Preterm Delivery
Conditions
Keywords
PTD
Brief summary
Pregnant women with iron deficiency anemia during third trimester will be assessed for serum ferritin and peak systolic value for fetal middle cerebral artery to find out their correlation with preterm delivery.
Detailed description
Preterm delivery, defined as delivery before 37 weeks of completed gestation (259 days), is a major cause of neonatal morbidity and mortality. Despite extensive research, preterm birth still accounts for 5-10% of all deliveries in developed countries and rates are on the increase, including in the UK. While mortality associated with preterm delivery has declined due to use of antenatal steroids and improvements in neonatal intensive care, preterm babies still remain at risk of major complications. These include respiratory distress syndrome, necrotising enterocolitis, retinopathy of prematurity, sepsis, intraventricular haemorrhage, periventricular leucomalacia and long-term cognitive and sensory impairment. Two major determinants for the mortality and morbidity of babies born preterm are gestation at delivery and birthweight. Prematurity therefore carries significant cost implications to both healthcare services and society in general. High hemoglobin along with anemia was examined in an observational study. At entry to care, which ranged between 6 and 8.4 wk gestation, women with hemoglobin levels exceeding 130g/L had a greater than twofold increase in risk of preterm delivery and infant low birth weight. Neither risk was statistically significant, however, because of the small numbers with high hemoglobin. Similarly, a concentration of the iron storage protein, ferritin, that is high for the third trimester of pregnancy is also associated with an increased risk for preterm and very preterm delivery. Over the last twenty years, interest has been shown in using ultrasound parameters or Doppler studies of fetal blood to assess fetal anaemia. Middle cerebral artery Doppler has taken over and has replaced amniocentesis as a screening test for fetal anaemia in high risk pregnancies.
Interventions
PROCEDUREserum ferritin
serum ferritin will be measured serially at 26, 30 and 34 weeks gestation.
PROCEDUREMCA Doppler
MCA peak systolic value will be assessed at 26, 30 and 34 weeks gestation.
Sponsors
Cairo University
Beni-Suef University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Pregnant female from 24 weeks till 37 weeks gestation. * Patients diagnosed as iron deficiency anemia.
Exclusion criteria
* Medical disorders as hypertension or diabetes. * Kidney and liver diseases. * Any other causes of anemia as haemoglobinopathies.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| High serum ferritin concentration | at 26 to 34 weeks gestation | The investigators will assess high serum ferritin concentration during third trimester and its effect on pregnancy outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PSV in fetal MCA doppler | 26 to 34 weeks gestation | Peak systolic velocity of fetal MCA will be measured to diagnose fetal anemia and if correlated with preterm delivery. |
| Preterm delivery | From 34 to 37 weeks gestation | The investigators will assess pregnancy outcome in the form og preterm delivery with abnormal parameters in the study. |
Countries
Egypt
Contacts
Primary ContactNesreen A Shehata, MD
Backup ContactAbdelgany M Hassan, MD
Outcome results
None listed