BMC Pregnancy and Childbirth最新文献

{"title":"Development and validation of a spontaneous preterm birth risk prediction algorithm based on maternal bioinformatics: A single-center retrospective study.","authors":"Yu Chen, Xinyan Shi, Zhiyi Wang, Lin Zhang","doi":"10.1186/s12884-024-06933-x","DOIUrl":"10.1186/s12884-024-06933-x","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous preterm birth (sPTB) is a primary cause of adverse neonatal outcomes. The objective of this study is to analyze the factors influencing the occurrence of sPTB in pregnant women and to construct and validate a predictive model for sPTB risk based on big data from clinical and laboratory assessments during pregnancy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 3,082 pregnant women, categorizing those who delivered before 37 weeks of gestation as the sPTB group and those who delivered at or after 37 weeks as the full-term group. The performance of five machine learning models was compared using metrics such as the AUC, accuracy, sensitivity, specificity, and precision to identify the optimal predictive model. The top 10 predictive variables were selected based on their significance in disease prediction. The data were then divided into a training set (70%) and a validation set (30%) for validation. External data were also utilized to validate the model's predictive performance.</p><p><strong>Results: </strong>A total of 24 indicators with significant differences were identified. In terms of predicting the risk of preterm birth, the XGBoost algorithm demonstrated the most outstanding performance, with an AUC_ROC of 0.89 (95% CI: 0.88-0.90). The top 10 critical indicators included ALP, AFP, ALB, HCT, TC, DBP, ALT, PLT, height, and SBP, which are essential for constructing an accurate predictive model. The model exhibited stable performance on both the training and validation sets, with AUC values of 0.93 and 0.87, respectively. Furthermore, the external testing set also showed superior performance, with an AUC of 0.79.</p><p><strong>Conclusions: </strong>At the time of delivery, ALP, AFP, ALB, HCT, TC, DBP, ALT, PLT, height, and SBP are influential factors for sPTB in pregnant women. The XGBoost algorithm, constructed based on these factors, demonstrated the most outstanding performance.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"763"},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666980","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":"Surgical treatment of fallopian tubal pregnancy and interstitial pregnancy has no differential effect on intrauterine pregnancy after in vitro fertilization-embryo transfer.","authors":"Mingxiang Zheng, Yangqin Peng, Pei Cai, Qingwen He, Gong Fei, Chen Hui, Yuyao Mao, Xihong Li, Yan Ouyang","doi":"10.1186/s12884-024-06943-9","DOIUrl":"10.1186/s12884-024-06943-9","url":null,"abstract":"<p><strong>Background: </strong>Due to the specific nature of interstitial pregnancy (IP), there are significant risks to both the mother and the foetus in women with a heterotopic interstitial pregnancy (HIP). IP alone has been analysed as a site-specific ectopic pregnancy (EP) in previous studies; however, according to the latest European Society of Human Reproduction and Embryology criteria, IP is classified as a tubal pregnancy. If IP can be classified as a tubal pregnancy, then there is no difference in the effects of these two methods on intrauterine pregnancies (IUPs). Under the premise of timely surgery, disposing of IPs and tubal pregnancy (excluding IPs) should also have no differential effect on IUPs.</p><p><strong>Methods: </strong>Patients with heterotopic fallopian tubal pregnancy (HP-tube) and HIP seen at our hospital from January 2005 to December 2020 were included. All included patients were diagnosed by transvaginal sonography (TVS), and EPs were confirmed by surgery and pathological analysis. The IUP outcomes after surgical treatment of the EPs were compared between the HP-tube group (n = 464) and the HIP group (n = 206). The outcomes of IUPs were evaluated in patients with HIP who underwent either laparoscopy (169 cases) or laparotomy (36 cases).</p><p><strong>Results: </strong>There was no significant difference in postoperative miscarriage (6.90% vs. 6.80%, odds ratio (OR) = 1.859, 95% confidence interval (CI) (0.807-4.279), p = 0.145); early spontaneous miscarriage (19.61% vs. 18.93%, OR = 0.788, 95% CI (0.495-1.255), p = 0.316); or late miscarriage (0.43% vs. 0.49%, OR = 0.823, 95% CI (0.070-9.661), p = 0.877) between the HP-tube group and the HIP group. There was no significant difference between the two groups in terms of preterm birth (7.33% vs. 6.80%, OR = 1.044, 95% CI (0.509-2.139), p = 0.907), live birth rate (71.60% vs. 73.30%, OR = 1.010, 95% CI (0.670-1.530), p = 0.980), or perinatal mortality rate (2.00% vs. 0.65%, OR = 0.580, 95% CI (0.030-3.590), p = 0.620). Compared to laparotomy for HIPs, laparoscopic treatment was associated with similar rates of postoperative miscarriage (5.33% vs. 13.90%, p = 0.076), live birth rate (72.80% vs. 75.00%, p = 0.948), caesarean Sect. (83.90% vs. 77.80%, p = 0.414).</p><p><strong>Conclusions: </strong>After early diagnosis and treatment of EPs, patients in the HP-tube and HIP groups achieved comparable outcomes. Laparotomy and laparoscopy for treating HIPs yielded similar pregnancy outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"762"},"PeriodicalIF":2.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666989","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":"Mothers prefer a hybrid model of postpartum care: a pilot mixed method study.","authors":"Aminath Shiwaza Moosa, Zhimin Poon, Lindy Ai Keng Koh, Dhana Letchimy Kagradaimdoo, Yaesol Park, Yuhan Yang, Suliha Bivi, Ding Xuan Ng, Eileen Koh Yi Ling, Ngiap Chuan Tan","doi":"10.1186/s12884-024-06963-5","DOIUrl":"10.1186/s12884-024-06963-5","url":null,"abstract":"<p><strong>Background: </strong>Telehealth, including video consultation (VC), has become prevalent during the COVID-19 pandemic. However, the experience and concern of women using VC for postpartum care has yet to be adequately studied but is crucial for their adoption. The study aimed to assess the experience and attitude of postpartum mothers (PPM) towards using VC as a novel model of care delivery and the factors that could potentially affect their adoption.</p><p><strong>Method: </strong>Data were gathered from PPM participating in VC using Zoom platform for postpartum care using mixed method. In-depth interviews (IDI) of twenty-five PPM were audio-recorded, transcribed verbatim and audited for accuracy. Thematic analysis was conducted to identify themes relating to perceived threat, usefulness, ease of use, and attitudes toward using VC in postpartum care. The themes are reported based on the \"Health Information Technology Acceptance Model\" framework. Preliminary quantitative data on the acceptability of VC were collected using structured surveys.</p><p><strong>Results: </strong>PPMs valued convenience, accessibility, and personalised care VC offered to address their immediate postpartum concerns. They perceived VC as suitable for seeking medical opinions, improving confidence in parent crafting, and providing better care access. They recognised the lack of physical examination as a major limitation in VC and proposed a hybrid postpartum care model, combining VC and in-person consultation to cater to individual needs and preferences. PPMs alluded to trust in the care providers, flexibility in VC appointment timings and enhanced interface of remote platforms as enablers for VC adoption. Preliminary quantitative data shows that PPMs found VC saved time (100%), energy (98%), and money (90%) and was appropriate (94%), easy to use (96%), acceptable (96%) for postpartum care.</p><p><strong>Conclusion: </strong>PPMs favoured combining VC and in-person consultation to mitigate their concerns and personalise their care needs.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"757"},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643659","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 of a habit-based intervention to support healthy eating and physical activity behaviours for pregnant women with overweight or obesity: Healthy Habits in Pregnancy and Beyond (HHIPBe).","authors":"Julia McClelland, Dunla Gallagher, Sarah E Moore, Caroline McGirr, Rebecca J Beeken, Helen Croker, Kelly-Ann Eastwood, Roisin F O'Neill, Jayne V Woodside, Laura McGowan, Michelle C McKinley","doi":"10.1186/s12884-024-06945-7","DOIUrl":"10.1186/s12884-024-06945-7","url":null,"abstract":"<p><strong>Background: </strong>The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG.</p><p><strong>Methods: </strong>A previous habit-based intervention 'Ten Top Tips for a Healthy Weight' (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council's (MRC) complex intervention development guidelines. It involved three key activities: (1) identifying the evidence base; (2) identifying appropriate theory; and, (3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI).</p><p><strong>Results: </strong>The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations.</p><p><strong>Conclusion: </strong>Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the adaption of 10TT habit-based weight management intervention into the 'Healthy Habits in Pregnancy and Beyond' (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial.</p><p><strong>Trial registration: </strong>This study was registered on Clinical Trials as 'Healthy Habits in Pregnancy and Beyond (HHIPBe)' ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"760"},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643642","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":"Application of artificial intelligence in VSD prenatal diagnosis from fetal heart ultrasound images.","authors":"Furong Li, Ping Li, Zhonghua Liu, Shunlan Liu, Pan Zeng, Haisheng Song, Peizhong Liu, Guorong Lyu","doi":"10.1186/s12884-024-06916-y","DOIUrl":"10.1186/s12884-024-06916-y","url":null,"abstract":"<p><strong>Background: </strong>Developing a combined artificial intelligence (AI) and ultrasound imaging to provide an accurate, objective, and efficient adjunctive diagnostic approach for fetal heart ventricular septal defects (VSD).</p><p><strong>Methods: </strong>1,451 fetal heart ultrasound images from 500 pregnant women were comprehensively analyzed between January 2016 and June 2022. The fetal heart region was manually labeled and the presence of VSD was discriminated by experts. The principle of five-fold cross-validation was followed in the training set to develop the AI model to assist in the diagnosis of VSD. The model was evaluated in the test set using metrics such as mAP@0.5, precision, recall, and F1 score. The diagnostic accuracy and inference time were also compared with junior doctors, intermediate doctors, and senior doctors.</p><p><strong>Results: </strong>The mAP@0.5, precision, recall, and F1 scores for the AI model diagnosis of VSD were 0.926, 0.879, 0.873, and 0.88, respectively. The accuracy of junior doctors and intermediate doctors improved by 6.7% and 2.8%, respectively, with the assistance of this system.</p><p><strong>Conclusions: </strong>This study reports an AI-assisted diagnostic method for VSD that has a high agreement with manual recognition. It also has a low number of parameters and computational complexity, which can also improve the diagnostic accuracy and speed of some physicians for VSD.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"758"},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643641","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":"Hemoglobin concentrations in early pregnancy and their associations with adverse pregnancy outcomes in Western China: a population-based study.","authors":"Li Tang, Yingjuan Luo, Yongcheng Sheng, Ting Lai, Wei Song, Xiao Yang, Liu Yang","doi":"10.1186/s12884-024-06968-0","DOIUrl":"10.1186/s12884-024-06968-0","url":null,"abstract":"<p><strong>Background: </strong>Despite the global standardization of hemoglobin (Hb) testing in early pregnancy, the impact of first trimester Hb concentrations on pregnancy outcomes remains inadequately understood. Also, the early pregnancy Hb concentrations have not been well documented in Western China. Therefore, this study aimed to assess the Hb concentrations during early pregnancy and their associations with adverse pregnancy outcomes in Western China.</p><p><strong>Methods: </strong>This cross-sectional study used data from the Chengdu Maternal and Child Health Information System for pregnant women who delivered between January 1, 2019, and December 31, 2023. A total of 454,815 Chinese females aged 15 to 49 years with available first trimester Hb data, including those with singleton or multiple gestations, were included in the analysis. Multivariable logistic regression models were performed to estimate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between Hb categories and adverse pregnancy outcomes.</p><p><strong>Results: </strong>The average first trimester Hb concentration was 126.0 (SD 10.5) g/L, with 5.8% of pregnant women experiencing anemia during early pregnancy. Multivariable logistic regression analyses revealed significantly increased odds of developing gestational diabetes mellitus (GDM) and gestational hypertensive disorders (GHD) across increasing Hb concentration categories. Compared to Hb concentrations of 110-119 g/L, Hb ≥ 140 g/L was associated with elevated risk of GDM (aOR: 1.57, 95% CI: 1.52, 1.62) and GHD (aOR: 1.87, 95% CI: 1.79, 1.96). Moreover, both Hb ≤ 99 g/L (aOR: 1.15, 95% CI: 1.03, 1.29) and Hb ≥ 140 g/L (aOR: 1.20, 95% CI: 1.13, 1.26) were associated with higher odds of preterm birth compared to Hb concentrations of 110-119 g/L. In addition, the restricted cubic spline demonstrated a U-shaped relationship for cesarean delivery, low birthweight and small for gestational age (p < 0.001). However, no significant associations were found between first trimester Hb concentrations and the odds of stillbirth, Apgar score < 7 at 5 min, or Apgar score < 7 at 10 min (p > 0.05).</p><p><strong>Conclusions: </strong>Our research findings suggest associations between first trimester Hb concentrations and various adverse pregnancy outcomes. We recommend interventions for early pregnancy anemia, particularly moderate to severe cases, and emphasize monitoring females with high Hb concentrations to reduce adverse outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"761"},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643655","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":"Intimate Partner Violence during the Index Pregnancy and its correlates among a panel of pregnant women in Ethiopia, evidence from performance, and monitoring for action (PMA) 2021 cohort two baseline survey.","authors":"Solomon Abrha Damtew, Solomon Shiferaw, Assefa Seme, Bezawork Ayele Kassa, Fitsum Tariku Fantaye, Addisalem Zebene Armdie, Seifu Yinneda Berhe, Desalegn Getachew Nerisho, Ayanaw Amogne, Mahari Yihdego Gidey, Niguse Tadele Atnafu","doi":"10.1186/s12884-024-06947-5","DOIUrl":"10.1186/s12884-024-06947-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Current intimate partner violence (IPV) in Ethiopia is considerably high. This study aimed at determining the prevalence of IPV among a panel of pregnant women during their index pregnancy and identify its correlates using Performance Monitoring for action (PMA) cohort 2 baseline data. Documenting the magnitude of IPV thus far during the index pregnancy and identifying factors affecting it contributes its share for the ministry and relevant developmental partners in tracking progress towards eliminating all forms of violence against women and girls by 2030.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a further analysis of national level follow up secondary data sets from Performance Monitoring for action Ethiopian (E_PMA). This study used PMA cohort two baseline data which enrolled pregnant and recently postpartum women and collected real time data on various sexual, reproductive, maternal and new born nationwide priority indicators using customized Open Data Kit Mobile application. These data were collected using standard pretested questionnaire prepared in three local languages (Amharic, Afan Oromo and Tigrigna) by well experienced resident enumerators. This study was restricted to 1,796 pregnant women at the enrollment. Frequency was computed to describe the study participant's characteristics, and chi-square statistics was used to assess cell sample size adequacy. Multilevel binary logistics regression model building process was employed to identify correlates of IPV. Results were presented in the form percentages and odds ratio with 95% Confidence Intervals. Candidate variables were selected using p-value of 0.25. Statistical significance was declared at p-value of 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One in six; 16.7% (14.81%, 18.76%) pregnant women have reported experiencing at least one form of physical and/or sexual IPV thus far in their index pregnancy. The prevalence of encountering at least one form of sexual violence was 12.53% (10.91%, 14.35%) while 7% (5.5%, 8.3%) of them experienced at least one form physical intimate partner violence thus far during their index pregnancy. Women perceived risk about contraceptive use ((AOR: 95% CI: 1.66 (1.10, 2.47)), higher birth order ((AOR: 95% CI: 1.88 (1.05, 3.34)), unhappy emotional fertility intention when learned their index pregnancy ((AOR: 95% CI: 1.7 (1.02, 2.84)) and a family size of 4 to 5 ((AOR: 95% CI: 1.87 (1.11. 3.14)) were the fixed effects factors found to increase the odds of IPV significantly and positively. On the contrary, being in the third trimester of gestation at enrollment was another fixed effect variable which contributed for the 44% lower odds ((AOR: 95% CI: 0.56 (0.34, 0.92)) of experiencing IPV thus far in their index pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The overall burden of IPV reported was high; with nearly double the percentage of women experiencing sexual violence during the index pregnancy compared to physical IPV","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"759"},"PeriodicalIF":2.8,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643657","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":"Exploring genetic associations between immune cells and hypertensive disorder of pregnancy using Mendelian randomization.","authors":"Jingting Liu, Yijun Dong, Yawei Zhou, Wendi Wang, Yan Li, Jianying Pei","doi":"10.1186/s12884-024-06950-w","DOIUrl":"10.1186/s12884-024-06950-w","url":null,"abstract":"<p><strong>Background: </strong>Observational epidemiological studies suggested that immunological dysregulation and inflammation play a significant role in the placental and renal dysfunction that leads to maternal hypertension. The immunophenotypes' possible causalities with hypertensive disease of pregnancy remain ambiguous. We performed two-sample Mendelian randomization (MR) analyses to comprehensively investigate the causal effect of immunophenotypes on hypertensive disorder of pregnancy (HDP).</p><p><strong>Methods: </strong>The large-scale genome-wide association studies (GWASs) data on immunological traits was taken from public catalog for 731 immunophenotypes. The summarized GWAS data in 4 types of HDP were retrieved from FinnGen database, including 811,605 Finnish individuals. The primary analysis was the inverse variance weighted (IVW) method, supplemented by conducting sensitivity analysis. To confirm whether cardiovascular proteins mediated the causal effect of immune cells on HDP, we additionally executed a mediation MR study.</p><p><strong>Results: </strong>After looking into genetically predicted immunophenotype biomarkers, we discovered 14 highly correlative immunophenotypes and 104 suggestive possible factors. The IVW analysis indicated that HLA DR on myeloid DC, HLA DR on plasmacytoid DC, and HLA DR on DC had a significant association with pre-eclampsia/eclampsia (PE), whereas CD4⁺ CD8^dim AC and CD4⁺ CD8^dim % leukocyte were protective against gestational hypertension (GH). All of HDP in our study had no statistically significant impact on immune cells, according to reverse MR analysis. The mediating role of LOX-1between HLA DR on plasmacytoid DC and chronic hypertension prior to pregnancy was validated.</p><p><strong>Conclusion: </strong>This study showed that many immunophenotypes are implicated in HDP. Furthermore, the level of LOX-1 mediated the pathophysiology relationship between HLA DR on plasmacytoid dendritic cells and chronic hypertension prior to pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"756"},"PeriodicalIF":2.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643653","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":"Heterotopic pregnancy and amniotic embolism: a case report.","authors":"Gabriella Soecki, Elisa Carolina Hlatchuk, Caroline Thereza Raymundo, Ana Carolina Sater Andrade, Marcela Clarissa Padeski Ferreira, Ana Paula Percicote, Denis José Nascimento, Narcizo Leopoldo Eduardo da Cunha Sobieray","doi":"10.1186/s12884-024-06969-z","DOIUrl":"10.1186/s12884-024-06969-z","url":null,"abstract":"<p><strong>Background: </strong>Heterotopic pregnancy and amniotic embolism are rare conditions that can be challenging to diagnose. To date, there are no cases of heterotopic pregnancy associated with amniotic embolism described in the literature. Therefore, we report the case of a pancreatic heterotopic pregnancy, which led to amniotic embolism and an unfavorable maternal outcome.</p><p><strong>Case presentation: </strong>A 20-year-old pregnant woman presented with nausea and abdominal pain refractory to drug treatment. She had an increased lipase of 205 U/L (reference 8 to 78 U/L) and a total abdominal ultrasound with biliary sludge. The pregnant woman had no known risk factors for ectopic and heterotopic pregnancy. The initial diagnostic suspicions were hyperemesis gravidarum or acute pancreatitis. During hospitalization, she fluctuated between periods of clinical improvement and worsening of abdominal pain, but serial laboratory control had a favorable and benign evolution. On the 30th day of hospitalization, the patient developed spontaneous abortion, respiratory failure, and cardiorespiratory arrest. Necropsy showed heterotopic pregnancy in the pancreatic tail, amniotic embolism, and consequent disseminated intravascular coagulation.</p><p><strong>Conclusion: </strong>Obstetricians should suspect heterotopic pregnancy in patients with an acute abdomen. The gold standard diagnostic method for this condition is laparoscopy. In the present case, the authors consider that pancreatic pregnancy allowed the introduction of fetal antigens and amniotic fluid into the maternal bloodstream, leading to amniotic embolism and consequent disseminated intravascular coagulation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"752"},"PeriodicalIF":2.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614130","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":"Prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis.","authors":"Theodora Dedo Azu, Susanna Aba Abraham, Patience Fakornam Doe, Mustapha Amoadu, Gifty Owusu","doi":"10.1186/s12884-024-06967-1","DOIUrl":"10.1186/s12884-024-06967-1","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 1750 postnatal mothers who had spontaneous vaginal using a questionnaire. Descriptive statistics were conducted to show the rate of episiotomy. Chi-square and binary logistic regression analyses were conducted using Jamovi software version 2.5.3.</p><p><strong>Results: </strong>The prevalence of episiotomy among the study population was 49.7% compared to the 10% of all deliveries recommended by World Health Organisation (WHO). Among those who had an episiotomy, 88.5% gave consent, and 77.6% required repairs. In the bivariate analysis educational status, age, perineal tearing, marital status, household monthly income, spontaneous vaginal deliveries and previous episiotomy had a significant association with episiotomy risk. In the multivariate analysis, married women, lower education levels, moderate household incomes, grand multiparous women, spontaneous vaginal delivery (SVD), instrumental deliveries, longer second stages of labour, and attending more antenatal care (ANC) sessions were all associated with a reduced likelihood of episiotomy. Higher one-minute Apgar scores and anemia also lowered the odds. Conversely, hypertensives, women with four or more previous vaginal deliveries, and those with a history of episiotomy were more likely to undergo the procedure.</p><p><strong>Conclusion: </strong>Episiotomies conducted was high, indicating potential overuse compared to WHO's recommendations. Antenatal attendance and timing should be prioritised to improve maternal preparation and outcomes. Policy interventions to reduce unnecessary episiotomies are needed. Midwifery education must also emphasise the importance of respectful maternity care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"750"},"PeriodicalIF":2.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614077","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}