This retrospective clinical observation was attempted to analyze 110 cases of prolonged pregnancies out of 14,783 cases compared with those of term pregnancies delivered at the Department of Obstetrics and Gynecology, Keimyung University from Jan. 1, 1994 to Dec. 31, 1996. The results as follows 1) The incidence of prolonged pregnancy was 0.7%. 2) The frequency of labor induction was significantly higher in prolonged pregnancies and controls. 3) The cesarean delivery rate was not significantly difference between the prolonged pregnancies and controls. 4) The prolonged pregnancy group didn't have a significant increase in the rate of low Apgar score. 5) The frequency of macrosomia was significantly increased in prolonged pregnancies than controls. 6) The frequency of oligohydroamnios was significantly increased in prolonged pregnancies than controls, but there was not significant difference between them. 7) Prolonged pregnancy has a high neonatal morbidity rate, but we didn't have a neonatal death in both.
Apgar Score ; Female ; Gynecology ; Incidence ; Obstetrics ; Pregnancy ; Pregnancy, Prolonged* ; Retrospective Studies

Pulmonary emboli originate from deep vein thrombi which occur frequently in pregnancies, prolonged bed-ridden state, cardiac diseases, cerebrovascular diseases, etc.. The authors analyzed 10 cases of sudden unexplained deaths and found that 4 cases of them probably had pulmonary embolism as a cause of deterioration and death. The estimated pulmonary embolism-related operative mortality was 0.1-0.3% according to the degree of suspicion. Most of the natural course of the disease are rapidly progressive ones and it is sometimes very difficult and impractical to obtain a definite diagnosis due to rapid deterioration and /or sudden death before studies. So the recognition of predisposing factors and prevention in risky patients are stressed.
Causality ; Death, Sudden ; Diagnosis ; Female ; Heart Diseases ; Humans ; Mortality* ; Pregnancy ; Pregnancy, Prolonged ; Pulmonary Embolism* ; Veins ; Venous Thrombosis

This study was done to evaluate transvaginal ultrasonographic measurement of cervical length at 20 to 24 weeks and 37 weeks as a predictor of prolonged pregnancy (defined as a pregnancy that extended beyond 41+2 weeks of gestation [289 days]) in nulliparous women. This prospective observational study enrolled 149 consecutive nulliparous women with singleton gestation at 37 weeks. Cervical length was measured by transvaginal ultrasonography at 20 to 24 weeks and 37 weeks. Cervical length at 37 weeks, but not at 20 to 24 weeks, was significantly longer in women delivered at >41+2 weeks than in those delivered at < or =41+2 weeks (p<0.005). There was a significant correlation between cervical length at 37 weeks and gestational age at delivery (Pearson correlation coefficient, r=0.387, p<0.0001). In the receiver operating curve, the best cut-off value of cervical length at 37 weeks for the prediction of prolonged pregnancy was 30 mm, with a sensitivity of 78% and a specificity of 62%. Cervical length assessed by transvaginal ultrasonography at 37 weeks can predict the likelihood of prolonged pregnancy in nulliparous women. However, there is no association between cervical length at 20 to 24 weeks and the occurrence of prolonged pregnancy.
Vagina ; ROC Curve ; Prospective Studies ; Pregnancy, Prolonged/*diagnosis ; Pregnancy ; Humans ; Gestational Age ; Female ; Cervix Uteri/*anatomy & histology/*ultrasonography ; Adult

Preterm birth defined as birth between 20-37 weeks age of gestation, poses major concerns as it causes serious health problems. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born and the Philippines ranks 8th out of 184 countries for the number of babies born prematurely, and ranks 17th for the total number of deaths due to complications from preterm birth. Management of incompetent cervix as one of the causes of preterm birth is cerclage. However, pessary insertion is an alternative especially in cases where cerclage may not be employed. To date, there have been no local published reports on effectiveness of pessary in prevention of preterm birth. Hence this study aims to report on cases supporting the use of pessary in preterm birth. This is a case series of three patients with short functional cervical lengths (<2.5 cm) seen in ultrasound, managed with pessary insertion showing its effectiveness in prolonging pregnancy. In conclusion, pessary is an affordable and safe alternative management of preterm birth which may be employed in our setting. Future clinical trials may be helpful in strengthening this evidence.

Human ; Female ; Adult ; Pregnancy ; Uterine Cervical Incompetence ; Pessaries ; Premature Birth ; Parturition ; Pregnancy, Prolonged ; Tnfrsf11a Protein, Human ; Receptor Activator Of Nuclear Factor-kappa B

Preterm birth defined as birth between 20-37 weeks age of gestation, poses major concerns as it causes serious health problems. Across 184 countries, the rate of preterm birth ranges from 5% to 18% of babies born and the Philippines ranks 8th out of 184 countries for the number of babies born prematurely, and ranks 17th for the total number of deaths due to complications from preterm birth. Management of incompetent cervix as one of the causes of preterm birth is cerclage. However, pessary insertion is an alternative especially in cases where cerclage may not be employed. To date, there have been no local published reports on effectiveness of pessary in prevention of preterm birth. Hence this study aims to report on cases supporting the use of pessary in preterm birth. This is a case series of three patients with short functional cervical lengths (<2.5 cm) seen in ultrasound, managed with pessary insertion showing its effectiveness in prolonging pregnancy. In conclusion, pessary is an affordable and safe alternative management of preterm birth which may be employed in our setting. Future clinical trials may be helpful in strengthening this evidence.

Human ; Female ; Adult ; Pregnancy ; Uterine Cervical Incompetence ; Pessaries ; Premature Birth ; Parturition ; Pregnancy, Prolonged ; Tnfrsf11a Protein, Human ; Receptor Activator Of Nuclear Factor-kappa B

Particulate matter (PM) is known to have serious health effects in individuals with respiratory or cardiovascular disease. Recent studies have shown that they also have noxious effects on cerebrovascular, metabolic, and neuropsychiatric disorders, as well as pregnancy. The aim of this study is to review the various diseases associated with PM in each human organ. Regarding respiratory diseases, PM has been associated with increased acute exacerbation in patients with chronic obstructive pulmonary disease, bronchial asthma, and several other respiratory diseases, resulting in increased hospitalization and mortality. In addition, PM increases the risk of lung cancer and accelerates the decline of lung function. Individuals with cardiovascular conditions such as ischemic heart disease, heart failure, hypertension, arrhythmia, and atherosclerosis have been also found to exhibit increased morbidity and mortality when exposed to PM. PM also has been reported to cause insulin resistance and to induce increasing rates of diabetes. During pregnancy, prolonged exposure to PM has been associated with increased rates of low birth weight and preterm birth. In individuals with neurological diseases, exposure to PM reduces cognitive ability and memory, and increases stroke incidence. It has been reported that PM also exacerbates psychiatric conditions, particularly depression and anxiety disorder. Thus, PM has been shown to exert very noxious health effects on the human body, with impacts including effects on respiratory and cerebrovascular diseases, cardiovascular diseases, neuropsychiatric diseases, and low birth weight.
Anxiety Disorders ; Arrhythmias, Cardiac ; Asthma ; Atherosclerosis ; Cardiovascular Diseases ; Cerebrovascular Disorders ; Depression ; Female ; Heart Failure ; Hospitalization ; Human Body ; Humans ; Hypertension ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Insulin Resistance ; Lung ; Lung Diseases ; Lung Neoplasms ; Memory ; Mortality ; Myocardial Ischemia ; Particulate Matter* ; Pregnancy ; Pregnancy, Prolonged ; Premature Birth ; Pulmonary Disease, Chronic Obstructive ; Stroke

OBJECTIVETo evaluate the effect and risk of misoprostol for stimulating cervical maturity in women with post-term pregnancy negative for insulin-like growth factor binding protein-1 (IGFBP-1) in cervical secretion with modified Bishop score less than 3.

METHODSSeventy-one women with post-term pregnancy randomized into misoprostol group (n=37) and control group (n=34) received misoprostol placement at the posterior vaginal fornix and routine intravenous oxytocin infusion, respectively, to stimulate cervical maturity. Failure to respond to the treatment within the initial 24 h necessitated a repeated administration for no more than 3 times in all. Modified Bishop score was recorded and fetal heart monitored once every 24 h, and IGFBP-1 in the cervical secretion was detected at 24 and 48 h after drug administration.

RESULTSThe misoprostol group showed better effect of cervical maturity stimulation than the control group (P<0.001), and the positivity rates of IGFBP-1 24 and 48 h after drug administration were significantly higher than that of the control group (P<0.01 and 0.001). The number of cases with indication for cesarean section was significant higher in the control group (P<0.001). There were no significant differences in postpartum hemorrhage, excessive uterine contraction, incidence of fecal contamination of the amniotic fluid or Apgar score of the newborn between the two groups (P>0.05).

CONCLUSIONSMisoprostol is safe and effective for stimulating cervical maturity in women with post-term pregnancy who have modified Bishop score lower than 3 and are negative for IGPBF-1 in cervical secretion. Oxytocin is not advised for use in such gravida for stimulating cervical maturity. IGFBP-1 in cervical secretion may serve as an important index for evaluating the cervical maturity.

Abortifacient Agents, Nonsteroidal ; administration & dosage ; adverse effects ; therapeutic use ; Administration, Intravaginal ; Adult ; Cervical Ripening ; drug effects ; Cervix Uteri ; drug effects ; metabolism ; Female ; Heart Rate, Fetal ; drug effects ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; metabolism ; Misoprostol ; administration & dosage ; adverse effects ; therapeutic use ; Pregnancy ; Pregnancy, Prolonged ; drug therapy ; Treatment Outcome