and CC play such a role mainly in the third trimester of pregnancy. Good metabolic control of diabetes by using an insulin pump seems to be important in the prophylaxis of PE. Placental insufficiency may be helpful in the diagnosis of PE however the presence of this abnormality is not necessary for the development of PE. Probably, this is a reason why aspirin may not be effective in the prevention of PE in this particular group of patients.
Correlation of elevated levels of lipoprotein(a), high-density lipoprotein and low-density lipoprotein with severity of preeclampsia: a prospective longitudinal study
Published in Journal of Obstetrics and Gynaecology, 2020
Elena Konrad, Onur Güralp, Waleed Shaalan, Alaa A. Elzarkaa, Reham Moftah, Doaa Alemam, Eduard Malik, Amr A. Soliman
Preeclampsia is a pregnancy-specific condition of unknown aetiology and pathogenesis. It is characterised by hypertension ≥140/90 mm Hg and significant proteinuria (0.3 g/24 h) after the 20th week of gestation (American College of Obstetrics and Gynecology 2002). According to the level of blood pressure elevation, proteinuria and the extent of vital organ involvement, preeclampsia is further subdivided into mild (blood pressure ≥140/90 mm Hg but <160/110 mm Hg) with no or subtle vital organ involvement, or severe (blood pressure ≥160/110 mm Hg) with one or more organ involvement. This manifests in the form of renal impairment (oliguria <500 mL/24 h, elevated creatinine levels), liver involvement (elevated liver enzymes), pulmonary oedema, thrombocytopenia, haemolysis, neurological symptoms and foetal growth restriction (National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy 2000; Tranquilli et al. 2013). Preeclampsia affects 5–15% of pregnancies and can have a serious impact on both mothers and foetuses (Roberts 1993). Maternal complications include hypertensive crises, eclamptic fits, renal failure and increased risk of hypertension as well as cardiovascular disease after pregnancy (Roberts 1993; Manten et al. 2007). Foetal complications include prematurity, low birth weight and intrauterine death due to placental insufficiency (Roberts 1993). The sole definitive treatment of preeclampsia is termination of pregnancy (Roberts 1993; American College of Obstetrics and Gynecology 2002).