Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Changes in short-term variation of antenatal cardiotocography to identify intraamniotic infection: a historical cohort study.","authors":"Brynhildur Tinna Birgisdottir, Tomas Andersson, Ingela Hulthén Varli, Sissel Saltvedt, Ke Lu, Farhad Abtahi, Ulrika Åden, Malin Holzmann","doi":"10.1080/14767058.2024.2434059","DOIUrl":"https://doi.org/10.1080/14767058.2024.2434059","url":null,"abstract":"<p><strong>Introduction: </strong>Intraamniotic infection (IAI) is one of the main possible complications of preterm prelabor rupture of membranes (PPROM) and can lead to severe consequences for the neonate, such as early onset neonatal sepsis (EONS). Available diagnostic tools for IAI have poor diagnostic performance, which may result in both over- and underdiagnoses of IAI. In a search for better diagnostic tools, we have examined short-term variation (STV) in fetal heart rate. We have previously shown that in IAI exposed pregnancies, the STV was more than 20% lower in the last cardiotocography trace before the start of labor, as compared to those not exposed to IAI. The association between IAI and STV needs further evaluation and we therefore continued by examining the longitudinal change in STV in association with IAI.</p><p><strong>Material and methods: </strong>We performed a historical cohort study on 628 singleton pregnancies with PPROM, delivering between 24 + 0 to 33 + 6 gestational weeks. The main exposure of the study was IAI, using EONS as a proxy as no easily available method exists for confirming IAI antepartum, and IAI and EONS are strongly associated. The main outcome was STV in fetal heart rate. At least two available cardiotocography traces per fetus were required as a minimum, from PPROM or from seven days before birth, whichever came later, until the start of labor or planned cesarean birth. A total of 9 690 cardiotocography traces were analyzed.</p><p><strong>Results: </strong>Fetuses exposed to IAI had a 26.5% steeper decline in their STV during the last 24 h before the start of labor when compared to fetuses not exposed (95% CI -32.9% to -19.4%; <i>p</i> < 0.001). After adjustment for antenatal corticosteroids, the decline remained significant. The decline became less prominent but the significance remained when also adjusting for the baseline frequency (-12.7% [95% CI -19.3% to -5.5%], <i>p</i> < 0.001). In the IAI-exposed group, the baseline frequency increased by 11.1 bpm during the last 12 h before the start of labor, beyond those who were not exposed (95% CI 8.3 bpm to 13.8 bpm; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In pregnancies affected by IAI the STV declines steeper in the last 24 h before the start of labor as compared to pregnancies not affected by IAI, even after adjustment for increasing baseline frequency. The association of STV in relation to IAI needs to be further studied in order to evaluate and establish STVs usefulness in monitoring patients for IAI.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2434059"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774340","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":"The significance of ultrasound parameters and clinical factors in predicting successful labor induction among nulliparous women.","authors":"Laura Rācene, Līva Ķīse, Ieva Pitkēviča, Zane Rostoka, Beāte Sārta, Maija Priedniece, Agnija Vecvagare, Ļubova Lapidus, Anda Ķīvīte-Urtāne, Dace Rezeberga, Natālija Vedmedovska","doi":"10.1080/14767058.2025.2450405","DOIUrl":"https://doi.org/10.1080/14767058.2025.2450405","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the values of ultrasound and clinical parameters for predicting outcomes of induction of labor (IOL) among healthy nulliparous women with a singleton, term cephalic pregnancy.</p><p><strong>Methods: </strong>The cervical length, cervical strain elastography, posterior cervical angle, head-perineum distance, Bishop score, and maternal parameters were assessed before IOL with a combined method-Foley catheter and Misoprostol perorally. The main outcome was vaginal delivery.</p><p><strong>Results: </strong>Variation in cervical tissue elasticity, represented by elasticity index (E), was significantly different between outcome groups-vaginal delivery and cesarean section (CS) in internal os, in the anterior lip near the cervical canal and the midpoint of the anterior and posterior lip (<i>p</i> < 0.05). The E was higher-softer in the vaginal delivery group. The overall elasticity was significantly higher in the middle part of the cervix in the vaginal delivery group. However, other ultrasound metrics did not differ significantly across the outcome groups. Overall, women who delivered vaginally were taller and had a lower pre-pregnancy BMI (<i>p</i> = 0.02 for both variables). Univariate and multivariate analyses showed maternal height was the significant independent predictor of CS (AOR 0.91, 95% CI 0.84-0.98). The prognostic value for vaginal delivery, based on cervical length, maternal height, Bishop score, and parameters of cervical strain elastography, was poor (AUC < 0.7).</p><p><strong>Conclusion: </strong>The study underscores the importance of cervical tissue elasticity in predicting vaginal delivery outcomes, while also highlighting that maternal height is a significant independent predictor of cesarean delivery. However, evaluated metrics in the study have limited prognostic value for predicting vaginal delivery. This suggests a need for further research to identify more reliable predictors of delivery outcomes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2450405"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973067","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":"Mendelian randomization analysis of blood uric acid and risk of preeclampsia: based on GWAS and eQTL data.","authors":"Jiao Wang, Xiaohu Liu, Youmou Fu, Baosheng Zhu, Jinman Zhang","doi":"10.1080/14767058.2024.2443673","DOIUrl":"https://doi.org/10.1080/14767058.2024.2443673","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The causal association between blood uric acid and preeclampsia (Preeclampsia, PE) has not been conclusively established based on the literature reviewed to date. This bi-directional Mendelian randomization study aimed to investigate the bi-directional causal association between blood uric acid concentration and PE at different genetic levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Pooled data on preeclampsia (sample size = 82,085) and blood uric acid (sample size = 129,405) were conducted based on publicly available genome-wide association analysis (Genome-Wide Association Study, GWAS) on the East Asian populations regarding preeclampsia and blood uric acid, respectively. We assessed blood uric acid and PE associations using two-sample Mendelian randomization (TSMR) analyses based on GWAS pooled statistics using inverse variance weighted (Inverse variance weighted), MR-Egger, and Weighted median (Weighted median) to examine the association between blood uric acid and pre-eclampsia. Causal relationship between blood uric acid and pre-eclampsia.Cochran's Q statistic was used to quantify the heterogeneity of instrumental variables among other methods. Subsequently, we extracted the expression quantitative trait loci (eQCTL, Expression quantitative trait loci) data corresponding to each gene as the instrumental variables using the genes corresponding to the intersecting instrumental variables of the exposure and the outcome in the respective analyses of the forward and backward TSMR respectively, so as to analyze the genetic causality of the genes with the different forward and backward TSMR methods further. Inverse variance weighted (IVW) was used to analyze the genetic causality of genes with different positive and negative outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Genetically determined blood uric acid level IVW method, ratio (OR) 1.30, 95% confidence interval (CI): [0.6, 2.83], &lt;i&gt;p&lt;/i&gt; = 0.51 was not risk associated with PE. In addition according to the inverse MR analysis, we found an OR of 0.99, 95% CI [0.99, 1.0], &lt;i&gt;p&lt;/i&gt; = 0.999) for PE on blood uric acid level IVW method and no significant heterogeneity in instrumental variables or level polytropy was found. (ii) Although GWAS data suggested no risk association between PE and uric acid, gene association analysis of eQTL data at blood uric acid levels with PE suggested a risk effect of the TP53INP1 gene for PE (IVW, OR = 11.476, 95% CI 2.511-52.452, &lt;i&gt;p&lt;/i&gt; = 1.648 × 10&lt;sup&gt;-3&lt;/sup&gt;) and a protective effect of CTSZ (IVW, OR = 0.011, 95% CI 0.001-0.189, &lt;i&gt;p&lt;/i&gt; = 1.804 × 10&lt;sup&gt;-3&lt;/sup&gt;), while a risk effect of ETV7 on hyperuricemia was suggested in a genetic association analysis of PE eQTL data with blood uric acid levels (OR = 1.018, 95% CI 1.007-1.029, &lt;i&gt;p&lt;/i&gt; = 1.289 × 10&lt;sup&gt;-3&lt;/sup&gt;).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our MR (Mendelian Randomization) study based on the GWAS database did not support a bidirectional causal effect between blood uric acid leve","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2443673"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923318","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":"Exploring the impact of nano platinum-hydrogen saline on oxygen-induced retinopathy in neonatal rats.","authors":"Yangcan Ming, Wanyi Xu, Zhe Yang, Zi Wang, Na Wang","doi":"10.1080/14767058.2025.2454374","DOIUrl":"https://doi.org/10.1080/14767058.2025.2454374","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to assess the impact of nano platinum-hydrogen saline (Pt NPs + H₂) on oxygen-induced retinopathy (OIR) in neonatal rats, with the goal to contribute new insights into the therapeutic strategies for retinopathy of prematurity.</p><p><strong>Methods: </strong>Pt NPs + H₂ formulation was synthesized to address OIR in a rat model. Subsequent examination included the assessment of retinal blood vessel distribution and morphology through hematoxylin and eosin (HE) and isolectin B4 (IB4) staining techniques. The levels of reactive oxygen species (ROS), malondialdehyde(MDA), and superoxide dismutase (SOD) were measured to reflect the oxidative stress in rats. Additionally, the protein expression of vascular endothelial growth factor (VEGF) in each experimental group was assessed using western blot analysis, while the gene expression of VEGF in retinal neovascularization tissues was assessed using reverse transcription-polymerase chain reaction (RT-PCR). Furthermore, the extent of retinal cell apoptosis was measured using a TdT-mediated dUTP Nick-End Labeling (TUNEL) apoptosis kit.</p><p><strong>Results: </strong>HE staining and IB4 staining revealed positive retinal neovascularization in the OIR group, whereas neovascularization in the Pt NPs + H₂ group exhibited reduced severity. Significantly fewer capillary globules and capillary tubules were observed in the Pt NPs + H₂ group compared to the OIR group (<i>p</i> < 0.05). Also, the Pt NPs + H₂ group demonstrated significant reductions in ROS and MDA levels within retinal tissues (<i>p</i> < 0.05, <i>p</i> < 0.001), along with a significant increase in SOD level (<i>p</i> < 0.05). Notably, the MDA level in the Pt NPs + H₂ group was notably lower than that in the OIR group (<i>p</i> < 0.01, <i>p</i> < 0.05), and even lower than that in the H₂ group. Pt NPs + H₂ intervention was associated with decreased protein and mRNA expression of VEGF, with statistical significance (<i>p</i> < 0.05). While the H₂ group exhibited a decreasing trend in apoptotic cell count in the retinal ganglion cell layer (<i>p</i> < 0.05), the Pt NPs + H₂ group demonstrated a more pronounced reduction, with a significant difference (<i>p</i> < 0.01). No significant discrepancy in apoptosis within the inner nuclear layer was observed (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>The synergistic effect of hydrogen saline and nano platinum manifests as enhanced antioxidant, anti-apoptotic, and anti-neovascular properties. Nano platinum-hydrogen saline demonstrates inhibitory effects on OIR in rats.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2454374"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030256","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":"Prenatal diagnosis and pregnancy outcomes in fetuses with vertebral abnormalities.","authors":"Jian Hu, Ling Zeng, Ting Wang, Meiqi Yi, Jieping Song","doi":"10.1080/14767058.2025.2468000","DOIUrl":"https://doi.org/10.1080/14767058.2025.2468000","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the genetic risk and pregnancy outcomes of fetuses who had the sonographic diagnosis of vertebral abnormalities (VA).</p><p><strong>Methods: </strong>Fifty-two fetuses with sonographically detected VA (excluding neural tube defects) were included in the study. Data on prenatal ultrasound scan, prenatal genetic testing by amniocentesis, and pregnancy outcomes were collected and reviewed.</p><p><strong>Results: </strong>Four types of VA were identified among 52 fetuses: butterfly vertebrae (26.9%, 14/52), hemivertebrae (59.6%, 31/52), hemivertebrae combined with butterfly vertebrae (9.6%, 5/52), and block vertebrae (3.9%, 2/52). Of the 52 fetuses, 33 presented VA as the sole sonographic anomaly, while the remaining 19 had associated anomalies. The positive rate of prenatal diagnosis for fetuses with VA was 19.2% (10/52). Chromosomal analysis, including karyotyping and chromosomal microarray analysis (CMA), detected one case of mosaic trisomy 9 and six cases of (likely) pathogenic copy number variants (CNVs). Whole exome sequencing (WES) identified four likely pathogenic variants in three cases with negative CMA results, specifically c.5110-1G > A in FLNB, c.8366G > A in KMT2D, and c.1275_1283dup as well as c.870 + 2T > C in DLL3. Among the 10 cases with diagnostic genetic testing results, seven fetuses exhibited isolated VA. There was no significant difference in the diagnostic rates between the isolated VA group (21.2%, 7/33) and the non-isolated VA group (15.8%, 3/19) (odds ratio [OR] 0.696, 95% confidence interval [CI] 0.157-3.087, <i>p</i> = 0.910). However, the live birth rate was significantly higher in the isolated VA group (71.9%, 23/32) compared to the non-isolated VA group (38.9%, 7/18) (OR 4.016, 95% CI 1.184-13.622, <i>p</i> = 0.022). Among the 30 live birth cases, two underwent spinal surgery and another two were identified with additional abnormalities. Following appropriate interventions, no apparent abnormalities were observed in the growth and development of 30 live birth cases.</p><p><strong>Conclusion: </strong>Invasive prenatal diagnosis is recommended for all fetuses diagnosed with VA, regardless of whether associated anomalies are present. WES can enhance the diagnostic yield for fetuses with negative CMA results. Fetuses with isolated VA can have favorable pregnancy outcomes when genetic testing results are negative. However, long-term follow-up remains necessary for the assessment of the prognosis of these fetuses.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2468000"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469752","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":"Angle of progression for predicting second-stage cesarean delivery complications.","authors":"Yossi Geron, Asaf Romano, Anat Shmueli, Ran Matot, Sharon Sigal-Kaplun, Sharon Daniel, Ron Charach, Yinon Gilboa","doi":"10.1080/14767058.2025.2463394","DOIUrl":"https://doi.org/10.1080/14767058.2025.2463394","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between the angle of progression (AOP) and maternal surgical complications following a second-stage cesarean delivery.</p><p><strong>Methods: </strong>We retrospectively evaluated singleton pregnancies at term (≥37 weeks) who underwent cesarean delivery for arrest of descent at the second stage of labor from January 2022 to December 2023. Only cases with recorded AOP were included. The fetal head position was confirmed by transabdominal ultrasound, and the fetal head station was assessed manually by digital examination. The main outcome was defined as a composite adverse maternal outcome, including challenging fetal extraction, uterine extension, requirement for blood transfusions, postpartum fever, ileus, and re-hospitalization due to endometritis or surgical site infection.</p><p><strong>Results: </strong>Twenty-five cases met the inclusion criteria, of whom 10 (40%) experienced the composite adverse maternal outcome. These patients had wider mean AOP compared to those without maternal morbidity (136.7 ± 7.4 vs. 124.7 ± 12.5, <i>p</i> = .017<b>).</b> Univariate logistic regression analysis showed a significant correlation between measured AOP and composite adverse maternal outcome (OR = 1.15, 95% CI 1.01-1.30, <i>p</i> = .028). The predicted probability for composite adverse maternal outcome by receiver-operating characteristics curve yielded an area under the curve of 0.79 (95% CI 0.60-0.98) for AOP, compared to an area under the curve of 0.53 (95% CI 0.30-0.75) for the manually measured fetal head station.</p><p><strong>Conclusions: </strong>We found a correlation between the angle of progression and maternal complications following second-stage cesarean delivery. Assessing the angle of progression before surgery may be of help to the obstetrical team to better identify susceptible cases and allow for appropriate preparation.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2463394"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383938","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":"The role of progesterone in the prevention of the \"great obstetrical syndromes\": current evidence.","authors":"Gian Carlo Di Renzo, Valentina Tosto, Valentina Tsibizova, Paola Bianchi, Giuseppe Benagiano","doi":"10.1080/14767058.2025.2451664","DOIUrl":"https://doi.org/10.1080/14767058.2025.2451664","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2451664"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973066","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":"Association of duration of intrapartum maternal hyperglycemia in well-controlled gestational diabetes mellitus women and risks of neonatal hypoglycemia: a retrospective cohort study.","authors":"Yilin He, Yiwei Liu, Yiran Peng, Yang Xu, Jie Yan, Huixia Yang","doi":"10.1080/14767058.2024.2431617","DOIUrl":"https://doi.org/10.1080/14767058.2024.2431617","url":null,"abstract":"<p><strong>Objectives: </strong>Achieving intrapartum euglycemia is recommended to reduce the risk of neonatal hypoglycemia. However, recent research relating the association of maternal intrapartum glucose and neonatal hypoglycemia showed conflicting results, particularly in women with gestational diabetes mellitus (GDM). We aimed to assess the association between intrapartum maternal hyperglycemia and neonatal hypoglycemia in women with GDM.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 508 pairs of women with GDM and their neonates in Peking University First Hospital from 18 October 2020 to 18 October 2021. Our exposure was the maternal time above range (TAR) for glucose during labor, defined as the duration when glucose levels exceeded 126 mg/dL. We split the participants into four groups according to their TAR quantiles and employed natural spline regression using the LOESS method to illustrate the relationship between maternal TAR and neonates' lowest glucose level within 24-h postbirth.</p><p><strong>Results: </strong>Of the 508 women included, 37.8% (192/508) experienced hyperglycemia with a TAR over 25%. TAR quantiles were not significantly associated with neonates' lowest glucose levels (adjusted coefficients [95%CI], Q1: reference, Q2: 0.24 [-0.04, 0.54], Q3: 0.11[-0.21, 0.43], Q4: 0.18[-0.15, 0.52]). However, increased TAR >100 mg/dL resulted in higher neonatal glucose values (adjusted coefficients [95%CI]: Q1: reference, Q2: 0.33 [-0.04, 0.71], Q3: 0.47 [0.11, 0.82], Q4: 0.35 [0.07, 0.63]). Moreover, maternal hypoglycemia was association with neonatal hypoglycemia (adjusted coefficients [95%CI]: -0.67 [-1.15, -0.18]).</p><p><strong>Conclusion: </strong>Intrapartum glycemic control may be considered not as critical, when the overall glucose control throughout pregnancy is optimized. As neonatal hypoglycemia shows association with maternal hypoglycemia, which may be induced by strict intrapartum glycemic control, a less stringent intrapartum glucose target is preferred.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2431617"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774335","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":"Analysis of the clinical characteristics and outcomes of pregnant women with different degrees of pulmonary hypertension.","authors":"Yangyang Shi, Dabao Wu, Ling Chen, Yongyun Shi","doi":"10.1080/14767058.2024.2352090","DOIUrl":"https://doi.org/10.1080/14767058.2024.2352090","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the clinical situation and pregnancy outcome of pregnant women with pulmonary arterial hypertension (PAH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 125 pregnant women with varying degrees of PAH who were treated in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of the University of Science and Technology between January 2016 and January 2023. The patients were divided into the mild group (58 cases), the moderate group (42 cases), and the severe group (25 cases) based on the pulmonary artery systolic blood pressure (PASBP) measurements. Mild was considered as PASBP 30-49 mmHg, moderate as PASBP 50-79 mmHg, and severe as PASBP ≥80 mmHg. The clinical data, cardiac function grade, etiology, and pregnancy outcome of the pregnant women with different degrees of severity of PASBP were analyzed.</p><p><strong>Results: </strong>Out of the 125 cases, the primary cause of PAH was congenital heart disease in 46 cases, followed by idiopathic heart disease in 32 cases, preeclampsia in 30 cases, rheumatic heart disease in 10 cases, and perinatal cardiomyopathy in 7 cases. A significant correlation was observed between the severity of PAH and the cardiac function grade, indicating that higher PASBP levels were associated with worse cardiac function (New York Heart Association functional classification system) (<i>p</i> < .05). Most deliveries were conducted <i>via</i> cesarean section, predominantly under intraspinal anesthesia. It was found that as the severity of PAH increased, there was a corresponding escalation in the incidence of adverse outcomes, including preterm birth, neonatal asphyxia, the need for intensive-care-unit transfer for both mothers and newborns, maternal death, perinatal death, extended postoperative hospital stay, and increased hospital expenses (<i>p</i> < .05).</p><p><strong>Conclusions: </strong>The higher the pulmonary artery pressure, the worse the prognosis and outcome in pregnant patients with severe PAH.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2352090"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933415","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":"The fetal cerebral Doppler in the last weeks of pregnancy can select very small fetuses unlikely to present intrapartum compromise.","authors":"José Morales-Roselló, Alicia Martínez-Varea, Blanca Novillo-Del Álamo, Asma Khalil","doi":"10.1080/14767058.2025.2456989","DOIUrl":"https://doi.org/10.1080/14767058.2025.2456989","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether, in late pregnancy, the cerebral Doppler can identify very small fetuses that are less likely to experience intrapartum compromise (IC).</p><p><strong>Material and methods: </strong>This was a retrospective study of 282 singleton pregnancies that underwent an ultrasound scan at 32 + 0- 40 + 6 weeks and were delivered after induction, or spontaneous onset of labor. Very small fetuses were defined as fetuses with estimated weight less than the 3rd centile. IC was diagnosed in case of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH < 7.20, requiring urgent cesarean section, neonatal pH below 7.10 and Apgar score at 5 min <7. The ability of the cerebral Doppler, middle cerebral artery pulsatility index, and cerebroplacental ratio, expressed in multiples of the median (MCA PI MoM and CPR MoM), to rule out the risk of IC was evaluated alone and combined with other sonographic and clinical parameters by means of logistic regression and ROC curve analyses.</p><p><strong>Results: </strong>The only significant parameters determining IC were parity, MCA PI, and CPR MoM. [AUC 0.62 (95% CI 0.54-0.71, <i>p</i> = 0.012), 0.62 (95% CI 0.53-0.71, <i>p</i> = 0.008), 0.60 (95% CI 0.51-0.69, <i>p</i> = 0.020), respectively], while the best prediction was obtained combining parity with MCA PI or CPR [AUC 0.68 (95% CI 0.60-0.76), 0.67 (95% CI 0.60-0.75), <i>p</i> < 0.0001 for both]. Moreover, 90% of IC cases had MCA PI and CPR values below 1.1 MoM, while 100% had MCA and CPR values below 1.5 and 1.3 MoM. Finally, the negative predictive value was 82% for any combination of parameters that included either the MCA MoM or CPR MoM.</p><p><strong>Conclusion: </strong>The cerebral Doppler can select a group of very small fetuses that are less likely to experience IC. These fetuses might be to some extent constitutionally small and might be candidates for a more conservative and individualized management.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2456989"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048199","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}