Journal of Perinatal Medicine最新文献

{"title":"Fetal origins of adult disease: transforming prenatal care by integrating Barker's Hypothesis with AI-driven 4D ultrasound.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Muhammad Ilham Aldika Akbar, Muhammad Alamsyah Aziz, Julian Dewantiningrum, Mochammad Besari Adi Pramono, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2024-0617","DOIUrl":"https://doi.org/10.1515/jpm-2024-0617","url":null,"abstract":"<p><strong>Introduction: </strong>The fetal origins of adult disease, widely known as Barker's Hypothesis, suggest that adverse fetal environments significantly impact the risk of developing chronic diseases, such as diabetes and cardiovascular conditions, in adulthood. Recent advancements in 4D ultrasound (4D US) and artificial intelligence (AI) technologies offer a promising avenue for improving prenatal diagnostics and validating this hypothesis. These innovations provide detailed insights into fetal behavior and neurodevelopment, linking early developmental markers to long-term health outcomes.</p><p><strong>Content: </strong>This study synthesizes contemporary developments in AI-enhanced 4D US, focusing on their roles in detecting fetal anomalies, assessing neurodevelopmental markers, and evaluating congenital heart defects. The integration of AI with 4D US allows for real-time, high-resolution visualization of fetal anatomy and behavior, surpassing the diagnostic precision of traditional methods. Despite these advancements, challenges such as algorithmic bias, data diversity, and real-world validation persist and require further exploration.</p><p><strong>Summary: </strong>Findings demonstrate that AI-driven 4D US improves diagnostic sensitivity and accuracy, enabling earlier detection of fetal abnormalities and optimization of clinical workflows. By providing a more comprehensive understanding of fetal programming, these technologies substantiate the links between early-life conditions and adult health outcomes, as proposed by Barker's Hypothesis.</p><p><strong>Outlook: </strong>The integration of AI and 4D US has the potential to revolutionize prenatal care, paving the way for personalized maternal-fetal healthcare. Future research should focus on addressing current limitations, including ethical concerns and accessibility challenges, to promote equitable implementation. Such advancements could significantly reduce the global burden of chronic diseases and foster healthier generations.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803633","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}

{"title":"Teaching prospective parents basic newborn life support (BNLS) for unplanned out-of-hospital births.","authors":"Abdul-Qader Tahir Ismail","doi":"10.1515/jpm-2025-0100","DOIUrl":"https://doi.org/10.1515/jpm-2025-0100","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803636","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}

{"title":"Comparative sonographic measurement of the fetal thymus size in singleton and twin pregnancies.","authors":"Anna-Lena Kuper, Ralf Schmitz, Kathrin Oelmeier, Chiara De Santis, Daniela Willy, Janina Braun, Laura Kerschke, Mareike Möllers","doi":"10.1515/jpm-2024-0356","DOIUrl":"https://doi.org/10.1515/jpm-2024-0356","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the size of the thymus gland of healthy fetuses in twin and singleton pregnancies using the thymic-thoracic ratio (TTR). As a second objective, the TTR difference between monochorionic and dichorionic twin thymus size was examined. Finally, a possible correlation between thymus size and gestational age (GA) at birth in twin pregnancies was investigated.</p><p><strong>Methods: </strong>The TTR was measured retrospectively using the plane of three-vessel view in prenatal ultrasound examinations. Images of 140 healthy twin fetuses (33 monochorionic and 107 dichorionic) between 19+0 and 33+2 weeks of gestation were utilized and compared to 248 healthy singleton fetuses.</p><p><strong>Results: </strong>A significant difference in thymus size could be observed between healthy fetuses from singleton and twin pregnancies (p<0.001). Thymus size in monochorionic and dichorionic fetuses did not differ. If only comparing fetuses after 37+0 weeks of pregnancy, the difference in the TTR was no longer significant. In addition, an association between prematurity and larger thymus was established. However, the effect size of this association was small.</p><p><strong>Conclusions: </strong>The results indicate that factors related to preterm birth, rather than the number of fetuses, are likely to influence the TTR. Utilizing fetal thymus size in ultrasound screening may hold potential for predicting adverse events like preterm birth in both singleton and twin pregnancies, but only in addition to other variables.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772574","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}

{"title":"Mechanisms of hypoxaemia in late pulmonary hypertension associated with bronchopulmonary dysplasia.","authors":"Eleanor Jeffreys, Fahad M S Arattu Thodika, Aaron Bell, Anne Greenough, Theodore Dassios","doi":"10.1515/jpm-2025-0058","DOIUrl":"https://doi.org/10.1515/jpm-2025-0058","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753192","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}

{"title":"Standardizing cord clamping: bridging physiology and recommendations from leading societies.","authors":"Mishu Mangla, Poojitha Kalyani Kanikaram, Nireesha Bukke, Naina Kumar, Deepak Singla","doi":"10.1515/jpm-2025-0010","DOIUrl":"https://doi.org/10.1515/jpm-2025-0010","url":null,"abstract":"<p><p>The timing of umbilical cord clamping has stirred much greater debate and evolution in the field of obstetrics and neonatology, spurred by advances in medical science as well shifting clinical paradigms. This review seeks to address the history, physiology and clinical applications of different umbilical cord clamping practices around a common theme. The history of these practices and their effects on the mothers as well as new-borns have been addressed in this article along with how modern evidence has been shaping our guidelines. By examining the physiological mechanisms underlying umbilical cord clamping (UCC) and the evolving clinical standards, this article seeks to inform healthcare providers and policymakers on the best approaches for optimizing maternal and neonatal health.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753198","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}

{"title":"Transversal cardiac diameter is increased in fetuses with dextro-transposition of the great arteries older than 28th weeks of gestation.","authors":"Oskar Sylwestrzak, Aleksandra Piórecka, Iwona Strzelecka, Łukasz Sokołowski, Maciej Słodki, Maria Respondek-Liberska","doi":"10.1515/jpm-2024-0621","DOIUrl":"https://doi.org/10.1515/jpm-2024-0621","url":null,"abstract":"<p><strong>Objectives: </strong>In majority of congenital heart defects the size of the fetal heart is normal (without cardiomegaly). Aim of this study was to establish normal ranges of fetal transversal cardiac diameter (4CV TW ED) and to compare fetal dextro-transposition of the great arteries (d-TGA) with normal ranges for 4CV TW ED.</p><p><strong>Methods: </strong>Retrospectively of 3,553 records we analyzed and included 1,154 healthy singleton fetuses as a control group. Consecutive percentiles for 4CV TW ED diameter according to the gestational age (GA) were calculated. 74 fetuses with d-TGA were analyzed in 3rd trimester.</p><p><strong>Results: </strong>The -2, -1, +1 and +2 Z-scores of 4CV TW ED between weeks 18 and 37 of gestation were calculated. In the group of fetuses with d-TGA 68 % of them had 4CV TW ED > +2 Z-score fitted for GA. Rashkind procedure during first 24 h after birth was performed in 63 % cases. Increased 4CV TW ED was more frequently seen in fetuses who needed Rashkind procedure after birth, but without statistical significance.</p><p><strong>Conclusions: </strong>4CV TW ED measurement during the third trimester scans as a cardiac screening tool in obstetrical practice may potentially help to detect d-TGA and indicate further echocardiographic examination in case of d-TGA suspicion. 4CV TW ED was not helpful to predict the necessity for neonatal Rashkind procedure.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753205","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}

{"title":"Pharmacologic thromboprophylaxis following cesarean delivery-what is the evidence? A critical reappraisal.","authors":"Werner Rath, Panagiotis Tsikouras, Ulrich Pecks","doi":"10.1515/jpm-2025-0041","DOIUrl":"https://doi.org/10.1515/jpm-2025-0041","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is a severe complication associated with cesarean delivery (c.d.). The risk of VTE has been estimated to be 2-4-fold higher compared to vaginal delivery and appears independent of other risk factors. Pharmacologic thromboprophylaxis after c.d. represents a daily challenge for obstetricians and is a common practice in many countries such as in Germany. However, the evidence of thromboprophylaxis efficacy is based on only four randomized controlled trials and one prospective cohort study. Risk assessment models to predict VTE after c.d. have not adequately been validated. According to meta-analyses pharmacologic thromboprophylaxis was not associated with a significant reduction in the risk of VTE but is associated with an increased risk of bleeding and hematomas compared to placebo. Due to the lack of evidence current guidelines differ markedly regarding recommendations on post-cesarean pharmacologic thromboprophylaxis. Most guidelines recommend no pharmacologic thromboprophylaxis after elective c.d. in the absence of additional VTE risk factors. In case of additional risk factors associated with elective c.d. as well as in case of emergency c.d. pharmacologic prophylaxis is advised for 7-10 days after delivery, and for at least 6 weeks after c.d. in high-risk patients. In view of the great number of various risk factors, the challenge not recognizing all risk factors timely and the low incidence of serious complications associated with the use of low molecular weight heparin (LMWH), we consent with others to suggest universal LMWH prophylaxis following c.d. rather than a selective being aware that universal LMWH prophylaxis is associated with significantly higher costs.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692464","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}

{"title":"Postpartum remote blood pressure monitoring and risk of hypertensive-related readmission: systematic review and meta-analysis of randomized controlled trials.","authors":"Fabrizio Zullo, Daniele Di Mascio, Farah H Amro, Sara Sorrenti, Elena D'Alberti, Antonella Giancotti, Giuseppe Rizzo, Suneet P Chauhan","doi":"10.1515/jpm-2024-0515","DOIUrl":"https://doi.org/10.1515/jpm-2024-0515","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the efficacy of remote blood pressure monitoring to prevent readmission due to complications of hypertensive disorders of pregnancy.</p><p><strong>Methods: </strong>The search was conducted using MEDLINE, EMBASE, Web-of-Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane-Library as electronic databases from the inception of each database to November 2023. Selection criteria included randomized controlled trials of postpartum individuals randomized to remote blood pressure monitoring or telehealth strategies vs. routine-care. The primary outcome was postpartum readmission, defined as postpartum hospital admission after discharge. Secondary maternal outcomes included stroke, eclampsia, ICU-admission, maternal death, emergency department visit, ascertainment of a blood pressure measurement within 7-10 days after delivery, attendance of the 4-6-week postpartum visit. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95 % confidence intervals (CI).</p><p><strong>Results: </strong>Four RCTs including 714 individuals randomized to either telematic reporting of blood pressure measurements (n=356, 49.8 %) or standard postpartum care (n=358, 50.1 %). There were no significant differences in the rate of hospital readmission due to hypertensive related causes (5.3 % vs. 11.8 %). However, emergency department visit rate differed significantly among the two groups (9.0 % vs. 4.4 %). With regards to postpartum follow up, blood pressure assessment at 10 days postpartum and 4-6-week postpartum visit attendance rate were similar. No included RCT provided data on maternal secondary outcome like pulmonary edema, stroke, maternal death, and ICU admission.</p><p><strong>Conclusions: </strong>Remote blood pressure monitoring is not superior to standard care to prevent hypertensive related readmission and increases emergency department visits.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692482","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}

{"title":"Enhancing external cephalic version success: insights from an Israeli tertiary center.","authors":"Nicolas Andre, Ayat Abu Hamad, Salvatore Andrea Mastrolia, Yael Baumfeld, Eyal Sheiner, Eli H Bernstein, Offer Erez, Giuseppe Trojano, Polina Schwarzman","doi":"10.1515/jpm-2024-0546","DOIUrl":"https://doi.org/10.1515/jpm-2024-0546","url":null,"abstract":"<p><strong>Objectives: </strong>With global cesarean delivery rates steadily rising, a more accessible and widely adopted approach to external cephalic version for breech presentations is essential. This study seeks to clarify controversial factors associated with the procedure's success and highlight the favorable fetal-maternal outcomes post-procedure to support its broader, guideline-based application where indicated.</p><p><strong>Methods: </strong>This observational study was conducted over 7 years at Soroka University Medical Center, including healthy pregnant women with breech fetal presentation at a minimum of 36 weeks. The procedure was performed by experienced obstetricians with over 10 years of expertise.</p><p><strong>Results: </strong>Out of 262 women who underwent the procedure, a 60 % success rate was achieved. Success was associated with factors such as parity and higher fetal weight, while BMI and placental location did not impact outcomes. Successful procedures were linked to increased rates of vaginal birth (p<0.001), longer gestational age at delivery (p<0.001), and higher birth weight (p<0.02) compared to failed versions. No significant adverse maternal or fetal outcomes were noted during or after the procedure.</p><p><strong>Conclusions: </strong>External cephalic version is a safe and effective method for reducing the rate of cesarean deliveries. Additionally, babies born after the procedure tend to have a higher gestational age and birth weight. We recommend factoring physician experience into predictive models and advocate for the widespread inclusion of simulation-based training in residency programs to enhance obstetricians' confidence and skills worldwide, promoting its broader use.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670172","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}

{"title":"Trends in gestational age and short-term neonatal outcomes in the United States.","authors":"Pranita Shenoy, Fredrick Dapaah-Siakwan","doi":"10.1515/jpm-2024-0590","DOIUrl":"https://doi.org/10.1515/jpm-2024-0590","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between shifts in gestational age (GA) at birth and the trends in assisted ventilation, neonatal intensive care unit (NICU) admissions, and neonatal antibiotic exposure in the United States (US).</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional analysis of national livebirth data from the US Centers for Disease Control from 2016 through 2023. The outcomes were the rate (per 1,000 live births) of NICU admissions, assisted ventilation, surfactant administration, and neonatal exposure to antibiotics. We used linear regression for trend analysis.</p><p><strong>Results: </strong>Between 2016 and 2023, the average GA at birth and BW decreased from 38.5 to 38.3 (p<0.01) and from 3,267 to 3,240 gm (p<0.001), respectively. NICU admission rates increased from 87 to 98 (p<0.001). Assisted ventilation >6 h increased from 13.7 to 20.9 (p<0.001) but the change in surfactant administration was not significant (4.83-5.04; p=0.19). Neonatal exposure to antibiotics for suspected sepsis declined from 23 to 19 (p<0.001; R=0.95) despite an increase in maternal chorioamnionitis from 15.3 to 17.6 per 1,000 (p=0.02).</p><p><strong>Conclusions: </strong>Between 2016 and 2023, GA and BW declined significantly, alongside increases in NICU admissions and respiratory morbidity. However, antibiotic exposure for neonatal sepsis declined significantly. The drivers behind these trends require further study.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649459","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}