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At least 163 records · Page 9Linked to original sources
PubMed1983

Probable amniotic fluid embolism after first-trimester pregnancy termination. A case report.

A patient collapsed immediately after dilatation and curettage for pregnancy termination. Disseminated intravascular coagulation supervened rapidly. Although the diagnosis of amniotic fluid embolism has remained unproven, it is the most likely explanation for the chain of events. We recommend rupture of the membranes prior to curettage or the administration of an oxytocic agent.

Abortion, Induced↗
PubMed2003

Extremes of body mass index do not affect first-trimester pregnancy outcome in patients with infertility.

OBJECTIVE: The study was undertaken to ascertain whether body mass index (BMI) affects first-trimester pregnancy outcome in patients with infertility. STUDY DESIGN: Records of 494 patients with a singleton gestation after treatment for infertility at a single academic center were retrospectively reviewed. Patients were classified with regard to BMI and treatment protocol. Outcomes were defined as ongoing pregnancy, spontaneous abortion, or ectopic pregnancy. RESULTS: The average rate of spontaneous abortion was 21.5% and of ongoing pregnancy 75.1%. This did not differ significantly in any of the BMI groups. When patients were further subdivided according to diagnosis or fertility treatment, the spontaneous abortion rate remained the same. CONCLUSION: The likelihood of a spontaneous abortion, ongoing pregnancy, or ectopic pregnancy in singleton gestations in the first trimester, after treatment for infertility, was not affected by BMI.

Abortion, Spontaneous↗
PubMed2004

A randomized comparison of sublingual and vaginal misoprostol for cervical priming before suction termination of first-trimester pregnancy.

This randomized trial compares the efficacy and side effects of sublingual and vaginal misoprostol for cervical priming before first-trimester pregnancy termination. One-hundred pregnant women between 6 and 12 weeks of gestation opting for termination of pregnancy by suction evacuation were included in this study. The women were randomly allocated into two groups. Group 1 received 400 microg of sublingual misoprostol and group 2 received 400 microg of vaginal misoprostol 2 h prior to suction evacuation. The abortion was carried out by suction evacuation using a Karman's cannula attached to an electrically operated suction machine under intravenous analgesia. Baseline cervical dilatation, duration of the procedure, operative blood loss, side effects and complications were noted in both groups. There was a significant difference between the sublingual and vaginal misoprostol groups with respect to mean cervical dilatation (8.6 mm vs. 6.8 mm, p < 0.05). However, the duration of the procedure (3.03 min vs. 3.16 min) and the amount of blood loss (29 mL vs. 31.2 mL) were not significantly different between the two groups. The women in the sublingual group experienced significantly more shivering and preoperative vaginal bleeding (68% vs. 56%, p < 0.05). None of the women in the two groups had either uterine perforation or excessive hemorrhage. In our study, sublingual misoprostol (400 microg) was significantly more effective in facilitating cervical dilation prior to surgical abortion than vaginal misoprostol.

Abortifacient Agents, Nonsteroidal↗
PubMed1989

Cervagem/Dilapan for preoperative cervical dilatation prior to vacuum aspiration for termination of first trimester pregnancy. A prospective randomized study.

The present study included 40 healthy nulliparous women admitted to the hospital for termination of first trimester pregnancy. The patients were randomly allocated to two study groups. One group was treated for 4 hours with one 1 mg Cervagem vaginal suppository prior to vacuum aspiration, the other was treated 4 hours with a Dilapan osmotic dilator intracervically. The patients were continuously supervised during treatment and after operation. Side effects and analgesic consumption were recorded. At operation the degree of cervical dilatation, blood loss and operative complications was registered. Dilapan was more effective and more uniform in dilating the cervix (p less than 0.05) and eventual further dilatation was easier (p less than 0.05). The blood loss was higher in the Dilapan-treated group (p less than 0.05). Side effects of postoperative pain and use of analgesic injections were higher in the Cervagem group (p less than 0.05). It is concluded that both methods are effective in dilating the cervix prior to vacuum aspiration, with Dilapan being the more effective dilator with the lower frequency of side effects.

Abortion, Induced↗
PubMed2000

[Ultrasonic diagnosis in the first trimester of multiple pregnancy].

Higher rate of morbidity and mortality has been noted in tween pregnancies comparing to singleton pregnancies. Early ultrasound investigation between 6 and 12 week of gestation is useful in determining time of gestation, amniocity and chorionicity (adequacy of diagnosis ranged from 95 to 100%). Determining of chorionicity and amniocity is extremly important in monozygotic twins, because of high risk of complications during next stages of pregnancy. First trimester ultrasound investigation allows to define abnormalities commonly associated with twin pregnancy and is useful in monitoring of fetal well-being.

Congenital Abnormalities↗
PubMed1991

Cost-effectiveness of routine ultrasound examination in first trimester of pregnancy.

The findings of first-trimester ultrasound scans are analyzed. The patients were divided into two groups according to the reliability of their alleged date of last menstrual period and the regularity of their menstrual cycle. The cost-effectiveness of a routine first trimester scan as compared to a selective approach is calculated. Based on these data we question the performance of a routine first-trimester scan.

Belgium↗
PubMed1996

Detection of cytochrome P450 gene expression in human placenta in first trimester of pregnancy.

Human first-trimester placentas were screened for the expression of xenobiotic-metabolizing cytochrome P450 (CYP) genes. mRNAs of CYP1A1, CYP1A2, CYP2C, CYP2D6, CYP2E1, CYP2F1, CYP3A4, CYP3A5, CYP3A7, and CYP4B1 were identified by reverse transcriptase-polymearse chain reaction (RT-PCR) in at least some of the six placental samples studied. CYP2A and CYP2B message were absent in all samples. The level of all of these CYP mRNAs was lower compared to the corresponding levels in liver or lung. the catalytic activity marker (7-ethoxyresorufin O-deethylase) was inducible in the placentas by maternal cigarette smoking. Thus, the regulatory system of placental CYP1A1, mediated by the Ah-receptor, appears to be developed as early as the first trimester of pregnancy. Three immunoreactive bands from placental microsomes were detected by an antihuman CYP3A4 antibody, but no functional activity of CYP3A enzymes could be detected. These results show that placental tissue during the first trimester of pregnancy has the potential of expressing several CYP genes, and forms a basis for subsequent analysis of these forms at the protein and functional level.

Base Sequence↗
PubMed1994

Fetal nuchal translucency: ultrasound screening for fetal trisomy in the first trimester of pregnancy.

OBJECTIVE: To investigate a new method of screening for fetal trisomies on the basis of maternal age and fetal nuchal translucency thickness at 10 to 13 weeks of gestation. DESIGN: A prospective screening study. SETTING: Tertiary referral centre. SUBJECTS: One thousand two hundred and seventy-three women with singleton pregnancies undergoing first trimester fetal karyotyping because of advanced maternal age, parental anxiety, or family history of a chromosomal abnormality in the absence of balanced parental translocation. METHODS: Estimates of maternal age-related risks for fetal trisomies 21, 18 and 13 at this gestation were used to derive the expected incidence of these trisomies in fetuses with nuchal translucency < 3 mm, 3 mm and > 3 mm, respectively, and the ratio of observed to expected number of cases was calculated. RESULTS: The nuchal translucency was > or = 3 mm in 86% of the trisomic and in 4.5% of the chromosomally normal fetuses. The observed number of trisomies in the 1185 cases with nuchal translucency < 3 mm was approximately five times less than the number expected on the basis of maternal age. In the groups with translucency of 3 mm (n = 52) and > 3 mm (n = 36), the observed numbers of trisomies were approximately five times and 24 times higher than the respective numbers expected on the basis of maternal age. CONCLUSION: The risk of fetal trisomy can be derived by combining maternal age and fetal nuchal translucency thickness at 10 to 13 weeks of gestation. It is predicted that for a false positive rate of 5%, the sensitivity of the new method of screening would be at least 85%, which compares favourably with the respective 20 to 30% and 50 to 60% of screening based on maternal age alone or the combination of maternal age with maternal serum biochemistry.

Adult↗
PubMed2006

Higher median levels of free beta-hCG and PAPP-A in the first trimester of pregnancy in a Chinese ethnic group. Implication for first trimester combined screening for Down's syndrome in the Chinese population.

OBJECTIVE: To study the effect of ethnic Chinese on the medians of free beta-hCG and PAPP-A in the first trimester of pregnancy. METHODS: The data of 943 women undergoing first trimester combined screening for fetal Down syndrome were analysed to derive the Chinese-specific medians. The calculated risk of Down syndrome based on these Chinese-specific medians was compared with that based on the original algorithm of the Fetal Medicine Foundation (FMF). RESULTS: The maternal serum levels of multiples of median of free beta-hCG and PAPP-A were significantly higher among the Chinese than among the Caucasians. The weight-adjusted gestation-specific medians were developed. Without adjustment for ethnicity, the original FMF algorithm underestimated the risk of Down syndrome by a median of 1%. Adjustment by ethnicity increased the false-positive rate by 10% (from 5.3 to 5.9%). CONCLUSION: Ethnic Chinese have a significantly higher maternal serum level of free beta-hCG and PAPP-A in the first trimester, which could not be explained by differences in maternal weight. Adjustment for ethnicity may be necessary for these biochemical markers in a first trimester screening program.

Biomarkers↗
PubMed2000

Choriocarcinoma-like human chorionic gonadotrophin (HCG) and HCG bioactivity during the first trimester of pregnancy.

The objective of this study was to evaluate the distribution of choriocarcinoma-like human chorionic gonadotrophin (HCG) isoforms during first trimester pregnancy and their relationship with in-vitro HCG bioactivity. This was done by means of a retrospective analysis of patients' sera with first trimester normal intrauterine and abnormal (ectopic) pregnancies. Serum samples were obtained from 38 women with an amenorrhoea of <10 weeks. From these, 19 had a normal intrauterine pregnancy (IUP) and 19 an ectopic pregnancy (EP). Total immunoreactive HCG (HCGi), free beta-HCGi and oestradiol were measured by enzyme immunoassays and bioactive HCG by the mouse Leydig cell bioassay. The alterations in HCG isoform content were measured by the combination of two immunometric assays, B152 for choriocarcinoma-like HCG and B109 for intact HCG detection and expressed as the B152/B109 ratio. Choriocarcinoma-like HCG isoforms ratio measured by B152 and B109 assays was significantly higher in the low subgroups of free beta-HCGi and gestational age (P = 0.0111 and 0.0036 respectively). Whereas bioactive to immunoreactive HCG ratios (b/i ratio) were significantly higher when free beta-HCGi concentrations were low (P = 0.0010), no correlation was found between the variation of bioactivity (b/i ratio) and the proportion of choriocarcinoma-like HCG isoforms (B159/B108). It is concluded that in first trimester pregnancies (i) the modulation of HCG in-vitro bioactivity is not related to the variation of choriocarcinoma-like HCG isoforms secretion and (ii) the amount of choriocarcinoma-like HCG isoforms secreted by the early trophoblast is predominant and may be the result of an early developmental regulation of glycosylation enzyme.

Amenorrhea↗
PubMed2004

The role and comparison of two techniques of paracervical block for pain relief during suction evacuation for first-trimester pregnancy termination.

This prospective study assessed the role and compared two techniques of paracervical block (PCB) for pain relief during suction evacuation for first-trimester termination of pregnancy following cervical priming with misoprostol. One-hundred and thirty-five women undergoing suction evacuation up to 12 weeks of gestation were randomized into three groups: (a) 5 mL of 1% lignocaine injected at the 4 and 8 o'clock positions of the vaginal vault; (b) 5 mL of 1% lignocaine injected at the 4 and 8 o'clock positions of the cervix and (c) no PCB. Pain scores during PCB, cervical dilatation and during and after suction evacuation were compared among the three groups. The sedation and satisfaction levels were also compared. There were no statistically significant differences in the pain levels during PCB, cervical dilatation and suction evacuation and in the satisfaction levels among the three groups. Patients with a lighter sedation level experienced more pain. In conclusion, PCB did not improve the pain levels during first-trimester suction termination of pregnancy after cervical priming with misoprostol and use of intravenous sedation, regardless of whether the local anaesthetic was injected into the cervix or the vaginal vault.

Abortion, Induced↗
PubMed2005

The regulation of trophoblast differentiation by oxygen in the first trimester of pregnancy.

In the first trimester of human pregnancy villous cytotrophoblasts are able to differentiate to form either the overlying syncytiotrophoblast layer or, in anchoring villi, extravillous trophoblasts which grow out from the villi and invade into the maternal decidua, acting to both physically attach the placenta to the decidua, and modify the maternal spiral arteries to sustain pregnancy. During the first 10-12 weeks of gestation, extravillous trophoblast plugs block the spiral arteries and prevent maternal blood flow entering the intervillous space, thereby creating an environment of physiological hypoxia in which placental and fetal development occur. As extravillous trophoblasts migrate away from the villus they differentiate from a proliferative to an invasive phenotype. The hypoxic environment of the first trimester is believed to play an important role in the regulation of trophoblast differentiation. However, there is currently a large body of conflicting experimental evidence concerning this topic. This review examines the experimental evidence to date on the role of oxygen in trophoblast differentiation.

Apoptosis Regulatory Proteins↗