21 research outputs found
Hyperreactio luteinalis in a monochorionic twin pregnancy complicated by preeclampsia: A case report.
Associations between Phthalate Exposure and Gestational Age at Delivery in a Diverse Pregnancy Cohort
The association between prenatal phthalate exposure and late preterm birth (LPTB) is unclear. We examined singleton pregnancies (2006–2011) from a racially and socioeconomically diverse sample of women in the CANDLE cohort of the ECHO-PATHWAYS Consortium. Urine collected in the second and third trimester was analyzed for 14 phthalate metabolites. Multivariate logistic and linear regressions were performed for LPTB, defined as delivery 34–37 weeks, and gestational week, respectively. Models were controlled for socio-demographics, behavioral factors, clinical measurements, medical history, and phthalates in the other trimester. Effect modification by race and pregnancy stress, indicated by intimate partner violence (IPV), was investigated. We conducted a secondary analysis in women with spontaneous preterm labor. The rate of LPTB among 1408 women (61% Black, 32% White) was 6.7%. There was no evidence of decreased gestational age (GA) in association with any phthalate metabolite. Each two-fold increase in third trimester mono-benzyl phthalate (MBzP) was associated with 0.08 weeks longer gestational age (95% CI: 0.03, 0.12). When restricting to women with spontaneous labor, second trimester mono-n-butyl phthalate (MBP) was associated with 54% higher odds (95% CI: 2%, 132%) of LPTB. Associations were not modified by maternal race or IPV exposure. In conclusion, we observed mixed evidence concerning our hypothesis that prenatal phthalate exposure increases risk of LPTB, though secondary analyses suggest increased risk of spontaneous LPTB associated with MBP, which is consistent with a recent pooled analysis of 16 cohorts
Recommended from our members
Hyperreactio luteinalis in a monochorionic twin pregnancy complicated by preeclampsia: A case report.
Hyperreactio luteinalis (HL) is a rare benign complication of pregnancy that is characterized by progressive ovarian enlargement and hyperandrogenism. We present a case of a 30-year-old woman with a spontaneous monochorionic diamniotic twin pregnancy who presented with early-onset preeclampsia, concern about possible twin-twin transfusion syndrome, and bilateral enlarged ovarian masses. Both ovaries had multiple thin-walled unilocular cysts; one ovary measured 17.9 × 17.5 × 9.1 cm and the other 12.5 × 11 × 12.3 cm. After extensive counseling, the patient underwent an uncomplicated dilation and evacuation. Postoperative assessment indicated elevated androgen levels, which spontaneously resolved, supporting the clinical diagnosis of HL. It is important to consider HL in the differential diagnosis of adnexal masses in pregnancy. HL spontaneously regresses after delivery and is managed expectantly. HL has been associated with gestational trophoblastic disease, multiple gestations, preeclampsia, and twin-twin transfusion syndrome
Hyperreactio luteinalis in a monochorionic twin pregnancy complicated by preeclampsia: A case report
Hyperreactio luteinalis (HL) is a rare benign complication of pregnancy that is characterized by progressive ovarian enlargement and hyperandrogenism. We present a case of a 30-year-old woman with a spontaneous monochorionic diamniotic twin pregnancy who presented with early-onset preeclampsia, concern about possible twin-twin transfusion syndrome, and bilateral enlarged ovarian masses. Both ovaries had multiple thin-walled unilocular cysts; one ovary measured 17.9 × 17.5 × 9.1 cm and the other 12.5 × 11 × 12.3 cm. After extensive counseling, the patient underwent an uncomplicated dilation and evacuation. Postoperative assessment indicated elevated androgen levels, which spontaneously resolved, supporting the clinical diagnosis of HL. It is important to consider HL in the differential diagnosis of adnexal masses in pregnancy. HL spontaneously regresses after delivery and is managed expectantly. HL has been associated with gestational trophoblastic disease, multiple gestations, preeclampsia, and twin-twin transfusion syndrome. Keywords: Adnexal mass, Pregnancy, Hyperandrogenism, Preeclampsia, Twin-twin transfusion syndrom
Recommended from our members
Management of Severe Range Blood Pressures During Obstetrical Care: A Quality Improvement Project
Predictive Modeling of Length of Hospital Stay Following Adult Spinal Deformity Correction: Analysis of 653 Patients with an Accuracy of 75% within 2 Days
Associations between Phthalate Exposure and Gestational Age at Delivery in a Diverse Pregnancy Cohort
The association between prenatal phthalate exposure and late preterm birth (LPTB) is unclear. We examined singleton pregnancies (2006-2011) from a racially and socioeconomically diverse sample of women in the CANDLE cohort of the ECHO-PATHWAYS Consortium. Urine collected in the second and third trimester was analyzed for 14 phthalate metabolites. Multivariate logistic and linear regressions were performed for LPTB, defined as delivery 34-37 weeks, and gestational week, respectively. Models were controlled for socio-demographics, behavioral factors, clinical measurements, medical history, and phthalates in the other trimester. Effect modification by race and pregnancy stress, indicated by intimate partner violence (IPV), was investigated. We conducted a secondary analysis in women with spontaneous preterm labor. The rate of LPTB among 1408 women (61% Black, 32% White) was 6.7%. There was no evidence of decreased gestational age (GA) in association with any phthalate metabolite. Each two-fold increase in third trimester mono-benzyl phthalate (MBzP) was associated with 0.08 weeks longer gestational age (95% CI: 0.03, 0.12). When restricting to women with spontaneous labor, second trimester mono-n-butyl phthalate (MBP) was associated with 54% higher odds (95% CI: 2%, 132%) of LPTB. Associations were not modified by maternal race or IPV exposure. In conclusion, we observed mixed evidence concerning our hypothesis that prenatal phthalate exposure increases risk of LPTB, though secondary analyses suggest increased risk of spontaneous LPTB associated with MBP, which is consistent with a recent pooled analysis of 16 cohorts