We assessed the impact of a lifestyle modification program (LMP) on weight gain in pregnancy and evaluated its effect on adverse pregnancy outcomes. A prospective matched controlled study design was employed. Inclusion criteria consisted of pregnant women with singleton gestations and body mass index (BMI) > or = 30 without underlying medical conditions. In the study group, patients were prospectively enrolled in the first trimester. Through the LMP, women participated in a comprehensive program on nutrition, exercise, and weight control in pregnancy. The control group consisted of matched patients by starting BMI, parity, and socioeconomic status during the same study period cared for at the same institution. The primary outcome evaluated was weight gain in pregnancy. Adverse pregnancy outcomes including preeclampsia, gestational diabetes, gestational hypertension, and various postpartum complications were evaluated between the two groups. Statistical analysis was performed using nonparametric methods, with p < 0.5 considered significant. Twenty-eight patients were recruited for this study and underwent the intervention. Patient compliance with the LMP was 75%, two patients were lost to follow-up, one had a preterm delivery, and four had incomplete data due to various reasons. Twenty-one patients completed their pregnancy and were available for analysis. Twenty matched control patients were identified for analysis. Study participants gained significantly less weight in their pregnancies when compared with controls (mean weight gain 17 versus 34 pounds, respectively; p = 0.008). Secondary outcomes of preeclampsia, gestational diabetes, cesarean section, as well as infant birth weight did not significantly differ between the groups. This study suggests an effective method of reducing prenatal weight gain in the obese population. This type of comprehensive intervention could be an important, cost-effective risk-reduction strategy.
The antenatal detection of fetal intra-abdominal masses poses a diagnostic dilemma for the clinician since the differential diagnosis is extensive. Approximately 15% of abdominal masses found in neonates are of gastrointestinal origin. The remaining abnormalities include ovarian cysts, renal tumors or obstructions, presacral teratomas, and mesenteric omental cysts. We present a case of twin pregnancy where one twin was found to have an enlarging abdominal mass on a prenatal sonogram. The infant was delivered 4 weeks after the lesion was detected, and an exploratory laparotomy was performed on the second day of life. The abdominal distention in this infant was due to a perforated congenital volvulus of the ileum and secondary cystic meconium peritonitis.
CASE REPORTA 28-year-old patient registered a t 15 weeks for prenatal care. Routine prenatal serologic and hematologic tests were unremarkable. At 17 weeks, menstrual age (MA), an ultrasound examination for datelsize discrepancy revealed a twin pregnancy consistent with dates. No fetal abnormalities were detected. A second scan was performed at 30 weeks which showed one twin to have asymmetric growth retardation. Twin A had an EFW of 1471 g (25% for 30 weeks) and twin B had an EFW of 1200 g (
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.