[Methods of detecting of fetal abnormalities in the first pregnancy trimesters and the role of chromosome aberrations].
Explore the source record for details and available documents.
Adult↗
SEARCH · PubMed Health
Results for “Pregnancy Trimester, First”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Reliability of transvaginal ultrasound in detecting first trimester pregnancy abnormalities.
OBJECTIVE: To evaluate the reliability of transvaginal ultrasound (US) and human chorionic gonadotropin (hCG) levels in detecting early abnormalities and predicting outcome of pregnancy. PATIENTS: One hundred thirty-two patients were studied, of which 113 had an intrauterine pregnancy and 19 had an ectopic pregnancy (EP). RESULTS: In 78 with singleton normal pregnancies, US revealed a normal crown-rump length, heart motion, and hCG levels between 1,000 to 107,000 mIU/mL. Of 16 patients with small crown-rump length, heart motion present, and normal hCG levels, 6 aborted and 10 reached term. Thus, 6 of 84 (7.14%) singleton with fetal heart motion aborted. Thirteen with small crown-rump and absent heart motion also aborted. All 8 with an empty gestational sac aborted. In 8, transvaginal US detected four twins, two triplets, and two quadruplets, whereas hCG was not discriminative. Transvaginal US revealed an empty uterus in 19 patients with an EP, whereas serum hCG varied between 37 and 10,500 mIU/mL. CONCLUSION: A fetal crown-rump length compatible with gestational age and fetal heart motion seen by transvaginal US can predict a term pregnancy in greater than 90% of patients.
Abortion, Spontaneous↗
[Diagnosis of a trisomy 21 in the first pregnancy trimester. Value of trophoblast sampling].
The authors report a diagnosis of trisomy 21 in the 11th week following the last menstrual period in a patient of 40 years of age. This was made by chorion villi aspiration and direct cytogenetic examination.
Adult↗
The management of failed first trimester pregnancy.
Explore the source record for details and available documents.
Abortion, Spontaneous↗
Failed first trimester pregnancy in perspective.
Explore the source record for details and available documents.
Abortion, Spontaneous↗
Use of a modified test system to determine early pregnancy factor (EPF) levels in patients with normal first trimester pregnancy and after therapeutic abortion.
Human pregnancy can be recognized as early as 48 hours after conception using the rosette inhibition test (RIT) to detect early pregnancy factor (EPF). A modification of the test as originally described by Morton et al. is demonstrated using a monoclonal pan T-cell antibody. Studies were performed to investigate the relationship between EPF levels during normal first trimester intact pregnancies and therapeutic abortions. The change in EPF levels is compared with those of hormones after interrupted pregnancy.
Abortion, Therapeutic↗
Advances in the diagnosis of first-trimester pregnancy problems.
Prompt diagnosis of problems in the first trimester of pregnancy is facilitated by ultrasound scanning and quantitative serum human chorionic gonadotropin and progesterone testing. When used appropriately, these tests can determine whether a patient has a normal early pregnancy, a miscarriage, a missed abortion, an ectopic pregnancy or a hydatidiform mole.
Chorionic Gonadotropin↗
Functional and biochemical aspects of laminaria use in first-trimester pregnancy termination.
The effect of laminaria-induced cervical dilatation of plasma levels of the prostaglandin metabolite 13, 14-dihydro- 15-keto prostaglandin (PGFM) was evaluated in women undergoing elective first-trimester pregnancy termination. Seventy-one women were randomly assigned to either a treatment (n = 45) or control (n = 26) group. Cervical dilatation measured at the time of insertion of the laminaria was 3.0 +/- 0.1 mm compared to 10.2 +/- 0.2 mm at the time of removal of the laminaria 14 to 16 hours later (p less than 0.001). Peripheral levels of PGFM rose from 28.3 +/- 2.4 pg/ml (mean +/- SEM) to 43.0 +/0 2.6 pg/ml at the time of removal of the laminaria (p less than 0.001). Peripheral concentrations of PGFM in controls remained unchanged. Peripheral concentrations of PGFM did not correlate with the patient's symptoms. Although the hydrophilic property of laminaria is considered to be the principal mechanism promoting cervical dilatation, laminaria may alter the elaboration, release, or degradation of uterine prostaglandin F2 alpha. Thus, biochemical as well as mechanical factors may enhance cervical dilatation in laminaria-treated women.
Abortion, Induced↗
A double-blind, randomized controlled trial on the use of a 50:50 mixture of nitrous oxide/oxygen in pain relief during suction evacuation for the first trimester pregnancy termination.
BACKGROUND: This prospective study assessed the role of a 50:50 mixture of nitrous oxide (N2O) and oxygen for pain relief during the termination of first trimester pregnancies by suction evacuation under conscious sedation. METHODS: Ninety women undergoing suction evacuation up to 12 weeks of gestation were randomized by a computer-generated randomization list and allocated using sealed envelopes to receive the N2O/O2 mixture or air during the operation. Pain scores during and after suction evacuation, post-operative side effects and satisfaction level were compared. RESULTS: No statistically significant differences in pain scores, post-operative side effects and satisfaction levels were found between the two groups. CONCLUSION: N2O/O2 did not reduce the pain level during suction evacuation for the first trimester pregnancy termination under conscious sedation.
Abortion, Induced↗
Changes in circulating alphafetoprotein following administration of mifepristone in first trimester pregnancy.
The occurrence of fetomaternal haemorrhage was investigated in 30 women by measuring maternal serum alphafetoprotein (AFP) levels before and after the administration of mifepristone (RU 486) for termination of first trimester pregnancy. A significant rise in AFP levels was seen in 21 women (70%), the increase ranging from 6 to 660% of baseline levels. The apparent frequency of fetomaternal haemorrhage was similar to that reported previously for surgical termination of first trimester pregnancies.
Abortifacient Agents, Nonsteroidal↗
The use of oral misoprostol for pre-abortion cervical priming: a randomised controlled trial of 400 versus 200 microg in first trimester pregnancies.
OBJECTIVE: To compare the impact of 200 and 400 microg oral misoprostol on pre-operative cervical priming in both primi- and multigravidae prior to first trimester termination of pregnancy. Pre-operative cervical dilatation and bleeding were assessed. DESIGN: Randomised controlled trial. SETTING: Norwegian university teaching hospital. SAMPLE: Five hundred and fifty-one women undergoing surgical termination of pregnancy between 7 and 12 weeks of gestation. METHODS: Patients were randomised to either 200 or 400 microg of oral misoprostol 10-16 hours before vacuum aspiration. The degree of cervical dilatation prior to abortion by vacuum aspiration was measured. Pre-operative bleeding and pain were recorded and vaginal bleeding was measured. MAIN OUTCOME MEASURES: Degree of pre-operative cervical dilatation and pre-operative bleeding. RESULTS: The mean cervical dilatation was 5.8 mm (SD 1.7) for the women who received 400 microg misoprostol and 5.4 mm (SD 1.4) for those who received 200 microg (P= 0.004). The pre-operative dilatation was larger in multigravidae than in primigravidae in both dosage groups. The odds ratio (OR) of pre-operative bleeding was 3.3 (95% confidence interval [CI] 2.1-5.0) in the 400 microg dosage group, as compared with the group receiving 200 microg misoprostol. The occurrence of bleeding was dose-dependent. Frequency of bleeding was similar in multigravidae compared with primigravidae in the 400 microg dosage group, whereas the occurrence of bleeding was less in primigravidae than multigravidae in the 200 microg dosage group. Only 89 out of 551 patients bled one or more grams. The volumes measured were not statistically significantly different. Complications were minor, and were distributed equally between the two dosage groups. CONCLUSIONS: The 200 microg oral misoprostol compared with the 400 microg oral misoprostol given 10-16 hours before first trimester surgical abortions results in less pre-operative vaginal bleeding and in a statistically, although not clinically significant reduction in cervical dilatation.
Abortifacient Agents, Nonsteroidal↗
Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy.
OBJECTIVE: To assess the diagnostic value of maternal CA 125 in patients with symptomatic first trimester pregnancy and to evaluate the prognostic significance of CA 125 versus beta-hCG in early pregnancies with intact fetal heartbeat, complicated by vaginal bleeding. STUDY DESIGN: Two prospective open-label studies with longitudinal follow-up in the second trial. SETTING: Academic Department of Obstetrics and Gynecology, University of Cologne. PATIENTS: Study 1: 168 patients presenting between gestational weeks 6 and 12 with: extrauterine pregnancy, 29; missed abortion, 50; incomplete spontaneous abortion, 38; imminent abortion, 33; and normal pregnancy (no history of endometriosis or ovarian mass), 18. Study 2: Fifty consecutive patients with vaginal bleeding during gestational weeks 6-12 all of whom having demostrable fetal heartbeat. Eighteen patients finally aborted whereas the remainder had normally continuing pregnancy until term. MAIN OUTCOME MEASURE: Study 1: Single serum determinations of CA 125 and beta-hCG were correlated with the different disorders observed. Study 2: Two sequential measurements of serum CA 125 and beta-hCG performed within a 5-7 days interval were related to the outcome of pregnancy as indicated by changes of the ultrasound presentation, miscarriage, future hospitalization, or delivery. RESULTS: Study 1: Patients with vaginal bleeding generally had higher median CA 125 values (38 IU/ml; range 1.3-540) compared to non-bleeding patients (17.8 IU/ml; range 1.0-157). No statistically significant differences in regard to median serum CA 125 levels between symptomatic and normal pregnancies occurred: normal pregnancy, 25.5 IU/ml (range 3.2-97); ectopic pregnancy, 26 IU/ml (range 1.3-157); missed abortion, 19.1IU/ml (range 1-242); threatened abortion, 48 IU/ml (range 5.2-540); spontaneous abortion, 40 IU/ml (range 5.4-442). Study 2: Initial CA 125 levels did not differ significantly between both groups of patients with 27/32 non-aborters and 13/18 aborters showing concentrations below 65 IU/ml. After 5-7 days, CA 125 in all patients who eventually aborted remained high or increased whereas non-aborters all had constantly low or steeply declining CA 125 measures. beta-hCG increased in all non-aborters but also in 13/18 aborters during the 5-7 day interval. CONCLUSION: Single serum measurements of CA 125 in symptomatic first trimester pregnant patients failed to discriminate spontaneous abortion, ectopic or normal pregnancies. However, sequential determinations of maternal CA 125 measurements appear to be a highly sensitive prognostic marker in patients with viable pregnancy at risk for abortion.
Abortion, Spontaneous↗
Cervical dilatation with prostaglandin analogues prior to vaginal termination of first trimester pregnancy in nulliparous patients.
Dilatation of the cervix with prostaglandin analogues prior to vaginal termination of pregnancy was attempted in 125 nulliparous women in the first trimester of pregnancy. The patients were divided into five groups (25 in each group) and given a single extra-amniotic dose of one of the following prostaglandin analogues 14-16 hours prior to the evacuation of the uterus by vacuum aspiration. (Group A) 15 (S) 15 methyl PGE2 (free acid); (Group B) 15 (S) 15 methyl PGE2 methyl ester; (Group C) 15 (S) 15 methyl PGF2alpha (free acid); (Group D) 15 (S) 15 methyl PGF2alpha methyl ester and(Group E) a mixture of 15 (S) 15 methyl PGE2methyl ester and 15 (S) 15 methyl PGF2alpha methyl ester. Evacuation of the uterus without mechanical dilatation of the cervix was possible in 111 (90%) of the patients. In an additional 10 patients (8%) there was some degree of cervical dilatation and further mechanical dilatation could be performed easily. With the combination of 15 (S) 15 methyl PGE2 methyl ester and 15 (S) 15 methyl PGF2alpha methyl ester the incidence of gastrointestinal side effects and pyrexia were considerably reduced.
Abortion, Induced↗
Endovaginal pulsed and color Doppler in first-trimester pregnancy.
Endovaginal pulsed and color Doppler techniques were used to evaluate 23 unselected first-trimester pregnancies prior to elective abortion. Mean estimated gestational age was 8.9 +/- 1.6 weeks (range = 6.6-13.0). Low impedance, high velocity peritrophoblastic flow was seen in all cases. Mean peak systolic and end-diastolic velocities were 41.0 +/- 19.7 and 22.9 +/- 6.5 cm/s; mean resistance index (RI) was 0.41 +/- 0.10. Forty-five uterine arteries were evaluated with mean peak systolic and end-diastolic velocities of 44.1 +/- 14.7 and 7.6 +/- 4.3 cm/s; mean RI was 0.81 +/- 0.10. The peritrophoblastic and uterine artery velocities did not correlate with gestational age. Both ovaries were evaluated in 14 patients. One had no detectable flow in either ovary. For the active ovary in the other 13 patients, mean peak systolic and end-diastolic velocities were 27.4 +/- 9.9 and 15.2 +/- 5.9 cm/s; mean RI was 0.44 +/- 0.09. The corresponding values for the inactive ovary were 8.9 +/- 3.8 cm/s, 2.0 +/- 2.0 cm/s, and 0.76 +/- 0.22. These results can be used as a baseline for future studies of abnormal pregnancies.
Adult↗
[Correlations between urinary prostaglandins, placental hormones and prolactin in the first pregnancy trimester].
In the first weeks of pregnancy there is a significant increase of vasodilatator prostaglandins in maternal blood. This increase could be in a cause-effect relation with the increase of progesterone, BHCG and HPRL typical of the first phase of pregnancy. Blood samples of 12 normotensive women reveal that there is not a correlation between placental hormons, HPRL and the increase of prostaglandins, but these hormones seem to offer an important control on other more complex biochemical mechanisms that cause the increase of vasodilator prostaglandins.
Blood Pressure↗
Two different methods of prostaglandin administration for cervix priming before interruption of the first trimester pregnancy.
Priming of uterine cervix with PGF2 alpha has been applied to 253 primigravidae before interruption of first trimester pregnancy. Of them, 140 patients were treated with intracervical PGF2 alpha, while 113 other patients with extraamniotic PGF2 alpha. Spontaneous abortion or complete dilatation occurred in 65% of cases in the first group and in 68% in the second one. Side effects were observed less frequently with intracervical application but no serious complication occurred in either of the groups. Intracervical application of PGF2 alpha gel is recommended because of its effectiveness and low rate of side-effects.
Abortion, Induced↗
Elevated circulating IL-1beta and TNF-alpha, and unaltered IL-6 in first-trimester pregnancies complicated by threatened abortion with an adverse outcome.
The purpose of the present study was to examine the profile of selected proinflammatory cytokines in maternal serum of first-trimester pregnancies complicated by threatened abortion (TACP) and its relevance to obstetric outcome. Serum levels of Th1-type cytokines interleukin-1beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), and Th2-type cytokine interleukin 6 (IL-6) were measured, by ELISA, in 22 women with TACP and adverse outcome at admission (group A) and compared with the corresponding levels of 31 gestational age-matched women with TACP and successful outcome at admission (group B1) and discharge (group B2) and 22 gestational age-matched women with first-trimester uncomplicated pregnancy (group C) who served as controls. Mann-Whitney U or Wilcoxon test was applied as appropriate to compare differences between groups. IL-1beta and TNF-alpha were detected with significantly higher levels in group A, compared to all other groups. On the contrary, IL-6 levels were detected with no significant difference among all the other groups studied. It is concluded that in first-trimester TACP with adverse outcome, a distinct immune response, as reflected by elevated maternal IL-1beta, TNF-alpha, and unaltered IL-6 levels, is relevant to a negative obstetric outcome.
Abortion, Threatened↗
[Serum Ca-125 levels in aneuploidy screening in first pregnancy trimester. Authors' experience].
BACKGROUND: The aims of the current study were to investigate the value of Ca-125 maternal serum levels at the first trimester of pregnancy in order to test heir usefulness for the screening of foetal aneuploidies. MATERIALS AND METHODS: The study was performed retrospectively on frozen maternal serum samples obtained in the antenatal clinics of the department of obstetrics and gynaecology: 85 control normally cycling women, 479 pregnant over 36 years from 8th to 12th week of pregnancy underwent the villocentesis, 383 pregnant women aged from 19 to 45 years underwent the "tritest" (AFP = alpha-fetoprotein, hCG = human chorionic gonadotropin, fE3 = free estriol, age) for the screening of the Down syndrome in the second trimester of pregnancy. All newborns have been tested by Apgar score. The immunoradiometric (IRMA) Ca-125 assay was performed without knowing the result of the cytogenetic test. Over all we have had 11 patients with aneuploidy, 7 Down, 3 Edwards and 1 Patau. The levels of Ca-125 are expressed as MoM multiple of median) in order to compare the levels at different gestational age. RESULTS: We had no significant differences between normal and pathological pregnancies, therefore we don't reckon the Ca-125 assay useful in the screening of aneuploidies in the first trimester of pregnancy.
Adult↗