Maternal-Fetal Medicine最新文献

{"title":"Fetoscopic laser photocoagulation for twin-twin transfusion syndrome in a dizygotic monochorionic twins","authors":"H. Tang, C. Dai, Huijun Li, Xiangyu Zhu, H. Duan, X. Xiao, L. Jin, Jie Li, M. Zheng","doi":"10.1097/fm9.0000000000000217","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000217","url":null,"abstract":"","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140745012","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 Impact of Regular Diet Recovery on Postoperative Rehabilitation After Elective Cesarean Section","authors":"Caihong Hu, Kuilin Fei, Yuelan Liu, Xiao'e Jiang, Wenjing Yong, Weishe Zhang, Ping Li","doi":"10.1097/fm9.0000000000000224","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000224","url":null,"abstract":"\u0000 \u0000 \u0000 To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.\u0000 \u0000 \u0000 \u0000 This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and chi-square test, with significance set at P < 0.05.\u0000 \u0000 \u0000 \u0000 Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours (P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours (P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days (P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 (P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 (P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days (P > 0.05).\u0000 \u0000 \u0000 \u0000 Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.\u0000","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743630","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 Preeclampsia Screening and Prevention: Perspective in Chinese Mainland","authors":"Jiao Liu, Yunyu Chen, Sin Ting Tai, Long Nguyen-Hoang, Kunping Li, Jing Lin, Xiaohong Lu, L. Poon","doi":"10.1097/fm9.0000000000000215","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000215","url":null,"abstract":"\u0000 Preeclampsia (PE), a multisystem disorder in pregnancy, is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide. Preterm PE with delivery at <37 weeks of gestation is associated with a higher risk of adverse maternal and perinatal outcomes than term PE with delivery at ≥37 weeks of gestation. A myriad of first trimester screening models have been developed to identifying women at risk of preterm PE. In fact, the Fetal Medicine Foundation (FMF) first trimester prediction model has undergone successful internal and external validation. The FMF triple test enables the estimation of patient-specific risks, using Bayes theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor. Establishing a quality control process for regular monitoring and to ensure data standardization, reliability, and accuracy is key to maintaining optimal screening performance. The rate of preterm PE can be reduced by 62% by using the FMF prediction model, followed by the administration of low-dose aspirin. Recent evidence has also demonstrated that metformin has the potential for preventing PE in patients at high-risk of the disorder. In this article, we will summarize the existing literature on the different screening methods, different components of risk assessment, therapeutic interventions, and clinical implementation of the first trimester screening and prevention program for PE with specific considerations for Chinese mainland.","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757241","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":"Erratum to Clinical Management Guidelines for Intrahepatic Cholestasis of Pregnancy. Volume 6, Issue 1, Janurary 2024","authors":"","doi":"10.1097/fm9.0000000000000228","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000228","url":null,"abstract":"","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759531","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":"Making Elimination of Perinatal Hepatitis B Infection a Reality","authors":"Jie Tang, Kuanhui Xiang, Yi-Hua Zhou","doi":"10.1097/fm9.0000000000000213","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000213","url":null,"abstract":"","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139599354","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":"Chinese Population Reference Curves for Ultrasound-Measured Amniotic Fluid Deepest Vertical Pocket in Dichorionic Twin Pregnancies, and Their Associations With Pregnancy Outcomes","authors":"Zhengxin Lyu, Tianchen Wu, Shan Lu, P. Yuan, Yangyu Zhao, Yuan Wei","doi":"10.1097/fm9.0000000000000208","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000208","url":null,"abstract":"\u0000 \u0000 \u0000 This study aimed to establish the Chinese population's amniotic fluid deepest vertical pocket (DVP) reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.\u0000 \u0000 \u0000 \u0000 This retrospective cohort study, conducted at Peking University Third Hospital from August 2011 to December 2020, used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound. After exclusions, reference curves were developed using 318 women with 3299 DVP scans, and the data analyzed included maternal demographics, pregnancy outcomes, ultrasound measurements, and neonatal information. DVPs were assessed via ultrasound at regular intervals and grouped by gestational age (GA) for analyses. Linear mixed models were used to create amniotic fluid reference curves. Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests. Logistic regression provided both crude and adjusted odds ratios (OR), adjusting for pre-pregnancy weight, age, ethnicity, parity, and conception mode. Significance was set at P < 0.05 with 95% confidence intervals (CI), and the analyses were conducted using SPSS ver. 26.0 (IBM Corp., Armonk, NY) and SAS ver. 9.4 (SAS Institute Inc., Cary, NC, USA) software.\u0000 \u0000 \u0000 \u0000 DVP increased from the first trimester to a maximum at 26 weeks (95% confidence interval (CI), 2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2) and then decreased gradually toward term. Differences between twins 1 and 2 were significant after 26 weeks (95% CI for twin 1: 5.3, 5.5; 95% CI for twin 2: 4.4,4.5; P < 0.010). Polyhydramnios of twin 1 increased the risk of large for GA. Oligohydramnios of twin 1 increased the risk of small for GA. Polyhydramnios of twin 2 increased the risk of small for GA, premature birth, and neonatal complications. Oligohydramnios of twin 2 increased the risk of preeclampsia, hypertensive disorder complicating pregnancy, and premature rupture of membranes.\u0000 \u0000 \u0000 \u0000 Reference curves for twin amniotic fluid volumes vary by GA and differ between twins, with potential implications for pregnancy outcomes.\u0000","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139619244","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":"Clinical Management Guidelines for Intrahepatic Cholestasis of Pregnancy","authors":"Xinyang Yu, Huixia Yang, Hongbo Qi","doi":"10.1097/fm9.0000000000000207","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000207","url":null,"abstract":"\u0000 Intrahepatic cholestasis of pregnancy (ICP) is a significant gestational complication in late pregnancy, potentially leading to severe perinatal complications such as intrauterine fetal demise and preterm birth. The Obstetrics Group of the Gynecology and Obstetrics Branch and the Perinatal Medicine Branch of the Chinese Medical Association organized a panel of domestic experts to deliberate and propose recommendations based on domestic and international guidelines, recent evidence-based medical evidence about key clinical issues including risk factors, clinical manifestations, perinatal outcomes, diagnosis, severity grading, maternal and fetal monitoring, treatment methods, timing and methods of pregnancy termination, and postpartum follow-up for ICP, with the aim to guide its clinical diagnosis, treatment, and management.","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139627593","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":"Promoting Healthy Longevity Should Start Young: A Life Course Journey","authors":"Cuilin Zhang, Claire Guivarch","doi":"10.1097/fm9.0000000000000212","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000212","url":null,"abstract":"","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638710","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":"Wernicke-Korsakoff Syndrome from Hyperemesis Gravidarum","authors":"Vaishnavi Jagat Patel, Jennifer Vu, Gisela Mercado, Sreenivas Avula, Shad Deering","doi":"10.1097/fm9.0000000000000198","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000198","url":null,"abstract":"To editor: Wernicke encephalopathy (WE) is an acute neurological disorder caused by a deficiency of vitamin B1 (thiamine), with a prevalence of 1.3% in autopsy studies.1 Eighty-four percent of patients with WE will develop Korsakoff syndrome, which is characterized by amnesia and confusion.2 Although WE is more common in alcoholics, it can also be caused by vomiting, malnourishment, and other situations. Hyperemesis gravidarum, a severe form of vomiting in pregnancy affecting 0.3% to 3% of pregnancies, can also cause thiamine deficiency.3 Although there are no specific diagnostic criteria for hyperemesis gravidarum, it is generally defined as persistent vomiting in pregnancy that has no other identifiable cause. Risk factors of hyperemesis gravidarum include a family history of hyperemesis, multiple gestation, and history of hyperemesis gravidarum. Hyperemesis gravidarum can be associated with other complications such as nutritional deficiencies, esophageal injury, psychosocial effects, and poor fetal outcomes.3 We report a case of WE associated with hyperemesis gravidarum. This case suggests that providers should have a high degree of suspicion for WE and initiate early treatment in pregnant women with severe vomiting and neurologic symptoms.4 The patient provided informed consent for publication of this case. Case presentation A 16-year-old (gravida 1, para 0) patient was transferred to our institution from a local emergency department for inpatient care at 15+4 weeks of gestation secondary to hyperemesis, altered mental status, slurred speech, difficulty ambulating, visual changes, and difficulty hearing. Her mother reported nausea and vomiting for the past 2 months with emesis occurring 4 times a day. The family also reported other symptoms such as progressive weakness, amnesia, and excessive somnolence. She had a history of generalized anxiety disorder, major depressive disorder, and one prior episode of intentional overdose of acetaminophen before pregnancy. It is possible that her symptoms were not recognized earlier due to this history as the mother stated that the patient liked to be alone. She denied tobacco, alcohol, or drug use and did not have any other known risk factors for hyperemesis gravidarum. Initial examination at the outside emergency department showed that the patient had notable ataxia and was not oriented to time or location. However, she was able to follow simple commands and answer straightforward questions. At this time, differential diagnoses for her included metabolic encephalopathy, drug abuse, alcohol intoxication, intracranial hemorrhage, cerebrovascular accident, cavernous sinus thrombosis, hyperemesis gravidarum, viral syndrome, and seizures. Laboratory results, including complete blood count, alcohol level, urine drug screen and urinalysis, were all negative. A complete metabolic panel showed hypokalemia to 2.7 mEq/L. A computed tomography of the head with contrast was initially obtained to rule out acute intra","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147449","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":"Clinical Parameters in the First 5 Minutes after Birth Have a Predictive Value for Survival of Extremely Preterm Infants","authors":"Laura Torrejón-Rodríguez, Álvaro Solaz-García, Inmaculada Lara-Cantón, Alejandro Pinilla-González, Marta Aguar, Máximo Vento","doi":"10.1097/fm9.0000000000000206","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000206","url":null,"abstract":"Abstract Extreme preterm infants (<28 weeks' gestation) often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room. To date, optimal inspired fraction of oxygen (FiO 2 ) still represents a conundrum in newborn care oscillating between higher (>60%) and lower (<30%) initial FiO 2 . Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry ≥85% at 5 minutes after birth. New clinical trials comparing higher versus lower initial FiO 2 have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.","PeriodicalId":53202,"journal":{"name":"Maternal-Fetal Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135963377","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}