Journal of Perinatal Medicine最新文献

{"title":"Structured stillbirth management in Slovenia: outcomes and comparison with international guidelines.","authors":"Maja Dolanc Merc, Tanja Premru-Sršen","doi":"10.1515/jpm-2025-0325","DOIUrl":"https://doi.org/10.1515/jpm-2025-0325","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth remains a major public health issue with long-lasting psychological impacts. Despite advancements in prenatal diagnostics, many stillbirths remain unexplained. Slovenia has implemented a structured, centralized algorithm for stillbirth investigation and care.</p><p><strong>Content: </strong>This mini-review analyzes a decade of clinical data (2013-2023) from the Department of Perinatology at University Medical Centre Ljubljana (UMC Ljubljana), assessing the outcomes of Slovenia's stillbirth management algorithm. The Slovenian approach is also compared with international guidelines from ACOG, RCOG, CNGOF, PSANZ, SOGC, and FOGSI. Slovenia reports one of the lowest stillbirth rates in Europe - 2 per 1,000 births at ≥24 weeks and 1.4 per 1,000 at ≥28 weeks. At UMC Ljubljana, fetal death rates remained stable between 0.4 % and 0.6 %. The structured algorithm includes maternal history, laboratory testing, placental and fetal pathology, and genetic evaluation. Active induction is preferred over expectant management, and routine TORCH screening and centralized committee oversight are emphasized.</p><p><strong>Summary: </strong>Slovenia's structured, algorithm-based system has led to notably low stillbirth rates, supported by uniform clinical care and systematic investigations. Although Slovenia's experience is encouraging, these results derive from a single-center national registry without comparative cohort analysis, limiting attribution of outcomes to specific elements of the algorithm.</p><p><strong>Outlook: </strong>Future progress will involve the expansion of WES access and full ICD-PM implementation by 2027, enhancing data comparability and facilitating broader international research.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086352","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":"Advantages of fully automated AI-enhanced algorithm (5D CNS+™) for generating a fetal neurosonogram in clinical routine.","authors":"Jann Lennard Scharf, Michael Gembicki, Achim Rody, Amrei Welp, Jan Weichert","doi":"10.1515/jpm-2025-0188","DOIUrl":"https://doi.org/10.1515/jpm-2025-0188","url":null,"abstract":"<p><strong>Objectives: </strong>The objective was to demonstrate superiority of a fully vs. semi-automated approach (5D CNS+™) and to verify operators could handle and benefit from a fully automated rendering volumetric datasets to generate a complete fetal neurosonogram.</p><p><strong>Methods: </strong>A total of 136 stored three-dimensional (3D) volumes of the brain of unselected, structurally normal fetuses were examined. Two operators applied both software versions for detailed assessment of the fetal central nervous system (CNS). The procession time was measured for each operator and for both program versions. The number of correctly calibrated planes were evaluated and necessity for manual adjustment of the planes was registered.</p><p><strong>Results: </strong>The intraclass correlation coefficient was 0.507 (0.307-0.648) for semi-automated and 0.782 (0.693-0.846) for fully automated 5D CNS+™. The acquisition time of application for semi-automated 5D CNS+™ was 27.70 s ± 6.28 s for operator 1 and 33.20 s ± 9.67 s for operator 2, for fully automated 5D CNS+™ 10.89 s ± 0.85 s for operator 1 and 10.79 s ± 0.60 s for operator 2 (p<0.0001). The statistical analysis for manually corrected planes by both operators between both software algorithms showed a Bland-Altman-Bias of 1.44/9 planes for operator 1 and 1.45/9 planes for operator 2.</p><p><strong>Conclusions: </strong>The fully automated 5D CNS+™ algorithm applied on 3D volume datasets provides examiners regardless their expertise not only enormous time efficiency, but also diagnostic confidence in evaluating details of the fetal CNS. This tremendously simplifies application in clinical routine.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085909","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":"Hemorrhage-related maternal morbidity of secondary compared to primary postpartum hemorrhage.","authors":"Matthew R Carroll, Sarah Tounsi, Jessica L Gerard, Susan M Leong-Kee, Laurie S Swaim, Mark A Turrentine","doi":"10.1515/jpm-2025-0165","DOIUrl":"https://doi.org/10.1515/jpm-2025-0165","url":null,"abstract":"<p><strong>Objectives: </strong>To compare a composite hemorrhage-related maternal morbidity in individuals with secondary to primary postpartum hemorrhage and treatment interventions utilized.</p><p><strong>Methods: </strong>A retrospective case-control study of deliveries complicated by secondary postpartum hemorrhage was performed at a tertiary care center. To estimate a clinically relevant increase of 50 % in the composite maternal hemorrhage-related maternal morbidity (35-53 % absolute increase) in individuals with secondary postpartum hemorrhage, a correlation coefficient of 0.2, at an 80 % power with a p < 0.05 with a two-sided test would require 95 individuals with secondary postpartum hemorrhage be matched to 95 individuals with a primary postpartum hemorrhage. Logistic regression analysis was used to evaluate the outcome of the composite of hemorrhage-related maternal morbidity.</p><p><strong>Results: </strong>From January 2018 through December 2022, 33,026 deliveries occurred, and 94 individuals were identified that were admitted with secondary postpartum hemorrhage, 0.28 % of deliveries, 95 % confidence interval (CI) 0.21-0.35 %. The composite hemorrhage-related maternal morbidity was increased in individuals with secondary compared to primary postpartum hemorrhage, adjusted odds ratio (OR) 14.0, 95 % CI 4.6 to 42.2. Most individuals with secondary postpartum hemorrhage had a dilation and curettage 91.5 % (86/94). In individuals with secondary postpartum hemorrhage that underwent uterine evacuation, histology revealed 45.2 % (38/84) had retained placenta, and 20.2 % (17/84) subinvolution.</p><p><strong>Conclusions: </strong>A composite maternal hemorrhage-related outcome is associated more often with secondary compared to primary postpartum hemorrhage and nearly all individuals with secondary postpartum hemorrhage undergo a dilation and curettage.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086226","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":"Effect of antenatal betamethasone on fetal heart rate short-term variability in growth restricted fetuses.","authors":"Tjaša Šikonja, Zala Sršen, Ivan Verdenik, Renata Košir Pogačnik, Miha Lučovnik, Gabrijela Bržan Šimenc, Tanja Premru-Sršen","doi":"10.1515/jpm-2025-0351","DOIUrl":"https://doi.org/10.1515/jpm-2025-0351","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to evaluate the magnitude and duration of the effect of antenatal betamethasone on fetal heart rate short-term variability (STV) in growth-restricted (FGR) fetuses in comparison with appropriate-for-gestational age (AGA) fetuses.</p><p><strong>Methods: </strong>A prospective observational study was conducted at the UMC Ljubljana between June 2023 and June 2024, including 21 FGR and 20 AGA fetuses. We measured STV before applying betamethasone and at regular intervals for seven days after the first application or until delivery. Confounding variables were fetal and maternal demographic and clinical characteristics. Analysis was done using linear regression, paired-sample t-tests and one-way and two-way analysis of variance.</p><p><strong>Results: </strong>The increase in STV 6-12 h after the first application was significant compared to baseline in both groups (p < 0.001). STV remained significantly elevated the first 24 h after the first application in the FGR group (p=0.018) but not in the AGA group. There was no significant difference in STV between baseline and 48 and 72 h after the first application in either group. When adjusted for gestational age, STV was significantly lower in the group of FGR compared to AGA fetuses at all times of cCTG recordings (p=0.031).</p><p><strong>Conclusions: </strong>Following the initial increase in STV after the first dose of betamethasone, STV declines and returns to levels that doesn't differ significantly from baseline after 24 h in AGA and 48 h in FGR fetuses. Longer-lasting response of FGR fetuses to betamethasone merits further investigation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086111","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":"First-trimester maternal serum PAPP-A levels and hyperemesis gravidarum: unraveling the link - a meta-analysis.","authors":"Antonia Varthaliti, Vasilios Pergialiotis, Vasilios Lygizos, Panos Antsaklis, Marianna Theodora, Dimitrios-Efthymios Vlachos, Maria Anastasia Daskalaki, Nikolaos Thomakos, George Daskalakis","doi":"10.1515/jpm-2025-0169","DOIUrl":"https://doi.org/10.1515/jpm-2025-0169","url":null,"abstract":"<p><strong>Objectives: </strong>Hyperemesis gravidarum is a severe form of nausea and vomiting that affects approximately 0.3-2 % of pregnancies, leading to significant perinatal complications. This systematic review and meta-analysis aims to investigate the potential link between hyperemesis gravidarum and maternal serum pregnancy-associated plasma protein-A (PAPP-A) levels in the first trimester.</p><p><strong>Methods: </strong>A thorough literature search of PubMed/MEDLINE, ScienceDirect, the Cochrane Library, and Google Scholar was conducted to identify relevant studies comparing PAPP-A levels in pregnant women diagnosed with hyperemesis gravidarum compared to healthy controls. Six studies met the inclusion criteria, with a total of 1,049 participants. Meta-analysis was performed to estimate the pooled mean difference in PAPP-A levels between hyperemesis gravidarum and control groups. A p-curve analysis and funnel plot assessment were conducted to evaluate publication bias and statistical power.</p><p><strong>Results: </strong>The meta-analysis demonstrated a pooled mean difference of 0.16 (95 % CI: 0.07-0.25), indicating that PAPP-A levels were significantly higher in pregnancies affected by HG. The heterogeneity statistic (I²=46 %) suggested moderate variability among studies. P-curve analysis showed a right-skewed distribution of significant p-values (p=0.033), suggesting evidential value and ruling out selective reporting bias. However, the prediction interval (-0.08-0.4) indicated that some future studies might yield non-significant or even negative findings. Funnel plot analysis revealed minimal publication bias, though a slight asymmetry suggested potential underrepresentation of small, non-significant studies.</p><p><strong>Conclusions: </strong>This study provides evidence that PAPP-A levels are elevated in pregnancies complicated by hyperemesis gravidarum, implicating potential placental dysfunction and hormonal influences in its pathogenesis. While the findings are statistically significant and robust against publication bias, moderate heterogeneity highlights the need for larger prospective studies with standardized methodologies to confirm this association and explore possible underlying mechanisms. Understanding the role of PAPP-A in hyperemesis gravidarum may contribute to improved screening and management strategies for affected pregnancies and as a result, improved perinatal care.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958205","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":"Fetoception: a window into maternal interoception?","authors":"Marion Imbault, Caroline Sévoz-Couche, Emmanuelle Corruble, Hugo Bottemanne","doi":"10.1515/jpm-2025-0393","DOIUrl":"https://doi.org/10.1515/jpm-2025-0393","url":null,"abstract":"<p><p>Fetoception refers to the maternal detection and integration of signals originating from the fetus, particularly the perception of fetal movements. This process reflects a specific form of maternal interoception, the central nervous system's capacity to process internal bodily signals. As such, fetoception offers a unique window into maternal interoceptive processing during pregnancy, a period marked by profound physiological and sensory changes. Exploring the mechanisms underlying fetoception may provide novel insights into the dynamic interactions between interoceptive systems and the maternal adaptation to pregnancy. Furthermore, potential links between fetoception, interoception, and perinatal mental health remain largely unexplored and warrant further investigation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958200","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":"Rationale for the use of fetal ventriculosubgaleal shunts for the treatment of aqueduct stenosis.","authors":"Shohra Qaderi, Weston T Northam, Ramen H Chmait, Mark Krieger, Yves Ville, Benjamin C Warf, Amos Grünebaum, Frank A Chervenak, Alireza A Shamshirsaz","doi":"10.1515/jpm-2025-0218","DOIUrl":"https://doi.org/10.1515/jpm-2025-0218","url":null,"abstract":"<p><p>Fetal hydrocephalus causes irreversible neural injury <i>in utero</i>, yet no prenatal therapy currently exists. Postnatal treatments such as ventriculoperitoneal shunts and endoscopic third ventriculostomy with choroid plexus cauterization cannot reverse pre-existing brain injury. We propose that the ventriculosubgaleal shunt (VSGS), widely used as a temporizing measure in severely premature neonates, may offer a feasible and ethically justifiable approach for <i>in utero</i> treatment. VSGS placement avoids the complications of ventriculoamniotic shunts and leverages a closed system that can relieve intracranial pressure and potentially preserve brain tissue integrity. Given its technical simplicity, established safety profile, and alignment with core ethical principles - including maternal autonomy and proportional risk-benefit, we argue for consideration of VSGS as an investigational fetal therapy in selected cases of progressive hydrocephalus. Given its investigational status, implementation should be limited to clinical trials with stringent IRB supervision and ethical safeguards.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957731","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":"Antenatal shunting and outcomes in fetuses with non-immune hydrops fetalis.","authors":"Valentina Fragala, Sanjeev Sabale, Ghalia Ashoor, Christopher Harris, Carolina Zorro, Anne Greenough","doi":"10.1515/jpm-2025-0198","DOIUrl":"https://doi.org/10.1515/jpm-2025-0198","url":null,"abstract":"<p><strong>Objectives: </strong>Hydrops fetalis is associated with high morbidity and perinatal mortality. The aim of our study was to compare the outcomes of infants who had non-immune hydrops fetalis (NIHF) who did or did not undergo antenatal shunting<b>.</b></p><p><strong>Methods: </strong>Between January 2014 and June 2023, 20 infants with the diagnosis of NIHF were admitted to the neonatal intensive care unit (NICU) at King's College Hospital NHS Foundation Trust. The criteria for antenatal shunt placement were development of hydrops fetalis, polyhydramnios due to oesophageal compression by a pleural effusion that would likely result in preterm labour or a large pleural effusion (no hydrops at presentation) resulting in likely inferior vena cava compression and significant risk of development of hydrops.</p><p><strong>Results: </strong>The 20 infants had a median gestational age of 34 (27-40) weeks of gestation at delivery and were diagnosed at a median gestational age of 29 (17-40) weeks. Eight infants had a shunt inserted antenatally (six pleuro amniotic and two abdominal amniotic) and they delivered at a significantly later median gestational age (36 vs. 32.5 weeks, p=0.025). After adjustment for gestational age at delivery and antenatal severity, those who had a shunt placed were not more likely to be oxygen dependent at 36 weeks post menstrual age (PMA) and had a lower length of stay (23 vs. 95 days, p=0.019).</p><p><strong>Conclusions: </strong>Infants who had NIHF and had antenatal shunting had favourable outcomes compared to those who did not, despite a more severe antenatal presentation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958218","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":"Sonographic surveillance and perinatal outcomes among pregnancies with periviable fetal growth restriction.","authors":"Felicia V LeMoine, Angela C Ranzini, Marisa R Imbroane, Esha V Ghosalkar, David N Hackney, Emily J Hamburg-Shields","doi":"10.1515/jpm-2025-0078","DOIUrl":"https://doi.org/10.1515/jpm-2025-0078","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared adverse perinatal outcomes between pregnancies complicated by periviable fetal growth restriction (pFGR) that underwent weekly sonographic surveillance vs. serial growth surveillance.</p><p><strong>Methods: </strong>In this retrospective cohort study, pFGR was defined as a 22 0/7-27 6/7-week singleton, <500 g, and ≤10 % for gestational age. The surveillance group initiated weekly Doppler surveillance while the serial growth (SG) group underwent growth assessment every 3-4 weeks between 22 and 27 6/7 weeks. Adverse perinatal outcomes were compared.</p><p><strong>Results: </strong>Eighty-one (36.2 %) underwent weekly Doppler surveillance. Chronic hypertension (18.5 % vs. 9.1 %, p=0.04), a prior history of fetal demise (8.6 % vs. 2.1 %, p=0.02), and an estimated fetal weight <3 % (22.2 % vs. 10.5 %, p=0.02) and any abnormal umbilical artery Doppler pattern at diagnosis (25.8 % vs. 12.9 %, p=0.046) occurred more frequently in the weekly Doppler surveillance group than the SG group. Despite no difference in perinatal death, the surveillance group demonstrated a higher rate of obstetric (65.4 % vs. 42.7 %, p<0.05) and neonatal (60.8 % vs. 28.4 %, p<0.05) adverse outcome composites compared to the SG group.</p><p><strong>Conclusions: </strong>The surveillance group experienced increased rates of obstetric and neonatal morbidity without difference in perinatal death though interpretation is limited by the observational nature of this study.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957946","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":"Amniotic Fluid Embolism: a comprehensive review of diagnosis and management.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, Caroline Setiawan, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0161","DOIUrl":"https://doi.org/10.1515/jpm-2025-0161","url":null,"abstract":"<p><strong>Introduction: </strong>Amniotic Fluid Embolism (AFE) is a rare but catastrophic obstetric emergency characterized by the sudden entry of amniotic fluid or fetal debris into the maternal circulation. This triggers acute cardiopulmonary collapse, disseminated intravascular coagulation (DIC), and multi-organ failure. Despite its low incidence, AFE remains a significant contributor to maternal mortality worldwide. The pathophysiology is poorly understood, involving immune-mediated anaphylactoid reactions and mechanical vascular obstruction.</p><p><strong>Content: </strong>This review provides a comprehensive synthesis of current knowledge on AFE, examining its epidemiology, pathophysiology, risk factors, clinical manifestations, diagnostic challenges, and management strategies. A systematic literature review was conducted following PRISMA guidelines, incorporating peer-reviewed articles and clinical protocols published from 2000 to 2024. Clinical tools such as diagnostic algorithms and resuscitation frameworks were developed from aggregated evidence and thematic analysis.</p><p><strong>Summary: </strong>AFE typically presents intrapartum or in the immediate postpartum period with sudden hypoxia, hypotension, and coagulopathy. Diagnosis is clinical, as no single confirmatory biomarker currently exists. Management is primarily supportive, focusing on rapid resuscitation, hemodynamic stabilization, and aggressive coagulopathy correction. Emerging strategies such as the A-OK regimen (Atropine, Ondansetron, Ketorolac) are discussed as investigational approaches under consideration.</p><p><strong>Outlook: </strong>AFE continues to challenge obstetric and critical care teams due to its abrupt onset and high fatality. Future priorities include the development of validated diagnostic biomarkers, refinement of therapeutic interventions, and establishment of standardized multidisciplinary response protocols to improve maternal and neonatal outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958253","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}