Publications by authors named "D Janga"
STATIN trial: predictive performance of competing-risks model in screening for pre-eclampsia at 35-37 weeks' gestation.
Ultrasound Obstet Gynecol
January 2022
Objective: To examine the predictive performance of a previously reported competing-risks model of screening for pre-eclampsia (PE) at 35-37 weeks' gestation by combinations of maternal risk factors, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFlt-1) in a validation dataset derived from the screened population of the STATIN study.
Methods: This was a prospective third-trimester multicenter study of screening for PE in singleton pregnancies by means of a previously reported algorithm that combines maternal risk factors and biomarkers. Women in the high-risk group were invited to participate in a trial of pravastatin vs placebo, but the trial showed no evidence of an effect of pravastatin in the prevention of PE.
Background: Effective screening for term preeclampsia is provided by a combination of maternal factors with measurements of mean arterial pressure, serum placental growth factor, and serum soluble fms-like tyrosine kinase-1 at 35 to 37 weeks of gestation, with a detection rate of ≈75% at a screen-positive rate of 10%. However, there is no known intervention to reduce the incidence of the disease.
Methods: In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1120 women with singleton pregnancies at high risk of term preeclampsia to receive pravastatin at a dose of 20 mg/d or placebo from 35 to 37 weeks of gestation until delivery or 41 weeks.
Research Question: Is there vertical transmission (from mother to baby antenatally or intrapartum) after SARS-CoV-2 (COVID-19) infected pregnancy?
Study Design: A systematic search related to SARS-CoV-2 (COVID-19), pregnancy, neonatal complications, viral and vertical transmission. The duration was from December 2019 to May 2020.
Results: A total of 84 studies with 862 COVID positive women were included.
Article Synopsis
- In singleton pregnancies, vaginal progesterone has been shown to lower the risk of early preterm birth and improve neonatal outcomes, but its effectiveness in twin pregnancies is not well-established.
- Previous trials indicate that progesterone's lack of effectiveness in twin pregnancies may result from inadequate dosage or late initiation of treatment.
- The current study aims to evaluate the impact of a higher dosage of vaginal progesterone (600 mg/day) given from 11 to 14 weeks until 34 weeks of gestation on reducing preterm birth rates in women with twin pregnancies across various hospitals in multiple countries.
Article Synopsis
- The systematic review examined the impact of the COVID-19 pandemic on medical and surgical education, highlighting challenges like shortages of protective gear, halted clinical training, and reduced surgical cases.
- The review synthesized findings from 1288 articles, focusing on challenges and innovative solutions, including the use of virtual learning, videoconferencing, and telemedicine to continue education.
- It emphasized the importance of mental health support for trainees and the potential involvement of medical students in frontline COVID-19 care.