Maternal-fetal medicine (Wolters Kluwer Health, Inc.)最新文献

{"title":"Postpartum Hemorrhage: A Comprehensive Review of Medical and Surgical Treatment.","authors":"Avery Lin Cox, Scott A Shainker","doi":"10.1097/FM9.0000000000000302","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000302","url":null,"abstract":"<p><p>Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. The incidence of PPH continues to rise. PPH is often responsive to both medical and surgical treatment. A stepwise multidisciplinary approach to PPH treatment has been shown to reduce maternal morbidity. Massive transfusion protocols are critical to any obstetrics unit. Intrauterine devices are often employed in the treatment of PPH. Placenta accreta spectrum greatly contributes to the PPH burden. Hysterectomy remains the definitive treatment of PPH; however, medical and surgical options are often successfully employed, avoiding the need for hysterectomy. Advances in interventional radiology have been shown to successfully treat PPH in the majority of cases. Clinical simulation has been shown to improve teamwork and outcomes in the treatment of PPH. Novel approaches to PPH show additional promise in reducing maternal morbidity.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"172-181"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Guidelines on Placenta Accreta Spectrum Disorders: A Commentary From the Chinese Perspective.","authors":"Yongdan Ma, Jingmei Ma","doi":"10.1097/FM9.0000000000000320","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000320","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"207-209"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on the Diagnosis and Management of Cervical Insufficiency in China (2026 Revision).","authors":"","doi":"10.1097/FM9.0000000000000343","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000343","url":null,"abstract":"<p><p>Cervical incompetence occurs when the cervix fails to maintain its normal morphology and function during second-trimester, leading to recurrent second-trimester miscarriages or preterm births. To standardize and guide the clinical diagnosis and treatment of cervical insufficiency in China, the Perinatal Medicine Branch of the Chinese Medical Association and the Obstetrics Group of the Chinese Society of Obstetrics and Gynecology developed this consensus by referencing related research evidence and so on. This consensus provides evidence-based analysis and recommendations on key clinical issues including the diagnosis of cervical incompetence, indications for cervical cerclage, surgical techniques, timing of intervention, perioperative management, and adjunctive therapies, offering evidence-based guidance for obstetric clinical practice.</p><p><strong>Practice guideline registration: </strong>International Practice Guidelines Registry and Transparency Platform (PREPARE-2024CN1155).</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"104-116"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Exposure to Organochlorine Compounds and Other Pesticides: A Systematic Review of Neonatal Health Outcomes.","authors":"Eyşan Hanzade Savaş, Sermin Dinç, Kafiye Eroğlu","doi":"10.1097/FM9.0000000000000328","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000328","url":null,"abstract":"<p><strong>Objective: </strong>To identify, evaluate, and summarize evidence on the effects of prenatal exposure to organochlorine compounds (OCCs) and other pesticides on neonatal growth parameters.</p><p><strong>Methods: </strong>Keywords were identified through systematic reviews and expert consultation, then finalized with an academic librarian. A comprehensive search was conducted in PubMed, Cochrane Library, MEDLINE (OVID), Scopus, Web of Science, and CINAHL from inception to February 26, 2024. Retrieved records were managed using EndNote 20. Two independent reviewers screened titles and abstracts based on predefined eligibility criteria. Full-text articles were further assessed for inclusion, with disagreements resolved by a third reviewer. A standardized process was followed during the full-text review. Studies were included if they involved pregnant women and their neonates, assessed prenatal exposure to OCCs, and reported at least one neonatal growth parameter. Data were extracted using Microsoft Excel^® and included study design, sample characteristics, exposure details (timing, route, and measurement), and neonatal growth outcomes. Methodological quality was assessed using the National Institutes of Health Quality Assessment Tool.</p><p><strong>Results: </strong>This systematic review included 16 studies conducted between 1997 and 2023 across various countries, with the majority from the United States (<i>n</i> = 6). The studies employed diverse designs, including cohort, case-control, longitudinal cohort, and cross-sectional studies, to investigate the impact of prenatal pesticide exposure on neonatal health outcomes. Key neonatal growth parameters assessed were birth weight, length, head circumference, and gestational age. The quality of the included studies varied, with overall scores ranging between 64.28%-91.66%.</p><p><strong>Conclusion: </strong>The findings demonstrate significant associations between prenatal exposure to OCCs and adverse neonatal growth outcomes. Frequently reported effects included reduced birth weight, smaller head circumference, shorter gestational age, and increased risk of growth restriction. These results underscore the importance of minimizing maternal exposure to persistent organic pollutants during pregnancy and highlight the need for targeted public health policies and preventive strategies.</p><p><strong>Registration no: </strong>CRD42024621439.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"151-159"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breech Presentation: Delivery Management and Future Perspectives.","authors":"Marta Fiorentini, Bianca Nedu, Fabrizio Dapoto, Silvia Brognoli, Elena Brunelli, Aly Youssef","doi":"10.1097/FM9.0000000000000254","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000254","url":null,"abstract":"<p><p>Breech presentation is a relatively common fetal malposition, affecting 3% to 5% of fetuses at term. Although various clinical conditions are associated with breech presentation, its prevalence decreases as gestational age progresses toward term. Despite ongoing global academic and clinical debates on the management of breech presentation, there is a growing recognition that the decision on the mode of delivery should consider the patient's preferences. Adequate counseling on available options is crucial. For patients with a term singleton fetus in a breech position who prefer a planned vaginal delivery, the external cephalic version (ECV) serves as an alternative to planned cesarean section (CS). ECV involves gently manipulating the fetus on the mother's abdomen to achieve a cephalic presentation, with a reported success rate of 58%. The procedure is typically performed at or after 37 weeks, and a thorough assessment of fetal well-being is mandatory. While short-term benefits of planned CS for term breech presentation have been demonstrated in neonatal and maternal outcomes, a trial of breech vaginal delivery can be considered in the absence of contraindications and based on the patient's preference. It is crucial for an experienced healthcare provider to offer appropriate assistance to ensure maternal and child well-being and minimize complications, whether attempting a vaginal birth or opting for a CS for breech presentation. Ultrasonography plays a crucial role in diagnosing breech presentation, and transabdominal ultrasound can offer valuable information for predicting ECV success, including placental location and amniotic fluid quantity. Emerging techniques in ultrasonography, such as transperineal ultrasound to assess fetal presenting part engagement and transabdominal ultrasound to evaluate fetal head flexion and position, are increasingly employed in labor ward evaluations. The recently introduced breech progression angle, a transperineal sonographic parameter, holds promise as a reliable tool not only for predicting ECV success but also for assessing the risk of cesarean delivery in patients who will undergo a trial of breech vaginal delivery.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"182-188"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Robust Artificial Intelligence Method for Detecting Near-Non-Reactive Non-Stress Test Patterns: What Should We Expect?","authors":"Haitian Chen, Caixia Zhu, Zhuyu Li, Xietong Wang, Bin Xu, Xiaohui Guo, Jingwan Huang, Bin Liu, Hongyan Li, Yan Kong, Xiaobo Yang, Jingyu Du, Zilian Wang","doi":"10.1097/FM9.0000000000000347","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000347","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"210-212"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal-Child Blood Group Discordance and Severity of Congenital Heart Disease: Insights From a Tertiary Referral Study.","authors":"Shadab Ahamad, Anagha Tulsi, Amita Sharma, Prachi Kukshal","doi":"10.1097/FM9.0000000000000340","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000340","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"204-206"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Era of Evidence-Based Medicine and the Artificial Intelligence: The Transition of Obstetric Decision-Making From Empirical to Precision-Based Approaches.","authors":"Ye Feng, Huixia Yang","doi":"10.1097/FM9.0000000000000348","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000348","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"95-97"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine Preservation in Systemic Lupus Erythematosus Complicated by Pregnancy With Diffuse Thin Myometrium: A Clinical Observation.","authors":"Linyan Zhang, Jinfang Wang, Kunkun Sun, Yuntao Li, Guoli Liu","doi":"10.1097/FM9.0000000000000338","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000338","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"195-197"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlations Between Pregnancy-Associated Plasma Protein A Levels and Pregnancy Characteristics, Placental Volume, Vascularization, and Histopathology.","authors":"István Dankó, András Tankó, Edit Kelemen, Béla Temesváry, Gábor Cserni","doi":"10.1097/FM9.0000000000000331","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000331","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the associations between pregnancy-associated plasma protein A (PAPP-A) levels and pregnancy-associated conditions, perinatal outcomes, and placental histopathology.</p><p><strong>Methods: </strong>This retrospective, single-center cohort analysis included cases of preterm and term deliveries from pregnancies complicated by preeclampsia and fetal growth restriction or gestational hypertension. A correlation analysis was performed to assess the relationship between PAPP-A levels and neonatal parameters, the prevalence of various pregnancy complications, and placental and birth weight percentiles and ratios. Associations between placental histopathological entities and PAPP-A were explored in different subgroups defined by PAPP-A multiple of the median (MoM) ranges. Potential associations between PAPP-A levels and placental capillarization were also investigated.</p><p><strong>Results: </strong>A total of 74 pregnancies were investigated. PAPP-A levels were significantly lower in cases involving cesarean section (<i>P</i> = 0.002), preterm birth (<i>P</i> = 0.030), and/or preeclampsia (<i>P</i> = 0.002). Among the preeclamptic cases, early-onset preeclampsia was associated with a significantly lower PAPP-A level (<i>P</i> < 0.001). No significant associations were identified between first-trimester PAPP-A levels and placental weight percentile, birth weight percentile, villous capillarization, or the percentage of intact terminal villi; however, correlations were found between low PAPP-A levels and placental weight-to-birth weight ratios of < 1:8 (Kruskal-Wallis test <i>P</i> = 0.004; Spearman's correlation <i>P</i> = 0.011). PAPP-A levels were also significantly lower in the presence of distal villous hypoplasia (<i>P</i> < 0.001), accelerated villous maturation (<i>P</i> < 0.001), or avascular villi (<i>P</i> < 0.001) in the placenta.</p><p><strong>Conclusion: </strong>Lower PAPP-A levels may represent an early marker of pathological placentation in the background of preeclampsia and fetal growth restriction-especially in early-onset cases-which are characterized by villous underdevelopment and a non-branching villous tree pattern on placental histopathology. From a clinical translation perspective, PAPP-A levels may serve as a potential early indicator of pregnancies that warrant close monitoring during clinical management.</p>","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"8 2","pages":"141-150"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}