BACKGROUND: The number of pregnancies in renal transplant recipients has increased. Many studies have shown that pregnancy increases the risk of graft, fetal, and maternal complications but does not affect the long-term outcome of the graft. We assessed the incidence and effect of pregnancy after renal transplantation and examined graft, fetal, and maternal outcomes. METHODS: Our study included 145 female recipients of child-bearing age (15~45 years) in our center from January 1990 to December 2011. The subjects were divided into two groups: pregnancy (n=17) and control (n=128). The 26 pregnancies in the 17 recipients were categorized as live births (n=10) or no-live births (n=16). These were analyzed for evaluation of pregnancy outcomes, graft function, and long-term graft survival. RESULTS: The pregnancy and control group had similar graft function and graft survival rates 5- and 10-year after renal transplantation. Outcomes of pregnancy were 10 live births, 8 therapeutic abortions, 7 spontaneous abortions, and 1 stillbirth. The mean serum creatinine levels of the pregnant recipients diminished during the first trimester (1.14+/-0.37 mg/dL) and increased slightly during the third trimester (1.18+/-0.37 mg/dL) to levels nearer the baseline (1.23+/-0.37 mg/dL). These ranges were stable. The mean time from transplantation to pregnancy was 20.73+/-3.57 months. Live birth rates were associated with the time from transplantation to pregnancy (71.78+/-37.75 months for live births and 19.38+/-12.71 months for no-live births, P=0.000). There were no significant differences in graft function, graft failure rates, and survival. CONCLUSIONS: Pregnancy does not appear to have an adverse effect on graft function and the long-term outcomes of renal transplantation. Recipients with stable renal function who want to become pregnant can have successful pregnancies.
Abortion, Spontaneous ; Abortion, Therapeutic ; Allografts* ; Creatinine ; Female ; Graft Survival ; Humans ; Incidence ; Kidney Transplantation* ; Live Birth ; Parturition ; Pregnancy Outcome* ; Pregnancy Trimester, First ; Pregnancy Trimester, Third ; Pregnancy* ; Stillbirth ; Transplantation ; Transplants

OBJECTIVE: We performed this study to evaluate maternal and fetal outcomes of pregnancies with IgA nephropathy. METHODS: We reviewed 20 pregnancies occurred in 14 women who were diagnosed as IgA nephropathy with the method of renal biopsy between 1997 and 2006. We used clinical and laboratory data from medical records and statistic analysis using SPSS 15.0. RESULTS: Of 20 prenancies, there were 17 live births and 3 spontaneous abortions. There was no stillbirth and congenital anomaly. We found severe preeclampsia in 47%, low birth weight in 53% and preterm birth (comprising medical indications) in 59%. But most were late preterm birth and all were alive. Blood pressure was elevated after delivery compared with pre-pregnancy. CONCLUSION: Although pregnancy is not contraindicated in IgA nephropathy, it is associated with significant complications comprising preeclampsia, preterm birth and low birth weight.
Abortion, Spontaneous ; Biopsy ; Blood Pressure ; Female ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Infant, Low Birth Weight ; Infant, Newborn ; Live Birth ; Medical Records ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Stillbirth

BACKGROUND: Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein. METHODS: Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis. RESULTS: A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04-1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increased risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07; 95% CI 1.03-1.12). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63; 95% CI 3.99-5.38). CONCLUSIONS: Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors. REGISTRATION No. CRD42021259776 at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ).
Pregnancy ; Infant, Newborn ; Female ; Humans ; Pregnancy Outcome ; Premature Birth/epidemiology* ; Stillbirth/epidemiology* ; Temperature ; Pregnancy Complications

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

Pregnancy Outcome

Objective: The elderly primigravid has inherent pregnancy risks which may have deleterious effects on both maternal and fetal outcomes. The purpose of this study is to review the obstetric and neonatal outcomes of singleton gestations among Filipino elderly primigravids who delivered in a tertiary government hospital from January 1, 2012 to December 31, 2016. Methods: This is a retrospective cohort study of including 80 primigravid women aged 35 years and older (study group) and 160 primigravid women aged 20 to 34 years old (control group). Data was collected through review of hospital records, and data processing and analysis were carried out using the software, Stata 13. Results: A total of 24,751 deliveries were attended to for the five-year period covered, giving the elderly primigravids a prevalence of 6.91%, with a mean age of 38 ± 2.63 years (range 35-43). Significantly, more women in the elderly group delivered at less than 36 weeks age of gestation, delivered abdominally, and had a history of infertility and important co-morbid conditions. No significant difference in the neonatal outcomes were noted between the two groups. Conclusion It can be suggested that there was no noted difference in terms of the maternal and neonatal outcomes between elderly primigravids than otherwise. Nevertheless, inherent differences between the study groups may be clinically important in customizing the management of these women.
Pregnancy Outcome

Background: For the past decade, advanced maternal age (AMA) became more common in developed and developing countries due to the postponement of pregnancy because of career goals, widespread use of family planning, and advances in assisted reproductive techniques. This increase bears an impact on maternal and perinatal outcomes. The link between AMA and adverse maternal, perinatal, and neonatal outcome showed contradicting results. This study was conducted to investigate the association between AMA and adverse outcomes among nulliparous, Filipino with singleton pregnancies who gave birth in a private tertiary hospital. Methodology: Medical records of patients admitted for delivery between January 2015 and December 2019 were reviewed retrospectively. The control (20–34 years), AMA 35–39 years, very AMA 40–44 years, and extremely advanced maternal age (EAMA) 45 years and above groups included 206, 111, 18, and 2, respectively. Results: Five-year total deliveries at a private tertiary hospital were 8495 with a prevalence of 38.9% (95% confidence interval CI: 33.6%–44.3%) for elderly Filipino primigravids. AMA is a risk factor for diabetes mellitus and small for gestational age newborn in all 3 advanced age groups. Pregnancy induced hypertension, having cesarean section, admission of newborn to neonatal intensive care unit, and administration of antibiotics were more common to AMA but same risk for EAMA. AMA predisposes to having oligohydramnios, placenta previa and preterm delivery but pregnancy at EAMA predisposes more complications in maternal and neonatal outcomes such as having polyhydramnios, abruptio placenta, postpartum hemorrhage, maternal and neonatal death, low Appearance Pulse Grimace Activity and Respiration score, and stillbirth. There is no noted association between AMA and large for gestational age newborn, having meconium staining and delivering by classical cesarean section. Conclusion AMA in Filipino gravida patients is markedly linked with adverse obstetrical, perinatal, and neonatal outcomes. This study confirms the current trend among women over 45 years that leads to more significant obstetric complications and neonatal morbidities.
Pregnancy Outcome

In adolescents, pregnancy and birth can cause not only severe outcomes but also the harassment for their families and the load for society. Due to insufficiency in nutrition for developing fetus and the body has not developed fully, the pregnant adolescents usually suffer from malnutrition and anemia and have more likely to be intervened during delivery, affect to health of mother and child. The lack of knowledge on childbirth and anxiety can lead to functional mental disorders. Adolescent pregnancy and birth also has severe impact on economic and social status. Some resolutions were proposed, including sexual education for adolescents; safe abortion; family-planing services must be available and easy to access. Information, education and counseling must be provided effectively both in family and school.
Pregnancy ; Adolescent ; Pregnancy Outcome

OBJECTIVE: To examine the therapeutic outcomes of methotrexate (MTX) in the treatment of unruptured interstitial pregnancy. METHODS: We reviewed the medical records of patients who were diagnosed with interstitial pregnancy and received MTX as first-line treatment between January 2003 and July 2014 at CHA Gangnam Medical Center. The treatment success rates and subsequent pregnancy outcomes were examined. RESULTS: Ninety-seven patients were diagnosed with interstitial pregnancy between January 2003 and July 2014. Of them, 38 initially received MTX treatment. The diagnosis was made at a median of 6+3 weeks (5+0 to 11+3 weeks). Thirty patients received a systemic MTX injection, while the other 8 received a local MTX injection. Systemic treatment composed of an 8-day alternating MTX regimen, single-dose regimen, or high-dose regimen (100 mg/m2 + 200 mg/m2 intravenously over 12 hours). The local injection consisted of a direct MTX injection into the gestational sac with or without systemic MTX injection. Twenty-one patients (55.3%) were successfully treated with MTX. However, MTX therapy failed in 17 patients (44.7%), who required surgery. Mode of MTX treatment was the only predictive variable of MTX treatment success (P=0.039). Treatment success was seen in 7 of 8 patients (87.5%) in the local MTX group vs. 14 of 30 patients (46.7%) in the systemic MTX group. After treatment, 13 patients attempted a successive pregnancy; of them, 10 patients had a confirmed clinical pregnancy and healthy live birth. CONCLUSION: Combined MTX treatment including a local injection might be an initial approach to the treatment of interstitial pregnancy.
Diagnosis ; Female ; Gestational Sac ; Humans ; Live Birth ; Medical Records ; Methotrexate* ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Pregnancy, Interstitial*

No abstract available.
Female ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*