BMC Pregnancy and Childbirth最新文献

{"title":"Effect of intermittent abdominal ice application on postoperative pain and opioid consumption after elective cesarean section: a randomized controlled study.","authors":"Seval Kılbasanlı, Osman Aydın, Bülent Çakmak","doi":"10.1186/s12884-026-09687-w","DOIUrl":"10.1186/s12884-026-09687-w","url":null,"abstract":"<p><strong>Background: </strong>Effective postoperative pain management after cesarean section is essential for maternal recovery and patient comfort. This prospective randomized controlled study aimed primarily to evaluate the effect of intermittent abdominal ice application on postoperative pain after elective cesarean section. Postoperative opioid consumption, patient satisfaction, and other recovery outcomes were evaluated as secondary outcomes.</p><p><strong>Methods: </strong>This prospective randomized controlled study included 80 patients undergoing elective cesarean delivery under spinal anesthesia between May 2022 and October 2022. Patients were randomly allocated into two groups using a computer-generated randomization sequence in a 1:1 ratio: the ice group (n = 40) and the control group (n = 40). Allocation concealment was achieved using sequentially numbered opaque sealed envelopes prepared by an investigator who was not involved in patient recruitment or postoperative assessment. In the ice group, intermittent abdominal ice application was performed during the first 12 postoperative hours with a total application duration of 2 h. Postoperative pain intensity was evaluated using the Numeric Rating Scale (NRS) at postoperative 0, 2, 6, 12, and 24 h. Secondary outcomes included rescue tramadol and morphine use, time to first rescue analgesic administration, patient satisfaction, and length of hospital stay. Additional secondary analyses included the area under the postoperative NRS-time curve, responder analysis, and effect size assessment.</p><p><strong>Results: </strong>Baseline demographic and perioperative characteristics were similar between the groups. Compared with the control group, the ice group demonstrated significantly lower median postoperative NRS scores at 2, 6, and 12 h (all p < 0.001), whereas no significant difference was observed at 24 h. Tramadol consumption [25.0 (0.0-25.0) mg vs. 50.0 (50.0-50.0) mg, p < 0.001] and morphine consumption [0.0 (0.0-0.0) mg vs. 0.0 (0.0-2.0) mg, p < 0.001] were significantly lower in the ice group. Patient satisfaction scores were significantly higher in the ice group [4.0 (3.0-4.0) vs. 3.0 (3.0-4.0), p < 0.001]. AUC analysis demonstrated a significantly lower postoperative pain burden in the ice group. Responder analysis demonstrated higher rates of acceptable postoperative pain control in patients receiving abdominal ice application.</p><p><strong>Conclusion: </strong>Intermittent abdominal ice application was associated with lower early postoperative pain scores and higher patient satisfaction after elective cesarean section. Lower postoperative opioid consumption was also observed; however, this secondary finding should be interpreted cautiously because the initial rescue tramadol dose differed between the study groups. The intervention may serve as a simple adjunct to multimodal analgesia protocols after cesarean delivery.</p><p><strong>Trial registration: </strong>ClinicalTrials.","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535173","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":"Critical ovarian hyperstimulation syndrome leading to severe malnutrition: shedding some lights on an extremely rare case report from Vietnam and narrative review.","authors":"Anh Dinh Bao Vuong, Ngoc Hai Tran, Tuan Kiet Tao, Phuc Nhon Nguyen","doi":"10.1186/s12884-026-09603-2","DOIUrl":"10.1186/s12884-026-09603-2","url":null,"abstract":"<p><strong>Background: </strong>Ovarian hyperstimulation syndrome (OHSS) is a self-limited iatrogenic complication of controlled-ovarian stimulation. The condition occurs spontaneously or secondary to exogenous gonadotropins which may cause a severe condition. Herein, we outline an extremely rare complication of a such entity leading to severe malnutrition. Additionally, the patient underwent resected surgery of ovarian hyperstimulated tissue in pregnancy.</p><p><strong>Presentation case: </strong>A 34-year-old nulliparous pregnant with a history of polyendocrine metabolic ovarian syndrome (PMOS) received an ovarian stimulation protocol at a private clinic setting. The patient was scheduled for in vitro fertilization (IVF) due to infertility during 15 months. However, on the day 4-5 of trigger, the patient was detected with co-existence of OHSS and spontaneous pregnancy. The pregnant woman was hospitalized at 25-26 weeks of gestational age (GA) for critical OHSS complicating in asthenia and malnutrition following the expectant management of OHSS at 16 weeks of GA. Ultrasound scan revealed multiple anechogenic enlarged cysts extending to the bilateral diaphragm and a great amount of intraabdominal fluid accumulation. During hospitalization, the woman was unable to feed herself, thus leading to severe loss of weight, amyotrophy, and anemia rapidly. Her condition was completely worsened. Seriously, a significant disturbance of bowel motility was noted. The electrocytes disturbance was remarkable. Serum albumin decreased gradually. Therefore, the patient underwent laparotomy to reduce the abdominal fluid and cytoreductive surgery owing to critical OHSS. After surgical intervention, the serum laboratory returned progressively to normal value and the clinical symptoms were steadily subsided. The patient was discharged and continued her pregnancy. Ultrasound showed a complete regression of the ovarian cysts; however, the fetal growth restriction (FGR) was recorded. The patient underwent a planned cesarean delivery at 36 weeks 3 days of GA due to severe FGR and fetal-pelvic disproportion. Both mother and neonate were discharged uneventfully.</p><p><strong>Conclusion: </strong>In the patient with PMOS, co-existence of OHSS and spontaneous pregnancy at the beginning of ovarian stimulation should be recognized. In general, a rapid progression of OHSS associated with adverse outcomes relating to gastro-intestinal complications are extremely scarce. FGR ought to be taken into account in a pregnancy with OHSS. Surgical intervention with a multidisciplinary management could improve materno-neonatal outcomes. Thus, this endeavor insight could be considered in critical cases with potentially life-threatening complications.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496956","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":"Factors associated with treatment decisions in pregnant women with symptomatic hydronephrosis presenting to the emergency department: a retrospective cohort study.","authors":"Esat Barut, Ramazan Gi̇den, Kemal Barut, İbrahim Halil Yasak, Cansu Doğan, Hüseyin Gürbüz","doi":"10.1186/s12884-026-09678-x","DOIUrl":"10.1186/s12884-026-09678-x","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to identify the factors associated with the clinician's decision between conservative and invasive treatment for pregnant women with symptomatic hydronephrosis who presented to the emergency department.</p><p><strong>Methods: </strong>A total of 102 pregnant patients presenting to the emergency department between 2022 and 2025 with symptoms of urinary tract infection or obstruction and diagnosed with hydronephrosis by renal ultrasonography were included in the study. Demographic and obstetric characteristics, hydronephrosis grades, laboratory findings, and treatment approaches were recorded. Statistical analyses included nonparametric tests, categorical comparisons, correlation analysis, logistic regression, Firth's penalized logistic regression, and ROC curve analysis. Multiple comparisons were adjusted using the Benjamini-Hochberg FDR method, and the model was internally validated by bootstrap resampling.</p><p><strong>Results: </strong>Grade 2 hydronephrosis was detected in 46.1% of patients, Grade 3 in 50.0%, and Grade 4 in 3.9%. Conservative treatment was administered to 68.6% of the patients, while 31.4% underwent invasive treatment. Hydronephrosis grade was the most significant factor associated with the treatment decision (AUC: 0.856), with Grade ≥ 3 as the optimal cutoff value. Gestational week showed a negative correlation with hydronephrosis grade. A significant difference was found in leukocyte counts across different grades of hydronephrosis, and a moderate-to-strong positive correlation was detected between leukocyte count and the neutrophil/lymphocyte ratio. In the Firth penalized multivariable logistic regression model, higher hydronephrosis grade (OR: 121.27) and younger age (OR: 0.84) were independently associated with the decision for invasive treatment.</p><p><strong>Conclusion: </strong>The grade of hydronephrosis is the dominant factor associated with the clinical decision for invasive intervention in pregnant patients with symptomatic hydronephrosis. While other clinical markers may appear predictive, they largely act as proxies for hydronephrosis severity. Prospective studies with standardized treatment protocols and comprehensive outcome assessment are warranted.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496990","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":"Factors associated with pharmacologic serum concentration of magnesium and corresponding obstetric outcomes among women with severe preeclampsia at Iringa regional referral hospital.","authors":"Joshua Stephen Kileo, Shubi Matovelo, Gabriel Kitinusa, Ipyana Mwampagatwa, Athanase Lilunguru, Maria Angelica Rweyemamu, Alfred M Laison, Scolastica M Malangalila, Francis R Kwetukia, John Dt Lawi","doi":"10.1186/s12884-026-09502-6","DOIUrl":"10.1186/s12884-026-09502-6","url":null,"abstract":"<p><strong>Introduction: </strong>Severe pre-eclampsia is managed by using magnesium sulphate (MgSO4) to prevent its progression to eclampsia, with a success rate of more than 50%. Blood levels of Magnesium following initiation of the MgSO4 are key in ensuring effective management of severe pre-eclampsia while preventing toxicity.</p><p><strong>Objective: </strong>This study aimed at establishing reliable data pertaining to factors influencing the pharmacologic serum concentration of magnesium and their association to obstetric outcomes.</p><p><strong>Methods: </strong>This analytical cross-sectional study was carried out at the Iringa regional referral hospital for six months from November 2023 to April 2024. Due to the limited cases and study duration, a purposeful sampling technique was used to recruit 121 women with severe pre-eclampsia. Recruited women were tested for serum magnesium at admission, 4 and 12 hours after initial administration of MgSO4. IBM SPSS version 29 was used for analysis, where continuous variables were summarized using the median and interquartile range, while categorical variables were summarized using frequency and percentages. The associations between variables were determined using chi-square tests, univariate, and multivariable logistic regression models. A p value<0.05 was considered statistically significant.</p><p><strong>Results: </strong>he proportion of women who attained none-therapeutic serum Mg at 4 hours was 38.8%, with a median of 1.9±1.02 IQR Mmol/L. Multivariable logistic regression showed that; low serum Mg at admission [p<0.001, OR= 9.17, 95% CI (3.07- 27.37)], high creatinine level [p = 0.012, OR= 4.49, 95% CI (1.38- 14.6)], overweight [p = 0.002, OR= 5.52, 95% CI (1.83- 16.68)] and proteinuria +++ [p-value = 0.004, OR= 7.13, 95% CI (1.84- 26.86)] were significantly associated with subtherapeutic level. After adjusting for other factors, it was found that subtherapeutic levels [p<0.001, OR=25.44(5.73-112.90)], elevated creatinine [p=0.040, OR=3.59(1.66-12.15)], and reduced urine output [p=0.001, OR=6.69(2.15-20.90)] were significant predictors of adverse maternal outcomes.</p><p><strong>Conclusion: </strong>A large proportion of women with severe pre-eclampsia were observed to have low serum magnesium concentration at admission prior to the administration of the loading dose of MgSO4. Subtherapeutic serum concentration of magnesium is associated with unfavorable obstetric outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496952","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":"Determining factors of birthplace choice among women in Ghana: evidence from the 2022 nationally representative data.","authors":"Issah Haruna, Abdul-Rauf Sulemana, Osei Kwame Wiredu, Baaba Amoah-Saah","doi":"10.1186/s12884-026-09683-0","DOIUrl":"10.1186/s12884-026-09683-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The availability and accessibility of high-quality maternal healthcare remain a significant challenge for health systems worldwide. Evidence demonstrates that health insurance positively influences the utilization of maternal healthcare services in Sub-Saharan Africa. But some subscribers of health insurance poorly utilize health facilities due to some persistent sociodemographic factors in Ghana. Low Facility-based delivery increases the risk of both maternal and child mortalities. Most of the recent studies conducted in Ghana have not determined the regional prevalence of Facility-based delivery and the health insurance subscription rates. This study estimated the prevalence of Facility-based delivery and assessed the associated factors that determine mothers' birthplace choice in Ghana.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The 2022 Ghana Demographic and Health Survey data were used in this cross-sectional study. Descriptive statistics for the variables were summarized using frequencies and percentages. The prevalence of facility-based delivery was determined by dividing all facility-based deliveries by total deliveries. Determinants of Facility-based delivery by women in Ghana were assessed in a multiple logistic regression model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Women with National Health Insurance were 93% more likely to have Facility-based delivery than those without National Health Insurance [AOR = 1.93, 95% CI = 1.38-2.70]. Women in rural areas were 55% less likely to have facility-based delivery [AOR = 0.45, 95% CI = 0.32-0.62]. Expectant mothers with secondary education were 91% more likely to give birth to their babies through a facility-based delivery compared to mothers with no formal education [AOR = 1.91, 95% CI = 1.45-2.52]. Women with a tertiary education had an increased odds of giving birth at health facilities compared to uneducated women [AOR = 3.44, 95% CI = 1.13-10.76] Mothers who belong to other religions (traditionalists, etc.) were 72% [AOR = 0.28, 95% CI = 0.17-0.46] less likely to be delivered in health facilities. Mothers from richer and richest families had an elevated odds of giving birth at health facilities compared to women from the poorest family [AOR = 2.95, 95% CI = 1.61-5.42] and [AOR = 2.96, 95% CI = 1.27-6.94] respectively. Mothers from the Southern zone of Ghana were less likely to give birth at health facilities [AOR = 0.50, 95% CI = 0.31-0.79] compared to those from the Northern zone. Women who go for four or more ANC visits during pregnancy were 4.63 times more likely to give birth at a health facility compared to women who do not go for ANC visits during pregnancy [AOR = 4.63, 95% CI = 2.45-8.76].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study revealed that facility-based delivery was influenced by health insurance, residence, education, religion, zone, wealth status and antenatal care visits. Health insurance should be further subsidized for rural and women from poorest familie","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148496997","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":"Applying an educational program for primigravida women regarding their health and wellbeing.","authors":"Noura Adel Sayed Hassan, Nawal Mahmoud Soliman, Mona Abo Bakr Abdellatif, Fatma Gomaa Mohamed","doi":"10.1186/s12884-026-09423-4","DOIUrl":"10.1186/s12884-026-09423-4","url":null,"abstract":"<p><strong>Background: </strong>Primigravida women's health and well-being during pregnancy are crucial as they promote healthy fetal development and birth outcomes, reduce complications for both mother and baby, and positively impact the whole family. Primigravida is a term referred to a woman who is pregnant for the first time. This study evaluated an educational program's effect on health knowledge and well-being among primigravida women.</p><p><strong>Methods: </strong>A quasi-experimental design was conducted with 95 primigravida women in Cairo. The intervention involved six weekly sessions (45-60 min) based on the Health Promotion Model. Pre- and post-tests assessed knowledge and well-being. Cohen's d was used for effect size.</p><p><strong>Results: </strong>Post-intervention, participants' high knowledge levels significantly increased from 26.3% to 74.7% (p < 0.001). Similarly, high well-being levels improved from 10.5% to 71.6% (p < 0.001). A strong positive correlation (r = 0.65, p < 0.001) was established between health-related knowledge gains and overall well-being scores following the program implementation.</p><p><strong>Conclusion: </strong>The structured educational program effectively improved maternal knowledge and well-being among primigravida women. Integrating such tailored interventions into primary healthcare services is essential for enhancing maternal outcomes and promoting a positive pregnancy experience.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468770","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 pregnant women's experiences of a digital self-care intervention for gestational diabetes mellitus in Vietnam: a qualitative study.","authors":"Ai Thi Nguyen, Ngoc-Anh Thi Dang, Thi Kim Dung Vu, Thi Minh Phuong Nguyen, Thi Thuy Hanh Nguyen, Ib C Bygbjerg, Tine M Gammeltoft","doi":"10.1186/s12884-026-09651-8","DOIUrl":"10.1186/s12884-026-09651-8","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women with gestational diabetes mellitus (GDM) face complex challenges in managing their condition, especially in low-resource settings with limited healthcare and social support. Digital health interventions show promise, but their real-world applicability in rural contexts remains underexplored.</p><p><strong>Objective: </strong>This study explores the experiences of women using an online intervention for GDM self-care in Thai Binh, Vietnam.</p><p><strong>Methods: </strong>A qualitative study was conducted between February and December 2024 involving 21 pregnant women diagnosed with GDM. Participants were enrolled in a digital self-care program and interviewed in-depth during late pregnancy (29-39 weeks of gestation). The study drew on ethnographic methods, including attention to women's contexts and the use of fieldnotes. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.</p><p><strong>Results: </strong>Participants reported improved self-management of GDM through healthier diets, increased physical activity, and regular glucose monitoring. Five main themes emerged: (1) making healthy food choices with family and peer support, (2) learning and practicing blood glucose self-monitoring with guidance, (3) engagement in physical activity encouraged by others, (4) emotional well-being supported by social relationships, and (5) challenges affecting women's acceptance of the online intervention. Professional support enhanced trust in medical advice, while the peer-support component fostered motivation, companionship, and emotional resilience. The intervention also encouraged family involvement in care.</p><p><strong>Conclusions: </strong>Online interventions that combine expert guidance with peer and family support can support women to manage the physical and mental aspects of living with GDM. This hybrid model shows promise for broader application in low- and middle-income countries. Further research is recommended to assess long-term impacts and scalability.</p><p><strong>Trial registration: </strong>NCT05744856 (Registration Date 20230215 and Last Update Posted 20240430).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468742","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":"Association between antenatal care utilization, preeclampsia, and neonatal Apgar scores among postnatal women in Eswatini: an analytical cross-sectional study.","authors":"Busi N Ngubeni, Angelina A Joho, Golden M Masika","doi":"10.1186/s12884-026-09614-z","DOIUrl":"10.1186/s12884-026-09614-z","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a hypertensive disorder that occurs during pregnancy significantly associated with maternal morbidity and mortality worldwide. It is associated with complications for both mothers and babies although 10 - 20% may be prevented through proper antenatal care (ANC) utilization. In Eswatini, despite high ANC coverage, there has been an increase in maternal and neonatal deaths with limited evidence of the associated factors. Therefore, this study examined the utilization of ANC services, prevalence, and factors associated with pre-eclampsia and low Apgar Score among Postnatal Women in Eswatini.</p><p><strong>Method: </strong>A hospital-based cross-sectional analytical study among 216 postnatal women was conducted in Eswatini between April and June 2024. Data were collected through face-to-face interviews using a validated questionnaire and by extracting data from hospital records. Multivariate logistic regression was used to determine the association between ANC service utilization, preeclampsia, Apgar score, and other factors (socio-demographic and obstetric characteristics). Results presenting a p-value < 0.05 were considered significant.</p><p><strong>Results: </strong>The mean age of participants was 26.78 ± 6.7 years. All participants had attended ANC services, and over half, 20.4% (n = 44) of the women, booked early. Only about two percent (1.9%, n = 4) of postnatal women had greater than 8 ANC service utilization. Among all women, 19.0% (n = 41) were diagnosed with preeclampsia: 16.7% (n = 36) during ANC visits and 2.3% (n = 5) during postpartum care. Among neonates, 17.3% (n = 37) had a low Apgar score. The mean Apgar score among them was 8.4 ± 1.8. Adequate ANC frequency was associated with 42% lower odds of preeclampsia (AOR: 0.58, 95% CI: 0.76, 0.90) and 71% lower odds of low Apgar score (AOR: 0.29, 95% CI: 0.09, 0.55). Gestational age was another factor associated with lower odds of both pre-eclampsia and low Apgar score (AOR: 0.05, 95% CI: 0.02,0.15) and (AOR: 0.22, 95% CI: 0.08, 0.62), respectively.</p><p><strong>Conclusion: </strong>The study highlights that adequate utilization of ANC services reduces the odds of pre-eclampsia and low Apgar scores. The findings are consistent and confirm the previous studies, but provide the first nationally relevant estimates from Eswatini, offering important insights for improving ANC quality and reducing maternal and neonatal morbidity. We recommend a community intervention in Eswatini to create awareness about the importance of ANC utilization.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468766","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":"Integrated pregnancy and perinatal management of complex fetal congenital heart disease: a preliminary retrospective study.","authors":"Xie Junshu, Yin Fufen, Yin Xiuju, Han Tiantian, Pei Qiuyan, Zhang Lin, Zhang Huili, Li Shoujun, Zhang Xiaohong","doi":"10.1186/s12884-026-09616-x","DOIUrl":"10.1186/s12884-026-09616-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Congenital heart disease (CHD) is the most prevalent congenital abnormality worldwide and is the primary contributor to neonatal mortality. Obstetricians in China continue to face uncertainties about optimal delivery timing, appropriate delivery mode, perinatal interventions, and postnatal surgical outcomes for fetuses with complex CHD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate integrated pregnancy and perinatal management strategies for fetuses diagnosed with complex CHD by prenatal ultrasound in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on 123 fetuses with complex CHD diagnosed by prenatal ultrasound at Peking University People's Hospital between 2016 and 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean gestational age at ultrasound diagnosis was 23.7 ± 3.4 weeks. Among the 123 cases, 11 (8.9%) were total anomalous pulmonary venous connection (TAPVC), 14 (11.4%) pulmonary valve abnormalities (PVA), 7 (5.7%) right ventricular double outlet (DORV), 13 (10.6%) aortic arch abnormalities, 69 (56.1%) complete transposition of the great arteries (D-TGA), and 9 (7.3%) other types. Following prenatal counseling, all pregnancies were continued. Among the 72 fetuses undergoing prenatal genetic testing, 9 (9/72) showed chromosomal variants. Fifty-five pregnant women (44.72%) attempted trial of labor, of whom 46 (37.40%) achieved vaginal delivery, including 6 (4.88%) assisted with forceps. Trial of labor failed in 9 cases, requiring cesarean section. In total, 77 pregnancies were delivered by cesarean section, yielding a cesarean rate of 62.6%. The mean gestational age at delivery was 37.9 ± 1.4 weeks, and the mean neonatal birth weight was 3099.0 ± 479.6 g. The mean umbilical arterial blood gas pH was 7.31 ± 0.05. Postnatally, 86 infants (69.9%) received prostaglandin. Average oxygen saturation increased from 72.8 ± 6.0% before alprostadil administration to 80.5 ± 5.0% afterward, a statistically significant improvement (p = 0.000). A total of 114 neonates underwent surgical intervention; 98.2% achieved favorable outcomes, whereas two infants (1.8%) died postoperatively. Approximately 13.0% were anticipated to require secondary surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pregnancies involving fetuses with complex CHD should avoid preterm birth whenever possible. Complex fetal CHD alone is not an indication for cesarean delivery; the delivery mode should instead be determined by standard obstetric considerations, and individualized management may be adopted according to their opinions and preferences. When both maternal and fetal status remain stable, scheduling delivery at or beyond 39 weeks may be considered. Newborns who present with low postnatal oxygen saturation should receive prostaglandin to keep the ductus arteriosus open, followed by urgent transfer to pediatric cardiac surgery for definitive management. Coordinated, multidisciplinary care supports favorable clinical outcomes.","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468772","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":"Correlation between artificial intelligence-based IDAScore and embryo morphokinetic parameters: a retrospective cohort study.","authors":"Lanxiang He, Qiulei Ke, Huizhen Li, Wei Yu Huang, Yiyu Tian, Wen Zhang, Tianzhong Ma","doi":"10.1186/s12884-026-09662-5","DOIUrl":"10.1186/s12884-026-09662-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The rapid advancement of artificial intelligence (AI) has brought new opportunities for embryo evaluation. The integration of AI with time-lapse (TL) imaging technology has significantly enhanced the pregnancy rates in assisted reproductive technologies (ART). However, the fully automated AI-based embryo screening model, IDAScore lacks transparency and specific justifications in assessing the internal processes of embryos, and its interpretability remains limited. The aim of this study is to explore the correlation between IDAScore and embryonic morphological kinetics, providing a convincing explanation for AI-driven embryo assessment and selection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was performed on clinical data from 102 first fresh embryo transfer cycles involving cleavage-stage embryos, all morphologically graded as 8-cell, grade 1 (8C1), and 210 first frozen-thawed blastocyst transfer cycles with embryos uniformly scored as 4AA, conducted at the Reproductive Medicine Center of the Affiliated Hospital of Guangdong Medical University between August 2023 and March 2025.All embryos were cultured using a time-lapse imaging system and evaluated by the fully automated AI-based scoring model, IDAScore V2.0.Cleavage-stage embryos were stratified into two groups based on their IDAScore: Group A [8cells, IDA:1.0-5.7]n=27and Group B [8cells, IDA:5.8-8.0]n=75. Blastocysts were similarly divided into Group C [IDA:1.0-7.7]n=98 and Group D [IDA:7.8-9.9]n=112. Clinical baseline characteristics, ovarian stimulation parameters, embryonic kinetic data, and pregnancy outcomes were compared across the four groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were no significant differences in baseline clinical characteristics-including patient age, anti-Müllerian hormone (AMH) levels, body mass index (BMI), and basal hormone profiles-among the four groups. In cleavage-stage embryos, Group B (higher IDAScore) showed significantly faster developmental timings compared to Group A (low IDAScore), including time to 3 cells (t3), 4 cells (t4), 5 cells (t5), and 8 cells (t8), as well as the duration from 2-cell to 3-cell (cc2) and from 3-cell to 5-cell (cc3) stages (P &lt; 0.05). Moreover, Group B demonstrated significantly higher rates of high-quality embryos, blastocyst formation, usable blastocysts, and clinical pregnancy compared to Group A (P &lt; 0.05).Logistic regression analysis revealed that the cc2 interval was significantly associated with IDAScore on Day 3 (OR = 0.410; 95% CI: 0.253-0.666; P &lt; 0.001).In blastocyst-stage embryos, Group D (higher IDAScore) exhibited significantly faster development to the 2-cell (t2), 3-cell (t3), 4-cell (t4), and 5-cell (t5) stages, as well as earlier time to full blastocyst expansion (tB), compared to Group C (low IDAScore) (P &lt; 0.05). Additionally, significant differences were observed between Groups C and D in both inner cell mass (ICM) and trophectoderm (TE) grading (P &lt; 0.05). The bl","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468785","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}