BMC Pregnancy and Childbirth最新文献

{"title":"Perspectives of midwives on respectful maternity care.","authors":"Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe","doi":"10.1186/s12884-024-06894-1","DOIUrl":"10.1186/s12884-024-06894-1","url":null,"abstract":"<p><strong>Background: </strong>Respectful maternity care forms the foundation of maternity services; however, delivery of dignified, efficient, and effective care in these settings remains inconsistent. Research has identified several factors that influence respectful maternity care. To understand the South African context, these factors were explored and described from the perspectives of midwives.  METHODS: A qualitative descriptive inquiry was conducted, with participants recruited through snowball sampling on the social networking site Facebook. Semi-structured questions were used to collect data, to which participants responded in writing, detailing factors that influenced respectful care, including words and practices they associated with respectful maternity care. The data was analyzed using content analysis to identify common categories.</p><p><strong>Results: </strong>Twenty-five responses from participants were analyzed; four categories and six sub-categories emerged as representations of respectful maternity care. The categories and sub-categories were as follows: healthcare professional behavior (ethical conduct and professional attributes related to education and training), managerial support (conducive work environment), interpersonal facet of care (characteristics of healthcare providers), and the birth environment (caring within the birth environment and client-centered care).</p><p><strong>Conclusion: </strong>Midwives emphasized the importance of understanding respectful maternity care to ensure optimal outcomes for women, families, and communities. However, given the complexity of maternity care, it is crucial for policymakers, administrators, and midwives to comprehend and appreciate the various elements that define respectful care, as this understanding can significantly enhance its successful implementation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589498","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":"Determinants of retroplacental hematoma at the Maradi mother and child health center, Niger: a case‒control study.","authors":"Zaratou Ali, Balkissa Issoufou Harouna, Habibatou Idé Amadou, Adamou Sayo Djibo","doi":"10.1186/s12884-024-06927-9","DOIUrl":"10.1186/s12884-024-06927-9","url":null,"abstract":"<p><strong>Introduction: </strong>Retroplacental hematoma is a paroxysmal accident that threatens maternal and fetal prognosis. It is a major emergency in obstetric pathology. The objective of this study was to identify the factors associated with retroplacental hematomas at the Maradi Mother and Child Health Center in 2022.</p><p><strong>Methods: </strong>This was a case‒control cross-sectional analytical study that used patient records for the year 2022 from September 20 to October 20, 2023. The presence of a retropl placental hematoma was the outcome variable and was measured by a case (yes) or control (no) response. The exposure variables included sociodemographic characteristics, obstetric characteristics, care, progression of patients and neonatal characteristics. Pearson's chi-square tests at the 5% significance level were used to analyze differences between categorical variables. All variables that had a bilateral p value < 0.05 in the bivariate analysis were introduced into the binary logistic regression model to identify factors associated with retroplacental hematoma.</p><p><strong>Results: </strong>A total of 246 cases of retroplacental hematoma were recorded out of 4731 deliveries recorded during the study period, for an estimated frequency of 5.20%. The mean age of the patients was 29.41 ± 6.94 years. Factors associated with retroplacental hematoma included multiple parity [adjusted odds ratio (ORA): 0.38, 95% confidence interval (CI) (0.24-0.61)], fewer than 4 antenatal visits [AOR: 10.70, 95% CI (1.14-99.74)], blood transfusion [AOR: 2.01, 95% CI (1.11-3.60)], a newborn birth weight less than 2500 g [AOR: 1.92, 95% CI (1.53-2.42)] and fetal mortality in utero [AOR: 13.20, 95% CI (1.86-93.70)].</p><p><strong>Conclusion: </strong>This study identified the factors associated with retroplacental hematoma. Prevention requires regular, high-quality prenatal care. Early diagnosis and cesarean section improve maternal-fetal prognosis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589364","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":"The impact of scaling and root planning combined with mouthwash during pregnancy on preterm birth and low birth weight: a systematic review and meta-analysis.","authors":"May Salama, Abdullah Al-Taiar, Denise C McKinney, Estiar Rahman, Anwar T Merchant","doi":"10.1186/s12884-024-06905-1","DOIUrl":"10.1186/s12884-024-06905-1","url":null,"abstract":"<p><strong>Background: </strong>The effect of treating periodontal disease (PD) during pregnancy on adverse birth outcomes, such as preterm birth (PTB) and/or low birth weight (LBW), remains unclear. This is partially due to the fact that Randomized Controlled Trials (RCTs) have used different combinations of treatment approaches to test this hypothesis. In this meta-analysis of RCTs, we assessed the impact of treating PD during pregnancy with scaling and root planning (SRP) and mouthwash use on PTB and LBW.</p><p><strong>Methods: </strong>A systematic review with meta-analysis was conducted following PRISMA guidelines. A comprehensive search strategy was employed across electronic databases, including PubMed/Medline, Embase, and Google Scholar. Quality assessment was performed using the Cochrane Risk of Bias 2 Tool. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effect models.</p><p><strong>Results: </strong>Out of 133 initially identified reports, 9 RCTs involving 3,985 pregnant women met the inclusion criteria. Periodontal treatment with SRP and mouthwash use in pregnancy was associated with a lower risk of PTB and LBW in meta-analysis with random effects models (pooled RR for PTB = 0.44, 95% CI: 0.22-0.88) and (pooled RR for LBW = 0.33, 95% CI: 0.13-0.84). Substantial heterogeneity was observed among studies (I² = 91% and 90% for PTB and LBW, respectively), with sensitivity analysis suggesting potential sources of heterogeneity. Funnel plot assessment for publication bias showed evidence of asymmetry.</p><p><strong>Conclusion: </strong>SRP with mouthwash use during pregnancy were associated with significantly lower risks of PTB and LBW. Larger, well-conducted RCTs are warranted to address this issue, as existing trials are small and exhibit methodological and statistical heterogeneity.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589451","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":"Outcomes of peripartum cardiomyopathy in North Africa: insights from a single-center observational study in Tunisia.","authors":"Rania Hammami, Omar Abdelhedi, Fatma Khanfir, Raeesah Sohawon Oummée Shahlaq, Rania Gargouri, Leila Abid, Sahar Elleuch, Mootez Billah Oueslati, Hassen IbnHadj Amor, Mohamed Derbel, Aymen Dammak, Faiza Safi, Kais Chaabene","doi":"10.1186/s12884-024-06911-3","DOIUrl":"10.1186/s12884-024-06911-3","url":null,"abstract":"<p><strong>Background: </strong>Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening condition. Due to the scarcity of epidemiological data in North Africa, we conducted this study to assess the outcomes of PPCM in our region.</p><p><strong>Materials and methods: </strong>This monocentric retrospective cohort study involving all patients diagnosed with PPCM was conducted between January 2010 and December 2022.</p><p><strong>Results: </strong>Twenty-seven PPCM patients, with a median age of 33 years (Interquartile range (IQR) = 9), were included. 52% of patients were diagnosed during the postpartum period. Dyspnea New York Heart Association III/IV(NYHA III/IV) was the most common functional symptom (85%). The median left ventricle ejection fraction (LVEF) was 30% (IQR = 11%). Atrial fibrillation occurred in 11.1% of patients, thromboembolic complications occurred in 18.5%, Pulmonary edema occurred in 85% of patients and cardiogenic shock occurred in 14.8% of patients, with two patients requiring Extracorporeal Membrane Oxygenation (ECMO) support. The predominant mode of delivery was a cesarean Sect. (82% of patients), and the indication for a cesarean delivery was obstetrical in 59% of patients. Prematurity occurred in 36% of newborns, and intrauterine fetal death occurred in one pregnancy. The median follow-up was 24 months [6-144 months]. LVEF recovery was noted in 67% of patients. Bromocriptine was administered to six patients (22%), and none of these patients died and out of them, five patients recovered their LVEF (83%). The overall mortality rate during the follow-up period was 15%, comprising three in-hospital cardiac deaths and one occurring two years later due to refractory advanced heart failure. No significant differences were observed between LVEF recovery and LVEF non-recovery groups. Factors significantly associated with mortality were multiparity, poor antenatal care (ANC) attendance, thromboembolic events, cardiogenic shock, and Pulmonary edema. Five patients with LV recovery subsequently became pregnant, none experienced a relapse of PPCM. However, one of the descendants of a patient was diagnosed with dilated cardiomyopathy.</p><p><strong>Conclusion: </strong>This study revealed that the diagnosis of PPCM in our hospital is often delayed until symptoms become more advanced, resulting in high morbi-mortality.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589497","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":"What supports mothers of very preterm babies to start and continue breast milk feeding neonatal units? A qualitative COM-B analysis of mothers' experiences.","authors":"Jenny McLeish, Annie Aloysius, Chris Gale, Maria A Quigley, Jennifer J Kurinczuk, Fiona Alderdice","doi":"10.1186/s12884-024-06910-4","DOIUrl":"10.1186/s12884-024-06910-4","url":null,"abstract":"<p><strong>Background: </strong>It is challenging for mothers who give birth very preterm to produce sufficient breast milk by expressing for weeks before their baby is able to feed from the breast, and then to transition from tube feeding to breastfeeding. Lactation is most successful when stimulated shortly after birth, established within 72 h, and maintained by expressing 6-8 times a day. This study explored mothers' experiences of how breast milk feeding and breastfeeding for very preterm babies can be supported by staff and the facilities of a neonatal unit.</p><p><strong>Methods: </strong>Twenty-three mothers of very preterm babies were interviewed, from four neonatal units in England with high or low rates of breast milk feeding at discharge. Interviews were analysed using the COM-B framework to consider how mothers' behaviour (breast milk feeding and breastfeeding) is affected by capability, opportunity and motivation.</p><p><strong>Results: </strong>Mothers' motivation in the traumatic situation of very preterm birth was strongly affected by information from staff about the benefits of breast milk for their baby, the importance of early and frequent expressing, and how to assess the effectiveness of direct breastfeeding. It was maintained through positive feedback about their efforts which built their confidence, and reassurance about what is 'normal' growth when a baby begins direct breastfeeding. Motivation needed to be supported by opportunity, including access to equipment for expressing and facilities to stay near the neonatal unit, and also by capability, which required proactive and skilled information and support from staff. Specialist support and facilities varied between units, and some mothers were not given necessary information or had their motivation undermined by staff comments.</p><p><strong>Conclusions: </strong>Interventions to increase breast milk feeding and breastfeeding for very preterm babies should address mothers' motivation, capability and opportunity, aiming for systematic elimination of obstacles. Mothers value personalised and skilled specialist support, but also need other staff to be able to give consistent information and affirmation focused on their efforts rather than their success, with a trauma-informed approach. Investing in rooming-in facilities that minimise the separation of mothers and babies is likely to overcome a key obstacle.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589581","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":"Providers' perspective on vaginal birth after cesarean birth: a qualitative systematic review.","authors":"Antita Kanjanakaew, Atchareya Jiramanee, Manassawee Srimoragot","doi":"10.1186/s12884-024-06921-1","DOIUrl":"10.1186/s12884-024-06921-1","url":null,"abstract":"<p><strong>Background: </strong>Vaginal Birth after Cesarean Birth (VBAC) is a birth mode recommended for reducing repeat cesarean which potentially contributes to adverse outcomes. However, VBAC is not normally practiced in some countries. Providers are an important part of the decision-making process on modes of birth among pregnant individuals. Providers' perspective on VBAC can influence whether they support or avoid conducting VBAC. This review aimed to explore providers' perspective on VBAC.</p><p><strong>Methods: </strong>The comprehensive search was conducted from six databases including PubMed, MEDLINE, Scopus, Cochrane Library, EMBASE, and Google scholar. The studies published in English between 2013 and 2023 were review. The Medical Subject Heading terms for VBAC and perspective were used to search. The eligible studies were selected by the PRISMA flow chart. The initial search yielded 558 articles. After excluding duplicates, articles not retrieved for full-text, and not meeting inclusion and exclusion criteria, eight articles were recruited. Quality appraisal of the studies was performed by the tool of the Joanna Briggs Institute. The meta-aggregation approach was applied to synthesize the findings.</p><p><strong>Results: </strong>Eight qualitative articles were included in this review, and six themes were developed including (1) different recognition of VBAC, (2) differences of willingness level of conducting Trial of Labor after Cesarean (TOLAC) (the approach attempting to have VBAC), (3) skills and resources needed when performing TOLAC, (4) protocol for recruiting candidacy and TOLAC management, (5) final decision making on VBAC, and (6) onset and duration of providing TOLAC information.</p><p><strong>Conclusion: </strong>Providers play an important role in influencing individuals' decision on modes of birth. Providers' positive recognition and willingness of conducting TOLAC potentially impact successful VBAC rate. However, the lawsuit caused by adverse outcomes from TOLAC/VBAC is a main reason for choosing repeat cesarean.</p><p><strong>Trial registration: </strong>PROSPERO registration number of this systematic review: CRD42023427662.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589428","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":"Prenatal diagnosis, ultrasound findings and pregnancy outcome of 7q11.23 deletion and duplication syndromes: what are the fetal features?","authors":"Xiaojin Luo, Hongyan Niu, Fei Zhou, Xiaohang Chen, Yuanyuan Pei, Weiqiang Liu, Fengxiang Wei","doi":"10.1186/s12884-024-06920-2","DOIUrl":"10.1186/s12884-024-06920-2","url":null,"abstract":"<p><strong>Objective: </strong>Analyze the ultrasound findings, single nucleotide polymorphism array (SNP-array) results, and pregnancy outcomes of fetuses with 7q11.23 deletions and duplications in the second and third trimesters. Investigate the prenatal ultrasound characteristics and follow up information of these fetuses.</p><p><strong>Methods: </strong>Seven fetuses were diagnosed with 7q11.23 deletion and six with 7q11.23 duplication via SNP-array at the prenatal diagnosis center of a single Chinese tertiary medical center from January 2017 to May 2024. Maternal demographics, ultrasound findings, SNP-array results, pregnancy outcomes, and follow-up information were comprehensively reviewed and analyzed.</p><p><strong>Results: </strong>The copy number variations (CNVs) ranged from 1.43 Mb to 1.78 Mb in cases of 7q11.23 deletions and from 1.42 Mb to 1.68 Mb in cases of 7q11.23 duplications. These CNVs encompassed 29 OMIM-listed genes, including ELN, DNAJC30, GTF2IRD1, and GTF2I. Among the seven cases of 7q11.23 deletion syndrome, six exhibited ultrasound abnormalities. The main clinical phenotypes included three cases of intrauterine growth restriction and four cases of cardiovascular system abnormalities, specifically two cases with ventricular septal defects, one case with aortic narrowing, and one case with supravalvular pulmonary stenosis. One case was particularly notable, exhibiting complex multi-organ structural malformations. Out of six cases of 7q11.23 duplication syndrome, five exhibited ultrasound abnormalities. These included two cases of cardiovascular abnormalities: one case with a widened left ventricle and another case with a shortened fetal humerus length. One case revealed complex multi-organ structural malformations, including hydronephrosis, a microgallbladder, and a cleft lip and palate. All seven cases of 7q11.23 deletions and three cases of 7q11.23 duplications opted for termination of the pregnancy. The remaining three cases of 7q11.23 duplications chose to continue the pregnancy. One case underwent surgical treatment for a ventricular septal defect after birth, and the prognosis was favorable. Another case involved a full-term delivery, this child was followed up at the age of 4 and exhibited a phenotype of poor language expression ability.</p><p><strong>Conclusion: </strong>Our study broadened the clinical phenotype spectrum of fetuses with 7q11.23 deletions and duplications. Additionally, it conducted a preliminary evaluation of prenatal ultrasound findings and postnatal clinical phenotypes in follow-up cases. The clinical phenotype of fetuses with 7q11.23 deletion and duplication syndromes involves multiple systems and is relatively complex. Cardiovascular abnormalities and intrauterine growth restriction are the most common clinical manifestations observed in prenatal 7q11.23 deletion syndrome. Fetuses with 7q11.23 duplications exhibit a wide range of clinical phenotypes that lack specificity.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589500","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":"Postnatal care after gestational diabetes - a systematic review of clinical practice guidelines.","authors":"Phyllis Ohene-Agyei, Ariba Iqbal, Jane E Harding, Caroline A Crowther, Luling Lin","doi":"10.1186/s12884-024-06899-w","DOIUrl":"10.1186/s12884-024-06899-w","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy and later is associated with an increased risk of type 2 diabetes and other metabolic disorders. Consistent and evidence based postnatal care is key to improving maternal long-term health. We therefore aimed to review and compare recommendations of national and international clinical practice guidelines (CPG) for postnatal care after GDM and identify any evidence gaps in recommendations needing further research.</p><p><strong>Methods: </strong>We searched five databases and forty professional organization websites for CPGs providing recommendations for postnatal care after GDM. CPGs which had full versions in English, endorsed, prepared, or authorized by a professional body, and published between 2013 and 2023 were eligible for inclusion. Two reviewers independently screened the articles, extracted the recommendations, and appraised the included CPGs using the Appraisal of Guidelines, Research, and Evaluation (AGREE) II tool.</p><p><strong>Results: </strong>Twenty-six CPGs from 22 countries were included. Twelve CPGs (46%) were appraised as low quality with the lowest scoring domains being rigor of development and editorial independence. We found little high certainty evidence for most recommendations and few recommendations were made for maternal mental health and postpartum metabolic screening. Evidence gaps pertained to postpartum glucose screening, including frequency, tests, and ways to improve uptake, evaluation of effective uptake of lifestyle interventions, and ongoing long-term follow up care.</p><p><strong>Conclusions: </strong>Most of the postnatal care recommendations in GDM guidelines are not based on high certainty evidence. Further efforts are needed to improve the global evidence base for postnatal care after GDM to improve long-term maternal health.</p><p><strong>Protocol registration: </strong>This review was registered in PROSEPRO (CRD42023454900).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575490","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":"Development and validation of an ultrasound-based estimated fetal weight reference for Chinese twin pregnancy: a retrospective cohort study.","authors":"Jing Yang, Hongzhao Yu, Yangyu Zhao, Zhihao Cheng, Yufeng Du, Pengbo Yuan, Aiqing Zhang, Yang Liu, Xiaoli Gong, Yang Yu, Yixin Li, Xiaoyan You, Nana Huang, Youzhen Zhang, Xiya Sun, Hongbo Qi, Hong-Tian Li, Yuan Wei","doi":"10.1186/s12884-024-06924-y","DOIUrl":"10.1186/s12884-024-06924-y","url":null,"abstract":"<p><strong>Background: </strong>Fetal growth monitoring is important for twin pregnancies. However, there has been no clinically validated tool for monitoring fetal growth of twin pregnancies in China. This study aims to develop and validate a chorionicity-specific growth chart of ultrasound estimated fetal weight (EFW) for Chinese twin pregnancies.</p><p><strong>Methods: </strong>This retrospective cohort study included all twin pregnancies who delivered two live fetuses with gestational age ≥ 34 weeks without severe obstetric complications at a tertiary hospital from January 2007 to March 2021. The participants were divided into a development set (delivered in or before December 2017) and a validation set (delivered in or after January 2018). Chorionicity-specific growth charts were created using the generalized additive models for location, scale, and shape (GAMLSS) based on the development set. The fetuses from the validation set were classified into three groups based on the last EFW: small-for-gestational-age (SGA) indicated by both the newly established twin charts and the Hadlock singleton chart currently used for twin pregnancies in China, suspected SGA indicated by only the singleton chart, and no SGA indicated by either chart. The incidence of neonatal outcomes among the three groups was then compared accordingly, including intensive care unit (NICU) stay length, respiratory diseases, and neurological disorders.</p><p><strong>Results: </strong>The development set included 883 twin pregnancies and a total of 6374 EFW measurements between 16 and 38 weeks of gestation, and the validation set included 801 twin pregnancies and 7630 EFW measurements. In the development set, monochorionic diamniotic (MCDA) twins had a significantly lower EFW compared to dichorionic diamniotic (DCDA) twins beginning at 26 weeks, with the difference gradually increasing thereafter, supporting the establishment of chorionicity-specific growth charts. Of the 1,602 twin neonates in the validation set, 103 (6.4%) were classified into the SGA group, 164 (10.2%) into the suspected SGA group, and 1335 (83.3%) into the no SGA group. The incidence of respiratory diseases and neurological disorders was comparable between the suspected SGA group and the no SGA group, but apparently higher in the SGA group. Meanwhile, NICU stay lengths were consistently longer for twins in the SGA group compared to the no SGA group (difference: 0.57, 95% CI: 0.31-0.83), with no significant differences observed between the suspected SGA and no SGA groups.</p><p><strong>Conclusions: </strong>The fetal growth trajectories differed by chorionicity, with a lower EFW for MCDA twins beginning at 26 weeks. The establishment of chorionicity-specific growth chart could reduce overdiagnosis of SGA and improve fetal growth monitoring of twin pregnancies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575487","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":"The effect of hereditary thrombophilia on recurrent pregnancy loss: a retrospective cohort study.","authors":"Hasan Berkan Sayal, Mehmet Sinan Beksac","doi":"10.1186/s12884-024-06926-w","DOIUrl":"10.1186/s12884-024-06926-w","url":null,"abstract":"<p><strong>Objective: </strong>Thrombophilia screening has been performed in patients with conditions such as previous fetal death, (fetal growth restriction) FGR, preeclampsia, (hemolysis. elevated liver enzyme, low platelet count) HELLP Syndrome, previous abruptio placentae, previous thrombosis in pregnancy, and abnormal placental histology. The actual role of hereditary thrombophilia in recurrent pregnancy loss (RPL) is still debated. This study was intended to determine the incidence of specific gene defects for hereditary thrombophilia and to ascertain their impact on RPL in central Anatolia in Turkey.</p><p><strong>Methods: </strong>This retrospective cohort study was performed between January 2012 and December 2022. All pregnant women with a complete hereditary screening profile were included. The investigated gene polymorphisms were methylenetetrahydrofolate reductase (MTHFR) C677T, MTHFR A1298C, Factor V Leiden G1691A, and Factor II prothrombin G20210A. Cases of pregnant women at least two or more consecutive pregnancy losses before 22 weeks of gestation were defined as RPL. The rates of genetic screening and their association with RPL were analyzed.</p><p><strong>Results: </strong>RPL was identified in 224 (27.58%) of the 812 pregnant women with complete genetic screening. Although there was no difference in terms of age, body mass index, numbers of ectopic pregnancies, molar pregnancies, or dilatation & curettage (p > 0.05), gravity (2.0 [2.0-3.0] vs. 4.0 [3.0-5.0]), parity (1.0 [1.0-2.0] vs. 1.0 [0-1.0]), live birth (1.0 [1.0-2.0] vs. 1.0 [0-1.0]), anembryonic pregnancy (0 [0-0] vs. 0 [0-0]), miscarriage (0 [0-1.0] vs. 3.0 [2.0-3.0]), and stillbirth (0 [0-0] vs. 0 [0-0]) numbers differed significantly between the groups (p < 0.05). While no significant differences were determined in MTHFR A1298C, Factor V Leiden, factor II prothrombin G20210A, or homocysteine levels (p > 0.05), the homozygous MTHFR C677T positivity rates differed significantly (6.3% in the non-RPL group vs. 11.6% in the RPL group, p = 0.027) .</p><p><strong>Conclusion: </strong>The homozygous MTHFR C677T polymorphisms was found to be more frequent in women with RPL. Further studies with larger cohorts are needed to confirm our results.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575492","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}