BMC Pregnancy and Childbirth最新文献

{"title":"Unlocking the path to quality maternity care: a qualitative study on work environment dynamics, providers' responsiveness, and professionalism in central region, Malawi.","authors":"Bianca Kandeya, Wanangwa Chimwaza-Manda, Princess Kaira, Claudia Hanson, Dorcus Kiwanuka Henriksson, William Stones, Helle Molsted Alvesson, Effie Chipeta","doi":"10.1186/s12884-025-07525-z","DOIUrl":"https://doi.org/10.1186/s12884-025-07525-z","url":null,"abstract":"<p><strong>Background: </strong>Responsiveness and professionalism are essential components of high-quality maternity care. Responsiveness involves effective communication, respectful interactions, and consideration of the emotional, physical, and cultural needs of women, while professionalism encompasses clinical competence, ethical adherence, and respectful engagement with patients and colleagues. However, various workplace factors, including managerial structures, resource constraints, and institutional culture, influence the extent to which maternity care providers uphold these principles. This study aims to explore how organizational culture, management styles, and resource availability influence responsiveness and professionalism in Malawian maternity care settings, with the goal of identifying strategies to enhance provider motivation and improve maternal healthcare delivery.</p><p><strong>Methods: </strong>A qualitative study was conducted in two maternity care units in Malawi. Data were collected using Twelve semi-structured interviews, two focus group discussions and sixteen observations with maternity care providers in one faith-based hospital and one government-owned hospital, sampled purposively. Transcripts were imported into NVIVO 14 software, and a reflexive thematic analysis was conducted.</p><p><strong>Findings: </strong>The study found that limited physical space, resource shortages, and heavy workloads constrained providers' ability to deliver responsive care. Rigid managerial structures, lack of professional recognition, and restricted autonomy contributed to low morale and reluctance to take initiative. Hierarchical power dynamics and inadequate institutional support further discouraged collaboration and accountability. Despite these challenges, providers highlighted the importance of teamwork, mutual support, and a positive work environment in fostering professionalism and responsiveness. Unpredictable work schedules and poor work-life balance also emerged as key concerns, impacting provider well-being and engagement.</p><p><strong>Conclusion: </strong>The study provides insights into the complex interplay of systemic, managerial, and interpersonal factors affecting responsiveness and professionalism in maternity care. Addressing these challenges requires targeted interventions that can strengthen resource allocation, supportive leadership, and policies that promote provider well-being and motivation which can in turn enhance maternal and newborn outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"410"},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810426","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":"LC-MS/MS assay to confirm that the endogenous metabolite L-Arginine promotes trophoblast invasion in the placenta accreta spectrum through upregulation of the GPRC6A/PI3K/AKT pathway.","authors":"Zhou Gao, Min Xue, Zhibiao Wang","doi":"10.1186/s12884-025-07475-6","DOIUrl":"10.1186/s12884-025-07475-6","url":null,"abstract":"<p><strong>Objective: </strong>Placental accreta spectrum (PAS) is a collective term for a range of pregnancy complications caused by abnormal placental implantation, posing a threat to the lives of both the mother and the fetus. This study aimed to screen for placental marker metabolites of PAS and assess the effect of L-Arginine on trophoblast invasion.</p><p><strong>Methods: </strong>Placental tissues were collected from a total of 15 pregnant women, including 10 women diagnosed with PAS and 5 women with normal pregnancies. Histological staining was used to characterize pathological changes in the placenta. The changes in endogenous placental metabolites by LC-MS/MS. Subsequently, the role of marker metabolite L-Arginine on HTR-8/Svneo invasion was explored, and protein transcription and expression levels of GPRC6A/PI3K/AKT/MMP2/MMP9 were determined by RT-qPCR and western blot.</p><p><strong>Results: </strong>The placentas of PAS patients were mostly infiltrative invasion, with active proliferation and inhibited apoptosis of trophoblast cells. By LC-MS/MS, we identified 13 significantly different metabolites between healthy and PAS pregnant women's placenta tissue. Among them, placental concentrations of L-Arginine were significantly higher in PAS pregnant women than in controls. In vitro, L-Arginine promoted the proliferation and migration of HTR8/SVneo cells and upregulated the transcription and expression of proteins related to the GPRC6A/PI3K/AKT pathway.</p><p><strong>Conclusions: </strong>Our study demonstrates that L-Arginine may promote trophoblast invasion and migration in placental implantation by upregulating the GPRC6A/PI3K/AKT pathway. This provides a new basis for screening appropriate metabolic markers for PAS, thus contributing to the prevention and treatment of PAS.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"402"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802333","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":"Management and outcomes of women with placenta accreta spectrum grade 3: an INOSS multicountry multiperiod population-based study.","authors":"Anne Pinton, Sara Ornaghi, Marian Knight, Loïc Sentilhes, Serena Donati, Gilles Kayem, Catherine Deneux-Tharaux","doi":"10.1186/s12884-025-07271-2","DOIUrl":"10.1186/s12884-025-07271-2","url":null,"abstract":"<p><strong>Background: </strong>Management and outcomes in women with placenta accreta spectrum grade 3 are rarely reported from population-based studies. The objective of this study is to describe profiles, management, and outcomes, of women with placenta accreta spectrum (PAS) grade 3 from three multiperiod studies.</p><p><strong>Methods: </strong>This analysis used data from three multiperiod population-based cohort studies from the United Kingdom (UK) (May 2010-April 2011), France (November 2013-October 2015), and Italy (September 2014-August 2016) to compare the management and outcomes of women with grade 3 PAS. The main outcome measures were postpartum hemorrhage (PPH) ≥ 3000 mL, blood transfusion ≥ 4 units, and other severe maternal complications (death, damage to bowel or urinary tract).</p><p><strong>Results: </strong>This study included 39 women with PAS grade 3 in the UK, 51 in France, and 34 in Italy, a total of 124 women. PAS was suspected before birth in 59% of the UK cases, 88% in France, and 82% in Italy (P < .01). Conservative management was attempted only in the UK (38%) and in France (61%). PPH ≥ 3000 mL occurred in 54% of the UK women, 25% in France, and 12% in Italy (P < .01); 67% in the UK, 47% in France, and 41% in Italy received blood transfusion ≥ 4 units (P = .06). The final (immediate and secondary) hysterectomy rate differed significantly between the three countries: 69% in the UK, 57% in France, 100% in Italy (P < .01).</p><p><strong>Conclusion: </strong>Maternal outcomes in women with grade 3 PAS varied between the three periods and countries, alongside the evolution in prenatal screening and peri-operative management.</p><p><strong>Trial registration: </strong>For the UK: reference number: RP-PG-0608-10038. For France: reference number: AOR12156. For Italy: reference number: Port. PRE-839/13.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"401"},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802335","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":"Effects of M-DEPTH model of depression care on maternal depression, functioning, and HIV care adherence, and infant developmental over eighteen months post-partum: results from a cluster randomized controlled trial.","authors":"Glenn J Wagner, Bonnie Ghosh-Dastidar, Violet Gwokyalya, Laura J Faherty, Jolly Beyeza-Kashesya, Juliet Nakku, Linda Kisaakye Nabitaka, Dickens Akena, Janet Nakigudde, Victoria Ngo, Ryan McBain, Hafsa Lukwata, Leticia Kyohangirwe, Barbara Mukasa, Rhoda K Wanyenze","doi":"10.1186/s12884-025-07443-0","DOIUrl":"10.1186/s12884-025-07443-0","url":null,"abstract":"<p><strong>Background: </strong>Perinatal depression is associated with poor outcomes related to HIV care adherence, maternal functioning, and early child development. We examined whether the M-DEPTH (Maternal Depression Treatment in HIV) depression care model-including antidepressant therapy and individual problem-solving therapy-and depression alleviation would affect improvement in each of these outcome domains.</p><p><strong>Methods: </strong>A sample of 354 pregnant women living with HIV (WLH) with at least mild depressive symptoms (177 in each of intervention and usual care control arms) enrolled in a cluster randomized controlled trial across eight antenatal care clinics in Uganda and had a live birth delivery. Longitudinal mixed effects models were used to examine survey data and chart-abstracted HIV viral load and antiretroviral pharmacy refill data collected at baseline and months 2, 6, 12 and 18 post-partum.</p><p><strong>Results: </strong>69% had clinical depression at enrollment; 70% of women in the intervention group (including 96% of those with clinical depression) received depression treatment. Mixed-effects longitudinal regression analysis showed (1) strong effects of the intervention on maternal depression at each post-partum follow-up assessment; and (2) moderate effects of the intervention and reduced depression on maternal functioning (self-care and infant care, in particular). However, there was little evidence of effects of the intervention and depression reduction on early child development, maternal viral suppression, or ART adherence.</p><p><strong>Conclusion: </strong>These findings suggest that depression care for pregnant WLH is important for maternal mental health, but it also helps women to better manage parenting and care for their infant. Supplementary interventions may be needed to impact early child development.</p><p><strong>Trial registration: </strong>The trial was registered with the NIH Clinical Trial Registry (clinicaltrials.gov: NCT03892915) on 27/03/2019.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"400"},"PeriodicalIF":2.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787549","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":"Predictive factors of maternal obesity and its effects on pregnancy symptoms and sexuality: a hospital-based study.","authors":"Ebru Gozuyesil, Burcu Avcibay Vurgec, Sule Gokyildiz Surucu, Ayseren Cevik, Cemile Onat Koroglu, Emine Aksut Akcay, Aslihan Turan","doi":"10.1186/s12884-025-07504-4","DOIUrl":"10.1186/s12884-025-07504-4","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is one of the periods when women of reproductive age have a high risk of weight gain, and maternal obesity is an important risk factor in this period. This study aimed to investigate the predictive factors of maternal obesity and its impact on pregnancy symptoms and sexual function in pregnant women living in the Eastern Mediterranean region of southern Türkiye.</p><p><strong>Methods: </strong>This study utilized a cross-sectional, hospital-based, and multi-center design. The study was participated in by 647 pregnant women. Data were collected through the Socio-demographic Form, the Pregnancy Symptoms Inventory, and the Female Sexual Function Index.</p><p><strong>Results: </strong>The obesity prevalence of pregnant women was 36.6% in this study. This study found that maternal obesity was a predictive factor on pregnancy symptoms (p < 0.05). However, no difference was found between FSFI scores according to pregnancy symptoms in obese and non-obese pregnant women (p > 0.05).</p><p><strong>Conclusions: </strong>Quality pre-conceptional midwifery care and consultancy accompanied by regular pregnancy follow-ups are considered to prevent the development of maternal obesity, pregnancy complaints, and sexual dysfunction and be a fundamental step that can improve maternal health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"397"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787589","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":"Predicting placenta accreta spectrum and high postpartum hemorrhage risk using radiomics from T2-weighted MRI.","authors":"Jinli Zou, Wei Wei, Yingzhen Xiao, Xinlian Wang, Keyang Wang, Lizhi Xie, Yuting Liang","doi":"10.1186/s12884-025-07516-0","DOIUrl":"10.1186/s12884-025-07516-0","url":null,"abstract":"<p><strong>Background: </strong>Antenatal diagnosis of placenta accreta spectrum (PAS) is of critical importance, considering that women have much better outcomes when delivery occurs at a level III or IV maternal care facility before labor initiation or bleeding, thus avoiding placental disruption. Herein, we aimed to investigate the performance of magnetic resonance imaging (MRI) in antenatal prediction of PAS and postpartum hemorrhage (PPH).</p><p><strong>Methods: </strong>This retrospective study included 433 women with singleton pregnancies (PAS group, n = 208; non-PAS group, n = 225; PPH-positive (PPH (+)) group, n = 80; PPH-negative (PPH (-)) group, n = 353), who were randomly divided into a training set and a test set in a 7:3 ratio. Radiomic features were extracted from T2WI (T2-weighted imaging). Features strongly correlated with PAS and PPH (p < 0.05) were selected using Pearson correlation, followed by LASSO regression for dimensionality reduction. Subsequently, radiomics models were constructed for PAS and PPH risk prediction, respectively. Regression analyses were conducted using radiomics score (R-score) and clinical factors to identify independent clinical risk factors for PAS and PPH, leading to the development of corresponding clinical models. Next, clinical-radiomics models were built by combining R-score and clinical risk factors. The predictive performance of the models was evaluated using nomograms, calibration curves, and decision curves.</p><p><strong>Results: </strong>The clinical-radiomics models and radiomics models for predicting PAS and PPH risk both outperformed their clinical models in the training and testing sets. For PAS, the AUC (Area Under the Receiver Operating Characteristic Curve) of the clinical-radiomics model, radiomics model, and clinical model in the training set are 0.918, 0.908, and 0.755, respectively, and in the testing set, the AUCs are 0.885, 0.866, and 0.771, respectively. For PPH, the AUCs of the clinical-radiomics model, radiomics model, and clinical model in the training set are 0.918, 0.884, and 0.723, respectively, and in the testing set, the AUCs are 0.905, 0.860, and 0.688, respectively. The DeLong test p-values between the clinical-radiomics models and radiomics models for predicting PAS and PPH are both less than 0.05. Additionally, in the testing set, the clinical-radiomics models perform best in predicting PAS and PPH risk, with accuracies of 82.31% and 84.61%, respectively.</p><p><strong>Conclusion: </strong>This novel clinical-radiomics model has a robust performance in predicting PAS antepartum and predicting massive PPH in pregnancies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"398"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787562","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":"Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls.","authors":"Lindsay M Parlberg, Jamie E Newman, Stephanie L Merhar, Brenda Poindexter, Sara B DeMauro, Scott A Lorch, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Namasivayam Ambalavanan, Catherine Limperopoulos, Nicole Mack, Jonathan M Davis, Michele C Walsh, Carla M Bann","doi":"10.1186/s12884-025-07499-y","DOIUrl":"10.1186/s12884-025-07499-y","url":null,"abstract":"<p><strong>Background: </strong>Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity.</p><p><strong>Methods: </strong>This research utilized data from 254 biological mothers of infants in the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes of Babies with Opioid Exposure (OBOE) Study. We examined factors associated with food insecurity among mothers of infants with antenatal opioid exposure and their unexposed (control) counterparts. Chi-square tests and logistic regression were used to compare food insecurity by sociodemographic characteristics, opioid use, prior traumatic experiences, and housing instability. Similar analyses were conducted to examine the relationship between food insecurity during pregnancy and receipt of adequate prenatal care.</p><p><strong>Results: </strong>Overall, 58 (23%) of the mothers screened positive for food insecurity. Prevalence of food insecurity was higher among mothers who took opioids during pregnancy compared to controls (28% vs. 14%; p = 0.007). However, the difference between the two groups was no longer significant after accounting for demographics, housing instability, and prior trauma (AOR (95% CI) = 1.85 (0.82, 4.20), p = 0.140). Mothers with food insecurity during pregnancy were less likely to have received adequate prenatal care (78% vs. 90%), after controlling for other factors (AOR (95% CI) = 0.39 (0.16, 1.00), p = 0.049).</p><p><strong>Conclusions: </strong>Food insecurity frequently co-occurred with housing instability and prior trauma among mothers of infants with antenatal opioid exposure, for which limited data are available. Although those with food insecurity are at increased risk for poor pregnancy outcomes, they were less likely to have received adequate prenatal care despite high levels of public insurance coverage, suggesting alternative approaches are needed to address barriers to healthcare among this population. Wrap-around care models are recommended to provide multifaceted and continuous support during the perinatal period. Care models should provide for staff training in trauma-informed care and include resources to address housing and food concerns.</p><p><strong>Trial registration: </strong>The Outcomes of Babies with Opioid Exposure (OBOE) Study is registered at Clinical Trials.gov (NCT04149509) (04/11/2019).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"396"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787596","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":"Maternal telomere length and oxidative stress in pregnancy: cross-sectional analysis with an exploratory examination of systemic inflammation.","authors":"Laura Etzel, Qiaofeng Ye, Abner T Apsley, Chris Chiaro, Lauren E Petri, John Kozlosky, Cathi Propper, Roger Mills-Koonce, Sarah J Short, Patricia Garrett-Peters, Idan Shalev","doi":"10.1186/s12884-025-07542-y","DOIUrl":"10.1186/s12884-025-07542-y","url":null,"abstract":"<p><strong>Background: </strong>Telomere length (TL) is a marker of cellular aging associated with risk for age-related diseases and is known to be influenced by various factors, including oxidative stress and inflammation, in the contexts of stress and aging. The physiological demands of pregnancy may impact maternal TL, though research in this area is sparse. We tested oxidative stress and explored inflammation as predictors of maternal TL in a sample of women with normative pregnancies.</p><p><strong>Methods: </strong>Participants (N = 88, aged 18 to 46 years, 25% non-Hispanic Black, 65% non-Hispanic White) were recruited during their 2nd or 3rd trimester. TL was measured using saliva via qPCR as absolute TL. Oxidative stress was derived from principal component analysis of selected metabolites measured via urinary metabolomics. Inflammation was quantified as total IL-6 in serum. Hypotheses were tested with stepwise generalized linear models.</p><p><strong>Results: </strong>Longer TL was predicted by higher oxidative stress (b = 0.20 ± 0.08; P =.019), controlling for maternal age, gestational age, race/ethnicity, maternal BMI, and income-to-needs ratio. In our exploratory analysis, longer TL was also predicted by higher IL-6 (b = 0.76 ± 0.20; P =.0003) controlling for covariates. There was no significant interaction between oxidative stress and inflammation predicting TL.</p><p><strong>Conclusion: </strong>Our findings suggest that in normative pregnancies, both oxidative stress and inflammation are independently associated with longer telomere length. Given that these associations are inconsistent with the role of oxidative stress and inflammation on telomere biology in non-pregnant samples, future work should aim to replicate these findings in both normal and high-risk pregnancies, explore mechanisms underlying these associations using longitudinal designs, and examine how these relationships influence maternal and fetal health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"395"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787557","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 sonographic diagnosis of cloacal malformation associated with uterus didelphys and bilateral hydrometrocolpos: a case report.","authors":"Xing Xu, Hongxia Yuan, Rong Tian, Xiaohong Lu, Lingling Li","doi":"10.1186/s12884-025-07530-2","DOIUrl":"10.1186/s12884-025-07530-2","url":null,"abstract":"<p><strong>Introduction: </strong>Cloacal malformation is a rare and complex group of congenital abnormalities involving anomalies of the genitourinary and gastrointestinal systems. The most common prenatal ultrasound finding is the presence of abnormal pelvic cystic masses.</p><p><strong>Case presentation: </strong>We present a case of cloacal malformation associated with uterus didelphys and bilateral hydrometrocolpos, diagnosed by prenatal ultrasound at 29 weeks of gestation. The diagnosis was confirmed by postmortem examination following induced labor.</p><p><strong>Conclusion: </strong>Abnormal pelvic cystic masses detected prenatally require close observation and monitoring. Prenatal ultrasound provides accurate and detailed diagnostic information, which is crucial to prenatal counseling and management.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"399"},"PeriodicalIF":2.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787593","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":"Lateral recumbent position versus kneeling prone position combined with unprotected perineal delivery in natural childbirth: implication for clinical care.","authors":"Xiuli Dai, Nan Jin","doi":"10.1186/s12884-025-07497-0","DOIUrl":"10.1186/s12884-025-07497-0","url":null,"abstract":"<p><strong>Background: </strong>Posture management significantly influences the natural childbirth process and the maternal experience. The aim of this study is to analyze the effects of the lateral recumbent position versus the kneeling prone position combined with unprotected perineal delivery in natural childbirth, providing evidence-based support for clinical maternal care and posture management.</p><p><strong>Methods: </strong>This research constitutes a retrospective cohort investigation, encompassing a period from January 2022 to December 2023, and focusing on women in labor who experienced childbirth at our medical facility. The study meticulously assessed and compared the characteristics and clinical outcomes of those who adopted the lateral recumbent position with those who utilized the kneeling prone position during the process of natural childbirth.</p><p><strong>Results: </strong>A total of 168 women in labor were included, 86 women in labor underwent lateral recumbent position and 82 women in labor underwent kneeling prone position for natural childbirth. There were no statistical differences in first, second, third and total stage of labor between lateral recumbent position group and kneeling prone position group were found (all P > 0.05). Visual Analogue Scale (VAS) and Self-Rating Anxiety Scale (SAS) score after labor in lateral recumbent position group were statistically lower than that of kneeling prone position group(all P < 0.05). The lateral recumbent position reduced the likelihood of episiotomy and perineal edema, the severity of perineal lacerations compared with kneeling prone position for natural childbirth (all P < 0.05).</p><p><strong>Conclusion: </strong>Lateral recumbent position in natural childbirth offers the advantage of reducing perineal trauma, alleviating maternal pain and anxiety, and may be therefore deemed worthy of utilization in clinical maternal care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"394"},"PeriodicalIF":2.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778926","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}