Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Pregnancy outcomes of cerclage in twin gestations: a multicenter retrospective cohort study.","authors":"Jee Yoon Park, Kyong-No Lee, Hyeon Ji Kim, Kiroong Choe, Aeri Cho, Bohyoung Kim, Jinwook Seo, Hayan Kwon, Jong Woon Kim, Jin-Gon Bae, Ji-Hee Sung, Se Jin Lee, Young Mi Jung, You Jung Han, Subeen Hong, Jin-Hoon Chung, Hye-Sung Won, Jong Kwan Jun","doi":"10.1080/14767058.2024.2355495","DOIUrl":"10.1080/14767058.2024.2355495","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the effects of cerclage on twin pregnancies.</p><p><strong>Methods: </strong>A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records.</p><p><strong>Results: </strong>A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (<i>n</i> = 127) and the CL >2.5 cm group (<i>n</i> = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11-2.87; <i>p</i> = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30-0.82; <i>p</i> value = .006).</p><p><strong>Conclusions: </strong>In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2355495"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332385","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":"Nomogram for fetal limb bones in Chinese ethnicity.","authors":"Ho Yin Diana Lee, Wendy Shu, Kwok Yiu Choi, Lin Wai Chan","doi":"10.1080/14767058.2024.2380726","DOIUrl":"10.1080/14767058.2024.2380726","url":null,"abstract":"<p><strong>Objective: </strong>To construct fetal limb bone nomograms in the Chinese ethnic population.</p><p><strong>Methods: </strong>This was a prospective cross-sectional study on singleton pregnancies between 12 and 37 weeks of gestation. Femur, tibia, fibula, humerus, ulna, radius, and foot length were measured in a standardized manner by one of the three sonographers. Each fetus's measurements were only included once and those who developed maternal or fetal complications were excluded. Fractional polynomial regression model was used to obtain the 3rd, 10th, 50th, 90th, and 97th centiles for each of the limb measurement. <i>Z</i>-score for the 50th centile of each fetal limb measurement was then compared with published nomograms derived from other populations.</p><p><strong>Results: </strong>Of the 843 scans performed, 775 were included in analysis after excluding conditions such as pre-eclampsia, chromosomal abnormalities, single umbilical artery and skeletal dysplasia. Comparison with other populations showed that Chinese had shorter fetal limb bone lengths than the Caucasian and Afro-Caribbean populations.</p><p><strong>Conclusion: </strong>This study established nomograms for all the fetal limb bones in the Chinese ethnic population, which showed lengths comparatively shorter than Caucasian and Afro-Caribbean nomograms. This would reduce the false alarm of short fetal limb bone lengths and its consequent anxiety and intervention.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2380726"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762227","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":"Letter to editor regarding the article: resolution of acute cervical insufficiency after antibiotics in a case with amniotic fluid sludge.","authors":"Katarzyna Kosińska-Kaczyńska, Magdalena Smyka, Katarzyna Bednarek","doi":"10.1080/14767058.2024.2349790","DOIUrl":"10.1080/14767058.2024.2349790","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2349790"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946460","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":"Gestational diabetes mellitus: relationship of adverse outcomes with severity of disease.","authors":"Rebecca Karkia, Tara Giacchino, Frederick Hii, Charline Bradshaw, Ghada Ramadan, Ranjit Akolekar","doi":"10.1080/14767058.2024.2356031","DOIUrl":"https://doi.org/10.1080/14767058.2024.2356031","url":null,"abstract":"<p><strong>Aims: </strong>To derive accurate estimates of risk of maternal and neonatal complications in women with gestational diabetes mellitus (GDM) and to investigate the association of the effect size of these risks on subgroups of GDM managed with dietary modification, metformin and insulin therapy.</p><p><strong>Methods: </strong>This was a large retrospective cohort study undertaken at a large maternity unit in the United Kingdom between January 2010 and June 2022. We included singleton pregnancies that booked at our unit at 11-13 weeks' gestation. The rates of maternal and neonatal complications in pregnancies with GDM that were managed by a multidisciplinary team (MDT) in the specialist high-risk clinic were compared to those in non-diabetic pregnancies. We stratified pregnancies with GDM into those that were managed with diet, metformin and insulin to pregnancies without diabetes. Logistic regression analysis was carried out to determine risks of pregnancy complications in pregnancies with GDM and its treatment subgroups. Risks were expressed as absolute risks (AR) and odds ratio (OR) (95% confidence intervals [CI]). Forest plots were used to graphically demonstrate risks.</p><p><strong>Results: </strong>The study population included 51,211 singleton pregnancies including 2089 (4.1%) with GDM and 49,122 (95.9%) controls without diabetes. In pregnancies with GDM, there were 1247 (59.7%) pregnancies managed with diet, 451 (21.6%) with metformin and 391 (18.7%) who required insulin for maintaining euglycaemia. Pregnancies with GDM had higher maternal age, body mass index (BMI), higher rates of Afro-Caribbean and South Asian racial origin and higher rates of chronic hypertension. In pregnancies with GDM compared to non-diabetic controls, there was an increased rate of preterm delivery, delivery of LGA neonate, polyhydramnios, preeclampsia, need for IOL, elective and emergency CS and PPH whereas the rate of delivery of SGA neonates and likelihood of an unassisted vaginal delivery were lower. In pregnancies with GDM, there is significantly increased risk of maternal and neonatal complications in those that require insulin compared to those that are managed on dietary modification alone.</p><p><strong>Conclusions: </strong>There is a linear association between the risk of adverse outcomes and the severity of GDM with those on insulin treatment demonstrating an increased association with complications compared to those that have milder disease requiring only dietary modification.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2356031"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285228","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":"Effects of different physical exercise types on health outcomes of individuals with hypertensive disorders of pregnancy: a prospective randomized controlled clinical study.","authors":"Cong Chen, Jinguo Zhai, Shuiwang Hu, Xuantian Liu, Xinzhi Tu, Bin Li, Kui Huang, Fu-Ying Tian, Haiyin Liu, Ruowang Hu, Jingjing Guo","doi":"10.1080/14767058.2024.2421278","DOIUrl":"https://doi.org/10.1080/14767058.2024.2421278","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impacts of different types of physical exercise on health outcomes of individuals with hypertensive disorders of pregnancy (HDPs).</p><p><strong>Methods: </strong>Forty individuals with HDPs admitted to a tertiary hospital providing maternal and pediatric care between July 2023 and March 2024 were enrolled in this prospective randomized controlled clinical study and completed a ≥4-week intervention. Data were collected before the intervention and before delivery. Participants were assigned randomly to control (no exercise intervention), aerobic exercise (AE), resistance training (RT), and AE + RT groups. All participants downloaded a mobile health-education app for gestational hypertension developed by our research group. Exercise videos in the app guided participants' performance of different types of exercise. General information; physical activity and sleep quality data; morning blood pressure, lipid profiles, and urinary micro-albumin/creatinine ratios; serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and advanced oxidation protein product (AOPP) concentrations; and pregnancy outcome data were collected and compared among groups.</p><p><strong>Results: </strong>After the intervention, the physical activity status, sleep quality, morning blood pressure, lipid profiles, urinary micro-albumin/creatinine ratios, and pregnancy outcomes differed significantly among all groups comparing with control (all <i>p</i> < .05). In the three exercise groups, the serum sFlt-1, PlGF, and AOPPs levels improved significantly (all <i>p</i> < .05). All differences were most pronounced in the AE + RT group.</p><p><strong>Limitations: </strong>The study period was relatively short. The further long-term follow-up research is needed. A larger sample size study is also needed.</p><p><strong>Conclusions: </strong>The study results suggest that AE + RT interventions are beneficial for individuals with HDPs in clinical settings, and could be implemented with careful consideration of individuals' specific conditions.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2421278"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631521","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":"Maternal super obesity is increasing and is associated with an increased risk of pregnancy complications-a call for concern.","authors":"Sameer Khan, Nicholas Baranco, Martha Wojtowycz, Pamela Parker, Dimitrios S Mastrogiannis","doi":"10.1080/14767058.2024.2396071","DOIUrl":"https://doi.org/10.1080/14767058.2024.2396071","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the relationship of increased body mass index (BMI) with pregnancy complications.</p><p><strong>Study design: </strong>We obtained data for a retrospective cohort of singleton live births using an electronic birth certificate database from 2010 to 2022. Institutional review board exemption was obtained. BMI was assessed as a continuous variable and a categorical variable with groups of BMI 18.5-29.9 kg/m², 40-49.9 kg/m², and ≥50 kg/m² compared to patients with BMI 30-39.9 kg/m². Primary outcomes were pregnancy and maternal outcomes. Secondary outcomes were neonatal outcomes. ANOVA and χ² were used to compare continuous and categorical variables respectively, and logistic regression was used to obtain adjusted odds ratios for primary and secondary outcomes.</p><p><strong>Results: </strong>There were 223,837 patients with singleton live births with mean BMI 27.86 kg/m2. 54,385 (24.3%) had BMI 30-39.9 kg/m2, 13,299 (5.9%) had BMI 40-49.9 kg/m2, and 1,958 (0.87%) had BMI ≥50 kg/m2. Patients with BMI > 50 kg/m2 have a higher likelihood of APGAR scores <7 (aOR 1.38, 95% CI 1.05-1.83), and NICU admission or transfer out of facility (aOR 1.17, 95% CI 1.02-1.34). In the nulliparous subgroup analysis, For patients with BMI >50 kg/m2, there was a higher odds of preterm birth <37 weeks (aOR 1.57, 95% CI 1.23-2.00) and preterm birth <34 weeks (aOR 1.51 95% CI 1.00-2.30. There is also an increased odds of cesarean section in both of these BMI groups (aOR 1.68 95% CI 1.57-1.79 and aOR 2.30 95% CI 1.94-2.72).</p><p><strong>Conclusion: </strong>BMI ≥ 50 kg/m² was significantly associated with increased pregnancy complications.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2396071"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127211","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":"Which approach is better for labor induction: simultaneous or sequential administration of oxytocin and intrauterine balloon-a systematic review and a meta-analysis.","authors":"Qian Chen, Huihao Zhou, Yiqin Hu, Jingui Xue","doi":"10.1080/14767058.2024.2395490","DOIUrl":"10.1080/14767058.2024.2395490","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of simultaneous and sequential administration of oxytocin and intrauterine balloons in labor induction.</p><p><strong>Methods: </strong>The databases of Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase were thoroughly searched from their inception to November 2023. Randomized controlled trials (RCTs) investigating the simultaneous and sequential use of oxytocin and intrauterine balloons for labor induction in pregnancy were included. The meta-analysis was performed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was evaluated using the <i>I²</i> statistic. Dichotomous outcomes were estimated using relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were measured as the mean difference (MD).</p><p><strong>Results: </strong>A total of eight studies, involving a total of 1,315 nulliparous and multiparous women with an unfavorable cervix, were included in the systematic review. Moreover, a subgroup analysis was conducted, separately evaluating nulliparous and multiparous women. Compared with the sequential groups, simultaneous use of oxytocin and intrauterine balloons resulted in a significantly higher rate of delivery within 24h in nulliparas (RR = 1.30, 95%CI:1.04, 1.63, <i>p</i> = 0.02), a higher rate of vaginal delivery within 24h in multiparas (RR = 1.32, 95%CI:1.15,1.51, <i>p</i> < 0.00001), a superior rate of delivery within 12h and a shorter time to delivery in both nulliparas and multiparas. No statistically significant differences were observed in cesarean delivery and maternal and neonatal adverse outcomes between the sequential and simultaneous groups.</p><p><strong>Conclusions: </strong>These findings provide support for the simultaneous use of intrauterine balloons and oxytocin during labor induction in nulliparous women. Additionally, this approach may also prove beneficial for multiparas.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2395490"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114274","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":"Investigation of serum spexin concentrations in pregnant women diagnosed with hyperemesis gravidarum.","authors":"Işıl Ada Uçar, İbrahim Kale, Cem Yalçınkaya, Murat Muhcu","doi":"10.1080/14767058.2024.2398686","DOIUrl":"https://doi.org/10.1080/14767058.2024.2398686","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the serum concentration of the spexin, which has been shown to have an anorexic effect in animal models, in pregnant women with hyperemesis gravidarum (HG).</p><p><strong>Methods: </strong>This case-control study was conducted with 80 pregnant women who applied to the Umraniye Training and Research Hospital Gynecology and Obstetrics Clinic between April 2022 and September 2022. The HG group consisted of 40 pregnant women who were diagnosed with HG in the first 14 weeks of pregnancy, and the control group consisted of 40 healthy pregnant women matched with the HG group in terms of age, BMI, and gestational week.</p><p><strong>Results: </strong>Both groups were similar in terms of demographic characteristics and gestational age at blood sampling for spexin (<i>p</i> > 0.05). While maternal serum spexin concentration was 342.4 pg/ml in the HG group, it was 272.8 pg/ml in the control group (<i>p</i> = 0.003). ROC analysis was performed to determine the value of maternal serum spexin concentration in terms of predicting HG. AUC analysis of maternal serum spexin for HG estimation was 0.693 (<i>p</i> = 0.003, 95% CI =0.577 - 0.809). The optimal cutoff value for maternal serum spexin concentration was determined as 305.90 pg/ml with 65% sensitivity and 65% specificity.</p><p><strong>Conclusions: </strong>High serum spexin concentration is thought to play a role in the etiopathogenesis of HG, and this should be supported by demonstrating changes in serum spexin concentrations in pregnant women with HG whose symptoms alleviated and weight regain started after treatment.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2398686"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141658","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":"Combined fetal echocardiographic views improved prenatal differential diagnosis between right aortic arch and double aortic arch: a multicenter research.","authors":"Lijuan Yang, Yong Liu, Yu Lu, Fan Huang, Yan Xu, Tong Ru, Lan Yang, Min Ren","doi":"10.1080/14767058.2024.2430648","DOIUrl":"https://doi.org/10.1080/14767058.2024.2430648","url":null,"abstract":"<p><strong>Purpose: </strong>Congenital right aortic arch (RAA) and double aortic arch (DAA) were difficult to be diagnosed by traditional fetal echography. However, these two diseases have distinct clinical therapies and long-term outcomes which makes the differential diagnosis of great importance. While fetal screening by traditional fetal echography provides limited information about the branches of the aortic arch. This study aimed to discover and evaluate a novel combination of different echocardiography views in the diagnosis and differentiation of RAA and DAA.</p><p><strong>Methods: </strong>From January 2014 to December 2022, a total of 414,686 pregnant women underwent routine ultrasound examinations of the fetus during the second trimester. The scan of the fetal heart included a fetal four-chamber view, The left ventricular outflow tract (LVOT) view, a right ventricular outflow tract (RVOT) view, a three-vessel (3 V) view, and three vessels and trachea (3VT) view. Then the cases diagnosed as RAA or DAA by initial ultrasound screening from two hospitals were divided into the RAA group and the DAA group. Then enter the prenatal diagnosis consultation. All the pregnant women were offered invasive prenatal diagnosis. Genetic tests were fully discussed and decided after genetic counseling. Further ultrasound examination by two more experienced sonographers, in addition to the fetal echocardiogram views, includes further multi-angle scanning of the aortic arch branches with color Doppler flow imaging (CDFI) or high definition flow imaging (HDFI) for further diagnosis, and the reasons for misdiagnosis were analyzed and summarized.</p><p><strong>Results: </strong>A total of 332 cases were diagnosed with RAA or DAA by initial ultrasound, including RAA group 244 cases and DAA group 88 cases. In the RAA group, the mirror RAA (MRAA) could not be completely diagnosed by 3VT view alone in traditional echocardiography, with accuracy and sensitivity of 88.9% and 72.6%, respectively. In the DAA group, 36 cases were misdiagnosed only by 3VT view alone in traditional echocardiography, with the accuracy and specificity of 88.9% and 86.8%, respectively. However, the accuracy for MRAA or DAA could reach 100% when combined with 3VT and multi-angle scanning of the aortic arch branches. The abnormal detection rate of genetic tests was 10.5% (20/190), excluding the cases who refused the invasive prenatal diagnosis.</p><p><strong>Conclusion: </strong>Combining 3VT and multi-angle scanning of the aortic arch branches With CDFI or HDFI could effectively distinguish RAA variants from DAA. The invasive prenatal diagnosis should be recommended for patients with RAA or DAA, and the accurate prenatal diagnosis was highly valuable in providing appropriate perinatal counseling and prognostic evaluation.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2430648"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683279","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":"Effects of maternal posture and cognitive-behavioral interventions on labor outcomes in primigravidas with abnormal fetal head position: a randomized controlled clinical trial.","authors":"Xiaofeng Wan, Jinguo Zhai, Xiaoqin Lu, Xiuhong Wang, Hamza Saidi Lilenga, Mei Luo, Xiaochun Wang, Xueyan Wang, Yanli Zhou","doi":"10.1080/14767058.2024.2422448","DOIUrl":"10.1080/14767058.2024.2422448","url":null,"abstract":"<p><strong>Objective: </strong>Fetal head malposition can result in neonatal and maternal complications. Fetal head malposition occurs frequently in labor. Appropriate and timely managements are required. Maternal posture and cognitive-behavioral interventions could improve labor outcomes in primigravidas with fetal head malposition.</p><p><strong>Methods: </strong>A randomized controlled clinical trial was performed between January and December 2022 (Chinese Clinical Trial Registry, ChiCTR2100049359). Eligible primigravidas were randomly assigned into four groups. Group A received traditional perinatal care. Group B, C, and D received posture management, posture management with music therapy, and posture management with video education, respectively, in addition to traditional perinatal care. The maternal postures referred to place pregnant women in certain positions (lateral, lateral-prone, hands and knees, open knee-chest) to change the anatomical structure of pelvis, thus, to facilitate the fetal downward movement and birth. Maternal and neonatal outcomes were recorded and compared.</p><p><strong>Results: </strong>A total of 136 primigravidas were included, with 34, 35, 34, and 33 women in group A, B, C, and D, respectively. The incidences of cesarean section were lower in groups B, C, and D than that in group A (5.7%, 2.9%, and 3.0% versus 20.6%, <i>p</i> < 0.05). The fetal position correction rates at the time of full dilation of cervix were higher in groups B, C, and D than that in group A (66.7%, 63.6%, 68.8% versus 27.6%, <i>p</i> < 0.05). Primigravidas in groups B, C, and D had better experiences and a lower anxiety level than those in group A (<i>p</i> < 0.001). The four groups had no statistically significant differences in the total labor duration, operative vaginal delivery, umbilical artery blood pH, and neonatal Apgar scores.</p><p><strong>Conclusion: </strong>Fetal head malposition could happen in primigravidas. Maternal posture management and cognitive-behavioral interventions during labor could improve labor outcomes in primigravidas with fetal head malposition.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2422448"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631523","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}