Journal of Perinatal Medicine最新文献

Risk factors and outcomes of uterine rupture before onset of labor vs. during labor: a multicenter study.

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-02-13 DOI: 10.1515/jpm-2024-0309

Qingwen Nie, Shujuan Luo, Bingjun Chen, Lu Wang, Fang He

{"title":"Risk factors and outcomes of uterine rupture before onset of labor vs. during labor: a multicenter study.","authors":"Qingwen Nie, Shujuan Luo, Bingjun Chen, Lu Wang, Fang He","doi":"10.1515/jpm-2024-0309","DOIUrl":"https://doi.org/10.1515/jpm-2024-0309","url":null,"abstract":"Objectives: This study aims to reveal the distinctions between uterine rupture (UR) that occurs before onset of labor and during labor.Methods: This multicenter study was conducted across three tertiary hospitals in South China involving obstetrical UR from January 2009 to April 2022. Cases were categorized into two groups based on the timing of UR: prelabor and labor.Results: Among the cases of UR, 42 were classified in the prelabor group, and 27 in the labor group. The prelabor group had a higher prevalence of histories of myomectomies, ectopic pregnancy surgeries, congenital uterine anomalies, and prior URs. Among these ruptures, 45.2 % were located at cesarean section (CS) scars, compared to 81.5 % of cases during labor. Ruptures before onset of labor occurred across all gestational intervals, whereas those during labor, except one, occurred after 32 weeks. The median gestational age was 33 and 39 weeks in each group. Notably, prelabor cases demonstrated longer symptom-to-delivery intervals. Placenta percreta was more common in the prelabor group (16.7 vs. 3.7 % in the labor group). Among labor-related cases, 16 of the 27 occurred during trial of labor after cesarean (TOLAC), and four were identified following vaginal birth after cesarean (VBAC).Conclusions: URs differ by timing relative to labor. Ruptures before onset of labor more often resulted from scars other than CS and placenta percreta, occurring at earlier gestational weeks. This finding highlighted challenges in diagnosis and management. In contrast, ruptures during labor mostly occurred after 32 weeks and were strongly associated with TOLAC/VBAC.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399407","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

The reference ranges for fetal ductus venosus flow velocities and calculated waveform indices and their predictive values for right heart diseases.

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-02-06 DOI: 10.1515/jpm-2024-0577

Jian Wu, Yanping Ruan, Xinru Gao, Hairui Wang, Yuxuan Guan, Xiaoyan Hao, Jiancheng Han, Xiaoyan Gu, Yihua He

{"title":"The reference ranges for fetal ductus venosus flow velocities and calculated waveform indices and their predictive values for right heart diseases.","authors":"Jian Wu, Yanping Ruan, Xinru Gao, Hairui Wang, Yuxuan Guan, Xiaoyan Hao, Jiancheng Han, Xiaoyan Gu, Yihua He","doi":"10.1515/jpm-2024-0577","DOIUrl":"https://doi.org/10.1515/jpm-2024-0577","url":null,"abstract":"Objectives: This study endeavors to establish comprehensive normal reference ranges and Z score formulas for ductus venosus (DV) flow velocity parameters and calculated waveform indices across different gestational ages in low-risk fetuses. Furthermore, we aim to validate the predictive capabilities of these Z score calculation formulas in fetuses with diverse right heart diseases.Methods: 8,953 singleton low-risk fetuses and 70 fetuses diagnosed with different types of right heart diseases were retrospectively enrolled. The DV blood flow velocities during the cardiac cycle (ventricular systolic wave velocity [S], ventricular diastolic wave velocity [D], atrial contraction wave velocity [A], and time-averaged maximum velocity [Tamx]) and calculated waveform indices (preload index [PLI], peak velocity index [PVI], pulsatility index [PI], S/A, and S/D) were obtained. Ninety low-risk fetuses were randomly selected as the control group to verify the predictive value of the Z score model for fetuses with different types of right heart diseases.Results: As gestational age increased (16-39 weeks), the mean values of S, D, A, and Tamx progressively increased; conversely, the mean values of PLI, PVI, PI, and S/A decreased, respectively, and the median value of S/D remained stable. The Z score-transformed A, PLI, PVI, PI, and S/A could serve as predictors of overall right heart diseases. Different DV Doppler parameter Z scores exhibited varying predictive values for different subtypes of right heart diseases.Conclusions: Normal reference ranges and corresponding Z score calculation formulas for DV hemodynamic parameters were established, which have demonstrated significant diagnostic values in identifying right heart diseases.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256074","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

A crisis in U.S. maternal healthcare: lessons from Europe for the U.S.

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-02-06 DOI: 10.1515/jpm-2024-0606

Amos Grünebaum, Joachim Dudenhausen, Frank A Chervenak

引用次数: 0

Investigation of cardiac remodeling and cardiac function on fetuses conceived via artificial reproductive technologies: a review. 人工生殖技术胎儿心脏重构和心脏功能的研究进展。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-21 DOI: 10.1515/jpm-2024-0346

Konstantinos Tasias, Maria Papamichail, Zacharias Fasoulakis, Marianna Theodora, Georgios Daskalakis, Panos Antsaklis

{"title":"Investigation of cardiac remodeling and cardiac function on fetuses conceived via artificial reproductive technologies: a review.","authors":"Konstantinos Tasias, Maria Papamichail, Zacharias Fasoulakis, Marianna Theodora, Georgios Daskalakis, Panos Antsaklis","doi":"10.1515/jpm-2024-0346","DOIUrl":"https://doi.org/10.1515/jpm-2024-0346","url":null,"abstract":"The prevalence of artificial reproductive technologies (ART), such as intra-uterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), has surged in response to the global increase in infertility rates, now impacting 17.5 % of couples. With over nine million babies born through ART, the safety and efficacy of these methods are largely recognized; however, emerging concerns regarding their association with prenatal and long-term health risks, especially cardiovascular disease (CVD), necessitate a thorough examination. This review synthesizes recent findings on the cardiac remodeling observed in ART-conceived fetuses, highlighting the potential for sub-clinical dysfunction and subsequent cardiovascular anomalies that may extend into adolescence. It delves into the perinatal complications linked to ART and examines the contribution of the Renin-Angiotensin System, epigenetic modifications, and altered microRNA expressions to fetal cardiovascular development. The analysis further differentiates the cardiac effects of fresh vs. frozen ART cycles and investigates the enduring nature of these changes beyond birth. Addressing the elevated CVD risk among ART individuals, the review suggests proactive measures, including lifestyle adjustments initiated early in life, to mitigate potential adverse outcomes. It emphasizes the critical need for ongoing research and intervention strategies to safeguard the cardiovascular health of the increasing number of ART-conceived individuals.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007179","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

Comparing achievability and reproducibility of pulsed wave doppler and tissue doppler myocardial performance index and spatiotemporal image correlation annular plane systolic excursion in the cardiac function assessment of normal pregnancies. 比较脉冲波多普勒和组织多普勒心肌功能指数及时空图像相关性环面收缩偏移在正常妊娠心功能评估中的可实现性和可重复性。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-14 DOI: 10.1515/jpm-2023-0446

Avnet Hagai, Erenbourg Anna, Thomas Samantha, Yagel Simcha, Welsh Alec

{"title":"Comparing achievability and reproducibility of pulsed wave doppler and tissue doppler myocardial performance index and spatiotemporal image correlation annular plane systolic excursion in the cardiac function assessment of normal pregnancies.","authors":"Avnet Hagai, Erenbourg Anna, Thomas Samantha, Yagel Simcha, Welsh Alec","doi":"10.1515/jpm-2023-0446","DOIUrl":"https://doi.org/10.1515/jpm-2023-0446","url":null,"abstract":"Objectives: Multiple techniques have been proposed for functional fetal cardiology, including pulsed-wave (PW) and tissue Doppler imaging (TDI), Myocardial Performance Index (MPI), annular plane systolic excursion (TAPSE/MAPSE) and spatiotemporal image correlation (STIC). We aimed to compare these techniques' achievability and reproducibility to determine their clinical utility for each cardiac side.Methods: Uncomplicated pregnancies from 22 to 39 weeks were recruited and images and volumes stored for offline analysis. PWD-MPI values were calculated using previously demonstrated automation algorithms, and the remaining volumes were evaluated by two experienced operators.Results: 79 women were scanned generating 222 volumes, with high achievability (>86 %) for all three modalities on both cardiac sides; highest for TAPSE/MAPSE (94 %). Repeatability (ICC) on the right side of the heart was highest for TAPSE (inter-observer 0.86; intraobserver 0.73), compared to PWD-MPI (0.69) and TDI-MPI (0.83). For the left side, repeatability was high for both PWD-MPI (0.80) and TDI-MPI (0.86) though low for MAPSE (inter-observer 0.7, intra-observer 0.69). There was poor correlation between PWD-MPI and TDI-MPI values.Conclusions: TAPSE appears most reliable for evaluation of right heart function, compared to PWD-MPI for the left. As TDI-MPI correlates poorly with PWD-MPI, the latter appears to be the functional tool of choice.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971130","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

The J ournal of P erinatal M edicine is switching its publication model to open access. 《产前医学杂志》正将其出版模式改为开放获取。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-13 Print Date: 2025-01-29 DOI: 10.1515/jpm-2025-0009

Joachim W Dudenhausen

引用次数: 0

Antepartum multidisciplinary approach improves postpartum pain scores in patients with opioid use disorder. 产前多学科方法改善阿片类药物使用障碍患者产后疼痛评分。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-13 DOI: 10.1515/jpm-2024-0358

Tiffany Yang, Emily Stetler, Diana Garretto, Kimberly Herrera, David Garry, Cassandra Heiselman

{"title":"Antepartum multidisciplinary approach improves postpartum pain scores in patients with opioid use disorder.","authors":"Tiffany Yang, Emily Stetler, Diana Garretto, Kimberly Herrera, David Garry, Cassandra Heiselman","doi":"10.1515/jpm-2024-0358","DOIUrl":"https://doi.org/10.1515/jpm-2024-0358","url":null,"abstract":"Objectives: Pregnancies affected by opioid use disorder (OUD) face difficulties with postpartum pain control. This study aims to determine if prenatal anesthesia consultation for patients on medication for opioid use disorder (MOUD) affects maternal postpartum pain control.Methods: This is a retrospective cohort study of pregnant patients diagnosed on MOUD who received prenatal care and delivered at a single academic institution between January 2017 and July 2023. Subjects were divided into those who received prenatal anesthesia consultation and those who did not. Severe pain (numerical rating scale 0-10) was defined as score≥7. Statistical analysis was performed using Chi-square, Mann-Whitney U, and multivariable logistical regression tests with significance defined as p<0.05.Results: The cohort included 359 women on MOUD. Of these, 17.8 % (n=64) received anesthesia consultation and 82.2 % (n=295) did not. Factors found associated with receiving anesthesia consultation were prenatal care with an obstetric provider trained in maternal OUD (p<0.01), psychiatric diagnosis (p<0.01) and higher number of prenatal care visits (10.12 vs. 8.99, p=0.007). When comparing pain scores in the first 24 h postpartum, patients with prenatal anesthesia consultation had statistically significant lower rates of severe pain compared to those who did not (25 vs. 44.7 %, p=0.004). Anesthesia consultation (OR 0.34) and cesarean section (OR 2.81) were independent predictors of severe postpartum pain in the first 24 h after delivery.Conclusions: Patients on MOUD who received antenatal anesthesia consultation report lower postpartum pain scores than those without consultation, which supports that multidisciplinary care for pregnant patients with OUD may help the postpartum experience.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965580","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

Adrenal gland size in fetuses with congenital heart disease. 先天性心脏病胎儿的肾上腺大小。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-07 DOI: 10.1515/jpm-2024-0402

Kathleen M Oberste, Daniela Willy, Chiara de Santis, Mareike Möllers, Ralf Schmitz, Kathrin Oelmeier

{"title":"Adrenal gland size in fetuses with congenital heart disease.","authors":"Kathleen M Oberste, Daniela Willy, Chiara de Santis, Mareike Möllers, Ralf Schmitz, Kathrin Oelmeier","doi":"10.1515/jpm-2024-0402","DOIUrl":"https://doi.org/10.1515/jpm-2024-0402","url":null,"abstract":"Objectives: The aim of this study was to compare the adrenal gland size of fetuses with congenital heart diseases (CHD) and normal fetuses.Methods: In this cross-sectional prospective study we measured the fetal adrenal gland size (total width, cortex width, medulla width, adrenal gland ratio of total width divided by medulla width) in 62 fetuses with CHD and 62 gestational-age-matched controls between 20 + 0 and 39 + 3 weeks of gestation. First, we clustered three CHD subgroups: CHD group_1 with a normal outflow tract (n=7), CHD group_2 with an altered outflow tract and anterograde flow in the ascending aorta (n=39) and CHD group_3 with an altered outflow tract and retrograde flow in the ascending aorta (n=16). In a second step, we summed up all CHD cases with outflow tract anomalies to CHD group_2 + 3 (n=55). Each group was compared to their matched controls.Results: Prenatally, fetuses affected by CHD with outflow tract alterations show an elevated adrenal gland ratio (total width/medulla width) compared to normal fetuses (p<0.001). This finding applies to both subgroups of outflow tract alterations with anterograde (p<0.001) and retrograde perfusion of the ascending aorta (p<0.001).Conclusions: Fetuses affected by CHD with an altered outflow tract show a relatively larger cortex of the adrenal gland compared to normal fetuses. The results of this study suggest that haemodynamic changes during fetal maturation cause an elevated metabolic stress level that may be responsible for an enlarged adrenal gland ratio.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932149","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

Vasa previa guidelines and their supporting evidence. Vasa previa指南及其支持证据。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-07 DOI: 10.1515/jpm-2024-0473

Carine McMahon, Shelene Laiu, Yinka Oyelese, Daniel L Rolnik

{"title":"Vasa previa guidelines and their supporting evidence.","authors":"Carine McMahon, Shelene Laiu, Yinka Oyelese, Daniel L Rolnik","doi":"10.1515/jpm-2024-0473","DOIUrl":"https://doi.org/10.1515/jpm-2024-0473","url":null,"abstract":"Introduction: Vasa previa (VP) is a serious pregnancy complication in which fetal vessels, unprotected by the umbilical cord, run across or within close proximity to the internal cervical os, which can potentially result in fetal exsanguination in the event of membrane rupture. There is global consensus that women with antenatally diagnosed VP should have caesarean delivery prior to onset of labour to prevent the catastrophic complications of VP. However, there is variability in the approach to management of these women antenatally, particularly regarding hospitalisation and timing of steroid administration and delivery.Content: In this review, we aim to compare the VP guidelines of four prominent obstetric advisory bodies: The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), The Royal College of Obstetricians and Gynaecologists (RCOG), The Society for Maternal-Fetal Medicine (SMFM) and The Society of Obstetricians and Gynaecologists of Canada (SOGC) with a particular focus on antenatal hospitalisation, administration of steroids, and timing of birth in asymptomatic patients. We also aim to evaluate the evidence cited to support their recommendations.Summary: Current guidelines are based on low-quality evidence that often does not include insights from recent studies and are vague in their recommendations for antenatal hospitalisation and timing of delivery.Outlook: More robust evidence for management of VP is needed to inform future guidelines.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932077","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

Proposal of a novel index in assessing perinatal mortality in prenatal diagnosis of Sacrococcygeal Teratoma. 骶尾翼畸胎瘤产前诊断中围产儿死亡率评估新指标的提出。

IF 1.7 4区医学

Journal of Perinatal Medicine Pub Date : 2025-01-06 DOI: 10.1515/jpm-2024-0202

Pedro Llancarí, Diego Velarde-García, Rommy H Novoa, Walter Ventura

{"title":"Proposal of a novel index in assessing perinatal mortality in prenatal diagnosis of Sacrococcygeal Teratoma.","authors":"Pedro Llancarí, Diego Velarde-García, Rommy H Novoa, Walter Ventura","doi":"10.1515/jpm-2024-0202","DOIUrl":"https://doi.org/10.1515/jpm-2024-0202","url":null,"abstract":"Objectives: To describe obstetric characteristics and perinatal outcomes in a serie of fetuses with Sacrococcygeal Teratoma (SCT) and propose a novel index to assess postnatal mortality based on the THC ratio and the addition of the presence of polyhydramnios.Methods: A retrospective study in a referral teaching hospital between 2013 and 2023. A descriptive analysis and a receiver operating characteristic (ROC) curve were performed to the determine the optimal cutoff value of the THC plus polyhydramnios based on optimal sensitivity and specificity.Results: Eleven out of 15 fetuses were included in our series during the study period. The median gestational age at prenatal diagnosis was 30.9 weeks and the median gestational age at birth was 35.8 weeks. Seven patients developed polyhydramnios. There was no intrauterine death. There were four deaths after birth (36.4 %). A cutoff value of THC plus polyhydramnios higher than 3.0 was associated with postnatal mortality with 100 % sensitivity and 86 % specificity. There was no significant difference comparing TFR with THC plus polyhydramnios.Conclusions: We report a high postnatal mortality of 36 % among fetuses with diagnosis of Sacrococcygeal Teratoma. Additionally, we propose a potential useful index associated with postnatal mortality based on the THC and the addition of polyhydramnios with a sensitivity of 100 %.","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927433","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