Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Differential predictive utility of preoperative cervical length for preterm birth among various indications for cervical cerclage: a retrospective cohort study.","authors":"Nary Long, Yilin Fu, Zizhuo Wang, Ling Feng, Teng Ji","doi":"10.1080/14767058.2025.2479751","DOIUrl":"https://doi.org/10.1080/14767058.2025.2479751","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the predictive utility of preoperative cervical length (CL) for preterm birth (PTB) in cervical cerclage with different surgical indications.</p><p><strong>Methods: </strong>This study included data from 289 pregnant women who underwent transvaginal cervical cerclage at the Wuhan Tongji Hospital (Hubei, China) between 2015 and 2024. Participants were divided into three groups according to surgical indication(s) for cerclage: history indicated (<i>n</i> = 173); ultrasound indicated (<i>n</i> = 89); and examination indicated (<i>n</i> = 27).</p><p><strong>Results: </strong>The area under the receiver operating characteristic curve (AUC) revealed that preoperative CL for PTB was greater for ultrasound-indicated cerclage (AUC 0.6613, cutoff 13.5 mm) than that for history-indicated cerclage (AUC 0.5675, optimal cutoff 30.5 mm). In history-indicated cerclage, there were no difference in the rate of PTBs between preoperative CL > 30.5 mm and ≤ 30.5 mm, nor in the rate of postoperative CL ≤ 15 mm during the fourth week. In the ultrasound-indicated group, compared with preoperative CL > 13.5 mm, women with a CL ≤ 13.5 mm exhibited a higher rate of PTB (82.1% versus 48.0%; <i>p</i> < .001), and a higher rate of postoperative CL ≤ 15 mm in the fourth week (71.4% versus 37.5%; <i>p</i> = 0.009).</p><p><strong>Conclusion: </strong>The correlation between preoperative CL and PTB varied depending on the indication(s) for cerclage, and changes in postoperative CL contributed to varying predictive utility.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2479751"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671421","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":"Changes in adrenomedullin in bronchoalveolar lavage fluid with chorioamnionitis in a sheep-based model.","authors":"Adele Fabiano, Daniele Panichi, Simonetta Picone, Giuseppe Lapergola, Gabriella Levantini, Ebe D'Adamo, Mariachiara Strozzi, Danilo Aw Gavilanes, Boris W Kramer, Francesca Gazzolo, Ali Saber Abdelhameed, Diego Gazzolo","doi":"10.1080/14767058.2025.2456502","DOIUrl":"https://doi.org/10.1080/14767058.2025.2456502","url":null,"abstract":"<p><strong>Background: </strong>Adrenomedullin (AM) is a potent angiogenic, antioxidant and anti-inflammatory peptide protecting the developing lung from injury due to bronchopulmonary dysplasia (BPD) of the preterm infant. At this stage, no data on the potential effects of chorioamnionitis (CA) occurrence and glucocorticoids (GC) administration on AM in developing lungs are still lacking.</p><p><strong>Objective: </strong>to investigate, in a sheep-based model, the positive/side-effects of combined exposure to CA and GC on AM concentrations measured in bronchoalveolar lavage fluid (BALF).</p><p><strong>Methods: </strong>Time-mated ewes were randomly admitted to one of six treatment groups receiving injection: saline (controls); lipopolysaccharide (L) in intra-amniotic fluid treated alone at 7 or 14 d before delivery or associated with betamethasone (B) intramuscularly; B treated alone (7d) or associated with L (14d). Lambs were surgically delivered at 120 days gestation and euthanized. BALF was used for AM measurement in the studied groups.</p><p><strong>Results: </strong>AM BALF levels significantly (<i>p</i> < 0.05, for all) changed both to B and L exposure in a time-dependent manner. The latter was characterized by AM levels at short term superimposable to controls, whilst significantly (<i>p</i> > 0.05) decreased at long-term. The former showed increased AM at short and decreased at long-term (<i>p</i> < 0.05, for all), respectively.</p><p><strong>Conclusions: </strong>the present results showing AM BALF changes in a sheep-based model support the AM role in the hemodynamic patterns due to CA and BPD occurrence and open the way to further studies investigating the role of vasoactive agents as trustable markers of lung development/damage.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2456502"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030255","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":"Comparison of the value of transvaginal ultrasonography and MRI in the diagnosis of cesarean scar pregnancy: a meta-analysis.","authors":"Xiao Han, Boyang Zhang","doi":"10.1080/14767058.2024.2445661","DOIUrl":"https://doi.org/10.1080/14767058.2024.2445661","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic value of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) in cesarean scar pregnancy (CSP) by a method of meta-analysis.</p><p><strong>Methods: </strong>Studies on TVS and MRI for CSP were collected from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang data, and Chinese Scientific Journal Database (VIP database) until April 1, 2024. Stata 15.0 software was used for data analysis. Mann-Whitney U-test was applied to compare the diagnostic efficiency of the TVS and MRI groups.</p><p><strong>Results: </strong>Nine articles with 713 subjects were involved in this review. The pooled sensitivity (0.96, 95%CI: 0.94-0.97), specificity (0.90, 95%CI: 0.84-0.94), and DOR (197.28, 95%CI: 99.71-390.31) in the MRI group were higher than those (Sensitivity = 0.83, 95%CI: 0.77-0.87; Specificity= 0.74, 95%CI: 0.63-0.83; DOR = 13.66, 95%CI: 7.84-23.79) in the TVS group. The positive likelihood ratio and negative likelihood ratio of the MRI group were 9.56 (95%CI: 8.82-15.72) and 0.05 (95%CI: 0.03-0.07), while those of the TVS group were 3.21 (95%CI:2.18-4.74) and 0.24 (95%CI: 0.18-0.31), respectively. In the MRI and TVS groups, the area under the curve (AUC) of the summary receiver operating characteristic was 0.9497 and 0.86, respectively. The results of Mann-Whitney U-tests of the two groups showed significant differences in the pooled sensitivity (Z= -3.311, <i>p</i> < 0.001), specificity (Z= -2.123, <i>p</i> = 0.034), and DOR (Z= -3.272, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Both MRI and TVS can effectively diagnose CSP. However, compared with TVS, MRI has better diagnostic accuracy for CSP, with higher sensitivity and specificity. Considering the good diagnostic accuracy of ultrasound, patients with ultrasound suspicion of CSP should be sent to a reference center where MRI can express its full diagnostic potential regarding depth, topography of invasion and myometral residue, which is useful for subsequent management.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2445661"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958184","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":"Cerebral vein thrombosis: management tactics with a focus on pregnancy, the use of hormone therapy and assisted reproductive technologies.","authors":"Svetlana Akinshina, Viktoria Bitsadze, Jamilya Khizroeva, Maria Tretyakova, Kristina Grigoreva, Nilufar Gashimova, Alexander Vorobev, Vladislav Zubenko, Nataliya Makatsariya, Lala Valikhanova, Daredzhan Kapanadze, Marina Zainulina, Alina Solopova, Tamara Mashkova, Fidan Yagubova, Valentina Tsibizova, Jean-Christophe Gris, Ismail Elalamy, Grigoris Gerotziafas, Alexander Makatsariya","doi":"10.1080/14767058.2024.2447349","DOIUrl":"https://doi.org/10.1080/14767058.2024.2447349","url":null,"abstract":"<p><p><b>Purpose:</b> Cerebral vein thrombosis is a rare, life-threatening condition that has now become more commonly diagnosed due to advancements in imaging techniques. Our purpose is to improve understanding of pathogenesis, diagnosis and pregnancy and IVF management in patients with a history of cerebral thrombosis.</p><p><p><b>Materials and methods:</b> We present an overview of the modern tactics of anticoagulant therapy for cerebral thrombosis with a focus on pregnancy, the use of hormone therapy, and assisted reproductive technologies.</p><p><p><b>Results:</b> The most common risk factors for cerebral vein thrombosis are pregnancy, the postpartum period, and the use of oral contraceptives, which explains the high incidence of this pathology in women. The development of cerebral thrombosis is a vivid example of the interaction and synergetic effects of persistent factors that cause an increased risk of thrombotic complications, which include thrombophilia and acquired risk factors. Despite the possible risks, pregnancy after previously suffered cerebral thrombosis is not contraindicated provided adequate anticoagulant therapy.</p><p><p><b>Conclusions:</b> The most common provoking factors for the development of cerebral thrombosis in women are pregnancy and the use of estrogen-containing drugs. The issue of thromboprophylaxis during pregnancy, when using ART methods and the possibility of using hormonal therapy after cerebral vein thrombosis requires further study.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2447349"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933416","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 and neonatal outcomes with different screening strategies for gestational diabetes mellitus: a retrospective cohort study.","authors":"Shirley J Shao, Lucy J Fu, Llyke Ching, Katelin P Kramer, Nasim C Sobhani","doi":"10.1080/14767058.2025.2467996","DOIUrl":"10.1080/14767058.2025.2467996","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of an expanded gestational diabetes mellitus (GDM) screening strategy on perinatal outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included gravidas screened for GDM at a single academic center. The \"before\" cohort (estimated due dates (EDD) March 2018-April 2019) was screened using the standard 2-step method. The \"after\" cohort (EDD November 2019-July 2023) was screened using an expanded strategy that included the potential for GDM diagnosis based on 1-2 weeks of home glucose monitoring following isolated fasting hyperglycemia on the 3-hour glucose tolerance test (GTT). The primary outcomes were primary cesarean delivery (PCD) and neonatal intensive care unit (NICU) admission. Binomial regression and Kruskal Wallis tests were used to compare perinatal outcomes between the two cohorts in the general population and in a subgroup of those with isolated fasting hyperglycemia.</p><p><strong>Results: </strong>Outcomes for the \"before\" cohort (<i>n</i> = 1,733) were compared with those in the \"after\" cohort (<i>n</i> = 6,280). In the general population, A2GDM incidence increased after expansion of the screening protocol (4.8% vs. 6.4%, RR 1.34, 95% CI 1.07-1.69), but PCD and NICU admission rates were unchanged. In the subgroup of patients with isolated fasting hyperglycemia (<i>n</i> = 233), there was a significant increase in the incidence of any GDM (12.5 vs. 46.0%, RR 3.68, 95% CI 1.95-6.93) and A2GDM (8.3% vs. 37.3%, RR 4.47, 95% CI 2.03-9.87). There was no difference in PCD between cohorts, but NICU admission increased significantly in the \"after\" cohort (8.3% vs 22.4%, RR 2.68, 95% CI 1.18-6.08) in this subgroup.</p><p><strong>Conclusion: </strong>An expanded approach to GDM diagnosis using home blood glucose monitoring following isolated fasting hyperglycemia on 3-hour GTT was associated with increased A2GDM incidence but no improvements in primary maternal or neonatal outcomes. In the absence of clinical benefit, we do not recommend widespread implementation of this expanded strategy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2467996"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469750","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":"Cardiovascular disease in women with early-onset preeclampsia: a matched case-control study.","authors":"P Domínguez Del Olmo, I Herraiz, C Villalaín, B De la Parte, E Rodríguez-Sánchez, G Ruiz-Hurtado, L Fernández-Friera, E Morales, J L Ayala, J Solís, A Galindo","doi":"10.1080/14767058.2025.2459302","DOIUrl":"https://doi.org/10.1080/14767058.2025.2459302","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk of cardiovascular disease and the occurrence of cardiovascular events in the mid-long term after delivery, between women with and without a history of early-onset preeclampsia.</p><p><strong>Methods: </strong>A prospective case-control study has been conducted in Hospital Universitario 12 de Octubre, Madrid. 50 women with early-onset preeclampsia (diagnosed < 34 + 0 weeks) who delivered between 2008 and 2017 and a matched group (by age, parity, pregestational body mass index and date of delivery) of 50 women with uncomplicated pregnancies were recruited. In them, a 1-day visit for cardiovascular assessment was performed 3-12 years after delivery, consisting of the completion of blood and urine tests including oxidative stress analysis, vascular ultrasound to assess subclinical atherosclerosis and 24-hour blood pressure monitoring. Furthermore, Framingham10 and Framingham30 scales of cardiovascular disease risk were applied. Univariate analysis was used for comparisons, and the Kaplan-Meier method was performed to estimate their survival time until the development of a cardiovascular disease event (chronic hypertension, renal disease, myocardial infarction, thromboembolism and cerebrovascular disease).</p><p><strong>Results: </strong>Patients were evaluated at a median of 7.5 years (interquartile range, 6.5-9) after delivery. Women with a history of early-onset preeclampsia vs controls showed significantly lower levels of hemoglobin (12.9 vs 13.7 g/dL), hematocrit (38.9 vs 40.8%), prothrombin activity (93.1 vs 99.8%), IgA (223.5 vs 279.9 mg/dL) and C3 factor (101.0 vs 110.5 mg/dL) and prolongated prothrombin time (12.4 vs 11.6 s). Early-onset preeclampsia cases showed worse blood pressure control, with higher percentages of over-limit systolic blood pressure (17.9 vs. 11.2%, <i>p</i> < 0.01) and diastolic blood pressure (28.1 vs. 18.7%, <i>p</i> < 0.01) readings in 24 h. There were no significant differences in the vascular ultrasound studies as well as in the estimated cardiovascular risk obtained with the Framingham scales. At the visit time, a cardiovascular event was present in 44% women with history of early-onset preeclampsia vs 10% in the control group (<i>p</i> < 0.01). The most common event was chronic hypertension, with a relative risk of 4.7 (95% confidence interval 1.7-13.0) for the early-onset preeclampsia group.</p><p><strong>Conclusions: </strong>Women with a history of early-onset preeclampsia, compared to their matched controls, showed a greater risk of cardiovascular disease mainly at the expense of a 4.7-fold risk of developing chronic hypertension, with a median follow-up of 7.5 years after delivery.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2459302"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587937","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 the editor: \"Diagnostic capacity and interobserver variability in FIGO, ACOG, NICE and Chandraharan cardiotocographic guidelines to predict neonatal acidemia\" The authors should reconsider their conclusions.","authors":"Olivier Morel, Roselene Karassane, Anne-Laure Fijean, Charline Bertholdt, Matthieu Dap","doi":"10.1080/14767058.2025.2477078","DOIUrl":"https://doi.org/10.1080/14767058.2025.2477078","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2477078"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587947","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":"Adjunctive pessary therapy after emergency cervical cerclage in patients with protruding fetal membranes - a multicenter cohort study.","authors":"Michał Kostrzanowski, Katarzyna Kosińska-Kaczyńska, Katarzyna Chaberek, Anna Wójcikiewicz, Paweł Rybicki, Piotr Sieroszewski","doi":"10.1080/14767058.2025.2477075","DOIUrl":"https://doi.org/10.1080/14767058.2025.2477075","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to compare the perinatal outcomes in women with cervical dilatation with fetal membranes visible before 26 weeks of gestation managed with an adjunctive pessary after emergency cervical cerclage or emergency cerclage alone.</p><p><strong>Methods: </strong>We performed a retrospective analysis of women with singleton gestation, diagnosed with cervical dilatation accompanied by fetal membranes visible at or beyond the external os, who underwent emergency cervical cerclage. The participants were recruited at 3 tertiary perinatal centers. Adjunctive pessary treatment depended on the choice of the attending physician. The primary outcomes included preterm delivery before 34 weeks of gestation and a live infant discharged home.</p><p><strong>Results: </strong>Emergency cerclage alone was performed in 35 women, and 39 underwent emergency cerclage and adjunctive pessary therapy. Women in the adjunctive pessary group delivered significantly later (median 36, IQR 32-38 weeks vs 34, IQR 24-37 weeks of gestation; <i>p</i> = 0.03). No statistically significant differences were observed in rates of deliveries <34 weeks and rates of live infants discharged home. A significant prolongation of pregnancy (median 107, interquartile range 52-134 vs median 69, interquartile range 27-99 days; <i>p</i> = 0.02) and reduction in the rates of preterm deliveries <28 (7.7% vs 28.6%; <i>p</i> = 0.03) and <30 weeks of gestation (12.8% vs 34.3%; <i>p</i> = 0.05) were observed in adjunctive pessary group, despite more advanced cervical insufficiency. Adjunctive pessary significantly reduced the risk of delivery <30 weeks (aOR 0.2, 95% CI 0.06-0.7) and <34 weeks of gestation (aOR 0.2, 95% CI 0.05-0.81).</p><p><strong>Conclusion: </strong>The use of a pessary as an adjunctive therapy after emergency cervical cerclage may be effective in lowering the risk of delivery <30 weeks and may offer a new option for managing women with advanced cervical insufficiency.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2477075"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607059","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":"Validation of the clinical efficacy of one-day outpatient management of patients with gestational diabetes mellitus.","authors":"Jingwen Xu, Qian Jing, Huixia Shi, Hui Qian, Li Shi","doi":"10.1080/14767058.2024.2436086","DOIUrl":"https://doi.org/10.1080/14767058.2024.2436086","url":null,"abstract":"<p><strong>Objective: </strong>A comprehensive management model called the one-day care clinic has been established and implemented throughout the hospitals as well as maternal and child health care centers for gestational diabetes mellitus (GDM) in China. However, there is still a lack of high-level evidence for this management model. The objective of this study was to describe the one-day outpatient management model and assess its efficacy in managing GDM.</p><p><strong>Methods: </strong>A retrospective review was performed on patients who were admitted to the obstetrics clinic and diagnosed as GDM at our centers from July 2017 to June 2022. All enrolled patients were divided into two groups: the experimental group that participated in the one-day outpatient management and the control group that only received routine education on gestational diabetes in the outpatient department. Baseline characteristics and clinical data of enrolled patients were reviewed. Blood glucose level before and after attending one-day outpatient management, blood glucose and HbA1c before delivery, weight gain at the end of pregnancy, complications during pregnancy and pregnancy outcomes were collected.</p><p><strong>Results: </strong>A total of 546 patients were finally included in this study, with 276 in the experimental group and 270 in the control group. There were no significant differences between the two groups in terms of baseline characteristics. The 1h postprandial blood glucose (PBG) and 2h PBG levels were significantly lower after participating in the one-day outpatient management compared to before (all <i>p</i> value < 0.01). Before delivery, the FBG, 2hPBG, and HbA1c levels in the experimental group were significantly lower than those in the control group (all <i>p</i> value < 0.01). The experimental group experienced less weight gain and had a higher rate of achieving weight gain goals compared to the control group. In terms of complications during pregnancy, the incidence of premature rupture of fetal membranes, pregnancy induced hypertension, and hydramnion did not differ significantly between the two groups. In terms of pregnancy outcomes, the incidence of macrosomia and neonatal hypoglycemia in the experimental group was significantly lower than in the control group (all <i>p</i> value < 0.05).</p><p><strong>Conclusion: </strong>The adoption of the one-day outpatient management is more beneficial for controlling blood glucose levels and weight target during pregnancy in GDM patients. Additionally, this management can decrease the occurrence of adverse pregnancy outcomes, and improve the prognosis of both GDM patients and offspring.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2436086"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774360","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":"Proof of concept testing of a vascular closure device for use in fetal surgery.","authors":"Braxton Forde, Samuel Martin, Marc Oria, Jordan Kapke, Eyal Krispin, Jose L Peiro","doi":"10.1080/14767058.2024.2435468","DOIUrl":"https://doi.org/10.1080/14767058.2024.2435468","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Prior clinical findings have demonstrated that maternal laparotomy with trans-amniotic trans-uterine suturing of the fetoscopic port site during in utero myelomeningocele repair reduces the risk of membrane rupture. However, due to laparotomy-associated morbidity, we aimed to explore the feasibility of using a vascular closure device for percutaneous trans-amniotic trans-uterine suturing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This IRB and IACUC-exempt study utilized 2 strategies for proof-of-concept testing of using the Abbott Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; Device for suture placement; 1. Ultrasound guided application on a high fidelity maternal abdominal uterus model used for fetal procedures and 2. Placement under direct visualization with sheep undergoing cesarean delivery for other research purposes. In the high-fidelity uterus model, the Abbott Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; device was used to place a transuterine/transamniotic stitch with accompanying video recording of the approach (https://go.screenpal.com/watch/cZfhoDVsYvW password: perclose). Regarding the second approach, at the time of a cesarean section, 12 French Checkflo&lt;sup&gt;®&lt;/sup&gt; cannulas were inserted into the sheep amniotic space &lt;i&gt;via&lt;/i&gt; different approaches: (1) Seldinger technique, (2) Seldinger technique insertion of Checkflo&lt;sup&gt;®&lt;/sup&gt; cannula and subsequent use of the Abbott Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; device to suture the port site after check flow removal, (3) Abbott Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; device utilized in what is described as a \"pre-close\" technique, where prior to cannula placement, trans-uterine trans-amniotic stitches are placed followed by the insertion of a 12 French Checkflo&lt;sup&gt;®&lt;/sup&gt; cannula over the same guidewire. Samples of the sutured uterine wall were sent to pathology and H&E staining was performed to assess uterine hole closure and amnion-to-uterus fixation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The high-fidelity model confirmed that the Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; Device was easily visualized by ultrasound and suture deployment was without complication. In the animal model, the Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; device effectively sutured the amnion to the uterus in both the pre- and post-close approach. The pre-close technique achieved better amnion-to-uterus approximation and more appropriate uterine hole closure. H&E staining revealed that without suturing, amnion separation from the chorion layer occurred, and the uterine hole persisted. The post-close technique showed partial connection between the amnion and chorion, but inadequate uterine hole closure with amnion shift into the defect. Optimal closure, with secure amnion-to-chorion fixation and uterine closure, was achieved through the pre-close technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The Abbott Perclose&lt;sup&gt;™&lt;/sup&gt; ProStyle&lt;sup&gt;™&lt;/sup&gt; Device seems to be a feasible device for use of uterin","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2435468"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796253","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}