The developing brain in utero is highly vulnerable to maternal and environmental influences.As a mediator of maternal and environmental signals to the fetus, epigenetic processes within the placenta are particularly powerful such that alterations of placental gene expression, downstream function, and signaling during fetal development have the potential for dramatic changes in developmental programming.This influence of intrauterine experiences has been progressively extended from the modification of fetal brain to the susceptibility to develop neurodevelopmental disorders in childhood, as well as in adulthood.In this review, we describe maternal factors such as obesity, smoking, alcohol drinking, stress, and nutrition that moderate the impact on adverse neurodevelopment conditions.And, we also have depicted maternal disease that could result poor childhood neurodevelopment.Lastly, we describe evidence linking adverse environmental variation such as pollutant, heavy metal, air pollution during the fetal period and long-term neurodevelopmental changes in brain structure and function.detrimental effects in the offspring.A comprehensive understanding and accurate knowledge of prenatal factors that can influence neurodevelopmental disorders are invaluable for clinicians in providing informed guidance during pregnancy and newborn care counseling.This, in turn, contributes to improved outcomes for children and families, promoting lifelong health and disease prevention for the child.

Most subamniotic hemorrhages occur after birth and are result from excessive traction on the umbilical cord at delivery.These lesions have been rarely reported during pregnancy.According to the previous reports, subamniotic hemorrhage has not been related to severe obstetrical complications.But in recent case reports, some authors reported fetal growth retardation and preterm birth associated with subamniotic hemorrhage.We present a case with subamniotic hemorrhage diagnosed at 25 weeks' gestation.Her pregnancy ended in preterm birth by emergency cesarean section at 26 weeks.We report this case with a review of literature.

Atrial flutter is relatively common neonatal arrythmia, and immediate synchronized cardioversion is the treatment of choice.However, several challenges exist in the diagnosis and treatment of these patients.We report on 2 neonates who presented to our hospital with persistent tachycardia.Neither of the patients developed cardiovascular shock, and both were treated with electrical cardioversion.The arrhythmia did not recur for several months without medication.

Objective:The angiotensin converting enzyme 2 (ACE2) has been established as the receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and placental ACE2 expression has led to a few cases of vertical transmission via the placenta.In this study, we aimed to investigate placental infection in pregnant women with coronavirus disease 2019 (COVID-19) and the perinatal outcomes of neonates.Methods: We retrospectively reviewed the data of newborn infants and their mothers infected with SARS-CoV-2 at the Asan Medical Center from December 2021 to April 2022.We collected data on maternal and neonatal characteristics, histopathological and immunohistochemical results of placenta.Placental infection of SARS-CoV-2 was confirmed by positive immunohistochemical staining with antibodies bind to viral proteins.Nasopharyngeal polymerase chain reaction (PCR) tests with 24-hour intervals for newborns Results: Overall, 59 infants were born to mothers with confirmed COVID-19.The mean gestational age was 38.51.5 weeks, and the mean birth weight was 3,185.6497.3g.The median Apgar score was 8 and 9 at 1 and 5 minutes, respectively.The placenta showed various placental pathologies, such as placental inflammation (53.4%), and maternal vascular malperfusion (27.5%).SARS-CoV-2 antigen was detected in 55 cases of 58 (94.8%) placental tissues, mainly on the syncytiotrophoblast (89.7%).However, all newborn infants tested negative for nasopharyngeal SARS-CoV-2 PCR. Conclusion:In this single-center study, majority of pregnant women with COVID-19 also had evidence of placental infection during the Omicron wave in Korea.Nevertheless, none of the newborn infants were infected with SARS-CoV-2, and their perinatal outcomes were favorable.

Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is an extremely rare congenital disorder characterized by an enlarged bladder without renal obstruction, decreased intestinal motility, and microcolon.This genetic disease is challenging to diagnose prenatally because of its nonspecific ultrasonographic findings and low incidence.In a case study, a 36-year-old nullipara who was at 24 weeks of gestation and referred to Asan Medical Center with a chief complaint of fetal enlarged bladder.Fetal ultrasonography showed megacystis without definite renal obstruction, normal female genitalia, and a normal amniotic fluid index.Follow-up ultrasonography at 30 weeks of gestation revealed worsening bladder distention accompanied by hydronephrosis.At 34 weeks of gestation, ultrasonography showed dilatation of the stomach and small bowel and polyhydramnios.The final prenatal diagnosis was megacystis associated with hydronephrosis and additional small bowel obstruction.Thus, MMIHS was prenatally suspected.The patient underwent an elective cesarean section at 37 weeks of gestation.A female newborn was delivered, with a birth weight of 2,300 g, and was admitted to the neonatal intensive care unit.No urethral obstruction was confirmed by Foley catheter insertion; however, on neonatal abdominal ultrasonography, a long segment of the microcolon was observed.The newborn failed to defecate and urinate, and genetic testing was performed, which was ultimately diagnosed with MMIHS with an ACTG2 (actin gamma 2, smooth muscle) gene mutation.While MMIHS was once a fatal disease, treatments such as intestinal rehabilitation and transplantation have improved the survival rate.Therefore, prenatal diagnosis is crucial for counseling, early postnatal diagnosis, and treatment.

Objective:Recently, several studies reported that metabolic syndrome (MS) can also cause adverse pregnancy outcomes (APOs).However, the evidence regarding relationship between MS and APO is limited in Asian population, although the outcomes after MS has been reported to have ethnic diffe rences.Therefore, this study aimed to evaluate the relationship between MS and APO (gestational diabetes mellitus [DM], pregnancy associated hypertension [HTN], preterm birth [PTB], small for gestational age, large for gestational age [LGA]) in Korean population.Methods: This study is the secondary analysis of the database from a multicenter prospective cohort.The study population was divided into groups with or without MS, and the relationship between APO at delivery was compared.In addition, the risk of APO according to each diagnostic component of MS was examined.Results: The incidence of APO, especially the risk of gestational DM, PTB, LGA, and cesarean delivery was increased in women with MS.In addition, when examining each MS diagnostic component, all of them were associated to the risk of APO.For specific complications, abdominal obesity increased the risk of gestational DM, pregnancy associated HTN, LGA, and cesarean delivery, high blood pressure increased the risk of gestational DM and pregnancy associated HTN, and hyperglycemia increased the risk of gestational DM and PTB, whereas hypertriglyceridemia, and low lowdensity lipoprotein cholesterol increased only the risk of gestational DM.Conclusion: Pregnant women with MS in early pregnancy had increased risk of APO.Therefore, patient counseling regarding preventive strategies should be discussed in women with MS.

Heterotopic pregnancy with interstitial pregnancy is a rare condition with fatal consequences if diagnosis is delayed.Hence, previous reports have focused on criteria and tools that can expedite obstetricians' diagnosis.While early diagnosis is important, other differentials should also be kept in mind.Herein, we report a case of a patient who underwent resectoscopy and diagnostic laparoscopy with cornual mass resection under the diagnosis of heterotopic pregnancy (missed abortion of intrauterine pregnancy with interstitial pregnancy).Histopathologic examination revealed that suspected interstitial mass was leiomyoma that underwent cystic change.We hope this case will emphasize the importance of considering benign uterine mass with cystic formation for differential diagnosis of interstitial pregnancy.

While pulmonary pneumatocele in neonates is uncommon, it can be observed in the neonatal inten sive care unit.Pulmonary pneumatocele in preterm infants can be caused by either ventilatorinduced lung injury or complications due to pneumonia.There is still no consensus on the management of the lesion.Conservative treatment can be a treatment option if there are no complications.However, in some cases with mass effect or rupture, further management is needed.In this case report, we present an extremely low birth weight infant with multicystic pneumatocele at the left lower lobe caused by prolonged mechanical ventilator therapy.When the vital signs were unstable, we performed a percutaneous needle aspiration.Even after the intervention, the pneumatocele did not decrease in size.After we tried a variety of conservative management procedures, such as changing body positions and ventilator settings, the pneumatocele spontaneously resolved on the 65th day of life.The present case suggests that ventilator strategy and supportive care can be one of the option for management, even when the lesion is large and multicystic.