Journal of Obstetrics and Gynaecology最新文献

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A noninvasive method for the detection of foetal DNA in early pregnancy based on differential methylation pattern of Ras association domain family member 1A. 基于 Ras 关联结构域家族成员 1A 的不同甲基化模式的非侵入性检测早孕期胎儿 DNA 的方法。
IF 1.3 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-01-10 DOI: 10.1080/01443615.2023.2292611
Yulin Sha, Wei Liu, Jiongzhi Hong, Yan Yang, Jian Yu, Xiaodong Fu
{"title":"A noninvasive method for the detection of foetal DNA in early pregnancy based on differential methylation pattern of Ras association domain family member 1A.","authors":"Yulin Sha, Wei Liu, Jiongzhi Hong, Yan Yang, Jian Yu, Xiaodong Fu","doi":"10.1080/01443615.2023.2292611","DOIUrl":"10.1080/01443615.2023.2292611","url":null,"abstract":"<p><strong>Background: </strong>The detection of foetal DNA and extravillus trophoblasts (EVTs) in early pregnancy in cervical and uterine samples offers a potential pathway for non-invasive prenatal diagnostics. However, the challenge lies in effectively quantifying these samples. This study introduces a novel approach using the Ras association domain family 1 A (RASSF1A), which exhibits hypermethylation in foetal cells and hypomethylation in maternal cells. The differential methylation pattern of RASSF1A provides a unique biomarker for quantifying foetal cells in cervical and intrauterine samples.</p><p><strong>Methods: </strong>This study was conducted between September 2022 and May 2023. In total, 23 samples (12 cervical cell samples and 11 intrauterine samples) were collected from women in the Sichuan Jinxin Women & Children Hospital, Jingxiu District, Chengdu, China. The cervical cell samples were collected via lavage and brush techniques, and the intrauterine cell samples were obtained via uterine lavage. These samples were collected as part of a broader effort to advance our understanding of foetal cell dynamics during early pregnancy. The sampling methods were chosen for their minimally invasive nature and their potential in capturing a representative cell population from the respective sites. After digestion of the cell samples using a methylation-sensitive restriction enzyme cocktail, a critical step to differentiate between maternal and foetal DNA, the quantitative polymerase chain reaction (qPCR) of RASSF1A and β-actin (ACTB) were employed to measure foetal DNA and cell concentrations. Immunofluorescence techniques targeting histocompatibility complex, class I G (HLA-G) and GATA binding protein 3 (GATA-3) were employed to detect EVTs in the cell samples and in decidual tissue, with the latter providing an additional layer of confirmation for the presence of foetal cells.</p><p><strong>Results: </strong>The results showed no hypermethylated RASSF1A was detected in any of the cervical samples, irrespective of whether the samples were obtained by brush or lavage. However, an average of 17,236 ± 7490 foetal cells per sample were detected in the uterine lavage samples. Foetal cells accounted for approximately 0.14% ± 0.10% of the total cell population in these samples. The presence of EVTs in these samples was confirmed by their expression of both HLA-G and GATA-3.</p><p><strong>Conclusion: </strong>The detection of foetal cells in uterine cavity samples based on hypermethylation of RASSF1A and quantification of foetal cells can be used to prenatal screening. GATA-3 can be used to label EVTs.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bioinformatics analysis in obstetrics and gynaecology. 妇产科生物信息学分析。
IF 1.3 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-05-24 DOI: 10.1080/01443615.2024.2357517
Süleyman Cemil Oğlak
{"title":"Bioinformatics analysis in obstetrics and gynaecology.","authors":"Süleyman Cemil Oğlak","doi":"10.1080/01443615.2024.2357517","DOIUrl":"https://doi.org/10.1080/01443615.2024.2357517","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141092322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prenatal MRI for the diagnosis of foetal pial arteriovenous fistula: a case report and literature review. 产前磁共振成像用于诊断胎儿髂动静脉瘘:病例报告和文献综述。
IF 1.3 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-01-04 DOI: 10.1080/01443615.2023.2299372
Yimin Cao, Weixin Meng, JianXiong Zheng, Chengye Zhang, Duo Gao, LiXia Zhou
{"title":"Prenatal MRI for the diagnosis of foetal pial arteriovenous fistula: a case report and literature review.","authors":"Yimin Cao, Weixin Meng, JianXiong Zheng, Chengye Zhang, Duo Gao, LiXia Zhou","doi":"10.1080/01443615.2023.2299372","DOIUrl":"10.1080/01443615.2023.2299372","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
First-trimester 3D fetal neurosonography: five standardised views. 一胎胎儿三维神经超声:五种标准化视图。
IF 1.3 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-06-07 DOI: 10.1080/01443615.2024.2361848
Fred Ushakov, Adalina Sacco, Pranav Pandya
{"title":"First-trimester 3D fetal neurosonography: five standardised views.","authors":"Fred Ushakov, Adalina Sacco, Pranav Pandya","doi":"10.1080/01443615.2024.2361848","DOIUrl":"https://doi.org/10.1080/01443615.2024.2361848","url":null,"abstract":"<p><strong>Background: </strong>There are several international guidelines for foetal anomalies scanning at 11-14 weeks' gestation. The aim of this study is to present our first-trimester specialist neurosonography protocol with examples of pathology in order to develop a systematic approach to evaluating the first-trimester foetal brain.</p><p><strong>Methods: </strong>Women undergoing a first-trimester foetal medicine ultrasound scan between 2010 and 2020 for multiple indications underwent neurosonography according to a set protocol. 3D transvaginal brain examination was performed in all cases (2000 pregnancies scanned). We retrospectively reviewed all imaging to develop this protocol.</p><p><strong>Results: </strong>We propose that the following five axial-plane parallel views should be obtained when performing neurosonography in the first trimester, moving from cranial to caudal: 1. Lateral ventricles; 2. Third ventricle; 3. Thalamus and mesencephalon; 4. Cerebellum; 5. Fourth ventricle. Examples of these images and abnormalities that can be seen in each plane are given.</p><p><strong>Conclusions: </strong>We have presented a specialist protocol for systematically assessing the foetal brain in the first trimester and given examples of pathology which may be seen in each plane. Further work is needed to prospectively assess detection rates of major abnormalities using this protocol and assess the reproducibility and learning curve of this technique.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alteration of fractional anisotropy in preterm-born individuals: a systematic review and meta-analysis. 早产儿分数各向异性的改变:系统回顾和荟萃分析。
IF 0.9 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-07-10 DOI: 10.1080/01443615.2024.2371956
Le Zhou, Xinghui Liu, Guolin He, Meng Chen, Shuai Zeng, Chuntang Sun
{"title":"Alteration of fractional anisotropy in preterm-born individuals: a systematic review and meta-analysis.","authors":"Le Zhou, Xinghui Liu, Guolin He, Meng Chen, Shuai Zeng, Chuntang Sun","doi":"10.1080/01443615.2024.2371956","DOIUrl":"10.1080/01443615.2024.2371956","url":null,"abstract":"<p><strong>Backgroud: </strong>Neurological disorders are common in preterm (PT) born individuals. Diffusion tensor imaging (DTI) studies using tract-based spatial statistics (TBSS) effectively detect microstructural white matter (WM) abnormalities in the brain. We conducted this systematic review to integrate the findings of TBSS studies to determine the most consistent WM alterations in PT born individuals.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science and Science Direct were searched. DTI studies using TBSS in PT born individuals were screened up to October 2022. The systematic review included studies reporting alterations in FA values for the entire brain in a stereotactic space, with three coordinates (x, y, z), according to the seed-based d mapping method.</p><p><strong>Results: </strong>The search strategy identified seventeen studies that fulfilled our inclusion criteria, with a total of 911 PT-born individuals and 563 matched controls were analysed. Of the seventeen studies, eight were dedicated to 650 adults, five to 411 children and four to 413 infants. Ten studies recruited 812 individuals born very prematurely (GA <29 weeks), six studies recruited 386 moderately premature individuals (GA = 29-32 weeks) and one study recruited 276 individuals born late prematurely (GA >32 weeks). This meta-analysis of six studies including 388 individuals highlighted four brain regions in which fractional anisotropy (FA) was lower in PT group than in people born at term. The quantitative meta-analysis found that the most robust WM alterations were located in the corpus callosum (CC), the bilateral thalamus and the left superior longitudinal fasciculus (SLF) II. Significant changes in FA reflect WM abnormalities in PT born individuals from infant to young adulthood.</p><p><strong>Conclusions: </strong>Significant changes in FA reflect WM abnormalities in individuals born PT from infancy to young adulthood. The abnormal development of the CC, bilateral thalamus and left SLF may play a vital role in the neurodevelopment of PT individuals.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between pelvic floor muscle function and insulin resistance among non-diabetic females: a 3d ultrasound evaluation. 非糖尿病女性盆底肌肉功能与胰岛素抵抗之间的关系:3D 超声波评估。
IF 0.9 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-07-26 DOI: 10.1080/01443615.2024.2381569
Lei Wang, Yunyun Cao, Ping Li, Ping He, Ping Chen
{"title":"Relationship between pelvic floor muscle function and insulin resistance among non-diabetic females: a 3d ultrasound evaluation.","authors":"Lei Wang, Yunyun Cao, Ping Li, Ping He, Ping Chen","doi":"10.1080/01443615.2024.2381569","DOIUrl":"https://doi.org/10.1080/01443615.2024.2381569","url":null,"abstract":"<p><strong>Background: </strong>To use the three-dimensional (3D) ultrasound for assessment of pelvic floor muscle function in non-diabetic females with insulin resistance (IR), and to evaluate its functional relationship with insulin levels.</p><p><strong>Methods: </strong>From October 2022 to November 2023, 216 non-diabetic females with insulin-resistant (IR group) and 118 normal females (control group) were sequentially recruited from our hospital for our study. The 3D ultrasound was used to assess the levator hiatus in resting state for all females regarding diameter lines, perimeters and areas; as well as the Valsalva manoeuvre (VM). The <i>t</i>-test and linear regression model were used to analyse the collected data.</p><p><strong>Results: </strong>The analysis indicates that there were significant differences in the resting state of the levator hiatus between the IR and the control groups (14.8 ± 5.8 cm<sup>2</sup> and 11.6 ± 2.7 cm<sup>2</sup>, <i>p</i> < 0.05); and in the VM (18.2 ± 6.3 cm<sup>2</sup> and 13.4 ± 3. 4 cm<sup>2</sup>, <i>p</i> < 0.05). In addition, the anterior-posterior (AP) diameters of the hiatus on VM were significantly increased in the IR group (40.0 ± 4.7 mm and 33.0 ± 4.4 mm, <i>p</i> < 0.05). With insulin levels as the dependent variable, multivariate regression analysis shows that insulin levels were significantly correlated with the levator hiatus area on VM (<i>p</i> < 0.05) and waist circumference (<i>p</i> < 0.05). The pelvic organ descent on VM in the IR group was significant (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The areas of resting state levator hiatus and on VM were significantly larger in the IR than that in the control groups. In addition, the position of the pelvic organ on VM in the IR group was significantly descended. The insulin levels were correlated with the pelvic floor muscle function.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Causal effects between gut microbiota and endometriosis: a two-sample Mendelian randomisation study. 肠道微生物群与子宫内膜异位症之间的因果效应:双样本孟德尔随机研究。
IF 1.3 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-06-17 DOI: 10.1080/01443615.2024.2362415
Tiefeng Cao, Yunfei Wang, Shen Huimin
{"title":"Causal effects between gut microbiota and endometriosis: a two-sample Mendelian randomisation study.","authors":"Tiefeng Cao, Yunfei Wang, Shen Huimin","doi":"10.1080/01443615.2024.2362415","DOIUrl":"https://doi.org/10.1080/01443615.2024.2362415","url":null,"abstract":"<p><strong>Background: </strong>Previous observational evidence has indicated the potential involvement of the gut microbiota (GM) in the development of endometriosis. However, the causal relationship of the association remains to be investigated.</p><p><strong>Method: </strong>Genome-wide association study (GWAS) data of GM was obtained from the MiBioGen consortium, and GWAS for endometriosis data was from the FinnGen consortium. Initially, a two-sample Mendelian randomisation (MR) analysis was performed to identify specific bacteria associated with endometriosis. Inverse variance-weighted (IVW) was used as the main MR analysis to infer causal relationships. The other four popular MR methods including MR-Egger regression, weighted mode, weighted median, and simple mode were used for secondary confirmation. Subsequently, these selected bacteria were employed as exposure to investigate their causal effects on six sub-types of endometriosis. Furthermore, reverse MR analysis was implemented to evaluate the reverse causal effects. Cochran's Q statistics was used to test the heterogeneity of instrumental variables (IVs); MR-Egger regression was used to test horizontal pleiotropy; MR-PRESSO and leave-one-out sensitivity analysis were applied to find significant outliers.</p><p><strong>Result: </strong>A total of 1131 single nucleotide polymorphisms (SNPs) were collected as IVs for 196 GM taxa with endometriosis as the outcome. We identified 12 causal relationships between endometriosis and GM taxa including 1 phylum, 3 families, 2 orders, and 6 genera (Rikenellaceae RC9 gut group, Eubacterium ruminantium group, Faecalibacterium, Peptococcus, Clostridium sensu stricto 1, and Ruminococcaceae UCG005). Utilizing the Bonferroni method, we identified phylum Cyanobacteria as the strongest associated GM taxa. Subsequently, 6 significant causal effects were uncovered between the 12 selected specific GM and 6 sub-types of endometriosis. Meanwhile, no reverse causal relationship was found. Further, no horizontal pleiotropy and no significant outliers were detected in the sensitive analysis.</p><p><strong>Conclusions: </strong>This MR analysis revealed significant causal effects between GM and endometriosis and phylum Cyanobacteria had the strongest association.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between maternal gestation weight gain and preterm birth according to pre-pregnancy body mass index and HbA1c. 根据孕前体重指数和 HbA1c 确定孕产妇孕期体重增加与早产之间的关系。
IF 0.9 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-05-31 DOI: 10.1080/01443615.2024.2359671
Xiaoxiao Zhang, Binbin Yin, Kaiqi Wu, Lei Fang, Yan Chen
{"title":"Association between maternal gestation weight gain and preterm birth according to pre-pregnancy body mass index and HbA1c.","authors":"Xiaoxiao Zhang, Binbin Yin, Kaiqi Wu, Lei Fang, Yan Chen","doi":"10.1080/01443615.2024.2359671","DOIUrl":"10.1080/01443615.2024.2359671","url":null,"abstract":"<p><strong>Background: </strong>To investigate the association between gestational weight gain (GWG) and preterm birth (PTB) according to pre-pregnancy body mass index (pp-BMI) and glycated haemoglobin (HbA1c) within the normal range.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study between July 2017 and January 2020 at Women's Hospital, Zhejiang University School of Medicine. Women were classified into three groups (inadequate GWG, appropriate GWG, and excessive GWG). In addition, women were divided into different subgroups according to pp-BMI and HbA1c. We estimated the odds ratios (OR) with 95% confidence intervals (CI) to assess the associations between GWG and the risk of PTB. Meanwhile, we adjusted for possible confounding factors, including maternal age, infant sex, family history of diabetes, education, pregnancy mode, delivery mode, parity, and gravidity.</p><p><strong>Results: </strong>The study involved 23,699 pregnant women, of which 1124 (4.70%) were PTB. Women who had inadequate GWG were found to have a significantly higher risk of PTB compared to women with appropriate GWG. In contrast, women with excessive GWG had a reduced risk of PTB. Similarly, GWG and PTB had similar risk associations in the HbA1c and pp-BMI subgroups. Among women with pp-BMI <18.5 kg/m<sup>2</sup>, women with inadequate GWG had a significantly increased risk of PTB compared with women in the control group (HbA1c 4.6-5.0%, appropriate GWG), and the risk increased with increasing HbA1c levels. Similar results were observed in women with normal pp-BMI.</p><p><strong>Conclusions: </strong>There was a significant association between GWG and the risk of PTB, but the risk varied by pp-BMI and HbA1c levels. Reasonable weight gain during pregnancy is essential to prevent PTB. Furthermore, while HbA1c is within the normal range, the higher levels should be noticed.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cell salvage techniques and obstetric haemorrhage. 细胞挽救技术和产科大出血。
IF 0.9 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1080/01443615.2024.2394532
Hashviniya Sekar, Wasim Lodhi, Wai Yoong
{"title":"Cell salvage techniques and obstetric haemorrhage.","authors":"Hashviniya Sekar, Wasim Lodhi, Wai Yoong","doi":"10.1080/01443615.2024.2394532","DOIUrl":"https://doi.org/10.1080/01443615.2024.2394532","url":null,"abstract":"<p><p>Over the last decade, the incidence of postpartum haemorrhage has risen because of increasing maternal age at time of delivery, multiple births, obesity and increased obstetric interventions, resulting in most of these women requiring blood transfusions. While lifesaving, blood transfusion is not without risk. Recipients may rarely develop transfusion-transmitted infections or suffer immunological sequelae. Intraoperative cell salvage is recommended by several national policy making organisations as a safe cost-effective alternative to autologous blood transfusion in both emergency and elective settings. Moreover, emerging data has also revealed that autotransfusion of vaginally shed blood is both feasible and safe. These techniques are useful in patients who decline blood transfusions for both personal and religious reasons and should therefore be taken into consideration when planning place of birth.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Foetal cerebral blood redistribution in idiopathic polyhydramnios and the impact on perinatal outcomes. 特发性多胎妊娠的胎儿脑血再分布及其对围产期结局的影响。
IF 0.9 4区 医学
Journal of Obstetrics and Gynaecology Pub Date : 2024-12-01 Epub Date: 2024-10-03 DOI: 10.1080/01443615.2024.2408678
Inshirah Sgayer, Yousef Haddad, Yara Nakhleh Francis, Ruba Tuma, Lior Lowenstein, Marwan Odeh
{"title":"Foetal cerebral blood redistribution in idiopathic polyhydramnios and the impact on perinatal outcomes.","authors":"Inshirah Sgayer, Yousef Haddad, Yara Nakhleh Francis, Ruba Tuma, Lior Lowenstein, Marwan Odeh","doi":"10.1080/01443615.2024.2408678","DOIUrl":"10.1080/01443615.2024.2408678","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic polyhydramnios is associated with adverse neonatal outcome. The aim of this study was to examine the value of the middle cerebral artery pulsatility index (MCA-PI) in predicting adverse perinatal outcome in pregnancies affected by idiopathic polyhydramnios.</p><p><strong>Methods: </strong>A retrospective study was performed during 2013-2022 at a tertiary-care university affiliated hospital. The study included singleton pregnancies with idiopathic polyhydramnios. Obstetrical and perinatal outcomes were compared between women with MCA-PI <10th percentile and women with MCA-P ≥ 10th percentile. A composite adverse perinatal outcome was defined as an Apgar score <7 at 5 minutes, umbilical artery pH <7.15, emergent caesarean delivery (CD) or operative delivery due to foetal distress, neonatal intensive care admission or foetal death.</p><p><strong>Results: </strong>Among 45,459 pregnancies, 128 (0.3%) had idiopathic polyhydramnios; 27 exhibited MCA-PI <10th percentile. Among the latter, compared to pregnancies with MCA-PI ≥10th percentile group, the rates were higher of emergent CD (25.9% vs. 7.9%, p = 0.017) and adverse perinatal outcomes (37.0% vs. 15.8%, p = 0.020). These differences persisted in a subgroup analysis of women with moderate or severe polyhydramnios. In the MCA-PI <10th percentile group, the median MCA-PI and cerebroplacental ratio were lower: 0.9 vs. 1.7, <i>p</i> < 0.001 and 0.7 vs. 2.1, <i>p</i> < 0.001, respectively. Receiver operating characteristic curve analysis indicated a significant association of MCA-PI with emergent CD/operative delivery for foetal distress (area under curve = 0.672, p = 0.031); the sensitivity was 46.7% and specificity 82.3%. Cerebroplacental ratio values were not associated with adverse perinatal outcomes.</p><p><strong>Conclusions: </strong>Idiopathic polyhydramnios might be associated with foetal cerebral blood flow redistribution, potentially contributing to an increased risk of adverse neonatal outcomes. Prospective studies are required to establish the role of foetal Doppler studies in the antenatal surveillance of idiopathic polyhydramnios, and to determine whether evidence of abnormal MCA-PI serves as a reliable predictor of perinatal outcomes, potentially necessitating labour induction.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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