BMC Pregnancy and Childbirth最新文献

{"title":"Racial/ethnic disparities in the association of maternal diabetes and obesity with risk of preterm birth among 17 million mother-infant pairs in the United States: a population-based cohort study.","authors":"Juan Xie, Yuxiang Yan, Ziyi Ye, Yuxiao Wu, Yongfu Yu, Yangbo Sun, Shuang Rong, Donna A Santillan, Kelli Ryckman, Linda G Snetselaar, Buyun Liu, Wei Bao","doi":"10.1186/s12884-025-07352-2","DOIUrl":"10.1186/s12884-025-07352-2","url":null,"abstract":"<p><strong>Background: </strong>The racial/ethnic disparities in the prevalence of obesity, diabetes, and adverse birth outcomes such as preterm delivery indicate that it is essential to account for the varying risks associated with pregnant women of different races and ethnics during clinical prenatal examinations. However, the racial and ethnic disparities in how pre-pregnancy diabetes in mothers relates to preterm birth as well as the combined association of maternal diabetes and pre-pregnancy obesity with preterm birth remain unclear. In this study, we aimed to 1) examine the racial/ethnic disparities in the association of maternal diabetes including gestational diabetes mellitus (GDM) and pre-pregnancy diabetes with preterm birth 2) and the racial/ethnic disparities in the joint associations of maternal diabetes and pre-pregnancy obesity with preterm birth.</p><p><strong>Methods: </strong>In this population-based cohort study, we included 17,027,792 mothers documented in the National Vital Statistic System in the U.S. from 2016 to 2020. All these data were analyzed in 2021. Maternal pre-pregnancy diabetes was defined as having diabetes diagnosed prior to this pregnancy, and GDM was defined as having newly diagnosed diabetes in this pregnancy. Pre-pregnancy BMI (kg/m<sup>2</sup>) was classified as underweight (< 18.5 kg/ m<sup>2</sup>), normal weight (18.5-24.9 kg/m<sup>2</sup>), overweight (25.0-29.9 kg/m<sup>2</sup>), obesity class I (30.0-34.9 kg/m<sup>2</sup>), obesity class II (35.0-39.9 kg/m<sup>2</sup>), and obesity class III (≥ 40 kg/m<sup>2</sup>). Preterm birth, defined as delivery occurring at less than 37 weeks of gestation, was the main outcome of interest. We further categorized preterm birth into three subtypes: extremely (< 28 weeks), very (28-31 weeks), and moderately (32-36 weeks) preterm birth. Logistic regression models were used for association analyses in this study.</p><p><strong>Results: </strong>Among 17,027,792 mothers (mean age: 29.4 ± 5.4 years), 1,374,286 (8.07%) mothers delivered a preterm infant. Women with pre-pregnancy diabetes had the highest risk of preterm birth followed by women with GDM overall and across all racial/ ethnic groups. However, from pre-pregnancy underweight to obesity III, the magnitude of the association between pre-pregnancy diabetes and preterm birth decreased for non-Hispanic Black women (underweight, 4.47 [3.34-5.99], normal weight 4.28 [3.98-4.60], overweight 3.29 [3.11-3.49], obesity I 3.09 [2.93-3.26], obesity II 2.98 [2.82-3.16], obesity III 3.19 [3.04-3.35]), while it showed an increasing trend for non-Hispanic Asians ( underweight 1.45 [0.91-2.30], normal weight 2.16 [1.90-2.47], overweight 2.71 [2.47-2.97], obesity I 3.10 [2.82-3.41], obesity II 3.58 [3.13-4.09], obesity III 3.99 [3.34-4.77]). The corresponding OR was (underweight 4.33 [3.21-5.83], normal weight 3.69 [3.47-3.93], overweight 3.26 [3.10-3.42], obesity I 3.33 [3.19-3.49], obesity II 3.47 [3.29-3.65], obesity III 3.8","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"333"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676667","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":"Lethal acantholytic epidermolysis bullosa- a report on the prenatal phenotype of two cases and a review of antenatal sonographic signs of congenital denuding skin diseases.","authors":"Maya Lehavi, Hagit Daum, Nuphar Hacohen, Michal Gur, Jonathan Rips, Somaya Salah, Noa Ofek-Shlomai, Shay Porat","doi":"10.1186/s12884-025-07380-y","DOIUrl":"10.1186/s12884-025-07380-y","url":null,"abstract":"<p><strong>Background: </strong>The DSP gene encodes the desmosomal protein desmoplakin and is located on chromosome 6. Pathogenic variants in this gene have been linked to different phenotypes that may include the skin, hair, nails, teeth, and the heart. Lethal acantholytic epidermolysis bullosa (LAEB, OMIM # 609638) is a severe and lethal form of epidermolysis bullosa, caused by biallelic pathogenic variants in the DSP gene.</p><p><strong>Case presentation: </strong>This report describes two fetuses from the same family, both affected by LAEB. The parents were second degree cousins. Both fetuses showed multiple sonographic abnormalities antenatally. The first fetus had a lemon shaped skull, an abnormal profile with frontal bossing, flat nasal bridge, nasal hypoplasia and micrognathia. There was increased pericardial fluid, situs ambiguous (left stomach with dextrocardia) and hypoplastic aortic arch. The kidneys were suspected as dysplastic and indeed there was also oligohydramnios. Echogenic sediment was noted in the fetal stomach. The fetus was small for gestational age (SGA) with an estimated fetal weight (EFW) under the 3rd percentile. The second fetus exhibited a novel sonographic sign - constantly open eyelids. Additional notable sonographic signs were echogenic amniotic fluid, and an abnormal profile comprising of flat nasal bridge, hypoplastic nose and micrognathia. Furthermore, hypospadias was suspected as well as abnormal scrotum. The scan revealed echogenic sediment in stomach and SGA fetus with EFW under 3rd percentile similarly to the previous pregnancy. After delivery severe extensive skin and mucosal erosion and sloughing were evident and the neonate succumbed at day 2 of life. Extensive genetic workup diagnosed LAEB in both children.</p><p><strong>Discussion and conclusions: </strong>This is the first report to describe the antenatal sonographic phenotype of LAEB. We discuss the diverse phenotypes of DSP gene pathogenic variants and review the specific biochemical and sonographic findings in the context of congenital skin denudation diseases.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"327"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668918","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":"Anemia in pregnant women: findings from Kuwait birth cohort study.","authors":"Abdullah Al-Taiar, Ali H Ziyab, Majeda S Hammoud, Reem Al-Sabah, Saeed Akhtar","doi":"10.1186/s12884-025-07439-w","DOIUrl":"10.1186/s12884-025-07439-w","url":null,"abstract":"<p><strong>Background: </strong>Anemia is the most common hematologic disorder in pregnancy, affecting over one-third of pregnant women globally. This study aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait Birth Cohort study.</p><p><strong>Methods: </strong>The Kuwait birth cohort (n = 1,108) was a prospective study in which pregnant women were recruited during their second or third trimester. Data were collected through personal interviews during antenatal care visits, including data on sociodemographic and lifestyle factors. Blood samples were analyzed under strict quality control to measure various laboratory indicators. Anemia was defined as hemoglobin (Hb) < 110 g/L. Predictors of anemia were categorized as underlying or direct factors, and logistic regression models were used to investigate their association with anemia.</p><p><strong>Results: </strong>The prevalence of anemia was 28.16% (95% CI:25.53-30.91%), with 8.75% of women experiencing moderate anemia and 19.40% mild anemia. No cases of severe anemia were observed. Multivariable analysis identified current iron supplement use, (Adjusted Odds Ratio [AOR] 0.52, 95%CI:0.28-0.99; p = 0.049), vitamin D status (sufficient vs. insufficient/deficient), (AOR 0.63, 95%CI:0.43-0.92; p = 0.018), iron levels (p < 0.001), and ferritin levels (p < 0.001) as factors significantly associated with anemia.</p><p><strong>Conclusion: </strong>Anemia in pregnant women in Kuwait represents a mild to moderate public health concern, primarily driven by iron deficiency. The estimated prevalence of anemia is influenced by the Hb threshold used to define anemia, a topic currently subject to vigorous debate. Our findings suggest that improved screening for iron deficiency during pregnancy may further reduce anemia in pregnant women in Kuwait.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"326"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668947","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":"Iodine nutritional status in different trimesters of pregnancy and its association with dietary habits: a prospective observational study in Taiwan.","authors":"Li-Hsin Pan, Chang-Ching Yeh, Shun-Jie Yang, Chen-Chang Yang, Chii-Min Hwu, Harn-Shen Chen, Fan-Fen Wang, Chun-Jui Huang","doi":"10.1186/s12884-025-07445-y","DOIUrl":"10.1186/s12884-025-07445-y","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women are susceptible to iodine deficiency. Most iodine nutritional studies in pregnant women have involved cross-sectional evaluations of iodine status. This prospective observational study was designed to longitudinally follow the iodine status of pregnant women in different trimesters of pregnancy and to assess the demographic characteristics and dietary influences on iodine status.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at Taipei Veterans General Hospital from March 2019 to July 2022. A total of 211 women were enrolled and each subject was asked to provide a spot urine sample at each trimester. Urinary iodine concentration (UIC) was measured using inductively coupled plasma-mass spectrometry. Dietary habit was assessed via food frequency questionnaires (FFQs) at each trimester.</p><p><strong>Results: </strong>The median UICs for the first, second and third trimesters were 156.3 µg/L (interquartile range [IQR]: 100.7-241.1), 146.2 µg/L (84.6-224.4), and 169.9 µg/L (94.4-283.5), respectively. Compared to the first trimester, participants consumed seaweed (p = 0.004 and p < 0.001, respectively), fish (p < 0.001 for both), and prenatal multivitamins (p < 0.001 for both) more frequently during the second and third trimesters. Additionally, an increasing number of women raised their intake of dairy products as their pregnancies progressed. Multivariate analysis indicated a positive association between nulliparity and UIC < 150 µg/L (adjusted odds ratio [OR]: 2.258, 95% confidence interval [CI]: 1.167-4.367, p = 0.02). Additionally, less prenatal iodine-containing multivitamin intake increased the odds of UIC < 150 µg/L across all trimesters (adjusted OR: 2.562, 95% CI: 1.234-5.319; p = 0.01 for the first trimester; adjusted OR: 2.264, 95% CI: 1.167-4.395; p = 0.02 for the second trimester; and adjusted OR: 2.022, 95% CI: 1.031-3.967; p = 0.04 for the third trimester).</p><p><strong>Conclusions: </strong>Mild iodine deficiency was observed in the second trimester despite adequate iodine status in the first and third trimesters. Nulliparous women and those not ingesting iodine-containing multivitamins are at greater risk of iodine deficiency, highlighting the need for targeted dietary education and interventions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668977","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":"A machine learning model based on placental magnetic resonance imaging and clinical factors to predict fetal growth restriction.","authors":"Jida Wang, Zhuying Chen, Hongxi Zhang, Weikang Li, Kui Li, Meixiang Deng, Yu Zou","doi":"10.1186/s12884-025-07450-1","DOIUrl":"10.1186/s12884-025-07450-1","url":null,"abstract":"<p><strong>Objectives: </strong>To create a placental radiomics-clinical machine learning model to predict FGR.</p><p><strong>Materials and methods: </strong>Retrospectively analyzed placental MRI and clinical data of 110 FGR cases and 158 healthy controls at 28-37 weeks of gestation from two campuses of ZWH. 227 cases from Hubin campus were randomly divided into training (n = 182) and internal testing set (n = 45). 41 cases from Xiaoshan campus were included in external testing set. Placental MRI features were extracted from sagittal T2WI. Mann-Whitney U test, redundancy analysis, and LASSO were used to identify the radiomics signature, and the best-performing radiomics model was constructed by comparing eight machine learning algorithms. Clinical factors determined by univariate and multivariate analyses. A united model and nomogram combining the radiomics Rad-score and clinical factors were established. The performance of the models was assessed by DeLong test, calibration curve and decision curve analysis.</p><p><strong>Results: </strong>Of 1561 radiomics features, 10 strongly correlated with FGR were selected. The radiomics model using logistic regression performed best compared eight algorithms. 5 important clinical features identified by analysis. The united model demonstrated a good predictive performance in the training, internal testing and external testing sets, with AUC 0.941 (95% CI, 0.0.904-0.977), 0.899 (95% CI, 0.789-1) and 0.861 (95% CI 0.725-0.998), prediction accuracies 0.885, 0.844 and 0.805, precisions 0.871, 0.789 and 0.867, recalls 0.836, 0.833 and 0.684, and F1 scores 0.853, 0.811 and 0.765, respectively. The calibration and decision curves of the united model also showed good performance. Nomogram confirmed clinical applicability of the model.</p><p><strong>Conclusions: </strong>The proposed placental radiomics-clinical machine learning model is simple yet effective to predict FGR.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"325"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668932","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 correlation between serum fructose levels and pregnancy outcomes in IVF patients with and without PCOS: a case-control study.","authors":"Bowen Zhang, Yunfei Li, Yuxuan Li, Jiahui Song, Yuanyuan Fang, Zhijing Na, Da Li","doi":"10.1186/s12884-025-07415-4","DOIUrl":"10.1186/s12884-025-07415-4","url":null,"abstract":"<p><strong>Background: </strong>Excessive fructose intake can impact pregnancy health. Additionally, Polycystic ovary syndrome (PCOS) is associated with both elevated fructose levels and adverse pregnancy outcomes. Therefore, it is significant to investigate whether serum fructose levels influence pregnancy outcomes in patients with or without PCOS.</p><p><strong>Methods: </strong>This case-control study included 270 participants (PCOS, n = 135; non-PCOS, n = 135). The serum fructose levels of consecutively treated women undergoing in vitro fertilization - embryo transfer treatment at the Center of reproductive medicine in Shengjing hospital of China Medical University, from June 2020 to June 2021, were measured. Pregnancies were monitored until the ultimate outcome was determined. The antenatal, delivery, and neonatal outcomes were extracted from hospital records.</p><p><strong>Results: </strong>In patients with PCOS, those who experienced miscarriage had significantly higher serum fructose levels (P = 0.011). The incidence of miscarriage increased as the serum fructose quartiles increased in patients with PCOS (P = 0.010). There was a significant correlation between serum fructose levels and miscarriage (r = 0.258, P = 0.002). The results of multivariate logistic regression analysis remain consistent (odd ratio [OR] = 10.138, P = 0.005). Conversely, in women without PCOS, those who prematurely delivered had significantly higher serum fructose levels (P = 0.001). The incidence of preterm delivery increased as the serum fructose quartiles increased in patients without PCOS (P < 0.001). There was a significant correlation between serum fructose levels and preterm delivery (r = 0.311, P < 0.001) in non-PCOS group. The multivariate logistic regression analysis indicated the identical results (OR = 18.359, P = 0.008). The area under the curve for fructose-mediated prediction of miscarriage in PCOS was 0.686, while for prediction of preterm birth in non-PCOS individuals, the area under the curve was 0.731.</p><p><strong>Conclusions: </strong>Serum fructose levels are positively associated with miscarriage risk in patients with PCOS. Within the non-PCOS cohort, fructose levels are linked to preterm birth. Further investigation is warranted to comprehensively elucidate the underlying mechanisms, thus enhancing our profound understanding.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"324"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668992","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":"Investigating the association of albuminuria with the incidence of preeclampsia and its predictive capabilities: a systematic review and meta-analysis.","authors":"Pegah Rashidian, Mohammadamin Parsaei, Sedigheh Hantoushzadeh, Bahram Salmanian","doi":"10.1186/s12884-025-07444-z","DOIUrl":"10.1186/s12884-025-07444-z","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia (PE) is a severe hypertensive disorder affecting approximately 6.7% of pregnancies worldwide. Identifying reliable biomarkers for early prediction could significantly reduce the incidence of PE and facilitate closer monitoring and timely management. This study aims to investigate the association between albuminuria in early pregnancy and the subsequent development of PE, and to explore its predictive abilities.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Embase, and Web of Science on July 15, 2024, for studies published between January 1, 1990, and June 30, 2024. Quality assessments were performed using the Joanna Briggs Institute Critical Appraisal and Risk of Bias in Non-randomized Studies - of Exposures Checklists. Random-effects models in STATA were used to conduct meta-analyses comparing urine albumin and albumin-to-creatinine ratio levels in patients who later developed PE versus those who did not. The incidence of PE was also compared between patients with and without albuminuria in early pregnancy. The predictive ability of albuminuria for PE was assessed using META-DISC software.</p><p><strong>Results: </strong>A total of 26 studies comprising 7,640 pregnant women were systematically reviewed. Of these, 17 studies met the quality criteria for inclusion in the meta-analyses. Our findings indicate that urine albumin (Hedges's g = 0.48 [95% confidence interval (CI): 0.16-0.80]; p-value < 0.001) and albumin-to-creatinine ratio (Hedges's g = 0.48 [95% CI: 0.16-0.80]; p-value = 0.003) were significantly higher in the early stages of pregnancy in patients who later developed PE compared to those who did not. The incidence of PE was higher in patients with early-diagnosed albuminuria (log odds ratio = 2.56 [95% CI: 1.75-3.38]; p-value < 0.001). The pooled sensitivity and specificity for albuminuria in predicting PE were 56% [95% CI: 48-64%] and 87% [95% CI: 85-89%], respectively.</p><p><strong>Conclusions: </strong>Elevated maternal urine albumin and albumin-to-creatinine ratio in early pregnancy are associated with a higher risk of developing PE. While these biomarkers show promise for early identification of at-risk patients, the relatively low sensitivity suggests that albuminuria alone may not be a robust predictor of PE, which underscores the need for future research in this regard.</p><p><strong>Trial registration: </strong>Review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the code CRD42024575772.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668975","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":"Correction: Establishment and validation of a nomogram for predicting preterm birth in intrahepatic cholestasis during pregnancy: a retrospective study.","authors":"Wenchi Xie, Landie Ji, Dan Luo, Lili Ye, Qian Li, Landan Kang, Qingquan He, Jie Mei","doi":"10.1186/s12884-025-07446-x","DOIUrl":"10.1186/s12884-025-07446-x","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"328"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668950","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":"Conservative treatment of bladder flap hematoma complicated with uterine artery pseudoaneurysm after cesarean section via internal iliac artery embolization: a case report.","authors":"Jiayi Zhang, Guoliang Jiang, Yiting Lu, Chunyu Wang, Zhenguo Qiao, Juanjuan Yang","doi":"10.1186/s12884-025-07466-7","DOIUrl":"10.1186/s12884-025-07466-7","url":null,"abstract":"<p><strong>Background: </strong>Bladder flap hematoma (BFH) is a rare complication associated with cesarean section (CS). Its pathogenesis is linked to insufficient hemostasis and bleeding at the incision site, leading to the formation of a hematoma between the bladder and the lower uterine segment (LUS). To the best of the authors' knowledge, no specific protocols have been formulated to guide the treatment of BFH.</p><p><strong>Case presentation: </strong>A 29-year-old woman underwent an emergency CS due to relative cephalopelvic disproportion. Twenty-two hours after the CS, she developed pale red hematuria accompanied with a significant decrease in hemoglobin. The patient experienced two fainting episodes after standing and engaging in activity, along with vaginal bleeding. A bedside ultrasound revealed a 50 mm fluid-filled sonolucent area between the lower uterine segment (LUS) and bladder. Subsequently, the patient received conservative treatment with internal iliac artery embolization, antibiotics and blood transfusion, to avoid secondary laparotomy. The angiography and computer tomography examinations revealed the existence of uterine artery pseudoaneurysm and a large BFH. Her vital signs remained stable after the intervention and repeat ultrasonography demonstrated a significant reduction in the hematoma size.</p><p><strong>Conclusions: </strong>Selective pelvic artery embolization as a conservative treatment can be a safe and effective option for large BFH, provided the patient remains clinically stable. This interventional therapy presents an innovative, non-surgical approach to a condition that is typically treated surgically and may carry the risk of irreparable complications.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"315"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662331","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":"Increased circulating miR-155 identifies a subtype of preeclamptic patients.","authors":"Zhiyin Wang, Mingming Zheng, Honglei Duan, Yuan Wang, Yimin Dai, Huirong Tang, Ya Wang, Dan Liu, Chenrui Cao, Ning Gu, Qiao Weng, Yan Zhou, Guangfeng Zhao, Yali Hu","doi":"10.1186/s12884-025-07424-3","DOIUrl":"10.1186/s12884-025-07424-3","url":null,"abstract":"<p><strong>Introduction: </strong>Preeclampsia is a common and severe pregnancy complication. The syndrome is highly heterogeneous, making accurate classification difficult, which is not conductive to find ways to predict and prevent this syndrome. Recently, we reported that high placental miR-155 defined a new subtype of preeclampsia. Here, we aimed to examine whether high maternal sero-miR-155 could be a marker to identify this subtype.</p><p><strong>Methods: </strong>To explore whether the patients with high sero-miR-155 no matter in first and third trimester, we conducted a case-control and a longitudinal cohort study. We measured the sero-miR-155 levels at first, second and third trimesters in all pregnant women. Then, using the 95th percentile (P95) of sero-miR-155 in controls as the cut-off value, we divided the preeclamptic patients into high sero-miR-155 group (≥ P95) and normal sero-miR-155 group (< P95). We compared the difference of clinical manifestations between two groups and used t-distributed stochastic neighbor embedding (t-SNE) to evaluate whether the patients with high sero-miR-155 could be clustered as a subtype. Finally, we evaluated the predictive value of sero-miR-155 in the subtype.</p><p><strong>Results: </strong>The case-control study included 525 subjects (350 controls and 175 preeclampsia) and the longitudinal cohort study included 411 subjects (274 controls and 137 preeclampsia). Sero-miR-155 was significantly elevated in preeclampsia. Compared with preeclamptic patients with normal sero-miR-155 levels, the cases with high sero-miR-155 had significantly higher blood pressure and other severe preeclampsia-related complications. The incidences of HELLP syndrome [5.2% (5/96) vs. 0.9% (2/216), p < 0.01], visual disturbance [15.6% (15/96) vs. 4.6% (10/216), p < 0.01], hypertensive retinopathy [13.5% (13/96) vs. 3.2% (7/216), p < 0.01], and placenta abruption [7.3% (7/96) vs. 0.9% (2/216), p < 0.01] in patients with high miR-155 level were significantly increased. T-SNE analysis showed the patients with high sero-miR-155 were predominantly clustered on the left of the plot.</p><p><strong>Conclusions: </strong>The patients with high sero-miR-155 exhibited more severe clinical manifestations and sero-miR-155 could be a biomarker to identify a subtype of preeclampsia with high sero-miR-155.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662342","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}