Background Our hypothesis was that exposure to fine particulate matter (PM2.5) is related to abnormal cord insertion, which is categorized as a form of placental implantation abnormality. We investigated the association between exposure to total PM2.5 and its chemical components over the first trimester and abnormal cord insertion, which contributes to the occurrence of adverse birth outcomes. Methods From the Japan Perinatal Registry Network database, we used data on 83 708 women who delivered singleton births at 39 cooperating hospitals in 23 Tokyo wards (2013–2015). We collected PM2.5 on a filter and measured daily concentrations of carbon and ion components. Then, we calculated the average concentrations over the first trimester (0–13 weeks of gestation) for each woman. A multilevel logistic-regression model with the hospital as a random effect was used to estimate the odds ratios (ORs) of abnormal cord insertion. Results Among the 83 708 women (mean age at delivery = 33.7 years), the frequency of abnormal cord insertion was 4.5%, the median concentration [interquartile range (IQR)] of total PM2.5 was 16.1 (3.61) μg/m3 and the OR per IQR for total PM2.5 was 1.14 (95% confidence interval = 1.06–1.23). In the total PM2.5-adjusted models, total carbon, organic carbon, nitrate, ammonium and chloride were positively associated with abnormal insertion. Organic carbon was consistently, and nitrate tended to be, associated with specific types of abnormal insertion (marginal or velamentous cord insertion). Conclusions Exposure to total PM2.5 and some of its components over the first trimester increased the likelihood of abnormal cord insertion.
Poster abstracts superior vena cava with normal size of inferior vena cava, and abnormal intracranial structure. In addition, color US showed many dilated vessels in the intracranial supratentorial lesion. MR imaging/angiography revealed the huge space-occupying lesion in the posterior half of supratentorium, connected with the feeder vessels originated from bilateral middle dural arteries. These findings were compatible with DSM, and we had an expectant managemet until term. However, at 37w6d, just the day before the C/S had been planned, the fetus showed non-reassurring heart rate patterns, and emergent C-section was performed. A 2.790 gr baby girl was delivered at Apgar 1(1 min), 1(5 min), and in spite of intensive resuscitation, the baby died on the same day due to the cardiac failure. In case of congenital cardiomegaly, we always have to take it into consideration that extracardiac lesion might be involved. P27.08 Patients and Methods:A 28-year-old pregnant female was referred at 21 weeks' gestation for a routine prenatal ultrasound. Fetal monitoring was made by ultrasound scans for fetal growth, congenital malformations, and amniotic fluid volume. We also collected information about family medical history. Amniotic fluid samples were taken to perform prenatal cytogenetic diagnosis. Results: Ultrasound examination revealed a single fetus with an abnormal fetal craniofacial and limbs development and oligohydramnios. Craniofacial abnormalities as a sonographic marker suggested the possibility of a chromosomal anomaly. Multiple anomalies were detected, including craniofacial malformations and skeletal malformations. The head shape was markedly abnormal with bulging of the frontal areas and narrowing of the skull at the level of the coronal suture. Karyotype indicated a normal cytogenetic female: 46, XX. There was no family history of congenital anomalies. The couple chose to terminate the pregnancy. The family accepted autopsy. Autopsy findings confirmed the ultrasound diagnosis. Conclusions: The case was sporadic. Spontaneous mutation could be the cause of the case. The complex pattern of fetal anomalies identified and described suggested the possibility of CS. As the gene defect for Carpenter syndrome is unknown, the diagnosis of this condition remains a clinical one. The discovery of single or multiple fetal malformations requires not only complete echo graphic assessment, but also detailed post-abortum examination to allow optimal use of diagnostic aid programmes. Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital, Gyeonggi, Republic of KoreaA 34-year-old woman, G5P1 with five weeks of gestation at Feb., 2007, had been taken warfarin since 1993 because of prosthetic mitral valve replacement. Instead of warfarin, she took heparin 8.500 IU/mL subcutaneously twice a day from 6 weeks to 14 weeks of gestation and she took warfarin 7.5 mg per day from 15 weeks of gestation. After that the warfarin regimen was changed to 5 mg per day. During the pregnancy, the INR was maintained between...
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