The role of first trimester fetal heart rate in the prediction of gestational diabetes: A multicenter study
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01.12.2019 |
Sirico A.
Lanzone A.
Mappa I.
Sarno L.
Słodki M.
Pitocco D.
Zullo F.
Maruotti G.
Rizzo G.
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European Journal of Obstetrics and Gynecology and Reproductive Biology |
10.1016/j.ejogrb.2019.10.019 |
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© 2019 Elsevier B.V. Objective: Early pregnancy models for prediction of GDM have been proposed, mostly using anamnestic and biochemical parameters. The aim of our study was to evaluate the strength of association of first trimester fetal heart rate (FHR) in predicting the development of gestational diabetes (GDM). Study design: We considered in our analysis singleton non-diabetic pregnant women who underwent a first trimester screening at 11–14 weeks. Data on maternal age, BMI, cigarette smoking, NT, FHR, CRL, DV-PVI, β-hCG and PAPP-A were included in the analysis. Multivariate logistic regression analysis was used to estimate the association between maternal characteristics and first-trimester ultrasound measurements and GDM. We evaluated the efficacy of different models for the prediction of GDM. Results: We considered 603 women, of whom 199 (33%) were subsequently diagnosed with GDM. ROC analysis showed that first trimester FHR was highly predictive of GDM (AUC 0.809, 95% CI 0.769–0.849, p < 0.001). At FPR of 20%, first trimester FHR had a detection rate of 65.2% for GDM (positive likelihood ratio: 3.26; negative likelihood ratio: 0.43), which increased to 89.5% at FPR of 40% (positive likelihood ratio: 2.24; negative likelihood ratio: 0.17). When considering as threshold 162 bpm, FHR showed detection rate of 76.9%, specificity of 67.1% and negative predictive value of 85.5% for GDM. Conclusion: This is the first study to highlight the potential role of first trimester FHR as early predictor of GDM. In our cohort, a threshold of 162 bpm has shown high detection rate and NPV for GDM.
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Examination and evaluation of the normal facial anatomy of the fetus in the i trimester using 3D/4D echography
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01.01.2018 |
Voevodin S.
Shemanaeva T.
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Russian Electronic Journal of Radiology |
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© 2018 Russian Electronic Journal of Radiology. All rights reserved. The analysis of 523 ultrasound examinations of the face in fetuses in pregnancy 10-14 weeks. Studies performed using 2D/3D/4D equipment transabdominal and transvaginal accesses and different modes (surface, multiplane and multislice). Investigated and presented to the rendering capabilities of individual facial structures at different age of gestation. Presents new and original methods for the visualization of the hard palate. The high informativeness of 3D/4D echography, means and tools, and its advantages in assessing the anatomy of the face in the first trimester of pregnancy are shown.
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Vulvovaginal candidiasis during of pregnancy (Features of the therapy in the first trimester)
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01.01.2018 |
Borovikov I.
Kutsenko R.
Ermolaeva A.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. Objective. Evaluation method of therapy for pregnant women, with vulvovaginal candidiasis, with a combination of oral and intravaginal introduction polyene macrolide – natamycin. Subjects and methods. The results of treatment in 110 pregnant women, patients with invasive vulvovaginal 10-12 weeks gestation: group 1 (n = 55) therapy with natamycin intravaginal at a dose of 100 mg 1 times daily for 6 days; Group 2 (n = 55) had combined treatment natamicinum intravaginal at a dose of 100 mg 1 times daily for 6 days + natamicinum peroral at a dose of 100 mg 4 times daily for 10 days. Direct microscopy, measuring the pH of the vagina, cultural method was using. Results. Found that the combined intake of natamicinum (oral and intravaginal reception) increases the clinical efficacy of therapy vulvovaginal candidiasis in 1.7 ± 0.12, and microbiological -1.3 ± 0.1 times. Conclusion. Application of combined therapy antimycotics reasonable etiologically (simultaneous vaginal disinfection and colon) with polyene macrolides natamycin has the fewest side effects, absence of adverse effects on the fetus, and helps improve clinical microbiological efficacy of treatment in patients vulvovaginal invasive.
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