exudates and Fetal-Distress

Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%-15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low.. To determine whether dydrogesterone supplementation during the first trimester can reduce the incidence of GH among primigravidae.. A prospective cross-sectional comparative study was undertaken in 2010 on 116 primigravidae (study group) who conceived following ART or IUI and supplemented with dydrogesterone up to 16 weeks gestation. They were matched for age and race at 16 weeks gestation with a control patient from the early pregnancy clinic who were primigravidae (n = 116) who conceived spontaneously without dydrogesterone supplementation.. The incidence of GH in the study group was significantly lower than the control group (1.7% versus 12.9%, p = 0.001). The incidence of fetal distress was also significantly lower in the study group compared to the control group (4.3% versus 18.1%, p = 0.001).. Dydrogesterone supplementation during the first trimester significantly reduced the incidence of GH and fetal distress in primigravidae.

Topics: Adult; Cohort Studies; Cross-Sectional Studies; Dydrogesterone; Female; Fetal Distress; Gravidity; Hospitals, University; Humans; Hypertension, Pregnancy-Induced; Incidence; Infertility, Female; Insemination, Artificial; Malaysia; Outpatient Clinics, Hospital; Pilot Projects; Pregnancy; Pregnancy Trimester, First; Progestins; Prospective Studies; Reproductive Techniques, Assisted

The general lack of specialist obstetricians in a developing country such as Malaysia prompted us to develop a computer expert system for the management of fetal distress in rural hospitals. It was based on accepted production rules and implemented on a microcomputer. The clinical prototype was evaluated by 8 specialist obstetricians and 21 non-specialist doctors involved in obstetric care. The initial impression was that this type of expert system may help in diagnosis, decision-making and teaching.

Topics: Diagnosis, Computer-Assisted; Expert Systems; Female; Fetal Distress; Hospitals, Rural; Humans; Malaysia; Pregnancy; Therapy, Computer-Assisted