BMC Pregnancy and Childbirth最新文献

{"title":"Factors influencing antenatal care utilisation in Madang Province, Papua New Guinea: a qualitative study.","authors":"Elvin Lufele, Sophie Pascoe, Paula Tesine, Alma Auwun, Nalisa Neuendorf, Maria Ome-Kaius, Moses Laman, Kamala Thriemer, John W Bolnga, Stephen J Rogerson, Holger W Unger","doi":"10.1186/s12884-026-09657-2","DOIUrl":"10.1186/s12884-026-09657-2","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care (ANC) provides an opportunity to prevent or minimise adverse pregnancy outcomes and enhance women's health by providing essential interventions including malaria prevention measures. In Papua New Guinea (PNG), three quarters of women commence ANC after the first trimester of pregnancy and one in five women receive no ANC. The present qualitative study aimed to explore determinants of ANC utilisation in the context of a clinical trial of intermittent preventative treatment of malaria in pregnancy in PNG.</p><p><strong>Methods: </strong>A cross-sectional qualitative study was conducted at four health facilities in Madang Province, PNG, between 17 April and 6 September 2023. Data were collected through individual in-depth interviews, focus group discussions (FGDs) and observations of ANC proceedings at clinics. Study participants included 79 pregnant and 5 postpartum women, 15 healthcare providers, and 13 representatives of district, provincial and national health authorities involved with the programming of ANC. In-depth interviews and FGDs were audio-recorded and transcribed. Transcript data were coded using deductive and inductive approaches. Emerging themes from interviews and FGDs were triangulated with data from field notes and observations.</p><p><strong>Results: </strong>We identified four main themes in relation to ANC utilisation: accessibility of ANC; attitudes towards ANC; interpersonal factors; and timing of ANC. Accessibility of ANC services related to costs associated with ANC, healthcare service delivery challenges, proximity to clinics, and rigid clinic schedules. Attitudes toward ANC, including the perceived benefits and disadvantages, knowledge of ANC interventions and access to education, influenced utilisation. In terms of interpersonal factors, positive relationships and communication between women and healthcare providers, and community or family members participation, were enablers of ANC engagement, while negative healthcare provider attitudes and fear of pregnancy disclosure were identified as potential barriers. Timing of ANC contacts were influenced by personal choice, a desire to avoid many clinic visits, community attitudes, prior pregnancy experiences, distance to health facilities, anticipated travel and clinic costs, attitudes of community members around ANC timing and lack of awareness of pregnancy or gestational age. Most women considered ANC important and recognised the need for ANC to ensure safe pregnancy and delivery.</p><p><strong>Conclusions: </strong>Healthcare benefits of ANC were perceived as an important part of ensuring a safe pregnancy and delivery outcome. ANC initiation and utilisation were enhanced through clinic fee remission, ANC content, and community engagement provided in the context of a clinical trial. These findings highlight opportunities for strategic programmatic investments that could lead to improved ANC utilisation in Madang Province.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435002","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":"Duodenal stromal tumor in a high-risk pregnancy: a case report and literature review.","authors":"Dan Chen, Xue Xu, Wenbin Li, Hao Luo, Mingwei Zhu, Jun Du, Shaowei Wang, Jihua Shi, Qingfeng Luo","doi":"10.1186/s12884-026-09301-z","DOIUrl":"10.1186/s12884-026-09301-z","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal stromal tumor (GIST) is an extremely rare occurrence in pregnancy and, it can be challenging to manage. There is currently no consensus on the management of GIST during pregnancy.</p><p><strong>Case presentation: </strong>A 36-year-old woman with a scarred uterus presented with melena and vomiting at 17 weeks of gestation. She was profoundly anemic, with a hemoglobin of 58.0 g/L. Gastroduodenoscopy revealed an ulcerated, 20 mm mass capped with fresh blood in the descending duodenum. Endoscopic ultrasonography revealed a heterogeneous hypoechoic mass with a clear boundary and rich blood flow originating from the muscularis propria. A week later and after multidisciplinary discussion, the patient underwent duodenectomy. Postoperative pathology confirmed a diagnosis of duodenal stromal tumor of mixed spindle/epithelioid cell type, with a low risk of recurrence. A full-term healthy baby was delivered by cesarean section, and there were no signs of recurrence three years later.</p><p><strong>Conclusions: </strong>A review of 20 reported cases of GIST in pregnancy reveals that surgical intervention is feasible during gestation, particularly in the second trimester, and that delivery outcomes are generally favorable. In this case, multidisciplinary collaboration enabled successful duodenal tumor resection at 18 weeks of gestation, followed by term delivery and sustained recurrence-free survival at three years. These findings underscore the importance of individualized surgical timing, multidisciplinary teamwork, and shared decision-making in managing GIST during high-risk pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435082","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":"Metabolomic profiling reveals key metabolic pathway alterations in monochorionic diamniotic twins with selective intrauterine growth restriction.","authors":"Mengjie Liu, Xiaowei Zhang, Xiaona Li, Xiaoli Gong, Li Yang, Yuan Wei","doi":"10.1186/s12884-026-09380-y","DOIUrl":"10.1186/s12884-026-09380-y","url":null,"abstract":"<p><strong>Background: </strong>Selective intrauterine growth restricted (sIUGR) is a major cause of stillbirth and adverse pregnancy outcomes in monochorionic diamniotic (MCDA) twins. However, the underlying pathophysiologic mechanism of sIUGR remains poorly understood. The study aims to investigate the metabolite perturbations and metabolic mechanisms of sIUGR fetuses through a metabolomics study.</p><p><strong>Methods: </strong>Umbilical cord blood was collected from 30 pairs of MCDA sIUGR twin fetuses and 11 pairs of MCDA preterm (PT) twins, followed by non-targeted metabolomics using gas chromatography-mass spectrometry. Data were further analyzed using partial least squares discriminant analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and Spearman correlation analysis.</p><p><strong>Results: </strong>Our results revealed significant metabolic differences in the umbilical cord blood among small for gestational age, appropriate for gestational age and PT fetuses, potentially linked to abnormalities in carbohydrate, amino acid, and lipid metabolism. A total of 156 metabolites were identified, of which 53 showed significant differences between the groups. Specifically, tryptophan levels were higher in the sIUGR group, while glutamic acid and palmitic acid levels were lower. Based on the KEGG enrichment analysis and the correlation analysis, we hypothesize that the tryptophan-indole metabolism pathway, which may impact immune regulation and neurodevelopment, requires further attention. Other key metabolic pathways, such as arginine metabolism and the citrate cycle were also altered.</p><p><strong>Conclusions: </strong>Our findings offer valuable insights into the biochemical disruptions associated with sIUGR. These results enhance our understanding of the metabolic mechanisms underlying sIUGR and pave the way for future research on potential diagnostic and therapeutic strategies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435054","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 spiritual care on gestational diabetes self-management: a randomized controlled trial.","authors":"Negin Shaterian, Fatemeh Abbaszadeh, Mahboobeh Kafaei-Atrian, Zahra Sooki","doi":"10.1186/s12884-026-09638-5","DOIUrl":"10.1186/s12884-026-09638-5","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnancy requiring effective self-management. Spiritual care has been proposed as a supportive approach for chronic disease management.</p><p><strong>Objective: </strong>To determine the effect of spiritual care on self-management of gestational diabetes.</p><p><strong>Methods: </strong>This randomized controlled trial included 60 pregnant women with GDM (24-28 weeks gestation) attending two health centers in Kashan, Iran (2024). The intervention group received eight 80 min spiritual care sessions, while the control group received routine prenatal diabetes education. Diabetes self-management was assessed before, immediately after, and four weeks post intervention using a validated questionnaire. Data were analyzed using repeated measures adjusting for baseline differences.</p><p><strong>Results: </strong>Before the intervention, the mean self-management score was higher in the intervention group (32.90 ± 9.50) than in the control group (24.56 ± 8.90). After adjusting for baseline differences, the intervention group demonstrated significantly higher self-management scores immediately after the intervention (mean difference ≈ 10.3 points) and at four week follow-up (mean difference ≈ 9.8 points) compared with the control group (P < 0.001). The time effect (P = 0.660) and time × group interaction (P = 0.831) were non-significant, indicating that although scores improved, the pattern of change over time did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Spiritual care was associated with significantly higher diabetes self-management scores compared with usual care, even after adjusting for baseline differences. However, no significant time-dependent trends were observed, suggesting that the pattern of change between postintervention assessments did not reach a significant level. Future studies could be conducted over longer periods and with larger samples, and could also evaluate the integration of spiritual care with lifestyle and behavioral interventions.</p><p><strong>Trial registration: </strong>Approved by Iranian Registry of Clinical Trials (ID: IRCT20240509061721N1, 11-06-2024). https://irct.behdasht.gov.ir/trial/76736 . 11/06/2024.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429776","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":"Assessing the geographical variation of antenatal care and maternal mortality rates among pregnant women in Sierra Leone based on DHIS2 data from 2020-2022: a retrospective, descriptive, ecological study.","authors":"Morlai Sesay, Wenyi Lai, Pavan Kumar Sah, Guan Ying","doi":"10.1186/s12884-026-09551-x","DOIUrl":"10.1186/s12884-026-09551-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sierra Leone reported a high maternal mortality rate (MMR) of 717 per 100,000 live births in 2019 due to disparities in use, quality, and access to skilled birth attendants and antenatal care (ANC) services. Our study aimed to assess the geographical variation in MMR and ANC among pregnant women in Sierra Leone, based on District Health Information System-2 (DHIS2) data from 2020 to 2022.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective ecological study analysed aggregated DHIS2 data from health facilities across all five administrative regions of Sierra Leone from 2020-2022. The data analysis included all pregnant women and maternal deaths captured in DHIS2. The MMR was evaluated using descriptive statistics, while the geographical disparity between the MMR and ANC was assessed through factorial analysis. Multivariate regression and bivariate association analysis were performed to determine the relationship between ANC and MMR across the five administrative regions of Sierra Leone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The MMR reported in 2020 was 760 per 100,000 live births, which significantly decreased to 648 in 2021, and the lowest rate (288 per 100,000 live births) was reported in 2022. However, regional disparities persisted, particularly in the northern, western, and northwest regions. This study found that infection deaths, haemorrhage, and malaria were the significant causes of maternal deaths from 2020-2022. The correction coefficient for the causes ranged from 0.627 to 0.960. This study found that at the 1st ANC visiting time point, all regions, excluding the southern region, showed a non-significantly decreased relative number of screened pregnant women in 2021 and 2022 compared to 2020. However, at the 4th and 8th ANC visits, all regions, excluding the western region, showed a significantly increased relative number of screened pregnant women in 2021 and 2022 than in 2020. This pattern is consistent with growing awareness and adaptive strategies, though temporal trends alone cannot establish causality among pregnant women and healthcare systems in Sierra Leone. This study found that regional differences were less pronounced each year despite significant increases over time in haemoglobin testing, syphilis screening, and IPT doses. The multivariate regression results indicated that the IPT-1st dose showed the strongest negative association (standard regression coefficient = -1.307, P &lt; 0.001) with MMR. This study found a significant negative association between ANC-1st visit, iron folate, and malaria in the 2nd or 3rd trimester in pregnant women treated with artemisinin-based combination therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This ecological analysis revealed significant regional disparities in MMR and ANC utilisation in Sierra Leone. Regions with lower ANC utilisation rates were associated with higher MMRs, highlighting the need for targeted interventions. However, these associations do not imply ","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435018","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":"Comparison of the permeability of DPP-4 inhibitors-sitagliptin, vildagliptin, linagliptin, and alogliptin-in placental barrier cell models and exploration of their transport mechanisms by LC-MS/MS.","authors":"Mengru Bai, Qian Shen, Yong Wu, Mingyang Chen, Dan Liu, Nengming Lin, Wei Zhang","doi":"10.1186/s12884-026-09515-1","DOIUrl":"10.1186/s12884-026-09515-1","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled hyperglycemia in pregnancy poses risks to both mother and fetus, but treatment options are limited. Sitagliptin, vildagliptin, linagliptin, and alogliptin are dipeptidyl peptidase-4 (DPP-4) inhibitors effective in type 2 diabetes. However, data on their placental transfer and safety in pregnant women is lacking. Therefore, this study compared the permeability of these drugs in multiple placental cell models, including BeWo, HTR-8/SVneo, and primary human trophoblast cells, and attempted to explore their transport mechanisms.</p><p><strong>Methods: </strong>A cost-effective liquid chromatography-tandem mass spectrometry method was developed and validated to quantify the four DPP-4 inhibitors. The accumulation of these drugs in placental cell models was compared, and the BeWo Transwell transport assay was conducted to assess transport rates. Transporter inhibitors, siRNA knockdown, and transporter overexpression cell models were used to explore the transmembrane transport mechanism of these drugs.</p><p><strong>Results: </strong>Linagliptin had the highest accumulation in placental cells, followed by alogliptin, sitagliptin, and vildagliptin. The apparent permeability coefficient of linagliptin, alogliptin and sitagliptin was similar in BeWo cells, while vildagliptin was the lowest. The accumulation of linagliptin, alogliptin, sitagliptin and vildagliptin in BeWo cells at 37 °C were significantly higher than those at 4 °C, indicating the presence of carrier-mediated uptake. However, studies using transporter inhibitors, siRNA knockdown, and transporter overexpression cell models showed that equilibrative nucleoside transporters (ENTs), concentrative nucleoside transporters (CNTs), and organic anion transporter (OAT) 4 do not facilitate the placental transfer of linagliptin, alogliptin, sitagliptin, and vildagliptin.</p><p><strong>Conclusions: </strong>Vildagliptin had the lowest accumulation and permeability in placental cells among the four DPP-4 inhibitors. There might be carrier-mediated transmembrane transport of linagliptin, alogliptin, sitagliptin and vildagliptin, but ENTs, CNTs and OAT4 were not involved in. This study provides a basis for future research on their safety during pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435075","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":"Successful pregnancy following extensive myomectomy for diffuse uterine leiomyomatosis.","authors":"Ayako Okunaka, Hiroshi Ishikawa, Mika Sato, Yoshiko Saito, Akiko Omoto, Masato Nishida, Kiyotaka Kawai, Kaori Koga","doi":"10.1186/s12884-026-09644-7","DOIUrl":"10.1186/s12884-026-09644-7","url":null,"abstract":"<p><strong>Background: </strong>Diffuse uterine leiomyomatosis (DUL) is a rare condition characterized by innumerable leiomyomas (fibroids) diffusely replacing the myometrium, often leading to severe infertility due to distortion of the uterine cavity. Although assisted reproductive technologies are commonly attempted, implantation failure is frequent and effective treatment strategies remain unclear. Extensive myomectomy, involving the removal of numerous fibroids with uterine reconstruction, has been proposed as a fertility-preserving option; however, it is associated with substantial surgical morbidity and potential obstetric risks, including uterine rupture and abnormal placentation. Reports describing successful live birth following this approach with detailed perinatal management are limited.</p><p><strong>Case presentation: </strong>A 29-year-old nulligravid woman with DUL was referred for infertility after repeated implantation failure despite multiple cycles of assisted reproductive treatment. An initial myomectomy at 32 years of age removed 25 fibroids but did not result in pregnancy, and disease progression was observed. At 34 years of age, she underwent extensive myomectomy, during which 148 fibroids were removed through a longitudinal uterine incision. After postoperative recovery, pregnancy was achieved following embryo transfer, although the first pregnancy ended in miscarriage. A subsequent pregnancy was established at 35 years of age and closely monitored using serial ultrasonography and magnetic resonance imaging (MRI). Imaging findings suggested myometrial thinning and abnormal placentation. The patient was managed with hospitalization due to the risk of uterine rupture. An elective cesarean section was performed at 36 weeks of gestation after preoperative autologous blood preparation. A healthy male infant weighing 3,261 g was delivered. Although partial placental retention and significant bleeding occurred, hemostasis was achieved without allogeneic transfusion. The postoperative course was uneventful, and no recurrence of diffuse uterine leiomyomatosis was observed during follow-up.</p><p><strong>Conclusions: </strong>This case suggests that extensive myomectomy may represent a feasible fertility-preserving option for carefully selected patients with DUL, although successful pregnancy cannot be guaranteed and careful reproductive and obstetric management remains essential. MRI and repeated hysteroscopic evaluations were useful for assessing uterine cavity involvement and guiding fertility-preserving treatment. Careful antenatal surveillance and planned delivery are essential to manage the risks of uterine rupture and abnormal placentation. Individualized treatment strategies are required to optimize reproductive outcomes in this rare condition.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435191","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":"Clinical characteristics and genetic analysis of different Dandy-Walker malformation.","authors":"Xingye Wei, Ping Huo, Xuedong Shi, Pingping Zhang, Ning Zhang, Yanmei Sun","doi":"10.1186/s12884-026-09656-3","DOIUrl":"10.1186/s12884-026-09656-3","url":null,"abstract":"<p><strong>Background: </strong>Dandy-Walker malformation (DWM) is a rare congenital malformation of the central nervous system (CNS). It is characterized by variable hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, with or without an enlarged cisterna magna. Given that large-sample genetic analysis of DWM has not been conducted to date, this study aims to provide more comprehensive genetic counseling for prenatal diagnosis by summarizing the clinical features and genetic findings of DWM.</p><p><strong>Methods: </strong>Between January 2010 and May 2025, among 22,048 pregnant women, there were 487 cases of fetal DWM that underwent prenatal diagnosis. Karyotyping, copy number variation sequencing (CNV-seq), single-nucleotide polymorphism array (SNP-array) or whole-exome sequencing (WES) were employed for prenatal genetic diagnosis. The results of ultrasonography, genetic analyses, and prognoses were tabulated.</p><p><strong>Results: </strong>Among the 487 cases, 35 (7.19%) were diagnosed with classic Dandy-Walker malformation (cDWM), 59 (12.11%) with vermian hypoplasia (VH), and 393 (80.70%) with mega cisterna magna (MCM) according to ultrasonography. A total of 245 cases (50.31%) presented with additional ultrasound abnormalities; central nervous system (CNS) abnormalities were the most prevalent (21.36%), among which ventriculomegaly constituted the primary finding. Prenatal genetic abnormalities were detected in 50 cases (10.27%). Karyotyping identified chromosomal abnormalities in 42 cases (8.62%), including numerical abnormalities, structural abnormalities, and chromosomal mosaicism, with trisomy-18 (2.26%) being the most commonly detected. There were 8 cases with normal karyotypes, but among them, 6 cases were detected with chromosomal abnormalities by CNV-seq/SNP-array, and 2 cases were detected with gene mutations by WES. Advanced maternal age was associated with an increased risk of chromosomal abnormalities, a proportion of which may present with DWM. Among the 453 cases that underwent follow-up, the cDWM and VH groups exhibited a significantly higher incidence of pregnancy terminations compared to the MCM group. Subsequent follow-up of cases with continued pregnancies revealed 1 case of neonatal death in the VH group and 5 cases in the MCM group. Additionally, there was 1 case of abnormal postnatal development in the cDWM group and 3 cases in the MCM group.</p><p><strong>Conclusions: </strong>Pregnant women carrying DWM fetuses should undergo prenatal diagnosis including karyotyping, CNV-seq/SNP-array and WES if necessary, especially for fetuses with cDWM or VH, as the fetuses with cDWM or VH showed higher rates of genetic abnormalities. The pregnancy outcomes of most fetuses with MCM are favorable, while fetuses with cDWM or VH are prone to adverse gestational outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435090","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":"Trichomoniasis associated with amniotic sac rupture in pregnancy: a case report.","authors":"Hajar Ziaei Hezarjaribi, Maliheh Ghasemi Tirtashi, Marzieh Asadi","doi":"10.1186/s12884-026-08780-4","DOIUrl":"10.1186/s12884-026-08780-4","url":null,"abstract":"<p><p>The aim of this report is to present a rare case of pre‑labour premature rupture of membranes (PPROM) in a patient in the second trimester of pregnancy, in which an association with a lower genital tract infection caused by Trichomonas vaginalis was observed. The patient was a 26‑year‑old woman, gravida 2, at 25 weeks of gestation, who presented with clinical complaints of abnormal vaginal discharge and fluid leakage.Following a definitive diagnosis of trichomoniasis based on stained smear and culture findings, standard treatment with metronidazole was initiated. The treatment was effective, leading to complete resolution of maternal symptoms, full eradication of the infection, and a stable, viable fetal condition.This case highlights the potential importance of timely identification and management of common sexually transmitted infections during pregnancy, as such infections may be associated with alterations in fetal membrane integrity and adverse pregnancy outcomes, although a causal relationship cannot be inferred from a single observational report.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435179","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":"Carbetocin and oxytocin use in emergency cesarean delivery: a prospective observational study of 24-hour bleeding outcomes.","authors":"Tahir Eryılmaz, Tuğba Kolomuç Gayretli, Selver Özge Şefik, Ayşe Sena Küçükkayıcı, Hüseyin Levent Keskin","doi":"10.1186/s12884-026-09626-9","DOIUrl":"10.1186/s12884-026-09626-9","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage remains a major cause of maternal morbidity, and cesarean delivery is associated with greater blood loss than vaginal birth. This study evaluated 24-hour bleeding-related outcomes among antenatally low-risk women who received prophylactic oxytocin or carbetocin after National Institute for Health and Care Excellence (NICE) Category 1-2 emergency cesarean delivery and identified intrapartum factors associated with additional uterotonic use.</p><p><strong>Methods: </strong>This prospective observational, non-randomized comparative study was conducted between October 2024 and August 2025. Antenatally low-risk women admitted for intended vaginal birth who subsequently required NICE Category 1-2 emergency cesarean delivery received oxytocin 10 IU intravenous (IV) or carbetocin 100 µg IV immediately after delivery. The primary outcome was any additional uterotonic use within 24 h. Secondary outcomes were tranexamic acid use, hemoglobin decrease ≥ 2 g/dL at 24 h, absolute hemoglobin change (ΔHb), and postoperative hemoglobin < 8 g/dL. Multivariable logistic regression was performed for the primary outcome.</p><p><strong>Results: </strong>A total of 300 women were included, with 150 in each group. Additional uterotonic use occurred in 24.0% (36/150) of the carbetocin group and 33.3% (50/150) of the oxytocin group (p = 0.074). Tranexamic acid use did not differ significantly between groups (18.7% vs. 16.0%, p = 0.542). Hemoglobin decrease ≥ 2 g/dL occurred in 68.0% and 60.0%, respectively (p = 0.149). Mean ΔHb was 2.49 ± 1.13 g/dL in the carbetocin group and 2.38 ± 1.03 g/dL in the oxytocin group (p = 0.388). Postoperative hemoglobin < 8 g/dL occurred in 11.3% and 12.0%, respectively (p = 0.981). In multivariable analysis, induction/augmentation (adjusted OR 1.92, 95% CI 1.07-3.42, p = 0.028) and longer duration of membrane rupture (adjusted OR 1.23 per doubling, 95% CI 1.06-1.43, p = 0.006) were independently associated with additional uterotonic use, whereas uterotonic group was not (adjusted OR for oxytocin vs. carbetocin 1.51, 95% CI 0.90-2.54, p = 0.122).</p><p><strong>Conclusions: </strong>In this prospective observational non-randomized cohort of antenatally low-risk women undergoing emergency cesarean delivery, no statistically significant between-group differences were observed in additional uterotonic use or predefined 24-hour bleeding-related outcomes. Additional uterotonic use was numerically lower with carbetocin, but the difference was not statistically significant. Induction/augmentation and longer duration of membrane rupture were independently associated with higher odds of additional uterotonic use.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT07380529), first submitted on 18 January 2026. Retrospectively registered.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418571","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}