Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Uptake of orally administered tranexamic acid in women during active labor: A pilot intervention study on prophylactic treatment of postpartum hemorrhage","authors":"Gita Strindfors,&nbsp;Pelle G. Lindqvist,&nbsp;Margit Endler","doi":"10.1111/aogs.15129","DOIUrl":"10.1111/aogs.15129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Postpartum hemorrhage is the leading cause of maternal mortality worldwide. Several studies have confirmed that tranexamic acid is effective in treating postpartum hemorrhage once started, but its prophylactic effect is under debate. As of now, most studies involve intravenous administration, and the uptake of tranexamic acid in women during active labor is unknown. This is a pilot study in preparation for a larger randomized controlled trial on the prophylactic effect of oral tranexamic acid on postpartum hemorrhage. The study aims to assess the uptake of oral tranexamic acid during active labor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Our study is a pilot intervention study. The study population consisted of 51 women ≥36 gestational weeks with planned vaginal delivery at Södersjukhuset, Stockholm, from December 2022 through February 2023. The participants were randomized 1:1:1:1 to receive 2 g of tranexamic acid as an oral solution, tablets, effervescent tablets, or 1 g of intravenous tranexamic acid, near full cervical dilatation. Blood samples were taken before and 30, 60, 120, 240, 360, and 480 min after tranexamic acid administration. Plasma concentration of tranexamic acid was measured using liquid chromatography–tandem mass spectrometry. Mean values were compared between groups using analysis of variance. Our main outcome measures were time to therapeutic level, duration in therapeutic interval, and maximum plasma concentration of tranexamic acid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Therapeutic level (5.0 mg/L) was reached at the 2-h time point for oral (7.11 ± 3.31 mg/L) and the 30-min time point for intravenous forms (30.6 ± 15.0 mg/L). Duration in therapeutic intervals for oral and intravenous forms was 6 and 3.5 h (<i>p</i> &lt; 0.007). Peak plasma concentrations for oral and intravenous forms were 10.2 ± 3.9 mg/L and 30.6 ± 15.0 mg/L, respectively (<i>p</i> &lt; 0.001). Time-to-therapeutic level (<i>p</i> = 0.08), duration in therapeutic interval (<i>p</i> = 0.92), or peak concentration (<i>p</i> = 0.73) did not differ between oral forms. Overall, 37 women (88%) found the intake of oral tranexamic acid during active labor acceptable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>All oral forms of tranexamic acid show similar and adequate uptake when administered during labor. Uptake is lower and slower compared with intravenous administration, but the duration in the therapeutic interval is longer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1347-1356"},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating novel predictors of preterm birth in asymptomatic twin gestations.","authors":"Brijesh Sathian, Hanadi Al Hamad, Javed Iqbal","doi":"10.1111/aogs.15141","DOIUrl":"https://doi.org/10.1111/aogs.15141","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is captain of the ship? Navigating the birth voyage together","authors":"Julia Savchenko,&nbsp;Andrew Kotaska","doi":"10.1111/aogs.15138","DOIUrl":"10.1111/aogs.15138","url":null,"abstract":"&lt;p&gt;Times are changing. According to the WHO, the clinical management of labor and childbirth is well understood, while the emotional and psychological needs of women giving birth are now a priority.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This emphasis on the subjective experience of childbirth is relatively new. For generations, obstetricians were busy delivering babies, stopping bleeding, preventing convulsions, and treating childbed fever—working hard to ensure that a mother and her newborn survived without serious damage or disability. The physical well-being of mother and child is still a priority; however, medical safety alone is no longer enough: other aspects of the birth experience appear to be at least as important to families.&lt;/p&gt;&lt;p&gt;\u0000 &lt;i&gt;Feruza wants her real name to appear in this editorial. When one of the authors (J.S.) met her, she was 40 years old, 157 cm tall, para 3, and 36 weeks pregnant with dichorionic twins. The presenting twin was breech and small for gestational age. Her first birth was an elective cesarean for breech, followed by two fast, normal vaginal births. In her current pregnancy, she was repeatedly advised to undergo an elective cesarean section. She eventually responded by missing her booked antenatal visits and not answering phone calls.&lt;/i&gt;\u0000 &lt;/p&gt;&lt;p&gt;Within the profession, attitudes toward the shift in focus from objectively measurable outcomes to childbirth experience are mixed. There is reason to be proud of this development—it reflects that we are winning the battle for maternal and perinatal health. Unfortunately, serious complications still occur, but they are no longer the everyday fear they once were. Instead, they are seen as rare, catastrophic events that are not expected to happen. Families often believe that childbirth should be a pleasant life event; and obstetricians and midwives sometimes struggle when finding themselves working in an “experience industry” rather than “simply” saving lives. In a sense, obstetrics has become a victim of its own success—expectations are high and meeting them is not always easy.&lt;/p&gt;&lt;p&gt;\u0000 &lt;i&gt;Feruza clearly knew what she wanted. Her elective cesarean was tough for her physically and mentally, but she was very happy with her two vaginal births. She received abundant information about the risks of breech birth, growth restriction, uterine rupture, placental abruption, cord prolapse, birth asphyxia, and interlocked twins; yet she remained completely confident that she could give birth naturally and that everything would be fine. She definitively refused a planned cesarean, and when asked if she would accept an emergency cesarean if indicated in labor, she responded that she did not think it would be necessary.&lt;/i&gt;\u0000 &lt;/p&gt;&lt;p&gt;It does not require a medically adverse outcome to feel dissatisfied. Discussion around obstetric violence, disrespectful care, coercion, and physical and psychological abuse during childbirth is growing.&lt;span&gt;&lt;sup&gt;2-4&lt;/sup&gt;&lt;/sp","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1006-1008"},"PeriodicalIF":3.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Instrument selection in assisted vaginal delivery, when spontaneous vaginal delivery is no longer an option.","authors":"Sindre Grindheim, Svein Rasmussen, Johanne Kolvik Iversen, Jørg Kessler, Elham Baghestan","doi":"10.1111/aogs.15133","DOIUrl":"https://doi.org/10.1111/aogs.15133","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prenatal environmental tobacco smoke exposure and preterm birth: A systematic review and meta-analysis","authors":"Tong-tong Fu,&nbsp;Han-xiao Luo,&nbsp;Zhi-jing Na,&nbsp;Chun-ling Xia,&nbsp;Ling Fan","doi":"10.1111/aogs.15126","DOIUrl":"10.1111/aogs.15126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The purpose of this systematic review and meta-analysis is to evaluate the global risk of preterm birth associated with passive smoking. Specifically, the study aims to examine whether passive smoking continues to impact preterm birth rates, with particular attention to the potential effects following the implementation of stricter smoking bans in recent years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This systematic review and meta-analysis followed PRISMA guidelines and was preregistered in PROSPERO. A comprehensive literature search was conducted in PubMed, Embase, CINAHL, and Web of Science up to February 17, 2024, using keywords related to passive smoking and preterm birth. Eligible observational studies were selected, and data were independently extracted and assessed for quality by two authors. Statistical analysis used odds ratios (ORs) and the <i>I</i>² statistic for heterogeneity. Subgroup analyses and publication bias assessments were conducted. Review Manager and Stata were used for the analysis, with significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Meta-analysis showed a 21% increase in the odds of preterm birth in women exposed to environmental tobacco smoke (ETS) (OR, 1.21; 95% CI, 1.10–1.32) with significant heterogeneity (<i>I</i>² = 76.2%). Stronger associations were found in cohort and cross-sectional studies, studies in Asia, larger sample sizes, and recent publications. Findings were robust across various analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prenatal environmental tobacco smoke exposure significantly increases preterm birth risk. Effective public health interventions, including stringent smoke-free policies, public education, and awareness campaigns, are needed to reduce environmental tobacco smoke exposure and improve maternal and infant health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1244-1253"},"PeriodicalIF":3.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral distress among maternity and neonatal healthcare workers during the COVID-19 pandemic in Sweden: Results from the COPE staff longitudinal cohort study","authors":"Patricia Ernst,&nbsp;Karolina Linden,&nbsp;Marta Roczniewska,&nbsp;Emina Hadzibajramovic,&nbsp;Anna Wessberg,&nbsp;Ola Andersson,&nbsp;Ylva Carlsson,&nbsp;Sofie Graner,&nbsp;Maria Jonsson,&nbsp;Malin Veje,&nbsp;Verena Sengpiel,&nbsp;Magnus Akerstrom","doi":"10.1111/aogs.15125","DOIUrl":"10.1111/aogs.15125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Moral distress arises when healthcare workers face difficult decisions without adequate information and/or when patient care is compromised due to limited resources, communication issues, or altered work routines in exceptional circumstances. While moral distress in maternity and neonatal healthcare workers (MNHCWs) has been noted, its prevalence, intensity, and impact on well-being and turnover in Sweden remain unexplored. The aim of this study was to investigate the level of disturbance and frequency of experiencing moral distress among Swedish MNHCWs during the COVID-19 pandemic and the effects on MNHCWs' well-being and intention to leave their job.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A longitudinal cohort study was conducted during January–May 2021 (<i>n</i> = 645) and January–March 2022 (<i>n</i> = 503), utilizing the Moral Distress Scale-Revised (MDS-R). The study was set in hospital-based maternity and neonatal units across all 21 Swedish healthcare regions and included midwives, physicians, registered nurses, and assistant nurses. Quantitative and descriptive analyses were performed, with comparisons of moral distress levels between time points and professions. The main outcome measures were moral distress (level of disturbance and frequency) and intention to leave their job.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the respondents, 6%–47% reported being frequently exposed to morally challenging situations, and 51%–91% reported a high level of disturbance in connection to such situations. Uncertain staffing, continuity-of-care challenges, and limited opportunities for patient/family counseling posed frequent moral challenges across time and professions. Of the respondents, 14% in 2021 and 18% in 2022 considered leaving their jobs due to moral distress. There were no overall significant differences in outcomes between the two time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Swedish MNHCWs commonly experienced moral distress during the COVID-19 pandemic. Interventions targeting underlying reasons may be needed to ensure the well-being of MNHCWs in situations when the healthcare system is under strained working conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1399-1409"},"PeriodicalIF":3.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation of socioeconomic inequalities in preterm birth. A cohort analysis of Welsh linked data","authors":"Philip McHale,&nbsp;Daniela K. Schlüter,&nbsp;Hoda Abbasizanjani,&nbsp;Ashley Akbari,&nbsp;Ben Barr,&nbsp;David Taylor-Robinson","doi":"10.1111/aogs.15101","DOIUrl":"10.1111/aogs.15101","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Consistent socioeconomic inequalities in preterm birth prevalence are seen internationally. Understanding the pathways to inequalities in preterm birth and the mediators that contribute to these inequalities is essential to inform policies and interventions to reduce health inequalities across the life course.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a causal mediation analysis using routinely collected, anonymised population-scale, individual-level linked data within the SAIL Databank on all singleton live births in Wales between 1 January, 2000 and 30 September, 2019. Our outcome was preterm birth, and exposure was area-based deprivation. Mediators were smoking during pregnancy, maternal mental health, hospitalisation due to maternal physical health and obstetric conditions. We calculated inequalities in preterm birth (dichotomised as before or after 37 weeks) and estimated two measures of mediation: proportion eliminated, the percentage of the effect of deprivation on preterm birth eliminated by removing the mediators, through the Controlled Direct Effects; and proportion mediated, the percentage of the inequality removed by equalising the distribution of the mediators across socioeconomic strata. Multiple multivariate imputations by chained equations were used to deal with missing data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The final sample included 609 610 live births with 6.1% preterm. Socioeconomic gradients were seen in preterm birth and exposure to mediators, with a higher occurrence in mothers residing in the most compared to the least deprived quintiles. Compared with the least deprived quintile, the odds ratio for preterm births in the most deprived quintile was 1.26 (95% confidence interval 1.22–1.31). The proportion eliminated by the removal of all mediators at the same time was 21%. The proportion mediated by maternal smoking during pregnancy was 26%, and less than 10% for other mediators.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Smoking during pregnancy is a significant mediator of preterm birth inequalities. Maternal mental and physical health during pregnancy and obstetric conditions also lie on the pathway from socioeconomic status to preterm birth but mediate the relationship to a lesser extent. Significant socioeconomic inequalities remained after the effect of mediators was removed. These findings suggest that there is a need to reduce inequalities in smoking during pregnancy and direct action on socioeconomic status during pregnancy.&lt;/p&gt;\u0000","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1081-1091"},"PeriodicalIF":3.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gentle fundal pressure to facilitate vaginal delivery: A randomized clinical trial","authors":"Qing Guo,&nbsp;Hui Du,&nbsp;Ying Feng,&nbsp;Ruifen Jiao,&nbsp;Xu Xie,&nbsp;Mingwei Li,&nbsp;Dean V. Coonrod,&nbsp;Thomas Q. Zheng","doi":"10.1111/aogs.15130","DOIUrl":"10.1111/aogs.15130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fundal pressure during the second stage of labor is widely practiced but understudied. Violent fundal pressure can cause maternal and fetal injuries. Many providers believe the maneuver is effective. Administrative efforts to ban fundal pressure are unsuccessful and only drive the procedure to an underground practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In this single-center, open-label, randomized trial, nulliparous women with term singleton cephalic pregnancy under epidural analgesia were assigned to receive gentle manual fundal pressure (GMFP) or routine labor care. The GMFP was designed not to exceed a maximum of 120 mmHg. Women were randomized after 30 min of pushing in the second stage of labor. The primary outcome was the time from randomization to delivery. Secondary outcomes were mode of delivery, episiotomy, perineal laceration, cord blood pH, and other maternal and fetal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between July 2023 and January 2024, 164 women were randomized to GMFP (<i>n</i> = 82) or to routine care (<i>n</i> = 82). The time from randomization to vaginal delivery did not show statistical significance between the fundal pressure group and the control group (mean [SD], 46.3 [33.3] vs. 55.9 [45.8] min; <i>p</i> = 0.13). Significantly fewer women in the fundal pressure group had operative vaginal deliveries (4 of 82 [4.9%]) than women in the control group (13 of 82 [15.9%]; relative risk [RR] 0.308, 95% confidence interval [CI] 0.105–0.904; <i>p</i> = 0.021). Similarly, mediolateral episiotomy was performed in fewer women in the fundal pressure group (6 of 82 [7.32%]) than in the control group (16 of 82 [19.51%], RR 0.375, 95% CI 0.154–0.910; <i>p</i> = 0.022). Other maternal and fetal outcomes were similar in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GMFP resulted in a nonsignificant reduction in the second stage of labor and a significant reduction in operative vaginal delivery and episiotomy without an increase in adverse outcomes. Fundal pressure during the second stage of labor deserves further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1357-1365"},"PeriodicalIF":3.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial agenesis of the corpus callosum: Prenatal ultrasound characteristics, associations, and outcome","authors":"Changrong Zhou,&nbsp;Hezhou Li,&nbsp;Ruizheng Han,&nbsp;Hongrui Ren,&nbsp;Bin Shen,&nbsp;Xinxia Wang,&nbsp;Fangfang Feng,&nbsp;Mengmeng Wang,&nbsp;Ling Liu","doi":"10.1111/aogs.15121","DOIUrl":"10.1111/aogs.15121","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate prenatal ultrasound characteristics, associated abnormalities, and outcomes of partial agenesis of the corpus callosum (pACC).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 118 fetuses with pACC diagnosed using prenatal ultrasound were studied, and their prenatal ultrasound characteristics, associated abnormalities, genetics, and outcomes were collected. The fetuses were categorized into three groups according to gestational age: &lt;24 weeks, 24–28 weeks, and &gt;28 weeks, and the brain transverse plane ultrasound signs were compared among the three groups.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Prenatal ultrasound revealed the presence of abnormal cavum septi pellucidi (CSP), distention of the interhemispheric fissure (IF), dilated and elevated third ventricle (TV), and ventriculomegaly in 102 (86.4%), 91 (77.1%), 56 (47.4%), and 42 (35.6%) cases, respectively, in the transverse plane of the brain. Among the cases with dilatation and elevation of the TV, 38 (67.8%) showed posterior displacement, manifested by a cystic mass in the midline that communicated with the TV. There were statistically significant differences in the incidence of ventriculomegaly and abnormal CSP among the three groups at &lt;24 weeks, 24–28 weeks, and &gt;28 weeks. However, there were no statistically significant differences in the distention of the IF and TV among the three groups. Moreover, our cohort studies demonstrated that 32.2% (38/118), 18.6% (22/118), and 17.8% (21/118) of the cases were associated with intracranial, extracranial, and intra-extracranial anomalies, respectively. The most common intracranial and extracranial anomalies were cerebral cortical dysplasia and cardiovascular anomalies. Genetic analysis demonstrated that 37.8% (17/41) of patients had genetic abnormalities. 25% (4/16) and 52% (13/25) of isolated and non-isolated pACC cases showed genetic abnormalities. Eight isolated cases were born, with an average age of 28 months, and their neurological development was normal.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Abnormal CSP was the most common indirect sign of pACC. A cystic mass in the midline communicating with the TV can be another indirect sign of a pACC. pACC is likely to be accompanied by intracranial and extracranial abnormalities. The detection rate of genetic abnormalities was higher in non-isolated pACC cases than in isolated cases. Isolated pACC has a good prognosis but requires long-term follow-up of neurological development.&lt;/p&gt;\u0000 ","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1304-1317"},"PeriodicalIF":3.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental size and umbilical vein volume blood flow","authors":"Kari Flo,&nbsp;Carl Petter Skaar Kulseng,&nbsp;Helene Fjeldvik Peterson,&nbsp;Vigdis Hillestad,&nbsp;Silje Sommerfelt,&nbsp;Anne Eskild","doi":"10.1111/aogs.15110","DOIUrl":"10.1111/aogs.15110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The fetus receives oxygen and nutrition from the placenta through the umbilical vein. There is a large variation in placental size and placental size relative to fetal size (placental–fetal ratio). We studied whether placental size or placental–fetal ratio is related to blood flow in the umbilical vein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We performed a prospective study at Akershus University Hospital in Norway and a total of 73 women were examined in gestational weeks 27 and 37. Fifty-six women were examined at both time points. B-mode ultrasound and Doppler ultrasonography were used to measure the umbilical vein volume blood flow per minute. Magnetic resonance imaging was used to measure placental and fetal volume. Pearson's and Spearman's correlation coefficients were applied for estimations of associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In gestational week 27, the umbilical vein volume blood flow was positively correlated with fetal size (Pearson's correlation coefficient <i>r</i> = 0.372, <i>p</i> = 0.003, and Spearman's correlation coefficient r = 0.384, <i>p</i> = 0.002), but not with placental size (Pearson's r = 0.130, <i>p</i> = 0.317, and Spearman's r = − 0.53, <i>p</i> = 0.687) or placental–fetal ratio (Pearson's r = − 0.61, <i>p</i> = 0.641, and Spearman's r = − 0.218, <i>p</i> = 0.092). In gestational week 37, we found positive correlations of the umbilical vein volume blood flow with fetal size (Pearson's r = 0.428, p = &lt;0.001, and Spearman's r = 0.391, <i>p</i> &lt;0.001), placental size (Pearson's r = 0.400, <i>p</i> = 0.001, and Spearman's r = 0.643, p &lt;0.001), and with placental–fetal ratio (Pearson's r = 0.224, <i>p</i> = 0.066, and Spearman's r = 0.266, <i>p</i> = 0.028).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A large placenta and a high placental–fetal ratio are associated with increased umbilical vein blood flow.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1135-1142"},"PeriodicalIF":3.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}