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Results for “Pregnancy Trimester, Second”

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At least 19 recordsLinked to original sources
PubMed2005

[Effect of heparin on the ratio of peak systolic to least diastolic flow velocity of umbilical artery at second-trimester pregnancies].

OBJECTIVE: To evaluate the efficiency of heparin on the ratio of peak systolic to least diastolic flow velocity (S/D) of umbilical artery flow velocity waveforms at second-trimester pregnancies. METHODS: Sixty-seven pregnant women carrying 72 fetuses (5 twins) whose fetal umbilical artery flow S/D ratios were more than the 95(th) percentage were divided into study and control groups. In study group, 35 women carrying 38 fetuses were treated with heparin at a dose of 6250 U or 12,500 U + 5% glucose 500 ml intravenously per day for a mean of (3.7 +/- 2.1) days, ranging from 1 to 10 days. In control group, another 32 women with 34 fetuses were treated regularly with dextran-40,500 ml and 10% glucose 500 ml + rooted salvia 30 ml; and 10% glucose 500 ml + 654-II 20 mg for a mean of (6.8 +/- 2.8) days, ranging from 3 to 14 days. After treatment the S/D ratios were re-examined, and compared between two groups. RESULTS: The mean of decreased S/D ratios per day in heparin group and control group was 0.37 (t = 3.620, P < 0.01) and 0.135 (t = 3.061, P < 0.01), respectively. There was significant deference between two groups (t = 1.998, P < 0.05). The treatment time was significantly shorter in heparin group than in the control (t = 3.435, P < 0.01). The effective rate was significantly higher in heparin group than in the control (chi(2) = 10.636, P < 0.01). In the control group, there were 10 cases with S/D ratio increasing continuously. Two of them died of S/D ratio infinity. None of the study group died. CONCLUSIONS: Heparin can significantly decrease the high S/D ratios of umbilical artery flow velocity waveforms at second trimester of pregnancy. It is effective for improving fetal outcomes.

Adult↗
PubMed2006

Placental inflammation and viral infection are implicated in second trimester pregnancy loss.

OBJECTIVE: Second trimester pregnancy loss continues to be a poorly understood adverse obstetric outcome. A case control study was performed to determine if: (1) similar to early spontaneous preterm birth, second trimester loss is associated with histologic chorioamnionitis (HCA); and (2) if HCA is present, which organisms may mediate this placental inflammation. STUDY DESIGN: Cases were patients with a spontaneous second trimester loss. Controls were patients who presented for induction of labor for fetal or maternal indications. Nested polymerase chain reaction (PCR) was performed on placental tissues to detect the presence of viruses and pathogenic and atypical bacteria. Chi-square and Fisher exact test were used to determine if HCA and/or the presence of virus or bacteria were significantly associated with second trimester loss. The associations of interest were adjusted for possible confounders using multivariable logistic regression. RESULTS: HCA was more prevalent in cases (67%) than controls (16%) (P < .001). Seventy-nine percent (66/84) of cases and 44% (7/16) of controls were positive for any virus (P = .01). The rate of bacterial infection was similar in both cases and controls (P = .35). In multivariable logistic regression models, HCA (odds ratio [OR] 14.58, 2.62-81.15) and the presence of any virus (OR 6.62, 1.56-28.07) were independently associated with second trimester loss. CONCLUSION: These studies demonstrate that spontaneous second trimester loss is strongly associated with HCA and viral infections.

Abortion, Spontaneous↗
PubMed2004

Reduced antioxidant capacity in second-trimester pregnancies with pathological uterine perfusion.

OBJECTIVES: To examine whether pathological perfusion in the second trimester is characterized by an altered plasma antioxidant capacity and to investigate whether the total antioxidant capacity in maternal plasma is related to the clinical outcome of these high-risk pregnancies. METHODS: This was a prospective cohort study that included 25 pregnancies with normal and 25 pregnancies with pathological uterine perfusion. Doppler ultrasound measurement of uterine perfusion was performed between 18 and 23 weeks of gestation. Total antioxidant capacity in maternal plasma was measured using a specific photometric assay. RESULTS: Plasma antioxidant capacity of pregnant women with pathological uterine perfusion (227.3 +/- 4.0 micro mol/L) was significantly lower compared with the group with normal uterine perfusion (275.2 +/- 10.5 micro mol/L; P < 0.05). There was a significant negative correlation between antioxidant capacity and mean pulsatility index of the uterine arteries (r = -0.363; P < 0.05). Patients with pathological perfusion and a normal course of pregnancy did not show significantly changed values compared with those patients with later pre-eclampsia or intrauterine growth restriction (235.0 +/- 4.9 micro mol/L vs. 218.6 +/- 6.7 micro mol/L). CONCLUSIONS: Second-trimester pregnancies with pathological uterine perfusion are characterized by a decreased antioxidant capacity in maternal plasma. This reduction is related to the impaired uteroplacental blood flow, but does not reflect the changes characteristic of the oxidative status for diseases like pre-eclampsia since the reduction of the plasma antioxidant capacity is not related to the clinical outcome of these high-risk pregnancies.

Adult↗
PubMed2004

[Combination of screening tests for fetal abnormalities in the first and second pregnancy trimesters].

OBJECTIVE: Screening for fetal abnormalities in the second trimester of pregnancy, based on the concentrations of various markers in serum and maternal age, has become widely used in the past decade. In the first trimester fetal malformations are associated with high values for fetal NT. DESIGN: We propose a new screening method in which measurements obtained during both trimesters are integrated to provide a single estimate of a woman's risk of having a pregnancy affected by genetic syndrome. MATERIAL AND METHODS: Study groups comprised 775 pregnant women where examinations were done between 11th-14th and 15th-19th pregnancy weeks. Nuchal translucency thickness was measured by ultrasound examination in both trimesters of pregnancy. AFP, -HCG and oestriol were measured by ELISA assays. Derived risks were then calculated. RESULTS: Eight fetal aneuploidies were diagnosed. When we used a risk of 1:250 as the cutoff to define a positive result on the integrated test, the rate of detection of fetal abnormalities was 100%, with a false positive rate of 0.6%. CONCLUSION: Integrated test, which is a combination of the ultrasound examination and the triple test allows to achieve high sensitivity and the decrease in the percentage of false positive results, which leads to the reduction in the number of amniocentesis to be performed.

Adult↗
PubMed2005

Study of intrinsic flow properties at the normal pregnancy second trimester.

During normal pregnancy the cardiovascular system undergoes extensive changes. In a previous work we demonstrated the role of the haemorheological profile as predictor of hypertensive gestational disorders through a retrospective study. In an attempt to clarify the rheological characteristics during normal gestation, blood and plasma viscosity, erythrocyte deformability and aggregation, and plasma fibrinogen levels were measured at second trimester of pregnancy. The interrelationships of different haemorheologic parameters, were analysed by Pearson correlation coefficient. The results showed decreased erythrocyte deformability, and increased plasma viscosity and erythrocyte aggregation due to increased fibrinogen in pregnant women. Despite these modifications blood viscosity did not increase, but there was a decrease in relative blood viscosity, therefore, a profile in accordance, from the haemorheological point of view, with the classical concept stating that haemodilution is of the utmost importance to maintain an adequate microcirculation in the uteroplacental unit during normal gestation.

Adolescent↗
PubMed1997

Color Doppler ultrasound of spiral arteries in normal second-trimester pregnancies.

BACKGROUND: Blood flow resistance of the subplacental spiral arteries in second-trimester pregnancies has not been previously reported. A reference range of blood flow resistance of the subplacental spiral arteries at 13-25 gestational weeks was designed in the hope the reference data could provide a basis for Doppler studies of pathologic disorders in second-trimester pregnancies. METHODS: A cross-sectional study was performed in 175 uncomplicated pregnancies at 13-25 gestational weeks. Doppler flow examinations of the subplacental spiral arteries were done. RESULTS: In the 175 normal pregnancies, both the predicted systolic/diastolic ratios(S/ D) (Y = 1.96258-0.02061x gestational age (GA), adjusted R2 = 0.03773, p = 0.003) and resistance indices (RI) (Y = 0.52131-0.00871 x GA, adjusted R2 = 0.03797, p = 0.003) of the subplacental spiral arteries decreased progressively with advancing gestational age. The predicted S/D value of the subplacental spiral artery decreased from 1.695 at the 13th week's gestation (5th% = 1.221, 95th% = 2.169) to 1.468 at the 24th week's gestation (5th% = 1.057, 95th% = 1.878). The predicted RI value of the subplacental spiral artery also decreased from 0.408 at the 13th week's gestation (5th% = 0.193, 95th% = 0.623) to 0.312 at the 24th week's gestation (5th% = 0.148, 95th% = 0.477). CONCLUSIONS: Normal blood flow resistance of the subplacental spiral arteries at 13-25 gestational weeks decreases progressively with advancing gestational age. The fact suggests that trophoblastic invasion of the spiral arteries occurred continuously throughout normal second-trimester pregnancies.

Cross-Sectional Studies↗
PubMed1997

Vaginal misoprostol compared with oral misoprostol in termination of second-trimester pregnancy.

OBJECTIVE: To compare the efficacy of vaginal with oral misoprostol in termination of second-trimester pregnancy after pretreatment with mifepristone. METHODS: Women requesting termination of second-trimester pregnancy were randomized into two groups. Thirty-six to 48 hours after oral administration of 200 mg of mifepristone, women were given either oral or vaginal misoprostol 200 microg every 3 hours for a maximum of five doses in the first 24 hours. Women receiving oral misoprostol also were given a vaginal placebo (vitamin B6), whereas those receiving vaginal misoprostol were given an oral placebo. If they failed to abort, a second course was given by the same route. RESULTS: The median induction-abortion interval in the vaginal group (9 hours) was significantly shorter than that in the oral group (13 hours). The percentage of women aborting within 24 hours in the vaginal group (90%) was significantly higher than that in the oral group (69%). The median amount of misoprostol used in the vaginal group (600 microg) also was significantly less than that in the oral group (1000 microg). There was no significant difference in the incidence of side effects between the two groups except for fatigue and breast tenderness, which were more common in the oral group. Seventy-six percent of the women preferred the oral route, and 24.5% of the women preferred the vaginal route. CONCLUSION: Vaginal misoprostol is more effective than oral misoprostol in termination of second-trimester pregnancy after pretreatment with mifepristone, but more women preferred the oral route.

Abortifacient Agents, Nonsteroidal↗
PubMed1998

Vaginal misoprostol compared with vaginal gemeprost in termination of second trimester pregnancy. A randomized trial.

A prospective randomized trial was conducted in 140 women to compare the efficacy of vaginal gemeprost with vaginal misoprostol for termination of second trimester pregnancy. Women requesting termination of second trimester pregnancy were randomized into two groups. Group A women were given 1 mg vaginal gemeprost every 3 h for a maximum of five doses in the first 24 h, whereas group B women were given 400 micrograms vaginal misoprostol every 3 h for a maximum of five doses in 24 h. The median induction-abortion interval in the vaginal misoprostol group (14.1 h) was significantly shorter than that in the gemeprost group (19.5 h). The percentage of women who achieved successful abortion within 24 h in the misoprostol group (80.0%) was significantly higher than that in the gemeprost group (58.6%). There was no significant difference in the incidence of side effects between the two groups except for diarrhea, which was more common in the gemeprost group. The incidence of fever was more common in the misoprostol group. It is concluded that vaginal misoprostol is more effective than gemeprost in termination of second trimester pregnancy.

Abortifacient Agents, Nonsteroidal↗
PubMed2006

Second-trimester pregnancy interruption with vaginal misoprostol in women with previous cesarean section.

OBJECTIVE: To describe the experience of misoprostol use for pregnancy interruption in the second trimester of women with previous cesarean section. MATERIAL AND METHOD: Seventeen pregnant women with viable fetuses and with previous cesarean section indicated for second trimester pregnancy interruption attending Maharaj Nakorn Chiang Mai Hospital were recruited. All received the same regimen of 400 mcg intravaginal misoprostol every 6 hours. The data was analyzed for demographic characteristics, the adverse outcomes, success rate, and time interval to fetal expulsion. RESULTS: The incidences of adverse outcomes were as follows, fever (47.1%), chill (23.5%), and nausea (17.6%). No uterine rupture occurred in this series at all. The rate of oxytocin use and analgesia requirement was 29.4%. Success rate of pregnancy interruption was 100%, though two of them had an abortion time of more than 48 hours. Time interval from misoprostol administration to fetal expulsion was 25.9 +/- 34. 1 hours (range 4.0-142.7 hours). CONCLUSION: This case series reaffirms the efficacy of misoprostol and suggests that misoprostol may relatively be safe even in cases with previous cesarean section. Therefore, misoprostol may be an option of pregnancy interruption in the second trimester to avoid unnecessary surgical procedure including hysterotomy. However, the safety should be tested by further studies with a larger sample size.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

A comparison of intravaginal misoprostol with prostaglandin E2 for termination of second-trimester pregnancy.

BACKGROUND: The most widely used medical method of terminating second-trimester pregnancy is the intravaginal administration of prostaglandin E2 (dinoprostone [PGE2]). This treatment is highly effective but is associated with severe gastrointestinal side effects and hyperpyrexia. METHODS: We conducted a prospective, randomized trial comparing the efficacy and safety of misoprostol, a prostaglandin E1 analogue (200 micrograms intravaginally every 12 hours), with the efficacy and safety of PGE2 (20 mg intravaginally every 3 hours). The study population included 55 pregnant women between 12 and 22 weeks' gestation who were undergoing termination of pregnancy for either intrauterine fetal death (37 women) or medical or genetic reasons (18 women). RESULTS: The rate of successful abortions within 24 hours was 81 percent (22 of 27 women) with PGE2 and 89 percent (25 of 28 women) with misoprostol (P = 0.47). All the women who received misoprostol had successful abortions within 38 hours. Among those who had an abortion within 24 hours, the mean interval from treatment to abortion was similar in both groups (10.6 hours with PGE2 and 12.0 hours with misoprostol, P = 0.33). The rate of complete abortion, defined as the passage of the fetus and the placenta simultaneously, was 32 percent for PGE2 and 43 percent for misoprostol (P = 0.56). Certain side effects were more frequent in the women receiving PGE2 than in those receiving misoprostol: pyrexia (63 percent vs. 11 percent; P < 0.001), uterine pain (67 percent vs. 57 percent, P = 0.58), vomiting (33 percent vs. 4 percent, P = 0.005), and diarrhea (30 percent vs. 4 percent, P = 0.012). The average cost per treatment was $315.30 for PGE2, as compared with $0.97 for misoprostol. CONCLUSIONS: Misoprostol is at least as effective as PGE2 for the termination of second-trimester pregnancy involving either a dead or a living fetus, but it is less costly, is easier to administer, and is associated with fewer adverse effects.

Abortion, Induced↗
PubMed2003

Second-trimester pregnancy termination: comparison of three different methods.

The object of this study was to compare intravaginal misoprostol and dinoprostone (prostaglandin E2) for second-trimester pregnancy termination, and to examine the role of the nitric oxide donor, glyceryl trinitrate, as a possible alternative to prostaglandins to induce cervical ripening in second-trimester pregnancy termination. This was a randomised clinical trial. The trial involved pregnant women between 13 and 28 weeks' gestation admitted with clear medical or obstetric indications for pregnancy termination, and was carried out in the department of obstetrics and gynecology, Assiut University Hospital, Egypt. Patients were classified into Group A, where pregnancy termination was induced by vaginal misoprostol 100 micrograms every 4 hours with a maximum dose of 500 micrograms; Group B, where induction was by vaginal dinoprostone 6 mg every 6 hours with a maximum dose of 24 mg; and Group C, where induction involved vaginal glyceryl trinitrate 500 micrograms every 6 hours with a maximum dose of 2.5 mg. Twenty-four hours after the start of induction, the rate of complete abortion in the three groups was 100%, 66.67% and 0%, respectively. The rate of complete abortion was 100% in the nitric oxide (glyceryl trinitrate)-induced group after introducing a complementary procedure. The induction-abortion interval was significantly shorter, the number of doses needed was less and the maximum Bishop score reached was greater with misoprostol than with dinoprostone. A higher rate of side effects occurred with the misoprostol-induced group (74%) compared with the other two groups (46.6% and 0%). Misoprostol is a cheap, effective drug for second-trimester pregnancy termination with short induction abortion intervals but a higher rate of side effects. Prostin E2 is also effective in termination of second-trimester pregnancy but is expensive and may require high doses to be administered. Glyceryl trinitrate is an effective drug for cervical ripening (softening) but it has no role in the stimulation of uterine contractions.

Abortifacient Agents↗
PubMed1994

The effect of placenta previa on blood loss in second-trimester pregnancy termination.

OBJECTIVE: To determine whether placenta previa increases bleeding during second-trimester pregnancy termination. METHODS: The records of 131 consecutive women undergoing elective pregnancy termination at 13-24 weeks' gestation were reviewed and divided into those with and without placenta previa based on an ultrasound examination before the procedure. These two groups were then compared for differences in maternal characteristics, estimated blood loss, operative time, infection, and hospital admission. RESULTS: Twenty-three of 131 women (17.6%) had placenta previa. Sixty-seven percent of the previa patients smoked, versus 37% in the control group, a statistically significant difference. A statistical difference was noted with respect to placenta previa in intraoperative blood loss (P < .05), but not operative time, time to discharge, infection, hemorrhage, or other complications. CONCLUSION: Second-trimester pregnancy terminations in the presence of placenta previa are associated with a higher estimated blood loss, but no apparent increase in abortion-related infection, postoperative transfusion requirements, hysterectomy, or other complications.

Abortion, Therapeutic↗
PubMed2003

Nuchal translucence incorporated into a one-stage multifactorial screening model for Down syndrome prediction at second-trimester pregnancy.

The aim of this study was to achieve one-stage screening for trisomy 21 using a combination of nuchal translucency (NuT) measurement and maternal serum alpha-fetoprotein (AFP) and free beta-human chorionic gonadotrophin (hCG) biochemistry levels in the second trimester among a high-risk study population. From January 1998 to June 2001, 45 cases of trisomy 21 were prenatally found and confirmed in the hospital-based cytogenetic diagnosis laboratory. A total of 867 normal singleton pregnancies were enrolled as controls from the antenatal care clinics in the hospital. All study and control subjects between 13 weeks and 18 weeks of gestation with a mean age of 15.2 +/- 1.3 weeks underwent one-stage nuchal translucence measurements and maternal serum biochemical screening for Down syndrome. The final logistic model contained beta-hCG (multiples of the gestational median or MoM), maternal age (matA), nuchal translucence (NuT MoM) and AFP (MoM) as covariates. Also, the estimated coefficients of the regression were highly significant. This model provided the estimated probability of Down syndrome as follows: Pr (Down syndrome) = exp (Z)/ [1 + exp (Z)], where Z = -11.18 + 0.64 x (beta-hCG MoM) + 0.25 x matA + 1.32 x NuT MoM -2.23 x AFP MoM. The logistic regression with estimated coefficients was installed in a Palm digital assistant (PDA) equipped with Excel (Microsoft). The risk probability of Down syndrome could be readily calculated after inputting data for all four predictor variables.

Adult↗
PubMed1985

[Intra-amniotic injection of crystal trichosanthin for induction of labour in second trimester pregnancy].

Labor was induced in a group of 200 women in 2nd trimester of pregnancy by crystal trichosanthia injected into the amniotic cavity. It was effective and the success rate was 99.5%. The average abortion inducing interval was 4.69 days porm 1.15 days. Blood loss was scanty during labor in 90.5% cases, being less than 100 ml. There was only 1 case suffering laceration of cervix. The side effects of crystal trichosanthin were dramatically reduced with the simultaneous use of betamethason intramuscularly for 3 successive days. Side effects were reduced because the drug was concentrated in the cavity and only a little was present in the blood stream and, what's more, the anti-allergic action of betamethason was effective. Trichosanthin is a kind of plant protein so it will possibly cause allergic reaction, which can induce the production of antibodies that will influence the effect of its reinjection.

Abortifacient Agents↗